Title: EFCA Act
Policy area: Health

Summary:
Ensuring Forensic Care for All Victims Act or the EFCA Act
This bill establishes a demonstration program and requires other actions to increase access to generalist forensic services for patients who have experienced interpersonal violence. These services include medical forensic assessments, data and evidence collection, and related activities that meet the needs of both patients and law enforcement.
The Department of Health and Human Services (HHS) must award grants to institutions of higher education or Indian tribes for training health care providers to administer medical forensic assessments and treatments to patients who have experienced interpersonal violence.
Additionally, to increase access to and the quality of generalist forensic services, HHS must establish (1) a resource center for health care providers and community health aides, (2) regional learning collectives of states and hospitals, and (3) an online repository of best practices and other resources.
The bill also requires designated offices and agencies of HHS and the Department of Justice to annually report on the unmet need for and other issues related to generalist forensic services.

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 2655 Introduced in Senate (IS)]

<DOC>






117th CONGRESS
  1st Session
                                S. 2655

    To provide funding for demonstration grants to support clinical 
   training of health care providers to administer medical forensic 
 examinations and treatments to survivors of interpersonal violence of 
                               all ages.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             August 5, 2021

    Ms. Murkowski (for herself and Mr. Hickenlooper) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
    To provide funding for demonstration grants to support clinical 
   training of health care providers to administer medical forensic 
 examinations and treatments to survivors of interpersonal violence of 
                               all ages.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Ensuring Forensic Care for All 
Victims Act'' or the ``EFCA Act''.

SEC. 2. PURPOSE.

    It is the purpose of this Act to provide eligible entities funding 
through demonstration grants to develop trauma informed standards of 
care through pilot programs that promote generalist forensic training 
using a module-based, conceptual learning program with competency-based 
activities tailored to meet health care professional and first 
responder needs.

SEC. 3. DEFINITIONS.

    In this Act:
            (1) Community health aide; community health practitioner.--
        The terms ``community health aide'' and ``community health 
        practitioner'' have the meanings given such terms for purposes 
        of section 119 of the Indian Health Care Improvement Act (25 
        U.S.C. 1616l).
            (2) First responder.--The term ``first responder'' includes 
        a firefighter, law enforcement officer, paramedic, emergency 
        medical technician, or other individual (including an employee 
        of a legally organized and recognized volunteer organization, 
        whether compensated or not), who, in the course of his or her 
        professional duties, responds to fire, medical, hazardous 
        material, or other similar emergencies.
            (3) Generalist forensic services.--The term ``generalist 
        forensic services'' with respect to health care providers, 
        means enabling such providers to have expanded forensic 
        knowledge and skills to ensure that individuals, families, and 
        communities that have experienced interpersonal violence or 
        trauma are provided medical forensic assessment, evidence 
        collection, and documentation that aids in meeting the needs of 
        patients as well as improves future law enforcement 
        investigation and prosecution, provides needed data for 
        research to support response and prevention of violence, and 
        improves ability to adequately respond to patients who exhibit 
        signs of victimization.
            (4) Health care provider.--The term ``health care 
        provider'' has the meaning given such term by the Secretary, 
        and includes registered nurses, nurse practitioners, nurse 
        midwives, clinical nurse specialists, physician assistants, and 
        physicians.
            (5) Indian tribes.--The terms ``Indian Tribe'' and ``Tribal 
        organization'' shall have the meanings given such terms in 
        section 4 of the Indian Self-Determination and Education 
        Assistance Act (25 U.S.C. 5304). The term ``Urban Indian 
        organization'' has the meaning given such term in section 4 of 
        the Indian Health Care Improvement Act (25 U.S.C. 1603).
            (6) Interpersonal violence.--The term ``interpersonal 
        violence'' means any form of violence which is emotional and 
        trauma inducing for victims, families of victims, perpetrators, 
        and communities.
            (7) Program.--The term ``program'' means the program 
        established under section 101.
            (8) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (9) Standard of care.--The term ``standard of care'' means 
        evaluation and treatment that is accepted by medical experts 
        and reflected in peer-reviewed medical literature as the 
        appropriate medical approach for a condition, symptoms, 
        illness, or disease and that is widely used by health care 
        professionals.
            (10) Trauma informed care.--The term ``trauma informed 
        care'' means care which trauma survivors receive that is 
        culturally competent in accordance with professional standards 
        of practice and accounting for patients' experiences and 
        preferences in order to eliminate or mitigate triggers that may 
        cause re-traumatization of the patient.

  TITLE I--ESTABLISHING A GENERALIST FORENSIC HEALTHCARE CLINICAL AND 
                  CONTINUING EDUCATION PILOT PROGRAM.

SEC. 101. ESTABLISHMENT OF PROGRAM.

    (a) In General.--The Secretary, in conjunction with Attorney 
General, shall establish a demonstration program to award grants to 
eligible partnered entities for the clinical training of health care 
providers, first responders, community health aides, community health 
practitioners, and students and to enable such providers, first 
responders, community health aides, community health practitioners, and 
students to administer medical forensic examinations and treatments to 
survivors, perform medical forensic assessments, evidence collection, 
and documentation that aids in meeting the needs of patients as well as 
improves future law enforcement investigation and prosecution, provides 
needed data for research to support response and prevention of 
interpersonal violence, and improves the ability of providers, first 
responders, community health aides, community health practitioners, and 
students to adequately respond in difficult situations.
    (b) Purpose.--The purpose of the program is to enable each grant 
recipient to work with inter-professional partners, including law 
enforcement, legal services, victims advocacy organizations, and others 
to expand access to generalist forensic services by providing providers 
with the clinical training necessary to establish and maintain 
competency in general forensic services and to test the provisions of 
such services at new facilities in expanded health care settings.

SEC. 102. DEMONSTRATION GRANTS FOR COMPREHENSIVE FORENSIC TRAINING.

    (a) Establishment of Program.--The Secretary shall establish a 
demonstration program to award grants to eligible partnered entities 
for the clinical training of health care providers to administer 
medical forensic examinations and treatments to survivors of 
interpersonal violence of all ages.
    (b) Purpose.--The purpose of the demonstration program is to 
develop training and curriculum to provide health care providers with 
the skills to provide competent medical forensic assessment and care to 
individuals, families, and communities that have experienced violence 
or trauma and be available to collaborate with members of an inter-
professional forensic team.
    (c) Term.--Grants under this section shall be for a term of 5 
years.
    (d) Eligible Entities.--To be eligible to receive a grant under 
this section, an entity shall--
            (1) be--
                    (A) an institute of higher education; or
                    (B) Indian Tribes or Tribal organizations; and
            (2) submit to the Secretary an application at such time, in 
        such manner, and containing such information as the Secretary 
        may require.
    (e) Grant Amount.--Each grant awarded under this section shall be 
in an amount that does not exceed $400,000 per year. A grant recipient 
may carry over funds from one fiscal year to the next without obtaining 
approval from the Secretary.
    (f) Authorization of Appropriations.--
            (1) In general.--There is authorized to be appropriated to 
        carry out this section $11,000,000 for each of fiscal years 
        2022 through 2026.
            (2) Set-aside.--Of the amount appropriated under this 
        subsection for a fiscal year, the Secretary shall reserve 10 
        percent of such amount for purposes of making grants to 
        entities that are affiliated with Indian Tribes or Tribal 
        organizations, or Urban Indian organizations. Amounts so 
        reserved may be used to support referrals and the delivery of 
        emergency first aid, culturally competent support, and forensic 
        evidence collection training.

     TITLE II--TECHNICAL ASSISTANCE GRANTS AND LEARNING COLLECTIVES

SEC. 201. TECHNICAL ASSISTANCE GRANTS AND LEARNING COLLECTIVES.

    Part B of title VIII of the Public Health Service Act (42 U.S.C. 
296j et seq.) is amended by adding at the end the following:

``SEC. 812. TECHNICAL ASSISTANCE CENTER AND REGIONAL LEARNING 
              COLLECTIVES.

    ``(a) In General.--The Secretary shall establish a State and 
forensic provider technical resource center to provide technical 
assistance to health care providers and community health aides to 
increase the quality of, and access to, generalist forensic services by 
entering into contracts with national experts (such as the Academy of 
Forensic Nursing and others).
    ``(b) Regional Learning Collectives.--The Secretary shall convene 
State and hospital regional learning collectives to assist health care 
providers and States in sharing best practices, discussing practices, 
and improving the quality of, and access to, generalist forensic 
services.
    ``(c) Repository.--The Secretary shall establish and maintain a 
secure Internet-based data repository to serve as an online learning 
collective for State and entity collaborations. An entity receiving a 
grant under section 102 may use such repository for--
            ``(1) technical assistance; and
            ``(2) best practice sharing.
    ``(d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $2,000,000 for each of fiscal 
years 2022 through 2026.''.

TITLE III--NATIONAL REPORT ON THE NEED FOR GENERALIST FORENSIC SERVICES 
                     IN OUR NATION'S HEALTH SYSTEM

SEC. 301. NATIONAL REPORT.

    Not later than 1 year after the date of enactment of this Act, and 
annually thereafter, the Office for Victims of Crime of the Department 
of Justice, the Centers for Disease Control and Prevention, the Health 
Resources and Services Administration, the Indian Health Service, the 
Office on Women's Health of the Department of Health and Human 
Services, and the Office of Violence Against Women of the Department of 
Justice (hereafter referred to in this section collectively as the 
``Agencies''), shall submit to the Secretary a report on the need 
throughout the United States and territories for increased access to 
generalist medical forensic services, evidence collection, and 
documentation that aids in meeting the needs of health care patients as 
well as improves future law enforcement investigation and prosecution, 
the need for data for research to support response and prevention of 
interpersonal violence, and improved ability of health care providers 
to adequately respond to patients who exhibit signs of victimization.
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