I 117th CONGRESS 2d Session H. R. 6735 IN THE HOUSE OF REPRESENTATIVES February 15, 2022 Mr. Joyce of Ohio (for himself and Ms. Ross ) introduced the following bill; which was referred to the Committee on the Judiciary A BILL To amend the DNA Sexual Assault Justice Act of 2004 to increase access to Sexual Assault Nurse Examiners, and for other purposes.

1. Short title This Act may be cited as the Supporting Access to Nurse Exams Act or the SANE Act . 2. Definitions Section 304 of the DNA Sexual Assault Justice Act of 2004 ( 34 U.S.C. 40723 ) is amended by striking subsections (a), (b), and (c) and inserting the following: (a) Definitions In this section: (1) Culturally competent The term culturally competent , used with respect to services, supports, or other assistance, means services, supports, or other assistance that is conducted or provided in a manner that— (A) is responsive to the beliefs, interpersonal styles, attitudes, languages, and behaviors of individuals receiving the services, supports, or other assistance; and (B) has the greatest likelihood of ensuring the maximum participation of individuals receiving the services, supports, or other assistance. (2) Eligible entity The term eligible entity includes— (A) a Tribal government or hospital; (B) a sexual assault examination program, including— (i) a SANE program; (ii) a SAFE program; (iii) a SART program; (iv) medical personnel, including a doctor or nurse, involved in treating victims of sexual assault; and (v) a victim service provider involved in treating victims of sexual assault; (C) a State sexual assault coalition; (D) a health care facility, including a hospital that provides sexual assault forensic examinations by a qualified or certified SANE or SAFE; (E) a sexual assault examination program that provides SANE or SAFE training; and (F) a community-based program that provides sexual assault forensic examinations, including pediatric forensic exams in a multidisciplinary setting, by a qualified or certified SANE or SAFE outside of a traditional health care setting. (3) Health care facility The term health care facility means any State, local, Tribal, community, free, nonprofit, academic, or private medical facility, including a hospital, that provides emergency medical care to patients. (4) Medical forensic examination; MFE The term medical forensic examination or MFE means an examination of a sexual assault patient by a health care provider, who has specialized education and clinical experience in the collection of forensic evidence and treatment of these patients, which includes— (A) gathering information from the patient for the medical forensic history; (B) an examination; (C) coordinating treatment of injuries, documentation of biological and physical findings, and collection of evidence from the patient; (D) documentation of findings; (E) providing information, treatment, and referrals for sexually transmitted infections, pregnancy, suicidal ideation, alcohol and substance abuse, and other non-acute medical concerns; and (F) providing follow-up as needed to provide additional healing, treatment, or collection of evidence. (5) Pediatric SANE and SAFE The term pediatric SANE and SAFE means a SANE or SAFE who is trained to conduct sexual assault forensic examinations on children and youth between the ages of 0 and 18. (6) Qualified personnel The term qualified personnel includes a registered or advanced practice nurse, physician, doctor of osteopathy, or physician assistant who has specialized training conducting medical forensic examinations. (7) Qualified SANE and SAFE training program The term qualified SANE and SAFE training program means a program that— (A) is qualified to prepare current and future sexual assault nurse examiners to be profession-ready and meet the applicable State and National certification and licensure requirements, through didactic, clinical, preceptor, or capstone programs that include longer-term training; (B) provides that preparation under a health care model that uses trauma-informed techniques; and (C) is approved as meeting the most recent National Training Standards for Sexual Assault Medical Forensic Examiners. (8) Rural area The term rural area has the meaning given the term in section 40002 of the Violence Against Women Act of 1994 ( 34 U.S.C. 12291 ). (9) Secretary The term Secretary means the Secretary of Health and Human Services. (10) Sexual assault The term sexual assault means any nonconsensual sexual act or sexual contact proscribed by Federal, Tribal, or State law, including when the individual lacks capacity to consent. (11) Sexual assault forensic examiner; SAFE The term sexual assault forensic examiner or SAFE means an individual who has specialized forensic training in treating sexual assault survivors and conducting medical forensic examinations. (12) Sexual assault forensic examination The term sexual assault forensic examination means an examination of a sexual assault patient by a health care provider, who has specialized education and clinical experience in the collection of forensic evidence and treatment of these patients, which includes— (A) gathering information from the patient for the medical forensic history; (B) an examination; (C) coordinating treatment of injuries, documentation of biological and physical findings, and collection of evidence from the patient; (D) documentation of findings; (E) providing information, treatment, and referrals for sexually transmitted infections, pregnancy, suicidal ideation, alcohol and substance abuse, and other non-acute medical concerns; and (F) providing follow-up as needed to provide additional healing, treatment, or collection of evidence. (13) Sexual assault nurse examiner; SANE The term sexual assault nurse examiner or SANE means a registered or advanced practice nurse who has specialized training conducting medical forensic examinations. (14) Sexual assault response team; SART The term sexual assault response team or SART means a multidisciplinary team that— (A) provides a specialized and immediate response to survivors of sexual assault; and (B) may include health care personnel, law enforcement representatives, community-based survivor advocates, prosecutors, and forensic scientists. (15) State The term State means any State of the United States, the District of Columbia, and any territory or possession of the United States. (16) Trauma-informed The term trauma-informed means, with respect to services or training, services or training that— (A) uses a patient-centered approach to providing services or care; (B) promotes the dignity, strength, and empowerment of patients who have experienced trauma; and (C) incorporates evidence-based practices based on knowledge about the impact of trauma on patients’ lives. (17) Underserved populations The term underserved populations has the meaning given the term in section 40002 of the Violence Against Women Act of 1994 ( 34 U.S.C. 12291 ). . 3. Sexual assault nursing examiner grants Section 304 of the DNA Sexual Assault Justice Act of 2004 ( 34 U.S.C. 40723 ) is amended by inserting after subsection (a), as amended by section 2, the following: (b) Sexual assault nurse examiner training program grants (1) Authorization for grants The Attorney General, in consultation with the Secretary, shall make grants to eligible entities for the following purposes: (A) To establish qualified regional SANE training programs— (i) to provide clinical education for SANE students; (ii) to provide salaries for full- and part-time SANE instructors, including those specializing in pediatrics and working in a multidisciplinary team setting, to help with the clinical training of SANEs; and (iii) to provide access to simulation laboratories and other resources necessary for clinical education. (B) To provide full- and part-time salaries for SANEs and SAFEs, including pediatric SANEs and SAFEs. (C) To increase access to SANEs and SAFEs by otherwise providing training, education, or technical assistance relating to the collection, preservation, analysis, and use of DNA samples and DNA evidence by SANEs, SAFEs, and other qualified personnel. (2) Preference for grants In reviewing applications for grants under this section, the Attorney General shall give preference to any eligible entity that certifies in the grant application that the entity will coordinate with a rape crisis center or the State sexual assault coalition to facilitate sexual assault advocacy to support sexual assault survivors and use the grant funds to— (A) establish qualified SANE training programs in localities with a high volume of forensic trauma cases, including adult and child sexual assault, domestic violence, elder abuse, sex trafficking, and strangulation cases; (B) increase the local and regional availability of full- and part-time sexual assault nurse examiners in a rural area, Tribal area, an area with a health professional shortage, or for an underserved population, including efforts to provide culturally competent services; or (C) establish or sustain sexual assault mobile teams or units or otherwise enhance SANE and SAFE access through telehealth. . 4. Directive Section 304 of the DNA Sexual Assault Justice Act of 2004 ( 34 U.S.C. 40723 ) is amended— (1) by redesignating subsection (d) as subsection (e); and (2) by inserting after subsection (b), as added by section 3, the following: (c) Directive to the Attorney General (1) In general Not later than the beginning of fiscal year 2022, the Attorney General shall coordinate with the Secretary to inform health care facilities, including Federally qualified health centers and hospitals, colleges and universities, and other appropriate health-related entities about— (A) the availability of grant funding under this section; and (B) the role of sexual assault nurse examiners, both adult and pediatric, and available resources of the Department of Justice and the Department of Health and Human Services to train or employ sexual assault nurse examiners to address the needs of communities dealing with sexual assault, domestic violence, sex trafficking, elder abuse, strangulation, and, in particular, the need for pediatric SANEs, including such nurse examiners working in the multidisciplinary setting, in responding to abuse of both children and adolescents. (2) Requirement In carrying out paragraph (1), the Attorney General shall collaborate with nongovernmental organizations representing SANEs. (d) Public information on access to sexual assault forensic examinations (1) In general Not later than 2 years after the date of enactment of the Supporting Access to Nurse Exams Act , the Attorney General, in consultation with the Secretary, shall establish, and update annually, a public website on the access to forensic nurse examiners. (2) Contents The website required under paragraph (1) shall with specificity describe, by State— (A) funding opportunities for SANE training and continuing education; and (B) the availability of sexual assault advocates at locations providing sexual assault forensic exams. (3) Report to Congress Not later than 4 years after the date of enactment of the Supporting Access to Nurse Exams Act , the Attorney General, in consultation with the Secretary, shall submit to the Committee on the Judiciary of the Senate and the Committee on the Judiciary of the House of Representatives a report on— (A) the availability of, and patient access to, trained SANEs and other providers who perform MFEs or sexual assault forensic examinations; (B) the health care facilities, including hospitals or clinics, that offer SANEs and sexual assault forensic examinations and whether each health care facility, including a hospital or clinic, has full-time, part-time, or on-call coverage; (C) regional, provider, or other barriers to access for SANE care and services, including MFEs and sexual assault forensic examinations; (D) State requirements, minimum standards, and protocols for training SANEs, including trauma-informed and culturally competent training standards; (E) State requirements, minimum standards, and protocols for training emergency services personnel involved in MFEs and sexual assault forensic examinations; (F) the availability of sexual assault nurse examiner training, frequency of when training is convened, the providers of such training, the State’s role in such training, and what process or procedures are in place for continuing education of such examiners; (G) the dedicated Federal and State funding to support SANE training; (H) funding opportunities for SANE training and continuing education; (I) the availability of sexual assault advocates at locations providing MFEs and sexual assault forensic exams; and (J) the total annual cost of conducting sexual assault forensic exams described in section 2010(b) of title I of the Omnibus Crime Control and Safe Streets Act of 1968 ( 34 U.S.C. 10449(b) ). . 5. Authorization of appropriations Subsection (e) of section 304 of the DNA Sexual Assault Justice Act of 2004 ( 34 U.S.C. 40723 ), as redesignated by section 4 of this Act, is amended to read as follows: (e) Authorization of appropriations There are authorized to be appropriated $30,000,000 for each of fiscal years 2023 through 2028 to carry out this section. .