2000 
[DOCID: f:h4032ih.txt]






107th CONGRESS
  2d Session
                                H. R. 4032

To amend titles V and XIX of the Social Security Act and chapter 89 of 
title 5, United States Code, to provide coverage for domestic violence 
screening and treatment under the maternal and child health block grant 
    program, the Medicaid Program, and the Federal employees health 
                           benefits program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 20, 2002

Mrs. Capps (for herself, Mr. LaTourette, Mr. Waxman, and Mr. Greenwood) 
 introduced the following bill; which was referred to the Committee on 
  Energy and Commerce, and in addition to the Committee on Government 
 Reform, for a period to be subsequently determined by the Speaker, in 
   each case for consideration of such provisions as fall within the 
                jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
To amend titles V and XIX of the Social Security Act and chapter 89 of 
title 5, United States Code, to provide coverage for domestic violence 
screening and treatment under the maternal and child health block grant 
    program, the Medicaid Program, and the Federal employees health 
                           benefits program.

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

SECTION 1. SHORT TITLE; FINDINGS.

    (a) Short Title.--This Act may be cited as the ``Domestic Violence 
Screening and Treatment Act of 2002''.
    (b) Findings.--Congress finds the following:
            (1) Nearly one-third of American women (31 percent) report 
        being physically or sexually abused by a husband or boyfriend 
        at some point in their lives, and about 1200 women are murdered 
        every year by their intimate partner, nearly 3 each day.
            (2) 85 percent of violent victimizations are experienced by 
        women.
            (3) 37 percent of all women who sought care in hospital 
        emergency rooms for violence-related injuries were injured by a 
        current or former spouse, boyfriend, or girlfriend.
            (4) In addition to injuries sustained during violent 
        episodes, physical and psychological abuse are linked to a 
        number of adverse physical health effects including arthritis, 
        chronic neck or back pain, migraine and other frequent 
        headaches, stammering, problems with vision, and sexually 
        transmitted infections, including HIV/AIDS.
            (5) Medical services for abused women cost an estimated 
        $857.3 million every year.
            (6) Each year, at least six percent of all pregnant women, 
        about 240,000 pregnant women, in this country are battered by 
        the men in their lives. This battering leads to complications 
        of pregnancy, including low weight gain, anemia, infections, 
        and first and second trimester bleeding.
            (7) Pregnant and recently pregnant women are more likely to 
        be victims of homicide than to die of any other cause, and 
        evidence exists that a significant proportion of all female 
        homicide victims are killed by their intimate partners.
            (8) Children who witness domestic violence are more likely 
        to exhibit behavioral and physical health problems including 
        depression, anxiety, and violence towards peers. They are also 
        more likely to attempt suicide, abuse drugs and alcohol, run 
        away from home, engage in teenage prostitution, and commit 
        sexual assault crimes.
            (9) Fifty percent of men who frequently assault their wives 
        frequently assault their children. The U.S. Advisory Board on 
        Child Abuse and Neglect suggests that domestic violence may be 
        the single major precursor to child abuse and neglect 
        fatalities in this country.
            (10) Currently, about 10 percent of primary care physicians 
        routinely screen for intimate partner abuse during new patient 
        visits and nine percent routinely screen during periodic 
        checkups.
            (11) Recent clinical studies have proven the effectiveness 
        of a 2-minute screening for early detection of abuse of 
        pregnant women. Additional longitudinal studies have tested a 
        10-minute intervention that was proven highly effective in 
        increasing the safety of pregnant abused women. Comparable 
        research does not yet exist to support the effectiveness of 
        screening men.
            (12) 70 to 81 percent of the patients studied reported that 
        they would like their healthcare providers to ask them 
        privately about intimate partner violence.

SEC. 2. COVERAGE OF DOMESTIC VIOLENCE SCREENING AND TREATMENT UNDER THE 
              MEDICAID PROGRAM.

    (a) In General.--Section 1905 of the Social Security Act (42 U.S.C. 
1396d) is amended--
            (1) in subsection (a)(26), by striking ``and'' at the end;
            (2) by redesignating paragraph (27) of subsection (a) as 
        paragraph (28); and
            (3) by inserting after paragraph (26) of subsection (a) the 
        following new paragraph:
            ``(27) domestic violence screening and treatment services 
        (as defined in subsection (x));''; and
            (4) by adding at the end the following new subsection:
    ``(x) The term `domestic violence screening and treatment services' 
means the following services (as specified under the State plan) 
furnished by an attending health care provider (or, in the case of 
services described in paragraph (3), under arrangements between the 
provider and domestic violence experts) to women 18 years of age or 
older:
            ``(1) Routine verbal screening for domestic violence by a 
        provider if the provider has not previously screened the 
        patient or if the patient has been screened but the patient 
        indicates that she is in a new relationship regardless of 
        whether there are any clinical indicators or suspicion of 
        abuse.
            ``(2) Danger assessment for women who positively identify 
        for domestic violence, including an immediate safety 
        assessment, an initial risk assessment, and follow-up risk 
        assessments during subsequent visits.
            ``(3) Treatment relating to domestic violence, including 
        the following:
                    ``(A) Safety education to assist the patient in 
                developing a plan to promote her safety and well-being, 
                such as keeping an emergency kit, talking to someone, 
                and arranging for a place to stay, and appropriate 
                follow up.
                    ``(B) Health education which provides written and 
                verbal information about domestic violence, its impact 
                on health, options for services, and any necessary 
                follow up.
                    ``(C) Psycho-social and counseling services that 
                include an initial assessment, development of a plan of 
                care, individual or group counseling (as needed), and 
                follow-up assessment, treatment, or intervention.
                    ``(D) Documentation of screening, assessment, 
                treatment, referrals, injuries, and illnesses related 
                to domestic violence and who inflicted them, using 
                appropriate diagnostic codes and absolute 
                confidentiality (except as required by applicable State 
                law).
            ``(4) Referral and case coordination for additional 
        services, including services from domestic violence programs, 
        community agencies, and judicial and other systems.''.
    (b) Effective Date.--The amendments made by this section shall take 
effect on the dat
1468
e of the enactment of this Act and shall apply to 
services furnished on or after such date.

SEC. 3. FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM.

    (a) In General.--Section 8902 of title 5, United States Code, is 
amended by adding at the end the following:
    ``(p)(1) A contract may not be made or a plan approved which does 
not include coverage for domestic violence screening and treatment 
services.
    ``(2) For purposes of this subsection, the term `domestic violence 
screening and treatment services' has the meaning given such term in 
section 1905(x) of the Social Security Act.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to contracts made, and plans approved, after the end of the 6-
month period beginning on the date of the enactment of this Act.

SEC. 4. MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT.

    (a) Requirement for Portion of Expenditures on Domestic Violence 
Screening and Treatment.--Section 505(a)(5) of the Social Security Act 
(42 U.S.C. 705(a)(5)) is amended--
            (1) by striking ``and'' at the end of subparagraph (E);
            (2) by striking the period at the end of subparagraph (F) 
        and inserting ``; and''; and
            (3) by inserting after subparagraph (F) the following new 
        subparagraph:
                    ``(G) the State will set aside a reasonable portion 
                (based upon the State's previous use of funds under 
                this title) of the funds provided for domestic violence 
                screening and treatment services (as defined in section 
                1902(x)).''.
    (b) Preference in Certain Funding.--Section 502(b)(2) of such Act 
(42 U.S.C. 702(b)(2)) is amended by adding at the end the following new 
subparagraph:
    ``(C) Of the amounts retained for projects described in 
subparagraphs (A) through (F) of section 501(a)(3), the Secretary shall 
provide preference to qualified applicants which demonstrate that the 
activities to be carried out with such amounts includes training of 
providers in how to screen for, and treat, domestic violence and 
training that includes--
            ``(i) identifying victims of domestic violence and 
        maintaining complete medical records that include documentation 
        of the examination, treatment given, and referrals made, and 
        recording the location and nature of the victim's injuries;
            ``(ii) examining and treating such victims, within the 
        scope of the health professional's discipline, training, and 
        practice (including medical advice regarding the dynamics and 
        nature of domestic violence);
            ``(iii) assessing the immediate and short-term safety of 
        the victim and assisting the victim in developing a plan to 
        promote his or her safety; and
            ``(iv) referring the victim to public and private nonprofit 
        private entities that provide services for such victims.''.
    (c) Reporting Data.--Section 506(a)(2) of such Act (42 U.S.C. 
706(a)(2)) is amended by adding at the end the following new 
subparagraph:
            ``(F) Information on how funds provided under this title 
        are used to screen for and treat domestic violence.''.
    (d) Separate Program for Domestic Violence Screening and 
Treatment.--Title V of such Act is amended by adding at the end the 
following new section:

    ``separate program for domestic violence screening and treatment

    ``Sec. 511. (a) For the purpose described in subsection (b), the 
Secretary shall, for fiscal year 2003 and each subsequent fiscal year, 
allot to each State which has transmitted an application for the fiscal 
year under section 505(a) an amount equal to the product of
            ``(1) the amount appropriated in subsection (d) for the 
        fiscal year; and
            ``(2) the percentage determined for the State under section 
        502(c)(1)(B)(ii).
    ``(b) The purpose of an allotment under subsection (a) to a State 
is to enable the State to provide for domestic violence screening and 
treatment, including the provision of domestic violence screening and 
treatment services (as defined in section 1905(x)), increasing the 
number of women screened, assessed, treated, and referred and including 
training of health care providers on how to identify and respond to 
victims of domestic violence.
    ``(c)(1) Sections 503, 507, and 508 apply to allotments under 
subsection (a) to the same extent and in the same manner as such 
sections apply to allotments under section 502(c).
    ``(2) Sections 505 and 506 apply to allotments under subsection (a) 
to the extent determined by the Secretary to be appropriate.
    ``(d) For the purpose of allotments under subsection (a), there is 
authorized to be appropriated for each fiscal year, beginning with 
fiscal year 2003, such sums as may be necessary.''.
    (e) Effective Date.--The amendments made by subsections (a) and (b) 
shall apply to fiscal years beginning after the date of the enactment 
of this Act and the amendment made by subsection (c) shall apply to 
annual reports submitted for such fiscal years.
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