GRANTS TO STRENGTHEN THE HEALTH CARE SYSTEM’S RESPONSE TO DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, AND STALKING.

SEC. 501. GRANTS TO STRENGTHEN THE HEALTH CARE SYSTEM’S RESPONSE TO DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, AND STALKING. Section 399P of the Public Health Service Act (42 U.S.C. 280g-4) is amended— (1) in subsection (a)— (A) in paragraph (1), by inserting “community health workers, violence prevention advocates working with health providers,” after “health staff,”; (B) in paragraph (2), by striking “for medical” and all that follows through “stalking; and” and inserting “for medical, psychology, dental, social work, nursing, and other health profession students, interns, residents, fellows, or current health care providers (including midwives and doulas);”; and (C) in paragraph (3)— (i) by striking “response” and inserting “capacity”; (ii) by inserting “prevent and respond to” after “(including behavioral and mental health programs) to”; and (iii) by striking the period at the end and inserting a semicolon; and (D) by adding at the end the following: “(4) the development or enhancement and implementation of training programs to improve the capacity of early childhood programs to address domestic violence, dating violence, sexual assault, and stalking among families they serve; and “(5) the development or enhancement and implementation of comprehensive statewide strategies for health and violence prevention programs to work together to promote primary prevention of domestic violence, dating violence, sexual assault, and stalking.” ; (2) in subsection (b)(1)— (A) in subparagraph (A)(i)— (i) by striking “to identify and provide” and inserting “to provide universal education on healthy relationships and provide trauma-informed”; and (ii) by striking “and” at the end; (B) in subparagraph (A)(ii)— (i) by striking “culturally competent clinical training components” and inserting “training components that center the experiences of, and are developed in collaboration with, culturally specific individuals and American Indians and Alaska Natives, and include community-defined practices such as the use of doulas, midwives, and traditional healers,”; (ii) by inserting “(including labor and sex trafficking)” after “other forms of violence and abuse”; and (iii) by striking “disparities” and inserting “inequities”; (C) in subparagraph (A), by inserting after clause (ii) the following: “(iii) are designed to be inclusive of the experiences of all individuals, including LGBT individuals, and include training on improving equity and reducing disparities in access to health care services and prevention resources; and “(iv) include training on the use of a universal prevention education approach to both prevent and respond to domestic violence, dating violence, sexual assault, or stalking in health care settings;” ; (D) in subparagraph (B), in the matter preceding clause (i), by striking “response of the health care system” and inserting “capacity of the health care system to prevent and respond”; (E) in subparagraph (B)(i)— (i) by striking “identifying and responding to”inserting “identifying, responding to, and promoting prevention of”; (ii) by inserting “during in-person or virtual visits” after “and stalking”; and (iii) by inserting “and to maximize victim choice on the use and sharing of their health information” before the semicolon at the end; (F) in subparagraph (B)(ii)— (i) by striking “on-site access to” and all that follows through the semicolon at the end and inserting the following:“services to address the safety, medical, and mental health needs of patients by— “(I) increasing the capacity of existing health care professionals (including professionals who specialize in trauma or in substance use disorders) in behavioral and mental health care, community health workers, and public health staff to address domestic violence, dating violence, sexual assault, stalking, and children exposed to violence; “(II) contracting with or hiring advocates for victims of domestic violence or sexual assault to provide such services; or “(III) providing funding to State domestic and sexual violence coalitions to improve the capacity of such coalitions to coordinate and support health advocates and other health system partnerships;” ; (G) in subparagraph (B)(iii)— (i) by striking “of identification” and inserting “of prevention”; (ii) by inserting “during in-person or virtual visits” after “and stalking”; and (iii) by striking “and” at the end; (H) in subparagraph (B)(iv)— (i) by inserting “and promote prevention during in-person or virtual visits,” after “or stalking,”; and (ii) by striking the period at the end and inserting a semicolon; (I) in subparagraph (B), by adding at the end the following: “(v) the development, implementation, dissemination, and evaluation of best practices, tools, and training materials, including culturally relevant tools, for mental health, behavioral health, and substance use disorder professionals to identify and respond to domestic violence, sexual violence, stalking, and dating violence; and “(vi) the development and provision of culturally relevant training and follow-up technical assistance to health care professionals, and public health staff, and allied health professionals to identify, assess, treat, and refer clients who are victims of domestic violence, dating violence, sexual assault, or stalking from culturally specific communities and promote prevention, using tools and training materials, developed by and for culturally specific communities, with priority given to trainings provided by culturally specific organizations; and” ; and (J) by inserting after subparagraph (B) the following: “(C) design and implement comprehensive strategies to prevent domestic or sexual violence including through the use of universal education in clinical and public health settings, hospitals, clinics and other health settings.” ; (3) in subsection (b)(2)(A)— (A) in the subparagraph heading, by striking “Child and elder abuse” and inserting “Child abuse and abuse in later life”; and (B) by striking “child or elder abuse” and inserting “child abuse or abuse in later life”; (4) in subsection (b)(2)(C)(i), by striking “elder abuse” and inserting “abuse in later life”; (5) in subsection (b)(2)(C)(ii), by inserting “programs that promote the prevention of sexual assault as well as” after “implementation of”; (6) in subsection (b)(2)(C)(iii)— (A) by inserting “and exposure to violence across generations” after “abuse”; and (B) by striking “or” at the end; (7) in subsection (b)(2)(C)(iv)— (A) by inserting “mental health,” after “dental,”; and (B) by striking “exams.” and inserting “exams and certifications;”; (8) in subsection (b)(2)(C), by inserting after clause (iv) the following: “(v) providing funding to culturally specific organizations to improve the capacity of such organizations to engage and partner with health care providers to support victims and meet increased referrals from health systems; “(vi) developing a State-level pilot program to— “(I) improve the response of substance use disorder treatment programs, harm reduction programs for people who use substances, and systems to domestic violence, dating violence, sexual assault, and stalking; “(II) improve the capacity of substance use disorder treatment programs, harm reduction programs for people who use substances, and systems to serve survivors of domestic violence, dating violence, sexual assault, and stalking dealing with substance use disorder; and “(III) improve the capacity of domestic violence, dating violence, sexual assault, and stalking programs to serve survivors who have substance use history; or “(vii) developing and utilizing existing technical assistance and training resources to improve the capacity of substance use disorder treatment programs and harm reduction programs for people who use substances to address domestic violence, dating violence, sexual assault, and stalking among patients the programs serve.” ; (9) in subsection (c)(3)(A), by striking “given to outcome based evaluations.” and inserting the following:“given to— “(i) outcome based evaluations; “(ii) culturally specific and population specific organizations; and “(iii) programs developing and implementing community-driven solutions to address domestic violence, dating violence, sexual assault, or stalking.” ; (10) in subsection (c)(3)(B)(i)(III), by inserting “, including a culturally specific organization or community-based organization working to address the social determinants of health,” after “nonprofit entity”; (11) in subsection (c)(3)(C)(ii)— (A) by striking “strategies for” and inserting the following:“strategies— “(I) for” ; (B) by inserting “and generations” after “lifespan”; (C) by striking “settings;” and inserting “settings; and”; and (D) by adding at the end the following: “(II) to address primary prevention of domestic violence, dating violence, sexual assault, and stalking over the lifespan and generations, including strategies that address related social determinants of health, economic justice, and equity issues, and that are inclusive of LGBT individuals;” ; (12) in subsection (c)(3)(C)(iii), by striking “State or tribal law enforcement task forces (where appropriate)” and inserting “culturally specific organizations”; (13) in subsection (c)(3)(C)(iv), by inserting “(including culturally specific organizations)” after “service providers”; (14) in subsection (d)(2)(A)— (A) by inserting “(including mental health or substance abuse agencies)” after “of health”; (B) by striking “or mental” and inserting “or behavioral”; and (C) by inserting “and substance use disorder prevention and treatment” before the semicolon at the end; (15) in subsection (d)(2)(B)— (A) by inserting “behavioral health treatment system,” after “hospital,”; (B) by striking “or any other community-based” and inserting “a community-based”; and (C) by inserting “or substance use disorder prevention and treatment, or a community-based organization with a history of partnership with programs in the field of domestic violence, dating violence, sexual assault, or stalking and health care, including physical or mental health care or substance use disorder prevention and treatment” after “mental health care”; (16) in subsection (g)— (A) by striking “$10,000,000” and inserting “$20,000,000”; and (B) by striking “2014 through 2018” and inserting “2023 through 2027”; and (17) in subsection (h)— (A) by striking “herein”; and (B) by striking “provided for”.