Women in Trauma Act of 2003 - Amends the Public Health Service Act to require the Secretary of Health and Human Services, through the Director of the National Institute of Mental Health, to award grants to build treatment interventions simultaneously addressing trauma, substance abuse, and psychiatric disorders, including the integration of existing interventions.
Requires the Secretary, through the Administrator of the Substance Abuse and Mental Health Services Administration, to make grants and provide technical assistance for the provision of comprehensive community-based mental health and substance abuse services to women with a history of physical or sexual abuse or other trauma. Targets minority community services. Authorizes the use of grant funds for childcare to facilitate participation.
[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 1810 Introduced in Senate (IS)]
108th CONGRESS
1st Session
S. 1810
To amend the Public Health Service Act to improve treatment for the
mental health and substance abuse needs of women with histories of
trauma, including domestic and sexual violence.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
October 31, 2003
Mr. Daschle (for Mr. Edwards) introduced the following bill; which was
read twice and referred to the Committee on Health, Education, Labor,
and Pensions
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to improve treatment for the
mental health and substance abuse needs of women with histories of
trauma, including domestic and sexual violence.
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 ``Women in Trauma Act of 2003''.
SEC. 2. FINDINGS.
Congress finds as follows:
(1) Researchers have concluded that women may experience
significant adverse mental health consequences relating to
trauma exposure, often the result of sexual or domestic
violence.
(2) The majority of women suffering from both substance
abuse and mental health problems have been victims of rape,
incest, or physical or emotional abuse and hundreds of
thousands of these same women are also severely beaten by their
husbands or a significant male intimate. Surveys have indicated
that approximately 1,500,000 children are physically abused
each year and 700,000 are victims of sexual abuse.
(3) Women with serious mental illnesses are over-
represented in samples that experienced trauma, including
physical, sexual, and emotional abuse. Between 50 and 70
percent of women hospitalized for mental health disorders have
a history of trauma.
(4) Even for people whose mental health problems are caused
by other factors, a history of early physical or sexual abuse
leads to the earlier onset of their illness, a more severe
course of illness, and a greater likelihood of suicide and
other poor outcomes.
(5) Trauma exposure is generally prevalent in people who
suffer from mental health and substance abuse problems, and can
worsen the course and overall impact of these illnesses.
(6) In a recent study, 97 percent of homeless women with
mental illness were found to have experienced severe physical
or sexual abuse and 87 percent experienced this abuse both as
children and as adults.
(7) Of women in prisons and jails, 80 to 100 percent have
been victims of physical and sexual abuse.
(8) The prevalence of violence- and trauma-related problems
among women with mental health and substance abuse problems is
not adequately addressed by most treatment practices.
(9) There is an urgent need to provide services that
directly address the issue of trauma for women suffering from
mental health and substance abuse problems.
(10) To improve mental health and substance abuse services
for women, further research to expand the development and
implementation of trauma-sensitive services is needed as well
as additional services to improve access to comprehensive
therapeutic interventions and to the support needed to overcome
barriers to recovery.
SEC. 3. GRANTS TO IMPROVE TREATMENT FOR WOMEN WITH HISTORIES OF TRAUMA.
Subpart 3 of part B of title V of the Public Health Service Act (42
U.S.C. 290bb-31 et seq.) is amended by adding at the end the following:
``SEC. 520K. GRANTS TO IMPROVE TREATMENT FOR WOMEN WITH HISTORIES OF
TRAUMA.
``(a) Research Grants.--
``(1) Grants authorized.--
``(A) In general.--The Secretary, acting through
the Director of the National Institute of Mental Health
and in consultation with the Administrator of the
Substance Abuse and Mental Health Services
Administration, shall award grants, contracts, or
cooperative agreements to public and nonprofit private
entities, as well as Indian tribes and tribal
organizations, for the purpose of building the evidence
base for new treatment interventions that
simultaneously address trauma, substance abuse, and
mental health disorders, including depression and
anxiety disorders (including post-traumatic stress
disorder), psychotic and dissociative disorders, and
the integration of existing interventions for the
treatment of trauma, substance abuse, and mental health
disorders, including depression and anxiety disorders
(including post-traumatic stress disorder), psychotic
and dissociative disorders.
``(B) Geographical distribution.--The Secretary
shall ensure that grants, contracts, or cooperative
agreements awarded pursuant to this paragraph are
distributed equitably among regions of the country and
among urban and rural areas.
``(C) Duration of awards.--Grants, contracts, or
cooperative agreements awarded pursuant to this
paragraph may not exceed 5 years. Such grants,
contracts, or agreements may be renewed.
``(2) Application.--
``(A) In general.--Each entity desiring a grant
under this subsection shall submit an application to
the Secretary at such time, in such manner, and
accompanied by such information as the Secretary may
reasonably require.
``(B) Contents.--Each application submitted
pursuant to subparagraph (A) shall--
``(i) describe the activities for which
assistance under this subsection is sought; and
``(ii) demonstrate that the testing of
treatment interventions will be carried out
through community-based treatment programs.
``(3) Authorization of appropriations.--There are
authorized to be appropriated to carry out this subsection,
such sums as may be necessary.
``(b) Treatment Grants.--
``(1) Grants authorized.--
``(A) In general.--The Secretary, acting through
the Administrator of the Substance Abuse and Mental
Health Services Administration, shall make grants to
public and nonprofit private entities, including Indian
tribes and tribal organizations, for the purpose of
providing comprehensive community-based mental health
and substance abuse services to women who have
experienced a history of physical or sexual abuse, or
other types of trauma.
``(B) Grantmaking considerations.--The Secretary
shall ensure that--
``(i) grants awarded pursuant to this
paragraph are distributed equitably among the
regions of the country and among urban and
rural areas; and
``(ii) preference is given to applicants
with strong ties to minority communities and
those that offer services that are culturally
and linguistically appropriate.
``(C) Duration.--The Secretary shall award grants
under this paragraph for a period not to exceed 5
years. Such grants may be renewed.
``(2) Technical assistance.--The Secretary, acting through
the Administrator of the Substance Abuse and Mental Health
Services Administration, shall provide technical assistance to
entities awarded grants pursuant to paragraph (1) with respect
to the implementation of programs described in paragraph (3).
``(3) Use of funds.--An entity awarded a grant pursuant to
paragraph (1) shall--
``(A) establish and operate 1 or more
multidisciplinary integrated systems of community-based
care--
``(i) to include medical, social, and
behavioral services for the simultaneous and
coordinated treatment of trauma, substance
abuse, and mental health disorders, including
depression and anxiety disorders (including
post-traumatic stress disorder), psychotic and
dissociative disorders;
``(ii) that specifically addresses the
impact of trauma on the lives of women
receiving services through the grant; and
``(iii) that may include services for
children of women who are survivors of trauma;
``(B) establish avenues for the involvement of
women who access the services described in subparagraph
(A), in all phases of service delivery and design
including in the development of individualized
treatment plans;
``(C) offer specialized and structured treatment
components addressing trauma that are culture- and
gender-specific;
``(D) implement collaboration among public and
private nonprofit entities likely to serve women with
histories of trauma including rape and domestic
violence programs, hospital emergency rooms,
appropriate branches of the criminal justice system,
low-income housing authorities, substance abuse and
mental health service providers, consolidated health
centers, battered women's shelters, and churches and
other community-based organizations;
``(E) undertake aggressive outreach efforts to
encourage women from minority communities, in
particular, to participate; and
``(F) offer educational materials or training,
through subparagraph (D) or other avenues, to agencies
and community-based organizations that serve women with
histories of trauma to increase awareness of the
devastating impact of chronic exposures to traumatic
experiences on women's mental health and of the need to
address this impact in the context of mental health and
substance abuse treatment.
``(4) Access to child care.--An entity awarded a grant
pursuant to paragraph (1) may use grant funds to provide child
care, either directly or through an off site, licensed child
care provider, to women offered services under such grant to
facilitate participation and address a primary barrier to care.
``(5) Application.--
``(A) In general.--Each entity desiring a grant
under this subsection shall submit an application to
the Secretary at such time, in such manner, and
accompanied by such information as the Secretary may
reasonably require.
``(B) Contents.--Each application submitted
pursuant to subparagraph (A) shall--
``(i) describe the activities for which
assistance under this subsection is sought; and
``(ii) describe a plan for the rigorous
evaluation of such activities, including both
process and outcome evaluation, and the
submission of the evaluation at the end of the
project period.
``(6) Authorization of appropriations.--There are
authorized to be appropriated to carry out this subsection,
such sums as may be necessary.''.
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Introduced in Senate
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
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