Compassionate Assistance for Rape Emergencies Act - Prohibits any federal funds from being provided to a hospital unless the hospital meets certain conditions related to a woman who is a victim of sexual assault, including that the hospital: (1) provides the woman with accurate and unbiased information about emergency contraception; (2) offers emergency contraception to the woman; (3) provides the woman such contraception at the hospital on her request; and (4) does not deny any such services because of the inability of the woman to pay.
Prohibits any hospital from receiving federal funds unless such hospital provides to survivors of sexual assault, regardless of ability to pay: (1) an assessment of the individual's risk for contracting sexually transmitted infections; (2) advice concerning significantly prevalent infections for which effective post-exposure prophylaxis exists and for which the deferral of treatment either would significantly reduce treatment efficacy or would pose substantial risk to the individual's health; and (3) such prophylactic treatment for infections, upon request.
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 1264 Introduced in Senate (IS)]
109th CONGRESS
1st Session
S. 1264
To provide for the provision by hospitals of emergency contraceptives
to women, and post-exposure prophylaxis for sexually transmitted
disease to individuals, who are survivors of sexual assault.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 16, 2005
Mr. Corzine (for himself, Mrs. Clinton, Mrs. Murray, Mr. Lautenberg,
Mrs. Boxer, Ms. Cantwell, Mr. Kennedy, Mr. Inouye, and Mr. Kerry)
introduced the following bill; which was read twice and referred to the
Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To provide for the provision by hospitals of emergency contraceptives
to women, and post-exposure prophylaxis for sexually transmitted
disease to individuals, who are survivors of sexual assault.
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 ``Compassionate Assistance for Rape
Emergencies Act''.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) It is estimated that 25,000 to 32,000 women become
pregnant each year as a result of rape or incest. An estimated
22,000 of these pregnancies could be prevented if rape
survivors had timely access to emergency contraception.
(2) A 1996 study of rape-related pregnancies (published in
the American Journal of Obstetrics and Gynecology) found that
50 percent of the pregnancies described in paragraph (1) ended
in abortion.
(3) Surveys have shown that many hospitals do not routinely
provide emergency contraception to women seeking treatment
after being sexually assaulted.
(4) The risk of pregnancy after sexual assault has been
estimated to be 4.7 percent in survivors who were not protected
by some form of contraception at the time of the attack.
(5) The Food and Drug Administration has declared emergency
contraception to be safe and effective in preventing unintended
pregnancy, reducing the risk by as much as 89 percent if taken
within days of unprotected intercourse and up to 95 percent if
taken in the first 24 hours.
(6) Medical research strongly indicates that the sooner
emergency contraception is administered, the greater the
likelihood of preventing unintended pregnancy.
(7) In light of the safety and effectiveness of emergency
contraceptive pills, both the American Medical Association and
the American College of Obstetricians and Gynecologists have
endorsed more widespread availability of such pills.
(8) The American College of Emergency Physicians and the
American College of Obstetricians and Gynecologists agree that
offering emergency contraception to female patients after a
sexual assault should be considered the standard of care.
(9) Approximately 30 percent of American women of
reproductive age are unaware of the availability of emergency
contraception.
(10) New data from a survey of women having abortions
estimates that 51,000 abortions were prevented by use of
emergency contraception in 2000 and that increased use of
emergency contraception accounted for 43 percent of the
decrease in total abortions between 1994 and 2000.
(11) It is essential that all hospitals that provide
emergency medical treatment provide emergency contraception as
a treatment option to any woman who has been sexually
assaulted, so that she may prevent an unintended pregnancy.
(12) Victims of sexual assault are at increased risk of
contracting sexually transmitted diseases.
(13) Some sexually-transmitted infections cannot be
reliably cured if treatment is delayed, and may result in high
morbidity and mortality. HIV has killed over 520,000 Americans,
and the Centers for Disease Control and Prevention currently
estimates that over 1,000,000 Americans are infected with the
virus. Even modern drug treatment has failed to cure infected
individuals. Nearly 80,000 Americans are infected with
hepatitis B each year, with some individuals unable to fully
recover. An estimated 1,250,000 Americans remain chronically
infected with the hepatitis B virus and at present, one in five
of these may expect to die of liver failure.
(14) It is possible to prevent some sexually transmitted
diseases by treating an exposed individual promptly. The use of
post-exposure prophylaxis using antiretroviral drugs has been
demonstrated to effectively prevent the establishment of HIV
infection. Hepatitis B infection may also be eliminated if an
exposed individual receives prompt treatment.
(15) The Centers for Disease Control and Prevention has
recommended risk evaluation and appropriate application of
post-exposure treatment for victims of sexual assault. For such
individuals, immediate treatment is the only means to prevent a
life threatening infection.
(16) It is essential that all hospitals that provide
emergency medical treatment provide assessment and treatment of
sexually-transmitted infections to minimize the harm to victims
of sexual assault.
SEC. 3. SURVIVORS OF SEXUAL ASSAULT; PROVISION BY HOSPITALS OF
EMERGENCY CONTRACEPTIVES WITHOUT CHARGE.
(a) In General.--Federal funds may not be provided to a hospital
under any health-related program, unless the hospital meets the
conditions specified in subsection (b) in the case of--
(1) any woman who presents at the hospital and states that
she is a victim of sexual assault, or is accompanied by someone
who states she is a victim of sexual assault; and
(2) any woman who presents at the hospital whom hospital
personnel have reason to believe is a victim of sexual assault.
(b) Assistance for Victims.--The conditions specified in this
subsection regarding a hospital and a woman described in subsection (a)
are as follows:
(1) The hospital promptly provides the woman with medically
and factually accurate and unbiased written and oral
information about emergency contraception, including
information explaining that--
(A) emergency contraception has been approved by
the Food and Drug Administration as a safe and
effective way to prevent pregnancy after unprotected
intercourse or contraceptive failure if taken in a
timely manner, and is more effective the sooner it is
taken; and
(B) emergency contraception does not cause an
abortion and cannot interrupt an established pregnancy.
(2) The hospital promptly offers emergency contraception to
the woman, and promptly provides such contraception to her at
the hospital on her request.
(3) The information provided pursuant to paragraph (1) is
in clear and concise language, is readily comprehensible, and
meets such conditions regarding the provision of the
information in languages other than English as the Secretary
may establish.
(4) The services described in paragraphs (1) through (3)
are not denied because of the inability of the woman to pay for
the services.
SEC. 4. PREVENTION OF TRANSMISSIBLE DISEASE.
(a) In General.--No hospital shall receive Federal funds unless
such hospital provides risk assessment, counseling, and treatment as
required under this section to a survivor of sexual assault described
in subsection (b).
(b) Survivors of Sexual Assault.--An individual is a survivor of a
sexual assault as described in this subsection if the individual--
(1) presents at the hospital and declares that the
individual is a victim of sexual assault, or the individual is
accompanied to the hospital by another individual who declares
that the first individual is a victim of a sexual assault; or
(2) presents at the hospital and hospital personnel have
reason to believe the individual is a victim of sexual assault.
(c) Requirement for Risk Assessment, Counseling, and Treatment.--
The following shall apply with respect to a hospital described in
subsection (a):
(1) Risk assessment.--A hospital shall promptly provide a
survivor of a sexual assault with an assessment of the
individual's risk for contracting sexually transmitted
infections as described in paragraph (2)(A), which shall be
conducted by a licensed medical professional and be based
upon--
(A) available information regarding the assault as
well as the subsequent findings from medical
examination and any tests that may be conducted; and
(B) established standards of risk assessment which
shall include consideration of any recommendations
established by the Centers for Disease Control and
Prevention, and may also incorporate findings of peer-
reviewed clinical studies and appropriate research
utilizing in vitro and non-human primate models of
infection.
(2) Counseling.--A hospital shall provide a survivor of a
sexual assault with advice, provided by a licensed medical
professional, concerning--
(A) significantly prevalent sexually transmissible
infections for which effective post-exposure
prophylaxis exists, and for which the deferral of
treatment would either significantly reduce treatment
efficacy or would pose substantial risk to the
individual's health; and
(B) the requirement that prophylactic treatment for
infections as described in subparagraph (A) shall be
provided to the individual upon request, regardless of
the ability of the individual to pay for such
treatment.
(3) Treatment.--A hospital shall provide a survivor of a
sexual assault, upon request, with prophylactic treatment for
infections described in paragraph (2)(A).
(4) Ability to pay.--The services described in paragraphs
(1) through (3) shall not be denied because of the inability of
the individual involved to pay for the services.
(5) Language.--Any information provided pursuant to this
subsection shall be clear and concise, readily comprehensible,
and meet such conditions regarding the provision of the
information in languages other than English as the Secretary
may establish.
(d) Rule of Construction.--Nothing in this section shall be
construed to--
(1) require that a hospital provide prophylactic treatment
for a victim of sexual assault when risk evaluation according
to criteria adopted by the Centers for Disease Control and
Prevention clearly recommend against the application of post-
exposure prophylaxis;
(2) prohibit a hospital from seeking reimbursement for the
cost of services provided under this section to the extent that
health insurance may reimburse for such services; and
(3) establish a requirement that any victim of sexual
assault submit to diagnostic testing for the presence of any
infectious disease.
(e) Limitation.--Federal funds may not be provided to a hospital
under any health-related program unless the hospital complies with the
requirements of this section.
SEC. 5. DEFINITIONS.
In this Act:
(1) Emergency contraception.--The term ``emergency
contraception'' means a drug, drug regimen, or device that is--
(A) approved by the Food and Drug Administration to
prevent pregnancy; and
(B) is used postcoitally.
(2) Hospital.--The term ``hospital'' has the meaning given
such term in title XVIII of the Social Security Act, including
the meaning applicable in such title for purposes of making
payments for emergency services to hospitals that do not have
agreements in effect under such title. Such term includes a
health care facility that is located within, or contracted to,
a correctional institution or a post-secondary educational
institution.
(3) Licensed medical professional.--The term ``licensed
medical professional'' means a doctor of medicine, doctor of
osteopathy, registered nurse, physician assistant, or any other
healthcare professional determined appropriate by the
Secretary.
(4) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(5) Sexual assault.--
(A) In general.--The term ``sexual assault'' means
a sexual act (as defined in subparagraphs (A) through
(C) of section 2246(2) of title 18, United States Code)
where the victim involved does not consent or lacks the
capacity to consent.
(B) Application of provisions.--The definition
under subparagraph (A) shall--
(i) in the case of section 2, apply to
males and females, as appropriate;
(ii) in the case of section 3, apply only
to females; and
(iii) in the case of section 4, apply to
all individuals.
SEC. 6. EFFECTIVE DATE; AGENCY CRITERIA.
This Act shall take effect upon the expiration of the 180-day
period beginning on the date of the enactment of this Act. Not later
than 30 days prior to the expiration of such period, the Secretary of
Health and Human Services shall publish in the Federal Register
criteria for carrying out this Act.
<all>
Introduced in Senate
Sponsor introductory remarks on measure. (CR S6759-6760)
Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S6760-6761)
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