42 U.S.C. § 280g–4

The Family Violence Prevention and Services Act, referred to in subsec. (c)(1)(A), is title III of Pub. L. 98–457, Oct. 9, 1984, 98 Stat. 1757, which is classified generally to chapter 110 (§ 10401 et seq.) of this title. For complete classification of this Act to the Code, see Short Title note set out under section 10401 of this title and Tables.

2022—Subsec. (a)(1). Pub. L. 117–103, § 501(1)(A), inserted “community health workers, violence prevention advocates working with health providers,” after “health staff,”.

Subsec. (a)(2). Pub. L. 117–103, § 501(1)(B), substituted “for medical, psychology, dental, social work, nursing, and other health profession students, interns, residents, fellows, or current health care providers (including midwives and doulas);” for “for medical, nursing, dental, and other health profession students and residents to prevent and respond to domestic violence, dating violence, sexual assault, and stalking; and”.

Subsec. (a)(3). Pub. L. 117–103, § 501(1)(C)(i), (ii), substituted “capacity” for “response” and inserted “prevent and respond to” after “(including behavioral and mental health programs) to”.

Subsec. (a)(4), (5). Pub. L. 117–103, § 501(1)(C)(iii), (D), added pars. (4) and (5).

Subsec. (b)(1)(A)(i). Pub. L. 117–103, § 501(2)(A)(i), substituted “to provide universal education on healthy relationships and provide trauma-informed” for “to identify and provide”.

Subsec. (b)(1)(A)(ii). Pub. L. 117–103, § 501(2)(B), substituted “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,” for “culturally competent clinical training components” and “inequities” for “disparities” and inserted “(including labor and sex trafficking)” after “other forms of violence and abuse”.

Subsec. (b)(1)(A)(iii), (iv). Pub. L. 117–103, § 501(2)(A)(ii), (C), added cls. (iii) and (iv).

Subsec. (b)(1)(B). Pub. L. 117–103, § 501(2)(D), substituted “capacity of the health care system to prevent and respond” for “response of the health care system” in introductory provisions.

Subsec. (b)(1)(B)(i). Pub. L. 117–103, § 501(2)(E), substituted “identifying, responding to, and promoting prevention of” for “identifying and responding to” and inserted “during in-person or virtual visits” after “and stalking” and “and to maximize victim choice on the use and sharing of their health information” before semicolon at end.

Subsec. (b)(1)(B)(ii). Pub. L. 117–103, § 501(2)(F), substituted “services to address the safety, medical, and mental health needs of patients by—” and subcls. (I) to (III) for “on-site access to services to address the safety, medical, and mental health needs of patients by increasing the capacity of existing health care professionals and public health staff to address domestic violence, dating violence, sexual assault, and stalking, or by contracting with or hiring domestic or sexual assault advocates to provide such services or to model other services appropriate to the geographic and cultural needs of a site;”.

Subsec. (b)(1)(B)(iii). Pub. L. 117–103, § 501(2)(G)(i), (ii), substituted “of prevention” for “of identification” and inserted “during in-person or virtual visits” after “and stalking”.

Subsec. (b)(1)(B)(iv). Pub. L. 117–103, § 501(2)(H)(i), inserted “and promote prevention during in-person or virtual visits,” after “or stalking,”.

Subsec. (b)(1)(B)(v), (vi). Pub. L. 117–103, § 501(2)(G)(iii), (H)(ii), (I), added cls. (v) and (vi).

Subsec. (b)(1)(C). Pub. L. 117–103, § 501(2)(J), added subpar. (C).

Subsec. (b)(2)(A). Pub. L. 117–103, § 501(3), substituted “Child abuse and abuse in later life” for “Child and elder abuse” in heading and “child abuse or abuse in later life” for “child or elder abuse” in text.

Subsec. (b)(2)(C)(i). Pub. L. 117–103, § 501(4), substituted “abuse in later life” for “elder abuse”.

Subsec. (b)(2)(C)(ii). Pub. L. 117–103, § 501(5), inserted “programs that promote the prevention of sexual assault as well as” after “implementation of”.

Subsec. (b)(2)(C)(iii). Pub. L. 117–103, § 501(6)(A), inserted “and exposure to violence across generations” after “abuse”.

Subsec. (b)(2)(C)(iv). Pub. L. 117–103, § 501(7), inserted “mental health,” after “dental,” and substituted “exams and certifications;” for “exams.”

Subsec. (b)(2)(C)(v) to (vii). Pub. L. 117–103, § 501(6)(B), (8), added cls. (v) to (vii).

Subsec. (c)(3)(A). Pub. L. 117–103, § 501(9), substituted “given to—” and cls. (i) to (iii) for “given to outcome based evaluations.”

Subsec. (c)(3)(B)(i)(III). Pub. L. 117–103, § 501(10), inserted “, including a culturally specific organization or community-based organization working to address the social determinants of health,” after “nonprofit entity”.

Subsec. (c)(3)(C)(ii). Pub. L. 117–103, § 501(11), substituted “strategies—” for “strategies”, inserted subcl. (I) designation before “for the development”, inserted “and generations” after “lifespan” and added subcl. (II).

Subsec. (c)(3)(C)(iii). Pub. L. 117–103, § 501(12), substituted “culturally specific organizations” for “State or tribal law enforcement task forces (where appropriate)”.

Subsec. (c)(3)(C)(iv). Pub. L. 117–103, § 501(13), inserted “(including culturally specific organizations)” after “service providers”.

Subsec. (d)(2)(A). Pub. L. 117–103, § 501(14)(C), which directed insertion of “and substance use disorder prevention and treatment” before “the semicolon at the end”, was executed by making the insertion before “; or”, to reflect the probable intent of Congress.

Pub. L. 117–103, § 501(14)(A), (B), inserted “(including mental health or substance abuse agencies)” after “of health” and substituted “or behavioral” for “or mental”.

Subsec. (d)(2)(B). Pub. L. 117–103, § 501(15), substituted “hospital, behavioral health treatment system, or health system, a community-based” for “hospital, or health system, or any other community-based” and inserted “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”.

Subsec. (g). Pub. L. 117–103, § 501(16), substituted “$20,000,000” for “$10,000,000” and “2023 through 2027” for “2014 through 2018”.

Subsec. (h). Pub. L. 117–103, § 501(17), struck out “herein” after “otherwise provided” and “provided for” after “definitions”.

2013—Pub. L. 113–4 amended section generally. Prior to amendment, section related to grants to foster public health responses to domestic violence, dating violence, sexual assault, and stalking.

Amendment by Pub. L. 117–103 not effective until Oct. 1 of the first fiscal year beginning after Mar. 15, 2022, see section 4(a) of div. W of Pub. L. 117–103, set out as an Effective Date note under section 6851 of Title 15, Commerce and Trade.

Pub. L. 109–162, title V, § 501, Jan. 5, 2006, 119 Stat. 3023, provided that: “Congress makes the following findings:“(1) The health-related costs of intimate partner violence in the United States exceed $5,800,000,000 annually.“(2) Thirty-seven 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.“(3) In addition to injuries sustained during violent episodes, physical and psychological abuse is linked to a number of adverse physical and mental health effects. Women who have been abused are much more likely to suffer from chronic pain, diabetes, depression, unintended pregnancies, substance abuse and sexually transmitted infections, including HIV/AIDS.“(4) Health plans spend an average of $1,775 more a year on abused women than on general enrollees.“(5) Each year about 324,000 pregnant women in the United States 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.“(6) Pregnant and recently pregnant women are more likely to be victims of homicide than to die of any other pregnancy-related cause, and evidence exists that a significant proportion of all female homicide victims are killed by their intimate partners.“(7) 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.“(8) Recent research suggests that women experiencing domestic violence significantly increase their safety-promoting behaviors over the short- and long-term when health care providers screen for, identify, and provide followup care and information to address the violence.“(9) Currently, only about 10 percent of primary care physicians routinely screen for intimate partner abuse during new patient visits and 9 percent routinely screen for intimate partner abuse during periodic checkups.“(10) 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.“(11) Seventy to 81 percent of the patients studied reported that they would like their healthcare providers to ask them privately about intimate partner violence.”

Pub. L. 109–162, title V, § 502, Jan. 5, 2006, 119 Stat. 3024, provided that: “It is the purpose of this title [enacting this section, sections 294h and 13973 of this title, and provisions set out as a note above] to improve the health care system’s response to domestic violence, dating violence, sexual assault, and stalking through the training and education of health care providers, developing comprehensive public health responses to violence against women and children, increasing the number of women properly screened, identified, and treated for lifetime exposure to violence, and expanding research on effective interventions in the health care setting.”