[House Report 115-327]
[From the U.S. Government Publishing Office]
115th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 115-327
======================================================================
SOAR TO HEALTH AND WELLNESS ACT OF 2017
_______
September 25, 2017.--Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
_______
Mr. Walden, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 767]
[Including cost estimate of the Congressional Budget Office]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 767) to establish the Stop, Observe, Ask, and
Respond to Health and Wellness Training pilot program to
address human trafficking in the health care system, having
considered the same, report favorably thereon with amendments
and recommend that the bill as amended do pass.
CONTENTS
Page
Purpose and Summary.............................................. 3
Background and Need for Legislation.............................. 3
Committee Action................................................. 3
Committee Votes.................................................. 4
Oversight Findings and Recommendations........................... 4
New Budget Authority, Entitlement Authority, and Tax Expenditures 4
Congressional Budget Office Estimate............................. 4
Federal Mandates Statement....................................... 6
Statement of General Performance Goals and Objectives............ 6
Duplication of Federal Programs.................................. 6
Committee Cost Estimate.......................................... 6
Earmark, Limited Tax Benefits, and Limited Tariff Benefits....... 6
Disclosure of Directed Rule Makings.............................. 6
Advisory Committee Statement..................................... 6
Applicability to Legislative Branch.............................. 7
Section-by-Section Analysis of the Legislation................... 7
Changes in Existing Law Made by the Bill, as Reported............ 7
The amendments are as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Stop, Observe, Ask, and Respond to
Health and Wellness Act of 2017'' or the ``SOAR to Health and Wellness
Act of 2017''.
SEC. 2. DEFINITIONS.
In this Act:
(1) Human trafficking.--The term ``human trafficking'' has
the meaning given the term ``severe forms of trafficking in
persons'' as defined in section 103 of the Trafficking Victims
Protection Act of 2000 (22 U.S.C. 7102).
(2) Secretary.--The term ``Secretary'' means the Secretary of
Health and Human Services.
SEC. 3. PROGRAM ESTABLISHMENT.
(a) In General.--The Secretary shall establish a program to be known
as the Stop, Observe, Ask, and Respond to Health and Wellness Training
Program or the SOAR to Health and Wellness Training Program (in this
Act referred to as the ``Program'') to provide training to health care
providers and other related providers, at all levels, on human
trafficking in accordance with the purpose described in subsection (c).
(b) Grants.--The Secretary may carry out the Program through the
award of grants to health care sites and health care professional
organizations that represent diversity in--
(1) geography;
(2) the demographics of the population served;
(3) the predominant types of human trafficking cases; and
(4) health care provider profiles.
(c) Purpose.--The purpose of the Program shall be to train health
care providers and other related providers to enable such providers
to--
(1) identify potential human trafficking victims;
(2) implement proper protocols and procedures for working
with law enforcement to report, and facilitate communication
with, such victims, in accordance with all applicable Federal,
State, local, and tribal requirements, including legal
confidentiality requirements for patients and health care
providers;
(3) implement proper protocols and procedures for referring
such victims to appropriate health care, social, or victims
service agencies or organizations;
(4) provide such victims care that is--
(A) coordinated;
(B) victim centered;
(C) culturally relevant;
(D) comprehensive;
(E) evidence-based;
(F) gender responsive;
(G) age-appropriate, with a focus on care for youth;
and
(H) trauma-informed; and
(5) consider the potential for integrating the training
described in paragraphs (1) through (4) with training programs,
in effect on the date of enactment of this Act, for victims of
domestic violence, dating violence, sexual assault, stalking,
child abuse, child neglect, child maltreatment, and child
sexual exploitation.
(d) Functions.--
(1) In general.--The functions of the Program shall include
the functions of the Stop, Observe, Ask, and Respond to Health
and Wellness Training program that was operating on the day
before the date of enactment of this Act and the authorized
initiatives described in paragraph (2).
(2) Authorized initiatives.--The authorized initiatives of
the Program shall include--
(A) engaging stakeholders, including victims of human
trafficking and any Federal, State, local, or tribal
partners, to develop a flexible training module--
(i) for achieving the purpose described in
subsection (c); and
(ii) that adapts to changing needs, settings,
health care providers, and other related
providers;
(B) providing technical assistance for health
education programs and health care professional
organizations to implement health care protocols, or
develop continuing education training materials, that
assist in achieving the purpose described in subsection
(c);
(C) facilitating the dissemination of best practices
and recommendations as the Secretary determines
appropriate; and
(D) developing a reliable methodology for collecting
data, and reporting such data, on the number of human
trafficking victims identified and served in health
care settings or other related provider settings.
SEC. 4. DATA COLLECTION AND REPORTING REQUIREMENTS.
(a) Data Collection.--
(1) In general.--During each of fiscal years 2018 through
2022, the Secretary shall collect data on each of the
following:
(A) The total number of grantees operating under the
Program.
(B) The total number of health care providers and
other related providers trained through the Program.
(2) Initial report.--In addition to the data required to be
collected under paragraph (1), for purposes of the initial
report to be submitted under subsection (b), the Secretary
shall collect data on the total number of facilities and health
care professional organizations that were operating under, and
the total number of health care providers and other related
providers trained through, the Stop, Observe, Ask, and Respond
to Health and Wellness Training program that was operating
before the establishment under section 3(a) of the Program.
(b) Reporting.--Not later than 90 days after the first day of each of
fiscal years 2019 through 2023, the Secretary shall prepare and submit
to Congress a report on the data collected under subsection (a).
SEC. 5. AUTHORIZATION OF APPROPRIATIONS.
There is authorized to be appropriated to carry out this Act
$4,000,000 for each of fiscal years 2018 through 2022.
Amend the title so as to read:
A bill to establish the Stop, Observe, Ask, and Respond to
Health and Wellness Training Program to address human
trafficking in the health care system.
PURPOSE AND SUMMARY
H.R. 767 was introduced on January 31, 2017, by Rep. Steve
Cohen (D-TN). The bill expands and further codifies the Stop,
Observe, Ask, and Respond (SOAR) training program at the
Administration for Children and Families, Office on Trafficking
in Persons, which provides health care professionals training
on how to identify and appropriately treat human trafficking
victims.
BACKGROUND AND NEED FOR LEGISLATION
According to the International Labour Organization (ILO),
nearly 21 million people worldwide are victims of human
trafficking, forced labor, or sexual exploitation. Many of
these unidentified victims come into contact with health care
professionals during their captivity. These professionals may
be the only people that a victim has an opportunity to speak
to, but may be ill-equipped to recognize victimization or to
respond in an appropriate manner.
The Stop, Observe, Ask, and Respond pilot initiative was
originally launched in 2013 by the Administration for Children
and Families, Office on Trafficking in Persons to enhance the
health care system's response to trafficking. Training is
currently a three-hour course delivered either in-person or
through a webinar. Given that health professionals are in a
unique position on the front lines to assist to human
trafficking victims, enhancing SOAR program training to help
them recognize the signs of exploitation and provide trauma-
informed, culturally-appropriate care will help increase
opportunities to offer trafficked victims help and ultimately
save lives.
COMMITTEE ACTION
On May 17, 2017, the Subcommittee on Health held a hearing
on H.R. 767. The hearing was entitled ``Examining Initiatives
to Advance Public Health.'' The Subcommittee received testimony
from:
Kevin O'Connor, Assistant to the General
President, International Association of Fire Fighters;
Cheryl D. Watson-Lowry, DDS; General
Dentist, American Dental Association;
Martin S. Levine, DO, MPH, FACOFP, dist;
Interim Clinical Dean, Professor of Family and
Community Medicine, Touro College of Osteopathic
Medicine; and
Jordan Greenbaum, MD; Medical Director,
Institute for Healthcare and Human Trafficking at
Children's Healthcare of Atlanta; Medical Director,
Global Initiative for Child Health and Well Being at
the International Centre for Missing and Exploited
Children.
On June 29, 2017, the Subcommittee on Health met in open
markup session and forwarded H.R. 767, as amended, to the full
Committee by a voice vote. On July 27, 2017, the full Committee
on Energy and Commerce met in open markup session and ordered
H.R. 767, as amended, favorably reported to the House by a
voice vote.
COMMITTEE VOTES
Clause 3(b) of rule XIII requires the Committee to list the
record votes on the motion to report legislation and amendments
thereto. There were no record votes taken in connection with
ordering H.R. 767 reported.
OVERSIGHT FINDINGS AND RECOMMENDATIONS
Pursuant to clause 2(b)(1) of rule X and clause 3(c)(1) of
rule XIII, the Committee held a hearing and made findings that
are reflected in this report.
NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX EXPENDITURES
Pursuant to clause 3(c)(2) of rule XIII, the Committee
finds that H.R. 767 would result in no new or increased budget
authority, entitlement authority, or tax expenditures or
revenues.
CONGRESSIONAL BUDGET OFFICE ESTIMATE
Pursuant to clause 3(c)(3) of rule XIII, the following is
the cost estimate provided by the Congressional Budget Office
pursuant to section 402 of the Congressional Budget Act of
1974.
U.S. Congress,
Congressional Budget Office,
Washington, DC, September 8, 2017.
Hon. Greg Walden,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 767, the SOAR to
Health and Wellness Act of 2017.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Tia Caldwell.
Sincerely,
Keith Hall,
Director.
Enclosure.
H.R. 767--SOAR to Health and Wellness Act of 2017
Summary: H.R. 767 would require the Department of Health
and Human Services (HHS) to establish a pilot program called
Stop, Observe, Ask, and Respond (SOAR) to Health and Wellness
Training.
CBO estimates that implementing the legislation would cost
$17 million over the 2017-2022 period, assuming appropriation
of the specified amounts. Enacting the bill would not affect
direct spending or revenues; therefore, pay-as-you-go
procedures do not apply.
CBO estimates that enacting H.R. 767 would not increase net
direct spending or on-budget deficits in any of the four
consecutive 10-year periods beginning in 2028.
H.R. 767 contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act (UMRA)
and would impose no costs on state, local, or tribal
governments.
Estimated cost to the Federal Government: The estimated
budgetary effect of H.R. 767 is shown in the following table.
The costs of this legislation fall within budget function 500
(education, training, employment and social services).
----------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
----------------------------------------------------
2017 2018 2019 2020 2021 2022 2017-2022
----------------------------------------------------------------------------------------------------------------
INCREASES IN SPENDING SUBJECT TO APPROPRIATION
Authorization Level........................................ 0 4 4 4 4 4 20
Estimated Outlays.......................................... 0 2 3 4 4 4 17
----------------------------------------------------------------------------------------------------------------
Basis of estimate: For this estimate, CBO assumes that H.R.
767 will be enacted near the start of 2018 and that the
specified amounts will be appropriated for each year. The
estimated outlays reflect historical spending patterns for
similar programs administered by HHS.
H.R. 767 would authorize the appropriation of $4 million
for each of fiscal years 2018 through 2022 for HHS to provide
grants for training health care providers on how to identify
and care for the victims of human trafficking. The program
would continue the functions of an existing pilot program,
provide additional technical assistance, and seek to improve
data collection.
CBO estimates that implementing the legislation would cost
$17 million over the 2018-2022 period, assuming appropriation
of the specified amounts; the remainder would be spent in the
years after 2022.
Pay-As-You-Go considerations: None.
Increase in long-term direct spending and deficits: CBO
estimates that enacting H.R. 767 would not increase net direct
spending or on-budget deficits in any of the four consecutive
10-year periods beginning in 2028.
Intergovernmental and private-sector impact: H.R. 767
contains no intergovernmental or private-sector mandates as
defined in UMRA.
Estimate prepared by: Federal costs: Tia Caldwell; Impact
on state, local, and tribal governments: Zach Byrum; Impact on
the private sector: Amy Petz.
Estimate approved by: H. Samuel Papenfuss, Deputy Assistant
Director for Budget Analysis.
FEDERAL MANDATES STATEMENT
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES
Pursuant to clause 3(c)(4) of rule XIII, the general
performance goal or objective of this legislation is to expand
and further codify the SOAR program by allowing the program to
provide grants to health care sites and health care
professional organizations that support training to recognize
and respond to human trafficking. The legislation also requires
the program, in conjunction with stakeholders, to develop
training modules, provide technical assistance to health
education programs and professional organizations, help
disseminate best practices, and develop data collection and
reporting on the number of trafficking victims served in health
care settings.
DUPLICATION OF FEDERAL PROGRAMS
Pursuant to clause 3(c)(5) of rule XIII, no provision of
H.R. 767 is known to be duplicative of another Federal program,
including any program that was included in a report to Congress
pursuant to section 21 of Public Law 111-139 or the most recent
Catalog of Federal Domestic Assistance.
COMMITTEE COST ESTIMATE
Pursuant to clause 3(d)(1) of rule XIII, the Committee
adopts as its own the cost estimate prepared by the Director of
the Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974.
EARMARK, LIMITED TAX BENEFITS, AND LIMITED TARIFF BENEFITS
Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the
Committee finds that H.R. 767 contains no earmarks, limited tax
benefits, or limited tariff benefits.
DISCLOSURE OF DIRECTED RULE MAKINGS
Pursuant to section 3(i) of H. Res. 5, the Committee finds
that H.R. 767 contains no directed rule makings.
ADVISORY COMMITTEE STATEMENT
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act were created by this
legislation.
APPLICABILITY TO LEGISLATIVE BRANCH
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION
Section 1. Short title
Section 1 provides that the Act may be cited as the ``Stop,
Observe, Ask, and Respond to Health and Wellness Act of 2017''
or the ``SOAR to Health and Wellness Act of 2017.''
Section 2. Definitions
Section 2 provides the meanings for the terms ``human
trafficking'' and ``Secretary.''
Section 3. Program establishment
Section 3 authorizes the Secretary to establish a grant
program known as the Stop, Observe, Ask, and Respond to Health
and Wellness Training Program to provide training to health
care providers on identifying potential human trafficking
victims and implementing the proper procedures for providing
appropriate care, working with law enforcement, and referring
victims to the necessary health, social, or victims service
agencies or organizations.
Section 4. Data collection and reporting requirements
Section 4 requires the Secretary to collect data and report
on the total number of grantees operating under the SOAR
Program, and the total number of health care providers trained
through the program.
Section 5. Authorization of appropriations
Section 5 authorizes the appropriation of $4 million for
each of fiscal years 2018 to 2022.
CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED
This legislation does not amend any existing Federal
statute.
[all]