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Forensic Nurses On The Hill

December, 2014

President Obama Signs National Defense Authorization Act

On Friday, December 19, 2014, President Barack Obama signed into law the fiscal 2015 defense authorization bill (HR3979), which includes a provision (Section 539) that establishes requirements relating to sexual assault forensic examiners (SAFEs) for the armed forces.  The provision establishes the following:

  • that physicians, nurse practitioners, nurse-midwives, physician assistants, and registered nurses are eligible for assignment in the military as SAFEs.  
  • The Secretary of Defense must establish and maintain a training and certification program for SAFEs.
  • Such training must be uniform to all SAFEs across the military branches and provided by qualified personnel who possess a SANE-A certification or equivalent certification or training and experience necessary to be certified.  
  • The training and certification program must incorporate and reflect best practices and standards on sexual assault forensic examinations.
  • Within one year from the date the law was enacted, the Defense Department may not assign for duty as a SAFE anyone that has not completed all training and certification requirements.
  • The Secretary of Defense is required to report within 120 days on the current adequacy of the training and qualifications of all SAFEs, what improvements the Secretary considers appropriate in the process to selection and assign members and employees as SAFEs, what improvements the Secretary considers appropriate to improve training and certification as SAFEs.

 

March, 2014

The Senate passed a measure Monday that would expand protections for victims of sexual assault in the military.

Lawmakers passed 97-0 a bill (S 1917) sponsored by Claire McCaskill, D-Mo., that would build on provisions she helped insert in the fiscal 2014 defense authorization law (PL 113-66). On Thursday the Senate voted unanimously to limit debate on the measure.

Passage of the bill comes after last week’s rejection of a competing bill to remove the decision for prosecuting such crimes from the chain of command.

The McCaskill measure would expand the role of special counsels for victims of sexual assault and rape to provide advice on the advantages of prosecution by court-martial or by a civilian court. The most recent defense policy law created the special counsel role.

That law also made retaliating against victims who report instances of sexual assault a crime under the Uniform Code of Military Justice. Under the McCaskill measure, evaluations would be conducted to determine the extent to which commanding officers have established a command climate in which allegations of sexual assault are properly managed and fairly evaluated. Evaluations would also judge whether the command climate would allow a victim to report criminal activity, including sexual assault, without fear of retaliation.

 

 

Domestic Violence Bill Passes in Senate

The Senate endorsed 78-22 a five-year renewal (S 47) of the 1994 law known as the Violence Against Women Act, which combats domestic violence, sexual assault and stalking. The vote came a day after senators rebuffed, 31-59, a proposal by Sen. Tom Coburn, R-Okla., to strike contentious language that would give tribal courts more authority over non-tribal domestic violence offenders. The measure now heads to the House, where lawmakers are working to forge consensus on tribal provisions.

Week of February 4, 2013

VAWA Update

The U.S. Senate is poised to pass a renewal of the Violence Against Women Act on Thursday, February 7, 2013.  Senator Patrick Leahy (D-VT) introduced the reauthorization bill, S.47, on January 24, 2013.  The bill is almost identical to the bill passed in the Senate last year during the 112th Congress.

A companion bill was introduced in the House of Representatives by House Democrats, H.R.11, but until today Republicans in the House had been largely silent.  Rep. Eric Cantor (R-VA), the House Majority Leader, indicted today on the House floor that he would make VAWA passage a priority of the House chamber. He indicated he was working with Vice President Joseph Biden and Minority Whip Steny Hoyer (D-MD) to bridge the differences on the legislation.

Reports are the final sticking point on the measure involves domestic abuse that occurs on Indian tribal lands. The Senate bill allows tribal courts to prosecute American citizens accused of domestic violence offenses against Indian victims. Many Republicans have protested, however, questioning whether U.S. citizens’ constitutional rights would be respected in tribal courts.

IAFN endorses S.47 and is eager for its swift enactment.

 

Week of January 3, 2013

DNA Sampling Measure Awaits President's Signature

The Senate cleared a bill Friday, December 28, 2012, that would provide grants to states to collect DNA from those charged with felonies.

The chamber gave unanimous consent to send the measure (HR6014) to President Obama for his signature. The House passed the bill by voice vote Dec. 18.

The legislation would establish a grant program at the Justice Department to help states establish DNA collection programs for those arrested for rape, homicide, kidnapping or certain other felonies. The samples would then be added to the FBI’s DNA database, called the Combined DNA Index System.

Known as Katie’s law, the bill is named after Katie Sepich, a 22-year-old graduate student at New Mexico State University, who was raped and murdered and her body burned and left at a dump site near her home in 2003. Law enforcement officials checked DNA samples from skin and blood under Sepich’s fingernails against the federal DNA database and identified her murderer as Gabriel Avila, a native of Mexico serving time in prison on unrelated charges. When confronted with the evidence, Avila confessed to the crime and was later sentenced to 69 years in prison.

The legislation would allow up to $10 million annually for the grants through fiscal 2015, which would be taken from money appropriated to clear the federal backlog of DNA samples. To receive money, states would have to have in place procedures to expunge collected DNA records.

 

Week of October 15, 2012

VAWA Outlook and IAFN Grassroots Plan

It is clear that after the November elections the reauthorization of the Violence Against Women Act (VAWA) will be on a short list of legislation the House and Senate will attempt to complete.  Challenges exist for its enactment however.  Both Republican and Democratic leaders say they want to renew the law during the post-election session, but it appears that will only happen if both chambers are willing to make difficult trade-offs. House Republicans need to decide if they will drop their resistance to the Senate’s proposed expansion of domestic violence protections for victims who are gay and lesbian, American Indian and immigrants. Senate Democrats will have to decide which, if any, provisions of the Senate bill they are willing to give up.

On April 26th the Senate passed a five-year reauthorization (S 1925) on a 68-31 vote. The House passed a similar but narrower version (HR 4970) on a largely party-line vote, 222-205, a little less than a month later.  

IAFN is planning a grassroots push for the Congress to complete its work on the reauthorization of VAWA.  Congress returns to work on November 13th and will likely be in session to the end of the year.  Stay tuned for more information and a grassroots push from IAFN.

Domestic Violence Awareness Month

October is Domestic Violence Awareness Month in the U.S.  Please click on the following link to see the statement from the Office of Violence Against Women and the Proclamation from the President of the United States.

 

Week of September 20, 2012

House Passes Continuing Resolution

On September 13, 2012, the House passed, 329-91, the Continuing Appropriations for FY2013 Resolution (H. J. Res. 117). Fiscal Year 2012 ends on September 30. Although the House and Senate have each made progress on a number of FY2013 appropriations bills, none of the twelve annual appropriations bills have yet been signed into law.  Congress, therefore, is required to pass continuing appropriations legislation to avoid a government shutdown on October 1st. The six-month continuing resolution would provide funding for all government agencies and programs through March 27, 2013.  The legislation would increase funding for most federal programs and agencies by 0.6 percent above FY2012 levels.

2012 OJP Grants to be Announced on OJP.gov!

The Office of Justice Programs (OJP) announced it is providing its external stakeholders, and the general public, an opportunity to view regular updates on grants awarded for Fiscal Year 2012.   Each Monday, the OJP Office of Communications (OCOM) will post a weekly report of grants awarded, including the grantee's name, city, state, award amount, and program office, located at www.OJP.gov.  Their goal is to provide grantees, stakeholders, and the general public current information on the grants OJP has awarded; to highlight the work of OJP program offices and the impact on communities; and to improve transparency on OJP's grant award process.

IAFN Visits with Senator Rockefeller's Staff on Forensic Science and Standards Act of 2012

On Friday, September 14, 2012, an IAFN representative met with staff from the Senate Commerce, Science and Transportation Committee to discuss the Forensic Science Standards Act (S.3378), introduced by Senator Jay Rockefeller (D-WV) on July 12, 2012. 

The bill establishes a national forensic science research program to improve, expand, and coordinate federal research in forensic sciences.  It requires the Director of the National Science Foundation (NSF) to enter into a contract with the National Academy of Sciences (NAS) to develop a report identifying the most critical forensic science disciplines that require further research to strengthen the scientific foundation in those disciplines and making recommendations.

It establishes a National Forensic Science Coordinating Office at the NSF to coordinate among federal agencies: 1) the development of a unified federal research strategy to enhance the validity and reliability of forensic science disciplines; 2) the development of a five-year roadmap, updated triennially, for the unified strategy; and 3) any necessary programs, policies, and budgets to support implementation of the roadmap.

It directs NSF to create a merit-reviewed, competitive forensic science research grants program to improve the foundation and practice of forensic science in the United States, based on recommendations in the unified strategy.

It requires NSF to: 1) establish two forensic science research centers to conduct research consistent with the unified strategy, 2) award a grant of up to $10 million to each center, and 3) conduct a comprehensive evaluation of the grants program every four years.

The bill also directs the National Institute of Standards and Technology (NIST) to identify or coordinate the development of forensic science standards to enhance the validity and reliability of forensic science activities.

Finally, it requires NIST to establish a Forensic Science Advisory Committee to provide advice to federal agencies, NIST, and the Department of Justice. Instructs the Attorney General to promote the adoption of the standards developed under this Act.

IAFN has no formal position on the legislation but is dialoguing with the Committee about the impact of the legislation on forensic science and specifically forensic nurses.  Reaction from the forensic science community and law enforcement community to the bill has been mixed.  Action is not expected on the bill this Congress but IAFN expects the bill to be reintroduced and considered in the 113th Congress.

Week of August 9, 2012

State vs. Federal Health Insurance Exchanges by 2014

Federal regulators in charge of health insurance exchange and other health care reforms says federal exchanges will be ready to operate by 2014 in states that do not create their own by that date.  More guidance on federal exchanges as well as proposed rule on essential health benefits to be issued soon.

Since not all states will be ready to set up online health insurance markets required by 2014 under the health care reform law, the federal government will be ready to operate a federally operated exchange in states that are not ready. HHS plans to go through a rulemaking process for the essential health benefits (EHBs) that ACA requires all individual and small group plans to cover by 2014, both inside and outside of exchanges.

Like exchanges that will be run directly by states, the federally run exchange will cover the functions required by the Affordable Care Act (ACA)—plan management, eligibility and enrollment functions, the determination of advance premium tax credits and cost-sharing reductions for low- and moderate-income individuals, and financial management responsibilities for payments to issuers of qualified health plans (QHPs) that will be sold in the exchanges.

To date, thirty-four states and the District of Columbia have received $850 million in grants to establish state-based exchanges.  States can apply for the grants through 2014 to use to establish exchanges after that date.  Many states have hesitated to move to set up exchanges to implement the controversial health care reform law. States that plan to build their own exchanges or that plan to form partnerships with HHS in which states conduct plan management and consumer assistance functions must notify HHS of their intent by November 16, 2012. In states that do not do so, HHS will operate federal exchanges.

CMS Provides Up to $200 Million To Help Hospitals Train More Nurses

The Centers for Medicare & Medicaid Services will give five hospitals in five states up to $200 million over four years under a demonstration project designed to help train more advanced practice registered nurses (APRNs), the Department of Health and Human Services announced July 30.

Under the Graduate Nurse Education Demonstration, hospitals in Pennsylvania, North Carolina, Arizona, Illinois, and Texas will receive additional reimbursement linked to the number of APRNs they help train.  The funding for the demo is authorized under the Patient Protection and Affordable Care Act.

Providers to receive funding are the Hospital of the University of Pennsylvania in Philadelphia; Duke University Hospital in Durham, N.C.; Scottsdale Healthcare Medical Center in Arizona; Rush University Medical Center in Chicago; and Memorial Hermann-Texas Medical Center Hospital in Houston.

Half of all clinical training in the demo must occur in nonhospital settings in the community, and will provide APRNs with the primary care, preventive care, transitional care, and chronic care management skills needed to provide effective and well-coordinated care, HHS said.  Hospitals participating in the demo must partner with accredited schools of nursing and nonhospital community-based care settings.

More information is available at http://innovations.cms.gov/initiatives/GNE/

Access to Preventive Health Services for Women

As of August 1, 2012, about 47 million American women will have access to free preventive health services as part of a new provision in President Obama’s Affordable Care Act. Comprehensive preventive care coverage will now be provided for insured women enrolling in new health care plans or renewing their existing policies.

The following are the eight services women are now eligible to receive under the new provision without a copay or any cost sharing:

Well-woman visits: This includes an annual well-woman preventive care visit for adult women to obtain the recommended preventive services, plus additional visits if women and their doctors determine they’re necessary.

Gestational diabetes screening: This screening is for women 24 to 28 weeks pregnant, and those at high risk of developing gestational diabetes. Women who have gestational diabetes have an increased risk of developing Type 2 diabetes in the future, and their children are at a significantly increased risk of being overweight and insulin-resistant throughout childhood.

HPV DNA testing: Women who are 30 or older will now have access to high-risk human papillomavirus (HPV) DNA testing every  three years, regardless of Pap smear results. Early screening, detection and treatment have been shown to help reduce the prevalence of cervical cancer.

STI counseling: Sexually active women may receive annual counseling on sexually transmitted infections (STIs). The sessions have been shown to reduce risky behavior in patients, but only 28% of women aged 18 to 44 discuss STIs with a doctor or nurse.

HIV screening and counseling: Sexually active women can receive annual counseling on HIV. Women are at increased risk of becoming infected with HIV: from 1999 to 2003, the Centers for Disease Control and Prevention reported a 15% increase in AIDS cases among women, and a 1% increase among men.

Contraception and contraceptive counseling: Women will have free access to all government-approved contraceptive methods, sterilization procedures and patient education and counseling. This does not include abortion drugs. Most workers in employer-sponsored plans are currently covered for contraceptives; however, employers with religious affiliations will not be required to pay for birth control. Rather, insurance companies providing health plans to such employers will cover the cost.

Breast-feeding support, supplies and counseling: Pregnant and postpartum women now have access to comprehensive lactation support and counseling from trained providers, as well as breastfeeding equipment.

Interpersonal and domestic violence screening and counseling: Screening and counseling for interpersonal and domestic violence is provided free for all adolescent and adult women. An estimated 25% of women in the U.S. report being targets of intimate partner violence during their lifetimes.

These services are in addition to the existing preventive care that the ACA makes available without copay to those with private health insurance and Medicare, including annual wellness visits, cholesterol screening, other cardiovascular screenings and cancer screenings, including mammograms, colonoscopy and cervical cancer tests.

 

Week of July 12, 2012

US Senate Hearing on Forensic Nursing

On July 18, 2012, the Senate Judiciary Committee is holding a hearing to explore the topic of "Improving Criminal Justice Forensic Science." 

On the same day, the Subcommittee on Labor, Health and Human Services, Education of the House Appropriations Committee will hold a markup of a bill to fund these agencies for FY2013.  IAFN signed on to a letter to the Committee from the Nursing Community urging support to provide $251 million for the Nursing Workforce Development programs (Title VIII of the Public Health Service Act), $150 million for the National Institute of Nursing Research (NINR), and $20 million for the Nurse-Managed Health Clinics (NMHCs) (Title III of the Public Health Service Act) grants. 
 

Week of June 28, 2012

Senate Panel Votes to Reauthorize DNA-Testing Grants
 

On Thursday, June 21, 2012, the Senate Judiciary Committee advanced a measure intended to reduce backlogs in DNA evidence collected from crime scenes and convicted criminals.

Sponsored by panel Chairman Patrick J. Leahy, D-Vt., the legislation (S 250) would reauthorize several grant programs that help states and localities cover the cost of testing DNA samples. The Judiciary panel backed an amended version of the bill in a voice vote. Much of the bill is devoted to a five-year, $755 million renewal of a backlog-reduction grant program to help law enforcement and laboratories process DNA evidence, including samples from rape kits.

The Debbie Smith DNA Backlog Grant Program is named after a rape victim who has advocated for reducing the substantial backlog of untested rape kits. The new legislation would call on the National Institute of Justice to develop standards for states and localities to process DNA evidence in a timely and accurate manner.

The House VAWA renewal (HR 4970) calls for 75 percent of program funds to be used on actual DNA tests. Senate Democrats agreed that more money is needed to eliminate the backlog but preferred to address the issue in the bill advanced Thursday rather than in their VAWA bill (S 1925).

In addition to renewing the Smith program, Thursday’s bill would require government entities to coordinate with regional health care providers to notify sexual assault victims of the availability of free rape exams.

The legislation also seeks to improve post-conviction testing of DNA evidence to help exonerate those arrested for crimes they did not commit. It would require the development of evidence-retention standards and provide for a $50 million allocation for the Kirk Bloodsworth Post-Conviction DNA Testing Grant Program, which helps states cover the costs of considering claims of innocence in criminal cases. 

IAFN Submits Comments on CMS Proposed Rule Impacting Emergency Room Services
 

On June 25, 2012, IAFN submitted official comments on a proposed rule issued by the Centers for Medicare and Medicaid Services (CMS) expressing concerns that new requirements to track and report “Emergency Department (ED) Throughput Measures” as part of the FY2015 Inpatient Quality Reporting program will have a negative impact on quality of care provided victims of sexual assault and/or intimate partner violence.
 
IAFN urged CMS to consider exempting that portion of patient cases involving sexual assault and domestic violence relating to collection of forensic evidence by a forensic examiner from the IQR program as it relates to hospital emergency room services.  The unique nature of such cases warrants significant time to stabilize and treat the patient.  It is also often necessary to collect evidence relating to an assault to support law enforcement efforts.  Without an exception to the IQR IAFN believes the potential exists for rushing victims through the emergency room for no clinical benefit.
 

SCOTUS Announces Fate of the Affordable Care Act on Thursday, June 28!
 

The Supreme Court of the United States is set to announce its determination in a case regarding the constitutionality of various parts of the Affordable Care Act this Thursday, June 28, 2012.   The ACA was signed into law by President Obama on March 23, 2010. 

Week of June 18, 2012

HHS Announces Funds for Elder Abuse Prevention

Department of Health and Human Services Secretary Kathleen Sebelius announced June 14 a $5.5 million funding opportunity for states and tribes to test ways to prevent elder abuse, neglect, and exploitation.  Sebelius made the announcement at a White House Elder Abuse Awareness Day ceremony.  The initiative helps implement the Elder Justice Act, which was enacted as part of the Patient Protection and Affordable Care Act.  Initiatives funded will test methods of preventing elder abuse, neglect, or exploitation, and build knowledge of risk factors for elder abuse. Pilot programs can involve health professionals, law enforcement and legal services agencies, social workers, clergy, and community organizations. Sebelius also announced she will convene the first Elder Justice Coordinating Council meeting, called for under PPACA. The Elder Abuse Prevention Interventions Program applications are available through http://www.grants.gov and will be due July 31. Final awards will be made by Sept. 30.

Congressional Committees

Senate Appropriations, Departments of Labor, Health and Human Services, and Education, and Related Agencies, held a business meeting June 12, to mark up proposed budget estimates for fiscal year 2013 for Labor, Health and Human Services, and Education, and related agencies.

Highlights of the bill of interest to forensic nurses include:

    Domestic Violence and Sexual Exploitation -The Committee recommendation includes a $5,000,000 increase, for a total of $137,774,000 for family violence prevention and related services, which include emergency shelters and services for victims of domestic violence. In addition, the Committee recommendation includes $5,000,000 for a new program to improve services for child victims of sex trafficking.

    Education and Prevention Grants to Reduce Sexual Abuse of Runaway Youth - The Committee recommendation includes $17,901,000, the same as the fiscal year 2012 level and the budget request, for education and prevention grants to reduce sexual abuse of runaway and homeless youth. This program provides competitive grants for street-based outreach and education services for runaway and homeless youth who are subjected to or are at risk of being subjected to sexual abuse or exploitation. 
     
    Office of Women's Health - The Committee recommends $29,120,000, the same as the administration request, for OWH. The comparable level for fiscal year 2012 is $33,682,000. OWH develops, stimulates, and coordinates women's health research, healthcare services, and public and healthcare professional education across the Department. It advances important crosscutting initiatives and develops public-private partnerships, providing leadership and policy direction, and initiating and synthesizing program activities to redress the disparities in women's health.

    The Committee recommendation includes $3,010,000 to continue the violence against women's initiative. This initiative provides funding to public health programs that integrate domestic and sexual violence assessment and intervention into basic care, as well as encourages collaborations between healthcare providers, public health programs, and domestic and sexual violence programs., and related agencies.

 

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