109th CONGRESS
2d Session
H. R. 6083
To reduce the spread of sexually transmitted infections in correctional
facilities, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
September 14, 2006
Ms. LEE (for herself, Mrs. CHRISTENSEN, Mr. JACKSON of Illinois, Ms. WATERS,
and Mr. WAXMAN) introduced the following bill; which was referred to the
Committee on the Judiciary
A BILL
To reduce the spread of sexually transmitted infections in correctional
facilities, and for other purposes.
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 `Justice for the Unprotected Against Sexually
Transmitted Infections among the Confined and Exposed Act of 2006' or the
`JUSTICE Act of 2006'.
SEC. 2. FINDINGS.
The Congress makes the following findings:
(1) According to the Bureau of Justice Statistics (BJS), 2,186,230 persons
were incarcerated in the United States as of midyear 2005. Between 1995
and midyear 2005, the number of persons incarcerated in Federal or State
correctional facilities increased by an average of 3.4 percent per year.
One in every 136 United States residents was incarcerated in a Federal,
State, or local correctional facility as of midyear 2005.
(2) As of 2001, 64 percent of incarcerated persons were racial or ethnic
minorities. Based on current incarceration rates, BJS estimates that 32
percent of African-American males will enter State or Federal correctional
facilities during their lifetime, compared with 17 percent of Hispanic
males and 5.9 percent of White males.
(3) There is a disproportionately high rate of HIV/AIDS among incarcerated
persons, especially among minorities. Approximately 25 percent of the
HIV-positive population of the United States passes through correctional
facilities each year. BJS determined that the rate of confirmed AIDS cases
is 3 times higher among incarcerated persons than in the general population.
Minorities account for the majority of AIDS-related deaths among incarcerated
persons, with African-American incarcerated persons 3.5 times more likely
than White incarcerated persons and 2.5 times more likely than Hispanic
incarcerated persons to die from AIDS-related causes.
(4) Studies suggest that other sexually transmitted infections (STIs),
such as gonorrhea, chlamydia, syphilis, genital herpes, viral hepatitis,
and human papillomavirus, also exist at a higher rate among incarcerated
persons than in the general population. For instance, researchers have
estimated that the rate of Hepatitis C (HCV) infection among incarcerated
persons is somewhere between 8 and 20 times higher than that of the general
population.
(5) Correctional facilities lack a uniform system of STI testing and reporting.
Establishing a uniform data collection system would assist in developing
and targeting counseling and treatment programs for incarcerated persons.
Better developed and targeted programs may reduce the spread of STIs.
(6) Although Congress has acted to reduce the spread of sexual violence
in correctional facilities by enacting the National Prison Rape Elimination
Act (PREA) of 2003, BJS reported 8,210 allegations of sexual violence
in correctional facilities in 2004.
(7) Approximately 95 percent of all incarcerated persons eventually return
to society. According to one study, every year approximately 100,000 persons
infected with both HIV and HCV are released from correctional facilities.
These individuals comprise approximately 50 percent of all persons with
both infections in the United States.
(8) According to the Centers for Disease Control and Prevention (CDC),
latex condoms, when used consistently and correctly, are highly effective
in preventing the transmission of HIV. Latex condoms also reduce the risk
of other STIs. Despite the effectiveness of condoms in reducing the spread
of STIs, the Bureau of Prisons does not recommend their use in correctional
facilities.
(9) The distribution of condoms in correctional facilities is currently
legal in certain parts of the United States and the world. The States
of Vermont and Mississippi and the District of Columbia allow condom distribution
programs in their correctional facilities. The cities of New York, San
Francisco, Los Angeles, and Philadelphia also allow condom distribution
in their correctional facilities. However, these States and cities operate
fewer than 1 percent of all correctional facilities. In one study, researchers
found that 18 of 31 countries surveyed allowed condom distribution in
correctional facilities.
(10) In 2000 and 2001, researchers surveyed 300 incarcerated persons and
100 correctional officers at the Central Detention Facility, a correctional
facility operated by the District of Columbia at which condoms are available.
Researchers found that both incarcerated persons and correctional officers
generally supported the condom distribution program and considered it
to be important. Furthermore, the researchers determined that the program
had not caused any major security infractions. In Canada, the Expert Committee
on AIDS and Prisons surveyed more than 400 correctional officers in the
Federal prison system of Canada in 1995 and reported that 82 percent of
those responding indicated that the availability of condoms had created
no problems at their facility.
(11) The American Public Health Association, the United Nations Joint
Program on HIV/AIDS, and the World Health Organization have endorsed the
effectiveness of condom distribution programs in correctional facilities.
(12) Many correctional facilities in the United States do not provide
comprehensive testing and treatment programs to reduce the spread of STIs.
According to BJS surveys from 2000, only 899 of the 1,668 Federal and
State correctional facilities (i.e. 54 percent) provided HIV/AIDS counseling
programs. Only 1,104 of the 1,584 State correctional facilities (i.e.
70 percent) reported having a policy of treating incarcerated persons
for HCV.
SEC. 3. AUTHORITY TO ALLOW COMMUNITY ORGANIZATIONS TO PROVIDE STI COUNSELING,
STI PREVENTION EDUCATION, AND SEXUAL BARRIER PROTECTION DEVICES IN FEDERAL
CORRECTIONAL FACILITIES.
(a) Directive to Attorney General- Not later than 30 days after the date
of enactment of this Act, the Attorney General shall direct the Bureau of
Prisons to allow community organizations to distribute sexual barrier protection
devices and to engage in STI counseling and STI prevention education in
Federal correctional facilities. These activities shall be subject to all
relevant Federal laws and regulations which govern visitation in correctional
facilities.
(b) Information Requirement- Any community organization permitted to distribute
sexual barrier protection devices under subsection (a) must ensure that
the persons to whom the devices are distributed are informed about the proper
use and disposal of sexual barrier protection devices in accordance with
established public health practices. Any community organization conducting
STI counseling or STI prevention education under subsection (a) must offer
comprehensive sexuality education.
(c) Possession of Device Protected- No Federal correctional facility may,
because of the possession or use of a sexual barrier protection device--
(1) take adverse action against an incarcerated person; or
(2) consider possession or use as evidence of prohibited activity for
the purpose of any Federal correctional facility administrative proceeding.
(d) Implementation- The Attorney General and Bureau of Prisons shall implement
this section according to established public health practices in a manner
that protects the health, safety, and privacy of incarcerated persons and
of correctional facility staff.
SEC. 4. SENSE OF CONGRESS REGARDING DISTRIBUTION OF SEXUAL BARRIER PROTECTION
DEVICES IN STATE PRISON SYSTEMS.
It is the sense of Congress that States should allow for the legal distribution
of sexual barrier protection devices in State correctional facilities to
reduce the prevalence and spread of STIs in those facilities.
SEC. 5. SURVEY OF AND REPORT ON CORRECTIONAL FACILITY PROGRAMS AIMED AT
REDUCING THE SPREAD OF STIS.
(a) Survey- The Attorney General, after consulting with the Secretary of
Health and Human Services, State officials, and community organizations,
shall, to the maximum extent practicable, conduct a survey of all Federal
and State correctional facilities no later than 180 days after the date
of enactment of this Act and annually thereafter for five years to determine:
(1) PREVENTION EDUCATION OFFERED- The type of prevention education, information,
or training offered to incarcerated persons and correctional facility
staff regarding sexual violence and the spread of STIs, including whether
such education, information, or training--
(A) constitutes comprehensive sexuality education;
(B) is compulsory for new incarcerated persons and for new staff; and
(C) is offered on an on-going basis.
(2) ACCESS TO SEXUAL BARRIER PROTECTION DEVICES- Whether incarcerated
persons can--
(A) possess sexual barrier protection devices;
(B) purchase sexual barrier protection devices;
(C) purchase sexual barrier protection devices at a reduced cost; and
(D) obtain sexual barrier protection devices without cost.
(3) INCIDENCE OF SEXUAL VIOLENCE- The incidence of sexual violence and
assault committed by incarcerated persons and by correctional facility
staff.
(4) COUNSELING, TREATMENT, AND SUPPORTIVE SERVICES- Whether the correctional
facility requires incarcerated persons to participate in counseling, treatment,
and supportive services related to STIs, or whether it offers such programs
to incarcerated persons.
(5) STI TESTING- Whether the correctional facility tests incarcerated
persons for STIs or gives them the option to undergo such testing--
(B) on a regular basis; and
(6) STI TEST RESULTS- The number of incarcerated persons who are tested
for STIs and the outcome of such tests at each correctional facility,
disaggregated to include results for--
(A) the type of sexually transmitted infection tested for;
(B) the race and/or ethnicity of individuals tested;
(C) the age of individuals tested; and
(D) the gender of individuals tested.
(7) PRE-RELEASE REFERRAL POLICY- Whether incarcerated persons are informed
prior to release about STI-related services or other health services in
their communities, including free and low-cost counseling and treatment
options.
(8) PRE-RELEASE REFERRALS MADE- The number of referrals to community-based
organizations or public health facilities offering STI-related or other
health services provided to incarcerated persons prior to release, and
the type of counseling or treatment for which the referral was made.
(9) OTHER ACTIONS TAKEN- Whether the correctional facility has taken any
other action, in conjunction with community organizations or otherwise,
to reduce the prevalence and spread of STIs in that facility.
(b) Privacy- In conducting the survey, the Attorney General shall not request
or retain the identity of any person who has sought or been offered counseling,
treatment, testing, or prevention education information regarding an STI
(including information about sexual barrier protection devices), or who
has tested positive for an STI.
(c) Report- The Attorney General shall transmit to Congress and make publicly
available the results of the survey required under subsection (a), both
for the Nation as a whole and disaggregated as to each State and each correctional
facility. To the maximum extent possible, the Attorney General shall issue
the first report no later than 1 year after the date of enactment of this
Act and shall issue reports annually thereafter for 5 years.
SEC. 6. STRATEGY.
(a) Directive to Attorney General- The Attorney General, in consultation
with the Secretary of Health and Human Services, State officials, and community
organizations, shall develop and implement a 5-year strategy to reduce the
prevalence and spread of STIs in Federal and State correctional facilities.
To the maximum extent possible, the strategy shall be developed, transmitted
to Congress, and made publicly available no later than 180 days after the
transmission of the first report required under subsection 5(c) of this
Act.
(b) Contents of Strategy- The strategy shall include the following:
(1) PREVENTION EDUCATION- A plan for improving prevention education, information,
and training offered to incarcerated persons and correctional facility
staff, including information and training on sexual violence and the spread
of STIs, and comprehensive sexuality education.
(2) SEXUAL BARRIER PROTECTION DEVICE ACCESS- A plan for expanding access
to sexual barrier protection devices in correctional facilities.
(3) SEXUAL VIOLENCE REDUCTION- A plan for reducing the incidence of sexual
violence among incarcerated persons and correctional facility staff, developed
in consultation with the National Prison Rape Elimination Commission.
(4) COUNSELING AND SUPPORTIVE SERVICES- A plan for expanding access to
counseling and supportive services related to STIs in correctional facilities.
(5) TESTING- A plan for testing incarcerated persons for STIs during intake,
during regular health exams, and prior to release, and that--
(A) is conducted in accordance with guidelines established by the Centers
for Disease Control;
(B) includes pre-test counseling;
(C) requires that incarcerated persons are notified of their option
to decline testing at any time;
(D) requires that incarcerated persons are confidentially notified of
their test results in a timely manner; and
(E) ensures that incarcerated persons testing positive for STIs receive
post-test counseling, care, treatment and supportive services.
(6) TREATMENT- A plan for ensuring that correctional facilities have the
necessary medicine and equipment to treat and monitor STIs and for ensuring
that incarcerated persons living with or testing positive for STIs receive
and have access to care and treatment services.
(7) STRATEGIES FOR DEMOGRAPHIC GROUPS- A plan for developing and implementing
culturally appropriate, sensitive, and specific strategies to reduce the
spread of STIs among demographic groups heavily impacted by STIs.
(8) LINKAGES WITH COMMUNITIES AND FACILITIES- A plan for establishing
and strengthening linkages to local communities and health facilities
that provide counseling, testing, care, and treatment services and that
may receive persons recently released from incarceration who are living
with STIs.
(9) OTHER PLANS- Any other plans developed by the Attorney General for
reducing the spread of STIs or improving the quality of health care in
correctional facilities.
(10) MONITORING SYSTEM- A monitoring system that establishes performance
goals related to reducing the prevalence and spread of STIs in correctional
facilities and which, where feasible, expresses such goals in quantifiable
form.
(11) MONITORING SYSTEM PERFORMANCE INDICATORS- Performance indicators
that measure or assess the achievement of the performance goals described
in paragraph (9).
(12) COST ESTIMATE- A detailed estimate of the funding necessary to implement
the strategy at the Federal and State levels for all 5 years, including
the amount of funds required by community organizations to implement the
parts of the strategy in which they take part.
(c) Report- The Attorney General shall transmit to Congress and make publicly
available an annual progress report regarding the implementation and effectiveness
of the strategy described in subsection (a). The progress report shall include
an evaluation of the implementation of the strategy using the monitoring
system and performance indicators provided for in paragraphs (9) and (10)
of subsection (b).
SEC. 7. APPROPRIATIONS.
(a) In General- There are authorized to be appropriated such sums as may
be necessary to carry out this Act for each of the fiscal years 2007 through
2013.
(b) Availability of Funds- Amounts made available under paragraph (1) are
authorized to remain available until expended.
SEC. 8. DEFINITIONS.
For the purposes of this Act:
(1) CORRECTIONAL FACILITY- The term `correctional facility' means any
prison, penitentiary, adult detention facility, juvenile detention facility,
jail, or other facility to which persons may be sent after conviction
of a crime or act of juvenile delinquency within the United States.
(2) INCARCERATED PERSON- The term `incarcerated person' means any person
who is serving a sentence in a correctional facility after conviction
of a crime.
(3) SEXUALLY TRANSMITTED INFECTION- The term `sexually transmitted infection'
or `STI' means any disease or infection that is commonly transmitted through
sexual activity, including HIV/AIDS, gonorrhea, chlamydia, syphilis, genital
herpes, viral hepatitis, and human papillomavirus.
(4) SEXUAL BARRIER PROTECTION DEVICE- The term `sexual barrier protection
device' means any FDA-approved physical device which has not been tampered
with and which reduces the probability of STI transmission or infection
between sexual partners, including female condoms, male condoms, and dental
dams.
(5) COMPREHENSIVE SEXUALITY EDUCATION- The term `comprehensive sexuality
education' means sexuality education that includes information about abstinence
and about the proper use and disposal of sexual barrier protection devices
and which is--
(6) COMMUNITY ORGANIZATION- The term `community organization' means a
public health care facility or a non-profit organization which provides
health or STI related services according to established public health
standards.
(7) STATE- The term `State' includes the District of Columbia, American
Samoa, the Commonwealth of the North Mariana Islands, Guam, Puerto Rico,
and the Virgin Islands of the United States.
END
