Directs the Secretary of Health and Human Services (HHS) (Secretary) to make available within the National Institute of Child Health and Human Development enhanced support for extramural activities relating to the training and career development of pediatric researchers. Authorizes appropriations.
Subtitle B: Other Programs - Extends through FY 2003 programs under the Act for: (1) immunizations; (2) screenings, referrals, and education regarding lead poisoning; and (3) the prevention and control of injuries, including traumatic brain injury.
Title II: Children's Health Research and Prevention Activities - Subtitle A: Early Detection, Diagnosis, and Treatment Regarding Hearing Loss in Infants - Newborn and Infant Hearing Screening and Intervention Act of 1999 - Mandates grants or cooperative agreements to: (1) develop statewide newborn and infant hearing screening, evaluation, and intervention programs and systems; and (2) provide technical assistance to State agencies to complement an intramural program and to conduct applied research related to newborn and infant hearing screening, evaluation, and intervention programs and systems. Requires NIH to continue a program of research and development on the efficacy of new screening techniques and technology. Mandates Federal coordination and collaboration with State and local agencies, consumer groups, national medical, health, and education specialty organizations, deaf or hard-of-hearing individuals and their families, qualified professional personnel, and related commercial industries. Authorizes appropriations.
Subtitle B: Autism - Chapter 1: Surveillance and Research Regarding Prevalence and Pattern of Autism - Autism Statistics, Surveillance, Research, and Epidemiology Act of 1999 (ASSURE) - Authorizes grants and cooperative agreements for the collection, analysis, and reporting of data on autism and pervasive developmental disabilities.
Mandates establishment, through grants or cooperative agreements, of three to five centers of excellence in autism and pervasive developmental disabilities epidemiology to collect and analyze autism information.
Requires that the Centers for Disease Control and Prevention (CDCP) serve as the coordinating agency for autism and pervasive development disabilities surveillance through the establishment of a clearinghouse for data generated from the monitoring programs created under this chapter.
Mandates establishment of an Advisory Committee for Autism and Pervasive Developmental Disabilities Epidemiology Research.
Authorizes appropriations.
Chapter 2: Expansion, Intensification, and Coordination of Activities of Department of Health and Human Services With Respect to Autism - Advancement in Pediatric Autism Research Act of 1999 - Directs the NIH Director to expand, intensify, and coordinate the activities of NIH with respect to autism. Requires such Director, among other things, to make awards of grants or contracts to public or nonprofit entities for centers of excellence regarding research on autism. Authorizes appropriations.
Authorizes the Secretary to make awards of grants and cooperative agreements for the collection, analysis, and reporting of data on autism and pervasive developmental disabilities. Directs the Secretary to establish no less than three regional centers of excellence in autism and pervasive developmental disabilities epidemiology to collect and analyze information on the number, incidence, correlates, and causes of autism and related developmental disabilities. Directs the Secretary to: (1) establish a clearinghouse within the CDCP for the collection and storage of such data; and (2) coordinate the Federal response to requests for assistance regarding potential or alleged autism or developmental disability clusters. Authorizes appropriations.
Requires the Secretary to establish a program to provide information and education on autism to health professionals and the general public. Authorizes appropriations.
Directs the Secretary to establish an Autism Coordinating Committee to coordinate HHS efforts concerning autism.
Subtitle C: Poison Control Center Enhancement and Awareness - Poison Control Center Enhancement and Awareness Act - Directs the Secretary to provide coordination and assistance to regional poison control centers for the establishment of a nationwide toll-free telephone number to be used to access such centers. Authorizes appropriations.
Mandates a national media campaign to educate the public about poison prevention and the availability of local poison control resources and to conduct advertising campaigns concerning the nationwide toll-free number. Authorizes appropriations.
Mandates grants for certified regional poison control centers to achieve financial stability and to prevent, and provide treatment recommendations for, poisoning. Mandates other grant uses. Sets forth center certification requirements. Authorizes appropriations.
Subtitle D: Birth Defects Prevention Activities - Chapter 1: Folic Acid - Folic Acid Promotion and Birth Defects Prevention Act of 1999 - Directs the Secretary to carry out a program, directly or through grants or contracts, for professional and public education and training, research, and epidemiological activities regarding folic acid and birth defects. Authorizes appropriations.
Chapter 2: National Center on Birth Defects and Developmental Disabilities - Establishes a National Center on Birth Defects and Developmental Disabilities to: (1) collect, analyze, and make available date on birth defects; (2) conduct applied epidemiological research on prevention of such defects; and (3) provide birth defect prevention information and education to the public. Transfers to such Center all activities, budgets, and personnel of the National Center for Environmental Health that relate to birth defects, folic acid, cerebral palsy, mental retardation, child development, newborn screening, autism, fragile X syndrome, fetal alcohol syndrome, pediatric genetics, and disability prevention. Authorizes appropriations.
Subtitle E: Safe Motherhood Monitoring and Prevention Research - Safe Motherhood Monitoring and Prevention Research Act - Authorizes the Secretary to: (1) establish a national monitoring and surveillance program to identify and promote the investigation of deaths and severe complications that occur during pregnancy; (2) expand the Pregnancy Risk Assessment Monitoring System to provide surveillance and collect data in each State; and (3) expand the Maternal and Child Health Epidemiology Program to provide technical support, financial assistance, or the time-limited assignment of senior epidemiologists to maternal and child health programs in each State. Authorizes appropriations.
Permits the Secretary to carry out specified activities to promote safe motherhood. Authorizes appropriations.
Subtitle F: Pregnant Mothers and Infants Health Promotion - Pregnant Mothers and Infants Health Protection Act - Requires the Secretary to: (1) collect, analyze, and make available data on prenatal smoking and alcohol and illegal drug usage; (2) conduct applied epidemiological research on the prevention of prenatal and postnatal smoking and alcohol and illegal drug usage; (3) support, conduct, and evaluate the effectiveness of educational and cessation programs; and (4) provide information and education to the public on the prevention and implications of prenatal and postnatal smoking and alcohol and illegal drug usage. Authorizes appropriations.
Subtitle G: Utilization of Preventive Health Services - Directs the Secretary to make grants to public or nonprofit entities to establish and operate regional centers for identifying particular populations of patients and to facilitate the appropriate utilization of preventive health services by such patients. Requires the Secretary to give priority to various populations of infants, young children, and their mothers. Requires the evaluation of strategies developed through grant funding. Authorizes appropriations.
Subtitle H: Research and Development Regarding Fragile X - Fragile X Research Breakthrough Act of 1999 - Requires the Director of the National Institute of Child Health and Human Development to: (1) expand, intensify, and coordinate the Institute's activities respecting research on the mental retardation disease known as fragile X; and (2) make grants to, and enter into contracts with, public or private nonprofit entities for the development and operation of at least three centers for fragile X research. Requires each center to conduct basic and clinical research, which may include clinical trials of new or improved diagnostic methods and drugs or other treatment approaches. Allows such centers to use grant funds to provide fees to individuals serving as subjects in clinical trials.
Requires the Director to provide for the coordination of the centers' activities, including the exchange of information. Requires each center to use the facilities of a single institution, or be formed from a consortium of cooperating institutions. Allows support to be provided to a center for up to five years, with authorized extensions. Authorizes appropriations.
Requires the Secretary to enter into contracts with qualified health professionals who agree to conduct fragile X research in return for repayment (up to $35,000 for each year of service) of such health professionals' educational loans. Authorizes appropriations.
Subtitle I: Children and Epilepsy - Directs the Secretary, through grants to or contracts with public or nonprofit private entities, to develop and implement public health surveillance, education, research, and intervention strategies to improve the lives of persons with epilepsy, with a particular emphasis on children. Authorizes appropriations.
Authorizes the Secretary to make grants to State and local governments for carrying out demonstration projects to improve access to health and other services regarding seizures to encourage early detection and treatment in children and others residing in medically underserved areas. Authorizes appropriations.
Subtitle J: Asthma Treatment Services for Children - Children's Asthma Relief Act of 1999 - Directs the Secretary to award grants to eligible entities to establish an asthma treatment grants program providing comprehensive asthma services for children and other individuals. Authorizes appropriations.
Directs the Secretary to encourage States to implement plans to carry out activities to assist children with asthma in accordance with the guidelines of the National Asthma Education and Prevention Program and the National Heart, Lung, and Blood Institute (Institute).
Provides that if a State child health plan under title XXI (Children's Health Insurance) of the Social Security Act provides for such activities to the Secretary's satisfaction, the Secretary shall make a grant to assist the State in carrying them out. Sets forth certain matching funds requirements. Authorizes appropriations.
Amends the Act to include, within the preventive health and health services block grant, any system for reducing asthma and asthma-related illnesses, especially with regard to children, through urban cockroach pest management in public facilities through a combination of biological, cultural, physical, and chemical tools that minimizes economic, health, and environmental risks.
Requires the Institute Director to: (1) identify all Federal programs carrying out asthma-related activities; (2) develop a Federal plan for responding to asthma; and (3) submit recommendations to Congress on ways to strengthen and improve Federal coordination of such activities. Authorizes appropriations.
Requires the CDCP Director to: (1) conduct local asthma surveillance activities to collect data on the prevalence and severity of asthma and the quality of asthma management; and (2) compile and publish annually data on the prevalence of children suffering from asthma in each State and the childhood mortality rate associated with asthma nationally and in each State.
Subtitle K: Juvenile Arthritis and Related Conditions - Requires the Directors of the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the National Institute of Allergies and Infectious Diseases to expand and intensify their respective programs of research and related activities concerning juvenile arthritis and related conditions. Requires the NIH Director, through a grant, cooperative agreement, or contract, to establish an information resource center on arthritis and related conditions. Authorizes appropriations.
Subtitle L: Childhood Skeletal Malignancies - Directs the Secretary to: (1) study environmental and other risk factors for childhood skeletal cancers; (2) carry out projects to improve outcomes among children with such cancers and related secondary conditions; and (3) ensure that such activities are coordinated with other Public Health Service activities focused on childhood cancers and limb loss. Authorizes appropriations.
Subtitle M: Reducing Burden of Diabetes Among Children and Youth - Directs the Secretary to: (1) develop a system to collect data on juvenile diabetes, including its incidence and prevalence, and to establish a national database for such data; (2) conduct or support long-term epidemiological studies concerning juvenile diabetes; (3) implement a national public health effort to address type 2 diabetes in youth; (4) support regional clinical centers for the cure of juvenile diabetes; and (5) implement a national effort to develop a vaccine for type 1 diabetes. Authorizes appropriations.
Subtitle N: Miscellaneous Provisions - Requires the NIH Director to report to Congress concerning research activities with respect to rare diseases in children.
[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3301 Introduced in House (IH)]
106th CONGRESS
1st Session
H. R. 3301
To amend the Public Health Service Act with respect to children's
health.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
November 10, 1999
Mr. Bilirakis (for himself, Mr. Brown of Ohio, Mrs. Emerson, Mr. Towns,
Mr. Greenwood, Mr. Upton, Ms. DeGette, Mr. Smith of New Jersey, Mr.
Waxman, and Mr. Walsh) introduced the following bill; which was
referred to the Committee on Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act with respect to children's
health.
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 ``Children's Health Research and
Prevention Amendments of 1999''.
SEC. 2. TABLE OF CONTENTS.
The table of contents for this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
TITLE I--REVISION AND EXTENSION OF PROGRAMS
Subtitle A--Pediatric Research Initiative
Sec. 101. Short title.
Sec. 102. Establishment of a pediatric research initiative.
Sec. 103. Investment in tomorrow's pediatric researchers.
Subtitle B--Other Programs
Sec. 111. Childhood immunizations.
Sec. 112. Screenings, referrals, and education regarding lead
poisoning.
Sec. 113. Prevention and control of injuries; traumatic brain injury.
TITLE II--CHILDREN'S HEALTH RESEARCH AND PREVENTION ACTIVITIES
Subtitle A--Early Detection, Diagnosis, and Treatment Regarding Hearing
Loss in Infants
Sec. 201. Short title.
Sec. 202. Early detection, diagnosis, and interventions for newborns
and infants with hearing loss.
Subtitle B--Autism
Chapter 1--Surveillance and Research Regarding Prevalence and Pattern
of Autism
Sec. 211. Short title.
Sec. 212. Developmental disabilities surveillance and research
programs.
Sec. 213. Clearinghouse.
Sec. 214. Advisory committee.
Sec. 215. Report to Congress.
Sec. 216. Definition.
Sec. 217. Authorization of appropriations.
Chapter 2--Expansion, Intensification, and Coordination of Activities
of Department of Health and Human Services With Respect to Autism
Sec. 218. Short title.
Sec. 218A. Expansion, intensification, and coordination of activities
of National Institutes of Health.
Sec. 219. Developmental disabilities surveillance and research
programs.
Sec. 220. Information and education.
Sec. 220A. Interagency autism coordinating committee.
Sec. 220B. Report to Congress.
Subtitle C--Poison Control Center Enhancement and Awareness
Sec. 221. Short title.
Sec. 222. Definition.
Sec. 223. Establishment of a national toll-free number.
Sec. 224. Establishment of nationwide media campaign.
Sec. 225. Establishment of a grant program.
Subtitle D--Birth Defects Prevention Activities
Chapter 1--Folic Acid Promotion
Sec. 231. Short title.
Sec. 232. Program regarding effects of folic acid in prevention of
birth defects.
Chapter 2--National Center on Birth Defects and Developmental
Disabilities
Sec. 236. National Center on Birth Defects and Developmental
Disabilities.
Subtitle E--Safe Motherhood Monitoring and Prevention Research
Sec. 241. Short title.
Sec. 242. Amendment to Public Health Service Act.
Subtitle F--Pregnant Mothers and Infants Health Promotion
Sec. 251. Short title.
Sec. 252. Establishment.
Subtitle G--Utilization of Preventive Health Services
Sec. 261. Grants regarding utilization of preventive health services.
Subtitle H--Research and Development Regarding Fragile X
Sec. 266. Short title.
Sec. 267. National Institute of Child Health and Human Development;
research on fragile X.
Sec. 268. National Institute of Child Health and Human Development;
loan repayment program regarding research
on fragile X.
Subtitle I--Children and Epilepsy
Sec. 271. Programs of the Centers for Disease Control and Prevention;
national public health campaign on
epilepsy.
Sec. 272. Programs of Health Resources and Services Administration;
State and local grants for seizure disorder
demonstration projects in medically
underserved areas.
Sec. 273. Definitions.
Subtitle J--Asthma Treatment Services for Children
Sec. 276. Short title.
Sec. 277. Children's asthma relief.
Sec. 278. Incorporation of asthma prevention treatment and services
into State children's health insurance
programs.
Sec. 279. Preventive health and health services block grant; systems
for reducing asthma and asthma-related
illnesses through urban cockroach
management.
Sec. 279A. Coordination of Federal activities to address asthma-related
health care needs.
Sec. 279B. Compilation of data by the Centers for Disease Control and
Prevention.
Subtitle K--Juvenile Arthritis and Related Conditions
Sec. 281. Research on juvenile arthritis and related conditions.
Subtitle L--Childhood Skeletal Malignancies
Sec. 286. Programs of Centers for Disease Control and Prevention.
Subtitle M--Reducing Burden of Diabetes Among Children and Youth
Sec. 291. Programs regarding diabetes in children and youth.
Subtitle N--Miscellaneous Provisions
Sec. 296. Report regarding research on rare diseases in children.
TITLE I--REVISION AND EXTENSION OF PROGRAMS
Subtitle A--Pediatric Research Initiative
SEC. 101. SHORT TITLE.
This subtitle may be cited as the ``Pediatric Research Initiative
Act of 1999''.
SEC. 102. ESTABLISHMENT OF A PEDIATRIC RESEARCH INITIATIVE.
Part A of title IV of the Public Health Service Act (42 U.S.C. 281
et seq.) is amended by adding at the end the following:
``SEC. 404F. PEDIATRIC RESEARCH INITIATIVE.
``(a) Establishment.--The Secretary shall establish within the
Office of the Director of NIH a Pediatric Research Initiative (referred
to in this section as the `Initiative'). The Initiative shall be headed
by the Director of NIH.
``(b) Purpose.--The purpose of the Initiative is to provide funds
to enable the Director of NIH to encourage--
``(1) increased support for pediatric biomedical research
within the National Institutes of Health to ensure that the
expanding opportunities for advancement in scientific
investigations and care for children are realized;
``(2) enhanced collaborative efforts among the Institutes
to support multidisciplinary research in the areas that the
Director deems most promising; and
``(3) the development of adequate pediatric clinical trials
and pediatric use information to promote the safer and more
effective use of prescription drugs in the pediatric
population.
``(c) Duties.--In carrying out subsection (b), the Director of NIH
shall--
``(1) consult with the Institute of Child Health and Human
Development and the other Institutes, in considering their
requests for new or expanded pediatric research efforts, and
consult with other advisors as the Director determines
appropriate;
``(2) have broad discretion in the allocation of any
Initiative assistance among the Institutes, among types of
grants, and between basic and clinical research so long as
the--
``(A) assistance is directly related to the
illnesses and conditions of children; and
``(B) assistance is extramural in nature; and
``(3) be responsible for the oversight of any newly
appropriated Initiative funds and annually report to Congress
and the public on the extent of the total extramural support
for pediatric research across the NIH, including the specific
support and research awards allocated through the Initiative.
``(d) Authorization.--For the purpose of carrying out this section,
there are authorized to be appropriated such sums as may be necessary
for each of the fiscal years 2000 through 2003.
``(e) Transfer of Funds.--The Director of NIH may transfer amounts
appropriated under this section to any of the Institutes for a fiscal
year to carry out the purposes of the Initiative under this section.''.
SEC. 103. INVESTMENT IN TOMORROW'S PEDIATRIC
RESEARCHERS.
Subpart 7 of part C of title IV of the Public Health Service Act
(42 U.S.C. 285g et seq.) is amended by adding at the end the following:
``SEC. 452E. INVESTMENT IN TOMORROW'S PEDIATRIC
RESEARCHERS.
``(a) In General.--The Secretary shall make available within the
National Institute of Child Health and Human Development enhanced
support for extramural activities relating to the training and career
development of pediatric researchers.
``(b) Purpose.--The purpose of support provided under subsection
(a) shall be to ensure the future supply of researchers dedicated to
the care and research needs of children by providing for--
``(1) an increase in the number and size of institutional
training grants to medical school pediatric departments and
children's hospitals; and
``(2) an increase in the number of career development
awards for pediatricians building careers in pediatric basic
and clinical research.
``(c) Authorization.--For the purpose of carrying out this section,
there are authorized to be appropriated such sums as may be necessary
for each of the fiscal years 2000 through 2003.''.
Subtitle B--Other Programs
SEC. 111. CHILDHOOD IMMUNIZATIONS.
Section 317(j)(1) of the Public Health Service Act (42 U.S.C.
247b(j)(1)) is amended in the first sentence by striking ``1998'' and
all that follows and inserting ``1998 through 2003.''.
SEC. 112. SCREENINGS, REFERRALS, AND EDUCATION
REGARDING LEAD POISONING.
Section 317A(l)(1) of the Public Health Service Act (42 U.S.C.
247b-1(l)(1)) is amended by striking ``1994'' and all that follows and
inserting ``1994 through 2003.''.
SEC. 113. PREVENTION AND CONTROL OF INJURIES; TRAUMATIC BRAIN INJURY.
Section 394A of the Public Health Service Act (42 U.S.C. 280b-3) is
amended by striking ``and'' after ``1994'' and by inserting before the
period the following: ``, and such sums as may be necessary for each of
the fiscal years 2000 through 2003.''.
TITLE II--CHILDREN'S HEALTH RESEARCH AND PREVENTION ACTIVITIES
Subtitle A--Early Detection, Diagnosis, and Treatment Regarding Hearing
Loss in Infants
SEC. 201. SHORT TITLE.
This subtitle may be cited as the ``Newborn and Infant Hearing
Screening and Intervention Act of 1999''.
SEC. 202. EARLY DETECTION, DIAGNOSIS, AND INTERVENTIONS FOR NEWBORNS
AND INFANTS WITH HEARING LOSS.
(a) Definitions.--For the purposes of this subtitle only, the
following terms in this section are defined as follows:
(1) Hearing screening.--Newborn and infant hearing
screening consists of objective physiologic procedures to
detect possible hearing loss and to identify newborns and
infants who, after rescreening, require further audiologic and
medical evaluations.
(2) Audiologic evaluation.--Audiologic evaluation consists
of procedures to assess the status of the auditory system; to
establish the site of the auditory disorder; the type and
degree of hearing loss, and the potential effects of hearing
loss on communication; and to identify appropriate treatment and
referral options. Referral options should include linkage to state IDEA
Part C coordinating agencies or other appropriate agencies, medical
evaluation, hearing aid/sensory aid assessment, audiologic
rehabilitation treatment, national and local consumer, self-help,
parent, and education organizations, and other family-centered
services.
(3) Medical evaluation.--Medical evaluation by a physician
consists of key components including history, examination, and
medical decision making focused on symptomatic and related body
systems for the purpose of diagnosing the etiology of hearing
loss and related physical conditions, and for identifying
appropriate treatment and referral options.
(4) Medical intervention.--Medical intervention is the
process by which a physician provides medical diagnosis and
direction for medical and/or surgical treatment options of
hearing loss and/or related medical disorder associated with
hearing loss.
(5) Audiologic rehabilitation.--Audiologic rehabilitation
(intervention) consists of procedures, techniques, and
technologies to facilitate the receptive and expressive
communication abilities of a child with hearing loss.
(6) Early intervention.--Early intervention (e.g.,
nonmedical) means providing appropriate services for the child
with hearing loss and ensuring that families of the child are
provided comprehensive, consumer-oriented information about the
full range of family support, training, information services,
communication options and are given the opportunity to consider
the full range of educational and program placements and
options for their child.
(b) Purposes.--The purposes of this subtitle are to clarify the
authority within the Public Health Service Act to authorize statewide
newborn and infant hearing screening, evaluation and intervention
programs and systems, technical assistance, a national applied research
program, and interagency and private sector collaboration for policy
development, in order to assist the States in making progress toward
the following goals:
(1) All babies born in hospitals in the United States and
its territories should have a hearing screening before leaving
the birthing facility. Babies born in other countries and
residing in the United States via immigration or adoption
should have a hearing screening as early as possible.
(2) All babies who are not born in hospitals in the United
States and its territories should have a hearing screening
within the first 3 months of life.
(3) Appropriate audiologic and medical evaluations should
be conducted by 3 months for all newborns and infants suspected
of having hearing loss to allow appropriate referral and
provisions for audiologic rehabilitation, medical and early
intervention before the age of 6 months.
(4) All newborn and infant hearing screening programs and
systems should include a component for audiologic
rehabilitation, medical and early intervention options that
ensures linkage to any new and existing state-wide systems of
intervention and rehabilitative services for newborns and
infants with hearing loss.
(5) Public policy in regard to newborn and infant hearing
screening and intervention should be based on applied research
and the recognition that newborns, infants, toddlers, and
children who are deaf or hard-of-hearing have unique language,
learning, and communication needs, and should be the result of
consultation with pertinent public and private sectors.
(c) Statewide Newborn and Infant Hearing Screening, Evaluation and
Intervention Programs and Systems.--The Secretary of Health and Human
Services (in this subtitle referred to as the ``Secretary''), acting
through the Administrator of the Health Resources and Services
Administration, shall make awards of grants or cooperative agreements
to develop statewide newborn and infant hearing screening, evaluation
and intervention programs and systems for the following purposes:
(1) To develop and monitor the efficacy of state-wide
newborn and infant hearing screening, evaluation and
intervention programs and systems. Early intervention includes
referral to schools and agencies, including community,
consumer, and parent-based agencies and organizations and other
programs mandated by Part C of the Individuals with
Disabilities Education Act, which offer programs specifically
designed to meet the unique language and communication needs of
deaf and hard of hearing newborns, infants, toddlers, and
children.
(2) To collect data on statewide newborn and infant hearing
screening, evaluation and intervention programs and systems
that can be used for applied research, program evaluation and
policy development.
(d) Technical Assistance, Data Management, and Applied Research.--
(1) Centers for disease control and prevention.--The
Secretary, acting through the Director of the Centers for
Disease Control and Prevention, shall make awards of grants or
cooperative agreements to provide technical assistance to State
agencies to complement an intramural program and to conduct
applied research related to newborn and infant hearing
screening, evaluation and intervention programs and systems.
The program shall develop standardized procedures for data
management and program effectiveness and costs, such as--
(A) to ensure quality monitoring of newborn and
infant hearing loss screening, evaluation, and
intervention programs and systems;
(B) to provide technical assistance on data
collection and management;
(C) to study the costs and effectiveness of newborn
and infant hearing screening, evaluation and
intervention programs and systems conducted by State-
based programs in order to answer issues of importance
to state and national policymakers;
(D) to identify the causes and risk factors for
congenital hearing loss;
(E) to study the effectiveness of newborn and
infant hearing screening, audiologic and medical
evaluations and intervention programs and systems by
assessing the health, intellectual and social
developmental, cognitive, and language status of these
children at school age; and
(F) to promote the sharing of data regarding early
hearing loss with state-based birth defects and
developmental disabilities monitoring programs for the
purpose of identifying previously unknown causes of
hearing loss.
(2) National institutes of health.--The Director of the
National Institutes of Health, acting through the Director of
the National Institute on Deafness and Other Communication
Disorders, shall for purposes of this section, continue a
program of research and development on the efficacy of new
screening techniques and technology, including clinical studies
of screening methods, studies on efficacy of intervention, and
related research.
(e) Coordination and Collaboration.--
(1) In general.--In carrying out programs under this
section, the Administrator of the Health Resources and Services
Administration, the Director of the Centers for Disease Control
and Prevention, and the Director of the National Institutes of
Health shall collaborate and consult with other Federal
agencies; State and local agencies, including those responsible
for early intervention services pursuant to Title XIX of the
Social Security Act (Medicaid Early and Periodic Screening,
Diagnosis and Treatment Program); Title XXI of the Social
Security Act (State Children's Health Insurance Program); Title
V of the Social Security Act (Maternal and Child Health Block
Grant Program; and Part C of the Individuals with Disabilities
Education Act); consumer groups of and that serve individuals
who are deaf and hard-of-hearing and their families;
appropriate national medical and other health and education
specialty organizations; persons who are deaf and hard-of-
hearing and their families; other qualified professional
personnel who are proficient in deaf or hard-of-hearing
children's language and who possess the specialized knowledge,
skills, and attributes needed to serve deaf and hard-of-hearing
newborns, infants, toddlers, children, and their families;
third-party payers and managed care organizations; and related
commercial industries.
(2) Policy development.--The Administrator of the Health
Resources and Services Administration, the Director of the
Centers for Disease Control and Prevention, and the Director of
the National Institutes of Health shall coordinate and
collaborate on recommendations for policy development at the
Federal and state levels and with the private sector, including
consumer, medical and other health and education professional-
based organizations, with respect to newborn and infant hearing
screening, evaluation and intervention programs and systems.
(3) State early detection, diagnosis, and intervention
programs and systems; data collection.--The Administrator of
the Health Resources and Services Administration and the
Director of the Centers for Disease Control and Prevention
shall coordinate and collaborate in assisting States to
establish newborn and infant hearing screening, evaluation and
intervention programs and systems under subsection (c) and to
develop a data collection system under subsection (d).
(f) Rule of Construction.--Nothing in this subtitle shall be
construed to preempt any State law.
(g) Authorization of Appropriations.--
(1) Statewide newborn and infant hearing screening,
evaluation and intervention programs and systems.--For the
purpose of carrying out subsection (c), there are authorized to
be appropriated to the Health Resources and Services
Administration such sums as may be necessary for each of the
fiscal years 2000 through 2003.
(2) Technical assistance, data management, and applied
research; centers for disease control and prevention.--For the
purpose of carrying out subsection (d)(1), there are authorized
to be appropriated to the Centers for Disease Control and
Prevention such sums as may be necessary for each of the fiscal
years 2000 through 2003.
(3) Technical assistance, data management, and applied
research; national institute on deafness and other
communication disorders.--For the purpose of carrying out
subsection (d)(2), there are authorized to be appropriated to
the National Institute on Deafness and Other Communication
Disorders such sums as may be necessary for each of the fiscal
years 2000 through 2003.
Subtitle B--Autism
CHAPTER 1--SURVEILLANCE AND RESEARCH REGARDING PREVALENCE AND PATTERN
OF AUTISM
SEC. 211. SHORT TITLE.
This chapter may be cited as the ``Autism Statistics, Surveillance,
Research, and Epidemiology Act of 1999 (ASSURE)''.
SEC. 212. DEVELOPMENTAL DISABILITIES SURVEILLANCE AND RESEARCH
PROGRAMS.
(a) National Autism and Pervasive Developmental Disabilities
Surveillance Program.--The Secretary of Health and Human Services (in
this chapter referred to as the ``Secretary''), acting through the
Director of the Centers for Disease Control and Prevention, may make
awards of grants and cooperative agreements for the collection,
analysis, and reporting of data on autism and pervasive developmental
disabilities. An entity may receive such an award only if the entity is
a public or nonprofit private entity (including health departments of
States and political subdivisions of States, and including universities
and other educational entities). In making such awards, the Secretary
may provide direct technical assistance in lieu of cash.
(b) Centers of Excellence in Autism and Pervasive Developmental
Disabilities Epidemiology.--
(1) In general.--The Secretary, acting through the Director
of the Centers for Disease Control and Prevention, shall
(subject to the extent of amounts made available in
appropriations Acts) establish not less than three, and not
more than five, regional centers of excellence in autism and
pervasive developmental disabilities epidemiology for the
purpose of collecting and analyzing information on the number,
incidence, correlates, and causes of autism and related
developmental disabilities.
(2) Recipients of awards for establishment of centers.--
Centers under paragraph (1) shall be established and operated
through the award of grants or cooperative agreements to public
or nonprofit private entities that conduct research, including
health departments of States and political subdivisions of
States, and including universities and other educational
entities.
(3) Certain requirements.--An award for a center under
paragraph (1) may be made only if the entity involved submits
to the Secretary an application containing such agreements and
information as the Secretary may require, including an
agreement that the center involved will operate in accordance
with the following:
(A) The center will collect, analyze, and report
autism and pervasive developmental disabilities data
according to guidelines prescribed by the Director,
after consultation with relevant State and local public
health officials, private sector developmental
disability researchers, and advocates for those with
developmental disabilities;
(B) The center will assist with the development and
coordination of State autism and pervasive
developmental disabilities surveillance efforts within
a region;
(C) The center will provide education, training,
and clinical skills improvement for health
professionals aimed at better understanding and
treatment of autism and related developmental
disabilities; and
(D) The center will identify eligible cases and
controls through its surveillance systems and conduct
research into factors which may cause autism and
related developmental disabilities; each program will
develop or extend an area of special research expertise
(including, but not limited to, genetics, environmental
exposure to contaminants, immunology, and other
relevant research specialty areas).
SEC. 213. CLEARINGHOUSE.
The Secretary, acting through the Director of the Centers for
Disease Control and Prevention, shall carry out the following:
(1) The Centers for Disease Control and Prevention shall
serve as the coordinating agency for autism and pervasive
developmental disabilities surveillance activities through the
establishment of a clearinghouse for the collection and storage
of data generated from the monitoring programs created by this
chapter. The functions of such a clearinghouse shall include
facilitating the coordination of research and policy
development relating to the epidemiology of autism and other
pervasive developmental disabilities.
(2) The Secretary, acting through the Centers for Disease
Control and Prevention, shall coordinate the Federal response
to requests for assistance from State health department
officials regarding potential or alleged autism or
developmental disability clusters.
SEC. 214. ADVISORY COMMITTEE.
(a) In General.--The Secretary shall establish an Advisory
Committee for Autism and Pervasive Developmental Disabilities
Epidemiology Research (in this section referred to as the
``Committee''). The Committee shall provide advice and recommendations
to the Director of the Centers for Disease Control and Prevention on--
(1) the establishment of a national autism and pervasive
developmental disabilities surveillance program;
(2) the establishment of centers of excellence in autism
and pervasive developmental disabilities epidemiology;
(3) methods and procedures to more effectively coordinate
government and non-government programs and research on autism
and pervasive developmental disabilities epidemiology; and
(4) the effective operation of autism and pervasive
developmental disabilities epidemiology research activities.
(b) Composition.--
(1) In general.--The Committee shall be composed of ex
officio members in accordance with paragraph (2) and 11
appointed members in accordance with paragraph (3).
(2) Ex officio members.--The following officials shall
serve as ex officio members of the Committee:
(A) The Director of the National Center for
Environmental Health.
(B) The Assistant Administrator of the Agency for
Toxic Substances and Disease Registry.
(C) The Director of the National Institute of Child
Health and Human Development.
(D) The Director of the National Institute of
Neurological Disorders and Stroke.
(3) Appointed members.--Appointments to the Committee shall
be made in accordance with the following:
(A) Two members shall be research scientists with
demonstrated achievements in research related to autism
and related developmental disabilities. The scientists
shall be appointed by the Secretary in consultation
with the National Academy of Sciences.
(B) Five members shall be representatives of the
five national organizations whose primary emphasis is
on research into autism and other pervasive developmental disabilities.
One representative from each of such organizations shall be appointed
by the Secretary in consultation with the National Academy of Sciences.
(C) Two members shall be clinicians whose practice
is primarily devoted to the treatment of individuals
with autism and other pervasive developmental
disabilities. The clinicians shall be appointed by the
Secretary in consultation with the Institute of
Medicine and the National Academy of Sciences.
(D) Two members shall be individuals who are the
parents or legal guardians of a person or persons with
autism or other pervasive developmental disabilities.
The individuals shall be appointed by the Secretary in
consultation with the ex officio members under
paragraph (1) and the five national organizations
referred to in subparagraph (B).
(c) Administrative Support; Terms of Service; Other Provisions.--
The following apply with respect to the Committee:
(1) The Committee shall receive necessary and appropriate
administrative support from the Department of Health and Human
Services.
(2) Members of the Committee shall be appointed for a term
of three years, and may serve for an unlimited number of terms
if reappointed.
(3) The Committee shall meet no less than two times per
year.
(4) Members of the Committee shall not receive additional
compensation for their service. Such members may receive
reimbursement for appropriate and additional expenses that are
incurred through service on the Committee which would not have
incurred had they not been a member of the Committee.
SEC. 215. REPORT TO CONGRESS.
The Secretary shall prepare and submit to the Congress, after
consultation and comment by the Advisory Committee, an annual report
regarding the prevalence and incidence of autism and other pervasive
developmental disorders, the results of research into the etiology of
autism and other pervasive developmental disorders, public health
responses to known or preventable causes of autism and other pervasive
developmental disorders, and the need for additional research into
promising lines of scientific inquiry.
SEC. 216. DEFINITION.
For purposes of this chapter, the term ``State'' means each of the
several States, the District of Columbia, the Commonwealth of Puerto
Rico, American Samoa, Guam, the Commonwealth of the Northern Mariana
Islands, the Virgin Islands, and the Trust Territory of the Pacific
Islands.
SEC. 217. AUTHORIZATION OF APPROPRIATIONS.
For the purpose of carrying out this chapter, there are authorized
to be appropriated such sums as may be necessary for each of the fiscal
years 2000 through 2003.
CHAPTER 2--EXPANSION, INTENSIFICATION, AND COORDINATION OF ACTIVITIES
OF DEPARTMENT OF HEALTH AND HUMAN SERVICES WITH RESPECT TO AUTISM
SEC. 218. SHORT TITLE.
This Act may be cited as the ``Advancement in Pediatric Autism
Research Act of 1999''.
SEC. 218A. EXPANSION, INTENSIFICATION, AND COORDINATION OF ACTIVITIES
OF NATIONAL INSTITUTES OF HEALTH.
Part B of title IV of the Public Health Service Act (42 U.S.C. 284
et seq.) is amended by adding at the end the following section:
``autism
``Sec. 409C. (a) In General.--
``(1) Expansion of activities.--The Director of NIH (in
this section referred to as the `Director') shall expand,
intensify, and coordinate the activities of the National
Institutes of Health with respect to research on autism.
``(2) Administration of program; collaboration among
agencies.--The Director shall carry out this section acting
through the Director of the National Institute of Mental Health
and in collaboration with any other agencies that the Director
determines appropriate.
``(b) Centers of Excellence.--
``(1) In general.--The Director shall under subsection
(a)(1) make awards of grants and contracts to public or
nonprofit private entities to pay all or part of the cost of
planning, establishing, improving, and providing basic
operating support for centers of excellence regarding research
on autism.
``(2) Research.--Each center under paragraph (1) shall
conduct basic and clinical research into autism. Such research
should include investigations into the cause, diagnosis, early
detection, prevention, control, and treatment of autism. These
centers, as a group, shall conduct research including but not
limited to the fields of developmental neurobiology, genetics,
and psychopharmacology.
``(3) Services for patients.--A center under paragraph (1)
may expend amounts provided under such paragraph to carry out a
program to make individuals aware of opportunities to
participate as subjects in research conducted by the centers.
The program may, in accordance with such criteria as the
Director may establish, provide to such subjects referrals for
health and other services, and such patient care costs as are
required for research. The extent to which the center can
demonstrate availability and access to clinical services shall
be considered by the Director in decisions about awarding the
grants to applicants which meet the scientific criteria for
funding.
``(4) Coordination of centers; reports.--The Director
shall, as appropriate, provide for the coordination of
information among centers under paragraph (1) and ensure
regular communication between such centers, and may require the
periodic preparation of reports on the activities of the centers and
the submission of the reports to the Director.
``(5) Organization of centers.--Each center under paragraph
(1) shall use the facilities of a single institution, or be
formed from a consortium of cooperating institutions, meeting
such requirements as may be prescribed by the Director.
``(6) Number of centers; duration of support.--The Director
shall provide for the establishment of not less than five
centers under paragraph (1). Support of such a center may be
for a period not exceeding 5 years. Such period may be extended
for one or more additional periods not exceeding 5 years if the
operations of such center have been reviewed by an appropriate
technical and scientific peer review group established by the
Director and if such group has recommended to the Director that
such period should be extended.
``(c) Facilitation of Research.--The Director shall under
subsection (a)(1) provide for a program under which samples of tissues
and genetic materials that are of use in research on autism are
donated, collected, preserved, and made available for such research.
The program shall be carried out in accordance with accepted scientific
and medical standards for the donation, collection, and preservation of
such samples.
``(d) Public Input.--The Director shall under subsection (a)(1)
provide for means through which the public can obtain information on
the existing and planned programs and activities of the National
Institutes of Health with respect to autism and through which the
Director can receive comments from the public regarding such programs
and activities.
``(e) Funding.--For the purpose of carrying out this section, there
are authorized to be appropriated such sums as may be necessary for
each of the fiscal years 2000 through 2003. Such authorizations of
appropriations are in addition to any other authorization of
appropriations that is available for such purpose.''.
SEC. 219. DEVELOPMENTAL DISABILITIES SURVEILLANCE AND RESEARCH
PROGRAMS.
(a) National Autism and Pervasive Developmental Disabilities
Surveillance Program.--The Secretary of Health and Human Services (in
this chapter referred to as the ``Secretary''), acting through the
Director of the Centers for Disease Control and Prevention, may make
awards of grants and cooperative agreements for the collection,
analysis, and reporting of data on autism and pervasive developmental
disabilities. An entity may receive such an award only if the entity is
a public or nonprofit private entity (including health departments of
States and political subdivisions of States, and including universities
and other educational entities). In making such awards, the Secretary
may provide direct technical assistance in lieu of cash.
(b) Centers of Excellence in Autism and Pervasive Developmental
Disabilities Epidemiology.--
(1) In general.--The Secretary, acting through the Director
of the Centers for Disease Control and Prevention, shall
establish not less than 3, regional centers of excellence in
autism and pervasive developmental disabilities epidemiology
for the purpose of collecting and analyzing information on the
number, incidence, correlates, and causes of autism and related
developmental disabilities.
(2) Recipients of awards for establishment of centers.--
Centers under paragraph (1) shall be established and operated
through the awarding of grants or cooperative agreements to
public or nonprofit private entities that conduct research,
including health departments of States and political
subdivisions of States, and including universities and other
educational entities.
(3) Certain requirements.--An award for a center under
paragraph (1) may be made only if the entity involved submits
to the Secretary an application containing such agreements and
information as the Secretary may require, including an
agreement that the center involved will operate in accordance
with the following:
(A) The center will collect, analyze, and report
autism and pervasive developmental disabilities data
according to guidelines prescribed by the Director,
after consultation with relevant State and local public
health officials, private sector developmental
disability researchers, and advocates for those with
developmental disabilities.
(B) The center will assist with the development and
coordination of State autism and pervasive
developmental disabilities surveillance efforts within
a region.
(C) The center will identify eligible cases and
controls through its surveillance systems and conduct
research into factors which may cause autism and
related developmental disabilities. Each program will
develop or extend an area of special research expertise
(including genetics, environmental exposure to
contaminants, immunology, and other relevant research
specialty areas).
(c) Clearinghouse.--The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, shall carry out the
following:
(1) The Secretary shall establish a clearinghouse within
the Centers for Disease Control and Prevention for the
collection and storage of data generated from the monitoring
programs created by this chapter. Through the clearinghouse,
such Centers shall serve as the coordinating agency for autism
and pervasive developmental disabilities surveillance
activities. The functions of such a clearinghouse shall include
facilitating the coordination of research and policy
development relating to the epidemiology of autism and other
pervasive developmental disabilities.
(2) The Secretary, acting through the Centers for Disease
Control and Prevention, shall coordinate the Federal response
to requests for assistance from State health department
officials regarding potential or alleged autism or
developmental disability clusters.
(d) Definition.--In this chapter, the term ``State'' means each of
the several States, the District of Columbia, the Commonwealth of
Puerto Rico, American Samoa, Guam, the Commonwealth of the Northern
Mariana Islands, the Virgin Islands, and the Trust Territory of the
Pacific Islands.
(e) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.
SEC. 220. INFORMATION AND EDUCATION.
(a) In General.--The Secretary shall establish and implement a
program to provide information and education on autism to health
professionals and the general public, including information and
education on advances in the diagnosis and treatment of autism and
training and continuing education through programs for scientists,
physicians, and other health professionals who provide care for
patients with autism.
(b) Stipends.--The Secretary may use amounts made available under
this section to provide stipends for health professionals who are
enrolled in training programs under this section.
(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.
SEC. 220A. INTERAGENCY AUTISM COORDINATING COMMITTEE.
(a) Establishment.--The Secretary shall establish a committee to be
known as the ``Autism Coordinating Committee'' (in this section
referred to as the ``Committee'') to coordinate all efforts within the
Department of Health and Human Services concerning autism, including
activities carried out through the National Institutes of Health and
the Centers for Disease Control and Prevention under this chapter (and
the amendment made by this chapter).
(b) Membership.--
(1) In general.--The Committee shall be composed of the
Directors of such national research institutes, of the Centers
for Disease Control and Prevention, and of such other agencies
and such other officials as the Secretary determines
appropriate.
(2) Additional members.--If determined appropriate by the
Secretary, the Secretary may appoint to the Committee--
(A) parents or legal guardians of individuals with
autism or other pervasive developmental disorders; and
(B) representatives of other governmental agencies
that serve children with autism such as the Department
of Education.
(c) Administrative Support; Terms of Service; Other Provisions.--
The following shall apply with respect to the Committee:
(1) The Committee shall receive necessary and appropriate
administrative support from the Department of Health and Human
Services.
(2) Members of the Committee appointed under subsection
(b)(2)(A) shall serve for a term of 3 years, and may serve for
an unlimited number of terms if reappointed.
(3) The Committee shall meet not less than 2 times per
year.
SEC. 220B. REPORT TO CONGRESS.
Not later than January 1, 2000, and each January 1 thereafter, the
Secretary shall prepare and submit to the appropriate committees of
Congress, a report concerning the implementation of this chapter and
the amendments made by this chapter.
Subtitle C--Poison Control Center Enhancement and Awareness
SEC. 221. SHORT TITLE.
This subtitle may be cited as the ``Poison Control Center
Enhancement and Awareness Act''.
SEC. 222. DEFINITION.
For purposes of this subtitle, the term ``Secretary'' means the
Secretary of Health and Human Services.
SEC. 223. ESTABLISHMENT OF A NATIONAL TOLL-FREE NUMBER.
(a) In General.--The Secretary shall provide coordination and
assistance to regional poison control centers for the establishment of
a nationwide toll-free phone number to be used to access such centers.
(b) Rule of Construction.--Nothing in this section shall be
construed as prohibiting the establishment or continued operation of
any privately funded nationwide toll-free phone number used to provide
advice and other assistance for poisonings or accidental exposures.
(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003. Funds
appropriated under this subsection shall not be used to fund any toll-
free phone number described in subsection (b).
SEC. 224. ESTABLISHMENT OF NATIONWIDE MEDIA
CAMPAIGN.
(a) In General.--The Secretary shall establish a national media
campaign to educate the public and health care providers about poison
prevention and the availability of poison control resources in local
communities and to conduct advertising campaigns concerning the
nationwide toll-free number established under section 223.
(b) Contract With Entity.--The Secretary may carry out subsection
(a) by entering into contracts with 1 or more nationally recognized
media firms for the development and distribution of monthly television,
radio, and newspaper public service announcements.
(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.
SEC. 225. ESTABLISHMENT OF A GRANT PROGRAM.
(a) Regional Poison Control Centers.--The Secretary shall award
grants to certified regional poison control centers for the purposes of
achieving the financial stability of such centers, and for preventing
and providing treatment recommendations for poisonings.
(b) Other Improvements.--The Secretary shall also use amounts
received under this section to--
(1) develop standard education programs;
(2) develop standard patient management protocols for
commonly encountered toxic exposures;
(3) improve and expand the poison control data collection
systems;
(4) improve national toxic exposure surveillance; and
(5) expand the physician/medical toxicologist supervision
of poison control centers.
(c) Certification.--Except as provided in subsection (d), the
Secretary may make a grant to a center under subsection (a) only if--
(1) the center has been certified by a professional
organization in the field of poison control, and the Secretary
has approved the organization as having in effect standards for
certification that reasonably provide for the protection of the
public health with respect to poisoning; or
(2) the center has been certified by a State government,
and the Secretary has approved the State government as having
in effect standards for certification that reasonably provide
for the protection of the public health with respect to
poisoning.
(d) Waiver of Certification Requirements.--
(1) In general.--The Secretary may grant a waiver of the
certification requirement of subsection (c) with respect to a
noncertified poison control center or a newly established
center that applies for a grant under this section if such
center can reasonably demonstrate that the center will obtain
such a certification within a reasonable period of time as
determined appropriate by the Secretary.
(2) Renewal.--The Secretary may only renew a waiver under
paragraph (1) for a period of 3 years.
(e) Supplement Not Supplant.--Amounts made available to a poison
control center under this section shall be used to supplement and not
supplant other Federal, State, or local funds provided for such center.
(f) Maintenance of Effort.--A poison control center, in utilizing
the proceeds of a grant under this section, shall maintain the
expenditures of the center for activities of the center at a level that
is not less than the level of such expenditures maintained by the
center for the fiscal year preceding the fiscal year for which the
grant is received.
(g) Matching Requirement.--The Secretary may impose a matching
requirement with respect to amounts provided under a grant under this
section if the Secretary determines appropriate.
(h) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.
Subtitle D--Birth Defects Prevention Activities
CHAPTER 1--FOLIC ACID
SEC. 231. SHORT TITLE.
This chapter may be cited as the ``Folic Acid Promotion and Birth
Defects Prevention Act of 1999''.
SEC. 232. PROGRAM REGARDING EFFECTS OF FOLIC ACID IN PREVENTION OF
BIRTH DEFECTS.
Part B of title III of the Public Health Service Act (42 U.S.C. 243
et seq.) is amended by inserting after section 317G the following
section:
``effects of folic acid in prevention of birth defects
``Sec. 317H. (a) In General.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, shall carry
out a program (directly or through grants or contracts) for the
following purposes:
``(1) To provide education and training for health
professionals and the general public for purposes of explaining
the effects of folic acid in preventing birth defects and for
purposes of encouraging each woman of reproductive capacity
(whether or not planning a pregnancy) to consume on a daily
basis a dietary supplement that provides an appropriate level
of folic acid.
``(2) To conduct research with respect to such education
and training, including identifying effective strategies for
increasing the rate of consumption of folic acid by women of
reproductive capacity.
``(3) To conduct research to increase the understanding of
the effects of folic acid in preventing birth defects,
including understanding with respect to cleft lip, cleft
palate, and heart defects.
``(4) To provide for appropriate epidemiological activities
regarding folic acid and birth defects, including
epidemiological activities regarding neural tube defects.
``(b) Consultations With States and Private Entities.--In carrying
out subsection (a), the Secretary shall consult with the States and
with other appropriate public or private entities, including national
nonprofit private organizations, health professionals, and providers of
health insurance and health plans.
``(c) Technical Assistance.--The Secretary may (directly or through
grants or contracts) provide technical assistance to public and
nonprofit private entities in carrying out the activities described in
subsection (a).
``(d) Evaluations.--The Secretary shall (directly or through grants
or contracts) provide for the evaluation of activities under subsection
(a) in order to determine the extent to which such activities have been
effective in carrying out the purposes of the program under such
subsection, including the effects on various demographic populations.
Methods of evaluation under the preceding sentence may include surveys
of knowledge and attitudes on the consumption of folic acid and on
blood folate levels. Such methods may include complete and timely
monitoring of infants who are born with neural tube defects.
``(e) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.''.
CHAPTER 2--NATIONAL CENTER ON BIRTH DEFECTS AND DEVELOPMENTAL
DISABILITIES
SEC. 236. NATIONAL CENTER ON BIRTH DEFECTS AND
DEVELOPMENTAL DISABILITIES.
Title III of the Public Health Service Act (42 U.S.C. 241 et seq.)
is amended--
(1) in part O--
(A) by redesignating sections 399G through 399J as
sections 399M through 399P, respectively;
(B) in section 399O(b) (as so redesignated), by
striking ``section 399G(d)'' and inserting ``section
399M(d)''; and
(C) in section 399P (as so redesignated), by
striking ``section 399G(d)(1)'' and inserting ``section
399M(d)(1)''; and
(2) by adding at the end the following part:
``Part P--Pediatric Public Health Promotion
``SEC. 399Q. NATIONAL CENTER ON BIRTH DEFECTS AND DEVELOPMENTAL
DISABILITIES.
``(a) Establishment.--There is established within the Centers for
Disease Control and Prevention a center to be known as the National
Center on Birth Defects and Developmental Disabilities.
``(b) Purpose.--The general purpose of the National Center
established under subsection (a) shall be to--
``(1) collect, analyze, and make available data on birth
defects, including data on the causes of such defects and on
the incidence and prevalence of such defects;
``(2) conduct applied epidemiological research on the
prevention of such defects; and
``(3) provide information and education to the public on
the prevention of such defects.
``(c) Director.--The National Center established under subsection
(a) shall be headed by a director to be appointed by the Secretary.
``(d) Transfers.--There shall be transferred to the National Center
established under subsection (a) all activities, budgets and personnel
of the National Center for Environmental Health that relate to birth
defects, folic acid, cerebral palsy, mental retardation, child
development, newborn screening, autism, fragile X syndrome, fetal
alcohol syndrome, pediatric genetics, and disability prevention.
``(e) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.''.
Subtitle E--Safe Motherhood Monitoring and Prevention Research
SEC. 241. SHORT TITLE.
This subtitle may be cited as the ``Safe Motherhood Monitoring and
Prevention Research Act''.
SEC. 242. AMENDMENT TO PUBLIC HEALTH SERVICE ACT.
Title III of the Public Health Service Act, as amended by section
236 of this Act, is amended by adding at the end the following part:
``Part Q--Safe Motherhood
``SEC. 399R. SAFE MOTHERHOOD MONITORING.
``(a) Purpose.--It is the purpose of this section to develop
monitoring systems at the local, State, and national level to better
understand the burden of maternal complications and mortality and to
decrease the disparities among population at risk of death and
complications from pregnancy.
``(b) Activities.--For the purpose described in subsection (a), the
Secretary may carry out the following activities:
``(1) The Secretary may establish and implement a national
monitoring and surveillance program to identify and promote the
investigation of deaths and severe complications that occur
during pregnancy.
``(2) The Secretary may expand the Pregnancy Risk
Assessment Monitoring System to provide surveillance and
collect data in each of the 50 States.
``(3) The Secretary may expand the Maternal and Child
Health Epidemiology Program to provide technical support,
financial assistance, or the time-limited assignment of senior
epidemiologists to maternal and child health programs in each
of the 50 States.
``(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.''.
``SEC. 399S. PREVENTION RESEARCH TO ENSURE SAFE MOTHERHOOD.
``(a) Purpose.--It is the purpose of this section to provide the
Secretary with the authority to further expand research concerning risk
factors, prevention strategies, and the roles of the family, health
care providers and the community in safe motherhood.
``(b) Research.--The Secretary may carry out activities to expand
research relating to--
``(1) encouraging preconception counseling, especially for
at risk populations such as diabetics;
``(2) the identification of critical components of prenatal
delivery and postpartum care;
``(3) the identification of outreach and support services,
such as folic acid education, that are available for pregnant
women;
``(4) the identification of women who are at high risk for
complications;
``(5) preventing preterm delivery;
``(6) preventing urinary tract infections;
``(7) preventing unnecessary caesarean sections;
``(8) an examination of the higher rates of maternal
mortality among African American women;
``(9) an examination of the relationship between domestic
violence and maternal complications and mortality;
``(10) preventing smoking, alcohol and illegal drug usage
before, during and after pregnancy;
``(11) preventing infections that cause maternal and infant
complications; and
``(12) other areas determined appropriate by the Secretary.
``(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.
``SEC. 399T. PREVENTION PROGRAMS TO ENSURE SAFE MOTHERHOOD.
``(a) In General.--The Secretary may carry out activities to
promote safe motherhood, including--
``(1) public education campaigns on healthy pregnancies and
the building of partnerships with outside organizations
concerned about safe motherhood;
``(2) education programs for physicians, nurses and other
health care providers; and
``(3) activities to promote community support services for
pregnant women.
``(b) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.''.
Subtitle F--Pregnant Mothers and Infants Health Promotion
SEC. 251. SHORT TITLE.
This subtitle may be cited as the ``Pregnant Mothers and Infants
Health Protection Act''.
SEC. 252. ESTABLISHMENT.
Title III of the Public Health Service Act, as amended by section
242 of this Act, is amended by adding at the end the following part:
``Part R--Additional Programs
``SEC. 399U. PROGRAMS REGARDING PRENATAL AND POSTNATAL HEALTH.
``(a) In General.--The Secretary shall carry out programs--
``(1) to collect, analyze, and make available data on
prenatal smoking, alcohol and illegal drug usage, including
data on the implications of such activities and on the
incidence and prevalence of such activities and their
implications;
``(2) to conduct applied epidemiological research on the
prevention of prenatal and postnatal smoking, alcohol and
illegal drug usage;
``(3) to support, conduct, and evaluate the effectiveness
of educational and cessation programs; and
``(4) to provide information and education to the public on
the prevention and implications of prenatal and postnatal
smoking, alcohol and illegal drug usage.
``(b) Grants.--In carrying out subsection (a), the Secretary may
award grants to and enter into contracts with States, local
governments, scientific and academic institutions, Federally qualified
health centers, and other public and nonprofit entities, and may
provide technical and consultative assistance to such entities.
``(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.''.
Subtitle G--Utilization of Preventive Health Services
SEC. 261. GRANTS REGARDING UTILIZATION OF PREVENTIVE HEALTH SERVICES.
Part D of title III of the Public Health Service Act (42 U.S.C.
254b et seq.) is amended by adding at the end the following section:
``SEC. 330D. CENTERS FOR STRATEGIES ON FACILITATING UTILIZATION OF
PREVENTIVE HEALTH SERVICES AMONG VARIOUS POPULATIONS.
``(a) In General.--The Secretary, acting through the appropriate
agencies of the Public Health Service, shall make grants to public or
nonprofit private entities for the establishment and operation of
regional centers whose purpose is to identify particular populations of
patients and facilitate the appropriate utilization of preventive
health services by patients in the populations through developing and
disseminating strategies to improve the methods used by public and
private health care programs and providers in interacting with such
patients.
``(b) Research and Training.--The activities carried out by a
center under subsection (a) may include establishing programs of
research and training with respect to the purpose described in such
subsection, including the development of curricula for training
individuals in implementing the strategies developed under such
subsection.
``(c) Quality Management.--A condition for the receipt of a grant
under subsection (a) is that the applicant involved agree that, in
order to ensure that the strategies developed under such subsection
take into account principles of quality management with respect to
consumer satisfaction, the applicant will make arrangements with one or
more private entities that have experience in applying such principles.
``(d) Priority Regarding Infants and Children.--In carrying out the
purpose described in subsection (a), the Secretary shall give priority
to various populations of infants, young children, and their mothers.
``(e) Evaluations.--The Secretary, acting through the appropriate
agencies of the Public Health Service, shall (directly or through
grants or contracts) provide for the evaluation of strategies under
subsection (a) in order to determine the extent to which the strategies
have been effective in facilitating the appropriate utilization of
preventive health services in the populations with respect to which the
strategies were developed.
``(f) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.''.
Subtitle H--Research and Development Regarding Fragile X
SEC. 266. SHORT TITLE.
This subtitle may be cited as the ``Fragile X Research Breakthrough
Act of 1999''.
SEC. 267. NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT;
RESEARCH ON FRAGILE X.
Subpart 7 of part C of title IV of the Public Health Service Act,
as amended by section 103 of this Act, is amended by adding at the end
the following section:
``fragile x
``Sec. 452F. (a) Expansion and Coordination of Research
Activities.--The Director of the Institute, after consultation with the
advisory council for the Institute, shall expand, intensify, and
coordinate the activities of the Institute with respect to research on
the disease known as fragile X.
``(b) Research Centers.--
``(1) In general.--The Director of the Institute, after
consultation with the advisory council for the Institute, shall
make grants to, or enter into contracts with, public or
nonprofit private entities for the development and operation of
centers to conduct research for the purposes of improving the diagnosis
and treatment of, and finding the cure for, fragile X.
``(2) Number of centers.--In carrying out paragraph (1),
the Director of the Institute shall, to the extent that amounts
are appropriated, provide for the establishment of at least
three fragile X research centers.
``(3) Activities.--
``(A) In general.--Each center assisted under
paragraph (1) shall, with respect to fragile X--
``(i) conduct basic and clinical research,
which may include clinical trials of--
``(I) new or improved diagnostic
methods; and
``(II) drugs or other treatment
approaches; and
``(ii) conduct research to find a cure.
``(B) Fees.--A center may use funds provided under
paragraph (1) to provide fees to individuals serving as
subjects in clinical trials conducted under
subparagraph (A).
``(4) Coordination among centers.--The Director of the
Institute shall, as appropriate, provide for the coordination
of the activities of the centers assisted under this section,
including providing for the exchange of information among the
centers.
``(5) Certain administrative requirements.--Each center
assisted under paragraph (1) shall use the facilities of a
single institution, or be formed from a consortium of
cooperating institutions, meeting such requirements as may be
prescribed by the Director of the Institute.
``(6) Duration of support.--Support may be provided to a
center under paragraph (1) for a period not exceeding 5 years.
Such period may be extended for one or more additional periods,
each of which may not exceed 5 years, if the operations of such
center have been reviewed by an appropriate technical and
scientific peer review group established by the Director and if
such group has recommended to the Director that such period be
extended.
``(7) Authorization of appropriations.--For the purpose of
carrying out this subsection, there are authorized to be
appropriated such sums as may be necessary for each of the
fiscal years 2000 through 2003.''.
SEC. 268. NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT;
LOAN REPAYMENT PROGRAM REGARDING RESEARCH ON FRAGILE X.
Part G of title IV of the Public Health Service Act (42 U.S.C. 288
et seq.) is amended by inserting after section 487E the following
section:
``loan repayment program regarding research on fragile x
``Sec. 487F. (a) In General.--The Secretary, in consultation with
the Director of the National Institute of Child Health and Human
Development, shall establish a program under which the Federal
Government enters into contracts with qualified health professionals
(including graduate students) who agree to conduct research regarding
fragile X in consideration of the Federal Government's agreement to
repay, for each year of such service, not more than $35,000 of the
principal and interest of the educational loans owed by such health
professionals.
``(b) Applicability of Certain Provisions.--With respect to the
National Health Service Corps Loan Repayment Program established in
subpart III of part D of title III, the provisions of such subpart
(including section 338B(g)(3)) shall, except as inconsistent with
subsection (a) of this section, apply to the program established in
such subsection in the same manner and to the same extent as such
provisions apply to the National Health Service Corps Loan Repayment
Program established in such subpart.
``(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.''.
Subtitle I--Children and Epilepsy
SEC. 271. PROGRAMS OF THE CENTERS FOR DISEASE CONTROL AND PREVENTION;
NATIONAL PUBLIC HEALTH CAMPAIGN ON EPILEPSY.
(a) In General.--The Secretary of Health and Human Services (in
this subtitle referred to as the ``Secretary''), acting through the
Director of the Centers for Disease Control and Prevention, shall
develop and implement public health surveillance, education, research,
and intervention strategies to improve the lives of persons with
epilepsy, with a particular emphasis on children. Such projects may be
carried out by the Secretary directly and through awards of grants or
contracts to public or nonprofit private entities. The Secretary may
directly or through such awards provide technical assistance with
respect to the planning, development, and operation of such projects.
(b) Certain Activities.--Activities under subsection (a) shall
include--
(1) expanding current surveillance activities through
existing monitoring systems and improving registries that
maintain data on individuals with epilepsy, including children;
(2) enhancing research activities on the management and
control of epilepsy;
(3) implementing public and professional information and
education programs regarding epilepsy, including initiatives
which promote effective management and control of the disease
through children's programs which are targeted to parents,
schools, daycare providers, patients;
(4) undertaking educational efforts with the media,
providers of health care, schools and others regarding stigmas
and secondary disabilities related to epilepsy and seizures,
and also its affects on youth;
(5) utilizing and expanding partnerships with organizations
with experience addressing the health and related needs of
people with disabilities; and
(6) other activities the Secretary deems appropriate.
(c) Coordination of Activities.--The Secretary shall ensure that
activities under this section are coordinated as appropriate with other
agencies of the Public Health Service that carry out activities
regarding epilepsy and seizure.
(d) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.
SEC. 272. PROGRAMS OF HEALTH RESOURCES AND SERVICES ADMINISTRATION;
STATE AND LOCAL GRANTS FOR SEIZURE DISORDER DEMONSTRATION
PROJECTS IN MEDICALLY UNDERSERVED AREAS.
(a) In General.--The Secretary, acting through the Administrator of
the Health Resources and Services Administration, may make grants to
States and local governments for the purpose of carrying out
demonstration projects to improve access to health and other services
regarding seizures to encourage early detection and treatment in
children and others residing in medically underserved areas.
(b) Application for Grant.--The Secretary may make a grant under
subsection (a) only if the application for the grant is submitted to
the Secretary and the application is in such form, is made in such
matter, and contains such agreements, assurances, and information as
the Secretary determines to be necessary to carry out this section.
(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.
SEC. 273. DEFINITIONS.
For purposes of this subtitle:
(1) The term ``epilepsy'' refers to a chronic and serious
neurological condition which produces excessive electrical
discharges in the brain causing recurring seizures affecting
all life activities. The Secretary may revise the definition of
such term as the Secretary.
(2) The term ``medically underserved'' has the meaning
applicable under section 799B(6) of the Public Health Service
Act.
Subtitle J--Asthma Treatment Services for Children
SEC. 276. SHORT TITLE.
This subtitle may be cited as the ``Children's Asthma Relief Act of
1999''.
SEC. 277. CHILDREN'S ASTHMA RELIEF.
Title III of the Public Health Service Act, as amended by section
252 of this Act, is amended by adding at the end the following:
``Part S--Children's Asthma Relief
``SEC. 399V. ASTHMA TREATMENT GRANTS PROGRAM.
``(a) Purposes.--The purposes of this section are as follows:
``(1) To provide access to quality medical care for
children who live in areas that have a high prevalence of
asthma and who lack access to medical care.
``(2) To provide on-site education to parents, children,
health care providers, and medical teams to recognize the signs
and symptoms of asthma, and to train them in the use of
medications to prevent and treat asthma.
``(3) To decrease preventable trips to the emergency room
by making medication available to individuals who have not
previously had access to treatment or education in the
prevention of asthma.
``(4) To provide other services, such as smoking cessation
programs, home modification, and other direct and support
services that ameliorate conditions that exacerbate or induce
asthma.
``(b) Authority To Make Grants.--
``(1) In general.--In addition to any other payments made
under this Act or title V of the Social Security Act, the
Secretary shall award grants to eligible entities to carry out
the purposes of this section, including grants that are
designed to develop and expand projects to--
``(A) provide comprehensive asthma services to
children, including access to care and treatment for
asthma in a community-based setting;
``(B) fully equip mobile health care clinics that
provide preventive asthma care including diagnosis,
physical examinations, pharmacological therapy, skin
testing, peak flow meter testing, and other asthma-
related health care services;
``(C) conduct study validated asthma management
education programs for patients with asthma and their
families, including patient education regarding asthma
management, family education on asthma management, and
the distribution of materials, including displays and
videos, to reinforce concepts presented by medical
teams; and
``(D) identify eligible children for the medicaid
program under title XIX of the Social Security Act, the
State Children's Health Insurance Program under title
XXI of such Act, or other children's health programs.
``(2) Award of grants.--
``(A) Application.--
``(i) In general.--An eligible entity shall
submit an application to the Secretary for a
grant under this section in such form and
manner as the Secretary may require.
``(ii) Required information.--An
application submitted under this subparagraph
shall include a plan for the use of funds
awarded under the grant and such other
information as the Secretary may require.
``(B) Requirement.--In awarding grants under this
section, the Secretary shall give preference to
eligible entities that demonstrate that the activities
to be carried out under this section shall be in
localities within areas of known high prevalence of
childhood asthma or high asthma-related mortality
(relative to the average asthma incidence rates and
associated mortality rates in the United States).
Acceptable data sets to demonstrate a high prevalence
of childhood asthma or high asthma-related mortality
may include data from Federal, State, or local vital
statistics, claims data under title XIX or XXI of the
Social Security Act, other public health statistics or
surveys, or other data that the Secretary, in
consultation with the Director of the Centers for
Disease Control and Prevention, deems appropriate.
``(3) Definition of eligible entity.--For purposes of this
section, the term `eligible entity' means a State agency or
other entity receiving funds under title V of the Social
Security Act, a local community, a nonprofit children's
hospital or foundation, or a nonprofit community-based
organization.
``(c) Coordination With Other Children's Programs.--An eligible
entity shall identify in the plan submitted as part of an application
for a grant under this section how the entity will coordinate
operations and activities under the grant with--
``(1) other programs operated in the State that serve
children with asthma, including any such programs operated
under titles V, XIX, or XXI of the Social Security Act; and
``(2) one or more of the following--
``(A) the child welfare and foster care and
adoption assistance programs under parts B and E of
title IV of such Act;
``(B) the head start program established under the
Head Start Act (42 U.S.C. 9831 et seq.);
``(C) the program of assistance under the special
supplemental nutrition program for women, infants and
children (WIC) under section 17 of the Child Nutrition
Act of 1966 (42 U.S.C. 1786);
``(D) local public and private elementary or
secondary schools; or
``(E) public housing agencies, as defined in
section 3 of the United States Housing Act of 1937 (42
U.S.C. 1437a).
``(d) Evaluation.--An eligible entity that receives a grant under
this section shall submit to the Secretary an evaluation of the
operations and activities carried out under the grant that includes--
``(1) a description of the health status outcomes of
children assisted under the grant;
``(2) an assessment of the utilization of asthma-related
health care services as a result of activities carried out
under the grant;
``(3) the collection, analysis, and reporting of asthma
data according to guidelines prescribed by the Director of the
Centers for Disease Control and Prevention; and
``(4) such other information as the Secretary may require.
``(e) Applicability of Certain Provisions.--The following
provisions of title V of the Social Security Act shall apply to a grant
made under this section to the same extent and in the same manner as
such provisions apply to allotments made under section 502(c) of such
Act:
``(1) Section 504(b)(4) (relating to expenditures of funds
as a condition of receipt of Federal funds).
``(2) Section 504(b)(6) (relating to prohibition on
payments to excluded individuals and entities).
``(3) Section 506 (relating to reports and audits, but only
to the extent determined by the Secretary to be appropriate for
grants made under this section).
``(4) Section 508 (relating to nondiscrimination).
``(f) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.''.
SEC. 278. INCORPORATION OF ASTHMA PREVENTION TREATMENT AND SERVICES
INTO STATE CHILDREN'S HEALTH INSURANCE PROGRAMS.
(a) In General.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary'') shall, in accordance
with subsection (b), carry out a program to encourage States to
implement plans to carry out activities to assist children with respect
to asthma in accordance with guidelines of the National Asthma
Education and Prevention Program (NAEPP) and the National Heart, Lung
and Blood Institute.
(b) Relation to Children's Health Insurance Program.--
(1) In general.--Subject to paragraph (2), if a State child
health plan under title XXI of the Social Security Act (42
U.S.C. 1397aa et seq.) provides for activities described in
subsection (a) to an extent satisfactory to the Secretary, the
Secretary shall, with amounts appropriated under
subsection (c), make a grant to the State involved to assist the State
in carrying out such activities.
(2) Criteria regarding eligibility for grant; rule of
construction regarding authority of secretary.--The Secretary
shall publish in the Federal Register criteria describing the
circumstances in which the Secretary will consider a State plan
to be satisfactory for purposes of paragraph (1), subject to
the condition that this section may not be construed as
modifying (or authorizing the Secretary to modify) any
requirement or authority established in or under title XXI of
the Social Security Act.
(3) Requirement of matching funds.--
(A) In general.--With respect to the costs of the
activities to be carried out by a State pursuant to
paragraph (1), the Secretary may make a grant under
such paragraph only if the State agrees to make
available (directly or through donations from public or
private entities) non-Federal contributions toward such
costs in an amount that is not less than 15 percent of
the costs.
(B) Determination of amount contributed.--Non-
Federal contributions required in subparagraph (A) may
be in cash or in kind, fairly evaluated, including
equipment or services. Amounts provided by the Federal
Government, or services assisted or subsidized to any
significant extent by the Federal Government, may not
be included in determining the amount of such non-
Federal contributions.
(4) Technical assistance.--With respect to State child
health plans under title XXI of the Social Security Act (42
U.S.C. 1397aa et seq.), the Secretary, acting through the
Director of the Centers for Disease Control and Prevention, in
consultation with the heads of other Federal agencies involved
in asthma treatment and prevention, shall make available to the
States technical assistance in developing the provision of such
plans that will provide for activities pursuant to paragraph
(1).
(c) Funding.--For the purpose of carrying out this section, there
are authorized to be appropriated such sums as may be necessary for
each of the fiscal years 2000 through 2003.
SEC. 279. PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT; SYSTEMS
FOR REDUCING ASTHMA AND ASTHMA-RELATED ILLNESSES THROUGH
URBAN COCKROACH MANAGEMENT.
Section 1904(a)(1) of the Public Health Service Act (42 U.S.C.
300w-3(a)(1)) is amended--
(1) by redesignating subparagraphs (E) and (F) as
subparagraphs (F) and (G), respectively;
(2) by adding a period at the end of subparagraph (G) (as
so redesignated);
(3) by inserting after subparagraph (D), the following:
``(E) The establishment, operation, and coordination of
effective and cost-efficient systems to reduce the prevalence
of asthma and asthma-related illnesses among urban populations,
especially children, by reducing the level of exposure to
cockroach allergen through the use of integrated pest
management, as applied to cockroaches. Amounts expended for
such systems may include the costs of structural rehabilitation
of housing, public schools, and other public facilities to
reduce cockroach infestation, the costs of building
maintenance, and the costs of programs to promote community
participation in the carrying out at such sites of integrated
pest management, as applied to cockroaches. For purposes of
this subparagraph, the term `integrated pest management' means
an approach to the management of pests in public facilities
that combines biological, cultural, physical, and chemical
tools in a way that minimizes economic, health, and
environmental risks.'';
(4) in subparagraph (F) (as so redesignated), by striking
``subparagraphs (A) through (D)'' and inserting ``subparagraphs
(A) through (E)''; and
(5) in subparagraph (G) (as so redesignated), by striking
``subparagraphs (A) through (E)'' and inserting ``subparagraphs
(A) through (F)''.
SEC. 279A. COORDINATION OF FEDERAL ACTIVITIES TO ADDRESS ASTHMA-RELATED
HEALTH CARE NEEDS.
(a) In General.--The Director of the National Heart, Lung, and
Blood Institute shall, through the National Asthma Education Prevention
Program Coordinating Committee--
(1) identify all Federal programs that carry out asthma-
related activities;
(2) develop, in consultation with appropriate Federal
agencies and professional and voluntary health organizations, a
Federal plan for responding to asthma; and
(3) not later than 12 months after the date of enactment of
this Act, submit recommendations to Congress on ways to
strengthen and improve the coordination of asthma-related
activities of the Federal Government.
(b) Representation of the Department of Housing and Urban
Development.--A representative of the Department of Housing and Urban
Development shall be included on the National Asthma Education
Prevention Program Coordinating Committee for the purpose of performing
the tasks described in subsection (a).
(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.
SEC. 279B. COMPILATION OF DATA BY THE CENTERS FOR DISEASE CONTROL AND
PREVENTION.
(a) In General.--The Director of the Centers for Disease Control
and Prevention, in consultation with the National Asthma Education
Prevention Program Coordinating Committee, shall--
(1) conduct local asthma surveillance activities to collect
data on the prevalence and severity of asthma and the quality
of asthma management, including--
(A) telephone surveys to collect sample household
data on the local burden of asthma; and
(B) health care facility specific surveillance to
collect asthma data on the prevalence and severity of
asthma, and on the quality of asthma care; and
(2) compile and annually publish data on--
(A) the prevalence of children suffering from
asthma in each State; and
(B) the childhood mortality rate associated with
asthma nationally and in each State.
(b) Collaborative Efforts.--The activities described in subsection
(a)(1) may be conducted in collaboration with eligible entities awarded
a grant under section 399V of the Public Health Service Act (as added
by section 277 of this Act).
Subtitle K--Juvenile Arthritis and Related Conditions
SEC. 281. RESEARCH ON JUVENILE ARTHRITIS AND RELATED CONDITIONS.
(a) Establishment.--The Directors of the National Institute of
Arthritis and Musculoskeletal and Skin Diseases and the National
Institute of Allergy and Infectious Diseases shall expand and intensify
the programs of such Institutes with respect to research and related
activities concerning juvenile arthritis and related conditions.
(b) Coordination.--The Directors referred to in subsection (a)
shall jointly coordinate the programs referred to in such subsection
and consult with the Arthritis and Musculoskeletal Diseases Interagency
Coordinating Committee.
(c) Information Resource Center.--
(1) In general.-- In order to assist in carrying out the
purpose described in subsection (a), the Director of the
National Institutes of Health shall provide for the
establishment of an information resource center on arthritis
and related conditions, including juvenile arthritis, to
facilitate and enhance knowledge and understanding on the part
of patients, health professionals, and the public through the
effective dissemination of information.
(2) Establishment through grant or contract.--For the
purpose of carrying out paragraph (1), the Director of the
National Institutes of Health shall enter into a grant,
cooperative agreement, or contract with a national, nonprofit
private entity involved in activities regarding the prevention
and control of arthritis and related conditions through the
National Arthritis Action Plan.
(c) Pediatric Rheumatology.--The Secretary of Health and Human
Services, acting through the Director of the National Institutes of
Health and the Administrator of the Health Resources and Services
Administration, shall develop a coordinated effort to ensure that a
national infrastructure is in place to train and develop pediatric
rheumatologists to address the health care services requirements of
children with arthritis and related conditions.
(d) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.
Subtitle L--Childhood Skeletal Malignancies
SEC. 286. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND PREVENTION.
(a) In General.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary''), acting through the
Director of the Centers for Disease Control and Prevention, shall study
environmental and other risk factors for childhood skeletal cancers,
and carry out projects to improve outcomes among children with
childhood skeletal cancers and resultant secondary conditions,
including limb loss. Such projects shall be carried out by the
Secretary directly and through awards of grants or contracts to public
or nonprofit entities.
(b) Certain Activities.--Activities under subsection (a) include--
(1) the expansion of current demographic data collection
and population surveillance efforts to include childhood
skeletal cancers nationally;
(2) the development of a uniform reporting system under
which treating physicians, hospitals, clinics, and states
report the diagnosis of childhood skeletal cancers, including
relevant associated epidemiological data; and
(3) support for the National Limb Loss Information Center
to address, in part, the primary and secondary needs of persons
who experience childhood skeletal cancers in order to prevent
or minimize the disabling nature of these cancers.
(c) Coordination of Activities.--The Secretary shall assure that
activities under this section are coordinated as appropriate with other
agencies of the Public Health Service that carry out activities focused
on childhood cancers and limb loss.
(d) Definition.--For purposes of this section, the term ``childhood
skeletal cancer'' refers to any malignancy originating in the
connective tissue of a person before skeletal maturity including the
appendicular and axial skeleton. The Secretary may revise the
definition of such term as determined necessary to carry out the intent
of this effort.
(e) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.
Subtitle M--Reducing Burden of Diabetes Among Children and Youth
SEC. 291. PROGRAMS REGARDING DIABETES IN CHILDREN AND YOUTH.
(a) National Registry on Juvenile Diabetes.--The Secretary of
Health and Human Services (in this section referred to as the
``Secretary''), acting through the Director of the Centers for Disease
Control and Prevention, shall develop a system to collect data on
juvenile diabetes, including with respect to incidence and prevalence,
and shall establish a national database for such data.
(b) Long-Term Epidemiology Studies on Juvenile Diabetes.--
(1) In general.--The Secretary, acting through the Director
of the National Institutes of Health, shall conduct or support
long-term epidemiology studies in which individuals with type
1, or juvenile, diabetes are followed for 10 years or more.
Such studies shall, in order to provide a valuable resource for
the purposes specified in paragraph (2), provide for complete
characterization of disease manifestations, appropriate medical
history, elucidation of environmental factors, delineation of
complications, results of usual medical treatment and a variety
of other potential valuable (such as samples of blood).
(2) Purposes.--The purposes referred to in paragraph (1)
with respect to type 1 diabetes are the following:
(A) Delineation of potential environmental triggers
thought precipitating or causing type 1 diabetes.
(B) Delineation of those clinical characteristics
or lab measures associated with complications of the
disease.
(C) Potential study population to enter into
clinical trials for prevention and treatment, as well
as genetic studies.
(c) Type 2 Diabetes in Youth.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, shall
implement a national public health effort to address type 2 diabetes in
youth, including--
(1) enhancing surveillance systems and expanding research
to better assess the prevalence of type 2 diabetes in youth and
determine the extent to which type 2 diabetes is incorrectly
diagnosed as type 1 diabetes among children; and
(2) assisting States in establishing coordinated school
health programs and physical activity and nutrition
demonstration programs to control weight and increase physical
activity among youth.
(d) Clinical Trial Infrastructure/Innovative Treatments for
Juvenile Diabetes.--The Secretary, acting through the Director of the
National Institutes of Health, shall support regional clinical centers
for the cure of juvenile diabetes and shall through such centers
provide for--
(1) well-characterized population of children appropriate
for study;
(2) well-trained clinical scientists able to conduct such
trials;
(3) appropriate clinical settings able to house such
studies; and
(4) appropriate statistical capability, data, safety and
other monitoring capacity.
(e) Development of Vaccine.--The Secretary, acting through the
appropriate agencies of the Public Health Service, shall provide for a
national effort to develop a vaccine for type 1 diabetes. Such effort
shall provide for a combination of increased efforts in research and
development of candidate vaccines, coupled with appropriate ability to
conduct large clinical trials in children.
(f) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2000 through 2003.
Subtitle N--Miscellaneous Provisions
SEC. 296. REPORT REGARDING RESEARCH ON RARE DISEASES IN CHILDREN.
Not later than 180 days after the date of the enactment of this
Act, the Director of the National Institutes of Health shall submit to
the Congress a report on--
(1) the activities that, during fiscal year 1999, were
conducted and supported by such Institutes with respect to rare
diseases in children, including Friedreich's ataxia; and
(2) the activities that are planned to be conducted and
supported by such Institutes with respect to such diseases
during the fiscal years 2000 through 2003.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Commerce.
Referred to the Subcommittee on Health and Environment.
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