[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[S. 923 Introduced in Senate (IS)]

103d CONGRESS
  1st Session
                                 S. 923

   To amend the Public Health Service Act to provide a comprehensive 
  program for the prevention of Fetal Alcohol Syndrome, and for other 
                               purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                May 7 (legislative day, April 19), 1993

Mr. Daschle (for himself, Mr. Bingaman, Mr. DeConcini, Mr. Conrad, Mr. 
 Campbell, Mr. Stevens, Mr. Inouye, and Ms. Moseley-Braun) introduced 
the following bill; which was read twice and referred to the Committee 
                      on Labor and Human Resources

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act to provide a comprehensive 
  program for the prevention of Fetal Alcohol Syndrome, and for other 
                               purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Comprehensive Fetal Alcohol Syndrome 
Prevention Act''.

SEC. 2. FINDINGS.

    Congress finds that--
            (1) Fetal Alcohol Syndrome is the leading known cause of 
        mental retardation, and it is 100 percent preventable;
            (2) each year, more than 5,000 infants are born in the 
        United States with Fetal Alcohol Syndrome, suffering 
        irreversible physical and mental damage;
            (3) 50,000 more infants are born each year with lesser, 
        though still serious, alcohol-related birth defects, known as 
        Fetal Alcohol Effects;
            (4) Fetal Alcohol Syndrome is a national problem, it can 
        impact any child, family, or community, but its threat to 
        American Indians and Alaska Natives is especially alarming;
            (5) in some American Indian communities, where alcohol 
        dependency rates reach 50 percent and above, the chances of a 
        newborn suffering Fetal Alcohol Syndrome or Fetal Alcohol 
        Effects are 30 times greater than national averages;
            (6) researchers have determined that the possibility of 
        giving birth to a baby with Fetal Alcohol Syndrome or Fetal 
        Alcohol Effects increases in proportion to the amount and 
        frequency of alcohol consumed by a pregnant woman, and that 
        stopping alcohol consumption at any point in the pregnancy 
        reduces the risks and the emotional, physical, and mental 
        consequences of alcohol exposure to the baby;
            (7) in addition to the immeasurable toll on Fetal Alcohol 
        Syndrome and Fetal Alcohol Effects children and their families, 
        Fetal Alcohol Syndrome and Fetal Alcohol Effects pose 
        extraordinary financial costs to the Nation, including the 
        costs of health care, education, foster care, job training, and 
        general support services for affected individuals;
            (8) as a reliable comparison, delivery and care costs are 
        four times greater for infants who were exposed to illicit 
        substances than for infants with no indication of substance 
        exposure, and over a lifetime, health care costs for one Fetal 
        Alcohol Syndrome child are estimated, to be at least 
        $1,400,000; and
            (9) we know of no safe dose of alcohol during pregnancy, or 
        of any safe time to drink during pregnancy, thus, it is in the 
        best interest of the Nation for the Federal Government to take 
        an active role in encouraging all women to abstain from alcohol 
        consumption during pregnancy.

SEC. 3. PURPOSE.

    It is the purpose of this Act to establish, within the Department 
of Health and Human Services, a comprehensive program to help prevent 
Fetal Alcohol Syndrome and Fetal Alcohol Effects nationwide. Such 
program shall--
            (1) coordinate and support applied epidemiologic research 
        concerning Fetal Alcohol Syndrome and Fetal Alcohol Effects;
            (2) coordinate and support national, State, and community-
        based public awareness, prevention, and education programs on 
        Fetal Alcohol Syndrome and Fetal Alcohol Effects;
            (3) assist in establishing and conducting nation-wide Fetal 
        Alcohol Syndrome and Fetal Alcohol Effects surveillance and 
        monitoring of prevention programs; and
            (4) foster coordination among all Federal agencies that 
        conduct or support Fetal Alcohol Syndrome and Fetal Alcohol 
        Effects research, programs, and surveillance and otherwise meet 
        the general needs of populations actually or potentially 
        impacted by Fetal Alcohol Syndrome and Fetal Alcohol Effects.

SEC. 4. ESTABLISHMENT OF PROGRAM.

    Part B of title V of the Public Health Service Act (42 U.S.C. 290bb 
et seq.) is amended by adding at the end thereof the following new 
subpart:

 ``Subpart 4--Provisions Relating to Fetal Alcohol Syndrome and Fetal 
                            Alcohol Effects

``SEC. 520E. ESTABLISHMENT OF FETAL ALCOHOL SYNDROME PREVENTION 
              PROGRAM.

    ``(a) In General.--The Secretary, acting through the Centers for 
Disease Control and Prevention, the Substance Abuse and Mental Health 
Services Administration, the National Institutes of Health, and other 
relevant offices, shall establish a comprehensive program to help 
prevent Fetal Alcohol Syndrome and Fetal Alcohol Effects and coordinate 
Federal efforts to prevent Fetal Alcohol Syndrome and Fetal Alcohol 
Effects.
    ``(b) Elements of Program.--Under the program established under 
subsection (a), the Secretary shall establish a program that shall--
            ``(1) coordinate and support national and targeted public 
        awareness, prevention, and education programs on Fetal Alcohol 
        Syndrome and Fetal Alcohol Effects;
            ``(2) assist in establishing and conducting nationwide 
        Fetal Alcohol Syndrome and Fetal Alcohol Effects surveillance 
        and monitoring of prevention programs; and
            ``(3) coordinate and support applied epidemiologic research 
        concerning Fetal Alcohol Syndrome and Fetal Alcohol Effects;
            ``(4) direct the Director of the National Institutes of 
        Health to direct the National Institute on Alcoholism and 
        Alcohol Abuse to establish a program that shall conduct and 
        support basic research targeted to developing data to improve 
        prevention and treatment of Fetal Alcohol Syndrome and Fetal 
        Alcohol Effects;
            ``(5) convene a panel of national experts to develop 
        diagnostic criteria for Fetal Alcohol Effects and review and 
        update diagnostic criteria for Fetal Alcohol Syndrome, and 
        develop a plan to disseminate criteria to health care and 
        social services providers; and
            ``(6) establish an Inter-Agency Task Force on Fetal Alcohol 
        Syndrome and Fetal Alcohol Effects, which shall be chaired by 
        the Associate Administrator for Alcohol Prevention and 
        Treatment of the Substance Abuse and Mental Health Services 
        Administration, and which shall include representatives from 
        all relevant agencies and offices within the Department of 
        Health and Human Services (including the Indian Health Service) 
        Department of Agriculture, Department of Education, Department 
        of Defense, Department of the Interior (including the Bureau of 
        Indian Affairs), Department of Justice, Bureau of Alcohol, 
        Tobacco, and Firearms, Federal Trade Commission, and any other 
        relevant Federal Agency.

``SEC. 520F. EDUCATION AND PUBLIC AWARENESS.

    ``The Secretary shall direct the Directors of the Centers for 
Disease Control and Prevention and the Substance Abuse and Mental 
Health Services Administration to--
            ``(1) support, conduct and evaluate the effectiveness of--
                    ``(A) training programs for health care providers, 
                educators, school-based health care providers, social 
                workers, child welfare workers and family members 
                concerning the prevention, diagnosis, and treatment of 
                Fetal Alcohol Syndrome and Fetal Alcohol Effects;
                    ``(B) prevention and education programs, including 
                health education, and school-based clinic programs, for 
                school-age children with respect to Fetal Alcohol 
                Syndrome and Fetal Alcohol Effects; and
                    ``(C) public and community awareness programs 
                concerning Fetal Alcohol Syndrome and Fetal Alcohol 
                Effects;
            ``(2) provide technical and consultative assistance to 
        States, Indian tribal governments, local governments, school-
        based health care providers, scientific and academic 
        institutions, and non-profit organizations concerning the 
        programs referred to in paragraph (1); and
            ``(3) award grants to and enter into cooperative agreements 
        and contracts with States, Indian tribal governments, local 
        governments, scientific and academic institutions, entities 
        that fund school-based clinics, and non-profit organizations 
        for the purpose of--
                    ``(A) enabling such entities to evaluate the 
                effectiveness, with particular emphasis on the cultural 
                sensitivity and age-appropriateness, of the prevention, 
                education and community-based public awareness programs 
                referred to in paragraph (1);
                    ``(B) enabling such entities to provide training to 
                health care providers, school nurses and other school 
                health care providers, including school-based clinic 
                health care providers, educators, family members, 
                social workers, child welfare workers, and others in 
                the prevention, diagnosis and treatment of Fetal 
                Alcohol Syndrome and Fetal Alcohol Effects;
                    ``(C) educating children and youth, including 
                pregnant and high-risk youth, concerning such syndrome 
                and effects through sequential school health education 
                programs, with priority given to those programs that 
                are part of a sequential, comprehensive school health 
                education program; and
                    ``(D) increasing public and community awareness 
                concerning Fetal Alcohol Syndrome and Fetal Alcohol 
                Effects through culturally sensitive projects, 
                programs, and campaigns, and improving the 
                understanding of the general public and targeted groups 
                concerning the most effective methods for intervening 
                with friends and family to prevent fetal exposure to 
                alcohol.

``SEC. 520G. FETAL ALCOHOL SYNDROME AND FETAL ALCOHOL EFFECTS 
              SURVEILLANCE AND PREVENTION PROGRAM ASSESSMENT.

    ``The Secretary shall--
            ``(1) develop, conduct, and evaluate Fetal Alcohol Syndrome 
        and Fetal Alcohol Effects surveillance and prevention programs;
            ``(2) provide technical and consultative assistance to 
        States, Indian tribal governments, local governments, 
        scientific and academic institutions, and non-profit 
        organizations concerning the surveillance and assessment of the 
        incidence of Fetal Alcohol Syndrome and Fetal Alcohol Effects 
        and the assessment and evaluation of prevention, education, and 
        public awareness programs with respect to Fetal Alcohol 
        Syndrome and Fetal Alcohol Effects; and
            ``(3) award grants to and enter into cooperative agreements 
        and contracts with States and Indian tribal governments to--
                    ``(A) assist such States and Tribal governments in 
                initiating and improving methods and mechanisms needed 
                to conduct effective Fetal Alcohol Syndrome and Fetal 
                Alcohol Effects surveillance; and
                    ``(B) enable such States and Tribal governments to 
                evaluate the effectiveness of community-based Fetal 
                Alcohol Syndrome prevention, education, and public 
                awareness projects.

``SEC. 520H. APPLIED EPIDEMIOLOGIC RESEARCH AND PREVENTION PROGRAM.

    ``The Secretary shall direct the appropriate agencies within the 
Department of Health and Human Services to--
            ``(1) conduct and support research on the causes, 
        mechanisms, diagnostic methods, and treatment and prevention of 
        Fetal Alcohol Syndrome and Fetal Alcohol Effects;
            ``(2) provide technical and consultative assistance and 
        training to States, Indian tribal governments, local 
        governments, other public entities, scientific and academic 
        institutions, and non-profit organizations engaged in the 
        conduct of--
                    ``(A) Fetal Alcohol Syndrome prevention and early 
                intervention programs; and
                    ``(B) research relating to the causes, mechanisms, 
                diagnosis methods, treatment and prevention, of Fetal 
                Alcohol Syndrome and Fetal Alcohol Effects; and
            ``(3) award grants to, and enter into cooperative 
        agreements and contracts with States, Indian tribal 
        governments, local governments, other public entities, 
        scientific and academic institutions, and non-profit 
        organizations to--
                    ``(A) assist such entities in conducting innovative 
                demonstration and evaluation projects designed to 
                determine effective strategies, including community-
                based prevention programs and multi-cultural education 
                campaigns, for preventing and intervening in fetal 
                exposure to alcohol;
                    ``(B) improve and coordinate the surveillance and 
                ongoing assessment methods implemented by such entities 
                and the Federal Government, with respect to Fetal 
                Alcohol Syndrome and Fetal Alcohol Effects for the 
                purpose of--
                            ``(i) tracking progress toward achieving 
                        relevant Year 2000 Prevention Objectives, set 
                        forth by the Public Health Service in the 
                        Healthy People 2000: National Health Promotion 
                        and Disease Prevention Objectives;
                            ``(ii) identifying successful, culturally 
                        sensitive prevention efforts; and
                            ``(iii) identifying children who have 
                        symptoms of Fetal Alcohol Syndrome and Fetal 
                        Alcohol Effects and may need special health, 
                        education, and support services;
                    ``(C) develop and evaluate effective age-
                appropriate and culturally-sensitive prevention 
                programs for infants, children, adolescents, and adults 
                identified as being at-risk of becoming chemically 
                dependent on alcohol and associated with or developing 
                Fetal Alcohol Syndrome and Fetal Alcohol Effects; and
                    ``(D) facilitate coordination and collaboration 
                among Federal, State, Tribal, and local Fetal Alcohol 
                Syndrome prevention programs.

``SEC. 520I. BASIC RESEARCH PROGRAM.

    ``The Director of the National Institutes of Health shall direct 
the National Institute on Alcoholism and Alcohol Abuse to conduct and 
support research on services research and effective prevention 
treatments and interventions for pregnant alcohol dependant women and 
individuals with Fetal Alcohol Syndrome and Fetal Alcohol Effects.

``SEC. 520J. DIAGNOSTIC CRITERIA FOR FETAL ALCOHOL EFFECTS.

    ``Not later than 90 days after the date of enactment of this 
subpart, the Secretary shall--
            ``(1) convene a panel of nationally-recognized experts to 
        develop a set of diagnostic criteria for Fetal Alcohol Effects 
        and review and update diagnostic criteria for Fetal Alcohol 
        Syndrome; and
            ``(2) direct such panel to develop a plan for widely-
        disseminating the criteria to health care providers, educators, 
        social workers, child welfare workers, and other individuals 
        within 16 months of such date of enactment.

``SEC. 520K. INTER-AGENCY TASK FORCE ON FETAL ALCOHOL SYNDROME AND 
              FETAL ALCOHOL EFFECTS.

    ``(a) Establishment.--Not later than 30 days after the date of 
enactment of this subpart, the Secretary shall establish an Inter-
Agency Task Force on Fetal Alcohol Syndrome and Fetal Alcohol Effects 
to foster coordination among all Federal agencies that conduct or 
support Fetal Alcohol Syndrome and Fetal Alcohol Effects research, 
programs, and surveillance and otherwise meet the general needs of 
populations actually or potentially impacted by Fetal Alcohol Syndrome 
and Fetal Alcohol Effects.
    ``(b) Membership.--The Task Force established under subsection (a) 
shall--
            ``(1) be chaired by the Associate Administrator for Alcohol 
        Prevention and Treatment of the Substance Abuse and Mental 
        Health Services Administration and staffed by the 
        Administration; and
            ``(2) include representatives from all relevant agencies 
        and offices within the Department of Health and Human Services, 
        Department of Agriculture, Department of Education, Department 
        of Defense, Department of Interior, Department of Justice, 
        Bureau of Alcohol, Tobacco and Firearms, Federal Trade 
        Commission, and any other relevant Federal agency.
    ``(c) Functions.--The Task Force established under subsection (a) 
shall--
            ``(1) coordinate all Federal programs and research 
        concerning Fetal Alcohol Syndrome, Fetal Alcohol Effects, and 
        other forms of maternal substance abuse, including those 
        programs--
                    ``(A) targeting individuals, families, and 
                populations identified as being at risk of acquiring 
                Fetal Alcohol Syndrome, Fetal Alcohol Effects, or other 
                maternal substance abuse; and
                    ``(B) providing health, education, treatment, and 
                social services to infants, children, and adults with 
                Fetal Alcohol Syndrome, Fetal Alcohol Effects, and 
                other drug exposures and their families; and
            ``(2) coordinate its efforts with existing Department of 
        Health and Human Services task forces on substance abuse 
        prevention and maternal and child health;
            ``(3) report on an annual basis to the Secretary and 
        relevant Committees of Congress on the current and planned 
        activities of the participating agencies.

``SEC. 520L. ADMINISTRATIVE PROVISIONS WITH RESPECT TO GRANTS, 
              COOPERATIVE AGREEMENTS AND CONTRACTS.

    ``(a) Eligibility.--To be eligible to receive a grant, cooperative 
agreement or contract under this subpart, an entity shall--
            ``(1) be a State, Indian tribal government, local 
        government, entity that funds a school-based health clinic 
        scientific or academic institution or non-profit organization;
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may prescribe, including a description of the 
        activities that the entity intends to carry out using amounts 
        received under a grant, cooperative agreement, or contract; and
            ``(3) provide assurances that amounts received under such 
        grants, cooperative agreements or contracts will be used in 
        accordance with this subpart.
    ``(b) Maintenance of Effort.--No grant, cooperative agreement, or 
contract may be awarded to an entity under this subpart unless the 
entity agrees to maintain the expenditures of the entity for activities 
of the type for which the amounts to be received under a grant, 
cooperative agreement, or contract are to be used, at a level equal to 
not less than the level of such expenditures maintained by the entity 
for the fiscal year preceding the fiscal year for which the entity is 
applying to receive the grant, cooperative agreement or contract.
    ``(c) Amounts in Lieu of Cash.--At the request of a recipient of a 
grant, cooperative agreement, or contract under this subpart, the 
Secretary may reduce the amount provided under such grant, agreement, 
or contract by--
            ``(1) an amount equal to the fair market value of any 
        supplies or equipment furnished the recipient; and
            ``(2) an amount equal to the amount of the pay, allowances, 
        and travel expenses of any officer or employee of the Federal 
        Government which was detailed to the recipient and the amount 
        of any other cost incurred in connection with the detail of 
        such officer or employee.

``SEC. 520M. AUTHORIZATION OF APPROPRIATIONS.

    ``There are authorized to be appropriated to carry out this 
subpart, such sums as are necessary for each of the fiscal years 1994 
through 1997.''.

                                 <all>

S 923 IS----2