[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4365 Introduced in House (IH)]
106th CONGRESS
2d Session
H. R. 4365
To amend the Public Health Service Act with respect to children's
health.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 3, 2000
Mr. Bilirakis (for himself and Mr. Brown of Ohio) 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 Act of 2000''.
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--AUTISM
Subtitle A--Surveillance and Research Regarding Prevalence and Pattern
of Autism
Sec. 101. Short title.
Sec. 102. Surveillance and research programs; clearinghouse; advisory
committee.
Subtitle B--Expansion, Intensification, and Coordination of Autism
Activities of National Institutes of Health
Sec. 111. Short title.
Sec. 112. Expansion, intensification, and coordination; information and
education; interagency coordinating
committee.
TITLE II--RESEARCH AND DEVELOPMENT REGARDING
FRAGILE X
Sec. 201. Short title.
Sec. 202. National Institute of Child Health and Human Development;
research on fragile X.
Sec. 203. National Institute of Child Health and Human Development;
loan repayment program regarding research
on fragile X.
TITLE III--JUVENILE ARTHRITIS AND RELATED CONDITIONS
Sec. 301. National Institute of Arthritis and Musculoskeletal and Skin
Diseases; research on juvenile arthritis
and related conditions.
Sec. 302. Information clearinghouse.
TITLE IV--REDUCING BURDEN OF DIABETES AMONG CHILDREN AND YOUTH
Sec. 401. Programs of Centers for Disease Control and Prevention.
Sec. 402. Programs of National Institutes of Health.
TITLE V--ASTHMA TREATMENT SERVICES FOR CHILDREN
Sec. 501. Short title.
Subtitle A--Treatment Services
Sec. 511. Grants for children's asthma relief.
Sec. 512. Technical and conforming amendments.
Subtitle B--Prevention Activities
Sec. 521. Preventive health and health services block grant; systems
for reducing asthma-related illnesses
through urban cockroach management.
Subtitle C--Coordination of Federal Activities
Sec. 531. Coordination through National Institutes of Health.
Subtitle D--Compilation of Data
Sec. 541. Compilation of data by Centers for Disease Control and
Prevention.
TITLE VI--BIRTH DEFECTS PREVENTION ACTIVITIES
Subtitle A--Folic Acid Promotion
Sec. 601. Short title.
Sec. 602. Program regarding effects of folic acid in prevention of
birth defects.
Subtitle B--National Center on Birth Defects and Developmental
Disabilities
Sec. 611. National Center on Birth Defects and Developmental
Disabilities.
TITLE VII--EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING HEARING
LOSS IN INFANTS
Sec. 701. Short title.
Sec. 702. Purposes.
Sec. 703. Programs of Health Resources and Services Administration,
Centers for Disease Control and Prevention,
and National Institutes of Health.
TITLE VIII--CHILDREN AND EPILEPSY
Sec. 801. National public health campaign on epilepsy; seizure disorder
demonstration projects in medically
underserved areas.
TITLE IX--SAFE MOTHERHOOD; INFANT HEALTH PROMOTION
Subtitle A--Safe Motherhood Monitoring and Prevention Research
Sec. 901. Short title.
Sec. 902. Monitoring; prevention research and other activities.
Subtitle B--Pregnant Mothers and Infants Health Promotion
Sec. 911. Short title.
Sec. 912. Programs regarding prenatal and postnatal health.
TITLE X--REVISION AND EXTENSION OF CERTAIN PROGRAMS
Subtitle A--Pediatric Research Initiative
Sec. 1001. Short title.
Sec. 1002. Establishment of pediatric research initiative.
Sec. 1003. Investment in tomorrow's pediatric researchers.
Subtitle B--Other Programs
Sec. 1011. Childhood immunizations.
Sec. 1012. Screenings, referrals, and education regarding lead
poisoning.
TITLE XI--CHILDHOOD SKELETAL MALIGNANCIES
Sec. 1101. Programs of Centers for Disease Control and Prevention and
National Institutes of Health.
TITLE XII--ADOPTION AWARENESS
Subtitle A--Infant Adoption Awareness
Sec. 1201. Short title.
Sec. 1202. Grants regarding infant adoption awareness.
Subtitle B--Special Needs Adoption Awareness
Sec. 1211. Short title.
Sec. 1212. Special needs adoption programs; public awareness campaign
and other activities.
TITLE XIII--TRAUMATIC BRAIN INJURY
Sec. 1301. Short title.
Sec. 1302. Programs of Centers for Disease Control and Prevention.
Sec. 1303. Programs of National Institutes of Health.
Sec. 1304. Programs of Health Resources and Services Administration.
TITLE XIV--PREVENTION AND CONTROL OF INJURIES
Sec. 1401. Authorization of Appropriations for programs of Centers for
Disease Control and Prevention.
TITLE XV--HEALTHY START INITIATIVE
Sec. 1501. Short title.
Sec. 1502. Continuation of healthy start program.
TITLE XVI--ORAL HEALTH PROMOTION AND DISEASE PREVENTION
Sec. 1601. Oral health promotion and disease prevention.
TITLE XVII--VACCINE COMPENSATION PROGRAM
Sec. 1701. Short title.
Sec. 1702. Content of petitions.
TITLE XVIII--HEPATITIS C
Sec. 1801. Short title.
Sec. 1802. Surveillance and education regarding hepatitis C.
TITLE XIX--NIH INITIATIVE ON AUTOIMMUNE DISEASES
Sec. 1901. Short title.
Sec. 1902. Juvenile diabetes, juvenile arthritis, lupus, multiple
sclerosis, and other autoimmune-diseases;
initiative through Directior of National
Institutes of Health.
TITLE XX--GRADUATE MEDICAL EDUCATION PROGRAMS IN CHILDREN'S HOSPITALS
Sec. 2001. Extension of authorization of appropriations.
TITLE XXI--SPECIAL NEEDS OF CHILDREN REGARDING ORGAN TRANSPLANTATION
Sec. 2101. Short title.
Sec. 2102. Organ Procurement and Transplantation Network; amendments
regarding needs of children.
TITLE XXII--MISCELLANEOUS PROVISIONS
Sec. 2201. Report regarding research on rare diseases in children.
TITLE XXIII--EFFECTIVE DATE
Sec. 2301. Effective date.
TITLE I--AUTISM
Subtitle A--Surveillance and Research Regarding Prevalence and Pattern
of Autism
SEC. 101. SHORT TITLE.
This subtitle may be cited as the ``Autism Statistics,
Surveillance, Research, and Epidemiology Act of 2000 (ASSURE)''.
SEC. 102. SURVEILLANCE AND RESEARCH PROGRAMS; CLEARINGHOUSE; ADVISORY
COMMITTEE.
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:
``surveillance and research regarding autism and pervasive
developmental disorders
``Sec. 317H. (a) In General.--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
disorders. 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
Disorders 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 disorders epidemiology for the purpose
of collecting and analyzing information on the number,
incidence, correlates, and causes of autism and related
developmental disorders.
``(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 disorders data
according to guidelines prescribed by the Director,
after consultation with relevant State and local public
health officials, private sector developmental disorder
researchers, and advocates for those with developmental
disorders;
``(B) The center will assist with the development
and coordination of State autism and pervasive
developmental disorders 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
disorders; 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 disorders; 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).
``(c) 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 disorders surveillance activities through the
establishment of a clearinghouse for the collection and storage
of data generated from the monitoring programs created by this
section. 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 disorders.
``(2) The Secretary shall coordinate the Federal response
to requests for assistance from State health department
officials regarding potential or alleged autism or
developmental disorder clusters.
``(d) Advisory Committee.--
``(1) In general.--The Secretary shall establish an
Advisory Committee for Autism and Pervasive developmental
disorders 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--
``(A) the establishment of a national autism and
pervasive developmental disorders surveillance program;
``(B) the establishment of centers of excellence in
autism and pervasive developmental disorders
epidemiology;
``(C) methods and procedures to more effectively
coordinate government and non-government programs and
research on autism and pervasive developmental
disorders epidemiology; and
``(D) the effective operation of autism and
pervasive developmental disorders epidemiology research
activities.
``(2) Composition.--
``(A) In general.--The Committee shall be composed
of ex officio members in accordance with subparagraph
(B) and 11 appointed members in accordance with
subparagraph (C).
``(B) Ex officio members.--The following officials
shall serve as ex officio members of the Committee:
``(i) The Director of the National Center
for Environmental Health.
``(ii) The Assistant Administrator of the
Agency for Toxic Substances and Disease
Registry.
``(iii) The Director of the National
Institute of Child Health and Human
Development.
``(iv) The Director of the National
Institute of Neurological Disorders and Stroke.
``(C) Appointed members.--Appointments to the
Committee shall be made in accordance with the
following:
``(i) Two members shall be research
scientists with demonstrated achievements in
research related to autism and related
developmental disorders. The scientists shall
be appointed by the Secretary in consultation
with the National Academy of Sciences.
``(ii) Five members shall be
representatives of the five national
organizations whose primary emphasis is on
research into autism and other pervasive
developmental disorders. One representative
from each of such organizations shall be
appointed by the Secretary in consultation with
the National Academy of Sciences.
``(iii) Two members shall be clinicians
whose practice is primarily devoted to the
treatment of individuals with autism and other
pervasive developmental disorders. The
clinicians shall be appointed by the Secretary
in consultation with the Institute of Medicine
and the National Academy of Sciences.
``(iv) Two members shall be individuals who
are the parents or legal guardians of a person
or persons with autism or other pervasive
developmental disorders. The individuals shall
be appointed by the Secretary in consultation
with the ex officio members under subparagraph
(B) and the five national organizations
referred to in clause (ii).
``(3) Administrative support; terms of service; other
provisions.--The following apply with respect to the Committee:
``(A) The Committee shall receive necessary and
appropriate administrative support from the Department
of Health and Human Services.
``(B) Members of the Committee shall be appointed
for a term of three years, and may serve for an
unlimited number of terms if reappointed.
``(C) The Committee shall meet no less than two
times per year.
``(D) 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.
``(e) Report to Congress.--The Secretary shall prepare and submit
to the Congress, after consultation with and comment by the advisory
committee under subsection (d), 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.
``(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 2001 through 2005.''.
Subtitle B--Expansion, Intensification, and Coordination of Autism
Activities of National Institutes of Health With Respect to Autism
SEC. 111. SHORT TITLE.
This subtitle may be cited as the ``Advancement in Pediatric Autism
Research Act of 2000''.
SEC. 112. EXPANSION, INTENSIFICATION, AND COORDINATION; INFORMATION AND
EDUCATION; INTERAGENCY COORDINATING COMMITTEE.
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 (other
than subsection (b)) acting through the Director of the
National Institute of Mental Health and in collaboration with
any other agencies that the Director determines appropriate.
``(b) Interagency Coordinating Committee.--
``(1) In general.--The Secretary shall ensure that there is
in operation an interagency committee to be known as the
`Autism Coordinating Committee' (referred to in this subsection
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 under this section and activities carried
out through the Centers for Disease Control and Prevention
under section 317H.
``(2) Membership.--The Committee shall be composed of such
directors of the national research institutes, such directors
of centers within the Centers for Disease Control and
Prevention, and such other officials within the Department of
Health and Human Services as the Secretary determines to be
appropriate. The Committee may include representatives of other
Federal agencies that serve children with autism, such as the
Department of Education.
``(3) Meetings.--The Committee shall meet not less than
twice per year.
``(c) 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), subject to the extent of amounts
made available in appropriations Acts. 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.
``(d) 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.
``(e) Information and Education.--
``(1) In general.--The Director 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.
``(2) Stipends.--The Director may use amounts made
available under this section to provide stipends for health
professionals who are enrolled in training programs under this
section.
``(f) 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.
``(g) Annual Report to Congress.--The Director shall prepare and
submit to the appropriate committees of the Congress reports regarding
the activities carried out under this section. The first report shall
be submitted not later than January 10, 2002, and subsequent reports
shall be submitted annually thereafter.
``(h) 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 2001 through 2005. Such authorizations of
appropriations are in addition to any other authorizations of
appropriations that are available for such purpose.''.
TITLE II--RESEARCH AND DEVELOPMENT REGARDING FRAGILE X
SEC. 201. SHORT TITLE.
This title may be cited as the ``Fragile X Research Breakthrough
Act of 2000''.
SEC. 202. 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 is
amended by adding at the end the following section:
``fragile x
``Sec. 452E. (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 2001 through 2005.''.
SEC. 203. 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 2001 through 2005.''.
TITLE III--JUVENILE ARTHRITIS AND RELATED CONDITIONS
SEC. 301. NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN
DISEASES; RESEARCH ON JUVENILE ARTHRITIS AND RELATED
CONDITIONS.
Subpart 4 of part C of title IV of the Public Health Service Act
(42 U.S.C. 285d et seq.) is amended by inserting after section 442 the
following section:
``juvenile arthritis and related conditions
``Sec. 442A. (a) Expansion and Coordination of Activities.--The
Director of the Institute, in coordination with the Director of 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) Pediatric Rheumatology.--The Secretary, acting through the
appropriate agencies of the Public Health Service, shall develop a
coordinated effort to help 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 2001 through 2005.''.
SEC. 302. INFORMATION CLEARINGHOUSE.
Section 438(b) of the Public Health Service Act (42 U.S.C. 285d-
3(b)) is amended by inserting ``, including juvenile arthritis and
related conditions,'' after ``diseases''.
TITLE IV--REDUCING BURDEN OF DIABETES AMONG CHILDREN AND YOUTH
SEC. 401. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND PREVENTION.
Part B of title III of the Public Health Service Act, as amended by
section 102 of this Act, is amended by inserting after section 317H the
following section:
``diabetes in children and youth
``Sec. 317I. (a) National Registry on Juvenile Diabetes.--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) Type 2 Diabetes in Youth.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention and in
consultation with the Administrator of the Health Resources and
Services Administration, 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;
``(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; and
``(3) developing and improving laboratory methods to assist
in diagnosis, treatment, and prevention of diabetes including,
but not limited to, developing noninvasive ways to monitor
blood glucose to prevent hypoglycema and improving existing
glucometers that measure blood glucose.
``(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 2001 through 2005.''.
SEC. 402. PROGRAMS OF NATIONAL INSTITUTES OF HEALTH.
Subpart 3 of part C of title IV of the Public Health Service Act
(42 U.S.C. 285c et seq.) is amended by inserting after section 434 the
following section:
``juvenile diabetes
``Sec. 434A. (a) Long-Term Epidemiology Studies.--
``(1) In general.--The Director of the Institute 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.
``(b) 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.
``(c) 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.
``(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 2001 through 2005.''.
TITLE V--ASTHMA TREATMENT SERVICES FOR CHILDREN
SEC. 501. SHORT TITLE.
This title may be cited as the ``Children's Asthma Relief Act of
2000''.
Subtitle A--Treatment
SEC. 511. GRANTS FOR CHILDREN'S ASTHMA RELIEF.
Title III of the Public Health Service Act (42 U.S.C. 241 et seq.)
is amended by adding at the end the following part:
``PART P--ADDITIONAL PROGRAMS
``SEC. 399L. CHILDREN'S ASTHMA TREATMENT GRANTS PROGRAM.
``(a) 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 following purposes:
``(A) 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.
``(B) 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 treat asthma
and prevent its exacerbations.
``(C) 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 management of asthma.
``(D) 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.
``(2) Certain projects.--In making grants under paragraph
(1), the Secretary may make grants designed to develop and
expand the following projects:
``(A) Projects to provide comprehensive asthma
services to children in accordance with the guidelines
of the National Asthma Education and Prevention Program
(through the National Heart, Lung and Blood Institute),
including access to care and treatment for asthma in a
community-based setting;
``(B) Projects to demonstrate mobile health care
clinics that in accordance with such guidelines provide
preventive asthma care. Such projects shall be
evaluated and reports describing the findings of the
evaluations shall be submitted to the Congress.
``(C) Projects to conduct 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.
``(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 or suspected high
prevalence of childhood asthma or high asthma-related
mortality (relative to the average asthma prevalence
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.
``(b) 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).
``(c) 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.
``(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 2001 through 2005.''.
SEC. 512. TECHNICAL AND CONFORMING AMENDMENTS.
Title III of the Public Health Service Act (42 U.S.C. 241 et seq.)
is amended--
(1) in part L, by redesignating section 399D as section
399A;
(2) in part M--
(A) by redesignating sections 399H through 399L as
sections 399B through 399F, respectively;
(B) in section 399B (as so redesignated), in
subsection (e)--
(i) by striking ``section 399K(b)'' and
inserting ``subsection (b) of section 399E'';
and
(ii) by striking ``section 399C'' and
inserting ``such section'';
(C) in section 399E (as so redesignated), in
subsection (c), by striking ``section 399H(a)'' and
inserting ``section 399B(a)''; and
(D) in section 399F (as so redesignated)--
(i) in subsection (a), by striking
``section 399I'' and inserting ``section
399C'';
(ii) in subsection (a), by striking
``subsection 399J'' and inserting ``section
399D''; and
(iii) in subsection (b), by striking
``subsection 399K'' and inserting ``section
399E'';
(3) in part N, by redesignating section 399F as section
399G; and
(4) in part O--
(A) by redesignating sections 399G through 399J as
sections 399H through 399K, respectively;
(B) in section 399H (as so redesignated), in
subsection (b), by striking ``section 399H'' and
inserting ``section 399I'';
(C) in section 399J (as so redesignated), in
subsection (b), by striking ``section 399G(d)'' and
inserting ``section 399H(d)''; and
(D) in section 399K (as so redesignated), by
striking ``section 399G(d)(1)'' and inserting ``section
399H(d)(1)''.
Subtitle B--Prevention Activities
SEC. 521. PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT; SYSTEMS
FOR REDUCING 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 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)''.
Subtitle C--Coordination of Federal Activities
SEC. 531. COORDINATION THROUGH NATIONAL INSTITUTES OF HEALTH.
Subpart 2 of part C of title IV of the Public Health Service Act
(42 U.S.C. 285b et seq.) is amended by inserting after section 424A the
following section:
``coordination of federal asthma activities
``Sec. 424B (a) In General.--The Director of 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 the
enactment of the Children's Health Act of 2000, submit
recommendations to the appropirate committees of the 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 2001 through 2005.''.
Subtitle D--Compilation of Data
SEC. 541. COMPILATION OF DATA BY CENTERS FOR DISEASE CONTROL AND
PREVENTION.
Part B of title III of the Public Health Service Act, as amended by
section 401 of this Act, is amended by inserting after section 317I the
following section:
``compilation of data on asthma
``Sec. 317J. (a) In General.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention and in
consultation with the Director of the National Heart, Lung, and Blood
Institute, shall--
``(1) conduct local asthma surveillance activities to
collect data on the prevalence and severity of asthma and the
quality of asthma management;
``(2) compile and annually publish data on the prevalence
of children suffering from asthma in each State; and
``(3) to the extent practicable, compile and publish data
on the childhood mortality rate associated with asthma
nationally.
``(b) National Coordinating Committee.--The Director of the
National Heart, Lung, and Blood Institute shall in carrying out
subsection (a) consult with the National Asthma Education Prevention
Program Coordinating Committee.
``(c) Collaborative Efforts.--The activities described in
subsection (a)(1) may be conducted in collaboration with eligible
entities awarded a grant under section 399L.''.
TITLE VI--BIRTH DEFECTS PREVENTION ACTIVITIES
Subtitle A--Folic Acid
SEC. 601. SHORT TITLE.
This subtitle may be cited as the ``Folic Acid Promotion and Birth
Defects Prevention Act of 2000''.
SEC. 602. PROGRAM REGARDING EFFECTS OF FOLIC ACID IN PREVENTION OF
BIRTH DEFECTS.
Part B of title III of the Public Health Service Act, as amended by
section 541 of this Act, is amended by inserting after section 317J the
following section:
``effects of folic acid in prevention of birth defects
``Sec. 317K. (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 2001 through 2005.''.
Subtitle B--National Center on Birth Defects and Developmental
Disabilities
SEC. 611. NATIONAL CENTER ON BIRTH DEFECTS AND
DEVELOPMENTAL DISABILITIES.
Section 317C of the Public Health Service Act (42 U.S.C. 247b-4) is
amended--
(1) by striking the heading for the section and inserting
the following:
``national center on birth defects and developmental disabilities'';
(2) by striking ``Sec. 317C. (a)'' and all that follows
through the end of subsection (a) and inserting the following:
``Sec. 317C. (a) In General.--
``(1) National center.--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 (referred to in this section as the `Center'),
which shall be headed by a director appointed by the Director
of the Centers for Disease Control and Prevention.
``(2) General duties.--The Secretary shall carry out
programs--
(A) to collect, analyze, and make available data on
birth defects (in a manner that facilitates compliance
with subsection (d)(2)), including data on the causes
of such defects and on the incidence and prevalence of
such defects;
(B) to operate regional centers for the conduct of
applied epidemiological research on the prevention of
such defects; and
(C) to provide information and education to the
public on the prevention of such defects.
``(3) Folic acid.--The Secretary shall carry out section
317K through the Center.
``(4) Certain programs.--
``(A) Transfers.--All programs and functions
described in subparagraph (B) are transferred to the
Center, effective on the date of the enactment of the
Children's Health Act of 2000.
``(B) Relevant programs.--The programs and
functions described in this subparagraph are all
programs and functions that--
``(i) relate to birth defects, folic acid,
cerebral palsy, mental retardation, child
development, newborn screening, autism, fragile
X syndrome, fetal alcohol syndrome, pediatric
genetics, or disability prevention; and
``(ii) were carried out through the
National Center for Environmental Health as of
the day before the date of the enactment of the
Act referred to in subparagraph (A).
``(C) Related transfers.--Personnel employed in
connection with the programs and functions specified in
subparagraph (B), and amounts available for carrying
out the programs and functions, are tranferred to the
Center, effective on the date of the enactment of the
Act referred to in subparagraph (A). Such transfer of
amounts does not affect the period of availability of
the amounts, or the availability of the amounts with
respect to the purposes for which the amounts may be
expended.''; and
(3) in subsection (b)(1), in the matter preceding
subparagraph (A), by striking ``(a)(1)'' and inserting
``(a)(2)(A)''.
TITLE VII--EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING HEARING
LOSS IN INFANTS
SEC. 701. SHORT TITLE.
This title may be cited as the ``Newborn and Infant Hearing
Screening and Intervention Act of 2000''.
SEC. 702. 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.
SEC. 703. PROGRAMS OF HEALTH RESOURCES AND SERVICES ADMINISTRATION,
CENTERS FOR DISEASE CONTROL AND PREVENTION, AND NATIONAL
INSTITUTES OF HEALTH.
Part P of title III of the Public Health Service Act, as added by
section 511 of this Act, is amended by adding at the end the following
section:
``SEC. 399M. EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING
HEARING LOSS IN INFANTS.
``(a) Statewide Newborn and Infant Hearing Screening, Evaluation
and Intervention Programs and Systems.--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.
``(b) 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.
``(c) 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 (a) and to
develop a data collection system under subsection (b).
``(d) Rule of Construction.--Nothing in this section shall be
construed to preempt any State law.
``(e) Definitions.--For purposes of this section:
``(1) The term `audiologic evaluation' refers to 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 coordinating agencies under part C of the Individuals
with Disabilities Education Act 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.
``(2) The terms `audiologic rehabilitation' and `audiologic
intervention' refer to procedures, techniques, and technologies
to facilitate the receptive and expressive communication
abilities of a child with hearing loss.
``(3) The term `early intervention' refer to providing
appropriate services for the child with hearing loss, including
nonmedical services, 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.
``(4) The term `medical evaluation by a physician' refers
to 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.
``(5) The term `medical intervention' refers to 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.
``(6) The term `newborn and infant hearing screening'
refers to objective physiologic procedures to detect possible
hearing loss and to identify newborns and infants who, after
rescreening, require further audiologic and medical
evaluations.
``(f) Authorization of Appropriations.--
``(1) Statewide newborn and infant hearing screening,
evaluation and intervention programs and systems.--For the
purpose of carrying out subsection (a), 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 2001 through 2005.
``(2) Technical assistance, data management, and applied
research; centers for disease control and prevention.--For the
purpose of carrying out subsection (b)(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 2001 through 2005.
``(3) Technical assistance, data management, and applied
research; national institute on deafness and other
communication disorders.--For the purpose of carrying out
subsection (b)(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 2001 through 2005.''.
TITLE VIII--CHILDREN AND EPILEPSY
SEC. 801. NATIONAL PUBLIC HEALTH CAMPAIGN ON EPILEPSY; SEIZURE DISORDER
DEMONSTRATION PROJECTS IN MEDICALLY UNDERSERVED AREAS.
Subpart I of part D of title III of the Public Health Service Act
(42 U.S.C. 254b) is amended by adding at the end the following section:
``SEC. 330E. EPILEPSY; SEIZURE DISORDER.
``(a) National Public Health Campaign.--
``(1) In general.--The Secretary 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.
``(2) Certain activities.--Activities under paragraph (1)
shall include--
``(A) expanding current surveillance activities
through existing monitoring systems and improving
registries that maintain data on individuals with
epilepsy, including children;
``(B) enhancing research activities on patient
management and control of epilepsy;
``(C) 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;
``(D) 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;
``(E) utilizing and expanding partnerships with
organizations with experience addressing the health and
related needs of people with disabilities; and
``(F) other activities the Secretary deems
appropriate.
``(3) Coordination of activities.--The Secretary shall
ensure that activities under this subsection are coordinated as
appropriate with other agencies of the Public Health Service
that carry out activities regarding epilepsy and seizure.
``(b) Seizure Disorder; Demonstration Projects in Medically
Underserved Areas.--
``(1) 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.
``(2) Application for grant.--The Secretary may make a
grant under paragraph (1) 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 subsection.
``(c) Definitions.--For purposes of this section:
``(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).
``(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 2001 through 2005.''.
TITLE IX--SAFE MOTHERHOOD; INFANT HEALTH PROMOTION
Subtitle A--Safe Motherhood Monitoring and Prevention Research
SEC. 901. SHORT TITLE.
This title may be cited as the ``Safe Motherhood Monitoring and
Prevention Research Act''.
SEC. 902. MONITORING; PREVENTION RESEARCH AND OTHER ACTIVITIES.
Part B of title III of the Public Health Service Act, as amended by
section 602 of this Act, is amended by inserting after section 317K the
following section:
``safe motherhood
``Sec. 317L. (a) Monitoring.--
``(1) Purpose.--The purpose of this subsection is 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.
``(2) Activities.--For the purpose described in paragraph
(1), the Secretary, acting through the Director of the Centers
for Disease Control and Prevention, may carry out the following
activities:
``(A) 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.
``(B) The Secretary may expand the Pregnancy Risk
Assessment Monitoring System to provide surveillance
and collect data in each of the 50 States.
``(C) 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.
``(b) Prevention Research.--
``(1) Purpose.--The purpose of this subsection is 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.
``(2) Research.--The Secretary, acting through the Director
of the Centers for Disease Control and Prevention, may carry
out activities to expand research relating to--
``(A) encouraging preconception counseling,
especially for at risk populations such as diabetics;
``(B) the identification of critical components of
prenatal delivery and postpartum care;
``(C) the identification of outreach and support
services, such as folic acid education, that are
available for pregnant women;
``(D) the identification of women who are at high
risk for complications;
``(E) preventing preterm delivery;
``(F) preventing urinary tract infections;
``(G) preventing unnecessary caesarean sections;
``(H) an examination of the higher rates of
maternal mortality among african american women;
``(I) an examination of the relationship between
domestic violence and maternal complications and
mortality;
``(J) preventing smoking, alcohol and illegal drug
usage before, during and after pregnancy;
``(K) preventing infections that cause maternal and
infant complications; and
``(L) other areas determined appropriate by the
Secretary.
``(c) Prevention Programs.--
``(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, may
carry out activities to promote safe motherhood, including--
``(A) public education campaigns on healthy
pregnancies and the building of partnerships with
outside organizations concerned about safe motherhood;
``(B) education programs for physicians, nurses and
other health care providers; and
``(C) activities to promote community support
services for pregnant women.
``(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 2001 through 2005.''.
Subtitle B--Pregnant Mothers and Infants Health Promotion
SEC. 911. SHORT TITLE.
This subtitle may be cited as the ``Pregnant Mothers and Infants
Health Protection Act''.
SEC. 912. PROGRAMS REGARDING PRENATAL AND POSTNATAL HEALTH.
Part B of title III of the Public Health Service Act, as amended by
section 902 of this Act, is amended by inserting after section 317L the
following section:
``prenatal and postnatal health
``Sec. 317M. (a) In General.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, 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 2001 through 2005.''.
TITLE X--REVISION AND EXTENSION OF PROGRAMS
Subtitle A--Pediatric Research Initiative
SEC. 1001. SHORT TITLE.
This subtitle may be cited as the ``Pediatric Research Initiative
Act of 2000''.
SEC. 1002. ESTABLISHMENT OF PEDIATRIC RESEARCH
INITIATIVE.
Part B of title IV of the Public Health Service Act, as amended by
section 112 of this Act, is amended by adding at the end the following:
``pediatric research initiative
``Sec. 409D. (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 provide--
``(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 Director of the National Institute
of Child Health and Human Development and the Directors of the
other national research institutes, in considering their
requests for new or expanded pediatric research efforts, and
consult with the Administrator of the Health Resources and
Services Administration and other advisors as the Director
determines to be 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 2001 through 2005.
``(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. 1003. INVESTMENT IN TOMORROW'S PEDIATRIC
RESEARCHERS.
Subpart 7 of part C of title IV of the Public Health Service Act,
as amended by section 921 of this Act, is amended by adding at the end
the following:
``investment in tomorrow's pediatric researchers
``Sec. 452G. (a) In General.--In order to ensure the future supply
of researchers dedicated to the care and research needs of children,
the Director of the Institute, after consultation with the
Administrator of the Health Resources and Services Administration,
shall support activities to provide for--
``(1) an increase in the number and size of institutional
training grants to pediatric departments of medical schools and
to children's hospitals; and
``(2) an increase in the number of career development
awards for health professionals who are in pediatric
specialties or subspecialties and intend to build careers in
pediatric basic and clinical research.
``(b) 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 2001 through 2005.''.
Subtitle B--Other Programs
SEC. 1011. 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. 1012. 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.''.
TITLE XI--CHILDHOOD SKELETAL MALIGNANCIES
SEC. 1101. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND PREVENTION AND
NATIONAL INSTITUTES OF HEALTH.
Part P of title III of the Public Health Service Act, as amended by
section 703 of this Act, is amended by adding at the end the following
section:
``SEC. 399N. CHILDHOOD SKELETAL MALIGNANCIES.
``(a) In General.--The Secretary, acting as appropriate through the
Director of the Centers for Disease Control and Prevention and the
Director of the National Institutes of Health, 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 for purposes of this
section revise the definition of such term to the extent determined by
the Secretary to be appropriate.
``(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 2001 through 2005.''.
TITLE XII--ADOPTION AWARENESS
Subtitle A--Infant Adoption Awareness
SEC. 1201. SHORT TITLE.
This subtitle may be cited as the ``Infant Adoption Awareness Act
of 2000''.
SEC. 1202. GRANTS REGARDING INFANT ADOPTION AWARENESS.
Subpart I of part D of title III of the Public Health Service Act,
as amended by section 801 of this Act, is amended by adding at the end
the following section:
``SEC. 330F. CERTAIN SERVICES FOR PREGNANT WOMEN.
``(a) Infant Adoption Awareness.--
``(1) In general.--The Secretary shall make grants to
national, regional, or local adoption organizations for the
purpose of developing and implementing programs to train the
designated staff of eligible health centers in providing
adoption information and referrals to pregnant women on an
equal basis with all other courses of action included in
nondirective counseling.
``(2) Best-practices guidelines.--
``(A) In general.--A condition for the receipt of a
grant under paragraph (1) is that the adoption
organization involved agree that, in providing training
under such paragraph, the organization will follow the
guidelines developed under subparagraph (B).
``(B) Process for development of guidelines.--
``(i) In general.--The Secretary shall
establish and supervise a process described in
clause (ii) in which the participants are--
``(I) an appropriate number and
variety of adoption organizations that
have expertise in all models of
adoption practice and that represent
all members of the adoption triad
(birth mother, infant, and adoptive
parent); and
``(II) affected public health
entities.
``(ii) Description of process.--The process
referred to in clause (i) is a process in which
the participants described in such clause
collaborate to develop best-practices
guidelines on the provision of adoption
information and referrals to pregnant women on
an equal basis with all other courses of action
included in nondirective counseling.
``(iii) Date certain for developement.--The
Secretary shall ensure that the guidelines
described in clause (ii) are developed not
later than 180 days after the date of the
enactment of the Children's Health Act of 2000.
``(C) Relation to authority for grants.--The
Secretary may not make any grant under paragraph (1)
before the date on which the guidelines under
subparagraph (B) are developed.
``(3) Use of grant.--
``(A) In general.--With respect to a grant under
paragraph (1)--
``(i) an adoption organization may expend
the grant to carry out the programs directly or
through grants to or contracts with other
adoption organizations;
``(ii) the purposes for which the adoption
organization expends the grant may include the
development of a training curriculum,
consistent with the guidelines developed under
paragraph (2)(B); and
``(iii) a condition for the receipt of the
grant is that the adoption organization agree
that, in providing training for the designated
staff of eligible health centers, such
organization will make reasonable efforts to
ensure that the individuals who provide the
training are individuals who are experienced in
providing adoption information and referrals in
the geographic areas in which the eligible
health centers are located, and that the
designated staff receive the training in such
areas.
``(B) Rule of construction regarding training of
trainers.--With respect to individuals who under a
grant under paragraph (1) provide training for the
designated staff of eligible health centers (referred
to in this subparagraph as `trainers'), subparagraph
(A)(iii) may not be construed as establishing any
limitation regarding the geographic area in which the
trainers receive instruction in being such trainers. A
trainer may receive such instruction in a different
geographic area than the area in which the trainer
trains (or will train) the designated staff of eligible
health centers.
``(4) Adoption organizations; eligible health centers;
other definitions.--For purposes of this section:
``(A) The term `adoption organization' means a
national, regional, or local organization--
``(i) among whose foci are adoption;
``(ii) that is knowledgeable on the process
for adopting a child and on providing adoption
information and referrals to pregnant women;
and
``(iii) that is a nonprofit private entity.
``(B) The term `designated staff', with respect to
an eligible health center, means staff of the center
who provide pregnancy or adoption information and
referrals (or will provide such information and
referrals after receiving training under a grant under
paragraph (1)).
``(C) The term `eligible health centers' means
public and nonprofit private entities that provide
health-related services to pregnant women.
``(5) Training for certain eligible health centers.--A
condition for the receipt of a grant under paragraph (1) is
that the adoption organization involved agree to make
reasonable efforts to ensure that the eligible health centers
with respect to which training under the grant is provided
include--
``(A) eligible health centers that receive grants
under section 1001 (relating to voluntary family
planning projects);
``(B) eligible health centers that receive grants
under section 330 (relating to community health
centers, migrant health centers, and centers regarding
homeless individuals and residents of public housing); and
``(C) eligible health centers that receive grants
under this Act for the provision of services in
schools.
``(6) Participation of certain eligible health clinics.--In
the case of eligible health centers that receive grants under
section 330 or 1001:
``(A) The Secretary shall require that, within a
reasonable period after the Secretary begins making
grants under paragraph (1), such centers make
reasonable efforts to encourage the designated staff of
the centers to undergo training through the program
under such paragraph.
``(B) All costs of such centers in obtaining the
training shall be reimbursed by the organization that
provides the training, using grants under paragraph
(1).
``(C) Beginning one year after the date on which
the Secretary first makes grants under paragraph (1),
the Secretary shall commence a study to evaluate the
extent of compliance of health centers with
subparagraph (A) and the extent to which nondirective
counseling and referrals includes adoption information
and referrals. After conducting the study for a
reasonable period of time, the Secretary shall submit
to the appropriate committees of the Congress a
reporting describing the findings of the study.
``(b) Requirements Regarding Federally-Funded Family Planning
Services.--The Secretary shall require that each program providing
voluntary family planning services with a grant from the Secretary
provide nondirective counseling and referrals on all the options,
including but not limited to adoption.
``(c) Application for Grant.--The Secretary may make a grant under
subsection (a) only if an application for the grant is submitted to the
Secretary and the application is in such form, is made in such manner,
and contains such agreements, assurances, and information as the
Secretary determines to be necessary to carry out this section.
``(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 2001 through 2005.''.
Subtitle B--Special Needs Adoption Awareness
SEC. 1211. SPECIAL NEEDS ADOPTION PROGRAMS; PUBLIC AWARENESS CAMPAIGN
AND OTHER ACTIVITIES.
Subpart I of part D of title III of the Public Health Service Act,
as amended by section 1202 of this Act, is amended by adding at the end
the following section:
``SEC. 330G. SPECIAL NEEDS ADOPTION PROGRAMS; PUBLIC AWARENESS CAMPAIGN
AND OTHER ACTIVITIES.
``(a) Special Needs Adoption Awareness Campaign.--
``(1) In general.--The Secretary shall, through making
grants to nonprofit private entities, provide for the planning,
development, and carrying out of a national campaign to provide
information to the public regarding the adoption of children
with special needs.
``(2) Input on planning and development.--In providing for
the planning and development of the national campaign under
paragraph (1), the Secretary shall provide for input from a
number and variety of adoption organizations throughout the
States in order that the full national diversity of interests
among adoption organizations is represented in the planning and
development of the campaign.
``(3) Certain features.--With respect to the national
campaign under paragraph (1):
``(A) The campaign shall be directed at various
populations, taking into account as appropriate
differences among geographic regions, and shall be
carried out in the language and cultural context that
is most appropriate to the population involved.
``(B) The means through which the campaign may be
carried out include--
``(i) placing public service announcements
on television, radio, and billboards; and
``(ii) providing information through means
that the Secretary determines will reach
individuals who are most likely to adopt
children with special needs.
``(C) The campaign shall provide information on the
subsidies and supports that are available to
individuals regarding the adoption of children with
special needs.
``(D) The Secretary may provide that the placement
of public service announcements, and the dissemination
of brochures and other materials, is subject to review
by the Secretary.
``(4) Matching requirement.--
``(A) In general.--With respect to the costs of the
activities to be carried out by an entity pursuant to
paragraph (1), a condition for the receipt of a grant
under such paragraph is that the entity agree 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 50 percent of
such costs ($1 for each $1 provided in the grant).
``(B) Determination of amount contributed.--Non-
Federal contributions under subparagraph (A) may be in
cash or in kind, fairly evaluated, including plant,
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
contributions.
``(b) National Resources Program.--The Secretary shall (directly or
through grant or contract) carry out a program that, through toll-free
telecommunications, makes available to the public information regarding
the adoption of children with special needs. Such information shall
include the following:
``(1) A list of national, State, and regional organizations
that provide services regarding such adoptions, including
exchanges and other information on communicating with the
organizations. The list shall represent the full national
diversity of adoption organizations.
``(2) Information beneficial to individuals who adopt such
children, including lists of support groups for adoptive
parents and other postadoptive services.
``(c) Other Programs.--With respect to the adoption of children
with special needs, the Secretary shall make grants--
``(1) to provide assistance to support groups for adoptive
parents, adopted children, and siblings of adopted children;
and
``(2) to carry out studies to identify the reasons for
adoption disruptions.
``(d) Application for Grant.--The Secretary may make an award of a
grant or contract under this section only if an application for the
award is submitted to the Secretary and the application is in such
form, is made in such manner, and contains such agreements, assurances,
and information as the Secretary determines to be necessary to carry
out this section.
``(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 2001 through 2005.''.
TITLE XIII--TRAUMATIC BRAIN INJURY
SEC. 1301. SHORT TITLE.
This title may be cited as the ``Traumatic Brain Injury Act
Amendments of 2000''.
SEC. 1302. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND PREVENTION.
(a) In General.--Section 393A of the Public Health Service Act (42
U.S.C. 280b-1b) is amended--
(1) in subsection (b)--
(A) in paragraph (1), by striking ``and'' at the
end;
(B) in paragraph (2), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(3) the implementation of a national education and
awareness campaign regarding such injury (in conjunction with
the program of the Secretary regarding health-status goals for
2010, commonly referred to as Healthy People 2010), including
the national dissemination of information on--
``(A) incidence and prevalence;
``(B) secondary conditions arising from traumatic
brain injury upon discharge from hospitals and trauma
centers.'';
(2) in subsection (d)--
(A) in the second sentence, by striking ``anoxia
due to near drowning.'' and inserting ``anoxia.''; and
(B) in the third sentence, by inserting before the
period the following: ``, after consultation with
States and other appropriate public or nonprofit
private entities''.
(b) National Registry.--Part J of title III of the Public Health
Service Act (42 U.S.C. 280b et seq.) is amended by inserting after
section 393A the following section:
``national program for traumatic brain injury registries
``Sec. 393B. (a) In General.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, may make
grants to States or their designees to operate the State's traumatic
brain injury registry, and to academic institutions to conduct applied
research that will support the development of such registries, to
collect data concerning--
``(1) demographic information about each traumatic brain
injury;
``(2) information about the circumstances surrounding the
injury event associated with each traumatic brain injury;
``(3) administrative information about the source of the
collected information, dates of hospitalization and treatment,
and the date of injury; and
``(4) information characterizing the clinical aspects of
the traumatic brain injury, including the severity of the
injury, the types of treatments received, and the types of
services utilized.''.
SEC. 1303. PROGRAMS OF NATIONAL INSTITUTES OF HEALTH.
(a) Interagency Program.--Section 1261(d)(4) of the Public Health
Service Act (42 U.S.C. 300d-61(d)(4)) is amended--
(1) in subparagraph (A), by striking ``degree of injury''
and inserting ``degree of brain injury'';
(2) in subparagraph (B), by striking ``acute injury'' and
inserting ``acute brain injury''; and
(3) in subparagraph (D), by striking ``injury treatment''
and inserting ``brain injury treatment''.
(b) Definition.--Section 1261(h)(4) of the Public Health Service
Act (42 U.S.C. 300d-61(h)(4)) is amended--
(1) in the second sentence, by striking ``anoxia due to
near drowning.'' and inserting ``anoxia.''; and
(2) in the third sentence, by inserting before the period
the following: ``, after consultation with States and other
appropriate public or nonprofit private entities''.
(c) Authorization of Appropriations.--Section 1261 of the Public
Health Service Act (42 U.S.C. 300d-61) is amended by adding at the end
the following:
``(i) 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 2004.''.
SEC. 1304. PROGRAMS OF HEALTH RESOURCES AND SERVICES ADMINISTRATION.
Section 1252 of the Public Health Service Act (42 U.S.C. 300d-51)
is amended--
(1) in subsection (b)(3)--
(A) in subparagraph (A)(iv), by striking
``representing traumatic brain injury survivors'' and
inserting ``representing individuals with traumatic brain injury''; and
(B) in subparagraph (B), by striking ``who are
survivors of'' and inserting ``with'';
(2) in subsection (c)--
(A) in paragraph (1), by striking ``, in cash,'';
and
(B) in paragraph (2), by amending the paragraph to
read as follows:
``(2) Determination of amount contributed.--Non-Federal
contributions under paragraph (1) may be in cash or in kind,
fairly evaluated, including plant, 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 contributions.'';
(3) by designating subsections (e) through (h) as
subsections (g) through (j), respectively; and
(4) by inserting after subsection (d) the following
subsections:
``(e) Continuation of Previously Awarded Demonstration Projects.--A
State that received a grant under this section prior to the date of
enactment of the Children's Health Act of 2000 may compete for new
project grants under this section after such date of enactment.
``(f) Use of State Grants.--
``(1) Community services and supports.--A State shall
(directly or through awards of contracts to nonprofit private
entities) use amounts received under a grant under this section
for the following:
``(A) To develop, change, or enhance community-
based service delivery systems that include timely
access to comprehensive appropriate services and
supports. Such service and supports--
``(i) shall promote full participation by
individuals with brain injury and their
families in decision making regarding the
services and supports; and
``(ii) shall be designed for children and
other individuals with traumatic brain injury.
``(B) To focus on outreach to underserved and
inappropriately served individuals, such as individuals
in institutional settings, individuals with low
socioeconomic resources, individuals in rural
communities, and individuals in culturally and
linguistically diverse communities.
``(C) To award contracts to nonprofit entities for
consumer or family service access training, consumer
support, peer mentoring, and parent to parent programs.
``(D) To provide individual and family service
coordination or case management systems.
``(E) To support other needs identified by the
advisory board under subsection (b) for the State
involved.
``(2) Best practices.--
``(A) In general.--State services and supports
provided under a grant under this section shall reflect
the best practices in the field of traumatic brain
injury, shall be in compliance with title II of the
Americans with Disabilities Act of 1990, and shall be
supported by quality assurance measures as well as
state-of-the-art health care and integrated community
supports, regardless of the severity of injury.
``(B) Demonstration by state agency.--The State
agency responsible for administering amounts received
under a grant under this section shall demonstrate or
express a willingness to obtain expertise and knowledge
of traumatic brain injury and the unique needs
associated with traumatic brain injury.
``(3) State capacity building.--A State may use amounts
received under a grant under this section to--
``(A) educate consumers and families;
``(B) train professionals in public and private
sector financing (such as third party payers, State
agencies, community-based providers, schools, and
educators);
``(C) develop or improve case management or service
coordination systems;
``(D) develop best practices in areas such as
family or consumer support, return to work, housing or
supportive living personal assistance services,
assistive technology and devices, behavioral health
services, substance abuse services, and traumatic brain
injury treatment and rehabilitation;
``(E) tailor existing State systems to provide
accommodations to the needs of individuals with brain
injury (including systems administered by the State
departments responsible for health, mental health,
labor, education, mental retardation/developmental
disorders, transportation, and correctional systems);
``(F) improve data sets coordinated across systems
and other needs identified by a State plan supported by
its advisory council; and
``(G) develop capacity within targeted
communities.'';
(5) in subsection (g) (as so redesignated), by striking
``agencies of the Public Health Service'' and inserting
``Federal agencies'';
(6) in subsection (i) (as redesignated by paragraph (3))--
(A) in the second sentence, by striking ``anoxia
due to near drowning.'' and inserting ``anoxia.''; and
(B) in the third sentence, by inserting before the
period the following: ``, after consultation with
States and other appropriate public or nonprofit
private entities''; and
(7) in subsection (j) (as so redesignated), by amending the
subsection to read as follows:
``(j) 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 2001 through 2005.''.
TITLE XIV--PREVENTION AND CONTROL OF INJURIES
SEC. 1401. AUTHORIZATION OF APPROPRIATIONS FOR PROGRAMS OF CENTERS FOR
DISEASE CONTROL AND PREVENTION.
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 2001 through 2005.''.
TITLE XV--HEALTHY START INITIATIVE
SEC. 1501. SHORT TITLE.
This title may be cited as the ``Healthy Start Initiative
Continuation Act''.
SEC. 1502. CONTINUATION OF HEALTHY START PROGRAM.
Subpart I of part D of title III of the Public Health Service Act,
as amended by section 1203 of this Act, is amended by adding at the end
the following section:
``SEC. 330H. HEALTHY START FOR INFANTS.
``(a) In General.--
``(1) Continuation and expansion of program.--The
Secretary, acting through the Administrator of the Health
Resources and Services Administration, Maternal and Child
Health Bureau, shall under authority of this section continue
in effect the Healthy Start Initiative and may, during fiscal
year 2001 and subsequent years, carry out such program on a
national basis.
``(2) Definition.--For purposes of paragraph (1), the term
`Healthy Start Initiative' is a reference to the program that,
as an initiative to reduce the rate of infant mortality and
improve perinatal outcomes, makes grants for project areas with
high annual rates of infant mortality and that, prior to the
effective date of this section, was a demonstration program
carried out under section 301.
``(3) Additional grants.-- Effective upon increased funding
beyond fiscal year 1999 for such Initiative, additional grants
may be made to States to assist communities with technical
assistance, replication of successful projects, and State
policy formation to reduce infant and maternal mortality and
morbidity.
``(b) Requirements for Making Grants.--In making grants under
subsection (a), the Secretary shall require that applicants (in
addition to meeting all eligibility criteria established by the
Secretary) establish, for project areas under such subsection,
community-based consortia of individuals and organizations (including
agencies responsible for administering block grant programs under title
V of the Social Security Act, consumers of project services, public
health departments, hospitals, health centers under section 330, and
other significant sources of health care services) that are appropriate
for participation in projects under subsection (a).
``(c) Coordination.--Recipients of grants under subsection (a)
shall coordinate their services and activities with the State agency or
agencies that administer block grant programs under title V of the
Social Security Act in order to promote cooperation, integrity, and
dissemination of information with Statewide systems and with other
community services funded under the Maternal and Child Health Block
Grant.
``(d) Rule of Construction.--Except to the extent inconsistent with
this section, this section may not be construed as affecting the
authority of the Secretary to make modifications in the program carried
out under subsection (a).
``(e) Medically Appropriate Ultrasound Services; Medically
Appropriate Services for At-Risk Mothers and Infants.--
``(1) In general.--The Secretary may make grants to health
care entities to provide--
``(A) for pregnant women, ultrasound services
provided by qualified health care professionals upon
medical indication and referral from health care
professionals who provide comprehensive prenatal
services; and
``(B) for pregnant women or infants, other health
services (including prenatal care, genetic counseling,
and fetal and other surgery) that--
``(i) are determined by a qualified
treating health care professional to be
medically appropriate in order to prevent or
mitigate congenital defects (including but not
limited to spina bifida and hydrocephaly) or
other serious obstetric complications
(including but not limited to placenta previa,
premature rupture of membranes, or
preeclampsia); and
``(ii) are provided during pregnancy or
during the first year after birth.
``(2) Eligible project area.--The Secretary may make a
grant under paragraph (1) only if the geographic area in which
services under the grant will be provided is a geographic area
in which a project under subsection (a) is being carried out,
and if the Secretary determines that the grant will add to or
expand the level of health services available in such area to
pregnant women and infants.
``(3) Transportation and subsistence expenses for certain
patients.--The purposes for which a grant under paragraph
(1)(B) may be expended include paying, on behalf of a pregnant
woman who is in need of the health services described in such
paragraph, transportation and subsistence expenses to assist
the pregnant woman in obtaining such health services from the
grantee involved. The Secretary may establish such restrictions
regarding payments under the preceding sentence as the
Secretary determines to be appropriate.
``(4) Certain conditions.--A condition for the receipt of a
grant under paragraph (1) is that the applicant for the grant
agree as follows:
``(A) In the case of a grant under paragraph
(1)(A), if ultrasound services indicate that there is a
fetal anomaly or other serious obstetric complication,
the applicant will refer the pregnant woman involved
for appropriate medical services, including, as
appropriate, for health services described in paragraph
(1)(B) provided by grantees under such paragraph.
``(B) If the applicant provides nondirective
pregnancy counseling to patients and is not subject to
the condition under section 330F(b), such counseling
provided by the applicant to patients will include (but
is not limited to) the provision of adoption
information and referrals.
``(5) Relationship to payments under other programs.--A
grant may be made under paragraph (1) only if the applicant
involved agrees that the grant will not be expended to pay the
expenses of providing any service under such paragraph to a
pregnant woman to the extent that payment has been made, or can
reasonably be expected to be made, with respect to such
expenses--
``(A) under any State compensation program, under
an insurance policy, or under any Federal or State
health benefits program; or
``(B) by an entity that provides health services on
a prepaid basis.
``(6) Evaluation by general accounting office.--
``(A) In general.--During fiscal year 2004, the
Comptroller General of the United States shall conduct
an evaluation of activities under grants under
paragraph (1) in order to determine whether the
activities have been effective in serving the needs of
pregnant women with respect to ultrasound services and
the other health services described in paragraph
(1)(B). The evaluation shall include an analysis of
whether such activities have been effective in reducing
the disparity in health status between the general
population and individuals who are members of racial or
ethnic minority groups. Not later than January 10,
2005, the Comptroller General shall submit to the
Committee on Commerce in the House of Representatives,
and to the Committee on Health, Education, Labor, and
Pensions in the Senate, a report describing the
findings of the evaluation.
``(B) Relation to grants regarding medically
appropriate services for at-risk mothers and infants.--
Before the date on which the evaluation under
subparagraph (A) is submitted in accordance with such
subparagraph--
``(i) the Secretary shall ensure that there
are not more than three grantees under
paragraph (1)(B); and
``(ii) an entity is not eligible to receive
grants under such paragraph unless the entity
has substantial experience in providing the
health services described in such paragraph.
``(e) Funding.--
``(1) General program.--
``(A) Authorization of appropriations.--For the
purpose of carrying out this section (other than
subsection (e)), there are authorized to be
appropriated such sums as may be necessary for each of
the fiscal years 2001 through 2005.
``(B) Allocations.--
``(i) Program administration.--Of the
amounts appropriated under subparagraph (A) for
a fiscal year, the Secretary may reserve up to
5 percent for coordination, dissemination,
technical assistance, and data activities that
are determined by the Secretary to be
appropriate for carrying out the program under
this section.
``(ii) Evaluation.--Of the amounts
appropriated under subparagraph (A) for a
fiscal year, the Secretary may reserve up to 1
percent for evaluations of projects carried out
under subsection (a). Each such evaluation
shall include a determination of whether such
projects have been effective in reducing the
disparity in health status between the general
population and individuals who are members of
racial or ethnic minority groups.
``(2) Medically appropriate ultrasound services; medically
appropriate services for at-risk mothers and infants.--
``(A) Authorization of appropriations.--For the
purpose of carrying out subsection (e), there are
authorized to be appropriated such sums as may be
necessary for each of the fiscal years 2001 through
2005.
``(B) Allocation.--Of the amounts appropriated
under subparagraph (A) for a fiscal year, the Secretary
shall make available not less than 10 percent for
providing ultrasound services under subsection
(d)(1)(A) (provided by qualified health care
professionals upon medical indication and referral from
health care professionals who provide comprehensive
prenatal services) through visits by mobile units to
communities that are eligible for services under
subsection (a).''.
TITLE XVI--ORAL HEALTH PROMOTION AND DISEASE PREVENTION
SEC. 1601. ORAL HEALTH PROMOTION AND DISEASE
PREVENTION.
Part B of title III of the Public Health Service Act, as amended by
section 912 of this Act, is amended by inserting after section 317M the
following section:
``oral health promotion and disease prevention
``Sec. 317N. (a) Grants to Increase Resources for Community Water
Fluoridation.--
``(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, may
make grants to States and Indian tribes for the purpose of
increasing the resources available for community water
fluoridation.
``(2) Use of funds.--A State shall use amounts provided
under a grant under paragraph (1)--
``(A) to purchase fluoridation equipment;
``(B) to train fluoridation engineers;
``(C) to develop educational materials on the
benefits of fluoridation; or
``(D) to support the infrastructure necessary to
monitor and maintain the quality of water fluoridation.
``(b) Community Water Fluoridation.--
``(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention and
in collaboration with the Director of the Indian Health
Service, shall establish a demonstration project that is
designed to assist rural water systems in successfully
implementing the water fluoridation guidelines of the Centers
for Disease Control and Prevention that are entitled
``Engineering and Administrative Recommendations for Water
Fluoridation, 1995'' (referred to in this subsection as the
`EARWF').
``(2) Requirements.--
``(A) Collaboration.--In collaborating under
paragraph (1), the Directors referred to in such
paragraph shall ensure that technical assistance and
training are provided to tribal programs located in
each of the 12 areas of the Indian Health Service. The
Director of the Indian Health Service shall provide
coordination and administrative support to tribes under
this section.
``(B) General use of funds.--Amounts made available
under paragraph (1) shall be used to assist small water
systems in improving the effectiveness of water
fluoridation and to meet the recommendations of the
EARWF.
``(C) Fluoridation specialists.--
``(i) In general.--In carrying out this
subsection, the Secretary shall provide for the
establishment of fluoridation specialist
engineering positions in each of the Dental
Clinical and Preventive Support Centers through
which technical assistance and training will be
provided to tribal water operators, tribal
utility operators and other Indian Health
Service personnel working directly with
fluoridation projects.
``(ii) Liaison.--A fluoridation specialist
shall serve as the principal technical liaison
between the Indian Health Service and the
Centers for Disease Control and Prevention with
respect to engineering and fluoridation issues.
``(iii) CDC.--The Director of the Centers
for Disease Control and Prevention shall
appoint individuals to serve as the
fluoridation specialists.
``(D) Implementation.--The project established
under this subsection shall be planned, implemented and
evaluated over the 5-year period beginning on the date
on which funds are appropriated under this section and
shall be designed to serve as a model for improving the
effectiveness of water fluoridation systems of small
rural communities.
``(3) Evaluation.--In conducting the ongoing evaluation as
provided for in paragraph (2)(D), the Secretary shall ensure
that such evaluation includes--
``(A) the measurement of changes in water
fluoridation compliance levels resulting from
assistance provided under this section;
``(B) the identification of the administrative,
technical and operational challenges that are unique to
the fluoridation of small water systems;
``(C) the development of a practical model that may
be easily utilized by other tribal, state, county or
local governments in improving the quality of water
fluoridation with emphasis on small water systems; and
``(D) the measurement of any increased percentage
of Native Americans or Alaskan Natives who receive the
benefits of optimally fluoridated water.
``(c) School-Based Dental Sealant Program.--
``(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention and
in collaboration with the Administrator of the Health Resources
and Services Administration, may award grants to States and
Indian tribes to provide for the development of school-based
dental sealant programs to improve the access of children to
sealants.
``(2) Use of funds.--A State shall use amounts received
under a grant under paragraph (1) to provide funds to eligible
school-based entities or to public elementary or secondary
schools to enable such entities or schools to provide children
in second and sixth grades with access to dental care and
dental sealant services. Such services shall be provided by
licensed dental health professionals in accordance with State
practice licensing laws.
``(3) Eligibility.--To be eligible to receive funds under
paragraph (1), an entity shall--
``(A) prepare and submit to the State an
application at such time, in such manner and containing
such information as the state may require; and
``(B) be a public elementary or secondary school--
``(i) that is located in an urban area in
which and more than 50 percent of the student
population is participating in federal or state
free or reduced meal programs; or
``(ii) that is located in a rural area and,
with respect to the school district in which
the school is located, the district involved
has a median income that is at or below 235
percent of the poverty line, as defined in
section 673(2) of the Community Services Block
Grant Act (42 U.S.C. 9902(2)).
``(d) Definitions.--For purposes of this section, the term `Indian
tribe' means an Indian tribe or tribal organization as defined in
section 4(b) and section 4(c) of the Indian Self-Determination and
Education Assistance Act.
``(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 2001 through 2005.''.
TITLE XVII--VACCINE COMPENSATION PROGRAM
SEC. 1701. SHORT TITLE.
This title may be cited as the ``Vaccine Injury Compensation
Program Amendments of 2000.''.
SEC. 1702. CONTENT OF PETITIONS.
(a) In General.--Section 2111(c)(1)(D) of the Public Health Service
Act (42 U.S.C. 300aa-11(c)(1)(D)) is amended by striking ``and'' at the
end and inserting ``or (iii) suffered such illness, disability, injury,
or condition from the vaccine which resulted in inpatient
hospitalization and surgical intervention, and''.
(b) Effective Date.--The amendment made by subsection (a) takes
effect upon the date of the enactment of this Act, including with
respect to petitions under section 2111 of the Public Health Service
Act that are pending on such date.
TITLE XVIII--HEPATITIS C
SEC. 1801. SHORT TITLE.
This title may be cited as the ``Hepatitis C and Children Act of
2000''.
SEC. 1802. SURVEILLANCE AND EDUCATION REGARDING HEPATITIS C.
Part B of title III of the Public Health Service Act, as amended by
section 1601 of this Act, is amended by inserting after section 317N
the following section:
``surveillance and education regarding hepatitis c virus
``Sec. 317O. (a) In General.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, may
(directly and through grants to public and nonprofit private entities)
provide for programs to carry out the following:
``(1) To cooperate with the States in implementing a
national system to determine the incidence and prevalence of
cases of infection with hepatitis C virus, including the
reporting of chronic hepatitis C cases.
``(2) To identify and contact individuals who became
infected with such virus as a result of receiving blood
transfusions prior to July 1992 when the individuals were
infants, small children, or adolescents.
``(3) To provide appropriate referrals for counseling,
testing, and medical treatment of individuals identified under
paragraph (2) and to ensure, to the extent practicable, the
provision of appropriate follow-up services.
``(4) To develop and disseminate public information and
education programs for the detection and control of hepatitis
C, with priority given to recipients of blood transfusions;
women who gave birth by caesarean section; children who were
high-risk neonates; veterans of the Armed Forces; and health
professionals.
``(5) To improve the education, training, and skills of
health professionals in the detection and control of cases of
infection with hepatitis C, with priority given to
pediatricians and other primary care physicians.
``(b) Laboratory Procedures.--The Secretary may (directly and
through grants to public and nonprofit private entities) carry out
programs to provide for improvements in the quality of clinical-
laboratory procedures regarding hepatitis C, including reducing
variability in laboratory results on hepatitis C antibody and PCR
testing.
``(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 2001 through 2005.''.
TITLE XIX--NIH INITIATIVE ON AUTOIMMUNE DISEASES
SEC. 1901. SHORT TITLE.
This title may be cited as the ``NIH Autoimmune Diseases Initiative
Act of 2000''.
SEC. 1902. JUVENILE DIABETES, JUVENILE ARTHRITIS, LUPUS, MULTIPLE
SCLEROSIS, AND OTHER AUTOIMMUNE-DISEASES; INITIATIVE
THROUGH DIRECTOR OF NATIONAL INSTITUTES OF HEALTH.
Part B of title IV of the Public Health Service Act, as amended by
section 1002 of this Act, is amended by adding at the end the
following:
``autoimmune diseases
``Sec. 409E. (a) Expansion, Intensification, and Coordination of
Activities.--
``(1) In general.--The Director of NIH shall expand,
intensify, and coordinate research and other activities of the
National Institutes of Health with respect to juvenile-onset
diabetes, rheumatoid arthritis, systemic lupus erthematosus,
multiple sclerosis, Sjogren's syndrome, scleroderma, chronic
fatigue syndrome, Crohn's disease and colitis (in this section
referred to as `autoimmune diseases').
``(2) Allocations by director of nih.--With respect to
amounts appropriated to carry out this section for a fiscal
year, the Director of NIH shall allocate the amounts among the
national research institutes that are carrying out paragraph
(1).
``(3) Additional diseases or disorders.--In addition to the
diseases or disorders specified in paragraph (1), the term
`autoimmune disease' includes for purposes of this section such
other diseases or disorders as the Secretary determines to be
appropriate.
``(b) Coordinating Committee.--
``(1) In general.--The Secretary shall establish a
committee to be known as Autoimmune Diseases Coordinating
Committee (referred to in this subsection as the `Coordinating
Committee').
``(2) Duties.--The Coordinating Committee shall, with
respect to autoimmune diseases--
``(A) provide for the coordination of the
activities of the national research institutes; and
``(B) coordinate the aspects of all Federal health
programs and activities relating to such diseases in
order to assure the adequacy and technical soundness of
such programs and activities and in order to provide
for the full communication and exchange of information
necessary to maintain adequate coordination of such
programs and activities.
``(3) Composition.--The Coordinating Committee shall be
composed of the directors of each of the national research
institutes involved in research with respect to autoimmune
diseases and representatives of all other Federal departments
and agencies whose programs involve health functions or
responsibilities relevant to such diseases, including the
Centers for Disease Control and Prevention and the Food and
Drug Administration.
``(4) Chair.--From among the members of the Coordinating
Committee, the Committee shall designate an individual to serve
as the chair of the Committee. With respect to autoimmune
diseases, the Chair shall serve as the principal advisor to the
Secretary, the Assistant Secretary for Health, and the Director
of NIH, and shall provide advice to the Director of the Centers
for Disease Control and Prevention, the Commissioner of Food
and Drugs, and other relevant agencies.
``(5) Full-time staff.--The Secretary shall ensure that the
Coordinating Committee is staffed and supported by not fewer
than three scientists or health professionals for whom such
service is a full-time Federal position. The Secretary shall in
addition ensure that the Committee is provided with such
administrative staff and support as may be necessary to carry
out the duties of the Committee.
``(c) Advisory Council.--
``(1) In general.--The Secretary shall establish an
advisory council to be known as the Autoimmune Diseases Public
Advisory Council (referred to in this subsection as the
`Advisory Council').
``(2) Duties.--The Advisory Council shall provide to the
Director of NIH and the Coordinating Committee under subsection
(b) recommendations on carrying out this section, including the
plan under subsection (d).
``(3) Composition.--The Advisory Council shall be composed
exclusively of not more than 18 members appointed to the
Council by the Secretary from among individuals who are not
officers or employees of the United States. The Secretary shall
ensure that the membership of the Advisory Council includes--
``(A) scientists or health professionals who are
knowledgeable with respect to autoimmune diseases;
``(B) representatives of autoimmune disease patient
advocacy organizations, including organizations
advocating on behalf of diseases affecting small
patient populations; and
``(C) patients and parents of children with such
diseases, including autoimmune diseases affecting small
patient populations.
``(d) Plan for NIH Activities.--
``(1) In general.--The Coordinating Committee shall develop
a plan for conducting and supporting research and education on
autoimmune diseases through the national research institutes,
shall review the plan not less frequently than once each fiscal
year, and shall revise the plan as appropriate. The plan
shall--
``(A) provide for a broad range of research and
education activities relating to biomedical,
psychosocial, and rehabilitative issues, including
studies of the disproportionate impact of such diseases
on women; and
``(B) establish priorities among the programs and
activities of the National Institutes of Health
regarding such diseases.
``(2) Certain elements of plan.--The plan under paragraph
(1) shall, with respect to autoimmune diseases, provide for the
following:
``(A) Research to determine the reasons underlying
the incidence and prevalence of the diseases.
``(B) Basic research concerning the etiology and
causes of the diseases.
``(C) Epidemiological studies to address the
frequency and natural history of the diseases,
including any differences among the sexes and among
racial and ethnic groups.
``(D) The development of improved screening
techniques.
``(E) Clinical research for the development and
evaluation of new treatments, including new biological
agents.
``(F) Information and education programs for health
care professionals and the public.
``(3) Recommendations of advisory council.--In developing
the plan under paragraph (1), and reviewing and revising the
plan, the Coordinating Committee shall consider the
recommendations of the Advisory Council regarding the plan.
``(4) Implementation of plan.--The Director of NIH shall
ensure that programs and activities of the National Institutes
of Health regarding autoimmune diseases are implemented in
accordance with the plan under paragraph (1).
``(e) Reports to Congress.--The Coordinating Committee under
subsection (b)(1) shall annually submit to the Committee on Commerce of
the House of Representatives, and the Committee on Health, Education,
Labor and Pensions of the Senate, a report that describes the research,
education, and other activities on autoimmune diseases being conducted
or supported through the national research institutes, and that in
addition includes the following:
``(1) The plan under subsection (d)(1) (or revisions to the
plan, as the case may be).
``(2) The recommendations of the advisory council under
subsection (c) regarding the plan (or revisions, as the case
may be).
``(3) Provisions specifying the amounts expended by the
National Institues of Health with respect to each of the
autoimmune diseases included in the plan.
``(4) Provisions identifying particular projects or types
of projects that should in the future be conducted or supported
by the national research institutes or other entities in the
field of research on autoimmune diseases.
``(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 2001 through 2005. The
authorization of appropriations established in the preceding sentence
is in addition to any other authorization of appropriations that is
available for conducting or supporting through the National Institutes
of Health research and other activities with respect to autoimmune
diseases.''.
TITLE XX--GRADUATE MEDICAL EDUCATION PROGRAMS IN CHILDREN'S HOSPITALS
SEC. 2001. EXTENSION OF AUTHORIZATION OF APPROPRIATIONS.
Section 340E(f) of the Public Health Service Act (42 U.S.C.
256e(f)) is amended--
(1) in paragraph (1)(A)--
(A) in clause (i), by striking ``and'' at the end;
(B) in clause (ii), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(iii) for each of the fiscal years 2002
through 2005, such sums as may be necessary.'';
and
(2) in paragraph (2)--
(A) in subparagraph (A), by striking ``and'' at the
end;
(B) in subparagraph (B), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(C) for each of the fiscal years 2002 through
2005, such sums as may be necessary.''.
TITLE XXI--SPECIAL NEEDS OF CHILDREN REGARDING ORGAN TRANSPLANTATION
SEC. 2101. SHORT TITLE.
This title may be cited as the ``Pediatric Organ Transplantation
Improvement Act of 2000''.
SEC. 2102. ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK; AMENDMENTS
REGARDING NEEDS OF CHILDREN.
(a) In General.--Section 372(b)(2) of the Public Health Service Act
(42 U.S.C. 274(b)(2)) is amended--
(1) in subparagraph (J), by striking ``and'' at the end;
(2) in each of subparagraphs (K) and (L), by striking the
period and inserting a comma; and
(3) by adding at the end the following subparagraphs:
``(M) recognize the differences in health and in
organ transplantation issues between children and
adults throughout the system and adopt criteria,
polices, and procedures that address the unique health
care needs of children,
``(N) carry out studies and demonstration projects
for the purpose of improving procedures for organ
donation procurement and allocation, including but not
limited to projects to examine and attempt to increase
transplantation among populations with special needs,
including children and individuals who are members of
racial or ethnic minority groups, and among populations
with limited access to transportation, and
``(O) provide that for purposes of this paragraph,
the term `children' refers to individuals who are under
the age of 18.''.
(b) Study Regarding Immunosuppressive Drugs.--
(1) In general.--The Secretary of Health and Human Services
(referred to in this subsection as the ``Secretary'') shall
provide for a study to determine the costs of immunosuppressive
drugs that are provided to children pursuant to organ
transplants and to determine the extent to which health plans
and health insurance cover such costs. The Secretary may carry
out the study directly or through a grant to the Institute of
Medicine (or other public or nonprofit private entity).
(2) Recommendations regarding certain issues.--The
Secretary shall ensure that, in addition to making
determinations under paragraph (1), the study under such
paragraph makes recommendations regarding the following issues:
(A) The costs of immunosuppressive drugs that are
provided to children pursuant to organ transplants and
to determine the extent to which health plans, health
insurance and government programs cover such costs.
(B) The extent of denial of organs to be released
for transplant by coroners and medical examiners.
(C) The special growth and developmental issues
that children have pre- and post- organ
transplantation.
(D) Other issues that are particular to the special
health and transplantation needs of children.
(3) Report.--The Secretary shall ensure that, not later
than December 31, 2000, the study under paragraph (1) is
completed and a report describing the findings of the study is
submitted to the Congress.
TITLE XXII--MISCELLANEOUS PROVISIONS
SEC. 2201. 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 2000, 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 2001 through 2005.
TITLE XXIII--EFFECTIVE DATE
SEC. 2301. EFFECTIVE DATE.
This Act and the amendments made by this Act take effect October 1,
2000, or upon the date of the enactment of this Act, whichever occurs
later.
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