[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4365 Referred in Senate (RFS)]

  2d Session
                                H. R. 4365


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 10, 2000

     Received; read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 AN ACT


 
   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 appropriate 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 transferred 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 title 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' refers 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 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 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 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, 
                                as a group, 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 development.--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 knowledgeable 
                        on the process for adopting a child and 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 primary purposes 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) Within a reasonable period after the 
                Secretary begins making grants under paragraph (1), the 
                Secretary shall provide eligible health centers with 
                complete information about the training available from 
                organizations receiving grants under such paragraph. 
                The Secretary shall make reasonable efforts to 
                encourage eligible health centers to arrange for 
                designated staff to participate in such training.
                    ``(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) Not later than one year after the date of the 
                enactment the Children's Health Act of 2000, the 
                Secretary shall submit to the appropriate committees of 
                the Congress a report evaluating the extent to which 
                adoption information, and referral upon request, is 
                provided by eligible health centers. Within a 
                reasonable time after training under this section is 
                initiated, the Secretary shall submit to the 
                appropriate committees of the Congress a report 
                evaluating the extent to which adoption information, 
                and referral upon request, is provided by eligible 
                health centers in order to determine the effectiveness 
                of such training. In preparing the reports required by 
                this subparagraph, the Secretary shall in no respect 
                interpret the provisions of this section to allow any 
                interference in the provider-patient relationship, any 
                breach of patient confidentiality, or any monitoring or 
                auditing of the counseling process or patient records 
                which breaches patient confidentiality or reveals 
                patient identity.
    ``(b) 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.
    ``(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 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 25 percent of 
                such costs.
                    ``(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 the 
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 Institutes 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.

            Passed the House of Representatives May 9, 2000.

            Attest:

                                                 JEFF TRANDAHL,

                                                                 Clerk.