[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4426 Introduced in House (IH)]







106th CONGRESS
  2d Session
                                H. R. 4426

To amend the Public Health Service Act with respect to testing pregnant 
women and newborn infants for infection with the human immunodeficiency 
                                 virus.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 11, 2000

  Mr. Ackerman (for himself and Mr. Coburn) introduced the following 
         bill; which was referred to the Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
To amend the Public Health Service Act with respect to testing pregnant 
women and newborn infants for infection with the human immunodeficiency 
                                 virus.

    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 ``Women and Children's HIV Protection 
Act of 2000''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) Perinatal transmission is the leading cause of 
        pediatric cases of acquired immune deficiency syndrome 
        (commonly known as AIDS).
            (2) The Centers for Disease Control and Prevention (CDC) 
        estimates that nearly 7,000 HIV-infected women give birth in 
        the United States each year and as many as 400 babies continue 
        to be born with HIV infection each year.
            (3) Medical advances have made it possible to nearly 
        eliminate perinatal HIV transmission.
            (4) Research studies have demonstrated that the 
        administration of antiviral medication during pregnancy, during 
        labor, and immediately following birth can significantly reduce 
        the transmission of the human immunodeficiency virus (commonly 
        known as HIV) from an infected mother to her baby. Cesarean 
        section further reduces the risk of transmission.
            (5) Even if treatment begins shortly after birth, 
        antiretroviral therapy can substantially reduce the chance that 
        an HIV-exposed child will become infected.
            (6) Breastfeeding by HIV-infected mothers poses additional 
        significant risk of infection to babies.
            (7) The Institute of Medicine (IOM) has recommended the 
        adoption of a national policy of universal HIV testing, with 
        patient notification, as a routine component of prenatal care. 
        However, 15 percent of HIV-infected pregnant women receive no 
        prenatal care according to the IOM.
            (8) The American Medical Association recommends mandatory 
        HIV testing of all pregnant women and newborns with counseling 
        and recommendations for appropriate treatment.
            (9) Testing newborns whose mothers' status is unknown 
        ensures that every child at risk for HIV is identified.
            (10) The provision of testing of pregnant women and 
        newborns with appropriate counseling and treatment can 
        significantly reduce the number of pediatric cases of acquired 
        immune deficiency syndrome, can improve access to and medical 
        care for the woman and children, and can provide opportunities 
        to further reduce transmission among adults.
            (11) The provision of such testing, counseling, and 
        treatment can reduce the overall cost of pediatric cases of 
        AIDS.
            (12) For the reasons specified in paragraphs (1) through 
        (7)--
                    (A) universal routine HIV testing of pregnant women 
                and newborns should be the standard of care; and
                    (B) the relevant medical organizations, as well as 
                public health officials, should issue guidelines making 
                such testing, counseling, and treatment the standard of 
                care.

SEC. 3. ADDITIONAL REQUIREMENT FOR CERTAIN GRANTS.

    Subpart I of part B of title XXVI of the Public Health Service Act 
(42 U.S.C. 300ff-21 et seq.) is amended by inserting after section 2616 
the following section:

``SEC. 2616A. ADDITIONAL REQUIREMENT FOR CERTAIN GRANTS.

    ``For fiscal year 2002 and subsequent fiscal years, the Secretary 
shall not make a grant to a State under this part unless the State 
demonstrates that the law or regulations of the State are in accordance 
with the following:
            ``(1) That all pregnant women receiving prenatal care in 
        the State be offered counseling and testing regarding HIV 
        disease.
            ``(2) In the case of prenatal testing for such disease that 
        is conducted in the State, that the results of such testing be 
        promptly disclosed to the pregnant woman involved.
            ``(3) In the case of newborn infants who are born in the 
        State and whose biological mothers have not undergone prenatal 
        testing for HIV disease, that each such infant undergo testing 
        for such disease.
            ``(4) That the results of such testing of a newborn infant 
        be promptly disclosed in accordance with the following, as 
        applicable to the infant involved:
                    ``(A) To the biological mother of the infant 
                (without regard to whether she is the legal guardian of 
                the infant).
                    ``(B) If the State is the legal guardian of the 
                infant:
                            ``(i) To the appropriate official of the 
                        State agency with responsibility for the care 
                        of the infant.
                            ``(ii) To the appropriate official of each 
                        authorized agency providing assistance in the 
                        placement of the infant.
                            ``(iii) If the authorized agency is giving 
                        significant consideration to approving an 
                        individual as a foster parent of the infant, to 
                        the prospective foster parent.
                            ``(iv) If the authorized agency is giving 
                        significant consideration to approving an 
                        individual as an adoptive parent of the infant, 
                        to the prospective adoptive parent.
                    ``(C) If neither the biological mother nor the 
                State is the legal guardian of the infant, to another 
                legal guardian of the infant.
                    ``(D) To the child's health care provider.
            ``(5) That, in disclosing the test results to an individual 
        under paragraph (2) or (4), appropriate counseling on HIV 
        disease and appropriate referrals for health care be offered to 
        the individual (except in the case of a disclosure to an 
        official of a State or an authorized agency, or to a health 
        care provider).''.
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