[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 2868 Introduced in Senate (IS)]
106th CONGRESS
2d Session
S. 2868
To amend the Public Health Service Act with respect to children's
health.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
July 13, 2000
Mr. Frist (for himself, Mr. Jeffords, Mr. Kennedy, Mr. Dodd, Mr.
DeWine, Mr. Reed, Mrs. Murray, Mr. Bond, Mr. Hatch, Mr. Gorton, Mr.
Abraham, and Mr. Durbin) introduced the following bill; which was read
twice and referred to the Committee on Health, Education, Labor, and
Pensions
_______________________________________________________________________
A BILL
To amend the Public Health Service Act with respect to children's
health.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Children's Public
Health Act of 2000''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--INJURY PREVENTION
Subtitle A--Traumatic Brain Injury
Sec. 100. Purposes.
Sec. 101. Programs of Centers for Disease Control and Prevention.
Sec. 102. Study and monitor incidence and prevalence.
Sec. 103. Programs of the National Institutes of Health.
Sec. 104. Programs of Health Resources and Services Administration.
Subtitle B--Child Care Safety and Health Grants
Sec. 111. Definitions.
Sec. 112. Authorization of appropriations.
Sec. 113. Programs.
Sec. 114. Amounts reserved; allotments.
Sec. 115. State applications.
Sec. 116. Use of funds.
Sec. 117. Reports.
TITLE II--MATERNAL AND INFANT HEALTH
Subtitle A--Safe Motherhood and Infant Health Promotion
Sec. 201. Short title.
Sec. 202. Establishment of programs regarding prenatal and postnatal
health.
Subtitle B--Healthy Start Initiative
Sec. 211. Short title.
Sec. 212. Continuation of Healthy Start Program.
Subtitle C--National Center for Birth Defects and Developmental
Disabilities
Sec. 221. National Center for Birth Defects and Developmental
Disabilities.
Subtitle D--Folic Acid Education Program
Sec. 231. Program regarding effects of folic acid in prevention of
birth defects.
TITLE III--PEDIATRIC PUBLIC HEALTH PROMOTION
Subtitle A--Asthma
Sec. 301. Children's asthma relief.
Sec. 302. Preventive health and health services block grant; systems
for reducing asthma and asthma-related
illnesses.
Sec. 303. Coordination of Federal activities to address asthma-related
health care needs.
Sec. 304. Compilation of data by the Centers for Disease Control and
Prevention.
Subtitle B--Childhood Obesity Prevention
Sec. 311. Programs operated through the Centers for Disease Control and
Prevention.
Subtitle C--Early Detection and Treatment Regarding Childhood Lead
Poisoning
Sec. 321. Centers for Disease Control and Prevention efforts to combat
childhood lead poisoning.
Sec. 322. Grants for lead poisoning related activities.
Sec. 323. Training and reports by the Health Resources and Services
Administration.
Subtitle D--Oral Health
Sec. 331. Identification of interventions that reduce the burden and
transmission of oral, dental, and
craniofacial diseases in high risk
populations; development of approaches for
pediatric oral and craniofacial assessment.
Sec. 332. Oral health professional research and training program.
Sec. 333. Grants to increase resources for community water
fluoridation.
Sec. 334. Community water fluoridation.
Sec. 335. Dental sealant program.
Sec. 336. Coordinated program to improve pediatric oral health.
TITLE IV--PEDIATRIC RESEARCH
Subtitle A--Pediatric Research Initiative
Sec. 401. Establishment of a pediatric research initiative.
Sec. 402. Investment in tomorrow's pediatric researchers.
Subtitle B--Autism
Sec. 411. Expansion, intensification, and coordination of activities of
National Institutes of Health with respect
to research on autism.
Sec. 412. Developmental disabilities surveillance and research
programs.
Sec. 413. Information and education.
Sec. 414. Inter-agency Autism Coordinating Committee.
Sec. 415. Report to Congress.
Subtitle C--Long-Term Child Development
Sec. 421. Long-term child development study.
Subtitle D--Research on Rare Diseases in Children
Sec. 431. Report regarding research on rare diseases in children.
Subtitle E--GME Programs in Children's Hospitals
Sec. 441. Extension of authorization of appropriations.
TITLE I--INJURY PREVENTION
Subtitle A--Traumatic Brain Injury
SEC. 100. PURPOSES.
It is the purpose of this subtitle to--
(1) require the Secretary of Health and Human Services,
working in cooperation with other Federal agencies, to study
and monitor the incidence and prevalence of traumatic brain
injury and conduct national education activities to increase
awareness of the causes and consequences of traumatic brain
injury;
(2) require the Secretary of Health and Human Services to
identify best practices in diagnosis, emergent care, special
education, and rehabilitation with the ultimate goal of
independent functioning within the community;
(3) require the Secretary of Health and Human Services to
request that States build capacity and enhance community based
service delivery systems to provide adequate, appropriate, and
accessible services to individuals with traumatic brain injury
and their families; and
(4) require the Director of the National Institutes of
Health to conduct and support basic and applied research
regarding traumatic brain injury, including diagnosis,
treatment, and rehabilitation.
SEC. 101. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND PREVENTION.
Section 393A(b) of the Public Health Service Act (42 U.S.C. 280b-
1b(b)) is amended--
(1) in paragraph (1), by striking ``and'' at the end;
(2) in paragraph (2), by striking the period and inserting
``; and''; and
(3) by adding at the end the following:
``(3) the implementation of a national education and
awareness campaign after consultation with the Administrator of
the Health Resources and Services Administration and the
Director of the National Institutes of Health, including--
``(A) national dissemination and distribution of
incidence and prevalence findings;
``(B) national dissemination of information
relating to traumatic brain injury and the sequelae of
secondary conditions arising from traumatic brain
injury upon discharge from hospitals and trauma
centers; and
``(C) the provision of information in primary care
settings, including emergency rooms and trauma centers,
concerning the availability of State level services and
resources.''.
SEC. 102. STUDY AND MONITOR INCIDENCE AND PREVALENCE.
Section 4 of Public Law 104-166 (42 U.S.C. 300d-61 note) is
amended--
(1) in subsection (a)(1)(A)--
(A) by striking clause (i) and inserting the
following:
``(i)(I) determine the incidence and
prevalence of traumatic brain injury in all age
groups in the general population of the United
States, including institutional settings; and
``(II) determined appropriate
methodological strategies to obtain data on the
incidence and prevalence of mild traumatic
brain injury and report to Congress concerning
such within 18 months of the date of enactment
of the Children's Public Health Act of 2000;
and''; and
(B) in clause (ii), by striking ``, if the
Secretary determines that such a system is
appropriate'';
(2) in subsection (a)(1)(B)(i), by inserting ``, including
return to work or school and community participation,'' after
``functioning''; and
(3) in subsection (d), to read as follows:
``(d) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of the fiscal years 2001 through 2005.''.
SEC. 103. PROGRAMS OF THE 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) Research on Cognitive and Neurobehavioral Disorders Arising
From Traumatic Brain Injury.--Section 1261(d)(4) of the Public Health
Service Act (42 U.S.C. 300d-61(d)(4)) is amended--
(1) in subparagraph (C), by striking ``and'' after the
semicolon at the end;
(2) in subparagraph (D), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(E) carrying out subparagraphs (A) through (D)
with respect to cognitive disorders and neurobehavioral
consequences arising from traumatic brain injury,
including the development, modification, and evaluation
of therapies and programs of rehabilitation toward
reaching or restoring normal capabilities in areas such
as reading, comprehension, speech, reasoning, and
deduction.''.
(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.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of the fiscal years 2001 through 2005.''.
SEC. 104. PROGRAMS OF HEALTH RESOURCES AND SERVICES ADMINISTRATION.
Section 1252 of the Public Health Service Act (42 U.S.C. 300d-52)
is amended--
(1) in the section heading by striking ``demonstration'';
(2) in subsection (a), by striking ``demonstration'';
(3) 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'';
(4) in subsection (c)--
(A) by striking paragraph (2) and inserting the
following:
``(2) Determination of amount contributed.--With respect to
years beginning after the first fiscal year in which assistance
is provided under this section, 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 contribution.''; and
(B) by adding at the end the following:
``(3) Effective date.--The requirements of this subsection
shall apply with respect to a State for grant years beginning
after the first year in which the State receives a grant under
this section.'';
(5) by redesignating subsections (e) through (h) as
subsections (g) through (j), respectively;
(6) by inserting after subsection (d), the following:
``(e) Continuation of Previously Awarded Demonstration Projects.--A
State that received a grant under this section prior to the date of
enactment of the Traumatic Brain Injury Act Amendments of 2000 may
compete for new project grants under this section after such date of
enactment.
``(f) Use of State Grants.--
``(1) Community services.--A State shall use amounts
received under a grant under this section to, directly or
through grants or contracts with nonprofit entities--
``(A) develop, change, or enhance community based
service delivery systems that include timely access to
an array of comprehensive services and supports that
promote full community participation by individuals
with brain injury and their families;
``(B) address the needs of brain-injured
individuals of all ages;
``(C) provide outreach and services to underserved
and inappropriately served brain-injured individuals,
such as individuals in institutional settings,
individuals with low socioeconomic resources,
individuals in rural communities, and individuals in
culturally and linguistically diverse communities;
``(D) provide grants to nonprofit entities for
consumer or family service access training, peer
mentoring, and parent to parent or caretaker to
caretaker programs;
``(E) provide individual and family service
coordination or case management systems for families of
traumatic brain-injured individuals; and
``(F) support other needs identified by a State
plan that is supported by its advisory council.
``(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, and shall be supported by quality assurance
measures as well as the appropriate standard of health
care and integrated community supports.
``(B) Demonstration by state agency.--The State
agency responsible for administering amounts received
under a grant under this section shall demonstrate
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 leverage State
resources to--
``(A) educate individuals with traumatic brain
injury and their 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 support, return to work, housing or supportive
living, personal assistance services, assistive
technology, behavioral health services, substance abuse
services, and traumatic brain injury treatment and
rehabilitation;
``(E) tailor existing State systems to provide
accommodation to the needs of individuals with brain
injury (including systems administered by the State
departments responsible for health, mental health,
labor, education, mental retardation or developmental
disabilities, transportation, housing, and correctional
systems); and
``(F) improve data sets coordinated across systems
and other needs identified by a State plan supported by
its advisory council.'';
(7) in subsection (j) (as so redesignated), to read as
follows:
``(j) Authorization of Appropriations.--For the purpose of carrying
out this section, there is authorized to be appropriated such sums as
may be necessary for each of fiscal years 2001 through 2005.''; and
(8) by adding at the end the following:
``(k) State.--In this section, the term `State' includes
territories of the United States.''.
Subtitle B--Child Care Safety and Health Grants
SEC. 111. DEFINITIONS.
In this subtitle:
(1) Child with a disability; infant or toddler with a
disability.--The terms ``child with a disability'' and ``infant
or toddler with a disability'' have the meanings given the
terms in sections 602 and 632 of the Individuals with
Disabilities Education Act (20 U.S.C. 1401 and 1431).
(2) Eligible child care provider.--The term ``eligible
child care provider'' means a provider of child care services
for compensation, including a provider of care for a school-age
child during non-school hours, that--
(A) is licensed, regulated, registered, or
otherwise legally operating, under State and local law;
and
(B) satisfies the State and local requirements,
applicable to the child care services the provider provides.
(3) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(4) State.--The term ``State'' means any of the several
States of the United States, the District of Columbia, the
Commonwealth of Puerto Rico, the United States Virgin Islands,
Guam, American Samoa, and the Commonwealth of the Northern
Mariana Islands.
SEC. 112. AUTHORIZATION OF APPROPRIATIONS.
There are authorized to be appropriated to carry out this subtitle
$200,000,000 for fiscal year 2001 and such sums as may be necessary for
each subsequent fiscal year.
SEC. 113. PROGRAMS.
The Secretary shall make allotments to eligible States under
section 114. The Secretary shall make the allotments to enable the
States to establish programs to improve the health and safety of
children receiving child care outside the home, by preventing illnesses
and injuries associated with that care and promoting the health and
well-being of children receiving that care.
SEC. 114. AMOUNTS RESERVED; ALLOTMENTS.
(a) Amounts Reserved.--The Secretary shall reserve not more than
\1/2\ of 1 percent of the amount appropriated under section 112 for
each fiscal year to make allotments to Guam, American Samoa, the United
States Virgin Islands, and the Commonwealth of the Northern Mariana
Islands to be allotted in accordance with their respective needs.
(b) State Allotments.--
(1) General rule.--From the amounts appropriated under
section 112 for each fiscal year and remaining after
reservations are made under subsection (a), the Secretary shall
allot to each State an amount equal to the sum of--
(A) an amount that bears the same ratio to 50
percent of such remainder as the product of the young
child factor of the State and the allotment percentage
of the State bears to the sum of the corresponding
products for all States; and
(B) an amount that bears the same ratio to 50
percent of such remainder as the product of the school
lunch factor of the State and the allotment percentage
of the State bears to the sum of the corresponding
products for all States.
(2) Young child factor.--In this subsection, the term
``young child factor'' means the ratio of the number of
children under 5 years of age in a State to the number of such
children in all States, as provided by the most recent annual
estimates of population in the States by the Census Bureau of
the Department of Commerce.
(3) School lunch factor.--In this subsection, the term
``school lunch factor'' means the ratio of the number of
children who are receiving free or reduced price lunches under
the school lunch program established under the National School
Lunch Act (42 U.S.C. 1751 et seq.) in the State to the number
of such children in all States, as determined annually by the
Department of Agriculture.
(4) Allotment percentage.--
(A) In general.--For purposes of this subsection,
the allotment percentage for a State shall be
determined by dividing the per capita income of all
individuals in the United States, by the per capita
income of all individuals in the State.
(B) Limitations.--If an allotment percentage
determined under subparagraph (A) for a State--
(i) is more than 1.2 percent, the allotment
percentage of the State shall be considered to
be 1.2 percent; and
(ii) is less than 0.8 percent, the
allotment percentage of the State shall be
considered to be 0.8 percent.
(C) Per capita income.--For purposes of
subparagraph (A), per capita income shall be--
(i) determined at 2-year intervals;
(ii) applied for the 2-year period
beginning on October 1 of the first fiscal year
beginning after the date such determination is
made; and
(iii) equal to the average of the annual
per capita incomes for the most recent period
of 3 consecutive years for which satisfactory
data are available from the Department of
Commerce on the date such determination is
made.
(c) Data and Information.--The Secretary shall obtain from each
appropriate Federal agency, the most recent data and information
necessary to determine the allotments provided for in subsection (b).
(d) Definition.--In this section, the term ``State'' includes only
the several States of the United States, the District of Columbia, and
the Commonwealth of Puerto Rico.
SEC. 115. STATE APPLICATIONS.
To be eligible to receive an allotment under section 114, a State
shall submit an application to the Secretary at such time, in such
manner, and containing such information as the Secretary may require.
The application shall contain information assessing the needs of the
State with regard to child care health and safety, the goals to be
achieved through the program carried out by the State under this
subtitle, and the measures to be used to assess the progress made by
the State toward achieving the goals.
SEC. 116. USE OF FUNDS.
(a) In General.--A State that receives an allotment under section
114 shall use the funds made available through the allotment to carry
out 2 or more activities consisting of--
(1) providing training and education to eligible child care
providers on preventing injuries and illnesses in children, and
promoting health-related practices;
(2) strengthening licensing, regulation, or registration
standards for eligible child care providers;
(3) assisting eligible child care providers in meeting
licensing, regulation, or registration standards, including
rehabilitating the facilities of the providers, in order to
bring the facilities into compliance with the standards;
(4) enforcing licensing, regulation, or registration
standards for eligible child care providers, including holding
increased unannounced inspections of the facilities of those
providers;
(5) providing health consultants to provide advice to
eligible child care providers;
(6) assisting eligible child care providers in enhancing
the ability of the providers to serve children with
disabilities and infants and toddlers with disabilities;
(7) conducting criminal background checks for eligible
child care providers and other individuals who have contact
with children in the facilities of the providers;
(8) providing information to parents on what factors to
consider in choosing a safe and healthy child care setting; or
(9) assisting in improving the safety of transportation
practices for children enrolled in child care programs with
eligible child care providers.
(b) Supplement, Not Supplant.--Funds appropriated pursuant to the
authority of this subtitle shall be used to supplement and not supplant
other Federal, State, and local public funds expended to provide
services for eligible individuals.
SEC. 117. REPORTS.
Each State that receives an allotment under section 114 shall
annually prepare and submit to the Secretary a report that describes--
(1) the activities carried out with funds made available
through the allotment; and
(2) the progress made by the State toward achieving the
goals described in the application submitted by the State under
section 115.
TITLE II--MATERNAL AND INFANT HEALTH
Subtitle A--Safe Motherhood and Infant Health Promotion
SEC. 201. SHORT TITLE.
This subtitle may be cited as the ``Pregnant Women and Infants
Health Protection Act''.
SEC. 202. ESTABLISHMENT OF PROGRAMS REGARDING PRENATAL AND POSTNATAL
HEALTH.
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 P--MATERNAL AND INFANT HEALTH
``SEC. 399L. PROGRAMS REGARDING PRENATAL AND POSTNATAL HEALTH.
``(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, territories and Indian Tribes, 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.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of the fiscal years 2001 through 2005.
``SEC. 399M. SAFE MOTHERHOOD SURVEILLANCE.
``(a) Purpose.--It is the purpose of this section to develop
surveillance systems at the local, State, and national level to better
understand the burden of maternal complications and mortality and to
decrease the disparities among population at risk of death and
complications from pregnancy.
``(b) Activities.--For the purpose described in subsection (a), the
Secretary, acting through the Centers for Disease Control and
Prevention, may carry out the following activities:
``(1) Establish and implement a national surveillance
program to identify and promote the investigation of deaths and
severe complications that occur during pregnancy.
``(2) Expand the Pregnancy Risk Assessment Monitoring
System to provide surveillance and collect data in each of the
50 States.
``(3) Expand the Maternal and Child Health Epidemiology
Program to provide technical support, financial assistance, or
the time-limited assignment of senior epidemiologists to
maternal and child health programs in each of the 50 States.
``(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2001 through 2005.
``SEC. 399N. PREVENTION RESEARCH TO ENSURE SAFE MOTHERHOOD.
``(a) Purpose.--It is the purpose of this section to provide the
Secretary with the authority to further expand research concerning risk
factors, prevention strategies, and the roles of the family, health
care providers and the community in safe motherhood.
``(b) Research.--The Secretary, acting through the Centers for
Disease Control and Prevention, may carry out activities to expand
research relating to--
``(1) encouraging preconception counseling, especially for
at risk populations such as diabetics;
``(2) the identification of critical components of
prenatal, delivery and postpartum care;
``(3) the identification of outreach and support services
that are available for pregnant women;
``(4) the identification of women who are at high risk for
complications;
``(5) preventing preterm delivery;
``(6) preventing urinary tract infections;
``(7) preventing unnecessary caesarean sections;
``(8) an examination of the higher rates of maternal
mortality among African American women;
``(9) an examination of the relationship between domestic
violence and maternal complications and mortality;
``(10) preventing smoking, alcohol and illegal drug usage
before, during and after pregnancy;
``(11) preventing infections that cause maternal and infant
complications; and
``(12) other areas determined appropriate by the Secretary.
``(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2001 through 2005.
``SEC. 399O. PREVENTION PROGRAMS TO ENSURE SAFE MOTHERHOOD.
``(a) In General.--The Secretary may carry out activities to
promote safe motherhood, including--
``(1) public education campaigns on healthy pregnancies and
the building of partnerships with organizations concerned about
safe motherhood;
``(2) education programs for physicians, nurses and other
health care providers; and
``(3) activities to promote community support services for
pregnant women.
``(b) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2001 through 2005.''.
Subtitle B--Healthy Start Initiative
SEC. 211. SHORT TITLE.
This title may be cited as the ``Healthy Start Initiative
Continuation Act''.
SEC. 212. CONTINUATION OF HEALTHY START PROGRAM.
Subpart I of part D of title III of the Public Health Service Act
(42 U.S.C. 254b et seq.) is amended by adding at the end the following
section:
``SEC. 330E. 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 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 Services for At-Risk Pregnant Women and
Infants.--
``(1) In general.--The Secretary may make grants to health
care entities to provide for pregnant women or infants, other
health services (including ultrasound, prenatal care, genetic
counseling, and fetal and other surgery) that--
``(A) are determined by a qualified treating health
care professional to be medically appropriate in order
to prevent or mitigate congenital defects (including
spina bifida and hydrocephaly) or other serious
obstetric complications; and
``(B) 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) 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.
``(5) 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 health services
described in paragraph (1). 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.
``(f) 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 services for at-risk mothers
and infants.--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.''.
Subtitle C--National Center for Birth Defects and Developmental
Disabilities
SEC. 221. NATIONAL CENTER FOR BIRTH DEFECTS AND DEVELOPMENTAL
DISABILITIES.
Part P of title III of the Public Health Service Act (as added by
section 201) is amended by adding at the end the following:
``SEC. 399P. NATIONAL CENTER FOR BIRTH DEFECTS AND DEVELOPMENTAL
DISABILITIES.
``(a) Establishment.--There is established within the Centers for
Disease Control and Prevention a center to be known as the National
Center for Birth Defects and Developmental Disabilities.
``(b) Purpose.--The general purpose of the National Center
established under subsection (a) shall be to--
``(1) collect, analyze, and make available data on birth
defects and developmental disabilities, including data on the
causes of such defects and disabilities and on the incidence
and prevalence of such defects and disabilities;
``(2) conduct applied epidemiological research on the
prevention of such defects and disabilities; and
``(3) provide information and education to the public on
the prevention of such defects and disabilities.
``(c) Director.--The National Center established under subsection
(a) shall be headed by a director to be appointed by the Director of
the Centers for Disease Control and Prevention.
``(d) Transfers.--There shall be transferred to the National Center
established under subsection (a) all activities, budgets and personnel
of the National Center for Environmental Health that relate to birth
defects, folic acid, cerebral palsy, mental retardation, child
development, newborn screening, autism, Fragile X syndrome, fetal
alcohol syndrome, pediatric genetics, disability prevention, and other
relevant activities.
``(e) Authorization of Appropriations.--There is authorized to be
appropriated such sums as may be necessary to carry out this section
for each of fiscal years 2001 through 2005.''.
Subtitle D--Folic Acid Education Program
SEC. 231. PROGRAM REGARDING EFFECTS OF FOLIC ACID IN PREVENTION OF
BIRTH DEFECTS.
Part P of title III of the Public Health Service Act (as added by
section 201 and amended by section 221) is further amended by adding at
the end the following:
``SEC. 399Q. EFFECTS OF FOLIC ACID IN PREVENTION OF BIRTH DEFECTS.
``(a) In General.--The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, shall carry out a
program (within the National Center for Birth Defects and Developmental
Disabilities) 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 $20,000,000
for fiscal year 2001, and such sums as may be necessary for each of the
fiscal years 2002 through 2005.''.
TITLE III--PEDIATRIC PUBLIC HEALTH PROMOTION
Subtitle A--Asthma
SEC. 301. CHILDREN'S ASTHMA RELIEF.
Title III of the Public Health Service Act (42 U.S.C. 243 et seq.)
is amended by inserting after section 317G the following:
``SEC. 317H. ASTHMA TREATMENT GRANTS PROGRAM.
``(a) Purposes.--The purposes of this section are as follows:
``(1) To provide access to quality medical care for
children who live in areas that have a high prevalence of
asthma and who lack access to medical care.
``(2) To provide on-site education to parents, children,
health care providers, and medical teams to recognize the signs
and symptoms of asthma, and to train them in the use of
medications to prevent and treat asthma.
``(3) To decrease preventable trips to the emergency room
by making medication available to individuals who have not
previously had access to treatment or education in the
prevention of asthma.
``(4) To provide other services, such as smoking cessation
programs, home modification, and other direct and support
services that ameliorate conditions that exacerbate or induce
asthma.
``(b) Authority To Make Grants.--
``(1) In general.--In addition to any other payments made
under this title, the Secretary shall award grants to eligible
entities to carry out the purposes of this section, including
grants that are designed to develop and expand projects to--
``(A) provide comprehensive asthma services to
children, including access to care and treatment for
asthma in a community-based setting;
``(B) fully equip mobile health care clinics that
provide preventive asthma care including diagnosis,
physical examinations, pharmacological therapy, skin
testing, peak flow meter testing, and other asthma-
related health care services;
``(C) conduct study-validated asthma management
education programs for patients with asthma and their
families, including patient education regarding asthma
management, family education on asthma management, and
the distribution of materials, including displays and
videos, to reinforce concepts presented by medical
teams; and
``(D) identify, and refer for enrollment, eligible
children for the medicaid program under title XIX of
the Social Security Act (42 U.S.C. 1396 et seq.), the
State Children's Health Insurance Program under title
XXI of that Act (42 U.S.C. 1397aa et seq.), or other
children's health programs.
``(2) Award of grants.--
``(A) Application.--
``(i) In general.--An eligible entity shall
submit an application to the Secretary for a
grant under this section in such form and
manner as the Secretary may require.
``(ii) Required information.--An
application submitted under this subparagraph
shall include a plan for the use of funds
awarded under the grant and such other
information as the Secretary may require.
``(B) Requirement.--In awarding grants under this
section, the Secretary shall give preference to
eligible entities that demonstrate that the activities
to be carried out under this section shall be in
localities within areas of known high prevalence of
childhood asthma or high asthma-related mortality
(relative to the average asthma incidence rates and
associated mortality rates in the United States).
Acceptable data sets used 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 from title XIX or
XXI of the Social Security Act (42 U.S.C. 1396 et seq.,
1397aa), 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.--In this section, the
term `eligible entity' means a State agency or other entity
receiving funds under this title, a local community, a local
educational agency, a nonprofit children's hospital or
foundation, or a nonprofit community-based organization.
``(c) Coordination With Other Children's Programs.--An eligible
entity shall identify in the plan submitted as part of an application
for a grant under this section how the entity will coordinate
operations and activities under the grant with--
``(1) other programs operated in the State that serve
children with asthma, including any such programs operated
under title V of the Social Security Act (42 U.S.C. 701 et
seq.), title XIX of that Act (42 U.S.C. 1396 et seq.), and
title XXI of that Act (42 U.S.C. 1397aa et seq.); 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 the Social Security Act (42 U.S.C 620 et
seq., 670 et seq.);
``(B) the head start program established under the
Head Start Act (42 U.S.C. 9831 et seq.);
``(C) the program of assistance under the special
supplemental nutrition program for women, infants and
children (WIC) under section 17 of the Child Nutrition
Act of 1966 (42 U.S.C. 1786);
``(D) local public and private elementary or
secondary schools; or
``(E) public housing agencies, as defined in
section 3 of the United States Housing Act of 1937 (42
U.S.C. 1437a).
``(d) Evaluation.--An eligible entity that receives a grant under
this section shall submit to the Secretary an evaluation of the
operations and activities carried out under the grant that includes--
``(1) a description of the asthma-related 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 as described in
section 304 of the Children's Public Health Act of 2000; and
``(4) such other information as the Secretary may require.
``(e) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, $50,000,000 for each of the
fiscal years 2001 through 2005.''.
SEC. 302. PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT; SYSTEMS
FOR REDUCING ASTHMA AND ASTHMA-RELATED ILLNESSES.
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) Projects to reduce the prevalence of asthma and
asthma-related illnesses among urban populations, especially
children, by reducing the level of exposure to cockroach
allergen, or other known asthma triggers through the use of
integrated pest management, as applied to cockroaches or other
allergens. Such projects shall test the cost-effectiveness of
methods of integrated pest management. Amounts expended for
such systems may include the costs of structural rehabilitation
of housing, public schools, and other public facilities to
reduce cockroach infestation, the costs of building
maintenance, and the costs of programs to promote community
participation in the carrying out at such sites integrated pest
management, as applied to cockroaches or other known asthma
triggers. For purposes of this subparagraph, the term
`integrated pest management' means an approach to the
management of pests in public facilities that minimizes or
avoids the use of pesticide chemicals through a combination
of appropriate practices regarding the maintenance, cleaning, and
monitoring of such sites.'';
(4) in subparagraph (F) (as so redesignated), by striking
``subparagraphs (A) through (D)'' and inserting ``subparagraphs
(A) through (E)''; and
(5) in subparagraph (G) (as so redesignated), by striking
``subparagraphs (A) through (E)'' and inserting ``subparagraphs
(A) through (F)''.
SEC. 303. COORDINATION OF FEDERAL ACTIVITIES TO ADDRESS ASTHMA-RELATED
HEALTH CARE NEEDS.
The Secretary of Health and Human Services shall--
(1) identify all Federal programs that carry out asthma
research and asthma-related activities;
(2) develop, in consultation with appropriate Federal
agencies, including the Environmental Protection Agency and the
Department of Housing and Urban Development, and professional
and voluntary health organizations, a Federal plan for
responding to asthma; and
(3) not later than 12 months after the date of enactment of
this Act, submit recommendations to the Committee on Health,
Education, Labor, and Pensions of the Senate and the Committee
on Commerce of the House of Representatives, and other relevant
committees of Congress, on ways to strengthen and improve the
coordination of asthma-related activities of the Federal
Government.
SEC. 304. COMPILATION OF DATA BY THE CENTERS FOR DISEASE CONTROL AND
PREVENTION.
(a) In General.--The Director of the Centers for Disease Control
and Prevention, in consultation with the National Asthma Education
Prevention Program Coordinating Committee, shall--
(1) conduct local asthma surveillance activities to collect
data on the prevalence and severity of asthma and the quality
of asthma management, including--
(A) surveys to collect sample household data on the
local burden of asthma; and
(B) health care facility specific surveillance to
collect asthma data on the prevalence and severity of
asthma, and on the quality of asthma care; and
(2) compile and annually publish data on--
(A) the prevalence of children suffering from
asthma in each State; and
(B) the childhood mortality rate associated with
asthma nationally and in each State.
(b) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of the fiscal years 2001 through 2005.''.
Subtitle B--Childhood Obesity Prevention
SEC. 311. PROGRAMS OPERATED THROUGH THE CENTERS FOR DISEASE CONTROL AND
PREVENTION.
Title III of the Public Health Service Act (42 U.S.C. 241 et seq.),
as amended by section 221, is further amended by adding at the end the
following:
``PART Q--PROGRAMS TO IMPROVE THE HEALTH OF CHILDREN
``SEC. 399R. GRANTS TO PROMOTE CHILDHOOD NUTRITION AND PHYSICAL
ACTIVITY.
``(a) In General.--The Secretary, acting though the Director of the
Centers for Disease Control and Prevention, shall award competitive
grants to States and political subdivisions of States for the
development and implementation of State and community-based
intervention programs to promote good nutrition and physical activity
in children and adolescents.
``(b) Eligibility.--To be eligible to receive a grant under this
section a State or political subdivision of a State shall prepare and
submit to the Secretary an application at such time, in such manner,
and containing such information as the Secretary may require, including
a plan that describes--
``(1) how the applicant proposes to develop a comprehensive
program of school- and community-based approaches to encourage
and promote good nutrition and appropriate levels of physical
activity with respect to children or adolescents in local
communities;
``(2) the manner in which the applicant shall coordinate
with appropriate State and local authorities, such as State and
local school departments, State departments of health, chronic
disease directors, State directors of programs under section 17
of the Child Nutrition Act of 1966, 5-a-day coordinators,
governors councils for physical activity and good nutrition,
and State and local parks and recreation departments;
``(3) the manner in which the applicant will evaluate the
effectiveness of the program carried out under this section.
``(c) Use of Funds.--A State or political subdivision of a State
shall use amount received under a grant under this section to--
``(1) develop, implement, disseminate, and evaluate school-
and community-based strategies in States to reduce inactivity
and improve dietary choices among children and adolescents;
``(2) expand opportunities for physical activity programs
in school- and community-based settings; and
``(3) develop, implement, and evaluate programs that
promote good eating habits and physical activity including
opportunities for children with cognitive and physical
disabilities.
``(d) Technical Assistance.--The Secretary may set-aside an amount
not to exceed 10 percent of the amount appropriated for a fiscal year
under subsection (h) to permit the Director of the Centers for Disease
Control and Prevention to--
``(1) provide States and political subdivisions of States
with technical support in the development and implementation of
programs under this section; and
``(2) disseminate information about effective strategies
and interventions in preventing and treating obesity through
the promotion of good nutrition and physical activity.
``(e) Limitation on Administrative Costs.--Not to exceed 1 percent
of the amount of a grant awarded to the State or political subdivision
under subsection (a) for a fiscal year may be used by the State or
political subdivision for administrative expenses.
``(f) Term.--A grant awarded under subsection (a) shall be for a
term of 3 years.
``(g) Definition.--In this section, the term `children and
adolescents' means individuals who do not exceed 18 years of age.
``(h) Authorization of Appropriations.--There are authorized to be
appropriated, such sums as may be necessary to carry out this section
for each of fiscal years 2001 through 2005.
``SEC. 399S. APPLIED RESEARCH PROGRAM.
``The Secretary, acting through the Centers for Disease Control and
Prevention and in consultation with the Director of the National
Institutes of Health, shall--
``(1) conduct research to better understand the
relationship between physical activity, diet, and health and
factors that influence health-related behaviors;
``(2) develop and evaluate strategies for the prevention
and treatment of obesity to be used in community-based
interventions and by health professionals;
``(3) develop and evaluate strategies for the prevention
and treatment of eating disorders, such as anorexia and
bulimia;
``(4) conduct research to establish the prevalence,
consequences, and costs of childhood obesity and its effects in
adulthood;
``(5) identify behaviors and risk factors that contribute
to obesity;
``(6) evaluate materials and programs to provide nutrition
education to parents and teachers of children in child care or
pre-school and the food service staff of such child care and
pre-school entities; and
``(7) evaluate materials and programs that are designed to
educate and encourage physical activity in child care and pre-
school facilities.
``SEC. 399T. EDUCATION CAMPAIGN.
``The Secretary, acting through the Director of the Centers for
Disease Control and Prevention, and in collaboration with national,
State, and local partners, physical activity organizations, nutrition
experts, and health professional organizations, shall develop a
national public campaign to promote and educate children and their
parents concerning--
``(1) the health risks associated with obesity, inactivity,
and poor nutrition;
``(2) ways in which to incorporate physical activity into
daily living; and
``(3) the benefits of good nutrition and strategies to
improve eating habits.
``SEC. 399U. HEALTH PROFESSIONAL EDUCATION AND TRAINING.
``The Secretary, acting through the Director of the Centers for
Disease Control and Prevention, in collaboration with the Administrator
of the Health Resources and Services Administration and the heads of
other agencies, and in consultation with appropriate health
professional associations, shall develop and carry out a program to
educate and train health professionals in effective strategies to--
``(1) better identify and assess patients with obesity or
an eating disorder or patients at-risk of becoming obese or
developing an eating disorder;
``(2) counsel, refer, or treat patients with obesity or an
eating disorder; and
``(3) educate patients and their families about effective
strategies to improve dietary habits and establish appropriate
levels of physical activity.''.
Subtitle C--Early Detection and Treatment Regarding Childhood Lead
Poisoning
SEC. 321. CENTERS FOR DISEASE CONTROL AND PREVENTION EFFORTS TO COMBAT
CHILDHOOD LEAD POISONING.
(a) Requirements for Lead Poisoning Prevention Grantees.--Section
317A of the Public Health Service Act (42 U.S.C. 247b-1) is amended--
(1) in subsection (d)--
(A) by redesignating paragraph (7) as paragraph
(8); and
(B) by inserting after paragraph (6) the following:
``(7) Assurances satisfactory to the Secretary that the
applicant will ensure complete and consistent reporting of all
blood lead test results from laboratories and health care
providers to State and local health departments in accordance
with guidelines of the Centers for Disease Control and
Prevention for standardized reporting as described in
subsection (m).''; and
(2) in subsection (j)(2)--
(A) in subparagraph (F) by striking ``(E)'' and
inserting ``(F)'';
(B) by redesignating subparagraph (F) as
subparagraph (G); and
(C) by inserting after subparagraph (E) the
following:
``(F) The number of grantees that have established
systems to ensure mandatory reporting of all blood lead
tests from laboratories and health care providers to
State and local health departments.''.
(b) Guidelines for Standardized Reporting.--Section 317A of the
Public Health Service Act (42 U.S.C. 247b-1) is amended by adding at
the end the following:
``(m) Guidelines for Standardized Reporting.--The Secretary, acting
through the Director of the Centers for Disease Control and Prevention,
shall develop national guidelines for the uniform and complete
reporting of all blood lead test results to State and local health
departments.''.
(c) Development and Implementation of Effective Data Management by
the Centers for Disease Control and Prevention.--
(1) In general.--The Director of the Centers for Disease
Control and Prevention shall--
(A) assist with the improvement of data linkages
between State and local health departments and between
State health departments and the Centers for Disease
Control and Prevention;
(B) assist States with the development of flexible,
comprehensive State-based data management systems for
the surveillance of children with lead poisoning that
have the capacity to contribute to a national data set;
(C) assist with the improvement of the ability of
State-based data management systems and federally-
funded means-tested public benefit programs (including
the special supplemental food program for women,
infants and children (WIC) under section 17 of the
Child Nutrition Act of 1966 (42 U.S.C. 1786) and the
early head start program under section 645A of the Head
Start Act (42 U.S.C 9840a(h)) to respond to ad hoc
inquiries and generate progress reports regarding the
lead blood level screening of children enrolled in
those programs that may be used in training and
education programs conducted by the Centers for health
care providers;
(D) assist States with the establishment of a
capacity for assessing how many children enrolled in
the medicaid, WIC, early head start, and other
federally-funded means-tested public benefit programs
are being screened for lead poisoning at age-
appropriate intervals;
(E) use data obtained as result of activities under
this section to formulate or revise existing lead blood
screening and case management policies; and
(F) establish performance measures for evaluating
State and local implementation of the requirements and
improvements described in subparagraphs (A) through
(E).
(2) Authorization of appropriations.--There is authorized
to be appropriated to carry out this subsection, such sums as
may be necessary for each of fiscal years 2001 through 2005.
(3) Effective date.--This subsection takes effect on the
date of enactment of this Act.
SEC. 322. GRANTS FOR LEAD POISONING RELATED ACTIVITIES.
(a) In General.--Part B of title III of the Public Health Service
Act (42 U.S.C. 243 et seq.) is amended--
(1) by redesignating sections 317B through 317H as sections
317C through 317I, respectively; and
(2) by inserting after section 317A the following:
``SEC. 317B. GRANTS FOR LEAD POISONING RELATED ACTIVITIES.
``(a) Authority To Make Grants.--
``(1) In general.--The Secretary shall make grants to
States to support public health activities in States and
localities where data suggests that at least 5 percent of
preschool-age children have an elevated blood lead level
through--
``(A) effective, ongoing outreach and community
education targeted to families most likely to be at
risk for lead poisoning;
``(B) individual family education activities that
are designed to reduce ongoing exposures to lead for
children with elevated blood lead levels, including
through home visits and coordination with other
programs designed to identify and treat children at
risk for lead poisoning; and
``(C) the development, coordination and
implementation of community-based approaches for
comprehensive lead poisoning prevention from
surveillance to lead hazard control.
``(2) State match.--A State is not eligible for a grant
under this section unless the State agrees to expend (through
State or local funds) $1 for every $2 provided under the grant
to carry out the activities described in paragraph (1).
``(3) Application.--To be eligible to receive a grant under
this section, a State shall submit an application to the
Secretary in such form and manner and containing such
information as the Secretary may require.
``(b) Performance Measures.--The Secretary shall establish needs
indicators and performance measures to evaluate the activities carried
out under grants awarded under this section. Such indicators shall be
commensurate with national measures of maternal and child health
programs and shall be developed in consultation with the Director of
the Centers for Disease Control and Prevention.
``(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2001 through 2005.''.
(b) Conforming Amendment.--Section 340D of the Public Health
Service Act (42 U.S.C. 256d(c)(1)) is amended by striking ``317E'' and
inserting ``317F''.
SEC. 323. TRAINING AND REPORTS BY THE HEALTH RESOURCES AND SERVICES
ADMINISTRATION.
(a) Training.--The Secretary of Health and Human Services, acting
through the Administrator of the Health Resources and Services
Administration and in collaboration with the Administrator of the
Health Care Financing Administration and the Director of the Centers
for Disease Control and Prevention, shall conduct education and
training programs for physicians and other health care providers
regarding childhood lead poisoning, current screening and treatment
recommendations and requirements, and the scientific, medical, and
public health basis for those policies.
(b) Report.--The Secretary of Health and Human Services, acting
through the Administrator of the Health Resources and Services
Administration, annually shall report to Congress on the number of
children who received services through health centers established under
section 330 of the Public Health Service Act (42 U.S.C. 254b) and
received a blood lead screening test during the prior fiscal year,
noting the percentage that such children represent as compared to all
children who received services through such health centers.
(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2001 through 2005.
Subtitle D--Oral Health
SEC. 331. IDENTIFICATION OF INTERVENTIONS THAT REDUCE THE BURDEN AND
TRANSMISSION OF ORAL, DENTAL, AND CRANIOFACIAL DISEASES
IN HIGH RISK POPULATIONS; DEVELOPMENT OF APPROACHES FOR
PEDIATRIC ORAL AND CRANIOFACIAL ASSESSMENT.
(a) In General.--The Secretary of Health and Human Services,
through the Maternal and Child Health Bureau, the Indian Health
Service, and in consultation with the National Institutes of Health and
the Centers for Disease Control and Prevention, shall--
(1) support community-based research that is designed to
improve understanding of the etiology, pathogenesis, diagnosis,
prevention, and treatment of pediatric oral, dental,
craniofacial diseases and conditions and their sequelae in high
risk populations;
(2) support demonstrations of preventive interventions in
high risk populations including nutrition, parenting, and
feeding techniques; and
(3) develop clinical approaches to assess individual
patients for the risk of pediatric dental disease.
(b) Compliance With State Practice Laws.--Treatment and other
services shall be provided pursuant to this section by licensed dental
health professionals in accordance with State practice and licensing
laws.
(c) Authorization of Appropriations.--There is authorized to be
appropriated, such sums as may be necessary to carry out this section
for each of fiscal years 2001 through 2005.
SEC. 332. ORAL HEALTH PROFESSIONAL RESEARCH AND TRAINING PROGRAM.
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:
``SEC. 487F. ORAL HEALTH PROFESSIONAL RESEARCH AND TRAINING PROGRAM.
``(a) In General.--The Secretary, in consultation with the Director
of the National Institute of Dental and Craniofacial Research and
professional dental organizations, shall establish a program under
which the Secretary will enter into contracts with qualified oral
health professionals and such professionals will agree to conduct
research or provide training with respect to pediatric oral, dental,
and craniofacial diseases and conditions and in exchange the Secretary
will agree to repay, for each year of service, not more than $35,000 of
the principal and interest of the educational loans of such
professionals.
``(b) Qualified Oral Health Professional.--
``(1) Definition.--In this section, the term `qualified
oral health professional' includes dentists and allied dental
personnel serving in faculty positions.
``(2) Special preference.--In entering into contacts under
subsection (a), the Secretary shall give preference to
qualified oral health professionals--
``(A) who are serving, or who have served in
research or training programs of the National Institute
of Dental and Craniofacial Research; or
``(B) who are providing services at institutions
that provide oral health care to underserved pediatric
populations in rural areas.
``(c) Priorities.--The Secretary shall annually determine the
clinical and basic research and training priorities for contracts under
subsection (a), including dental caries, orofacial accidents or
traumas, birth defects such as cleft lip and palate and severe
malocclusions, and new techniques and approaches to treatment.
``(d) Contracts, Obligated Service, and Breach of Contract.--The
provisions of section 338B concerning contracts, obligated service, and
breach of contract, except as inconsistent with this section, shall
apply to contracts under this section to the same extent and in the
same manner as such provisions apply to contracts under such section
338B.
``(e) Availability of Funds.--Amounts available for carrying out
this section shall remain available until the expiration of the second
fiscal year beginning after the fiscal year for which such amounts were
made available.''.
SEC. 333. GRANTS TO INCREASE RESOURCES FOR COMMUNITY WATER
FLUORIDATION.
(a) In General.--The Secretary of Health and Human Services, acting
through the Director of the Division of Oral Health of the Centers for
Disease Control and Prevention, may make grants to State or locality
for the purpose of increasing the resources available for community
water fluoridation.
(b) Use of Funds.--A State shall use amounts provided under a grant
under subsection (a)--
(1) to purchase fluoridation equipment;
(2) to train fluoridation engineers; or
(3) to develop educational materials on the advantages of
fluoridation.
(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $25,000,000 for fiscal year
2001, and such sums as may be necessary for each subsequent fiscal
year.
SEC. 334. COMMUNITY WATER FLUORIDATION.
(a) In General.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary''), acting through the
Director of the Indian Health Service and the Director of the Centers
for Disease Control and Prevention, shall establish a demonstration
project that is designed to assist rural water systems in successfully
implementing the Centers for Disease Control and Prevention water
fluoridation guidelines entitled ``Engineering and Administrative
Recommendations for Water Fluoridation'' (referred to in this section
as the ``EARWF'').
(b) Requirements.--
(1) Collaboration.--The Director of the Indian Health
Services shall collaborate with the Director of the Centers for
Disease Control and Prevention in developing the project under
subsection (a). Through such collaboration the Directors 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.
(2) General use of funds.--Amounts made available under
this section shall be used to assist small water systems in
improving the effectiveness of water fluoridation and to meet
the recommendations of the EARWF.
(3) Fluoridation specialists.--
(A) In general.--In carrying out this section, 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.
(B) 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.
(C) CDC.--The Director of the Centers for Disease
Control and Prevention shall appoint individuals to
serve as the fluoridation specialists.
(4) Implementation.--The project established under this
section 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.
(c) Evaluation.--In conducting the ongoing evaluation as provided
for in subsection (b)(4), the Secretary shall ensure that such
evaluation includes--
(1) the measurement of changes in water fluoridation
compliance levels resulting from assistance provided under this
section;
(2) the identification of the administrative, technical and
operational challenges that are unique to the fluoridation of
small water systems;
(3) 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
(4) the measurement of any increased percentage of Native
Americans or Alaskan Natives who receive the benefits of
optimally fluoridated water.
(d) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $25,000,000 for fiscal year
2001, and such sums as may be necessary for each of fiscal years 2002
through 2005.
SEC. 335. DENTAL SEALANT PROGRAM.
(a) In General.--The Secretary of Health and Human Services, acting
through the Director of the Maternal and Child Health Bureau of the
Health Resources and Services Administration, may award grants to
States or localities, and the Indian Health Service and tribally
managed programs, to provide for the development of school-based dental
sealant programs to improve the access of children to sealants.
(b) Use of Funds.--A State shall use amounts received under a grant
under subsection (a) to provide funds to eligible school-based entities
or to public elementary or secondary schools to enable such entities or
schools to provide children 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.
(c) Eligibility.--To be eligible to receive funds under this
section an entity shall--
(1) prepare and submit to the State an application at such
time, in such manner and containing such information as the
State may require; and
(2) be a public elementary or secondary school--
(A) that is located in an urban area and in which
more than 50 percent of the student population is
participating in Federal or State free or reduced meal
programs; or
(B) 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) Coordination With Other Programs.--An entity that receives
funds from a State under this section shall provide information
regarding enrollment in the State plan under title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.) or in the State Children's Health
Insurance Program under title XXI of such Act (42 U.S.C. 1397aa et
seq.).
(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $5,000,000 for fiscal year
2001, and such sums as may be necessary for each subsequent fiscal
year.
SEC. 336. COORDINATED PROGRAM TO IMPROVE PEDIATRIC ORAL HEALTH.
Part B of the Public Health Service Act (42 U.S.C. 243 et seq.) is
amended by adding at the end the following:
``SEC. 320A. COORDINATED PROGRAM TO IMPROVE PEDIATRIC ORAL HEALTH.
``(a) In General.--The Secretary, acting through the Administrator
of the Health Resources and Services Administration, shall establish a
program to fund innovative oral health activities that improve the oral
health of children under 6 years of age who are eligible for services
provided under a Federal health program, to increase the utilization of
dental services by such children, and to decrease the incidence of
early childhood and baby bottle tooth decay.
``(b) Grants.--The Secretary shall award grants to or enter into
contracts with public or private nonprofit schools of dentistry or
accredited dental training institutions or programs, community dental
programs, and programs operated by the Indian Health Service (including
federally recognized Indian tribes that receive medical services from
the Indian Health Service, urban Indian health programs funded under
title V of the Indian Health Care Improvement Act, and tribes that
contract with the Indian Health Service pursuant to the Indian Self-
Determination and Education Assistance Act) to enable such schools,
institutions, and programs to develop programs of oral health
promotion, to increase training of oral health services providers in
accordance with State practice laws, or to increase the utilization of
dental services by eligible children.
``(c) Distribution.--In awarding grants under this section, the
Secretary shall, to the extent practicable, ensure an equitable
national geographic distribution of the grants, including areas of the
United States where the incidence of early childhood caries is highest.
``(d) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $10,000,000 for each of fiscal
years 2001 through 2005.''.
TITLE IV--PEDIATRIC RESEARCH
Subtitle A--Pediatric Research Initiative
SEC. 401. ESTABLISHMENT OF A PEDIATRIC RESEARCH INITIATIVE.
Part A of title IV of the Public Health Service Act (42 U.S.C. 281
et seq.) is amended by adding at the end the following:
``SEC. 404F. PEDIATRIC RESEARCH INITIATIVE.
``(a) Establishment.--The Secretary shall establish within the
Office of the Director of NIH a Pediatric Research Initiative (referred
to in this section as the `Initiative'). The Initiative shall be headed
by the Director of NIH. Amounts appropriated under subsection (d) shall
be used under the Initiative to conduct and support research that is
directly related to the illnesses and conditions of children.
``(b) Funding of Activities.--The Initiative shall provide funds
that will enable the Director of NIH to--
``(1) increase 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) increase collaborative efforts among the Institutes
to conduct and support multidisciplinary research in the areas
that the Director deems most promising; and
``(3) in coordination with the Food and Drug
Administration, increase the development of adequate pediatric
clinical trials and pediatric use information to promote the
safer and more effective use of prescription drugs in the
pediatric population.
``(c) Duties.--In carrying out subsection (b), the Director of NIH
shall--
``(1) consult with the Institute of Child Health and Human
Development and the other Institutes, in considering their
requests for new or expanded pediatric research efforts, and
consult with other advisors as the Director determines
appropriate;
``(2) have broad discretion in the allocation of any
Initiative funds among the Institutes, among types of grants,
and between basic and clinical research;
``(3) be responsible for the oversight of any newly
appropriated Initiative funds; and
``(4) 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.--To carry out this section, there is
authorized to be appropriated, $50,000,000 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. 402. INVESTMENT IN TOMORROW'S PEDIATRIC RESEARCHERS.
Subpart 7 of part C of title IV of the Public Health Service Act
(42 U.S.C. 285g et seq.) is amended by adding at the end the following:
``SEC. 452E. INVESTMENT IN TOMORROW'S PEDIATRIC RESEARCHERS.
``(a) Enhanced Support.--
``(1) In general.--The Secretary shall make available
within the National Institute of Child Health and Human
Development enhanced support for extramural activities relating
to the training and career development of pediatric
researchers.
``(2) Purpose.--The purpose of support provided under
paragraph (1) shall be to ensure the future supply of
researchers dedicated to the care and research needs of children by
providing for--
``(A) an increase in the number and size of
institutional training grants to medical school
pediatric departments and children's hospitals; and
``(B) an increase in the number of career
development awards for pediatricians building careers
in pediatric basic and clinical research.
``(3) Authorization.--To carry out this subsection, there
is authorized to be appropriated such sums as may be necessary
for each of fiscal year 2001 through 2005.
``(b) Pediatric Research Loan Repayment Program.--
``(1) In general.--The Secretary, in consultation with the
Director of the National Institute of Child Health and Human
Development, may establish a pediatric research loan repayment
program. Through such program--
``(A) the Secretary shall enter into contracts with
qualified pediatricians under which such pediatricians
will agree to conduct pediatric research in
consideration of the Federal government agreeing to
repay, for each year of such service, not more than
$35,000 of the principal and interest of the
educational loans of such pediatricians; and
``(B) the Secretary shall, for the purpose of
providing reimbursements for tax liability resulting
from payments made under paragraph (1) on behalf of an
individual, make payments, in addition to payments
under such paragraph, to the individual in an amount
equal to 39 percent of the total amount of loan
repayments made for the taxable year involved.
``(2) Application of other provisions.--The provisions of
sections 338B, 338C, and 338E shall, except as inconsistent
with paragraph (1), apply to the program established under such
paragraph to the same extent and in the same manner as such
provisions apply to the National Health Service Corps Loan
Repayment Program established under subpart III of part D of
title III.
``(3) Availability of funds.--Amounts made available to
carry out this subsection shall remain available until the
expiration of the second fiscal year beginning after the fiscal
year for which such amounts were made available.
``(4) Authorization of appropriations.--To carry out this
subsection, there is authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through
2005.''.
Subtitle B--Autism
SEC. 411. EXPANSION, INTENSIFICATION, AND COORDINATION OF ACTIVITIES OF
NATIONAL INSTITUTES OF HEALTH WITH RESPECT TO RESEARCH ON
AUTISM.
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:
``SEC. 409C. EXPANSION, INTENSIFICATION, AND COORDINATION OF ACTIVITIES
OF NATIONAL INSTITUTES OF HEALTH WITH RESPECT TO RESEARCH
ON AUTISM.
``(a) In General.--
``(1) Expansion of activities.--The Director of NIH (in
this section referred to as the `Director') shall expand,
intensify, and coordinate the activities of the National
Institutes of Health with respect to research on autism.
``(2) Administration of program; collaboration among
agencies.--The Director shall carry out this section acting
through the Director of the National Institute of Mental Health
and in collaboration with any other agencies that the Director
determines appropriate.
``(b) Centers of Excellence.--
``(1) In general.--The Director shall under subsection
(a)(1) make awards of grants and contracts to public or
nonprofit private entities to pay all or part of the cost of
planning, establishing, improving, and providing basic
operating support for centers of excellence regarding research
on autism.
``(2) Research.--Each center under paragraph (1) shall
conduct basic and clinical research into autism. Such research
should include investigations into the cause, diagnosis, early
detection, prevention, control, and treatment of autism. The
centers, as a group, shall conduct research including the
fields of developmental neurobiology, genetics, and
psychopharmacology.
``(3) Services for patients.--
``(A) In general.--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.
``(B) Referrals and costs.--A program under
subparagraph (A) may, in accordance with such criteria
as the Director may establish, provide to the subjects
described in such subparagraph, referrals for health
and other services, and such patient care costs as are
required for research.
``(C) Availability and access.--The extent to which
a center can demonstrate availability and access to
clinical services shall be considered by the Director
in decisions about awarding grants to applicants which
meet the scientific criteria for funding under this
section.
``(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.--
``(A) In general.--The Director shall provide for
the establishment of not less than 5 centers under
paragraph (1).
``(B) Duration.--Support for a center established
under paragraph (1) may be provided under this section
for a period of not to exceed 5 years. Such period may
be extended for 1 or more additional periods not
exceeding 5 years if the operations of such center have
been reviewed by an appropriate technical and
scientific peer review group established by the
Director and if such group has recommended to the
Director that such period should be extended.
``(c) Facilitation of Research.--The Director shall under
subsection (a)(1) provide for a program under which samples of tissues
and genetic materials that are of use in research on autism are
donated, collected, preserved, and made available for such research.
The program shall be carried out in accordance with accepted scientific
and medical standards for the donation, collection, and preservation of
such samples.
``(d) Public Input.--The Director shall under subsection (a)(1)
provide for means through which the public can obtain information on
the existing and planned programs and activities of the National
Institutes of Health with respect to autism and through which the
Director can receive comments from the public regarding such programs
and activities.
``(e) Funding.--There are authorized to be appropriated such sums
as may be necessary to carry out this section. Amounts appropriated
under this subsection are in addition to any other amounts appropriated
for such purpose.''.
SEC. 412. DEVELOPMENTAL DISABILITIES SURVEILLANCE AND RESEARCH
PROGRAMS.
(a) National Autism and Pervasive Developmental Disabilities
Surveillance Program.--
(1) In general.--The Secretary of Health and Human Services
(in this section referred to as the ``Secretary''), acting
through the Director of the Centers for Disease Control and
Prevention, may make awards of grants and cooperative
agreements for the collection, analysis, and reporting of data
on autism and pervasive developmental disabilities. In making
such awards, the Secretary may provide direct technical
assistance in lieu of cash.
(2) Eligibility.--To be eligible to receive an award under
paragraph (1) an entity shall be a public or nonprofit private
entity (including health departments of States and political
subdivisions of States, and including universities and other
educational entities).
(b) Centers of Excellence in Autism and Pervasive Developmental
Disabilities Epidemiology.--
(1) In general.--The Secretary, acting through the Director
of the Centers for Disease Control and Prevention, shall
establish not less than 3 regional centers of excellence in
autism and pervasive developmental disabilities epidemiology
for the purpose of collecting and analyzing information on the
number, incidence, correlates, and causes of autism and related
developmental disabilities.
(2) Recipients of awards for establishment of centers.--
Centers under paragraph (1) shall be established and operated
through the awarding of grants or cooperative agreements to
public or nonprofit private entities that conduct research,
including health departments of States and political
subdivisions of States, and including universities and other
educational entities.
(3) Certain requirements.--An award for a center under
paragraph (1) may be made only if the entity involved submits
to the Secretary an application containing such agreements and
information as the Secretary may require, including an
agreement that the center involved will operate in accordance
with the following:
(A) The center will collect, analyze, and report
autism and pervasive developmental disabilities data
according to guidelines prescribed by the Director,
after consultation with relevant State and local public
health officials, private sector developmental
disability researchers, and advocates for those with
developmental disabilities.
(B) The center will assist with the development and
coordination of State autism and pervasive
developmental disabilities surveillance efforts within
a region.
(C) The center will identify eligible cases and
controls through its surveillance systems and conduct
research into factors which may cause autism and
related developmental disabilities.
(D) The center will develop or extend an area of
special research expertise (including genetics,
environmental exposure to contaminants, immunology, and
other relevant research specialty areas).
(c) Clearinghouse.--The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, shall carry out the
following:
(1) The Secretary shall establish a clearinghouse within
the Centers for Disease Control and Prevention for the
collection and storage of data generated from the monitoring
programs established by this title. Through the clearinghouse,
such Centers shall serve as the coordinating agency for autism
and pervasive developmental disabilities surveillance
activities. The functions of such a clearinghouse shall include
facilitating the coordination of research and policy
development relating to the epidemiology of autism and other
pervasive developmental disabilities.
(2) The Secretary shall coordinate the Federal response to
requests for assistance from State health department officials
regarding potential or alleged autism or developmental
disability clusters.
(d) Definition.--In this subtitle, the term ``State'' means each of
the several States, the District of Columbia, the Commonwealth of
Puerto Rico, American Samoa, Guam, the Commonwealth of the Northern
Mariana Islands, the Virgin Islands, and the Trust Territory of the
Pacific Islands.
(e) Authorization of Appropriations.--There are authorized to be
appropriated such sums as may be necessary to carry out this section.
SEC. 413. INFORMATION AND EDUCATION.
(a) In General.--The Secretary shall establish and implement a
program to provide information and education on autism to health
professionals and the general public, including information and
education on advances in the diagnosis and treatment of autism and
training and continuing education through programs for scientists,
physicians, and other health professionals who provide care for
patients with autism.
(b) Stipends.--The Secretary may use amounts made available under
this section to provide stipends for health professionals who are
enrolled in training programs under this section.
(c) Authorization of Appropriations.--There are authorized to be
appropriated such sums as may be necessary to carry out this section.
SEC. 414. INTER-AGENCY AUTISM COORDINATING COMMITTEE.
(a) Establishment.--The Secretary shall establish a committee to be
known as the ``Autism Coordinating Committee'' (in this section
referred to as the ``Committee'') to coordinate all efforts within the
Department of Health and Human Services concerning autism, including
activities carried out through the National Institutes of Health and
the Centers for Disease Control and Prevention under this title (and
the amendment made by this title).
(b) Membership.--
(1) In general.--The Committee shall be composed of the
Directors of such national research institutes, of the Centers
for Disease Control and Prevention, and of such other agencies
and such other officials as the Secretary determines
appropriate.
(2) Additional members.--If determined appropriate by the
Secretary, the Secretary may appoint to the Committee--
(A) parents or legal guardians of individuals with
autism or other pervasive developmental disorders; and
(B) representatives of other governmental agencies
that serve children with autism such as the Department
of Education.
(c) Administrative Support; Terms of Service; Other Provisions.--
The following shall apply with respect to the Committee:
(1) The Committee shall receive necessary and appropriate
administrative support from the Department of Health and Human
Services.
(2) Members of the Committee appointed under subsection
(b)(2)(A) shall serve for a term of 3 years, and may serve for
an unlimited number of terms if reappointed.
(3) The Committee shall meet not less than 2 times each
year.
SEC. 415. REPORT TO CONGRESS.
Not later than January 1, 2001, and each January 1 thereafter, the
Secretary shall prepare and submit to the appropriate committees of
Congress, a report concerning the implementation of this subtitle and
the amendments made by this subtitle.
Subtitle C--Long-Term Child Development
SEC. 421. LONG-TERM CHILD DEVELOPMENT STUDY.
(a) Purpose.--It is the purpose of this section to authorize the
National Institute of Child Health and Human Development to conduct a
national longitudinal study of environmental influences on children's
health.
(b) In General.--The Director of the National Institute of Child
Health and Human Development shall establish a consortium of
representatives from appropriate Federal agencies (including the
Centers for Disease Control and Prevention, the Environmental
Protection Agency) to--
(1) plan, develop, and implement a prospective cohort study
to evaluate the effects of both chronic and intermittent
exposures on human development; and
(2) investigate basic mechanisms of developmental disorders
and environmental factors, both risk and protective, that
influence growth and developmental processes.
(c) Requirement.--The study under subsection (b) shall--
(1) incorporate behavioral, emotional, educational, and
contextual consequences to enable a complete assessment of the
physical, chemical, biological and psychosocial environmental
influences on children's well-being;
(2) gather data on environmental influences and outcomes on
diverse populations of children, which may include the
consideration of prenatal exposures;
(3) consider health disparities among children which may
include the consideration of prenatal exposures.
(d) Report.--Not later than 3 years after the date of enactment of
this Act, the Director of the National Institute of Child Health and
Human Development shall prepare and submit to the appropriate
committees of Congress a report on the findings and conclusions made
under the study conducted under this section.
(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $18,000,000 for fiscal year
2001, and such sums as may be necessary for each of fiscal years 2002
through 2005.
Subtitle D--Research on Rare Diseases in Children
SEC. 431. 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; 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.
Subtitle E--GME Programs in Children's Hospitals
SEC. 441. EXTENSION OF AUTHORIZATION OF APPROPRIATIONS.
(a) Payments.--Section 340E(a) of the Public Health Service Act (42
U.S.C. 256e(a)) is amended by striking ``and 2001'' and inserting
``through 2005''.
(b) 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.''.
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