[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.''.
                                 <all>