[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4644 Introduced in House (IH)]







107th CONGRESS
  2d Session
                                H. R. 4644

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


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 2, 2002

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

_______________________________________________________________________

                                 A BILL


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

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Women and Children's HIV Protection 
Act of 2002''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) Perinatal transmission is the leading cause of 
        pediatric HIV infections, including AIDS cases.
            (2) The Centers for Disease Control and Prevention 
        (``CDC'') estimates that nearly 7,000 HIV-infected women give 
        birth in the United States each year and as many as 400 babies 
        continue to be born with HIV infection each year.
            (3) Medical advances have made it possible to nearly 
        eliminate perinatal HIV transmission.
            (4) Research studies have demonstrated that the 
        administration of antiviral medication during pregnancy, during 
        labor, and immediately following birth can significantly reduce 
        the transmission of HIV from an infected mother to her baby. 
        Caesarean section further reduces the risk of transmission.
            (5) Even if treatment begins shortly after birth, 
        antiretroviral therapy can substantially reduce the chance that 
        an HIV-exposed infant will become infected.
            (6) Breastfeeding by HIV-infected mothers poses additional 
        significant risk of infection to babies.
            (7) The Institute of Medicine (``IOM'') has recommended the 
        adoption of a national policy of universal HIV testing, with 
        patient notification, as a routine component of prenatal care. 
        However, 15 percent of HIV-infected pregnant women receive no 
        prenatal care according to the IOM.
            (8) The CDC has recommended since 1995 that all pregnant 
        women be counseled and offered voluntary HIV testing. Yet 
        nearly half of pregnant women are still not tested according to 
        the CDC.
            (9) The American Medical Association recommends mandatory 
        HIV testing of all newborns with appropriate treatment for 
        affected mothers and children.
            (10) Testing newborns whose mothers' status is unknown 
        ensures that every child at risk for HIV is identified.
            (11) The provision of testing of pregnant women and 
        newborns with appropriate counseling and treatment can 
        significantly reduce the number of pediatric HIV infections, 
        including AIDS cases, can improve access to and medical care 
        for the woman and children, and can provide opportunities to 
        further reduce transmission among adults.
            (12) The provision of such testing, counseling, and 
        treatment can reduce the overall cost of pediatric HIV 
        infections, including AIDS cases.
            (13) New York State has required mandatory HIV counseling 
        and voluntary testing for pregnant women and mandatory HIV 
        testing of all newborns since February 1997. As a result, the 
        perinatal HIV transmission rate in the State has dropped from 
        25 percent to an all time low of 3.5 percent and over 99 
        percent of HIV-infected women and their children have been 
        linked to care.
            (14) For the reasons specified in paragraphs (1) through 
        (12)--
                    (A) universal routine HIV testing of pregnant women 
                and newborns should be the standard of care; and
                    (B) the relevant medical organizations, as well as 
                public health officials, should issue guidelines making 
                such testing, counseling, and treatment the standard of 
                care.

SEC. 3. ADDITIONAL REQUIREMENT FOR CERTAIN GRANTS.

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

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

    ``For fiscal year 2004 and subsequent fiscal years, the Secretary 
shall not make a grant to a State under this part unless the State 
demonstrates that the law or regulations of the State are in accordance 
with the following:
            ``(1) That all pregnant women receiving prenatal care in 
        the State be offered counseling and testing regarding HIV 
        disease.
            ``(2) In the case of prenatal testing for such disease that 
        is conducted in the State, that the results of such testing be 
        promptly disclosed to the pregnant woman involved.
            ``(3) In the case of newborn infants who are born in the 
        State and whose biological mothers have not undergone prenatal 
        testing for HIV disease, that each such infant undergo testing 
        for such disease.
            ``(4) That the results of such testing of a newborn infant 
        be promptly disclosed in accordance with the following, as 
        applicable to the infant involved:
                    ``(A) To the biological mother of the infant 
                (without regard to whether she is the legal guardian of 
                the infant).
                    ``(B) If the State is the legal guardian of the 
                infant:
                            ``(i) To the appropriate official of the 
                        State agency with responsibility for the care 
                        of the infant.
                            ``(ii) To the appropriate official of each 
                        authorized agency providing assistance in the 
                        placement of the infant.
                            ``(iii) If the authorized agency is giving 
                        significant consideration to approving an 
                        individual as a foster parent of the infant, to 
                        the prospective foster parent.
                            ``(iv) If the authorized agency is giving 
                        significant consideration to approving an 
                        individual as an adoptive parent of the infant, 
                        to the prospective adoptive parent.
                    ``(C) If neither the biological mother nor the 
                State is the legal guardian of the infant, to another 
                legal guardian of the infant.
                    ``(D) To the child's health care provider.
            ``(5) That, in disclosing the test results to an individual 
        under paragraph (2) or (4), appropriate counseling on HIV 
        disease and appropriate referrals for health care be offered to 
        the individual (except in the case of a disclosure to an 
        official of a State or an authorized agency, or to a health 
        care provider).''.
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