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<bill bill-stage="Introduced-in-Senate" public-private="public">
	<form>
		<distribution-code display="yes">II</distribution-code>
		<congress>111th CONGRESS</congress>
		<session>1st Session</session>
		<legis-num>S. 994</legis-num>
		<current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber>
		<action>
			<action-date date="20090507">May 7, 2009</action-date>
			<action-desc><sponsor name-id="S311">Ms. Klobuchar</sponsor> (for
			 herself, <cosponsor name-id="S245">Ms. Snowe</cosponsor>,
			 <cosponsor name-id="S331">Mrs. Gillibrand</cosponsor>,
			 <cosponsor name-id="S313">Mr. Sanders</cosponsor>, <cosponsor name-id="S264">Mr. Bayh</cosponsor>, <cosponsor name-id="S282">Mr. Nelson of
			 Florida</cosponsor>, <cosponsor name-id="S304">Mr. Martinez</cosponsor>,
			 <cosponsor name-id="S320">Mrs. Hagan</cosponsor>, <cosponsor name-id="S221">Mrs. Feinstein</cosponsor>, <cosponsor name-id="S284">Ms.
			 Stabenow</cosponsor>, <cosponsor name-id="S258">Ms. Landrieu</cosponsor>,
			 <cosponsor name-id="S229">Mrs. Murray</cosponsor>, <cosponsor name-id="S182">Ms. Mikulski</cosponsor>, and <cosponsor name-id="S299">Mr.
			 Vitter</cosponsor>) introduced the following bill; which was read twice and
			 referred to the <committee-name committee-id="SSHR00">Committee on Health,
			 Education, Labor, and Pensions</committee-name></action-desc>
		</action>
		<legis-type>A BILL</legis-type>
		<official-title>To amend the Public Health Service Act to increase
		  awareness of the risks of breast cancer in young women and provide support for
		  young women diagnosed with breast cancer.</official-title>
	</form>
	<legis-body>
		<section id="H1E270C081BFE47F9BCAC926E1E40136C" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the
			 <quote><short-title>Breast Cancer Education and Awareness
			 Requires Learning Young Act of 2009</short-title></quote> or
			 <quote><short-title>EARLY Act</short-title></quote>.</text>
		</section><section id="HC401CC2D907A45B89D793134360CF96C"><enum>2.</enum><header>Young women’s
			 breast cancer awareness and support</header><text display-inline="no-display-inline">Title III of the Public Health Service Act
			 (42 U.S.C. 241 et seq.) is amended by adding at the end the following:</text>
			<quoted-block display-inline="no-display-inline" id="H04DC34D303BB44EBA1949E7A2E2E0ABF" style="OLC">
				<part id="HB01341137BFC4E348249813D0075E8BE"><enum>S</enum><header>Programs relating
				to breast cancer</header>
					<section id="HDA3C1C0711D24B15A7AE33990EF0D263"><enum>399HH.</enum><header>Young women’s
				breast cancer awareness and support</header>
						<subsection id="H9D0CBD02C93344E5AA85161E54FD79A0"><enum>(a)</enum><header>Public education
				campaign</header>
							<paragraph id="H08F41F610C4A4F9FB5E51E0C3CA45EE1"><enum>(1)</enum><header>In
				general</header><text display-inline="yes-display-inline">The Secretary, acting
				through the Director of the Centers for Disease Control and Prevention, shall
				conduct a national evidence-based education campaign—</text>
								<subparagraph id="H8036B86D4F1743DA9398D6CFF014F321"><enum>(A)</enum><text>to increase public
				awareness regarding the threats posed by breast cancer to young women of all
				racial, ethnic, and cultural backgrounds, including the particular risks faced
				by certain racial, ethnic, and cultural groups; and</text>
								</subparagraph><subparagraph id="H82683F658C5F408DABC170E5640CF96F"><enum>(B)</enum><text>focusing on
				awareness of risk factors of breast cancer among young women and achieving
				early detection of breast cancer among young women through community-centered
				informational forums, public service advertisements, and media
				campaigns.</text>
								</subparagraph></paragraph><paragraph display-inline="no-display-inline" id="H80CF584981DF46B5A696F7C61D06B063"><enum>(2)</enum><header>Authorized
				activities</header><text>In conducting the education campaign under paragraph
				(1), the Secretary may—</text>
								<subparagraph id="H44C55C607F9D46C09F13086DE43BF643"><enum>(A)</enum><text>make public
				announcements targeted towards young women with the goal of educating them that
				breast cancer occurs in young women and the steps they can take to recognize
				their individual risk factors and ensure early detection of breast cancer,
				ensuring that such messaging is age-appropriate;</text>
								</subparagraph><subparagraph id="H79592D94C3634F3B98C131AE86A5BF2D"><enum>(B)</enum><text>provide education,
				through written materials, identifying evidence-based methods to lower the risk
				of breast cancer in young women through changes in lifestyle including diet,
				exercise, and environmental factors;</text>
								</subparagraph><subparagraph id="H6096CDB972B541BC9AE17AE8DE2CAB0F"><enum>(C)</enum><text>conduct other
				activities determined by the Secretary to promote educational awareness, early
				detection, and risk-reducing practices among young women and increase the
				number of young women with breast cancer warning signs who seek immediate
				care;</text>
								</subparagraph><subparagraph id="HE1B6D19A947A458EBD212188422C2558"><enum>(D)</enum><text>award grants,
				contracts, or cooperative agreements to appropriate State agencies to carry out
				secondary school and university education campaigns, focusing on breast cancer
				awareness among young women;</text>
								</subparagraph><subparagraph id="H65F6CA93B1AD4A758D70FD65DA226FAB"><enum>(E)</enum><text>develop and
				distribute to young women, physicians, and other appropriate health care
				professionals, educational materials—</text>
									<clause id="H11645D3FA0094A0093AB722EB643C0D3"><enum>(i)</enum><text>designed for young
				women;</text>
									</clause><clause id="H3327758291AC42A1B8AECC04211A6DA0"><enum>(ii)</enum><text>relating to
				particular risk factors for breast cancer in women under the age of 45;</text>
									</clause><clause id="HC67A9FFD5CDA4EB28CDB0BD65AF3359B"><enum>(iii)</enum><text display-inline="yes-display-inline">identifying methods for increasing early
				detection, including clinical breast exams;</text>
									</clause><clause id="id5FE708DB470F4D2CA7C8DB901351637E"><enum>(iv)</enum><text>encouraging
				genetic counseling and testing for appropriate individuals, in order to
				facilitate early diagnosis or prevention;</text>
									</clause><clause id="id42C2F20B02984A05B47F3FD147FDE26D"><enum>(v)</enum><text>supporting
				imaging-based screening for individuals with a genetic mutation or who have a
				high risk of early onset breast cancer based on family history or other
				pertinent factors;</text>
									</clause><clause id="idB0108AF9348049FC845D07BC4C665500"><enum>(vi)</enum><text>consistent with
				the most recent version of the National Comprehensive Cancer Network (NCCN)
				guidelines, identifying methods, such as breast self exams and knowing the
				signs of breast malignancies, for increasing breast self awareness;</text>
									</clause><clause id="H3771314CA1D24E09BC53586221271FFA"><enum>(vii)</enum><text>identifying
				evidence-based methods to lower the risk of breast cancer through changes in
				lifestyle, including diet, exercise, and environmental factors;</text>
									</clause><clause id="H63A765D6753144BCBEC87512EDC1D630"><enum>(viii)</enum><text>identifying
				available treatment options for breast cancer; and</text>
									</clause><clause id="H9EBEB19862EF471EBB8AC7BE1E110033"><enum>(ix)</enum><text>for young women
				who have been diagnosed with breast cancer, health information from credible
				sources that provides information on—</text>
										<subclause id="H56C84A4FB5D646468247A467CB6CE9D4"><enum>(I)</enum><text>fertility
				preservation;</text>
										</subclause><subclause id="HD753B42A18F644E694578F4D4391A45B"><enum>(II)</enum><text>support,
				including social, emotional, psychosocial, financial, lifestyle, and caregiver
				support;</text>
										</subclause><subclause id="HA9DA7F96F72F43E5A802787125A7A5B0"><enum>(III)</enum><text>familial risk
				factors; and</text>
										</subclause><subclause id="HA36EF062C9BB47729A391C7CCFF6CFC3"><enum>(IV)</enum><text>risk reduction
				strategies to reduce recurrence or metastasis; and</text>
										</subclause></clause></subparagraph><subparagraph id="H82B5B9D126F94960AF72581402A6509C"><enum>(F)</enum><text>carry out a health
				education program targeted to specific higher-risk populations of young women
				based on race, ethnicity, level of acculturation, and family history, including
				the African-American and Ashkenazi Jewish populations under 45 years of
				age.</text>
								</subparagraph></paragraph><paragraph display-inline="no-display-inline" id="HA759AD6B068E4BB29310C134A603166D"><enum>(3)</enum><header>Media
				campaign</header><text>In conducting the education campaign under paragraph
				(1), the Secretary shall award grants to entities to establish national
				multimedia campaigns oriented to young women that—</text>
								<subparagraph id="HB2DD2EE1E5CE478FBAF031EC3B6C0D88"><enum>(A)</enum><text>will encourage
				young women to be aware of—</text>
									<clause id="H54073E0088C64D16A6E40BAFBF2B3C60"><enum>(i)</enum><text>their personal
				risk factors, including by talking to their medical practitioner about those
				risks;</text>
									</clause><clause id="H36A728573AA14BD0AEFEDD391228312E"><enum>(ii)</enum><text>strategies for
				increasing early detection, including clinical breast exams;</text>
									</clause><clause id="id817EC61CAADF42BF93574DD2B4826A5C"><enum>(iii)</enum><text>genetic
				counseling and testing for appropriate individuals, in order to facilitate
				early diagnosis or prevention;</text>
									</clause><clause id="id1D75D9A3FD2F4243AE7C1E2EEEE53F12"><enum>(iv)</enum><text>imaging-based
				screening for individuals with a genetic mutation or who have a high risk of
				early onset breast cancer based on family history or other pertinent
				factors;</text>
									</clause><clause id="id0768DA9956DF4D9EAAD9ACDB6528E092"><enum>(v)</enum><text>consistent with
				the most recent version of the National Comprehensive Cancer Network (NCCN)
				guidelines, identifying methods, such as breast self exams and knowing the
				signs of breast malignancies, for increasing breast self awareness;</text>
									</clause><clause id="HA5635CB0970E47A59935A26AF92A4405"><enum>(vi)</enum><text display-inline="yes-display-inline">evidence-based preventative lifestyle
				changes, including eating healthily and maintaining a healthy weight;
				and</text>
									</clause><clause id="H525B54C3C6864F85BE7A46CC720E98FD"><enum>(vii)</enum><text>other breast
				cancer early detection and risk reduction strategies determined appropriate by
				the Secretary;</text>
									</clause></subparagraph><subparagraph id="HE0A40DB70BE543269F8E538B0C1FB55E"><enum>(B)</enum><text>will encourage
				young women of specific higher-risk populations based on race, ethnicity, level
				of acculturation, and family history, including the African-American and
				Ashkenazi Jewish populations under 45 years of age to talk to their medical
				practitioners about those risks and methods for appropriate screening and
				surveillance, including available genetic testing and counseling; and</text>
								</subparagraph><subparagraph id="H2EDEFFC636E84922AAB5D4566EED25A5"><enum>(C)</enum><text display-inline="yes-display-inline">may include advertising through television,
				radio, print media, billboards, posters, all forms of existing and emerging
				social networking media, other Internet media, and any other media determined
				appropriate by the Secretary.</text>
								</subparagraph></paragraph><paragraph id="HF1EEA3F100794A448370E8A5BB8C2E6A"><enum>(4)</enum><header>Advisory
				committee</header>
								<subparagraph id="H1693995100B748F49F7CC5DA35749AF2"><enum>(A)</enum><header>Establishment</header><text>Not
				later than 60 days after the date of the enactment of this section, the
				Secretary, acting through the Director of the Centers for Disease Control and
				Prevention, shall establish an advisory committee to assist in creating and
				conducting the education campaign under paragraph (1).</text>
								</subparagraph><subparagraph id="H6C2D9DFFF08B45FE9093C51197179D0A"><enum>(B)</enum><header>Membership</header><text>The
				Secretary, acting through the Director of the Centers for Disease Control and
				Prevention, shall appoint to the advisory committee under subparagraph (A) such
				members as deemed necessary to properly advise the Secretary, and shall include
				organizations and individuals with expertise in breast cancer prevention,
				diagnosis, genetic screening and counseling, treatment, and rehabilitation in
				young women.</text>
								</subparagraph></paragraph></subsection><subsection id="HB3780744702C4E7C9A5ECB1702B67CC2"><enum>(b)</enum><header>Health care
				professional education campaign</header>
							<paragraph id="H6FFAEF4E26B848138BC09808B615460A"><enum>(1)</enum><header>In
				general</header><text>The Secretary, acting through the Director of the Centers
				for Disease Control and Prevention, and in consultation with the Administrator
				of the Health Resources and Services Administration, shall conduct an education
				campaign to increase awareness among physicians and other health care
				professionals—</text>
								<subparagraph id="H7D5F4A3A969F4527A452A7BE66095BCB"><enum>(A)</enum><text>relating to the
				risk factors, risk reduction strategies, early diagnosis and treatment of
				breast cancer in young women;</text>
								</subparagraph><subparagraph id="H873C9AF197A148ACAC155EB7A288D734"><enum>(B)</enum><text>on when to refer
				patients to a health care provider with genetics expertise; and</text>
								</subparagraph><subparagraph id="H7D8F01E5F33B449BA25D5E2D988957F3"><enum>(C)</enum><text>on how to provide
				counseling that addresses long-term survivorship and health concerns of young
				women diagnosed with breast cancer.</text>
								</subparagraph></paragraph><paragraph id="H3F1B6BBB3FDE49F4B6B3B8E718BCCA16"><enum>(2)</enum><header>Materials</header><text>The
				education campaign under paragraph (1) may include the distribution of print,
				video, and Web-based materials on assisting physicians and other health care
				professionals in—</text>
								<subparagraph id="H5D5014CE9E4D4EB7BA9C9004409A297E"><enum>(A)</enum><text>identifying
				generally the risk factors and early warning signs and symptoms of breast
				cancer specific to women under the age of 45 and the specific risk factors that
				would require increased monitoring;</text>
								</subparagraph><subparagraph id="H2D0ED456E0FB4A569512447265AFA091"><enum>(B)</enum><text>counseling
				patients on the benefits of evidence-based healthy lifestyles which reduce the
				risks of breast cancer;</text>
								</subparagraph><subparagraph id="H8BFCE8F761974070BCDD34E7084F5FC8"><enum>(C)</enum><text display-inline="yes-display-inline">counseling patients on the importance of
				consistent breast self exams to facilitate breast self awareness and teaching
				patients how to perform such exams;</text>
								</subparagraph><subparagraph id="HAF2D580032494DD09C32F116588365CF"><enum>(D)</enum><text display-inline="yes-display-inline">understanding the importance of early
				diagnosis, including teaching young women the symptoms of breast cancer and
				early detection practices, including clinical breast exams, genetic counseling
				and testing where appropriate, and other strategies determined to be
				appropriate by the Secretary; and</text>
								</subparagraph><subparagraph id="H33A64B284AA847EFB1062583E4A9CEE8"><enum>(E)</enum><text>the unique
				long-term effects faced by young women with breast cancer that will need to be
				addressed over their lifetimes, including—</text>
									<clause id="ID109e6d31f6de439d9ea348d58e3a991c"><enum>(i)</enum><text>re-entry into the
				workforce or school;</text>
									</clause><clause id="ID2452fdc4e6c14139ba82edfc8a06bc8b"><enum>(ii)</enum><text>infertility as a
				result of treatment;</text>
									</clause><clause id="ID2b516a7a5aab412182cc4922efa55820"><enum>(iii)</enum><text>neuro-cognitive
				effects;</text>
									</clause><clause id="ID8a1d50e6122f44219739bf9ad4509a2c"><enum>(iv)</enum><text>important
				effects of cardiac, vascular, muscle, and skeletal complications; and</text>
									</clause><clause id="ID5121813a62264fc7b238fba4635d9c93"><enum>(v)</enum><text>secondary
				malignancies.</text>
									</clause></subparagraph></paragraph></subsection><subsection id="HC818087450DB4DA0B3DFC88740E5B16B"><enum>(c)</enum><header>Prevention
				research activities</header><text>The Secretary, acting through the Director of
				the Centers for Disease Control and Prevention, shall conduct prevention
				research on breast cancer in younger women, including the following:</text>
							<paragraph id="H9DF443BF3681426BA5DF13D27289B48C"><enum>(1)</enum><text>Behavioral and
				other research on the impact of breast cancer diagnosis on young women.</text>
							</paragraph><paragraph id="HEA438EBC15BB4FCF9812F3CF5E0010A6"><enum>(2)</enum><text>Formative research
				to assist with the development of educational messages and information for the
				public, targeted populations, and their families about breast cancer.</text>
							</paragraph><paragraph id="H981BA8A6F3384EB7A0E5606DA19289D6"><enum>(3)</enum><text>Surveys of
				physician and public knowledge, attitudes, and practices about breast cancer
				prevention and control in high-risk populations.</text>
							</paragraph></subsection><subsection id="H81B2367426D64E46B8DAB277A8253CF8"><enum>(d)</enum><header>Support for
				young women diagnosed with breast cancer</header>
							<paragraph id="H94F03BD23E9B45C0AEA4E0E3710DA97D"><enum>(1)</enum><header>In
				general</header><text>The Secretary shall award grants to organizations and
				institutions to provide health information from credible sources and
				substantive assistance directed to young women diagnosed with breast cancer
				on—</text>
								<subparagraph id="H84862180BD0B4CBC9396FAB28A325830"><enum>(A)</enum><text>education and
				counseling regarding fertility preservation;</text>
								</subparagraph><subparagraph id="H65667C557E7749C1B48063DEDBF8D5A3"><enum>(B)</enum><text>support, including
				social, emotional, psychosocial, financial, lifestyle, and caregiver
				support;</text>
								</subparagraph><subparagraph id="H4776D2E83B37475889BF0AB8028D0FD2"><enum>(C)</enum><text>familial risk
				factors; and</text>
								</subparagraph><subparagraph id="H8A68329CB96646CC9C1ED2A917436883"><enum>(D)</enum><text>risk reduction
				strategies to reduce recurrence or metastasis.</text>
								</subparagraph></paragraph><paragraph id="H663C1A781AF24689B54329A81BA22BFE"><enum>(2)</enum><header>Priority</header><text>In
				making grants under paragraph (1), the Secretary shall give priority to
				applicants that deal specifically with young women and breast cancer.</text>
							</paragraph></subsection><subsection id="HB1CA2AF9A38B4BF68D37FB2971456E58"><enum>(e)</enum><header>No duplication
				of effort</header><text>In conducting an education campaign or other program
				under subsections (a), (b), (c), or (d), the Secretary shall avoid duplicating
				other existing Federal breast cancer education efforts.</text>
						</subsection><subsection id="HCB9EA9F2F095455AA90B8E9403A0D531"><enum>(f)</enum><header>Measurement;
				reporting</header><text>The Secretary, acting through the Director of the
				Centers for Disease Control and Prevention, shall—</text>
							<paragraph id="HBE15F8666FE04A0888E58D1894211B9F"><enum>(1)</enum><text>measure young
				women’s awareness regarding breast cancer, including knowledge of specific risk
				factors and early warning signs, and young women’s proactive efforts at early
				detection, including seeking out information on risk-reducing lifestyle
				choices, the number or percentage of young women receiving regular clinical
				breast exams, the number or percentage of young women who perform breast self
				exams, and the frequency of such exams, before the implementation of this
				section;</text>
							</paragraph><paragraph id="H9534AF2A8987474B9F54FBEDB57094FF"><enum>(2)</enum><text>establish
				quantitative benchmarks to measure the impact of activities under this
				section;</text>
							</paragraph><paragraph id="H68EEDE69B7C84958B8F9F5F70F8E24A9"><enum>(3)</enum><text>not less than
				every 3 years, measure the impact of such activities; and</text>
							</paragraph><paragraph id="H171F5D96707148B68B7E8F5042FA4619"><enum>(4)</enum><text>submit reports to
				the Congress on the results of such measurements.</text>
							</paragraph></subsection><subsection id="HFA2333F0285D44258C8C58D5A5414578"><enum>(g)</enum><header>Definition</header><text>In
				this section, the term <term>young women</term> means women 15 to 44 years of
				age.</text>
						</subsection><subsection id="H8BB1AF14EE2F4118A29EA4887BCA59AF"><enum>(h)</enum><header>Authorization of
				appropriations</header><text>To carry out this section, there are authorized to
				be appropriated $9,000,000 for each of the fiscal years 2010 through
				2014.</text>
						</subsection></section></part><after-quoted-block>.</after-quoted-block></quoted-block>
		</section></legis-body>
</bill>
