1.This Act may be cited as the
Prematurity Research Expansion and
Education for Mothers who deliver Infants Early Reauthorization
Act
or the PREEMIE Reauthorization Act
.
2.It is the purpose of this Act to—
(1)help reduce
preterm birth, associated disabilities of preterm birth, and deaths of babies
born preterm;
(2)expand research
into the causes of preterm birth; and
(3)promote the
development, availability, and use of evidence-based practices of care for
pregnant women at risk of preterm labor or other serious pregnancy-related
complications and for infants born preterm.
3.Research and
activities at the national institutes of healthPart 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:
409K.Expansion and
coordination of research relating to preterm labor and delivery and infant
mortality
(a)The Secretary, acting through the Director of NIH, shall,
subject to the availability of appropriations, expand, intensify, and
coordinate the activities of the National Institutes of Health with respect to
research on the causes of preterm labor and delivery, tools to detect, prevent,
or reduce prevalence of preterm labor and delivery, and the care and treatment
of preterm infants.
(b)Authorization of
Clinical Research NetworksThere shall be established within the
National Institutes of Health a multi-center clinical program (that shall be
initially established utilizing existing networks) designed to—
(1)investigate
problems in clinical obstetrics, particularly those related to prevention of
low birth weight, prematurity, and medical problems of pregnancy;
(2)improve the care
and outcomes of neonates, especially very-low-birth weight infants; and
(3)enhance the
understanding of DNA and proteins as they relate to the underlying processes
that lead to preterm birth to aid in formulating more effective interventions
to prevent preterm birth.
(c)Trans-Disciplinary
centers for preterm birth research
(1)The Director of NIH shall, subject to appropriations made
available to carry out this subsection, award grants and contracts to public
and nonprofit private entities to pay all or part of the cost of planning,
establishing, improving, and providing basic operating support for
trans-disciplinary research centers for prematurity. Research supported under
this subsection shall integrate clinical, public health, basic, and behavioral
and social science disciplines together with bioinformatics, engineering,
mathematical, and computer sciences to address the causes of preterm labor and
delivery collaboratively.
(2)To
be eligible to receive a grant or contract under paragraph (1), an entity shall
submit to the Director an application at such time, in such manner, and
containing such information as the Director may require, including, if
appropriate, an assurance that the entity will coordinate with clinical
research networks authorized in subsection (b).
(3)The
Director of NIH shall include in the report under section 402A(c) information
on the activities of the trans-disciplinary research centers for prematurity
under this subsection.
(d)National
educational campaign
(1)The
Secretary, acting through the Surgeon General of the Public Health Service and
in consultation with the Director of the Eunice Kennedy Shriver National
Institute on Child Health and Human Development, shall establish and implement
a national science-based provider and consumer education campaign on promoting
healthy pregnancies and preventing preterm birth.
(2)The campaign established under paragraph
(1) shall target women of childbearing age, high risk populations, ethnic and
minority groups, individuals with a low socioeconomic status, obstetricians and
gynecologists, nurse practitioners, certified nurse-midwives, certified
midwives, and other health care
providers.
.
4.Research and
activities at the centers for disease control and prevention
(a)Section 3 of the Prematurity Research Expansion and
Education for Mothers who deliver Infants Early Act (42 U.S.C. 247b–4f) is
amended by striking subsection (b) and inserting the following:
(b)Studies and
Activities on Preterm Birth
(1)The Secretary of Health and Human Services, acting
through the Director of the Centers for Disease Control and Prevention, shall,
subject to the availability of appropriations—
(A)conduct ongoing
epidemiological studies on the clinical, biological, social, environmental,
genetic, and behavioral factors relating to prematurity;
(B)conduct activities
to improve national data to facilitate tracking the burden of preterm
birth;
(C)develop,
implement, and evaluate novel methods for prevention to better understand the
growing problem of late preterm birth;
(D)conduct etiologic
and epidemiologic studies of preterm birth;
(E)expand research on
racial and ethnic disparities as they relate to preterm birth; and
(F)conduct ongoing
epidemiological studies on the effectiveness of community based
interventions.
(2)Not
later than 2 years after the date of enactment of the PREEMIE Reauthorization
Act, and every 2 years thereafter, the Secretary of Health and Human Services,
acting through the Director of the Centers for Disease Control and Prevention,
shall submit to the appropriate committees of Congress reports concerning the
progress and any results of studies conducted under paragraph
(1).
.
(b)Section
3(e) of the Prematurity Research Expansion and Education for Mothers who
deliver Infants Early Act (42 U.S.C. 247b–4f(e)) is amended by striking
2011
and inserting 2016
.
5.Research and
activities at the health resources and services administration
(a)Telemedicine
demonstration project on high risk pregnanciesSection 330I of
the Public Health Service Act (42 U.S.C. 254c–14) is amended—
(1)by redesignating
subsections (q) through (s) as subsections (r) through (t),
respectively;
(2)by inserting after
subsection (p), the following:
(q)Telemedicine
demonstration project on high risk pregnancies
(1)The Director shall award grants under this section to
eligible entities to establish demonstration projects for—
(A)the provision of
preconception, antepartum, intrapartum, and obstetric services to high risk
women of child bearing age remotely by obstetricians and gynecologists, nurse
practitioners, certified nurse-midwives, certified midwives, or other health
care providers using telehealth; and
(B)for the conduct of
educational activities regarding risk factors for preterm birth.
(2)To
be eligible to receive a grant under paragraph (1), an entity shall submit an
application to the Director at such time, in such manner, and containing such
information as the Director my require.
;
and
(3)in subsection (t)
(as so redesignated)—
(A)in paragraph (1),
by striking and
at the end;
(B)in paragraph (2),
by striking the period and inserting ; and
; and
(C)by adding at the
end the following:
(3)for grants under
subsection (q), $1,000,000 for each of fiscal years 2012 through
2016.
.
(b)Public and
health care provider educationSection 399Q of the Public Health
Service Act (42 U.S.C. 280g–5) is amended—
(1)in subsection
(b)—
(A)in paragraph (1),
by striking subparagraphs (A) through (F) and inserting the following:
(A)the core risk
factors for preterm labor;
(B)medically
indicated deliveries before 39 weeks;
(C)outcomes for
infants born before 39 weeks;
(D)risk factors for
preterm delivery;
(E)the importance of
preconception and prenatal care;
(F)smoking cessation,
hypertension, and weight maintenance;
(G)treatments and
outcomes for babies born premature;
(H)the informational
needs of families during the stay of an infant in a neonatal intensive care
unit;
(I)preventable birth
injuries if evidence-based strategies had been utilized;
(J)depression;
and
(K)the use of
progesterone;
;
and
(B)by striking
paragraph (2) and by redesignating paragraphs (3) and (4) as paragraphs (2) and
(3), respectively;
(2)by redesignating
subsection (c) as subsection (d) and by inserting after subsection (b) the
following new subsection:
(c)
(1)The Secretary, acting through the Administrator of the
Health Resources and Services Administration and the heads of other appropriate
agencies, shall conduct (and report on) research studies and demonstration
projects that test maternity care models that are designed to reduce the rate
of preterm birth.
(2)The
Secretary may carry out this subsection through the awarding of grants to
eligible entities.
(3)To
be eligible to receive a grant under this section an entity shall—
(A)be—
(i)a
hospital or hospital systems that utilizes evidence-based best practices;
or
(ii)a
public or private nonprofit entity; and
(B)submit to the
Secretary an application at such time, in such manner, and containing such
information as the Secretary may require.
(4)In
awarding grants under this subsection, the Secretary shall give priority to
projects in geographic areas with a demonstrated persistent high rate of
preterm birth based on data from the National Center on Health
Statistics.
;
and
(3)in subsection (d),
as redesignated by paragraph (2), by striking 2011
and inserting
2016
.
6.
(a)Advisory
Committee on Infant Mortality
(1)The
Secretary shall establish an advisory committee known as the Advisory
Committee on Infant Mortality
(referred to in this section as the
Advisory Committee
).
(2)The
Advisory Committee shall provide advice and recommendations to the Secretary
concerning the following activities:
(A)Programs of the
Department of Health and Human Services that are directed at reducing infant
mortality and improving the health status of pregnant women and infants.
(B)Factors affecting
the continuum of care with respect to maternal and child health care, including
outcomes following childbirth and specifically preterm birth.
(C)Strategies to
coordinate the various Federal, State, local, and private programs and efforts
that are designed to deal with the health and social problems impacting infant
mortality.
(D)Implementation of
the Healthy Start program under section 330H of the Public Health Service Act
(42 U.S.C. 254c–8) and Healthy People 2020 infant mortality objectives.
(E)Strategies to
promote the collection of improved linked maternal and infant perinatal
data.
(F)Strategies to
reduce preterm birth rates through research, programs, and education.
(3)Plan for HHS
preterm birth activitiesNot later than 1 year after the date of
enactment of this section, the Advisory Committee shall develop a plan for
conducting and supporting research education and programs on preterm birth
through the Department of Health and Human Services and shall periodically
review and revise the plan. The plan shall—
(A)provide for a
broad range of research and educational activities relating to biomedical,
epidemiological, psychosocial, translational, and clinical activities,
including studies on racial and ethnic disparities in preterm birth
rates;
(B)identify
priorities among the programs and activities of the Department of Health and
Human Services regarding preterm birth; and
(C)reflect input from
a broad range of scientists, patients, and advocacy groups.
(4)The
Secretary shall ensure that the membership of the Advisory Committee includes
the following:
(A)Representatives
provided for in the original charter of the Advisory Committee.
(B)A representative
of the National Center for Health Statistics.
(b)Patient Safety
Study and report
(1)The Secretary shall
designate an appropriate agency within the Department of Health and Human
Services to conduct a study on hospital readmissions of preterm infants.
Findings and recommendations resulting from such study shall be based on data
collected to address the following questions and such other related questions
which the Secretary and such designated agency deem important:
(A)By State and by
health care system, what is the number and rate of inpatient readmission for
infants born preterm?
(B)What are the
leading diagnoses at the time of inpatient readmission for preterm
infants?
(C)What is the
average cost of treatment for preterm infant readmissions by diagnosis, by
health care system, and by State?
(D)What percentage of
readmissions are preventable if evidence-based strategies had been
utilized?
(E)What percentage of
treatment cost is attributable to preventable readmissions?
(F)What is the source
of health insurance coverage for preterm infants who are readmitted, such as
through publicly funded programs (including the Medicaid program under title
XIX of the Social Security Act and the Children’s Health Insurance Program
under title XXI of such Act), private health insurance, and self payments of
uninsured individuals?
(G)What
evidence-based interventions are effective in preventing readmission of preterm
infants, including measuring and reporting on quality of care and
outcomes?
(2)Report to
Secretary and CongressNot later than 1 year after the date of
the enactment of this Act, the agency designated under paragraph (1) shall
submit to the Secretary and to Congress a report containing the findings and
recommendations resulting from the study conducted under such subparagraph,
including recommendations for hospital discharge and follow-up procedures
designed to reduce rates of preventable hospital readmissions for preterm
infants.
(3)Authorization of
AppropriationsThere is authorized to be appropriated to carry
out this subsection, $1,000,000 for fiscal year 2012.