[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[S. 1440 Introduced in Senate (IS)]

112th CONGRESS
  1st Session
                                S. 1440

To reduce preterm labor and delivery and the risk of pregnancy-related 
    deaths and complications due to pregnancy, and to reduce infant 
                    mortality caused by prematurity.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 28, 2011

  Mr. Alexander (for himself and Mr. Bennet) introduced the following 
  bill; which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To reduce preterm labor and delivery and the risk of pregnancy-related 
    deaths and complications due to pregnancy, and to reduce infant 
                    mortality caused by prematurity.

    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 ``Prematurity Research Expansion and 
Education for Mothers who deliver Infants Early Reauthorization Act'' 
or the ``PREEMIE Reauthorization Act''.

SEC. 2. PURPOSES.

    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.

SEC. 3. RESEARCH AND ACTIVITIES AT THE NATIONAL INSTITUTES OF HEALTH.

    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:

``SEC. 409K. EXPANSION AND COORDINATION OF RESEARCH RELATING TO PRETERM 
              LABOR AND DELIVERY AND INFANT MORTALITY.

    ``(a) In General.--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 Networks.--There 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) In general.--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) Eligibility.--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) Report.--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) Establishment.--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) Targeting.--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.''.

SEC. 4. RESEARCH AND ACTIVITIES AT THE CENTERS FOR DISEASE CONTROL AND 
              PREVENTION.

    (a) Epidemiological Studies.--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) In general.--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) Report.--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) Reauthorization.--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''.

SEC. 5. RESEARCH AND ACTIVITIES AT THE HEALTH RESOURCES AND SERVICES 
              ADMINISTRATION.

    (a) Telemedicine Demonstration Project on High Risk Pregnancies.--
Section 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) In general.--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) Eligibility.--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 Education.--Section 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) Pilot Program.--
            ``(1) In general.--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) Grants.--The Secretary may carry out this subsection 
        through the awarding of grants to eligible entities.
            ``(3) Eligibility.--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) Targeting.--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''.

SEC. 6. OTHER ACTIVITIES.

    (a) Advisory Committee on Infant Mortality.--
            (1) Establishment.--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) Duties.--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 activities.--Not 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) Membership.--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) In general.--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 congress.--Not 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 appropriations.--There is authorized 
        to be appropriated to carry out this subsection, $1,000,000 for 
        fiscal year 2012.
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