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<dc:title>115 S2465 RS: Sickle Cell Disease Research, Surveillance, Prevention, and Treatment Act of 2018</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2018-02-28</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">II</distribution-code><calendar>Calendar No. 553</calendar><congress>115th CONGRESS</congress><session>2d Session</session><legis-num>S. 2465</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20180228">February 28, 2018</action-date><action-desc><sponsor name-id="S365">Mr. Scott</sponsor> (for himself, <cosponsor name-id="S370">Mr. Booker</cosponsor>, <cosponsor name-id="S393">Mr. Jones</cosponsor>, <cosponsor name-id="S373">Mr. Cassidy</cosponsor>, <cosponsor name-id="S284">Ms. Stabenow</cosponsor>, <cosponsor name-id="S366">Ms. Warren</cosponsor>, and <cosponsor name-id="S307">Mr. Brown</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name added-display-style="italic" committee-id="SSHR00" deleted-display-style="strikethrough">Committee on Health, Education, Labor, and Pensions</committee-name></action-desc></action><action stage="Reported-in-Senate"><action-date>August 15, 2018</action-date><action-desc>Reported by <sponsor name-id="S289">Mr. Alexander</sponsor>, with an amendment</action-desc><action-instruction>Strike out all after the enacting clause and insert the part printed in italic</action-instruction></action><legis-type>A BILL</legis-type><official-title>To amend the Public Health Service Act to reauthorize a sickle cell disease prevention and
			 treatment demonstration program and to provide for sickle cell disease
			 research, surveillance, prevention, and treatment.</official-title></form>
	<legis-body display-enacting-clause="yes-display-enacting-clause" id="HF1DE84963B294282A19083D2C9344011" style="OLC">
		<section changed="deleted" committee-id="SSHR00" id="HB5FD428F2192435C95A769A025806E15" reported-display-style="strikethrough" section-type="section-one"><enum>1.</enum><header>Short title; table of contents</header>
 <subsection id="H74F29F4ADD4940DC8382C2522A6262EC"><enum>(a)</enum><header>Short title</header><text display-inline="yes-display-inline">This Act may be cited as the <quote><short-title>Sickle Cell Disease Research, Surveillance, Prevention, and Treatment Act of 2018</short-title></quote>.</text> </subsection><subsection id="HF6804D9AE08945FFA28D764A64627DAF"><enum>(b)</enum><header>Table of contents</header><text display-inline="yes-display-inline">The table of contents of this Act is as follows:</text><toc changed="deleted" committee-id="SSHR00" reported-display-style="strikethrough"><toc-entry idref="HB5FD428F2192435C95A769A025806E15" level="section">Sec. 1. Short title; table of contents.</toc-entry><toc-entry idref="HF62802C2F9FE4A79A016CAB925A21581" level="section">Sec. 2. Sense of the Senate.</toc-entry><toc-entry idref="id7B20A20E71E447F8BC54CA08A9F55B91" level="section">Sec. 3. Sickle cell disease surveillance.</toc-entry><toc-entry idref="HA7CA1388CE8549B39D4B096717497329" level="section">Sec. 4. Sickle cell disease prevention and treatment.</toc-entry><toc-entry idref="H80F095901C08467F93E8ECDC73B26C06" level="section">Sec. 5. Collaboration with community-based entities.</toc-entry></toc>
 </subsection></section><section changed="deleted" committee-id="SSHR00" id="HF62802C2F9FE4A79A016CAB925A21581" reported-display-style="strikethrough"><enum>2.</enum><header>Sense of the Senate</header><text display-inline="no-display-inline">It is the Sense of the Senate that further research should be undertaken to expand the understanding of the cause of, and to find a cure for, sickle cell disease.</text>
 </section><section changed="deleted" committee-id="SSHR00" id="id7B20A20E71E447F8BC54CA08A9F55B91" reported-display-style="strikethrough"><enum>3.</enum><header>Sickle cell disease surveillance</header><text display-inline="no-display-inline">Part P of title III of the Public Health Service Act is amended by inserting after section 399V–6 (<external-xref legal-doc="usc" parsable-cite="usc/42/280g-17">42 U.S.C. 280g–17</external-xref>) the following:</text>
			<quoted-block changed="deleted" committee-id="SSHR00" display-inline="no-display-inline" id="H46A7D192BAF64D139EDE708ADF23FF76" reported-display-style="strikethrough" style="OLC">
				<section id="id9BEAAFDB98F24A7CB9BCD09D0EE474CE"><enum>399V–7.</enum><header>National Sickle Cell Disease Surveillance, Prevention, and Treatment Program</header>
					<subsection id="H701633849B984C5691394680F805000A"><enum>(a)</enum><header>Surveillance</header>
 <paragraph id="HA95C4B9864CC44B2815649FC153239A6"><enum>(1)</enum><header>Grants</header><text>The Secretary may, for each fiscal year for which appropriations are available to carry out this subsection, make grants to not more than 20 eligible entities for the following purposes:</text>
 <subparagraph id="H534622CC31E64C7AA8A5A4BE31277499"><enum>(A)</enum><text>To conduct surveillance and maintain data on the prevalence and distribution of sickle cell disease and its associated health outcomes, complications, and treatments.</text>
 </subparagraph><subparagraph id="HBAF3F2B315224D7EA24AF46C3D5C34AD"><enum>(B)</enum><text display-inline="yes-display-inline">To conduct public health initiatives with respect to sickle cell disease, including one or more of the following:</text>
 <clause id="HB94CE75BF5384D2EBC0E55EAF5A1C455"><enum>(i)</enum><text display-inline="yes-display-inline">Increasing efforts to improve access to high-quality sickle cell disease-related health care, including the use of treatments approved under section 505 of the Federal Food, Drug, and Cosmetic Act or licensed under section 351 of this Act.</text>
 </clause><clause id="HCF02C4EC9B994FB0BDF9EF78A82274B4"><enum>(ii)</enum><text>Working with partners to improve health outcomes of people with sickle cell disease over the lifespan by promoting guidelines for sickle cell disease screening, prevention, and treatment, including management of sickle cell disease complications.</text>
 </clause><clause id="HD2BE30BAF53049219E152A57C83A5312"><enum>(iii)</enum><text>Providing support to community-based organizations and State and local health departments in conducting sickle cell disease education and training activities for patients, communities, and health care providers.</text>
 </clause><clause id="H9762227E6B5345C8BDBCD9229D2EB89B"><enum>(iv)</enum><text>Supporting and training State health departments and regional laboratories in comprehensive testing to identify specific forms of sickle cell disease in people of all ages.</text>
 </clause></subparagraph><subparagraph id="H13D1313A4CC24CF0A654D0D16634D405"><enum>(C)</enum><text>To identify and evaluate promising strategies for prevention and treatment of sickle cell disease complications, including through one or more of the following:</text>
 <clause id="HDD1881D3CF0C43389D70066E60369A04"><enum>(i)</enum><text>Improving estimates of the national incidence and prevalence of sickle cell disease, including estimates about the specific types of sickle cell disease.</text>
 </clause><clause id="H818803E1B9D84EDEA6759785BD3CFF28"><enum>(ii)</enum><text>Identifying health disparities related to sickle cell disease.</text> </clause><clause id="H0EA5F417430B4001BDCEB632B0CDF2B7"><enum>(iii)</enum><text>Assessing the utilization of therapies and strategies to prevent complications related to sickle cell disease.</text>
 </clause><clause id="HA68ADB1C2E4D430C879DE1768864C1BF"><enum>(iv)</enum><text>Evaluating the impact of genetic, environmental, behavioral, and other risk factors that may affect sickle cell disease health outcomes.</text>
 </clause></subparagraph></paragraph><paragraph id="HE086DCBEA323424A9368CE2E5C0F0EFA"><enum>(2)</enum><header>Population included</header><text>The Secretary shall, to the extent practicable, award grants under this subsection to eligible entities across the United States so as to include data on the majority of the United States population with sickle cell disease.</text>
 </paragraph><paragraph id="HABFA487C5FE2473D9F4D60BF84EE7C64"><enum>(3)</enum><header>Application</header><text>To seek a grant under this subsection, an eligible entity shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require.</text>
 </paragraph><paragraph id="H5FA3601C2836467D8F4F3C7D451E2E2D"><enum>(4)</enum><header>Eligible entity</header><text>In this subsection, the term <term>eligible entity</term> includes the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, the United States Virgin Islands, the Commonwealth of the Northern Mariana Islands, American Samoa, Guam, the Federated States of Micronesia, the Republic of Marshall Islands, the Republic of Palau, a State health or public health department, an institution of higher education, or a nonprofit entity.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
		</section><section changed="deleted" committee-id="SSHR00" id="HA7CA1388CE8549B39D4B096717497329" reported-display-style="strikethrough"><enum>4.</enum><header>Sickle cell disease prevention and treatment</header>
 <subsection id="HD2A8F03301084597852ABF38E3E644AF"><enum>(a)</enum><header>Reauthorization</header><text display-inline="yes-display-inline">Section 712(c) of the American Jobs Creation Act of 2004 (<external-xref legal-doc="public-law" parsable-cite="pl/108/357">Public Law 108–357</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/42/300b-1">42 U.S.C. 300b–1</external-xref> note) is amended—</text>
 <paragraph id="H819376E2F2394548AAF7E4EC35755BF9"><enum>(1)</enum><text>by striking <quote>Sickle Cell Disease</quote> each place it appears and inserting <quote>sickle cell disease</quote>;</text> </paragraph><paragraph id="H78D36BFDBBA845C9AD96AC4532E9C4AD"><enum>(2)</enum><text display-inline="yes-display-inline">in paragraph (1)(A), by striking <quote>grants to up to 40 eligible entities for each fiscal year in which the program is conducted under this section for the purpose of developing and establishing systemic mechanisms to improve the prevention and treatment of Sickle Cell Disease</quote> and inserting <quote>grants to up to 25 eligible entities for each fiscal year in which the program is conducted under this section for the purpose of developing and establishing systemic mechanisms to improve the prevention and treatment of sickle cell disease in populations with a high density of sickle cell disease patients</quote>;</text>
 </paragraph><paragraph id="HFBA7B62484B9436E973ECC152C721E42"><enum>(3)</enum><text>in paragraph (1)(B)—</text> <subparagraph id="H2F6F4BE5C0E54DC9B76A58ED0A2F1FE4"><enum>(A)</enum><text>by striking clause (ii) (relating to priority); and</text>
 </subparagraph><subparagraph id="HC98EBE335E1248DD93E4DD7FC3A01097"><enum>(B)</enum><text>by striking <quote><header-in-text level="subparagraph" style="OLC">Grant award requirements</header-in-text></quote> and all that follows through <quote>The Administrator shall</quote> and inserting <quote><header-in-text level="subparagraph" style="OLC">Geographic diversity</header-in-text>.—The Administrator shall</quote>;</text> </subparagraph></paragraph><paragraph id="H8D69EF90507B41939F3BEBE8E1573060"><enum>(4)</enum><text>in paragraph (2), by adding the following new subparagraph at the end:</text>
					<quoted-block changed="deleted" committee-id="SSHR00" display-inline="no-display-inline" id="HAFD0789EDB8140BAABBAA6FD2E396B06" reported-display-style="strikethrough" style="OLC">
 <subparagraph id="H47EB0517D01B4E5D8B1124EB0EF41A0A"><enum>(E)</enum><text>To expand, coordinate, and implement transition services for adolescents with sickle cell disease making the transition to adult health care.</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block>
 </paragraph><paragraph id="HD08DE8F83283443CBDB1B735D2A56053"><enum>(5)</enum><text display-inline="yes-display-inline">in paragraph (6), by striking <quote>$10,000,000 for each of fiscal years 2005 through 2009</quote> and inserting <quote>$4,455,000 for each of fiscal years 2018 through 2022</quote>.</text> </paragraph></subsection><subsection id="HDF634BE7CE72497A9814679A59D68B05"><enum>(b)</enum><header>Technical changes</header><text>Subsection (c) of section 712 of the American Jobs Creation Act of 2004 (<external-xref legal-doc="public-law" parsable-cite="pl/108/357">Public Law 108–357</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/42/300b-1">42 U.S.C. 300b–1</external-xref> note), as amended by subsection (a), is—</text>
 <paragraph id="HE584DDC08203473E9209C748B9436885"><enum>(1)</enum><text>transferred to the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/201">42 U.S.C. 201</external-xref> et seq.);</text> </paragraph><paragraph id="idAA6D551DD62D4437964782C5927FD5FD"><enum>(2)</enum><text>redesignated as subsection (b); and</text>
 </paragraph><paragraph id="HB9D06156A4704B23B127958E0EB1BFF3"><enum>(3)</enum><text>inserted at the end of section 399V–7 of such Act, as added by section 2 of this Act.</text>
 </paragraph></subsection></section><section changed="deleted" committee-id="SSHR00" id="H80F095901C08467F93E8ECDC73B26C06" reported-display-style="strikethrough"><enum>5.</enum><header>Collaboration with community-based entities</header><text display-inline="no-display-inline">Section 399V–7 of the Public Health Service Act, as amended by section 3, is further amended by adding at the end the following:</text>
			<quoted-block changed="deleted" committee-id="SSHR00" display-inline="no-display-inline" id="H43C232B539B845DA8C85402F2B5AAA62" reported-display-style="strikethrough" style="OLC">
 <subsection id="H6E2F92C10B4F47B691AE762A88EE34BF"><enum>(c)</enum><header>Collaboration with community-Based entities</header><text display-inline="yes-display-inline">To be eligible to receive a grant or other assistance under subsection (a) or (b), an eligible entity must have in effect a collaborative agreement with a community-based organization with five or more years of experience in providing services to sickle cell disease patients.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></section></legis-body>
	<legis-body display-enacting-clause="no-display-enacting-clause" style="OLC">
 <section changed="added" committee-id="SSHR00" id="id1d69815d-a457-4d70-a93d-9c3b343f51d5" reported-display-style="italic" 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>Sickle Cell Disease and Other Heritable Blood Disorders Research, Surveillance, Prevention, and Treatment Act of 2018</short-title></quote>.</text>
 </section><section changed="added" committee-id="SSHR00" id="id595160d2-eee0-4630-a8cb-6e01ac01d2af" reported-display-style="italic"><enum>2.</enum><header>Data collection on certain blood disorders</header><text display-inline="no-display-inline">Part A of title XI of the Public Health Service Act is amended by inserting after section 1105 (<external-xref legal-doc="usc" parsable-cite="usc/42/300b-4">42 U.S.C. 300b-4</external-xref>) the following:</text>
			<quoted-block changed="added" committee-id="SSHR00" display-inline="no-display-inline" id="idb1c9e4f3-6963-4348-b3f2-b1983f41dddd" reported-display-style="italic" style="OLC">
				<section id="id3e9d2ad2-bb4d-4356-ab27-ab059de66cb1"><enum>1106.</enum><header>Sickle cell disease and other heritable blood disorders research, surveillance, prevention, and
			 treatment</header>
					<subsection id="id72307B900B8E4FDD8D0ECF0B64081F06"><enum>(a)</enum><header>Grants</header>
 <paragraph id="ida95708cf-4dba-4dde-beb7-e534d7aea807"><enum>(1)</enum><header>In general</header><text>The Secretary may award grants related to heritable blood disorders, including sickle cell disease, for one or more of the following purposes:</text>
 <subparagraph id="id9b6854d6-733b-482b-8071-3078eb45b17c"><enum>(A)</enum><text>To collect and maintain data on such diseases and conditions, including subtypes as applicable, and their associated health outcomes and complications, including for the purpose of—</text>
 <clause id="id36FCD7C45B0B4F9C80C25C1793F6C78D"><enum>(i)</enum><text>improving national incidence and prevalence data;</text> </clause><clause id="id50830028217C4B40BC3A716B8BBCC921"><enum>(ii)</enum><text>identifying health disparities, including the geographic distribution, related to such diseases and conditions;</text>
 </clause><clause id="id141E3ED890084D41BF47AABE74DC2AE7"><enum>(iii)</enum><text>assessing the utilization of therapies and strategies to prevent complications; and</text> </clause><clause id="id4D6C7A48785E4C9192A7072E4A28AF5F"><enum>(iv)</enum><text>evaluating the effects of genetic, environmental, behavioral, and other risk factors that may affect such individuals.</text>
 </clause></subparagraph><subparagraph id="id60bcd2ad-ca14-48e2-8f04-a6fe15188e5b"><enum>(B)</enum><text display-inline="yes-display-inline">To conduct public health activities with respect to such conditions, which may include—</text> <clause id="id7409ca59-dab8-4567-9bdf-124cdddc9630"><enum>(i)</enum><text display-inline="yes-display-inline">developing strategies to improve health outcomes and access to quality health care for the screening for, and treatment and management of, such diseases and conditions, including through public-private partnerships;</text>
 </clause><clause id="id2a1feede-6554-445f-8a1c-24755a0fe875"><enum>(ii)</enum><text>providing support to community-based organizations and State and local health departments in conducting education and training activities for patients, communities, and health care providers concerning such diseases and conditions;</text>
 </clause><clause id="id0d990ddc-2206-476f-bffc-93da4579f3e8"><enum>(iii)</enum><text>supporting State health departments and regional laboratories, including through training, in testing to identify such diseases and conditions, including specific forms of sickle cell disease, in individuals of all ages; and</text>
 </clause><clause id="ide7d3bf2f-b4ec-4d4a-846a-eeb93ab49bb6"><enum>(iv)</enum><text>the identification and evaluation of best practices for treatment of such diseases and conditions, and prevention and management of their related complications.</text>
 </clause></subparagraph></paragraph><paragraph id="id9856eca8-df32-4989-acc5-c83a9aeef548"><enum>(2)</enum><header>Population included</header><text>The Secretary shall, to the extent practicable, award grants under this subsection to eligible entities across the United States to improve data on the incidence and prevalence of heritable blood disorders, including sickle cell disease, and the geographic distribution of such diseases and conditions.</text>
 </paragraph><paragraph id="id04d88844-4ced-4af9-bf24-82941eaeb3f7"><enum>(3)</enum><header>Application</header><text>To seek a grant under this subsection, an eligible entity shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require.</text>
 </paragraph><paragraph id="idF3591B8922EC4B96A34DE1E35AC1559F"><enum>(4)</enum><header>Priority</header><text>In awarding grants under this subsection, the Secretary may give priority, as appropriate, to eligible entities that have a relationship with a community-based organization that has experience in, or is capable of, providing services to individuals with heritable blood disorders, including sickle cell disease.</text>
 </paragraph><paragraph id="id1496029b-a83c-45bb-a6ad-943438a55e27"><enum>(5)</enum><header>Eligible entity</header><text>In this subsection, the term <term>eligible entity</term> includes the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, the United States Virgin Islands, the Commonwealth of the Northern Mariana Islands, American Samoa, Guam, the Federated States of Micronesia, the Republic of Marshall Islands, the Republic of Palau, Indian tribes, a State or local health department, an institution of higher education, or a nonprofit entity with appropriate experience to conduct the activities under this subsection.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
		</section><section changed="added" committee-id="SSHR00" id="id5f51440a-ff5e-4b52-9647-cca2aa7619b9" reported-display-style="italic"><enum>3.</enum><header>Sickle cell disease prevention and treatment</header>
 <subsection id="id19D1C69FE596422790F4D5F62705EAD4"><enum>(a)</enum><header>Reauthorization</header><text display-inline="yes-display-inline">Section 712(c) of the American Jobs Creation Act of 2004 (<external-xref legal-doc="public-law" parsable-cite="pl/108/357">Public Law 108–357</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/42/300b-1">42 U.S.C. 300b–1</external-xref> note) is amended—</text>
 <paragraph id="idbe9a4d64-f1e9-421b-aa59-ee587b38379e"><enum>(1)</enum><text>by striking <quote>Sickle Cell Disease</quote> each place it appears and inserting <quote>sickle cell disease</quote>;</text> </paragraph><paragraph id="idc2757785-a0ce-4ef2-b0bc-05e2fa6a2630"><enum>(2)</enum><text display-inline="yes-display-inline">in paragraph (1)(A), by striking <quote>shall conduct a demonstration program by making grants to up to 40 eligible entities for each fiscal year in which the program is conducted under this section for the purpose of developing and establishing systemic mechanisms to improve the prevention and treatment of Sickle Cell Disease</quote> and inserting <quote>shall continue efforts, including by awarding grants, to develop or establish mechanisms to improve the treatment of sickle cell disease, and to improve the prevention and treatment of complications of sickle cell disease, in populations with a high proportion of individuals with sickle cell disease</quote>;</text>
 </paragraph><paragraph id="ida471725c-526b-4932-8d43-03cd36232b37"><enum>(3)</enum><text>in paragraph (1)(B)—</text> <subparagraph id="id21cd23b1-4a22-45b0-abda-5c261766bdd6"><enum>(A)</enum><text>by striking clause (ii) (relating to priority); and</text>
 </subparagraph><subparagraph id="id16a7a5c5-95a6-4019-aa48-2d5463f70324"><enum>(B)</enum><text>by striking <quote><header-in-text level="subparagraph" style="OLC">Grant award requirements</header-in-text></quote> and all that follows through <quote>The Administrator shall</quote> and inserting <quote><header-in-text level="subparagraph" style="OLC">Geographic diversity</header-in-text>.—The Administrator shall</quote>;</text> </subparagraph></paragraph><paragraph id="id62db9c2b-313a-4e73-8125-03eac0f48a8f"><enum>(4)</enum><text>in paragraph (2), by adding the following new subparagraph at the end:</text>
					<quoted-block changed="added" committee-id="SSHR00" display-inline="no-display-inline" id="ida89e6859-7f63-45cb-a321-ee80e0397ae9" reported-display-style="italic" style="OLC">
 <subparagraph id="idac12e59b-2e4a-4292-b076-014b9c84f882"><enum>(E)</enum><text>To provide or coordinate services for adolescents with sickle cell disease making the transition to adult health care.</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block>
 </paragraph><paragraph id="id4d18a2f1-c86b-4d8e-a9d6-d31a30575eff"><enum>(5)</enum><text display-inline="yes-display-inline">in paragraph (6), by striking <quote>$10,000,000 for each of fiscal years 2005 through 2009</quote> and inserting <quote>$4,455,000 for each of fiscal years 2019 through 2023</quote>.</text> </paragraph></subsection><subsection id="id0A173DCF813F4A22A12364C71A4A9AC7"><enum>(b)</enum><header>Technical changes</header><text display-inline="yes-display-inline">Subsection (c) of section 712 of the American Jobs Creation Act of 2004 (<external-xref legal-doc="public-law" parsable-cite="pl/108/357">Public Law 108–357</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/42/300b-1">42 U.S.C. 300b-1</external-xref> note), as amended by subsection (a), is—</text>
 <paragraph id="id685763079B474552B223CDFA1C6008EC"><enum>(1)</enum><text display-inline="yes-display-inline">transferred to the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/201">42 U.S.C. 201</external-xref> et seq.);</text> </paragraph><paragraph id="id4CC21EED6022400B9E7292FA7B7AE027"><enum>(2)</enum><text display-inline="yes-display-inline">redesignated as subsection (b); and</text>
 </paragraph><paragraph id="id3944612670D34D9C8FA8E9659D76CB06"><enum>(3)</enum><text display-inline="yes-display-inline">inserted at the end of section 1106 of such Act, as added by section 2 of this Act.</text> </paragraph></subsection></section><section changed="added" committee-id="SSHR00" id="id1b129765a7a04cafb3f608c3a1ba128a" reported-display-style="italic"><enum>4.</enum><header>Sense of the Senate</header><text display-inline="no-display-inline">It is the Sense of the Senate that further research should be undertaken to expand the understanding of the causes of, and to find cures for, heritable blood disorders, including sickle cell disease.</text></section></legis-body><endorsement><action-date>August 15, 2018</action-date><action-desc>Reported with an amendment</action-desc></endorsement></bill>


