<?xml version="1.0"?>
<?xml-stylesheet type="text/xsl" href="billres.xsl"?>
<!DOCTYPE bill PUBLIC "-//US Congress//DTDs/bill.dtd//EN" "bill.dtd">
<bill bill-stage="Introduced-in-House" dms-id="HA84239FF83A0445096A1D30B9A617497" public-private="public" key="H" bill-type="olc"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
<dublinCore>
<dc:title>118 HR 6746 IH: Iron Deficiency Education and Awareness Act</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2023-12-13</dc:date>
<dc:format>text/xml</dc:format>
<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>
</dublinCore>
</metadata>
<form>
<distribution-code display="yes">I</distribution-code><congress display="yes">118th CONGRESS</congress><session display="yes">1st Session</session><legis-num display="yes">H. R. 6746</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20231213">December 13, 2023</action-date><action-desc><sponsor name-id="C001134">Ms. Caraveo</sponsor> (for herself, <cosponsor name-id="B001315">Ms. Budzinski</cosponsor>, <cosponsor name-id="S001185">Ms. Sewell</cosponsor>, <cosponsor name-id="C001067">Ms. Clarke of New York</cosponsor>, <cosponsor name-id="P000620">Ms. Pettersen</cosponsor>, <cosponsor name-id="C001125">Mr. Carter of Louisiana</cosponsor>, <cosponsor name-id="G000551">Mr. Grijalva</cosponsor>, <cosponsor name-id="D000230">Mr. Davis of North Carolina</cosponsor>, and <cosponsor name-id="G000586">Mr. Garc&#237;a of Illinois</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HIF00">Committee on Energy and Commerce</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To amend the Public Health Service Act to provide for a public awareness campaign with respect to iron deficiency.</official-title></form><legis-body id="H4AE38F1E018A464A8A26D13FA9CD5825" style="OLC"> 
<section id="H817C2399301D4244B7D8508B0B2BE5FF" 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>Iron Deficiency Education and Awareness Act</short-title></quote>. </text></section> <section id="H22F58B946DDE4372904DE8D15D38812E"><enum>2.</enum><header>Findings</header><text display-inline="no-display-inline">Congress finds the following:</text> 
<paragraph id="H011178068A464F3B9B1E00B58FCDF33B"><enum>(1)</enum><text>Iron deficiency occurs when there are insufficient amounts of iron in the body. Without enough iron, the body cannot produce sufficient amounts of hemoglobin, which is the protein that enables red blood cells to carry oxygen.</text></paragraph> <paragraph id="HA9F8182DF1984631BBF33DAA54CD0FAF"><enum>(2)</enum><text>Menstrual bleeding and pregnancy are major reasons for lower levels of iron in the body. The symptoms of iron deficiency include fatigue, cold extremities, hair loss, cognitive issues, shortness of breath, headaches, and sleep disorders.</text></paragraph> 
<paragraph id="HC4DE59796FF64360A085A7BCED4D5B82"><enum>(3)</enum><text>Iron deficiency often goes undiagnosed due to difficulty recognizing symptoms and lack of urgency in diagnosing. When left untreated, the condition can progress to iron-deficiency anemia. This may increase the risk of developing organ complications, such as an abnormally fast heartbeat, or tachycardia, and heart failure.</text></paragraph> <paragraph id="H616D06AB78F14ED1942C50E713FBAD37"><enum>(4)</enum><text>Among pregnant women, iron deficiency and iron-deficiency anemia has been linked to increased maternal illness, premature birth and low birth weight among babies, and intrauterine growth restriction.</text></paragraph> 
<paragraph id="HDB17F41C7C40472C8905AF3DC0AAA1BA"><enum>(5)</enum><text display-inline="yes-display-inline">Approximately 35 percent of women of reproductive age in the United States do not have a sufficient amount of iron in their bodies. Additionally, nearly 40 percent of girls and young women ages 12 to 21 are affected by iron deficiency, and 6 percent are iron-deficient anemic.</text></paragraph> <paragraph id="H62B82ACD800348109BC833EDC77ED3F5"><enum>(6)</enum><text display-inline="yes-display-inline">Children under the age of two are at a high risk for iron deficiency. About 6 percent of children ages 1–2 have iron deficiency. </text></paragraph> 
<paragraph id="HAEA8C854B20949309DF1F6F7061439C7"><enum>(7)</enum><text>Eliminating barriers to awareness, education, and screening will assist in preventing and treating iron deficiency, iron deficiency anemia, and related health issues among women and children under the age of two.</text></paragraph> </section> <section id="H503922CF9DDB4FF3ABAAB3D2AAF4F344"><enum>3.</enum><header>Iron deficiency awareness campaign</header> <subsection id="H3AC933787AB34F29A4C7D7749DAA60FA"><enum>(a)</enum><header>In general</header><text>Section 317 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/247b">42 U.S.C. 247b</external-xref>) is amended by adding at the end the following:</text> 
<quoted-block id="H9C7FE84101424284B71664B7B2BF00C3" style="OLC"> 
<subsection id="H042D65E745E34C019DF5DB8BD2282BA4"><enum>(o)</enum><header>Iron deficiency public awareness campaign</header> 
<paragraph id="HBE903E23EC594646827B001F2E05EA7A"><enum>(1)</enum><header>In general</header><text>The Secretary shall carry out a national campaign to—</text> <subparagraph id="HF0584E5A5181414895171FECF86EFCA1"><enum>(A)</enum><text>increase awareness of the importance of iron deficiency screening;</text></subparagraph> 
<subparagraph id="H1DB5A16333ED40B7ACADBBFD7B801D32"><enum>(B)</enum><text display-inline="yes-display-inline">combat misconceptions about iron deficiency, including misconceptions in diagnosis and management of iron deficiency;</text></subparagraph> <subparagraph id="HB3A35E280F0A488D995C949034CBBBCD"><enum>(C)</enum><text>increase awareness about missed diagnoses due to inadequate screening tests; and</text></subparagraph> 
<subparagraph id="H0A275DFD46D941EFB166639828827B1B"><enum>(D)</enum><text>increase iron deficiency screening among women and children under the age of two.</text></subparagraph></paragraph> <paragraph id="HB58C2B32CF4D4D1CB7460649FFCC213A"><enum>(2)</enum><header>Consultation</header><text>In carrying out the national campaign required by paragraph (1), the Secretary shall consult with the National Academy of Medicine, health care providers, public health associations, nonprofit organizations, State and local public health departments, and institutions of higher education to solicit advice on evidence-based information for policy development and program development, implementation, and evaluation.</text></paragraph> 
<paragraph id="HE184FF6DA5C14F26AC37040B868393A0"><enum>(3)</enum><header>Requirements</header><text>The national campaign required by paragraph (1) shall—</text> <subparagraph id="HF2C78109EE90479F823B1A2F9E62F143"><enum>(A)</enum><text>include the use of evidence-based media and public engagement;</text></subparagraph> 
<subparagraph id="H9EB02A99E6BC44CCA50EF62F565A660E"><enum>(B)</enum><text>be carried out through competitive grants or cooperative agreements awarded to 1 or more private, nonprofit entities with a history developing and implementing similar campaigns;</text></subparagraph> <subparagraph id="H4B375785FCE840B9B6EC42F8F98E03AB"><enum>(C)</enum><text>include the development of culturally and linguistically competent resources that shall be tailored for—</text> 
<clause id="H6A51850A139340768D0466F02E731136" display-inline="no-display-inline"><enum>(i)</enum><text>women who are pregnant, recently gave birth, or are breastfeeding;</text></clause> <clause id="H65836811CC854B80B62CFA2516D226E0"><enum>(ii)</enum><text>women who menstruate, especially if menstrual periods are heavy;</text></clause> 
<clause id="H82B9E9A0B9844D80B6F196298E0FFB19"><enum>(iii)</enum><text>women who have undergone major surgery or physical trauma;</text></clause> <clause id="HA0ECCFCCEA674F1C8C291979BCC307E3"><enum>(iv)</enum><text>women with limited English proficiency;</text></clause>
<clause id="H5C8883870B954937B812196E8923A898"><enum>(v)</enum><text display-inline="yes-display-inline">women with gastrointestinal diseases, such as Celiac disease and inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease;</text></clause> <clause id="HF568D21BCE2B4E5C85C190F28E071822"><enum>(vi)</enum><text>women with peptic ulcer disease;</text></clause> 
<clause id="HF6BDDF5CB9084E7BBA54770A216D1DDD"><enum>(vii)</enum><text>populations with a high prevalence of iron deficiency (such as Black and Hispanic women);</text></clause> <clause id="HFA49579F0F704A18AFF09FACF542DE62"><enum>(viii)</enum><text>parents with children under the age of two;</text></clause> 
<clause id="H8ACB1386A4A748328CA4607FDEEE176D"><enum>(ix)</enum><text>rural communities; and</text></clause> <clause id="HE7C0D5BB870F4489B8319B3D167FFFE8"><enum>(x)</enum><text>such other communities as the Secretary determines appropriate;</text></clause> </subparagraph> 
<subparagraph id="HAED1F9A2EA824F068E76C73959D8BC22"><enum>(D)</enum><text>include the dissemination of iron deficiency information and communication resources to health care providers and health care facilities (including pediatricians, primary care providers, community health centers, dentists, obstetricians, and gynecologists), State and local public health departments, elementary and secondary schools, child care centers, and colleges and universities;</text></subparagraph> <subparagraph id="H645BB9BED6CE4E37B2087F8605AE23BE"><enum>(E)</enum><text>be complementary to, and coordinated with, any other Federal efforts with respect to iron deficiency awareness;</text></subparagraph> 
<subparagraph id="HBB5B8E1858D44BE29AE6BD3E9609C475"><enum>(F)</enum><text>include message testing to identify culturally competent and effective messages for behavioral change; and</text></subparagraph> <subparagraph id="HF2510D575CB04C27B69E8CA9E3841D53"><enum>(G)</enum><text>include the award of grants or cooperative agreements to State, local, and Tribal public health departments to engage with—</text> 
<clause id="H9037ACB480824D2399AF5E63C0D39E49"><enum>(i)</enum><text>communities specified in subparagraph (C);</text></clause> <clause id="HB2ED32AAED914E2AA5BB88E88B99F80C"><enum>(ii)</enum><text>local educational agencies;</text></clause> 
<clause id="H6DB5196DD7FC4217A44D20EDC8F5A869"><enum>(iii)</enum><text>health care providers;</text></clause> <clause id="H9EFF66525C50406DB8D33F806B197FEB"><enum>(iv)</enum><text>community organizations; or</text></clause> 
<clause id="H9486F7E5F6B6464DA78403B84044B036"><enum>(v)</enum><text>other groups the Secretary determines are appropriate to develop and deliver effective strategies to decrease iron deficiency rates.</text></clause></subparagraph></paragraph> <paragraph id="H3F5825C07D414ACD9068010656BAE709"><enum>(4)</enum><header>Options for dissemination of information</header><text>The national campaign required by paragraph (1) may—</text> 
<subparagraph id="HFD9721AE8C98408F99295EF9009315DC"><enum>(A)</enum><text>include the use of—</text> <clause id="HFFE6DA79D52D4EC9B8B2D8B2A11BE511"><enum>(i)</enum><text>social media, television, radio, print, the internet, and other media;</text></clause> 
<clause id="H64B80069B6C242BAA014F13239076D42"><enum>(ii)</enum><text>in-person or virtual public communications; and</text></clause> <clause id="H331ECBF69AE3430B92BCCEC1E605B9D3"><enum>(iii)</enum><text>recognized, trusted figures;</text></clause></subparagraph> 
<subparagraph id="HB7208446FC5B41A683F7FB793BC973B6"><enum>(B)</enum><text>be targeted to specific communities specified in paragraph (3)(C); and</text></subparagraph> <subparagraph id="H98A3928B828543CDB17D7173A8AE2104"><enum>(C)</enum><text>include the dissemination of information highlighting—</text> 
<clause id="HE6DF1F3BF222489AA6A06DB747525F41"><enum>(i)</enum><text>appropriate screening for iron deficiency, including the recommended populations to be screened by age range or other criteria;</text></clause> <clause id="H8A886042F38D4B5F8B77530D788D0918"><enum>(ii)</enum><text>the prevalence of iron deficiency;</text></clause> 
<clause id="H769006B731B04F0792BBC4E1A0896402"><enum>(iii)</enum><text>symptoms of iron deficiency; and</text></clause> <clause id="HD951561DA00D427087A3CE213E148376"><enum>(iv)</enum><text>mechanisms of preventing and managing iron deficiency.</text></clause></subparagraph></paragraph> 
<paragraph id="H2D11E7B8E6AF466F8F7493FC1600C1D1"><enum>(5)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this subsection $7,000,000 for each of fiscal years 2024 through 2028.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H189DB88317D44E9A8C9DA40E90E32422"><enum>(b)</enum><header>Report to Congress</header> <paragraph id="H90AC2B6035684B7FA42932BD13702D12"><enum>(1)</enum><header>In general</header><text>Not later than the end of fiscal year 2027, the Secretary of Health and Human Services shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report on the campaign under section 317(o) of the Public Health Service Act, as added by subsection (a).</text> </paragraph> 
<paragraph id="H5E2AFA41D627459A9DDD243D5DDACE87"><enum>(2)</enum><header>Qualitative assessment</header><text display-inline="yes-display-inline">The report under paragraph (1) shall include a qualitative assessment of—</text> <subparagraph id="H409ABFB96A7B47B195950E4A2C42586F"><enum>(A)</enum><text display-inline="yes-display-inline">the overall campaign under section 317(o) of the Public Health Service Act, as added by subsection (a); and</text></subparagraph> 
<subparagraph id="H9E7A46D1F419455D918AF33752F1083A"><enum>(B)</enum><text>the impacts of the activities conducted through the campaign, including such impacts on iron deficiency, and iron deficiency anemia, among women and children under the age of two.</text></subparagraph></paragraph> </subsection></section> </legis-body></bill>

