[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 4246 Introduced in Senate (IS)]

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118th CONGRESS
  2d Session
                                S. 4246

 To improve menopause care and mid-life women's health, and for other 
                               purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 2, 2024

Mrs. Murray (for herself, Ms. Murkowski, Ms. Baldwin, Ms. Collins, Ms. 
Klobuchar, Mrs. Capito, Ms. Cantwell, Ms. Cortez Masto, Ms. Duckworth, 
 Mrs. Gillibrand, Ms. Hassan, Ms. Hirono, Ms. Rosen, Mrs. Shaheen, Ms. 
  Sinema, Ms. Smith, and Ms. Stabenow) introduced the following bill; 
     which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
 To improve menopause care and mid-life women's health, and for other 
                               purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Advancing 
Menopause Care and Mid-Life Women's Health Act''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Research with respect to menopause and mid-life women's health.
Sec. 3. Public health promotion and prevention.
Sec. 4. Public health awareness, education, and outreach program on 
                            menopause and mid-life women's health.
Sec. 5. Training programs to improve care and treatment of menopausal 
                            symptoms.
Sec. 6. Centers of excellence in menopause cause and mid-life women's 
                            health.
Sec. 7. Reporting requirement.
Sec. 8. Coordination.

SEC. 2. RESEARCH WITH RESPECT TO MENOPAUSE AND MID-LIFE WOMEN'S HEALTH.

    (a) NIH Research.--Part A of title IV of the Public Health Service 
Act (42 U.S.C. 281 et seq.) is amended by adding at the end the 
following:

``SEC. 404P. RESEARCH WITH RESPECT TO MENOPAUSE AND MID-LIFE WOMEN'S 
              HEALTH.

    ``(a) Research and Innovation.--
            ``(1) In general.--The Director of NIH, acting through the 
        Director of the Office of Research on Women's Health, shall 
        coordinate and expand research activities conducted by all 
        institutes, centers, and offices of the National Institutes of 
        Health to develop and implement Federal research programs with 
        respect to--
                    ``(A) the impact of the symptoms and trajectories 
                of changes across the menopausal transition and the 
                postmenopausal period on women's physical, mental, 
                behavioral, and cognitive health; and
                    ``(B) the prevention of related adverse health 
                outcomes among women during the menopausal transition 
                and the postmenopausal period.
            ``(2) Grants.--In carrying out paragraph (1), the Director 
        of NIH shall award grants to eligible entities to support--
                    ``(A) biomedical and public health research and 
                innovation in the development of new treatments and 
                diagnostic testing services for perimenopause and acute 
                and chronic menopausal symptoms; and
                    ``(B) researchers and clinicians engaged in 
                clinical and translational research on menopause and 
                mid-life women's health.
            ``(3) Eligible entities.--To be eligible to receive a grant 
        under subsection (b), an entity shall meet such criteria as the 
        Director of NIH may establish, and shall be--
                    ``(A) an accredited entity that offers education to 
                students in various health professions, such as_
                            ``(i) a teaching hospital;
                            ``(ii) an accredited school of medicine, 
                        osteopathic medicine, nursing, or pharmacy, or 
                        a physician assistant training program, 
                        including a historically Black college or 
                        university (as defined by the term `part B 
                        institution' in section 322 of the Higher 
                        Education Act of 1965 or described in section 
                        326(e)(1) of the Higher Education Act of 1965) 
                        or other minority-serving institutions (as 
                        described in section 371(a) of the Higher 
                        Education Act of 1965));
                            ``(iii) a certified behavioral health 
                        clinic with an accredited medical or nursing 
                        residency program;
                            ``(iv) an accredited public or nonprofit 
                        private hospital with an accredited medical or 
                        nursing residency program;
                            ``(v) an accredited nurse practitioner 
                        residency program that includes and accredited 
                        nursing residency program; or
                            ``(vi) a related accredited program engaged 
                        in the care, treatment, or management of 
                        menopausal symptoms;
                    ``(B) an academic research institution or other 
                nonprofit research institution;
                    ``(C) a small business; or
                    ``(D) such other entity as the Director of NIH may 
                determine appropriate.
    ``(b) Research, Condition, and Disease Categorization.--The 
Director of NIH shall designate, in the Research, Condition, and 
Disease Categorization, new categories for chronic or debilitating 
conditions among women, to analyze and coordinate current and future 
research on menopause, menopausal symptoms, and short-term and long-
term effects of such symptoms on mid-life women's health.
    ``(c) Coordination.--The Director of the NIH shall coordinate and 
expand Federal research programs and activities to study acute and 
chronic menopausal symptoms, including--
            ``(1) vasomotor symptoms;
            ``(2) osteoporosis;
            ``(3) sarcopenia;
            ``(4) temporomandibular disorders;
            ``(5) joint and nerve pain;
            ``(6) trauma, anxiety, depression, mood disorders, and 
        related mental and behavioral health conditions;
            ``(7) short-term memory loss;
            ``(8) genitourinary conditions;
            ``(9) alopecia;
            ``(10) vision or hearing impairments;
            ``(11) digestive and metabolic disorders;
            ``(12) chronic sleep deficiency, insomnia, and related 
        sleep disorders; and
            ``(13) other menopausal symptoms and related conditions, as 
        the Director of NIH determines appropriate.
    ``(d) Translational Research.--The Secretary shall expand 
translational research activities to accelerate translation of Federal 
research on perimenopause and menopausal symptoms and facilitate 
equitable delivery of perimenopause and menopause care and related mid-
life women's health services.
    ``(e) Outreach and Engagement.--The Secretary shall expand outreach 
and engagement activities with accredited schools of medicine, 
institutions of higher education, and research institutions to support 
Federal research activities with respect to menopausal symptoms.''.
    (b) Public Health Research and Data Reporting Activities.--Part A 
of title III of the Public Health Service Act (42 U.S.C. 241 et seq.) 
is amended by adding at the end the following:

``SEC. 310C. RESEARCH RELATING TO MID-LIFE WOMEN'S HEALTH.

    ``(a) Public Health Research.--The Secretary shall expand research 
activities with respect to the severity and duration of menopausal 
symptoms and related chronic conditions affecting mid-life health 
outcomes among women, including mental and behavioral health outcomes. 
In carrying out activities under this section, the Secretary shall 
coordinate with existing programs and activities of the Department of 
Health and Human Services.
    ``(b) Health Care Quality Research.--The Secretary shall expand 
research, program evaluation, and quality improvement activities to 
improve health care delivery for the care, treatment, or management of 
perimenopause and menopausal symptoms and related chronic conditions, 
including data collection with respect to preventive services that 
support mid-life health outcomes among women and barriers to care.
    ``(c) Dashboard.--The Secretary shall establish and maintain a 
dashboard for the reporting of data on menopausal symptoms and mid-life 
health outcomes among women gathered through public health surveillance 
activities with respect to screening, testing, treatment, and 
prevention services, and the impact of this section and section 404P on 
such efforts.
    ``(d) Occupational Health Research.--The Secretary shall conduct 
research activities and expand data collection with respect to 
workplace stressors related to severe acute or chronic menopausal 
symptoms, physical injury, or other adverse health outcomes among 
women, including traumatic stress, anxiety, depression, and related 
mental and behavioral health conditions. The Secretary shall review 
existing evidence, identify gaps in services, and develop evidence-
informed recommendations for related public health interventions and 
support services.
    ``(e) Interagency Coordination.--The Secretary shall develop and 
implement new interagency research initiatives or programs to address 
menopausal symptoms.''.
    (c) Authorization of Appropriations.--For the purpose of carrying 
out sections 404P and 310C of the Public Health Service Act, as added 
by subsections (a) and (b), respectively, there are authorized to be 
appropriated $25,000,000 for each of fiscal years 2025 through 2029.

SEC. 3. PUBLIC HEALTH PROMOTION AND PREVENTION.

    Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) 
is amended by adding at the end the following:

        ``PART W--ACTIVITIES TO PROMOTE MID-LIFE WOMEN'S HEALTH

``SEC. 399OO. PUBLIC HEALTH PROMOTION ACTIVITIES.

    ``(a) Chronic Conditions and Public Health Promotion.--The 
Secretary shall expand public health promotion and prevention 
activities with respect to mid-life women's health and chronic 
conditions, including diabetes, hypertension, heart disease, iron-
deficiency anemia, inflammation, fibroids, endometriosis, and other 
related conditions and adverse health outcomes, at the discretion of 
the Secretary.
    ``(b) Early Detection, Diagnosis, and Treatment.--
            ``(1) In general.--The Secretary shall award grants to 
        eligible entities to improve the early detection, diagnosis, 
        and treatment of perimenopause and menopausal symptoms and 
        support public health activities to expand access to quality 
        care services and improve mid-life health outcomes among women.
            ``(2) Eligible entities.--To be eligible to receive a grant 
        under paragraph (1), an entity shall_
                    ``(A) be--
                            ``(i) a State, local, Tribal, or 
                        territorial public health department;
                            ``(ii) an accredited entity that offers 
                        education to students in various health 
                        professions; or
                            ``(iii) such other type of entity, as the 
                        Secretary determines appropriate; and
                    ``(B) submit an application to the Secretary at 
                such time, in such manner, and containing such 
                information as the Secretary may require.
    ``(c) Care Coordination.--The Secretary shall award grants to 
eligible entities described in subsection (b)(2) to support care 
coordination and care planning activities, including such activities 
otherwise supported under this Act, and expand access to quality 
primary care and specialty care services to improve--
            ``(1) mid-life women's health, including activities to 
        support the integration of primary care and specialty care;
            ``(2) bone health and muscle loss;
            ``(3) mental and behavioral health care services;
            ``(4) joint, nerve, and muscle pain prevention services;
            ``(5) digestive and metabolic health;
            ``(6) prevention and management of multiple chronic 
        conditions;
            ``(7) physical therapy and injury prevention support 
        services for populations affected by acute and chronic 
        menopausal symptoms; and
            ``(8) other services that address acute and chronic 
        conditions that affect women's health in perimenopause and 
        menopause.
    ``(d) Mental Health and Substance Use Prevention.--The Secretary 
shall develop recommendations and best practices to--
            ``(1) increase access to mental and behavioral health care 
        services and substance use disorder prevention services for 
        women experiencing perimenopause or menopausal symptoms; and
            ``(2) expand substance use disorder treatment, recovery, 
        and support services for women experiencing perimenopause, 
        early menopause, premature menopause, and related conditions.
    ``(e) Health Care Delivery.--The Secretary shall develop 
recommendations and best practices for--
            ``(1) reducing disparities in the management of menopausal 
        symptoms;
            ``(2) improving access to perimenopause and menopause 
        health care services; and
            ``(3) providing patient-centered perimenopause and 
        menopause counseling and treatment.
    ``(f) Safety and Effectiveness.--The Secretary shall carry out and 
support--
            ``(1) outreach and engagement activities of the Food and 
        Drug Administration with health care providers on perimenopause 
        and menopause and mid-life women's health;
            ``(2) oversight efforts to assess the safety and 
        effectiveness of new diagnostic tools for perimenopause or 
        menopausal symptoms, including devices that use artificial 
        intelligence; and
            ``(3) support existing activities of the Department of 
        Health and Human Services to enforce privacy protections for 
        patients.
    ``(g) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated $10,000,000 for each of fiscal 
years 2025 through 2029.''.

SEC. 4. PUBLIC HEALTH AWARENESS, EDUCATION, AND OUTREACH PROGRAM ON 
              MENOPAUSE AND MID-LIFE WOMEN'S HEALTH.

    Part W of title III of the Public Health Service Act (42 U.S.C. 241 
et seq.), as added by section 3, is amended by adding at the end the 
following:

``SEC. 399OO-1. PUBLIC HEALTH AWARENESS, EDUCATION, AND OUTREACH 
              PROGRAM ON MENOPAUSE AND MID-LIFE WOMEN'S HEALTH.

    ``(a) In General.--The Secretary shall develop and carry out a 
national awareness, education, and outreach program relating to 
menopausal symptoms, mid-life women's health, and related care, 
treatment, and preventive services directed at patients, health care 
providers, first responders (such as emergency medical service 
providers), and related stakeholders. Such awareness, education, and 
outreach program shall--
            ``(1) disseminate educational materials and provide 
        technical assistance for health care providers and patients to 
        support engagement about perimenopause and menopause care and 
        treatment options for menopausal symptoms;
            ``(2) help such providers to identify risk factors and 
        prevent injury among women with menopausal symptoms; and
            ``(3) address barriers to related care and treatment 
        services for women.
    ``(b) Outreach.--In carrying out this section, the Secretary 
shall--
            ``(1) conduct outreach and education activities related to 
        perimenopause and menopause and mid-life women's health that--
                    ``(A) include evidence-based information; and
                    ``(B) are culturally appropriate, in the case of 
                such outreach and education activities for Indian 
                Tribes;
            ``(2) provide opportunities for State, local, Tribal, and 
        territorial public health departments to customize public 
        health awareness, education, and outreach materials for their 
        populations; and
            ``(3) prioritize populations in areas affected by barriers 
        to care, including rural and underserved areas.
    ``(c) Coordination.--In carrying out this section, the Secretary 
shall coordinate with existing awareness, education, and outreach 
programs and activities of the Department of Health and Human Services.
    ``(d) Online Resources.--The Secretary shall develop, operate, and 
maintain a website to provide educational materials in accessible 
formats for health care providers, patients, and caregivers, regarding 
perimenopause, menopause, and mid-life women's health. Such educational 
materials may include--
            ``(1) webinars, continuing education modules, videos, fact 
        sheets, infographics, stakeholder toolkits, or other materials 
        in formats as appropriate and applicable; and
            ``(2) tailored for health care providers, patients, 
        caregivers, and other audiences, as the Secretary determines 
        appropriate.
    ``(e) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated $10,000,000 for each of fiscal 
years 2025 through 2029.''.

SEC. 5. TRAINING PROGRAMS TO IMPROVE CARE AND TREATMENT OF MENOPAUSAL 
              SYMPTOMS.

    Part D of title VII of the Public Health Service Act (42 U.S.C. 294 
et seq.) is amended by inserting after section 757 (42 U.S.C. 294f) the 
following:

``SEC. 758. TRAINING PROGRAMS TO IMPROVE CARE AND TREATMENT OF 
              MENOPAUSAL SYMPTOMS.

    ``(a) Grants To Train Health Professionals.--
            ``(1) In general.--The Secretary shall award grants to 
        eligible entities for the purpose described in paragraph (2).
            ``(2) Use of funds.--A grant awarded under this subsection 
        shall be used to develop, establish, or expand training 
        programs (including accredited residency programs, fellowships, 
        or other related clinical training) for physicians, registered 
        nurses, nurse practitioners, physician assistants, pharmacists, 
        other health care providers, and students and trainees to 
        improve care, treatment, or management services for 
        perimenopause, menopausal symptoms, and related chronic 
        conditions.
            ``(3) Eligibility.--To be eligible to receive a grant under 
        this subsection, an entity shall--
                    ``(A) be--
                            ``(i) an accredited school of medicine or 
                        osteopathic medicine;
                            ``(ii) an accredited nursing school;
                            ``(iii) an accredited school of pharmacy;
                            ``(iv) an accredited public or nonprofit 
                        private hospital;
                            ``(v) an accredited medical residency 
                        program;
                            ``(vi) an accredited nurse practitioner 
                        residency program; or
                            ``(vii) a related training program for 
                        clinicians, allied health professionals, or 
                        social workers that interface with affected 
                        populations, which may include hospitals and 
                        research institutions, as determined by the 
                        Secretary; and
                    ``(B) submit an application to the Secretary at 
                such time, in such manner, and containing such 
                information as the Secretary may require.
    ``(b) Training Opportunities.--The Secretary shall expand outreach 
activities to support and expand training programs, fellowships, and 
other opportunities for students, faculty, and trainees (including 
continuing medical education) or establish new training opportunities 
to address barriers to access to--
            ``(1) primary and specialty care services to support mid-
        life women's health; and
            ``(2) early detection, diagnosis, treatment, and care 
        services for perimenopause, menopausal symptoms, and related 
        chronic conditions.
    ``(c) Coordination.--In carrying out this section, the Secretary 
shall coordinate with existing awareness, education, and outreach 
programs and activities of the Department of Health and Human Services.
    ``(d) Authorization of Appropriations.--To carry out this section 
there are authorized to be appropriated $10,000,000 for each of fiscal 
years 2025 through 2029.''.

SEC. 6. CENTERS OF EXCELLENCE IN MENOPAUSE CAUSE AND MID-LIFE WOMEN'S 
              HEALTH.

    Part W of title III of the Public Health Service Act (42 U.S.C. 241 
et seq.), as amended by section 4, is further amended by adding at the 
end the following:

``SEC. 399OO-2. CENTERS OF EXCELLENCE IN MENOPAUSE CARE AND MID-LIFE 
              WOMEN'S HEALTH.

    ``(a) In General.--The Secretary shall designate eligible entities 
as Centers of Excellence in Menopause and Mid-Life Women's Health, and 
award grants to such entities, for purposes of improving professional 
training resources for health care providers on mid-life women's health 
with respect to the care, treatment, and management of perimenopause 
and menopausal symptoms, and related support services.
    ``(b) Eligibility.--To be eligible to receive a designation and 
grant under subsection (a), an entity shall_
            ``(1) be an accredited entity that offers education to 
        students in various health professions, or such other type of 
        entity, as the Secretary determines appropriate;
            ``(2) demonstrate community engagement and partnerships 
        with community stakeholders, including entities that train 
        health professionals, social workers, community health centers, 
        health systems administrators, certified behavioral health 
        clinics, and research institutions; and
            ``(3) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require.
    ``(c) Activities.--An entity receiving an award under subsection 
(a) shall develop and distribute evidence-based resources to health 
care providers, patients, and public health departments regarding the 
care, treatment, and management of perimenopause and menopausal 
symptoms. Such resources may include information on--
            ``(1) advancements in the treatment or management of 
        perimenopause and acute or chronic menopausal symptoms;
            ``(2) the prevention and treatment of related chronic 
        conditions across different patient populations to support mid-
        life women's health; and
            ``(3) other topic areas that are relevant to the objectives 
        described in subsection (a).
    ``(d) Geographic Distribution.--In awarding grants under subsection 
(a), the Secretary shall take into account regional differences among 
eligible entities and ensure equitable geographic distribution.
    ``(e) Priority.--In awarding grants under subsection (a), the 
Secretary shall prioritize eligible entities that provide services in a 
health professional shortage area designated under section 332 or to 
medically underserved populations, as defined in section 330(b)(3).
    ``(f) Evaluation.--Each entity receiving an award under subsection 
(a) shall submit an annual report to the Secretary on the activities 
carried out using such award. The Secretary shall evaluate each project 
carried out by an entity receiving an award under this section and 
shall report the findings with respect to each such evaluation to 
appropriate Federal agencies and public and private entities.
    ``(g) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for each of fiscal years 2025 through 2029.''.

SEC. 7. REPORTING REQUIREMENT.

    (a) Report on Activities Carried Out Under This Act.--Not later 
than 2 years after the date of enactment of this Act, and every year 
thereafter, the Secretary of Health and Human Services shall submit to 
the Committee on Appropriations, the Committee on Health, Education, 
Labor, and Pensions, the Committee on Finance, the Committee on 
Homeland Security and Government Affairs, the Committee on Indian 
Affairs, the Committee on Veterans' Affairs, and the Special Committee 
on Aging of the Senate and the Committee on Appropriations, the 
Committee on Energy and Commerce, the Committee on Ways and Means, the 
Committee on Education and the Workforce, the Committee on Veterans' 
Affairs, the Committee on Natural Resources, and the Committee on 
Oversight and Accountability of the House of Representatives a report 
describing the progress of activities carried out under this Act and 
the amendments made by this Act. Each such report shall contain--
            (1) information with respect to Federal research activities 
        related to perimenopause and menopause and mid-life women's 
        health, including information related public health awareness, 
        education, and outreach activities, including--
                    (A) data and knowledge gaps, or other barriers, 
                related to research, diagnostic testing, and treatments 
                with respect to perimenopause, menopause, menopausal 
                symptoms, and related health outcomes;
                    (B) data or information related to barriers to 
                health care and support services among women 
                experiencing perimenopause or menopausal symptoms in 
                rural and underserved areas; and
                    (C) data or information related to barriers to 
                training opportunities and resources for health care 
                providers serving women experiencing perimenopause or 
                menopausal symptoms in rural and underserved areas;
            (2) recommendations and best practices for health care 
        providers and public health departments to expand access to 
        care and increase public awareness and understanding of 
        menopausal symptoms and related chronic conditions; and
            (3) information about related Federal activities, as the 
        Secretary determines appropriate.
    (b) Report on Access to Care and Treatment.--Not later than 2 years 
after the date of enactment of this Act, the Secretary shall release a 
report on barriers to access to care and treatment services for 
perimenopause and menopausal symptoms, and recommendations to reduce 
any such barriers.
    (c) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for each of fiscal years 2025 through 2029.

SEC. 8. COORDINATION.

    The Secretary of Health and Human Services shall coordinate 
activities carried out under this Act (including the amendments made by 
this Act) with other existing Federal efforts relating to menopausal 
symptoms, mid-life women's health, aging, or public health promotion 
carried out by the Department of Veterans Affairs, the Department of 
Defense, and other Federal departments and agencies, as appropriate.
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