[Congressional Record Volume 144, Number 144 (Monday, October 12, 1998)]
[Senate]
[Pages S12396-S12397]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PUBLIC HEALTH SERVICE ACT AMENDMENTS
Mr. JEFFORDS. Mr. President, I ask unanimous consent that the Labor
Committee be discharged from further consideration of S. 1722 and that
the Senate then proceed to its immediate consideration.
The PRESIDING OFFICER. Without objection, it is so ordered. The clerk
will report.
The legislative clerk read as follows:
A bill (S. 1722) to amend the Public Health Service Act to
revise and extend certain programs with respect to women's
health research and prevention activities at the National
Institutes of Health and the Centers for Disease Control and
Prevention.
The Senate proceeded to consider the bill.
Amendment No. 3815
(Purpose: To provide for a complete substitute)
Mr. JEFFORDS. Mr. President, Senator Frist has a substitute amendment
at the desk, and I ask for its immediate consideration.
The PRESIDING OFFICER. The clerk will report.
The legislative clerk read as follows:
The Senator from Vermont [Mr. Jeffords], for Mr. Frist,
proposes an amendment numbered 3815.
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Women's Health Research and
Prevention Amendments of 1998''.
TITLE I--PROVISIONS RELATING TO WOMEN'S HEALTH RESEARCH AT NATIONAL
INSTITUTES OF HEALTH
SEC. 101. RESEARCH ON DRUG DES; NATIONAL PROGRAM OF
EDUCATION.
(a) Research.--Section 403A(e) of the Public Health Service
Act (42 U.S.C. 283a(e)) is amended by striking ``1996'' and
inserting ``2003''.
(b) National Program for Education of Health Professionals
and Public.--Title XVII of the Public Health Service Act (42
U.S.C. 300u et seq.) is amended by adding at the end the
following:
``education regarding des
``Sec. 1710. (a) In General.--The Secretary, acting through
the heads of the appropriate agencies of the Public Health
Service, shall carry out a national program for the education
of health professionals and the public with respect to the
drug diethylstilbestrol (commonly known as DES). To the
extent appropriation, such national program shall use
methodologies developed through the education demonstration
program carried out under section 403A. In developing and
carrying out the national program, the Secretary shall
consult closely with representatives of nonprofit private
entities that represent individuals who have been exposed to
DES and that have expertise in community-based information
campaigns for the public and for health care providers. The
implementation of the national program shall begin during
fiscal year 1999.
``(b) Authorization of Appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated such sums as may be necessary for each of the
fiscal years 1999 through 2003. The authorization of
appropriations established in the preceding sentence is in
addition to any other authorization of appropriation that is
available for such purpose.''.
SEC. 102. RESEARCH ON OSTEOPOROSIS, PAGET'S DISEASE, AND
RELATED BONE DISORDERS.
Section 409A(d) of the Public Health Service Act (42 U.S.C.
284e(d)) is amended by striking ``and 1996'' and inserting
``through 2003''.
SEC. 103. RESEARCH ON CANCER.
(A) Research on Breast Cancer.--Section 417B(b)(1) of the
Public Health Service Act (42 U.S.C. 286a-8(b)(1)) is
amended--
(1) in subparagraph (A), by striking ``and 1996'' and
inserting ``through 2003''; and
(2) in subparagraph (B), by striking ``and 1996'' and
inserting ``through 2003''.
(b) Research on Ovarian and Related Cancer Research.--
Section 417B(b)(2) of the Public Health Service Act (42
U.S.C. 286a-8(b)(2)) is amended by striking ``and 1996'' and
inserting ``through 2003''.
SEC. 104. RESEARCH ON HEART ATTACK, STROKE, AND OTHER
CARDIOVASCULAR DISEASES IN WOMEN.
Subpart 2 of part C of title IV of the Public Health
Service Act (42 U.S.C. 285b et seq.) is amended by inserting
after section 424 the following:
``heart attack, stroke, and other cardiovascular diseases in women
``Sec. 424A. (a) In General.--The Director of the Institute
shall expand, intensify, and coordinate research and related
activities of the Institute with respect to heart attack,
stroke, and other cardiovascular diseases in women.
``(b) Coordination With Other Institutes.--The Director of
the Institute shall coordinate activities under subsection
(a) with similar activities conducted by the other national
research institutes and agencies of the National Institutes
of Health to the extent that such Institutes and agencies
have responsibilities that are related to heart attack,
stroke, and other cardiovascular diseases in women.
``(c) Certain Programs.--In carrying out subsection (a),
the Director of the Institute shall conduct or support
research to expand the understanding of the causes of, and to
develop methods for preventing, cardiovascular diseases in
women. Activities under such subsection shall include
conducting and supporting the following:
``(1) Research to determine the reasons underlying the
prevalence of heart attack, stroke, and other cardiovascular
diseases in women, including African-American women and other
women who are members of racial or ethnic minority groups.
``(2) Basic research concerning the etiology and causes of
cardiovascular diseases in women.
``(3) Epidemiological studies to address the frequency and
natural history of such diseases and the differences among
men and women, and among racial and ethnic groups, with
respect to such diseases.
``(4) The development of safe, efficient, and cost-
effective diagnostic approaches to evaluating women with
suspected ischemic heart disease.
``(5) Clinical research for the development and evaluation
of new treatments for women, including rehabilitation.
``(6) Studies to gain a better understanding of methods of
preventing cardiovascular diseases in women, including
applications of effective methods for the control of blood
pressure, lipids, and obesity.
``(7) Information and education programs for patients and
health care providers on risk factors associated with heart
attack, stroke, and other cardiovascular diseases in women,
and on the importance of the prevention or control of such
risk factors and timely referral with appropriate diagnosis
and treatment. Such programs shall include information and
education on health-related behaviors that can improve such
important risk factors as smoking, obesity, high blood
cholesterol, and lack of exercise.
``(d) Authorization of Appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated such sums as may be necessary for each of the
fiscal years 1999 through 2003. The authorization of
appropriations established in the preceding sentence is in
addition to any other authorization of appropriation that is
available for such purpose.''.
SEC. 105. AGING PROCESSES REGARDING WOMEN.
Section 445H of the Public Health Service Act (42 U.S.C.
285e-10) is amended--
(1) by striking ``The Director'' and inserting ``(a) The
Director''; and
(2) by adding at the end the following subsection:
[[Page S12397]]
``(b) For the purpose of carrying out this section, there
are authorized to be appropriated such sums as may be
necessary for each of the fiscal years 1999 through 2003. The
authorization of appropriations established in the preceding
sentence is in addition to any other authorization of
appropriation that is available for such purpose.''.
SEC. 106. OFFICE OF RESEARCH ON WOMEN'S HEALTH.
Section 486(d)(2) of the Public Health Service Act (42
U.S.C. 287d(d)(2)) is amended by striking ``Director of the
Office'' and inserting ``Director of NIH''.
TITLE II--PROVISIONS RELATING TO WOMEN'S HEALTH AT CENTERS FOR DISEASE
CONTROL AND PREVENTION
SEC. 201. NATIONAL CENTER FOR HEALTH STATISTICS.
Section 306(n) of the Public Health Service Act (42 U.S.C.
242k(n)) is amended--
(1) in paragraph (1), by striking ``through 1998'' and
inserting ``through 2003''; and
(2) in paragraph (2), by striking ``through 1998'' and
inserting ``through 2003''.
SEC. 202. NATIONAL PROGRAM OF CANCER REGISTRIES.
Section 399L(a) of the Public Health Service Act (42 U.S.C.
280e-4(a)) is amended by striking ``through 1998'' and
inserting ``through 2003''.
SEC. 203. NATIONAL BREAST AND CERVICAL CANCER EARLY DETECTION
PROGRAM.
(a) Services.--Section 1501(a)(2) of the Public Health
Service Act (42 U.S.C. 300k(a)(2)) is amended by inserting
before the semicolon the following: ``and support services
such as case management''.
(b) Providers of Services.--Section 1501(b) of the Public
Health Service Act (42 U.S.C. 300k(b)) is amended--
(1) in paragraph (1), by striking ``through grants'' and
all that follows and inserting the following: ``through
grants to public and nonprofit private entities and through
contracts with public and private entities.''; and
(2) by striking paragraph (2) and inserting the following:
``(2) Certain applications.--If a nonprofit private entity
and a private entity that is not a non-profit entity both
submit applications to a State to receive an award of a grant
or contract pursuant to paragraph (1), the State may give
priority to the application submitted by the nonprofit
private entity in any case in which the State determines that
the quality of such application is equivalent to the quality
of the application submitted by the other private entity.''.
(c) Authorizations of Appropriations.--
(1) Supplemental grants for additional preventive health
services.--Section 1509(d)(1) of the Public Health Service
Act (42 U.S.C. 300n-4a(d)(1)) is amended by striking
``through 1998'' and inserting ``through 2003''.
(2) General program.--Section 1510(a) of the Public Health
Service Act (42 U.S.C. 300n-5(a)) is amended by striking
``through 1998'' and inserting ``through 2003''.
SEC. 204. CENTERS FOR RESEARCH AND DEMONSTRATION OF HEALTH
PROMOTION.
Section 1706(e) of the Public Health Service Act (42 U.S.C.
300u-5(e)) is amended by striking ``through 1998'' and
inserting ``through 2003''.
Mr. JEFFORDS. Mr. President, I ask unanimous consent that the
amendment be agreed to.
The PRESIDING OFFICER. Without objection, it is so ordered.
The amendment (No. 3815) was agreed to.
Mr. JEFFORDS. Mr. President, I ask unanimous consent that the bill,
as amended, be considered read a third time and passed; that the motion
to reconsider be laid upon the table; and that any statements relating
to the bill be printed at the appropriate place in the Record.
The PRESIDING OFFICER. Without objection, it is so ordered.
The bill (S. 1722), as amended, was considered read the third time
and passed.
Mr. FRIST. Mr. President, I am pleased to rise today before we
adjourn the 105th Congress to acknowledge significant legislation
addressing women's health needs in the United States. I originally
introduced S. 1722, the ``Women's Health Research and Prevention
Amendments of 1998,'' on March 6, 1998, with our Majority Leader,
Senator Trent Lott, to increase awareness of some of the most pressing
diseases and health issues that confront women in our country. I am
gratified that the Senate has moved to enact this legislation which
will reauthorize important women's health activities at the National
Institutes of Health (NIH) and the Centers for Disease Control and
Prevention (CDC).
We introduced this bill to create greater awareness of women's health
issues and to highlight the critical role our public health agencies,
the NIH and CDC, play in providing a broad spectrum of activities to
improve women's health--including research, screening, prevention,
treatment, education, and data collection. The bill has enjoyed broad
bipartisan support, which is a testament to the need to combat the
diseases affecting women and to maintain the crucial health services
that help prevent these diseases. Today we move from raising awareness
of these important issues to acting upon them.
This bill includes valuable provisions which support basic and
clinical research at the National Institutes of Health. Among other
things, these provisions reauthorize research on osteoporosis and aging
processes in women; the drug diethylstilbestrol (DES) which was widely
prescribed from 1938 to 1971 and has been shown to be harmful to
pregnant women and their children; and breast and cervical cancer.
These provisions also establish a new program focused on cardiovascular
disease--the number one cause of death in women. The reauthorization of
these research programs will help assure scientific progress in our
fight against these diseases and will lessen their burden on women and
their families.
At the Centers for Disease Control and Prevention, the bill
reauthorizes the National Breast and Cervical Cancer Early Detection
Program which provides for crucial screening services for breast and
cervical cancers to underserved women. It is especially fitting that we
enact this legislation today since October is Breast Cancer Awareness
month. The American Cancer Society estimates that this year more than
180,000 women will be diagnosed with breast cancer and more than 40,000
women will lose their lives. These are not just statistics--they
represent our mothers, sisters, aunts, and daughters. It is with them
in mind that we pass this legislation today.
The bill also includes reauthorizations of data collection activities
through the National Center for Health Statistics and the National
Program of Cancer Registries, the leading sources of national data on
the health status of U.S. women. These programs make significant
contributions to the health and well-being of women in the United
States.
Mr. President, I am proud of our work on women's health. I would like
to take this opportunity to thank our Majority Leader, Senator Lott,
for his leadership and support on this issue. I would also like to
thank Anne Phelps and Zoe Beckerman of my staff for their hard work on
the reauthorization of these programs.
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