[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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