[Congressional Record Volume 146, Number 117 (Wednesday, September 27, 2000)]
[House]
[Pages H8206-H8265]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
CHILDREN'S HEALTH ACT OF 2000
Ms. PRYCE of Ohio. Mr. Speaker, by direction of the Committee on
Rules, I call up House Resolution 594 and ask for its immediate
consideration.
The Clerk read the resolution, as follows:
H. Res. 594
Resolved, That upon adoption of this resolution it shall be
in order to take from the
[[Page H8207]]
Speaker's table the bill (H.R. 4365) to amend the Public
Health Service Act with respect to children's health, with
Senate amendment thereto, and to consider in the House,
without intervention of any point of order, a motion offered
by the chairman of the Committee on Commerce or his designee
that the House concur in the Senate amendment. The Senate
amendment and the motion shall be considered as read. The
motion shall be debatable for one hour equally divided and
controlled by the chairman and ranking minority member of the
Committee on Commerce. The previous question shall be
considered as ordered on the motion to final adoption without
intervening motion.
The SPEAKER pro tempore (Mr. Ose). The gentlewoman from Ohio (Ms.
Pryce) is recognized for 1 hour.
Ms. PRYCE of Ohio. Mr. Speaker, for the purpose of debate only, I
yield the customary 30 minutes to the gentleman from Texas (Mr. Frost);
pending which I yield myself such time as I may consume. During
consideration of the resolution, all time yielded is for the purpose of
debate only.
Mr. Speaker, House Resolution 594 is a rule waiving all points of
order against a motion to concur in the Senate amendment to H.R. 4365,
the Children's Health Act of the year 2000.
The rule provides 1 hour of debate on the motion to be equally
divided and controlled by the chairman and ranking minority member of
the Committee on Commerce.
Mr. Speaker, H.R. 4365, the Children's Health Act of 2000, was passed
in the House earlier this year on May 9 by a vote of 419 to two. Last
week, our colleagues in the other body considered and passed this
important legislation with an amendment by unanimous consent.
Adoption of this rule and passage of this legislation today is the
last step in our work to sending this bill to the President for his
signature and thus making this important package a reality.
I would like to congratulate the gentleman from Florida (Mr.
Bilirakis) and the gentleman from Ohio (Mr. Brown) for their renewed
efforts and success on this important legislation and also to commend
the gentleman from Virginia (Mr. Bliley), chairman of the Committee on
Commerce and the gentleman from Michigan (Mr. Dingell), ranking member,
for their hard work and leadership.
H.R. 4365, along with the decisions made by the other body, is a
comprehensive package of several important children's health bills.
Together it addresses a wide variety of critical issues, including day
care safety, maternal and infant health, pediatric public health
promotion, pediatric research, along with efforts to fight youth drug
abuse and provide mental health services.
{time} 1030
The legislation includes two important divisions. Division A
addresses issues regarding children's health; while Division B focuses
on youth drug abuse. Together this package will form the foundation for
efforts to address the unique needs of one of our most important
constituencies: Our children.
The provisions contained in the second part of this legislation,
Division D, include a number of provisions previously introduced and
considered in the House of Representatives and will allow us to tackle
the plague of drug abuse and addiction which are moving through many of
our communities.
The 1999 National Household Survey on drug abuse reported that some
10.9 percent of our youths, between the ages of 12 and 17, use some
form of illicit drug. Just as tragic are the report's findings that
alcohol use is also on the rise with our Nation's youth, with some 10.4
million drinkers under the legal age of 21.
H.R. 4365 reauthorizes and improves the Substance Abuse and Mental
Health Services Administration, SAMSHA, by giving it greater focus on
our youth and increased flexibility and accountability for the States.
It will provide the needed funds for community-based programs, helping
individuals with substance abuse and mental health disorders.
It includes the Drug Addiction Treatment Act, introduced by the
gentleman from Virginia (Mr. Bliley), to permit qualified physicians to
treat their addicted patients and speed up the drug approval process of
narcotic drugs needed for additional treatment.
Finally, H.R. 4365 includes important provisions to reduce the
proliferation of the drug methamphetamine, and tackle the devastating
drug currently on the rise with our youth commonly known as Ecstasy.
Mr. Speaker, we all hope that the wealth of our Nation and the
amazing technological advances that have been made in medicine will
give us the necessary resources to protect our children from harm. We
have made tremendous progress, but the sad fact is that there are still
so many diseases that affect our children for which there is no cure or
even an effective treatment.
Division A of the legislation before us will give child victims and
their families hope by devoting more Federal resources to diseases such
as autism, asthma, juvenile diabetes and arthritis. I am especially
pleased that this new version of H.R. 4365 includes specific provisions
on childhood cancer.
By awarding grants, expanding data collection, encouraging uniform
reporting standards and urging the national coordination of activities,
this bill will go a long way in the battle against this disease that
takes the lives of so many of our Nation's children.
This legislation also focuses on a new pediatric research initiative
at NIH, and reauthorizes money to train physicians at children's
hospitals, in order to help us better understand the way in which
diseases attack children and how to give them the most effective and
appropriate care.
There are critical differences between medical care for adults and
medical care for children that must be reflected in the training of
physicians and treatments designed for a child's system, which is still
developing. The children's hospitals across the Nation need funding to
adequately train their physicians, and I am so very pleased that H.R.
4365 extends the authorization of appropriations for graduate medical
education programs in children's hospitals through fiscal year 2005.
This is an issue of fairness, and full authorization is necessary to
provide children's hospitals support that is on par with that received
by teaching hospitals that care for adults. This legislation recognizes
and focuses on these many important differences.
Mr. Speaker, while we may never be able to make a child understand
why he or she is sick or is made to suffer, we can invest in the
research that will allow our best and brightest scientists to solve the
mysteries of childhood disease so that more children can have the
carefree youths to which they are entitled. What better way to invest
our Nation's resources?
Mr. Speaker, this measure is straightforward and noncontroversial and
its adoption will allow us to complete the work and the business of the
House and pass this comprehensive package. I urge all my colleagues to
support both the rule and this very important child health initiative.
Mr. Speaker, I reserve the balance of my time.
Mr. FROST. Mr. Speaker, I yield myself such time as I may consume.
As the gentlewoman has explained, this rule will take a Senate
amendment from the Speaker's desk and agree to it. Under this
procedure, there will be no opportunity to change the bill under
consideration with a motion to recommit.
Mr. Speaker, 6 years after the Republican majority took control of
this House, the Republican leadership has yet to find a way to
effectively manage the business of the House. It is 3 days before the
end of the fiscal year and 9 days before the Congress is scheduled to
end, yet only 2 of the 13 appropriation bills have been sent to the
President to be signed; we have yet to consider on this floor the
funding bills we need to help people find housing or have safe
transportation to get to work or plow their ground to produce food or
learn the basic skills to be able to get and hold a job in the modern
day workplace.
Last night, the members of the Committee on Rules were held hostage
for hours past the last vote so that we might be available to bail out
the Republican leadership so that the House might have some business to
conduct today. Why should the Committee on Rules be held here until
9:30? For one very simple reason, Mr. Speaker. And that is because the
majority party still has not figured out how to run this institution in
an efficient manner and
[[Page H8208]]
could not find anything to do on the floor today.
However, sometime around 9 p.m. the Republican leadership came up
with a solution. So what did they do? The Republican leadership has
taken one of the bills that was supposed to be considered yesterday
under procedures for noncontroversial bills, suspension of the rules,
and moved it to today to be considered under a rule.
I do not mean to take anything away from the value of this bill. The
Children's Health Act is vitally important to help find new ways to
prevent or cure diseases which affect our children. But it should have
been passed last night under suspension of the rules, as it was
intended to be done. The health organizations, including the March of
Dimes, the Spina Bifida Foundation, the Autism Society of America, the
Association of Maternal and Child Health Programs, the Epilepsy
Foundation, the Cereberal Palsy Association, and many, many others have
worked hard to see the bill to completion and were counting on us to do
our work. It is past time to get on with this business.
Mr. Speaker, I strongly support the Children's Health Act of 2000.
This bill now spans 400 pages and has two basic purposes. The first
addresses a host of specific childhood health problems and prenatal
risk factors, including many provisions which passed in the House
earlier this year. The bill authorizes research and public health and
health education services that respond to fragile X syndrome, epilepsy,
asthma, childhood lead poisoning, pediatric cancers, childhood obesity
prevention, traumatic brain injury, juvenile diabetes, hearing loss,
oral health, autism, arthritis, muscular dystrophy, autoimmune
conditions, child care safety and pediatric organ transplants.
It also provides block grants to the States for laboratory
infrastructure and patient care services for those affected with or at
risk for genetic conditions. The bill contains the first ever
authorization of the very successful Healthy Start demonstration
project, now in their ninth year of reducing infant mortality and
improving pregnancy outcomes in underserved populations.
The second feature of this bill covers a wide range of youth drug and
mental health service programs that will strengthen America's
communities, including extending and reauthorizing programs
administered by the Substance Abuse and Mental Health Services
Administration. These programs provide critical safety net services for
individuals and families with substance abuse problems and mental
illness, and also exclusively target youth. It also supports public and
professional education programs related to substance abuse and mental
illness. The breadth of services provided here range from an underage
drinking provision and a suicide prevention initiative, to services for
youth offenders, the homeless, and adults with fetal alcohol syndrome.
This large and complex bill, however, is marked with a number of
procedural irregularities. As worthy as the goals may be, no bill of
this scope and magnitude should proceed to the floor without going
through the committee process, yet this occurred in the majority's
apparent rush to move this bill to the floor.
For example, the bill contains a provision that invokes charitable
choice. This is a difficult issue for many Members, yet the Committee
on the Judiciary was never given the opportunity for public debate on
this issue. I know this is of particular concern to my colleague, the
gentleman from Virginia (Mr. Scott), who is here to voice his concerns
this morning.
The second example is marked with some irony. The fine provision
promoting safe motherhood includes a public education initiative
addressing the dangers of alcohol, tobacco and illicit drug use in
pregnancy. Most women do not begin smoking during pregnancy, they begin
as adolescents. Yet neither the House nor the Committee on Commerce had
the opportunity to even debate the issue of FDA regulation of youth
tobacco use during this Congress.
I will vote for this bill, however, I want America's children to know
that while H.R. 4365 is a measurable step toward improving the quality
of their collective health, we can and should do better. It is obvious
that this Congress will fail to address many major health care issues
that confront us. I am only grateful we have the opportunity to vote
for this bill and do something constructive to improve the health care
of our Nation's children.
Mr. Speaker, I yield 3 minutes to the gentleman from Virginia (Mr.
Scott).
Mr. SCOTT. Mr. Speaker, I thank the gentleman for yielding me this
time, and I rise to oppose the rule because, in its present form, good
health care for children now includes a bad crime bill and a provision
which waters down our fundamental civil rights. A good child health
care bill should not come at such a price.
By adopting the rule, we will prohibit amendments to the bill that
could fix the methamphetamine drug part of the bill. A similar bill was
considered in the Committee on the Judiciary, and amendments could have
conformed that 46-page bill to the formal deliberations of the
committee. But the rule prohibits amendments, and so the bill now
provides new Draconian mandatory minimums for violations of
methamphetamines, mandatory minimums that everyone knows do not work.
The same mandatory minimums as for crack cocaine.
Now, it is interesting that crack cocaine is prevalent in the black
community; methamphetamine is more prevalent in the Hispanic community.
They get the Draconian mandatory minimums. However, there is an
exception to all of this. Ecstasy, which is prevalent in the middle
class white community, does not suffer the same mandatory minimums. The
Committee on the Judiciary at least had the common decency to make them
all equal. But now we have a rule which prohibits any consideration for
equalizing this penalty. We have this exemption and, because of the
rule, we have to just do it.
The rule also protects another form of discrimination: Religious
discrimination. Section 3305 has a provision that allows some sponsors
of federally funded programs to discriminate on employment based on
religion. That is they can tell otherwise qualified individuals that
they do not hire their kind because of their religion. These are
federally funded programs. We cannot address this discrimination
because the rule protects that provision and does not allow any
amendments.
So if we want good child health care, we have to accept the
discrimination; we have to accept the mandatory minimums, with the
exception for the middle class white kids. We should not be forced to
accept ineffective counterproductive mandatory minimums and religious
discrimination as a price for good child health care, and that is why I
oppose this rule.
Mr. FROST. Mr. Speaker, I yield 2 minutes to the gentleman from New
Jersey (Mr. Pascrell).
(Mr. PASCRELL asked and was given permission to revise and extend his
remarks.)
Mr. PASCRELL. Mr. Speaker, I thank the gentleman from Texas for
yielding me this time.
Mr. Speaker, I am thrilled that the Children's Health Act of 2000 is
on the floor today. I would like to thank the Chair of the Subcommittee
on Health and the Environment, the gentleman from Florida (Mr.
Bilirakis), and the ranking member, the gentleman from Ohio (Mr.
Brown), for their leadership and determination to see the bill through.
But I want to take special time to salute the gentleman from
Pennsylvania (Mr. Greenwood) for his work on behalf of children in
America. The gentleman from Pennsylvania has worked tirelessly on
behalf of millions of Americans suffering from traumatic brain injury.
He has also assisted in my efforts to create the first national
traumatic brain injury registry, which is critical.
I first became involved with this issue several years ago when a
constituent of mine, Dennis Benigno, approached me to tell me about his
son, who was struck by a car, hospitalized for months, leaving him with
severe cognitive and physical damage.
{time} 1045
As a result of his son's accident, Mr. Benigno has been on the front
lines researching the disease, informing others, reaching out to the
medical research and scientific community, and lobbying elected
officials like myself.
I am proud of the efforts and the progress my good friend has made on
[[Page H8209]]
behalf of traumatic brain injury, and I am pleased that the national
registry will be included in the Children's Health Act.
These brain injury registries will also charge hospitals and local
and State departments of health with the task of collecting data for up
to a year following the injury.
A national registry will help all of us to better understand the
injury, what types of treatment people have received, what services
they use, and how we can best link people with services.
I also hope that we fight each day, like Dennis does, to raise
awareness of this disease and to fight for the injured, like his son.
I urge all my colleagues to, when the bill comes up after we debate
the rule, vote for the passage of this bill.
Ms. PRYCE of Ohio. Mr. Speaker, I reserve the balance of my time.
Mr. FROST. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, as I indicated in my opening remarks, this is a good
bill. The gentleman from Virginia (Mr. Scott) has some legitimate
concerns about a particular matter that he was not able to address. The
overall bill is an important piece of legislation.
We have concerns on this side that we seem to be treading water here
in not being able to bring anything up on the floor on a regular basis.
We do not know from day to day what is going to be considered.
This bill could have been done on suspension yesterday. That does not
diminish the bill. This is an important piece of legislation. I support
the bill and support the rule.
Mr. Speaker, I yield back the balance of my time.
Ms. PRYCE of Ohio. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, in closing, let me just respond. This very well could
have been considered under the suspension calendar last night. We would
all have been considering this bill at about 11 p.m. if that were the
case.
Instead, we chose to come back in the light of day and with everyone
well rested and alert and consider this important piece of legislation
and allow the American public to hear all the goods things that we are
promoting and adopting.
In closing, let me remind my colleagues that the House has already
passed this with a strong bipartisan support vote of 419-2. Our work
today will allow us to dedicate important resources and focus Members
on the very unique needs in the health and well-being of our children.
I urge adoption of this straightforward, noncontroversial rule and
passage of the comprehensive legislation.
I applaud my colleagues, the gentleman from Florida (Chairman
Bilirakis), and my colleague, the gentleman from Ohio (Mr. Brown), on
their hard work.
Mr. Speaker, I yield back the balance of my time, and I move the
previous question on the resolution.
The previous question was ordered.
The resolution was agreed to.
A motion to reconsider was laid on the table.
Mr. BILIRAKIS. Mr. Speaker, pursuant to House Resolution 594, I call
up from the Speaker's table the bill (H.R. 4365) to amend the Public
Health Service Act with respect to children's health, with the Senate
amendment thereto, and ask for its immediate consideration.
The Clerk read the title of the bill.
Motion Offered by Mr. Bilirakis
Mr. BILIRAKIS. Mr. Speaker, I offer a motion.
The SPEAKER pro tempore (Mr. Ose). The Clerk will designate the
motion.
The text of the motion is as follows:
Mr. Bilirakis moves that the House concur in the Senate
amendment to H.R. 4365, as follows:
Senate amendment:
Strike out all after the enacting clause and insert:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Children's Health Act of
2000''.
SEC. 2. TABLE OF CONTENTS.
The table of contents for this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
DIVISION A--CHILDREN'S HEALTH
TITLE I--AUTISM
Sec. 101. Expansion, intensification, and coordination of activities of
National Institutes of Health with respect to research on
autism.
Sec. 102. Developmental disabilities surveillance and research
programs.
Sec. 103. Information and education.
Sec. 104. Inter-agency Autism Coordinating Committee.
Sec. 105. Report to Congress.
TITLE II--RESEARCH AND DEVELOPMENT REGARDING FRAGILE X
Sec. 201. National Institute of Child Health and Human Development;
research on fragile X.
TITLE III--JUVENILE ARTHRITIS AND RELATED CONDITIONS
Sec. 301. National Institute of Arthritis and Musculoskeletal and Skin
Diseases; research on juvenile arthritis and related
conditions.
Sec. 302. Information clearinghouse.
TITLE IV--REDUCING BURDEN OF DIABETES AMONG CHILDREN AND YOUTH
Sec. 401. Programs of Centers for Disease Control and Prevention.
Sec. 402. Programs of National Institutes of Health.
TITLE V--ASTHMA SERVICES FOR CHILDREN
Subtitle A--Asthma Services
Sec. 501. Grants for children's asthma relief.
Sec. 502. Technical and conforming amendments.
Subtitle B--Prevention Activities
Sec. 511. Preventive health and health services block grant; systems
for reducing asthma-related illnesses through integrated
pest management.
Subtitle C--Coordination of Federal Activities
Sec. 521. Coordination through National Institutes of Health.
Subtitle D--Compilation of Data
Sec. 531. Compilation of data by Centers for Disease Control and
Prevention.
TITLE VI--BIRTH DEFECTS PREVENTION ACTIVITIES
Subtitle A--Folic Acid Promotion
Sec. 601. Program regarding effects of folic acid in prevention of
birth defects.
Subtitle B--National Center on Birth Defects and Developmental
Disabilities
Sec. 611. National Center on Birth Defects and Developmental
Disabilities.
TITLE VII--EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING HEARING
LOSS IN INFANTS
Sec. 701. Purposes.
Sec. 702. Programs of Health Resources and Services Administration,
Centers for Disease Control and Prevention, and National
Institutes of Health.
TITLE VIII--CHILDREN AND EPILEPSY
Sec. 801. National public health campaign on epilepsy; seizure disorder
demonstration projects in medically underserved areas.
TITLE IX--SAFE MOTHERHOOD; INFANT HEALTH PROMOTION
Subtitle A--Safe Motherhood Prevention Research
Sec. 901. Prevention research and other activities.
Subtitle B--Pregnant Women and Infants Health Promotion
Sec. 911. Programs regarding prenatal and postnatal health.
TITLE X--PEDIATRIC RESEARCH INITIATIVE
Sec. 1001. Establishment of pediatric research initiative.
Sec. 1002. Investment in tomorrow's pediatric researchers.
Sec. 1003. Review of regulations.
Sec. 1004. Long-term child development study.
TITLE XI--CHILDHOOD MALIGNANCIES
Sec. 1101. Programs of Centers for Disease Control and Prevention and
National Institutes of Health.
TITLE XII--ADOPTION AWARENESS
Subtitle A--Infant Adoption Awareness
Sec. 1201. Grants regarding infant adoption awareness.
Subtitle B--Special Needs Adoption Awareness
Sec. 1211. Special needs adoption programs; public awareness campaign
and other activities.
TITLE XIII--TRAUMATIC BRAIN INJURY
Sec. 1301. Programs of Centers for Disease Control and Prevention.
Sec. 1302. Study and monitor incidence and prevalence.
Sec. 1303. Programs of National Institutes of Health.
Sec. 1304. Programs of Health Resources and Services Administration.
Sec. 1305. State grants for protection and advocacy services.
Sec. 1306. Authorization of appropriations for certain programs.
TITLE XIV--CHILD CARE SAFETY AND HEALTH GRANTS
Sec. 1401. Definitions.
Sec. 1402. Authorization of appropriations.
Sec. 1403. Programs.
Sec. 1404. Amounts reserved; allotments.
Sec. 1405. State applications.
Sec. 1406. Use of funds.
Sec. 1407. Reports.
TITLE XV--HEALTHY START INITIATIVE
Sec. 1501. Continuation of healthy start program.
[[Page H8210]]
TITLE XVI--ORAL HEALTH PROMOTION AND DISEASE PREVENTION
Sec. 1601. Identification of interventions that reduce the burden and
transmission of oral, dental, and craniofacial diseases
in high risk populations; development of approaches for
pediatric oral and craniofacial assessment.
Sec. 1602. Oral health promotion and disease prevention.
Sec. 1603. Coordinated program to improve pediatric oral health.
TITLE XVII--VACCINE-RELATED PROGRAMS
Subtitle A--Vaccine Compensation Program
Sec. 1701. Content of petitions.
Subtitle B-- Childhood Immunizations
Sec. 1711. Childhood immunizations.
TITLE XVIII--HEPATITIS C
Sec. 1801. Surveillance and education regarding hepatitis C.
TITLE XIX--NIH INITIATIVE ON AUTOIMMUNE DISEASES
Sec. 1901. Autoimmune diseases; initiative through Director of National
Institutes of Health.
TITLE XX--GRADUATE MEDICAL EDUCATION PROGRAMS IN CHILDREN'S HOSPITALS
Sec. 2001. Provisions to revise and extend program.
TITLE XXI--SPECIAL NEEDS OF CHILDREN REGARDING ORGAN TRANSPLANTATION
Sec. 2101. Organ Procurement and Transplantation Network; amendments
regarding needs of children.
TITLE XXII--MUSCULAR DYSTROPHY RESEARCH
Sec. 2201. Muscular dystrophy research.
TITLE XXIII--CHILDREN AND TOURETTE SYNDROME AWARENESS
Sec. 2301. Grants regarding Tourette Syndrome.
TITLE XXIV--CHILDHOOD OBESITY PREVENTION
Sec. 2401. Programs operated through the Centers for Disease Control
and Prevention.
TITLE XXV--EARLY DETECTION AND TREATMENT REGARDING CHILDHOOD LEAD
POISONING
Sec. 2501. Centers for Disease Control and Prevention efforts to combat
childhood lead poisoning.
Sec. 2502. Grants for lead poisoning related activities.
Sec. 2503. Training and reports by the Health Resources and Services
Administration.
Sec. 2504. Screenings, referrals, and education regarding lead
poisoning.
TITLE XXVI--SCREENING FOR HERITABLE DISORDERS
Sec. 2601. Program to improve the ability of States to provide newborn
and child screening for heritable disorders.
TITLE XXVII--PEDIATRIC RESEARCH PROTECTIONS
Sec. 2701. Requirement for additional protections for children involved
in research.
TITLE XXVIII--MISCELLANEOUS PROVISIONS
Sec. 2801. Report regarding research on rare diseases in children.
Sec. 2802. Study on metabolic disorders.
TITLE XXIX--EFFECTIVE DATE
Sec. 2901. Effective date.
DIVISION B--YOUTH DRUG AND MENTAL HEALTH SERVICES
Sec. 3001. Short title.
TITLE XXXI--PROVISIONS RELATING TO SERVICES FOR CHILDREN AND
ADOLESCENTS
Sec. 3101. Children and violence.
Sec. 3102. Emergency response.
Sec. 3103. High risk youth reauthorization.
Sec. 3104. Substance abuse treatment services for children and
adolescents.
Sec. 3105. Comprehensive community services for children with serious
emotional disturbance.
Sec. 3106. Services for children of substance abusers.
Sec. 3107. Services for youth offenders.
Sec. 3108. Grants for strengthening families through community
partnerships.
Sec. 3109. Programs to reduce underage drinking.
Sec. 3110. Services for individuals with fetal alcohol syndrome.
Sec. 3111. Suicide prevention.
Sec. 3112. General provisions.
TITLE XXXII--PROVISIONS RELATING TO MENTAL HEALTH
Sec. 3201. Priority mental health needs of regional and national
significance.
Sec. 3202. Grants for the benefit of homeless individuals.
Sec. 3203. Projects for assistance in transition from homelessness.
Sec. 3204. Community mental health services performance partnership
block grant.
Sec. 3205. Determination of allotment.
Sec. 3206. Protection and Advocacy for Mentally Ill Individuals Act of
1986.
Sec. 3207. Requirement relating to the rights of residents of certain
facilities.
Sec. 3208. Requirement relating to the rights of residents of certain
non-medical, community-based facilities for children and
youth.
Sec. 3209. Emergency mental health centers.
Sec. 3210. Grants for jail diversion programs.
Sec. 3211. Improving outcomes for children and adolescents through
services integration between child welfare and mental
health services.
Sec. 3212. Grants for the integrated treatment of serious mental
illness and co-occurring substance abuse.
Sec. 3213. Training grants.
TITLE XXXIII--PROVISIONS RELATING TO SUBSTANCE ABUSE
Sec. 3301. Priority substance abuse treatment needs of regional and
national significance.
Sec. 3302. Priority substance abuse prevention needs of regional and
national significance.
Sec. 3303. Substance abuse prevention and treatment performance
partnership block grant.
Sec. 3304. Determination of allotments.
Sec. 3305. Nondiscrimination and institutional safeguards for religious
providers.
Sec. 3306. Alcohol and drug prevention or treatment services for
Indians and Native Alaskans.
Sec. 3307. Establishment of commission.
TITLE XXXIV--PROVISIONS RELATING TO FLEXIBILITY AND ACCOUNTABILITY
Sec. 3401. General authorities and peer review.
Sec. 3402. Advisory councils.
Sec. 3403. General provisions for the performance partnership block
grants.
Sec. 3404. Data infrastructure projects.
Sec. 3405. Repeal of obsolete addict referral provisions.
Sec. 3406. Individuals with co-occurring disorders.
Sec. 3407. Services for individuals with co-occurring disorders.
TITLE XXXV--WAIVER AUTHORITY FOR PHYSICIANS WHO DISPENSE OR PRESCRIBE
CERTAIN NARCOTIC DRUGS FOR MAINTENANCE TREATMENT OR DETOXIFICATION
TREATMENT
Sec. 3501. Short title.
Sec. 3502. Amendment to Controlled Substances Act.
TITLE XXXVI--METHAMPHETAMINE AND OTHER CONTROLLED SUBSTANCES
Sec. 3601. Short title.
Subtitle A--Methamphetamine Production, Trafficking, and Abuse
Part I--Criminal Penalties
Sec. 3611. Enhanced punishment of amphetamine laboratory operators.
Sec. 3612. Enhanced punishment of amphetamine or methamphetamine
laboratory operators.
Sec. 3613. Mandatory restitution for violations of Controlled
Substances Act and Controlled Substances Import and
Export Act relating to amphetamine and methamphetamine.
Sec. 3614. Methamphetamine paraphernalia.
Part II--Enhanced Law Enforcement
Sec. 3621. Environmental hazards associated with illegal manufacture of
amphetamine and methamphetamine.
Sec. 3622. Reduction in retail sales transaction threshold for non-safe
harbor products containing pseudoephedrine or
phenylpropanolamine.
Sec. 3623. Training for Drug Enforcement Administration and State and
local law enforcement personnel relating to clandestine
laboratories.
Sec. 3624. Combating methamphetamine and amphetamine in high intensity
drug trafficking areas.
Sec. 3625. Combating amphetamine and methamphetamine manufacturing and
trafficking.
Part III--Abuse Prevention and Treatment
Sec. 3631. Expansion of methamphetamine research.
Sec. 3632. Methamphetamine and amphetamine treatment initiative by
Center for Substance Abuse Treatment.
Sec. 3633. Study of methamphetamine treatment.
Part IV--Reports
Sec. 3641. Reports on consumption of methamphetamine and other illicit
drugs in rural areas, metropolitan areas, and
consolidated metropolitan areas.
Sec. 3642. Report on diversion of ordinary, over-the-counter
pseudoephedrine and phenylpropanolamine products.
Subtitle B--Controlled Substances Generally
Sec. 3651. Enhanced punishment for trafficking in list I chemicals.
Sec. 3652. Mail order requirements.
Sec. 3653. Theft and transportation of anhydrous ammonia for purposes
of illicit production of controlled substances.
Subtitle C--Ecstasy Anti-Proliferation Act of 2000
Sec. 3661. Short title.
Sec. 3662. Findings.
Sec. 3663. Enhanced punishment of Ecstasy traffickers.
Sec. 3664. Emergency authority to United States Sentencing Commission.
Sec. 3665. Expansion of Ecstasy and club drugs abuse prevention
efforts.
Subtitle D--Miscellaneous
Sec. 3671. Antidrug messages on Federal Government Internet websites.
Sec. 3672. Reimbursement by Drug Enforcement Administration of expenses
incurred to remediate methamphetamine laboratories.
Sec. 3673. Severability.
[[Page H8211]]
DIVISION A--CHILDREN'S HEALTH
TITLE I--AUTISM
SEC. 101. EXPANSION, INTENSIFICATION, AND COORDINATION OF
ACTIVITIES OF NATIONAL INSTITUTES OF HEALTH
WITH RESPECT TO RESEARCH ON AUTISM.
Part B of title IV of the Public Health Service Act (42
U.S.C. 284 et seq.) is amended by adding at the end the
following section:
``expansion, intensification, and coordination of activities of
national institutes of health with respect to research on autism
``Sec. 409C. (a) In General.--
``(1) Expansion of activities.--The Director of NIH (in
this section referred to as the `Director') shall expand,
intensify, and coordinate the activities of the National
Institutes of Health with respect to research on autism.
``(2) Administration of program; collaboration among
agencies.--The Director shall carry out this section acting
through the Director of the National Institute of Mental
Health and in collaboration with any other agencies that the
Director determines appropriate.
``(b) Centers of Excellence.--
``(1) In general.--The Director shall under subsection
(a)(1) make awards of grants and contracts to public or
nonprofit private entities to pay all or part of the cost of
planning, establishing, improving, and providing basic
operating support for centers of excellence regarding
research on autism.
``(2) Research.--Each center under paragraph (1) shall
conduct basic and clinical research into autism. Such
research should include investigations into the cause,
diagnosis, early detection, prevention, control, and
treatment of autism. The centers, as a group, shall conduct
research including the fields of developmental neurobiology,
genetics, and psychopharmacology.
``(3) Services for patients.--
``(A) In general.--A center under paragraph (1) may expend
amounts provided under such paragraph to carry out a program
to make individuals aware of opportunities to participate as
subjects in research conducted by the centers.
``(B) Referrals and costs.--A program under subparagraph
(A) may, in accordance with such criteria as the Director may
establish, provide to the subjects described in such
subparagraph, referrals for health and other services, and
such patient care costs as are required for research.
``(C) Availability and access.--The extent to which a
center can demonstrate availability and access to clinical
services shall be considered by the Director in decisions
about awarding grants to applicants which meet the scientific
criteria for funding under this section.
``(4) Coordination of centers; reports.--The Director
shall, as appropriate, provide for the coordination of
information among centers under paragraph (1) and ensure
regular communication between such centers, and may require
the periodic preparation of reports on the activities of the
centers and the submission of the reports to the Director.
``(5) Organization of centers.--Each center under paragraph
(1) shall use the facilities of a single institution, or be
formed from a consortium of cooperating institutions, meeting
such requirements as may be prescribed by the Director.
``(6) Number of centers; duration of support.--
``(A) In general.--The Director shall provide for the
establishment of not less than 5 centers under paragraph (1).
``(B) Duration.--Support for a center established under
paragraph (1) may be provided under this section for a period
of not to exceed 5 years. Such period may be extended for 1
or more additional periods not exceeding 5 years if the
operations of such center have been reviewed by an
appropriate technical and scientific peer review group
established by the Director and if such group has recommended
to the Director that such period should be extended.
``(c) Facilitation of Research.--The Director shall under
subsection (a)(1) provide for a program under which samples
of tissues and genetic materials that are of use in research
on autism are donated, collected, preserved, and made
available for such research. The program shall be carried out
in accordance with accepted scientific and medical standards
for the donation, collection, and preservation of such
samples.
``(d) Public Input.--The Director shall under subsection
(a)(1) provide for means through which the public can obtain
information on the existing and planned programs and
activities of the National Institutes of Health with respect
to autism and through which the Director can receive comments
from the public regarding such programs and activities.
``(e) Funding.--There are authorized to be appropriated
such sums as may be necessary to carry out this section.
Amounts appropriated under this subsection are in addition to
any other amounts appropriated for such purpose.''.
SEC. 102. DEVELOPMENTAL DISABILITIES SURVEILLANCE AND
RESEARCH PROGRAMS.
(a) National Autism and Pervasive Developmental
Disabilities Surveillance Program.--
(1) In general.--The Secretary of Health and Human Services
(in this section referred to as the ``Secretary''), acting
through the Director of the Centers for Disease Control and
Prevention, may make awards of grants and cooperative
agreements for the collection, analysis, and reporting of
data on autism and pervasive developmental disabilities. In
making such awards, the Secretary may provide direct
technical assistance in lieu of cash.
(2) Eligibility.--To be eligible to receive an award under
paragraph (1) an entity shall be a public or nonprofit
private entity (including health departments of States and
political subdivisions of States, and including universities
and other educational entities).
(b) Centers of Excellence in Autism and Pervasive
Developmental Disabilities Epidemiology.--
(1) In general.--The Secretary, acting through the Director
of the Centers for Disease Control and Prevention, shall
establish not less than 3 regional centers of excellence in
autism and pervasive developmental disabilities epidemiology
for the purpose of collecting and analyzing information on
the number, incidence, correlates, and causes of autism and
related developmental disabilities.
(2) Recipients of awards for establishment of centers.--
Centers under paragraph (1) shall be established and operated
through the awarding of grants or cooperative agreements to
public or nonprofit private entities that conduct research,
including health departments of States and political
subdivisions of States, and including universities and other
educational entities.
(3) Certain requirements.--An award for a center under
paragraph (1) may be made only if the entity involved submits
to the Secretary an application containing such agreements
and information as the Secretary may require, including an
agreement that the center involved will operate in accordance
with the following:
(A) The center will collect, analyze, and report autism and
pervasive developmental disabilities data according to
guidelines prescribed by the Director, after consultation
with relevant State and local public health officials,
private sector developmental disability researchers, and
advocates for those with developmental disabilities.
(B) The center will assist with the development and
coordination of State autism and pervasive developmental
disabilities surveillance efforts within a region.
(C) The center will identify eligible cases and controls
through its surveillance systems and conduct research into
factors which may cause autism and related developmental
disabilities.
(D) The center will develop or extend an area of special
research expertise (including genetics, environmental
exposure to contaminants, immunology, and other relevant
research specialty areas).
(c) Clearinghouse.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention,
shall carry out the following:
(1) The Secretary shall establish a clearinghouse within
the Centers for Disease Control and Prevention for the
collection and storage of data generated from the monitoring
programs established by this title. Through the
clearinghouse, such Centers shall serve as the coordinating
agency for autism and pervasive developmental disabilities
surveillance activities. The functions of such a
clearinghouse shall include facilitating the coordination of
research and policy development relating to the epidemiology
of autism and other pervasive developmental disabilities.
(2) The Secretary shall coordinate the Federal response to
requests for assistance from State health department
officials regarding potential or alleged autism or
developmental disability clusters.
(d) Definition.--In this title, the term ``State'' means
each of the several States, the District of Columbia, the
Commonwealth of Puerto Rico, American Samoa, Guam, the
Commonwealth of the Northern Mariana Islands, the Virgin
Islands, and the Trust Territory of the Pacific Islands.
(e) Authorization of Appropriations.--There are authorized
to be appropriated such sums as may be necessary to carry out
this section.
SEC. 103. INFORMATION AND EDUCATION.
(a) In General.--The Secretary shall establish and
implement a program to provide information and education on
autism to health professionals and the general public,
including information and education on advances in the
diagnosis and treatment of autism and training and continuing
education through programs for scientists, physicians, and
other health professionals who provide care for patients with
autism.
(b) Stipends.--The Secretary may use amounts made available
under this section to provide stipends for health
professionals who are enrolled in training programs under
this section.
(c) Authorization of Appropriations.--There are authorized
to be appropriated such sums as may be necessary to carry out
this section.
SEC. 104. INTER-AGENCY AUTISM COORDINATING COMMITTEE.
(a) Establishment.--The Secretary shall establish a
committee to be known as the ``Autism Coordinating
Committee'' (in this section referred to as the
``Committee'') to coordinate all efforts within the
Department of Health and Human Services concerning autism,
including activities carried out through the National
Institutes of Health and the Centers for Disease Control and
Prevention under this title (and the amendment made by this
title).
(b) Membership.--
(1) In general.--The Committee shall be composed of the
Directors of such national research institutes, of the
Centers for Disease Control and Prevention, and of such other
agencies and such other officials as the Secretary determines
appropriate.
(2) Additional members.--If determined appropriate by the
Secretary, the Secretary may appoint to the Committee--
(A) parents or legal guardians of individuals with autism
or other pervasive developmental disorders; and
[[Page H8212]]
(B) representatives of other governmental agencies that
serve children with autism such as the Department of
Education.
(c) Administrative Support; Terms of Service; Other
Provisions.--The following shall apply with respect to the
Committee:
(1) The Committee shall receive necessary and appropriate
administrative support from the Department of Health and
Human Services.
(2) Members of the Committee appointed under subsection
(b)(2)(A) shall serve for a term of 3 years, and may serve
for an unlimited number of terms if reappointed.
(3) The Committee shall meet not less than 2 times each
year.
SEC. 105. REPORT TO CONGRESS.
Not later than January 1, 2001, and each January 1
thereafter, the Secretary shall prepare and submit to the
appropriate committees of Congress, a report concerning the
implementation of this title and the amendments made by this
title.
TITLE II--RESEARCH AND DEVELOPMENT REGARDING FRAGILE X
SEC. 201. NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN
DEVELOPMENT; RESEARCH ON FRAGILE X.
Subpart 7 of part C of title IV of the Public Health
Service Act is amended by adding at the end the following
section:
``fragile x
``Sec. 452E. (a) Expansion and Coordination of Research
Activities.--The Director of the Institute, after
consultation with the advisory council for the Institute,
shall expand, intensify, and coordinate the activities of the
Institute with respect to research on the disease known as
fragile X.
``(b) Research Centers.--
``(1) In general.--The Director of the Institute shall make
grants or enter into contracts for the development and
operation of centers to conduct research for the purposes of
improving the diagnosis and treatment of, and finding the
cure for, fragile X.
``(2) Number of centers.--
``(A) In general.--In carrying out paragraph (1), the
Director of the Institute shall, to the extent that amounts
are appropriated, and subject to subparagraph (B), provide
for the establishment of at least three fragile X research
centers.
``(B) Peer review requirement.--The Director of the
Institute shall make a grant to, or enter into a contract
with, an entity for purposes of establishing a center under
paragraph (1) only if the grant or contract has been
recommended after technical and scientific peer review
required by regulations under section 492.
``(3) Activities.--The Director of the Institute, with the
assistance of centers established under paragraph (1), shall
conduct and support basic and biomedical research into the
detection and treatment of fragile X.
``(4) Coordination among centers.--The Director of the
Institute shall, as appropriate, provide for the coordination
of the activities of the centers assisted under this section,
including providing for the exchange of information among the
centers.
``(5) Certain administrative requirements.--Each center
assisted under paragraph (1) shall use the facilities of a
single institution, or be formed from a consortium of
cooperating institutions, meeting such requirements as may be
prescribed by the Director of the Institute.
``(6) Duration of support.--Support may be provided to a
center under paragraph (1) for a period not exceeding 5
years. Such period may be extended for one or more additional
periods, each of which may not exceed 5 years, if the
operations of such center have been reviewed by an
appropriate technical and scientific peer review group
established by the Director and if such group has recommended
to the Director that such period be extended.
``(7) Authorization of appropriations.--For the purpose of
carrying out this subsection, there are authorized to be
appropriated such sums as may be necessary for each of the
fiscal years 2001 through 2005.''.
TITLE III--JUVENILE ARTHRITIS AND RELATED CONDITIONS
SEC. 301. NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL
AND SKIN DISEASES; RESEARCH ON JUVENILE
ARTHRITIS AND RELATED CONDITIONS.
(a) In General.--Subpart 4 of part C of title IV of the
Public Health Service Act (42 U.S.C. 285d et seq.) is amended
by inserting after section 442 the following section:
``juvenile arthritis and related conditions
``Sec. 442A. (a) Expansion and Coordination of
Activities.--The Director of the Institute, in coordination
with the Director of the National Institute of Allergy and
Infectious Diseases, shall expand and intensify the programs
of such Institutes with respect to research and related
activities concerning juvenile arthritis and related
conditions.
``(b) Coordination.--The Directors referred to in
subsection (a) shall jointly coordinate the programs referred
to in such subsection and consult with the Arthritis and
Musculoskeletal Diseases Interagency Coordinating Committee.
``(c) 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 2001 through 2005.''.
(b) Pediatric Rheumatology.--Subpart 1 of part E of title
VII of the Public Health Service Act (42 U.S.C. 294n et seq.)
is amended by adding at the end the following:
``SEC. 763. PEDIATRIC RHEUMATOLOGY.
``(a) In General.--The Secretary, acting through the
appropriate agencies, shall evaluate whether the number of
pediatric rheumatologists is sufficient to address the health
care needs of children with arthritis and related conditions,
and if the Secretary determines that the number is not
sufficient, shall develop strategies to help address the
shortfall.
``(b) Report to Congress.--Not later than October 1, 2001,
the Secretary shall submit to the Congress a report
describing the results of the evaluation under subsection
(a), and as applicable, the strategies developed under such
subsection.
``(c) 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 2001 through 2005.''.
SEC. 302. INFORMATION CLEARINGHOUSE.
Section 438(b) of the Public Health Service Act (42 U.S.C.
285d-3(b)) is amended by inserting ``, including juvenile
arthritis and related conditions,'' after ``diseases''.
TITLE IV--REDUCING BURDEN OF DIABETES AMONG CHILDREN AND YOUTH
SEC. 401. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND
PREVENTION.
Part B of title III of the Public Health Service Act (42
U.S.C. 243 et seq.) is amended by inserting after section
317G the following section:
``diabetes in children and youth
``Sec. 317H. (a) Surveillance on Juvenile Diabetes.--The
Secretary, acting through the Director of the Centers for
Disease Control and Prevention, shall develop a sentinel
system to collect data on juvenile diabetes, including with
respect to incidence and prevalence, and shall establish a
national database for such data.
``(b) Type 2 Diabetes in Youth.--The Secretary shall
implement a national public health effort to address type 2
diabetes in youth, including--
``(1) enhancing surveillance systems and expanding research
to better assess the prevalence and incidence of type 2
diabetes in youth and determine the extent to which type 2
diabetes is incorrectly diagnosed as type 1 diabetes among
children; and
``(2) developing and improving laboratory methods to assist
in diagnosis, treatment, and prevention of diabetes
including, but not limited to, developing noninvasive ways to
monitor blood glucose to prevent hypoglycemia and improving
existing glucometers that measure blood glucose.
``(c) 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 2001 through 2005.''.
SEC. 402. PROGRAMS OF NATIONAL INSTITUTES OF HEALTH.
Subpart 3 of part C of title IV of the Public Health
Service Act (42 U.S.C. 285c et seq.) is amended by inserting
after section 434 the following section:
``juvenile diabetes
``Sec. 434A. (a) Long-Term Epidemiology Studies.--The
Director of the Institute shall conduct or support long-term
epidemiology studies in which individuals with or at risk for
type 1, or juvenile, diabetes are followed for 10 years or
more. Such studies shall investigate the causes and
characteristics of the disease and its complications.
``(b) Clinical Trial Infrastructure/Innovative Treatments
for Juvenile Diabetes.--The Secretary, acting through the
Director of the National Institutes of Health, shall support
regional clinical research centers for the prevention,
detection, treatment, and cure of juvenile diabetes.
``(c) Prevention of Type 1 Diabetes.--The Secretary, acting
through the appropriate agencies, shall provide for a
national effort to prevent type 1 diabetes. Such effort shall
provide for a combination of increased efforts in research
and development of prevention strategies, including
consideration of vaccine development, coupled with
appropriate ability to test the effectiveness of such
strategies in large clinical trials of children and young
adults.
``(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 2001 through 2005.''.
TITLE V--ASTHMA SERVICES FOR CHILDREN
Subtitle A--Asthma Services
SEC. 501. GRANTS FOR CHILDREN'S ASTHMA RELIEF.
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:
``PART P--ADDITIONAL PROGRAMS
``SEC. 399L. CHILDREN'S ASTHMA TREATMENT GRANTS PROGRAM.
``(a) Authority To Make Grants.--
``(1) In general.--In addition to any other payments made
under this Act or title V of the Social Security Act, the
Secretary shall award grants to eligible entities to carry
out the following purposes:
``(A) To provide access to quality medical care for
children who live in areas that have a high prevalence of
asthma and who lack access to medical care.
``(B) To provide on-site education to parents, children,
health care providers, and medical teams to recognize the
signs and symptoms of asthma, and to train them in the use of
medications to treat asthma and prevent its exacerbations.
``(C) To decrease preventable trips to the emergency room
by making medication available to individuals who have not
previously had access to treatment or education in the
management of asthma.
``(D) To provide other services, such as smoking cessation
programs, home modification, and other direct and support
services that ameliorate conditions that exacerbate or induce
asthma.
``(2) Certain projects.--In making grants under paragraph
(1), the Secretary may make
[[Page H8213]]
grants designed to develop and expand the following projects:
``(A) Projects to provide comprehensive asthma services to
children in accordance with the guidelines of the National
Asthma Education and Prevention Program (through the National
Heart, Lung and Blood Institute), including access to care
and treatment for asthma in a community-based setting.
``(B) Projects to fully equip mobile health care clinics
that provide preventive asthma care including diagnosis,
physical examinations, pharmacological therapy, skin testing,
peak flow meter testing, and other asthma-related health care
services.
``(C) Projects to conduct validated asthma management
education programs for patients with asthma and their
families, including patient education regarding asthma
management, family education on asthma management, and the
distribution of materials, including displays and videos, to
reinforce concepts presented by medical teams.
``(2) Award of grants.--
``(A) Application.--
``(i) In general.--An eligible entity shall submit an
application to the Secretary for a grant under this section
in such form and manner as the Secretary may require.
``(ii) Required information.--An application submitted
under this subparagraph shall include a plan for the use of
funds awarded under the grant and such other information as
the Secretary may require.
``(B) Requirement.--In awarding grants under this section,
the Secretary shall give preference to eligible entities that
demonstrate that the activities to be carried out under this
section shall be in localities within areas of known or
suspected high prevalence of childhood asthma or high asthma-
related mortality or high rate of hospitalization or
emergency room visits for asthma (relative to the average
asthma prevalence rates and associated mortality rates in the
United States). Acceptable data sets to demonstrate a high
prevalence of childhood asthma or high asthma-related
mortality may include data from Federal, State, or local
vital statistics, claims data under title XIX or XXI of the
Social Security Act, other public health statistics or
surveys, or other data that the Secretary, in consultation
with the Director of the Centers for Disease Control and
Prevention, deems appropriate.
``(3) Definition of eligible entity.--For purposes of this
section, the term `eligible entity' means a public or
nonprofit private entity (including a State or political
subdivision of a State), or a consortium of any of such
entities.
``(b) Coordination With Other Children's Programs.--An
eligible entity shall identify in the plan submitted as part
of an application for a grant under this section how the
entity will coordinate operations and activities under the
grant with--
``(1) other programs operated in the State that serve
children with asthma, including any such programs operated
under titles V, XIX, or XXI of the Social Security Act; and
``(2) one or more of the following--
``(A) the child welfare and foster care and adoption
assistance programs under parts B and E of title IV of such
Act;
``(B) the head start program established under the Head
Start Act (42 U.S.C. 9831 et seq.);
``(C) the program of assistance under the special
supplemental nutrition program for women, infants and
children (WIC) under section 17 of the Child Nutrition Act of
1966 (42 U.S.C. 1786);
``(D) local public and private elementary or secondary
schools; or
``(E) public housing agencies, as defined in section 3 of
the United States Housing Act of 1937 (42 U.S.C. 1437a).
``(c) Evaluation.--An eligible entity that receives a grant
under this section shall submit to the Secretary an
evaluation of the operations and activities carried out under
the grant that includes--
``(1) a description of the health status outcomes of
children assisted under the grant;
``(2) an assessment of the utilization of asthma-related
health care services as a result of activities carried out
under the grant;
``(3) the collection, analysis, and reporting of asthma
data according to guidelines prescribed by the Director of
the Centers for Disease Control and Prevention; and
``(4) such other information as the Secretary may require.
``(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 2001 through 2005.''.
SEC. 502. TECHNICAL AND CONFORMING AMENDMENTS.
Title III of the Public Health Service Act (42 U.S.C. 241
et seq.) is amended--
(1) in part L, by redesignating section 399D as section
399A;
(2) in part M--
(A) by redesignating sections 399H through 399L as sections
399B through 399F, respectively;
(B) in section 399B (as so redesignated), in subsection
(e)--
(i) by striking ``section 399K(b)'' and inserting
``subsection (b) of section 399E''; and
(ii) by striking ``section 399C'' and inserting ``such
section'';
(C) in section 399E (as so redesignated), in subsection
(c), by striking ``section 399H(a)'' and inserting ``section
399B(a)''; and
(D) in section 399F (as so redesignated)--
(i) in subsection (a), by striking ``section 399I'' and
inserting ``section 399C'';
(ii) in subsection (a), by striking ``subsection 399J'' and
inserting ``section 399D''; and
(iii) in subsection (b), by striking ``subsection 399K''
and inserting ``section 399E'';
(3) in part N, by redesignating section 399F as section
399G; and
(4) in part O--
(A) by redesignating sections 399G through 399J as sections
399H through 399K, respectively;
(B) in section 399H (as so redesignated), in subsection
(b), by striking ``section 399H'' and inserting ``section
399I'';
(C) in section 399J (as so redesignated), in subsection
(b), by striking ``section 399G(d)'' and inserting ``section
399H(d)''; and
(D) in section 399K (as so redesignated), by striking
``section 399G(d)(1)'' and inserting ``section 399H(d)(1)''.
Subtitle B--Prevention Activities
SEC. 511. PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT;
SYSTEMS FOR REDUCING ASTHMA-RELATED ILLNESSES
THROUGH INTEGRATED PEST MANAGEMENT.
Section 1904(a)(1) of the Public Health Service Act (42
U.S.C. 300w-3(a)(1)) is amended--
(1) by redesignating subparagraphs (E) and (F) as
subparagraphs (F) and (G), respectively;
(2) by adding a period at the end of subparagraph (G) (as
so redesignated);
(3) by inserting after subparagraph (D), the following:
``(E) The establishment, operation, and coordination of
effective and cost-efficient systems to reduce the prevalence
of illness due to asthma and asthma-related illnesses,
especially among children, by reducing the level of exposure
to cockroach allergen or other known asthma triggers through
the use of integrated pest management, as applied to
cockroaches or other known allergens. Amounts expended for
such systems may include the costs of building maintenance
and the costs of programs to promote community participation
in the carrying out at such sites of integrated pest
management, as applied to cockroaches or other known
allergens. For purposes of this subparagraph, the term
`integrated pest management' means an approach to the
management of pests in public facilities that combines
biological, cultural, physical, and chemical tools in a way
that minimizes economic, health, and environmental risks.'';
(4) in subparagraph (F) (as so redesignated), by striking
``subparagraphs (A) through (D)'' and inserting
``subparagraphs (A) through (E)''; and
(5) in subparagraph (G) (as so redesignated), by striking
``subparagraphs (A) through (E)'' and inserting
``subparagraphs (A) through (F)''.
Subtitle C--Coordination of Federal Activities
SEC. 521. COORDINATION THROUGH NATIONAL INSTITUTES OF HEALTH.
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 424A the following section:
``coordination of federal asthma activities
``Sec. 424B (a) In General.--The Director of Institute
shall, through the National Asthma Education Prevention
Program Coordinating Committee--
``(1) identify all Federal programs that carry out asthma-
related activities;
``(2) develop, in consultation with appropriate Federal
agencies and professional and voluntary health organizations,
a Federal plan for responding to asthma; and
``(3) not later than 12 months after the date of the
enactment of the Children's Health Act of 2000, submit
recommendations to the appropriate committees of the Congress
on ways to strengthen and improve the coordination of asthma-
related activities of the Federal Government.
``(b) Representation of the Department of Housing and Urban
Development.--A representative of the Department of Housing
and Urban Development shall be included on the National
Asthma Education Prevention Program Coordinating Committee
for the purpose of performing the tasks described in
subsection (a).
``(c) 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 2001 through 2005.''.
Subtitle D--Compilation of Data
SEC. 531. COMPILATION OF DATA BY CENTERS FOR DISEASE CONTROL
AND PREVENTION.
Part B of title III of the Public Health Service Act, as
amended by section 401 of this Act, is amended by inserting
after section 317H the following section:
``compilation of data on asthma
``Sec. 317I. (a) In General.--The Secretary, acting through
the Director of the Centers for Disease Control and
Prevention, shall--
``(1) conduct local asthma surveillance activities to
collect data on the prevalence and severity of asthma and the
quality of asthma management;
``(2) compile and annually publish data on the prevalence
of children suffering from asthma in each State; and
``(3) to the extent practicable, compile and publish data
on the childhood mortality rate associated with asthma
nationally.
``(b) Surveillance Activities.--The Director of the Centers
for Disease Control and Prevention, acting through the
representative of the Director on the National Asthma
Education Prevention Program Coordinating Committee, shall,
in carrying out subsection (a), provide an update on
surveillance activities at each Committee meeting.
``(c) Collaborative Efforts.--The activities described in
subsection (a)(1) may be conducted in collaboration with
eligible entities awarded a grant under section 399L.
``(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 2001 through 2005.''.
[[Page H8214]]
TITLE VI--BIRTH DEFECTS PREVENTION ACTIVITIES
Subtitle A--Folic Acid Promotion
SEC. 601. PROGRAM REGARDING EFFECTS OF FOLIC ACID IN
PREVENTION OF BIRTH DEFECTS.
Part B of title III of the Public Health Service Act, as
amended by section 531 of this Act, is amended by inserting
after section 317I the following section:
``effects of folic acid in prevention of birth defects
``Sec. 317J. (a) In General.--The Secretary, acting through
the Director of the Centers for Disease Control and
Prevention, shall expand and intensify programs (directly or
through grants or contracts) for the following purposes:
``(1) To provide education and training for health
professionals and the general public for purposes of
explaining the effects of folic acid in preventing birth
defects and for purposes of encouraging each woman of
reproductive capacity (whether or not planning a pregnancy)
to consume on a daily basis a dietary supplement that
provides an appropriate level of folic acid.
``(2) To conduct research with respect to such education
and training, including identifying effective strategies for
increasing the rate of consumption of folic acid by women of
reproductive capacity.
``(3) To conduct research to increase the understanding of
the effects of folic acid in preventing birth defects,
including understanding with respect to cleft lip, cleft
palate, and heart defects.
``(4) To provide for appropriate epidemiological activities
regarding folic acid and birth defects, including
epidemiological activities regarding neural tube defects.
``(b) Consultations With States and Private Entities.--In
carrying out subsection (a), the Secretary shall consult with
the States and with other appropriate public or private
entities, including national nonprofit private organizations,
health professionals, and providers of health insurance and
health plans.
``(c) Technical Assistance.--The Secretary may (directly or
through grants or contracts) provide technical assistance to
public and nonprofit private entities in carrying out the
activities described in subsection (a).
``(d) Evaluations.--The Secretary shall (directly or
through grants or contracts) provide for the evaluation of
activities under subsection (a) in order to determine the
extent to which such activities have been effective in
carrying out the purposes of the program under such
subsection, including the effects on various demographic
populations. Methods of evaluation under the preceding
sentence may include surveys of knowledge and attitudes on
the consumption of folic acid and on blood folate levels.
Such methods may include complete and timely monitoring of
infants who are born with neural tube defects.
``(e) 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 2001 through 2005.''.
Subtitle B--National Center on Birth Defects and Developmental
Disabilities
SEC. 611. NATIONAL CENTER ON BIRTH DEFECTS AND DEVELOPMENTAL
DISABILITIES.
Section 317C of the Public Health Service Act (42 U.S.C.
247b-4) is amended--
(1) by striking the heading for the section and inserting
the following:
``national center on birth defects and developmental disabilities'';
(2) by striking ``Sec. 317C. (a)'' and all that follows
through the end of subsection (a) and inserting the
following:
``Sec. 317C. (a) In General.--
``(1) National center.--There is established within the
Centers for Disease Control and Prevention a center to be
known as the National Center on Birth Defects and
Developmental Disabilities (referred to in this section as
the `Center'), which shall be headed by a director appointed
by the Director of the Centers for Disease Control and
Prevention.
``(2) General duties.--The Secretary shall carry out
programs--
(A) to collect, analyze, and make available data on birth
defects and developmental disabilities (in a manner that
facilitates compliance with subsection (d)(2)), including
data on the causes of such defects and disabilities and on
the incidence and prevalence of such defects and
disabilities;
(B) to operate regional centers for the conduct of applied
epidemiological research on the prevention of such defects
and disabilities; and
(C) to provide information and education to the public on
the prevention of such defects and disabilities.
``(3) Folic acid.--The Secretary shall carry out section
317J through the Center.
``(4) Certain programs.--
``(A) Transfers.--All programs and functions described in
subparagraph (B) are transferred to the Center, effective
upon the expiration of the 180-day period beginning on the
date of the enactment of the Children's Health Act of 2000.
``(B) Relevant programs.--The programs and functions
described in this subparagraph are all programs and functions
that--
``(i) relate to birth defects; folic acid; cerebral palsy;
mental retardation; child development; newborn screening;
autism; fragile X syndrome; fetal alcohol syndrome; pediatric
genetic disorders; disability prevention; or other relevant
diseases, disorders, or conditions as determined the
Secretary; and
``(ii) were carried out through the National Center for
Environmental Health as of the day before the date of the
enactment of the Act referred to in subparagraph (A).
``(C) Related transfers.--Personnel employed in connection
with the programs and functions specified in subparagraph
(B), and amounts available for carrying out the programs and
functions, are transferred to the Center, effective upon the
expiration of the 180-day period beginning on the date of the
enactment of the Act referred to in subparagraph (A). Such
transfer of amounts does not affect the period of
availability of the amounts, or the availability of the
amounts with respect to the purposes for which the amounts
may be expended.''; and
(3) in subsection (b)(1), in the matter preceding
subparagraph (A), by striking ``(a)(1)'' and inserting
``(a)(2)(A)''.
TITLE VII--EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING HEARING
LOSS IN INFANTS
SEC. 701. PURPOSES.
The purposes of this title are to clarify the authority
within the Public Health Service Act to authorize statewide
newborn and infant hearing screening, evaluation and
intervention programs and systems, technical assistance, a
national applied research program, and interagency and
private sector collaboration for policy development, in order
to assist the States in making progress toward the following
goals:
(1) All babies born in hospitals in the United States and
its territories should have a hearing screening before
leaving the birthing facility. Babies born in other countries
and residing in the United States via immigration or adoption
should have a hearing screening as early as possible.
(2) All babies who are not born in hospitals in the United
States and its territories should have a hearing screening
within the first 3 months of life.
(3) Appropriate audiologic and medical evaluations should
be conducted by 3 months for all newborns and infants
suspected of having hearing loss to allow appropriate
referral and provisions for audiologic rehabilitation,
medical and early intervention before the age of 6 months.
(4) All newborn and infant hearing screening programs and
systems should include a component for audiologic
rehabilitation, medical and early intervention options that
ensures linkage to any new and existing state-wide systems of
intervention and rehabilitative services for newborns and
infants with hearing loss.
(5) Public policy in regard to newborn and infant hearing
screening and intervention should be based on applied
research and the recognition that newborns, infants,
toddlers, and children who are deaf or hard-of-hearing have
unique language, learning, and communication needs, and
should be the result of consultation with pertinent public
and private sectors.
SEC. 702. PROGRAMS OF HEALTH RESOURCES AND SERVICES
ADMINISTRATION, CENTERS FOR DISEASE CONTROL AND
PREVENTION, AND NATIONAL INSTITUTES OF HEALTH.
Part P of title III of the Public Health Service Act, as
added by section 501 of this Act, is amended by adding at the
end the following section:
``SEC. 399M. EARLY DETECTION, DIAGNOSIS, AND TREATMENT
REGARDING HEARING LOSS IN INFANTS.
``(a) Statewide Newborn and Infant Hearing Screening,
Evaluation and Intervention Programs and Systems.--The
Secretary, acting through the Administrator of the Health
Resources and Services Administration, shall make awards of
grants or cooperative agreements to develop statewide newborn
and infant hearing screening, evaluation and intervention
programs and systems for the following purposes:
``(1) To develop and monitor the efficacy of state-wide
newborn and infant hearing screening, evaluation and
intervention programs and systems. Early intervention
includes referral to schools and agencies, including
community, consumer, and parent-based agencies and
organizations and other programs mandated by part C of the
Individuals with Disabilities Education Act, which offer
programs specifically designed to meet the unique language
and communication needs of deaf and hard of hearing newborns,
infants, toddlers, and children.
``(2) To collect data on statewide newborn and infant
hearing screening, evaluation and intervention programs and
systems that can be used for applied research, program
evaluation and policy development.
``(b) Technical Assistance, Data Management, and Applied
Research.--
``(1) Centers for disease control and prevention.--The
Secretary, acting through the Director of the Centers for
Disease Control and Prevention, shall make awards of grants
or cooperative agreements to provide technical assistance to
State agencies to complement an intramural program and to
conduct applied research related to newborn and infant
hearing screening, evaluation and intervention programs and
systems. The program shall develop standardized procedures
for data management and program effectiveness and costs, such
as--
``(A) to ensure quality monitoring of newborn and infant
hearing loss screening, evaluation, and intervention programs
and systems;
``(B) to provide technical assistance on data collection
and management;
``(C) to study the costs and effectiveness of newborn and
infant hearing screening, evaluation and intervention
programs and systems conducted by State-based programs in
order to answer issues of importance to state and national
policymakers;
``(D) to identify the causes and risk factors for
congenital hearing loss;
``(E) to study the effectiveness of newborn and infant
hearing screening, audiologic and medical evaluations and
intervention programs and systems by assessing the health,
intellectual and social developmental, cognitive, and
language status of these children at school age; and
``(F) to promote the sharing of data regarding early
hearing loss with State-based birth defects
[[Page H8215]]
and developmental disabilities monitoring programs for the
purpose of identifying previously unknown causes of hearing
loss.
``(2) National institutes of health.--The Director of the
National Institutes of Health, acting through the Director of
the National Institute on Deafness and Other Communication
Disorders, shall for purposes of this section, continue a
program of research and development on the efficacy of new
screening techniques and technology, including clinical
studies of screening methods, studies on efficacy of
intervention, and related research.
``(c) Coordination and Collaboration.--
``(1) In general.--In carrying out programs under this
section, the Administrator of the Health Resources and
Services Administration, the Director of the Centers for
Disease Control and Prevention, and the Director of the
National Institutes of Health shall collaborate and consult
with other Federal agencies; State and local agencies,
including those responsible for early intervention services
pursuant to title XIX of the Social Security Act (Medicaid
Early and Periodic Screening, Diagnosis and Treatment
Program); title XXI of the Social Security Act (State
Children's Health Insurance Program); title V of the Social
Security Act (Maternal and Child Health Block Grant Program);
and part C of the Individuals with Disabilities Education
Act; consumer groups of and that serve individuals who are
deaf and hard-of-hearing and their families; appropriate
national medical and other health and education specialty
organizations; persons who are deaf and hard-of-hearing and
their families; other qualified professional personnel who
are proficient in deaf or hard-of-hearing children's language
and who possess the specialized knowledge, skills, and
attributes needed to serve deaf and hard-of-hearing newborns,
infants, toddlers, children, and their families; third-party
payers and managed care organizations; and related commercial
industries.
``(2) Policy development.--The Administrator of the Health
Resources and Services Administration, the Director of the
Centers for Disease Control and Prevention, and the Director
of the National Institutes of Health shall coordinate and
collaborate on recommendations for policy development at the
Federal and State levels and with the private sector,
including consumer, medical and other health and education
professional-based organizations, with respect to newborn and
infant hearing screening, evaluation and intervention
programs and systems.
``(3) State early detection, diagnosis, and intervention
programs and systems; data collection.--The Administrator of
the Health Resources and Services Administration and the
Director of the Centers for Disease Control and Prevention
shall coordinate and collaborate in assisting States to
establish newborn and infant hearing screening, evaluation
and intervention programs and systems under subsection (a)
and to develop a data collection system under subsection (b).
``(d) Rule of Construction; Religious Accommodation.--
Nothing in this section shall be construed to preempt or
prohibit any State law, including State laws which do not
require the screening for hearing loss of newborn infants or
young children of parents who object to the screening on the
grounds that such screening conflicts with the parents'
religious beliefs.
``(e) Definitions.--For purposes of this section:
``(1) The term `audiologic evaluation' refers to procedures
to assess the status of the auditory system; to establish the
site of the auditory disorder; the type and degree of hearing
loss, and the potential effects of hearing loss on
communication; and to identify appropriate treatment and
referral options. Referral options should include linkage to
State coordinating agencies under part C of the Individuals
with Disabilities Education Act or other appropriate
agencies, medical evaluation, hearing aid/sensory aid
assessment, audiologic rehabilitation treatment, national and
local consumer, self-help, parent, and education
organizations, and other family-centered services.
``(2) The terms `audiologic rehabilitation' and `audiologic
intervention' refer to procedures, techniques, and
technologies to facilitate the receptive and expressive
communication abilities of a child with hearing loss.
``(3) The term `early intervention' refers to providing
appropriate services for the child with hearing loss,
including nonmedical services, and ensuring that families of
the child are provided comprehensive, consumer-oriented
information about the full range of family support, training,
information services, communication options and are given the
opportunity to consider the full range of educational and
program placements and options for their child.
``(4) The term `medical evaluation by a physician' refers
to key components including history, examination, and medical
decision making focused on symptomatic and related body
systems for the purpose of diagnosing the etiology of hearing
loss and related physical conditions, and for identifying
appropriate treatment and referral options.
``(5) The term `medical intervention' refers to the process
by which a physician provides medical diagnosis and direction
for medical and/or surgical treatment options of hearing loss
and/or related medical disorder associated with hearing loss.
``(6) The term `newborn and infant hearing screening'
refers to objective physiologic procedures to detect possible
hearing loss and to identify newborns and infants who, after
rescreening, require further audiologic and medical
evaluations.
``(f) Authorization of Appropriations.--
``(1) Statewide newborn and infant hearing screening,
evaluation and intervention programs and systems.--For the
purpose of carrying out subsection (a), there are authorized
to be appropriated to the Health Resources and Services
Administration such sums as may be necessary for fiscal year
2002.
``(2) Technical assistance, data management, and applied
research; centers for disease control and prevention.--For
the purpose of carrying out subsection (b)(1), there are
authorized to be appropriated to the Centers for Disease
Control and Prevention such sums as may be necessary for
fiscal year 2002.
``(3) Technical assistance, data management, and applied
research; national institute on deafness and other
communication disorders.--For the purpose of carrying out
subsection (b)(2), there are authorized to be appropriated to
the National Institute on Deafness and Other Communication
Disorders such sums as may be necessary for fiscal year
2002.''.
TITLE VIII--CHILDREN AND EPILEPSY
SEC. 801. NATIONAL PUBLIC HEALTH CAMPAIGN ON EPILEPSY;
SEIZURE DISORDER DEMONSTRATION PROJECTS IN
MEDICALLY UNDERSERVED AREAS.
Subpart I of part D of title III of the Public Health
Service Act (42 U.S.C. 254b) is amended by adding at the end
the following section:
``SEC. 330E. EPILEPSY; SEIZURE DISORDER.
``(a) National Public Health Campaign.--
``(1) In general.--The Secretary shall develop and
implement public health surveillance, education, research,
and intervention strategies to improve the lives of persons
with epilepsy, with a particular emphasis on children. Such
projects may be carried out by the Secretary directly and
through awards of grants or contracts to public or nonprofit
private entities. The Secretary may directly or through such
awards provide technical assistance with respect to the
planning, development, and operation of such projects.
``(2) Certain activities.--Activities under paragraph (1)
shall include--
``(A) expanding current surveillance activities through
existing monitoring systems and improving registries that
maintain data on individuals with epilepsy, including
children;
``(B) enhancing research activities on the diagnosis,
treatment, and management of epilepsy;
``(C) implementing public and professional information and
education programs regarding epilepsy, including initiatives
which promote effective management of the disease through
children's programs which are targeted to parents, schools,
daycare providers, patients;
``(D) undertaking educational efforts with the media,
providers of health care, schools and others regarding
stigmas and secondary disabilities related to epilepsy and
seizures, and its effects on youth;
``(E) utilizing and expanding partnerships with
organizations with experience addressing the health and
related needs of people with disabilities; and
``(F) other activities the Secretary deems appropriate.
``(3) Coordination of activities.--The Secretary shall
ensure that activities under this subsection are coordinated
as appropriate with other agencies of the Public Health
Service that carry out activities regarding epilepsy and
seizure.
``(b) Seizure Disorder; Demonstration Projects in Medically
Underserved Areas.--
``(1) In general.--The Secretary, acting through the
Administrator of the Health Resources and Services
Administration, may make grants for the purpose of carrying
out demonstration projects to improve access to health and
other services regarding seizures to encourage early
detection and treatment in children and others residing in
medically underserved areas.
``(2) Application for grant.--A grant may not be awarded
under paragraph (1) unless an application therefore is
submitted to the Secretary and the Secretary approves such
application. Such application shall be submitted in such form
and manner and shall contain such information as the
Secretary may prescribe.
``(c) Definitions.--For purposes of this section:
``(1) The term ``epilepsy'' refers to a chronic and serious
neurological condition characterized by excessive electrical
discharges in the brain causing recurring seizures affecting
all life activities. The Secretary may revise the definition
of such term to the extent the Secretary determines
necessary.
``(2) The term ``medically underserved'' has the meaning
applicable under section 799B(6).
``(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 2001 through 2005.''.
TITLE IX--SAFE MOTHERHOOD; INFANT HEALTH PROMOTION
Subtitle A--Safe Motherhood Prevention Research
SEC. 901. PREVENTION RESEARCH AND OTHER ACTIVITIES.
Part B of title III of the Public Health Service Act, as
amended by section 601 of this Act, is amended by inserting
after section 317J the following section:
``safe motherhood
``Sec. 317K. (a) Surveillance.--
``(1) Purpose.--The purpose of this subsection is to
develop surveillance systems at the local, State, and
national level to better understand the burden of maternal
complications and mortality and to decrease the disparities
among population at risk of death and complications from
pregnancy.
``(2) Activities.--For the purpose described in paragraph
(1), the Secretary, acting through the Director of the
Centers for Disease Control and Prevention, may carry out the
following activities:
``(A) The Secretary may establish and implement a national
surveillance program to identify
[[Page H8216]]
and promote the investigation of deaths and severe
complications that occur during pregnancy.
``(B) The Secretary may expand the Pregnancy Risk
Assessment Monitoring System to provide surveillance and
collect data in each State.
``(C) The Secretary may expand the Maternal and Child
Health Epidemiology Program to provide technical support,
financial assistance, or the time-limited assignment of
senior epidemiologists to maternal and child health programs
in each State.
``(b) Prevention Research.--
``(1) Purpose.--The purpose of this subsection is to
provide the Secretary with the authority to further expand
research concerning risk factors, prevention strategies, and
the roles of the family, health care providers and the
community in safe motherhood.
``(2) Research.--The Secretary may carry out activities to
expand research relating to--
``(A) encouraging preconception counseling, especially for
at risk populations such as diabetics;
``(B) the identification of critical components of prenatal
delivery and postpartum care;
``(C) the identification of outreach and support services,
such as folic acid education, that are available for pregnant
women;
``(D) the identification of women who are at high risk for
complications;
``(E) preventing preterm delivery;
``(F) preventing urinary tract infections;
``(G) preventing unnecessary caesarean sections;
``(H) an examination of the higher rates of maternal
mortality among African American women;
``(I) an examination of the relationship between domestic
violence and maternal complications and mortality;
``(J) preventing and reducing adverse health consequences
that may result from smoking, alcohol and illegal drug use
before, during and after pregnancy;
``(K) preventing infections that cause maternal and infant
complications; and
``(L) other areas determined appropriate by the Secretary.
``(c) Prevention Programs.--
``(1) In general.--The Secretary may carry out activities
to promote safe motherhood, including--
``(A) public education campaigns on healthy pregnancies and
the building of partnerships with outside organizations
concerned about safe motherhood;
``(B) education programs for physicians, nurses and other
health care providers; and
``(C) activities to promote community support services for
pregnant women.
``(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 2001 through 2005.''.
Subtitle B--Pregnant Women and Infants Health Promotion
SEC. 911. PROGRAMS REGARDING PRENATAL AND POSTNATAL HEALTH.
Part B of title III of the Public Health Service Act, as
amended by section 901 of this Act, is amended by inserting
after section 317K the following section:
``prenatal and postnatal health
``Sec. 317L. (a) In General.--The Secretary, acting through
the Director of the Centers for Disease Control and
Prevention, shall carry out programs--
``(1) to collect, analyze, and make available data on
prenatal smoking, alcohol and illegal drug use, including
data on the implications of such activities and on the
incidence and prevalence of such activities and their
implications;
``(2) to conduct applied epidemiological research on the
prevention of prenatal and postnatal smoking, alcohol and
illegal drug use;
``(3) to support, conduct, and evaluate the effectiveness
of educational and cessation programs; and
``(4) to provide information and education to the public on
the prevention and implications of prenatal and postnatal
smoking, alcohol and illegal drug use.
``(b) Grants.--In carrying out subsection (a), the
Secretary may award grants to and enter into contracts with
States, local governments, scientific and academic
institutions, Federally qualified health centers, and other
public and nonprofit entities, and may provide technical and
consultative assistance to such entities.
``(c) 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 2001 through 2005.''.
TITLE X-- PEDIATRIC RESEARCH INITIATIVE
SEC. 1001. ESTABLISHMENT OF PEDIATRIC RESEARCH INITIATIVE.
Part B of title IV of the Public Health Service Act, as
amended by section 101 of this Act, is amended by adding at
the end the following:
``pediatric research initiative
``Sec. 409D. (a) Establishment.--The Secretary shall
establish within the Office of the Director of NIH a
Pediatric Research Initiative (referred to in this section as
the `Initiative') to conduct and support research that is
directly related to diseases, disorders, and other conditions
in children. The Initiative shall be headed by the Director
of NIH.
``(b) Purpose.--The purpose of the Initiative is to provide
funds to enable the Director of NIH--
``(1) to increase support for pediatric biomedical research
within the National Institutes of Health to realize the
expanding opportunities for advancement in scientific
investigations and care for children;
``(2) to enhance collaborative efforts among the Institutes
to conduct and support multidisciplinary research in the
areas that the Director deems most promising; and
``(3) in coordination with the Food and Drug
Administration, to increase the development of adequate
pediatric clinical trials and pediatric use information to
promote the safer and more effective use of prescription
drugs in the pediatric population.
``(c) Duties.--In carrying out subsection (b), the Director
of NIH shall--
``(1) consult with the Director of the National Institute
of Child Health and Human Development and the other national
research institutes, in considering their requests for new or
expanded pediatric research efforts, and consult with the
Administrator of the Health Resources and Services
Administration and other advisors as the Director determines
to be appropriate;
``(2) have broad discretion in the allocation of any
Initiative assistance among the Institutes, among types of
grants, and between basic and clinical research so long as
the assistance is directly related to the illnesses and
conditions of children; and
``(3) be responsible for the oversight of any newly
appropriated Initiative funds and annually report to Congress
and the public on the extent of the total funds obligated to
conduct or support pediatric research across the National
Institutes of Health, including the specific support and
research awards allocated through the Initiative.
``(d) Authorization.--For the purpose of carrying out this
section, there are authorized to be appropriated $50,000,000
for fiscal year 2001, and such sums as may be necessary for
each of the fiscal years 2002 through 2005.
``(e) Transfer of Funds.--The Director of NIH may transfer
amounts appropriated under this section to any of the
Institutes for a fiscal year to carry out the purposes of the
Initiative under this section.''.
SEC. 1002. INVESTMENT IN TOMORROW'S PEDIATRIC RESEARCHERS.
(a) In General.--Subpart 7 of part C of title IV of the
Public Health Service Act, as amended by section 921 of this
Act, is amended by adding at the end the following:
``investment in tomorrow's pediatric researchers
``Sec. 452G. (a) Enhanced Support.--In order to ensure the
future supply of researchers dedicated to the care and
research needs of children, the Director of the Institute,
after consultation with the Administrator of the Health
Resources and Services Administration, shall support
activities to provide for--
``(1) an increase in the number and size of institutional
training grants to institutions supporting pediatric
training; and
``(2) an increase in the number of career development
awards for health professionals who intend to build careers
in pediatric basic and clinical research.
``(b) Authorization.--For the purpose of carrying out
subsection (a), there are authorized to be appropriated such
sums as may be necessary for each of the fiscal years 2001
through 2005.''.
(b) Pediatric Research Loan Repayment Program.--Part G of
title IV of the Public Health Service Act (42 U.S.C. 288 et
seq.) is amended by inserting after section 487E the
following section:
``pediatric research loan repayment program
``Sec. 487F. (a) In General.--The Secretary, in
consultation with the Director of NIH, may establish a
pediatric research loan repayment program. Through such
program--
``(1) the Secretary shall enter into contracts with
qualified health professionals under which such professionals
will agree to conduct pediatric research, in consideration of
the Federal government agreeing to repay, for each year of
such service, not more than $35,000 of the principal and
interest of the educational loans of such professionals; and
``(2) the Secretary shall, for the purpose of providing
reimbursements for tax liability resulting from payments made
under paragraph (1) on behalf of an individual, make
payments, in addition to payments under such paragraph, to
the individual in an amount equal to 39 percent of the total
amount of loan repayments made for the taxable year involved.
``(b) Application of other provisions.--The provisions of
sections 338B, 338C, and 338E shall, except as inconsistent
with paragraph (1), apply to the program established under
such paragraph to the same extent and in the same manner as
such provisions apply to the National Health Service Corps
Loan Repayment Program established under subpart III of part
D of title III.
``(c) Funding.--
``(1) In general.--For the purpose of carrying out this
section with respect to a national research institute the
Secretary may reserve, from amounts appropriated for such
institute for the fiscal year involved, such amounts as the
Secretary determines to be appropriate.
``(2) Availability of funds.--Amounts made available to
carry out this section shall remain available until the
expiration of the second fiscal year beginning after the
fiscal year for which such amounts were made available.''.
SEC. 1003. REVIEW OF REGULATIONS.
(a) Review.--By not later than 6 months after the date of
enactment of this Act, the Secretary of Health and Human
Services shall conduct a review of the regulations under
subpart D of part 46 of title 45, Code of Federal
Regulations, consider any modifications necessary to ensure
the adequate and appropriate protection of children
participating in research, and report the findings of the
Secretary to Congress.
(b) Areas of Review.--In conducting the review under
subsection (a), the Secretary of Health and Human Services
shall consider--
[[Page H8217]]
(1) the appropriateness of the regulations for children of
differing ages and maturity levels, including legal status;
(2) the definition of ``minimal risk'' for a healthy child
or for a child with an illness;
(3) the definitions of ``assent'' and ``permission'' for
child clinical research participants and their parents or
guardians and of ``adequate provisions'' for soliciting
assent or permission in research as such definitions relate
to the process of obtaining the agreement of children
participating in research and the parents or guardians of
such children;
(4) the definitions of ``direct benefit to the individual
subjects'' and ``generalizable knowledge about the subject's
disorder or condition'';
(5) whether payment (financial or otherwise) may be
provided to a child or his or her parent or guardian for the
participation of the child in research, and if so, the amount
and type given;
(6) the expectations of child research participants and
their parent or guardian for the direct benefits of the
child's research involvement;
(7) safeguards for research involving children conducted in
emergency situations with a waiver of informed assent;
(8) parent and child notification in instances in which the
regulations have not been complied with;
(9) compliance with the regulations in effect on the date
of enactment of this Act, the monitoring of such compliance,
and enforcement actions for violations of such regulations;
and
(10) the appropriateness of current practices for
recruiting children for participation in research.
(c) Consultation.--In conducting the review under
subsection (a), the Secretary of Health and Human Services
shall consult broadly with experts in the field, including
pediatric pharmacologists, pediatricians, pediatric
professional societies, bioethics experts, clinical
investigators, institutional review boards, industry experts,
appropriate Federal agencies, and children who have
participated in research studies and the parents, guardians,
or families of such children.
(d) Consideration of Additional Provisions.--In conducting
the review under subsection (a), the Secretary of Health and
Human Services shall consider and, not later than 6 months
after the date of enactment of this Act, report to Congress
concerning--
(1) whether the Secretary should establish data and safety
monitoring boards or other mechanisms to review adverse
events associated with research involving children; and
(2) whether the institutional review board oversight of
clinical trials involving children is adequate to protect
children.
SEC. 1004. LONG-TERM CHILD DEVELOPMENT STUDY.
(a) Purpose.--It is the purpose of this section to
authorize the National Institute of Child Health and Human
Development to conduct a national longitudinal study of
environmental influences (including physical, chemical,
biological, and psychosocial) on children's health and
development.
(b) In General.--The Director of the National Institute of
Child Health and Human Development shall establish a
consortium of representatives from appropriate Federal
agencies (including the Centers for Disease Control and
Prevention, the Environmental Protection Agency) to--
(1) plan, develop, and implement a prospective cohort
study, from birth to adulthood, to evaluate the effects of
both chronic and intermittent exposures on child health and
human development; and
(2) investigate basic mechanisms of developmental disorders
and environmental factors, both risk and protective, that
influence health and developmental processes.
(c) Requirement.--The study under subsection (b) shall--
(1) incorporate behavioral, emotional, educational, and
contextual consequences to enable a complete assessment of
the physical, chemical, biological and psychosocial
environmental influences on children's well-being;
(2) gather data on environmental influences and outcomes on
diverse populations of children, which may include the
consideration of prenatal exposures;
(3) consider health disparities among children which may
include the consideration of prenatal exposures.
(d) Report.--Beginning not later than 3 years after the
date of enactment of this Act, and periodically thereafter
for the duration of the study under this section, the
Director of the National Institute of Child Health and Human
Development shall prepare and submit to the appropriate
committees of Congress a report on the implementation and
findings made under the planning and feasibility study
conducted under this section.
(e) Authorization of Appropriations.--There are authorized
to be appropriated to carry out this section $18,000,000 for
fiscal year 2001, and such sums as may be necessary for each
the fiscal years 2002 through 2005.
TITLE XI--CHILDHOOD MALIGNANCIES
SEC. 1101. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND
PREVENTION AND NATIONAL INSTITUTES OF HEALTH.
Part P of title III of the Public Health Service Act, as
amended by section 702 of this Act, is amended by adding at
the end the following section:
``SEC. 399N. CHILDHOOD MALIGNANCIES.
``(a) In General.--The Secretary, acting as appropriate
through the Director of the Centers for Disease Control and
Prevention and the Director of the National Institutes of
Health, shall study environmental and other risk factors for
childhood cancers (including skeletal malignancies,
leukemias, malignant tumors of the central nervous system,
lymphomas, soft tissue sarcomas, and other malignant
neoplasms) and carry out projects to improve outcomes among
children with childhood cancers and resultant secondary
conditions, including limb loss, anemia, rehabilitation, and
palliative care. Such projects shall be carried out by the
Secretary directly and through awards of grants or contracts.
``(b) Certain Activities.--Activities under subsection (a)
include--
``(1) the expansion of current demographic data collection
and population surveillance efforts to include childhood
cancers nationally;
``(2) the development of a uniform reporting system under
which treating physicians, hospitals, clinics, and states
report the diagnosis of childhood cancers, including relevant
associated epidemiological data; and
``(3) support for the National Limb Loss Information Center
to address, in part, the primary and secondary needs of
persons who experience childhood cancers in order to prevent
or minimize the disabling nature of these cancers.
``(c) Coordination of Activities.--The Secretary shall
assure that activities under this section are coordinated as
appropriate with other agencies of the Public Health Service
that carry out activities focused on childhood cancers and
limb loss.
``(d) Definition.--For purposes of this section, the term
`childhood cancer' refers to a spectrum of different
malignancies that vary by histology, site of disease, origin,
race, sex, and age. The Secretary may for purposes of this
section revise the definition of such term to the extent
determined by the Secretary to be appropriate.
``(e) 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 2001 through 2005.''.
TITLE XII--ADOPTION AWARENESS
Subtitle A--Infant Adoption Awareness
SEC. 1201. GRANTS REGARDING INFANT ADOPTION AWARENESS.
Subpart I of part D of title III of the Public Health
Service Act, as amended by section 801 of this Act, is
amended by adding at the end the following section:
``SEC. 330F. CERTAIN SERVICES FOR PREGNANT WOMEN.
``(a) Infant Adoption Awareness.--
``(1) In general.--The Secretary shall make grants to
national, regional, or local adoption organizations for the
purpose of developing and implementing programs to train the
designated staff of eligible health centers in providing
adoption information and referrals to pregnant women on an
equal basis with all other courses of action included in
nondirective counseling to pregnant women.
``(2) Best-practices guidelines.--
``(A) In general.--A condition for the receipt of a grant
under paragraph (1) is that the adoption organization
involved agree that, in providing training under such
paragraph, the organization will follow the guidelines
developed under subparagraph (B).
``(B) Process for development of guidelines.--
``(i) In general.--The Secretary shall establish and
supervise a process described in clause (ii) in which the
participants are--
``(I) an appropriate number and variety of adoption
organizations that, as a group, have expertise in all models
of adoption practice and that represent all members of the
adoption triad (birth mother, infant, and adoptive parent);
and
``(II) affected public health entities.
``(ii) Description of process.--The process referred to in
clause (i) is a process in which the participants described
in such clause collaborate to develop best-
practices guidelines on the provision of adoption
information and referrals to pregnant women on an equal
basis with all other courses of action included in
nondirective counseling to pregnant women.
``(iii) Date certain for development.--The Secretary shall
ensure that the guidelines described in clause (ii) are
developed not later than 180 days after the date of the
enactment of the Children's Health Act of 2000.
``(C) Relation to authority for grants.--The Secretary may
not make any grant under paragraph (1) before the date on
which the guidelines under subparagraph (B) are developed.
``(3) Use of grant.--
``(A) In general.--With respect to a grant under paragraph
(1)--
``(i) an adoption organization may expend the grant to
carry out the programs directly or through grants to or
contracts with other adoption organizations;
``(ii) the purposes for which the adoption organization
expends the grant may include the development of a training
curriculum, consistent with the guidelines developed under
paragraph (2)(B); and
``(iii) a condition for the receipt of the grant is that
the adoption organization agree that, in providing training
for the designated staff of eligible health centers, such
organization will make reasonable efforts to ensure that the
individuals who provide the training are individuals who are
knowledgeable in all elements of the adoption process and are
experienced in providing adoption information and referrals
in the geographic areas in which the eligible health centers
are located, and that the designated staff receive the
training in such areas.
``(B) Rule of construction regarding training of
trainers.--With respect to individuals who under a grant
under paragraph (1) provide training for the designated staff
of eligible health centers (referred to in this subparagraph
as `trainers'), subparagraph (A)(iii) may not be construed as
establishing any limitation
[[Page H8218]]
regarding the geographic area in which the trainers receive
instruction in being such trainers. A trainer may receive
such instruction in a different geographic area than the area
in which the trainer trains (or will train) the designated
staff of eligible health centers.
``(4) Adoption organizations; eligible health centers;
other definitions.--For purposes of this section:
``(A) The term `adoption organization' means a national,
regional, or local organization--
``(i) among whose primary purposes are adoption;
``(ii) that is knowledgeable in all elements of the
adoption process and on providing adoption information and
referrals to pregnant women; and
``(iii) that is a nonprofit private entity.
``(B) The term `designated staff', with respect to an
eligible health center, means staff of the center who provide
pregnancy or adoption information and referrals (or will
provide such information and referrals after receiving
training under a grant under paragraph (1)).
``(C) The term `eligible health centers' means public and
nonprofit private entities that provide health services to
pregnant women.
``(5) Training for certain eligible health centers.--A
condition for the receipt of a grant under paragraph (1) is
that the adoption organization involved agree to make
reasonable efforts to ensure that the eligible health centers
with respect to which training under the grant is provided
include--
``(A) eligible health centers that receive grants under
section 1001 (relating to voluntary family planning
projects);
``(B) eligible health centers that receive grants under
section 330 (relating to community health centers, migrant
health centers, and centers regarding homeless individuals
and residents of public housing); and
``(C) eligible health centers that receive grants under
this Act for the provision of services in schools.
``(6) Participation of certain eligible health clinics.--In
the case of eligible health centers that receive grants under
section 330 or 1001:
``(A) Within a reasonable period after the Secretary begins
making grants under paragraph (1), the Secretary shall
provide eligible health centers with complete information
about the training available from organizations receiving
grants under such paragraph. The Secretary shall make
reasonable efforts to encourage eligible health centers to
arrange for designated staff to participate in such training.
Such efforts shall affirm Federal requirements, if any, that
the eligible health center provide nondirective counseling to
pregnant women.
``(B) All costs of such centers in obtaining the training
shall be reimbursed by the organization that provides the
training, using grants under paragraph (1).
``(C) Not later than one year after the date of the
enactment of the Children's Health Act of 2000, the Secretary
shall submit to the appropriate committees of the Congress a
report evaluating the extent to which adoption information
and referral, upon request, are provided by eligible health
centers. Within a reasonable time after training under this
section is initiated, the Secretary shall submit to the
appropriate committees of the Congress a report evaluating
the extent to which adoption information and referral, upon
request, are provided by eligible health centers in order to
determine the effectiveness of such training and the extent
to which such training complies with subsection (a)(1). In
preparing the reports required by this subparagraph, the
Secretary shall in no respect interpret the provisions of
this section to allow any interference in the provider-
patient relationship, any breach of patient confidentiality,
or any monitoring or auditing of the counseling process or
patient records which breaches patient confidentiality or
reveals patient identity. The reports required by this
subparagraph shall be conducted by the Secretary acting
through the Administrator of the Health Resources and
Services Administration and in collaboration with the
Director of the Agency for Healthcare Research and Quality.
``(b) Application for Grant.--The Secretary may make a
grant under subsection (a) only if an application for the
grant is submitted to the Secretary and the application is in
such form, is made in such manner, and contains such
agreements, assurances, and information as the Secretary
determines to be necessary to carry out this section.
``(c) 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 2001 through 2005.''.
Subtitle B--Special Needs Adoption Awareness
SEC. 1211. SPECIAL NEEDS ADOPTION PROGRAMS; PUBLIC AWARENESS
CAMPAIGN AND OTHER ACTIVITIES.
Subpart I of part D of title III of the Public Health
Service Act, as amended by section 1201 of this Act, is
amended by adding at the end the following section:
``SEC. 330G. SPECIAL NEEDS ADOPTION PROGRAMS; PUBLIC
AWARENESS CAMPAIGN AND OTHER ACTIVITIES.
``(a) Special Needs Adoption Awareness Campaign.--
``(1) In general.--The Secretary shall, through making
grants to nonprofit private entities, provide for the
planning, development, and carrying out of a national
campaign to provide information to the public regarding the
adoption of children with special needs.
``(2) Input on planning and development.--In providing for
the planning and development of the national campaign under
paragraph (1), the Secretary shall provide for input from a
number and variety of adoption organizations throughout the
States in order that the full national diversity of interests
among adoption organizations is represented in the planning
and development of the campaign.
``(3) Certain features.--With respect to the national
campaign under paragraph (1):
``(A) The campaign shall be directed at various
populations, taking into account as appropriate differences
among geographic regions, and shall be carried out in the
language and cultural context that is most appropriate to the
population involved.
``(B) The means through which the campaign may be carried
out include--
``(i) placing public service announcements on television,
radio, and billboards; and
``(ii) providing information through means that the
Secretary determines will reach individuals who are most
likely to adopt children with special needs.
``(C) The campaign shall provide information on the
subsidies and supports that are available to individuals
regarding the adoption of children with special needs.
``(D) The Secretary may provide that the placement of
public service announcements, and the dissemination of
brochures and other materials, is subject to review by the
Secretary.
``(4) Matching Requirement.--
``(A) In general.--With respect to the costs of the
activities to be carried out by an entity pursuant to
paragraph (1), a condition for the receipt of a grant under
such paragraph is that the entity agree to make available
(directly or through donations from public or private
entities) non-Federal contributions toward such costs in an
amount that is not less than 25 percent of such costs.
``(B) Determination of amount contributed.--Non-Federal
contributions under subparagraph (A) may be in cash or in
kind, fairly evaluated, including plant, equipment, or
services. Amounts provided by the Federal Government, or
services assisted or subsidized to any significant extent by
the Federal Government, may not be included in determining
the amount of such contributions.
``(b) National Resources Program.--The Secretary shall
(directly or through grant or contract) carry out a program
that, through toll-free telecommunications, makes available
to the public information regarding the adoption of children
with special needs. Such information shall include the
following:
``(1) A list of national, State, and regional organizations
that provide services regarding such adoptions, including
exchanges and other information on communicating with the
organizations. The list shall represent the full national
diversity of adoption organizations.
``(2) Information beneficial to individuals who adopt such
children, including lists of support groups for adoptive
parents and other postadoptive services.
``(c) Other Programs.--With respect to the adoption of
children with special needs, the Secretary shall make
grants--
``(1) to provide assistance to support groups for adoptive
parents, adopted children, and siblings of adopted children;
and
``(2) to carry out studies to identify--
``(A) the barriers to completion of the adoption process;
and
``(B) those components that lead to favorable long-term
outcomes for families that adopt children with special needs.
``(d) Application for Grant.--The Secretary may make an
award of a grant or contract under this section only if an
application for the award is submitted to the Secretary and
the application is in such form, is made in such manner, and
contains such agreements, assurances, and information as the
Secretary determines to be necessary to carry out this
section.
``(e) Funding.--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 2001 through
2005.''.
TITLE XIII--TRAUMATIC BRAIN INJURY
SEC. 1301. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND
PREVENTION.
(a) In General.--Section 393A of the Public Health Service
Act (42 U.S.C. 280b-1b) is amended--
(1) in subsection (b)--
(A) in paragraph (1), by striking ``and'' at the end;
(B) in paragraph (2), by striking the period and inserting
``; and''; and
(C) by adding at the end the following:
``(3) the implementation of a national education and
awareness campaign regarding such injury (in conjunction with
the program of the Secretary regarding health-status goals
for 2010, commonly referred to as Healthy People 2010),
including--
``(A) the national dissemination of information on--
``(i) incidence and prevalence; and
``(ii) information relating to traumatic brain injury and
the sequelae of secondary conditions arising from traumatic
brain injury upon discharge from hospitals and trauma
centers; and
``(B) the provision of information in primary care
settings, including emergency rooms and trauma centers,
concerning the availability of State level services and
resources.'';
(2) in subsection (d)--
(A) in the second sentence, by striking ``anoxia due to
near drowning.'' and inserting ``anoxia due to trauma.''; and
(B) in the third sentence, by inserting before the period
the following: ``, after consultation with States and other
appropriate public or nonprofit private entities''.
(b) National Registry.--Part J of title III of the Public
Health Service Act (42 U.S.C. 280b et seq.) is amended by
inserting after section 393A the following section:
``national program for traumatic brain injury registries
``Sec. 393B. (a) In General.--The Secretary, acting through
the Director of the Centers for
[[Page H8219]]
Disease Control and Prevention, may make grants to States or
their designees to operate the State's traumatic brain injury
registry, and to academic institutions to conduct applied
research that will support the development of such
registries, to collect data concerning--
``(1) demographic information about each traumatic brain
injury;
``(2) information about the circumstances surrounding the
injury event associated with each traumatic brain injury;
``(3) administrative information about the source of the
collected information, dates of hospitalization and
treatment, and the date of injury; and
``(4) information characterizing the clinical aspects of
the traumatic brain injury, including the severity of the
injury, outcomes of the injury, the types of treatments
received, and the types of services utilized.''.
SEC. 1302. STUDY AND MONITOR INCIDENCE AND PREVALENCE.
Section 4 of Public Law 104-166 (42 U.S.C. 300d-61 note) is
amended--
(1) in subsection (a)(1)(A)--
(A) by striking clause (i) and inserting the following:
``(i)(I) determine the incidence and prevalence of
traumatic brain injury in all age groups in the general
population of the United States, including institutional
settings; and
``(II) determine appropriate methodological strategies to
obtain data on the incidence and prevalence of mild traumatic
brain injury and report to Congress concerning such within 18
months of the date of enactment of the Children's Health Act
of 2000; and''; and
(B) in clause (ii), by striking ``, if the Secretary
determines that such a system is appropriate'';
(2) in subsection (a)(1)(B)(i), by inserting ``, including
return to work or school and community participation,'' after
``functioning''; and
(3) in subsection (d), to read as follows:
``(d) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section such
sums as may be necessary for each of the fiscal years 2001
through 2005.''.
SEC. 1303. PROGRAMS OF NATIONAL INSTITUTES OF HEALTH.
(a) Interagency Program.--Section 1261(d)(4) of the Public
Health Service Act (42 U.S.C. 300d-61(d)(4)) is amended--
(1) in subparagraph (A), by striking ``degree of injury''
and inserting ``degree of brain injury'';
(2) in subparagraph (B), by striking ``acute injury'' and
inserting ``acute brain injury''; and
(3) in subparagraph (D), by striking ``injury treatment''
and inserting ``brain injury treatment''.
(b) Definition.--Section 1261(h)(4) of the Public Health
Service Act (42 U.S.C. 300d-61(h)(4)) is amended--
(1) in the second sentence, by striking ``anoxia due to
near drowning.'' and inserting ``anoxia due to trauma.''; and
(2) in the third sentence, by inserting before the period
the following: ``, after consultation with States and other
appropriate public or nonprofit private entities''.
(c) Research on Cognitive and Neurobehavioral Disorders
Arising From Traumatic Brain Injury.--Section 1261(d)(4) of
the Public Health Service Act (42 U.S.C. 300d-61(d)(4)) is
amended--
(1) in subparagraph (C), by striking ``and'' after the
semicolon at the end;
(2) in subparagraph (D), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(E) carrying out subparagraphs (A) through (D) with
respect to cognitive disorders and neurobehavioral
consequences arising from traumatic brain injury, including
the development, modification, and evaluation of therapies
and programs of rehabilitation toward reaching or restoring
normal capabilities in areas such as reading, comprehension,
speech, reasoning, and deduction.''.
(d) Authorization of Appropriations.--Section 1261 of the
Public Health Service Act (42 U.S.C. 300d-61) is amended by
adding at the end the following:
``(i) 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 2001 through 2005.''.
SEC. 1304. PROGRAMS OF HEALTH RESOURCES AND SERVICES
ADMINISTRATION.
Section 1252 of the Public Health Service Act (42 U.S.C.
300d-51) is amended--
(1) in the section heading by striking ``DEMONSTRATION'';
(2) in subsection (a), by striking ``demonstration'';
(3) in subsection (b)(3)--
(A) in subparagraph (A)(iv), by striking ``representing
traumatic brain injury survivors'' and inserting
``representing individuals with traumatic brain injury''; and
(B) in subparagraph (B), by striking ``who are survivors
of'' and inserting ``with'';
(4) in subsection (c)--
(A) in paragraph (1), by striking ``, in cash,''; and
(B) in paragraph (2), by amending the paragraph to read as
follows:
``(2) Determination of amount contributed.--Non-Federal
contributions under paragraph (1) may be in cash or in kind,
fairly evaluated, including plant, equipment, or services.
Amounts provided by the Federal Government, or services
assisted or subsidized to any significant extent by the
Federal Government, may not be included in determining the
amount of such contributions.'';
(5) by redesignating subsections (e) through (h) as
subsections (g) through (j), respectively; and
(6) by inserting after subsection (d) the following
subsections:
``(e) Continuation of Previously Awarded Demonstration
Projects.--A State that received a grant under this section
prior to the date of the enactment of the Children's Health
Act of 2000 may compete for new project grants under this
section after such date of enactment.
``(f) Use of State Grants.--
``(1) Community services and supports.--A State shall
(directly or through awards of contracts to nonprofit private
entities) use amounts received under a grant under this
section for the following:
``(A) To develop, change, or enhance community-based
service delivery systems that include timely access to
comprehensive appropriate services and supports. Such service
and supports--
``(i) shall promote full participation by individuals with
brain injury and their families in decision making regarding
the services and supports; and
``(ii) shall be designed for children and other individuals
with traumatic brain injury.
``(B) To focus on outreach to underserved and
inappropriately served individuals, such as individuals in
institutional settings, individuals with low socioeconomic
resources, individuals in rural communities, and individuals
in culturally and linguistically diverse communities.
``(C) To award contracts to nonprofit entities for consumer
or family service access training, consumer support, peer
mentoring, and parent to parent programs.
``(D) To develop individual and family service coordination
or case management systems.
``(E) To support other needs identified by the advisory
board under subsection (b) for the State involved.
``(2) Best practices.--
``(A) In general.--State services and supports provided
under a grant under this section shall reflect the best
practices in the field of traumatic brain injury, shall be in
compliance with title II of the Americans with Disabilities
Act of 1990, and shall be supported by quality assurance
measures as well as state-of-the-art health care and
integrated community supports, regardless of the severity of
injury.
``(B) Demonstration by state agency.--The State agency
responsible for administering amounts received under a grant
under this section shall demonstrate that it has obtained
knowledge and expertise of traumatic brain injury and the
unique needs associated with traumatic brain injury.
``(3) State capacity building.--A State may use amounts
received under a grant under this section to--
``(A) educate consumers and families;
``(B) train professionals in public and private sector
financing (such as third party payers, State agencies,
community-based providers, schools, and educators);
``(C) develop or improve case management or service
coordination systems;
``(D) develop best practices in areas such as family or
consumer support, return to work, housing or supportive
living personal assistance services, assistive technology and
devices, behavioral health services, substance abuse
services, and traumatic brain injury treatment and
rehabilitation;
``(E) tailor existing State systems to provide
accommodations to the needs of individuals with brain injury
(including systems administered by the State departments
responsible for health, mental health, labor/employment,
education, mental retardation/developmental disorders,
transportation, and correctional systems);
``(F) improve data sets coordinated across systems and
other needs identified by a State plan supported by its
advisory council; and
``(G) develop capacity within targeted communities.'';
(5) in subsection (g) (as so redesignated), by striking
``agencies of the Public Health Service'' and inserting
``Federal agencies'';
(6) in subsection (i) (as redesignated by paragraph (3))--
(A) in the second sentence, by striking ``anoxia due to
near drowning.'' and inserting ``anoxia due to trauma.''; and
(B) in the third sentence, by inserting before the period
the following: ``, after consultation with States and other
appropriate public or nonprofit private entities''; and
(7) in subsection (j) (as so redesignated), by amending the
subsection to read as follows:
``(j) 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 2001 through 2005.''.
SEC. 1305. STATE GRANTS FOR PROTECTION AND ADVOCACY SERVICES.
Part E of title XII of the Public Health Service Act (42
U.S.C. 300d-51 et seq.) is amended by adding at the end the
following:
``SEC. 1253. STATE GRANTS FOR PROTECTION AND ADVOCACY
SERVICES.
``(a) In General.--The Secretary, acting through the
Administrator of the Health Resources and Services
Administration (referred to in this section as the
`Administrator'), shall make grants to protection and
advocacy systems for the purpose of enabling such systems to
provide services to individuals with traumatic brain injury.
``(b) Services Provided.--Services provided under this
section may include the provision of--
``(1) information, referrals, and advice;
``(2) individual and family advocacy;
``(3) legal representation; and
``(4) specific assistance in self-advocacy.
``(c) Application.--To be eligible to receive a grant under
this section, a protection and advocacy system shall submit
an application to the Administrator at such time, in such
form and manner, and accompanied by such information
[[Page H8220]]
and assurances as the Administrator may require.
``(d) Appropriations Less Than $2,700,000.--
``(1) In general.--With respect to any fiscal year in which
the amount appropriated under subsection (i) to carry out
this section is less than $2,700,000, the Administrator shall
make grants from such amount to individual protection and
advocacy systems within States to enable such systems to plan
for, develop outreach strategies for, and carry out services
authorized under this section for individuals with traumatic
brain injury.
``(2) Amount.--The amount of each grant provided under
paragraph (1) shall be determined as set forth in paragraphs
(2) and (3) of subsection (e).
``(e) Appropriations of $2,700,000 or More.--
``(1) Population basis.--Except as provided in paragraph
(2), with respect to each fiscal year in which the amount
appropriated under subsection (i) to carry out this section
is $2,700,000 or more, the Administrator shall make a grant
to a protection and advocacy system within each State.
``(2) Amount.--The amount of a grant provided to a system
under paragraph (1) shall be equal to an amount bearing the
same ratio to the total amount appropriated for the fiscal
year involved under subsection (i) as the population of the
State in which the grantee is located bears to the population
of all States.
``(3) Minimums.--Subject to the availability of
appropriations, the amount of a grant a protection and
advocacy system under paragraph (1) for a fiscal year shall--
``(A) in the case of a protection and advocacy system
located in American Samoa, Guam, the United States Virgin
Islands, or the Commonwealth of the Northern Mariana Islands,
and the protection and advocacy system serving the American
Indian consortium, not be less than $20,000; and
``(B) in the case of a protection and advocacy system in a
State not described in subparagraph (A), not be less than
$50,000.
``(4) Inflation adjustment.--For each fiscal year in which
the total amount appropriated under subsection (i) to carry
out this section is $5,000,000 or more, and such appropriated
amount exceeds the total amount appropriated to carry out
this section in the preceding fiscal year, the Administrator
shall increase each of the minimum grants amount described in
subparagraphs (A) and (B) of paragraph (3) by a percentage
equal to the percentage increase in the total amount
appropriated under subsection (i) to carry out this section
between the preceding fiscal year and the fiscal year
involved.
``(f) Carryover.--Any amount paid to a protection and
advocacy system that serves a State or the American Indian
consortium for a fiscal year under this section that remains
unobligated at the end of such fiscal year shall remain
available to such system for obligation during the next
fiscal year for the purposes for which such amount was
originally provided.
``(g) Direct Payment.--Notwithstanding any other provision
of law, the Administrator shall pay directly to any
protection and advocacy system that complies with the
provisions of this section, the total amount of the grant for
such system, unless the system provides otherwise for such
payment.
``(h) Annual Report.--Each protection and advocacy system
that receives a payment under this section shall submit an
annual report to the Administrator concerning the services
provided to individuals with traumatic brain injury by such
system.
``(i) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section
$5,000,000 for fiscal year 2001, and such sums as may be
necessary for each the fiscal years 2002 through 2005.
``(j) Definitions.--In this section:
``(1) American indian consortium.--The term `American
Indian consortium' means a consortium established under part
C of the Developmental Disabilities Assistance Bill of Rights
Act (42 U.S.C. 6042 et seq.).
``(2) Protection and advocacy system.--The term `protection
and advocacy system' means a protection and advocacy system
established under part C of the Developmental Disabilities
Assistance and Bill of Rights Act (42 U.S.C. 6042 et seq.).
``(3) State.--The term `State', unless otherwise specified,
means the several States of the United States, the District
of Columbia, the Commonwealth of Puerto Rico, the United
States Virgin Islands, Guam, American Samoa, and the
Commonwealth of the Northern Mariana Islands.''.
SEC. 1306. AUTHORIZATION OF APPROPRIATIONS FOR CERTAIN
PROGRAMS.
Section 394A of the Public Health Service Act (42 U.S.C.
280b-3) is amended by striking ``and'' after ``1994'' and by
inserting before the period the following: ``, and such sums
as may be necessary for each of the fiscal years 2001 through
2005.''.
TITLE XIV--CHILD CARE SAFETY AND HEALTH GRANTS
SEC. 1401. DEFINITIONS.
In this title:
(1) Child with a disability; infant or toddler with a
disability.--The terms ``child with a disability'' and
``infant or toddler with a disability'' have the meanings
given the terms in sections 602 and 632 of the Individuals
with Disabilities Education Act (20 U.S.C. 1401 and 1431).
(2) Eligible child care provider.--The term ``eligible
child care provider'' means a provider of child care services
for compensation, including a provider of care for a school-
age child during non-school hours, that--
(A) is licensed, regulated, registered, or otherwise
legally operating, under State and local law; and
(B) satisfies the State and local requirements,
applicable to the child care services the provider provides.
(3) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(4) State.--The term ``State'' means any of the several
States of the United States, the District of Columbia, the
Commonwealth of Puerto Rico, the United States Virgin
Islands, Guam, American Samoa, and the Commonwealth of the
Northern Mariana Islands.
SEC. 1402. AUTHORIZATION OF APPROPRIATIONS.
There are authorized to be appropriated to carry out this
title $200,000,000 for fiscal year 2001, and such sums as may
be necessary for each subsequent fiscal year.
SEC. 1403. PROGRAMS.
The Secretary shall make allotments to eligible States
under section 1404. The Secretary shall make the allotments
to enable the States to establish programs to improve the
health and safety of children receiving child care outside
the home, by preventing illnesses and injuries associated
with that care and promoting the health and well-being of
children receiving that care.
SEC. 1404. AMOUNTS RESERVED; ALLOTMENTS.
(a) Amounts Reserved.--The Secretary shall reserve not more
than \1/2\ of 1 percent of the amount appropriated under
section 1402 for each fiscal year to make allotments to Guam,
American Samoa, the United States Virgin Islands, and the
Commonwealth of the Northern Mariana Islands to be allotted
in accordance with their respective needs.
(b) State Allotments.--
(1) General rule.--From the amounts appropriated under
section 1402 for each fiscal year and remaining after
reservations are made under subsection (a), the Secretary
shall allot to each State an amount equal to the sum of--
(A) an amount that bears the same ratio to 50 percent of
such remainder as the product of the young child factor of
the State and the allotment percentage of the State bears to
the sum of the corresponding products for all States; and
(B) an amount that bears the same ratio to 50 percent of
such remainder as the product of the school lunch factor of
the State and the allotment percentage of the State bears to
the sum of the corresponding products for all States.
(2) Young child factor.--In this subsection, the term
``young child factor'' means the ratio of the number of
children under 5 years of age in a State to the number of
such children in all States, as provided by the most recent
annual estimates of population in the States by the Census
Bureau of the Department of Commerce.
(3) School lunch factor.--In this subsection, the term
``school lunch factor'' means the ratio of the number of
children who are receiving free or reduced price lunches
under the school lunch program established under the National
School Lunch Act (42 U.S.C. 1751 et seq.) in the State to the
number of such children in all States, as determined annually
by the Department of Agriculture.
(4) Allotment percentage.--
(A) In general.--For purposes of this subsection, the
allotment percentage for a State shall be determined by
dividing the per capita income of all individuals in the
United States, by the per capita income of all individuals in
the State.
(B) Limitations.--If an allotment percentage determined
under subparagraph (A) for a State--
(i) is more than 1.2 percent, the allotment percentage of
the State shall be considered to be 1.2 percent; and
(ii) is less than 0.8 percent, the allotment percentage of
the State shall be considered to be 0.8 percent.
(C) Per capita income.--For purposes of subparagraph (A),
per capita income shall be--
(i) determined at 2-year intervals;
(ii) applied for the 2-year period beginning on October 1
of the first fiscal year beginning after the date such
determination is made; and
(iii) equal to the average of the annual per capita incomes
for the most recent period of 3 consecutive years for which
satisfactory data are available from the Department of
Commerce on the date such determination is made.
(c) Data and Information.--The Secretary shall obtain from
each appropriate Federal agency, the most recent data and
information necessary to determine the allotments provided
for in subsection (b).
(d) Definition.--In this section, the term ``State''
includes only the several States of the United States, the
District of Columbia, and the Commonwealth of Puerto Rico.
SEC. 1405. STATE APPLICATIONS.
To be eligible to receive an allotment under section 1404,
a State shall submit an application to the Secretary at such
time, in such manner, and containing such information as the
Secretary may require. The application shall contain
information assessing the needs of the State with regard to
child care health and safety, the goals to be achieved
through the program carried out by the State under this
title, and the measures to be used to assess the progress
made by the State toward achieving the goals.
SEC. 1406. USE OF FUNDS.
(a) In General.--A State that receives an allotment under
section 1404 shall use the funds made available through the
allotment to carry out 2 or more activities consisting of--
(1) providing training and education to eligible child care
providers on preventing injuries and illnesses in children,
and promoting health-related practices;
(2) strengthening licensing, regulation, or registration
standards for eligible child care providers;
(3) assisting eligible child care providers in meeting
licensing, regulation, or registration standards, including
rehabilitating the facilities of the providers, in order to
bring the facilities into compliance with the standards;
[[Page H8221]]
(4) enforcing licensing, regulation, or registration
standards for eligible child care providers, including
holding increased unannounced inspections of the facilities
of those providers;
(5) providing health consultants to provide advice to
eligible child care providers;
(6) assisting eligible child care providers in enhancing
the ability of the providers to serve children with
disabilities and infants and toddlers with disabilities;
(7) conducting criminal background checks for eligible
child care providers and other individuals who have contact
with children in the facilities of the providers;
(8) providing information to parents on what factors to
consider in choosing a safe and healthy child care setting;
or
(9) assisting in improving the safety of transportation
practices for children enrolled in child care programs with
eligible child care providers.
(b) Supplement, Not Supplant.--Funds appropriated pursuant
to the authority of this title shall be used to supplement
and not supplant other Federal, State, and local public funds
expended to provide services for eligible individuals.
SEC. 1407. REPORTS.
Each State that receives an allotment under section 1404
shall annually prepare and submit to the Secretary a report
that describes--
(1) the activities carried out with funds made available
through the allotment; and
(2) the progress made by the State toward achieving the
goals described in the application submitted by the State
under section 1405.
TITLE XV--HEALTHY START INITIATIVE
SEC. 1501. CONTINUATION OF HEALTHY START PROGRAM.
Subpart I of part D of title III of the Public Health
Service Act, as amended by section 1211 of this Act, is
amended by adding at the end the following section:
``SEC. 330H. HEALTHY START FOR INFANTS.
``(a) In General.--
``(1) Continuation and expansion of program.--The
Secretary, acting through the Administrator of the Health
Resources and Services Administration, Maternal and Child
Health Bureau, shall under authority of this section continue
in effect the Healthy Start Initiative and may, during fiscal
year 2001 and subsequent years, carry out such program on a
national basis.
``(2) Definition.--For purposes of paragraph (1), the term
`Healthy Start Initiative' is a reference to the program
that, as an initiative to reduce the rate of infant mortality
and improve perinatal outcomes, makes grants for project
areas with high annual rates of infant mortality and that,
prior to the effective date of this section, was a
demonstration program carried out under section 301.
``(3) Additional grants.-- Effective upon increased funding
beyond fiscal year 1999 for such Initiative, additional
grants may be made to States to assist communities with
technical assistance, replication of successful projects, and
State policy formation to reduce infant and maternal
mortality and morbidity.
``(b) Requirements for Making Grants.--In making grants
under subsection (a), the Secretary shall require that
applicants (in addition to meeting all eligibility criteria
established by the Secretary) establish, for project areas
under such subsection, community-based consortia of
individuals and organizations (including agencies responsible
for administering block grant programs under title V of the
Social Security Act, consumers of project services, public
health departments, hospitals, health centers under section
330, and other significant sources of health care services)
that are appropriate for participation in projects under
subsection (a).
``(c) Coordination.--Recipients of grants under subsection
(a) shall coordinate their services and activities with the
State agency or agencies that administer block grant programs
under title V of the Social Security Act in order to promote
cooperation, integration, and dissemination of information
with Statewide systems and with other community services
funded under the Maternal and Child Health Block Grant.
``(d) Rule of Construction.--Except to the extent
inconsistent with this section, this section may not be
construed as affecting the authority of the Secretary to make
modifications in the program carried out under subsection
(a).
``(e) Additional Services for At-Risk Pregnant Women and
Infants.--
``(1) In general.--The Secretary may make grants to conduct
and support research and to provide additional health care
services for pregnant women and infants, including grants to
increase access to prenatal care, genetic counseling,
ultrasound services, and fetal or other surgery.
``(2) Eligible project area.--The Secretary may make a
grant under paragraph (1) only if the geographic area in
which services under the grant will be provided is a
geographic area in which a project under subsection (a) is
being carried out, and if the Secretary determines that the
grant will add to or expand the level of health services
available in such area to pregnant women and infants.
``(3) Evaluation by general accounting office.--
``(A) In general.--During fiscal year 2004, the Comptroller
General of the United States shall conduct an evaluation of
activities under grants under paragraph (1) in order to
determine whether the activities have been effective in
serving the needs of pregnant women with respect to services
described in such paragraph. The evaluation shall include an
analysis of whether such activities have been effective in
reducing the disparity in health status between the general
population and individuals who are members of racial or
ethnic minority groups. Not later than January 10, 2004, the
Comptroller General shall submit to the Committee on Commerce
in the House of Representatives, and to the Committee on
Health, Education, Labor, and Pensions in the Senate, a
report describing the findings of the evaluation.
``(B) Relation to grants regarding additional services for
at-risk pregnant women and infants.--Before the date on which
the evaluation under subparagraph (A) is submitted in
accordance with such subparagraph--
``(i) the Secretary shall ensure that there are not more
than five grantees under paragraph (1); and
``(ii) an entity is not eligible to receive grants under
such paragraph unless the entity has substantial experience
in providing the health services described in such paragraph.
``(f) Funding.--
``(1) General program.--
``(A) Authorization of appropriations.--For the purpose of
carrying out this section (other than subsection (e)), there
are authorized to be appropriated such sums as may be
necessary for each of the fiscal years 2001 through 2005.
``(B) Allocations.--
``(i) Program administration.--Of the amounts appropriated
under subparagraph (A) for a fiscal year, the Secretary may
reserve up to 5 percent for coordination, dissemination,
technical assistance, and data activities that are determined
by the Secretary to be appropriate for carrying out the
program under this section.
``(ii) Evaluation.--Of the amounts appropriated under
subparagraph (A) for a fiscal year, the Secretary may reserve
up to 1 percent for evaluations of projects carried out under
subsection (a). Each such evaluation shall include a
determination of whether such projects have been effective in
reducing the disparity in health status between the general
population and individuals who are members of racial or
ethnic minority groups.
``(2) Additional services for at-risk pregnant women and
infants.--
``(A) Authorization of appropriations.--For the purpose of
carrying out subsection (e), there are authorized to be
appropriated such sums as may be necessary for each of the
fiscal years 2001 through 2005.
``(B) Allocation for community-based mobile health units.--
Of the amounts appropriated under subparagraph (A) for a
fiscal year, the Secretary shall make available not less than
10 percent for providing services under subsection (e)
(including ultrasound services) through visits by mobile
units to communities that are eligible for services under
subsection (a).''.
TITLE XVI--ORAL HEALTH PROMOTION AND DISEASE PREVENTION
SEC. 1601. IDENTIFICATION OF INTERVENTIONS THAT REDUCE THE
BURDEN AND TRANSMISSION OF ORAL, DENTAL, AND
CRANIOFACIAL DISEASES IN HIGH RISK POPULATIONS;
DEVELOPMENT OF APPROACHES FOR PEDIATRIC ORAL
AND CRANIOFACIAL ASSESSMENT.
(a) In General.--The Secretary of Health and Human
Services, through the Maternal and Child Health Bureau, the
Indian Health Service, and in consultation with the National
Institutes of Health and the Centers for Disease Control and
Prevention, shall--
(1) support community-based research that is designed to
improve understanding of the etiology, pathogenesis,
diagnosis, prevention, and treatment of pediatric oral,
dental, craniofacial diseases and conditions and their
sequelae in high risk populations;
(2) support demonstrations of preventive interventions in
high risk populations including nutrition, parenting, and
feeding techniques; and
(3) develop clinical approaches to assess individual
patients for the risk of pediatric dental disease.
(b) Compliance With State Practice Laws.--Treatment and
other services shall be provided pursuant to this section by
licensed dental health professionals in accordance with State
practice and licensing laws.
(c) Authorization of Appropriations.--There are authorized
to be appropriated such sums as may be necessary to carry out
this section for each the fiscal years 2001 through 2005.
SEC. 1602. ORAL HEALTH PROMOTION AND DISEASE PREVENTION.
Part B of title III of the Public Health Service Act, as
amended by section 911 of this Act, is amended by inserting
after section 317L the following section:
``oral health promotion and disease prevention
``Sec. 317M. (a) Grants to Increase Resources for Community
Water Fluoridation.--
``(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention,
may make grants to States and Indian tribes for the purpose
of increasing the resources available for community water
fluoridation.
``(2) Use of funds.--A State shall use amounts provided
under a grant under paragraph (1)--
``(A) to purchase fluoridation equipment;
``(B) to train fluoridation engineers;
``(C) to develop educational materials on the benefits of
fluoridation; or
``(D) to support the infrastructure necessary to monitor
and maintain the quality of water fluoridation.
``(b) Community Water Fluoridation.--
``(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention
and in collaboration with the Director of the Indian Health
Service, shall establish a demonstration project that is
designed to assist rural water systems in successfully
implementing the water fluoridation guidelines of the Centers
for Disease Control and Prevention that are entitled
``Engineering
[[Page H8222]]
and Administrative Recommendations for Water Fluoridation,
1995'' (referred to in this subsection as the `EARWF').
``(2) Requirements.--
``(A) Collaboration.--In collaborating under paragraph (1),
the Directors referred to in such paragraph shall ensure that
technical assistance and training are provided to tribal
programs located in each of the 12 areas of the Indian Health
Service. The Director of the Indian Health Service shall
provide coordination and administrative support to tribes
under this section.
``(B) General use of funds.--Amounts made available under
paragraph (1) shall be used to assist small water systems in
improving the effectiveness of water fluoridation and to meet
the recommendations of the EARWF.
``(C) Fluoridation specialists.--
``(i) In general.--In carrying out this subsection, the
Secretary shall provide for the establishment of fluoridation
specialist engineering positions in each of the Dental
Clinical and Preventive Support Centers through which
technical assistance and training will be provided to tribal
water operators, tribal utility operators and other Indian
Health Service personnel working directly with fluoridation
projects.
``(ii) Liaison.--A fluoridation specialist shall serve as
the principal technical liaison between the Indian Health
Service and the Centers for Disease Control and Prevention
with respect to engineering and fluoridation issues.
``(iii) CDC.--The Director of the Centers for Disease
Control and Prevention shall appoint individuals to serve as
the fluoridation specialists.
``(D) Implementation.--The project established under this
subsection shall be planned, implemented and evaluated over
the 5-year period beginning on the date on which funds are
appropriated under this section and shall be designed to
serve as a model for improving the effectiveness of water
fluoridation systems of small rural communities.
``(3) Evaluation.--In conducting the ongoing evaluation as
provided for in paragraph (2)(D), the Secretary shall ensure
that such evaluation includes--
``(A) the measurement of changes in water fluoridation
compliance levels resulting from assistance provided under
this section;
``(B) the identification of the administrative, technical
and operational challenges that are unique to the
fluoridation of small water systems;
``(C) the development of a practical model that may be
easily utilized by other tribal, state, county or local
governments in improving the quality of water fluoridation
with emphasis on small water systems; and
``(D) the measurement of any increased percentage of Native
Americans or Alaskan Natives who receive the benefits of
optimally fluoridated water.
``(c) School-Based Dental Sealant Program.--
``(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention
and in collaboration with the Administrator of the Health
Resources and Services Administration, may award grants to
States and Indian tribes to provide for the development of
school-based dental sealant programs to improve the access of
children to sealants.
``(2) Use of funds.--A State shall use amounts received
under a grant under paragraph (1) to provide funds to
eligible school-based entities or to public elementary or
secondary schools to enable such entities or schools to
provide children with access to dental care and dental
sealant services. Such services shall be provided by licensed
dental health professionals in accordance with State practice
licensing laws.
``(3) Eligibility.--To be eligible to receive funds under
paragraph (1), an entity shall--
``(A) prepare and submit to the State an application at
such time, in such manner and containing such information as
the state may require; and
``(B) be a public elementary or secondary school--
``(i) that is located in an urban area in which and more
than 50 percent of the student population is participating in
federal or state free or reduced meal programs; or
``(ii) that is located in a rural area and, with respect to
the school district in which the school is located, the
district involved has a median income that is at or below 235
percent of the poverty line, as defined in section 673(2) of
the Community Services Block Grant Act (42 U.S.C. 9902(2)).
``(d) Definitions.--For purposes of this section, the term
`Indian tribe' means an Indian tribe or tribal organization
as defined in section 4(b) and section 4(c) of the Indian
Self-Determination and Education Assistance Act.
``(e) 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 2001 through 2005.''.
SEC. 1603. COORDINATED PROGRAM TO IMPROVE PEDIATRIC ORAL
HEALTH.
Part B of the Public Health Service Act (42 U.S.C. 243 et
seq.) is amended by adding at the end the following:
``coordinated program to improve pediatric oral health
``Sec. 320A. (a) In General.--The Secretary, acting through
the Administrator of the Health Resources and Services
Administration, shall establish a program to fund innovative
oral health activities that improve the oral health of
children under 6 years of age who are eligible for services
provided under a Federal health program, to increase the
utilization of dental services by such children, and to
decrease the incidence of early childhood and baby bottle
tooth decay.
``(b) Grants.--The Secretary shall award grants to or enter
into contracts with public or private nonprofit schools of
dentistry or accredited dental training institutions or
programs, community dental programs, and programs operated by
the Indian Health Service (including federally recognized
Indian tribes that receive medical services from the Indian
Health Service, urban Indian health programs funded under
title V of the Indian Health Care Improvement Act, and tribes
that contract with the Indian Health Service pursuant to the
Indian Self-Determination and Education Assistance Act) to
enable such schools, institutions, and programs to develop
programs of oral health promotion, to increase training of
oral health services providers in accordance with State
practice laws, or to increase the utilization of dental
services by eligible children.
``(c) Distribution.--In awarding grants under this section,
the Secretary shall, to the extent practicable, ensure an
equitable national geographic distribution of the grants,
including areas of the United States where the incidence of
early childhood caries is highest.
``(d) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section $10,000,000 for
each the fiscal years 2001 through 2005.''.
TITLE XVII--VACCINE-RELATED PROGRAMS
Subtitle A--Vaccine Compensation Program
SEC. 1701. CONTENT OF PETITIONS.
(a) In General.--Section 2111(c)(1)(D) of the Public Health
Service Act (42 U.S.C. 300aa-11(c)(1)(D)) is amended by
striking ``and'' at the end and inserting ``or (iii) suffered
such illness, disability, injury, or condition from the
vaccine which resulted in inpatient hospitalization and
surgical intervention, and''.
(b) Effective Date.--The amendment made by subsection (a)
takes effect upon the date of the enactment of this Act,
including with respect to petitions under section 2111 of the
Public Health Service Act that are pending on such date.
Subtitle B--Childhood Immunizations
SEC. 1711. CHILDHOOD IMMUNIZATIONS.
Section 317(j)(1) of the Public Health Service Act (42
U.S.C. 247b(j)(1)) is amended in the first sentence by
striking ``1998'' and all that follows and inserting ``1998
through 2005.''.
TITLE XVIII--HEPATITIS C
SEC. 1801. SURVEILLANCE AND EDUCATION REGARDING HEPATITIS C.
Part B of title III of the Public Health Service Act, as
amended by section 1602 of this Act, is amended by inserting
after section 317M the following section:
``surveillance and education regarding hepatitis c virus
``Sec. 317N. (a) In General.--The Secretary, acting through
the Director of the Centers for Disease Control and
Prevention, may (directly and through grants to public and
nonprofit private entities) provide for programs to carry out
the following:
``(1) To cooperate with the States in implementing a
national system to determine the incidence of hepatitis C
virus infection (in this section referred to as `HCV
infection') and to assist the States in determining the
prevalence of such infection, including the reporting of
chronic HCV cases.
``(2) To identify, counsel, and offer testing to
individuals who are at risk of HCV infection as a result of
receiving blood transfusions prior to July 1992, or as a
result of other risk factors.
``(3) To provide appropriate referrals for counseling,
testing, and medical treatment of individuals identified
under paragraph (2) and to ensure, to the extent practicable,
the provision of appropriate follow-up services.
``(4) To develop and disseminate public information and
education programs for the detection and control of HCV
infection, with priority given to high risk populations as
determined by the Secretary.
``(5) To improve the education, training, and skills of
health professionals in the detection and control of HCV
infection, with priority given to pediatricians and other
primary care physicians, and obstetricians and gynecologists.
``(b) Laboratory Procedures.--The Secretary may (directly
and through grants to public and nonprofit private entities)
carry out programs to provide for improvements in the quality
of clinical-laboratory procedures regarding hepatitis C,
including reducing variability in laboratory results on
hepatitis C antibody and PCR testing.
``(c) 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 2001 through 2005.''.
TITLE XIX--NIH INITIATIVE ON AUTOIMMUNE DISEASES
SEC. 1901. AUTOIMMUNE DISEASES; INITIATIVE THROUGH DIRECTOR
OF NATIONAL INSTITUTES OF HEALTH.
Part B of title IV of the Public Health Service Act (42
U.S.C. 284 et seq.), as amended by section 1001 of this Act,
is amended by adding at the end the following:
``SEC. 409E. AUTOIMMUNE DISEASES.
``(a) Expansion, Intensification, and Coordination of
Activities.--
``(1) In general.--The Director of NIH shall expand,
intensify, and coordinate research and other activities of
the National Institutes of Health with respect to autoimmune
diseases.
``(2) Allocations by director of nih.--With respect to
amounts appropriated to carry out this section for a fiscal
year, the Director of NIH shall allocate the amounts among
the national research institutes that are carrying out
paragraph (1).
[[Page H8223]]
``(3) Definition.--The term `autoimmune disease' includes,
for purposes of this section such diseases or disorders with
evidence of autoimmune pathogensis as the Secretary
determines to be appropriate.
``(b) Coordinating Committee.--
``(1) In general.--The Secretary shall ensure that the
Autoimmune Diseases Coordinating Committee (referred to in
this section as the `Coordinating Committee') coordinates
activities across the National Institutes and with other
Federal health programs and activities relating to such
diseases.
``(2) Composition.--The Coordinating Committee shall be
composed of the directors or their designees of each of the
national research institutes involved in research with
respect to autoimmune diseases and representatives of all
other Federal departments and agencies whose programs involve
health functions or responsibilities relevant to such
diseases, including the Centers for Disease Control and
Prevention and the Food and Drug Administration.
``(3) Chair.--
``(A) In general.--With respect to autoimmune diseases, the
Chair of the Committee shall serve as the principal advisor
to the Secretary, the Assistant Secretary for Health, and the
Director of NIH, and shall provide advice to the Director of
the Centers for Disease Control and Prevention, the
Commissioner of Food and Drugs, and other relevant agencies.
``(B) Director of nih.--The Chair of the Committee shall be
directly responsible to the Director of NIH.
``(c) Plan for NIH Activities.--
``(1) In general.--Not later than 1 year after the date of
enactment of this section, the Coordinating Committee shall
develop a plan for conducting and supporting research and
education on autoimmune diseases through the national
research institutes and shall periodically review and revise
the plan. The plan shall--
``(A) provide for a broad range of research and education
activities relating to biomedical, psychosocial, and
rehabilitative issues, including studies of the
disproportionate impact of such diseases on women;
``(B) identify priorities among the programs and activities
of the National Institutes of Health regarding such diseases;
and
``(C) reflect input from a broad range of scientists,
patients, and advocacy groups.
``(2) Certain elements of plan.--The plan under paragraph
(1) shall, with respect to autoimmune diseases, provide for
the following as appropriate:
``(A) Research to determine the reasons underlying the
incidence and prevalence of the diseases.
``(B) Basic research concerning the etiology and causes of
the diseases.
``(C) Epidemiological studies to address the frequency and
natural history of the diseases, including any differences
among the sexes and among racial and ethnic groups.
``(D) The development of improved screening techniques.
``(E) Clinical research for the development and evaluation
of new treatments, including new biological agents.
``(F) Information and education programs for health care
professionals and the public.
``(3) Implementation of plan.--The Director of NIH shall
ensure that programs and activities of the National
Institutes of Health regarding autoimmune diseases are
implemented in accordance with the plan under paragraph (1).
``(d) Reports to Congress.--The Coordinating Committee
under subsection (b)(1) shall biennially submit to the
Committee on Commerce of the House of Representatives, and
the Committee on Health, Education, Labor and Pensions of the
Senate, a report that describes the research, education, and
other activities on autoimmune diseases being conducted or
supported through the national research institutes, and that
in addition includes the following:
``(1) The plan under subsection (c)(1) (or revisions to the
plan, as the case may be).
``(2) Provisions specifying the amounts expended by the
National Institutes of Health with respect to each of the
autoimmune diseases included in the plan.
``(3) Provisions identifying particular projects or types
of projects that should in the future be considered by the
national research institutes or other entities in the field
of research on autoimmune diseases.
``(e) 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 2001 through 2005. The authorization of
appropriations established in the preceding sentence is in
addition to any other authorization of appropriations that is
available for conducting or supporting through the National
Institutes of Health research and other activities with
respect to autoimmune diseases.''.
TITLE XX--GRADUATE MEDICAL EDUCATION PROGRAMS IN CHILDREN'S HOSPITALS
SEC. 2001. PROVISIONS TO REVISE AND EXTEND PROGRAM.
(a) Payments.--Section 340E(a) of the Public Health Service
Act (42 U.S.C. 256e(a)) is amended--
(1) by striking ``and 2001'' and inserting ``through
2005''; and
(2) by adding at the end the following: ``The Secretary
shall promulgate regulations pursuant to the rulemaking
requirements of title 5, United States Code, which shall
govern payments made under this subpart.''.
(b) Updating Rates.--Section 340E(c)(2)(F) of the Public
Health Service Act (42 U.S.C. 256e(c)(2)(F)) is amended by
striking ``hospital's cost reporting period that begins
during fiscal year 2000'' and inserting ``Federal fiscal year
for which payments are made''.
(c) Resident Count for Interim Payments.--Section
340E(e)(1) of the Public Health Service Act (42 U.S.C.
256e(e)(1)) is amended by adding at the end the following:
``Such interim payments to each individual hospital shall be
based on the number of residents reported in the hospital's
most recently filed medicare cost report prior to the
application date for the Federal fiscal year for which the
interim payment amounts are established. In the case of a
hospital that does not report residents on a medicare cost
report, such interim payments shall be based on the number of
residents trained during the hospital's most recently
completed medicare cost report filing period.''.
(d) Withholding.--Section 340E(e)(2) of the Public Health
Service Act (42 U.S.C. 256e(e)(2)) is amended--
(1) by adding ``and indirect'' after ``direct'';
(2) by adding at the end the following: ``The Secretary
shall withhold up to 25 percent from each interim installment
for direct and indirect graduate medical education paid under
paragraph (1) as necessary to ensure a hospital will not be
overpaid on an interim basis.''.
(e) Reconciliation.--Section 340E(e)(3) of the Public
Health Service Act (42 U.S.C. 256e(e)(3)) is amended to read
as follows:
``(3) Reconciliation.--Prior to the end of each fiscal
year, the Secretary shall determine any changes to the number
of residents reported by a hospital in the application of the
hospital for the current fiscal year to determine the final
amount payable to the hospital for the current fiscal year
for both direct expense and indirect expense amounts. Based
on such determination, the Secretary shall recoup any
overpayments made to pay any balance due to the extent
possible. The final amount so determined shall be considered
a final intermediary determination for the purposes of
section 1878 of the Social Security Act and shall be subject
to administrative and judicial review under that section in
the same manner as the amount of payment under section
1186(d) of such Act is subject to review under such
section.''.
(f) Authorization of Appropriations.--Section 340E(f) of
the Public Health Service Act (42 U.S.C. 256e(f)) is
amended--
(1) in paragraph (1)(A)--
(A) in clause (i), by striking ``and'' at the end;
(B) in clause (ii), by striking the period and inserting
``; and''; and
(C) by adding at the end the following:
``(iii) for each of the fiscal years 2002 through 2005,
such sums as may be necessary.''; and
(2) in paragraph (2)--
(A) in subparagraph (A), by striking ``and'' at the end;
(B) in subparagraph (B), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(C) for each of the fiscal years 2002 through 2005, such
sums as may be necessary.''.
(g) Definition of Children's Hospital.--Section 340E(g)(2)
of the Public Health Service Act (42 U.S.C. 256e(g)(2)) is
amended by striking ``described in'' and all that follows and
inserting the following: ``with a medicare payment agreement
and which is excluded from the medicare inpatient prospective
payment system pursuant to section 1886(d)(1)(B)(iii) of the
Social Security Act and its accompanying regulations.''.
TITLE XXI--SPECIAL NEEDS OF CHILDREN REGARDING ORGAN TRANSPLANTATION
SEC. 2101. ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK;
AMENDMENTS REGARDING NEEDS OF CHILDREN.
(a) In General.--Section 372(b)(2) of the Public Health
Service Act (42 U.S.C. 274(b)(2)) is amended--
(1) in subparagraph (J), by striking ``and'' at the end;
(2) in each of subparagraphs (K) and (L), by striking the
period and inserting a comma; and
(3) by adding at the end the following subparagraphs:
``(M) recognize the differences in health and in organ
transplantation issues between children and adults throughout
the system and adopt criteria, polices, and procedures that
address the unique health care needs of children,
``(N) carry out studies and demonstration projects for the
purpose of improving procedures for organ donation
procurement and allocation, including but not limited to
projects to examine and attempt to increase transplantation
among populations with special needs, including children and
individuals who are members of racial or ethnic minority
groups, and among populations with limited access to
transportation, and
``(O) provide that for purposes of this paragraph, the term
`children' refers to individuals who are under the age of
18.''.
(b) Study Regarding Immunosuppressive Drugs.--
(1) In general.--The Secretary of Health and Human Services
(referred to in this subsection as the ``Secretary'') shall
provide for a study to determine the costs of
immunosuppressive drugs that are provided to children
pursuant to organ transplants and to determine the extent to
which health plans and health insurance cover such costs. The
Secretary may carry out the study directly or through a grant
to the Institute of Medicine (or other public or nonprofit
private entity).
(2) Recommendations regarding certain issues.--The
Secretary shall ensure that, in addition to making
determinations under paragraph (1), the study under such
paragraph makes recommendations regarding the following
issues:
(A) The costs of immunosuppressive drugs that are provided
to children pursuant to organ transplants and to determine
the extent to which health plans, health insurance and
government programs cover such costs.
[[Page H8224]]
(B) The extent of denial of organs to be released for
transplant by coroners and medical examiners.
(C) The special growth and developmental issues that
children have pre- and post- organ transplantation.
(D) Other issues that are particular to the special health
and transplantation needs of children.
(3) Report.--The Secretary shall ensure that, not later
than December 31, 2001, the study under paragraph (1) is
completed and a report describing the findings of the study
is submitted to the Congress.
TITLE XXII--MUSCULAR DYSTROPHY RESEARCH
SEC. 2201. MUSCULAR DYSTROPHY RESEARCH.
Part B of title IV of the Public Health Service Act, as
amended by section 1901 of this Act, is amended by adding at
the end the following:
``muscular dystrophy research
``Sec. 409F. (a) Coordination of Activities.--The Director
of NIH shall expand and increase coordination in the
activities of the National Institutes of Health with respect
to research on muscular dystrophies, including Duchenne
muscular dystrophy.
``(b) Administration of Program; Collaboration Among
Agencies.--The Director of NIH shall carry out this section
through the appropriate institutes, including the National
Institute of Neurological Disorders and Stroke and in
collaboration with any other agencies that the Director
determines appropriate.
``(c) Authorization of Appropriations.--There are
authorized to be appropriated such sums as may be necessary
to carry out this section for each of the fiscal years 2001
through 2005. Amounts appropriated under this subsection
shall be in addition to any other amounts appropriated for
such purpose.''.
TITLE XXIII--CHILDREN AND TOURETTE SYNDROME AWARENESS
SEC. 2301. GRANTS REGARDING TOURETTE SYNDROME.
Part A of title XI of the Public Health Service Act is
amended by adding at the end the following section:
``tourette syndrome
``Sec. 1108. (a) In General.--The Secretary shall develop
and implement outreach programs to educate the public, health
care providers, educators and community based organizations
about the etiology, symptoms, diagnosis and treatment of
Tourette Syndrome, with a particular emphasis on children
with Tourette Syndrome. Such programs may be carried out by
the Secretary directly and through awards of grants or
contracts to public or nonprofit private entities.
``(b) Certain Activities.--Activities under subsection (a)
shall include--
``(1) the production and translation of educational
materials, including public service announcements;
``(2) the development of training material for health care
providers, educators and community based organizations; and
``(3) outreach efforts directed at the misdiagnosis and
underdiagnosis of Tourette Syndrome in children and in
minority groups.
``(c) 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 2001 through 2005.''.
TITLE XXIV--CHILDHOOD OBESITY PREVENTION
SEC. 2401. PROGRAMS OPERATED THROUGH THE CENTERS FOR DISEASE
CONTROL AND PREVENTION.
Title III of the Public Health Service Act (42 U.S.C. 241
et seq.), as amended by section 1101 of this Act, is amended
by adding at the end the following part:
``PART Q--PROGRAMS TO IMPROVE THE HEALTH OF CHILDREN
``SEC. 399W. GRANTS TO PROMOTE CHILDHOOD NUTRITION AND
PHYSICAL ACTIVITY.
``(a) In General.--The Secretary, acting though the
Director of the Centers for Disease Control and Prevention,
shall award competitive grants to States and political
subdivisions of States for the development and implementation
of State and community-based intervention programs to promote
good nutrition and physical activity in children and
adolescents.
``(b) Eligibility.--To be eligible to receive a grant under
this section a State or political subdivision of a State
shall prepare and submit to the Secretary an application at
such time, in such manner, and containing such information as
the Secretary may require, including a plan that describes--
``(1) how the applicant proposes to develop a comprehensive
program of school- and community-based approaches to
encourage and promote good nutrition and appropriate levels
of physical activity with respect to children or adolescents
in local communities;
``(2) the manner in which the applicant shall coordinate
with appropriate State and local authorities, such as State
and local school departments, State departments of health,
chronic disease directors, State directors of programs under
section 17 of the Child Nutrition Act of 1966, 5-a-day
coordinators, governors councils for physical activity and
good nutrition, and State and local parks and recreation
departments; and
``(3) the manner in which the applicant will evaluate the
effectiveness of the program carried out under this section.
``(c) Use of Funds.--A State or political subdivision of a
State shall use amount received under a grant under this
section to--
``(1) develop, implement, disseminate, and evaluate school-
and community-based strategies in States to reduce inactivity
and improve dietary choices among children and adolescents;
``(2) expand opportunities for physical activity programs
in school- and community-based settings; and
``(3) develop, implement, and evaluate programs that
promote good eating habits and physical activity including
opportunities for children with cognitive and physical
disabilities.
``(d) Technical Assistance.--The Secretary may set-aside an
amount not to exceed 10 percent of the amount appropriated
for a fiscal year under subsection (h) to permit the Director
of the Centers for Disease Control and Prevention to--
``(1) provide States and political subdivisions of States
with technical support in the development and implementation
of programs under this section; and
``(2) disseminate information about effective strategies
and interventions in preventing and treating obesity through
the promotion of good nutrition and physical activity.
``(e) Limitation on Administrative Costs.--Not to exceed 10
percent of the amount of a grant awarded to the State or
political subdivision under subsection (a) for a fiscal year
may be used by the State or political subdivision for
administrative expenses.
``(f) Term.--A grant awarded under subsection (a) shall be
for a term of 3 years.
``(g) Definition.--In this section, the term `children and
adolescents' means individuals who do not exceed 18 years of
age.
``(h) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section such
sums as may be necessary for each of the fiscal years 2001
through 2005.
``SEC. 399X. APPLIED RESEARCH PROGRAM.
``(a) In General.--The Secretary, acting through the
Centers for Disease Control and Prevention and in
consultation with the Director of the National Institutes of
Health, shall--
``(1) conduct research to better understand the
relationship between physical activity, diet, and health and
factors that influence health-related behaviors;
``(2) develop and evaluate strategies for the prevention
and treatment of obesity to be used in community-based
interventions and by health professionals;
``(3) develop and evaluate strategies for the prevention
and treatment of eating disorders, such as anorexia and
bulimia;
``(4) conduct research to establish the prevalence,
consequences, and costs of childhood obesity and its effects
in adulthood;
``(5) identify behaviors and risk factors that contribute
to obesity;
``(6) evaluate materials and programs to provide nutrition
education to parents and teachers of children in child care
or pre-school and the food service staff of such child care
and pre-school entities; and
``(7) evaluate materials and programs that are designed to
educate and encourage physical activity in child care and
pre-school facilities.
``(b) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section such
sums as may be necessary for each of the fiscal years 2001
through 2005.
``SEC. 399Y. EDUCATION CAMPAIGN.
``(a) In General.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention,
and in collaboration with national, State, and local
partners, physical activity organizations, nutrition experts,
and health professional organizations, shall develop a
national public campaign to promote and educate children and
their parents concerning--
``(1) the health risks associated with obesity, inactivity,
and poor nutrition;
``(2) ways in which to incorporate physical activity into
daily living; and
``(3) the benefits of good nutrition and strategies to
improve eating habits.
``(b) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section such
sums as may be necessary for each of the fiscal years 2001
through 2005.
``SEC. 399Z. HEALTH PROFESSIONAL EDUCATION AND TRAINING.
``(a) In General.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention,
in collaboration with the Administrator of the Health
Resources and Services Administration and the heads of other
agencies, and in consultation with appropriate health
professional associations, shall develop and carry out a
program to educate and train health professionals in
effective strategies to--
``(1) better identify and assess patients with obesity or
an eating disorder or patients at-risk of becoming obese or
developing an eating disorder;
``(2) counsel, refer, or treat patients with obesity or an
eating disorder; and
``(3) educate patients and their families about effective
strategies to improve dietary habits and establish
appropriate levels of physical activity.
``(b) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section such
sums as may be necessary for each of the fiscal years 2001
through 2005.''.
TITLE XXV--EARLY DETECTION AND TREATMENT REGARDING CHILDHOOD LEAD
POISONING
SEC. 2501. CENTERS FOR DISEASE CONTROL AND PREVENTION EFFORTS
TO COMBAT CHILDHOOD LEAD POISONING.
(a) Requirements for Lead Poisoning Prevention Grantees.--
Section 317A of the Public Health Service Act (42 U.S.C.
247b-1) is amended--
(1) in subsection (d)--
(A) by redesignating paragraph (7) as paragraph (8); and
(B) by inserting after paragraph (6) the following:
``(7) Assurances satisfactory to the Secretary that the
applicant will ensure complete and consistent reporting of
all blood lead test results
[[Page H8225]]
from laboratories and health care providers to State and
local health departments in accordance with guidelines of the
Centers for Disease Control and Prevention for standardized
reporting as described in subsection (m).''; and
(2) in subsection (j)(2)--
(A) in subparagraph (F) by striking ``(E)'' and inserting
``(F)'';
(B) by redesignating subparagraph (F) as subparagraph (G);
and
(C) by inserting after subparagraph (E) the following:
``(F) The number of grantees that have established systems
to ensure mandatory reporting of all blood lead tests from
laboratories and health care providers to State and local
health departments.''.
(b) Guidelines for Standardized Reporting.--Section 317A of
the Public Health Service Act (42 U.S.C. 247b-1) is amended
by adding at the end the following:
``(m) Guidelines for Standardized Reporting.--The
Secretary, acting through the Director of the Centers for
Disease Control and Prevention, shall develop national
guidelines for the uniform reporting of all blood lead test
results to State and local health departments.''.
(c) Development and Implementation of Effective Data
Management by the Centers for Disease Control and
Prevention.--
(1) In general.--The Director of the Centers for Disease
Control and Prevention shall--
(A) assist with the improvement of data linkages between
State and local health departments and between State health
departments and the Centers for Disease Control and
Prevention;
(B) assist States with the development of flexible,
comprehensive State-based data management systems for the
surveillance of children with lead poisoning that have the
capacity to contribute to a national data set;
(C) assist with the improvement of the ability of State-
based data management systems and federally-funded means-
tested public benefit programs (including the special
supplemental food program for women, infants and children
(WIC) under section 17 of the Child Nutrition Act of 1966 (42
U.S.C. 1786) and the early head start program under section
645A of the Head Start Act (42 U.S.C. 9840a(h)) to respond to
ad hoc inquiries and generate progress reports regarding the
lead blood level screening of children enrolled in those
programs;
(D) assist States with the establishment of a capacity for
assessing how many children enrolled in the medicaid, WIC,
early head start, and other federally-funded means-tested
public benefit programs are being screened for lead poisoning
at age-appropriate intervals;
(E) use data obtained as result of activities under this
section to formulate or revise existing lead blood screening
and case management policies; and
(F) establish performance measures for evaluating State and
local implementation of the requirements and improvements
described in subparagraphs (A) through (E).
(2) Authorization of appropriations.--There are authorized
to be appropriated to carry out this subsection such sums as
may be necessary for each the fiscal years 2001 through 2005.
(3) Effective date.--This subsection takes effect on the
date of enactment of this Act.
SEC. 2502. GRANTS FOR LEAD POISONING RELATED ACTIVITIES.
(a) In General.--Part B of title III of the Public Health
Service Act (42 U.S.C. 243 et seq.), as amended by section
1801 of this Act, is amended by inserting after section 317N
the following section:
``grants for lead poisoning related activities
``Sec. 317O. (a) Authority To Make Grants.--
``(1) In general.--The Secretary shall make grants to
States to support public health activities in States and
localities where data suggests that at least 5 percent of
preschool-age children have an elevated blood lead level
through--
``(A) effective, ongoing outreach and community education
targeted to families most likely to be at risk for lead
poisoning;
``(B) individual family education activities that are
designed to reduce ongoing exposures to lead for children
with elevated blood lead levels, including through home
visits and coordination with other programs designed to
identify and treat children at risk for lead poisoning; and
``(C) the development, coordination and implementation of
community-based approaches for comprehensive lead poisoning
prevention from surveillance to lead hazard control.
``(2) State match.--A State is not eligible for a grant
under this section unless the State agrees to expend (through
State or local funds) $1 for every $2 provided under the
grant to carry out the activities described in paragraph (1).
``(3) Application.--To be eligible to receive a grant under
this section, a State shall submit an application to the
Secretary in such form and manner and containing such
information as the Secretary may require.
``(b) Coordination With Other Children's Programs.--A State
shall identify in the application for a grant under this
section how the State will coordinate operations and
activities under the grant with--
``(1) other programs operated in the State that serve
children with elevated blood lead levels, including any such
programs operated under titles V, XIX, or XXI of the Social
Security Act; and
``(2) one or more of the following--
``(A) the child welfare and foster care and adoption
assistance programs under parts B and E of title IV of such
Act;
``(B) the head start program established under the Head
Start Act (42 U.S.C. 9831 et seq.);
``(C) the program of assistance under the special
supplemental nutrition program for women, infants and
children (WIC) under section 17 of the Child Nutrition Act of
1966 (42 U.S.C. 1786);
``(D) local public and private elementary or secondary
schools; or
``(E) public housing agencies, as defined in section 3 of
the United States Housing Act of 1937 (42 U.S.C. 1437a).
``(c) Performance Measures.--The Secretary shall establish
needs indicators and performance measures to evaluate the
activities carried out under grants awarded under this
section. Such indicators shall be commensurate with national
measures of maternal and child health programs and shall be
developed in consultation with the Director of the Centers
for Disease Control and Prevention.
``(d) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section such
sums as may be necessary for each of the fiscal years 2001
through 2005.''.
(b) Conforming Amendment.--Section 340D(c)(1) of the Public
Health Service Act (42 U.S.C. 256d(c)(1)) is amended by
striking ``317E'' and inserting ``317F''.
SEC. 2503. TRAINING AND REPORTS BY THE HEALTH RESOURCES AND
SERVICES ADMINISTRATION.
(a) Training.--The Secretary of Health and Human Services,
acting through the Administrator of the Health Resources and
Services Administration and in collaboration with the
Administrator of the Health Care Financing Administration and
the Director of the Centers for Disease Control and
Prevention, shall conduct education and training programs for
physicians and other health care providers regarding
childhood lead poisoning, current screening and treatment
recommendations and requirements, and the scientific,
medical, and public health basis for those policies.
(b) Report.--The Secretary of Health and Human Services,
acting through the Administrator of the Health Resources and
Services Administration, annually shall report to Congress on
the number of children who received services through health
centers established under section 330 of the Public Health
Service Act (42 U.S.C. 254b) and received a blood lead
screening test during the prior fiscal year, noting the
percentage that such children represent as compared to all
children who received services through such health centers.
(c) Authorization of Appropriations.--There are authorized
to be appropriated to carry out this section such sums as may
be necessary for each the fiscal years 2001 through 2005.
SEC. 2504. SCREENINGS, REFERRALS, AND EDUCATION REGARDING
LEAD POISONING.
Section 317A(l)(1) of the Public Health Service Act (42
U.S.C. 247b-1(l)(1)) is amended by striking ``1994'' and all
that follows and inserting ``1994 through 2005.''.
TITLE XXVI--SCREENING FOR HERITABLE DISORDERS
SEC. 2601. PROGRAM TO IMPROVE THE ABILITY OF STATES TO
PROVIDE NEWBORN AND CHILD SCREENING FOR
HERITABLE DISORDERS.
Part A of title XI of the Public Health Service Act, as
amended by section 2301 of this Act, is amended by adding at
the end the following:
``SEC. 1109. IMPROVED NEWBORN AND CHILD SCREENING FOR
HERITABLE DISORDERS.
``(a) In General.--The Secretary shall award grants to
eligible entities to enhance, improve or expand the ability
of State and local public health agencies to provide
screening, counseling or health care services to newborns and
children having or at risk for heritable disorders.
``(b) Use of Funds.--Amounts provided under a grant awarded
under subsection (a) shall be used to--
``(1) establish, expand, or improve systems or programs to
provide screening, counseling, testing or specialty services
for newborns and children at risk for heritable disorders;
``(2) establish, expand, or improve programs or services to
reduce mortality or morbidity from heritable disorders;
``(3) establish, expand, or improve systems or programs to
provide information and counseling on available therapies for
newborns and children with heritable disorders;
``(4) improve the access of medically underserved
populations to screening, counseling, testing and specialty
services for newborns and children having or at risk for
heritable disorders; or
``(5) conduct such other activities as may be necessary to
enable newborns and children having or at risk for heritable
disorders to receive screening, counseling, testing or
specialty services, regardless of income, race, color,
religion, sex, national origin, age, or disability.
``(c) Eligible Entities.--To be eligible to receive a grant
under subsection (a) an entity shall--
``(1) be a State or political subdivision of a State, or a
consortium of 2 or more States or political subdivisions of
States; and
``(2) prepare and submit to the Secretary an application
that includes--
``(A) a plan to use amounts awarded under the grant to meet
specific health status goals and objectives relative to
heritable disorders, including attention to needs of
medically underserved populations;
``(B) a plan for the collection of outcome data or other
methods of evaluating the degree to which amounts awarded
under this grant will be used to achieve the goals and
objectives identified under subparagraph (A);
``(C) a plan for monitoring and ensuring the quality of
services provided under the grant;
``(D) an assurance that amounts awarded under the grant
will be used only to implement the approved plan for the
State;
``(E) an assurance that the provision of services under the
plan is coordinated with services
[[Page H8226]]
provided under programs implemented in the State under titles
V, XVIII, XIX, XX, or XXI of the Social Security Act (subject
to Federal regulations applicable to such programs) so that
the coverage of services under such titles is not
substantially diminished by the use of granted funds; and
``(F) such other information determined by the Secretary to
be necessary.
``(d) Limitation.--An eligible entity may not use amounts
received under this section to--
``(1) provide cash payments to or on behalf of affected
individuals;
``(2) provide inpatient services;
``(3) purchase land or make capital improvements to
property; or
``(4) provide for proprietary research or training.
``(e) Voluntary Participation.--The participation by any
individual in any program or portion thereof established or
operated with funds received under this section shall be
wholly voluntary and shall not be a prerequisite to
eligibility for or receipt of any other service or assistance
from, or to participation in, another Federal or State
program.
``(f) Supplement Not Supplant.--Funds appropriated under
this section shall be used to supplement and not supplant
other Federal, State, and local public funds provided for
activities of the type described in this section.
``(g) Publication.
``(1) In general.--An application submitted under
subsection (c)(2) shall be made public by the State in such a
manner as to facilitate comment from any person, including
through hearings and other methods used to facilitate
comments from the public.
``(2) Comments.--Comments received by the State after the
publication described in paragraph (1) shall be addressed in
the application submitted under subsection (c)(2).
``(h) Technical Assistance.--The Secretary shall provide to
entities receiving grants under subsection (a) such technical
assistance as may be necessary to ensure the quality of
programs conducted under this section.
``(i) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section such
sums as may be necessary for each of the fiscal years 2001
through 2005.
``SEC. 1110. EVALUATING THE EFFECTIVENESS OF NEWBORN AND
CHILD SCREENING PROGRAMS.
``(a) In General.--The Secretary shall award grants to
eligible entities to provide for the conduct of demonstration
programs to evaluate the effectiveness of screening,
counseling or health care services in reducing the morbidity
and mortality caused by heritable disorders in newborns and
children.
``(b) Demonstration Programs.--A demonstration program
conducted under a grant under this section shall be designed
to evaluate and assess, within the jurisdiction of the entity
receiving such grant--
``(1) the effectiveness of screening, counseling, testing
or specialty services for newborns and children at risk for
heritable disorders in reducing the morbidity and mortality
associated with such disorders;
``(2) the effectiveness of screening, counseling, testing
or specialty services in accurately and reliably diagnosing
heritable disorders in newborns and children; or
``(3) the availability of screening, counseling, testing or
specialty services for newborns and children at risk for
heritable disorders.
``(c) Eligible Entities.--To be eligible to receive a grant
under subsection (a) an entity shall be a State or political
subdivision of a State, or a consortium of 2 or more States
or political subdivisions of States.
``SEC. 1111. ADVISORY COMMITTEE ON HERITABLE DISORDERS IN
NEWBORNS AND CHILDREN.
``(a) Establishment.--The Secretary shall establish an
advisory committee to be known as the 'Advisory Committee on
Heritable Disorders in Newborns and Children' (referred to in
this section as the 'Advisory Committee').
``(b) Duties.--The Advisory Committee shall--
``(1) provide advice and recommendations to the Secretary
concerning grants and projects awarded or funded under
section 1109;
``(2) provide technical information to the Secretary for
the development of policies and priorities for the
administration of grants under section 1109; and
``(3) provide such recommendations, advice or information
as may be necessary to enhance, expand or improve the ability
of the Secretary to reduce the mortality or morbidity from
heritable disorders.
``(c) Membership.--
``(1) In general.--The Secretary shall appoint not to
exceed 15 members to the Advisory Committee. In appointing
such members, the Secretary shall ensure that the total
membership of the Advisory Committee is an odd number.
``(2) Required members.--The Secretary shall appoint to the
Advisory Committee under paragraph (1)--
``(A) the Administrator of the Health Resources and
Services Administration;
``(B) the Director of the Centers for Disease Control and
Prevention;
``(C) the Director of the National Institutes of Health;
``(D) the Director of the Agency for Healthcare Research
and Quality;
``(E) medical, technical, or scientific professionals with
special expertise in heritable disorders, or in providing
screening, counseling, testing or specialty services for
newborns and children at risk for heritable disorders;
``(F) members of the public having special expertise about
or concern with heritable disorders; and
``(G) representatives from such Federal agencies, public
health constituencies, and medical professional societies as
determined to be necessary by the Secretary, to fulfill the
duties of the Advisory Committee, as established under
subsection (b).''.
TITLE XXVII--PEDIATRIC RESEARCH PROTECTIONS
SEC. 2701. REQUIREMENT FOR ADDITIONAL PROTECTIONS FOR
CHILDREN INVOLVED IN RESEARCH.
Notwithstanding any other provision of law, not later than
6 months after the date of enactment of this Act, the
Secretary of Health and Human Services shall require that all
research involving children that is conducted, supported, or
regulated by the Department of Health and Human Services be
in compliance with subpart D of part 45 of title 46, Code of
Federal Regulations.
TITLE XXVIII--MISCELLANEOUS PROVISIONS
SEC. 2801. REPORT REGARDING RESEARCH ON RARE DISEASES IN
CHILDREN.
Not later than 180 days after the date of the enactment of
this Act, the Director of the National Institutes of Health
shall submit to the Congress a report on--
(1) the activities that, during fiscal year 2000, were
conducted and supported by such Institutes with respect to
rare diseases in children, including Friedreich's ataxia and
Hutchinson-Gilford progeria syndrome; and
(2) the activities that are planned to be conducted and
supported by such Institutes with respect to such diseases
during the fiscal years 2001 through 2005.
SEC. 2802. STUDY ON METABOLIC DISORDERS.
(a) In General.--The Secretary of Health and Human Services
(in this section referred to as the ``Secretary'') shall, in
consultation with relevant experts or through the Institute
of Medicine, study issues related to treatment of PKU and
other metabolic disorders for children, adolescents, and
adults, and mechanisms to assure access to effective
treatment, including special diets, for children and others
with PKU and other metabolic disorders. Such mechanisms shall
be evidence-based and reflect the best scientific knowledge
regarding effective treatment and prevention of disease
progression.
(b) Dissemination of Results.--Upon completion of the study
referred to in subsection (a), the Secretary shall
disseminate and otherwise make available the results of the
study to interested groups and organizations, including
insurance commissioners, employers, private insurers, health
care professionals, State and local public health agencies,
and State agencies that carry out the medicaid program under
title XIX of the Social Security Act or the State children's
health insurance program under title XXI of such Act.
(c) Authorization of Appropriations.--There are authorized
to be appropriated to carry out this section such sums as may
be necessary for each of the fiscal years 2001 through 2003.
TITLE XXIX--EFFECTIVE DATE
SEC. 2901. EFFECTIVE DATE.
This division and the amendments made by this division take
effect October 1, 2000, or upon the date of the enactment of
this Act, whichever occurs later.
DIVISION B--YOUTH DRUG AND MENTAL HEALTH SERVICES
SEC. 3001. SHORT TITLE.
This division may be cited as the ``Youth Drug and Mental
Health Services Act''.
TITLE XXXI--PROVISIONS RELATING TO SERVICES FOR CHILDREN AND
ADOLESCENTS
SEC. 3101. CHILDREN AND VIOLENCE.
Title V of the Public Health Service Act (42 U.S.C. 290aa
et seq.) is amended by adding at the end the following:
``Part G--Projects for Children and Violence
``SEC. 581. CHILDREN AND VIOLENCE.
``(a) In General.--The Secretary, in consultation with the
Secretary of Education and the Attorney General, shall carry
out directly or through grants, contracts or cooperative
agreements with public entities a program to assist local
communities in developing ways to assist children in dealing
with violence.
``(b) Activities.--Under the program under subsection (a),
the Secretary may--
``(1) provide financial support to enable local communities
to implement programs to foster the health and development of
children;
``(2) provide technical assistance to local communities
with respect to the development of programs described in
paragraph (1);
``(3) provide assistance to local communities in the
development of policies to address violence when and if it
occurs;
``(4) assist in the creation of community partnerships
among law enforcement, education systems and mental health
and substance abuse service systems; and
``(5) establish mechanisms for children and adolescents to
report incidents of violence or plans by other children or
adolescents to commit violence.
``(c) Requirements.--An application for a grant, contract
or cooperative agreement under subsection (a) shall
demonstrate that--
``(1) the applicant will use amounts received to create a
partnership described in subsection (b)(4) to address issues
of violence in schools;
``(2) the activities carried out by the applicant will
provide a comprehensive method for addressing violence, that
will include--
``(A) security;
``(B) educational reform;
``(C) the review and updating of school policies;
``(D) alcohol and drug abuse prevention and early
intervention services;
``(E) mental health prevention and treatment services; and
[[Page H8227]]
``(F) early childhood development and psychosocial
services; and
``(3) the applicant will use amounts received only for the
services described in subparagraphs (D), (E), and (F) of
paragraph (2).
``(d) Geographical Distribution.--The Secretary shall
ensure that grants, contracts or cooperative agreements under
subsection (a) will be distributed equitably among the
regions of the country and among urban and rural areas.
``(e) Duration of Awards.--With respect to a grant,
contract or cooperative agreement under subsection (a), the
period during which payments under such an award will be made
to the recipient may not exceed 5 years.
``(f) Evaluation.--The Secretary shall conduct an
evaluation of each project carried out under this section and
shall disseminate the results of such evaluations to
appropriate public and private entities.
``(g) Information and Education.--The Secretary shall
establish comprehensive information and education programs to
disseminate the findings of the knowledge development and
application under this section to the general public and to
health care professionals.
``(h) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section, $100,000,000
for fiscal year 2001, and such sums as may be necessary for
each of fiscal years 2002 and 2003.
``SEC. 582. GRANTS TO ADDRESS THE PROBLEMS OF PERSONS WHO
EXPERIENCE VIOLENCE RELATED STRESS.
``(a) In General.--The Secretary shall award grants,
contracts or cooperative agreements to public and nonprofit
private entities, as well as to Indian tribes and tribal
organizations, for the purpose of developing programs
focusing on the behavioral and biological aspects of
psychological trauma response and for developing knowledge
with regard to evidence-based practices for treating
psychiatric disorders of children and youth resulting from
witnessing or experiencing a traumatic event.
``(b) Priorities.--In awarding grants, contracts or
cooperative agreements under subsection (a) related to the
development of knowledge on evidence-based practices for
treating disorders associated with psychological trauma, the
Secretary shall give priority to mental health agencies and
programs that have established clinical and basic research
experience in the field of trauma-related mental disorders.
``(c) Geographical Distribution.--The Secretary shall
ensure that grants, contracts or cooperative agreements under
subsection (a) with respect to centers of excellence are
distributed equitably among the regions of the country and
among urban and rural areas.
``(d) Evaluation.--The Secretary, as part of the
application process, shall require that each applicant for a
grant, contract or cooperative agreement under subsection (a)
submit a plan for the rigorous evaluation of the activities
funded under the grant, contract or agreement, including both
process and outcomes evaluation, and the submission of an
evaluation at the end of the project period.
``(e) Duration of Awards.--With respect to a grant,
contract or cooperative agreement under subsection (a), the
period during which payments under such an award will be made
to the recipient may not exceed 5 years. Such grants,
contracts or agreements may be renewed.
``(f) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section, $50,000,000 for
fiscal year 2001, and such sums as may be necessary for each
of fiscal years 2002 and 2003.''.
SEC. 3102. EMERGENCY RESPONSE.
Section 501 of the Public Health Service Act (42 U.S.C.
290aa) is amended--
(1) by redesignating subsection (m) as subsection (o);
(2) by inserting after subsection (l) the following:
``(m) Emergency Response.--
``(1) In general.--Notwithstanding section 504 and except
as provided in paragraph (2), the Secretary may use not to
exceed 2.5 percent of all amounts appropriated under this
title for a fiscal year to make noncompetitive grants,
contracts or cooperative agreements to public entities to
enable such entities to address emergency substance abuse or
mental health needs in local communities.
``(2) Exceptions.--Amounts appropriated under part C shall
not be subject to paragraph (1).
``(3) Emergencies.--The Secretary shall establish criteria
for determining that a substance abuse or mental health
emergency exists and publish such criteria in the Federal
Register prior to providing funds under this subsection.
``(n) Limitation on the Use of Certain Information.--No
information, if an establishment or person supplying the
information or described in it is identifiable, obtained in
the course of activities undertaken or supported under
section 505 may be used for any purpose other than the
purpose for which it was supplied unless such establishment
or person has consented (as determined under regulations of
the Secretary) to its use for such other purpose. Such
information may not be published or released in other form if
the person who supplied the information or who is described
in it is identifiable unless such person has consented (as
determined under regulations of the Secretary) to its
publication or release in other form.''; and
(3) in subsection (o) (as so redesignated), by striking
``1993'' and all that follows through the period and
inserting ``2001, and such sums as may be necessary for each
of the fiscal years 2002 and 2003.''.
SEC. 3103. HIGH RISK YOUTH REAUTHORIZATION.
Section 517(h) of the Public Health Service Act (42 U.S.C.
290bb-23(h)) is amended by striking ``$70,000,000'' and all
that follows through ``1994'' and inserting ``such sums as
may be necessary for each of the fiscal years 2001 through
2003''.
SEC. 3104. SUBSTANCE ABUSE TREATMENT SERVICES FOR CHILDREN
AND ADOLESCENTS.
(a) Substance Abuse Treatment Services.--Subpart 1 of part
B of title V of the Public Health Service Act (42 U.S.C.
290bb et seq.) is amended by adding at the end the following:
``SEC. 514. SUBSTANCE ABUSE TREATMENT SERVICES FOR CHILDREN
AND ADOLESCENTS.
``(a) In General.--The Secretary shall award grants,
contracts, or cooperative agreements to public and private
nonprofit entities, including Native Alaskan entities and
Indian tribes and tribal organizations, for the purpose of
providing substance abuse treatment services for children and
adolescents.
``(b) Priority.--In awarding grants, contracts, or
cooperative agreements under subsection (a), the Secretary
shall give priority to applicants who propose to--
``(1) apply evidenced-based and cost effective methods for
the treatment of substance abuse among children and
adolescents;
``(2) coordinate the provision of treatment services with
other social service agencies in the community, including
educational, juvenile justice, child welfare, and mental
health agencies;
``(3) provide a continuum of integrated treatment services,
including case management, for children and adolescents with
substance abuse disorders and their families;
``(4) provide treatment that is gender-specific and
culturally appropriate;
``(5) involve and work with families of children and
adolescents receiving treatment;
``(6) provide aftercare services for children and
adolescents and their families after completion of substance
abuse treatment; and
``(7) address the relationship between substance abuse and
violence.
``(c) Duration of Grants.--The Secretary shall award
grants, contracts, or cooperative agreements under subsection
(a) for periods not to exceed 5 fiscal years.
``(d) Application.--An entity desiring a grant, contract,
or cooperative agreement under subsection (a) shall submit an
application to the Secretary at such time, in such manner,
and accompanied by such information as the Secretary may
reasonably require.
``(e) Evaluation.--An entity that receives a grant,
contract, or cooperative agreement under subsection (a) shall
submit, in the application for such grant, contract, or
cooperative agreement, a plan for the evaluation of any
project undertaken with funds provided under this section.
Such entity shall provide the Secretary with periodic
evaluations of the progress of such project and such
evaluation at the completion of such project as the Secretary
determines to be appropriate.
``(f) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section,
$40,000,000 for fiscal year 2001, and such sums as may be
necessary for fiscal years 2002 and 2003.
``SEC. 514A. EARLY INTERVENTION SERVICES FOR CHILDREN AND
ADOLESCENTS.
``(a) In General.--The Secretary shall award grants,
contracts, or cooperative agreements to public and private
nonprofit entities, including local educational agencies (as
defined in section 14101 of the Elementary and Secondary
Education Act of 1965 (20 U.S.C. 8801)), for the purpose of
providing early intervention substance abuse services for
children and adolescents.
``(b) Priority.--In awarding grants, contracts, or
cooperative agreements under subsection (a), the Secretary
shall give priority to applicants who demonstrate an ability
to--
``(1) screen for and assess substance use and abuse by
children and adolescents;
``(2) make appropriate referrals for children and
adolescents who are in need of treatment for substance abuse;
``(3) provide early intervention services, including
counseling and ancillary services, that are designed to meet
the developmental needs of children and adolescents who are
at risk for substance abuse; and
``(4) develop networks with the educational, juvenile
justice, social services, and other agencies and
organizations in the State or local community involved that
will work to identify children and adolescents who are in
need of substance abuse treatment services.
``(c) Condition.--In awarding grants, contracts, or
cooperative agreements under subsection (a), the Secretary
shall ensure that such grants, contracts, or cooperative
agreements are allocated, subject to the availability of
qualified applicants, among the principal geographic regions
of the United States, to Indian tribes and tribal
organizations, and to urban and rural areas.
``(d) Duration of Grants.--The Secretary shall award
grants, contracts, or cooperative agreements under subsection
(a) for periods not to exceed 5 fiscal years.
``(e) Application.--An entity desiring a grant, contract,
or cooperative agreement under subsection (a) shall submit an
application to the Secretary at such time, in such manner,
and accompanied by such information as the Secretary may
reasonably require.
``(f) Evaluation.--An entity that receives a grant,
contract, or cooperative agreement under subsection (a) shall
submit, in the application for such grant, contract, or
cooperative agreement, a plan for the evaluation of any
project undertaken with funds provided under this section.
Such entity shall provide the Secretary with periodic
evaluations of the progress of such project and such
evaluation at the completion of such project as the Secretary
determines to be appropriate.
``(g) Authorization of Appropriations.--There are
authorized to be appropriated to carry
[[Page H8228]]
out this section, $20,000,000 for fiscal year 2001, and such
sums as may be necessary for fiscal years 2002 and 2003.''.
(b) Youth Interagency Centers.--Subpart 3 of part B of
title V of the Public Health Service Act (42 U.S.C. 290bb-31
et seq.) is amended by adding the following:
``SEC. 520C. YOUTH INTERAGENCY RESEARCH, TRAINING, AND
TECHNICAL ASSISTANCE CENTERS.
``(a) Program Authorized.--The Secretary, acting through
the Administrator of the Substance Abuse and Mental Health
Services Administration, and in consultation with the
Administrator of the Office of Juvenile Justice and
Delinquency Prevention, the Director of the Bureau of Justice
Assistance and the Director of the National Institutes of
Health, shall award grants or contracts to public or
nonprofit private entities to establish not more than 4
research, training, and technical assistance centers to carry
out the activities described in subsection (c).
``(b) Application.--A public or private nonprofit entity
desiring a grant or contract under subsection (a) shall
prepare and submit an application to the Secretary at such
time, in such manner, and containing such information as the
Secretary may require.
``(c) Authorized Activities.--A center established under a
grant or contract under subsection (a) shall--
``(1) provide training with respect to state-of-the-art
mental health and justice-related services and successful
mental health and substance abuse-justice collaborations that
focus on children and adolescents, to public policymakers,
law enforcement administrators, public defenders, police,
probation officers, judges, parole officials, jail
administrators and mental health and substance abuse
providers and administrators;
``(2) engage in research and evaluations concerning State
and local justice and mental health systems, including system
redesign initiatives, and disseminate information concerning
the results of such evaluations;
``(3) provide direct technical assistance, including
assistance provided through toll-free telephone numbers,
concerning issues such as how to accommodate individuals who
are being processed through the courts under the Americans
with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.), what
types of mental health or substance abuse service approaches
are effective within the judicial system, and how community-
based mental health or substance abuse services can be more
effective, including relevant regional, ethnic, and gender-
related considerations; and
``(4) provide information, training, and technical
assistance to State and local governmental officials to
enhance the capacity of such officials to provide appropriate
services relating to mental health or substance abuse.
``(d) Authorization of Appropriations.--For the purpose of
carrying out this section, there is authorized to be
appropriated $4,000,000 for fiscal year 2001, and such sums
as may be necessary for fiscal years 2002 and 2003.''.
(c) Prevention of Abuse and Addiction.--Subpart 2 of part B
of title V of the Public Health Service Act (42 U.S.C. 290bb-
21 et seq.) is amended by adding the following:
``SEC. 519E. PREVENTION OF METHAMPHETAMINE AND INHALANT ABUSE
AND ADDICTION.
``(a) Grants.--The Director of the Center for Substance
Abuse Prevention (referred to in this section as the
`Director') may make grants to and enter into contracts and
cooperative agreements with public and nonprofit private
entities to enable such entities--
``(1) to carry out school-based programs concerning the
dangers of methamphetamine or inhalant abuse and addiction,
using methods that are effective and evidence-based,
including initiatives that give students the responsibility
to create their own anti-drug abuse education programs for
their schools; and
``(2) to carry out community-based methamphetamine or
inhalant abuse and addiction prevention programs that are
effective and evidence-based.
``(b) Use of Funds.--Amounts made available under a grant,
contract or cooperative agreement under subsection (a) shall
be used for planning, establishing, or administering
methamphetamine or inhalant prevention programs in accordance
with subsection (c).
``(c) Prevention Programs and Activities.--
``(1) In general.--Amounts provided under this section may
be used--
``(A) to carry out school-based programs that are focused
on those districts with high or increasing rates of
methamphetamine or inhalant abuse and addiction and targeted
at populations which are most at risk to start
methamphetamine or inhalant abuse;
``(B) to carry out community-based prevention programs that
are focused on those populations within the community that
are most at-risk for methamphetamine or inhalant abuse and
addiction;
``(C) to assist local government entities to conduct
appropriate methamphetamine or inhalant prevention
activities;
``(D) to train and educate State and local law enforcement
officials, prevention and education officials, members of
community anti-drug coalitions and parents on the signs of
methamphetamine or inhalant abuse and addiction and the
options for treatment and prevention;
``(E) for planning, administration, and educational
activities related to the prevention of methamphetamine or
inhalant abuse and addiction;
``(F) for the monitoring and evaluation of methamphetamine
or inhalant prevention activities, and reporting and
disseminating resulting information to the public; and
``(G) for targeted pilot programs with evaluation
components to encourage innovation and experimentation with
new methodologies.
``(2) Priority.--The Director shall give priority in making
grants under this section to rural and urban areas that are
experiencing a high rate or rapid increases in
methamphetamine or inhalant abuse and addiction.
``(d) Analyses and Evaluation.--
``(1) In general.--Up to $500,000 of the amount available
in each fiscal year to carry out this section shall be made
available to the Director, acting in consultation with other
Federal agencies, to support and conduct periodic analyses
and evaluations of effective prevention programs for
methamphetamine or inhalant abuse and addiction and the
development of appropriate strategies for disseminating
information about and implementing these programs.
``(2) Annual reports.--The Director shall submit to the
Committee on Health, Education, Labor, and Pensions and the
Committee on Appropriations of the Senate and the Committee
on Commerce and Committee on Appropriations of the House of
Representatives, an annual report with the results of the
analyses and evaluation under paragraph (1).
``(e) Authorization of Appropriations.--There is authorized
to be appropriated to carry out subsection (a), $10,000,000
for fiscal year 2001, and such sums as may be necessary for
each of fiscal years 2002 and 2003.''.
SEC. 3105. COMPREHENSIVE COMMUNITY SERVICES FOR CHILDREN WITH
SERIOUS EMOTIONAL DISTURBANCE.
(a) Matching Funds.--Section 561(c)(1)(D) of the Public
Health Service Act (42 U.S.C. 290ff(c)(1)(D)) is amended by
striking ``fifth'' and inserting ``fifth and sixth''.
(b) Flexibility for Indian Tribes and Territories.--Section
562 of the Public Health Service Act (42 U.S.C. 290ff-1) is
amended by adding at the end the following:
``(g) Waivers.--The Secretary may waive 1 or more of the
requirements of subsection (c) for a public entity that is an
Indian Tribe or tribal organization, or American Samoa, Guam,
the Marshall Islands, the Federated States of Micronesia, the
Commonwealth of the Northern Mariana Islands, the Republic of
Palau, or the United States Virgin Islands if the Secretary
determines, after peer review, that the system of care is
family-centered and uses the least restrictive environment
that is clinically appropriate.''.
(c) Duration of Grants.--Section 565(a) of the Public
Health Service Act (42 U.S.C. 290ff-4(a)) is amended by
striking ``5 fiscal'' and inserting ``6 fiscal''.
(d) Authorization of Appropriations.--Section 565(f)(1) of
the Public Health Service Act (42 U.S.C. 290ff-4(f)(1)) is
amended by striking ``1993'' and all that follows and
inserting ``2001, and such sums as may be necessary for each
of the fiscal years 2002 and 2003.''.
(e) Current Grantees.--
(1) In general.--Entities with active grants under section
561 of the Public Health Service Act (42 U.S.C. 290ff) on the
date of enactment of this Act shall be eligible to receive a
6th year of funding under the grant in an amount not to
exceed the amount that such grantee received in the 5th year
of funding under such grant. Such 6th year may be funded
without requiring peer and Advisory Council review as
required under section 504 of such Act (42 U.S.C. 290aa-3).
(2) Limitation.--Paragraph (1) shall apply with respect to
a grantee only if the grantee agrees to comply with the
provisions of section 561 as amended by subsection (a).
SEC. 3106. SERVICES FOR CHILDREN OF SUBSTANCE ABUSERS.
(a) Administration and Activities.--
(1) Administration.--Section 399D(a) of the Public Health
Service Act (42 U.S.C. 280d(a)(1)) is amended--
(A) in paragraph (1), by striking ``Administrator'' and all
that follows through ``Administration'' and insert
``Administrator of the Substance Abuse and Mental Health
Services Administration''; and
(B) in paragraph (2), by striking ``Administrator of the
Substance Abuse and Mental Health Services Administration''
and inserting ``Administrator of the Health Resources and
Services Administration''.
(2) Activities.--Section 399D(a)(1) of the Public Health
Service Act (42 U.S.C. 280d(a)(1)) is amended--
(A) in subparagraph (B), by striking ``and'' at the end;
(B) in subparagraph (C), by striking the period and
inserting the following: ``through youth service agencies,
family social services, child care providers, Head Start,
schools and after-school programs, early childhood
development programs, community-based family resource and
support centers, the criminal justice system, health,
substance abuse and mental health providers through
screenings conducted during regular childhood examinations
and other examinations, self and family member referrals,
substance abuse treatment services, and other providers of
services to children and families; and''; and
(C) by adding at the end the following:
``(D) to provide education and training to health,
substance abuse and mental health professionals, and other
providers of services to children and families through youth
service agencies, family social services, child care, Head
Start, schools and after-school programs, early childhood
development programs, community-based family resource and
support centers, the criminal justice system, and other
providers of services to children and families.''.
(3) Identification of certain children.--Section
399D(a)(3)(A) of the Public Health Service Act (42 U.S.C.
280d(a)(3)(A)) is amended--
(A) in clause (i), by striking ``(i) the entity'' and
inserting ``(i)(I) the entity'';
(B) in clause (ii)--
(i) by striking ``(ii) the entity'' and inserting ``(II)
the entity''; and
[[Page H8229]]
(ii) by striking the period and inserting ``; and''; and
(C) by adding at the end the following:
``(ii) the entity will identify children who may be
eligible for medical assistance under a State program under
title XIX or XXI of the Social Security Act.''.
(b) Services for Children.--Section 399D(b) of the Public
Health Service Act (42 U.S.C. 280d(b)) is amended--
(1) in paragraph (1), by inserting ``alcohol and drug,''
after ``psychological,'';
(2) by striking paragraph (5) and inserting the following:
``(5) Developmentally and age-appropriate drug and alcohol
early intervention, treatment and prevention services.''; and
(3) by inserting after paragraph (8), the following:
``Services shall be provided under paragraphs (2) through (8)
by a public health nurse, social worker, or similar
professional, or by a trained worker from the community who
is supervised by a professional, or by an entity, where the
professional or entity provides assurances that the
professional or entity is licensed or certified by the State
if required and is complying with applicable licensure or
certification requirements.''.
(c) Services for Affected Families.--Section 399D(c) of the
Public Health Service Act (42 U.S.C. 280d(c)) is amended--
(1) in paragraph (1)--
(A) in the matter preceding subparagraph (A), by inserting
before the colon the following: ``, or by an entity, where
the professional or entity provides assurances that the
professional or entity is licensed or certified by the State
if required and is complying with applicable licensure or
certification requirements''; and
(B) by adding at the end the following:
``(D) Aggressive outreach to family members with substance
abuse problems.
``(E) Inclusion of consumer in the development,
implementation, and monitoring of Family Services Plan.'';
(2) in paragraph (2)--
(A) by striking subparagraph (A) and inserting the
following:
``(A) Alcohol and drug treatment services, including
screening and assessment, diagnosis, detoxification,
individual, group and family counseling, relapse prevention,
pharmacotherapy treatment, after-care services, and case
management.'';
(B) in subparagraph (C), by striking ``, including
educational and career planning'' and inserting ``and
counseling on the human immunodeficiency virus and acquired
immune deficiency syndrome'';
(C) in subparagraph (D), by striking ``conflict and''; and
(D) in subparagraph (E), by striking ``Remedial'' and
inserting ``Career planning and''; and
(3) in paragraph (3)(D), by inserting ``which include child
abuse and neglect prevention techniques'' before the period.
(d) Eligible Entities.--Section 399D(d) of the Public
Health Service Act (42 U.S.C. 280d(d)) is amended--
(1) by striking the matter preceding paragraph (1) and
inserting:
``(d) Eligible Entities.--The Secretary shall distribute
the grants through the following types of entities:'';
(2) in paragraph (1), by striking ``drug treatment'' and
inserting ``drug early intervention, prevention or treatment;
and
(3) in paragraph (2)--
(A) in subparagraph (A), by striking ``; and'' and
inserting ``; or''; and
(B) in subparagraph (B), by inserting ``or pediatric health
or mental health providers and family mental health
providers'' before the period.
(e) Submission of Information.--Section 399D(h) of the
Public Health Service Act (42 U.S.C. 280d(h)) is amended--
(1) in paragraph (2)--
(A) by inserting ``including maternal and child health''
before ``mental'';
(B) by striking ``treatment programs''; and
(C) by striking ``and the State agency responsible for
administering public maternal and child health services'' and
inserting ``, the State agency responsible for administering
alcohol and drug programs, the State lead agency, and the
State Interagency Coordinating Council under part H of the
Individuals with Disabilities Education Act; and''; and
(2) by striking paragraph (3) and redesignating paragraph
(4) as paragraph (3).
(f) Reports to the Secretary.--Section 399D(i)(6) of the
Public Health Service Act (42 U.S.C. 280d(i)(6)) is amended--
(1) in subparagraph (B), by adding ``and'' at the end; and
(2) by striking subparagraphs (C), (D), and (E) and
inserting the following:
``(C) the number of case workers or other professionals
trained to identify and address substance abuse issues.''.
(g) Evaluations.--Section 399D(l) of the Public Health
Service Act (42 U.S.C. 280d(l)) is amended--
(1) in paragraph (3), by adding ``and'' at the end;
(2) in paragraph (4), by striking the semicolon and
inserting the following: ``, including increased
participation in work or employment-related activities and
decreased participation in welfare programs.''; and
(3) by striking paragraphs (5) and (6).
(h) Report to Congress.--Section 399D(m) of the Public
Health Service Act (42 U.S.C. 280d(m)) is amended--
(1) in paragraph (2), by adding ``and'' at the end;
(2) in paragraph (3)--
(A) in subparagraph (A), by adding ``and'' at the end;
(B) in subparagraph (B), by striking the semicolon and
inserting a period; and
(C) by striking subparagraphs (C), (D), and (E); and
(3) by striking paragraphs (4) and (5).
(i) Data Collection.--Section 399D(n) of the Public Health
Service Act (42 U.S.C. 280d(n)) is amended by adding at the
end the following: ``The periodic report shall include a
quantitative estimate of the prevalence of alcohol and drug
problems in families involved in the child welfare system,
the barriers to treatment and prevention services facing
these families, and policy recommendations for removing the
identified barriers, including training for child welfare
workers.''.
(j) Definition.--Section 399D(o)(2)(B) of the Public Health
Service Act (42 U.S.C. 280d(o)(2)(B)) is amended by striking
``dangerous''.
(k) Authorization of Appropriations.--Section 399D(p) of
the Public Health Service Act (42 U.S.C. 280d(p)) is amended
to read as follows:
``(p) Authorization of Appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated $50,000,000 for fiscal year 2001, and such sums
as may be necessary for each of fiscal years 2002 and
2003.''.
(l) Grants for Training and Conforming Amendments.--Section
399D of the Public Health Service Act (42 U.S.C. 280d) is
amended--
(1) by striking subsection (f);
(2) by striking subsection (k);
(3) by redesignating subsections (d), (e), (g), (h), (i),
(j), (l), (m), (n), (o), and (p) as subsections (e) through
(o), respectively;
(4) by inserting after subsection (c), the following:
``(d) Training for Providers of Services to Children and
Families.--The Secretary may make a grant under subsection
(a) for the training of health, substance abuse and mental
health professionals and other providers of services to
children and families through youth service agencies, family
social services, child care providers, Head Start, schools
and after-school programs, early childhood development
programs, community-based family resource centers, the
criminal justice system, and other providers of services to
children and families. Such training shall be to assist
professionals in recognizing the drug and alcohol problems of
their clients and to enhance their skills in identifying and
understanding the nature of substance abuse, and obtaining
substance abuse early intervention, prevention and treatment
resources.'';
(5) in subsection (k)(2) (as so redesignated), by striking
``(h)'' and inserting ``(i)''; and
(6) in paragraphs (3)(E) and (5) of subsection (m) (as so
redesignated), by striking ``(d)'' and inserting ``(e)''.
(m) Transfer and Redesignation.--Section 399D of the Public
Health Service Act (42 U.S.C. 280d), as amended by this
section--
(1) is transferred to title V;
(2) is redesignated as section 519; and
(3) is inserted after section 518.
(n) Conforming Amendment.--Title III of the Public Health
Service Act (42 U.S.C. 241 et seq.) is amended by striking
the heading of part L.
SEC. 3107. SERVICES FOR YOUTH OFFENDERS.
Subpart 3 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb-31 et seq.), as amended by section
3104(b), is further amended by adding at the end the
following:
``SEC. 520D. SERVICES FOR YOUTH OFFENDERS.
``(a) In General.--The Secretary, acting through the
Director of the Center for Mental Health Services, and in
consultation with the Director of the Center for Substance
Abuse Treatment, the Administrator of the Office of Juvenile
Justice and Delinquency Prevention, and the Director of the
Special Education Programs, shall award grants on a
competitive basis to State or local juvenile justice agencies
to enable such agencies to provide aftercare services for
youth offenders who have been discharged from facilities in
the juvenile or criminal justice system and have serious
emotional disturbances or are at risk of developing such
disturbances.
``(b) Use of Funds.--A State or local juvenile justice
agency receiving a grant under subsection (a) shall use the
amounts provided under the grant--
``(1) to develop a plan describing the manner in which the
agency will provide services for each youth offender who has
a serious emotional disturbance and has been detained or
incarcerated in facilities within the juvenile or criminal
justice system;
``(2) to provide a network of core or aftercare services or
access to such services for each youth offender, including
diagnostic and evaluation services, substance abuse treatment
services, outpatient mental health care services, medication
management services, intensive home-based therapy, intensive
day treatment services, respite care, and therapeutic foster
care;
``(3) to establish a program that coordinates with other
State and local agencies providing recreational, social,
educational, vocational, or operational services for youth,
to enable the agency receiving a grant under this section to
provide community-based system of care services for each
youth offender that addresses the special needs of the youth
and helps the youth access all of the aforementioned
services; and
``(4) using not more than 20 percent of funds received, to
provide planning and transition services as described in
paragraph (3) for youth offenders while such youth are
incarcerated or detained.
``(c) Application.--A State or local juvenile justice
agency that desires a grant under subsection (a) shall submit
an application to the Secretary at such time, in such manner,
and accompanied by such information as the Secretary may
reasonably require.
``(d) Report.--Not later than 3 years after the date of
enactment of this section and annually
[[Page H8230]]
thereafter, the Secretary shall prepare and submit, to the
Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Commerce of the House of
Representatives, a report that describes the services
provided pursuant to this section.
``(e) Definitions.--In this section:
``(1) Serious emotional disturbance.--The term `serious
emotional disturbance' with respect to a youth offender means
an offender who currently, or at any time within the 1-year
period ending on the day on which services are sought under
this section, has a diagnosable mental, behavioral, or
emotional disorder that functionally impairs the offender's
life by substantially limiting the offender's role in family,
school, or community activities, and interfering with the
offender's ability to achieve or maintain 1 or more
developmentally-appropriate social, behavior, cognitive,
communicative, or adaptive skills.
``(2) Community-based system of care.--The term `community-
based system of care' means the provision of services for the
youth offender by various State or local agencies that in an
interagency fashion or operating as a network addresses the
recreational, social, educational, vocational, mental health,
substance abuse, and operational needs of the youth offender.
``(3) Youth offender.--The term `youth offender' means an
individual who is 21 years of age or younger who has been
discharged from a State or local juvenile or criminal justice
system, except that if the individual is between the ages of
18 and 21 years, such individual has had contact with the
State or local juvenile or criminal justice system prior to
attaining 18 years of age and is under the jurisdiction of
such a system at the time services are sought.
``(f) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section $40,000,000 for
fiscal year 2001, and such sums as may be necessary for each
of fiscal years 2002 and 2003.''.
SEC. 3108. GRANTS FOR STRENGTHENING FAMILIES THROUGH
COMMUNITY PARTNERSHIPS.
Subpart 2 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb-21 et seq) is amended by adding at the
end the following:
``SEC. 519A. GRANTS FOR STRENGTHENING FAMILIES.
``(a) Program Authorized.--The Secretary, acting through
the Director of the Prevention Center, may make grants to
public and nonprofit private entities to develop and
implement model substance abuse prevention programs to
provide early intervention and substance abuse prevention
services for individuals of high-risk families and the
communities in which such individuals reside.
``(b) Priority.--In awarding grants under subsection (a),
the Secretary shall give priority to applicants that--
``(1) have proven experience in preventing substance abuse
by individuals of high-risk families and reducing substance
abuse in communities of such individuals;
``(2) have demonstrated the capacity to implement
community-based partnership initiatives that are sensitive to
the diverse backgrounds of individuals of high-risk families
and the communities of such individuals;
``(3) have experience in providing technical assistance to
support substance abuse prevention programs that are
community-based;
``(4) have demonstrated the capacity to implement research-
based substance abuse prevention strategies; and
``(5) have implemented programs that involve families,
residents, community agencies, and institutions in the
implementation and design of such programs.
``(c) Duration of Grants.--The Secretary shall award grants
under subsection (a) for a period not to exceed 5 years.
``(d) Use of Funds.--An applicant that is awarded a grant
under subsection (a) shall--
``(1) in the first fiscal year that such funds are received
under the grant, use such funds to develop a model substance
abuse prevention program; and
``(2) in the fiscal year following the first fiscal year
that such funds are received, use such funds to implement the
program developed under paragraph (1) to provide early
intervention and substance abuse prevention services to--
``(A) strengthen the environment of children of high risk
families by targeting interventions at the families of such
children and the communities in which such children reside;
``(B) strengthen protective factors, such as--
``(i) positive adult role models;
``(ii) messages that oppose substance abuse;
``(iii) community actions designed to reduce accessibility
to and use of illegal substances; and
``(iv) willingness of individuals of families in which
substance abuse occurs to seek treatment for substance abuse;
``(C) reduce family and community risks, such as family
violence, alcohol or drug abuse, crime, and other behaviors
that may effect healthy child development and increase the
likelihood of substance abuse; and
``(D) build collaborative and formal partnerships between
community agencies, institutions, and businesses to ensure
that comprehensive high quality services are provided, such
as early childhood education, health care, family support
programs, parent education programs, and home visits for
infants.
``(e) Application.--To be eligible to receive a grant under
subsection (a), an applicant shall prepare and submit to the
Secretary an application that--
``(1) describes a model substance abuse prevention program
that such applicant will establish;
``(2) describes the manner in which the services described
in subsection (d)(2) will be provided; and
``(3) describe in as much detail as possible the results
that the entity expects to achieve in implementing such a
program.
``(f) Matching Funding.--The Secretary may not make a grant
to a entity under subsection (a) unless that entity agrees
that, with respect to the costs to be incurred by the entity
in carrying out the program for which the grant was awarded,
the entity will make available non-Federal contributions in
an amount that is not less than 40 percent of the amount
provided under the grant.
``(g) Report to Secretary.--An applicant that is awarded a
grant under subsection (a) shall prepare and submit to the
Secretary a report in such form and containing such
information as the Secretary may require, including an
assessment of the efficacy of the model substance abuse
prevention program implemented by the applicant and the
short, intermediate, and long term results of such program.
``(h) Evaluations.--The Secretary shall conduct
evaluations, based in part on the reports submitted under
subsection (g), to determine the effectiveness of the
programs funded under subsection (a) in reducing substance
use in high-risk families and in making communities in which
such families reside in stronger. The Secretary shall submit
such evaluations to the appropriate committees of Congress.
``(i) High-Risk Families.--In this section, the term `high-
risk family' means a family in which the individuals of such
family are at a significant risk of using or abusing alcohol
or any illegal substance.
``(j) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section, $3,000,000 for
fiscal year 2001, and such sums as may be necessary for each
of the fiscal years 2002 and 2003.''.
SEC. 3109. PROGRAMS TO REDUCE UNDERAGE DRINKING.
Subpart 2 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb-21 et seq), as amended by section 3108,
is further amended by adding at the end the following:
``SEC. 519B. PROGRAMS TO REDUCE UNDERAGE DRINKING.
``(a) In General.--The Secretary shall make awards of
grants, cooperative agreements, or contracts to public and
nonprofit private entities, including Indian tribes and
tribal organizations, to enable such entities to develop
plans for and to carry out school-based (including
institutions of higher education) and community-based
programs for the prevention of alcoholic-beverage consumption
by individuals who have not attained the legal drinking age.
``(b) Eligibility Requirements.--To be eligible to receive
an award under subsection (a), an entity shall provide any
assurances to the Secretary which the Secretary may require,
including that the entity will--
``(1) annually report to the Secretary on the effectiveness
of the prevention approaches implemented by the entity;
``(2) use science based and age appropriate approaches; and
``(3) involve local public health officials and community
prevention program staff in the planning and implementation
of the program.
``(c) Evaluation.--The Secretary shall evaluate each
project under subsection (a) and shall disseminate the
findings with respect to each such evaluation to appropriate
public and private entities.
``(d) Geographical Distribution.--The Secretary shall
ensure that awards will be distributed equitably among the
regions of the country and among urban and rural areas.
``(e) Duration of Award.--With respect to an award under
subsection (a), the period during which payments under such
award are made to the recipient may not exceed 5 years. The
preceding sentence may not be construed as establishing a
limitation on the number of awards under such subsection that
may be made to the recipient.
``(f) Authorization of Appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated $25,000,000 for fiscal year 2001, and such sums
as may be necessary for each of the fiscal years 2002 and
2003.''.
SEC. 3110. SERVICES FOR INDIVIDUALS WITH FETAL ALCOHOL
SYNDROME.
Subpart 2 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb-21 et seq), as amended by sections 3108
and 3109, is further amended by adding at the end the
following:
``SEC. 519C. SERVICES FOR INDIVIDUALS WITH FETAL ALCOHOL
SYNDROME.
``(a) In General.--The Secretary shall make awards of
grants, cooperative agreements, or contracts to public and
nonprofit private entities, including Indian tribes and
tribal organizations, to provide services to individuals
diagnosed with fetal alcohol syndrome or alcohol-related
birth defects.
``(b) Use of Funds.--An award under subsection (a) may,
subject to subsection (d), be used to--
``(1) screen and test individuals to determine the type and
level of services needed;
``(2) develop a comprehensive plan for providing services
to the individual;
``(3) provide mental health counseling;
``(4) provide substance abuse prevention services and
treatment, if needed;
``(5) coordinate services with other social programs
including social services, justice system, educational
services, health services, mental health and substance abuse
services, financial assistance programs, vocational services
and housing assistance programs;
``(6) provide vocational services;
``(7) provide health counseling;
``(8) provide housing assistance;
``(9) parenting skills training;
``(10) overall case management;
``(11) supportive services for families of individuals with
Fetal Alcohol Syndrome; and
[[Page H8231]]
``(12) provide other services and programs, to the extent
authorized by the Secretary after consideration of
recommendations made by the National Task Force on Fetal
Alcohol Syndrome.
``(c) Requirements.--To be eligible to receive an award
under subsection (a), an applicant shall--
``(1) demonstrate that the program will be part of a
coordinated, comprehensive system of care for such
individuals;
``(2) demonstrate an established communication with other
social programs in the community including social services,
justice system, financial assistance programs, health
services, educational services, mental health and substance
abuse services, vocational services and housing assistance
services;
``(3) show a history of working with individuals with fetal
alcohol syndrome or alcohol-related birth defects;
``(4) provide assurance that the services will be provided
in a culturally and linguistically appropriate manner; and
``(5) provide assurance that at the end of the 5-year award
period, other mechanisms will be identified to meet the needs
of the individuals and families served under such award.
``(d) Relationship to Payments Under Other Programs.--An
award may be made under subsection (a) only if the applicant
involved agrees that the award will not be expended to pay
the expenses of providing any service under this section to
an individual to the extent that payment has been made, or
can reasonably be expected to be made, with respect to such
expenses--
``(1) under any State compensation program, under an
insurance policy, or under any Federal or State health
benefits program; or
``(2) by an entity that provides health services on a
prepaid basis.
``(e) Duration of Awards.--With respect to an award under
subsection (a), the period during which payments under such
award are made to the recipient may not exceed 5 years.
``(f) Evaluation.--The Secretary shall evaluate each
project carried out under subsection (a) and shall
disseminate the findings with respect to each such evaluation
to appropriate public and private entities.
``(g) Funding.--
``(1) Authorization of appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated $25,000,000 for fiscal year 2001, and such sums
as may be necessary for each of the fiscal years 2002 and
2003.
``(2) Allocation.--Of the amounts appropriated under
paragraph (1) for a fiscal year, not less than $300,000
shall, for purposes relating to fetal alcohol syndrome and
alcohol-related birth defects, be made available for
collaborative, coordinated interagency efforts with the
National Institute on Alcohol Abuse and Alcoholism, the
National Institute on Child Health and Human Development, the
Health Resources and Services Administration, the Agency for
Healthcare Research and Quality, the Centers for Disease
Control and Prevention, the Department of Education, and the
Department of Justice.
``SEC. 519D. CENTERS OF EXCELLENCE ON SERVICES FOR
INDIVIDUALS WITH FETAL ALCOHOL SYNDROME AND
ALCOHOL-RELATED BIRTH DEFECTS AND TREATMENT FOR
INDIVIDUALS WITH SUCH CONDITIONS AND THEIR
FAMILIES.
``(a) In General.--The Secretary shall make awards of
grants, cooperative agreements, or contracts to public or
nonprofit private entities for the purposes of establishing
not more than 4 centers of excellence to study techniques for
the prevention of fetal alcohol syndrome and alcohol-related
birth defects and adaptations of innovative clinical
interventions and service delivery improvements for the
provision of comprehensive services to individuals with fetal
alcohol syndrome or alcohol-related birth defects and their
families and for providing training on such conditions.
``(b) Use of Funds.--An award under subsection (a) may be
used to--
``(1) study adaptations of innovative clinical
interventions and service delivery improvements strategies
for children and adults with fetal alcohol syndrome or
alcohol-related birth defects and their families;
``(2) identify communities which have an exemplary
comprehensive system of care for such individuals so that
they can provide technical assistance to other communities
attempting to set up such a system of care;
``(3) provide technical assistance to communities who do
not have a comprehensive system of care for such individuals
and their families;
``(4) train community leaders, mental health and substance
abuse professionals, families, law enforcement personnel,
judges, health professionals, persons working in financial
assistance programs, social service personnel, child welfare
professionals, and other service providers on the
implications of fetal alcohol syndrome and alcohol-related
birth defects, the early identification of and referral for
such conditions;
``(5) develop innovative techniques for preventing alcohol
use by women in child bearing years;
``(6) perform other functions, to the extent authorized by
the Secretary after consideration of recommendations made by
the National Task Force on Fetal Alcohol Syndrome.
``(c) Report.--
``(1) In general.--A recipient of an award under subsection
(a) shall at the end of the period of funding report to the
Secretary on any innovative techniques that have been
discovered for preventing alcohol use among women of child
bearing years.
``(2) Dissemination of findings.--The Secretary shall upon
receiving a report under paragraph (1) disseminate the
findings to appropriate public and private entities.
``(d) Duration of Awards.--With respect to an award under
subsection (a), the period during which payments under such
award are made to the recipient may not exceed 5 years.
``(e) Evaluation.--The Secretary shall evaluate each
project carried out under subsection (a) and shall
disseminate the findings with respect to each such evaluation
to appropriate public and private entities.
``(f) Authorization of Appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated $5,000,000 for fiscal year 2001, and such sums
as may be necessary for each of the fiscal years 2002 and
2003.''.
SEC. 3111. SUICIDE PREVENTION.
Subpart 3 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb-31 et seq), as amended by section 3107,
is further amended by adding at the end the following:
``SEC. 520E. SUICIDE PREVENTION FOR CHILDREN AND ADOLESCENTS.
``(a) In General.--The Secretary shall award grants,
contracts, or cooperative agreements to States, political
subdivisions of States, Indian tribes, tribal organizations,
public organizations, or private nonprofit organizations to
establish programs to reduce suicide deaths in the United
States among children and adolescents.
``(b) Collaboration.--In carrying out subsection (a), the
Secretary shall ensure that activities under this section are
coordinated among the Substance Abuse and Mental Health
Services Administration, the relevant institutes at the
National Institutes of Health, the Centers for Disease
Control and Prevention, the Health Resources and Services
Administration, and the Administration on Children and
Families.
``(c) Requirements.--A State, political subdivision of a
State, Indian tribe, tribal organization, public
organization, or private nonprofit organization desiring a
grant, contract, or cooperative agreement under this section
shall demonstrate that the suicide prevention program such
entity proposes will--
``(1) provide for the timely assessment, treatment, or
referral for mental health or substance abuse services of
children and adolescents at risk for suicide;
``(2) be based on best evidence-based, suicide prevention
practices and strategies that are adapted to the local
community;
``(3) integrate its suicide prevention program into the
existing health care system in the community including
primary health care, mental health services, and substance
abuse services;
``(4) be integrated into other systems in the community
that address the needs of children and adolescents including
the educational system, juvenile justice system, welfare and
child protection systems, and community youth support
organizations;
``(5) use primary prevention methods to educate and raise
awareness in the local community by disseminating evidence-
based information about suicide prevention;
``(6) include suicide prevention, mental health, and
related information and services for the families and friends
of those who completed suicide, as needed;
``(7) provide linguistically appropriate and culturally
competent services, as needed;
``(8) provide a plan for the evaluation of outcomes and
activities at the local level, according to standards
established by the Secretary, and agree to participate in a
national evaluation; and
``(9) ensure that staff used in the program are trained in
suicide prevention and that professionals involved in the
system of care have received training in identifying persons
at risk of suicide.
``(d) Use of Funds.--Amounts provided under grants,
contracts, or cooperative agreements under subsection (a)
shall be used to supplement and not supplant other Federal,
State, and local public funds that are expended to provide
services for eligible individuals.
``(e) Condition.--An applicant for a grant, contract, or
cooperative agreement under subsection (a) shall demonstrate
to the Secretary that the applicant has the support of the
local community and relevant public health officials.
``(f) Special Populations.--In awarding grants, contracts,
and cooperative agreements under subsection (a), the
Secretary shall ensure that such awards are made in a manner
that will focus on the needs of communities or groups that
experience high or rapidly rising rates of suicide.
``(g) Application.--A State, political subdivision of a
State, Indian tribe, tribal organization, public
organization, or private nonprofit organization receiving a
grant, contract, or cooperative agreement under subsection
(a) shall prepare and submit an application to the Secretary
at such time, in such manner, and containing such information
as the Secretary may reasonably require. Such application
shall include a plan for the rigorous evaluation of
activities funded under the grant, contract, or cooperative
agreement, including a process and outcome evaluation.
``(h) Distribution of Awards.--In awarding grants,
contracts, and cooperative agreements under subsection (a),
the Secretary shall ensure that such awards are distributed
among the geographical regions of the United States and
between urban and rural settings.
``(i) Evaluation.--A State, political subdivision of a
State, Indian tribe, tribal organization, public
organization, or private nonprofit organization receiving a
grant, contract, or cooperative agreement under subsection
(a) shall prepare and submit to the Secretary at the end of
the program period, an evaluation of all activities funded
under this section.
``(j) Dissemination and Education.--The Secretary shall
ensure that findings derived
[[Page H8232]]
from activities carried out under this section are
disseminated to State, county and local governmental agencies
and public and private nonprofit organizations active in
promoting suicide prevention and family support activities.
``(k) Duration of Projects.--With respect to a grant,
contract, or cooperative agreement awarded under this
section, the period during which payments under such award
may be made to the recipient may not exceed 5 years.
``(l) Study.--Within 1 year after the date of enactment of
this section, the Secretary shall, directly or by grant or
contract, initiate a study to assemble and analyze data to
identify--
``(1) unique profiles of children under 13 who attempt or
complete suicide;
``(2) unique profiles of youths between ages 13 and 21 who
attempt or complete suicide; and
``(3) a profile of services which might have been available
to these groups and the use of these services by children and
youths from paragraphs (1) and (2).
``(m) Authorization of Appropriation.--
``(1) In general.--For purposes of carrying out this
section, there is authorized to be appropriated $75,000,000
for fiscal year 2001 and such sums as may be necessary for
each of the fiscal years 2002 through 2003.
``(2) Program management.--In carrying out this section,
the Secretary shall use 1 percent of the amount appropriated
under paragraph (1) for each fiscal year for managing
programs under this section.''.
SEC. 3112. GENERAL PROVISIONS.
(a) Duties of the Center for Substance Abuse Treatment.--
Section 507(b) of the Public Health Service Act (42 U.S.C.
290bb(b)) is amended--
(1) by redesignating paragraphs (2) through (12) as
paragraphs (4) through (14), respectively;
(2) by inserting after paragraph (1), the following:
``(2) ensure that emphasis is placed on children and
adolescents in the development of treatment programs;
``(3) collaborate with the Attorney General to develop
programs to provide substance abuse treatment services to
individuals who have had contact with the Justice system,
especially adolescents;'';
(3) in paragraph (7) (as so redesignated), by striking
``services, and monitor'' and all that follows through
``1925'' and inserting ``services'';
(4) in paragraph (13) (as so redesignated), by striking
``treatment, including'' and all that follows through ``which
shall'' and inserting ``treatment, which shall''; and
(5) in paragraph 14 (as so redesignated), by striking
``paragraph (11)'' and inserting ``paragraph (13)''.
(b) Office for Substance Abuse Prevention.--Section 515(b)
of the Public Health Service Act (42 U.S.C. 290bb-21(b)) is
amended--
(1) by redesignating paragraphs (9) and (10) as (10) and
(11);
(2) by inserting after paragraph (8), the following:
``(9) collaborate with the Attorney General of the
Department of Justice to develop programs to prevent drug
abuse among high risk youth;''; and
(3) in paragraph (10) (as so redesignated), by striking
``public concerning'' and inserting ``public, especially
adolescent audiences, concerning''.
(c) Duties of the Center for Mental Health Services.--
Section 520(b) of the Public Health Service Act (42 U.S.C.
290bb-3(b)) is amended--
(1) by redesignating paragraphs (3) through (14) as
paragraphs (4) through (15), respectively;
(2) by inserting after paragraph (2), the following:
``(3) collaborate with the Department of Education and the
Department of Justice to develop programs to assist local
communities in addressing violence among children and
adolescents;'';
(3) in paragraph (8) (as so redesignated), by striking
``programs authorized'' and all that follows through
``Programs'' and inserting ``programs under part C''; and
(4) in paragraph (9) (as so redesignated), by striking
``program and programs'' and all that follows through ``303''
and inserting ``programs''.
TITLE XXXII--PROVISIONS RELATING TO MENTAL HEALTH
SEC. 3201. PRIORITY MENTAL HEALTH NEEDS OF REGIONAL AND
NATIONAL SIGNIFICANCE.
(a) In General.--Section 520A of the Public Health Service
Act (42 U.S.C. 290bb-32) is amended to read as follows:
``SEC. 520A. PRIORITY MENTAL HEALTH NEEDS OF REGIONAL AND
NATIONAL SIGNIFICANCE.
``(a) Projects.--The Secretary shall address priority
mental health needs of regional and national significance (as
determined under subsection (b)) through the provision of or
through assistance for--
``(1) knowledge development and application projects for
prevention, treatment, and rehabilitation, and the conduct or
support of evaluations of such projects;
``(2) training and technical assistance programs;
``(3) targeted capacity response programs; and
``(4) systems change grants including statewide family
network grants and client-oriented and consumer run self-help
activities.
The Secretary may carry out the activities described in this
subsection directly or through grants or cooperative
agreements with States, political subdivisions of States,
Indian tribes and tribal organizations, other public or
private nonprofit entities.
``(b) Priority Mental Health Needs.--
``(1) Determination of needs.--Priority mental health needs
of regional and national significance shall be determined by
the Secretary in consultation with States and other
interested groups. The Secretary shall meet with the States
and interested groups on an annual basis to discuss program
priorities.
``(2) Special consideration.--In developing program
priorities described in paragraph (1), the Secretary shall
give special consideration to promoting the integration of
mental health services into primary health care systems.
``(c) Requirements.--
``(1) In general.--Recipients of grants, contracts, and
cooperative agreements under this section shall comply with
information and application requirements determined
appropriate by the Secretary.
``(2) Duration of award.--With respect to a grant,
contract, or cooperative agreement awarded under this
section, the period during which payments under such award
are made to the recipient may not exceed 5 years.
``(3) Matching funds.--The Secretary may, for projects
carried out under subsection (a), require that entities that
apply for grants, contracts, or cooperative agreements under
this section provide non-Federal matching funds, as
determined appropriate by the Secretary, to ensure the
institutional commitment of the entity to the projects funded
under the grant, contract, or cooperative agreement. Such
non-Federal matching funds may be provided directly or
through donations from public or private entities and may be
in cash or in kind, fairly evaluated, including plant,
equipment, or services.
``(4) Maintenance of effort.--With respect to activities
for which a grant, contract or cooperative agreement is
awarded under this section, the Secretary may require that
recipients for specific projects under subsection (a) agree
to maintain expenditures of non-Federal amounts for such
activities at a level that is not less than the level of such
expenditures maintained by the entity for the fiscal year
preceding the fiscal year for which the entity receives such
a grant, contract, or cooperative agreement.
``(d) Evaluation.--The Secretary shall evaluate each
project carried out under subsection (a)(1) and shall
disseminate the findings with respect to each such evaluation
to appropriate public and private entities.
``(e) Information and Education.--
``(1) In general.--The Secretary shall establish
information and education programs to disseminate and apply
the findings of the knowledge development and application,
training, and technical assistance programs, and targeted
capacity response programs, under this section to the general
public, to health care professionals, and to interested
groups. The Secretary shall make every effort to provide
linkages between the findings of supported projects and State
agencies responsible for carrying out mental health services.
``(2) Rural and underserved areas.--In disseminating
information on evidence-based practices in the provision of
children's mental health services under this subsection, the
Secretary shall ensure that such information is distributed
to rural and medically underserved areas.
``(f) Authorization of Appropriation.--
``(1) In general.--There are authorized to be appropriated
to carry out this section, $300,000,000 for fiscal year 2001,
and such sums as may be necessary for each of the fiscal
years 2002 and 2003.
``(2) Data infrastructure.--If amounts are not appropriated
for a fiscal year to carry out section 1971 with respect to
mental health, then the Secretary shall make available, from
the amounts appropriated for such fiscal year under paragraph
(1), an amount equal to the sum of $6,000,000 and 10 percent
of all amounts appropriated for such fiscal year under such
paragraph in excess of $100,000,000, to carry out such
section 1971.''.
(b) Conforming Amendments.--
(1) Section 303 of the Public Health Service Act (42 U.S.C.
242a) is repealed.
(2) Section 520B of the Public Health Service Act (42
U.S.C. 290bb-33) is repealed.
(3) Section 612 of the Stewart B. McKinney Homeless
Assistance Act (42 U.S.C. 290aa-3 note) is repealed.
SEC. 3202. GRANTS FOR THE BENEFIT OF HOMELESS INDIVIDUALS.
Section 506 of the Public Health Service Act (42 U.S.C.
290aa-5) is amended to read as follows:
``SEC. 506. GRANTS FOR THE BENEFIT OF HOMELESS INDIVIDUALS.
``(a) In General.--The Secretary shall award grants,
contracts and cooperative agreements to community-based
public and private nonprofit entities for the purposes of
providing mental health and substance abuse services for
homeless individuals. In carrying out this section, the
Secretary shall consult with the Interagency Council on the
Homeless, established under section 201 of the Stewart B.
McKinney Homeless Assistance Act (42 U.S.C. 11311).
``(b) Preferences.--In awarding grants, contracts, and
cooperative agreements under subsection (a), the Secretary
shall give a preference to--
``(1) entities that provide integrated primary health,
substance abuse, and mental health services to homeless
individuals;
``(2) entities that demonstrate effectiveness in serving
runaway, homeless, and street youth;
``(3) entities that have experience in providing substance
abuse and mental health services to homeless individuals;
``(4) entities that demonstrate experience in providing
housing for individuals in treatment for or in recovery from
mental illness or substance abuse; and
``(5) entities that demonstrate effectiveness in serving
homeless veterans.
``(c) Services for Certain Individuals.--In awarding
grants, contracts, and cooperative agreements under
subsection (a), the Secretary shall not--
[[Page H8233]]
``(1) prohibit the provision of services under such
subsection to homeless individuals who are suffering from a
substance abuse disorder and are not suffering from a mental
health disorder; and
``(2) make payments under subsection (a) to any entity that
has a policy of--
``(A) excluding individuals from mental health services due
to the existence or suspicion of substance abuse; or
``(B) has a policy of excluding individuals from substance
abuse services due to the existence or suspicion of mental
illness.
``(d) Term of the Awards.--No entity may receive a grant,
contract, or cooperative agreement under subsection (a) for
more than 5 years.
``(e) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section, $50,000,000 for
fiscal year 2001, and such sums as may be necessary for each
of the fiscal years 2002 and 2003.''.
SEC. 3203. PROJECTS FOR ASSISTANCE IN TRANSITION FROM
HOMELESSNESS.
(a) Waivers for Territories.--Section 522 of the Public
Health Service Act (42 U.S.C. 290cc-22) is amended by adding
at the end the following:
``(i) Waiver for Territories.--With respect to the United
States Virgin Islands, Guam, American Samoa, Palau, the
Marshall Islands, and the Commonwealth of the Northern
Mariana Islands, the Secretary may waive the provisions of
this part that the Secretary determines to be appropriate.''.
(b) Authorization of Appropriation.--Section 535(a) of the
Public Health Service Act (42 U.S.C. 290cc-35(a)) is amended
by striking ``1991 through 1994'' and inserting ``2001
through 2003''.
SEC. 3204. COMMUNITY MENTAL HEALTH SERVICES PERFORMANCE
PARTNERSHIP BLOCK GRANT.
(a) Criteria for Plan.--Section 1912(b) of the Public
Health Service Act (42 U.S.C. 300x-2(b)) is amended by
striking paragraphs (1) through (12) and inserting the
following:
``(1) Comprehensive community-based mental health
systems.--The plan provides for an organized community-based
system of care for individuals with mental illness and
describes available services and resources in a
comprehensive system of care, including services for
dually diagnosed individuals. The description of the
system of care shall include health and mental health
services, rehabilitation services, employment services,
housing services, educational services, substance abuse
services, medical and dental care, and other support
services to be provided to individuals with Federal, State
and local public and private resources to enable such
individuals to function outside of inpatient or
residential institutions to the maximum extent of their
capabilities, including services to be provided by local
school systems under the Individuals with Disabilities
Education Act. The plan shall include a separate
description of case management services and provide for
activities leading to reduction of hospitalization.
``(2) Mental health system data and epidemiology.--The plan
contains an estimate of the incidence and prevalence in the
State of serious mental illness among adults and serious
emotional disturbance among children and presents
quantitative targets to be achieved in the implementation of
the system described in paragraph (1).
``(3) Children's services.--In the case of children with
serious emotional disturbance, the plan--
``(A) subject to subparagraph (B), provides for a system of
integrated social services, educational services, juvenile
services, and substance abuse services that, together with
health and mental health services, will be provided in order
for such children to receive care appropriate for their
multiple needs (such system to include services provided
under the Individuals with Disabilities Education Act);
``(B) provides that the grant under section 1911 for the
fiscal year involved will not be expended to provide any
service under such system other than comprehensive community
mental health services; and
``(C) provides for the establishment of a defined
geographic area for the provision of the services of such
system.
``(4) Targeted services to rural and homeless
populations.--The plan describes the State's outreach to and
services for individuals who are homeless and how community-
based services will be provided to individuals residing in
rural areas.
``(5) Management systems.--The plan describes the financial
resources, staffing and training for mental health providers
that is necessary to implement the plan, and provides for the
training of providers of emergency health services regarding
mental health. The plan further describes the manner in which
the State intends to expend the grant under section 1911 for
the fiscal year involved.
Except as provided for in paragraph (3), the State plan shall
contain the information required under this subsection with
respect to both adults with serious mental illness and
children with serious emotional disturbance.''.
(b) Review of Planning Council of State's Report.--Section
1915(a) of the Public Health Service Act (42 U.S.C. 300x-
4(a)) is amended--
(1) in paragraph (1), by inserting ``and the report of the
State under section 1942(a) concerning the preceding fiscal
year'' after ``to the grant''; and
(2) in paragraph (2), by inserting before the period ``and
any comments concerning the annual report''.
(c) Maintenance of Effort.--Section 1915(b) of the Public
Health Service Act (42 U.S.C. 300x-4(b)) is amended--
(1) by redesignating paragraphs (2) and (3) as paragraphs
(3) and (4), respectively; and
(2) by inserting after paragraph (1), the following:
``(2) Exclusion of certain funds.--The Secretary may
exclude from the aggregate State expenditures under
subsection (a), funds appropriated to the principle agency
for authorized activities which are of a non-recurring nature
and for a specific purpose.''.
(d) Application for Grants.--Section 1917(a)(1) of the
Public Health Service Act (42 U.S.C. 300x-6(a)(1)) is amended
to read as follows:
``(1) the plan is received by the Secretary not later than
September 1 of the fiscal year prior to the fiscal year for
which a State is seeking funds, and the report from the
previous fiscal year as required under section 1941 is
received by December 1 of the fiscal year of the grant;''.
(e) Waivers for Territories.--Section 1917(b) of the Public
Health Service Act (42 U.S.C. 300x-6(b)) is amended by
striking ``whose allotment under section 1911 for the fiscal
year is the amount specified in section 1918(c)(2)(B)'' and
inserting in its place ``except Puerto Rico''.
(f) Authorization of Appropriation.--Section 1920 of the
Public Health Service Act (42 U.S.C. 300x-9) is amended--
(1) in subsection (a), by striking ``$450,000,000'' and all
that follows through the end and inserting ``$450,000,000 for
fiscal year 2001, and such sums as may be necessary for each
of the fiscal years 2002 and 2003.''; and
(2) in subsection (b)(2), by striking ``section 505'' and
inserting ``sections 505 and 1971''.
SEC. 3205. DETERMINATION OF ALLOTMENT.
Section 1918(b) of the Public Health Service Act (42 U.S.C.
300x-7(b)) is amended to read as follows:
``(b) Minimum Allotments for States.--With respect to
fiscal year 2000, and subsequent fiscal years, the amount of
the allotment of a State under section 1911 shall not be less
than the amount the State received under such section for
fiscal year 1998.''.
SEC. 3206. PROTECTION AND ADVOCACY FOR MENTALLY ILL
INDIVIDUALS ACT OF 1986.
(a) Short Title.--The first section of the Protection and
Advocacy for Mentally Ill Individuals Act of 1986 (Public Law
99-319) is amended to read as follows:
``SECTION 1. SHORT TITLE.
``This Act may be cited as the `Protection and Advocacy for
Individuals with Mental Illness Act'.''.
(b) Definitions.--Section 102 of the Protection and
Advocacy for Individuals with Mental Illness Act (as amended
by subsection (a)) (42 U.S.C. 10802) is amended--
(1) in paragraph (4)--
(A) in the matter preceding subparagraph (A), by inserting
``, except as provided in section 104(d),'' after ``means'';
(B) in subparagraph (B)--
(i) by striking ``(i)'' who'' and inserting ``(i)(I) who'';
(ii) by redesignating clauses (ii) and (iii) as subclauses
(II) and (III);
(iii) in subclause (III) (as so redesignated), by striking
the period and inserting ``; or''; and
(iv) by adding at the end the following:
``(ii) who satisfies the requirements of subparagraph (A)
and lives in a community setting, including their own
home.''; and
(2) by adding at the end the following:
``(8) The term `American Indian consortium' means a
consortium established under part C of the Developmental
Disabilities Assistance and Bill of Rights Act (42 U.S.C.
6042 et seq.).''.
(c) Use of Allotments.--Section 104 of the Protection and
Advocacy for Individuals with Mental Illness Act (as amended
by subsection (a)) (42 U.S.C. 10804) is amended by adding at
the end the following:
``(d) The definition of `individual with a mental illness'
contained in section 102(4)(B)(iii) shall apply, and thus an
eligible system may use its allotment under this title to
provide representation to such individuals, only if the total
allotment under this title for any fiscal year is $30,000,000
or more, and in such case, an eligible system must give
priority to representing persons with mental illness as
defined in subparagraphs (A) and (B)(i) of section 102(4).''.
(d) Minimum Amount.--Paragraph (2) of section 112(a) of the
Protection and Advocacy for Individuals with Mental Illness
Act (as amended by subsection (a)) (42 U.S.C. 10822(a)(2)) is
amended to read as follows:
``(2)(A) The minimum amount of the allotment of an eligible
system shall be the product (rounded to the nearest $100) of
the appropriate base amount determined under subparagraph (B)
and the factor specified in subparagraph (C).
``(B) For purposes of subparagraph (A), the appropriate
base amount--
``(i) for American Samoa, Guam, the Marshall Islands, the
Federated States of Micronesia, the Commonwealth of the
Northern Mariana Islands, the Republic of Palau, and the
Virgin Islands, is $139,300; and
``(ii) for any other State, is $260,000.
``(C) The factor specified in this subparagraph is the
ratio of the amount appropriated under section 117 for the
fiscal year for which the allotment is being made to the
amount appropriated under such section for fiscal year 1995.
``(D) If the total amount appropriated for a fiscal year is
at least $25,000,000, the Secretary shall make an allotment
in accordance with subparagraph (A) to the eligible system
serving the American Indian consortium.''.
(e) Technical Amendments.--Section 112(a) of the Protection
and Advocacy for Individuals with Mental Illness Act (as
amended by subsection (a)) (42 U.S.C. 10822(a)) is amended--
(1) in paragraph (1)(B), by striking ``Trust Territory of
the Pacific Islands'' and inserting ``Marshall Islands, the
Federated States of Micronesia, the Republic of Palau''; and
(2) by striking paragraph (3).
[[Page H8234]]
(f) Reauthorization.--Section 117 of the Protection and
Advocacy for Individuals with Mental Illness Act (as amended
by subsection (a)) (42 U.S.C. 10827) is amended by striking
``1995'' and inserting ``2003''.
SEC. 3207. REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF
CERTAIN FACILITIES.
Title V of the Public Health Service Act (42 U.S.C. 290aa
et seq.) is amended by adding at the end the following:
``PART H--REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN
FACILITIES
``SEC. 591. REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS
OF CERTAIN FACILITIES.
``(a) In General.--A public or private general hospital,
nursing facility, intermediate care facility, or other health
care facility, that receives support in any form from any
program supported in whole or in part with funds appropriated
to any Federal department or agency shall protect and promote
the rights of each resident of the facility, including the
right to be free from physical or mental abuse, corporal
punishment, and any restraints or involuntary seclusions
imposed for purposes of discipline or convenience.
``(b) Requirements.--Restraints and seclusion may only be
imposed on a resident of a facility described in subsection
(a) if--
``(1) the restraints or seclusion are imposed to ensure the
physical safety of the resident, a staff member, or others;
and
``(2) the restraints or seclusion are imposed only upon the
written order of a physician, or other licensed practitioner
permitted by the State and the facility to order such
restraint or seclusion, that specifies the duration and
circumstances under which the restraints are to be used
(except in emergency circumstances specified by the Secretary
until such an order could reasonably be obtained).
``(c) Current Law.--This part shall not be construed to
affect or impede any Federal or State law or regulations that
provide greater protections than this part regarding
seclusion and restraint.
``(d) Definitions.--In this section:
``(1) Restraints.--The term `restraints' means--
``(A) any physical restraint that is a mechanical or
personal restriction that immobilizes or reduces the ability
of an individual to move his or her arms, legs, or head
freely, not including devices, such as orthopedically
prescribed devices, surgical dressings or bandages,
protective helmets, or any other methods that involves the
physical holding of a resident for the purpose of conducting
routine physical examinations or tests or to protect the
resident from falling out of bed or to permit the resident to
participate in activities without the risk of physical harm
to the resident (such term does not include a physical
escort); and
``(B) a drug or medication that is used as a restraint to
control behavior or restrict the resident's freedom of
movement that is not a standard treatment for the resident's
medical or psychiatric condition.
``(2) Seclusion.--The term `seclusion' means a behavior
control technique involving locked isolation. Such term does
not include a time out.
``(3) Physical escort.--The term `physical escort' means
the temporary touching or holding of the hand, wrist, arm,
shoulder or back for the purpose of inducing a resident who
is acting out to walk to a safe location.
``(4) Time out.--The term `time out' means a behavior
management technique that is part of an approved treatment
program and may involve the separation of the resident from
the group, in a non-locked setting, for the purpose of
calming. Time out is not seclusion.
``SEC. 592. REPORTING REQUIREMENT.
``(a) In General.-- Each facility to which the Protection
and Advocacy for Mentally Ill Individuals Act of 1986 applies
shall notify the appropriate agency, as determined by the
Secretary, of each death that occurs at each such facility
while a patient is restrained or in seclusion, of each death
occurring within 24 hours after the patient has been removed
from restraints and seclusion, or where it is reasonable to
assume that a patient's death is a result of such seclusion
or restraint. A notification under this section shall include
the name of the resident and shall be provided not later than
7 days after the date of the death of the individual
involved.
``(b) Facility.--In this section, the term `facility' has
the meaning given the term `facilities' in section 102(3) of
the Protection and Advocacy for Mentally Ill Individuals Act
of 1986 (42 U.S.C. 10802(3)).''.
``SEC. 593. REGULATIONS AND ENFORCEMENT.
``(a) Training.--Not later than 1 year after the date of
enactment of this part, the Secretary, after consultation
with appropriate State and local protection and advocacy
organizations, physicians, facilities, and other health care
professionals and patients, shall promulgate regulations that
require facilities to which the Protection and Advocacy for
Mentally Ill Individuals Act of 1986 (42 U.S.C. 10801 et
seq.) applies, to meet the requirements of subsection (b).
``(b) Requirements.--The regulations promulgated under
subsection (a) shall require that--
``(1) facilities described in subsection (a) ensure that
there is an adequate number of qualified professional and
supportive staff to evaluate patients, formulate written
individualized, comprehensive treatment plans, and to provide
active treatment measures;
``(2) appropriate training be provided for the staff of
such facilities in the use of restraints and any alternatives
to the use of restraints; and
``(3) such facilities provide complete and accurate
notification of deaths, as required under section 592(a).
``(c) Enforcement.--A facility to which this part applies
that fails to comply with any requirement of this part,
including a failure to provide appropriate training, shall
not be eligible for participation in any program supported in
whole or in part by funds appropriated to any Federal
department or agency.''.
SEC. 3208. REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF
CERTAIN NON-MEDICAL, COMMUNITY-BASED FACILITIES
FOR CHILDREN AND YOUTH.
Title V of the Public Health Service Act (42 U.S.C. 290aa
et seq.), as amended by section 3207, is further amended by
adding at the end the following:
``PART I--REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN
NON-MEDICAL, COMMUNITY-BASED FACILITIES FOR CHILDREN AND YOUTH
``SEC. 595. REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS
OF CERTAIN NON-MEDICAL, COMMUNITY-BASED
FACILITIES FOR CHILDREN AND YOUTH.
``(a) Protection of Rights.--
``(1) In general.--A public or private non-medical,
community-based facility for children and youth (as defined
in regulations to be promulgated by the Secretary) that
receives support in any form from any program supported in
whole or in part with funds appropriated under this Act shall
protect and promote the rights of each resident of the
facility, including the right to be free from physical or
mental abuse, corporal punishment, and any restraints or
involuntary seclusions imposed for purposes of discipline or
convenience.
``(2) Nonapplicability.--Notwithstanding this part, a
facility that provides inpatient psychiatric treatment
services for individuals under the age of 21, as authorized
and defined in subsections (a)(16) and (h) of section 1905 of
the Social Security Act, shall comply with the requirements
of part H.
``(3) Applicability of medicaid provisions.--A non-medical,
community-based facility for children and youth funded under
the medicaid program under title XIX of the Social Security
Act shall continue to meet all existing requirements for
participation in such program that are not affected by this
part.
``(b) Requirements.--
``(1) In general.--Physical restraints and seclusion may
only be imposed on a resident of a facility described in
subsection (a) if--
``(A) the restraints or seclusion are imposed only in
emergency circumstances and only to ensure the immediate
physical safety of the resident, a staff member, or others
and less restrictive interventions have been determined to be
ineffective; and
``(B) the restraints or seclusion are imposed only by an
individual trained and certified, by a State-recognized body
(as defined in regulation promulgated by the Secretary) and
pursuant to a process determined appropriate by the State and
approved by the Secretary, in the prevention and use of
physical restraint and seclusion, including the needs and
behaviors of the population served, relationship building,
alternatives to restraint and seclusion, de-escalation
methods, avoiding power struggles, thresholds for restraints
and seclusion, the physiological and psychological impact of
restraint and seclusion, monitoring physical signs of
distress and obtaining medical assistance, legal issues,
position asphyxia, escape and evasion techniques, time
limits, the process for obtaining approval for continued
restraints, procedures to address problematic restraints,
documentation, processing with children, and follow-up with
staff, and investigation of injuries and complaints.
``(2) Interim procedures relating to training and
certification.--
``(A) In general.--Until such time as the State develops a
process to assure the proper training and certification of
facility personnel in the skills and competencies referred in
paragraph (1)(B), the facility involved shall develop and
implement an interim procedure that meets the requirements of
subparagraph (B).
``(B) Requirements.--A procedure developed under
subparagraph (A) shall--
``(i) ensure that a supervisory or senior staff person with
training in restraint and seclusion who is competent to
conduct a face-to-face assessment (as defined in regulations
promulgated by the Secretary), will assess the mental and
physical well-being of the child or youth being restrained or
secluded and assure that the restraint or seclusion is being
done in a safe manner;
``(ii) ensure that the assessment required under clause (i)
take place as soon as practicable, but in no case later than
1 hour after the initiation of the restraint or seclusion;
and
``(iii) ensure that the supervisory or senior staff person
continues to monitor the situation for the duration of the
restraint and seclusion.
``(3) Limitations.--
``(A) In general.--The use of a drug or medication that is
used as a restraint to control behavior or restrict the
resident's freedom of movement that is not a standard
treatment for the resident's medical or psychiatric condition
in nonmedical community-based facilities for children and
youth described in subsection (a)(1) is prohibited.
``(B) Prohibition.--The use of mechanical restraints in
non-medical, community-based facilities for children and
youth described in subsection (a)(1) is prohibited.
``(C) Limitation.--A non-medical, community-based facility
for children and youth described in subsection (a)(1) may
only use seclusion when a staff member is continuously face-
to-face monitoring the resident and when strong licensing or
accreditation and internal controls are in place.
``(c) Rule of Construction.--
[[Page H8235]]
``(1) In general.--Nothing in this section shall be
construed as prohibiting the use of restraints for medical
immobilization, adaptive support, or medical protection.
``(2) Current law.--This part shall not be construed to
affect or impede any Federal or State law or regulations that
provide greater protections than this part regarding
seclusion and restraint.
``(d) Definitions.--In this section:
``(1) Mechanical restraint.--The term `mechanical
restraint' means the use of devices as a means of restricting
a resident's freedom of movement.
``(2) Physical escort.--The term `physical escort' means
the temporary touching or holding of the hand, wrist, arm,
shoulder or back for the purpose of inducing a resident who
is acting out to walk to a safe location.
``(3) Physical restraint.--The term `physical restraint'
means a personal restriction that immobilizes or reduces the
ability of an individual to move his or her arms, legs, or
head freely. Such term does not include a physical escort.
``(4) Seclusion.--The term `seclusion' means a behavior
control technique involving locked isolation. Such term does
not include a time out.
``(5) Time out.--The term `time out' means a behavior
management technique that is part of an approved treatment
program and may involve the separation of the resident from
the group, in a non-locked setting, for the purpose of
calming. Time out is not seclusion.
``SEC. 595A. REPORTING REQUIREMENT.
``Each facility to which this part applies shall notify the
appropriate State licensing or regulatory agency, as
determined by the Secretary--
``(1) of each death that occurs at each such facility. A
notification under this section shall include the name of the
resident and shall be provided not later than 24 hours after
the time of the individuals death; and
``(2) of the use of seclusion or restraints in accordance
with regulations promulgated by the Secretary, in
consultation with the States.
``SEC. 595B. REGULATIONS AND ENFORCEMENT.
``(a) Training.--Not later than 6 months after the date of
enactment of this part, the Secretary, after consultation
with appropriate State, local, public and private protection
and advocacy organizations, health care professionals, social
workers, facilities, and patients, shall promulgate
regulations that--
``(1) require States that license non-medical, community-
based residential facilities for children and youth to
develop licensing rules and monitoring requirements
concerning behavior management practice that will ensure
compliance with Federal regulations and to meet the
requirements of subsection (b);
``(2) require States to develop and implement such
licensing rules and monitoring requirements within 1 year
after the promulgation of the regulations referred to in the
matter preceding paragraph (1); and
``(3) support the development of national guidelines and
standards on the quality, quantity, orientation and training,
required under this part, as well as the certification or
licensure of those staff responsible for the implementation
of behavioral intervention concepts and techniques.
``(b) Requirements.--The regulations promulgated under
subsection (a) shall require--
``(1) that facilities described in subsection (a) ensure
that there is an adequate number of qualified professional
and supportive staff to evaluate residents, formulate written
individualized, comprehensive treatment plans, and to provide
active treatment measures;
``(2) the provision of appropriate training and
certification of the staff of such facilities in the
prevention and use of physical restraint and seclusion,
including the needs and behaviors of the population served,
relationship building, alternatives to restraint, de-
escalation methods, avoiding power struggles, thresholds for
restraints, the physiological impact of restraint and
seclusion, monitoring physical signs of distress and
obtaining medical assistance, legal issues, position
asphyxia, escape and evasion techniques, time limits for the
use of restraint and seclusion, the process for obtaining
approval for continued restraints and seclusion, procedures
to address problematic restraints, documentation, processing
with children, and follow-up with staff, and investigation of
injuries and complaints; and
``(3) that such facilities provide complete and accurate
notification of deaths, as required under section 595A(1).
``(c) Enforcement.--A State to which this part applies that
fails to comply with any requirement of this part, including
a failure to provide appropriate training and certification,
shall not be eligible for participation in any program
supported in whole or in part by funds appropriated under
this Act.''.
SEC. 3209. EMERGENCY MENTAL HEALTH CENTERS.
Subpart 3 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb-31 et seq.), as amended by section 3111,
is further amended by adding at the end the following:
``SEC. 520F. GRANTS FOR EMERGENCY MENTAL HEALTH CENTERS.
``(a) Program Authorized.--The Secretary shall award grants
to States, political subdivisions of States, Indian tribes,
and tribal organizations to support the designation of
hospitals and health centers as Emergency Mental Health
Centers.
``(b) Health Center.--In this section, the term `health
center' has the meaning given such term in section 330, and
includes community health centers and community mental health
centers.
``(c) Distribution of Awards.--The Secretary shall ensure
that such grants awarded under subsection (a) are equitably
distributed among the geographical regions of the United
States, between urban and rural populations, and between
different settings of care including health centers, mental
health centers, hospitals, and other psychiatric units or
facilities.
``(d) Application.--A State, political subdivision of a
State, Indian tribe, or tribal organization that desires a
grant under subsection (a) shall submit an application to the
Secretary at such time, in such manner, and containing such
information as the Secretary may require, including a plan
for the rigorous evaluation of activities carried out with
funds received under this section.
``(e) Use of Funds.--
``(1) In general.--A State, political subdivision of a
State, Indian tribe, or tribal organization receiving a grant
under subsection (a) shall use funds from such grant to
establish or designate hospitals and health centers as
Emergency Mental Health Centers.
``(2) Emergency mental health centers.--Such Emergency
Mental Health Centers described in paragraph (1)--
``(A) shall--
``(i) serve as a central receiving point in the community
for individuals who may be in need of emergency mental health
services;
``(ii) purchase, if needed, any equipment necessary to
evaluate, diagnose and stabilize an individual with a mental
illness;
``(iii) provide training, if needed, to the medical
personnel staffing the Emergency Mental Health Center to
evaluate, diagnose, stabilize, and treat an individual with a
mental illness; and
``(iv) provide any treatment that is necessary for an
individual with a mental illness or a referral for such
individual to another facility where such treatment may be
received; and
``(B) may establish and train a mobile crisis intervention
team to respond to mental health emergencies within the
community.
``(f) Evaluation.--A State, political subdivision of a
State, Indian tribe, or tribal organization that receives a
grant under subsection (a) shall prepare and submit an
evaluation to the Secretary at such time, in such manner, and
containing such information as the Secretary may reasonably
require, including an evaluation of activities carried out
with funds received under this section and a process and
outcomes evaluation.
``(g) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section, $25,000,000 for
fiscal year 2001 and such sums as may be necessary for each
of the fiscal years 2002 through 2003.''.
SEC. 3210. GRANTS FOR JAIL DIVERSION PROGRAMS.
Subpart 3 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb-31 et seq.), as amended by section 3209,
is further amended by adding at the end the following:
``SEC. 520G. GRANTS FOR JAIL DIVERSION PROGRAMS.
``(a) Program Authorized.--The Secretary shall make up to
125 grants to States, political subdivisions of States,
Indian tribes, and tribal organizations, acting directly or
through agreements with other public or nonprofit entities,
to develop and implement programs to divert individuals with
a mental illness from the criminal justice system to
community-based services.
``(b) Administration.--
``(1) Consultation.--The Secretary shall consult with the
Attorney General and any other appropriate officials in
carrying out this section.
``(2) Regulatory authority.--The Secretary shall issue
regulations and guidelines necessary to carry out this
section, including methodologies and outcome measures for
evaluating programs carried out by States, political
subdivisions of States, Indian tribes, and tribal
organizations receiving grants under subsection (a).
``(c) Applications.--
``(1) In general.--To receive a grant under subsection (a),
the chief executive of a State, chief executive of a
subdivision of a State, Indian tribe or tribal organization
shall prepare and submit an application to the Secretary at
such time, in such manner, and containing such information as
the Secretary shall reasonably require.
``(2) Content.--Such application shall--
``(A) contain an assurance that--
``(i) community-based mental health services will be
available for the individuals who are diverted from the
criminal justice system, and that such services are based on
the best known practices, reflect current research findings,
include case management, assertive community treatment,
medication management and access, integrated mental health
and co-occurring substance abuse treatment, and psychiatric
rehabilitation, and will be coordinated with social services,
including life skills training, housing placement, vocational
training, education job placement, and health care;
``(ii) there has been relevant interagency collaboration
between the appropriate criminal justice, mental health, and
substance abuse systems; and
``(iii) the Federal support provided will be used to
supplement, and not supplant, State, local, Indian tribe, or
tribal organization sources of funding that would otherwise
be available;
``(B) demonstrate that the diversion program will be
integrated with an existing system of care for those with
mental illness;
``(C) explain the applicant's inability to fund the program
adequately without Federal assistance;
``(D) specify plans for obtaining necessary support and
continuing the proposed program following the conclusion of
Federal support; and
``(E) describe methodology and outcome measures that will
be used in evaluating the program.
[[Page H8236]]
``(d) Use of Funds.--A State, political subdivision of a
State, Indian tribe, or tribal organization that receives a
grant under subsection (a) may use funds received under such
grant to--
``(1) integrate the diversion program into the existing
system of care;
``(2) create or expand community-based mental health and
co-occurring mental illness and substance abuse services to
accommodate the diversion program;
``(3) train professionals involved in the system of care,
and law enforcement officers, attorneys, and judges; and
``(4) provide community outreach and crisis intervention.
``(e) Federal Share.--
``(1) In general.--The Secretary shall pay to a State,
political subdivision of a State, Indian tribe, or tribal
organization receiving a grant under subsection (a) the
Federal share of the cost of activities described in the
application.
``(2) Federal share.--The Federal share of a grant made
under this section shall not exceed 75 percent of the total
cost of the program carried out by the State, political
subdivision of a State, Indian tribe, or tribal organization.
Such share shall be used for new expenses of the program
carried out by such State, political subdivision of a State,
Indian tribe, or tribal organization.
``(3) Non-federal share.--The non-Federal share of payments
made under this section may be made in cash or in kind fairly
evaluated, including planned equipment or services. The
Secretary may waive the requirement of matching
contributions.
``(f) Geographic Distribution.--The Secretary shall ensure
that such grants awarded under subsection (a) are equitably
distributed among the geographical regions of the United
States and between urban and rural populations.
``(g) Training and Technical Assistance.--Training and
technical assistance may be provided by the Secretary to
assist a State, political subdivision of a State, Indian
tribe, or tribal organization receiving a grant under
subsection (a) in establishing and operating a diversion
program.
``(h) Evaluations.--The programs described in subsection
(a) shall be evaluated not less than 1 time in every 12-month
period using the methodology and outcome measures identified
in the grant application.
``(i) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section
$10,000,000 for fiscal year 2001, and such sums as may be
necessary for fiscal years 2002 through 2003.''.
SEC. 3211. IMPROVING OUTCOMES FOR CHILDREN AND ADOLESCENTS
THROUGH SERVICES INTEGRATION BETWEEN CHILD
WELFARE AND MENTAL HEALTH SERVICES.
Subpart 3 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb-31 et seq.), as amended by section 3210,
is further amended by adding at the end the following:
``SEC. 520H. IMPROVING OUTCOMES FOR CHILDREN AND ADOLESCENTS
THROUGH SERVICES INTEGRATION BETWEEN CHILD
WELFARE AND MENTAL HEALTH SERVICES.
``(a) In General.--The Secretary shall award grants,
contracts or cooperative agreements to States, political
subdivisions of States, Indian tribes, and tribal
organizations to provide integrated child welfare and mental
health services for children and adolescents under 19 years
of age in the child welfare system or at risk for becoming
part of the system, and parents or caregivers with a mental
illness or a mental illness and a co-occurring substance
abuse disorder.
``(b) Duration.--With respect to a grant, contract or
cooperative agreement awarded under this section, the period
during which payments under such award are made to the
recipient may not exceed 5 years.
``(c) Application.--
``(1) In general.--To be eligible to receive an award under
subsection (a), a State, political subdivision of a State,
Indian tribe, or tribal organization shall submit an
application to the Secretary at such time, in such manner,
and accompanied by such information as the Secretary may
reasonably require.
``(2) Content.--An application submitted under paragraph
(1) shall--
``(A) describe the program to be funded under the grant,
contract or cooperative agreement;
``(B) explain how such program reflects best practices in
the provision of child welfare and mental health services;
and
``(C) provide assurances that--
``(i) persons providing services under the grant, contract
or cooperative agreement are adequately trained to provide
such services; and
``(ii) the services will be provided in accordance with
subsection (d).
``(d) Use of Funds.--A State, political subdivision of a
State, Indian tribe, or tribal organization that receives a
grant, contract, or cooperative agreement under subsection
(a) shall use amounts made available through such grant,
contract or cooperative agreement to--
``(1) provide family-centered, comprehensive, and
coordinated child welfare and mental health services,
including prevention, early intervention and treatment
services for children and adolescents, and for their parents
or caregivers;
``(2) ensure a single point of access for such coordinated
services;
``(3) provide integrated mental health and substance abuse
treatment for children, adolescents, and parents or
caregivers with a mental illness and a co-occurring substance
abuse disorder;
``(4) provide training for the child welfare, mental health
and substance abuse professionals who will participate in the
program carried out under this section;
``(5) provide technical assistance to child welfare and
mental health agencies;
``(6) develop cooperative efforts with other service
entities in the community, including education, social
services, juvenile justice, and primary health care agencies;
``(7) coordinate services with services provided under the
medicaid program and the State Children's Health Insurance
Program under titles XIX and XXI of the Social Security Act;
``(8) provide linguistically appropriate and culturally
competent services; and
``(9) evaluate the effectiveness and cost-efficiency of the
integrated services that measure the level of coordination,
outcome measures for parents or caregivers with a mental
illness or a mental illness and a co-occurring substance
abuse disorder, and outcome measures for children.
``(e) Distribution of Awards.--The Secretary shall ensure
that grants, contracts, and cooperative agreements awarded
under subsection (a) are equitably distributed among the
geographical regions of the United States and between urban
and rural populations.
``(f) Evaluation.--The Secretary shall evaluate each
program carried out by a State, political subdivision of a
State, Indian tribe, or tribal organization under subsection
(a) and shall disseminate the findings with respect to each
such evaluation to appropriate public and private entities.
``(g) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section, $10,000,000 for
fiscal year 2001, and such sums as may be necessary for each
of fiscal years 2002 and 2003.''.
SEC. 3212. GRANTS FOR THE INTEGRATED TREATMENT OF SERIOUS
MENTAL ILLNESS AND CO-OCCURRING SUBSTANCE
ABUSE.
Subpart 3 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb-31 et seq.), as amended by section 3211,
is further amended by adding at the end the following:
``SEC. 520I. GRANTS FOR THE INTEGRATED TREATMENT OF SERIOUS
MENTAL ILLNESS AND CO-OCCURRING SUBSTANCE
ABUSE.
``(a) In General.--The Secretary shall award grants,
contracts, or cooperative agreements to States, political
subdivisions of States, Indian tribes, tribal organizations,
and private nonprofit organizations for the development or
expansion of programs to provide integrated treatment
services for individuals with a serious mental illness and a
co-occurring substance abuse disorder.
``(b) Priority.--In awarding grants, contracts, and
cooperative agreements under subsection (a), the Secretary
shall give priority to applicants that emphasize the
provision of services for individuals with a serious mental
illness and a co-occurring substance abuse disorder who--
``(1) have a history of interactions with law enforcement
or the criminal justice system;
``(2) have recently been released from incarceration;
``(3) have a history of unsuccessful treatment in either an
inpatient or outpatient setting;
``(4) have never followed through with outpatient services
despite repeated referrals; or
``(5) are homeless.
``(c) Use of Funds.--A State, political subdivision of a
State, Indian tribe, tribal organization, or private
nonprofit organization that receives a grant, contract, or
cooperative agreement under subsection (a) shall use funds
received under such grant--
``(1) to provide fully integrated services rather than
serial or parallel services;
``(2) to employ staff that are cross-trained in the
diagnosis and treatment of both serious mental illness and
substance abuse;
``(3) to provide integrated mental health and substance
abuse services at the same location;
``(4) to provide services that are linguistically
appropriate and culturally competent;
``(5) to provide at least 10 programs for integrated
treatment of both mental illness and substance abuse at sites
that previously provided only mental health services or only
substance abuse services; and
``(6) to provide services in coordination with other
existing public and private community programs.
``(d) Condition.--The Secretary shall ensure that a State,
political subdivision of a State, Indian tribe, tribal
organization, or private nonprofit organization that receives
a grant, contract, or cooperative agreement under subsection
(a) maintains the level of effort necessary to sustain
existing mental health and substance abuse programs for other
populations served by mental health systems in the community.
``(e) Distribution of Awards.--The Secretary shall ensure
that grants, contracts, or cooperative agreements awarded
under subsection (a) are equitably distributed among the
geographical regions of the United States and between urban
and rural populations.
``(f) Duration.--The Secretary shall award grants,
contract, or cooperative agreements under this subsection for
a period of not more than 5 years.
``(g) Application.--A State, political subdivision of a
State, Indian tribe, tribal organization, or private
nonprofit organization that desires a grant, contract, or
cooperative agreement under this subsection shall prepare and
submit an application to the Secretary at such time, in such
manner, and containing such information as the Secretary may
require. Such application shall include a plan for the
rigorous evaluation of activities funded with an award under
such subsection, including a process and outcomes evaluation.
``(h) Evaluation.--A State, political subdivision of a
State, Indian tribe, tribal organization, or private
nonprofit organization that receives a grant, contract, or
cooperative agreement under this subsection shall prepare and
submit a plan
[[Page H8237]]
for the rigorous evaluation of the program funded under such
grant, contract, or agreement, including both process and
outcomes evaluation, and the submission of an evaluation at
the end of the project period.
``(i) Authorization of Appropriation.--There is authorized
to be appropriated to carry out this subsection $40,000,000
for fiscal year 2001, and such sums as may be necessary for
fiscal years 2002 through 2003.''.
SEC. 3213. TRAINING GRANTS.
Subpart 3 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb-31 et seq.), as amended by section 3212,
is further amended by adding at the end the following:
``SEC. 520J. TRAINING GRANTS.
``(a) In General.--The Secretary shall award grants in
accordance with the provisions of this section.
``(b) Mental Illness Awareness Training Grants.--
``(1) In general.--The Secretary shall award grants to
States, political subdivisions of States, Indian tribes,
tribal organizations, and nonprofit private entities to train
teachers and other relevant school personnel to recognize
symptoms of childhood and adolescent mental disorders, to
refer family members to the appropriate mental health
services if necessary, to train emergency services personnel
to identify and appropriately respond to persons with a
mental illness, and to provide education to such teachers and
personnel regarding resources that are available in the
community for individuals with a mental illness.
``(2) Emergency Services Personnel.--In this subsection,
the term `emergency services personnel' includes paramedics,
firefighters, and emergency medical technicians.
``(3) Distribution of Awards.--The Secretary shall ensure
that such grants awarded under this subsection are equitably
distributed among the geographical regions of the United
States and between urban and rural populations.
``(4) Application.--A State, political subdivision of a
State, Indian tribe, tribal organization, or nonprofit
private entity that desires a grant under this subsection
shall submit an application to the Secretary at such time, in
such manner, and containing such information as the Secretary
may require, including a plan for the rigorous evaluation of
activities that are carried out with funds received under a
grant under this subsection.
``(5) Use of Funds.--A State, political subdivision of a
State, Indian tribe, tribal organization, or nonprofit
private entity receiving a grant under this subsection shall
use funds from such grant to--
``(A) train teachers and other relevant school personnel to
recognize symptoms of childhood and adolescent mental
disorders and appropriately respond;
``(B) train emergency services personnel to identify and
appropriately respond to persons with a mental illness; and
``(C) provide education to such teachers and personnel
regarding resources that are available in the community for
individuals with a mental illness.
``(6) Evaluation.--A State, political subdivision of a
State, Indian tribe, tribal organization, or nonprofit
private entity that receives a grant under this subsection
shall prepare and submit an evaluation to the Secretary at
such time, in such manner, and containing such information as
the Secretary may reasonably require, including an evaluation
of activities carried out with funds received under the grant
under this subsection and a process and outcome evaluation.
``(7) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this subsection, $25,000,000
for fiscal year 2001 and such sums as may be necessary for
each of fiscal years 2002 through 2003.''.
TITLE XXXIII--PROVISIONS RELATING TO SUBSTANCE ABUSE
SEC. 3301. PRIORITY SUBSTANCE ABUSE TREATMENT NEEDS OF
REGIONAL AND NATIONAL SIGNIFICANCE.
(a) Residential Treatment Programs for Pregnant and
Postpartum Women.--Section 508(r) of the Public Health
Service Act (42 U.S.C. 290bb-1(r)) is amended to read as
follows:
``(r) Authorization of Appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated such sums as may be necessary to fiscal years
2001 through 2003.''.
(b) Priority Substance Abuse Treatment.--Section 509 of the
Public Health Service Act (42 U.S.C. 290bb-1) is amended to
read as follows:
``SEC. 509. PRIORITY SUBSTANCE ABUSE TREATMENT NEEDS OF
REGIONAL AND NATIONAL SIGNIFICANCE.
``(a) Projects.--The Secretary shall address priority
substance abuse treatment needs of regional and national
significance (as determined under subsection (b)) through the
provision of or through assistance for--
``(1) knowledge development and application projects for
treatment and rehabilitation and the conduct or support of
evaluations of such projects;
``(2) training and technical assistance; and
``(3) targeted capacity response programs.
The Secretary may carry out the activities described in this
section directly or through grants or cooperative agreements
with States, political subdivisions of States, Indian tribes
and tribal organizations, other public or nonprofit private
entities.
``(b) Priority Substance Abuse Treatment Needs.--
``(1) In general.--Priority substance abuse treatment needs
of regional and national significance shall be determined by
the Secretary after consultation with States and other
interested groups. The Secretary shall meet with the States
and interested groups on an annual basis to discuss program
priorities.
``(2) Special consideration.--In developing program
priorities under paragraph (1), the Secretary shall give
special consideration to promoting the integration of
substance abuse treatment services into primary health care
systems.
``(c) Requirements.--
``(1) In general.--Recipients of grants, contracts, or
cooperative agreements under this section shall comply with
information and application requirements determined
appropriate by the Secretary.
``(2) Duration of award.--With respect to a grant,
contract, or cooperative agreement awarded under this
section, the period during which payments under such award
are made to the recipient may not exceed 5 years.
``(3) Matching funds.--The Secretary may, for projects
carried out under subsection (a), require that entities that
apply for grants, contracts, or cooperative agreements under
that project provide non-Federal matching funds, as
determined appropriate by the Secretary, to ensure the
institutional commitment of the entity to the projects funded
under the grant, contract, or cooperative agreement. Such
non-Federal matching funds may be provided directly or
through donations from public or private entities and may be
in cash or in kind, fairly evaluated, including plant,
equipment, or services.
``(4) Maintenance of effort.--With respect to activities
for which a grant, contract, or cooperative agreement is
awarded under this section, the Secretary may require that
recipients for specific projects under subsection (a) agree
to maintain expenditures of non-Federal amounts for such
activities at a level that is not less than the level of such
expenditures maintained by the entity for the fiscal year
preceding the fiscal year for which the entity receives such
a grant, contract, or cooperative agreement.
``(d) Evaluation.--The Secretary shall evaluate each
project carried out under subsection (a)(1) and shall
disseminate the findings with respect to each such evaluation
to appropriate public and private entities.
``(e) Information and Education.--The Secretary shall
establish comprehensive information and education programs to
disseminate and apply the findings of the knowledge
development and application, training and technical
assistance programs, and targeted capacity response programs
under this section to the general public, to health
professionals and other interested groups. The Secretary
shall make every effort to provide linkages between the
findings of supported projects and State agencies responsible
for carrying out substance abuse prevention and treatment
programs.
``(f) Authorization of Appropriation.--There are authorized
to be appropriated to carry out this section, $300,000,000
for fiscal year 2001 and such sums as may be necessary for
each of the fiscal years 2002 and 2003.''.
(c) Conforming Amendments.--The following sections of the
Public Health Service Act are repealed:
(1) Section 510 (42 U.S.C. 290bb-3).
(2) Section 511 (42 U.S.C. 290bb-4).
(3) Section 512 (42 U.S.C. 290bb-5).
(4) Section 571 (42 U.S.C. 290gg).
SEC. 3302. PRIORITY SUBSTANCE ABUSE PREVENTION NEEDS OF
REGIONAL AND NATIONAL SIGNIFICANCE.
(a) In General.--Section 516 of the Public Health Service
Act (42 U.S.C. 290bb-1) is amended to read as follows:
``SEC. 516. PRIORITY SUBSTANCE ABUSE PREVENTION NEEDS OF
REGIONAL AND NATIONAL SIGNIFICANCE.
``(a) Projects.--The Secretary shall address priority
substance abuse prevention needs of regional and national
significance (as determined under subsection (b)) through the
provision of or through assistance for--
``(1) knowledge development and application projects for
prevention and the conduct or support of evaluations of such
projects;
``(2) training and technical assistance; and
``(3) targeted capacity response programs.
The Secretary may carry out the activities described in this
section directly or through grants or cooperative agreements
with States, political subdivisions of States, Indian tribes
and tribal organizations, or other public or nonprofit
private entities.
``(b) Priority Substance Abuse Prevention Needs.--
``(1) In general.--Priority substance abuse prevention
needs of regional and national significance shall be
determined by the Secretary in consultation with the States
and other interested groups. The Secretary shall meet with
the States and interested groups on an annual basis to
discuss program priorities.
``(2) Special consideration.--In developing program
priorities under paragraph (1), the Secretary shall give
special consideration to--
``(A) applying the most promising strategies and research-
based primary prevention approaches; and
``(B) promoting the integration of substance abuse
prevention information and activities into primary health
care systems.
``(c) Requirements.--
``(1) In general.--Recipients of grants, contracts, and
cooperative agreements under this section shall comply with
information and application requirements determined
appropriate by the Secretary.
``(2) Duration of award.--With respect to a grant,
contract, or cooperative agreement awarded under this
section, the period during which payments under such award
are made to the recipient may not exceed 5 years.
``(3) Matching funds.--The Secretary may, for projects
carried out under subsection (a), require that entities that
apply for grants, contracts, or cooperative agreements under
that project provide non-Federal matching funds, as
determined appropriate by the Secretary, to ensure the
institutional commitment of the entity
[[Page H8238]]
to the projects funded under the grant, contract, or
cooperative agreement. Such non-Federal matching funds may be
provided directly or through donations from public or private
entities and may be in cash or in kind, fairly evaluated,
including plant, equipment, or services.
``(4) Maintenance of effort.--With respect to activities
for which a grant, contract, or cooperative agreement is
awarded under this section, the Secretary may require that
recipients for specific projects under subsection (a) agree
to maintain expenditures of non-Federal amounts for such
activities at a level that is not less than the level of such
expenditures maintained by the entity for the fiscal year
preceding the fiscal year for which the entity receives such
a grant, contract, or cooperative agreement.
``(d) Evaluation.--The Secretary shall evaluate each
project carried out under subsection (a)(1) and shall
disseminate the findings with respect to each such evaluation
to appropriate public and private entities.
``(e) Information and Education.--The Secretary shall
establish comprehensive information and education programs to
disseminate the findings of the knowledge development and
application, training and technical assistance programs, and
targeted capacity response programs under this section to the
general public and to health professionals. The Secretary
shall make every effort to provide linkages between the
findings of supported projects and State agencies responsible
for carrying out substance abuse prevention and treatment
programs.
``(f) Authorization of Appropriation.--There are authorized
to be appropriated to carry out this section, $300,000,000
for fiscal year 2001, and such sums as may be necessary for
each of the fiscal years 2002 and 2003.''.
(b) Conforming Amendments.--Section 518 of the Public
Health Service Act (42 U.S.C. 290bb-24) is repealed.
SEC. 3303. SUBSTANCE ABUSE PREVENTION AND TREATMENT
PERFORMANCE PARTNERSHIP BLOCK GRANT.
(a) Allocation Regarding Alcohol and Other Drugs.--Section
1922 of the Public Health Service Act (42 U.S.C. 300x-22) is
amended by--
(1) striking subsection (a); and
(2) redesignating subsections (b) and (c) as subsections
(a) and (b).
(b) Group Homes for Recovering Substance Abusers.--Section
1925(a) of the Public Health Service Act (42 U.S.C. 300x-
25(a)) is amended by striking ``For fiscal year 1993'' and
all that follows through the colon and inserting the
following: ``A State, using funds available under section
1921, may establish and maintain the ongoing operation of a
revolving fund in accordance with this section to support
group homes for recovering substance abusers as follows:''.
(c) Maintenance of Effort.--Section 1930 of the Public
Health Service Act (42 U.S.C. 300x-30) is amended--
(1) by redesignating subsections (b) and (c) as subsections
(c) and (d) respectively; and
(2) by inserting after subsection (a), the following:
``(b) Exclusion of Certain Funds.--The Secretary may
exclude from the aggregate State expenditures under
subsection (a), funds appropriated to the principle agency
for authorized activities which are of a non-recurring nature
and for a specific purpose.''.
(d) Applications for Grants.--Section 1932(a)(1) of the
Public Health Service Act (42 U.S.C. 300x-32(a)(1)) is
amended to read as follows:
``(1) the application is received by the Secretary not
later than October 1 of the fiscal year for which the State
is seeking funds;''.
(e) Waiver for Territories.--Section 1932(c) of the Public
Health Service Act (42 U.S.C. 300x-32(c)) is amended by
striking ``whose allotment under section 1921 for the fiscal
year is the amount specified in section 1933(c)(2)(B)'' and
inserting ``except Puerto Rico''.
(f) Waiver Authority for Certain Requirements.--
(1) In general.--Section 1932 of the Public Health Service
Act (42 U.S.C. 300x-32) is amended by adding at the end the
following:
``(e) Waiver Authority for Certain Requirements.--
``(1) In general.--Upon the request of a State, the
Secretary may waive the requirements of all or part of the
sections described in paragraph (2) using objective criteria
established by the Secretary by regulation after consultation
with the States and other interested parties including
consumers and providers.
``(2) Sections.--The sections described in paragraph (1)
are sections 1922(c), 1923, 1924 and 1928.
``(3) Date certain for acting upon request.--The Secretary
shall approve or deny a request for a waiver under paragraph
(1) and inform the State of that decision not later than 120
days after the date on which the request and all the
information needed to support the request are submitted.
``(4) Annual reporting requirement.--The Secretary shall
annually report to the general public on the States that
receive a waiver under this subsection.''.
(2) Conforming amendments.--Effective upon the publication
of the regulations developed in accordance with section
1932(e)(1) of the Public Health Service Act (42 U.S.C. 300x-
32(d))--
(A) section 1922(c) of the Public Health Service Act (42
U.S.C. 300x-22(c)) is amended by--
(i) striking paragraph (2); and
(ii) redesignating paragraph (3) as paragraph (2); and
(B) section 1928(d) of the Public Health Service Act (42
U.S.C. 300x-28(d)) is repealed.
(g) Authorization of Appropriation.--Section 1935 of the
Public Health Service Act (42 U.S.C. 300x-35) is amended--
(1) in subsection (a), by striking ``$1,500,000,000'' and
all that follows through the end and inserting
``$2,000,000,000 for fiscal year 2001, and such sums as may
be necessary for each of the fiscal years 2002 and 2003.'';
(2) in subsection (b)(1), by striking ``section 505'' and
inserting ``sections 505 and 1971'';
(3) in subsection (b)(2), by striking ``1949(a)'' and
inserting ``1948(a)''; and
(4) in subsection (b), by adding at the end the following:
``(3) Core data set.--A State that receives a new grant,
contract, or cooperative agreement from amounts available to
the Secretary under paragraph (1), for the purposes of
improving the data collection, analysis and reporting
capabilities of the State, shall be required, as a condition
of receipt of funds, to collect, analyze, and report to the
Secretary for each fiscal year subsequent to receiving such
funds a core data set to be determined by the Secretary in
conjunction with the States.''.
SEC. 3304. DETERMINATION OF ALLOTMENTS.
Section 1933(b) of the Public Health Service Act (42 U.S.C.
300x-33(b)) is amended to read as follows:
``(b) Minimum Allotments for States.--
``(1) In general.--With respect to fiscal year 2000, and
each subsequent fiscal year, the amount of the allotment of a
State under section 1921 shall not be less than the amount
the State received under such section for the previous fiscal
year increased by an amount equal to 30.65 percent of the
percentage by which the aggregate amount allotted to all
States for such fiscal year exceeds the aggregate amount
allotted to all States for the previous fiscal year.
``(2) Limitations.--
``(A) In general.--Except as provided in subparagraph (B),
a State shall not receive an allotment under section 1921 for
a fiscal year in an amount that is less than an amount equal
to 0.375 percent of the amount appropriated under section
1935(a) for such fiscal year.
``(B) Exception.--In applying subparagraph (A), the
Secretary shall ensure that no State receives an increase in
its allotment under section 1921 for a fiscal year (as
compared to the amount allotted to the State in the prior
fiscal year) that is in excess of an amount equal to 300
percent of the percentage by which the amount appropriated
under section 1935(a) for such fiscal year exceeds the amount
appropriated for the prior fiscal year.
``(3) Decrease in or equal appropriations.--If the amount
appropriated under section 1935(a) for a fiscal year is equal
to or less than the amount appropriated under such section
for the prior fiscal year, the amount of the State allotment
under section 1921 shall be equal to the amount that the
State received under section 1921 in the prior fiscal year
decreased by the percentage by which the amount appropriated
for such fiscal year is less than the amount appropriated or
such section for the prior fiscal year.''.
SEC. 3305. NONDISCRIMINATION AND INSTITUTIONAL SAFEGUARDS FOR
RELIGIOUS PROVIDERS.
Subpart III of part B of title XIX of the Public Health
Service Act (42 U.S.C. 300x-51 et seq.) is amended by adding
at the end the following:
``SEC. 1955. SERVICES PROVIDED BY NONGOVERNMENTAL
ORGANIZATIONS.
``(a) Purposes.--The purposes of this section are--
``(1) to prohibit discrimination against nongovernmental
organizations and certain individuals on the basis of
religion in the distribution of government funds to provide
substance abuse services under this title and title V, and
the receipt of services under such titles; and
``(2) to allow the organizations to accept the funds to
provide the services to the individuals without impairing the
religious character of the organizations or the religious
freedom of the individuals.
``(b) Religious Organizations Included as Nongovernmental
Providers.--
``(1) In general.--A State may administer and provide
substance abuse services under any program under this title
or title V through grants, contracts, or cooperative
agreements to provide assistance to beneficiaries under such
titles with nongovernmental organizations.
``(2) Requirement.--A State that elects to utilize
nongovernmental organizations as provided for under paragraph
(1) shall consider, on the same basis as other
nongovernmental organizations, religious organizations to
provide services under substance abuse programs under this
title or title V, so long as the programs under such titles
are implemented in a manner consistent with the Establishment
Clause of the first amendment to the Constitution. Neither
the Federal Government nor a State or local government
receiving funds under such programs shall discriminate
against an organization that provides services under, or
applies to provide services under, such programs, on the
basis that the organization has a religious character.
``(c) Religious Character and Independence.--
``(1) In general.--A religious organization that provides
services under any substance abuse program under this title
or title V shall retain its independence from Federal, State,
and local governments, including such organization's control
over the definition, development, practice, and expression of
its religious beliefs.
``(2) Additional safeguards.--Neither the Federal
Government nor a State or local government shall require a
religious organization--
``(A) to alter its form of internal governance; or
``(B) to remove religious art, icons, scripture, or other
symbols;
in order to be eligible to provide services under any
substance abuse program under this title or title V.
``(d) Employment Practices.--
``(1) Substance abuse.--A religious organization that
provides services under any substance
[[Page H8239]]
abuse program under this title or title V may require that
its employees providing services under such program adhere to
rules forbidding the use of drugs or alcohol.
``(2) Title vii exemption.--The exemption of a religious
organization provided under section 702 or 703(e)(2) of the
Civil Rights Act of 1964 (42 U.S.C. 2000e-1, 2000e-2(e)(2))
regarding employment practices shall not be affected by the
religious organization's provision of services under, or
receipt of funds from, any substance abuse program under this
title or title V.
``(e) Rights of Beneficiaries of Assistance.--
``(1) In general.--If an individual described in paragraph
(3) has an objection to the religious character of the
organization from which the individual receives, or would
receive, services funded under any substance abuse program
under this title or title V, the appropriate Federal, State,
or local governmental entity shall provide to such individual
(if otherwise eligible for such services) within a reasonable
period of time after the date of such objection, services
that--
``(A) are from an alternative provider that is accessible
to the individual; and
``(B) have a value that is not less than the value of the
services that the individual would have received from such
organization.
``(2) Notice.--The appropriate Federal, State, or local
governmental entity shall ensure that notice is provided to
individuals described in paragraph (3) of the rights of such
individuals under this section.
``(3) Individual described.--An individual described in
this paragraph is an individual who receives or applies for
services under any substance abuse program under this title
or title V.
``(f) Nondiscrimination Against Beneficiaries.--A religious
organization providing services through a grant, contract, or
cooperative agreement under any substance abuse program under
this title or title V shall not discriminate, in carrying out
such program, against an individual described in subsection
(e)(3) on the basis of religion, a religious belief, a
refusal to hold a religious belief, or a refusal to actively
participate in a religious practice.
``(g) Fiscal Accountability.--
``(1) In general.--Except as provided in paragraph (2), any
religious organization providing services under any substance
abuse program under this title or title V shall be subject to
the same regulations as other nongovernmental organizations
to account in accord with generally accepted accounting
principles for the use of such funds provided under such
program.
``(2) Limited audit.--Such organization shall segregate
government funds provided under such substance abuse program
into a separate account. Only the government funds shall be
subject to audit by the government.
``(h) Compliance.--Any party that seeks to enforce such
party's rights under this section may assert a civil action
for injunctive relief exclusively in an appropriate Federal
or State court against the entity, agency or official that
allegedly commits such violation.
``(i) Limitations on Use of Funds for Certain Purposes.--No
funds provided through a grant or contract to a religious
organization to provide services under any substance abuse
program under this title or title V shall be expended for
sectarian worship, instruction, or proselytization.
``(j) Effect on State and Local Funds.--If a State or local
government contributes State or local funds to carry out any
substance abuse program under this title or title V, the
State or local government may segregate the State or local
funds from the Federal funds provided to carry out the
program or may commingle the State or local funds with the
Federal funds. If the State or local government commingles
the State or local funds, the provisions of this section
shall apply to the commingled funds in the same manner, and
to the same extent, as the provisions apply to the Federal
funds.
``(k) Treatment of Intermediate Contractors.--If a
nongovernmental organization (referred to in this subsection
as an `intermediate organization'), acting under a contract
or other agreement with the Federal Government or a State or
local government, is given the authority under the contract
or agreement to select nongovernmental organizations to
provide services under any substance abuse program under this
title or title V, the intermediate organization shall have
the same duties under this section as the government but
shall retain all other rights of a nongovernmental
organization under this section.''.
SEC. 3306. ALCOHOL AND DRUG PREVENTION OR TREATMENT SERVICES
FOR INDIANS AND NATIVE ALASKANS.
Part A of title V of the Public Health Service Act (42
U.S.C. 290aa et seq.) is amended by adding at the end the
following:
``SEC. 506A. ALCOHOL AND DRUG PREVENTION OR TREATMENT
SERVICES FOR INDIANS AND NATIVE ALASKANS.
``(a) In General.--The Secretary shall award grants,
contracts, or cooperative agreements to public and private
nonprofit entities, including Native Alaskan entities and
Indian tribes and tribal organizations, for the purpose of
providing alcohol and drug prevention or treatment services
for Indians and Native Alaskans.
``(b) Priority.--In awarding grants, contracts, or
cooperative agreements under subsection (a), the Secretary
shall give priority to applicants that--
``(1) propose to provide alcohol and drug prevention or
treatment services on reservations;
``(2) propose to employ culturally-appropriate approaches,
as determined by the Secretary, in providing such services;
and
``(3) have provided prevention or treatment services to
Native Alaskan entities and Indian tribes and tribal
organizations for at least 1 year prior to applying for a
grant under this section.
``(c) Duration.--The Secretary shall award grants,
contracts, or cooperative agreements under subsection (a) for
a period not to exceed 5 years.
``(d) Application.--An entity desiring a grant, contract,
or cooperative agreement under subsection (a) shall submit an
application to the Secretary at such time, in such manner,
and accompanied by such information as the Secretary may
reasonably require.
``(e) Evaluation.--An entity that receives a grant,
contract, or cooperative agreement under subsection (a) shall
submit, in the application for such grant, a plan for the
evaluation of any project undertaken with funds provided
under this section. Such entity shall provide the Secretary
with periodic evaluations of the progress of such project and
such evaluation at the completion of such project as the
Secretary determines to be appropriate. The final evaluation
submitted by such entity shall include a recommendation as to
whether such project shall continue.
``(f) Report.--Not later than 3 years after the date of
enactment of this section and annually thereafter, the
Secretary shall prepare and submit, to the Committee on
Health, Education, Labor, and Pensions of the Senate, a
report describing the services provided pursuant to this
section.
``(g) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section,
$15,000,000 for fiscal year 2001, and such sums as may be
necessary for fiscal years 2002 and 2003.
SEC. 3307. ESTABLISHMENT OF COMMISSION.
(a) In General.--There is established a commission to be
known as the Commission on Indian and Native Alaskan Health
Care that shall examine the health concerns of Indians and
Native Alaskans who reside on reservations and tribal lands
(hereafter in this section referred to as the `Commission').
(b) Membership.--
(1) In general.--The Commission established under
subsection (a) shall consist of--
(A) the Secretary;
(B) 15 members who are experts in the health care field and
issues that the Commission is established to examine; and
(C) the Director of the Indian Health Service and the
Commissioner of Indian Affairs, who shall be nonvoting
members.
(2) Appointing authority.--Of the 15 members of the
Commission described in paragraph (1)(B)--
(A) 2 shall be appointed by the Speaker of the House of
Representatives;
(B) 2 shall be appointed by the Minority Leader of the
House of Representatives;
(C) 2 shall be appointed by the Majority Leader of the
Senate;
(D) 2 shall be appointed by the Minority Leader of the
Senate; and
(E) 7 shall be appointed by the Secretary.
(3) Limitation.--Not fewer than 10 of the members appointed
to the Commission shall be Indians or Native Alaskans.
(4) Chairperson.--The Secretary shall serve as the
Chairperson of the Commission.
(5) Experts.--The Commission may seek the expertise of any
expert in the health care field to carry out its duties.
(c) Period of Appointment.--Members shall be appointed for
the life of the Commission. Any vacancy in the Commission
shall not affect its powers, but shall be filed in the same
manner as the original appointment.
(d) Duties of the Commission.--The Commission shall--
(1) study the health concerns of Indians and Native
Alaskans; and
(2) prepare the reports described in subsection (i).
(e) Powers of the Commission.--
(1) Hearings.--The Commission may hold such hearings,
including hearings on reservations, sit and act at such times
and places, take such testimony, and receive such information
as the Commission considers advisable to carry out the
purpose for which the Commission was established.
(2) Information from federal agencies.--The Commission may
secure directly from any Federal department or agency such
information as the Commission considers necessary to carry
out the purpose for which the Commission was established.
Upon request of the Chairperson of the Commission, the head
of such department or agency shall furnish such information
to the Commission.
(f) Compensation of Members.--
(1) In general.--Except as provided in subparagraph (B),
each member of the Commission may be compensated at a rate
not to exceed the daily equivalent of the annual rate of
basic pay prescribed for level IV of the Executive Schedule
under section 5315 of title 5, United States Code, for each
day (including travel time), during which that member is
engaged in the actual performance of the duties of the
Commission.
(2) Limitation.--Members of the Commission who are officers
or employees of the United States shall receive no additional
pay on account of their service on the Commission.
(g) Travel Expenses of Members.--The members of the
Commission shall be allowed travel expenses, including per
diem in lieu of subsistence, at rates authorized for
employees of agencies under section 5703 of title 5, United
States Code, while away from their homes or regular places of
business in the performance of services for the Commission.
(h) Commission Personnel Matters.--
(1) In general.--The Secretary, in accordance with rules
established by the Commission, may select and appoint a staff
director and other personnel necessary to enable the
Commission to carry out its duties.
(2) Compensation of personnel.--The Secretary, in
accordance with rules established by
[[Page H8240]]
the Commission, may set the amount of compensation to be paid
to the staff director and any other personnel that serve the
Commission.
(3) Detail of government employees.--Any Federal Government
employee may be detailed to the Commission without
reimbursement, and the detail shall be without interruption
or loss of civil service status or privilege.
(4) Consultant services.--The Chairperson of the Commission
is authorized to procure the temporary and intermittent
services of experts and consultants in accordance with
section 3109 of title 5, United States Code, at rates not to
exceed the daily equivalent of the annual rate of basic pay
prescribed for level IV of the Executive Schedule under
section 5315 of such title.
(i) Report.--
(1) In general.--Not later than 3 years after the date of
enactment of the Youth Drug and Mental Health Services Act,
the Secretary shall prepare and submit, to the Committee on
Health, Education, Labor, and Pensions of the Senate, a
report that shall--
(A) detail the health problems faced by Indians and Native
Alaskans who reside on reservations;
(B) examine and explain the causes of such problems;
(C) describe the health care services available to Indians
and Native Alaskans who reside on reservations and the
adequacy of such services;
(D) identify the reasons for the provision of inadequate
health care services for Indians and Native Alaskans who
reside on reservations, including the availability of
resources;
(E) develop measures for tracking the health status of
Indians and Native Americans who reside on reservations; and
(F) make recommendations for improvements in the health
care services provided for Indians and Native Alaskans who
reside on reservations, including recommendations for
legislative change.
(2) Exception.--In addition to the report required under
paragraph (1), not later than 2 years after the date of
enactment of the Youth Drug and Mental Health Services Act,
the Secretary shall prepare and submit, to the Committee on
Health, Education, Labor, and Pensions of the Senate, a
report that describes any alcohol and drug abuse among
Indians and Native Alaskans who reside on reservations.
(j) Permanent Commission.--Section 14 of the Federal
Advisory Committee Act (5 U.S.C. App.) shall not apply to the
Commission.
(k) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section $5,000,000 for
fiscal year 2001, and such sums as may be necessary for
fiscal years 2002 and 2003.
TITLE XXXIV--PROVISIONS RELATING TO FLEXIBILITY AND ACCOUNTABILITY
SEC. 3401. GENERAL AUTHORITIES AND PEER REVIEW.
(a) General Authorities.--Paragraph (1) of section 501(e)
of the Public Health Service Act (42 U.S.C. 290aa(e)) is
amended to read as follows:
``(1) In general.--There may be in the Administration an
Associate Administrator for Alcohol Prevention and Treatment
Policy to whom the Administrator may delegate the functions
of promoting, monitoring, and evaluating service programs for
the prevention and treatment of alcoholism and alcohol abuse
within the Center for Substance Abuse Prevention, the Center
for Substance Abuse Treatment and the Center for Mental
Health Services, and coordinating such programs among the
Centers, and among the Centers and other public and private
entities. The Associate Administrator also may ensure that
alcohol prevention, education, and policy strategies are
integrated into all programs of the Centers that address
substance abuse prevention, education, and policy, and that
the Center for Substance Abuse Prevention addresses the
Healthy People 2010 goals and the National Dietary Guidelines
of the Department of Health and Human Services and the
Department of Agriculture related to alcohol consumption.''.
(b) Peer Review.--Section 504 of the Public Health Service
(42 U.S.C. 290aa-3) is amended as follows:
``SEC. 504. PEER REVIEW.
``(a) In General.--The Secretary, after consultation with
the Administrator, shall require appropriate peer review of
grants, cooperative agreements, and contracts to be
administered through the agency which exceed the simple
acquisition threshold as defined in section 4(11) of the
Office of Federal Procurement Policy Act.
``(b) Members.--The members of any peer review group
established under subsection (a) shall be individuals who by
virtue of their training or experience are eminently
qualified to perform the review functions of the group. Not
more than \1/4\ of the members of any such peer review group
shall be officers or employees of the United States.
``(c) Advisory Council Review.--If the direct cost of a
grant or cooperative agreement (described in subsection (a))
exceeds the simple acquisition threshold as defined by
section 4(11) of the Office of Federal Procurement Policy
Act, the Secretary may make such a grant or cooperative
agreement only if such grant or cooperative agreement is
recommended--
``(1) after peer review required under subsection (a); and
``(2) by the appropriate advisory council.
``(d) Conditions.--The Secretary may establish limited
exceptions to the limitations contained in this section
regarding participation of Federal employees and advisory
council approval. The circumstances under which the Secretary
may make such an exception shall be made public.''.
SEC. 3402. ADVISORY COUNCILS.
Section 502(e) of the Public Health Service Act (42 U.S.C.
290aa-1(e)) is amended in the first sentence by striking ``3
times'' and inserting ``2 times''.
SEC. 3403. GENERAL PROVISIONS FOR THE PERFORMANCE PARTNERSHIP
BLOCK GRANTS.
(a) Plans for Performance Partnerships.--Section 1949 of
the Public Health Service Act (42 U.S.C. 300x-59) is amended
as follows:
``SEC. 1949. PLANS FOR PERFORMANCE PARTNERSHIPS.
``(a) Development.--The Secretary in conjunction with
States and other interested groups shall develop separate
plans for the programs authorized under subparts I and II for
creating more flexibility for States and accountability based
on outcome and other performance measures. The plans shall
each include--
``(1) a description of the flexibility that would be given
to the States under the plan;
``(2) the common set of performance measures that would be
used for accountability, including measures that would be
used for the program under subpart II for pregnant addicts,
HIV transmission, tuberculosis, and those with a co-occurring
substance abuse and mental disorders, and for programs under
subpart I for children with serious emotional disturbance and
adults with serious mental illness and for individuals with
co-occurring mental health and substance abuse disorders;
``(3) the definitions for the data elements to be used
under the plan;
``(4) the obstacles to implementation of the plan and the
manner in which such obstacles would be resolved;
``(5) the resources needed to implement the performance
partnerships under the plan; and
``(6) an implementation strategy complete with
recommendations for any necessary legislation.
``(b) Submission.--Not later than 2 years after the date of
enactment of this Act, the plans developed under subsection
(a) shall be submitted to the Committee on Health, Education,
Labor, and Pensions of the Senate and the Committee on
Commerce of the House of Representatives.
``(c) Information.--As the elements of the plans described
in subsection (a) are developed, States are encouraged to
provide information to the Secretary on a voluntary basis.
``(d) Participants.--The Secretary shall include among
those interested groups that participate in the development
of the plan consumers of mental health or substance abuse
services, providers, representatives of political divisions
of States, and representatives of racial and ethnic groups
including Native Americans.''.
(b) Availability to States of Grant Programs.--Section 1952
of the Public Health Service Act (42 U.S.C. 300x-62) is
amended as follows:
``SEC. 1952. AVAILABILITY TO STATES OF GRANT PAYMENTS.
``Any amounts paid to a State for a fiscal year under
section 1911 or 1921 shall be available for obligation and
expenditure until the end of the fiscal year following the
fiscal year for which the amounts were paid.''.
SEC. 3404. DATA INFRASTRUCTURE PROJECTS.
Part C of title XIX of the Public Health Service Act (42
U.S.C. 300y et seq.) is amended--
(1) by striking the headings for part C and subpart I and
inserting the following:
``PART C--CERTAIN PROGRAMS REGARDING MENTAL HEALTH AND SUBSTANCE ABUSE
``Subpart I--Data Infrastructure Development'';
(2) by striking section 1971 (42 U.S.C. 300y) and inserting
the following:
``SEC. 1971. DATA INFRASTRUCTURE DEVELOPMENT.
``(a) In General.--The Secretary may make grants to, and
enter into contracts or cooperative agreements with States
for the purpose of developing and operating mental health or
substance abuse data collection, analysis, and reporting
systems with regard to performance measures including
capacity, process, and outcomes measures.
``(b) Projects.--The Secretary shall establish criteria to
ensure that services will be available under this section to
States that have a fundamental basis for the collection,
analysis, and reporting of mental health and substance abuse
performance measures and States that do not have such basis.
The Secretary will establish criteria for determining whether
a State has a fundamental basis for the collection, analysis,
and reporting of data.
``(c) Condition of Receipt of Funds.--As a condition of the
receipt of an award under this section a State shall agree to
collect, analyze, and report to the Secretary within 2 years
of the date of the award on a core set of performance
measures to be determined by the Secretary in conjunction
with the States.
``(d) Matching Requirement.--
``(1) In general.--With respect to the costs of the program
to be carried out under subsection (a) by a State, the
Secretary may make an award under such subsection only if the
applicant agrees to make available (directly or through
donations from public or private entities) non-Federal
contributions toward such costs in an amount that is not less
than 50 percent of such costs.
``(2) Determination of amount contributed.--Non-Federal
contributions under paragraph (1) may be in cash or in kind,
fairly evaluated, including plant, equipment, or services.
Amounts provided by the Federal Government, or services
assisted or subsidized to any significant extent by the
Federal Government, may not be included in determining the
amount of such contributions.
``(e) Duration of Support.--The period during which
payments may be made for a project under subsection (a) may
be not less than 3 years nor more than 5 years.
``(f) Authorization of Appropriation.--
[[Page H8241]]
``(1) In general.--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 2001, 2002 and
2003.
``(2) Allocation.--Of the amounts appropriated under
paragraph (1) for a fiscal year, 50 percent shall be expended
to support data infrastructure development for mental health
and 50 percent shall be expended to support data
infrastructure development for substance abuse.''.
SEC. 3405. REPEAL OF OBSOLETE ADDICT REFERRAL PROVISIONS.
(a) Repeal of Obsolete Public Health Service Act
Authorities.--Part E of title III (42 U.S.C. 257 et seq.) is
repealed.
(b) Repeal of Obsolete NARA Authorities.--Titles III and IV
of the Narcotic Addict Rehabilitation Act of 1966 (Public Law
89-793) are repealed.
(c) Repeal of Obsolete Title 28 Authorities.--
(1) In general.--Chapter 175 of title 28, United States
Code, is repealed.
(2) Table of contents.--The table of contents to part VI of
title 28, United States Code, is amended by striking the
items relating to chapter 175.
SEC. 3406. INDIVIDUALS WITH CO-OCCURRING DISORDERS.
The Public Health Service Act is amended by inserting after
section 503 (42 U.S.C. 290aa-2) the following:
``SEC. 503A. REPORT ON INDIVIDUALS WITH CO-OCCURRING MENTAL
ILLNESS AND SUBSTANCE ABUSE DISORDERS.
``(a) In General.--Not later than 2 years after the date of
enactment of this section, the Secretary shall, after
consultation with organizations representing States, mental
health and substance abuse treatment providers, prevention
specialists, individuals receiving treatment services, and
family members of such individuals, prepare and submit to the
Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Commerce of the House of
Representatives, a report on prevention and treatment
services for individuals who have co-occurring mental illness
and substance abuse disorders.
``(b) Report Content.--The report under subsection (a)
shall be based on data collected from existing Federal and
State surveys regarding the treatment of co-occurring mental
illness and substance abuse disorders and shall include--
``(1) a summary of the manner in which individuals with co-
occurring disorders are receiving treatment, including the
most up-to-date information available regarding the number of
children and adults with co-occurring mental illness and
substance abuse disorders and the manner in which funds
provided under sections 1911 and 1921 are being utilized,
including the number of such children and adults served with
such funds;
``(2) a summary of improvements necessary to ensure that
individuals with co-occurring mental illness and substance
abuse disorders receive the services they need;
``(3) a summary of practices for preventing substance abuse
among individuals who have a mental illness and are at risk
of having or acquiring a substance abuse disorder; and
``(4) a summary of evidenced-based practices for treating
individuals with co-occurring mental illness and substance
abuse disorders and recommendations for implementing such
practices.
``(c) Funds for Report.--The Secretary may obligate funds
to carry out this section with such appropriations as are
available.''.
SEC. 3407. SERVICES FOR INDIVIDUALS WITH CO-OCCURRING
DISORDERS.
Subpart III of part B of title XIX of the Public Health
Service Act (42 U.S.C. 300x-51 et seq.) (as amended by
section 3305) is further amended by adding at the end the
following:
``SEC. 1956. SERVICES FOR INDIVIDUALS WITH CO-OCCURRING
DISORDERS.
``States may use funds available for treatment under
sections 1911 and 1921 to treat persons with co-occurring
substance abuse and mental disorders as long as funds
available under such sections are used for the purposes for
which they were authorized by law and can be tracked for
accounting purposes.''.
TITLE XXXV--WAIVER AUTHORITY FOR PHYSICIANS WHO DISPENSE OR PRESCRIBE
CERTAIN NARCOTIC DRUGS FOR MAINTENANCE TREATMENT OR DETOXIFICATION
TREATMENT
SEC. 3501. SHORT TITLE.
This title may be cited as the ``Drug Addiction Treatment
Act of 2000''.
SEC. 3502. AMENDMENT TO CONTROLLED SUBSTANCES ACT.
(a) In General.--Section 303(g) of the Controlled
Substances Act (21 U.S.C. 823(g)) is amended--
(1) in paragraph (2), by striking ``(A) security'' and
inserting ``(i) security'', and by striking ``(B) the
maintenance'' and inserting ``(ii) the maintenance'';
(2) by redesignating paragraphs (1) through (3) as
subparagraphs (A) through (C), respectively;
(3) by inserting ``(1)'' after ``(g)'';
(4) by striking ``Practitioners who dispense'' and
inserting ``Except as provided in paragraph (2),
practitioners who dispense''; and
(5) by adding at the end the following paragraph:
``(2)(A) Subject to subparagraphs (D) and (J), the
requirements of paragraph (1) are waived in the case of the
dispensing (including the prescribing), by a practitioner, of
narcotic drugs in schedule III, IV, or V or combinations of
such drugs if the practitioner meets the conditions specified
in subparagraph (B) and the narcotic drugs or combinations of
such drugs meet the conditions specified in subparagraph (C).
``(B) For purposes of subparagraph (A), the conditions
specified in this subparagraph with respect to a practitioner
are that, before the initial dispensing of narcotic drugs in
schedule III, IV, or V or combinations of such drugs to
patients for maintenance or detoxification treatment, the
practitioner submit to the Secretary a notification of the
intent of the practitioner to begin dispensing the drugs or
combinations for such purpose, and that the notification
contain the following certifications by the practitioner:
``(i) The practitioner is a qualifying physician (as
defined in subparagraph (G)).
``(ii) With respect to patients to whom the practitioner
will provide such drugs or combinations of drugs, the
practitioner has the capacity to refer the patients for
appropriate counseling and other appropriate ancillary
services.
``(iii) In any case in which the practitioner is not in a
group practice, the total number of such patients of the
practitioner at any one time will not exceed the applicable
number. For purposes of this clause, the applicable number is
30, except that the Secretary may by regulation change such
total number.
``(iv) In any case in which the practitioner is in a group
practice, the total number of such patients of the group
practice at any one time will not exceed the applicable
number. For purposes of this clause, the applicable number is
30, except that the Secretary may by regulation change such
total number, and the Secretary for such purposes may by
regulation establish different categories on the basis of the
number of practitioners in a group practice and establish for
the various categories different numerical limitations on the
number of such patients that the group practice may have.
``(C) For purposes of subparagraph (A), the conditions
specified in this subparagraph with respect to narcotic drugs
in schedule III, IV, or V or combinations of such drugs are
as follows:
``(i) The drugs or combinations of drugs have, under the
Federal Food, Drug, and Cosmetic Act or section 351 of the
Public Health Service Act, been approved for use in
maintenance or detoxification treatment.
``(ii) The drugs or combinations of drugs have not been the
subject of an adverse determination. For purposes of this
clause, an adverse determination is a determination published
in the Federal Register and made by the Secretary, after
consultation with the Attorney General, that the use of the
drugs or combinations of drugs for maintenance or
detoxification treatment requires additional standards
respecting the qualifications of practitioners to provide
such treatment, or requires standards respecting the
quantities of the drugs that may be provided for unsupervised
use.
``(D)(i) A waiver under subparagraph (A) with respect to a
practitioner is not in effect unless (in addition to
conditions under subparagraphs (B) and (C)) the following
conditions are met:
``(I) The notification under subparagraph (B) is in writing
and states the name of the practitioner.
``(II) The notification identifies the registration issued
for the practitioner pursuant to subsection (f).
``(III) If the practitioner is a member of a group
practice, the notification states the names of the other
practitioners in the practice and identifies the
registrations issued for the other practitioners pursuant to
subsection (f).
``(ii) Upon receiving a notification under subparagraph
(B), the Attorney General shall assign the practitioner
involved an identification number under this paragraph for
inclusion with the registration issued for the practitioner
pursuant to subsection (f). The identification number so
assigned shall be appropriate to preserve the confidentiality
of patients for whom the practitioner has dispensed narcotic
drugs under a waiver under subparagraph (A).
``(iii) Not later than 45 days after the date on which the
Secretary receives a notification under subparagraph (B), the
Secretary shall make a determination of whether the
practitioner involved meets all requirements for a waiver
under subparagraph (B). If the Secretary fails to make such
determination by the end of the such 45-day period, the
Attorney General shall assign the physician an identification
number described in clause (ii) at the end of such period.
``(E)(i) If a practitioner is not registered under
paragraph (1) and, in violation of the conditions specified
in subparagraphs (B) through (D), dispenses narcotic drugs in
schedule III, IV, or V or combinations of such drugs for
maintenance treatment or detoxification treatment, the
Attorney General may, for purposes of section 304(a)(4),
consider the practitioner to have committed an act that
renders the registration of the practitioner pursuant to
subsection (f) to be inconsistent with the public interest.
``(ii)(I) Upon the expiration of 45 days from the date on
which the Secretary receives a notification under
subparagraph (B), a practitioner who in good faith submits a
notification under subparagraph (B) and reasonably believes
that the conditions specified in subparagraphs (B) through
(D) have been met shall, in dispensing narcotic drugs in
schedule III, IV, or V or combinations of such drugs for
maintenance treatment or detoxification treatment, be
considered to have a waiver under subparagraph (A) until
notified otherwise by the Secretary, except that such a
practitioner may commence to prescribe or dispense such
narcotic drugs for such purposes prior to the expiration of
such 45-day period if it facilitates the treatment of an
individual patient and both the Secretary and the Attorney
General are notified by the practitioner of the intent to
commence prescribing or dispensing such narcotic drugs.
[[Page H8242]]
``(II) For purposes of subclause (I), the publication in
the Federal Register of an adverse determination by the
Secretary pursuant to subparagraph (C)(ii) shall (with
respect to the narcotic drug or combination involved) be
considered to be a notification provided by the Secretary to
practitioners, effective upon the expiration of the 30-day
period beginning on the date on which the adverse
determination is so published.
``(F)(i) With respect to the dispensing of narcotic drugs
in schedule III, IV, or V or combinations of such drugs to
patients for maintenance or detoxification treatment, a
practitioner may, in his or her discretion, dispense such
drugs or combinations for such treatment under a registration
under paragraph (1) or a waiver under subparagraph (A)
(subject to meeting the applicable conditions).
``(ii) This paragraph may not be construed as having any
legal effect on the conditions for obtaining a registration
under paragraph (1), including with respect to the number of
patients who may be served under such a registration.
``(G) For purposes of this paragraph:
``(i) The term `group practice' has the meaning given such
term in section 1877(h)(4) of the Social Security Act.
``(ii) The term `qualifying physician' means a physician
who is licensed under State law and who meets one or more of
the following conditions:
``(I) The physician holds a subspecialty board
certification in addiction psychiatry from the American Board
of Medical Specialties.
``(II) The physician holds an addiction certification from
the American Society of Addiction Medicine.
``(III) The physician holds a subspecialty board
certification in addiction medicine from the American
Osteopathic Association.
``(IV) The physician has, with respect to the treatment and
management of opiate-dependent patients, completed not less
than eight hours of training (through classroom situations,
seminars at professional society meetings, electronic
communications, or otherwise) that is provided by the
American Society of Addiction Medicine, the American Academy
of Addiction Psychiatry, the American Medical Association,
the American Osteopathic Association, the American
Psychiatric Association, or any other organization that the
Secretary determines is appropriate for purposes of this
subclause.
``(V) The physician has participated as an investigator in
one or more clinical trials leading to the approval of a
narcotic drug in schedule III, IV, or V for maintenance or
detoxification treatment, as demonstrated by a statement
submitted to the Secretary by the sponsor of such approved
drug.
``(VI) The physician has such other training or experience
as the State medical licensing board (of the State in which
the physician will provide maintenance or detoxification
treatment) considers to demonstrate the ability of the
physician to treat and manage opiate-dependent patients.
``(VII) The physician has such other training or experience
as the Secretary considers to demonstrate the ability of the
physician to treat and manage opiate-dependent patients. Any
criteria of the Secretary under this subclause shall be
established by regulation. Any such criteria are effective
only for 3 years after the date on which the criteria are
promulgated, but may be extended for such additional discrete
3-year periods as the Secretary considers appropriate for
purposes of this subclause. Such an extension of criteria may
only be effectuated through a statement published in the
Federal Register by the Secretary during the 30-day period
preceding the end of the 3-year period involved.
``(H)(i) In consultation with the Administrator of the Drug
Enforcement Administration, the Administrator of the
Substance Abuse and Mental Health Services Administration,
the Director of the National Institute on Drug Abuse, and the
Commissioner of Food and Drugs, the Secretary shall issue
regulations (through notice and comment rulemaking) or issue
practice guidelines to address the following:
``(I) Approval of additional credentialing bodies and the
responsibilities of additional credentialing bodies.
``(II) Additional exemptions from the requirements of this
paragraph and any regulations under this paragraph.
Nothing in such regulations or practice guidelines may
authorize any Federal official or employee to exercise
supervision or control over the practice of medicine or the
manner in which medical services are provided.
``(ii) Not later than 120 days after the date of the
enactment of the Drug Addiction Treatment Act of 2000, the
Secretary shall issue a treatment improvement protocol
containing best practice guidelines for the treatment and
maintenance of opiate-dependent patients. The Secretary shall
develop the protocol in consultation with the Director of the
National Institute on Drug Abuse, the Administrator of the
Drug Enforcement Administration, the Commissioner of Food and
Drugs, the Administrator of the Substance Abuse and Mental
Health Services Administration and other substance abuse
disorder professionals. The protocol shall be guided by
science.
``(I) During the 3-year period beginning on the date of the
enactment of the Drug Addiction Treatment Act of 2000, a
State may not preclude a practitioner from dispensing or
prescribing drugs in schedule III, IV, or V, or combinations
of such drugs, to patients for maintenance or detoxification
treatment in accordance with this paragraph unless, before
the expiration of that 3-year period, the State enacts a law
prohibiting a practitioner from dispensing such drugs or
combinations of drug.
``(J)(i) This paragraph takes effect on the date of the
enactment of the Drug Addiction Treatment Act of 2000, and
remains in effect thereafter except as provided in clause
(iii) (relating to a decision by the Secretary or the
Attorney General that this paragraph should not remain in
effect).
``(ii) For purposes relating to clause (iii), the Secretary
and the Attorney General may, during the 3-year period
beginning on the date of the enactment of the Drug Addiction
Treatment Act of 2000, make determinations in accordance with
the following:
``(I) The Secretary may make a determination of whether
treatments provided under waivers under subparagraph (A) have
been effective forms of maintenance treatment and
detoxification treatment in clinical settings; may make a
determination of whether such waivers have significantly
increased (relative to the beginning of such period) the
availability of maintenance treatment and detoxification
treatment; and may make a determination of whether such
waivers have adverse consequences for the public health.
``(II) The Attorney General may make a determination of the
extent to which there have been violations of the numerical
limitations established under subparagraph (B) for the number
of individuals to whom a practitioner may provide treatment;
may make a determination of whether waivers under
subparagraph (A) have increased (relative to the beginning of
such period) the extent to which narcotic drugs in schedule
III, IV, or V or combinations of such drugs are being
dispensed or possessed in violation of this Act; and may make
a determination of whether such waivers have adverse
consequences for the public health.
``(iii) If, before the expiration of the period specified
in clause (ii), the Secretary or the Attorney General
publishes in the Federal Register a decision, made on the
basis of determinations under such clause, that this
paragraph should not remain in effect, this paragraph ceases
to be in effect 60 days after the date on which the decision
is so published. The Secretary shall in making any such
decision consult with the Attorney General, and shall in
publishing the decision in the Federal Register include any
comments received from the Attorney General for inclusion in
the publication. The Attorney General shall in making any
such decision consult with the Secretary, and shall in
publishing the decision in the Federal Register include any
comments received from the Secretary for inclusion in the
publication.''.
(b) Conforming Amendments.--Section 304 of the Controlled
Substances Act (21 U.S.C. 824) is amended--
(1) in subsection (a), in the matter after and below
paragraph (5), by striking ``section 303(g)'' each place such
term appears and inserting ``section 303(g)(1)''; and
(2) in subsection (d), by striking ``section 303(g)'' and
inserting ``section 303(g)(1)''.
(c) Additional Authorization of Appropriations.--For the
purpose of assisting the Secretary of Health and Human
Services with the additional duties established for the
Secretary pursuant to the amendments made by this section,
there are authorized to be appropriated, in addition to other
authorizations of appropriations that are available for such
purpose, such sums as may be necessary for each of fiscal
years 2001 through 2003.
TITLE XXXVI--METHAMPHETAMINE AND OTHER CONTROLLED SUBSTANCES
SEC. 3601. SHORT TITLE.
This title may be cited as the ``Methamphetamine Anti-
Proliferation Act of 2000''.
Subtitle A--Methamphetamine Production, Trafficking, and Abuse
PART I--CRIMINAL PENALTIES
SEC. 3611. ENHANCED PUNISHMENT OF AMPHETAMINE LABORATORY
OPERATORS.
(a) Amendment to Federal Sentencing Guidelines.--Pursuant
to its authority under section 994(p) of title 28, United
States Code, the United States Sentencing Commission shall
amend the Federal sentencing guidelines in accordance with
this section with respect to any offense relating to the
manufacture, importation, exportation, or trafficking in
amphetamine (including an attempt or conspiracy to do any of
the foregoing) in violation of--
(1) the Controlled Substances Act (21 U.S.C. 801 et seq.);
(2) the Controlled Substances Import and Export Act (21
U.S.C. 951 et seq.); or
(3) the Maritime Drug Law Enforcement Act (46 U.S.C. App.
1901 et seq.).
(b) General Requirement.--In carrying out this section, the
United States Sentencing Commission shall, with respect to
each offense described in subsection (a) relating to
amphetamine--
(1) review and amend its guidelines to provide for
increased penalties such that those penalties are comparable
to the base offense level for methamphetamine; and
(2) take any other action the Commission considers
necessary to carry out this subsection.
(c) Additional Requirements.--In carrying out this section,
the United States Sentencing Commission shall ensure that the
sentencing guidelines for offenders convicted of offenses
described in subsection (a) reflect the heinous nature of
such offenses, the need for aggressive law enforcement action
to fight such offenses, and the extreme dangers associated
with unlawful activity involving amphetamines, including--
(1) the rapidly growing incidence of amphetamine abuse and
the threat to public safety that such abuse poses;
(2) the high risk of amphetamine addiction;
(3) the increased risk of violence associated with
amphetamine trafficking and abuse; and
(4) the recent increase in the illegal importation of
amphetamine and precursor chemicals.
(d) Emergency Authority to Sentencing Commission.--The
United States Sentencing Commission shall promulgate
amendments pursuant to this section as soon as practicable
after
[[Page H8243]]
the date of enactment of this Act in accordance with the
procedure set forth in section 21(a) of the Sentencing Act of
1987 (Public Law 100-182), as though the authority under that
Act had not expired.
SEC. 3612. ENHANCED PUNISHMENT OF AMPHETAMINE OR
METHAMPHETAMINE LABORATORY OPERATORS.
(a) Federal Sentencing Guidelines.--
(1) In general.--Pursuant to its authority under section
994(p) of title 28, United States Code, the United States
Sentencing Commission shall amend the Federal sentencing
guidelines in accordance with paragraph (2) with respect to
any offense relating to the manufacture, attempt to
manufacture, or conspiracy to manufacture amphetamine or
methamphetamine in violation of--
(A) the Controlled Substances Act (21 U.S.C. 801 et seq.);
(B) the Controlled Substances Import and Export Act (21
U.S.C. 951 et seq.); or
(C) the Maritime Drug Law Enforcement Act (46 U.S.C. App.
1901 et seq.).
(2) Requirements.--In carrying out this paragraph, the
United States Sentencing Commission shall--
(A) if the offense created a substantial risk of harm to
human life (other than a life described in subparagraph (B))
or the environment, increase the base offense level for the
offense--
(i) by not less than 3 offense levels above the applicable
level in effect on the date of enactment of this Act; or
(ii) if the resulting base offense level after an increase
under clause (i) would be less than level 27, to not less
than level 27; or
(B) if the offense created a substantial risk of harm to
the life of a minor or incompetent, increase the base offense
level for the offense--
(i) by not less than 6 offense levels above the applicable
level in effect on the date of enactment of this Act; or
(ii) if the resulting base offense level after an increase
under clause (i) would be less than level 30, to not less
than level 30.
(3) Emergency authority to sentencing commission.--The
United States Sentencing Commission shall promulgate
amendments pursuant to this subsection as soon as practicable
after the date of enactment of this Act in accordance with
the procedure set forth in section 21(a) of the Sentencing
Act of 1987 (Public Law 100-182), as though the authority
under that Act had not expired.
(b) Effective Date.--The amendments made pursuant to this
section shall apply with respect to any offense occurring on
or after the date that is 60 days after the date of enactment
of this Act.
SEC. 3613. MANDATORY RESTITUTION FOR VIOLATIONS OF CONTROLLED
SUBSTANCES ACT AND CONTROLLED SUBSTANCES IMPORT
AND EXPORT ACT RELATING TO AMPHETAMINE AND
METHAMPHETAMINE.
(a) Mandatory Restitution.--Section 413(q) of the
Controlled Substances Act (21 U.S.C. 853(q)) is amended--
(1) in the matter preceding paragraph (1), by striking
``may'' and inserting ``shall'';
(2) by inserting ``amphetamine or'' before
``methamphetamine'' each place it appears;
(3) in paragraph (2)--
(A) by inserting ``, the State or local government
concerned, or both the United States and the State or local
government concerned'' after ``United States'' the first
place it appears; and
(B) by inserting ``or the State or local government
concerned, as the case may be,'' after ``United States'' the
second place it appears; and
(4) in paragraph (3), by striking ``section 3663 of title
18, United States Code'' and inserting ``section 3663A of
title 18, United States Code''.
(b) Deposit of Amounts in Department of Justice Assets
Forfeiture Fund.--Section 524(c)(4) of title 28, United
States Code, is amended--
(1) by striking ``and'' at the end of subparagraph (B);
(2) by striking the period at the end of subparagraph (C)
and inserting ``; and''; and
(3) by adding at the end the following:
``(D) all amounts collected--
``(i) by the United States pursuant to a reimbursement
order under paragraph (2) of section 413(q) of the Controlled
Substances Act (21 U.S.C. 853(q)); and
``(ii) pursuant to a restitution order under paragraph (1)
or (3) of section 413(q) of the Controlled Substances Act for
injuries to the United States.''.
(c) Clarification of Certain Orders of Restitution.--
Section 3663(c)(2)(B) of title 18, United States Code, is
amended by inserting ``which may be'' after ``the fine''.
(d) Expansion of Applicability of Mandatory Restitution.--
Section 3663A(c)(1)(A)(ii) of title 18, United States Code,
is amended by inserting ``or under section 416(a) of the
Controlled Substances Act (21 U.S.C. 856(a)),'' after ``under
this title,''.
(e) Treatment of Illicit Substance Manufacturing Operations
as Crimes Against Property.--Section 416 of the Controlled
Substances Act (21 U.S.C. 856) is amended by adding at the
end the following new subsection:
``(c) A violation of subsection (a) shall be considered an
offense against property for purposes of section
3663A(c)(1)(A)(ii) of title 18, United States Code.''.
SEC. 3614. METHAMPHETAMINE PARAPHERNALIA.
Section 422(d) of the Controlled Substances Act (21 U.S.C.
863(d)) is amended in the matter preceding paragraph (1) by
inserting ``methamphetamine,'' after ``PCP,''.
PART II--ENHANCED LAW ENFORCEMENT
SEC. 3621. ENVIRONMENTAL HAZARDS ASSOCIATED WITH ILLEGAL
MANUFACTURE OF AMPHETAMINE AND METHAMPHETAMINE.
(a) Use of Amounts or Department of Justice Assets
Forfeiture Fund.--Section 524(c)(1)(E) of title 28, United
States Code, is amended--
(1) by inserting ``(i) for'' before ``disbursements'';
(2) by inserting ``and'' after the semicolon; and
(3) by adding at the end the following:
``(ii) for payment for--
``(I) costs incurred by or on behalf of the Department of
Justice in connection with the removal, for purposes of
Federal forfeiture and disposition, of any hazardous
substance or pollutant or contaminant associated with the
illegal manufacture of amphetamine or methamphetamine; and
``(II) costs incurred by or on behalf of a State or local
government in connection with such removal in any case in
which such State or local government has assisted in a
Federal prosecution relating to amphetamine or
methamphetamine, to the extent such costs exceed equitable
sharing payments made to such State or local government in
such case;''.
(b) Grants Under Drug Control and System Improvement Grant
Program.--Section 501(b)(3) of the Omnibus Crime Control and
Safe Streets Act of 1968 (42 U.S.C. 3751(b)(3)) is amended by
inserting before the semicolon the following: ``and to remove
any hazardous substance or pollutant or contaminant
associated with the illegal manufacture of amphetamine or
methamphetamine''.
(c) Amounts Supplement and Not Supplant.--
(1) Assets forfeiture fund.--Any amounts made available
from the Department of Justice Assets Forfeiture Fund in a
fiscal year by reason of the amendment made by subsection (a)
shall supplement, and not supplant, any other amounts made
available to the Department of Justice in such fiscal year
from other sources for payment of costs described in section
524(c)(1)(E)(ii) of title 28, United States Code, as so
amended.
(2) Grant program.--Any amounts made available in a fiscal
year under the grant program under section 501(b)(3) of the
Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C.
3751(b)(3)) for the removal of hazardous substances or
pollutants or contaminants associated with the illegal
manufacture of amphetamine or methamphetamine by reason of
the amendment made by subsection (b) shall supplement, and
not supplant, any other amounts made available in such fiscal
year from other sources for such removal.
SEC. 3622. REDUCTION IN RETAIL SALES TRANSACTION THRESHOLD
FOR NON-SAFE HARBOR PRODUCTS CONTAINING
PSEUDOEPHEDRINE OR PHENYLPROPANOLAMINE.
(a) Reduction in Transaction Threshold.--Section
102(39)(A)(iv)(II) of the Controlled Substances Act (21
U.S.C. 802(39)(A)(iv)(II)) is amended--
(1) by striking ``24 grams'' both places it appears and
inserting ``9 grams''; and
(2) by inserting before the semicolon at the end the
following: ``and sold in package sizes of not more than 3
grams of pseudoephedrine base or 3 grams of
phenylpropanolamine base''.
(b) Effective Date.--The amendments made by subsection (a)
shall take effect 1 year after the date of enactment of this
Act.
SEC. 3623. TRAINING FOR DRUG ENFORCEMENT ADMINISTRATION AND
STATE AND LOCAL LAW ENFORCEMENT PERSONNEL
RELATING TO CLANDESTINE LABORATORIES.
(a) In General.--
(1) Requirement.--The Administrator of the Drug Enforcement
Administration shall carry out the programs described in
subsection (b) with respect to the law enforcement personnel
of States and localities determined by the Administrator to
have significant levels of methamphetamine-related or
amphetamine-related crime or projected by the Administrator
to have the potential for such levels of crime in the future.
(2) Duration.--The duration of any program under that
subsection may not exceed 3 years.
(b) Covered Programs.--The programs described in this
subsection are as follows:
(1) Advanced mobile clandestine laboratory training
teams.--A program of advanced mobile clandestine laboratory
training teams, which shall provide information and training
to State and local law enforcement personnel in techniques
utilized in conducting undercover investigations and
conspiracy cases, and other information designed to assist in
the investigation of the illegal manufacturing and
trafficking of amphetamine and methamphetamine.
(2) Basic clandestine laboratory certification training.--A
program of basic clandestine laboratory certification
training, which shall provide information and training--
(A) to Drug Enforcement Administration personnel and State
and local law enforcement personnel for purposes of enabling
such personnel to meet any certification requirements under
law with respect to the handling of wastes created by illegal
amphetamine and methamphetamine laboratories; and
(B) to State and local law enforcement personnel for
purposes of enabling such personnel to provide the
information and training covered by subparagraph (A) to other
State and local law enforcement personnel.
(3) Clandestine laboratory recertification and awareness
training.--A program of clandestine laboratory
recertification and awareness training, which shall provide
information and training to State and local law enforcement
personnel for purposes of enabling such personnel to provide
recertification and awareness training relating to
clandestine laboratories to additional State and local law
enforcement personnel.
(c) Authorization of Appropriations.--There are authorized
to be appropriated for
[[Page H8244]]
each of fiscal years 2000, 2001, and 2002 amounts as follows:
(1) $1,500,000 to carry out the program described in
subsection (b)(1).
(2) $3,000,000 to carry out the program described in
subsection (b)(2).
(3) $1,000,000 to carry out the program described in
subsection (b)(3).
SEC. 3624. COMBATING METHAMPHETAMINE AND AMPHETAMINE IN HIGH
INTENSITY DRUG TRAFFICKING AREAS.
(a) In General.--
(1) In general.--The Director of National Drug Control
Policy shall use amounts available under this section to
combat the trafficking of methamphetamine and amphetamine in
areas designated by the Director as high intensity drug
trafficking areas.
(2) Activities.--In meeting the requirement in paragraph
(1), the Director shall transfer funds to appropriate
Federal, State, and local governmental agencies for employing
additional Federal law enforcement personnel, or facilitating
the employment of additional State and local law enforcement
personnel, including agents, investigators, prosecutors,
laboratory technicians, chemists, investigative assistants,
and drug-prevention specialists.
(b) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section--
(1) $15,000,000 for fiscal year 2000; and
(2) such sums as may be necessary for each of fiscal years
2001 through 2004.
(c) Apportionment of Funds.--
(1) Factors in apportionment.--The Director shall apportion
amounts appropriated for a fiscal year pursuant to the
authorization of appropriations in subsection (b) for
activities under subsection (a) among and within areas
designated by the Director as high intensity drug trafficking
areas based on the following factors:
(A) The number of methamphetamine manufacturing facilities
and amphetamine manufacturing facilities discovered by
Federal, State, or local law enforcement officials in the
previous fiscal year.
(B) The number of methamphetamine prosecutions and
amphetamine prosecutions in Federal, State, or local courts
in the previous fiscal year.
(C) The number of methamphetamine arrests and amphetamine
arrests by Federal, State, or local law enforcement officials
in the previous fiscal year.
(D) The amounts of methamphetamine, amphetamine, or listed
chemicals (as that term is defined in section 102(33) of the
Controlled Substances Act (21 U.S.C. 802(33)) seized by
Federal, State, or local law enforcement officials in the
previous fiscal year.
(E) Intelligence and predictive data from the Drug
Enforcement Administration and the Department of Health and
Human Services showing patterns and trends in abuse,
trafficking, and transportation in methamphetamine,
amphetamine, and listed chemicals (as that term is so
defined).
(2) Certification.--Before the Director apportions any
funds under this subsection to a high intensity drug
trafficking area, the Director shall certify that the law
enforcement entities responsible for clandestine
methamphetamine and amphetamine laboratory seizures in that
area are providing laboratory seizure data to the national
clandestine laboratory database at the El Paso Intelligence
Center.
(d) Limitation on Administrative Costs.--Not more than 5
percent of the amount appropriated in a fiscal year pursuant
to the authorization of appropriations for that fiscal year
in subsection (b) may be available in that fiscal year for
administrative costs associated with activities under
subsection (a).
SEC. 3625. COMBATING AMPHETAMINE AND METHAMPHETAMINE
MANUFACTURING AND TRAFFICKING.
(a) Activities.--In order to combat the illegal
manufacturing and trafficking in amphetamine and
methamphetamine, the Administrator of the Drug Enforcement
Administration may--
(1) assist State and local law enforcement in small and
mid-sized communities in all phases of investigations related
to such manufacturing and trafficking, including assistance
with foreign-language interpretation;
(2) staff additional regional enforcement and mobile
enforcement teams related to such manufacturing and
trafficking;
(3) establish additional resident offices and posts of duty
to assist State and local law enforcement in rural areas in
combating such manufacturing and trafficking;
(4) provide the Special Operations Division of the
Administration with additional agents and staff to collect,
evaluate, interpret, and disseminate critical intelligence
targeting the command and control operations of major
amphetamine and methamphetamine manufacturing and trafficking
organizations;
(5) enhance the investigative and related functions of the
Chemical Control Program of the Administration to implement
more fully the provisions of the Comprehensive
Methamphetamine Control Act of 1996 (Public Law 104-237);
(6) design an effective means of requiring an accurate
accounting of the import and export of list I chemicals, and
coordinate investigations relating to the diversion of such
chemicals;
(7) develop a computer infrastructure sufficient to
receive, process, analyze, and redistribute time-sensitive
enforcement information from suspicious order reporting to
field offices of the Administration and other law enforcement
and regulatory agencies, including the continuing development
of the Suspicious Order Reporting and Tracking System (SORTS)
and the Chemical Transaction Database (CTRANS) of the
Administration;
(8) establish an education, training, and communication
process in order to alert the industry to current trends and
emerging patterns in the illegal manufacturing of amphetamine
and methamphetamine; and
(9) carry out such other activities as the Administrator
considers appropriate.
(b) Additional Positions and Personnel.--
(1) In general.--In carrying out activities under
subsection (a), the Administrator may establish in the
Administration not more than 50 full-time positions,
including not more than 31 special-agent positions, and may
appoint personnel to such positions.
(2) Particular positions.--In carrying out activities under
paragraphs (5) through (8) of subsection (a), the
Administrator may establish in the Administration not more
than 15 full-time positions, including not more than 10
diversion investigator positions, and may appoint personnel
to such positions. Any positions established under this
paragraph are in addition to any positions established under
paragraph (1).
(c) Authorization of Appropriations.--There are authorized
to be appropriated for the Drug Enforcement Administration
for each fiscal year after fiscal year 1999, $9,500,000 for
purposes of carrying out the activities authorized by
subsection (a) and employing personnel in positions
established under subsection (b), of which $3,000,000 shall
be available for activities under paragraphs (5) through (8)
of subsection (a) and for employing personnel in positions
established under subsection (b)(2).
PART III--ABUSE PREVENTION AND TREATMENT
SEC. 3631. EXPANSION OF METHAMPHETAMINE RESEARCH.
Section 464N of the Public Health Service Act (42 U.S.C.
285o-2) is amended by adding at the end the following:
``(c) Methamphetamine Research.--
``(1) Grants or cooperative agreements.--The Director of
the Institute may make grants or enter into cooperative
agreements to expand the current and on-going
interdisciplinary research and clinical trials with treatment
centers of the National Drug Abuse Treatment Clinical Trials
Network relating to methamphetamine abuse and addiction and
other biomedical, behavioral, and social issues related to
methamphetamine abuse and addiction.
``(2) Use of funds.--Amounts made available under a grant
or cooperative agreement under paragraph (1) for
methamphetamine abuse and addiction may be used for research
and clinical trials relating to--
``(A) the effects of methamphetamine abuse on the human
body, including the brain;
``(B) the addictive nature of methamphetamine and how such
effects differ with respect to different individuals;
``(C) the connection between methamphetamine abuse and
mental health;
``(D) the identification and evaluation of the most
effective methods of prevention of methamphetamine abuse and
addiction;
``(E) the identification and development of the most
effective methods of treatment of methamphetamine addiction,
including pharmacological treatments;
``(F) risk factors for methamphetamine abuse;
``(G) effects of methamphetamine abuse and addiction on
pregnant women and their fetuses; and
``(H) cultural, social, behavioral, neurological and
psychological reasons that individuals abuse methamphetamine,
or refrain from abusing methamphetamine.
``(3) Research results.--The Director shall promptly
disseminate research results under this subsection to
Federal, State and local entities involved in combating
methamphetamine abuse and addiction.
``(4) Authorization of appropriations.--
``(A) Authorization of appropriations.--There is authorized
to be appropriated to carry out paragraph (1), such sums as
may be necessary for each fiscal year.
``(B) Supplement not supplant.--Amounts appropriated
pursuant to the authorization of appropriations in
subparagraph (A) for a fiscal year shall supplement and not
supplant any other amounts appropriated in such fiscal year
for research on methamphetamine abuse and addiction.''.
SEC. 3632. METHAMPHETAMINE AND AMPHETAMINE TREATMENT
INITIATIVE BY CENTER FOR SUBSTANCE ABUSE
TREATMENT.
Subpart 1 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb et seq.) is amended by adding at the end
the following new section:
``methamphetamine and amphetamine treatment initiative
``Sec. 514. (a) Grants.--
``(1) Authority to make grants.--The Director of the Center
for Substance Abuse Treatment may make grants to States and
Indian tribes recognized by the United States that have a
high rate, or have had a rapid increase, in methamphetamine
or amphetamine abuse or addiction in order to permit such
States and Indian tribes to expand activities in connection
with the treatment of methamphetamine or amphetamine abuser
or addiction in the specific geographical areas of such
States or Indian tribes, as the case may be, where there is
such a rate or has been such an increase.
``(2) Recipients.--Any grants under paragraph (1) shall be
directed to the substance abuse directors of the States, and
of the appropriate tribal government authorities of the
Indian tribes, selected by the Director to receive such
grants.
``(3) Nature of activities.--Any activities under a grant
under paragraph (1) shall be based on reliable scientific
evidence of their efficacy in the treatment of
methamphetamine or amphetamine abuse or addiction.
``(b) Geographic Distribution.--The Director shall ensure
that grants under subsection (a) are distributed equitably
among the various regions of the country and among rural,
urban,
[[Page H8245]]
and suburban areas that are affected by methamphetamine or
amphetamine abuse or addiction.
``(c) Additional Activities.--The Director shall--
``(1) evaluate the activities supported by grants under
subsection (a);
``(2) disseminate widely such significant information
derived from the evaluation as the Director considers
appropriate to assist States, Indian tribes, and private
providers of treatment services for methamphetamine or
amphetamine abuser or addiction in the treatment of
methamphetamine or amphetamine abuse or addiction; and
``(3) provide States, Indian tribes, and such providers
with technical assistance in connection with the provision of
such treatment.
``(d) Authorization of Appropriations.--
``(1) In general.--There are authorized to be appropriated
to carry out this section $10,000,000 for fiscal year 2000
and such sums as may be necessary for each of fiscal years
2001 and 2002.
``(2) Use of certain funds.--Of the funds appropriated to
carry out this section in any fiscal year, the lesser of 5
percent of such funds or $1,000,000 shall be available to the
Director for purposes of carrying out subsection (c).''.
SEC. 3633. STUDY OF METHAMPHETAMINE TREATMENT.
(a) Study.--
(1) Requirement.--The Secretary of Health and Human
Services shall, in consultation with the Institute of
Medicine of the National Academy of Sciences, conduct a study
on the development of medications for the treatment of
addiction to amphetamine and methamphetamine.
(2) Report.--Not later than 9 months after the date of
enactment of this Act, the Secretary shall submit to the
Committees on the Judiciary of the Senate and House of
Representatives a report on the results of the study
conducted under paragraph (1).
(b) Authorization of Appropriations.--There are hereby
authorized to be appropriated for the Department of Health
and Human Services for fiscal year 2000 such sums as may be
necessary to meet the requirements of subsection (a).
PART IV--REPORTS
SEC. 3641. REPORTS ON CONSUMPTION OF METHAMPHETAMINE AND
OTHER ILLICIT DRUGS IN RURAL AREAS,
METROPOLITAN AREAS, AND CONSOLIDATED
METROPOLITAN AREAS.
The Secretary of Health and Human Services shall include in
each National Household Survey on Drug Abuse appropriate
prevalence data and information on the consumption of
methamphetamine and other illicit drugs in rural areas,
metropolitan areas, and consolidated metropolitan areas.
SEC. 3642. REPORT ON DIVERSION OF ORDINARY, OVER-THE-COUNTER
PSEUDOEPHEDRINE AND PHENYLPROPANOLAMINE
PRODUCTS.
(a) Study.--The Attorney General shall conduct a study of
the use of ordinary, over-the-counter pseudoephedrine and
phenylpropanolamine products in the clandestine production of
illicit drugs. Sources of data for the study shall include
the following:
(1) Information from Federal, State, and local clandestine
laboratory seizures and related investigations identifying
the source, type, or brand of drug products being utilized
and how they were obtained for the illicit production of
methamphetamine and amphetamine.
(2) Information submitted voluntarily from the
pharmaceutical and retail industries involved in the
manufacture, distribution, and sale of drug products
containing ephedrine, pseudoephedrine, and
phenylpropanolamine, including information on changes in the
pattern, volume, or both, of sales of ordinary, over-the-
counter pseudoephedrine and phenylpropanolamine products.
(b) Report.--
(1) Requirement.--Not later than 1 year after the date of
enactment of this Act, the Attorney General shall submit to
Congress a report on the study conducted under subsection
(a).
(2) Elements.--The report shall include--
(A) the findings of the Attorney General as a result of the
study; and
(B) such recommendations on the need to establish
additional measures to prevent diversion of ordinary, over-
the-counter pseudoephedrine and phenylpropanolamine (such as
a threshold on ordinary, over-the-counter pseudoephedrine and
phenylpropanolamine products) as the Attorney General
considers appropriate.
(3) Matters considered.--In preparing the report, the
Attorney General shall consider the comments and
recommendations including the comments on the Attorney
General's proposed findings and recommendations, of State and
local law enforcement and regulatory officials and of
representatives of the industry described in subsection
(a)(2).
(c) Regulation of Retail Sales.--
(1) In general.--Notwithstanding section 401(d) of the
Comprehensive Methamphetamine Control Act of 1996 (21 U.S.C.
802 note) and subject to paragraph (2), the Attorney General
shall establish by regulation a single-transaction limit of
not less than 24 grams of ordinary, over-the-counter
pseudoephedrine or phenylpropanolamine (as the case may be)
for retail distributors, if the Attorney General finds, in
the report under subsection (b), that--
(A) there is a significant number of instances (as set
forth in paragraph (3)(A) of such section 401(d) for purposes
of such section) where ordinary, over-the-counter
pseudoephedrine products, phenylpropanolamine products, or
both such products that were purchased from retail
distributors were widely used in the clandestine production
of illicit drugs; and
(B) the best practical method of preventing such use is the
establishment of single-transaction limits for retail
distributors of either or both of such products.
(2) Due process.--The Attorney General shall establish the
single-transaction limit under paragraph (1) only after
notice, comment, and an informal hearing.
Subtitle B--Controlled Substances Generally
SEC. 3651. ENHANCED PUNISHMENT FOR TRAFFICKING IN LIST I
CHEMICALS.
(a) Amendments to Federal Sentencing Guidelines.--Pursuant
to its authority under section 994(p) of title 28, United
States Code, the United States Sentencing Commission shall
amend the Federal sentencing guidelines in accordance with
this section with respect to any violation of paragraph (1)
or (2) of section 401(d) of the Controlled Substances Act (21
U.S.C. 841(d)) involving a list I chemical and any violation
of paragraph (1) or (3) of section 1010(d) of the Controlled
Substance Import and Export Act (21 U.S.C. 960(d)) involving
a list I chemical.
(b) Ephedrine, Phenylpropanolamine, and Pseudoephedrine.--
(1) In general.--In carrying this section, the United
States Sentencing Commission shall, with respect to each
offense described in subsection (a) involving ephedrine,
phenylpropanolamine, or pseudoephedrine (including their
salts, optical isomers, and salts of optical isomers), review
and amend its guidelines to provide for increased penalties
such that those penalties corresponded to the quantity of
controlled substance that could reasonably have been
manufactured using the quantity of ephedrine,
phenylpropanolamine, or pseudoephedrine possessed or
distributed.
(2) Conversion ratios.--For the purposes of the amendments
made by this subsection, the quantity of controlled substance
that could reasonably have been manufactured shall be
determined by using a table of manufacturing conversion
ratios for ephedrine, phenylpropanolamine, and
pseudoephedrine, which table shall be established by the
Sentencing Commission based on scientific, law enforcement,
and other data the Sentencing Commission considers
appropriate.
(c) Other List I Chemicals.--In carrying this section, the
United States Sentencing Commission shall, with respect to
each offense described in subsection (a) involving any list I
chemical other than ephedrine, phenylpropanolamine, or
pseudoephedrine, review and amend its guidelines to provide
for increased penalties such that those penalties reflect the
dangerous nature of such offenses, the need for aggressive
law enforcement action to fight such offenses, and the
extreme dangers associated with unlawful activity involving
methamphetamine and amphetamine, including--
(1) the rapidly growing incidence of controlled substance
manufacturing;
(2) the extreme danger inherent in manufacturing controlled
substances;
(3) the threat to public safety posed by manufacturing
controlled substances; and
(4) the recent increase in the importation, possession, and
distribution of list I chemicals for the purpose of
manufacturing controlled substances.
(d) Emergency Authority to Sentencing Commission.--The
United States Sentencing Commission shall promulgate
amendments pursuant to this section as soon as practicable
after the date of enactment of this Act in accordance with
the procedure set forth in section 21(a) of the Sentencing
Act of 1987 (Public Law 100-182), as though the authority
under that Act had not expired.
SEC. 3652. MAIL ORDER REQUIREMENTS.
Section 310(b)(3) of the Controlled Substances Act (21
U.S.C. 830(b)(3)) is amended--
(1) by redesignating subparagraphs (A) and (B) as
subparagraphs (B) and (C), respectively;
(2) by inserting before subparagraph (B), as so
redesignated, the following new subparagraph (A):
``(A) As used in this paragraph:
``(i) The term `drug product' means an active ingredient in
dosage form that has been approved or otherwise may be
lawfully marketed under the Food, Drug, and Cosmetic Act for
distribution in the United States.
``(ii) The term `valid prescription' means a prescription
which is issued for a legitimate medical purpose by an
individual practitioner licensed by law to administer and
prescribe the drugs concerned and acting in the usual course
of the practitioner's professional practice.'';
(3) in subparagraph (B), as so redesignated, by inserting
``or who engages in an export transaction'' after
``nonregulated person''; and
(4) adding at the end the following:
``(D) Except as provided in subparagraph (E), the following
distributions to a nonregulated person, and the following
export transactions, shall not be subject to the reporting
requirement in subparagraph (B):
``(i) Distributions of sample packages of drug products
when such packages contain not more than 2 solid dosage units
or the equivalent of 2 dosage units in liquid form, not to
exceed 10 milliliters of liquid per package, and not more
than one package is distributed to an individual or
residential address in any 30-day period.
``(ii) Distributions of drug products by retail
distributors that may not include face-to-face transactions
to the extent that such distributions are consistent with the
activities authorized for a retail distributor as specified
in section 102(46).
``(iii) Distributions of drug products to a resident of a
long term care facility (as that term is defined in
regulations prescribed by the Attorney General) or
distributions of drug products to a long term care facility
for dispensing to or for use by a resident of that facility.
``(iv) Distributions of drug products pursuant to a valid
prescription.
``(v) Exports which have been reported to the Attorney
General pursuant to section 1004 or
[[Page H8246]]
1018 or which are subject to a waiver granted under section
1018(e)(2).
``(vi) Any quantity, method, or type of distribution or any
quantity, method, or type of distribution of a specific
listed chemical (including specific formulations or drug
products) or of a group of listed chemicals (including
specific formulations or drug products) which the Attorney
General has excluded by regulation from such reporting
requirement on the basis that such reporting is not necessary
for the enforcement of this title or title III.
``(E) The Attorney General may revoke any or all of the
exemptions listed in subparagraph (D) for an individual
regulated person if he finds that drug products distributed
by the regulated person are being used in violation of this
title or title III. The regulated person shall be notified of
the revocation, which will be effective upon receipt by the
person of such notice, as provided in section 1018(c)(1), and
shall have the right to an expedited hearing as provided in
section 1018(c)(2).''.
SEC. 3653. THEFT AND TRANSPORTATION OF ANHYDROUS AMMONIA FOR
PURPOSES OF ILLICIT PRODUCTION OF CONTROLLED
SUBSTANCES.
(a) In General.--Part D of the Controlled Substances Act
(21 U.S.C. 841 et seq.) is amended by adding at the end the
following:
``anhydrous ammonia
``Sec. 423. (a) It is unlawful for any person--
``(1) to steal anhydrous ammonia, or
``(2) to transport stolen anhydrous ammonia across State
lines,
knowing, intending, or having reasonable cause to believe
that such anhydrous ammonia will be used to manufacture a
controlled substance in violation of this part.
``(b) Any person who violates subsection (a) shall be
imprisoned or fined, or both, in accordance with section
403(d) as if such violation were a violation of a provision
of section 403.''.
(b) Clerical Amendment.--The table of contents for that Act
is amended by inserting after the item relating to section
421 the following new items:
``Sec. 422. Drug paraphernalia.
``Sec. 423. Anhydrous ammonia.''.
(c) Assistance for Certain Research.--
(1) Agreement.--The Administrator of the Drug Enforcement
Administration shall seek to enter into an agreement with
Iowa State University in order to permit the University to
continue and expand its current research into the development
of inert agents that, when added to anhydrous ammonia,
eliminate the usefulness of anhydrous ammonia as an
ingredient in the production of methamphetamine.
(2) Reimbursable provision of funds.--The agreement under
paragraph (1) may provide for the provision to Iowa State
University, on a reimbursable basis, of $500,000 for purposes
the activities specified in that paragraph.
(3) Authorization of appropriations.--There is hereby
authorized to be appropriated for the Drug Enforcement
Administration for fiscal year 2000, $500,000 for purposes of
carrying out the agreement under this subsection.
Subtitle C--Ecstasy Anti-Proliferation Act of 2000
SEC. 3661. SHORT TITLE.
This subtitle may be cited as the ``Ecstasy Anti-
Proliferation Act of 2000''.
SEC. 3662. FINDINGS.
Congress makes the following findings:
(1) The illegal importation of 3,4-methylenedioxy
methamphetamine, commonly referred to as ``MDMA'' or
``Ecstasy'' (referred to in this subtitle as ``Ecstasy''),
has increased in recent years, as evidenced by the fact that
Ecstasy seizures by the United States Customs Service have
increased from less than 500,000 tablets during fiscal year
1997 to more than 9,000,000 tablets during the first 9 months
of fiscal year 2000.
(2) Use of Ecstasy can cause long-lasting, and perhaps
permanent, damage to the serotonin system of the brain, which
is fundamental to the integration of information and emotion,
and this damage can cause long-term problems with learning
and memory.
(3) Due to the popularity and marketability of Ecstasy,
there are numerous Internet websites with information on the
effects of Ecstasy, the production of Ecstasy, and the
locations of Ecstasy use (often referred to as ``raves'').
The availability of this information targets the primary
users of Ecstasy, who are most often college students, young
professionals, and other young people from middle- to high-
income families.
(4) Greater emphasis needs to be placed on--
(A) penalties associated with the manufacture,
distribution, and use of Ecstasy;
(B) the education of young people on the negative health
effects of Ecstasy, since the reputation of Ecstasy as a
``safe'' drug is the most dangerous component of Ecstasy;
(C) the education of State and local law enforcement
agencies regarding the growing problem of Ecstasy trafficking
across the United States;
(D) reducing the number of deaths caused by Ecstasy use and
the combined use of Ecstasy with other ``club'' drugs and
alcohol; and
(E) adequate funding for research by the National Institute
on Drug Abuse to--
(i) identify those most vulnerable to using Ecstasy and
develop science-based prevention approaches tailored to the
specific needs of individuals at high risk;
(ii) understand how Ecstasy produces its toxic effects and
how to reverse neurotoxic damage;
(iii) develop treatments, including new medications and
behavioral treatment approaches;
(iv) better understand the effects that Ecstasy has on the
developing children and adolescents; and
(v) translate research findings into useful tools and
ensure their effective dissemination.
SEC. 3663. ENHANCED PUNISHMENT OF ECSTASY TRAFFICKERS.
(a) Amendment to Federal Sentencing Guidelines.--Pursuant
to its authority under section 994(p) of title 28, United
States Code, the United States Sentencing Commission
(referred to in this section as the ``Commission'') shall
amend the Federal sentencing guidelines regarding any offense
relating to the manufacture, importation, or exportation of,
or trafficking in--
(1) 3,4-methylenedioxy methamphetamine;
(2) 3,4-methylenedioxy amphetamine;
(3) 3,4-methylenedioxy-N-ethylamphetamine;
(4) paramethoxymethamphetamine (PMA); or
(5) any other controlled substance, as determined by the
Commission in consultation with the Attorney General, that is
marketed as Ecstasy and that has either a chemical structure
substantially similar to that of 3,4-methylenedioxy
methamphetamine or an effect on the central nervous system
substantially similar to or greater than that of 3,4-
methylenedioxy methamphetamine;
including an attempt or conspiracy to commit an offense
described in paragraph (1), (2), (3), (4), or (5) in
violation of the Controlled Substances Act (21 U.S.C. 801 et
seq.), the Controlled Substances Import and Export Act (21
U.S.C. 951 et seq.), or the Maritime Drug Law Enforcement Act
(46 U.S.C. 1901 et seq.).
(b) General Requirements.--In carrying out this section,
the Commission shall, with respect to each offense described
in subsection (a)--
(1) review and amend the Federal sentencing guidelines to
provide for increased penalties such that those penalties
reflect the seriousness of these offenses and the need to
deter them; and
(2) take any other action the Commission considers to be
necessary to carry out this section.
(c) Additional Requirements.--In carrying out this section,
the Commission shall ensure that the Federal sentencing
guidelines for offenders convicted of offenses described in
subsection (a) reflect--
(1) the need for aggressive law enforcement action with
respect to offenses involving the controlled substances
described in subsection (a); and
(2) the dangers associated with unlawful activity involving
such substances, including--
(A) the rapidly growing incidence of abuse of the
controlled substances described in subsection (a) and the
threat to public safety that such abuse poses;
(B) the recent increase in the illegal importation of the
controlled substances described in subsection (a);
(C) the young age at which children are beginning to use
the controlled substances described in subsection (a);
(D) the fact that the controlled substances described in
subsection (a) are frequently marketed to youth;
(E) the large number of doses per gram of the controlled
substances described in subsection (a); and
(F) any other factor that the Commission determines to be
appropriate.
(d) Sense of Congress.--It is the sense of Congress that--
(1) the base offense levels for Ecstasy are too low,
particularly for high-level traffickers, and should be
increased, such that they are comparable to penalties for
other drugs of abuse; and
(2) based on the fact that importation of Ecstasy has
surged in the past few years, the traffickers are targeting
the Nation's youth, and the use of Ecstasy among youth in the
United States is increasing even as other drug use among this
population appears to be leveling off, the base offense
levels for importing and trafficking the controlled
substances described in subsection (a) should be increased.
(e) Report.--Not later than 60 days after the amendments
pursuant to this section have been promulgated, the
Commission shall--
(1) prepare a report describing the factors and information
considered by the Commission in promulgating amendments
pursuant to this section; and
(2) submit the report to--
(A) the Committee on the Judiciary, the Committee on
Health, Education, Labor, and Pensions, and the Committee on
Appropriations of the Senate; and
(B) the Committee on the Judiciary, the Committee on
Commerce, and the Committee on Appropriations of the House of
Representatives.
SEC. 3664. EMERGENCY AUTHORITY TO UNITED STATES SENTENCING
COMMISSION.
The United States Sentencing Commission shall promulgate
amendments under this subtitle as soon as practicable after
the date of enactment of this Act in accordance with the
procedure set forth in section 21(a) of the Sentencing Act of
1987 (Public Law 100-182), as though the authority under that
Act had not expired.
SEC. 3665. EXPANSION OF ECSTASY AND CLUB DRUGS ABUSE
PREVENTION EFFORTS.
(a) Public Health Service Act.--Part A of title V of the
Public Health Service Act (42 U.S.C. 290aa et seq.), as
amended by section 3306, is further amended by adding at the
end the following:
``SEC. 506B. GRANTS FOR ECSTASY AND OTHER CLUB DRUGS ABUSE
PREVENTION.
``(a) Authority.--The Administrator may make grants to, and
enter into contracts and cooperative agreements with, public
and nonprofit private entities to enable such entities--
``(1) to carry out school-based programs concerning the
dangers of the abuse of and addiction to 3,4-methylenedioxy
methamphetamine, related drugs, and other drugs commonly
referred to as `club drugs' using methods that are effective
and science-based, including initiatives
[[Page H8247]]
that give students the responsibility to create their own
anti-drug abuse education programs for their schools; and
``(2) to carry out community-based abuse and addiction
prevention programs relating to 3,4-methylenedioxy
methamphetamine, related drugs, and other club drugs that are
effective and science-based.
``(b) Use of Funds.--Amounts made available under a grant,
contract or cooperative agreement under subsection (a) shall
be used for planning, establishing, or administering
prevention programs relating to 3,4-methylenedioxy
methamphetamine, related drugs, and other club drugs.
``(c) Use of Funds.--
``(1) Discretionary functions.--Amounts provided to an
entity under this section may be used--
``(A) to carry out school-based programs that are focused
on those districts with high or increasing rates of abuse and
addiction to 3,4-methylenedioxy methamphetamine, related
drugs, and other club drugs and targeted at populations that
are most at risk to start abusing these drugs;
``(B) to carry out community-based prevention programs that
are focused on those populations within the community that
are most at-risk for abuse of and addiction to 3,4-
methylenedioxy methamphetamine, related drugs, and other club
drugs;
``(C) to assist local government entities to conduct
appropriate prevention activities relating to 3,4-
methylenedioxy methamphetamine, related drugs, and other club
drugs;
``(D) to train and educate State and local law enforcement
officials, prevention and education officials, health
professionals, members of community anti-drug coalitions and
parents on the signs of abuse of and addiction to 3,4-
methylenedioxy methamphetamine, related drugs, and other club
drugs and the options for treatment and prevention;
``(E) for planning, administration, and educational
activities related to the prevention of abuse of and
addiction to 3,4-methylenedioxy methamphetamine, related
drugs, and other club drugs;
``(F) for the monitoring and evaluation of prevention
activities relating to 3,4-methylenedioxy methamphetamine,
related drugs, and other club drugs and reporting and
disseminating resulting information to the public; and
``(G) for targeted pilot programs with evaluation
components to encourage innovation and experimentation with
new methodologies.
``(2) Priority.--The Administrator shall give priority in
awarding grants under this section to rural and urban areas
that are experiencing a high rate or rapid increases in abuse
and addiction to 3,4-methylenedioxy methamphetamine, related
drugs, and other club drugs.
``(d) Allocation and Report.--
``(1) Prevention program allocation.--Not less than
$500,000 of the amount appropriated in each fiscal year to
carry out this section shall be made available to the
Administrator, acting in consultation with other Federal
agencies, to support and conduct periodic analyses and
evaluations of effective prevention programs for abuse of and
addiction to 3,4-methylenedioxy methamphetamine, related
drugs, and other club drugs and the development of
appropriate strategies for disseminating information about
and implementing such programs.
``(2) Report.--The Administrator shall annually prepare and
submit to the Committee on Health, Education, Labor, and
Pensions, the Committee on the Judiciary, and the Committee
on Appropriations of the Senate, and the Committee on
Commerce, the Committee on the Judiciary, and the Committee
on Appropriations of the House of Representatives, a report
containing the results of the analyses and evaluations
conducted under paragraph (1).
``(e) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section--
``(1) $10,000,000 for fiscal year 2001; and
``(2) such sums as may be necessary for each succeeding
fiscal year.''.
Subtitle D--Miscellaneous
SEC. 3671. ANTIDRUG MESSAGES ON FEDERAL GOVERNMENT INTERNET
WEBSITES.
Not later than 90 days after the date of enactment of this
Act, the head of each department, agency, and establishment
of the Federal Government shall, in consultation with the
Director of the Office of National Drug Control Policy, place
antidrug messages on appropriate Internet websites controlled
by such department, agency, or establishment which messages
shall, where appropriate, contain an electronic hyperlink to
the Internet website, if any, of the Office.
SEC. 3672. REIMBURSEMENT BY DRUG ENFORCEMENT ADMINISTRATION
OF EXPENSES INCURRED TO REMEDIATE
METHAMPHETAMINE LABORATORIES.
(a) Reimbursement Authorized.--The Attorney General, acting
through the Administrator of the Drug Enforcement
Administration, may reimburse States, units of local
government, Indian tribal governments, other public entities,
and multi-jurisdictional or regional consortia thereof for
expenses incurred to clean up and safely dispose of
substances associated with clandestine methamphetamine
laboratories which may present a danger to public health or
the environment.
(b) Additional DEA Personnel.--From amounts appropriated or
otherwise made available to carry out this section, the
Attorney General may hire not more than 5 additional Drug
Enforcement Administration personnel to administer this
section.
(c) Authorization of Appropriations.--There is authorized
to be appropriated to the Attorney General to carry out this
section $20,000,000 for fiscal year 2001.
SEC. 3673. SEVERABILITY.
Any provision of this title held to be invalid or
unenforceable by its terms, or as applied to any person or
circumstance, shall be construed as to give the maximum
effect permitted by law, unless such provision is held to be
utterly invalid or unenforceable, in which event such
provision shall be severed from this title and shall not
affect the applicability of the remainder of this title, or
of such provision, to other persons not similarly situated or
to other, dissimilar circumstances.
The SPEAKER pro tempore. Pursuant to House Resolution 594, the
gentleman from Florida (Mr. Bilirakis) and the gentlewoman from
Colorado (Ms. DeGette) each will control 30 minutes.
The Chair recognizes gentleman from Florida (Mr. Bilirakis).
General Leave
Mr. BILIRAKIS. Mr. Speaker, I ask unanimous consent that all Members
may have 5 legislative days within which to revise and extend their
remarks and to include extraneous material on H.R. 4365.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Florida?
There was no objection.
Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I am very pleased to bring H.R. 4365, the Children's
Health Act of 2000, to the floor of the House today. This measure is a
result of strong bipartisan, and I underline strong bipartisan,
bicameral cooperation and extensive negotiations.
The bill before us today includes the original children's health bill
passed by the House in May, as well as provisions to reauthorize the
Substance Abuse and Mental Health Services Administration. The Senate
passed the revised bill last Friday. Since then, more than a dozen
children's health advocacy groups have issued statements publicly
applauding the bill and praising this effort.
In developing this legislation, my Committee on Commerce colleagues
and I examined many of the difficult barriers we face in working to
improve children's health and well-being. Witnesses testified about a
variety of serious childhood afflictions, including autism, Fragile X,
childhood asthma, and juvenile diabetes.
The bill before us authorizes and reauthorizes children's disease
research and prevention activities conducted under the Public Health
Service Act. Among its key provisions, the bill establishes a new
Pediatric Research Initiative within the National Institutes of Health
to enhance opportunities for research and improve coordination of
efforts to prevent or cure diseases affecting children.
The bill also addresses a number of specific concerns, including
autism, Fragile X, birth defects, early hearing loss, epilepsy, asthma,
juvenile arthritis, childhood malignancies, juvenile diabetes, safe
motherhood and infant health promotion, adoption awareness, traumatic
brain injury, Healthy Start, oral health, vaccine injury compensation,
Hepatitis C, autoimmune diseases, graduate medical education in
children's hospitals, muscular dystrophy, and rare pediatric diseases.
Equally important, Mr. Speaker, it does not include specific funding
earmarks or other controversial provisions.
This legislation incorporates a number of separate legislative
proposals, and I would like to acknowledge the efforts of those Members
who worked to develop provisions that were included in the bill.
I also want to acknowledge all of the patient advocates, there were
many, as there were many Members and also cosponsors of the original
children's health bill, who lent us strong support for this initiative.
Their dedication helped keep this legislation alive.
We can never estimate the human toll of childhood diseases. However,
they also have an enormous financial impact through billions of dollars
in increased health care costs. Every dollar spent by the Federal
Government on disease research and prevention is an extremely wise
investment.
Any parent can tell us that nothing is more heart-wrenching than
watching their own child suffer with an illness. As a father and
grandfather myself, I know how terrible that can be. Today, however, we
have a rare opportunity to do something that will give hope to families
devastated by childhood disease.
This bill, Mr. Speaker, also takes great steps to reauthorize and
refine
[[Page H8248]]
the mission of the Substance Abuse and Mental Health Services
Administration. It gives States more flexibility in the use of their
block grant funds and follows the trend in other Federal programs to
require more accountability based on performance.
The bill authorizes funding for many important services for youths
and adolescents. These include youth drug treatment, early intervention
for juvenile substance abuse, prevention of methamphetamine and
inhalant use, follow-up services for youth offenders released from
juvenile justice facilities, comprehensive community services for
children with serious emotional disturbances, services for individuals
with fetal alcohol syndrome, and prevention of underage drinking and
suicide prevention.
The bill also addresses the needs of adults by authorizing grants for
emergency mental health centers, programs to divert individuals with
mental illness from the criminal justice system, and programs to expand
mental health and substance abuse treatment services for the homeless.
In addition, this bill facilitates some physicians' ability to
prescribe certain narcotics, such at buprenorpine, that are used in
treating narcotics addiction. It also provides a comprehensive strategy
to combat methamphetamine use. These provisions were approved by my
subcommittee as H.R. 2634, the Drug Addiction Treatment Act of 2000,
and this language was carefully worked out with the Committee on the
Judiciary.
In closing, Mr. Speaker, I urge all of my colleagues to support this
important legislation in addition to reauthorizing the Federal
Substance Abuse and Mental Health Services programs. The bill before us
will provide vital resources targeted at ending the scourge of
childhood diseases.
Mr. Speaker, I want to thank the gentleman from Ohio (Mr. Brown), a
member of the subcommittee, for his tireless efforts. Together, we did
put kids ahead of politicians, and I am truly grateful for his
commitment to improve the health of our Nation's children.
I also want to recognize the staff who worked to advance this
legislation, and first and foremost, to thank my health policy advisor,
Anne Esposito, for her hard work and dedication through long hours and
extensive negotiations.
I am also grateful to her partner in that effort, Ellie Dehoney from
the staff of the gentleman from Ohio (Mr. Brown). Together they
demonstrated the patience and determination necessary to keep this
process on track and moving forward.
Additionally, I would like to thank Mr. Jeremy Allen, who was with me
for a short time as, I guess, a presidential fellow. He worked to pass
the bill through the House and helped with the Senate negotiations;
Michael Reilly, who was also with us in that capacity at one time; and,
of course, my chief of staff, Todd Tuten, because it was his consent
based on our success with the women's health initiative that led to
doing this; and, additionally, Dr. Carolyn Sporn, who is a third-year
resident at George Washington University in the Emergency room who
chose to spend a month in my office to gain the knowledge that I think
all medical doctors should have regarding this process.
Together we are doing something good for kids. I urge every Member to
support passage of H.R. 4365.
Mr. Speaker, I reserve the balance of my time.
Ms. DeGETTE. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I am pleased that the House is moving forward today to
pass legislation seeking to improve the health care of our Nation's
children.
While much of the health focus in the 106th Congress has been in the
area of Medicare programs and other areas of health care policy,
Congress has largely neglected the area of children's health and
development until my colleagues, the gentleman from Florida (Mr.
Bilirakis) and the gentleman from Ohio (Mr. Brown), spearheaded this
important initiative.
I would like to thank the chairman and the ranking member for their
work in this area and really forcing this issue before the end of the
106th Congress.
I, too, want to add my thanks to the staff, particularly John Ford,
Judith Bankendorf, and Eleanor Dehoney of the Committee on Commerce and
Bruce Lesley from my staff for their outstanding work on this
legislation, as it has been improved through every step of the process
due to their hard work and diligence.
As the chairman knows, nothing could be more important to our
Nation's future than our children. Numerous indicators of the well-
being of our children paint a mixed picture. Both in terms of success
and shortcomings, they give us a mixed view of what our Nation's future
holds.
Reports of both gains and continued unmet needs are also apparent
with regard to a variety of other pediatric health care needs including
infant mortality, immunization rates, pediatric asthma care, youth
violence, and the critically important fact that over 11 million
children in this country still remain uninsured.
It is on this latter point, the issue of uninsured children and
adolescents, that I hope this Congress will choose to address through
legislative action in the near future. We cannot fully address the
health care needs of children without addressing the fact that 11
million children still continue to have limited, sporadic, if any,
access to health care.
H.R. 4365 takes very important strides to expand pediatric research
efforts and increase coordination in Federal resources for a variety of
childhood diseases or health problems. While some have questioned such
a focus on the needs of children, the Federal Government commitment
related to child and adolescent health and development is completely
inadequate and desperately needs greater focus and attention to the
unique health care problems facing children.
According to a report issued by the President's National Science and
Technology Council entitled ``Investing in Our Future: A National
Research Initiative for America's Children for the 21st Century,'' the
combined research spending for children and adolescents through the
Federal Government represents ``less than three percent of the total
Federal research enterprise''.
Thus, the Federal Government commits less than 3 percent of its
research focus to improve the lives of children despite the fact that
they represent over 30 percent of our Nation's population and our
future.
{time} 1100
As such, pediatric research and prevention efforts must be at the
forefront. As the President's National Science and Technology Council
concluded:
``Our Nation has a clear stake in ensuring that all of America's
children grow up to be healthy, educated, productive and contributing
adults. Scientific research is and will continue to be a catalyst for
achieving that goal.''
I would like to highlight those provisions in this bill that come
from legislation that I introduced in this Congress, including:
H.R. 4008, the Pediatric Organ Transplantation Improvement Act of
2000. This legislation, introduced with the gentleman from Pennsylvania
(Mr. Peterson), will require that our Nation's organ transplant system
recognizes children's unique health care needs and increases research
into improving pediatric organ transplantation. For some of our
Nation's most vulnerable citizens, children awaiting lifesaving organ
transplants, this language should improve their care and even save
lives.
H.R. 4594, the Pediatric Diabetes Research and Prevention Act. This
initiative, introduced with the gentleman from Washington (Mr.
Nethercutt), the gentleman from Pennsylvania (Mr. Weldon) and the
gentleman from New York (Mr. LaFalce) as well as in the Senate by
Senator Collins improves our Nation's research and prevention efforts
into pediatric diabetes. The language increases the necessary tools to
expand clinical trials on children with diabetes to move some of the
remarkable research that we are seeing on diabetes from the laboratory
bench to the patient's bedside.
H.R. 5198, the Children's Research Protection Act. This legislation,
introduced with the gentleman from Ohio (Mr. LaTourette) and Senators
Dodd and DeWine, promotes the improvement of pediatric research and
protections for children involved in medical
[[Page H8249]]
research. The provision requires that all HHS-funded and regulated
research comply with pediatric-specific human subject protections and
has many other important provisions.
Finally, H.R. 1313, the Patient Freedom from Restraint Act of 1999.
This initiative, which was introduced as companion legislation to bills
by Senators Lieberman and Dodd, would take important steps to protect
both children and adults with mental illness or mental retardation from
being inappropriately placed in endangering restraints or seclusion,
which has caused personal harm and even death.
There are many other fine provisions of this bill. Several I would
like to talk about is the reauthorization of the Substance Abuse and
Mental Health Services Administration, or SAMHSA, Act which improves
mental health and substance abuse services for children and
adolescents. There are several provisions that have become known as the
Columbine provisions because they deal with children and adolescents
who are at great risk. One, grants to public entities, seeks to develop
ways to assist children in dealing with violence. Another allows the
Secretary to use up to 2.5 percent of the funds appropriated for
discretionary grants for responding to emergencies. Yet another
reauthorizes the high-risk youth program which provides funds to public
and nonprofit private entities to establish programs for the prevention
of drug abuse among high-risk youths. There are many other fine
provisions of SAMHSA which are in this bill and which we will hear
about from my colleagues.
In addition, the bill has numerous other important children's health
provisions, including fragile X research, pediatric asthma, birth
defects, hearing loss and newborn screening, childhood cancer,
traumatic brain injury, child care safety, graduate medical education
for our Nation's children's hospitals and lead poisoning.
I am proud of this legislation. I know we are all proud of this
legislation. Again I would like to thank the chairman and the ranking
member for their courageous leadership on this broad bill.
Mr. Speaker, I reserve the balance of my time.
Mr. BILIRAKIS. Mr. Speaker, I yield 3 minutes to the gentleman from
Tennessee (Mr. Bryant), a member of the Subcommittee on Health and
Environment and a very conscientious and active Member.
Mr. BRYANT. Mr. Speaker, I thank the gentleman for yielding me this
time. I thank him for bringing this bill to the floor and for his
leadership on all health care issues.
Mr. Speaker, I do rise in support of the Children's Health Act and
would like to alert my colleagues to two issues which specifically are
addressed in this bill and which are of concern to me and interest to
me: Duchenne muscular dystrophy and day care safety. Duchenne muscular
dystrophy is the most common and most catastrophic form of genetic
childhood disease, occurring in one of every 3,500 live births and
generally killing its victims in their late teens or early twenties.
My first experience with a family suffering from this devastating
disease was in 1998 when my constituents Roy and Carol Henderson from
Memphis first contacted my office. Their son had been diagnosed with
Duchenne muscular dystrophy. I remember the pain and frustration that
that strong family expressed to me as they began to search for answers
to the difficult questions of why their child was afflicted with this
awful, debilitating disease. Why were there so few treatment options
for their son? And, most importantly, why had the government failed to
prioritize more Federal resources toward finding a cure to this
terrible disease?
Despite the 1987 discovery of the dystrophin gene, the survivability
of this childhood disease has not been extended in any significant way.
For decades, the only treatment known to somewhat alter the course of
this disease was the use of steroids whose serious side effects are
well known.
For these reasons it is imperative that the National Institutes of
Health, NIH, begin to focus some of its Federal resources toward
muscular dystrophy research. Today we will be voting on comprehensive
children's health legislation which directs NIH to provide a more
coordinated emphasis on muscular dystrophy research and assigns the
National Institute of Neurological Disorders and Stroke with the
responsibility of leading NIH's efforts in this promising field.
The bill also includes legislation authored by Senator Bill Frist and
introduced in the House by myself and the gentlewoman from New York
(Mrs. McCarthy). This section will provide the States with over $200
million to improve the safety of its day care centers throughout the
United States. The bill would allow States the flexibility to use the
funding for a number of purposes, including training child care
providers, rehabilitating child care facilities, improving the safety
of transporting children and conducting criminal background checks for
child care providers. With the all too frequent reports of abuse and
neglect in child care facilities, there was a need to give States
additional resources to provide quality child care. Under the bill's
formula, my State, Tennessee, would receive $4.2 million to give child
care providers the tools needed to offer safe, affordable, quality
child care to the children of Tennessee.
In conclusion, too many of our children needlessly suffer and even
die from abuse, birth defects and diseases which can be prevented given
the proper investment of our time and resources. With the passage of
this bill, Congress will renew its commitment to America's children. I
am pleased that the sponsors of this legislation recognized the
seriousness of these issues by including them in this legislation. I
encourage my colleagues to support its passage.
Ms. DeGETTE. Mr. Speaker, I am pleased to yield 2 minutes to the
gentlewoman from Texas (Ms. Jackson-Lee).
Ms. JACKSON-LEE of Texas. Mr. Speaker, I thank the gentlewoman from
Colorado for her leadership along with the gentleman from Ohio (Mr.
Brown), who is the ranking member, and as well the chairman, the
gentleman from Florida (Mr. Bilirakis) for their leadership.
This is an important issue. I know there are many legislative
initiatives that are found in this legislation dealing with children's
health. I applaud the reauthorization of SAMHSA dealing specifically
with the important issues of substance abuse and also the provisions
that assist children in dealing with violence as well as the $2.5
million in grants to assist local communities in reauthorizing high-
risk programs dealing with children susceptible to drug use. That is
clearly still a viable concern in our communities. My 15-year-old son
acknowledges that we have a problem, and I imagine that he may be
representative of many of our children around the Nation.
I would hope, however, that as we look at the question of children's
health as we will be hearing from many members of the Democratic Caucus
discussing specifically this question of children's health and this
poor state of children's health in the Nation that we will continue to
do this in a more deliberative fashion, that we will be able to give
more time to addressing the needs of children, particularly the
concerns I have and the legislation I filed, H.R. 3455, the Give a Kid
a Chance omnibus mental health bill that is a comprehensive assessment
of providing resources to parents, immediate resources so that children
who are in need of access to mental health care are not channeled to
the juvenile justice system. That is what happens now.
Along with the 11 million children that are uninsured, can you
imagine the children that do not have access to mental health services?
And even though I know that there are provisions in this bill, there is
still much to be accomplished.
Might I also take note of the charitable choice provisions that
raises much concern. I wish we would explore this question. We are for
these issues, but we want to have them in a nondiscriminatory fashion.
I would have hoped the Committee on the Judiciary would have been
allowed to address this question in a fair manner. Certainly I think we
are moving forward on children's health, but we still have a long way
to go on the needs of children's mental health.
Mr. BILIRAKIS. Mr. Speaker, I am pleased to yield 3 minutes to the
gentlewoman from Connecticut (Mrs. Johnson), my 98th Congress
colleague.
[[Page H8250]]
Mrs. JOHNSON of Connecticut. Mr. Speaker, I thank my friend and the
honored chairman of this subcommittee the gentleman from Florida (Mr.
Bilirakis) for bringing forward a really extremely important bill that
will provide many good services for children throughout America.
There are two specific provisions intended to protect children in
therapeutic group homes, patients in psychiatric hospitals, old folks
in nursing homes and youths in juvenile detention centers from hurting
themselves and others. The intent behind these provisions is to ensure
that vulnerable populations who live behind closed doors are safe and
treated with respect and dignity. This bill establishes standards for
the clinical use of restraints to physically stabilize a patient and
protocols for time-out situations that require the patient to be
separated from others. This is the first time that Congress has
attempted to legislate clinical practices in health care facilities as
well as nonmedical community-based facilities. For this reason it is
very important that this legislation be clear and unambiguous about the
kinds of practices that will be prohibited and the kinds that will be
encouraged.
Unfortunately, the legislation is not exactly clear. A distinction is
made in the legislation between health care facilities and nonmedical
community-based facilities, but there is no definition of either. Where
does a residential treatment center fit in? What rules will apply?
A standard practice in treatment facilities is the use of therapeutic
holding to calm a patient who is out of control through proximity and
physical touch. Therapeutic holds are used to protect children. They
are used to express affection. They are used to calm children. I worked
as an aide on the children's ward of a major psychiatric hospital and I
know the power of therapeutic holds. I chaired the community child
guidance clinic in my hometown for many years and as a State senator
visited residential facilities for children with serious psychiatric
problems throughout Connecticut. We must not deny these critical
facilities the ability to provide loving help for our kids.
My reading of section 591(d)(1) in part H where restraint is defined
as excluding ``any method that involves the physical holding of a
resident'' would allow the practice of therapeutic holding to be used
when appropriate to allow residents to resume their activities as soon
as possible. It is my expectation that the HHS regulations will reflect
this reading and that the Committee on Commerce agrees that therapeutic
holds are indeed excluded from any definition of restraint.
While the legislation calls for training and staff development in the
use of restraint and seclusion methods, two things are unclear: Who
will provide this training and who will pay for it? I would hope, and
it would be very helpful, if HHS would promulgate all regulations, both
those for health care facilities and those for nonmedical community-
based facilities, at the same time to avoid confusion and to ensure
seamless delivery of services to the most vulnerable populations in our
country.
In summary, I thank the chairman for his leadership on this
legislation.
Ms. DeGETTE. Mr. Speaker, I am pleased to yield 2 minutes to the
distinguished gentleman from Texas (Mr. Edwards).
Mr. EDWARDS. Mr. Speaker, I stand to speak not against the underlying
bill but specifically in regard to the so-called charitable choice
language in the bill. Let me make five points about that language:
First what it says is Federal tax dollars can go directly to
churches, synagogues and houses of worship. I believe that is clearly
unconstitutional and for good reason. Federal subsidies of our churches
and houses of worship is something we have not done for 200 years in
our country.
The second point. It mentions this language under the guise of not
wanting to have discrimination against religious organizations. That
might be cute marketing but it is faulty logic and it is
unconstitutional logic. What that says in effect is that the Bill of
Rights and the first amendment thereof discriminates against religion.
The reason Mr. Madison, Mr. Jefferson and our Founding Fathers set up a
distance between government and religion and church and state was to
protect religion, not to discriminate against it. Their argument is
that I guess the Bill of Rights is discriminating against religion.
The third point is it talks about stopping discrimination. Charitable
choice language in this bill actually subsidizes religious
discrimination.
{time} 1115
Very clearly it says you can take my Federal tax dollars, your
Federal tax dollars, and put out a government paid for sign that says
``No Catholics, no Jews, no Protestants need apply here for this
federally subsidized job.'' That is wrong. It is wrong to have Federal
taxpayers paying for religious job discrimination.
The fourth point is that charitable choice language in the name of
helping religion is actually going to bring government auditing on our
churches. According to the language of the bill itself, the churches
and houses of worship are going to have to face the same auditing
requirements as non-religious entities. I am not sure our religious
entities are helped in America by having Uncle Sam come in and audit.
This language is unnecessary, it is harmful, it is unconstitutional,
and it should not be in this bill.
Mr. BILIRAKIS. Mr. Speaker, I am pleased to yield 1 minute to the
gentleman from Washington (Mr. Nethercutt), who has been quite a leader
in diabetes in this House.
(Mr. NETHERCUTT asked and was given permission to revise and extend
his remarks.)
Mr. NETHERCUTT. Mr. Speaker, I thank the gentleman from Florida and
the gentlewoman from Colorado, both great friends of mine, with respect
to their commitment to curing the disease of diabetes that affects so
many people around this world, especially in the United States of
America.
This bill is a great bill with respect to its attention to diabetes.
It creates a national registry to track the incidence of juvenile
diabetes; it establishes long-term epidemiology studies, in which
persons with type 1 diabetes will be followed for 10 years; it
addresses type 2 diabetes in youth; it creates a critical trial
infrastructure for juvenile diabetes; it provides a look at animal
studies, which will provide hope and promise that a true vaccine can be
developed to prevent type 1 diabetes in humans; and it also contains a
loan repayment program to encourage research.
Overall, this bill is a very good effort as it relates to diabetes,
and I am very much supportive of it. I hope that all the 270 members of
the House Diabetes Caucus will get on board and support it as well.
Ms. DeGETTE. Mr. Speaker, I am pleased to yield 4 minutes to the
gentlewoman from California (Mrs. Capps).
Mrs. CAPPS. Mr. Speaker, I thank my colleague for yielding me time.
Mr. Speaker, I rise in very strong support of this legislation. H.R.
4365 reflects consensus around issues that are of deep importance to
all of us, keeping our children healthy and free of substance abuse and
mental illness.
This bill addresses major challenges in childhood disease and
reauthorizes the Substance Abuse and Mental Health Services
Administration. As a school nurse, a mother, and now a grandmother,
children's health is an issue that has been of great concern to me
throughout my entire life.
This bill would dedicate more Federal spending and intensify efforts
on childhood diseases, including fragile X, autism, early hearing loss,
juvenile diabetes and other child-specific conditions and diseases.
This legislation does much to help young victims of childhood disease.
Mr. Speaker, parents and families with children who suffer from these
childhood diseases have put their heart and soul into passing this
legislation, and we must thank them for their tireless efforts. They
have come forward with personal, often very painful stories,
illustrating the need for this bill. I commend them, and I urge support
for this important legislation.
This bill also includes reauthorization of SAMSHA, based on a version
of legislation that I introduced earlier this year. This
reauthorization will address substance abuse as it relates to children,
in addition to adults, with regard to under-age drinking, children
[[Page H8251]]
and violence, and fetal alcohol syndrome, to name a few.
To the extent that we can protect our children from alcohol and
substance abuse, we reduce their chances of addiction or abuse as
adults. Drug addiction is often an intergenerational family problem,
with future use by children of addicts a very common occurrence. Sadly,
this is a pattern I saw regularly as a school nurse.
This legislation also includes a bill I authored, the Youth Drinking
Elimination Act. This legislation, which has the support of the
American Academy of Pediatrics, will provide competitive grants to
private organizations and governmental agencies through SAMSHA to
develop and implement programs and services to reduce under-age
drinking.
I have seen the success of SAMSHA prevention programs in my own
district, particularly with Santa Barbara's Fighting Back and also with
Life Steps in San Luis Obispo. They provide highly successful public
awareness initiatives, mentoring, criminal justice partnerships and
health care intervention programs.
Mr. Speaker, SAMSHA reauthorization is the best way we can
comprehensively address the problems of substance abuse and mental
health confronting our communities. These problems are just too great
for us to treat in a piecemeal fashion.
I urge my colleagues to support this much-needed legislation.
Mr. BILIRAKIS. Mr. Speaker, I yield 1 minute to the gentlewoman from
Illinois (Mrs. Biggert).
Mrs. BIGGERT. Mr. Speaker, I thank the gentleman for yielding me
time.
Mr. Speaker, I want to bring to the attention of my colleagues a
provision in this legislation that I have authored that will help us
address the growing problem of so-called ``club drugs,'' such as
Ecstasy.
Five months ago, three young adults in the Chicago area, including
two in my Congressional District, died after ingesting what they
thought was the club drug Ecstasy, but was in fact a much more powerful
cousin called PMA.
These club drugs are flooding our country, and it is not hard to see
why. Ecstasy costs just pennies to make, but it is sold here in the
United States for as much as $40 per tablet, and the penalties for
trafficking are a joke. While the youth of this country believe that
Ecstasy is harmless, the problems they face range from paranoia to
brain damage, and even to death.
Under this bill, the penalties for Ecstasy trafficking will be
increased and we will authorize $10 million to teach our children that
these club drugs are dangerous. I believe that this will get the
attention of traffickers and the users of Ecstasy, and I urge passage
of this bill.
Ms. DeGETTE. Mr. Speaker, I am pleased to yield 2 minutes to the
gentlewoman from California (Ms. Millender-McDonald).
Ms. MILLENDER-McDONALD. Mr. Speaker, I thank all of those who have
been in the leadership role in bringing this important legislation to
the floor.
I support this legislation and any legislation that will help and
protect America's children. I do want to bring attention though to one
provision that is very dear to my heart and truly affects the inner-
city communities in my district. That provision authorizes funding for
important life-enhancing and life-saving asthma initiatives.
As author of the Asthma Awareness Education and Treatment Act and
founder of the Congressional Asthma Task Force with the gentleman from
Texas (Mr. Barton) and Senators Durbin and DeWine, I have been a vocal
and unyielding advocate for America's right to breathe.
Countless children and families in my district, which includes Watts,
Compton and other low-income inner cities, are literally struggling to
breathe, primarily because they lack information and access to
effective long-term asthma management medical care.
While the rate of asthma prevalence has grown throughout the country,
including rural and suburban areas, it has devastated our inner cities
minorities and low-income families. The asthma death rate is twice as
high among African Americans, and a staggering four times higher for
African-American children. African Americans are also five times more
likely to seek emergency room care for asthma, which does not provide
long-term management for this disease.
Asthma is also more prevalent among all age groups in lower-income
families. In families with an income average of less than $10,000, 80
out of 1,000 individuals have asthma, while in families with an average
income of $20,000 to $34,000, 54 out of 1,000 individuals have asthma.
That means close to 400,000 more people with extremely limited earnings
have asthma.
Mr. Speaker, we can do better. This bill provides that type of
funding, and I welcome and appreciate this legislation.
Mr. Speaker, today we will pass historic legislation which will help
and protect America's children. The Children's Health Act is the result
of bipartisan dedication to ensuring that we address critical problems
facing our youth today. From drug abuse to youth violence to prenatal
care, this legislation is comprised of critical programs that will
impact the lives of children most in need.
While I embrace all the initiatives included in the Children's Health
Act, today I would like to address one provision in particular, which
is dear to my heart and will truly affect the inner-city communities in
my district. That provision authorizes funding for important, life-
enhancing and life-saving asthma initiatives.
As author of the Asthma Awareness, Education and Treatment Act and
founder of the Congressional Asthma Task Force with Congressman Barton
and Senators Durbin and DeWine, I have been a vocal and unyielding
advocate for America's right to breathe. Countless children and
families in my district which includes Watts, Compton and other low-
income inner-city communities are literally struggling to breathe
primarily because they lack information and access to effective, long-
term asthma management medical care. While the rate of asthma
prevalence has grown throughout the country, including rural and
suburban areas, it has devastated our inner-cities, minorities and low
income families. The asthma death rate is twice as high among African
Americans and a staggering four times higher for African American
children. African Americans are also five times more likely to seek
emergency room care for asthma, which does not provide long-term
management of this disease. Asthma is also more prevalent among all age
groups in lower income families. In families with an annual income of
less than $10,000, 80 out of 1,000 individuals have asthma while in
families with an annual income of $20,000 to $34,999, 54 out of 1,000
individuals have asthma--that means close to 400,000 more people with
extremely limited earnings have asthma.
Whatever your income, we are all paying the price for the 160%
increase in asthma among preschool children over the past decade. The
total cost of asthma to Americans was close to $12 billion in 1998.
Parents miss work, children miss school, and too many cases are treated
in emergency rooms that could have been treated, or in some situations
prevented, by education, medication and on-going management by a
physician.
Today with the passage of the Children's Health Act, we are taking
meaningful steps to curb this staggering growth in asthma cases, its
high cost to society, and its disproportionate effect on minorities and
low income families. This bill provides comprehensive asthma services
to children, mobile health care clinics, patient and family education
on managing asthma, and identification of children eligible for
Medicaid, and other children's health programs.
In representing some of the poorest areas of the country in South
Central Los Angeles, I have seen the dire need for community
assistance, and that is why I applaud the efforts of Senator Durbin to
ensure this legislative language was included in the Senate-passed
bill. Furthermore, I urge my colleagues to not only vote for the
Children's Health Act but to ensure that you inform your constituents
of the asthma services this bill creates. As Members of Congress, it is
our job to educate our constituents on the policies we enact and
empower them to use the programs we create to improve their lives.
Mr. BILIRAKIS. Mr. Speaker, I am pleased to yield 2 minutes to the
gentleman from South Carolina (Mr. DeMint).
Mr. DeMINT. Mr. Speaker, I rise today to highlight one of the
specific provisions of this child health package, the Infant Adoption
Awareness Act.
It is truly my privilege to stand here and thank my colleagues in the
House and Senate and on many different sides of the family planning
issue for their ability to come together and pass adoption provisions
which allow us to celebrate life by celebrating adoption.
I would like to thank the leaders in sponsoring and negotiating this
legislation, the gentleman from Virginia
[[Page H8252]]
(Chairman Bliley); the ranking member, the gentleman from Michigan
(Mr. Dingell); Senator Frist; Senator Kennedy.
In particular, I would like to thank and honor the distinguished
chairman of the Committee on Commerce, the gentleman from Virginia (Mr.
Bliley), for his tireless efforts on behalf of adoption. As an adoptive
father and cochairman of the Congressional Coalition on Adoption, as
well as the chairman of the House Committee on Commerce, he has
championed the adoption issue to help build happy, loving homes across
America.
I would also like to thank Marc Wheat of the Committee on Commerce
staff for his excellent work and dedication and persistence on this
project.
Mr. Speaker, I am pleased that the infant adoption awareness
provisions in this bill are a step in the right direction to bring
complete and accurate adoption information to women facing unplanned
pregnancies. These women in difficult circumstances deserve to hear
about the options from a well-trained counselor who can provide
accurate, up-to-date information on adoption.
This act provides professional development for pregnancy counselors
in adoption counseling. The training will enable pregnancy counselors
to feel confident in their knowledge of the adoption process, relevant
State and local laws, and the legal, medical and financial resources
which can be provided to women with unplanned pregnancies.
Mr. Speaker, I know that it is not easy to get a diverse group of
organizations representing a wide variety of interests to agree on
anything. I am therefore particularly delighted to be on the floor
today praising the infant adoption awareness component of this bill,
which reflects the input of a broad range of organizations. I want to
thank everyone for their support.
Ms. DeGETTE. Mr. Speaker, I am very pleased to yield 2 minutes to the
gentlewoman from the District of Columbia (Ms. Norton).
Ms. NORTON. Mr. Speaker, I thank the gentlewoman for yielding me
time, and I especially thank her and the manager on the other side for
the hard work that succeeded in bringing this bill that we have waited
so long to get to the floor.
Mr. Speaker, I must say we had no right to subject such an important
bill to the constitutional attack it is going to get in the courts
almost immediately. We have marred this bill by incorporating two
provisions that involve deliberate discrimination. At least one of them
puts the bill at constitutional peril. That is the constitutional
choice provision.
I am a former Chair of the Equal Employment Opportunity Commission.
Title VII gives the broadest deference to religious institutions. They
can discriminate in employment involving religion, and even in secular
activities that they carry out, and even if conduct as they see it is
against their religion.
But once you give a religious organization the right to administer
Federal funds, our law and our Constitution require equal treatment.
Title VI and title VII both make that clear, and certainly the
Constitution does.
We are funding churches, synagogues, other religious entities, as if
they were Federal agencies. That in itself raises the most serious
constitutional questions, because these are pervasively religious
institutions, and that is exactly what the Supreme Court says you
cannot fund.
Then we go one unconstitutional step further. We allow these
religious institutions to discriminate as to whom they hire to
administer Federal funds. That is where the line surely must be drawn.
We go further in discriminating in this bill. We carry into this bill
discredited, discriminatory, mandatory sentencing minimums, and we
carry it to new legislation, turning a deaf ear to the Federal courts
and to all our experience. Worse, we effectively exempt white
defendants from mandatory minimums, while assuring black and Hispanic
defendants will get them. That is deliberate discrimination. That is
the very definition of racism.
Mr. BILIRAKIS. Mr. Speaker, I am pleased to yield 3 minutes to the
gentleman from Pennsylvania (Mr. Greenwood), who, as has already been
said, has spent an awful lot of time particularly on the autism portion
of this legislation, and so many other children's issues.
(Mr. GREENWOOD asked and was given permission to revise and extend
his remarks.)
Mr. GREENWOOD. Mr. Speaker, I thank the gentleman for yielding me
time and for his hard work. He has really been the leader on this.
Mr. Speaker, this is one of the happiest days for me in the House in
8 years here, because of the importance of this bill for America's
children. It does so much that none of us can do it justification in a
few minutes so I just want to just focus on the autism part.
Autism is not a rare disease. It is the third most common
developmental disorder to affect children, following mental retardation
and cerebral palsy. Autism currently affects over 400,000 individuals
in the United States. One of every 500 children born today will be
faced with autism.
The third most common developmental disorder, autism is more
prevalent than Down syndrome, childhood cancer or cystic fibrosis. It
is a life-long, severe neurological disorder that usually manifests
itself in children during their first two years of life and causes
severe impairment in language, cognition and communication.
{time} 1130
Mr. Speaker, I have a friend. His name is John. He lives in
California. He has a little boy named Dov. He told me about how this
young son of his was coming along, developmentally meeting all of the
milestones. And as a father, I can relate to that. I think the greatest
joy of childhood is watching your children move along the developmental
milestones.
John said that at a certain stage his son just sort of drifted off,
and it was like watching him on an ice flow drifting away, because he
could no longer communicate. He could not say ``Mommy,'' could not say
``Daddy,'' and he has been impossible to really reach ever since then.
John and his friends, other parents of autistic children, formed an
organization. Theirs is called Curing Autism Now, CAN. In my district,
we have mothers and fathers who created Caring and Sharing. They are
committed to doing something about these children. They are committed
to trying to find a cure, to find a way to identify this disorder
early.
Mr. Speaker, what this bill will do for these parents who have
struggled, because for many, many years doctors actually did not
understand what autism was, did not recognize the symptoms and blamed
the parents. Blamed usually the mothers and said that they were cold
and dispassionate and that is why their children were regressing. What
a cruel thing to do to a parent struggling with this awful malady.
Doctors still are lacking in their ability to recognize childhood
autism early.
What this bill will do is create five research centers geographically
dispersed around the country, so that parents who know that there is
something wrong with their child can go to get diagnosis, to get their
child in an early clinical program to find out what the state of the
art is in treatment, and what the state of the art is in curing this
disease.
I am delighted and proud today that the House of Representatives is
going to answer the prayers of these parents.
Ms. DeGETTE. Mr. Speaker, I yield 2 minutes and 15 seconds to the
gentleman from Virginia (Mr. Scott).
Mr. SCOTT. Mr. Speaker, although I support the children's health part
of the Children's Health Act, I rise to oppose the bill for several
reasons.
First, I must object to the process by which we merge an anti-drug
bill and attacks on religious liberty into legislation dealing with
children's health. Mr. Speaker, the anti-drug part of the bill provides
for more mandatory minimum sentences, making penalties for amphetamine
abuses comparable to those for abusing methamphetamine and crack
cocaine, which is 5 years for 5 grams of possession.
It is interesting to note that the majority has taken out the
mandatory minimums for penalties for Ecstasy, a methamphetamine-based
drug which is prevalent in the middle-class white community. This is
curious, because crack cocaine, prevalent in the African-American
community, Draconian
[[Page H8253]]
mandatory minimums. Methamphetamine, prevalent in the Hispanic
community, mandatory minimums. And for Ecstasy and powder cocaine,
prevalent in the white community, no mandatory minimums.
Now, I oppose mandatory minimums for the same reason the Judicial
Conference of the United States recently wrote to Chairman Hyde. They
said that mandatory minimums are a bad idea because they treat
dissimilar offenders in a similar manner, offenders who can be quite
different with respect to the seriousness of their conduct or a danger
to society. Mandatories require the sentencing court to impose the same
sentence on offenders, when sound policy and common sense call for
reasonable differences in punishment. But this bill requires no
exception except for those drugs used in the middle-class white
community.
Additionally, I oppose the bill because it attacks our civil rights
laws. It contains the charitable choice, as has already been mentioned
on the floor. Let me mention that if this bill passes, some sponsors of
federally sponsored programs, not church-run programs, federally funded
programs will be able to say for the first time in 30 years that ``we
do not hire your kind because of your religion.''
Mr. Speaker, if this bill passes, it contains counterproductive
mandatory minimums applied in a racially discriminatory manner and
allows religious bigotry to be practiced with Federal funds. There
seems to be a suggestion that if the dollar amount is high enough and
the programs are good enough, that civil rights can be bought and sold.
Mr. Speaker, I will not vote for this bill, even though it includes a
good Children's Health Care Act.
Mr. BILIRAKIS. Mr. Speaker, I reserve the balance of my time.
Ms. DeGETTE. Mr. Speaker, I yield 1 minute to the gentlewoman from
California (Mrs. Napolitano).
Mrs. NAPOLITANO. Mr. Speaker, I thank the gentlewoman from Colorado
(Ms. DeGette) for yielding me this time.
Mr. Speaker, this bill includes provisions for substance abuse and
mental health reauthorization, which allows us to think about our
Latino adolescents, ages 9 to 14, leading the Nation in attempted
suicide, depression, self-reported gun handling, asthma, diabetes,
besides an increase in HIV/AIDS cases and teen pregnancy.
I am sorry to have to recognize the need to pay special attention to
this segment of the population who are facing great challenges, and I
am thankful for the funding. It will help our communities, schools,
community-based organizations work together with families to combat
this phenomenon in the United States.
Mr. Speaker, the violence, the drugs, the cultural assimilation, peer
pressure, dysfunctional families, environment, media are all some of
the causes we must help our adolescents deal with. Our youngsters are
our future; and we must neither neglect, ignore, nor turn our backs on
them. They do not vote, but let us give them a voice for the future.
Mr. BILIRAKIS. Mr. Speaker, I yield 7 minutes to the gentleman from
Arkansas (Mr. Hutchinson), a member of the Committee on the Judiciary.
Mr. HUTCHINSON. Mr. Speaker, I thank the gentleman from Florida (Mr.
Bilirakis) for yielding me this time.
Mr. Speaker, I am pleased to speak in support of this bill,
especially in support of the bill's provision dealing with the growing
nationwide threat of methamphetamine. The legislation is substantially
similar to the Methamphetamine Antiproliferation Act that we considered
on the House side in Committee on the Judiciary. It was introduced by
the gentleman from Utah (Mr. Cannon).
The bill was brought up in committee after the Subcommittee on Crime
traveled across the country and held hearings on the growing problem of
methamphetamine. The subcommittee in these hearings heard from law
enforcement officials, treatment and prevention organizations, State
crime laboratories and concerned community leaders.
Some of the most compelling testimony came from the meth addicts
themselves. One recovering addict said that meth is so consuming, that
everything from family to employment, from self-dignity to self-
restraint is sacrificed for meth.
Mr. Speaker, this threat is real and immediate. My own State of
Arkansas was recently declared to have the highest number of meth lab
seizures per capita in the Nation. A similar story is repeated across
the country. The number of labs cleaned up by the DEA has almost
doubled each year since 1995. Last year, more than 5,500 labs were
seized by the DEA and other enforcement officials.
This resulted in millions of dollars spent on cleaning up pollutants
and toxins left behind by the operators of these labs, which can run as
much as $10,000 per lab. But let me emphasize that the legislation, the
provisions in the bill concerning meth are balanced in its approach.
First of all, the bill provides additional resources to fight the
production and use of methamphetamine. It provides training for State
and local agencies in handling the toxic waste created by meth labs,
and it provides for stiff penalties for the manufacturing and
trafficking of meth.
But in addition, besides the enforcement side, it authorizes
significant funding for drug prevention and treatment efforts. $10
million is allocated for State grants for addiction treatment, and $15
million for education programs. So it is a balanced approach to dealing
with the problem of meth.
If we look at some of the specifics of the legislation, it makes the
penalties for manufacturing and trafficking amphetamine, a lesser-known
but no less dangerous drug than meth, the same as methamphetamine. But
it increases the penalties when there is a substantial risk of harm to
human life or the environment, which is many times the case with meth
labs.
It also criminalizes the interstate transportation of anhydrous
ammonia, which is used by farmers in the production of fertilizer, but
is also used in the production of methamphetamine. And so to help the
farmers, though, the legislation authorizes funds to research
alternative substances for farming and other uses that cannot be used
in making meth.
It requires meth lab operators to reimburse society for the
environmental and physical damage they cause through their activity.
And it authorizes $5.5 million for DEA training of State and local law
enforcement in meth lab detection and investigation techniques.
Mr. Speaker, I could go on about some of the specific provisions of
the bill, but it helps us deal with the problem. There are some of the
objections raised by the methamphetamine legislation that were deleted
from this bill. For example, provisions allowing for delayed notice of
a search warrant have been deleted. Penalties for the advertisement of
illegal drugs and drug paraphernalia have been deleted. So some of
those questionable parts are not in this legislation.
I commend the gentlewoman from Illinois (Mrs. Biggert), who has done
an excellent job of dealing with the problem of Ecstasy and the club
drugs. Those provisions she has described are also in the legislation.
Let me just make some personal comments about the drug problem. When
I grew up in northwest Arkansas on the farm, I became aware of the drug
problems on the nightly news, thinking it did not affect us in the
rural areas. But the National Center for Addiction and Substance Abuse
announced recently that the drug use among young teens in rural America
is now higher than in the Nation's large urban centers. In fact, eighth
graders living in rural America are 100 percent more likely to use
amphetamines, 34 percent of rural eighth graders are more likely to
smoke marijuana than kids in urban areas.
Mr. Speaker, this should be a wakeup call to parents and community
leaders in our country. As a former Federal prosecutor, as a
legislator, but most importantly as a father of teenagers, my heart
aches over the lives that are ruined by the gripping terror of meth
that overpowers so many, from the curious teenager to the innocent
victim of its violence.
Recent surveys show that in 1999, 54 percent of high school seniors
had used an illicit substance. The number has risen for the past 6 of 7
years. These statistics show that drug-induced deaths now exceed the
national murder
[[Page H8254]]
rate. These statistics are a call to action. But the cost does not stop
with physical violence. The social consequences are equally
devastating. Just last August, police raided a heavily armed meth lab
in Conway, Arkansas, after discovering that a baby living in the drug
trailer had been left alone and had eaten the drugs left strewn around
the trailer. Clearly, additional resources are needed to thwart the
damage threatening the next generation. That is what is provided in
this legislation.
Mr. Speaker, I would like to respond to the objection raised by the
gentleman from Virginia (Mr. Scott). He has indicated that this creates
new mandatory minimums. I understand that he now agrees that new
mandatory minimums are not provided in this legislation. There are no
new mandatory minimums.
Secondly, there was a question raised about the discriminatory impact
of sentences between amphetamine, crack cocaine, and some of the club
drugs. First of all, we tried and I think we had a preferable House
bill, but this is the Senate bill and I think we probably can improve
upon that. I am willing to work with the gentleman from Virginia to
make sure that we have equal treatment.
We are giving direction to the Sentencing Commission, and I hope they
come up with recommendations that are fair and nondiscriminatory. But
we will be happy to look at that in the next Congress as well.
So I am pleased to support this legislation. I ask my colleagues to
support it as well. It is fair, and it is what addresses the problems
that faces our young people today.
Ms. DeGETTE. Mr. Speaker, I yield 3 minutes to the gentleman from
Texas (Mr. Bentsen).
(Mr. BENTSEN asked and was given permission to revise and extend his
remarks.)
Mr. BENTSEN. Mr. Speaker, I rise today in strong support of the
Children's Health Act, legislation that would reauthorize children's
health research and prevention programs, graduate medical education
programs for children's hospitals, substance abuse and drug abuse
prevention and treatment programs, and safety of child care programs.
As an original cosponsor of many of the initiatives that are included
in this comprehensive bill, I am pleased that Congress will be acting
to protect children's health.
One of the most important provisions is the reauthorization for 5
years of the Graduate Medical Education Program for independent
children's hospitals. As one who represents the largest independent
children's hospital in the United States, I strongly support the role
that pediatric hospitals play in advancing pediatric medicine in the
training of physicians dedicated to children's health care needs.
{time} 1145
Under the current law, Medicare, which is the main funder of graduate
medical education in the United States, does not provide funding for
pediatric residencies for freestanding children's hospitals such as
Texas Children's Hospital in my district because these hospitals, of
course, treat a very small number of Medicare patients who are under
the disability program.
Last year, Congress enacted a law that provided a one-time capped
entitlement for pediatric Medicare education programs. This legislation
would rightly extend this valuable program for 5 years.
Mr. Speaker, I am also working with my colleagues to ensure that the
pediatric graduate medical education program receives sufficient
funding through the annual appropriations process. Earlier this year,
the House of Representatives approved for the fiscal year 2001 Labor,
Health and Human Services and Education appropriations bills $80
billion for pediatric graduate medical education, an increase of $40
million, over this year's program. I am committed to maintaining this
funding level as the budget is finalized.
Another important issue in this bill is the pediatric research
initiative that would require the National Institutes of Health to
conduct pediatric biomedical research at the NIH. In particular, this
initiative will ensure that more research is done on how diseases
affected children as compared to adults. In most cases, clinical trials
are conducted on adults without any consideration of how these drugs
would affect children.
This initiative would also encourage the development of pediatric
clinical trials to ensure that safe and effective drug treatments are
available. When children face life-threatening diseases, it is very
difficult to determine how much and what type of treatments should be
given to them because there is insufficient information about how these
treatments would affect them.
With more data in clinical trials, there will be more options for
children who are fighting for their lives. The bill also directs the
National Institutes of Health to conduct more research on diseases
which directly affect children such as hearing loss, autism, asthma and
juvenile diabetes.
I think this is a step in the right direction. I commend the
gentleman from Florida (Mr. Bilirakis) and the ranking members of the
Subcommittee on Health and Environment, and I encourage my colleagues
to adopt this bill.
Mr. BILIRAKIS. Mr. Speaker, I yield 3 minutes to the gentleman from
Kansas (Mr. Moran).
Mr. MORAN of Kansas. Mr. Speaker, I thank the gentleman from Florida
(Mr. Bilirakis) for yielding me the time.
Mr. Speaker, I rise to support the comments made by the gentleman
from Arkansas (Mr. Hutchinson) who has been a tremendous leader on the
issue of combatting methamphetamine production, sale and distribution
in our country and from my perspective especially in rural America.
I am here today to speak on behalf of this legislation and,
particularly, the meth section, that in large part mirrors H.R. 2987, a
bill which I am a sponsor.
Kansas was one of those locations, certainly Kansas, a rural State,
was one of those locations in which the Committee on the Judiciary came
to on location to hear about the problems we face in our part of the
country. And the stories that were told, the testimony that was taken
was very compelling.
I brought with me today comments made by the sheriff of one of the
counties in Kansas who testified before the subcommittee on the
Judiciary on the impact of methamphetamines on his rural county, and I
think it can be said across the State of Kansas and rural places around
the country.
Sheriff Sherrer's testimony before the subcommittee in part is this,
``the adverse effect of meth on rural America is destroying our way of
life. We are now combatting narcotics problems on fertile farm ground;
problems that previously existed only in large cities with large police
forces having large narcotics and violent crime units. The idea that we
are living in Mayberry is a myth.
``We are living in a war zone. My office is totally unprepared to
combat the rapidly expanding problem of the manufacture of meth in
rural Kansas. The money and manpower necessary to combat the problem is
destroying my annual budget and exhausting my personnel.
``There were 25 labs seized in Pawnee County in 1999.'' And I might
add, as an aside, indicate that Pawnee County's population is 7,470. We
have had more than 500 meth busts in 1999 in our State alone, and we
are going to, unfortunately, exceed that record this year.
Sheriff Sherrer's testimony continues, ``my personnel are physically
exhausted and perhaps even worse is that they are mentally exhausted,
80- and 90-hour workweeks are not uncommon in our attempt to combat the
meth problem and still attend to our normal duties. I don't have the
budget or the manpower necessary to fight the current meth problem. I
have exhausted all manpower and financial efforts to address this
problem to no avail. As a law enforcement agency, we are exhausted.
``On behalf of all western Kansas law enforcement administrators,
concerning the problem of methamphetamine, we are understaffed,
underfunded, outgunned and out of our league.''
I thought originally when I got involved in this issue that it was
somewhat beyond the scope of the duties that I normally face as a rural
Member of Congress, but this is a problem that
[[Page H8255]]
is real in rural America. I am glad this Congress is addressing this
issue in this legislation.
Ms. DeGETTE. Mr. Speaker, I yield 2\1/2\ minutes to the gentlewoman
from New York (Mrs. McCarthy).
Mrs. McCARTHY of New York. Mr. Speaker, I rise and express my strong
support for the Children'S Health Act. This important legislation
includes the Children's Day Care Health and Safety Improvement Act, a
bill that I introduced with the gentleman from Tennessee (Mr. Bryant).
Mr. Speaker, I just want to take this opportunity to also thank the
gentleman from Michigan (Mr. Dingell), the gentleman from Virginia
(Chairman Bliley) and the gentleman from Tennessee (Mr. Bryant) and
certainly my colleague, the gentlewoman from Colorado (Ms. DeGette),
for the leadership and hard work on this issue.
Mr. Speaker, we are experiencing a national child care crisis. In
1997, 31,000 children ages 4 and younger were treated in hospital
emergency rooms for injuries sustained in child care facilities.
In 1999, in my home district of Nassau County, there were 55 cases of
suspected child abuse incidents in child care facilities. Our bill
gives $200 million in State grants to improve programs, to improve the
health and safety of our children in child care.
These grants can be used for a number of reasons, train and educate
child care providers to prevent injuries and illnesses and to promote
health-related practices; strengthen and enforce child care provider
licensing, regulation and registration; rehabilitate, which is probably
one of the most important parts of this bill, child care facilities to
meet health and safety standards; provide health consultants to give
health and safety advice to child care providers; enhance child care
providers' ability to serve children with disabilities; conduct
criminal background checks on child care providers, what I think is
really important, especially to give our parents the peace of mind of
where they are going to send their child is offering the best services
possible, and I think to provide information to parents on choosing a
safe and healthy setting for their children or to or improve the safety
of transportation of children in child care.
Mr. Speaker, being a new grandmother, I have to say watching my
daughter-in-law looking for day care is an experience that is happening
around this Nation, so the more that we can do to provide certainly our
children, the future leaders of this country, with a safe environment
and the best environment, we, in Congress, are doing a great job. I
appreciate the work of this committee for letting this to go forward
and hoping we can do more in the future.
Ms. DeGETTE. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, let me just close by saying we can sense the breadth of
this bill by listening to the debate on the floor today, everything
from child care to imaging, to medical research, vital, vital issues
for our children. Again, I am proud to be a part of this debate and of
this bill. I want to thank the gentleman from Florida (Mr. Bilirakis),
the chairman, and also the gentleman from Ohio (Mr. Brown), the ranking
member.
Mr. Speaker, I yield back the balance of my time.
Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I endorse the remarks of the gentlewoman from Colorado
(Ms. DeGette) and thank her for her role, the role that she has played,
not only in this legislation, but all matters involving particularly
children. I want to emphasize that this legislation came about as the
result of an awful lot of hard work on a bipartisan basis. The minority
was involved in every case, and I ask that everyone support.
Mr. UPTON. Mr. Speaker, I rise today in strong support of H.R. 4365,
the Children's Health Act of 2000. This comprehensive measure will make
a significant difference in the lives of millions of children and
families by boosting biomedical and clinical research on a range of
conditions and diseases that afflict children with particular severity
and by improving access to treatment. As a member of the Commerce
Committee's Subcommittee on Health and the Environment, I was fortunate
to have the opportunity to work closely with our chairman, Mike
Bilirakis, who has shown great leadership on this legislation.
I am especially pleased and grateful that the final version of this
bill includes provisions strengthening the National Institutes of
Health's focus on Duchenne muscular dystrophy research. This will be
the first time that Duchenne muscular dystrophy is mentioned in the
Public Health Service Act.
I have seen the human face of this disease and the toll that it takes
on children and families. Some time ago, I had the opportunity to visit
with Don and Joyce Carpenter of Kalamazoo, MI, and their young and
courageous son, Ben. Ben suffers from Duchenne muscular dystrophy. From
them I learned that Duchenne muscular dystrophy is the most common and
the most catastrophic form of genetic childhood disease. Sadly, it
generally kills its victims in their late teens or early 20's.
For decades, the only drug treatment known to somewhat alter the
course of the disease in the use of steroids--whose serious side
effects are well-known. We've simply got to do better. We have to find
a way to prevent this devastating disorder in the first place--perhaps
through the promise of gene therapy. And until we learn how to prevent
it, we've got to learn how to treat it more effectively.
I urge every Member of Congress to join me in voting for this bill
and giving hope to Don and Joyce and Ben Carpenter and the many like
them across this Nation and world. We can work miracles when we really
try.
Mr. GILMAN. Mr. Speaker, I rise today in support of H.R. 4365, the
Children's Health Act of 2000. This legislation renews America's
commitment to children and ensuring that their physical and mental
health are cared for.
This comprehensive bill contains a number of provisions that will
revise and establish programs with respect to children's health
research and prevention activities performed by Federal public health
agencies. Of these provisions there are five which I would like to
highlight. H.R. 4365 will:
(1) Improve autism research by directing the Director of the National
Institutes of Health (NIH) to expand and diversify the NIH's activities
with respect to autism, as well as requiring the Director to award
grants and contracts to public or nonprofit entities for research on
autism and creating the National Autism Developmental Disabilities
Surveillance Program, which uses a number of mechanisms to improve the
collection, analysis, and reporting of case data on autism and other
pervasive developmental disabilities.
(2) Direct the HHS Secretary to develop a system to collect data on
juvenile diabetes through the CDC, and establish a national data base
for this data and conduct and support long-term studies through the NIH
that follow individuals with juvenile, or type 1, diabetes for 10 years
or more and establish through the CDC a national health effort to
address type 2 diabetes in youth.
(3) Require the Secretary of Health and Human Services to distribute
to States sufficient funding to enable them to establish programs to
improve the health and safety of children receiving child care outside
the home by preventing illnesses and injuries.
(4) Provide funding to the Drug Enforcement Administration (DEA) and
Office of National Drug Control Policy (ONDCP) to assistance to State
and local law enforcement officials in methamphetamine investigations
and establishing additional DEA offices. This legislation provides law
enforcement officials with tools and training to combat the
methamphetamine and club drug epidemics in America today, and authorize
comprehensive prevention and treatment programs to combat abuse and
addiction as well.
(5) Modify the vaccine injury compensation program which currently
only provides compensation to someone injured from routinely
administered vaccines where the injury lasts more than 6 months.
Certain vaccines, like rotavirus, often require immediate surgery,
which would not be eligible for compensation. The modified program
makes compensation available if the injury requires a hospital stay or
surgery.
The programs I have mentioned, as well as the other important
provisions of this bill, will make significant changes in the lives of
children throughout this country. I applaud our colleague from Florida,
Mr. Bilirakis, for his leadership on this issue and I urge my
colleagues to support H.R. 4365, the Children's Health Act of 2000.
Mr. SHAYS. Mr. Speaker, I rise in strong support of H.R. 4365, the
Children's Health Act of 2000. In particular, I am pleased the
legislation includes S. 976 which reauthorizes the Substance Abuse and
Mental Health Services Administration (SAMHSA).
S. 976 includes comprehensive standards for the use of restraint and
seclusion in all facilities receiving Federal funding. The regulations,
authored primarily by my colleague from Connecticut, Senator
Christopher Dodd, will go a long way toward ensuring those receiving
treatment in federally funded facilities are not subject to potentially
life threatening inappropriate restraint and seclusion.
I became deeply concerned about the inappropriate use of restraint
and seclusion following a series of articles published by the
[[Page H8256]]
Hartford Courant in October 1998, entitled ``Deadly Restraint.'' The
series reported patient deaths related to the use of restraint or
seclusion in 142 cases over 10 years, and chronicled the deaths of 23
patients who had died within 11 months--all apparent victims of overuse
of seclusion or restraint.
Among the deaths the Courant investigated was Andrew McClain's.
Andrew was an 11 year old foster child from Bridgeport, CT--in my
district--who was a patient at Elmcrest Hospital, a State psychiatric
institution, in Portland, CT.
On March 22, 1998, Andrew was told to move to a different table than
the one where he was seated during breakfast. When he disobeyed, an
aide at the hospital forcibly restrained Andrew and placed him in a
face-down restraint hold.
Andrew's arms were drawn across his chest. The full weight of an
adult on his back pinned this 11-year-old child to the ground, making
it impossible for him to breathe, and eventually causing his death.
Andrew's horrifying death and others like it in the Courant series
raised serious questions surrounding the use of restraints in mental
health facilities nationwide, and more importantly, it raised public
awareness of a very serious issue.
It also caused significant concern among members of the Connecticut
delegation, who asked the General Accounting Office to study the use of
restraint and seclusion among our most vulnerable populations--those
with mental illness or mental retardation--who depend on care from
others for their well-being.
The study, published last September, revealed a number of disturbing
facts including at least 24 deaths associated with restraint or
seclusion in 1998 alone. The GAO study also found the lack of a
comprehensive reporting system to track injuries to both patients and
staff resulting from restraint and seclusion, and an inconsistency
among Federal and State regulations regarding restraint and seclusion
for the mentally ill and disabled.
The GAO recommended an improved reporting system and led to
conclusions that having regulatory protections and reporting
requirements in place would reduce the use of restraint and seclusion
and improve safety for patients and staff. The report also highlighted
the urgent need to regulate the use of restraint and seclusion in
federally funded facilities.
As a result of the GAO findings, both Senators Dodd and Lieberman
introduced comprehensive legislation to regulate the use of restraint
and seclusion in mental health facilities.
With the support of other members of the Connecticut delegation, on
November 1, I introduced H.R. 3010, the Restraint Safety Act--the House
companion to legislation introduced by Senator Lieberman.
Provisions from Senator Dodd's bill were included in the Senate-
passed SAMHSA reauthorization bill which we are considering today.
Mr. Speaker, only strong Federal guidelines will ensure those in all
facilities which receive federal funding will be free from unnecessary
restraint and seclusion and I urge my colleagues on both sides of the
aisle to support these life-saving provisions by voting for the
underlying bill.
Mr. McCOLLUM. Mr. Speaker, I submit the following letters re H.R.
4365 to be printed in the Record.
Department of Justice,
Drug Enforcement Administration,
Washington, DC, September 26, 2000.
Hon. Bill McCollum,
Chairman, Subcommittee on Crime, House of Representatives,
Washington, DC.
Dear Mr. Chairman: The enclosed letter dated March 15,
2000, from Mr. Robert Raben, Assistant Attorney General,
Office of Legislative Affairs, to Chairman Henry J. Hyde,
House Judiciary Committee, contains the views of the Drug
Enforcement Administration on provisions previously contained
in 486, now included in HR 4365, ``An Act to Amend the Public
Health Act of 2000'' as placed on the Senate calendar on
September 25, 2000.
We continue to support the objectives behind relaxing the
restrictions governing practitioners who dispense replacement
pharmacotherapies to make drug addiction treatment available
in greater numbers. The March 15 letter did state concerns,
however, regarding what is now Title XXXV which amends
Section 303(g) of the Controlled Substances Act.
Specifically, we are concerned about the (g)(2)(B)(II)
subparagraph which this amendment adds. As we stated, these
concerns would be resolved if the following language were
added to the report accompanying the bill to clarify
congressional intent regarding this section:
``Nothing in this section is intended to affect either the
long standing authority of the Attorney General to enforce
the standard that a controlled substance is legally dispensed
by a practitioner only when it is dispensed for a legitimate
medical purpose by the practitioner acting in the usual
course of his/her professional practice or the authority of
the Secretary of Health and Human Services under 42 U.S.C.
257a, after consultation with the Attorney General, to
determine appropriate methods of professional practice in the
medical treatment of narcotic addiction. See, U.S. v. Moore,
423 U.S. 122 (1975). The standard applies to the dispensing
of all controlled substances, including the dispensing in the
course of maintenance or detoxification of an individual.''
Thank you for the opportunity to reaffirm our views on the
bill. Please do not hesitate to call if we may be of
additional assistance.
Sincerely,
Donnie R. Marshall,
Administrator.
____
Department of Justice,
Office of Legislative Affairs,
Washington, DC, March 15, 2000.
Hon. Henry J. Hyde,
Chairman, Committee on the Judiciary, House of
Representatives, Washington, DC.
Dear Mr. Chairman: This letter presents the views of the
Department of Justice on S. 486, the ``Methamphetamine Anti-
Proliferation Act of 1999,'' as passed by the Senate on
November 19, 1999. The Department supports many of the
provisions in S. 486, because they provide important and
necessary tools for deterring the spread of methamphetamine
manufacturing and abuse in our Nation.
We are pleased that several suggested changes to the bill
were made to accommodate the Department's concerns. We,
however, continue to be troubled by section 211 (``Waiver
Authority for Physicians Who Dispense or Prescribe Certain
Narcotic Drugs for Maintenance Treatment or Detoxification
Treatment''). While we support the objectives behind relaxing
the restrictions governing practitioners who dispense
replacement pharmacotherapies to make drug addition treatment
available to greater numbers, we believe that federal law
enforcement must maintain the ability to prosecute
unauthorized dispensing of controlled substances.
Our major concern is with section 211(a)(5), adding section
303(g)(2)(B)(ii)(II) of the Controlled Substances Act [page
55, line 7-11, engrossed Senate bill]. That provision states
that ``[n]othing in the regulations or practice guidelines
under this clause may authorize any Federal official or
employee to exercise supervision or control over the practice
of medicine or the manner in which the medicinal services are
provided.'' As written, section 211 could be interpreted in a
way that would narrow the DEA's current authority under the
Controlled Substances Act (CSA) to prosecute physicians who
dispense controlled substances, but do so without a
legitimate medical purpose in the usual course of their
professional practice. It is well-settled law that a
physician's license is not an automatic and absolute shield
to prosecution under the CSA, since the CSA was designed by
Congress in part ``to confine authorized medical practice
within accepted limits,'' See United States v. Moore, 423
U.S. 122, 143 (1975). In Moore, for example, a defendant/
doctor was authorized to dispense methadone for
detoxification purposes only. A jury found that he exceeded
the bounds of his professional practice by prescribing large
quantities of methadone for patients without giving them
adequate physical examinations or specific instructions for
its use and charged fees according to the quantity of
methadone prescribed rather than fees for medical services
rendered. The Supreme Court concluded that the doctor was
using his medical license as an excuse to facilitate the sale
of controlled substances to addicts and, therefore, was in
violation of the CSA.
Our concerns would be resolved if the following language
were added to the report accompanying the bill to clarify
congressional intent regarding this section:
``Nothing in this section is intended to affect neither the
long standing authority of the Attorney General to enforce
the standard that a controlled substance is legally dispensed
by a practitioner only when it is dispensed for a legitimate
medical purpose by the practitioner acting in the usual
course of his/her professional practice nor the authority of
the Secretary of Health and Human Services under 42 U.S.C.
Sec. 257a, after consultation with the Attorney General, to
determine appropriate methods of professional practice in the
medical treatment of narcotic addiction. See, U.S. v. Moore,
423 U.S. 122 (1975). The standard applies to the dispensing
of all controlled substances, including the dispensing in the
course of maintenance or detoxification of an individual.''
On an unrelated matter, we recommend that section 123(a) of
the bill (``Expansion of Methamphetamine Abuse Prevention
Reports'') (enacting new section 515(e) of the Public Health
Service Act (42 U.S.C. Sec. 290bb(e)(1))) be amended by
adding after ``the Administrator'' ``of the Substance Abuse
and Mental Health Services Administration in the Department
of Health and Human Services, in consultation with the
Secretary of Education and the Attorney General.'' Although
we do not object to this provision as it is currently
drafted, we believe that the language we are suggesting would
help to ensure coordination among related and ongoing federal
initiatives.
Finally, section 114(c) of the bill would require the
Director of the Office of National Drug Control Policy
(ONDCP) to ``apportion'' funds appropriated for combating
methamphetamine in High Intensity Drug Trafficking Areas
(HIDTA's). Technically, this is an inaccurate use of the word
``apportion.'' Only the Office of Management and Budget is
authorized to ``apportion'' funds. We recommend that the word
``allocate'' be substituted for ``apportion.''
Thank you for the opportunity to present our views. Please
do not hesitate to call
[[Page H8257]]
upon us if we may be of additional assistance. The Office of
Management and Budget has advised that there is no objection
from the standpoint of the Administration's program to the
presentation of this report.
Sincerely,
Robert Raben,
Assistant Attorney General.
Identical letter to be sent to the ranking minority member,
Committee on the Judiciary.
Mr. WICKER. Mr. Speaker, I would like to thank those who have spent
so many hours working on developing a comprehensive children's health
bill to present to this House today. While this bill makes great
strides on many childhood diseases and health issues, I will focus my
remarks on the devastating affects that Duchenne Muscular Dystrophy has
on the children with the disease and their families.
Duchenne Muscular Dystrophy is the most common genetic illness,
crossing all cultures. Although Duchenne MD is an inherited disease and
is present from the initial stages of fetal development, there is
generally no indication at birth that the child has abnormal muscle
function. In the first year of life, it is rare for parents to detect
any delay in development. Typically a child is diagnosed between the
age of 2-5 years. As a child grows and his muscle cells deteriorate,
and he becomes noticeably weak. The child usually loses his ability to
walk around 10 years of age. As time progresses, the chest muscles
deteriorate, causing respiratory problems. Death often occurs in the
late teens unless mechanical breathing is instituted.
This is painful not only for the child but also for the mothers and
fathers who care for and love their child. To date there are efforts in
finding a cure for this disease and the Children's Health Bill will
allow these efforts to come to fruition. In addition, this bill will
begin to provide the resources needed to expand research efforts in
finding treatment and a cure for this disease.
As a member of the Labor-Health and Human Services, and Education
Appropriations Subcommittee, I have supported doubling the NIH's budget
over a five year period. I am pleased that this legislation's Muscular
Dystrophy title tracks with report language from both the House and
Senate Labor/HHS Appropriations bills, calling for increased research
and coordination among the institutes of NIH. One of the problems that
has confronted this disease community is that MD does not have a
natural ``home'' among the institutes. I am confident that the National
Institute for Neurological Disorders and Stroke, under the exemplary
leadership of Dr. Gerald Fischbach, will increase the pace of research
and provide a crucial coordination role.
An essential and logical portion of this heightened research would be
the creation of a muscle biology study section, which could easily be
accomplished in the context on an ongoing review of the study sections
and their scientific peer review processes of NIH. I am troubled that
out of the current 105 NIH study sections, there is no study section
for muscle, the largest organ of the body.
Mr. Speaker, not only are there no cures for this, the world's
number-one genetic killer of children, but there are no real therapies
for Duchenne and Becker Muscular Dystrophy. Astonishingly, the pace of
research, in real dollars, actually declined after the dystrophin gene
was discovered in 1986. Passage of the Children's Health Act is a clear
indication from Congress that this is unacceptable. I urge all Members
of this House to join me in supporting this legislation.
Mr. DeMINT. Mr. Speaker, as the original sponsor of H.R. 2511, the
Adoption Awareness Act, along with the gentleman from Virginia,
Chairman Bliley, a champion of adoption issues, I am pleased to endorse
the Infant Adoption Awareness Act included in the child health bill,
H.R. 4365.
Adoption is a wonderful option because it brings a positive, life-
giving end to what could be difficult circumstances. The mother can
place her child in a loving family, the child receives a warm and
welcoming home, and an adoptive couple gets to wear one of the greatest
titles in America--parent. Additionally, pro-life individuals, groups,
and communities should encourage adoption as one of the life-giving
choices of women with unplanned pregnancies. With the love and care
provided at crisis pregnancy centers and in homes, community and faith-
based organizations across the country, more women will hear about the
resources available to help them through this difficult time and to
encourage them to bring this newly-formed life into the world.
While this language is not as broad as the original legislation, it
does reflect significant efforts to advance the purpose of the Adoption
Awareness Act. This language was drafted with input from a wide variety
of organizations, including those in the adoption and public health
communities.
Women facing unplanned pregnancies deserve to hear about their
options from a well-trained counselor who can provide accurate, up-to-
date information on adoption. This Act provides professional
development for pregnancy counselors in adoption counseling. The
training will enable pregnancy counselors to feel confident in their
knowledge of the adoption process, relevant State and local laws, and
the legal, medical, and financial resources which can be provided to
women with unplanned pregnancies.
I am pleased to support the Infant Adoption Awareness Act as a step
in the right direction to bring complete and accurate adoption
information to women facing unplanned pregnancies. I hope that this
step significantly advances our Nation in the direction of eliminating
a perceived anti-adoption bias in pregnancy counseling in providing
lasting answers to difficult circumstances.
I truly believe that in our great Nation, while there may be unwanted
pregnancies, there are no unwanted children.
Mr. BLILEY. Mr. Speaker, I rise in support of H.R. 4365, the
Childrens' Health Act of 2000, as amended by the other body. This
important legislation is the result of long, hard negotiations on the
part of members of my staff and their counterparts on the staff of Mr.
Bilirakis, Mr. Bryant, Mr. Greenwood, Mr. Upton, Mr. Brown, Mr.
Dingell, and members of the other body that made this possible.
As members of the House will recall, after we passed H.R. 4365 the
first time, the other body moved forward on legislation that would have
left many health problems facing children unaddressed. I am pleased to
report that were able to restore the House provisions that were omitted
in the other body's legislation, and have added authorizations that
strengthen the bill.
Though too numerous to mention each provision individually, I want to
comment on three provisions that I believe are particularly important.
As a proud adoptive father of two, I am pleased that this bill advances
adoption policy in this country. The bill ensures that family planning
counselors have access to training on presenting complete and accurate
adoption information to women facing unplanned pregnancies. In the
interest of time, I will extend my remarks for a more full discussion
of this aspect of the legislation.
Moreover, this bill contains several initiatives that will foster the
adoption of special needs children. The bill also authorizes the
Healthy Start program for the first time. For at-risk pregnant women
served by this program, it authorizes mobile health clinics equipped
with ultra-sound screening technology and also expands access to
prenatal and other surgical services to the unborn child, mother, and
infant during the first year after birth.
I am also pleased that this bill directs NIH to expand and increase
coordination in activities with respect to research on muscular
dystrophies. It also makes important strides in the fight against
autism, which affects 1 in every 500 children born today. More
prevalent than Down syndrome, childhood cancer or cystic fibrosis,
autism hits children during the first two years of life and causes
severe impairment in language, cognition and communication. Since so
many of America's children suffer from so many disorders, it is right
that work to ensure that researchers are looking for the cures they
need.
Although this bill addresses many tragic disorders among children,
among the most tragic is that of drug abuse--and this bill extends a
powerful helping hand to help parents to secure their children's
future. This bill further extends the war on drugs to those who push
methamphetamine, ``ecstasy,'' and heroin onto our young people. Under
these provisions, criminal penalties are increased for individuals who
manufacture and traffic in methamphetamine and ``ecstasy.'' The
provisions also increase funding for law enforcement training and
targets high intensity methamphetamine trafficking areas.
Perhaps most importantly, we are attacking heroin abuse by reducing
the demand for this deadly drug. Let me relate some of the testimony
Mr. Odis Rivers of Detroit, Michigan shared with the Commerce
Subcommittee on Health and Environment last year. He has been addicted
to heroin for 30 years, and is undergoing treatment with a drug that
this bill will help more physicians prescribe to their patients. He
told the Subcommittee that he was back with his wife and family and was
enjoying their support. He had won their respect, and could again
assume his rightful place in their family. As the Detroit Free Press
stated on October 3rd of last year, ``this seems like the kind of
legislation that should be passed, especially in light of new
University of Michigan research showing that heroin use among teens
doubled from 1991 to 1998.'' These provisions will make new heroin-
blocking medications available to physicians treating patients
struggling to be free from heroin addiction.
Not only do we use innovative strategies to address the problems of
meth, ecstasy, and heroin, we also ensure that there is a Federal
agency that is focused on reducing the incidence of substance abuse and
mental illness throughout society. H.R. 4365 reauthorizes the
[[Page H8258]]
Substance Abuse and Mental Health Services Administration, which was
created in 1992 to assist States develop effective prevention and
treatment programs to protect America's children from the scourges of
mental illness and drug abuse. The important ``charitable choice''
provision in this legislation permits Federal assistance for religious
organizations providing substance abuse services, which is similar to
language that has been enacted into law several times with broad
support in the House.
It is important that the Members of this House vote for passage of
this critically important bill to secure a better future for America's
children by helping to reduce the incidence of disease and illness. We
know we can lessen the incidence of these diseases through heightened
research activities, and through the use of successful interventions
that still remain out of reach by many in our society.
Again, I thank my colleagues and many other Members who have
contributed to making this bill possible, and I would like to recognize
the hard work of the House staff who brought this bill together: Marc
Wheat, Jason Lee, Brent Del Monte, Patrick Morrisey, Anne Esposito,
Carolyn Sporn, John Ford, Judith Benkendorf, Ellie Dehoney, and Katie
Porter.
Last year, Congressman Jim DeMint of South Carolina and I introduced
H.R. 2511, the Adoption Awareness Act. After negotiations with all
interested parties, including adoption advocates, foster care
advocates, and representatives from the pro-life community as well as
the abortion industry, the language of H.R. 2511 changed but the
central purpose remained the same: the Infant Adoption Awareness Act
ensures that counselors in health clinics and other settings provide
women who have unplanned pregnancies complete and accurate information
on adoption.
The Infant Adoption Awareness Act passed the House as part of H.R.
4365 by a vote of 419-2 and passed the Senate by unanimous consent. As
Chairman of the Commerce Committee, I have been responsible for the
negotiations leading to the final form of the Infant Adoption Awareness
Act for these many months, and I want to take this opportunity to
explain the bill at length to my colleagues in case there is any
confusion with the text of the original Adoption Awareness Act, H.R.
2511.
What struck Congressman DeMint and me was that the studies and
statistics available in this field show a lack of activity which may
well reflect an anti-adoption bias in pregnancy counseling. According
to a University of Illinois study by Professor Edmund Mech,
Orientations of Pregnancy Counselors Toward Adoption, 40 percent of
self-identified ``pregnancy counselors'' in settings such as health,
family planning, and social service agencies do not even raise the
issue of adoption with their pregnant clients. Of the 60 percent who
raise the issue of adoption in some form, 40 percent provide inaccurate
or incomplete information. Furthermore, while pregnancy counselors
themselves may not have a negative bias towards adoption, they
presuppose that their client is not interested and therefore do not
present adoption as a true option for women facing unplanned
pregnancies (Source: Mech, Pregnant Adolescents: Communicating the
Adoption Option). The Infant Adoption Awareness Act would set up a
training program by which clinic workers and others could receive
professional in-service training in educational adoption counseling. If
properly trained, these counselors would be equipped to provide
valuable information on adoption to their clients.
While many societal factors have changed in the last twenty years,
including the acceptance of non-marital teen parenting, the
availability of welfare, and increased availability of abortion
services, there has been a dramatic drop in the number of adoptions
among live births to unwed mothers. Prior to 1973, an adoption
placement occurred for almost one of every ten premarital births. By
the 1990s, the number had dropped to an adoption placement for one of
less than every hundred premarital births. A long-term study of the
Adolescent Family Life (AFL) pregnancy programs which included an
adoption counseling component showed that--given necessary adjustments
for client and community characteristics--more women chose to place
their child for adoption when enrolled in an AFL Care project which
provided adoption counseling as a part of pregnancy resolution
decision-making (Source: McLaughlin and Johnson, Battelle Human Affairs
Research Centers, The Relationship of Client and Project
Characteristics to the Relinquishment Rates of the AFL Care
Demonstration Projects). Thus, this Act intends to ensure that the
public health and other professionals coming in contact with a high
percentage of women facing unplanned pregnancies--often unwed
adolescents--are properly prepared to have a complete and accurate
discussion of adoption.
The Act allows for a six month period in which representatives of the
adoption community come together to adopt or develop best-practices
guidelines for counseling on adoption to women facing unplanned
pregnancies. Specifically, the Secretary should include representatives
of diverse viewpoints in the adoption community, including
organizations representing agencies arranging infant adoptions,
adoption attorneys, adoptive parents, social services, and appropriate
groups representing the adoption triad (birth parents, infant, and
adoptive parents). Organizations with significant expertise and history
in this arena include the National Council For Adoption, Loving and
Caring, Bethany Christian Services, the American Academy of Adoption
Attorneys, and the American Bar Association Family Law Section's
Adoption Committee. These organizations should be represented on the
panel. While recognizing the sensitivity of making an adoption
decision, the organizations represented should be those which promote
adoption in a realistic, positive manner as beneficial to the birth
parents, child, and adoptive parents. The best-practices guidelines
should focus on the essential components of adoption information and
counseling to be presented during a pregnancy counseling session.
Furthermore, the guidelines should include important variables to be
presented, such as state laws on adoption, and available medical,
legal, and financial resources. Previous curricula developed for these
purposes should be the starting point and, as an interim set of
guidelines, be determinative.
The role of the public health clinics on the panel developing the
best practices guidelines (and organizations representing their
interests, such as the Family Planning Councils of America) is to
ensure the guidelines are relevant to the health clinic setting. The
experts in adoption counseling, including those who have a history of
developing and delivering training or tools to teach adoption
counseling, should shape the best-practices guidelines to provide an
excellent model for presenting adoption to women facing unplanned
pregnancies. Since different attitudes towards adoption exist
throughout the country which can be attributed to racial, ethnic,
religious, social, and geographic differences, the best-practices
guidelines should act as a blueprint or model while still allowing
localities the flexibility to address their local situation. Therefore,
the best-practices guidelines would be a model which could be tailored
to address the individual needs of the pregnant woman.
After the best-practices guidelines are developed, the Secretary
shall make grants to adoption organizations to carry out training,
which will often be training trainers, to teach pregnancy counselors
how to present complete and accurate information on adoption. The
guidelines are meant to be the basis for the adoption, improvement, or
development of a training curriculum by grantees. Furthermore, the
grantees can carry out the training programs directly or through grants
or contracts with other adoption organizations. For instance, a
national office could subgrant or contract with local affiliates
throughout the nation or a region thereof. The Secretary should use
discretion in ensuring that all regions of the nation will have
adequate access to the training without having duplicate services in an
area with a small number of eligible health clinics. There are no
geographic limitations on where the trainers should be trained. The
intent is to provide for training of trainers, often on a statewide or
regional basis, so truly expert trainers can teach others.
The trainers should be highly qualified individuals with an expertise
in adoption counseling. ``Adoption counseling'' in the adoption
community implies an in-depth discussion of adoption which includes
knowledge of various types of adoption and familiarity with the
viewpoint and challenges of birth mothers, putative fathers, adoptive
parents, and the best interest of the child. Trainers should have
experience in providing adoption information and referrals in the
geographic area of the eligible health centers. With a knowledge of
state laws and access to local support networks, a trainer will be able
to provide a more extensive review of local information and resources
to the pregnancy counselors. The most essential component of the
training, however, is to teach pregnancy counselors how to accurately
and completely present adoption as an option to their clients and to
ensure counselors are able to answer the frequently asked questions
clients have regarding adoption.
The Infant Adoption Awareness Act refers to pregnancy counselors
providing adoption information and referrals as a part of pregnancy
counseling. It is important to note that handing a client a piece of
paper or booklet explaining the adoption process and providing phone
numbers of agencies or attorneys for adoption referrals does not
constitute adoption information and referrals. Adoption information
means a counselor is able to fully explore the option of adoption with
a client. This includes answering relevant questions such as the types
of adoptions, financial and medical resources for birth mothers, and
state laws regarding relinquishment procedures and putative father
involvement. Referral upon request includes following the procedures of
the health clinic to make an appointment for the client and follow-
[[Page H8259]]
up as necessary. Referral may be made to an in-house adoption provider,
such as a staff member of a licensed adoption agency. Since adoption is
explored in the context of pregnancy counseling sessions in which
counselors and clients have a limited amount of time, it is essential
that the counselors provide complete and accurate summary information
to their clients at that time.
The intent of this Act is to ensure that pregnancy counselors are
well-trained, knowledgeable and comfortable presenting adoption to
their clients. While adoption may not be the right choice for every
women facing an unplanned pregnancy, each woman should be presented
adoption information to make a well-informed decision. Many women have
not thought of the possibility of adoption, do not know how to explore
the details of adoption, or have misconceptions of the adoption process
which hinder their consideration of the alternative of adoption. Since
pregnancy counselors act as an important resource for these women, they
must be equipped to fully address the option of adoption with their
clients.
The adoption organizations eligible to receive grants for training
(or subgrants or contracts) are those national, regional, or local
private, non-profit institutions among whose primary purposes is
adoption, and are knowledgeable in all elements of the adoption process
and on providing adoption information and referrals to pregnant women.
These adoption organizations must work in collaboration with existing
Health Resources Services Administration (HRSA) funded ``training
centers.'' Of particular importance is the organization's experience in
explaining the process involved to the birth mother placing the child
for adoption. It is essential that adoption is among the primary of the
entity, as it should be organizations with true experts in adoption
counseling who are training pregnancy counselors.
Health centers which are eligible to have staff receive training are
public and nonprofit private entities that provide health-related
services to pregnant women. The designated staff of the health centers
means the counselors who will interact and provide counseling to women
with unplanned pregnancies. The designated staff members are those who
provide pregnancy or adoption information and referrals (or will
provide such information and referrals after receiving training).
Furthermore, while the Act sets out those health centers which should
receive priority is being trained, nothing should be construed to
prohibit those who provide counseling in other settings, such as on
military bases and corrections facilities, to be eligible to
participate in the adoption counseling training sessions.
The grant is conditioned on the agreement of the adoption
organization to make reasonable efforts to ensure that the eligible
health centers which may receive training under this grant include, but
are not limited to, those that receive federal family planning funding,
community health centers, migrant health centers, centers for homeless
individuals and residents of public housing and school-based clinics.
The Secretary has the duty to provide eligible health centers (which
receive funding under Section 330 and 1001) with complete information
about the training available from the adoption organizations receiving
the training grants. Furthermore, the Secretary has the duty to
encourage eligible health centers to have their designated staff
participate in the training. The Secretary must make reasonable efforts
to encourage staff to undergo training within a reasonable period after
the Secretary begins making grants for such training. The grantees will
cover the costs of training the designated staff and reimbursing the
health center for costs associated with receiving the training.
Adoption counseling training is a type of professional development for
pregnancy counselors and should be reimbursed on a similar basis as
other professional development activities which staff receive in the
local area.
Within one year, the Secretary shall submit to the appropriate
Committees of Congress a report prepared by an independent evaluator,
paid for by funds set aside under this Act evaluating the extent to
which adoption information, and referral upon request, is provided by
eligible health centers. The bill directs the reports to be conducted
by the Secretary acting through the Administrator of the Health
Resources and Services Administration and in collaboration with the
Director of the Agency for Healthcare Research and Quality. The study
should be scientifically-based and sufficiently broad so as to gain an
understanding of the current practices of providing adoption
information in Federally funded health clinics throughout the country.
This should include the attention given to adoption relative to other
options discussed in pregnancy counseling. Further, the study should
indicate how often and in what form (written, verbal) adoption
information is offered, the completeness and accuracy of the adoption
information provided, and non-identifying information about the options
ultimately chosen by clients.
Within a reasonable period of time, the Secretary shall submit to the
appropriate Committees of Congress a report evaluating the extent to
which adoption information, and referral upon request, is provided by
eligible health centers to determine the effectiveness of the training.
The bill directs the reports to be conducted by the Secretary acting
through the Administrator of the Health Resources and Services
Administration and in collaboration with the Director of the Agency for
Health Care Research and Quality. Moreover, it is important that the
study is scientifically-based, that is, more than a checklist asserting
that adoption counseling, information, or referral has been provided,
and focus on those health centers in which designated staff have been
provided training through this Act. In conducting these studies, the
Secretary shall ensure that the research does not allow any
interference in the provider-patient relationship, any breach of
patient confidentiality, or any monitoring or auditing of the
counseling process which breaches patient confidentiality or reveals
patient identity.
Funding for research in adoption counseling practices has been
sporadic at best. Despite the acknowledged need to ensure pregnancy
counselors can present adoption in a positive, accurate manner, funding
for such studies has not materialized in proportion to the need. The
Adolescent Family Life Program in the Office of Population Affairs
provided for limited studies in the 1980s and follow-up studies on the
effectiveness of the AFL Demonstration Programs into the early 1990s.
The Office of Adolescent Pregnancy Programs in the 1990s proposed an
objective of increasing to 90 percent the number of pregnancy
counselors who are able to counsel on adoption in a complete, accurate
manner. With a change of Administration, this goal never materialized
as one of the priorities of the Public Health Service. Furthermore,
plans for follow-up study by the Department of Health and Human
Services to determine if the orientations of pregnancy counselors
toward adoption had changed were dropped in 1995. Thus, research in
this area is of critical importance.
Additionally, while the intention was to include ``charitable
choice'' language allowing faith-based organizations to compete for
grants on the same basis as any other non-governmental provider without
impairing the religious character of such institution, this language is
not in the final bill due to opposition from the minority. I hope
faith-based institutions will be able to compete for these grants in
the future. To clarify, under charitable choice, the Federal Government
cannot discriminate against an organization that applies to receive
such a grant on the bias that the organization has a religious
character and programs must be implemented consistent with the
Establishment and Free Exercise Clauses of the United States
Constitution. While following the agreed upon charitable choice model,
future charitable choice language must be crafted to conform it to the
purpose and structure of this Act.
As an adoptive father, Co-Chairman of the Congressional Coalition on
Adoption, and Chairman of the House Commerce Committee, I am proud to
have worked to make complete and accurate information on adoption a
reality for women across the country. I look forward to the
implementation of this important legislation as one my legacies to this
great country.
Finally, Mr. Speaker, I submit this statement on my behalf and the
behalf of Congressman Bill McCollum, Chairman, Subcommittee on Crime.
Joint Statement of the Honorable Tom Bliley and the Honorable Bill
McCollum
We write to clarify our intent with respect to Title XXXV
of H.R. 4653, the Child Health Act of 2000. We support the
objectives of this provision, to amend current law governing
practitioners in order to make certain addiction treatment
available in appropriate circumstances.
However, subsection within Title XXXV stating that
``Nothing in such regulations or practice guidelines may
authorize any Federal official or employee to exercise
supervision or control over the practice of medicine or the
manner in which medical services are provided'' requires
further clarification. Nothing in this subsection is intended
to affect either the long standing authority of the Attorney
General to enforce the standard governing the dispensing of
controlled substances, nor the authority of the Secretary of
Health and Human Services, after consultation with the
Attorney General, to determine the appropriate methods
professional practice in the medical treatment of narcotic
addiction. This authority applies to the dispensing of all
controlled substances, including that which is authorized by
this provision.
Mr. BROWN of Ohio. Mr. Speaker, in this town, it's difficult to take
action in any direction without creating controversy.
Consensus is a rarity.
This legislation bucks the trend. It reflects consensus around a
common-sense principle.
If we can protect children from needless surgery, preventable
disability, premature death--we should do it.
[[Page H8260]]
That's what this bill is all about.
We are placing our hope and trust in the National Institutes of
Health, the Centers for Disease Control, HRSA, and other federal
agencies that have responsibility for improving our nation's health.
We are asking them to intensify their efforts in areas of children's
health including juvenile arthritis, muscular dystrophy, asthma, and
Fragile X syndrome.
This bill provides screening and health care services for infants and
children at risk for heritable disorders, and it implements organ
donation policies that recognize the unique needs of children.
We have done a lot in this bill to help young victims of childhood
illness and disease. But we in Congress should not take the credit.
Parents and other advocates for children throughout the United States
should.
I especially want to acknowledge the parents. I've met with many
parents this year, and I am proud that this bill translates their
straightforward and eminently justifiable goals into action.
These parents want to see children's health research given the
priority it deserves.
We invest generously in our children's basic needs, their education,
their happiness . . . we should invest at least as generously in the
kind of research that can protect and restore their health.
Many of the parents I spoke with were bringing their stories to
Congress not for themselves, not for their own children, but for
children and families they will never meet.
These parents are working to prevent others from experiencing the
trauma and pain a childhood illness can inflict on a child and their
loved ones.
I want to thank the parents for their hard work, dedication and
unwavering conviction that we can do much, much more to ease the way
for our children.
This same conviction underlies the portion of the Children's Health
Act that reauthorizes the Substance Abuse and Mental Health Services
Administration (SAMHSA).
In this year's reauthorization of SAMHSA, we do more to address
substance abuse and mental health issues as they relate to children--
under age drinking, children and violence, and fetal alcohol syndrome,
to name a few.
To the extent we can protect our children from alcohol and substance
abuse, we reduce their chances of addiction or abuse as adults.
We owe them that.
This is a great success, but once again, it's the public's
accomplishment.
Substance abuse prevention is a public priority and has garnered
overwhelming support on both sides of the aisle.
We have been asked to make this, as well as children's health, a
priority for this Congress.
I am pleased to be among those helping to fulfill those wishes.
Mr. DINGELL. Mr. Speaker, I support H.R. 4365, the Children's Health
Act of 2000. This bill, which now contains provisions from the Senate's
bill, authorizes a variety of programs for expanding and intensifying
children's health research. It also includes prenatal care initiatives
(including the first formal authorization of the Healthy Start Program)
that were included in the bill we passed in May of this year.
The bill also covers a wide range of youth drug and mental health
services programs that will strengthen America's communities. I am very
pleased that this Congress is reauthorizing programs administered by
the Substance Abuse and Mental Health Services Administration (SAMHSA).
These programs provide critical safety-net services for individuals and
families with substance abuse problems and mental illness.
I wish to commend a number of my colleagues for their fine
contributions: Representative Diana DeGette, for championing provisions
on pediatric organ transplants, juvenile diabetes, limits on the use of
seclusion and restraints on hospitalized children, and a study
concerning the use of children as participants in clinical research;
Representative Strickland for his child mental health provisions and
for bringing state-of-the-art services to residents of rural
communities; and, Representative Capps for her efforts in this Chamber
not only to make the SAMHSA reauthorization a reality, but for her fine
provision on underage drinking. The ranking member of the Health and
Environment Subcommittee, Representative Brown, has done a splendid job
with this bill and he deserves our gratitude. Virtually every bill
affecting public health bears the mark of my good friend and colleague,
Representative Waxman, and this one is no exception. Many other of our
colleagues made significant contributions to this bill, as well.
Giving credit where it is due, this bill has been improved by our
Senate colleagues. Childhood obesity, now a focus of the bill, is one
of the Surgeon General's priorities for Healthy People 2010. I am also
delighted to see the program for newborn screening for heritable
metabolic disorders, an issue of great concern to my colleague,
Representative Pallone. This provision would establish an advisory
counsel to guide the Secretary in making timely and informed responses
to rapid advances in genetic technologies. State and local public
health departments will benefit from their provision as resources would
be made available to improve programmatic uniformity, from laboratory
infrastructure, to counseling, and healthcare services.
Other new provisions for America's children will develop strategies
for improving childcare facilities, increase funds for the early
detection and treatment of childhood lead poisoning, and fund a
longitudinal study of influences that shape child development. The new
National Center for Birth Defects and Developmental Disabilities at the
Centers for Disease Control and Prevention will track and identify
causes of birth defects and developmental disabilities with the goal of
creating effective interventions to prevent the conditions, or their
secondary health impacts. But without the full support of our
colleagues on the Appropriations Committee in fiscal year 2001 to build
and operate the Center, and in successive years to sustain and expand
it, the Center will only be a shell.
Despite its many worthy provisions, this bill has been marked by a
number of procedural irregularities. No bill of this scope and
magnitude should proceed to the House floor without going through the
committee process. No children's health bill worth its name should
neglect such programs as: (1) supplementing S-CHIP and Medicaid to
provide seamless access to state-of-the-art prenatal services to all
pregnant women; (2) assuring equal access to pediatric specialists,
medically necessary drugs and clinical trials for children with rare
and/or serious health problems; (3) establishing guidelines for the
administration of psychotropic medications to children under five,
which is a major concern to my good friend Representative Towns; and,
(4) addressing FDA regulation of youth tobacco use. Ironically, the
provision promoting safe motherhood includes a public education
initiative addressing the dangers of alcohol, tobacco, and illicit drug
use in pregnancy. Most women do not begin smoking during pregnancy;
they begin as adolescents. Yet, our Committee was unable to even debate
this issue this year.
The provision on narcotic addiction treatment unfortunately fails to
provide coverage for the majority of heroin addicts who cannot afford
new drugs, such as buprenorphine, which were developed with taxpayer
resources. Implementation of this provision, which exempts certain
physicians from future guidelines for treatment with a not yet approved
and labeled drug, will bear watching.
Finally, it is unfortunate that at a time when our Nation has more
than 120,000 children in the foster care and the child welfare system
who need homes, the only provision in this bill addressing adoption is
based on a very limited, heavily criticized, sixteen year old study of
how women with unintended pregnancies are counseled about their
options. It speaks volumes that not a single organization involved with
special needs adoptions has written to express support for this bill.
This provision is based on a pejorative assumption about our publicly
funded primary health care system and it burdens the already extended
community health centers and Title X family planning clinics. Our tax
dollars would be better spent addressing the needs of the more than
120,000 children of this Nation who so desperately need loving, caring
homes.
I will vote for this bill. However, I want America's children to know
that while H.R. 4365 is a significant step toward improving the quality
of your collective health, we can do better. It now seems clear that
the horizon of the 106th Congress will be rather limited with respect
to health issues. I have great hope and great confidence that in the
107th Congress we will do better.
Mr. GREENWOOD. Mr. Speaker, as a member of the Subcommittee on Health
and Environment of the House Committee on Commerce, the committee of
jurisdiction, I wish to clarify my intent in voting or H.R. 4365.
Section 3207 imposes new requirements on residents of certain
facilities with respect to the use of techniques of ``restraint'' and
``seclusion.'' While such practices should be avoided whenever
possible, I trust that the regulatory agencies implementing this law
will do so in a reasonable, practical manner. New Section 591(d)(1) of
the Public Health Service Act defines ``restraint'' to exclude ``any .
. . method that involves the physical holding of a resident . . . to
permit the resident to participate in activities without the risk of
physical harm to the resident . . .'' I construe this phrase to allow
facilities covered under this section providing services to children
and youth with serious emotional disturbances to continue using a
practice known as a ``therapeutic hold'' when appropriate to allow a
resident to resume activities as soon as possible.
Mr. CANNON. Mr. Speaker, I rise today in support of the underlying
legislation which includes within it an important bill that I sponsored
in the House, the Methamphetamine
[[Page H8261]]
Anti-Proliferation Act of 2000. Methamphetamine is a powerful and
dangerous drug. It differs from other popular illegal narcotics because
it can be made from readily available, domestically produced, legal but
dangerous chemicals and substances. It puts both human life and the
environment at risk and it is reaching epidemic proportions.
Meth has become the fastest growing illegal narcotic in America.
Within the last five years, meth use has increased in some communities
by as much as 300 percent. In some areas meth accounts for as much as
90 percent of all drug cases. An increasing amount of meth is imported,
but there are also hundreds of small ``Mom and Pop'' clandestine labs
manufacturing meth in my State of Utah and throughout the country.
Cheaply produced, but with a street value as high as $1,500 an ounce,
it is no wonder that meth has become the drug of choice for gangs and
criminals.
This legislation that I sponsored, and which we consider today, will
address the proliferation of methamphetamine and club drug
manufacturing, trafficking, use, and addiction in America. It provides
Federal, State, and local law enforcement officials with tools and
training to combat the methamphetamine and club drug epidemic in
America today. It furthermore authorizes comprehensive prevention and
treatment programs to combat abuse and addiction as well.
H.R. 2987 provides funding to the Drug Enforcement Administration
[DEA] and Office of National Drug Control Policy [ONDCP]. These
additional resources will be used to assist State and local law
enforcement officials in methamphetamine investigations and establish
additional DEA offices in rural areas. It provides training for toxic
methamphetamine waste clean up, and authorizes federal reimbursement to
states and localities for meth lab cleanup expenses.
H.R. 2987 also increases penalties for amphetamine production,
trafficking in meth precursor chemicals, and drug manufacturing that
creates a risk to human life or to the environment. The bill also
contains provisions to address the problems associated with
``Ecstasy,'' gamma-hydroxbutyric acid (GHB) to so-called ``date rape
drug,'' other enumerated ``club'' drugs, as well as similar controlled
substances. And finally, the bill contains a number of provisions
authorizing effective and science-based methamphetamine and club drug
prevention and addiction treatment programs and federal resources for
those programs.
Mr. Speaker, by passing this bill today we will be upholding our
responsibility to provide additional federal resources that will help
local law enforcement take back our cities and towns from the rising
tide of methamphetamine and club drugs. I thank all the Members who
worked on this bill for their efforts, and urge my colleagues to
support this legislation.
Mr. OSE. Mr. Speaker, when the Children's' Health Act was passed by
the Senate, the Anti-Methamphetamine Proliferation Act was added as an
amendment. I wish to speak about the importance of this provision in
the fight against methamphetamines.
Those of us who live on the east coast have not experienced the
devastation that methamphetamines can wreak on a community.
Unfortunately, in California, where 80 percent of the Nation's Meth
supply is produced, we know all too well the dangers of this drug.
Methamphetamines are a powerful drug that leaves a path of destruction
in its wake. Meth is highly addictive, giving the user a sense of power
and paranoia. As a result, a staggering proportion of violent crime in
many communities is tied to Meth use. Would you believe that in
Sacramento, 27 percent of male arrestees tested positive for Meth? In
other western cities, the numbers are equally alarming: San Diego--26
percent; Salt Lake City--25 percent; San Jose--24 percent; Spokane--20
percent; Portland--19 percent; Las Vegas--16 percent; Phoenix--16
percent.
The Meth crisis is full of youth tragedies as well. Since Meth is
largely produced on kitchen stoves, children are extremely vulnerable
to exposure to lethal chemicals. In addition, I have personally heard
horrific stories of child abuse at the hands of Meth users.
In March of this year I hosted a congressional field hearing in
Woodland, CA to discuss the Meth crisis. During the hearing I heard
from State and local law enforcement officials who fight the Meth
crisis. From them I learned the unique challenges that this drug
presents. The Anti-Methamphetamines Proliferation Act, for the first
time ever, takes a comprehensive approach to fighting Meth and
addresses those very problems that I heard from my local sheriffs and
police chiefs.
The Anti-Meth Proliferation Act would: increase penalties for
possession of precursor chemicals used to make Meth; add $15 million to
the High Intensity Drug Trafficking Areas (HIDTAs) specifically
targeted towards fighting Meth; increase funds to help state and local
officials clean up Meth labs, which are filled with dangerous chemicals
that threaten both human lives and the environment; adds funds for
research and treatment of Meth.
I congratulate the gentleman from Utah, Mr. Cannon and the gentleman
from Florida, Mr. McCollum for their hard work on this important bill.
With this legislation, we are finally giving our law enforcement
officials the resources they need to fight Meth production and
distribution.
Let's pass this bill and get serious about fighting the scourge of
methamphetamines.
Mr. WAXMAN. Mr. Speaker, I rise to express my strong support for H.R.
4365, the Children's Health Act. I am very pleased this bill represents
a bipartisan, consensus combination of the children's health
legislation and a long overdue reauthorization of the Substance Abuse
and Mental Health Administration [SAMHSA].
This legislation contains many important provisions which will
advance the treatment, cure and prevention of many childhood diseases
and disorders. Among other benefits, they promise to make significant
advances in the treatment and prevention of childhood asthma and of
autoimmune diseases, like multiple sclerosis, juvenile diabetes and
lupus, as well as in education and outreach regarding Tourette
Syndrome. And children participating in clinical research will be
afforded stronger protections under Federal law.
Title V of this bill consists of H.R. 2840, the Children's Asthma
Relief Act of 1999, introduced by Congressman Fred Upton and myself.
Title XIX is based on H.R. 2573, the NIH Office of Autoimmune Diseases
Act of 1999, which was authored by Congresswoman Connie Morella and
myself. Title XXIII consists of an amendment, ``Children and Tourette
Syndrome Awareness,'' authored by myself. Title XXVII includes enhanced
protections for children participating in clinical research, based on
H.R. 4605, the Human Research Subjects Protection Act introduced by
Congresswoman Diana DeGette, Congressman John Mica and myself.
Equally important, this legislation authorizes programs and grants
administered by SAMHSA which are essential to the health of many
Americans. The reauthorization of this agency's statutory authority is
long overdue and comes at an important juncture in our efforts to
improve our health care services
NIH Initiative on Autoimmune Diseases
I am pleased that H.R. 4365 establishes a new initiative at NIH to
``expand, intensify and corrdinate'' research and education on
autoimmune diseases.
Last year, Congresswoman Morella and I introduced the NIH Office of
Autoimmune Diseases Act of 1999. This legislation created an office in
the NIH Office of the Director to ensure that federal funding of
autoimmune disease research is used optimally and that clinical
treatments are developed as rapidly as possible.
There are more than 80 autoimmune diseases--including multiple
sclerosis, lupus, and rheumatoid arthritis--in which the body's immune
system mistakenly attacks healthy tissues. These diseases affect more
than 13.5 million Americans and are major causes of disability. Most
striking of all, three-quarters of those afflicted with an autoimmune
disease are women.
Research on autoimmune diseases is spread through many institutes of
the National Institutes of Health [NIH], just as treatments involve
many clinical specialties. Increasingly, however, scientists are
identifying the common risk factors and symptoms of autoimmune
diseases. This is why greater coordination and additional resources are
needed in our Nation's autoimmune research effort.
Title XIX of H.R. 4365 adopts our office, transferring its activities
and mission to an Autoimmune Diseases Coordinating Committee. Composed
of NIH institute directors and permanently staffed with scientists and
health professionals, the coordinating committee would be advised by a
public advisory council.
Most significantly, the coordinating committee, in close consultation
with the advisory council, will develop a plan for research and
education on autoimmune diseases. The plan will establish NIH
priorities and the Director of NIH will ensure the plan is fully and
appropriately funded. The strategic plan would create crucial new
funding opportunities for autoimmune research, based on the
professional and scientific judgements of researchers, patients and
clinicians. Finally, the committee would report to Congress on
implementation of the plan, including the actual amounts dedicated by
NIH to autoimmune disease research. The committee will also
prospectively identify areas and projects of great promise which
Congress should support. I cannot overstate the importance of these
activities. In conjunction with the strategic plan, these reports will
provide an objective, scientifically sound roadmap to Congress and NIH
to follow in the pursuit of new treatments and cures for autoimmune
diseases.
Asthma Services for Children
Title V will benefit the more than five million American children who
have asthma, one of the most significant and prevalent chronic diseases
in America. Surgeon General David
[[Page H8262]]
Satcher recently concluded that the United States is ``moving in the
wrong direction, especially among minority children in the urban
communities.''
That is why the Children's Asthma Relief Act provides new funding for
pediatric asthma prevention and treatment programs, allowing states and
local communities to target and improve the health of low-income
children suffering from asthma. The act would also increase the
enrollment of these children into Medicaid and state Children's Health
Insurance Programs [CHIP], such as California's Healthy Families.
I am particularly pleased that Title V includes mobile
``breathmobiles'' among the community-based programs eligible for
funding. These school-based mobile clinics were developed by the
Southern California chapter of the Asthma and Allergy Foundation of
America, in conjunction with Los Angeles County, Los Angeles Unified
School District and the University of Southern California.
Finally, this title reflects the leadership and work of Senators Dick
Durbin and Mike DeWine. It also has the strong support of leading child
health and asthma organizations, including the American Lung
Association, the American Academy of Pediatrics, Association of
Maternal and Child Health Programs, the National Association of
Children's Hospitals, the American Academy of Chest Physicians and the
Children's Health Fund.
Children and Tourette Syndrome Awareness
Because I had intended to offer title III of this legislation as an
amendment to the House legislation, I am very pleased it has been
included. This title provides grants to develop and implement outreach
programs, with a particular emphasis on children. These programs will
target health providers, community groups and educators with enhanced
information about the etiology, diagnosis and treatment of Tourette
Syndrome [TS], a serious, often misunderstood and frequently
misdiagnosed inherited neurological disorder.
I am particularly pleased that this provision reflects the
contributions and expertise of the Tourette Syndrome Association, a
national organization dedicated to providing information about TS, its
treatment and support services and current research to individuals with
TS and their families.
Research Subject Protections for Children
I am also very pleased that provisions from Congresswoman DeGette's
Human Research Subjects Protection Act have been included in title
XXVII of this legislation. This bipartisan legislation represents the
first comprehensive reforms of research protections in a quarter
century. This provision benefitting children is a downpayment on the
additional reforms which are urgently needed in informed consent and
our national system of Institutional Review Boards [IRBs]. These
protections are indispensable to medical research, and recent abuses
and failures have understandably shaken public confidence.
In the past, Congress has acted to protect research volunteers in the
face of crisis or scandals like Tuskeegee, Willowbrook, and the
government's cold war radiation experiments. But today, there is a
clear consensus that we must strengthen and expand current protections.
In doing so, we will restore the confidence of courageous people who
are willing to put their health and welfare on the line to help find
new cures and treatments. Without their trust, research simply cannot
continue.
Adoption Policy
Finally, the adoption awareness provisions in title XII were the
subject to great controversy and debate. The original language raised
many serious objections concerning adoption policy as well as abortion
policy. These objections were made by Members, including myself, and
important public health organizations including the American College of
Obstetricians and Gynecologists, the National Association of Community
Health Centers, and the National Abortion and Reproductive Rights
Action League.
I recognize the sincerity of Chairman Tom Bliley's concern on the
issue of adoption and the significant efforts he has made to achieve a
compromise and to remove the more troubling provisions from this Title.
samhsa reauthorization
With respect to the reauthorization of SAMHSA, substance and alcohol
abuse remain complex, troubling issues which elude simply or quick
solutions. In light of surveys which indicate a recent increase in
teenage drug use, it was particularly troubling to recently learn that
nearly half of all parents are simply resigned to having their teenage
children be exposed to illegal drugs. Unmet treatment needs continue to
drive the annual $160 billion in societal costs from substance and
alcohol abuse. Instead of receiving appropriate care, millions of
Americans actively seeking treatment are being forced onto waiting
lists. This is an unacceptable situation, especially as we have begun
to receive conclusive data on the cost-effective health outcomes and
dramatic savings produced by effective treatment.
For these reasons, I want to commend Congresswoman Lois Capps on her
authorship of the provisions on youth alcohol and fetal alcohol
syndrome, Congressman Ted Strickland for his hard work on the mental
health provisions, and Congresswoman DeGette on her provision
strengthening protections against the use of seclusion and restraints.
I am also particularly pleased that the grant programs targeting
homeless individuals, the Grants for the Benefit of Homeless
Individuals [GBHI] and the Projects for Assistance in Transition from
Homelessness [PATH] have been reauthorized.
charitable choice
There is one provision which I regret has been included in the SAMHSA
reauthorization. It relates to ``charitable choice,'' and wholly
exempts faith-based organizations from the application of Federal
employment and discrimination laws in the provision of services funded
by SAMHSA. I am also concerned that ``pervasively sectarian''
organizations may receive such funding, weakening the clear
constitutional separation of church and state. Finally, I question
whether this provision weakens the standards for certifying facilities
and personnel providing substance abuse or mental health services, and
for measuring and assessing the delivery of such services by a faith-
based organization.
In conclusion, I urge my colleagues to support H.R. 4365 and commend
the House staff for their hard work and dedication on this important
public health legislation, particularly Judith Benkendorf, Eleanor
Dehoney, Anne Esposito, John Ford and Marc Wheat.
Mr. TOWNS. Mr. Speaker, I'm very pleased that the House approved H.R.
4365, the Children's Health Act of 2000, reflecting a compromise
agreement that was reached on a bipartisan basis with the Senate last
week. This legislation will establish various children's health
research and prevention programs conducted through federal public
health agencies. The legislation will amend the Public Health Service
Act to authorize additional federal resources targeted at many
children's diseases, such as traumatic brain injury, autism, Fragile X,
juvenile arthritis, childhood skeletal malignancies, diabetes, birth
defects, hepatitis C, and epilepsy.
Today, however, I want to specifically make mention of title 22 of
the legislation, which mandates increased research by the National
Institutes of Health into Muscular Dystrophy. Passage of this title
represents the first time that Muscular Dystrophy, and specifically
Duchesne Muscular Dystrophy, has been acknowledged in a federal
statute. This is long overdue.
As a member of the Health Subcommittee of the Commerce Committee, I
am greatly heartened by the efforts of the gentleman from Ohio, ranking
member Sherrod Brown, to include this title in the legislation.
Duchesne Muscular Dystrophy is the world's most prevalent lethal
childhood genetic disease, cutting equally across all races and all
citizens. To look at the record of research on this disease is to
realize that despite our country's enormous resources, sometimes many
children are left behind. Today, despite all the advances in medical
science, victims of this disease--which afflicts one of every 3,500
boys--have no cures and no effective treatments available to them.
Children afflicted with Duchesne Muscular Dystrophy have no ability
to produce the protein dystrophin, the protein that binds the muscle
cells together. First, they lose their ability to climb and walk, then
the disease spreads to their arms, and ultimately pulmonary or cardiac
failure results by the late teens or early twenties. It is an
exceptionally cruel disease that slowly robs boys of their independence
and ultimately immobilizes them, leading invariably to an untimely and
early loss of life.
Sadly, the federal response to this disease has been exceptionally
poor. This year, in a NIH budget of more than $18 billion, research
into Duchesne and Becker Muscular Dystrophies totals $9.2 million.
Because it is a difficult disease that affects only tens of thousands
of children--not millions--there is no current commitment from private
drug manufacturers to conduct research on this disease. If you want to
understand why there is nothing available to treat these children, you
need look no further than the weak federal response to this disease.
The gene that is flawed in this disease is readily identifiable, and
has been so for 14 years. But astonishingly, the pace of research on
DMD actually slowed down after the gene was discovered.
It is not that the scientists of NIH do not care about the victims of
this disease. Rather, there are significant structural problems that
have inhibited leadership at the Institutes in creating the platform
for expanded research. Specifically, research into DMD is spread among
the institutes of NIH. The National Institute of Child Health and
Development does nothing on DMD, even though DMD victims exclusively
are children. Of even more concern is the reality that of the more than
100 separate study sections at NIH through which scientists seek grants
for research, none are devoted to muscle, the largest organ of the
[[Page H8263]]
body. The scientists who work in this area are frequently frustrated by
the wide array of study sections through which they must apply for
grants, and the lack of affinity that the peer review processes afford
them.
Mr. Speaker, passage of this legislation will improve coordination of
research into the various forms of Muscular Dystrophy. This is
imperative. But beyond that, NIH should take additional steps to ensure
that DMD gets a fair share of federal resources based on the severity
and prevalence of the disease. An Office of Dystrophinopathies, or a
branch devoted to study of Muscular Dystrophy, is certainly called for.
A study section is essential. I believe that the Commerce Committee
should conduct ongoing oversight of NIH's compliance with the
Children's Health Act, specifically in this important area.
While I am neither a scientist nor a doctor, I think it is highly
probable that sooner or later gene therapy is going to be able to cure
diseases of this nature, particularly those that involve flaws on a
single, identifiable gene. Yet the words ``sooner'' and ``later'' have
profound consequences in the lives of tens of thousands of American
children and their families that are suffering with this disease. With
the passage of H.R. 4365, we move a step closer to giving those
families hope.
Thank you, and I thank the bipartisan leadership of the Commerce
Committee for their hard work in producing this important piece of
legislation.
Mrs. EMERSON. Mr. Speaker, I'd like to take this opportunity to show
my commitment and support to the children's health bill before us
today. This comprehensive children's health legislation was cultivated
out of several individual bills, including the Healthy Kids 2000 Act
that I introduced last year with my colleague Senator Kit Bond. It was
a tremendous pleasure working with Representatives Bilirakis and Brown
in developing the first version of this comprehensive children's health
legislation, and I applaud their dedication and commitment to seeing
the important issue of children's health addressed this year.
Specifically within this bill, there are three key components that I
am especially proud of the conferees for including. The first provision
is with respect to safe motherhood. Most Americans are surprised to
learn that total maternal mortality has not declined in the United
States since 1982. Between 1982 and 1996, the national maternal
mortality ratio has remained approximately 7.5 maternal deaths per
100,000 live births. Additionally, the CDC estimates that of the 10,000
women who give birth in the United States every day: 2-3 women die from
pregnancy-related conditions; 2,100 women experience major pregnancy
related complications before labor; 2,500 women have Caesarean section
delivery; 2,600 women experience severe labor-related complications.
These rates of mortality and morbidity are simply unacceptable.
Fortunately, with passage of the children's health bill today, the CDC
will now have the ability and resources to increase surveillance
research on maternal health issues, and also implement additional
prevention and maternal health promotion programs nationwide.
A second provision I was pleased to sponsor and support earlier this
year with my colleague Representative Lucille Royball-Allard was the
folic acid education initiative. This bill contains the authorization
of a comprehensive national health education campaign promoting folic
acid to prevent serious birth defects. In 1991, research proved that
the B vitamin folic acid could prevent serious birth defects of the
brain and spine, known as neural tube defects [NTDs]. Spina bifida and
anencephaly are two common NTDs. The Centers for Disease Control and
Prevention [CDC] has stated that if all American women of childbearing
age consumed 400 micrograms of the B vitamin folic acid each day up to
70 percent of all cases of neural tube defects could be prevented.
However, this scientific breakthrough has not been translated into a
reduction in neural tube defects because millions of women are not
aware of the role of folic acid in preventing NTDs. While public
awareness is improving, a majority of women are uninformed about the
benefits of folic acid and they are not consuming the recommended daily
amount. According to a June 2000 March of Dimes national survey
conducted by the Gallup Organizations, only 34 percent of women of
childbearing age reported taking a multivitamin with folic acid on a
daily basis. The survey also found that 9 out of 10 women do not know
that folic acid must be consumed before pregnancy to be effective, and
that only 1 in 7 know that folic acid prevents birth defects.
This provision outlines the components of a comprehensive national
campaign that would enable CDC to assist states and others to develop
and implement programs to reduce the incidence of neural tube birth
defects which effect an estimated 2,500 babies each year.
Lastly, I want to take a moment to express my support for title XXII
of the bill, which directs the National Institutes of Health to develop
a more coordinated research strategy with regards to muscular
dystrophy, giving particular attention to Duchenne Muscular Dystrophy.
This form of the disease is the most common and most devastating of the
muscular dystrophies. One in 3,500 male children born worldwide will be
born with Duchenne and will lose the ability to walk by age 10;
however, most children are diagnosed between the ages of two and three.
Muscle deterioration will continue in the back and chest making it more
and more difficult to breathe. The deterioration process will continue
until it takes the life of a child some where in their late teens or
early twenties. This is a process that no family should ever have to
undergo, and I am happy to see that the National Institute for
Neurological Disorders and Stroke has been challenged with the task of
ensuring a stronger federal focus at NIH towards finding a cure and
alternative treatments for Duchenne Muscular Dystrophy. I applaud and
thank my colleagues for pushing NIH to take a more responsible role in
finding a cure for this devastating disease, and for their commitment
to ensuring passage of this important legislation impacting the lives
of millions of children throughout the country.
Mr. BENTSEN. Mr. Speaker, I rise today in strong support of the
Children's Health Act (H.R. 4365), legislation that would reauthorize
children's health research and prevention programs, graduate medical
education programs for children's hospital, substance abuse and drug
abuse prevention and treatment programs, and safety of children care
programs.
As an original cosponsor of many of initiatives that were included in
this comprehensive bill, I am pleased that Congress will be acting to
protect children's health. One of the most important provisions is the
reauthorization for 5 years of the graduate medical education program
for independent children's hospitals. I strongly support the role that
pediatric hospitals play in advancing pediatric medicine and the
training of physicians dedicated to children's health care needs. Under
current law, Medicare does not provide funding for pediatric
residencies for freestanding children's hospitals such as Texas
Children's Hospital in my district because these hospitals do not treat
a large number of Medicare patients. Last year, we enacted a law that
provided a one-time capped entitlement for pediatric graduate medical
education programs. This legislation would extend this valuable program
for five years.
I am also working to ensure that the pediatric graduate medical
education program receives sufficient funding through the annual
appropriations process. Earlier this year, the House of Representatives
approved the Fiscal Year 2001 Labor, Health and Human Services and
Education appropriations bill (H.R. 4577) that includes $80 million for
the pediatric graduate medical education program, an increase of $40
above this year's program. I am committed to maintaining this funding
level as the budget is finalized.
Another important issue is the bill is the Pediatric Research
Initiative that would require the National Institutes of Health (NIH)
to conduct pediatric biomedical research at the NIH. In particular,
this initiative will ensure that more research is done on how diseases
affect children as compared to adults. In most cases, clinical trials
are conducted on adults without any consideration of how these drugs
will affect children.
This initiative would also encourage the development of pediatric
clinical trials to ensure that safe and effective drug treatments are
available for children. When children face life-threatening diseases,
it is very difficult to determine how much and what types of treatments
should be given to them, because there is insufficient information
about how these treatments affect children. With more data and clinical
trials, there will more options for children who are fighting for their
lives.
This bill would also direct the National Institutes of Health to
conduct more research on diseases which directly affect children such
as hearing loss, autism, asthma, and juvenile diabetes. For autism,
this legislation requires the NIH to establish five Centers for
Excellence on autism research as well as three regional centers at the
Centers for Disease Control. For asthma, this legislation would
establish a grant program to provide comprehensive asthma services to
children, equipping mobile health care clinics and conducting patient
and family education on managing asthma. For juvenile diabetes, this
bill establishes a national database at the Centers for Disease
Control. With more information about juvenile diabetes, it will be
easier to delineate potential environmental triggers related to type 1
diabetes. This bill would also provide funding for research related to
a vaccine to prevent juvenile diabetes.
Another important initiative in this legislation is the creation of a
nationwide toll-free phone number for parents to call to get
information about poison control centers. Regrettably, the number of
accidental poisonings is a real threat to our children. This initiative
will ensure
[[Page H8264]]
that parents have one location to call to determine what is the best
treatment for an accidental poisoning. This legislation also includes
funding for a national public information campaign to educate the
public about poison prevention and how to access poison control centers
in their area. With appropriate information, parents can learn how to
reduce the number of poisonings each year.
I am also supportive of provisions in this legislation that would
provide new funding to prevent birth defects. In particular, this
legislation would authorize the Centers for Disease Controls to conduct
a public health program about the effects of folic acid in preventing
birth defects in pregnant women. This bill would also establish a
National Center on Birth Defects and Development Disabilities to
collect and analyze available data on birth defects. With more
information, I believe we will discover new ways to prevent birth
defects.
This bill would also provide several new programs to address the
mental health of our children. This measure authorizes $75 million for
a program to provide grants to public and nonprofit organizations to
prevent suicide among children and adolescents. This bill also
authorizes $300 million next year for grants to prevent substance abuse
among children. The legislation also creates a High-Risk Youth Program
to help public and nonprofit organizations to combat drug abuse for
high-risk youths.
Another importation provision in this bill would create a grant
program to improve the health and safety of children in child care
facilities. This bill authorizes $200 million next year to ensure that
child care facilities are safe for our children. These grants can also
be used to improve the training for child care providers as well as
rehabilitating existing centers to meet current health and safety
requirements. Today, with more children enrolled in child care centers,
it is critically important that these facilities are well-equipped so
that our children will learn and prosper.
I strongly urge my colleagues to support this effort and vote for
H.R. 4365.
Mrs. MINK of Hawaii. Mr. Speaker, I rise today in very strong support
of this legislation. I also wish to thank the Senate Committee on
Health, Education, Labor and Pensions for including language in H.R.
4365 that will help those who have suffered traumatic brain injury
receive cognitive therapy. Traumatic brain injury or TBI is one the
leading causes of death and disability among young persons in the
United States. The Centers for Disease Control and Prevention recently
announced that there are currently 5.3 million Americans living with a
serious long-term disability as a result of brain injury.
This important measure will, for the first time, clarify that
cognitive therapy is necessary for individuals who have suffered
traumatic brain injury. In many cases, rehabilitation focuses
exclusively on physical treatment without regard for cognitive
treatment, such as reading, speaking, comprehension, reasoning and
deductive capabilities.
This provision is based on H.R. 477, which I introduced on February
2, 1999, to clarify that cognitive therapy is a necessary component of
treatment for TBI.
There is no widely accepted nor standardized long-term procedure for
TBI treatment. The availability of cognitive therapy varies by state,
which causes inequitable and varying treatment for TBI victims. But
this measure seeks to change that. It clarifies that the National
Institutes of Health should conduct research on cognitive therapy
needed for TBI patients and that cognitive therapy for TBI should be
funded by the Health Resources and Services Administration under its
TBI grant program.
Persons with traumatic brain injuries are greatly in need of help to
rehabilitate and recover their mental, as well as their physical,
capabilities. By passing H.R. 4365, we can help those persons do just
that.
I urge all Members to vote for this important legislation.
Mr. WELDON of Florida. Mr. Speaker, I rise in strong support of this
bill. I am particularly pleased with the provisions authorizing the
Healthy Start Project and pursuing an aggressive effort to address the
epidemic of autism in America today. I was pleased to play a role in
moving both of these initiatives forward. The Healthy Start project
will reduce the rate of infant mortality and improve prenatal care by
providing grants to areas with high rates of infant mortality and low
birth weight infants. Healthy Start authorizes new grants to provide
research and services like mobile health clinics which will provide
poor women and their developing child access to ultrasound screenings.
This will undoubtedly enhance access to prenatal care, ultrasound
services, and prenatal surgery.
I have become increasingly concerned about the rapid increase in the
incidence of autism among our children. I have spent a considerable
amount of time over the past year on this very issue. I believe this
bill will be a great help in addressing this issue. This bill ensures
that the Director of National Institutes of Health [NIH] expands of
NIH's autism research initiatives. The centers of excellence in autism
research that are established under this program will lead to
significant advances in basic and clinical research into the cause,
diagnosis, early detection, prevention, control, and treatment of
autism.
Ms. PELOSI. Mr. Speaker, I serve on the Subcommittee on Labor, Health
and Human Services, and Education of the Committee on Appropriations.
Our subcommittee's jurisdiction concerns the welfare of America's
children in many ways: their health, their education and well-being,
and the economic security of their families, which is certainly related
to their well-being.
What we see in that subcommittee, from the scientists who come in and
tell us what the possibilities are now in science and what they know
about the development of children, is how essential it is for children
to have quality health care even before they are born. The research has
shown time and time again that investments in their good health are
very good investments for our country indeed.
The opportunities are great. The knowledge that we have gained
through our investments in biomedical research increases the
opportunities to help our children not only reach their own personal
fulfillment and strengthen the families from which they come, but also
enrich our country in terms of our family values and our economic
strength. So we all have a responsibility to all children. Every
parent, of course, has a responsibility to his or her child, but on the
Subcommittee we must think of every child in America as our child, all
the children as our children, because indeed they are our
responsibility. So in Congress, we have a responsibility to do all that
we can to prevent and treat childhood disease. The Children's Health
Act comprehensively addresses this responsibility by increasing our
commitment to children's health research, health promotion, and disease
prevention activities.
Although I strongly support the Children's Health Act, I would like
to join my colleagues who have expressed their concerns about the
Charitable Choice provisions included in the bill. These provisions
would weaken important anti-discrimination civil rights protections;
violate the constitutional separation of church and state; and entangle
religious institutions in the purview of government. These provisions
explicitly enable faith-based organizations to proselytize to those
receiving public services and discriminate in employment decisions with
public funds.
I am disappointed that the Republican leadership did not allow an
amendment to strengthen prohibitions against proselytizing and prevent
discrimination against beneficiaries. These needed protections are very
important to ensure that the religious rights and the civil rights of
Americans can be exercised, and where they overlap, there is an
appropriate balance. They also would serve to protect the separation of
church and state. Despite these concerns, I do support the underlying
language in this bill, and I urge my colleagues to vote yes on the
Children's Health Act.
Mr. BILIRAKIS. Mr. Speaker, I yield back the balance of my time.
The SPEAKER pro tempore (Mr. Ose). Pursuant to House Resolution 594,
the previous question is ordered.
The question is on the motion offered by the gentleman from Florida
(Mr. Bilirakis).
The question was taken; and the Speaker pro tempore announced that
the ayes appeared to have it.
Mr. BILIRAKIS. Mr. Speaker, on that I demand the yeas and nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, the 15-
minute vote on this motion will be followed by a 5-minute vote on the
motion to suspend the rules and pass H.R. 5272, as amended, on which
the yeas and nays were ordered yesterday.
The vote was taken by electronic device, and there were--yeas 394,
nays 25, not voting 14, as follows:
[Roll No. 496]
YEAS--394
Abercrombie
Ackerman
Aderholt
Allen
Andrews
Archer
Armey
Baca
Bachus
Baird
Baker
Baldacci
Baldwin
Ballenger
Barcia
Barr
Barrett (NE)
Barrett (WI)
Bartlett
Barton
Bass
Becerra
Bentsen
Bereuter
Berkley
Berman
Berry
Biggert
Bilbray
Bilirakis
Bishop
Blagojevich
Bliley
Blumenauer
Blunt
Boehlert
Boehner
Bonilla
Bonior
Bono
Borski
Boswell
Boucher
Boyd
Brady (PA)
Brady (TX)
Brown (FL)
Bryant
Burr
Burton
Buyer
Callahan
Calvert
Camp
Canady
Cannon
Capps
Capuano
Cardin
Carson
Castle
Chabot
Chambliss
[[Page H8265]]
Chenoweth-Hage
Clement
Coble
Coburn
Collins
Combest
Condit
Cook
Cooksey
Costello
Cox
Coyne
Cramer
Crane
Crowley
Cubin
Cunningham
Danner
Davis (FL)
Davis (VA)
Deal
DeFazio
DeGette
Delahunt
DeLauro
DeLay
DeMint
Deutsch
Diaz-Balart
Dickey
Dicks
Dingell
Dixon
Doggett
Dooley
Doolittle
Doyle
Dreier
Duncan
Dunn
Edwards
Ehlers
Ehrlich
Emerson
Engel
English
Eshoo
Etheridge
Evans
Everett
Farr
Filner
Fletcher
Foley
Forbes
Ford
Fossella
Fowler
Frank (MA)
Franks (NJ)
Frelinghuysen
Frost
Gallegly
Ganske
Gekas
Gephardt
Gibbons
Gilchrest
Gillmor
Gilman
Gonzalez
Goode
Goodlatte
Goodling
Gordon
Goss
Graham
Granger
Green (TX)
Green (WI)
Greenwood
Gutierrez
Gutknecht
Hall (OH)
Hall (TX)
Hansen
Hastings (WA)
Hayes
Hayworth
Hefley
Herger
Hill (IN)
Hill (MT)
Hilleary
Hinchey
Hinojosa
Hobson
Hoeffel
Hoekstra
Holden
Holt
Hooley
Horn
Hostettler
Houghton
Hoyer
Hulshof
Hunter
Hutchinson
Hyde
Inslee
Isakson
Istook
Jackson-Lee (TX)
Jefferson
Jenkins
John
Johnson (CT)
Johnson, Sam
Jones (NC)
Kanjorski
Kaptur
Kasich
Kelly
Kennedy
Kildee
Kind (WI)
King (NY)
Kingston
Kleczka
Knollenberg
Kolbe
Kucinich
Kuykendall
LaFalce
LaHood
Lampson
Lantos
Largent
Larson
Latham
LaTourette
Leach
Levin
Lewis (CA)
Lewis (KY)
Linder
Lipinski
LoBiondo
Lofgren
Lowey
Lucas (KY)
Lucas (OK)
Luther
Maloney (CT)
Maloney (NY)
Manzullo
Markey
Martinez
Mascara
Matsui
McCarthy (MO)
McCarthy (NY)
McCrery
McDermott
McGovern
McHugh
McInnis
McIntyre
McKeon
McNulty
Meehan
Meek (FL)
Menendez
Metcalf
Mica
Millender-McDonald
Miller (FL)
Miller, Gary
Minge
Mink
Moakley
Mollohan
Moore
Moran (KS)
Moran (VA)
Morella
Murtha
Myrick
Nadler
Napolitano
Neal
Nethercutt
Ney
Northup
Norwood
Nussle
Oberstar
Obey
Olver
Ortiz
Ose
Owens
Oxley
Packard
Pallone
Pascrell
Pastor
Pease
Pelosi
Peterson (MN)
Peterson (PA)
Petri
Phelps
Pickering
Pickett
Pitts
Pombo
Pomeroy
Porter
Portman
Price (NC)
Pryce (OH)
Quinn
Radanovich
Rahall
Ramstad
Rangel
Regula
Reyes
Reynolds
Riley
Rivers
Rodriguez
Roemer
Rogan
Rogers
Rohrabacher
Ros-Lehtinen
Rothman
Roukema
Roybal-Allard
Royce
Ryan (WI)
Ryun (KS)
Sabo
Salmon
Sanchez
Sanders
Sawyer
Scarborough
Schaffer
Schakowsky
Sensenbrenner
Serrano
Sessions
Shadegg
Shaw
Shays
Sherman
Sherwood
Shimkus
Shows
Shuster
Simpson
Sisisky
Skeen
Skelton
Smith (MI)
Smith (NJ)
Smith (TX)
Smith (WA)
Snyder
Souder
Spence
Spratt
Stabenow
Stark
Stearns
Stenholm
Strickland
Stump
Stupak
Sununu
Sweeney
Talent
Tancredo
Tanner
Tauscher
Tauzin
Taylor (MS)
Taylor (NC)
Terry
Thomas
Thompson (CA)
Thompson (MS)
Thornberry
Thune
Thurman
Tiahrt
Tierney
Toomey
Traficant
Turner
Udall (CO)
Udall (NM)
Upton
Velazquez
Visclosky
Vitter
Walden
Walsh
Wamp
Watkins
Watts (OK)
Waxman
Weiner
Weldon (FL)
Weldon (PA)
Weller
Wexler
Weygand
Whitfield
Wicker
Wilson
Wise
Wolf
Woolsey
Wu
Young (AK)
Young (FL)
NAYS--25
Clay
Clayton
Clyburn
Conyers
Cummings
Davis (IL)
Fattah
Gejdenson
Hastings (FL)
Hilliard
Jackson (IL)
Johnson, E. B.
Kilpatrick
Lee
Lewis (GA)
McKinney
Meeks (NY)
Miller, George
Payne
Sanford
Scott
Slaughter
Towns
Waters
Watt (NC)
NOT VOTING--14
Brown (OH)
Campbell
Ewing
Jones (OH)
Klink
Lazio
McCollum
McIntosh
Paul
Rush
Sandlin
Saxton
Vento
Wynn
{time} 1216
Messrs. CONYERS, CLAY, TOWNS, Ms. EDDIE BERNICE JOHNSON of Texas,
Messrs. GEJDENSON, HASTINGS of Florida, LEWIS of Georgia, MEEKS of New
York, GEORGE MILLER of California, and Ms. KILPATRICK changed their
vote from ``yea'' to ``nay.''
So the motion was agreed to.
The result of the vote was announced as above recorded.
A motion to reconsider was laid on the table.
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