[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.

                          ____________________