[Congressional Record Volume 148, Number 117 (Tuesday, September 17, 2002)]
[House]
[Pages H6262-H6268]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
WOMEN'S HEALTH OFFICE ACT OF 2002
Mr. BILIRAKIS. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 1784) to establish an Office on Women's Health within the
Department of Health and Human Services, and for other purposes, as
amended.
The Clerk read as follows:
H.R. 1784
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Women's Health Office Act of
2002''.
SEC. 2. HEALTH AND HUMAN SERVICES OFFICE ON WOMEN'S HEALTH.
(a) Establishment.--Part A of title II of the Public Health
Service Act (42 U.S.C. 202 et seq.) is amended by adding at
the end the following:
``health and human services office on women's health
``Sec. 229. (a) Establishment of Office.--The Secretary
shall establish through the last date for which
appropriations are authorized under subsection (e), within
the Office of the Secretary, an Office on Women's Health
(referred to in this section as the `Office'). The Office
shall be headed by a Deputy Assistant Secretary for Women's
Health.
``(b) Duties.--The Secretary, acting through the Office,
with respect to the health concerns of women, shall--
``(1) establish short-range and long-range goals and
objectives within the Department of Health and Human Services
and, as relevant and appropriate, coordinate with other
appropriate offices on activities within the Department that
relate to disease prevention, health promotion, service
delivery, research, and public and health care professional
education, for issues of particular concern to women;
``(2) provide expert advice and consultation to the
Secretary concerning scientific, legal, ethical, and policy
issues relating to women's health;
``(3) monitor the Department of Health and Human Services'
offices, agencies, and regional activities regarding women's
health and stimulate activities and facilitate coordination
of such departmental and agency offices on women's health;
``(4) establish a Department of Health and Human Services
Coordinating Committee on Women's Health, which shall be
chaired by the Deputy Assistant Secretary for Women's Health
and composed of senior level representatives from each of the
agencies and offices of the Department of Health and Human
Services;
``(5) establish a National Women's Health Information
Center to--
``(A) facilitate the exchange of information regarding
matters relating to health information, health promotion,
preventive health services, research advances, and education
in the appropriate use of health care;
``(B) facilitate access to such information;
``(C) assist in the analysis of issues and problems
relating to the matters described in this paragraph; and
``(D) provide technical assistance with respect to the
exchange of information (including facilitating the
development of materials for such technical assistance);
``(6) coordinate efforts to promote women's health programs
and policies with the private sector; and
``(7) through publications and any other means appropriate,
provide for the exchange of information between the Office
and recipients of grants, contracts, and agreements under
subsection (c), and between the Office and health
professionals and the general public.
``(c) Grants and Contracts Regarding Duties.--
``(1) Authority.--In carrying out subsection (b), the
Secretary may make grants to, and enter into cooperative
agreements, contracts, and interagency agreements with,
public and private entities, agencies, and organizations.
``(2) Evaluation and dissemination.--The Secretary shall
directly or through contracts with public and private
entities, agencies, and organizations, provide for
evaluations of projects carried out with financial assistance
provided under paragraph (1) and for the dissemination of
information developed as a result of such projects.
``(d) Reports.--Not later than January 31, 2003, and
January 31 of each second year thereafter, the Secretary
shall prepare and submit to the appropriate committees of
Congress a report describing the activities carried out under
this section during the period for which the report is being
prepared.
``(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 2003 through 2007.''.
(b) Transfer of Functions.--There are transferred to the
Office on Women's Health (established under section 229 of
the Public Health Service Act, as added by this section), all
functions exercised by the Office on Women's Health of the
Public Health Service prior to the date of enactment of this
section, including all personnel and compensation authority,
all delegation and assignment authority, and all remaining
appropriations. All orders, determinations, rules,
regulations, permits, agreements, grants, contracts,
certificates, licenses, registrations, privileges, and other
administrative actions that--
(1) have been issued, made, granted, or allowed to become
effective by the President, any Federal agency or official
thereof, or by a court of competent jurisdiction, in the
performance of functions transferred under this subsection;
and
(2) are in effect at the time this section takes effect, or
were final before the date of enactment of this section and
are to become effective on or after such date;
shall continue in effect according to their terms until
modified, terminated, superseded, set aside, or revoked in
accordance with law by the President, the Secretary, or other
authorized official, a court of competent jurisdiction, or by
operation of law.
SEC. 3. CENTERS FOR DISEASE CONTROL AND PREVENTION OFFICE OF
WOMEN'S HEALTH.
Part A of title III of the Public Health Service Act (42
U.S.C. 241 et seq.) is amended by adding at the end the
following:
``centers for disease control and prevention office of women's health
``Sec. 310A. (a) Establishment.--The Secretary shall
establish through the last date for which appropriations are
authorized under subsection (f), within the Office of the
Director of the Centers for Disease Control and Prevention,
an office to be known as the Office of Women's Health
(referred to in this section as the `Office'). The Office
shall be headed by a director who shall be appointed by the
Director of such Centers.
``(b) Purpose.--The Director of the Office shall--
``(1) report to the Director of the Centers for Disease
Control and Prevention on the current level of the Centers'
activity regarding women's health conditions across, where
appropriate, age, biological, and sociocultural contexts, in
all aspects of the Centers' work, including prevention
programs, public and professional education, services, and
treatment;
``(2) establish short-range and long-range goals and
objectives within the Centers for women's health and, as
relevant and appropriate, coordinate with other appropriate
offices on activities within the Centers that relate to
prevention, research, education and training, service
delivery, and policy development, for issues of particular
concern to women;
``(3) identify projects in women's health that should be
conducted or supported by the Centers;
``(4) consult with health professionals, nongovernmental
organizations, consumer organizations, women's health
professionals, and other individuals and groups, as
appropriate, on the policy of the Centers with regard to
women; and
``(5) serve as a member of the Department of Health and
Human Services Coordinating Committee on Women's Health
(established under section 229(b)(4)).
``(c) Coordinating Committee.--
``(1) Establishment.--In carrying out subsection (b), the
Director of the Office shall establish a committee to be
known as the Coordinating Committee on Research on Women's
Health (referred to in this subsection as the `Coordinating
Committee').
``(2) Composition.--The Coordinating Committee shall be
composed of the directors of the national centers and other
appropriate officials of the Centers for Disease Control and
Prevention.
``(3) Chairperson.--The Director of the Office shall serve
as the Chairperson of the Coordinating Committee.
``(4) Duties.--With respect to women's health, the
Coordinating Committee shall assist the Director of the
Office in--
``(A) identifying the need for programs and activities that
focus on women's health;
``(B) identifying needs regarding the coordination of
activities, including intramural and extramural
multidisciplinary activities; and
``(C) making recommendations to the Director of the Centers
for Disease Control and Prevention concerning findings made
under subparagraphs (A) and (B).
``(d) Reports.--Not later than January 31, 2003, and
January 31 of each second year thereafter, the Director of
the Office shall prepare and submit to the appropriate
committees of Congress a report describing the activities
carried out under this section during the period for which
the report is being prepared.
``(e) Definition.--As used in this section, the term
`women's health conditions', with respect to women of all
age, ethnic, and racial groups, means diseases, disorders,
and conditions--
``(1) unique to, significantly more serious for, or
significantly more prevalent in women; and
``(2) for which the factors of medical risk or type of
medical intervention are different for women.
``(f) 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 2003 through 2007.''.
SEC. 4. AGENCY FOR HEALTHCARE RESEARCH AND QUALITY ACTIVITIES
REGARDING WOMEN'S HEALTH.
Part C of title IX of the Public Health Service Act (42
U.S.C. 299c et seq.) is amended--
(1) by redesignating sections 927 and 928 as sections 928
and 929, respectively;
(2) by inserting after section 926 the following:
[[Page H6263]]
``SEC. 927. ACTIVITIES REGARDING WOMEN'S HEALTH.
``(a) Establishment.--The Director shall designate an
official of the Office of Priority Populations to carry out,
through the last date for which appropriations are authorized
under section 928(e), the responsibilities described in this
section for such official.
``(b) Purpose.--The official designated under subsection
(a) shall--
``(1) report to the Director on the current Agency level of
activity regarding women's health, across, where appropriate,
age, biological, and sociocultural contexts, in all aspects
of Agency work, including the development of evidence reports
and clinical practice protocols and the conduct of research
into patient outcomes, delivery of health care services,
quality of care, and access to health care;
``(2) establish short-range and long-range goals and
objectives within the Agency for research important to
women's health and, as relevant and appropriate, coordinate
with other appropriate offices on activities within the
Agency that relate to health services and medical
effectiveness research, for issues of particular concern to
women;
``(3) identify projects in women's health that should be
conducted or supported by the Agency;
``(4) consult with health professionals, nongovernmental
organizations, consumer organizations, women's health
professionals, and other individuals and groups, as
appropriate, on Agency policy with regard to women; and
``(5) serve as a member of the Department of Health and
Human Services Coordinating Committee on Women's Health
(established under section 229(b)(4)).
``(c) Coordinating Committee.--
``(1) Establishment.--In carrying out subsection (b), the
official designated under subsection (a) shall establish a
committee to be known as the Coordinating Committee on
Research on Women's Health (referred to in this subsection as
the `Coordinating Committee').
``(2) Composition.--The Coordinating Committee shall be
composed of the official designated under subsection (a) and
the directors of the centers and offices of the Agency.
``(3) Chairperson.--The official designated under
subsection (a) shall serve as the Chairperson of the
Coordinating Committee.
``(4) Duties.--With respect to research on women's health,
the Coordinating Committee shall assist the official
designated under subsection (a) in--
``(A) identifying the need for such research, and making an
estimate each fiscal year of the funds needed to adequately
support the research;
``(B) identifying needs regarding the coordination of
research activities, including intramural and extramural
multidisciplinary activities; and
``(C) making recommendations to the Director of the Agency
concerning findings made under subparagraphs (A) and (B).
``(d) Reports.--Not later than January 31, 2003, and
January 31 of each second year thereafter, the official
designated under subsection (a) shall prepare and submit to
the appropriate committees of Congress a report describing
the activities carried out under this section during the
period for which the report is being prepared.''; and
(3) by adding at the end of section 928 (as redesignated by
paragraph (1)) the following:
``(e) Women's Health.--For the purpose of carrying out
section 927 regarding women's health, there are authorized to
be appropriated such sums as may be necessary for each of the
fiscal years 2003 through 2007.''.
SEC. 5. HEALTH RESOURCES AND SERVICES ADMINISTRATION OFFICE
OF WOMEN'S HEALTH.
Title VII of the Social Security Act (42 U.S.C. 901 et
seq.) is amended by adding at the end the following:
``office of women's health
``Sec. 713. (a) Establishment.--The Secretary shall
establish through the last date for which appropriations are
authorized under subsection (f), within the Office of the
Administrator of the Health Resources and Services
Administration, an office to be known as the Office of
Women's Health. The Office shall be headed by a director who
shall be appointed by the Administrator.
``(b) Purpose.--The Director of the Office shall--
``(1) report to the Administrator on the current
Administration level of activity regarding women's health
across, where appropriate, age, biological, and sociocultural
contexts;
``(2) establish short-range and long-range goals and
objectives within the Health Resources and Services
Administration for women's health and, as relevant and
appropriate, coordinate with other appropriate offices on
activities within the Administration that relate to health
care provider training, health service delivery, research,
and demonstration projects, for issues of particular concern
to women;
``(3) identify projects in women's health that should be
conducted or supported by the bureaus of the Administration;
``(4) consult with health professionals, nongovernmental
organizations, consumer organizations, women's health
professionals, and other individuals and groups, as
appropriate, on Administration policy with regard to women;
and
``(5) serve as a member of the Department of Health and
Human Services Coordinating Committee on Women's Health
(established under section 229(b)(4) of the Public Health
Service Act).
``(c) Coordinating Committee.--
``(1) Establishment.--In carrying out subsection (b), the
Director of the Office shall establish a committee to be
known as the Coordinating Committee on Research on Women's
Health (referred to in this subsection as the `Coordinating
Committee').
``(2) Composition.--The Coordinating Committee shall be
composed of the directors of the bureaus of the
Administration.
``(3) Chairperson.--The Director of the Office shall serve
as the Chairperson of the Coordinating Committee.
``(4) Duties.--With respect to research on women's health,
the Coordinating Committee shall assist the Director of the
Office in--
``(A) identifying the need for programs and activities that
focus on women's health;
``(B) identifying needs regarding the coordination of
activities, including intramural and extramural
multidisciplinary activities; and
``(C) making recommendations to the Administrator
concerning findings made under subparagraphs (A) and (B).
``(d) Reports.--Not later than January 31, 2003, and
January 31 of each second year thereafter, the Director of
the Office shall prepare and submit to the appropriate
committees of Congress a report describing the activities
carried out under this section during the period for which
the report is being prepared.
``(e) Definitions.--For purposes of this section:
``(1) Administration.--The term `Administration' means the
Health Resources and Services Administration.
``(2) Administrator.--The term `Administrator' means the
Administrator of the Health Resources and Services
Administration.
``(3) Office.--The term `Office' means the Office of
Women's Health established under this section in the
Administration.
``(f) 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 2003 through 2007.''.
SEC. 6. FOOD AND DRUG ADMINISTRATION OFFICE OF WOMEN'S
HEALTH.
Chapter IX of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 391 et seq.) is amended by adding at the end the
following:
``SEC. 908. OFFICE OF WOMEN'S HEALTH.
``(a) Establishment.--The Secretary shall establish through
the last date for which appropriations are authorized under
subsection (e), within the Office of the Commissioner, an
office to be known as the Office of Women's Health (referred
to in this section as the `Office'). The Office shall be
headed by a director who shall be appointed by the
Commissioner of Food and Drugs.
``(b) Purpose.--The Director of the Office shall--
``(1) report to the Commissioner of Food and Drugs on
current Food and Drug Administration (referred to in this
section as the `Administration') levels of activity regarding
women's participation in clinical trials and the analysis of
data by sex in the testing of drugs, medical devices, and
biological products across, where appropriate, age,
biological, and sociocultural contexts;
``(2) establish short-range and long-range goals and
objectives within the Administration for issues of particular
concern to women's health within the jurisdiction of the
Administration, including, where relevant and appropriate,
adequate inclusion of women and analysis of data by sex in
Administration protocols and policies;
``(3) provide information to women and health care
providers on those areas in which differences between men and
women exist;
``(4) consult with pharmaceutical, biologics, and device
manufacturers, health professionals with expertise in women's
issues, consumer organizations, and women's health
professionals on Administration policy with regard to women;
``(5) make annual estimates of funds needed to monitor
clinical trials and analysis of data by sex in accordance
with needs that are identified; and
``(6) serve as a member of the Department of Health and
Human Services Coordinating Committee on Women's Health
(established under section 229(b)(4) of the Public Health
Service Act).
``(c) Coordinating Committee.--
``(1) Establishment.--In carrying out subsection (b), the
Director of the Office shall establish a committee to be
known as the Coordinating Committee on Women's Health
(referred to in this subsection as the `Coordinating
Committee').
``(2) Composition.--The Coordinating Committee shall be
composed of the directors of the centers of the
Administration.
``(3) Chairperson.--The Director of the Office shall serve
as the Chairperson of the Coordinating Committee.
``(4) Duties.--With respect to studies on women's health,
the Coordinating Committee shall assist the Director of the
Office in--
``(A) identifying whether there is a need for further
studies and, if so, developing strategies to foster such
studies;
``(B) identifying issues in specific areas of women's
health that fall within the mission of the Administration;
``(C) identifying whether any need exists for the
coordination of Administration activities, including internal
and external activities;
``(D) maintaining the Administration's focus in areas of
importance to women;
``(E) supporting the development of methodologies to
determine how to obtain data specific to women (including
data relating to the age of women and the membership of women
in ethnic or racial groups); and
``(F) supporting the development and expansion of clinical
trials of treatments and therapies for which obtaining such
data has been determined to be an appropriate function.
``(d) Reports.--Not later than January 31, 2003, and
January 31 of each second year thereafter, the Director of
the Office shall prepare and submit to the appropriate
committees of Congress a report describing the activities
carried out under this section during the period for which
the report is being prepared.
[[Page H6264]]
``(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 2003 through 2007.''.
SEC. 7. NO NEW REGULATORY AUTHORITY.
Nothing in this Act and the amendments made by this Act may
be construed as establishing regulatory authority or
modifying any existing regulatory authority.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Florida (Mr. Bilirakis) and the gentleman from Ohio (Mr. Brown) each
will control 20 minutes.
The Chair recognizes the 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 include extraneous material on H.R. 1784.
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, today the House will consider H.R. 1784, the Women's
Health Office Act of 2002. I would like to take a moment to sincerely
thank our colleague, the gentlewoman from Maryland (Mrs. Morella), for
her tireless, tireless support of this bill, which ensures that our key
public health agencies continue working together, and that is greatly
to be emphasized, continue working together, to address the unique
health needs of women.
President George H.W. Bush created the Office of Women's Health at
the Department of Health and Human Services to improve the health of
American women by advancing and coordinating a comprehensive women's
health agenda throughout the department.
The Office of Women's Health, OWH, is the government's champion and
focal point for women's health issues, and works to address inequities
in research, health care services and education. Furthermore, the
Office of Women's Health encourages women to take personal
responsibility for their own health and wellness. H.R. 1784 provides
statutory authority for this office.
This legislation, Mr. Speaker, also authorizes four additional
offices of women's health at the Centers for Disease Control and
Prevention, at the Agency for Healthcare Research and Quality, at the
Health Resources and Services Administration, and at the Food and Drug
Administration. A coordinating committee will be created within each of
these offices to identify the need for programs, activities and
research that focus on women's health.
Congress can and should play an active role in promoting women's
health research and prevention measures. This measure will create an
infrastructure within HHS that will help the department better focus
its energies on women's health, and I urge all Members to join me in
supporting passage of this important legislation. H.R. 1784 will
improve the health of all women.
Mr. Speaker, I reserve the balance of my time.
Mr. BROWN of Ohio. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I begin by thanking my friend, the gentleman from
Florida (Mr. Bilirakis), for his support and interest in this
legislation. I am pleased we are considering the Women's Health Office
Act passed out of our subcommittee and then passed the full committee
also. I applaud the gentlewoman from Maryland (Mrs. Morella) and the
gentlewoman from New York (Mrs. Maloney) for their involvement in this
issue.
Certain diseases and conditions, as we know, as we finally address,
exclusively affect women, are more prevalent in women, or affect women
differently. While research in women's health has traditionally been
far too limited, development of a number of women's health offices in
the past few years has begun to shrink that disparity.
{time} 1415
The Women's Health Office Act would statutorily create offices of
women's health in the Department of Health and Human Services, the
Agency for Health Care Research and Quality, Health Resource and
Services Administration, the Centers for Disease Control in Atlanta,
and the Food and Drug Administration. These offices have committed
themselves to promoting women's health. This bill will help ensure that
the needs and gaps in research, policy programs, education, and
training in women's health will continue to be addressed in a concerted
way. I recommend, Mr. Speaker, that my colleagues support it.
Mr. Speaker, I reserve the balance of my time.
Mr. BILIRAKIS. Mr. Speaker, I yield such time as she might consume to
the gentlewoman from Maryland (Mrs. Morella), who is the author of this
legislation and who did not just sit back, but kept pushing and pushing
every time certainly she saw me in the hallways or here in this
Chamber.
Mrs. MORELLA. Mr. Speaker, as the lead sponsor of this bill, H.R.
1784, the Women's Health Office Act of 2002, I must say I am delighted
to be here today. I am here today with this bill with great thanks to
the subcommittee chairman, the gentleman from Florida (Mr. Bilirakis),
and the gentleman from Ohio (Mr. Brown), the ranking member. Also, I
would like to thank the chairman of the committee, the gentleman from
Louisiana (Mr. Tauzin), and the ranking member, the gentleman from
Michigan (Mr. Dingell).
But it is true what the gentleman from Florida has said: I have
bugged him indefatigably, and I very much appreciate this important
piece of legislation coming before us. I also want to thank the 96
cosponsors and the gentlewoman from New York (Mrs. Maloney) for joining
with me on this legislation. I also wanted to thank all of the hard-
working organizations, the nonprofits and individuals, for their unity
in working together to advance women's health and to help to bring this
bill to the House floor for a vote.
Mr. Speaker, the Women's Health Office Act of 2002 will provide for
permanent authorization for offices of women's health in four Federal
agencies: the Department of Health and Human Services, the Centers for
Disease Control and Prevention, the Health Resources and Services
Administration, and the Food and Drug Administration.
In the Agency for Health Care Research and Quality, the bill requires
the director of the agency to designate an official of the Office of
Priority Populations to report to the director on activities regarding
women's health.
As many of my colleagues probably know, for years our Nation's
medical research community actually ignored the health concerns of
women. For example, in 1989, the Congressional Caucus for Women's
Issues asked the General Accounting Office to investigate the National
Institutes of Health, their policy regarding the inclusion of women in
clinical trials and protocols. Back then, women were routinely excluded
from critically important studies on heart disease, cancer, HIV and
AIDS; and it was found that diseases primarily affecting women were
severely underfunded.
In its report, the GAO found that NIH had made little progress in
implementing a policy that encourages the inclusion of women in
research populations. So the women's caucus then introduced the Women's
Health Equity Act which, among its provisions, called for the
establishment of an Office of Women's Health at NIH and a requirement
that women and minorities be included whenever appropriate in research
studies funded by NIH.
That fall, on the very day that Senator Mikulski, then Congresswoman
Pat Schroeder, and I went to NIH to discuss these inequities, NIH
announced that it had created an Office of Research of Women's Health.
This office would ensure that greater resources were devoted to
diseases primarily affecting women and ensure that women would be
included in clinical trials. We in Congress subsequently codified that,
and the office was signed into law by President Bush the First.
Since then, funding for breast and ovarian cancer at NCI, which is
the National Cancer Institute, has more than quadrupled, and funding
for osteoporosis has grown from only two osteoporosis-specific grants
in the entire country in the early 1980s to more than $80 million in
osteoporosis-specific grants today. Despite great strides on women's
health research, we
[[Page H6265]]
still have to be vigilant and we still must address issues that are not
receiving the public attention and the research priority that they
deserve.
For example, we do not understand why an estimated 75 percent of
autoimmune diseases occur in women, most frequently during the child-
bearing years. Hormones are thought to play a role, because some
autoimmune illnesses occur more frequently after menopause; others
suddenly improve during pregnancy with flare-ups occurring after
delivery, while still others will get worse during pregnancy. We do not
understand why more than 90 percent of those with eating disorders are
women. Further, the number of American women affected by these
illnesses has doubled to at least 5 million in the past 3 decades. In
fact, we do not even understand why more girls are affected by autism
than boys. This list continues with heart and stroke, cancer, and many
more diseases.
Mr. Speaker, another area of women's health where I would like to see
more efforts is this area of microbicides. Microbicides are a potential
new class of products that women can use to prevent HIV infection as
well as other sexually transmitted diseases. Today, the United States
has the highest incidence of sexually transmitted diseases in the
industrialized world. Mr. Speaker, 15.4 million Americans acquired an
STD in 1999 alone. STDs cause serious, costly, even deadly, conditions
for women and their children, including infertility, pregnancy
complications, cervical cancer, infant mortality, and a higher risk of
contracting HIV. Microbicides have the potential to save billions in
health care costs. The total cost to the U.S. economy of STDs,
excluding HIV infection, was approximately $8.4 billion in 1999 alone.
When the cost of sexually transmitted HIV infection is included, that
total rises to $20 billion.
Microbicide research and development receives less than 2 percent of
the Federal AIDS research budget, and best estimates show that less
than half of this amount is dedicated directly to product development.
Clearly, this is not nearly enough to keep pace with the growing STD
and HIV epidemics.
Mr. Speaker, it is my hope that, with passage of this bill, it will
bring us closer to the day when women will no longer have to fear
getting HIV and STDs.
Well, H.R. 1783 is a simple, clean bill. All it does is it provides
statutory authority for offices that are already in place. These
offices and programs have a very good track record. For example, heart
disease is the number one killer of American women. AHRQ has funded
studies to develop tools to improve diagnostic accuracy in emergency
rooms and dramatically increase the timely use of clot-busting drugs in
women.
AHRQ is also working to reduce the impact of breast cancer, another
disease which takes a heavy toll on women. The agency is currently
conducting outreach to poor and minority women who are less likely to
get mammograms to ensure that they receive this critical preventive
health care.
Providing statutory authorization for Federal women's health offices,
as we do today, is a critical step in ensuring that women's health
research continues to receive the attention that it requires in this
21st century.
So concluding, Mr. Speaker, I can say without exaggeration that women
working together as patients, lawyers, advocates, medical researchers,
and Members of Congress have been a powerful catalyst for the advances
that we have made in the research and treatment of breast, ovarian,
cervical cancer, osteoporosis and heart disease. The men have been
there for us, bringing forward this bill and others that do help with
the focus on health for women, as well as men and all.
So I urge my colleagues to support this legislation and programs to
address the health needs of all of our citizens and the fundamental
challenges posed by our Nation's health care system.
Mr. BROWN of Ohio. Mr. Speaker, I yield 3 minutes to the gentlewoman
from the District of Columbia (Ms. Norton).
Ms. NORTON. Mr. Speaker, I thank the gentleman for yielding me this
time, and I appreciate the work of the distinguished chairman and the
distinguished ranking member and the bipartisan effort that has brought
this bill to the floor.
I rise in strong support of the Women's Health Office Act. Anyone
trying to keep track of women's health issues today is literally on a
merry-go-round. The best recent example is the hormone replacement
treatment quagmire, HRT. Here we had a major drug, progesterone, where
a study has just shown serious health consequences for a drug that was
being administered to millions of women to promote serious health
benefits. I mean, that is just how complicated it is. But that is the
nature of the women's health beast. And we do not need to make it more
complicated than it already is. Having multiple offices that do not
relate one to another with no statutory imprimatur makes it more
complicated than it really is.
Speaking of complications, what I think these offices help us to do
is to face the fact that females are a particularly complicated
organism. Throughout her life, a woman emerges as diametrically opposed
to what she once was. A woman of child-bearing age is the opposite of
the menopausal woman she shall become.
Now, I have not even got to the differences between women and men. If
we are dealing with these kinds of complications in a single human
being, we have to figure out ways to make sure that what happens to her
health is as good as it gets, or as good as we can get it.
Because of such complications, the bipartisan women's caucus
successfully fought, for example, to have medical and scientific
studies that included women and not only men, because not including
women had terrible consequences for us. That is one of the reasons that
the average American woman today does not know that heart disease is
the number one killer of women, because these studies, this
information, has not been out there, because we have not paid the kind
of close and coordinated attention to women's health that this bill
will help to promote. It has been very important to test women
differently from men when putting drugs on the market, because let us
face it, women have very different chemistry.
Mr. Speaker, a year ago I signed on to a bipartisan letter asking HHS
Secretary Tommy Thompson to help authorize the multiple women's
offices, only one of which was statutorily authorized. The best way to
do it is the permanent authorization embodied in this bill, and I
strongly support it; and I ask for the support of Members of this
House.
Mr. BILIRAKIS. Mr. Speaker, I have no further requests for time, but
I will reserve the balance of my time.
Mr. BROWN of Ohio. Mr. Speaker, I yield 3 minutes to the gentlewoman
from Houston, Texas (Ms. Jackson-Lee).
Ms. JACKSON-LEE of Texas. Mr. Speaker, I thank the distinguished
ranking member; and I thank the distinguished chairman for being a
leader on these issues. The chemistry between the ranking member and
the chairman has presented a lot of good initiatives on this floor; and
I thank them for that, because health care is American. It involves all
of us. I thank the gentlewoman from Maryland (Mrs. Morella), and of
course my colleague, the gentlewoman from New York (Mrs. Maloney); and
I announce as well that I was very pleased to be one of the original
cosponsors of this legislation.
It is important to delineate what this legislation actually does. It
codifies and provides statutory authority for a women's health center
in four very vital health agencies of this government, and that is, of
course, the Centers for Disease Control and Prevention, the Health
Resources and Services Administration, the Food and Drug
Administration, and the Office of Priority Populations within the
Agency for Health Care Research and Quality, the lead agency for
women's research.
{time} 1430
But the Centers for Disease Control certainly is the key as it
relates to the fighting of diseases here in the United States.
I think something else is important, as well, as we look at this
legislation, that all of these agencies will be brought to bear on the
complexity of women's health and will be required to identify projects
in women's health that should be conducted by the particular centers.
[[Page H6266]]
In addition, they will be brought to bear to consult with health
professionals, nongovernmental organizations, consumer organizations,
women's health professionals, and other individuals and groups as
appropriate on the policy of the centers' work as it is regarding
women.
I heard my friend and colleague, the gentleman from Ohio (Mr. Brown),
mention just a few moments ago or sometime before on the need for a
guaranteed drug benefit under Medicare. I see my seniors, in particular
women, as I visit with them in my district needing to have this kind of
legislation.
This legislation that we are debating on the floor of the House will
go a long way in helping the health of women of all ages, including
those in puberty and young women of child-bearing age, now that we find
that women can have children a longer period of time; and minority
women in particular, who we find have the highest percentage of
infections of HIV/AIDS in the United States of America.
A lot of this research, as well, can help our friends around the
world, particularly developing nations, where we use now more women in
clinical testing; and we can get more of the data that can be utilized
by our friends around the world, particularly in our work with the
United Nations.
So this is a historic occasion to begin to understand that the study
of women's health should be focused. We should get one science, one
consistent science, so that when there are prescriptions on certain
hormone treatment, that we can have the research and the science to
make sure that what we are suggesting or treating women with is the
right direction to go. I applaud this legislation.
In conclusion, let me say that I have filed legislation dealing with
cultural competence. It relates to this issue, and I look forward to
working with the committees on this issue.
I rise in support of H.R. 1784, the Women's Health Office Act of
2002.
In the last century, the life expectancy of American women has
increased by 30 years. Now we face the challenge of keeping women alive
and healthy. American in the new millennium faces increasingly complex
public health challenges. I stand here today, ashamed to say that thus
far our nation has not taken advantage of the opportunities and
advancements in medical technology to meet the goal of improved health
for all Americans.
The Women's Health Office Act of 2002 amends the Public Health
Services Act to establish within the Office of the Secretary of Health
and Human Services an office on Women's Health, headed by a Deputy
Assistant Secretary for Women's Health. In addition, the Women's Health
Act requires the establishment of a Department of Health and Human
Services Coordinating Committee, a National Women's Health Information
Center, and requires biennial reports to Congress.
Research has established that the existence of persistent racial and
socioeconomic disparities in women's health in the United States. We
know that coronary disease is the leading cause of dealth for both men
and women. But, nearly twice as many women in the U.S. die of heart
disease and stroke every year as die from all types of cancer. Yet,
multiple studies have shown that women are less likely than men to be
referred for invasive cardiac procedures.
While the life expectancy of women in the United States has risen, as
a group, African American women have a shorter life expectancy and
experience earlier onset of such chronic conditions such as diabetes
and hypertension. If we look at the death rates for diseases of the
heart, African American women are clearly at risk with 147 deaths per
100,000. When we look at cervical cancer, we see that the incidence
rate of invasive cervical cancer is higher among Asian-American women.
Yet, we cannot explain the causes of these higher rates.
Disparities are perhaps most alarming when we look at HIV/AIDS.
Twenty-two percent of Americans currently living with HIV are women,
and 77 percent of those are African American or Hispanic. Many people
are shocked to know that AIDS is the second leading cause of death
among African American women age 25 to 44.
There are nearly 40 million women in America who are members of
racial and ethnic minority groups. These women suffer
disproportionately from premature death, disease, and disabilities.
Many also face tremendous barriers to optimal health. This is a growing
challenge in our nation.
The challenge is even greater when we consider the aging population.
By the year 2050, nearly 1 in 4 adult women will be 65 years old or
older, and an astonishing 1 in 17 will be 85 years old or older. We
must ensure that our Federal agencies are in the forefront working to
find solutions to the challenges our nation faces in caring for the
health of our women.
The ``Women's Health office Act of 2002'' provides permanent
authorization for offices of women's health in five federal agencies:
the Department of Health and Human Services (HHS); the Centers for
Disease Control and Prevention (CDC); the Agency for Health Care
Research and Quality (AHRQ); the Health Resources and Services
Administration; and the Food and Drug Administration (FDA).
Mr. Speaker, behind each impersonal statistic is a woman whose life
is potentially at risk because of health disparities and a family that
will be devastated by the loss of a mother or sister. The Women's
Health Act of 2002 would be a tremendous step toward eliminating health
disparities. In the last century we made improvements that expanded the
life-span of women. In this century we have the challenge of meeting
the health care needs and improving the quality of life for all women.
Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may
consume.
I, too, thank the gentleman from Ohio (Mr. Brown) for his
cooperation, Mr. Speaker. Yes, even though we disagree on matters of
philosophy, we do have a chemistry that works well for the legislation
that is up before this House.
Mr. BROWN of Ohio. Mr. Speaker, I yield myself such time as I may
consume, just to say that I feel the same way, to be sure.
Mrs. CHRISTENSEN. Mr. Speaker, in good conscience, I rise in support
of H.R. 1784. The Women's Health Office Act of 2002 amends the Public
Health Service Act to establish within the Office of the Secretary of
Health and Human Services (HHS) an Office on Women's Health, headed by
a Deputy Assistant Secretary for Women's Health, requires the
establishment of a Department of Health and Human Services Coordinating
Committee and a National Women's Health Information Center, requires
biennial reports to Congress and authorizes appropriations for FY 2003
through 2007.
Women make up the largest number of Americans afflicted by so many of
today's leading illness--many of which are preventable if steps are
taken earlier in life through routine care and a balanced and healthy
lifestyle.
Heart disease is the number one killer of American women. Although
the incidence of HIV/AIDS is decreasing in white males, it has become
the third leading cause of death among women ages 25 to 44 and the
leading cause of death among African American women in this age group.
Even more alarming is the younger ages at which infection is occurring.
As we carry out our myriad responsibilities, we have too often
forsaken not only our physical health, but our mental health as well.
We make up 12 percent of the U.S. population suffering from mental
illness. Nearly 4.1 million women in this country currently use illicit
drugs, and over 1.2 million misuse prescription drugs for nonmedical
reasons.
Currently, minority women receive fewer preventive health
interventions than white women. 55 percent of Asian American women, 43
percent of Hispanic women and 37 percent of African American women did
not have a Pap test within the past year.
54 percent of Asian American women, 52 percent of African American
women, and 51 percent of Hispanic women did not have a mammogram within
the past two years. 74 percent of Hispanic women and 73 percent of
Asian American women did not have a blood pressure screening within the
past year; and stroke occurs at a higher rate among African American
and Hispanic women compared with white women.
We in the Congressional Black Caucus, who work to close the gaps in
health care and raise the health status for African Americans and
People of Color, are committed to improving the health of women and all
Americans.
Mr. Speaker, this bill directs the Secretary of HHS to establish
within the Office of the Director of the Centers for Disease Control
and Prevention the Office of Women's Health, headed by a Director,
requires the director to establish the Coordinating Committee on
Research on Women's Health and requires biennial reports to Congress.
Mr. Speaker, in efforts to eliminate health disparities I am proud to
support my colleague on the other side of the aisle in this campaign to
give all women health information and to guide them in making the
choices which will enable them to embark on a path to good health.
Mr. BLUMENAUER. Mr. Speaker, I am pleased that the House is debating
and voting today on H.R. 1784, the Women's Health Office Act, a bill
that I support and have cosponsored. This measure will provide the
tools necessary for successful coordination of women's health efforts
in the federal government. Passage of this bill will bring needed
attention and
[[Page H6267]]
coordination to federal efforts to prevent, treat and research women's
health needs.
Streamlined federal communication regarding women's health issues is
vital. This bill will also prevent attempts, like those made last year,
to eliminate the offices of women's health throughout federal health
agencies. Specific statutory authorization, as provided under this
bill, will allow the women's health offices to carry out their tasks
without fear that their programs or funding will be cut.
It is essential that we provide stable funding and statutory support
for the good work these programs do to promote women's health, study
diseases that affect women and promote the inclusion of women in
research studies. I urge the speedy adoption of this important measure.
Ms. SCHAKOWSKY. Mr. Speaker, I rise today in support of H.R. 1784,
the Women's Health Office Act. By establishing Offices of Women's
Health throughout different agencies in the Department of Health and
Human Services, this legislation recognizes the ongoing need to focus
attention on various health issues particularly related to women. Women
make up over half the adult population of this country and it is
critical that we make women's health a top priority.
For years, almost all medical research was conducted from a male
perspective, while women's medical needs were ignored. Today there is a
need for more research on breast, cervical, and ovarian cancer, hormone
replacement therapy, and how various ailments such as osteoporosis and
heart disease specifically affect women. It is important that we
conduct this research, not as an afterthought, but as primary research
important to everyone's well-being.
There is also a need to ensure that all women in the U.S. have access
to health care coverage, including comprehensive reproductive health
care, prenatal care, preventative care, and coverage throughout
menopause and old age. Too many poor and low-income women in this
country have little or no access to health care. This is particularly
harmful and unacceptable for pregnant women and women suffering from
ongoing ailments.
I also expect the new Offices of Women's Health within the various
agencies to focus on domestic violence and sexual assault as serious
threats to both women's health and public health in general. Violence
against women is the leading cause of injury to women in America
between the ages of 15 and 54. Not only does this violence leave
victims with visible injuries, but it can lead to other physical
problems and emotional distress. It is critical that we look at
violence against women from a medical perspective, as well as examine
its social consequences, in order to recognize it, address it, and work
to end it.
I am pleased that the House of Representatives is addressing the
issue of women's health today and I urge my colleagues to vote for H.R.
1784, the Women's Health Office Act.
Ms. SLAUGHTER. Mr. Speaker, I rise in strong support of H.R. 1784,
the Women's Health Office Act.
As an original cosponsor and vocal advocate of this legislation, I am
delighted that it is finally being considered by the House. Congress
has delayed far too long in addressing the second-class status of the
various offices of women's health throughout the Department of Health
and Human Services (HHS).
As other speakers have attested, only two of the HHS offices of
women's health are currently established in statute: the Office of
Research on Women's Health at the National Institutes of Health, and
the women's health associate administrator at the Substance Abuse and
Mental Health Services Administration. While offices of women's health
exist at a number of other agencies, they can be moved, altered, or
eliminated at the discretion of the agency director. This lack of
permanence is extremely detrimental to long-term planning and multi-
year efforts. It also sends a message to our nation's women that we are
not firmly committed to improving their health.
Women's health is not a passing fancy or a fad that will go out of
fashion. It is a serious discipline that will require the attention of
doctors, scientists, and health care providers far into the future. The
offices of women's health should not be an afterthought. H.R. 1784 is a
vital step in permanently integrating women's health into the structure
of our health care system. I look forward to voting for this important
initiative, and I urge my colleagues to do the same.
Mr. WU. Mr. Speaker, for too long, women's health needs have been
ignored or excluded in federal medical research. For instance, one
federally funded study examined the ability of aspirin to prevent heart
attacks in 20,000 medical doctors, all of whom were men, despite the
fact that heart disease is a leading cause of death among women.
Another study on breast cancer examined hundreds of men.
Fortunately, this attitude has changed. Today, medical researchers
and health care providers know and understand the importance of
distinguishing women's health. I strongly support these efforts, but I
realize that more needs to be done. Last May, the GAO released a report
on the status of women's research at NIH. Although noting that much
progress has been made, the report stated that the Institute had made
less progress in implementing the requirement that certain clinical
trials be designed and carried out to permit valid analysis by sex,
which could reveal whether interventions affect women and men
differently. It also found that NIH researchers, even though they would
include women in their trials, would either do no analysis on the basis
of sex, or would not publish the sex-based results if no difference was
found.
This must change. We need to continue to eliminate this health care
gender gap and improve women's access to affordable, quality health
services. The bill before us today, by Women's Health Office Act, will
bring us one step closer to eliminating this gap by providing permanent
authorization for Offices of Women's Health in five Federal agencies:
the Department of Health and Human Services (HHS); the Centers for
Disease Control and Prevention (CDC); the Agency for Health Care
Research and Quality (AHRQ); the Health Resources and Services
Administration (HRSA); and the Food and Drug Administration (FDA).
Currently, only two women's health offices in the Federal Government
have statutory authorization: the Office of Research on Women's Health
at the National Institutes of Health, and the Office for Women's
Services within the Substance Abuse and Mental Health Services
Administration (SAMHSA).
Offices of Women's Health across the Public Health Service are
charged with coordinating women's health activities and monitoring
progress on women's health issues within their respective agencies, and
they have been successful in making Federal programs and policies more
responsive to women's health issues. Unfortunately, all of the good
work these offices are doing is not guaranteed in Public Health Service
authorizing law. Providing statutory authorization for federal women's
health offices is a critical step in ensuring that women's health
research will continue to receive the attention it requires in future
years.
I urge my colleagues to join me in support of this important
legislation.
Mrs. MALONEY of New York. Mr. Speaker, I am delighted to have the
opportunity to speak on the floor in favor of H.R. 1784, The Women's
Health Office Act. Congresswoman Morella and I have worked on this bill
for a number of years and I want to thank the Congresswoman for her
leadership on this issue.
In addition, I want to thank the Energy & Commerce committee,
Chairman Tauzin, Congressman Dingell, Chairman Bilirakis, and
Congressman Sherrod Brown for moving this bill forward and for their
dedication to women's health.
The other body has also taken action on this issue. I am pleased to
see that this legislation was included in the Senate's ``Women's Health
Act,'' S. 2328, that passed out of the Senate Committee on Health,
Education, Labor, and Pensions earlier this month.
By permanently establishing offices for women's health within the
Department of Health and Human Services, the Agency for Health Care
Research and Quality, the Health Resources and Services Administration,
the Centers for Disease Control and Prevention, and the Food and Drug
Administration, the Women's Health Office Act will provide the much
needed statutory authority to further develop women's health research.
H.R. 1784 is endorsed by 50 advocacy organizations who represent
women, health care professionals and consumers, including the Society
for Women's Health Research, the Women's Research and Education
Institute, and the YWCA of the U.S.A.
H.R. 1784 is grounded in a basic premise: only through good science
and research do we find better treatments and cures. Women and girls
should benefit equitably in the advances made in health care and
medical research.
Women around the United States need and deserve to have their health
protected and not overlooked. Yet, various health differences between
men and women have long gone unnoticed and not studied. Just last
spring, the GAO reported that 8 out of 10 drugs pulled off the market
were more harmful to women than to men. These were drugs that underwent
extensive clinical trials and were approved by the FDA. Yet, once on
the market these drugs caused serious health hazards for the women they
were prescribed to.
Obviously, there is still much work to be done in the area of women's
health. Congress, Federal health agencies, and the scientific community
are working to ensure that women's health is made a priority. This
legislation is another important step towards equity in health.
I support this legislation. Women need this legislation. Let's work
to improve the lives and health of women in this country. Support H.R.
1784, The Women's Health Office Act.
[[Page H6268]]
I'm honored to be the lead Democrat on this bill.
Mr. DINGELL. Mr. Speaker, I rise in strong support for this bill. The
General Accounting Office released a report in 1990 that exposed the
historical pattern of neglect of women in health research. As a result
of this report, there was a significant increase in government
initiatives in women's health research and the creation of women's
health offices, advisors, and coordinators in many governmental
institutions.
But that was just a beginning. We must now work to ensure that these
highly beneficial institutions remain funded and operational into the
future.
Currently, there are only two agencies which have federally
authorized women's health offices: the Office of Research on Women's
Health in the National Institutes of Health, and the Office for Women's
Services in the Substance Abuse and Mental Health Services
Administration. Since these two agencies are the only women's health
offices established under statute, these are the only two women's
health offices that are federally authorized and protected by law. The
women's health offices, advisors, and coordinators of other government
agencies face the possibility that future administrations will not
continue to support them, or that future funding will be insufficient
to meet their needs.
H.R. 1784 would provide permanent authorization for women's health
offices in the Department of Health and Human Services, the Agency for
Health Care Research and Quality, the Health Resource and Service
Administration, the Centers for Disease Control and Prevention, and the
Food and Drug Administration. It will ensure that these women's health
offices will continue under statute and carry on the important work to
improve the health of women through ongoing evaluation in the areas of
education, prevention, treatment, research, and delivery of services.
I want to note the outstanding leadership on this legislation of my
friend and colleague, Representative Carolyn Maloney. I urge my
colleagues to join me in support of this important and beneficial piece
of legislation.
Mr. BROWN of Ohio. Mr. Speaker, I yield back the balance of my time.
Mr. BILIRAKIS. Mr. Speaker, I yield back the balance of my time.
The SPEAKER pro tempore (Mr. Boozman). The question is on the motion
offered by the gentleman from Florida (Mr. Bilirakis) that the House
suspend the rules and pass the bill, H.R. 1784, as amended.
The question was taken; and (two-thirds having voted in favor
thereof) the rules were suspended and the bill, as amended, was passed.
A motion to reconsider was laid on the table.
____________________