[Congressional Record Volume 150, Number 103 (Thursday, July 22, 2004)]
[Senate]
[Pages S8723-S8727]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DASCHLE:
  S. 2741. A bill to amend the Public Health Service Act to reauthorize 
and extend the Fetal Alcohol Syndrome prevention and services program, 
and for other purposes; to the Committee on Health, Education, Labor, 
and Pensions.
  Mr. DASCHLE. Mr. President, I am pleased to introduce today the 
Advancing FASD Research, Prevention, and Services Act. For many years 
now, I have met and worked with people whose lives have been profoundly 
affected by the consumption of alcohol during pregnancy. Prenatal 
exposure to alcohol can cause a wide range of serious, life-long 
problems known as Fetal Alcohol Syndrome Disorders. Individuals with 
FASD can have a low IQ, behavioral impairments, growth retardation, 
facial abnormalities, and birth defects. About 40,000 children are born 
with FASD each year.
  A great deal of progress has been made in raising awareness of the 
dangers of alcohol consumption during pregnancy, but much more needs to 
be done. The bill I am introducing today addresses the need for more 
research, better screening systems to identify children with FASD, 
effective prevention programs, and enhanced access to treatment and 
support services. It is my sincere hope that this bill--when combined 
with the tireless efforts of parents, health professionals, teachers, 
and countless others--will help prevent FASD and support the children 
and families who are living with its consequences. I ask unanimous 
consent that a fact sheet containing a description of the bill be 
printed in the Record.
  I ask unanimous consent that the text of the bill be printed in the 
Record.

                                S. 2741

       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 ``Advancing FASD Research, 
     Prevention, and Services Act''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) Fetal Alcohol Spectrum Disorders are the spectrum of 
     serious, life-long disorders caused by prenatal exposure to 
     alcohol, which include Fetal Alcohol Syndrome, Alcohol-
     Related Neurodevelopmental Disorder, and Alcohol-Related 
     Birth Defects.
       (2) In the decades that have passed since Fetal Alcohol 
     Syndrome was first recognized in the United States, this 
     fully preventable condition has continued to affect American 
     children and families.
       (3) Prenatal alcohol exposure can cause brain damage that 
     produces cognitive and behavioral impairments. Prenatal 
     alcohol exposure can cause mental retardation or low IQ and 
     difficulties with learning, memory, attention, and problem-
     solving. It can also create problems with mental health and 
     social interactions.
       (4) Prenatal alcohol exposure also can cause growth 
     retardation, birth defects involving the heart, kidney, 
     vision and hearing, and a characteristic pattern of facial 
     abnormalities.
       (5) About 13 percent of women report using alcohol during 
     pregnancy even though there is no known safe level of alcohol 
     consumption during pregnancy.
       (6) Estimates of individuals with Fetal Alcohol Syndrome 
     vary but are estimated to be between 0.5 and 2.0 per 1,000 
     births. The prevalence rate is considerably higher for all 
     Fetal Alcohol Spectrum Disorders: about 10 out of 1,000 
     births (1 percent of births).
       (7) Prevalence of Fetal Alcohol Spectrum Disorders can be 
     even higher in certain populations, such as Native Americans, 
     and in certain areas, such as those characterized by low 
     socioeconomic status.
       (8) Fetal Alcohol Spectrum Disorders pose extraordinary 
     financial costs to the Nation, including the cost of 
     specialized health care, education, foster care, 
     incarceration, job training, and general support services for 
     individuals affected by Fetal Alcohol Spectrum Disorders.
       (9) Lifetime health costs for an individual with Fetal 
     Alcohol Syndrome average $860,000, and can run as high as 
     $4,200,000. The direct and indirect economic costs of Fetal 
     Alcohol Syndrome in the United States were $5,400,000,000 in 
     2003. Total economic costs would be even higher for all Fetal 
     Alcohol Spectrum Disorders.
       (10) There is a great need for research, surveillance, 
     prevention, treatment, and support services for individuals 
     with Fetal Alcohol Spectrum Disorders and their families.

     SEC. 3. PROGRAMS FOR FETAL ALCOHOL SPECTRUM DISORDERS.

       Section 399H of the Public Health Service Act (48 U.S.C. 
     280f) is amended--
       (1) by striking the section heading and inserting the 
     following:

     ``SEC. 399H. PROGRAMS FOR FETAL ALCOHOL SPECTRUM 
                   DISORDERS.'';

       (2) by redesignating subsections (a) through (d) as 
     subsections (h) through (k), respectively;
       (3) by inserting after the section heading, the following:
       ``(a) Research on FAS and Related Disorders.--
       ``(1) In general.--The Secretary, acting through the 
     Director of the National Institutes of Health and in 
     coordination with the Interagency Coordinating Committee on 
     Fetal Alcohol Syndrome, shall--

[[Page S8724]]

       ``(A) establish a research agenda for Fetal Alcohol 
     Spectrum Disorders; and
       ``(B) award grants, contracts, or cooperative agreements to 
     public or private nonprofit entities to pay all or part of 
     carrying out research under such agenda.
       ``(2) Types of research.--In carrying out paragraph (1), 
     the Secretary, acting through the Director of the National 
     Institute of Alcohol Abuse and Alcoholism, shall conduct 
     national and international research in coordination with 
     other Federal agencies that includes--
       ``(A) the identification of the mechanisms that produce the 
     cognitive and behavioral problems associated with fetal 
     alcohol exposure;
       ``(B) the development of a neurocognitive phenotype for 
     Fetal Alcohol Syndrome and Alcohol-Related Neurodevelopmental 
     Disorder;
       ``(C) the identification of biological markers that can be 
     used to indicate fetal alcohol exposure;
       ``(D) the identification of fetal and maternal risk factors 
     that increase susceptibility to Fetal Alcohol Spectrum 
     Disorders;
       ``(E) the investigation of behavioral and pharmacotherapies 
     for alcohol-dependent women to determine new approaches for 
     sustaining recovery;
       ``(F) the development of scientific-based therapeutic 
     interventions for individuals with Fetal Alcohol Spectrum 
     Disorders;
       ``(G) the development of screening instruments to identify 
     women who consume alcohol during pregnancy and the 
     development of standards for measuring, reporting, and 
     analyzing alcohol consumption patterns in pregnant women; and
       ``(H) other research that the Director determines to be 
     appropriate.
       ``(3) Study.--The Secretary, acting through the Director of 
     the National Institute of Mental Health, shall--
       ``(A) conduct a study on the behavioral disorders that may 
     be associated with prenatal alcohol exposure;
       ``(B) not later than 1 year after the date of enactment of 
     the Advancing FASD Research, Prevention, and Services Act, 
     submit to Congress a report on the appropriateness of 
     characterizing Fetal Alcohol Spectrum Disorders and their 
     secondary behavioral disorders as mental health disorders; 
     and
       ``(C) conduct additional research on the epidemiology of 
     behavior disorders associated with Fetal Alcohol Spectrum 
     Disorders in collaboration with the Centers for Disease 
     Control and Prevention.
       ``(4) Authorization of appropriations.--There are 
     authorized to be appropriated to carry out this subsection, 
     such sums as may be necessary for each of fiscal years 2005 
     through 2009.
       ``(b) Surveillance, Identification, and Prevention 
     Activities.--
       ``(1) In general.--The Secretary, acting through the 
     Director of the National Center on Birth Defects and 
     Developmental Disabilities, shall facilitate surveillance, 
     identification, and prevention of Fetal Alcohol Spectrum 
     Disorders as provided for in this subsection.
       ``(2) Surveillance, identification, and prevention.--In 
     carrying out this subsection, the Secretary shall--
       ``(A) develop and implement a uniform surveillance case 
     definition for Fetal Alcohol Syndrome and a uniform 
     surveillance case definition for Alcohol Related 
     Neurodevelopmental Disorder;
       ``(B) develop a comprehensive screening process for Fetal 
     Alcohol Spectrum Disorders that covers different age, race, 
     and ethnic groups and is based on the uniform surveillance 
     case definitions developed under subparagraph (A);
       ``(C) disseminate and provide the necessary training and 
     support for the screening process developed under 
     subparagraph (B) to--
       ``(i) hospitals, community health centers, outpatient 
     programs, and other appropriate health care providers;
       ``(ii) incarceration and detainment facilities;
       ``(iii) primary and secondary schools;
       ``(iv) social work and child welfare offices;
       ``(v) foster care providers and adoption agencies;
       ``(vi) State offices and others providing services to 
     individuals with disabilities; and
       ``(vii) other entities that the Secretary determines to be 
     appropriate;
       ``(D) conduct activities related to risk factor 
     surveillance including the annual monitoring and reporting of 
     alcohol consumption among pregnant women and women of child 
     bearing age; and
       ``(E) conduct applied public health prevention research and 
     implement strategies for reducing alcohol-exposed pregnancies 
     in women at high risk for alcohol-exposed pregnancies.
       ``(3) Authorization of appropriation.--There are authorized 
     to be appropriated to carry out this subsection, such sums as 
     may be necessary for each of fiscal years 2005 through 2009.
       ``(c) Building State FASD Systems.--
       ``(1) In general.--The Secretary, acting through the 
     Administrator of the Substance Abuse and Mental Health 
     Services Administration, shall award grants, contracts, or 
     cooperative agreements to States for the purpose of 
     establishing or expanding statewide programs of surveillance, 
     prevention, and treatment of individuals with Fetal Alcohol 
     Spectrum Disorders.
       ``(2) Eligibility.--To be eligible to receive a grant, 
     contract, or cooperative agreement under paragraph (1) a 
     State shall--
       ``(A) prepare and submit to the Secretary an application at 
     such time, in such manner, and containing such information as 
     the Secretary may reasonably require;
       ``(B) develop and implement a statewide strategic plan for 
     preventing and treating Fetal Alcohol Spectrum Disorders;
       ``(C) consult with public and private non-profit entities 
     with relevant expertise on Fetal Alcohol Spectrum Disorders 
     within the State, including--
       ``(i) parent-led groups and other organizations that 
     support and advocate for individuals with Fetal Alcohol 
     Spectrum Disorders; and
       ``(ii) Indian tribes and tribal organizations; and
       ``(D) designate an individual to serve as the coordinator 
     of the State's Fetal Alcohol Spectrum Disorders program.
       ``(3) Strategic plan.--The statewide strategic plan 
     prepared under paragraph (2)(B) shall include--
       ``(A) the identification of existing State programs and 
     systems that could be used to identify and treat individuals 
     with Fetal Alcohol Spectrum Disorders and prevent alcohol 
     consumption during pregnancy, such as--
       ``(i) programs for the developmentally disabled, the 
     mentally ill, and individuals with alcohol dependency;
       ``(ii) primary and secondary educational systems;
       ``(iii) judicial systems for juveniles and adults;
       ``(iv) child welfare programs and social service programs; 
     and
       ``(v) other programs or systems the State determines to be 
     appropriate;
       ``(B) the identification of any barriers for individuals 
     with Fetal Alcohol Spectrum Disorders or women at risk for 
     alcohol consumption during pregnancy to access the programs 
     identified under subparagraph (A); and
       ``(C) proposals to eliminate barriers to prevention and 
     treatment programs and coordinate the activities of such 
     programs.
       ``(4) Use of funds.--Amounts received under a grant, 
     contract, or cooperative agreement under paragraph (1) shall 
     be used for one or more of the following activities:
       ``(A) Establishing a statewide surveillance system.
       ``(B) Collecting, analyzing and interpreting data.
       ``(C) Establishing a diagnostic center.
       ``(D) Developing, implementing, and evaluating population-
     based and targeted prevention programs for Fetal Alcohol 
     Spectrum Disorders, including public awareness campaigns.
       ``(E) Referring individuals with Fetal Alcohol Spectrum 
     Disorders to appropriate support services.
       ``(F) Developing and sharing best practices for the 
     prevention, identification, and treatment of Fetal Alcohol 
     Spectrum Disorders.
       ``(G) Providing training to health care providers on the 
     prevention, identification, and treatment of Fetal Alcohol 
     Spectrum Disorders.
       ``(H) Disseminating information about Fetal Alcohol 
     Spectrum Disorders and the availability of support services 
     to families of individuals with Fetal Alcohol Spectrum 
     Disorders.
       ``(I) Other activities determined appropriate by the 
     Secretary.
       ``(5) Multi-state programs.--The Secretary shall permit the 
     formation of multi-State Fetal Alcohol Spectrum Disorders 
     programs under this subsection.
       ``(6) Other contracts and agreements.--A State may carry 
     out activities under paragraph (4) through contacts or 
     cooperative agreements with public and private non-profit 
     entities with a demonstrated expertise in Fetal Alcohol 
     Spectrum Disorders.
       ``(7) Authorization of appropriations.--There are 
     authorized to be appropriated to carry out this subsection, 
     such sums as may be necessary for fiscal years 2005 through 
     2009.
       ``(d) Promoting Community Partnerships.--
       ``(1) In general.--The Secretary shall award grants, 
     contracts, or cooperative agreements to eligible entities to 
     enable such entities to establish, enhance, or improve 
     community partnerships for the purpose of collaborating on 
     common objectives and integrating the services available to 
     individuals with Fetal Alcohol Spectrum Disorders, such as 
     surveillance, prevention, treatment, and provision of support 
     services.
       ``(2) Eligible entities.--To be eligible to receive a 
     grant, contract, or cooperative agreement under paragraph 
     (1), an entity shall--
       ``(A) be a public or private nonprofit entity, including--
       ``(i) a health care provider or health professional;
       ``(ii) a primary or secondary school;
       ``(iii) a social work or child welfare office;
       ``(iv) an incarceration or detainment facility;
       ``(v) a parent-led group or other organization that 
     supports and advocates for individuals with Fetal Alcohol 
     Spectrum Disorders;
       ``(vi) an Indian tribe or tribal organization;
       ``(vii) any other entity the Secretary determines to be 
     appropriate; or
       ``(viii) a consortium of any of the entities described in 
     clauses (i) through (vii); and
       ``(B) prepare and submit to the Secretary an application at 
     such time, in such manner,

[[Page S8725]]

     and containing such information as the Secretary may 
     reasonably require, including assurances that the entity 
     submitting the application does, at the time of application, 
     or will, within a reasonable amount of time from the date of 
     application, include substantive participation of a broad 
     range of entities that work with or provide services for 
     individuals with Fetal Alcohol Spectrum Disorders.
       ``(3) Activities.--An eligible entity shall use amounts 
     received under a grant, contract, or cooperative agreement 
     under this subsection shall carry out 1 or more of the 
     following activities:
       ``(A) Identifying and integrating existing programs and 
     services available in the community for individuals with 
     Fetal Alcohol Spectrum Disorders.
       ``(B) Conducting a needs assessment to identify services 
     that are not available in a community.
       ``(C) Developing and implementing community-based 
     initiatives to prevent, diagnose, treat, and provide support 
     services to individuals with Fetal Alcohol Spectrum 
     Disorders.
       ``(D) Disseminating information about Fetal Alcohol 
     Spectrum Disorders and the availability of support services.
       ``(E) Developing and implementing a community-wide public 
     awareness and outreach campaign focusing on the dangers of 
     drinking alcohol while pregnant.
       ``(F) Providing mentoring or other support to families of 
     individuals with Fetal Alcohol Spectrum Disorders.
       ``(G) Other activities determined appropriate by the 
     Secretary.
       ``(4) Authorization of appropriation.--There are authorized 
     to be appropriated to carry out this subsection, such sums as 
     may be necessary for each of fiscal years 2005 through 2009.
       ``(e) Development of Best Practices.--
       ``(1) In general.--The Secretary, in coordination with the 
     National Task Force on Fetal Alcohol Spectrum Disorders, 
     shall award grants to States, Indian tribes and tribal 
     organizations, and nongovernmental organizations for the 
     establishment of pilot projects to identify and implement 
     best practices for--
       ``(A) educating children with fetal alcohol spectrum 
     disorders, including--
       ``(i) activities and programs designed specifically for the 
     identification, treatment, and education of such children; 
     and
       ``(ii) curricula development and credentialing of teachers, 
     administrators, and social workers who implement such 
     programs;
       ``(B) educating judges, attorneys, child advocates, law 
     enforcement officers, prison wardens, alternative 
     incarceration administrators, and incarceration officials on 
     how to treat and support individuals suffering from Fetal 
     Alcohol Spectrum Disorders within the criminal justice 
     system, including--
       ``(i) programs designed specifically for the 
     identification, treatment, and education of those with Fetal 
     Alcohol Spectrum Disorders; and
       ``(ii) curricula development and credentialing within the 
     justice system for individuals who implement such programs; 
     and
       ``(C) educating adoption or foster care agency officials 
     about available and necessary services for children with 
     fetal alcohol spectrum disorders, including--
       ``(i) programs designed specifically for the 
     identification, treatment, and education of those with Fetal 
     Alcohol Spectrum Disorders; and
       ``(ii) education and training for potential parents of an 
     adopted child with Fetal Alcohol Spectrum Disorders.
       ``(2) Application.--To be eligible for a grant under 
     paragraph (1), an entity shall prepare and submit to the 
     Secretary an application at such time, in such manner, and 
     containing such information as the Secretary may reasonably 
     require.
       ``(3) Authorization of appropriations.--There are 
     authorized to be appropriated to carry out this subsection, 
     such sums as may be necessary for each of fiscal years 2005 
     through 2009.
       ``(f) Transitional Services.--
       ``(1) In general.--The Secretary shall award demonstration 
     grants, contracts, and cooperative agreements to States, 
     Indian tribes and tribal organizations, and nongovernmental 
     organizations for the purpose of establishing integrated 
     systems for providing transitional services for those 
     affected by prenatal alcohol exposure and evaluating their 
     effectiveness.
       ``(2) Application.--To be eligible for a grant, contract, 
     or cooperative agreement under paragraph (1), an entity shall 
     prepare and submit to the Secretary an application at such 
     time, in such manner, and containing such information as the 
     Secretary may reasonably require.
       ``(3) Allowable uses.--An entity shall use amounts received 
     under a grant, contract, or cooperative agreement under 
     paragraph (1) to--
       ``(A) provide housing assistance to adults with Fetal 
     Alcohol Spectrum Disorders;
       ``(B) provide vocational training and placement services 
     for adults with Fetal Alcohol Spectrum Disorders;
       ``(C) provide medication monitoring services for adults 
     with Fetal Alcohol Spectrum Disorders; and
       ``(D) provide training and support to organizations 
     providing family services or mental health programs and other 
     organizations that work with adults with Fetal Alcohol 
     Spectrum Disorders.
       ``(4) Authorization of appropriations.--There are 
     authorized to be appropriated to carry out this subsection, 
     such sums as may be necessary for each of fiscal years 2005 
     through 2009.
       ``(g) Community Health Center Initiative.--
       ``(1) In general.--The Secretary, acting through the 
     Administrator of the Health Resources and Services 
     Administration, shall award grants to community health 
     centers acting in collaboration with States, Indian tribes, 
     tribal organizations, and nongovernmental organizations, for 
     the establishment of a 5-year demonstration program under the 
     direction of the Interagency Coordinating Committee on Fetal 
     Alcohol Syndrome to implement and evaluate a program to 
     increase awareness and identification of Fetal Alcohol 
     Spectrum Disorders in community health centers and to refer 
     affected individuals to appropriate support services.
       ``(2) Application.--To be eligible to receive a grant under 
     paragraph (1), a community health center shall prepare and 
     submit to the Administrator an application at such time, in 
     such manner, and containing such information as the 
     Administrator may reasonably require.
       ``(3) Activities.--A community health center shall use 
     amounts received under a grant under paragraph (1) to--
       ``(A) provide training for health care providers on 
     identifying and educating women who are at risk for alcohol 
     consumption during pregnancy;
       ``(B) provide training for health care providers on 
     screening children for Fetal Alcohol Spectrum Disorders;
       ``(C) educate health care providers and other relevant 
     community health center workers on the support services 
     available for those with Fetal Alcohol Spectrum Disorders and 
     treatment services available for women at risk for alcohol 
     consumption during pregnancy; and
       ``(D) implement a tracking system that can identify the 
     rates of Fetal Alcohol Spectrum Disorders by racial, ethnic, 
     and economic backgrounds.
       ``(4) Selection of participants.--The Administrator shall 
     determine the number of community health centers that will 
     participate in the demonstration program under this 
     subsection and shall select participants, to the extent 
     practicable, that are located in different regions of the 
     United States and that serve a racially and ethnically 
     diverse population.
       ``(5) Authorization of appropriations.--There are 
     authorized to be appropriated to carry out this subsection, 
     such sums as may be necessary for each of fiscal years 2005 
     through 2009.
       ``(6) Report to congress.--Not later than 1 year after 
     completion of the demonstration program under this 
     subsection, the Administrator shall prepare and submit to 
     Congress a report on the results of the demonstration 
     program, including--
       ``(A) changes in the number of women screened for and 
     identified as at risk for alcohol consumption during 
     pregnancy;
       ``(B) changes in the number of individuals identified as 
     having a Fetal Alcohol Spectrum Disorder; and
       ``(C) changes in the number of alcohol-consuming pregnant 
     women and individuals with Fetal Alcohol Spectrum Disorders 
     who were referred to appropriate services.'';
       (4) in subsection (h)(1) (as so redesignated).
       (A) in subparagraph (C), by striking ``and'' after the 
     semicolon;
       (B) in subparagraph (D), by adding ``and'' after the 
     semicolon; and
       (C) by adding at the end the following:
       ``(E) national public service announcements to raise public 
     awareness of the risks associated with alcohol consumption 
     during pregnancy with the purpose of reducing the prevalence 
     of Fetal Alcohol Spectrum Disorders, that shall--
       ``(i) be conducted by relevant Federal agencies under the 
     coordination of the Interagency Coordinating Committee on 
     Fetal Alcohol Syndrome;
       ``(ii) be developed by the appropriate Federal agencies, as 
     determined by the Interagency Coordinating Committee on Fetal 
     Alcohol Syndrome taking into consideration the expertise and 
     experience of other relevant Federal agencies, and shall test 
     and evaluate the public service announcement's effectiveness 
     prior to broadcasting the announcements nationally;
       ``(iii) be broadcast through appropriate media outlets, 
     including television or radio, in a manner intended to reach 
     women at risk of alcohol consumption during pregnancy; and
       ``(iv) be measured prior to broadcast of the national 
     public service announcements to provide baseline data that 
     will be used to evaluate the effectiveness of the 
     announcements.''; and
       (5) in subsection (k) (as so redesignated)--
       (A) in paragraph (1), by striking ``National Task Force on 
     Fetal Alcohol Syndrome and Fetal Alcohol Effect'' and 
     inserting ``National Task Force on Fetal Alcohol Spectrum 
     Disorders'';
       (B) in paragraph (3)--
       (i) in subparagraph (B), by striking ``and'' after the 
     semicolon;
       (ii) in subparagraph (C), by adding ``and'' after the 
     semicolon; and
       (iii) by adding at the end the following:
       ``(D) develop, in collaboration with the Interagency 
     Coordinating Committee on Fetal Alcohol Syndrome, a report 
     that identifies and describes the 10 most important

[[Page S8726]]

     actions that must be taken to reduce prenatal alcohol 
     exposure and all its adverse outcomes, and that shall--
       ``(i) describe the state of the current epidemiology of 
     Fetal Alcohol Spectrum Disorders, risk factors, and 
     successful approaches in policy and services that have 
     reduced alcohol-exposed pregnancies and outcomes;
       ``(ii) identify innovative approaches that have worked in 
     related areas such as tobacco control or HIV prevention that 
     may provide models for Fetal Alcohol Spectrum Disorders 
     prevention;
       ``(iii) recommend short-term and long-term action plans for 
     achieving the Healthy 2010 Objectives for the United States, 
     such as increasing abstinence from alcohol among pregnant 
     women and reducing the occurrence of Fetal Alcohol Syndrome; 
     and
       ``(iv) recommend in coordination with the National 
     Institute on Mental Health whether Fetal Alcohol Syndrome and 
     other prenatal alcohol disorders, or a subset of these 
     disorders, should be included in the Diagnostic and 
     Statistical Manual of Mental Disorders.''; and
       (C) by striking ``Fetal Alcohol Syndrome and Fetal Alcohol 
     Effect'' each place that such appears and inserting ``Fetal 
     Alcohol Spectrum Disorders''.

     SEC. 4. COORDINATION AMONG FEDERAL ENTITIES.

       Part O of title III of the Public Health Service Act (42 
     U.S.C. 280f et seq.) is amended by adding at the end the 
     following:

     ``SEC. 399K-1. COORDINATION AMONG FEDERAL ENTITIES.

       ``(a) Interagency Coordinating Committee on Fetal Alcohol 
     Syndrome.--The Secretary, acting through the Director of the 
     National Institute on Alcohol Abuse and Alcoholism, shall 
     provide for the continuation of the Interagency Coordinating 
     Committee on Fetal Alcohol Syndrome so that such Committee 
     may--
       ``(1) coordinate activities conducted by the Federal 
     Government on Fetal Alcohol Spectrum Disorders, including 
     convening meetings, establishing work groups, sharing 
     information, and facilitating and promoting collaborative 
     projects among Federal agencies; and
       ``(2) develop, in consultation with the National Task Force 
     on Fetal Alcohol Spectrum Disorders, priority areas for years 
     2006 through 2010 to guide Federal programs and activities 
     related to Fetal Alcohol Spectrum Disorders.
       ``(b) Coordination Among Federal Entities.--
       ``(1) In general.--The Comptroller General of the United 
     States shall evaluate and make recommendations regarding the 
     appropriate roles and responsibilities of Federal entities 
     with respect to programs and activities related to Fetal 
     Alcohol Spectrum Disorders.
       ``(2) Covered entities.--The Federal entities under 
     paragraph (1) shall include entities within the National 
     Institutes of Health, the Centers for Disease Control and 
     Prevention, the Substance Abuse and Mental Health Services 
     Administration, the Health Resources and Services 
     Administration, the Indian Health Service, the Agency for 
     Healthcare Research and Quality, the Interagency Coordinating 
     Committee on Fetal Alcohol Syndrome, the National Task Force 
     on Fetal Alcohol Spectrum Disorders, as well as the Office of 
     Special Education and Rehabilitative Services in the 
     Department of Education and the Office of Juvenile Justice 
     and Delinquency Prevention in the Department of Justice.
       ``(3) Evaluation.--The evaluation conducted by the 
     Comptroller General under paragraph (1) shall include--
       ``(A) an assessment of the current roles and 
     responsibilities of Federal entities with programs and 
     activities related to Fetal Alcohol Spectrum Disorders; and
       ``(B) an assessment of whether there is duplication in 
     programs and activities, conflicting roles and 
     responsibilities, or lack of coordination among Federal 
     entities.
       ``(4) Recommendation.--The Comptroller General shall 
     provide recommendations on the appropriate roles and 
     responsibilities of the Federal entities described in 
     paragraph (2) in order to maximize the effectiveness of 
     Federal programs and activities related to Fetal Alcohol 
     Spectrum Disorders.
       ``(5) Completion.--Not later than 1 year after the date of 
     enactment of the Advancing FASD Research, Prevention, and 
     Services Act, the Comptroller General shall complete the 
     evaluation and submit to Congress a report on the findings 
     and recommendations made as a result of the evaluation.''.

     SEC. 5. SERVICES FOR INDIVIDUALS WITH FETAL ALCOHOL SYNDROME.

       Section 519C(b) of the Public Health Service Act (42 U.S.C. 
     290bb-25c(b)) is amended--
       (1) in paragraph (11), by striking ``and'' after the 
     semicolon;
       (2) by redesignating paragraph (12) as paragraph (15); and
       (3) by inserting after paragraph (11), the following:
       ``(12) provide respite care for caretakers of individuals 
     with Fetal Alcohol Syndrome and other prenatal alcohol-
     related disorders;
       ``(13) recruit and train mentors for adolescents with Fetal 
     Alcohol Syndrome and other prenatal alcohol-related 
     disorders;
       ``(14) provide educational and supportive services to 
     families of individuals with Fetal Alcohol Spectrum 
     Disorders; and''.

     SEC. 6. PREVENTION, INTERVENTION, AND SERVICES IN THE 
                   EDUCATION SYSTEM.

       The Secretary of Education shall direct the Office of 
     Special Education and Rehabilitative Services to--
       (1) implement screening procedures and conduct training on 
     a nationwide Fetal Alcohol Spectrum Disorders surveillance 
     campaign for the educational system in collaboration with the 
     efforts of the National Center on Birth Defects and 
     Developmental Disabilities under section 399H(b) of the 
     Public Health Service Act (as added by this Act);
       (2) introduce curricula previously developed by the 
     National Center on Birth Defects and Developmental 
     Disabilities and the Substance Abuse and Mental Health 
     Services Administration on how to most effectively educate 
     and support children with Fetal Alcohol Spectrum Disorders in 
     both special education and traditional education settings, 
     and investigate incorporating information about the 
     identification, prevention, and treatment of the Disorders 
     into teachers' credentialing requirements;
       (3) integrate any special techniques on how to deal with 
     Fetal Alcohol Spectrum Disorders children into parent-teacher 
     or parent-administrator interactions, including after-school 
     programs, special school services, and family aid programs;
       (4) collaborate with other Federal agencies to introduce a 
     standardized educational unit within schools' existing sexual 
     and health education curricula, or create one if needed, on 
     the deleterious effects of prenatal alcohol exposure; and
       (5) organize a peer advisory network of adolescents in 
     schools to discourage the use of alcohol while pregnant or 
     considering getting pregnant.

     SEC. 7. PREVENTION, INTERVENTION, AND SERVICES IN THE JUSTICE 
                   SYSTEM.

       The Attorney General shall direct the Office of Juvenile 
     Justice and Delinquency Prevention to--
       (1) implement screening procedures and conduct training on 
     a nationwide Fetal Alcohol Spectrum Disorders surveillance 
     campaign for the justice system in collaboration with the 
     efforts of the National Center on Birth Defects and 
     Developmental Disabilities under section 399H(b) of the 
     Public Health Service Act (as added by this Act);
       (2) introduce training curricula, in collaboration with the 
     National Center on Birth Defects and Developmental 
     Disabilities and the Substance Abuse and Mental Health 
     Services Administration, on how to most effectively identify 
     and interact with individuals with Fetal Alcohol Spectrum 
     Disorders in both the juvenile and adult justice systems, and 
     investigate incorporating information about the 
     identification, prevention, and treatment of the disorders 
     into justice professionals' credentialing requirements;
       (3) promote the tracking of individuals entering the 
     juvenile justice system with at-risk backgrounds that 
     indicates them as high probability for having a Fetal Alcohol 
     Spectrum Disorder, especially those whose individuals mothers 
     have a high record of drinking during pregnancy as reported 
     by the appropriated child protection agency;
       (4) educate judges, attorneys, child advocates, law 
     enforcement officers, prison wardens, alternative 
     incarceration administrators, and incarceration officials on 
     how to treat and support individuals suffering from Fetal 
     Alcohol Spectrum Disorders within the criminal justice 
     system, including--
       (A) programs designed specifically for the identification, 
     treatment, and education of such children; and
       (B) curricula development and credentialing of teachers, 
     administrators, and social workers who implement such 
     programs;
       (5) conduct a study on the inadequacies of how the current 
     system processes children with certain developmental delays 
     and subsequently develop alternative methods of incarceration 
     and treatment that are more effective for youth offenders 
     identified to have a Fetal Alcohol Spectrum Disorder; and
       (6) develop transition programs for individuals with Fetal 
     Alcohol Spectrum Disorders who are released from 
     incarceration.

     SEC. 8. MISCELLANEOUS PROVISIONS.

       (a) Authorization of Appropriations.--Section 399J of the 
     Public Health Service Act (42 U.S.C. 280f-2) is amended by 
     striking ``the part'' and all that follows through the period 
     and inserting ``subsections (h) thorough (k) of section 399H, 
     $27,000,000 for each of fiscal years 2005 through 2009''.
       (b) Repeal of Sunset.--Section 399K of the Public Health 
     Service Act (42 U.S.C. 280f-3) is repealed.
                                  ____


       The Advancing FASD Research, Prevention, and Services Act


                                research

       The adverse affects of alcohol consumption during pregnancy 
     are better understood today than they were when Fetal Alcohol 
     Syndrome (FAS) was first described in the medical literature 
     in 1968. But more research is needed. The bill would require 
     the National Institutes of Health to develop a research 
     agenda for Fetal Alcohol Spectrum Disorders (FASD) that would 
     include research related to:
       Identifying the mechanisms that produce the cognitive and 
     behavioral problems associated with fetal alcohol exposure; 
     development of a neurocognitive phenotype for FAS and 
     Alcohol-Related Neurodevelopmental Disorder (ARND); 
     identifying biological markers that indicate fetal alcohol 
     exposure; identifying risk factors that increase 
     susceptibility to FASD; investigating new approaches for 
     sustaining recovery from alcohol dependence; developing 
     therapeutic

[[Page S8727]]

     interventions for individuals with FASD; developing screening 
     instruments to identify women who consume alcohol during 
     pregnancy; and understanding the behavioral disorders 
     associated with FASD.


              surveillance, identification, and prevention

       FASD is often difficult to identify, which complicates 
     efforts to accurately estimate its prevalence. Improved 
     surveillance of FASD is needed to better understand the scope 
     of the problem and to effectively deploy public health 
     resources. The bill would improve surveillance and prevention 
     by:
       Developing a comprehensive screening process for FASD; 
     monitoring risk factors for FASD such as alcohol consumption 
     among pregnant women and women of child-bearing age; and 
     conducting research on prevention and implementing strategies 
     for reducing alcohol-exposed pregnancies.


                           state fasd systems

       To improve surveillance, prevention, and treatment of 
     individuals with FASD, the bill would facilitate the 
     development of statewide FASD systems. To be eligible for 
     federal grants, a state would have to develop a strategic 
     plan for preventing and treating FASD, consult with public 
     and non-profit private organizations with relevant expertise, 
     including family organizations, and designate an individual 
     as the state's FASD program coordinator.
       States would be required to identify existing state 
     programs that could be used for identification, prevention, 
     and treatment of FASD and to identify barriers that 
     individuals with FASD may now experience when trying to 
     access those programs. States could use the federal funds for 
     a number of activities, including:
       Establishing statewide surveillance systems and diagnostic 
     centers; developing and implementing prevention programs, 
     including public awareness campaigns; referring individuals 
     with FASD to appropriate support services; developing and 
     sharing best practices; training health care providers; and 
     disseminating information about FASD and the availability of 
     support services.


                         community partnerships

       Responding to FASD at the community level is also 
     important. The bill would provide federal grants to 
     partnerships of health professionals, school systems, child 
     welfare offices, incarceration facilities, parent 
     organizations, Indian tribes and others within a community. 
     These community partnerships would collaborate on common 
     objectives and integrate services. Federal funds could be 
     used to:
       Identify and integrate existing services; identify services 
     not available in a community; develop community-based 
     initiatives to prevent, diagnose, treat and provide support 
     services to individuals with FASD; disseminate information; 
     develop community-wide public awareness and outreach 
     campaigns; and provide mentoring or other support for 
     families of individuals with FASD.


                             best practices

       Individuals with FASD can find themselves in a number of 
     settings and under the supervision of individuals not trained 
     to work with them. The bill would provide federal grants for 
     pilot projects to identify and implement best practices for:
       Educating children with FASD within the school system; 
     educating judges, attorneys, child advocates, law enforcement 
     officers, prison wardens, and others on how to treat and 
     support individuals with FASD within the criminal justice 
     system; and educating adoption or foster care agency 
     officials about available and necessary services for children 
     with FASD.


                            support services

       Individuals with FASD often need special support services 
     as they transition from adolescence to adulthood. The bill 
     would provide federal grants that could be used to:
       Provide housing assistance to adults with FASD; provide 
     vocational training and placement services to adults with 
     FASD; provide medication monitoring services to adults with 
     FASD; and provide training and support to organizations 
     providing family services or mental health programs and other 
     organizations that work with adults with FASD.
       The bill would also allow federal funds to be used to 
     provide respite care to caregivers of individuals with FASD, 
     recruit and train mentors for adolescents with FASD, and 
     provide education and support services to families of 
     individuals with FASD.


                   community health center initiative

       Community health centers provide primary and preventive 
     health care services in rural and urban communities that are 
     medically underserved. The bill would provide federal grants 
     to implement and evaluate a program to increase awareness and 
     identification of FASD in community health centers. 
     Participating health centers would:
       Provide training to health care providers on identifying 
     and educating women who are at risk for alcohol consumption 
     during pregnancy; provide training to health care providers 
     on screening children for FASD; and educate health care 
     providers and other health center workers on the availability 
     of support services for individuals with FASD and treatment 
     services for women at risk for alcohol consumption during 
     pregnancy.


                     public awareness and education

       Even though FASD is completely preventable, many continue 
     to consume alcohol during pregnancy. The bill would authorize 
     the development and broadcast of national public service 
     announcements to raise public awareness of the risks 
     associated with alcohol consumption during pregnancy.


                      national task force on fasd

       The bill would require the National Task Force on FASD to 
     identify and report on the ten most important actions that 
     should be taken to reduce prenatal alcohol exposure and its 
     adverse outcomes, current epidemiological information, 
     innovative prevention models, short-term and long-term 
     recommendations for achieving the Healthy 2010 Objectives for 
     the Nation related to FASD, and a recommendation on whether 
     FAS and other prenatal alcohol disorders should be included 
     in the Diagnostic and Statistical Manual of Mental Disorders.


                  coordination among federal entities

       The bill provides statutory authority for the Interagency 
     Coordinating Committee on FAS and instructs the Comptroller 
     General of the United States to evaluate and make 
     recommendations regarding the appropriate roles and 
     responsibilities of federal entities with programs and 
     activities related to FASD.


     prevention, intervention, and services in the education system

       The education system must be involved in efforts to address 
     FASD. The bill would have the Department of Education 
     implement screening procedures, introduce curricula on how to 
     effectively educate and support children with FASD, include 
     information on the danger of alcohol consumption during 
     pregnancy in existing sexual and health education curricula, 
     and adopt other strategies to assist students with FASD.


      prevention, intervention, and services in the justice system

       Many FASD adolescents and adults are incarcerated or 
     otherwise involved in the justice system. The bill would have 
     the Attorney General implement screening procedures, 
     introduce training curricula on how to effectively identify 
     and interact with individuals with FASD, track individuals 
     entering the juvenile justice system whose background 
     indicates they have a high probability of having FASD, and 
     develop transition programs for individuals with FASD who are 
     released from incarceration.
                                 ______