Congressional Record, Volume 152 Issue 135 (Friday, December 8, 2006)

[Congressional Record Volume 152, Number 135 (Friday, December 8, 2006)]
[House]
[Pages H9304-H9306]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

PREMATURITY RESEARCH EXPANSION AND EDUCATION FOR MOTHERS WHO DELIVER
INFANTS EARLY ACT

Mr. BARTON of Texas. Mr. Speaker, I ask unanimous consent that the
Committee on Energy and Commerce be discharged from further
consideration of the Senate bill (S. 707) to reduce preterm labor and
delivery and the risk of pregnancy-related deaths and complications due
to pregnancy, and to reduce infant mortality caused by prematurity, and
ask for its immediate consideration in the House.
The Clerk read the title of the Senate bill.
The text of the Senate bill is as follows:

S. 707

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 ``Prematurity Research
Expansion and Education for Mothers who deliver Infants Early
Act'' or the ``PREEMIE Act''.

SEC. 2. FINDINGS AND PURPOSE.

(a) Findings.--Congress makes the following findings:
(1) Premature birth is a serious and growing problem. The
rate of preterm birth increased 27 percent between 1982 and
2002 (from 9.4 percent to 11.9 percent). In 2001, more than
480,000 babies were born prematurely in the United States.
(2) Preterm birth accounts for 24 percent of deaths in the
first month of life.
(3) Premature infants are 14 times more likely to die in
the first year of life.
(4) Premature babies who survive may suffer lifelong
consequences, including cerebral palsy, mental retardation,
chronic lung disease, and vision and hearing loss.
(5) Preterm and low birthweight birth is a significant
financial burden in health care. The estimated charges for
hospital stays for infants with any diagnosis of prematurity/
low birthweight were $15,500,000,000 in 2002. The average
lifetime medical costs of a premature baby are conservatively
estimated at $500,000.
(6) The proportion of preterm infants born to African-
American mothers (17.3 percent) was significantly higher
compared to the rate of infants born to white mothers (10.6
percent). Prematurity or low birthweight is the leading cause
of death for African-American infants.
(7) The cause of approximately half of all premature births
is unknown.
(8) Women who smoke during pregnancy are twice as likely as
nonsmokers to give birth to a low birthweight baby. Babies
born to smokers weigh, on average, 200 grams less than
nonsmokers' babies.
(9) To reduce the rates of preterm labor and delivery more
research is needed on the underlying causes of preterm
delivery, the development of treatments for prevention of
preterm birth, and treatments improving outcomes for infants
born preterm.
(b) Purposes.--It the purpose of this Act to--
(1) reduce rates of preterm labor and delivery;
(2) work toward an evidence-based standard of care for
pregnant women at risk of preterm labor or other serious
complications, and for infants born preterm and at a low
birthweight; and
(3) reduce infant mortality and disabilities caused by
prematurity.

SEC. 3. RESEARCH RELATING TO PRETERM LABOR AND DELIVERY AND
THE CARE, TREATMENT, AND OUTCOMES OF PRETERM
AND LOW BIRTHWEIGHT INFANTS.

(a) General Expansion of NIH Research.--Part B of title IV
of the Public Health Service Act (42 U.S.C. 284 et seq.) is
amended by adding at the end the following:

``SEC. 409J. EXPANSION AND COORDINATION OF RESEARCH RELATING
TO PRETERM LABOR AND DELIVERY AND INFANT
MORTALITY.

``(a) In General.--The Director of NIH shall expand,
intensify, and coordinate the activities of the National
Institutes of Health with respect to research on the causes
of preterm labor and delivery, infant mortality, and
improving the care and treatment of preterm and low
birthweight infants.
``(b) Authorization of Research Networks.--There shall be
established within the National Institutes of Health a
Maternal-Fetal Medicine Units Network and a Neonatal Research
Units Network. In complying with this subsection, the
Director of NIH shall utilize existing networks.
``(c) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section, such
sums as may be necessary for each of fiscal years 2005
through 2009.''.
(b) General Expansion of CDC Research.--Section 301 of the
Public Health Service Act (42 U.S.C. 241 et seq.) is amended
by adding at the end the following:
``(e) The Director of the Centers for Disease Control and
Prevention shall expand, intensify, and coordinate the
activities of the Centers for Disease Control and Prevention
with respect to preterm labor and delivery and infant
mortality.''.
(c) Study on Assisted Reproduction Technologies.--Section
1004(c) of the Children's Health Act of 2000 (Public Law 106-
310) is amended--
(1) in paragraph (2), by striking ``and'' at the end;
(2) in paragraph (3), by striking the period and inserting
``; and''; and
(3) by adding at the end the following:
``(4) consider the impact of assisted reproduction
technologies on the mother's and children's health and
development.''.
(d) Study on Relationship Between Prematurity and Birth
Defects.--
(1) In general.--The Director of the Centers for Disease
Control and Prevention shall conduct a study on the
relationship between prematurity, birth defects, and
developmental disabilities.
(2) Report.--Not later than 2 years after the date of
enactment of this Act, the Director of the Centers for
Disease Control and Prevention shall submit to the
appropriate committees of Congress a report concerning the
results of the study conducted under paragraph (1).
(e) Review of Pregnancy Risk Assessment Monitoring
Survey.--The Director of the Centers for Disease Control and
Prevention shall conduct a review of the Pregnancy Risk
Assessment Monitoring Survey to ensure that the Survey
includes information relative to medical care and
intervention received, in order to track pregnancy outcomes
and reduce instances of preterm birth.
(f) Study on the Health and Economic Consequences of
Preterm Birth.--
(1) In general.--The Director of the National Institutes of
Health in conjunction with the Director of the Centers for
Disease Control and Prevention shall enter into a contract
with the Institute of Medicine of the National Academy of
Sciences for the conduct of a study to define and address the
health and economic consequences of preterm birth. In
conducting the study, the Institute of Medicine shall--
(A) review and assess the epidemiology of premature birth
and low birthweight, and the associated maternal and child
health effects in the United States, with attention

[[Page H9305]]

paid to categories of gestational age, plurality, maternal
age, and racial or ethnic disparities;
(B) review and describe the spectrum of short and long-term
disability and health-related quality of life associated with
premature births and the impact on maternal health, health
care and quality of life, family employment, caregiver
issues, and other social and financial burdens;
(C) assess the direct and indirect costs associated with
premature birth, including morbidity, disability, and
mortality;
(D) identify gaps and provide recommendations for feasible
systems of monitoring and assessing associated economic and
quality of life burdens associated with prematurity;
(E) explore the implications of the burden of premature
births for national health policy;
(F) identify community outreach models that are effective
in decreasing prematurity rates in communities;
(G) consider options for addressing, as appropriate, the
allocation of public funds to biomedical and behavioral
research, the costs and benefits of preventive interventions,
public health, and access to health care; and
(H) provide recommendations on best practices and
interventions to prevent premature birth, as well as the most
promising areas of research to further prevention efforts.
(2) Report.--Not later than 1 year after the date on which
the contract is entered into under paragraph (1), the
Institute of Medicine shall submit to the Director of the
National Institutes of Health, the Director of the Centers
for Disease Control and Prevention, and the appropriate
committees of Congress a report concerning the results of the
study conducted under such paragraph.
(g) Evaluation of National Core Performance Measures.--
(1) In general.--The Administrator of the Health Resources
and Services Administration shall conduct an assessment of
the current national core performance measures and national
core outcome measures utilized under the Maternal and Child
Health Block Grant under title V of the Social Security Act
(42 U.S.C. 701 et seq.) for purposes of expanding such
measures to include some of the known risk factors of low
birthweight and prematurity, including the percentage of
infants born to pregnant women who smoked during pregnancy.
(2) Report.--Not later than 1 year after the date of
enactment of this Act, the Administrator of the Health
Resources and Services Administration shall submit to the
appropriate committees of Congress a report concerning the
results of the evaluation conducted under paragraph (1).

SEC. 4. PUBLIC AND HEALTH CARE PROVIDER EDUCATION AND SUPPORT
SERVICES.

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

``SEC. 399O. PUBLIC AND HEALTH CARE PROVIDER EDUCATION AND
SUPPORT SERVICES.

``(a) In General.--The Secretary, directly or through the
awarding of grants to public or private nonprofit entities,
shall conduct a demonstration project to improve the
provision of information on prematurity to health
professionals and other health care providers and the public.
``(b) Activities.--Activities to be carried out under the
demonstration project under subsection (a) shall include the
establishment of programs--
``(1) to provide information and education to health
professionals, other health care providers, and the public
concerning--
``(A) the signs of preterm labor, updated as new research
results become available;
``(B) the screening for and the treating of infections;
``(C) counseling on optimal weight and good nutrition,
including folic acid;
``(D) smoking cessation education and counseling; and
``(E) stress management; and
``(2) to improve the treatment and outcomes for babies born
premature, including the use of evidence-based standards of
care by health care professionals for pregnant women at risk
of preterm labor or other serious complications and for
infants born preterm and at a low birthweight.
``(c) Requirement.--Any program or activity funded under
this section shall be evidence-based.
``(d) NICU Family Support Programs.--The Secretary shall
conduct, through the awarding of grants to public and
nonprofit private entities, projects to respond to the
emotional and informational needs of families during the stay
of an infant in a neonatal intensive care unit, during the
transition of the infant to the home, and in the event of a
newborn death. Activities under such projects may include
providing books and videos to families that provide
information about the neonatal intensive care unit
experience, and providing direct services that provide
emotional support within the neonatal intensive care unit
setting.
``(e) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section, such
sums as may be necessary for each of fiscal years 2005
through 2009.''.

SEC. 5. INTERAGENCY COORDINATING COUNCIL ON PREMATURITY AND
LOW BIRTHWEIGHT.

(a) Purpose.--It is the purpose of this section to
stimulate multidisciplinary research, scientific exchange,
and collaboration among the agencies of the Department of
Health and Human Services and to assist the Department in
targeting efforts to achieve the greatest advances toward the
goal of reducing prematurity and low birthweight.
(b) Establishment.--The Secretary of Health and Human
Services shall establish an Interagency Coordinating Council
on Prematurity and Low Birthweight (referred to in this
section as the Council) to carry out the purpose of this
section.
(c) Composition.--The Council shall be composed of members
to be appointed by the Secretary, including representatives
of--
(1) the agencies of the Department of Health and Human
Services; and
(2) voluntary health care organizations, including
grassroots advocacy organizations, providers of specialty
obstetrical and pediatric care, and researcher organizations.
(d) Activities.--The Council shall--
(1) annually report to the Secretary of Health and Human
Services on current Departmental activities relating to
prematurity and low birthweight;
(2) plan and hold a conference on prematurity and low
birthweight under the sponsorship of the Surgeon General;
(3) establish a consensus research plan for the Department
of Health and Human Services on prematurity and low
birthweight;
(4) report to the Secretary of Health and Human Services
and the appropriate committees of Congress on recommendations
derived from the conference held under paragraph (2) and on
the status of Departmental research activities concerning
prematurity and low birthweight;
(5) carry out other activities determined appropriate by
the Secretary of Health and Human Services; and
(6) oversee the coordination of the implementation of this
Act.

SEC. 6. AUTHORIZATION OF APPROPRIATIONS.

There are authorized to be appropriated to carry out this
Act, such sums as may be necessary for each of fiscal years
2005 through 2009.

The SPEAKER. Is there objection to the request of the gentleman from
Texas?
There was no objection.

Amendment Offered by Mr. Barton of Texas

Mr. BARTON of Texas. Mr. Speaker, I offer an amendment.
The Clerk read as follows:

Amendment offered by Mr. Barton of Texas:
Strike out all after the enacting clause and insert the
following:

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Prematurity Research
Expansion and Education for Mothers who deliver Infants Early
Act'' or the ``PREEMIE Act''.

SEC. 2. PURPOSE.

It the purpose of this Act to--
(1) reduce rates of preterm labor and delivery;
(2) work toward an evidence-based standard of care for
pregnant women at risk of preterm labor or other serious
complications, and for infants born preterm and at a low
birthweight; and
(3) reduce infant mortality and disabilities caused by
prematurity.

SEC. 3. RESEARCH RELATING TO PRETERM LABOR AND DELIVERY AND
THE CARE, TREATMENT, AND OUTCOMES OF PRETERM
AND LOW BIRTHWEIGHT INFANTS.

(a) General Expansion of Cdc Research.--Section 301 of
the Public Health Service Act (42 U.S.C. 241 et seq.) is
amended by adding at the end the following:
``(e) The Secretary, acting through the Director of the
Centers for Disease Control and Prevention, shall expand,
intensify, and coordinate the activities of the Centers for
Disease Control and Prevention with respect to preterm labor
and delivery and infant mortality.''.
(b) Studies on Relationship Between Prematurity and Birth
Defects.--
(1) In general.--The Secretary of Health and Human
Services, acting through the Director of the Centers for
Disease Control and Prevention, shall, subject to the
availability of appropriations, conduct ongoing
epidemiological studies on the relationship between
prematurity, birth defects, and developmental disabilities.
(2) Report.--Not later than 2 years after the date of
enactment of this Act, and every 2 years thereafter, the
Secretary of Health and Human Services, acting through the
Director of the Centers for Disease Control and Prevention,
shall submit to the appropriate committees of Congress
reports concerning the progress and any results of studies
conducted under paragraph (1).
(c) Pregnancy Risk Assessment Monitoring Survey.--
(1) In general.--The Secretary of Health and Human
Services, acting through the Director of the Centers for
Disease Control and Prevention, shall establish systems for
the collection of maternal-infant clinical and biomedical
information, including electronic health records, electronic
databases, and biobanks, to link with the Pregnancy Risk
Assessment Monitoring System (PRAMS) and other
epidemiological studies of prematurity in order to track
pregnancy outcomes and prevent preterm birth.
(2) Authorization of appropriations.--There is authorized
to be appropriated to carry out paragraph (1) $3,000,000 for
each of fiscal years 2007 through 2011.
(d) Evaluation of Existing Tools and Measures.--The
Secretary of Health and Human Services shall review existing
tools

[[Page H9306]]

and measures to ensure that such tools and measures include
information related to the known risk factors of low birth
weight and preterm birth.
(e) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section, except for
subsection (c), $5,000,000 for each of fiscal years 2007
through 2011.

SEC. 4. PUBLIC AND HEALTH CARE PROVIDER EDUCATION AND SUPPORT
SERVICES.

Part P of title III of the Public Health Service Act (42
U.S.C. 280g et seq.) is amended--
(1) by redesignating the second section 399O (relating to
grants to foster public health responses to domestic
violence, dating violence, sexual assault, and stalking) as
section 399P; and
(2) by adding at the end the following:

``SEC. 399Q. PUBLIC AND HEALTH CARE PROVIDER EDUCATION AND
SUPPORT SERVICES.

``(a) In General.--The Secretary, directly or through the
awarding of grants to public or private nonprofit entities,
may conduct demonstration projects for the purpose of
improving the provision of information on prematurity to
health professionals and other health care providers and the
public and improving the treatment and outcomes for babies
born preterm.
``(b) Activities.--Activities to be carried out under the
demonstration project under subsection (a) may include the
establishment of--
``(1) programs to test and evaluate various strategies to
provide information and education to health professionals,
other health care providers, and the public concerning--
``(A) the signs of preterm labor, updated as new research
results become available;
``(B) the screening for and the treating of infections;
``(C) counseling on optimal weight and good nutrition,
including folic acid;
``(D) smoking cessation education and counseling;
``(E) stress management; and
``(F) appropriate prenatal care;
``(2) programs to improve the treatment and outcomes for
babies born premature, including the use of evidence-based
standards of care by health care professionals for pregnant
women at risk of preterm labor or other serious complications
and for infants born preterm and at a low birthweight;
``(3) programs to respond to the informational needs of
families during the stay of an infant in a neonatal intensive
care unit, during the transition of the infant to the home,
and in the event of a newborn death; and
``(4) such other programs as the Secretary determines
appropriate to achieve the purpose specified in subsection
(a).
``(c) Authorization of Appropriations.--There is
authorized to be appropriated to carry out this section
$5,000,000 for each of fiscal years 2007 through 2011.''.

SEC. 5. INTERAGENCY COORDINATING COUNCIL ON PREMATURITY AND
LOW BIRTHWEIGHT.

SEC. 6. SURGEON GENERAL'S CONFERENCE ON PRETERM BIRTH.

(a) Convening of Conference.--Not later than 1 year after
the date of enactment of this Act, the Secretary of Health
and Human Services, acting through the Surgeon General of the
Public Health Service, shall convene a conference on preterm
birth.
(b) Purpose of Conference.--The purpose of the conference
convened under subsection (a) shall be to--
(1) increase awareness of preterm birth as a serious,
common, and costly public health problem in the United
States;
(2) review the findings and reports issued by the
Interagency Coordinating Council, key stakeholders, and any
other relevant entities; and
(3) establish an agenda for activities in both the public
and private sectors that will speed the identification of,
and treatments for, the causes of and risk factors for
preterm labor and delivery.
(c) Report.--The Secretary of Health and Human Services
shall submit to the Congress and make available to the public
a report on the agenda established under subsection (b)(3),
including recommendations for activities in the public and
private sectors that will speed the identification of, and
treatments for, the causes of and risk factors for preterm
labor and delivery.
(d) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section (other than
subsection (c)) $125,000.

SEC. 7. EFFECTIVE DATE OF CERTAIN HEAD START REGULATIONS.

Section 1310.12(a) of title 45 of the Code of Federal
Regulations (October 1, 2004) shall not be effective until
June 30, 2007, or 60 days after the date of the enactment of
a statute that authorizes appropriations for fiscal year 2007
to carry out the Head Start Act, whichever date is earlier.

Mr. BARTON of Texas (during the reading). Mr. Speaker, I ask
unanimous consent that the amendment be considered as read and printed
in the Record.
The SPEAKER. Is there objection to the request of the gentleman from
Texas?
Mr. PALLONE. Reserving the right to object, I would just like to ask
the chairman if the bill as amended now is the version that we have
dated December 8 at 11:35 p.m.?
Mr. BARTON of Texas. That is exactly the bill that is at the desk. I
have a copy here and I have read it and I can assure the Members that
it is okay on both sides of the aisle.
Mr. PALLONE. Thank you, Mr. Chairman. We have no objection.
The SPEAKER pro tempore. Without objection, the amendment is agreed
to.
There was no objection.
The bill was ordered to be read a third time, was read the third
time, and passed, and a motion to reconsider was laid on the table.

____________________