[Congressional Record Volume 164, Number 152 (Wednesday, September 12, 2018)]
[Senate]
[Pages S6153-S6155]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  PREEMIE REAUTHORIZATION ACT OF 2018

  Mr. FLAKE. Mr. President, I ask unanimous consent that the Senate 
proceed to the immediate consideration of Calendar No. 503, S. 3029.
  The PRESIDING OFFICER. The clerk will report the bill by title.
  The senior assistant legislative clerk read as follows:

       A bill (S. 3029) to revise and extend the Prematurity 
     Research Expansion and Education for Mothers who deliver 
     Infants Early Act (PREEMIE Act).

  There being no objection, the Senate proceeded to consider the bill, 
which had been reported from the Committee on Health, Education, Labor, 
and Pensions, with an amendment to strike all after the enacting clause 
and insert in lieu thereof the following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Prematurity Research 
     Expansion and Education for Mothers who deliver Infants Early 
     Reauthorization Act of 2018'' or the ``PREEMIE 
     Reauthorization Act of 2018''.

     SEC. 2. RESEARCH RELATING TO PRETERM LABOR AND DELIVERY AND 
                   THE CARE, TREATMENT, AND OUTCOMES OF PRETERM 
                   AND LOW BIRTHWEIGHT INFANTS.

       Section 2 of the Prematurity Research Expansion and 
     Education for Mothers who deliver Infants Early Act (42 
     U.S.C. 247b-4f) is amended--
       (1) in subsection (b)--
       (A) in paragraph (1)(A), by striking ``clinical, 
     biological, social, environmental, genetic, and behavioral 
     factors relating'' and inserting ``factors relating to 
     prematurity, such as clinical, biological, social, 
     environmental, genetic, and behavioral factors, and other 
     determinants that contribute to health disparities and are 
     related''; and
       (B) in paragraph (2), by striking `` concerning the 
     progress and any results of studies conducted under paragraph 
     (1)'' and inserting ``regarding activities and studies 
     conducted under paragraph (1), including any applicable 
     analyses of preterm birth. Such report shall be posted on the 
     Internet website of the Department of Health and Human 
     Services.'';
       (2) by striking subsection (c) and inserting the following:
       ``(c) Pregnancy Risk Assessment Monitoring Survey.--The 
     Secretary of Health and Human Services, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     shall--
       ``(1) continue 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, to the extent practicable, 
     all pregnancy outcomes and prevent preterm birth; and
       ``(2) provide technical assistance, as appropriate, to 
     support States in improving the collection of information 
     pursuant to this subsection.''; and
       (3) in subsection (e), by striking ``except for subsection 
     (c), $1,880,000 for each of fiscal years 2014 through 2018'' 
     and inserting ``$2,000,000 for each of fiscal years 2019 
     through 2023''.

     SEC. 3. PUBLIC AND HEALTH CARE PROVIDER EDUCATION AND SUPPORT 
                   SERVICES.

       Section 399Q of the Public Health Service Act (42 U.S.C. 
     280g-5) is amended--
       (1) in subsection (a)--
       (A) by striking ``conduct demonstration projects'' and 
     inserting ``conduct activities, which may include 
     demonstration projects''; and
       (B) by striking ``for babies born preterm'' and inserting 
     ``mothers of infants born preterm, and infants born preterm, 
     as appropriate''; and
       (2) in subsection (b)--
       (A) in the matter preceding paragraph (1), by striking 
     ``under the demonstration project'';
       (B) in paragraph (1)--
       (i) in the matter preceding subparagraph (A), by striking 
     ``programs to test and evaluate various strategies to 
     provide'' and inserting ``programs, including those to test 
     and evaluate strategies, which, in collaboration with States, 
     localities, tribes, and community organizations, support the 
     provision of'';
       (ii) by redesignating subparagraphs (B) through (F) as 
     subparagraphs (C) through (G), respectively;
       (iii) by inserting after subparagraph (A), the following:
       ``(B) evidence-based strategies to prevent preterm birth 
     and associated outcomes;'';
       (iv) in subparagraph (C), as so redesignated, by inserting 
     ``, and the risks of non-medically indicated deliveries 
     before full term'' before the semicolon;
       (v) in subparagraph (D), as so redesignated--

       (I) in clause (ii), by inserting ``intake'' before the 
     semicolon;
       (II) in clause (iii), by striking ``and'' at the end;
       (III) by redesignating clause (iv) as clause (vii); and
       (IV) by inserting after clause (iii), the following:

       ``(iv) screening for and treatment of substance use 
     disorders;
       ``(v) screening for and treatment of maternal depression;
       ``(vi) maternal immunization; and'';
       (vi) in subparagraph (E), as so redesignated, by adding 
     ``and'' after the semicolon;
       (vii) in subparagraph (F), as so redesignated, by striking 
     ``; and'' and inserting a period; and
       (viii) by striking subparagraph (G), as so redesignated; 
     and
       (C) in paragraph (2), by inserting ``, as well as 
     prevention of a future preterm birth'' before the semicolon.

     SEC. 4. ADVISORY COMMITTEE ON MATERNAL AND INFANT HEALTH.

       Section 104(b) of the PREEMIE Reauthorization Act (42 
     U.S.C. 247b-4f note) is amended--
       (1) in paragraph (2)--
       (A) in the matter preceding subparagraph (A), by striking 
     ``and recommendations to the Secretary concerning the 
     following activities'' and inserting ``, recommendations, or 
     information to the Secretary as may be necessary to improve 
     activities and programs to reduce severe maternal morbidity, 
     maternal mortality, infant mortality, and preterm birth, 
     which may include recommendations, advice, or information 
     related to the following'';
       (B) in subparagraph (A), by striking ``and improving the 
     health status of pregnant women and infants'' and inserting 
     ``, preterm birth, and improving the health status of 
     pregnant women and infants, and information on cost-
     effectiveness and outcomes of such programs'';
       (C) in subparagraph (C), by striking ``Implementation of 
     the'' and inserting ``The''; and
       (D) by striking subparagraph (D) and inserting the 
     following:
       ``(D) Implementation of Healthy People objectives related 
     to maternal and infant health.
       ``(E) Strategies to reduce racial, ethnic, geographic, and 
     other health disparities in birth

[[Page S6154]]

     outcomes, including by increasing awareness of Federal 
     programs related to appropriate access to, or information 
     regarding, prenatal care to address risk factors for preterm 
     labor and delivery.
       ``(F) Strategies, including the implementation of such 
     strategies, to address gaps in Federal research, programs, 
     and education efforts related to the prevention of severe 
     maternal morbidity, maternal mortality, infant mortality, and 
     other adverse birth outcomes.'';
       (2) by striking paragraph (3) and redesignating paragraph 
     (4) as paragraph (3); and
       (3) by adding at the end the following:
       ``(4) Biennial report.--Not later than 1 year after the 
     date of enactment of the PREEMIE Reauthorization Act of 2018, 
     and every 2 years thereafter, the Advisory Committee shall--
       ``(A) publish a report summarizing activities and 
     recommendations of the Advisory Committee since the 
     publication of the previous report;
       ``(B) submit such report to the Secretary and the 
     appropriate Committees of Congress; and
       ``(C) post such report on the Internet website of the 
     Department of Health and Human Services.''.

     SEC. 5. INTERAGENCY WORKING GROUP.

       (a) In General.--The Secretary of Health and Human 
     Services, in collaboration with other departments, as 
     appropriate, may establish an interagency working group in 
     order to improve coordination of programs and activities to 
     prevent preterm birth, infant mortality, and related adverse 
     birth outcomes.
       (b) Duties.--The working group established under subsection 
     (a) shall--
       (1) identify gaps, unnecessary duplication, and 
     opportunities for improved coordination in Federal programs 
     and activities related to preterm birth and infant mortality;
       (2) assess the extent to which the goals and metrics of 
     relevant programs and activities within the Department of 
     Health and Human Services, and, as applicable, those in other 
     departments, are aligned; and
       (3) assess the extent to which such programs are 
     coordinated across agencies within such Department; and
       (4) make specific recommendations, as applicable, to reduce 
     or minimize gaps and unnecessary duplication, and improve 
     coordination of goals, programs, and activities across 
     agencies within such Department.
       (c) Report.--Not later than 1 year after the date on which 
     the working group is established under subsection (a), the 
     Secretary of Health and Human Services shall submit to the 
     Committee on Health, Education, Labor, and Pensions of the 
     Senate and the Committee on Energy and Commerce of the House 
     of Representatives a report summarizing the findings of the 
     working group under subsection (b) and the specific 
     recommendations to improve Federal programs at the Department 
     of Health and Human Services under subsection (b)(4).
  Mr. FLAKE. I ask unanimous consent that the Alexander amendment at 
the desk be agreed to; that the committee-reported substitute amendment 
be agreed to; that the bill, as amended, be considered read a third 
time and passed; and that the motion to reconsider be considered made 
and laid upon the table.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment (No. 4016) was agreed to as follows:

  (Purpose: To modify provisions relating to the interagency working 
                                 group)

       On page 16, line 22, insert ``, in collaboration with other 
     departments, as appropriate,'' after ``Services''.
       Beginning on page 16, line 24, strike ``within'' and all 
     that follows through ``Services'' on page 17, line 1.
       On page 17, line 11, insert ``, and, as applicable, those 
     in other departments,'' after ``Services''.

  The committee-reported amendment in the nature of a substitute was 
agreed to.
  The bill (S. 3029), as amended, was ordered to be engrossed for a 
third reading, was read the third time, and passed as follows:

                                S. 3029

       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 
     Reauthorization Act of 2018'' or the ``PREEMIE 
     Reauthorization Act of 2018''.

     SEC. 2. RESEARCH RELATING TO PRETERM LABOR AND DELIVERY AND 
                   THE CARE, TREATMENT, AND OUTCOMES OF PRETERM 
                   AND LOW BIRTHWEIGHT INFANTS.

       Section 2 of the Prematurity Research Expansion and 
     Education for Mothers who deliver Infants Early Act (42 
     U.S.C. 247b-4f) is amended--
       (1) in subsection (b)--
       (A) in paragraph (1)(A), by striking ``clinical, 
     biological, social, environmental, genetic, and behavioral 
     factors relating'' and inserting ``factors relating to 
     prematurity, such as clinical, biological, social, 
     environmental, genetic, and behavioral factors, and other 
     determinants that contribute to health disparities and are 
     related''; and
       (B) in paragraph (2), by striking `` concerning the 
     progress and any results of studies conducted under paragraph 
     (1)'' and inserting ``regarding activities and studies 
     conducted under paragraph (1), including any applicable 
     analyses of preterm birth. Such report shall be posted on the 
     Internet website of the Department of Health and Human 
     Services.'';
       (2) by striking subsection (c) and inserting the following:
       ``(c) Pregnancy Risk Assessment Monitoring Survey.--The 
     Secretary of Health and Human Services, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     shall--
       ``(1) continue 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, to the extent practicable, 
     all pregnancy outcomes and prevent preterm birth; and
       ``(2) provide technical assistance, as appropriate, to 
     support States in improving the collection of information 
     pursuant to this subsection.''; and
       (3) in subsection (e), by striking ``except for subsection 
     (c), $1,880,000 for each of fiscal years 2014 through 2018'' 
     and inserting ``$2,000,000 for each of fiscal years 2019 
     through 2023''.

     SEC. 3. PUBLIC AND HEALTH CARE PROVIDER EDUCATION AND SUPPORT 
                   SERVICES.

       Section 399Q of the Public Health Service Act (42 U.S.C. 
     280g-5) is amended--
       (1) in subsection (a)--
       (A) by striking ``conduct demonstration projects'' and 
     inserting ``conduct activities, which may include 
     demonstration projects''; and
       (B) by striking ``for babies born preterm'' and inserting 
     ``mothers of infants born preterm, and infants born preterm, 
     as appropriate''; and
       (2) in subsection (b)--
       (A) in the matter preceding paragraph (1), by striking 
     ``under the demonstration project'';
       (B) in paragraph (1)--
       (i) in the matter preceding subparagraph (A), by striking 
     ``programs to test and evaluate various strategies to 
     provide'' and inserting ``programs, including those to test 
     and evaluate strategies, which, in collaboration with States, 
     localities, tribes, and community organizations, support the 
     provision of'';
       (ii) by redesignating subparagraphs (B) through (F) as 
     subparagraphs (C) through (G), respectively;
       (iii) by inserting after subparagraph (A), the following:
       ``(B) evidence-based strategies to prevent preterm birth 
     and associated outcomes;'';
       (iv) in subparagraph (C), as so redesignated, by inserting 
     ``, and the risks of non-medically indicated deliveries 
     before full term'' before the semicolon;
       (v) in subparagraph (D), as so redesignated--

       (I) in clause (ii), by inserting ``intake'' before the 
     semicolon;
       (II) in clause (iii), by striking ``and'' at the end;
       (III) by redesignating clause (iv) as clause (vii); and
       (IV) by inserting after clause (iii), the following:

       ``(iv) screening for and treatment of substance use 
     disorders;
       ``(v) screening for and treatment of maternal depression;
       ``(vi) maternal immunization; and'';
       (vi) in subparagraph (E), as so redesignated, by adding 
     ``and'' after the semicolon;
       (vii) in subparagraph (F), as so redesignated, by striking 
     ``; and'' and inserting a period; and
       (viii) by striking subparagraph (G), as so redesignated; 
     and
       (C) in paragraph (2), by inserting ``, as well as 
     prevention of a future preterm birth'' before the semicolon.

     SEC. 4. ADVISORY COMMITTEE ON MATERNAL AND INFANT HEALTH.

       Section 104(b) of the PREEMIE Reauthorization Act (42 
     U.S.C. 247b-4f note) is amended--
       (1) in paragraph (2)--
       (A) in the matter preceding subparagraph (A), by striking 
     ``and recommendations to the Secretary concerning the 
     following activities'' and inserting ``, recommendations, or 
     information to the Secretary as may be necessary to improve 
     activities and programs to reduce severe maternal morbidity, 
     maternal mortality, infant mortality, and preterm birth, 
     which may include recommendations, advice, or information 
     related to the following'';
       (B) in subparagraph (A), by striking ``and improving the 
     health status of pregnant women and infants'' and inserting 
     ``, preterm birth, and improving the health status of 
     pregnant women and infants, and information on cost-
     effectiveness and outcomes of such programs'';
       (C) in subparagraph (C), by striking ``Implementation of 
     the'' and inserting ``The''; and
       (D) by striking subparagraph (D) and inserting the 
     following:
       ``(D) Implementation of Healthy People objectives related 
     to maternal and infant health.
       ``(E) Strategies to reduce racial, ethnic, geographic, and 
     other health disparities in birth outcomes, including by 
     increasing awareness of Federal programs related to 
     appropriate access to, or information regarding, prenatal 
     care to address risk factors for preterm labor and delivery.

[[Page S6155]]

       ``(F) Strategies, including the implementation of such 
     strategies, to address gaps in Federal research, programs, 
     and education efforts related to the prevention of severe 
     maternal morbidity, maternal mortality, infant mortality, and 
     other adverse birth outcomes.'';
       (2) by striking paragraph (3) and redesignating paragraph 
     (4) as paragraph (3); and
       (3) by adding at the end the following:
       ``(4) Biennial report.--Not later than 1 year after the 
     date of enactment of the PREEMIE Reauthorization Act of 2018, 
     and every 2 years thereafter, the Advisory Committee shall--
       ``(A) publish a report summarizing activities and 
     recommendations of the Advisory Committee since the 
     publication of the previous report;
       ``(B) submit such report to the Secretary and the 
     appropriate Committees of Congress; and
       ``(C) post such report on the Internet website of the 
     Department of Health and Human Services.''.

     SEC. 5. INTERAGENCY WORKING GROUP.

       (a) In General.--The Secretary of Health and Human 
     Services, in collaboration with other departments, as 
     appropriate, may establish an interagency working group in 
     order to improve coordination of programs and activities to 
     prevent preterm birth, infant mortality, and related adverse 
     birth outcomes.
       (b) Duties.--The working group established under subsection 
     (a) shall--
       (1) identify gaps, unnecessary duplication, and 
     opportunities for improved coordination in Federal programs 
     and activities related to preterm birth and infant mortality;
       (2) assess the extent to which the goals and metrics of 
     relevant programs and activities within the Department of 
     Health and Human Services, and, as applicable, those in other 
     departments, are aligned; and
       (3) assess the extent to which such programs are 
     coordinated across agencies within such Department; and
       (4) make specific recommendations, as applicable, to reduce 
     or minimize gaps and unnecessary duplication, and improve 
     coordination of goals, programs, and activities across 
     agencies within such Department.
       (c) Report.--Not later than 1 year after the date on which 
     the working group is established under subsection (a), the 
     Secretary of Health and Human Services shall submit to the 
     Committee on Health, Education, Labor, and Pensions of the 
     Senate and the Committee on Energy and Commerce of the House 
     of Representatives a report summarizing the findings of the 
     working group under subsection (b) and the specific 
     recommendations to improve Federal programs at the Department 
     of Health and Human Services under subsection (b)(4).

                          ____________________