[Congressional Record (Bound Edition), Volume 152 (2006), Part 18]
[House]
[Pages 23433-23436]
[From the U.S. 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 23434]]

      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.
  Ms. ESHOO. Mr. Speaker, as the Democratic sponsor of this bill, I am 
proud to rise today in strong support of this legislation.
  Since 1981, the CDC estimates that the number of infants born too 
soon has increased by over 30 percent. More than 500,000 infants are 
born prematurely each year. Tragically, premature infants are 14 times 
more likely to die in their first year of life and premature babies who 
survive may suffer lifelong consequences including cerebral palsy, 
mental retardation, chronic lung disease, and vision and hearing loss. 
Preterm delivery can happen to any pregnant woman and in nearly half of 
the cases, no one knows why.
  This legislation will help identify the causes of prematurity and 
reduce the episodes of preterm labor and delivery. It also aims to 
reduce the risk of pregnancy-related deaths and complications due to 
pregnancy, and reduce infant mortality caused by prematurity. But the 
overarching goal of this legislation is to bring hope to the 1,305 
babies born too soon each day, and extend hope to their families. This 
legislation gives us a chance to make a difference.
  The PREEMIE Act requires HHS and the CDC to expand and coordinate 
their research activities on preterm labor and delivery and infant 
mortality, and to conduct research on the relationship between 
prematurity, birth defects, and developmental disabilities. In order to 
increase awareness of preterm birth as a serious, common and costly 
public health problem, the bill also requires the Surgeon General to 
conduct an expert conference on prematurity and report to Congress its 
recommendations for how the public and private sectors can identify the 
causes of and risk factors for preterm labor and delivery, and improve 
treatments.
  This bill has the strong endorsement of the March of Dimes, which has 
worked closely with us to craft this legislation. I salute and thank 
them for their advocacy.
  This legislation has broad bipartisan support in the House of 
Representatives and the Senate. I thank the bill's many cosponsors for 
their support and I especially want to pay tribute to the sponsor of 
this legislation, Congressman Fred Upton, for his leadership on this 
issue. We introduced this bill together in previous Congresses and I'm 
proud to have worked with him to make this bill a reality.
  I also want to thank the bill's champions in the Senate, Senators 
Lamar Alexander and Chris Dodd. It has been a rewarding experience for 
me to work in a bipartisan, bicameral fashion to enact this 
legislation, and I think our collective efforts have made this bill 
stronger because of it.

[[Page 23435]]

  I want to thank Chairman Barton for acknowledging the importance of 
acting on this legislation before the end of the year and bringing it 
to the floor today. I also want to thank the staff members who have put 
so much time and energy into this legislation: Page Kranbuhl with 
Senator Alexander, Tamar Magarik with Senator Dodd, Jane Williams with 
Representative Upton, Randy Pate with Chairman Barton, and Jennifer 
Nieto of my staff.
  Mr. Speaker, this is an important bill which will help make a 
difference in the lives of families across America and around the world 
and I urge my colleagues to support it.


                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 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.

         (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 the agencies of the Department of Health 
     and Human Services.
         (d) Activities.--The Council shall--
         (1) annually report to the Secretary of Health and Human 
     Services and Congress on current Departmental activities 
     relating to prematurity and low birthweight;
         (2) carry out other activities determined appropriate by 
     the Secretary of Health and Human Services; and
         (3) oversee the coordination of the implementation of 
     this Act.

     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?

[[Page 23436]]


  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.

                          ____________________