[Congressional Record (Bound Edition), Volume 156 (2010), Part 11]
[House]
[Pages 16212-16214]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              {time}  1640
   NATIONALLY ENHANCING THE WELLBEING OF BABIES THROUGH OUTREACH AND 
                            RESEARCH NOW ACT

  Mr. PALLONE. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 3470) to authorize funding for the creation and 
implementation of infant mortality pilot programs in standard 
metropolitan statistical areas with high rates of infant mortality, and 
for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 3470

       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 ``Nationally Enhancing the 
     Wellbeing of Babies through Outreach and Research Now Act'' 
     or the ``NEWBORN Act''.

     SEC. 2. INFANT MORTALITY PILOT PROGRAMS.

       Section 330H of the Public Health Service Act (42 U.S.C. 
     254c-8) is amended--
       (1) by redesignating subsection (e) as subsection (f);
       (2) by inserting after subsection (d) the following:
       ``(e) Infant Mortality Pilot Programs.--
       ``(1) In general.--The Secretary, acting through the 
     Administrator, shall award grants to eligible entities to 
     create, implement, and oversee infant mortality pilot 
     programs.
       ``(2) Period of a grant.--The period of a grant under this 
     subsection shall be 5 consecutive fiscal years.
       ``(3) Preference.--In awarding grants under this 
     subsection, the Secretary shall give preference to eligible 
     entities proposing to serve any of the 15 counties or groups 
     of counties with the highest rates of infant mortality in the 
     United States in the past 3 years.
       ``(4) Use of funds.--Any infant mortality pilot program 
     funded under this subsection may--
       ``(A) include the development of a plan that identifies the 
     individual needs of each community to be served and 
     strategies to address those needs;
       ``(B) provide outreach to at-risk mothers through programs 
     deemed appropriate by the Administrator;
       ``(C) develop and implement standardized systems for 
     improved access, utilization, and quality of social, 
     educational, and clinical services to promote healthy 
     pregnancies, full-term births, and healthy infancies 
     delivered to women and their infants, such as--

[[Page 16213]]

       ``(i) counseling on infant care, feeding, and parenting;
       ``(ii) postpartum care;
       ``(iii) prevention of premature delivery; and
       ``(iv) additional counseling for at-risk mothers, including 
     smoking cessation programs, drug treatment programs, alcohol 
     treatment programs, nutrition and physical activity programs, 
     postpartum depression and domestic violence programs, social 
     and psychological services, dental care, and parenting 
     programs;
       ``(D) establish a rural outreach program to provide care to 
     at-risk mothers in rural areas;
       ``(E) establish a regional public education campaign, 
     including a campaign to--
       ``(i) prevent preterm births; and
       ``(ii) educate the public about infant mortality; and
       ``(F) provide for any other activities, programs, or 
     strategies as identified by the community plan.
       ``(5) Limitation.--Of the funds received through a grant 
     under this subsection for a fiscal year, an eligible entity 
     shall not use more than 10 percent for program evaluation.
       ``(6) Reports on pilot programs.--
       ``(A) In general.--Not later than 1 year after receiving a 
     grant, and annually thereafter for the duration of the grant 
     period, each entity that receives a grant under paragraph (1) 
     shall submit a report to the Secretary detailing its infant 
     mortality pilot program.
       ``(B) Contents of report.--The reports required under 
     subparagraph (A) shall include information such as the 
     methodology of, and outcomes and statistics from, the 
     grantee's infant mortality pilot program.
       ``(C) Evaluation.--The Secretary shall use the reports 
     required under subparagraph (A) to evaluate, and conduct 
     statistical research on, infant mortality pilot programs 
     funded through this subsection.
       ``(7) Definitions.--For the purposes of this subsection:
       ``(A) Administrator.--The term `Administrator' means the 
     Administrator of the Health Resources and Services 
     Administration.
       ``(B) Eligible entity.--The term `eligible entity' means a 
     State, county, city, territorial, or tribal health department 
     that has submitted a proposal to the Secretary that the 
     Secretary deems likely to reduce infant mortality rates 
     within the standard metropolitan statistical area involved.
       ``(C) Tribal.--The term `tribal' refers to an Indian tribe, 
     a Tribal organization, or an Urban Indian organization, as 
     such terms are defined in section 4 of the Indian Health Care 
     Improvement Act.''; and
       (3) by amending subsection (f), as so redesignated--
       (A) in paragraph (1)--
       (i) by amending the paragraph heading to read: ``Healthy 
     Start Initiative''; and
       (ii) by inserting after ``carrying out this section'' the 
     following: ``(other than subsection (e))'';
       (B) by redesignating paragraph (2) as paragraph (3);
       (C) by inserting after paragraph (1) the following:
       ``(2) Infant mortality pilot programs.--To carry out 
     subsection (e), there is authorized to be appropriated 
     $10,000,000 for each of fiscal years 2011 through 2015.''; 
     and
       (D) in paragraph (3)(A), as so redesignated, by striking 
     ``the program under this section'' and inserting ``the 
     program under subsection (a)''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
Jersey (Mr. Pallone) and the gentleman from Kentucky (Mr. Whitfield) 
each will control 20 minutes.
  The Chair recognizes the gentleman from New Jersey.


                             General Leave

  Mr. PALLONE. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous material in the Record.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, this bill authorizes a pilot program to address a 
serious public health problem, and that is infant mortality. According 
to the Centers for Disease Control and Prevention, the U.S. infant 
mortality rate is about 50 percent higher than the national goal of 4.5 
infant deaths for 1,000 births. As of 2005, the United States ranked 
30th in the world in infant mortality. The pilot program authorized in 
this legislation would give grants to eligible entities to fight infant 
mortality in the most impacted areas.
  I want to thank Representative Cohen, the sponsor of the NEWBORN Act, 
as it is called, for his deep commitment to and tireless leadership on 
this very important issue. I would also like to thank Ranking Member 
Barton and Ranking Member Shimkus and their staffs for working in a 
bipartisan manner to help get this legislation to the House floor.
  I reserve the balance of my time.
  Mr. WHITFIELD. Mr. Speaker, I yield myself such time as I may 
consume.
  There has been a lot of debate in the United States about infant 
mortality. And when we hear that the U.S. ranks 30th in the world, it 
certainly bothers all of us.
  I do think it is important that we also recognize, just for 
informational purposes, that not every country in the world uses the 
same method to determine infant mortality. For example, in the United 
States, all live births at any birthweight or gestational age must be 
reported. In France, for example, only live births of at least 22 weeks 
of gestation or weighing at least 500 grams must be reported. So some 
of these countries use different reporting facts to determine their 
mortality rates.
  There is no question that certain communities in the United States 
have infant mortality rates that are persistently high. And this 
legislation authorizes HHS to award grants for pilot projects to reduce 
infant mortality in the communities with the highest infant mortality 
rates and would require these projects be evaluated to ensure we are on 
the right track to reducing infant mortality rates in those areas and 
in the United States.
  I want to thank Congressman Cohen for his leadership on this issue as 
well as Congressmen Pallone and Shimkus.
  I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield such time as he may consume to the 
sponsor of the bill, Representative Cohen of Tennessee.
  Mr. COHEN. I want to thank Mr. Pallone for the time, and I want to 
thank Mr. Pallone, Mr. Andrews, and Chairman Waxman for their help in 
getting this particular proposal to the floor; and the minority side as 
well, Mr. Whitfield, my friend, Mr. Shimkus, and everyone who has 
worked on this.
  Mr. Speaker, this is a particularly important bill to me, and it's an 
important bill to my district. September is Infant Mortality Awareness 
Month, and it's appropriate that this month this bill will be brought 
up for consideration, the NEWBORN Act. ``NEWBORN'' is an acronym. 
Everything in Washington seems to be an acronym, and this acronym, 
``NEWBORN,'' stands for ``Nationally Enhancing the Wellbeing of Babies 
through Outreach and Research Now.''
  It is so important that we give children an opportunity to live and 
mothers and fathers an opportunity to see their children born and have 
a chance. My parents lost a child at about 4 months of age in 1946. 
They never got over it. There are so many people who have lost 
children, and it is something that stays with you forever.
  In my particular city of Memphis--while we talked about the United 
States' rate, we know it is too high no matter what it is and how you 
keep statistics--the city of Memphis has one of the highest infant 
mortality rates in the Nation. It is said to be second by the CDC among 
the 60 largest urban areas in the year 2002. In one particular ZIP code 
in my district, 38108, in the year 2007--it's in north Memphis, a 
predominately low-income African American neighborhood. I say 
predominately; it's an entirely low-income African American 
neighborhood--had an infant mortality rate of 31 deaths per 1,000 live 
births. That is almost five times the Nation's 2007 rate of seven 
deaths per 1,000 live births. And that ranks 38108 as worse than the 
developing nations of Iran, Indonesia, Nicaragua, El Salvador, Syria, 
and Vietnam in infant mortality for that year.
  It's an issue that can strike people of any race, but it is divided 
largely along racial lines, and there's a great racial disparity. The 
Office of Minority Health at the CDC has found that African Americans 
have 2.4 times the infant mortality rate than whites, that African 
Americans are four times as likely to die as infants due to 
complications related to low birthweight when compared to white 
infants. The CDC study found that African American mothers were 2.5 
times more likely than white mothers to begin prenatal care in their 
third trimester or not receive prenatal care at all. That's

[[Page 16214]]

where a lot of research and outreach can be done, particularly the 
outreach. That is why the NEWBORN bill is so needed, and that is why 
our office decided to make this our top priority.
  My chief of staff, Marilyn Dilihay; my district director, Randy Wade; 
and our whole team met in Memphis. Brittany Johnson, who is my 
legislative director in the area of health care, and my legislative 
director, Reisha Phills, the whole office worked on the issue and we 
brought it as a bill. But we also had it included in the health care 
bill that passed this House. And it was featured in the Speaker's 
bullet points about what it could possibly do for infant mortality. 
This would be the largest outreach program the Federal Government has 
ever engaged in. It's an authorization to find answers for the problem 
of infant mortality.
  Of course, because of the situation of the politics in the Senate and 
because we had to go to reconciliation, there wasn't a conference 
committee, and this part of the health care bill wasn't included 
because the Senate didn't have it, and reconciliation didn't allow 
consideration of proposals like this that didn't add to or decrease 
from the budget. This was an authorization. So it didn't make it 
through the final phase because of what happened in Massachusetts, and 
that hurt us in what could be an important step forward for mothers and 
children.
  We hope that the bill will pass here today and that the Senate will 
pick it up. We hope Senator Mikulski or Senator Dodd or somebody will 
help us with it, or Senator Harkin, and see that it gets through the 
Senate and the authorization is approved.
  It will authorize the Secretary of the Department of Health and Human 
Services to award 5-year-long grants to 15 municipalities or States to 
create infant mortality pilot programs. The legislation sets forth 
guidelines on what practices the pilot programs may employ in their 
quest to lower the infant mortality rate of the area they serve, and 
those include outreach to at-risk mothers, increased access to 
educational clinic services for pregnant women or potential mothers and 
families.
  The language suggests each program provide infant care counseling, 
postpartum care, additional care for at-risk mothers, a rural outreach 
program, and a public education program.
  All of these can save money in the long run in health care because 
some of the most expensive treatment rendered is for premature babies, 
and care in these particular ages of life can be very expensive. And if 
we can have better prenatal care and less problems, not only is it the 
right thing to do in every way possible, but it also saves money.
  It is my hope that those entities who apply for this funding will do 
so in conjunction with existing local, private, and not-for-profit 
groups that have already involved themselves in the fight against 
infant mortality. And there are several in Memphis that have done that. 
Our Governor, Phil Bredesen, and our city mayor and county mayor, A C 
Wharton, have headed up programs in our community, and our county 
mayor, Mark Luttrell, is continuing them.
  The cultivation of partnerships between local leaders is essential in 
order to ensure the problem is addressed in as efficient a manner as 
possible.
  I introduced the NEWBORN Act because of the number of devastating 
instances of infant mortality in Memphis, but I hope its passage and 
eventual enactment will help the incalculable number of people across 
the country who are possibly at risk to lose a child or grandchild in 
the years to come.
  Again, I thank Mr. Pallone and the other Members, particularly Mr. 
Waxman, for their help in getting this bill to the floor, and I hope 
that we will have the help in the Senate that the mothers, children, 
and grandchildren in this Nation deserve.

                              {time}  1650

  Mr. WHITFIELD. Mr. Speaker, I urge all Members to support this 
legislation, and I thank the gentleman from Tennessee (Mr. Cohen) and 
others who worked hard on this legislation.
  I yield back the balance of my time.
  Mr. DAVIS of Illinois. Mr. Speaker, I wish to take a moment to state 
my strong support for H.R. 3470, the Nationally Enhancing the Wellbeing 
of Babies through Outreach and Research Now--or the NEWBORN Act. This 
bill authorizes grants to create, implement, and oversee infant 
mortality pilot programs. These grants could support a number of 
important activities to reduce our national infant mortality rate, 
including: educational outreach to at-risk mothers; development and 
implementation of standardized systems for improved access and 
services; and regional public education campaigns.
  In order to fully understand the importance of this act, I believe 
our country needs to take a moment to reflect upon our infant mortality 
rate of 6.7 per thousand live births. The United States currently has 
one of the highest infant mortality rates among industrialized 
nations--higher than Cuba or Japan. Although the infant mortality rate 
has declined over time, this rate is unacceptably high and tragic 
because many of these infant deaths are preventable when mothers 
receive adequate care and education. Access to quality prenatal 
healthcare and parenting education greatly reduces many of the risk 
factors that contribute to infant mortality, such as low birth weight 
and short gestational age births.
  It is of serious concern that great disparity exists in infant 
mortality rates across our country based on geographic location and 
racial/ethnic minority status. According to the Centers for Disease 
Control and Prevention, the infant mortality rate is much higher in the 
Southeastern and Midwestern regions of our Nation. In my home State of 
Illinois in 2006 is 7.29 per thousand live births, well above the 
national average. For African Americans, the infant mortality rate is 
13.35, almost double the national average and almost triple the 
national average for Latino and White children. We cannot allow these 
disparities to continue. We cannot continue to allow particular groups 
of our citizens to lose their children at higher rates than others. We 
must work to dramatically reduce these deaths for all Americans.
  These numbers reflect the need for federal legislation to increase 
access to quality prenatal care. I am proud to have played an active 
role in creating a dedicated funding stream for the home visiting to 
support families with or expecting young children. Authorized by the 
Patient Protection and Affordable Care Law, the new Maternal, Infant, 
and Early Childhood Home Visiting Program will provide grants to States 
to provide evidence-based home visitation services to improve outcomes 
for children and families who reside in at-risk communities. Research 
shows that these programs are effective at improving the health and 
well-being of children and families.
  It is federal investments in home visiting and in the NEWBORN Act 
that will help improve children's well-being and lower the infant 
mortality rate. I stand in strong support of the NEWBORN Act and urge 
my colleagues to vote in favor of this bill.
  Mr. PALLONE. Mr. Speaker, I urge that the bill pass, and I yield back 
the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from New Jersey (Mr. Pallone) that the House suspend the 
rules and pass the bill, H.R. 3470, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. PALLONE. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

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