[House Report 105-762]
[From the U.S. Government Publishing Office]



105th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES

 2d Session                                                     105-762
_______________________________________________________________________


 
PROVIDING FOR THE CONSIDERATION OF H.R. 4274, THE DEPARTMENTS OF LABOR, 
   HEALTH AND HUMAN SERVICES, AND EDUCATION APPROPRIATION BILL, 1999


  October 1, 1998.--Referred to the House Calendar and ordered to be 
                                printed

_______________________________________________________________________


    Mr. Dreier, from the Committee on Rules, submitted the following

                              R E P O R T

                       [To accompany H. Res. 564]

    The Committee on Rules, having had under consideration 
House Resolution 564, by a nonrecord vote, report the same to 
the House with the recommendation that the resolution be 
adopted.

               brief summary of provisions of resolution

    The resolution provides for the consideration of H.R. 4274, 
the ``The Departments of Labor, Health and Human Services, and 
Education Appropriations Bill for FY 1999'' under an open rule. 
The rule provides ninety minutes of general debate equally 
between the chairman and ranking minority member of the 
Committee on Appropriations.
    The rule waives clause 2 (prohibiting unauthorized and 
legislative provisions in an appropriations bill) and clause 6 
(prohibiting reappropriations in an appropriations bill) of 
rule XXI against provisions in the bill except as otherwise 
specified in the rule.
    The rule makes in order those amendments printed in this 
report which may only be offered by the Member designated, 
shall be considered as read, shall be debatable for the time 
specified in the report equally divided and controlled by the 
proponent and an opponent, shall not to be subject to amendment 
except as specified in the report, and shall not be subject to 
a demand for a division. All points of order against the 
amendments are waived.
    Further, the rule authorizes the Chair to accord priority 
in recognition to Members who have pre-printed their amendments 
in the Congressional Record. The rule allows for the Chairman 
of the Committee of the Whole to postpone votes during 
consideration of the bill, and to reduce votes to five minutes 
on a postponed question if the vote follows a fifteen minute 
vote. Finally, the rule provides for one motion to recommit, 
with or without instructions.

 summary of amendments to be made in order to h.r. 4274, the labor/hhs/
                  education appropriations bill, 1999

    Porter--10 minutes: Manager's amendment.
    Greenwood/Castle--30 minutes: Strikes the language 
mandating parental consent or notification for Tile X programs, 
and it substitutes parental involvement and an emphasis on 
abstinence for minors seeking contraceptive drugs or devices. 
Provides Title X counselors with state of the art training on 
how to effectively intervene with minors to encourage 
abstinence, parental involvement and to avoid coercion, and it 
requires the Secretary of HHS to develop protocols in these 
areas, especially as they relate to younger adolescents.
    Istook/Barcia/Manzullo--30 minutes: Substitute amendment to 
the Greenwood/Castle amendment, consisting of the Istook Title 
X language already in the bill and the Greenwood/Castle 
abstinence language.
    Amendments made in order under the rule:

1. An Amendment To Be Offered by Representative Porter of Illinois, or 
                  a Designee, Debatable for 10 Minutes

    Page 2, line 16, strike ``$4,000,873,000'' and insert 
``$4,300,873,000'';
    Page 38, line 11, strike all beginning with ``Provided'' 
and continuing through the colon on line 16;
    Page 40, after line 14, insert:
    ``For making payments under tile XXVI of such Act, 
$600,000,000: Provided, That these funds are hereby designated 
by Congress to be emergency requirements pursuant to section 
251(b)(2)(A) of the Balanced Budget and Emergency Deficit 
Control Act of 1985, as amended: Provided further, That these 
funds shall be made available only after submission to Congress 
of a formal budget request by the President that includes 
designation of the entire amount of the request as an emergency 
requirement as defined in the Balanced Budget and Emergency 
Deficit Control Act.''
    Page 57, line 12, strike ``$354,000,000'' and insert 
``$355,000,000'';
    Page 59, line 20, strike ``$9,672,654,000'' and insert 
``$9,371,654,000''; and page 109, after line 19, insert the 
following new sections:
    Sec. 703. None of the funds made available in this Act may 
be used to promulgate or adopt any final standard under section 
1173(b) of the Social Security Act (42 U.S.C. 1320d-2(b)) 
providing for, or providing for the assignment of, a unique 
health identifier for an individual (except in an individual's 
capacity as an employer or a health care provider), until 
legislation is enacted specifically approving the standard.
  Sec. 704. (a) This section may be cited as the ``Early 
Hearing Loss Detection, Diagnosis, and Intervention Act of 
1998''.
  (b) The purposes of this section are to clarify the authority 
within the Public Health Service Act to authorize statewide 
early detection, diagnosis, referral, and intervention 
networks, technical assistance, a national applied research 
program, and interagency and private sector collaboration for 
policy development, in order to assist the States in making 
progress toward the following goals:
          (1) All babies born in hospitals in the United States 
        and its territories should be screened for hearing loss 
        before leaving the hospital (unless the parents of the 
        children object to the screening).
          (2) Babies who are not born in hospitals should be 
        screened within the first 3 months of life.
          (3) Diagnostic audiologic testing, if indicated, 
        should be performed in a timely manner to allow 
        appropriate referral for treatment/intervention before 
        the age of 6 months.
          (4) All universal newborn hearing screening programs 
        should include a component which ensures linkage to 
        diagnosis and the community system of early 
        intervention services.
          (5) Public policy in early hearing detection, 
        diagnosis, and intervention should be based on applied 
        research and the recognition that infants, toddlers, 
        and children who are deaf or hard-of-hearing have 
        unique language, learning, and communication needs, and 
        should be the result of consultation with pertinent 
        public and private sectors.
  (c) Under the existing authority under the Public Health 
Service Act, the Secretary of Health and Human Services (in 
this section referred to as the ``Secretary''), acting through 
the Administrator of the Health Resources and Services 
Administration, shall make awards of grants or cooperative 
agreements to develop statewide early detection, diagnosis, and 
intervention networks for the following purposes:
          (1) To develop State capacity to support newborn 
        hearing loss detection, diagnosis, and intervention.
          (2) To monitor the extent to which hearing detection 
        is conducted in birthing hospitals throughout the 
        State, and assist in the development of universal 
        newborn hearing detection programs in birthing 
        hospitals and nonhospital birthing sites.
          (3) To develop statewide models which ensure 
        effective screening, referral, and linkage with 
        appropriate diagnostic, medical, and qualified early 
        intervention services, providers, and programs. Early 
        intervention includes referral to schools and agencies, 
        including community, consumer, and parent-based 
        agencies and organizations, and other programs mandated 
        by part C of the Individuals With Disabilities 
        Education Act, which offer programs specifically 
        designed to meet the unique language and communication 
        needs of deaf and hard of hearing infants, toddlers, 
        and children.
          (4) To collect data on statewide early detection, 
        diagnosis, and intervention that can be used for 
        applied research and policy development.
  (d)(1) Under the existing authority under the Public Health 
Service Act, the Secretary, acting through the Director of the 
Centers for Disease Control and Prevention, shall make awards 
of grants or cooperative agreements to provide technical 
assistance to State agencies to complement an intramural 
program and to conduct applied research related to infant 
hearing detection, diagnosis, and treatment/intervention. The 
program shall carry out the following:
          (A) Provide technical assistance on data collection 
        and management.
          (B) Develop standardized procedures for data 
        management to ensure quality monitoring of infant 
        hearing loss detection, diagnosis, and intervention 
        programs.
          (C) Study the costs and effectiveness of hearing 
        detection conducted by State-based programs in order to 
        answer issues of importance to national and State 
        policymakers.
          (D) Identify the causes and risk factors for 
        congenital hearing loss.
          (E) Study the effectiveness of early hearing 
        detection, diagnosis, and treatment/intervention 
        programs by assessing the health, developmental, 
        cognitive, and language status of these children at 
        school age.
          (F) Promote the sharing of data regarding early 
        hearing loss with State-based birth defects and 
        developmental disabilities monitoring programs for the 
        purpose of identifying previously unknown causes of 
        hearing loss.
  (2) Under the existing authority under the Public Health 
Service Act, the Director of the National Institutes of Health, 
acting through the Director of the National Institute on 
Deafness and Other Communication Disorders, shall for purposes 
of this section continue a program of research on the efficacy 
of new screening techniques and technology, including studies 
of screening methods, studies on efficacy of intervention, and 
related basic and applied research.
  (e)(1) In carrying out programs under this section under the 
existing authority under the Public Health Service Act, the 
Administrator of the Health Resources and Services 
Administration, the Director of the Centers for Disease Control 
and Prevention, and the Director of the National Institutes of 
Health shall collaborate and consult with other Federal 
agencies; State and local agencies (including those responsible 
for early intervention services pursuant to part C of the 
Individuals with Disabilities Education Act); consumer groups 
serving individuals who are deaf and hard-of-hearing; persons 
who are deaf and hard-of-hearing and their families; qualified 
professional personnel who are proficient in deaf or hard-of-
hearing children's language and who possess the specialized 
knowledge, skills, and attributes needed to serve deaf and 
hard-of-hearing infants, toddlers, children, and their 
families; other health and education professionals and 
organizations; third-party payers and managed care 
organizations; and related commercial industries.
  (2) Under the existing authority under the Public Health 
Service Act, the Administrator of the Health Resources and 
Services Administration, the Director of the Centers for 
Disease Control and Prevention, and the Director of the 
National Institutes of Health shall coordinate and collaborate 
on recommendations for policy development at the Federal and 
State levels and with the private sector, including consumer 
and professional based organizations, with respect to early 
hearing detection, diagnosis, and treatment/intervention.
  (3) Under the existing authority under the Public Health 
Service Act, the Administrator of the Health Resources and 
Services Administration and the Director of the Centers for 
Disease Control and Prevention shall coordinate and collaborate 
in assisting States to establish early detection, diagnosis, 
and intervention networks under subsection (c) and to develop a 
data collection system under subsection (d).
  (f) Nothing in this section shall be construed to preempt or 
prohibit State laws which do not require the screening for 
hearing loss of newborn infants or young children of parents 
who object to the screening on the grounds that such screening 
conflicts with the parents' sincerely held religious beliefs.
  (g)(1) For the purpose of carrying out subsection (c) under 
the existing authority under the Public Health Service Act, 
there are authorized to be appropriated $5,000,000 for fiscal 
year 1999, $8,000,000 for fiscal year 2000, and such sums as 
may be necessary for each of the fiscal years 2001 through 
2003.
  (2)(A) For the purpose of carrying out subsection (d)(1) 
under the existing authority under the Public Health Service 
Act, there are authorized to be appropriated $5,000,000 for 
fiscal year 1999, $7,000,000 for fiscal year 2000, and such 
sums as may be necessary for each of the fiscal years 2001 
through 2003.
  (B) For the purpose of carrying out subsection (d)(2) under 
the existing authority under the Public Health Service Act, 
there are authorized to be appropriated such sums as may be 
necessary for each of the fiscal years 1999 through 2003.
                              ----------                              


     2. An Amendment To Be Offered by Representative Greenwood of 
  Pennsylvania, or Representative Castle of Delaware, or a Designee, 
                        Debatable for 30 Minutes

  Page 52, strike line 8 and all that follows through page 53, 
line 8, and insert the following:
  (b)(1) The Secretary of Health and Human Services (in this 
section referred to as the ``Secretary'') shall require that 
each family planning project under section 1001 of title X of 
the Public Health Service Act--
          (A) expressly inform all minors who seek the services 
        of the project that abstinence is the only certain way 
        to avoid pregnancy, sexually transmitted diseases, and 
        infection with the human immunodeficiency virus; and
          (B) ensure that all individuals who provide 
        counseling services to minors through the project are 
        trained to provide to minors counseling that encourages 
        the minors--
                  (i) to abstain from sexual activity;
                  (ii) to avoid being coerced into engaging in 
                sexual activities; and
                  (iii) to involve their parents in the 
                decision to seek family planning services.
  (2) The Secretary, acting through the Deputy Assistant 
Secretary for Population Affairs, shall carry out the following 
with respect to family planning projects referred to in 
paragraph (1):
          (A) The Secretary shall develop and disseminate to 
        the projects protocols for providing the counseling 
        described in paragraph (1)(B), including protocols for 
        training individuals to provide the counseling.
          (B) The Secretary shall ensure that such protocols 
        include protocols specific to younger adolescents.
          (C) In developing protocols under subparagraphs (A) 
        and (B), the Secretary shall consider the results of 
        research under title XX of the Public Health Service 
        Act.
                              ----------                              


3. A Substitute Amendment Offered by Representative Istook of Oklahoma 
 or His Designee to the Amendment Numbered 2 Offered by Representative 
               Greenwood of Pennsylvania or His Designee

  Strike section 220 (page 52, line 3, and all that follows 
through page 53, line 8) and insert the following:
  Sec. 220. (a) Notwithstanding any other provision of law, no 
provider of services under title X of the Public Health Service 
Act shall be exempt from any State law requiring notification 
or the reporting of child abuse, child molestation, sexual 
abuse, rape, or incest.
  (b) None of the funds appropriated in this or any other Act 
for any fiscal year for carrying out title X of the Public 
Health Service Act may be made available to any family planning 
project under section 1001 of such title if any provider of 
services in the project knowingly provides contraceptive drugs 
or devices to a minor, unless--
          (1) such provider of services has given actual 
        written notice to a custodial parent or custodial legal 
        guardian of the minor, notifying the parent or legal 
        guardian of the intent to provide the drugs or devices, 
        at least five business days before providing the drugs 
        or devices; or
          (2) the minor has the written consent of a custodial 
        parent or custodial legal guardian to receive the drugs 
        or devices; or
          (3) the minor is emancipated under applicable State 
        law; or
          (4) a court of competent jurisdiction has directed 
        that the minor may receive the drugs or devices.
  (c)(1) The Secretary of Health and Human Services (in this 
section referred to as the ``Secretary'') shall require that 
each family planning project under section 1001 of title X of 
the Public Health Service Act--
          (A) expressly inform all minors who seek the services 
        of the project that abstinence is the only certain way 
        to avoid pregnancy, sexually transmitted diseases, and 
        infection with the human immunodeficiency virus; and
          (B) ensure that all individuals who provide 
        counseling services to minors through the project are 
        trained to provide to minors counseling that encourages 
        the minors--
                  (i) to abstain from sexual activity;
                  (ii) to avoid being coerced into engaging in 
                sexual activities; and
                  (iii) to involve their parents in the 
                decision to seek family planning services.
  (2) The Secretary, acting through the Deputy Assistant 
Secretary for Population Affairs, shall carry out the following 
with respect to family planning projects referred to in 
paragraph (1):
          (A) The Secretary shall develop and disseminate to 
        the projects protocols for providing the counseling 
        described in paragraph (1)(B), including protocols for 
        training individuals to provide the counseling.
          (B) The Secretary shall ensure that such protocols 
        include protocols specific to younger adolescents.
          (C) In developing protocols under subparagraphs (A) 
        and (B), the Secretary shall consider the results of 
        research under title XX of the Public Health Service 
        Act.
  (d) Each provider of services under section 1001 of title X 
of the Public Health Service Act shall each year certify to the 
Secretary of Health and Human Services compliance with this 
section. Such Secretary shall prescribe such regulations as may 
be necessary to effectuate this section.

                                
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