[House Report 118-490]
[From the U.S. Government Publishing Office]
118th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 118-490
======================================================================
MATERNAL AND CHILD HEALTH STILLBIRTH PREVENTION ACT OF 2024
_______
May 7, 2024.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mrs. Rodgers of Washington, from the Committee on Energy and Commerce,
submitted the following
R E P O R T
[To accompany H.R. 4581]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 4581) to amend title V of the Social Security
Act to support stillbirth prevention and research, and for
other purposes, having considered the same, reports favorably
thereon with an amendment and recommends that the bill as
amended do pass.
CONTENTS
Page
Purpose and Summary.............................................. 2
Background and Need for Legislation.............................. 2
Committee Action................................................. 2
Committee Votes.................................................. 3
Oversight Findings and Recommendations........................... 5
New Budget Authority, Entitlement Authority, and Tax Expenditures 5
Congressional Budget Office Estimate............................. 5
Federal Mandates Statement....................................... 5
Statement of General Performance Goals and Objectives............ 5
Duplication of Federal Programs.................................. 5
Related Committee and Subcommittee Hearings...................... 5
Committee Cost Estimate.......................................... 6
Earmark, Limited Tax Benefits, and Limited Tariff Benefits....... 6
Advisory Committee Statement..................................... 6
Applicability to Legislative Branch.............................. 6
Section-by-Section Analysis of the Legislation................... 6
Changes in Existing Law Made by the Bill, as Reported............ 6
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Maternal and Child Health Stillbirth
Prevention Act of 2024''.
SEC. 2. CLARIFICATION SUPPORTING PERMISSIBLE USE OF FUNDS FOR
STILLBIRTH PREVENTION ACTIVITIES.
Section 501(a) of the Social Security Act (42 U.S.C. 701(a)) is
amended--
(1) in paragraph (1)(B), by inserting ``to reduce the
incidence of stillbirth,'' after ``among children,''; and
(2) in paragraph (2), by inserting after ``follow-up
services'' the following: ``, and for evidence-based programs
and activities and outcome research to reduce the incidence of
stillbirth (including tracking and awareness of fetal
movements, improvement of birth timing for pregnancies with
risk factors, initiatives that encourage safe sleeping
positions during pregnancy, screening and surveillance for
fetal growth restriction, efforts to achieve smoking cessation
during pregnancy, community-based programs that provide home
visits or other types of support, and any other research or
evidence-based programming to prevent stillbirths)''.
Purpose and Summary
H.R. 4581 clarifies that evidence-based activities and
research focused on reducing the incidence of stillbirth are
permissible uses of the Maternal and Child Health Services
Block Grant funding in Title V.
Background and Need for Legislation
Stillbirth affects about 1 in 175 births, and each year
about 21,000 babies are stillborn in the United States.\1\
Worldwide, there are more than 2.6 million stillbirths every
year.\2\ While there have been incredible advances and
improvements in medical technology over the last 30 years,
including in prenatal care, the rate of early stillbirth has
remained about the same.\3\ States are authorized to use their
Maternal and Child Health Services Block Grant funding for
stillbirth education and related activities, but due to a lack
of clear federal guidance, states have refrained from utilizing
this funding stream for these purposes. This legislation
clarifies that states can use Title V funding for evidence-
based programs, activities, and outcome research to help
prevent and reduce the incidence of stillbirths.
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\1\Centers for Disease Control and Prevention, ``What is
Stillbirth?'', 2022. https://www.cdc.gov/ncbddd/stillbirth/facts.html.
\2\Star Legacy Foundation, ``About Stillbirth'', 2024. https://
starlegacyfoundation.org/about-stillbirth/.
\3\Centers for Disease Control and Prevention, ``What is
Stillbirth?'', 2024.
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Committee Action
On February 14, 2024, the Subcommittee on Health held a
hearing on H.R. 4581. The title of the hearing was
``Legislative Proposals to Support Patients and Caregivers.''
The Subcommittee received testimony from:
Andy Shih, PhD, Chief Science Officer,
Autism Speaks;
Corey Feist, JD, MBA, Co-Founder and CEO,
Dr. Lorna Breen Heroes' Foundation;
Joanne Pike, DrPH, President and CEO,
Alzheimer's Association;
Gordon Tomaselli, MD, Former President,
American Heart Association; Marilyn and Stanley M. Katz
Dean, Emeritus and Professor of Medicine, Albert
Einstein College of Medicine; Adjunct Professor of
Medicine, Johns Hopkins University School of Medicine;
Michelle Whitten, President, CEO, and Co-
Founder, Global Down Syndrome Foundation;
Randy Strozyk, President, American Ambulance
Association; and
Christina Annunziata, MD, PhD, Senior Vice
President of Extramural Discovery Science, American
Cancer Society.
On March 12, 2024, the Subcommittee on Health met in open
markup session and forwarded H.R. 4581, as amended, to the full
Committee by a record vote of 25 yeas and 0 nays.
On March 20, 2024, the full Committee on Energy and
Commerce met in open markup session and ordered H.R. 4581, as
amended, favorably reported to the House by a record vote of 44
yeas and 0 nays.
Committee Votes
Clause 3(b) of rule XIII requires the Committee to list the
record votes on the motion to report legislation and amendments
thereto. The following reflects the record votes taken during
the Committee consideration:
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Oversight Findings and Recommendations
Pursuant to clause 2(b)(1) of rule X and clause 3(c)(1) of
rule XIII, the Committee held a hearing and made findings that
are reflected in this report.
New Budget Authority, Entitlement Authority, and Tax Expenditures
Pursuant to clause 3(c)(2) of rule XIII, the Committee
finds that H.R. 4581 would result in no new or increased budget
authority, entitlement authority, or tax expenditures or
revenues.
Congressional Budget Office Estimate
Pursuant to clause 3(c)(3) of rule XIII, at the time this
report was filed, the cost estimate prepared by the Director of
the Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974 was not available.
Federal Mandates Statement
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
Statement of General Performance Goals and Objectives
Pursuant to clause 3(c)(4) of rule XIII, the general
performance goal or objective of this legislation is to reduce
the rate of stillbirths by supporting research into evidence-
based preventative measures.
Duplication of Federal Programs
Pursuant to clause 3(c)(5) of rule XIII, no provision of
H.R. 4581 is known to be duplicative of another Federal
program, including any program that was included in a report to
Congress pursuant to section 21 of Public Law 111-139 or the
most recent Catalog of Federal Domestic Assistance.
Related Committee and Subcommittee Hearings
Pursuant to clause 3(c)(6) of rule XIII, the following
related hearing was used to develop or consider H.R. 4581:
On February 14, 2024, the Subcommittee on
Health held a hearing on H.R. 4581. The title of the
hearing was ``Legislative Proposals to Support Patients
and Caregivers.'' The Subcommittee received testimony
from:
Andy Shih, PhD, Chief Science
Officer, Autism Speaks;
Corey Feist, JD, MBA, Co-Founder
and CEO, Dr. Lorna Breen Heroes' Foundation;
Joanne Pike, DrPH, President and
CEO, Alzheimer's Association;
Gordon Tomaselli, MD, Former
President, American Heart Association; Marilyn
and Stanley M. Katz Dean, Emeritus and
Professor of Medicine, Albert Einstein College
of Medicine; Adjunct Professor of Medicine,
Johns Hopkins University School of Medicine;
Michelle Whitten, President,
CEO, and Co-Founder, Global Down Syndrome
Foundation;
Randy Strozyk, President,
American Ambulance Association; and
Christina Annunziata, MD, PhD,
Senior Vice President of Extramural Discovery
Science, American Cancer Society.
Committee Cost Estimate
Pursuant to clause 3(d)(1) of rule XIII, the Committee
adopts as its own the cost estimate prepared by the Director of
the Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974. At the time this report was
filed, the estimate was not available.
Earmark, Limited Tax Benefits, and Limited Tariff Benefits
Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the
Committee finds that H.R. 4581 contains no earmarks, limited
tax benefits, or limited tariff benefits.
Advisory Committee Statement
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act were created by this
legislation.
Applicability to Legislative Branch
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
Section-by-Section Analysis of the Legislation
Section 1. Short title
Section 1 provides that the Act may be cited as the
``Maternal and Child Health Stillbirth Prevention Act of
2024''.
Section 2. Clarification supporting permissible use of funds for
stillbirth prevention activities
Section 2 amends the Maternal and Child Health Services
Block Grant by expanding the scope and purpose to include
stillbirth research and prevention.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (new matter is
printed in italics and existing law in which no change is
proposed is shown in roman):
SOCIAL SECURITY ACT
TITLE V--MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT
* * * * * * *
authorization of appropriations
Sec. 501. (a) To improve the health of all mothers and
children consistent with the applicable health status goals and
national health objectives established by the Secretary under
the Public Health Service Act for the year 2000, there are
authorized to be appropriated $850,000,000 for fiscal year 2001
and each fiscal year thereafter--
(1) for the purpose of enabling each State--
(A) to provide and to assure mothers and
children (in particular those with low income
or with limited availability of health
services) access to quality maternal and child
health services;
(B) to reduce infant mortality and the
incidence of preventable diseases and
handicapping conditions among children, to
reduce the incidence of stillbirth, to reduce
the need for inpatient and long-term care
services, to increase the number of children
(especially preschool children) appropriately
immunized against disease and the number of low
income children receiving health assessments
and follow-up diagnostic and treatment
services, and otherwise to promote the health
of mothers and infants by providing prenatal,
delivery, and postpartum care for low income,
at-risk pregnant women, and to promote the
health of children by providing preventive and
primary care services for low income children;
(C) to provide rehabilitation services for
blind and disabled individuals under the age of
16 receiving benefits under title XVI, to the
extent medical assistance for such services is
not provided under title XIX; and
(D) to provide and to promote family-
centered, community-based, coordinated care
(including care coordination services, as
defined in subsection (b)(3)) for children with
special health care needs and to facilitate the
development of community-based systems of
services for such children and their families;
(2) for the purpose of enabling the Secretary
(through grants, contracts, or otherwise) to provide
for special projects of regional and national
significance, research, and training with respect to
maternal and child health and children with special
health care needs (including early intervention
training and services development), for genetic disease
testing, counseling, and information development and
dissemination programs, for grants (including funding
for comprehensive hemophilia diagnostic treatment
centers) relating to hemophilia without regard to age,
and for the screening of newborns for sickle cell
anemia, and other genetic disorders and follow-up
services, and for evidence-based programs and
activities and outcome research to reduce the incidence
of stillbirth (including tracking and awareness of
fetal movements, improvement of birth timing for
pregnancies with risk factors, initiatives that
encourage safe sleeping positions during pregnancy,
screening and surveillance for fetal growth
restriction, efforts to achieve smoking cessation
during pregnancy, community-based programs that provide
home visits or other types of support, and any other
research or evidence-based programming to prevent
stillbirths); and
(3) subject to section 502(b) for the purpose of
enabling the Secretary (through grants, contracts, or
otherwise) to provide for developing and expanding the
following--
(A) maternal and infant health home visiting
programs in which case management services as
defined in subparagraphs (A) and (B) of
subsection (b)(4), health education services,
and related social support services are
provided in the home to pregnant women or
families with an infant up to the age one by an
appropriate health professional or by a
qualified nonprofessional acting under the
supervision of a health care professional,
(B) projects designed to increase the
participation of obstetricians and
pediatricians under the program under this
title and under state plans approved under
title XIX,
(C) integrated maternal and child health
service delivery systems (of the type described
in section 1136 and using, once developed, the
model application form developed under section
6506(a) of the Omnibus Budget Reconciliation
Act of 1989),
(D) maternal and child health centers which
(i) provide prenatal, delivery, and postpartum
care for pregnant women and preventive and
primary care services for infants up to age
one, and (ii) operate under the direction of a
not-for-profit hospital,
(E) maternal and child health projects to
serve rural populations, and
(F) outpatient and community based services
programs (including day care services) for
children with special health care needs whose
medical services are provided primarily through
inpatient institutional care.
Funds appropriated under this section may only be used in a
manner consistent with the Assisted Suicide Funding Restriction
Act of 1997.
(b) For purposes of this title:
(1) The term ``consolidated health programs'' means
the programs administered under the provisions of--
(A) this title (relating to maternal and
child health and services for children with
special health care needs),
(B) section 1615(c) of this Act (relating to
supplemental security income for disabled
children),
(C) sections 316 (relating to lead-based
paint poisoning prevention programs), 1101
(relating to genetic disease programs), 1121
(relating to sudden infant death syndrome
programs) and 1131 (relating to hemophilia
treatment centers) of the Public Health Service
Act, and
(D) title VI of the Health Services and
Centers Amendments of 1978 (Public Law 95-626;
relating to adolescent pregnancy grants),
as such provisions were in effect before the date of
the enactment of the Maternal and Child Health Services
Block Grant Act.
(2) The term ``low income'' means, with respect to an
individual or family, such an individual or family with
an income determined to be below the income official
poverty line defined by the Office of Management and
Budget and revised annually in accordance with section
673(2) of the Omnibus Budget Reconciliation Act of
1981.
(3) The term ``care coordination services'' means
services to promote the effective and efficient
organization and utilization of resources to assure
access to necessary comprehensive services for children
with special health care needs and their families.
(4) The term ``case management services'' means--
(A) with respect to pregnant women, services
to assure access to quality prenatal, delivery,
and postpartum care; and
(B) with respect to infants up to age one,
services to assure access to quality preventive
and primary care services.
(c)(1)(A) For the purpose of enabling the Secretary (through
grants, contracts, or otherwise) to provide for special
projects of regional and national significance for the
development and support of family-to-family health information
centers described in paragraph (2), there is appropriated to
the Secretary, out of any money in the Treasury not otherwise
appropriated--
(i) $3,000,000 for fiscal year 2007;
(ii) $4,000,000 for fiscal year 2008;
(iii) $5,000,000 for each of fiscal years 2009
through 2013;
(iv) $2,500,000 for the portion of fiscal year 2014
before April 1, 2014;
(v) $2,500,000 for the portion of fiscal year 2014 on
or after April 1, 2014;
(vi) $5,000,000 for each of fiscal years 2015 through
2017;
(vii) $6,000,000 for each of fiscal years 2018
through 2024; and
(vii) $1,500,000 for the portion of the fiscal year
2025 before January 1, 2025.
(B) Funds appropriated or authorized to be appropriated under
subparagraph (A) shall--
(i) be in addition to amounts appropriated under
subsection (a) and retained under section 502(a)(1) for
the purpose of carrying out activities described in
subsection (a)(2); and
(ii) remain available until expended.
(2) The family-to-family health information centers described
in this paragraph are centers that--
(A) assist families of children with disabilities or
special health care needs to make informed choices
about health care in order to promote good treatment
decisions, cost-effectiveness, and improved health
outcomes for such children;
(B) provide information regarding the health care
needs of, and resources available for, such children;
(C) identify successful health delivery models for
such children;
(D) develop with representatives of health care
providers, managed care organizations, health care
purchasers, and appropriate State agencies, a model for
collaboration between families of such children and
health professionals;
(E) provide training and guidance regarding caring
for such children;
(F) conduct outreach activities to the families of
such children, health professionals, schools, and other
appropriate entities and individuals; and
(G) are staffed--
(i) by such families who have expertise in
Federal and State public and private health
care systems; and
(ii) by health professionals.
(3) The Secretary shall develop family-to-family health
information centers described in paragraph (2) in accordance
with the following:
(A) With respect to fiscal year 2007, such centers
shall be developed in not less than 25 States.
(B) With respect to fiscal year 2008, such centers
shall be developed in not less than 40 States.
(C) With respect to fiscal year 2009 and each fiscal
year thereafter, such centers shall be developed in all
States, and with respect to fiscal year 2018 and each
fiscal year thereafter, such centers shall also be
developed in all territories and at least one such
center shall be developed for Indian tribes.
(4) The provisions of this title that are applicable to the
funds made available to the Secretary under section 502(a)(1)
apply in the same manner to funds made available to the
Secretary under paragraph (1)(A).
(5) For purposes of this subsection--
(A) the term ``Indian tribe'' has the meaning given
such term in section 4 of the Indian Health Care
Improvement Act (25 U.S.C. 1603);
(B) the term ``State'' means each of the 50 States
and the District of Columbia; and
(C) the term ``territory'' means Puerto Rico, Guam,
American Samoa, the Virgin Islands, and the Northern
Mariana Islands.
* * * * * * *
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