II

106TH CONGRESS

1ST SESSION S. 1384

To amend the Public Health Service Act to provide for a national folic

acid education program to prevent birth defects, and for other purposes.

IN THE SENATE OF THE UNITED STATES

JULY 16, 1999

Mr. ABRAHAM (for himself, Mr. BOND and Mr. KOHL) introduced the following bill; which was read twice and referred to the Committee on

Health, Education, Labor, and Pensions

A BILL

To amend the Public Health Service Act to provide for

a national folic acid education program to prevent birth

defects, and for other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Folic Acid Promotion

5 and Birth Defects Prevention Act of 1999’’.

6 SEC. 2. FINDINGS.

7 The Congress finds as follows:
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1 (1) Each year an estimated 2,500 infants are

2 born in the United States with serious birth defects

3 of the brain and spine, called neural tube defects.

4 (2) The most common neural tube defects are

5 spina bifida and anencephaly.

6 (3) Spina bifida, the incomplete closure of the

7 spinal column, is a leading cause of childhood paral8 ysis.

9 (4) Anencephaly is a fatal condition in which an

10 infant is born with a severely underdeveloped brain

11 and skull.

12 (5) As many as 70 percent of neural tube birth

13 defects could be prevented if all women of child14 bearing age consumed 400 micrograms of folic acid

15 daily, beginning before pregnancy.

16 (6) Folic acid is a B vitamin found naturally in

17 foods such as leafy green vegetables, beans, citrus

18 fruits, and juices.

19 (7) Since January 1, 1998, the Food and Drug

20 Administration has required that all foods con21 taining enriched flour, such as breads, pasta and

22 breakfast cereal, be fortified with folic acid.

23 (8) In addition to consuming a diet high in

24 folate rich foods, a daily multivitamin is one of the

25 most reliable sources of folic acid.
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1 (9) A majority of women are not aware of this

2 prevention opportunity, nor are they consuming the

3 recommended daily amount.

4 (10) A national folic acid education campaign is

5 needed to urge women to take this simple step to

6 prevent neural tube defects.

7 SEC. 3. PROGRAM REGARDING EFFECTS OF FOLIC ACID IN

8 PREVENTION OF BIRTH DEFECTS.

9 Part B of title III of the Public Health Service Act

10 (42 U.S.C. 243 et seq.) is amended by inserting after sec11 tion 317G the following section:

12 ‘‘EFFECTS OF FOLIC ACID IN PREVENTION OF BIRTH

13 DEFECTS

14 ‘‘SEC. 317H. (a) IN GENERAL.—The Secretary, act15 ing through the Director of the Centers for Disease Con16 trol and Prevention, shall carry out a program (directly

17 or through grants or contracts) for the following purposes:

18 ‘‘(1) To provide education and training for

19 health professionals and the general public for pur20 poses of explaining the effects of folic acid in pre21 venting birth defects and for purposes of encour22 aging each woman of reproductive capacity (whether

23 or not planning a pregnancy) to consume on a daily

24 basis a dietary supplement that provides an appro25 priate level of folic acid.
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1 ‘‘(2) To conduct research with respect to such

2 education and training, including identifying effec3 tive strategies for increasing the rate of consumption

4 of folic acid by women of reproductive capacity.

5 ‘‘(3) To conduct research to increase the under6 standing of the effects of folic acid in preventing

7 birth defects, including understanding with respect

8 to cleft lip, cleft palate, and heart defects.

9 ‘‘(4) To provide for appropriate epidemiological

10 activities regarding folic acid and birth defects, in11 cluding epidemiological activities regarding neural

12 tube defects.

13 ‘‘(b) CONSULTATIONS WITH STATES AND PRIVATE

14 ENTITIES.—In carrying out subsection (a), the Secretary

15 shall consult with the States and with other appropriate

16 public or private entities, including national nonprofit pri17 vate organizations, health professionals, and providers of

18 health insurance and health plans.

19 ‘‘(c) TECHNICAL ASSISTANCE.—The Secretary may

20 (directly or through grants or contracts) provide technical

21 assistance to public and nonprofit private entities in car22 rying out the activities described in subsection (a).

23 ‘‘(d) EVALUATIONS.—The Secretary shall (directly or

24 through grants or contracts) provide for the evaluation of

25 activities under subsection (a) in order to determine the
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1 extent to which such activities have been effective in car2 rying out the purposes of the program under such sub3 section, including the effects on various demographic pop4 ulations. Methods of evaluation under the preceding sen5 tence may include surveys of knowledge and attitudes on

6 the consumption of folic acid and on blood folate levels.

7 Such methods may include complete and timely moni8 toring of infants who are born with neural tube defects.

9 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the

10 purpose of carrying out this section, there are authorized

11 to be appropriated $20,000,000 for fiscal year 2000, and

12 such sums as may be necessary for each of the fiscal years

13 2001 through 2004.’’.

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