I 

116TH CONGRESS 

1ST SESSION H. R. 4801 

To amend the Public Health Service Act to reauthorize the Healthy Start 

program. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 23, 2019 

Mr. RYAN (for himself, Ms. UNDERWOOD, Mr. GONZALEZ of Ohio, and Mr. 

STIVERS) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act to reauthorize the 

Healthy Start program. 

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 ‘‘Healthy Start Reau5 thorization Act of 2019’’. 

6 SEC. 2. REAUTHORIZATION OF HEALTHY START PROGRAM. 

7 Section 330H of the Public Health Service Act (42 

8 U.S.C. 254c–8) is amended— 

9 (1) in subsection (a)— 


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1 (A) in paragraph (1), by striking ‘‘, during 

2 fiscal year 2001 and subsequent years,’’; and 

3 (B) in paragraph (2), by inserting ‘‘or in4 creasing above the national average’’ after 

5 ‘‘areas with high’’; 

6 (2) in subsection (b)— 

7 (A) in paragraph (1), by striking ‘‘con8 sumers of project services, public health depart9 ments, hospitals, health centers under section 

10 330’’ and inserting ‘‘participants and former 

11 participants of project services, public health 

12 departments, hospitals, health centers under 

13 section 330, State substance abuse agencies’’; 

14 and 

15 (B) in paragraph (2)— 

16 (i) in subparagraph (A), by striking 

17 ‘‘such as low birthweight’’ and inserting 

18 ‘‘including poor birth outcomes (such as 

19 low birthweight and preterm birth) and so20 cial determinants of health’’; 

21 (ii) by redesignating subparagraph 

22 (B) as subparagraph (C); 

23 (iii) by inserting after subparagraph 

24 (A), the following: 

25 ‘‘(B) Communities with— 


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1 ‘‘(i) high rates of infant mortality or 

2 poor perinatal outcomes; or 

3 ‘‘(ii) high rates of infant mortality or 

4 poor perinatal outcomes in specific sub5 populations within the community.’’; and 

6 (iv) in subparagraph (C) (as so redes7 ignated)— 

8 (I) by redesignating clauses (i) 

9 and (ii) as clauses (ii) and (iii), re10 spectively; 

11 (II) by inserting before clause (ii) 

12 (as so redesignated) the following: 

13 ‘‘(i) collaboration with the local com14 munity in the development of the project;’’; 

15 (III) in clause (ii) (as so redesig16 nated), by striking ‘‘and’’ at the end; 

17 (IV) in clause (iii) (as so redesig18 nated), by striking the period and in19 serting ‘‘; and’’; and 

20 (V) by adding at the end the fol21 lowing: 

22 ‘‘(iv) the use and collection of data 

23 demonstrating the effectiveness of such 

24 program in decreasing infant mortality 

25 rates and improving perinatal outcomes, as 


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1 applicable, or the process by which new ap2 plicants plan to collect this data.’’; 

3 (3) in subsection (c)— 

4 (A) by striking ‘‘Recipients of grants’’ and 

5 inserting the following: 

6 ‘‘(1) IN GENERAL.—Recipients of grants’’; and 

7 (B) by adding at the end the following: 

8 ‘‘(2) OTHER PROGRAMS.—The Secretary shall 

9 ensure coordination of the program carried out pur10 suant to this section with other programs and activi11 ties related to the reduction of the rate of infant 

12 mortality and improved perinatal and infant health 

13 outcomes supported by the Department.’’; 

14 (4) in subsection (e)— 

15 (A) in paragraph (1), by striking ‘‘appro16 priated—’’ and all that follows through the end 

17 and inserting ‘‘appropriated $135,000,000 for 

18 each of fiscal years 2020 through 2024.’’; and 

19 (B) in paragraph (2)(B), by adding at the 

20 end the following: ‘‘Evaluations may also in21 clude, to the extent practicable, information re22 lated to— 

23 ‘‘(i) progress toward achieving any 

24 grant metrics or outcomes related to re25 ducing infant mortality rates, improving 


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1 perinatal outcomes, or reducing the dis2 parity in health status; 

3 ‘‘(ii) recommendations on potential 

4 improvements that may assist with ad5 dressing gaps, as applicable and appro6 priate; and 

7 ‘‘(iii) the extent to which the grantee 

8 coordinated with the community in which 

9 the grantee is located in the development 

10 of the project and delivery of services, in11 cluding with respect to technical assistance 

12 and mentorship programs.’’; and 

13 (5) by adding at the end the following: 

14 ‘‘(f) GAO REPORT.— 

15 ‘‘(1) IN GENERAL.—Not later than 4 years 

16 after the date of the enactment of this subsection, 

17 the Comptroller General of the United States shall 

18 conduct an independent evaluation, and submit to 

19 the appropriate Committees of Congress a report, 

20 concerning the Healthy Start program under this 

21 section. 

22 ‘‘(2) EVALUATION.—In conducting the evalua23 tion under paragraph (1), the Comptroller General 

24 shall consider, as applicable and appropriate, inforVerDate Sep 11 2014 18:43 Nov 05, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H4801.IH H4801

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1 mation from the evaluations under subsection 

2 (e)(2)(B). 

3 ‘‘(3) REPORT.—The report described in para4 graph (1) shall review, assess, and provide rec5 ommendations, as appropriate, on the following: 

6 ‘‘(A) The allocation of Healthy Start pro7 gram grants by the Health Resources and Serv8 ices Administration, including considerations 

9 made by such Administration regarding dispari10 ties in infant mortality or perinatal outcomes 

11 among urban and rural areas in making such 

12 awards. 

13 ‘‘(B) Trends in the progress made toward 

14 meeting the evaluation criteria pursuant to sub15 section (e)(2)(C), including programs which de16 crease infant mortality rates and improve 

17 perinatal outcomes, programs that have not de18 creased infant mortality rates or improved 

19 perinatal outcomes, and programs that have 

20 made an impact on disparities in infant mor21 tality or perinatal outcomes. 

22 ‘‘(C) The ability of grantees to improve 

23 health outcomes for project participants, pro24 mote the awareness of the Healthy Start pro25 gram services, incorporate and promote family 


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1 participation, facilitate coordination with the 

2 community in which the grantee is located, and 

3 increase grantee accountability through quality 

4 improvement, performance monitoring, evalua5 tion, and the effect such metrics may have to6 ward decreasing the rate of infant mortality 

7 and improve perinatal outcomes. 

8 ‘‘(D) The extent to which such Federal 

9 programs are coordinated across agencies and 

10 the identification of opportunities for improved 

11 coordination in such Federal programs and ac12 tivities.’’. 

Æ 


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