I 

108TH CONGRESS 

1ST SESSION H. R. 1470

To reduce health care costs and promote improved health by providing 

supplemental grants for additional preventive health services for women. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 27, 2003

Ms. DELAURO (for herself, Mr. LEACH, Mr. DOYLE, Mr. KILDEE, Mr. MEEHAN, Mr. CROWLEY, Mr. LANTOS, Mr. GRIJALVA, Mr. CONYERS, Ms. 

JACKSON-LEE of Texas, Mr. HINCHEY, Mr. ETHERIDGE, Ms. 

MILLENDER-MCDONALD, Ms. LEE, Mr. MENENDEZ, Mrs. LOWEY, Mr. 

FROST, Mr. UDALL of New Mexico, Mr. SERRANO, Mr. MCNULTY, Mr. 

GREEN of Texas, Mr. KENNEDY of Rhode Island, Mr. OWENS, Ms. 

LINDA T. SA ́NCHEZ of California, Mr. SCHIFF, Mr. MICHAUD, Mr. NADLER, Ms. WOOLSEY, Mr. STARK, Mr. DAVIS of Tennessee, Mr. STRICKLAND, Mr. LARSEN of Washington, Mr. INSLEE, Mr. BOSWELL, Mr. 

BERMAN, Mr. EMANUEL, Mr. MORAN of Virginia, Mrs. MALONEY, Mrs. 

CAPPS, and Ms. MCCOLLUM) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL

To reduce health care costs and promote improved health 

by providing supplemental grants for additional preventive health services for women.

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 ‘‘WISEWOMAN Ex5 pansion Act of 2003’’. 
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1 SEC. 2. FINDINGS. 

2 Congress makes the following findings: 

3 (1) Heart disease, stroke, and other cardio4 vascular diseases remain the leading cause of death 

5 among females in the United States, killing more 

6 than 500,000 women each year. 

7 (2) About 1 in 5 females have some form of 

8 cardiovascular disease, killing more American women 

9 than the next 14 causes of death combined. 

10 (3) In women, cardiovascular disease is fre11 quently undetected and untreated until the disease 

12 has become severe, causing 38 percent of women 

13 who have heart attacks to die within 1 year. 

14 (4) Obesity increases women’s risk for some of 

15 the leading causes of death: heart disease, stroke, di16 abetes, and certain cancers. 

17 (5) Better nutrition and lifestyle changes can 

18 effectively prevent and treat obesity. 

19 (6) Osteoporosis afflicts more than 20,000,000 

20 American women. 

(7) More than 1 21 ⁄2 of all women over 65 have 

22 osteoporosis. 

23 (8) One out of every 2 women over 50 will have 

24 an osteoporosis-related fracture during her lifetime. 

25 (9) The national annual costs associated with 

26 osteoporosis are estimated at $14,000,000,000. 
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1 (10) Physical activity is necessary for bone ac2 quisition and maintenance throughout adulthood. 

3 (11) Muscular strength and balance may be 

4 very significant in future risk reduction for 

5 osteoporosis. 

6 (12) There is consensus that adequate vitamin 

7 D and calcium intakes are required for bone health. 

8 (13) Seventeen million Americans have diabe9 tes, and over 200,000 people die each year from re10 lated complications. Among U.S. adults, diabetes in11 creased 61 percent from 1990 to 2001. Diabetes is 

12 the sixth leading cause of death in America. 

13 (14) Approximately 8.9 percent of all women 

14 over the age of 20 in the United States have diabetes, but about 1 15 ⁄3 of them are unaware of it. 

16 (15) The risk for cardiovascular disease, the 

17 most common complication attributable to diabetes, 

18 is more serious among women than men. Deaths 

19 from heart disease in women with diabetes have in20 creased 23 percent over the past 30 years. 

21 (16) The direct and indirect costs of diabetes 

22 are over $130 billion a year. 

23 (17) Better nutrition, physical activity, control 

24 of blood glucose levels, and access to services can 

25 delay the progression of diabetes. In fact, recent 
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1 findings show that modest, consistent physical activ2 ity and a healthy diet can cut a person’s risk for de3 veloping type 2 diabetes by nearly 60 percent. 

4 (18) Research has demonstrated that—

5 (A) the uninsured often have significantly 

6 poorer health than the insured; and 

7 (B) being uninsured is an obstacle to re8 ceiving preventive health care services. 

9 (19) The WISEWOMAN program has—

10 (A) provided one-stop shopping for preven11 tive health services such as cholesterol and 

12 blood pressure screening for more than 10,000 

13 women and identified risk factors for heart dis14 ease such as obesity, high cholesterol, high 

15 blood pressure, sedentary behavior and poor 

16 diet; and 

17 (B) found that many of the women 

18 screened have returned for additional interven19 tions and follow-up, resulting in improved 

20 weight management, lower blood pressure and 

21 lower cholesterol. 

22 (20) Expansion of the WISEWOMAN model 

23 program to additional States would help reduce 

24 women’s risk of illness and death from heart disease, 

25 diabetes, and other preventable diseases and provide 
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1 further insights into the feasibility and effectiveness 

2 of making comprehensive, integrated preventive serv3 ices available to low-income and uninsured women. 

4 SEC. 3. SUPPLEMENTAL GRANTS FOR ADDITIONAL PRE5 VENTIVE HEALTH SERVICES FOR WOMEN. 

6 Section 1509 of the Public Health Service Act (42 

7 U.S.C. 300n–4a) is amended to read as follows: 

8 ‘‘SEC. 1509. ESTABLISHMENT OF PROGRAM FOR ADDI9 TIONAL PREVENTIVE HEALTH SERVICES. 

10 ‘‘(a) IN GENERAL.—The Secretary, acting through 

11 the Director of the Centers for Disease Control and Pre12 vention, may, through a competitive review process, award 

13 grants to States that have received grants under section 

14 1501 for a fiscal year, to enable such State to carry out 

15 programs—

16 ‘‘(1) to provide preventive health services, in ad17 dition to the services authorized in such section 

18 1501, for diseases such as cardiovascular diseases, 

19 diabetes, osteoporosis, and obesity; 

20 ‘‘(2) to provide screenings, such as screening 

21 for blood pressure, cholesterol, osteoporosis, and dia22 betes, and other services that the Secretary deter23 mines to be appropriate and feasible; 

24 ‘‘(3) for health education, counseling, and inter25 ventions for behavioral risk factors, such as physical 
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1 inactivity and poor nutrition, and diseases such as 

2 cardiovascular diseases, diabetes, osteoporosis, and 

3 obesity; 

4 ‘‘(4) to provide appropriate referrals for medical 

5 treatment of women receiving services pursuant to 

6 paragraph (1) through (3), and ensuring, to the ex7 tent practicable, the provision of appropriate follow8 up services; and 

9 ‘‘(5) to evaluate the activities conducted under 

10 paragraphs (1) through (4) through appropriate sur11 veillance, research, or program monitoring activities. 

12 ‘‘(b) STATUS AS PARTICIPANT IN PROGRAM REGARD13 ING BREAST AND CERVICAL CANCER.—The Secretary 

14 may not make a grant to a State under subsection (a) 

15 unless the State involved agrees that services under the 

16 grant will be provided in conjunction with entities that are 

17 screening women for breast or cervical cancer pursuant 

18 to a grant under section 1501. 

19 ‘‘(c) APPLICABILITY OF PROVISIONS.—The provi20 sions of this title shall apply to a grant under subsection 

21 (a) to the same extent and in the same manner as such 

22 provisions apply to a grant under section 1501. 

23 ‘‘(d) FUNDING.—

24 ‘‘(1) IN GENERAL.—There is authorized to be 

25 appropriated to carry out this section—
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1 ‘‘(A) $20,000,000 for fiscal year 2004; 

2 ‘‘(B) $25,000,000 for fiscal year 2005; 

3 ‘‘(C) $30,000,000 for fiscal year 2006; and 

4 ‘‘(D) such sums as may be necessary for 

5 each subsequent fiscal year. 

6 ‘‘(2) LIMITATION REGARDING FUNDING WITH

7 RESPECT TO BREAST AND CERVICAL CANCER.—No 

8 additional resources shall be appropriated for a fis9 cal year under paragraph (1) unless the amount ap10 propriated under section 1510(a) for such fiscal year 

11 is at least $173,920,000.’’.

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