I 

110TH CONGRESS 

1ST SESSION H. R. 2404 

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 

MAY 21, 2007 

Ms. DELAURO (for herself, Ms. BORDALLO, Mrs. MALONEY of New York, Ms. 

NORTON, Mr. ROTHMAN, Ms. SCHAKOWSKY, Mr. SERRANO, Mr. SHERMAN, Ms. SLAUGHTER, Ms. SUTTON, Mr. UDALL of New Mexico, and Ms. 

JACKSON-LEE of Texas) 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 2007’’. 

6 SEC. 2. FINDINGS. 

7 The Congress finds as follows: 

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1 (1) Heart disease, stroke, and other cardio2 vascular diseases remain the leading cause of death 

3 among females in the United States, killing almost 

4 500,000 women each year. 

5 (2) About 1 in 3 females have some form of 

6 cardiovascular disease. 

7 (3) In women, cardiovascular disease is fre8 quently undetected and untreated until the disease 

9 has become severe, causing 42 percent of women 

10 who have heart attacks to die within 1 year. 

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

12 the leading causes of death: heart disease, stroke, di13 abetes, and certain cancers. 

14 (5) Better nutrition and lifestyle changes can 

15 effectively prevent and treat obesity. 

16 (6) Osteoporosis is a major public health threat 

17 for an estimated 44 million Americans. 

18 (7) Eighty percent of those affected by 

19 osteoporosis are women. 

20 (8) One out of every 2 women over the age of 

21 50 will have an osteoporosis-related fracture in her 

22 lifetime. 

23 (9) The rate of hip fractures is two to three 

24 times higher in women than men. 

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1 (10) The direct expenditures for osteoporotic 

2 fractures alone are estimated at 18 billion dollars 

3 each year in 2002 dollars. 

4 (11) Physical activity, calcium, and vitamin D 

5 are major contributors to bone health for individuals 

6 of all ages. 

7 (12) Muscular strength and balance may be 

8 very significant in future risk reduction for 

9 osteoporosis. 

10 (13) 20.8 million Americans have diabetes, and 

11 over 224,000 people die each year from related com12 plications. Among adults in the United States, dia13 betes increased 61 percent from 1990 to 2001. Dia14 betes is the sixth leading cause of death in America. 

15 (14) Approximately 8.8 percent of all women 

16 over the age of 20 in the United States have diabe17 tes, but one-third of them are unaware of it. 

18 (15) The risk for cardiovascular disease, the 

19 most common complication attributable to diabetes, 

20 is more serious among women than men. Deaths 

21 from heart disease in women with diabetes have in22 creased 23 percent over the past 30 years. 

23 (16) The direct and indirect costs of diabetes 

24 are over $132 billion a year. 

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1 (17) Better nutrition, physical activity, control 

2 of blood glucose levels, and access to services can 

3 delay the progression of diabetes. In fact, recent 

4 findings show that modest, consistent physical activ5 ity and a healthy diet can cut a person’s risk for de6 veloping type-2 diabetes by nearly 60 percent. 

7 (18) The WISEWOMAN program has— 

8 (A) provided one-stop shopping for preven9 tive health services such as cholesterol and 

10 blood pressure screening for more than 12,000 

11 women and identified risk factors for heart dis12 ease such as obesity, high cholesterol, high 

13 blood pressure, sedentary behavior, and poor 

14 diet; and 

15 (B) identified more than 5,783 cases of 

16 previously undiagnosed hypertension, 6,286 

17 cases of undiagnosed high cholesterol, and 800 

18 cases of undiagnosed diabetes in women who 

19 would have been unaware of their risk factors 

20 if not for WISEWOMAN. 

21 (19) Research has demonstrated that— 

22 (A) the uninsured often have significantly 

23 poorer health than the insured; and 

24 (B) being uninsured is an obstacle to re25 ceiving preventive health care services. 

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1 SEC. 3. SUPPLEMENTAL GRANTS FOR ADDITIONAL PRE2 VENTIVE HEALTH SERVICES FOR WOMEN. 

3 Section 1509 of the Public Health Service Act (42 

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

5 ‘‘SEC. 1509. ESTABLISHMENT OF PROGRAM FOR ADDI6 TIONAL PREVENTIVE HEALTH SERVICES. 

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

8 the Director of the Centers for Disease Control and Pre9 vention, may, through a competitive review process, award 

10 grants to States that have received grants under section 

11 1501 for a fiscal year, to enable such State to carry out 

12 programs— 

13 ‘‘(1) to provide preventive health services, in ad14 dition to the services authorized in such section 

15 1501, for diseases such as cardiovascular diseases, 

16 diabetes, osteoporosis, and obesity; 

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

18 for blood pressure, cholesterol, osteoporosis, and dia19 betes, and other services that the Secretary deter20 mines to be appropriate and feasible; 

21 ‘‘(3) for health education, counseling, and inter22 ventions for behavioral risk factors, such as physical 

23 inactivity and poor nutrition, and diseases such as 

24 cardiovascular diseases, diabetes, osteoporosis, and 

25 obesity; 

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

2 treatment of women receiving services pursuant to 

3 paragraphs (1) through (3), and ensuring, to the ex4 tent practicable, the provision of appropriate follow5 up services; and 

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

7 paragraphs (1) through (4) through appropriate sur8 veillance, research, or program monitoring activities. 

9 ‘‘(b) STATUS AS PARTICIPANT IN PROGRAM REGARD10 ING BREAST AND CERVICAL CANCER.—The Secretary 

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

12 unless the State involved agrees that services under the 

13 grant will be provided in conjunction with entities that are 

14 screening women for breast or cervical cancer pursuant 

15 to a grant under section 1501. 

16 ‘‘(c) APPLICABILITY OF PROVISIONS.—The provi17 sions of this title shall apply to a grant under subsection 

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

19 provisions apply to a grant under section 1501. 

20 ‘‘(d) FUNDING.— 

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

22 appropriated to carry out this section— 

23 ‘‘(A) $20,000,000 for fiscal year 2008; 

24 ‘‘(B) $25,000,000 for fiscal year 2009; 

25 ‘‘(C) $30,000,000 for fiscal year 2010; and 

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

2 each subsequent fiscal year. 

3 ‘‘(2) LIMITATION REGARDING FUNDING WITH

4 RESPECT TO BREAST AND CERVICAL CANCER.—No 

5 additional resources shall be appropriated for a fis6 cal year under paragraph (1) unless the amount ap7 propriated under section 1510(a) for such fiscal year 

8 is at least $173,920,000.’’. 

Æ 

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