```

[House Report 111-633]
[From the U.S. Government Publishing Office]

111th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 2d Session                                                     111-633

======================================================================

 
                    GESTATIONAL DIABETES ACT OF 2010

                                _______
                                

 September 28, 2010.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

 Mr. Waxman, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 5354]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 5354) to establish an Advisory Committee on 
Gestational Diabetes, to provide grants to better understand 
and reduce gestational diabetes, and for other purposes, having 
considered the same, report favorably thereon with amendments 
and recommend that the bill as amended do pass.

                                CONTENTS

                                                                   Page
Amendment........................................................     2
Purpose and Summary..............................................     4
Background and Need for Legislation..............................     4
Committee Consideration..........................................     4
Committee Votes..................................................     4
Committee Oversight Findings and Recommendations.................     5
New Budget Authority, Entitlement Authority, and Tax Expenditures     5
Statement of General Performance Goals and Objectives............     5
Constitutional Authority Statement...............................     5
Earmarks and Tax and Tariff Benefits.............................     5
Federal Advisory Committee Statement.............................     5
Applicability of Law to the Legislative Branch...................     5
Federal Mandates Statement.......................................     5
Committee Cost Estimate..........................................     6
Congressional Budget Office Cost Estimate........................     6
Section-by-Section Analysis of the Legislation...................     7
Explanation of Amendment.........................................     8
Changes in Existing Law Made by the Bill, as Reported............     8

                               Amendment

    The amendments are as follows:
    Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Gestational Diabetes Act of 2010'' or 
the ``GEDI Act''.

SEC. 2. GESTATIONAL DIABETES.

Part B of title III of the Public Health Service Act (42 U.S.C. 243 et 
seq.) is amended by adding after section 317H the following:

``SEC. 317H-1. GESTATIONAL DIABETES.

``(a) Understanding and Monitoring Gestational Diabetes.--
        ``(1) In general.--The Secretary, acting through the Director 
        of the Centers for Disease Control and Prevention, in 
        consultation with the Diabetes Mellitus Interagency 
        Coordinating Committee established under section 429 and 
        representatives of appropriate national health organizations, 
        shall develop a multisite gestational diabetes research project 
        within the diabetes program of the Centers for Disease Control 
        and Prevention to expand and enhance surveillance data and 
        public health research on gestational diabetes.
        ``(2) Areas to be addressed.--The research project developed 
        under paragraph (1) shall address--
                ``(A) procedures to establish accurate and efficient 
                systems for the collection of gestational diabetes data 
                within each State and commonwealth, territory, or 
                possession of the United States;
                ``(B) the progress of collaborative activities with the 
                National Vital Statistics System, the National Center 
                for Health Statistics, and State health departments 
                with respect to the standard birth certificate, in 
                order to improve surveillance of gestational diabetes;
                ``(C) postpartum methods of tracking women with 
                gestational diabetes after delivery as well as targeted 
                interventions proven to lower the incidence of type 2 
                diabetes in that population;
                ``(D) variations in the distribution of diagnosed and 
                undiagnosed gestational diabetes, and of impaired 
                fasting glucose tolerance and impaired fasting glucose, 
                within and among groups of women; and
                ``(E) factors and culturally sensitive interventions 
                that influence risks and reduce the incidence of 
                gestational diabetes and related complications during 
                childbirth, including cultural, behavioral, racial, 
                ethnic, geographic, demographic, socioeconomic, and 
                genetic factors.
        ``(3) Report.--Not later than 2 years after the date of the 
        enactment of this section, and annually thereafter, the 
        Secretary shall generate a report on the findings and 
        recommendations of the research project including prevalence of 
        gestational diabetes in the multisite area and disseminate the 
        report to the appropriate Federal and non-Federal agencies.
``(b) Expansion of Gestational Diabetes Research.--
        ``(1) In general.--The Secretary shall expand and intensify 
        public health research regarding gestational diabetes. Such 
        research may include--
                ``(A) developing and testing novel approaches for 
                improving postpartum diabetes testing or screening and 
                for preventing type 2 diabetes in women with a history 
                of gestational diabetes; and
                ``(B) conducting public health research to further 
                understanding of the epidemiologic, socioenvironmental, 
                behavioral, translation, and biomedical factors and 
                health systems that influence the risk of gestational 
                diabetes and the development of type 2 diabetes in 
                women with a history of gestational diabetes.
        ``(2) Authorization of appropriations.--There is authorized to 
        be appropriated to carry out this subsection $5,000,000 for 
        each fiscal year 2012 through 2016.
``(c) Demonstration Grants to Lower the Rate of Gestational Diabetes.--
        ``(1) In general.--The Secretary, acting through the Director 
        of the Centers for Disease Control and Prevention, shall award 
        grants, on a competitive basis, to eligible entities for 
        demonstration projects that implement evidence-based 
        interventions to reduce the incidence of gestational diabetes, 
        the recurrence of gestational diabetes in subsequent 
        pregnancies, and the development of type 2 diabetes in women 
        with a history of gestational diabetes.
        ``(2) Priority.--In making grants under this subsection, the 
        Secretary shall give priority to projects focusing on--
                ``(A) helping women who have 1 or more risk factors for 
                developing gestational diabetes;
                ``(B) working with women with a history of gestational 
                diabetes during a previous pregnancy;
                ``(C) providing postpartum care for women with 
                gestational diabetes;
                ``(D) tracking cases where women with a history of 
                gestational diabetes developed type 2 diabetes;
                ``(E) educating mothers with a history of gestational 
                diabetes about the increased risk of their child 
                developing diabetes;
                ``(F) working to prevent gestational diabetes and 
                prevent or delay the development of type 2 diabetes in 
                women with a history of gestational diabetes; and
                ``(G) achieving outcomes designed to assess the 
                efficacy and cost-effectiveness of interventions that 
                can inform decisions on long-term sustainability, 
                including third-party reimbursement.
        ``(3) Application.--An eligible entity desiring to receive a 
        grant under this subsection shall submit to the Secretary--
                ``(A) an application at such time, in such manner, and 
                containing such information as the Secretary may 
                require; and
                ``(B) a plan to--
                        ``(i) lower the rate of gestational diabetes 
                        during pregnancy; or
                        ``(ii) develop methods of tracking women with a 
                        history of gestational diabetes and develop 
                        effective interventions to lower the incidence 
                        of the recurrence of gestational diabetes in 
                        subsequent pregnancies and the development of 
                        type 2 diabetes.
        ``(4) Uses of funds.--An eligible entity receiving a grant 
        under this subsection shall use the grant funds to carry out 
        demonstration projects described in paragraph (1), including--
                ``(A) expanding community-based health promotion 
                education, activities, and incentives focused on the 
                prevention of gestational diabetes and development of 
                type 2 diabetes in women with a history of gestational 
                diabetes;
                ``(B) aiding State- and tribal-based diabetes 
                prevention and control programs to collect, analyze, 
                disseminate, and report surveillance data on women 
                with, and at risk for, gestational diabetes, the 
                recurrence of gestational diabetes in subsequent 
                pregnancies, and, for women with a history of 
                gestational diabetes, the development of type 2 
                diabetes; and
                ``(C) training and encouraging health care providers--
                        ``(i) to promote risk assessment, high-quality 
                        care, and self-management for gestational 
                        diabetes and the recurrence of gestational 
                        diabetes in subsequent pregnancies; and
                        ``(ii) to prevent the development of type 2 
                        diabetes in women with a history of gestational 
                        diabetes, and its complications in the practice 
                        settings of the health care providers.
        ``(5) Report.--Not later than 4 years after the date of the 
        enactment of this section, the Secretary shall prepare and 
        submit to the Congress a report concerning the results of the 
        demonstration projects conducted through the grants awarded 
        under this subsection.
        ``(6) Definition of eligible entity.--In this subsection, the 
        term `eligible entity' means a nonprofit organization (such as 
        a nonprofit academic center or community health center) or a 
        State, tribal, or local health agency.
        ``(7) Authorization of appropriations.--There is authorized to 
        be appropriated to carry out this subsection $5,000,000 for 
        each fiscal year 2012 through 2016.
``(d) Postpartum Follow-up Regarding Gestational Diabetes.--The 
Secretary, acting through the Director of the Centers for Disease 
Control and Prevention, shall work with the State- and tribal-based 
diabetes prevention and control programs assisted by the Centers to 
encourage postpartum follow-up after gestational diabetes, as medically 
appropriate, for the purpose of reducing the incidence of gestational 
diabetes, the recurrence of gestational diabetes in subsequent 
pregnancies, the development of type 2 diabetes in women with a history 
of gestational diabetes, and related complications.''.

Amend the title so as to read:

    A bill to provide grants to better understand and reduce 
gestational diabetes, and for other purposes.

                          Purpose and Summary

    H.R. 5354, the ``Gestational Diabetes Act of 2010'' or the 
``GEDI Act,'' was introduced on May 20, 2010, by Rep. Eliot L. 
Engel (D-NY) and referred to the Committee on Energy and 
Commerce.
    The goal of H.R. 5354 is to expand and intensify research 
on gestational diabetes and to provide grants to better 
understand and reduce the incidence of this disease.

                  Background and Need for Legislation

    Gestational Diabetes Mellitus (GDM)--generally known as 
gestational diabetes--is high blood sugar that starts or is 
first diagnosed during pregnancy. According to the Centers for 
Disease Control and Prevention (CDC) gestational diabetes 
affects between 3% and 7% of all pregnancies in the United 
States. It can have negative health effects on both mothers and 
their babies--an estimated 40% to 60% of women with gestational 
diabetes will develop type 2 diabetes within 10 years; babies 
born to mothers with the disease are at risk for having a high 
birth weight. Gestational diabetes also disproportionately 
affects minority populations.
    Gestational diabetes represents less than 1% of the 
diabetes burden in the United States, yet its impact on 
maternal and child health is significant, and federal support 
for research on the disease has been limited. Increased 
research is needed to better understand the risk factors for 
the disease and to develop evidence-based intervention 
strategies.

                        Committee Consideration

    H.R. 5354, the ``Gestational Diabetes Act of 2010'' or the 
``GEDI Act,'' was introduced by Mr. Engel of New York on May 
20, 2010, and referred to the Committee on Energy and Commerce. 
The bill was subsequently referred to the Subcommittee on 
Health on May 21, 2010. On September 15, 2010, the Subcommittee 
held a legislative hearing on the bill. The Subcommittee met in 
open markup session to consider H.R. 5354 on September 16, 
2010. An amendment in the nature of a substitute (manager's 
amendment) by Mr. Engel was adopted by a voice vote. 
Subsequently, H.R. 5354 was favorably forwarded to the full 
Committee, amended, by a voice vote.
    On September 23, 2010, the Committee on Energy and Commerce 
met in open markup session to consider H.R. 5354, as approved 
by the Subcommittee on Health. There were no amendments offered 
in full Committee and subsequently the Committee ordered H.R. 
5354 favorably reported to the House, as amended by the 
Subcommittee on Health, by a voice vote.

                            Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list each record vote 
on the motion to report legislation and amendments thereto. A 
motion by Mr. Waxman ordering H.R. 5354 reported to the House, 
as amended, was approved by a voice vote. There were no record 
votes taken during consideration of this bill.

            Committee Oversight Findings and Recommendations

    In compliance with clause 3(c)(1) of rule XIII and clause 
(2)(b)(1) of rule X of the Rules of the House of 
Representatives, the oversight findings and recommendations of 
the Committee are reflected in the descriptive portions of this 
report, including the finding that increased research is needed 
to better understand the risk factors for gestational diabetes 
and to develop evidence-based intervention strategies.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    Regarding compliance with clause 3(c)(2) of rule XIII of 
the Rules of the House of Representatives, the Committee finds 
that H.R. 5354 would result in no new budget authority, 
entitlement authority, or tax expenditures or revenues.

         Statement of General Performance Goals and Objectives

    In accordance with clause 3(c)(4) of rule XIII of the Rules 
of the House of Representatives, the performance goals and 
objectives of the Committee are reflected in the descriptive 
portions of this report, including the goal to support 
increased research on gestational diabetes.

                   Constitutional Authority Statement

    Pursuant to clause 3(d)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee finds that the 
constitutional authority for H.R. 5354 is provided under 
article I, section 8, clauses 3 and 18 of the Constitution of 
the United States.

                  Earmarks and Tax and Tariff Benefits

    H.R. 5354 does not contain any congressional earmarks, 
limited tax benefits, or limited tariff benefits as defined in 
clause 9 of rule XXI of the Rules of the House of 
Representatives.

                  Federal Advisory Committee Statement

    The Committee finds that the legislation does not establish 
or authorize the establishment of an advisory committee within 
the definition of 5 U.S.C. App., section 5(b) of the Federal 
Advisory Committee Act.

             Applicability of Law to the Legislative Branch

    Section 102(b)(3) of Public Law 104-1 requires a 
description of the application of this bill to the legislative 
branch where the bill relates to terms and conditions of 
employment or access to public services and accommodations. 
H.R. 5354 contains no such provisions.

                       Federal Mandates Statement

    Section 423 of the Congressional Budget and Impoundment 
Control Act of 1974 (as amended by section 101(a)(2) of the 
Unfunded Mandates Reform Act, Public Law 104-4) requires a 
statement on whether the provisions of the report include 
unfunded mandates. In compliance with this requirement the 
Committee adopts as its own the analysis of federal mandates 
prepared by the Director of the Congressional Budget Office 
regarding H.R. 5354.

                        Committee Cost Estimate

    Pursuant to clause 3(d)(2) of rule XIII of the Rules of the 
House of Representatives, the Committee adopts as its own the 
cost estimate of H.R. 5354 prepared by the Director of the 
Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974.

               Congressional Budget Office Cost Estimate

    With respect to the requirements of clause (3)(c)(3) of 
rule XIII of the Rules of the House of Representatives and 
section 402 of the Congressional Budget Act of 1974, the 
Committee has received the following cost estimate for H.R. 
5354 from the Director of Congressional Budget Office:

                                                September 24, 2010.
Hon. Henry A. Waxman,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 5354, the 
Gestational Diabetes Act of 2010.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Mindy Cohen.
            Sincerely,
                                              Douglas W. Elmendorf.
    Enclosure.

H.R. 5354--Gestational Diabetes Act of 2010

    Summary: H.R. 5354 would require the Secretary of the 
Department of Health and Human Services (HHS) to develop 
research projects and award grants for the purposes of tracking 
and reducing the prevalence of gestational diabetes. Assuming 
appropriation of the specified amounts, CBO estimates that 
implementing H.R. 5354 would cost $32 million over the 2011-
2015 period. Enacting H.R. 5354 would not affect direct 
spending or revenues; therefore, pay-as-you-go procedures do 
not apply.
    H.R. 5354 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act (UMRA).
    Estimated cost to the Federal Government: The estimated 
budgetary impact of H.R. 5354 is shown in the following table. 
The costs of this legislation fall within budget function 550 
(health).

----------------------------------------------------------------------------------------------------------------
                                                               By fiscal year, in millions of dollars--
                                                     -----------------------------------------------------------
                                                                                                          2011-
                                                        2011      2012      2013      2014      2015      2015
----------------------------------------------------------------------------------------------------------------
                                  CHANGES IN SPENDING SUBJECT TO APPROPRIATION

Authorization Level.................................         0        10        10        10        10        40
Estimated Outlays...................................         0         4         8        10        10        32
----------------------------------------------------------------------------------------------------------------

    Basis of estimate: H.R. 5354 would require the Secretary of 
HHS, acting through the Director of the Center for Disease 
Control and Prevention (CDC), to conduct research and grant 
activities relating to gestational diabetes. For example, the 
bill would require CDC to expand surveillance data and public 
health research, to test approaches for screening for the 
disease, and to award grants to entities that implement 
interventions to reduce the incidence of the disease.
    H.R. 5354 would authorize appropriations for fiscal years 
2012 through 2016 of $5 million a year for the research 
activities and $5 million a year for the grant activities. 
Based on historical spending patterns for similar activities, 
and assuming appropriation of the specified amounts, CBO 
estimates that implementing H.R. 5354 would cost $32 million 
over the 2012-2015 period, and an additional $18 million after 
2015.
    Pay-As-You-Go considerations: None.
    Intergovernmental and private-sector impact: H.R. 5354 
contains no intergovernmental or private-sector mandates as 
defined in UMRA. Grant funds authorized in the bill would 
benefit states that implement programs to reduce the incidence 
of gestational diabetes.
    Estimate prepared by: Federal costs: Mindy Cohen; Impact on 
state, local, and tribal governments: Lisa Ramirez-Branum; 
Impact on the private sector: Sarah Axeen.
    Estimate approved by: Holly Harvey, Deputy Assistant 
Director for Budget Analysis.

             Section-by-Section Analysis of the Legislation

Section 1. Short title

    Section 1 designates that the short title may be cited as 
the ``Gestational Diabetes Act of 2010'' or the ``GEDI Act.''

Section 2. Gestational Diabetes

    Section 2 establishes a new section 317H-1 in the Public 
Health Service Act (PHSA) on gestational diabetes. This section 
includes the following provisions:
    Subsection (a) requires the Secretary of Health and Human 
Services (HHS), acting through the Director of the Centers for 
Disease Control and Prevention (CDC), and in consultation with 
the HHS Diabetes Mellitus Interagency Coordinating Committee 
(DMICC) (established under section 429 of the Public Health 
Service Act), to develop a multisite, gestational diabetes 
research project at CDC to expand and enhance surveillance data 
and public health research on gestational diabetes.
    Subsection (b) requires the Secretary to expand and 
intensify public health research on gestational diabetes 
research. Such research may include (1) the development and 
testing of new approaches for improving postpartum diabetes 
screening and for preventing type 2 diabetes in women with a 
history of gestational diabetes; and (2) research to further 
understand various factors that influence the risk of 
gestational diabetes and the development of type 2 diabetes in 
women with a history of gestational diabetes. The Act 
authorizes $5 million to support these research activities in 
each of FY2012 through FY2016.
    Subsection (c) requires the Secretary, acting through the 
CDC Director, to award grants to non-profit organizations or 
state or local health agencies for demonstration projects to 
support various activities designed to implement evidence-based 
interventions to reduce the incidence of gestational diabetes 
and its recurrence and to prevent type 2 diabetes after 
pregnancy. The Act authorizes $5 million to fund these grants 
in each of FY2012 through FY2016.
    Subsection (d) requires the Secretary, acting through the 
CDC Director, to work with state and tribal-based diabetes 
prevention and control programs to encourage postpartum 
screenings after a diagnosis of gestational diabetes to reduce 
(1) the incidence of gestational diabetes and its recurrence; 
and (2) the progression to type 2 diabetes and its related 
complications.

                        Explanation of Amendment

    During the Subcommittee on Health markup, Mr. Engel of New 
York offered an amendment in the nature of a substitute 
(manager's amendment), which was adopted by a voice vote. The 
substance of the substitute amendment is reflected in the 
section-by-section analysis contained in this report.

         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 italic and existing law in which no change is 
proposed is shown in roman):

PUBLIC HEALTH SERVICE ACT

           *       *       *       *       *       *       *

TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE

           *       *       *       *       *       *       *

Part B--Federal-State Cooperation

           *       *       *       *       *       *       *

SEC. 317H-1. GESTATIONAL DIABETES.

  (a) Understanding and Monitoring Gestational Diabetes.--
          (1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and 
        Prevention, in consultation with the Diabetes Mellitus 
        Interagency Coordinating Committee established under 
        section 429 and representatives of appropriate national 
        health organizations, shall develop a multisite 
        gestational diabetes research project within the 
        diabetes program of the Centers for Disease Control and 
        Prevention to expand and enhance surveillance data and 
        public health research on gestational diabetes.
          (2) Areas to be addressed.--The research project 
        developed under paragraph (1) shall address--
                  (A) procedures to establish accurate and 
                efficient systems for the collection of 
                gestational diabetes data within each State and 
                commonwealth, territory, or possession of the 
                United States;
                  (B) the progress of collaborative activities 
                with the National Vital Statistics System, the 
                National Center for Health Statistics, and 
                State health departments with respect to the 
                standard birth certificate, in order to improve 
                surveillance of gestational diabetes;
                  (C) postpartum methods of tracking women with 
                gestational diabetes after delivery as well as 
                targeted interventions proven to lower the 
                incidence of type 2 diabetes in that 
                population;
                  (D) variations in the distribution of 
                diagnosed and undiagnosed gestational diabetes, 
                and of impaired fasting glucose tolerance and 
                impaired fasting glucose, within and among 
                groups of women; and
                  (E) factors and culturally sensitive 
                interventions that influence risks and reduce 
                the incidence of gestational diabetes and 
                related complications during childbirth, 
                including cultural, behavioral, racial, ethnic, 
                geographic, demographic, socioeconomic, and 
                genetic factors.
          (3) Report.--Not later than 2 years after the date of 
        the enactment of this section, and annually thereafter, 
        the Secretary shall generate a report on the findings 
        and recommendations of the research project including 
        prevalence of gestational diabetes in the multisite 
        area and disseminate the report to the appropriate 
        Federal and non-Federal agencies.
  (b) Expansion of Gestational Diabetes Research.--
          (1) In general.--The Secretary shall expand and 
        intensify public health research regarding gestational 
        diabetes. Such research may include--
                  (A) developing and testing novel approaches 
                for improving postpartum diabetes testing or 
                screening and for preventing type 2 diabetes in 
                women with a history of gestational diabetes; 
                and
                  (B) conducting public health research to 
                further understanding of the epidemiologic, 
                socioenvironmental, behavioral, translation, 
                and biomedical factors and health systems that 
                influence the risk of gestational diabetes and 
                the development of type 2 diabetes in women 
                with a history of gestational diabetes.
          (2) Authorization of appropriations.--There is 
        authorized to be appropriated to carry out this 
        subsection $5,000,000 for each fiscal year 2012 through 
        2016.
  (c) Demonstration Grants to Lower the Rate of Gestational 
Diabetes.--
          (1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and 
        Prevention, shall award grants, on a competitive basis, 
        to eligible entities for demonstration projects that 
        implement evidence-based interventions to reduce the 
        incidence of gestational diabetes, the recurrence of 
        gestational diabetes in subsequent pregnancies, and the 
        development of type 2 diabetes in women with a history 
        of gestational diabetes.
          (2) Priority.--In making grants under this 
        subsection, the Secretary shall give priority to 
        projects focusing on--
                  (A) helping women who have 1 or more risk 
                factors for developing gestational diabetes;
                  (B) working with women with a history of 
                gestational diabetes during a previous 
                pregnancy;
                  (C) providing postpartum care for women with 
                gestational diabetes;
                  (D) tracking cases where women with a history 
                of gestational diabetes developed type 2 
                diabetes;
                  (E) educating mothers with a history of 
                gestational diabetes about the increased risk 
                of their child developing diabetes;
                  (F) working to prevent gestational diabetes 
                and prevent or delay the development of type 2 
                diabetes in women with a history of gestational 
                diabetes; and
                  (G) achieving outcomes designed to assess the 
                efficacy and cost-effectiveness of 
                interventions that can inform decisions on 
                long-term sustainability, including third-party 
                reimbursement.
          (3) Application.--An eligible entity desiring to 
        receive a grant under this subsection shall submit to 
        the Secretary--
                  (A) an application at such time, in such 
                manner, and containing such information as the 
                Secretary may require; and
                  (B) a plan to--
                          (i) lower the rate of gestational 
                        diabetes during pregnancy; or
                          (ii) develop methods of tracking 
                        women with a history of gestational 
                        diabetes and develop effective 
                        interventions to lower the incidence of 
                        the recurrence of gestational diabetes 
                        in subsequent pregnancies and the 
                        development of type 2 diabetes.
          (4) Uses of funds.--An eligible entity receiving a 
        grant under this subsection shall use the grant funds 
        to carry out demonstration projects described in 
        paragraph (1), including--
                  (A) expanding community-based health 
                promotion education, activities, and incentives 
                focused on the prevention of gestational 
                diabetes and development of type 2 diabetes in 
                women with a history of gestational diabetes;
                  (B) aiding State- and tribal-based diabetes 
                prevention and control programs to collect, 
                analyze, disseminate, and report surveillance 
                data on women with, and at risk for, 
                gestational diabetes, the recurrence of 
                gestational diabetes in subsequent pregnancies, 
                and, for women with a history of gestational 
                diabetes, the development of type 2 diabetes; 
                and
                  (C) training and encouraging health care 
                providers--
                          (i) to promote risk assessment, high-
                        quality care, and self-management for 
                        gestational diabetes and the recurrence 
                        of gestational diabetes in subsequent 
                        pregnancies; and
                          (ii) to prevent the development of 
                        type 2 diabetes in women with a history 
                        of gestational diabetes, and its 
                        complications in the practice settings 
                        of the health care providers.
          (5) Report.--Not later than 4 years after the date of 
        the enactment of this section, the Secretary shall 
        prepare and submit to the Congress a report concerning 
        the results of the demonstration projects conducted 
        through the grants awarded under this subsection.
          (6) Definition of eligible entity.--In this 
        subsection, the term ``eligible entity'' means a 
        nonprofit organization (such as a nonprofit academic 
        center or community health center) or a State, tribal, 
        or local health agency.
          (7) Authorization of appropriations.--There is 
        authorized to be appropriated to carry out this 
        subsection $5,000,000 for each fiscal year 2012 through 
        2016.
  (d) Postpartum Follow-up Regarding Gestational Diabetes.--The 
Secretary, acting through the Director of the Centers for 
Disease Control and Prevention, shall work with the State- and 
tribal-based diabetes prevention and control programs assisted 
by the Centers to encourage postpartum follow-up after 
gestational diabetes, as medically appropriate, for the purpose 
of reducing the incidence of gestational diabetes, the 
recurrence of gestational diabetes in subsequent pregnancies, 
the development of type 2 diabetes in women with a history of 
gestational diabetes, and related complications.

           *       *       *       *       *       *       *

                                  

```