I

103D CONGRESS

1ST SESSION H. R. 3561

To amend the Public Health Service Act to reauthorize adolescent family

life demonstration projects, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

NOVEMBER 19, 1993

Mrs. JOHNSON of Connecticut (for herself, Mr. GREENWOOD, Ms. MCKINNEY,

Ms. VELA ́ZQUEZ, Mr. ACKERMAN, Mr. BEILENSON, Mr. FILNER, Mr.

HOCHBRUECKNER, Mr. SCOTT, Mr. SERRANO, Mrs. UNSOELD, Ms. WATERS, and Ms. WOOLSEY) 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 adolescent family life demonstration projects, 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 ‘‘Mickey Leland Adoles5 cent Pregnancy Prevention and Parenthood Act of 1993’’.
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1 SEC. 2. ADOLESCENT PREGNANCY PREVENTION, CARE,

2 AND RESEARCH GRANTS.

3 Title XX of the Public Health Service Act (42 U.S.C.

4 300z et seq.) is amended to read as follows:

5 ‘‘TITLE XX—ADOLESCENT PREG6 NANCY PREVENTION, CARE,

7 AND RESEARCH GRANTS

8 ‘‘SEC. 2001. FINDINGS AND PURPOSES.

9 ‘‘(a) FINDINGS.— The Congress finds that—

10 ‘‘(1) adolescents are at a high risk of unwanted

11 pregnancy;

12 ‘‘(2) in 1988, more than 1,000,000 teenagers

13 became pregnant, and nearly 500,000 teenagers car14 ried their pregnancies to term, of which more than

15 6 out of 10 births were out of wedlock;

16 ‘‘(3) the birthrate for adolescents between the

17 ages of 15 and 17 increased 23 percent between

18 1986 and 1989;

19 ‘‘(4) in a high proportion of cases, the pregnant

20 adolescent is herself the product of an unmarried

21 parenthood during adolescence and is continuing the

22 pattern in her own lifestyle;

23 ‘‘(5) pregnancy and childbirth among unmar24 ried adolescents, particularly young adolescents,

25 often results in severe adverse health, social, and

26 economic consequences, including—
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1 ‘‘(A) higher percentage of pregnancy and

2 childbirth complications;

3 ‘‘(B) higher incidence of low birth weight

4 babies;

5 ‘‘(C) higher infant mortality and morbid6 ity;

7 ‘‘(D) greater likelihood that an adolescent

8 marriage will end in divorce;

9 ‘‘(E) decreased likelihood of completing

10 schooling; and

11 ‘‘(F) higher risks of unemployment and

12 welfare dependency; and

13 therefore, education, training, and job research serv14 ices are important for adolescent parents; and

15 ‘‘(6) an adolescent who becomes pregnant once

16 is likely to experience rapid repeat pregnancies and

17 childbearing, with increased risks;

18 ‘‘(7) research has shown that in cases in which

19 there is a family involvement in comprehensive val20 ues-based projects and services—

21 ‘‘(A) low birth weight is significantly re22 duced;

23 ‘‘(B) delays in initiating sexual activity

24 occur;
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1 ‘‘(C) there are significant reductions in re2 peat pregnancy, welfare costs, and child abuse;

3 and

4 ‘‘(D) teens are more likely to return and

5 complete their high school education; and

6 therefore, the family should become a partner in the

7 development of curriculum and programs that reflect

8 the values of the community;

9 ‘‘(8) the problems of adolescent pregnancy and

10 parenthood are multiple and complex and are best

11 approached through a variety of integrated and es12 sential services, particularly those that allow the

13 pregnant adolescent and adolescent parent to stay in

14 school;

15 ‘‘(9) such services, including a wide array of

16 educational and supportive services, often are not

17 available to the adolescents who need them, or are

18 available but fragmented and thus of limited effec19 tiveness in preventing pregnancies and future wel20 fare dependency; and

21 ‘‘(10) Federal policy therefore should encourage

22 the development of appropriate health, educational,

23 and social services where they are now lacking or in24 adequate, and the better coordination of existing

25 services where they are available in order to prevent
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1 unwanted early and repeat pregnancies and to help

2 adolescents become productive, independent contrib3 utors to family and community life.

4 ‘‘(b) PURPOSES.—It is the purpose of this title—

5 ‘‘(1) to establish better coordination, integra6 tion, and linkages among existing programs in order

7 to expand and improve the availability of, and access

8 to, needed comprehensive community services that

9 assist in preventing unwanted initial and repeat

10 pregnancies among adolescents, enable pregnant

11 adolescents to obtain proper care and assist preg12 nant adolescents, their male partners, and adoles13 cent parents to become productive independent con14 tributors to family and community life, with primary

15 emphasis on services to adolescents who are 17 years

16 of age and under;

17 ‘‘(2) to expand the availability of such services

18 that are essential to that objective;

19 ‘‘(3) to promote innovative, comprehensive, and

20 integrated approaches to the delivery of such serv21 ices;

22 ‘‘(4) to encourage and support research pro23 grams concerning the societal causes and con24 sequences of pregnancy, childbearing, and child

25 rearing for adolescent females and males;
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1 ‘‘(5) to support evaluative research to identify

2 effective services that reduce adolescent pregnancy

3 rates and that improve the outcome of adolescent

4 childbearing for the parents, the child, and their

5 families; and

6 ‘‘(6) to encourage and provide for the dissemi7 nation of results, findings, and information from

8 programs and research projects relating to adoles9 cent pregnancy and parenthood.

10 ‘‘SEC. 2002. DEFINITIONS.

11 ‘‘For the purposes of this title:

12 ‘‘(1) ADOLESCENT.—The term ‘adolescent’

13 means an individual under the age of 21.

14 ‘‘(2) CARE SERVICES.—The term ‘care services’

15 means all services for the provision of care to adoles16 cents, both male and female, pregnant adolescents

17 and their male partners, and adolescent parents.

18 Such term shall include all core services and may in19 clude supplementary services, in accordance with

20 regulations prescribed by the Secretary.

21 ‘‘(3) CORE SERVICES.—The term ‘core services’

22 means those services that shall be provided by a

23 grantee, as determined by the Secretary by regula24 tion, which shall include—
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1 ‘‘(A) pregnancy testing and maternity

2 counseling, or referral for such services;

3 ‘‘(B) family planning services, except that

4 such services for adolescents who are not al5 ready parents may be limited to counseling and

6 referral unless suitable and appropriate family

7 planning services are not otherwise available in

8 the community;

9 ‘‘(C) counseling on all options regarding

10 pregnancy, or referral for such services;

11 ‘‘(D) primary and preventive health serv12 ices, including prenatal and postnatal care for

13 mother and children and arrangements for de14 livery;

15 ‘‘(E) well-baby care;

16 ‘‘(F) nutrition information and counseling;

17 ‘‘(G) screening, counseling and treatment

18 or referral for treatment and prevention of sex19 ually transmitted diseases, including acquired

20 immunodeficiency syndrome;

21 ‘‘(H) referral to appropriate pediatric care;

22 ‘‘(I) educational services relating to sexual23 ity and family life, including—

24 ‘‘(i) education on responsible decision25 making regarding sexual activity;
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1 ‘‘(ii) education on the responsibilities

2 of parenting;

3 ‘‘(iii) education on a full range of

4 means for delaying becoming pregnant, in5 cluding abstinence, natural family plan6 ning, and contraception;

7 ‘‘(iv) education on the prevention of

8 sexually transmitted diseases, including ac9 quired immunodeficiency syndrome; and

10 ‘‘(v) assistance to parents, schools,

11 youth agencies, and health care providers

12 to educate adolescents and pre-adolescents

13 concerning self-discipline and responsibility

14 in human sexuality;

15 ‘‘(J) referral to appropriate educational,

16 employment, employment training, and voca17 tional services;

18 ‘‘(K) mental health services and referral to

19 mental health services and to other appropriate

20 physical health and social services; and

21 ‘‘(L) encouragement of parent and family

22 involvement in each of the core services de23 scribed in subparagraphs (A) through (K).

24 ‘‘(4) ELIGIBLE GRANT RECIPIENT.—The term

25 ‘eligible grant recipient’ means a public or nonprofit
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1 private organization or agency that demonstrates, to

2 the satisfaction of the Secretary—

3 ‘‘(A) in the case of an organization that

4 will provide care services, the capability of pro5 viding all care services in a single setting or the

6 capability of creating a network through which

7 all care services would be provided; or

8 ‘‘(B) in the case of an organization that

9 will provide prevention services, the capability

10 of providing such services.

11 ‘‘(5) ELIGIBLE PERSON.—The term ‘eligible

12 person’ means—

13 ‘‘(A) with regard to the provision of pre14 vention services and referral to such other serv15 ices as may be appropriate, any adolescent; or

16 ‘‘(B) with regard to the provision of care

17 services, adolescent parents and (when appro18 priate) adolescents who are not parents.

19 ‘‘(6) PREVENTION SERVICES.—The term ‘pre20 vention services’ means services described in sub21 paragraphs (B) and (I) of paragraph (3) and refer22 rals to such other services as may be appropriate, in23 cluding services to be offered in schools at local

24 discretion.
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1 ‘‘(7) SECRETARY.—The term ‘Secretary’ means

2 the Secretary of Health and Human Services.

3 ‘‘(8) SUPPLEMENTAL SERVICES.—The term

4 ‘supplemental services’ means those services that

5 may be provided by a grantee, as determined by the

6 Secretary by regulation, which may include—

7 ‘‘(A) child care sufficient to enable the ad8 olescent parent to continue education or to

9 enter into employment, including services to be

10 provided within secondary schools at local dis11 cretion;

12 ‘‘(B) consumer education and home13 making;

14 ‘‘(C) counseling for the immediate and ex15 tended family members of the eligible person;

16 ‘‘(D) transportation;

17 ‘‘(E) referral to licensed residential care or

18 maternity home services;

19 ‘‘(F) referral to licensed adoption agencies

20 for adoption placement services;

21 ‘‘(G) employability training and counseling;

22 and

23 ‘‘(H) such other services as are consistent

24 with this title as the Secretary may approve in
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1 accordance with regulations promulgated by the

2 Secretary.

3 ‘‘SEC. 2003. AUTHORITY TO MAKE GRANTS FOR SERVICES.

4 ‘‘The Secretary may make grants to provide preven5 tion and care services to pregnant adolescents and their

6 male partners, adolescent parents, and nonpregnant ado7 lescents. Grants shall be used to provide, supplement, or

8 improve the quality of such services.

9 ‘‘SEC. 2004. USE OF GRANTS FOR SERVICES.

10 ‘‘(a) USES.—A grant made under this title may be

11 used to—

12 ‘‘(1) provide eligible persons—

13 ‘‘(A) prevention services;

14 ‘‘(B) care services; or

15 ‘‘(C) any combination of prevention and

16 care services;

17 ‘‘(2) coordinate, integrate, and provide linkages

18 among providers of prevention, care, and other serv19 ices for eligible persons in furtherance of the pur20 poses of this title;

21 ‘‘(3) provide supplemental services where such

22 services are not adequate or not available to eligible

23 persons in the community and that are essential to

24 the care of eligible persons and to the prevention of

25 adolescent pregnancy;
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1 ‘‘(4) plan, for a period of not more than 1 year,

2 for the administration and coordination of preg3 nancy prevention services and programs of care for

4 eligible persons that will further the objectives of

5 this title; and

6 ‘‘(5) fulfill assurances required for grant ap7 proval by section 2006.

8 ‘‘(b) FEES.—Grantees shall charge fees for services

9 only pursuant to a fee schedule, approved by the Secretary

10 as a part of the application described in section 2006, that

11 bases fees charged by the grantee on the income of the

12 eligible person and takes into account the difficulty adoles13 cents face in obtaining resources to pay for services. In

14 no case may a grantee discriminate with regard to the pro15 vision of services to any individual because of that individ16 ual’s inability to provide payment for such services.

17 ‘‘SEC. 2005. PRIORITIES, AMOUNTS, AND DURATION OF

18 GRANTS FOR SERVICES.

19 ‘‘(a) PRIORITIES.—In approving applications for

20 grants for services under this title, the Secretary shall give

21 priority to applicants who—

22 ‘‘(1) serve an area where there is a high inci23 dence of adolescent pregnancy;

24 ‘‘(2) serve an area with a high proportion of

25 low-income families and where the availability of
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1 programs of prevention and care for eligible persons

2 is low;

3 ‘‘(3) show evidence—

4 ‘‘(A) in the case of an applicant who will

5 provide prevention services, of having the ability

6 to provide prevention services for adolescents

7 and their families that are appropriate for the

8 target population and the geographic area to be

9 served, including the special needs of rural

10 areas; or

11 ‘‘(B) in the case of an applicant who will

12 provide care services, of having the ability to

13 bring together a wide range of needed core serv14 ices and, as appropriate, supplemental services

15 in comprehensive single-site programs, or to es16 tablish a well-integrated network of such serv17 ices (appropriate for the target population and

18 geographic area to be served including the spe19 cial needs of rural areas) for eligible persons;

20 ‘‘(4) will utilize to the maximum extent feasible

21 existing available programs and facilities such as

22 community health centers, child welfare agencies,

23 children and youth centers, maternal and infant

24 health centers, regional rural health facilities, li25 censed adoption agencies, maternity homes, school
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1 and other educational programs, family planning

2 clinics, mental health programs, nutrition programs,

3 recreation programs, and other ongoing pregnancy

4 prevention and pregnancy-related services;

5 ‘‘(5) make use, to the maximum extent feasible,

6 of other Federal, State, and local funds, programs,

7 contributions, and other third-party reimbursements;

8 ‘‘(6) can demonstrate a community commitment

9 to the program by making available to the program

10 non-Federal funds, personnel, and facilities;

11 ‘‘(7) have involved the community to be served,

12 including public and nonprofit private agencies, ado13 lescents, and families, in the planning and imple14 mentation of the program; and

15 ‘‘(8) will demonstrate innovative and effective

16 approaches in addressing the problems of adolescent

17 pregnancy or parenthood, including outreach to ado18 lescent males and approaches for providing pregnant

19 adolescents with adequate information about adop20 tion.

21 ‘‘(b) AMOUNTS.—

22 ‘‘(1) IN GENERAL.—The amount of a grant for

23 a program for services under this title shall be deter24 mined by the Secretary, based on factors such as the

25 incidence of adolescent pregnancy in the geographic
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1 area to be served, and the adequacy of pregnancy

2 prevention services and programs of care for eligible

3 persons in such area.

4 ‘‘(2) RURAL AREAS.—In making grants for

5 services under this title, the Secretary shall consider

6 the special needs of rural areas and, to the maxi7 mum extent practicable, shall distribute funds taking

8 into consideration the relative number of adolescents

9 in such areas in need of such services.

10 ‘‘(c) FEDERAL SHARE.—

11 ‘‘(1) IN GENERAL.—Subject to paragraph (3), a

12 grant for services under this title may not exceed 75

13 percent of the costs of the program for any year.

14 ‘‘(2) FORM OF NON-FEDERAL CONTRIBU15 TIONS.—Non-Federal contributions required by

16 paragraph (1) may be in cash or in kind, fairly eval17 uated, including plant, equipment, or services.

18 ‘‘(3) WAIVER.—The Secretary may waive the

19 limitation specified in paragraph (1) for any year in

20 accordance with criteria established by regulation.

21 ‘‘SEC. 2006. REQUIREMENTS FOR APPLICATIONS FOR

22 GRANTS FOR SERVICES.

23 ‘‘(a) IN GENERAL.—An application for a grant for

24 services under this title shall be in such form and contain
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1 such information as the Secretary may require, and shall

2 include—

3 ‘‘(1) an identification of the incidence of adoles4 cent pregnancy and related problems;

5 ‘‘(2) a description of the economic conditions

6 and income levels in the geographic area to be

7 served;

8 ‘‘(3) a description of existing pregnancy preven9 tion services and programs of care for eligible per10 sons (including adoption services), and including

11 where, how, by whom, and to which population

12 groups such services are provided, and the extent to

13 which they are coordinated in the geographic area to

14 be served;

15 ‘‘(4) a description of the major unmet needs for

16 services for adolescents at risk of initial or recurrent

17 pregnancies and an estimate of the number of ado18 lescents not being served in the area;

19 ‘‘(5)(A) in the case of an applicant who will

20 provide prevention services, a description of the nec21 essary services to be provided and how the applicant

22 will provide such services; or

23 ‘‘(B) in the case of an applicant who will pro24 vide care services, a description of how all core serv25 ices will be provided in the program using funds
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1 under this title or will otherwise be provided by the

2 grantee in the area to be served, the population to

3 which such services will be provided, how such serv4 ices will be coordinated, integrated, and linked with

5 other related programs and services and the source

6 or sources of funding of such core services in the

7 public and private sectors; or

8 ‘‘(6) a description of the manner in which ado9 lescents needing services other than the services pro10 vided directly by the applicant will be identified and

11 how access and appropriate referral to such other

12 services (such as but not limited to medicaid; li13 censed adoption agencies; maternity home services;

14 public assistance; employment services; child care

15 services for adolescent parents; and other city, coun16 ty, and State programs related to adolescent preg17 nancy) will be provided, including a description of a

18 plan to coordinate such other services with the serv19 ices supported under this title;

20 ‘‘(7) a description of the results expected from

21 the provision of services, and the procedures to be

22 used for evaluating those results;

23 ‘‘(8) assurances that the applicant will have an

24 ongoing quality assurance program;
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1 ‘‘(9) assurances that the applicant shall have a

2 system for maintaining the confidentiality of patient

3 records in accordance with regulations prescribed by

4 the Secretary;

5 ‘‘(10) assurances that the applicant will dem6 onstrate its financial responsibility by the use of

7 such accounting procedures and other requirements

8 as may be prescribed by the Secretary;

9 ‘‘(11) assurances that the applicant will make

10 maximum use of other sources of Federal and State

11 funding;

12 ‘‘(12)(A) a description of—

13 ‘‘(i) the schedule of fees to be used in the

14 provision of services, which shall comply with

15 section 2004(c); and

16 ‘‘(ii) a corresponding schedule of discounts

17 to be applied to the payment of such fees, which

18 shall—

19 ‘‘(I) comply with section 2004(b);

20 ‘‘(II) be adjusted on the basis of the

21 ability of the eligible person to pay; and

22 ‘‘(III) provide that no fee will be im23 posed on any eligible individual with an in24 come of less than 100 percent of the offi25 cial poverty line;
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1 ‘‘(B) assurances that the applicant has made

2 and will continue to make every reasonable effort—

3 ‘‘(i) to secure from eligible persons pay4 ment for services in accordance with such

5 schedules;

6 ‘‘(ii) to collect reimbursement for health or

7 other services provided to persons who are enti8 tled to have payment made on their behalf for

9 such services under any Federal or other gov10 ernment program or private insurance program;

11 and

12 ‘‘(iii) to seek such reimbursement on the

13 basis of the full amount of fees for services

14 without application of any discount; and

15 ‘‘(C) assurances that the applicant has submit16 ted or will submit to the Secretary such reports as

17 the Secretary may require to determine compliance

18 with this paragraph;

19 ‘‘(13) assurances that the applicant will make

20 maximum use of funds available under title X;

21 ‘‘(14) assurances that the acceptance by any in22 dividual of family planning services or family plan23 ning information (including educational materials)

24 provided through financial assistance under this title

25 shall be voluntary and shall not be a prerequisite to
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1 eligibility for or receipt of any other service fur2 nished by the applicant;

3 ‘‘(15) assurances that fees collected by the ap4 plicant for services rendered in accordance with this

5 title shall be used by the applicant to further the

6 purposes of this title;

7 ‘‘(16) assurances that the applicant, if provid8 ing both prevention and care services, will not ex9 clude or discriminate against any adolescent who re10 ceives prevention services and subsequently requires

11 care services as a pregnant adolescent;

12 ‘‘(17) a description of how the applicant will as13 certain whether services for which adolescents have

14 been referred have actually been obtained and de15 velop a plan to ensure that needed services actually

16 are received;

17 ‘‘(18) assurances that unemancipated minors

18 requesting services from the applicant will be en19 couraged to consult with their parents with respect

20 to such services and that services shall not be denied

21 to unemancipated minors who decide not to consult

22 their parents;

23 ‘‘(19) assurances that all pregnant adolescents

24 receiving services will be informed of the availability

25 of counseling (either by the entity providing core
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1 services or through a referral agreement with such

2 other entity that provides such counseling) on all op3 tions, regarding the pregnancy;

4 ‘‘(20) assurances that primary emphasis for

5 services supported under this title shall be given to

6 adolescents 17 and under who are not able to obtain

7 needed assistance through other means;

8 ‘‘(21) assurances that funds received under this

9 title shall not supplant funds received from any

10 other Federal, State, or local program or any private

11 sources of funds; and

12 ‘‘(22) a plan for the conduct of, and assurances

13 that the applicant will conduct, evaluations of the ef14 fectiveness of the services supported under this title

15 in accordance with subsection (b).

16 ‘‘(b) EVALUATIONS.—

17 ‘‘(1) IN GENERAL.—Each grantee that receives

18 funds for a grant for services under this title shall

19 expend at least 3 percent but not in excess of 10

20 percent of the amounts received under this title for

21 the conduct of evaluations of the services supported

22 under this title. The Secretary may, for a particular

23 grantee on good cause shown, waive the preceding

24 sentence with respect to the amounts to be expended
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1 on evaluations, but may not waive the requirement

2 that such evaluations be conducted.

3 ‘‘(2) INDEPENDENT EVALUATION.—Evaluations

4 required by paragraph (1) shall be conducted by an

5 organization or entity that is independent of the

6 grantee providing services supported under this title.

7 ‘‘(c) REPORTS.—

8 ‘‘(1) IN GENERAL.—Each grantee that partici9 pates in the program established by this title shall

10 make such reports concerning its use of Federal

11 funds as the Secretary may require, including re12 ports on prevention programs and care programs.

13 ‘‘(2) CONTENTS OF REPORTS ON PREVENTION

14 PROGRAMS.—Reports on prevention programs shall

15 be in a standard format as prescribed by the Sec16 retary and shall include a description of—

17 ‘‘(A) the characteristics, educational at18 tainments, and economic status of clients;

19 ‘‘(B) the clients’ previous exposure in

20 home, school, or other locations to educational

21 efforts regarding sexuality and family life;

22 ‘‘(C) the types of interventions employed in

23 the prevention program;
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1 ‘‘(D) the before and after outcome meas2 urements on variables appropriate to the inter3 vention;

4 ‘‘(E) to the extent possible and where ap5 propriate to program goals, the pregnancy and

6 sexually transmitted disease rates subsequent to

7 intervention; and

8 ‘‘(F) the extent of parent or family involve9 ment in the program.

10 ‘‘(3) CONTENTS OF REPORTS ON CARE PRO11 GRAMS.—Reports on care programs shall be in

12 standard format as prescribed by the Secretary and

13 shall include a description of—

14 ‘‘(A) the characteristics, health history,

15 educational attainments, and economic status of

16 clients at the time of entry;

17 ‘‘(B) the client prenatal care and preg18 nancy outcome, complications of pregnancy and

19 delivery, and infant birth outcomes;

20 ‘‘(C) the characteristics, educational at21 tainments, and economic status of clients at

22 time of follow-up and infant follow-up informa23 tion;

24 ‘‘(D) the types of services provided to cli25 ents; and
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1 ‘‘(E) the extent of parent or family involve2 ment in the services provided.

3 ‘‘(4) COMPARISON DATA.—Reports on preven4 tion programs and care programs shall include con5 trol group data or other appropriate comparison

6 data to provide comparisons with project data and to

7 indicate program impact or effectiveness.

8 ‘‘(5) FOLLOW-UP DATA.—Reports on prevention

9 programs and care programs shall include, to the ex10 tent possible, follow-up data on a random sample of

11 program graduates and dropouts.

12 ‘‘(d) TIMING OF SERVICES.—No application submit13 ted for a grant for a program for care services under this

14 title may be approved unless the Secretary is satisfied that

15 core services shall be available through the applicant with16 in a reasonable time after such grant is received.

17 ‘‘SEC. 2007. COORDINATION OF FEDERAL AND STATE PRO18 GRAMS.

19 ‘‘(a) FEDERAL PROGRAMS.—The Secretary shall co20 ordinate Federal policies and programs providing services

21 relating to the prevention of initial and recurrent adoles22 cent pregnancies and providing care services for eligible

23 persons. In achieving such coordination, the Secretary

24 shall—
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1 ‘‘(1) require grantees who receive grants for

2 services under this title to report periodically to the

3 Secretary concerning Federal, State, and local poli4 cies and programs that interfere with the delivery of

5 and coordination of pregnancy prevention services

6 and other programs of care for pregnant adolescents

7 and adolescent parents;

8 ‘‘(2) provide technical assistance to facilitate

9 coordination by State and local recipients of Federal

10 assistance;

11 ‘‘(3) give priority in the provision of funds,

12 where appropriate, to applicants using single or co13 ordinated grant applications for multiple programs;

14 and

15 ‘‘(4) give priority, where appropriate, to the

16 provision of funds under Federal programs adminis17 tered by the Secretary (other than the program es18 tablished by this title) to programs providing com19 prehensive prevention services and comprehensive

20 programs of care for eligible persons.

21 ‘‘(b) OTHER RECIPIENTS.—Any recipient of a grant

22 for services under this title shall coordinate its activities

23 with any other recipient of such a grant that is located

24 in the same locality.
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1 ‘‘SEC. 2008. GRANTS FOR RESEARCH.

2 ‘‘(a) IN GENERAL.—

3 ‘‘(1) AUTHORIZATION.—The Secretary may

4 make grants to public agencies or nonprofit private

5 organizations or institutions of higher education to

6 support the research and dissemination activities de7 scribed in paragraphs (4), (5), and (6) of section

8 2001(b).

9 ‘‘(2) DURATION.—The Secretary may make

10 grants or enter into contracts under this section for

11 a period of 1 year. A grant or contract under this

12 section for a program may be renewed for 4 addi13 tional 1-year periods, which need not be consecutive.

14 ‘‘(3) AMOUNT LIMITATION.—A grant or con15 tract for any 1-year period under this section may

16 not exceed $100,000 for the direct costs of conduct17 ing research or dissemination activities under this

18 section and may include such additional amounts for

19 the indirect costs of conducting such activities as the

20 Secretary determines appropriate. The Secretary

21 may waive the preceding sentence with respect to a

22 specific program if the Secretary determines that—

23 ‘‘(A) exceptional circumstances warrant

24 such waiver and that the program will have na25 tional impact;
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1 ‘‘(B) additional amounts are necessary for

2 the direct costs of conducting limited programs

3 for the provision of necessary services in order

4 to provide data for research carried out under

5 this title; or

6 ‘‘(C) several grantees together require

7 more than $100,000 to evaluate the effective8 ness of different combinations of services, and

9 if such grantees demonstrate evidence of rea10 sonable progress in the first year, such

11 multisite evaluation studies shall receive pref12 erence for funding renewal.

13 ‘‘(4) CARRYOVER FOR REPORT.—The amount

14 of any grant or contract made under this section

15 may remain available for obligation or expenditure

16 after the close of the 1-year period for which such

17 grant or contract is made in order to assist the re18 cipient in preparing the report required by sub19 section (f)(1).

20 ‘‘(b) USE OF FUNDS.—

21 ‘‘(1) IN GENERAL.—Funds provided for re22 search under this section may be used for descriptive

23 or explanatory surveys, evaluation studies, longitu24 dinal studies, or limited programs for services that

25 are for the purpose of increasing knowledge and un-
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1 derstanding of the matters described in paragraphs

2 (4) and (5) of section 2001(b).

3 ‘‘(2) LIMITATIONS.—Funds provided under this

4 section may not be used for the purchase or im5 provement of land, or the purchase, construction, or

6 permanent improvement (other than minor remodel7 ing) of any building or facility.

8 ‘‘(c) PREREQUISITES.—The Secretary may not make

9 any grant or enter into any contract to support research

10 or dissemination activities under this section unless—

11 ‘‘(1) the Secretary has received an application

12 for such grant or contract that is in such form and

13 that contains such information as the Secretary may

14 by regulation require;

15 ‘‘(2) the applicant has demonstrated that the

16 applicant is capable of conducting one or more of

17 the types of research or dissemination activities de18 scribed in paragraph (4), (5), or (6) of section

19 2001(b); and

20 ‘‘(3) in the case of an application for a research

21 program, the panel established by subsection (e)(2)

22 has determined that the program is of scientific

23 merit.

24 ‘‘(d) COORDINATION.—The Secretary shall coordi25 nate research and dissemination activities carried out
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1 under this section with research and dissemination activi2 ties carried out by the National Institutes of Health.

3 ‘‘(e) REVIEW OF APPLICATIONS.—

4 ‘‘(1) SYSTEM.—The Secretary shall establish a

5 system for the review of applications for grants and

6 contracts under this section. Such system shall be

7 substantially similar to the system for scientific peer

8 review of the National Institutes of Health and shall

9 meet the requirements of paragraphs (2) and (3).

10 ‘‘(2) PANEL.—

11 ‘‘(A) ESTABLISHMENT.—In establishing

12 the system required by paragraph (1), the Sec13 retary shall establish a panel to review applica14 tions under this section.

15 ‘‘(B) EXPERTISE.—Panel members should

16 have expertise in research and evaluation and

17 should represent disciplines relevant to the

18 study of adolescent pregnancy and parenting.

19 ‘‘(C) LIMIT ON PHYSICIANS.—Not more

20 than 25 percent of the members of the panel

21 shall be physicians.

22 ‘‘(D) MEETINGS.—The panel shall meet as

23 often as may be necessary to facilitate the expe24 ditious review of applications under this section,

25 but not less than once each year.
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1 ‘‘(E) REVIEW.—The panel shall review

2 each program for which an application is made

3 under this section, evaluate the scientific merit

4 of the program, determine whether the program

5 is of scientific merit, and make recommenda6 tions to the Secretary concerning whether the

7 application for the program should be approved.

8 ‘‘(3) GRANT DETERMINATION.—The Secretary

9 shall make grants under this section from among the

10 programs that the panel established by paragraph

11 (2) has determined to be of scientific merit and may

12 only approve an application for a program if the

13 panel has made such determination with respect to

14 such a program. The Secretary shall make a deter15 mination with respect to an application within 1

16 month after receiving the determinations and rec17 ommendations of such panel with respect to the

18 application.

19 ‘‘(f) REPORTS.—

20 ‘‘(1) RESEARCH REPORTS.—

21 ‘‘(A) IN GENERAL.—The recipient of a

22 grant or contract for a research program under

23 this section shall prepare and transmit to the

24 Secretary a report describing the results and

25 conclusions of such research. Except as pro-
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1 vided in subparagraph (B), such report shall be

2 transmitted to the Secretary not later than 12

3 months after the end of the year for which

4 funds are provided under this section. The re5 cipient may utilize reprints of articles published

6 or accepted for publication in professional jour7 nals to supplement or replace such report if the

8 research contained in such articles was sup9 ported under this section during the year for

10 which the report is required.

11 ‘‘(B) MULTIYEAR PROGRAMS.—In the case

12 of any research program for which assistance is

13 provided under this section for 2 or more con14 secutive 1-year periods, the recipient of such as15 sistance shall prepare and transmit the report

16 required by subparagraph (A) to the Secretary

17 not later than 12 months after the end of each

18 1-year period for which such funding is pro19 vided.

20 ‘‘(2) OTHER REPORTS.—Recipients of grants

21 and contracts for dissemination under this section

22 shall submit to the Secretary such reports as the

23 Secretary determines appropriate.
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1 ‘‘SEC. 2009. EVALUATION.

2 ‘‘Of the funds appropriated under this title, the Sec3 retary shall reserve not less than 1 percent and not more

4 than 3 percent for the evaluation of activities carried out

5 under this title. The Secretary shall submit to the appro6 priate committees of Congress a summary of each evalua7 tion conducted under this section and a summary of the

8 data reported by grantees under section 2006(c).

9 ‘‘SEC. 2010. AUTHORIZATION OF APPROPRIATIONS.

10 ‘‘(a) IN GENERAL.—For the purpose of carrying out

11 this title, there are authorized to be appropriated

12 $60,000,000 for each of the fiscal years 1995 through

13 1997.

14 ‘‘(b) GRANTS FOR SERVICES.—At least two-thirds of

15 the amounts appropriated to carry out this title shall be

16 used to make grants for services.

17 ‘‘(c) PREVENTION SERVICES.—Two-thirds of the

18 amounts specified under subsection (b) for use for grants

19 for services shall be used for grants for prevention

20 services.

21 ‘‘SEC. 2011. FUND RESTRICTION.

22 ‘‘No funds for grants made under this title may be

23 used for payment for the performance of an abortion.’’.

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