S620 CONGRESSIONAL RECORD — SENATE January 15, 2009 

adult who is long-term unemployed, a lowskilled individual, limited English proficient, an individual with a disability, or an 

older worker, with multiple barriers to finding a job in a viable industry. 

(c) GENERAL AUTHORITY.—The Secretary is 

authorized to reserve $800,000,000 of the funds 

appropriated under this Act to carry out this 

section. The Secretary shall use the reserved 

funds to make allotments to States and outlying areas, consistent with the allotment 

formula under section 132(b)(1) of the Workforce Investment Act of 1998 (29 U.S.C. 

2862(b)(1)) to provide employment and training activities to adults with multiple barriers to employment. 

(d) STATE ACTIVITIES.—Each State or outlying area may use 10 percent of the State’s 

or outlying area’s allotment to assist local 

boards in providing employment and training activities to adults with multiple barriers to employment, and assist the adults in 

attaining jobs in viable industries, with as 

much flexibility as is practicable. In providing assistance under this subsection, the 

State or outlying area may provide aid that 

includes assistance with system alignment 

(described in subsection (e)(1)(D), the provision of capacity building and professional development activities for staff, and the provision of enhanced regional sector-based labor 

market information. 

(e) LOCAL ACTIVITIES.— 

(1) IN GENERAL.—Each State or outlying 

area shall use 90 percent of the State’s or 

outlying area’s allotment to make grants, on 

a competitive basis, to local boards for local 

areas, to provide employment and training 

activities to adults with multiple barriers to 

employment. 

(2) PRIORITY.—In making the grants, the 

chief executive officer of the State or outlying area, in consultation with the State 

board involved, shall give priority to those 

local boards that— 

(A) align their local areas to create regions 

that reflect natural labor markets or economic development districts; 

(B) reflect regional strategic partnerships 

described in paragraph (3) among local 

boards, industry (including business and 

labor), schools (including community colleges), and other community organizations 

to provide coherent programs of employment 

and training activities; 

(C) make special efforts to conduct outreach and provide services to adults with 

multiple barriers to employment who need 

to advance their careers or seek second careers due to the economic downturn; 

(D) align adult education, career and technical education, workforce investment, economic development, and related systems and 

resources to provide career pathway strategies for helping low-skilled individuals navigate through the continuum of needed education and supports, to ultimately achieve a 

postsecondary education credential or an industry-recognized certificate and a job leading to economic self-sufficiency; 

(E) provide an assurance that the local 

board will use at least 90 percent of the grant 

funds for intensive services described in section 134(d)(3)(C) and training services described in section 134(d)(4)(D) of such Act (29 

U.S.C. 2864(d)(3)(C), 2864(d)(4)(D)), without regard to the eligibility requirements of section 134(d) of such Act (29 U.S.C. 2864(d)). 

(3) STRATEGIC PARTNERSHIP.— 

(A) IN GENERAL.—For purposes of this section, a strategic partnership shall, in particular, be composed of at least 1 representative of a local board serving a community, 

and of each of the 8 types of organizations 

described in subparagraph (B). 

(B) TYPES OF ORGANIZATIONS.—The types of 

organizations referred to in subparagraph (A) 

are businesses, unions, labor-management 

partnerships, schools (including community 

colleges), public agencies, nonprofit community organizations, economic development 

entities, and philanthropic organizations, 

that are actively engaged in providing employment and training activities, including 

work opportunities and support, to adults 

with multiple barriers to employment. 

(f) REPORT TO SECRETARY.— 

(1) IN GENERAL.—Each State, in submitting 

an annual report under section 136(d) of such 

Act (29 U.S.C. 2871(d)), shall include information— 

(A) on acquisition of a recognized postsecondary education credential or an industryrecognized certificate by adults with multiple barriers to employment who participated in employment and training activities 

under this section; 

(B) on entry of such adults, who participated in such activities, into positions in unsubsidized employment in viable industries; 

and 

(C) for adults referred to in subparagraph 

(B), on average wages in such positions. 

(2) REFINEMENTS.—In establishing standards for the reports, the Secretary shall refine indicators to eliminate any unintended 

consequences for adults with multiple barriers to employment, or such adults who 

may need and seek less than full-time employment along a career path. 

SEC. 7. ENERGY EFFICIENCY AND RENEWABLE 

ENERGY WORKER TRAINING PROGRAM. 

The Secretary shall reserve $625,000,000 of 

the funds appropriated under this Act to 

carry out section 171(e) of the Workforce Investment Act of 1998 (29 U.S.C. 2916(e)). 

SEC. 8. AUTHORIZATION OF APPROPRIATIONS. 

There is authorized to be appropriated to 

the Secretary of Labor for activities described in this Act, $3,425,000,000, which shall 

be available for the period of January 1, 2009 

through December 31, 2010. 

By Mr. CASEY (for himself and 

Mr. NELSON, of Nebraska): 

S. 270. A bill to provide for programs 

that reduce the need for abortion, help 

women bear healthy children, and support new parents; to the Committee on 

Health, Education, Labor, and Pensions. 

Mr. CASEY. Mr. President, I rise 

today to speak about a member of the 

American family for whom we all care, 

but for whom we don’t do nearly 

enough to support: pregnant women. 

I remember the times my wife Terese 

learned she was pregnant, and even 

though I can never experience it directly, I know through her and my sisters that there is one indelible and unforgettable moment when a woman 

finds out she is pregnant. For many 

women, this is a moment of great joy, 

the miracle of pregnancy. Perhaps it 

has been long awaited or perhaps it is 

something of a surprise, but it is welcome. Many of these women don’t need 

help beyond what their families provide and others may receive adequate 

support within our existing framework 

of programs and services. 

But there is another circumstance 

that a pregnant woman may face. For 

that woman, the moment of discovery 

is not a moment of joy. For her, it is a 

moment of terror, or panic or even 

shame. She may be in a doctor’s office 

or clinic or she may be at home. For 

her, that moment begins a crisis in 

which she feels overwhelmingly and 

perhaps almost unbearably alone. She 

could be wealthy, middle income or 

poor, but most likely poor. Whatever 

her income, she feels, very simply, all 

alone. 

A pregnant woman may have an abusive spouse or boyfriend who is tormenting her. She is all alone. 

Another pregnant woman may believe that she cannot support or care 

for a new baby at this point in her life. 

She is all alone. 

Another woman might believe that 

her financial situation is so precarious 

that she cannot care for and raise a 

child. She may feel alone and helpless. 

We know that 48 percent of all pregnancies are unintended and, excluding 

miscarriages, 54 percent of unintended 

pregnancies end in abortion. The response ‘‘cannot afford a baby’’ is the 

second most frequently cited reason 

why women choose to have an abortion 

and 73 percent of women having abortions cited this reason as a contributing factor. 

A woman who is facing the challenges of an unplanned pregnancy that 

may be a crisis for her does not need a 

lecture from a politician or a clinical 

reminder that she has a simple choice 

to make. The choice is never simple. 

Never. This woman needs support and 

love and understanding. She needs to 

be embraced in her time of crisis, not 

sent on her way to deal with it on her 

own. She needs our help to walk with 

her, not only throughout the nine 

months of her pregnancy, but also for 

the early months and years of her 

child’s life. 

We in the Congress, in both the 

House and Senate and both parties, 

need to address this issue in a comprehensive way that meets these needs. 

Some members have initiated good efforts and we should applaud and support those efforts, but I believe that 

neither political party is doing enough 

for pregnant women in America today. 

While there is tremendous disagreement on how we can best do this, there 

is one significant area of common 

ground—one thing we all agree upon. 

We all want to reduce the number of 

abortions. 

Many women who have abortions do 

so very reluctantly, and while ‘‘choice’’ 

is a term that is widely used in this debate, many women who face unplanned 

pregnancies do not feel they have a 

genuine choice. That is why I am introducing the Pregnant Women Support 

Act. With this bill, it is my fervent 

hope that a new dialogue—a common 

ground—will emerge on how we can reduce abortions by offering pregnant 

women real choices: 

This bill will: assist pregnant and 

parenting teens to finish high school 

and prepare for college or vocational 

training; help pregnant college students stay in school, offering them 

counseling as well as assistance with 

continuing their education, parenting 

support and classes, and child care assistance. 


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January 15, 2009 CONGRESSIONAL RECORD — SENATE S621 

It will provide counseling and shelter 

to pregnant women in abusive relationships who may be fearful of continuing 

a (pregnancy in a crisis situation; establish a national toll-free number and 

public awareness campaign to offer 

women support and knowledge about 

options and resources available to 

them when they face an unplanned 

pregnancy; give women free sonogram 

examinations by providing grants for 

the purchase of ultrasound equipment; 

provide parents with information about 

genetic disability testing, including 

support for parents who receive a diagnosis of Down Syndrome; ensure that 

pregnant women receive prenatal and 

postnatal care by eliminating pregnancy as a pre-existing condition in 

the individual healthcare market and 

also eliminating waiting periods for 

women with prior coverage; increase 

funding for nurse home visitation for 

pregnant and first time mothers. One 

example of this is the Nurse-Family 

Partnership, an evidence-based program and national model in which 

nurses mentor young first-time and 

primarily low-income mothers, establishing a supportive relationship with 

both mother and child. 

Studies have shown this program to 

be both cost effective and hugely successful in terms of life outcomes for 

both mothers and children; increase 

funding for the Women, Infants and 

Children Program, providing nutrition 

assessment, counseling and education, 

obesity prevention, breastfeeding support, prenatal and pediatric health care 

referrals, immunization screening and 

referral, and a host of other services 

for mothers and children; expand nutritional support for low-income parents 

by increasing the income eligibility 

level for food stamps; increase funding 

for the Child Care and Development 

Block Grant, the primary source of federal funding for child care assistance 

for low-income parents. 

I introduce this bill with the deepest 

conviction that we can find common 

ground. I believe that we can transform 

this debate by focusing upon the issues 

that unite us, not the issues that divide 

us. It’s well known where I stand on 

these issues. I am a pro-life Democrat. 

I believe that life begins at conception 

and ends when we draw our last breath. 

I believe that the role of government is 

to protect, enrich, and value life for everyone, at every moment, from beginning to end. And I believe that we as a 

nation have to do more to support 

women and their children when they 

are most vulnerable—during pregnancy 

and early childhood. 

I support family planning programs 

because they avoid what can be a dark 

moment, when a woman, often alone, 

faces a pregnancy she feels she can’t 

handle. I support family planning programs precisely because they reduce 

abortions. But that is not the issue I 

address today. Today, with this bill, I 

am focused on the woman who is pregnant and I am asking a question we 

should all be asking: ‘‘What more can I 

do?’’ ‘‘What more can we do for pregnant women who need our help?’’ 

I believe there is more common 

ground in America than we might realize—if only we focus on how we can 

truly help and support women who 

wish to carry their pregnancies to term 

and how we can give them and their babies what they really need to begin 

healthy and productive lives together. 

For the past 35 years, the abortion 

issue has been used mostly as a way to 

divide people, even as the number of 

abortions remains unacceptably high. 

We have to find a better way. I believe 

the Pregnant Women Support Act is 

part of that better way. We must work 

toward real solutions to the issue of 

abortion by targeting the underlying 

factors that often lead women to have 

abortions. This is precisely what the 

Pregnant Women Support Act will do. 

We need to walk in solidarity with 

pregnant women who face unplanned 

pregnancies and who need our support 

and help, not our judgment. That is exactly what this bill does for that 

woman who finds herself alone as she 

faces what may be the most difficult 

experience of her entire life: the 

woman who has no one to turn to for 

advice, for counsel, for support. I truly 

believe there are few things more terrifying than the prospect of supporting 

another human being when you have 

no support of your own. 

Reducing the number of abortions 

should not be a partisan issue. It 

should not pit Democrats against Republicans. I seek. common ground. I 

ask my colleagues on both sides of the 

aisle to join me in seeking real solutions that will unite us in providing 

life with dignity, before and after 

birth, for pregnant women, mothers 

and children. Surely we must all agree 

that no woman should ever have to 

face the crisis of an unplanned pregnancy alone. 

Mr. President, I ask unanimous consent that the text of the bill be printed 

in the RECORD. 

Mr. President, I ask unanimous consent that the text of the bill be printed 

in the RECORD. 

S. 270 

Be it enacted by the Senate and House of Representatives of the United States of America in 

Congress assembled, 

SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

(a) SHORT TITLE.—This Act may be cited as 

the ‘‘Pregnant Women Support Act’’. 

(b) TABLE OF CONTENTS.—The table of contents for this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Findings. 

Sec. 3. Definitions. 

TITLE I—PUBLIC AWARENESS AND ASSISTANCE FOR PREGNANT WOMEN AND 

NEW PARENTS 

Sec. 101. Grants for increasing public awareness of resources available to 

assist pregnant women in carrying their pregnancies to term 

and to assist new parents. 

TITLE II—INCREASING WOMEN’S 

KNOWLEDGE ABOUT THEIR PREGNANCY 

Sec. 201. Grants to health centers for purchase of ultrasound equipment. 

TITLE III—PREGNANCY AS A 

PREEXISTING CONDITION 

Sec. 301. Individual health insurance coverage for pregnant women. 

Sec. 302. Continuation of health insurance 

coverage for newborns. 

TITLE IV—MEDICAID AND SCHIP COVERAGE OF PREGNANT WOMEN AND UNBORN CHILDREN 

Sec. 401. Treatment of unborn children. 

Sec. 402. Coordination with the maternal 

and child health program. 

TITLE V—DISCLOSURE OF INFORMATION 

ON ABORTION SERVICES 

Sec. 501. Disclosure of information on abortion services. 

TITLE VI—SERVICES TO PATIENTS RECEIVING POSITIVE TEST DIAGNOSIS OF 

DOWN SYNDROME OR OTHER PRENATALLY DIAGNOSED CONDITIONS 

Sec. 601. Services to patients receiving positive test diagnosis for down 

syndrome or other prenatally 

diagnosed conditions. 

TITLE VII—SUPPORT FOR PREGNANT 

AND PARENTING COLLEGE STUDENTS 

Sec. 701. Sense of Congress. 

Sec. 702. Definitions. 

Sec. 703. Pregnant and parenting student 

services pilot program. 

Sec. 704. Application; number of grants. 

Sec. 705. Matching Requirement. 

Sec. 706. Use of funds. 

Sec. 707. Reporting. 

Sec. 708. Authorization of appropriations. 

TITLE VIII—SUPPORT FOR PREGNANT 

AND PARENTING TEENS 

Sec. 801. Grants to States. 

TITLE IX—IMPROVING SERVICES FOR 

PREGNANT WOMEN WHO ARE VICTIMS 

OF DOMESTIC VIOLENCE, DATING VIOLENCE, AND STALKING 

Sec. 901. Findings. 

Sec. 902. Program to support pregnant 

women who are victims of domestic violence. 

Sec. 903. Homicide death certificates of certain female victims. 

TITLE X—LIFE SUPPORT CENTERS FOR 

PREGNANT WOMEN, MOTHERS, AND 

CHILDREN 

Sec. 1001. Life support centers pilot program. 

TITLE XI—PROVIDING SUPPORT TO NEW 

PARENTS 

Sec. 1101. Increased support for WIC program. 

Sec. 1102. Nutritional support for low-income parents. 

Sec. 1103. Increased funding for the Child 

Care and Development Block 

Grant program. 

Sec. 1104. Teenage or first-time mothers; 

free home visits by registered 

nurses for education on health 

needs of infants. 

TITLE XII—COLLECTING AND 

REPORTING ABORTION DATA 

Sec. 1201. Grants for collection and reporting of abortion data. 

SEC. 2. FINDINGS. 

The Congress finds as follows: 

(1) In 2004, 839,226 abortions were reported 

to the Centers for Disease Control and Prevention. 

(2) 48 percent of all pregnancies in America 

are unintended. Excluding miscarriages, 54 

percent of unintended pregnancies end in 

abortion. 

(3) 57 percent of women who have abortions 

have incomes below 200 percent of the poverty level. 

(4) ‘‘Cannot afford a baby’’ is the second 

most frequently cited reason women choose 


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S622 CONGRESSIONAL RECORD — SENATE January 15, 2009 

to have an abortion; 73 percent of women 

having abortions cited this reason as a contributing factor. 

(5) This Act is an initiative to gather more 

complete information about abortion, to reduce the abortion rate by helping women 

carry their pregnancies to term and bear 

healthy children, and by affirming the right 

of women to be fully informed about their 

other options when they seek an abortion. 

(6) The initiative will work to support 

women facing unplanned pregnancies, new 

parents and their children by providing comprehensive measures for health care needs, 

supportive services and helpful prenatal information and postnatal services. 

SEC. 3. DEFINITIONS. 

For purposes of this Act: 

(1) The term ‘‘Secretary’’ means the Secretary of Health and Human Services. 

(2) The term ‘‘State’’ includes the 50 

States, the District of Columbia, the Commonwealth of Puerto Rico, the Commonwealth of the Northern Mariana Islands, 

American Samoa, Guam, the Virgin Islands, 

and any other territory or possession of the 

United States. 

TITLE I—PUBLIC AWARENESS AND ASSISTANCE FOR PREGNANT WOMEN AND 

NEW PARENTS 

SEC. 101. GRANTS FOR INCREASING PUBLIC 

AWARENESS OF RESOURCES AVAILABLE TO ASSIST PREGNANT WOMEN 

IN CARRYING THEIR PREGNANCIES 

TO TERM AND TO ASSIST NEW PARENTS. 

(a) GRANTS.—The Secretary may make 

grants to States to increase public awareness 

of resources available to pregnant women to 

carry their pregnancy to term and to new 

parents. 

(b) USE OF FUNDS.—The Secretary may 

make a grant to a State under this section 

only if the State agrees to use the grant for 

the following: 

(1) Identification of resources available to 

assist pregnant women to carry their pregnancy to term or to assist new parents, or 

both. 

(2) Conducting an advertising campaign to 

increase public awareness of such resources. 

(3) Establishing and maintaining a toll-free 

telephone line to direct people to— 

(A) organizations that provide support 

services for pregnant women to carry their 

pregnancy to term; 

(B) adoption centers; and 

(C) organizations that provide support 

services to new parents. 

(c) PROHIBITION.—The Secretary shall prohibit each State receiving a grant under this 

section from using the grant to direct people 

to an organization or adoption center that is 

for-profit. 

(d) IDENTIFICATION OF RESOURCES.—The 

Secretary shall require each State receiving 

a grant under this section to make publicly 

available by means of the Internet (electronic and paper form) a list of the following: 

(1) The resources identified pursuant to 

subsection (b)(1). 

(2) The organizations and adoption centers 

to which people are directed pursuant to an 

advertising campaign or telephone line funded under this section. 

(e) AUTHORIZATION OF APPROPRIATIONS.— 

The Secretary shall make such funds available as may be necessary to carry out the activities of this section. 

TITLE II—INCREASING WOMEN’S 

KNOWLEDGE ABOUT THEIR PREGNANCY 

SEC. 201. GRANTS TO HEALTH CENTERS FOR 

PURCHASE OF ULTRASOUND EQUIPMENT. 

Part B of title III of the Public Health 

Service Act (42 U.S.C. 243 et seq.) is amended 

by inserting after section 317L the following: 

‘‘SEC. 317L–1. GRANTS FOR THE PURCHASE OR 

UPGRADE OF ULTRASOUND EQUIPMENT. 

‘‘(a) IN GENERAL.—The Secretary may 

make grants for the purchase of ultrasound 

equipment. Such ultrasound equipment shall 

be used by the recipients of such grants to 

provide, under the direction and supervision 

of a licensed medical physician, ultrasound 

examinations to pregnant women consenting 

to such services. 

‘‘(b) ELIGIBILITY REQUIREMENTS.—An entity 

may receive a grant under subsection (a) 

only if the entity meets the following conditions: 

‘‘(1) The entity is a health center eligible 

to receive a grant under section 330 (relating 

to community health centers, migrant 

health centers, homeless health centers, and 

public-housing health centers). 

‘‘(2) The entity agrees to comply with the 

following medical procedures: 

‘‘(A) The entity will inform each pregnant 

woman upon whom the ultrasound equipment is used that she has the right to view 

the visual image of the unborn child from 

the ultrasound examination and that she has 

the right to hear a general anatomical and 

physiological description of the characteristics of the unborn child. 

‘‘(B) The entity will inform each pregnant 

woman that she has the right to learn, according to the best medical judgment of the 

physician performing the ultrasound examination or the physician’s agent performing 

such exam, the approximate age of the embryo or unborn child considering the number 

of weeks elapsed from the probable time of 

the conception of the embryo or unborn 

child, based upon the information provided 

by the client as to the time of her last menstrual period, her medical history, a physical 

examination, or appropriate laboratory 

tests. 

‘‘(c) APPLICATION FOR GRANT.—A grant may 

be made under subsection (a) only if an application for the grant is submitted to the 

Secretary and the application is in such 

form, is made in such manner, and contains 

such agreements, assurances, and information as the Secretary determines to be necessary to carry out this section. 

‘‘(d) ANNUAL REPORT TO SECRETARY.—A 

grant may be made under subsection (a) only 

if the applicant for the grant agrees to report on an annual basis to the Secretary, in 

such form and manner as the Secretary may 

require, on the ongoing compliance of the applicant with the eligibility conditions established in subsection (b). 

‘‘(e) AUTHORIZATION OF APPROPRIATIONS.— 

For the purpose of carrying out this section, 

there are authorized to be appropriated 

$3,000,000 for fiscal year 2010, and such sums 

as may be necessary for each of the fiscal 

years 2011 through 2014.’’. 

TITLE III—PREGNANCY AS A 

PREEXISTING CONDITION 

SEC. 301. INDIVIDUAL HEALTH INSURANCE COVERAGE FOR PREGNANT WOMEN. 

(a) LIMITATION ON IMPOSITION OF PRE-EXISTING CONDITION EXCLUSIONS AND WAITING

PERIODS FOR WOMEN WITH PRIOR COVERAGE.— 

Title XXVII of the Public Health Service Act 

(42 U.S.C. 300gg et seq.) is amended by inserting after section 2753 the following new section: 

‘‘SEC. 2754. PROVIDING INDIVIDUAL HEALTH INSURANCE COVERAGE WITHOUT REGARD TO PREEXISTING CONDITION 

EXCLUSION AND WAITING PERIODS 

FOR PREGNANT WOMEN WITHIN 

ONE YEAR OF CONTINUOUS PRIOR 

COVERAGE. 

‘‘In the case of a woman who has had at 

least 12 months of creditable coverage before 

seeking individual health insurance coverage, such individual health insurance coverage, and the health insurance issuer offering such coverage, may not impose any preexisting condition exclusion relating to pregnancy as a preexisting condition, any waiting period, or otherwise discriminate in coverage or premiums against the woman on the 

basis that she is pregnant.’’. 

(b) EFFECTIVE DATE.—The amendment 

made by subsection (a) shall take effect on 

October 1, 2009, and shall apply to women 

who become pregnant on or after such date. 

SEC. 302. CONTINUATION OF HEALTH INSURANCE 

COVERAGE FOR NEWBORNS. 

(a) GROUP HEALTH PLAN COVERAGE.—Title 

XXVII of the Public Health Service Act (42 

U.S.C. 300gg et seq.) is amended by inserting 

after section 2707 the following new section: 

‘‘SEC. 2708. CONTINUATION OF COVERAGE FOR 

NEWBORNS. 

‘‘(a) NOTIFICATION.—In the case of a pregnant woman who is covered under a group 

health plan, or under group health insurance 

coverage, for other than family coverage, the 

plan or issuer of the insurance shall provide 

notice to the woman during the 5th month of 

pregnancy, during the 8th month of pregnancy, and within 2 weeks after delivery, of 

the woman’s option to provide continuing 

coverage of the newborn child under the 

group health plan or health insurance coverage under subsection (b). 

‘‘(b) OPTION OF CONTINUED COVERAGE FOR

NEWBORNS.—In the case of a pregnant woman 

described in subsection (a) who has a newborn child under a group health plan or 

under group health insurance coverage, the 

plan or issuer offering the coverage shall 

provide the woman with the option of electing coverage of the newborn child at least 

through the end of the 30-day period beginning on the date of birth of the child and no 

waiting period or preexisting condition exclusion shall apply with respect to the coverage of such a newborn child under such 

plan or coverage. Such continuation coverage shall remain in effect, subject to payment of applicable premiums, for at least 

such period as the Secretary specifies.’’. 

(b) INDIVIDUAL HEALTH INSURANCE COVERAGE.—Such title is further amended by inserting after section 2754, as added by section 

301, the following new section: 

‘‘SEC. 2755. CONTINUATION OF COVERAGE FOR 

NEWBORNS. 

‘‘The provisions of section 2708 shall apply 

with respect to individual health insurance 

coverage and the issuer of such coverage in 

the same manner as they apply to group 

health insurance coverage and the issuer of 

such coverage.’’. 

(c) EFFECTIVE DATE.—The amendments 

made by this section shall take effect on 

January 1, 2010, and shall apply to women 

who become pregnant on or after such date 

and children who are born of such women. 

TITLE IV—MEDICAID AND SCHIP COVERAGE OF PREGNANT WOMEN AND UNBORN CHILDREN 

SEC. 401. TREATMENT OF UNBORN CHILDREN. 

(a) CODIFICATION OF CURRENT REGULATIONS.—Section 2110(c)(1) (42 U.S.C. 1397(c)(1)) 

is amended by striking the period at the end 

and inserting the following: ‘‘, and includes, 

at the option of a State, an unborn child.’’. 

(b) CLARIFICATIONS REGARDING COVERAGE

OF MOTHERS.—Section 2103 (42 U.S.C. 1397cc) 

is amended by adding at the end the following new subsection: 

‘‘(g) CLARIFICATIONS REGARDING AUTHORITY

TO PROVIDE POSTPARTUM SERVICES AND MATERNAL HEALTH CARE.—Any State that provides child health assistance to an unborn 

child under the option described in section 

2110(c)(1) may— 

‘‘(1) continue to provide such assistance to 

the mother, as well as postpartum services, 

through the end of the month in which the 


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January 15, 2009 CONGRESSIONAL RECORD — SENATE S623 

60-day period (beginning on the last day of 

pregnancy) ends; and 

‘‘(2) in the interest of the child to be born, 

have flexibility in defining and providing 

services to benefit either the mother or unborn child consistent with the health of 

both.’’. 

SEC. 402. COORDINATION WITH THE MATERNAL 

AND CHILD HEALTH PROGRAM. 

(a) IN GENERAL.—Section 2102(b)(3) of the 

Social Security Act (42 U.S.C. 1397bb(b)(3)) is 

amended— 

(1) in subparagraph (D), by striking ‘‘and’’ 

at the end; 

(2) in subparagraph (E), by striking the period and inserting ‘‘; and’’; and 

(3) by adding at the end the following new 

subparagraph: 

‘‘(F) that operations and activities under 

this title are developed and implemented in 

consultation and coordination with the program operated by the State under title V in 

areas including outreach and enrollment, 

benefits and services, service delivery standards, public health and social service agency 

relationships, and quality assurance and 

data reporting.’’. 

(b) CONFORMING MEDICAID AMENDMENT.— 

Section 1902(a)(11) of such Act (42 U.S.C. 

1396a(a)(11)) is amended— 

(1) by striking ‘‘and’’ before ‘‘(C)’’; and 

(2) by inserting before the semicolon at the 

end the following: ‘‘, and (D) provide that operations and activities under this title are 

developed and implemented in consultation 

and coordination with the program operated 

by the State under title V in areas including 

outreach and enrollment, benefits and services, service delivery standards, public 

health and social service agency relationships, and quality assurance and data reporting’’. 

(c) EFFECTIVE DATE.—The amendments 

made by this section take effect on October 

1, 2009. 

TITLE V—DISCLOSURE OF INFORMATION 

ON ABORTION SERVICES 

SEC. 501. DISCLOSURE OF INFORMATION ON 

ABORTION SERVICES. 

(a) IN GENERAL.—Health facilities that perform abortions in or affecting interstate 

commerce shall obtain informed consent 

from the pregnant woman seeking to have 

the abortion. Informed consent shall exist 

only after a woman has voluntarily completed or opted not to complete pre-abortion 

counseling sessions. 

(b) ACCURATE INFORMATION.—Counseling 

sessions under subsection (a) shall include 

the following information: 

(1) The probable gestational age and characteristics of the unborn child at the time 

the abortion will be performed. 

(2) How the abortion procedure is performed. 

(3) Possible short-term and long-term risks 

and complications of the procedure to be performed. 

(4) Options or alternatives to abortion, including, but not limited to, adoption, and 

the resources available in the community to 

assist women choosing these options. 

(5) The availability of post-procedure medical services to address the risks and complications of the procedure. 

(c) EXCEPTION.—This section shall not 

apply when the pregnant woman is herself 

incapable, under State law, of making medical decisions. This section does not affect or 

modify any requirement under State law for 

making medical decisions for such patients. 

(d) CIVIL REMEDIES.— 

(1) CIVIL ACTION.—Any female upon whom 

an abortion has been performed or attempted 

without complying with the informed consent requirements may bring a civil action 

in an appropriate district court of the United 

States against the person who performed the 

abortion in knowing or reckless violation of 

this section for actual and punitive damages. 

(2) CERTAIN AUTHORITIES AND REQUIREMENTS.—With respect to an action under 

paragraph (1): 

(A) The court may award attorney’s fees to 

the plaintiff if judgment is rendered in favor 

of the plaintiff, and may award attorney’s 

fees to the defendant if judgment is rendered 

in favor of the defendant and the court finds 

that the plaintiff’s case was frivolous and 

brought in bad faith. 

(B) The court shall determine whether the 

anonymity of the female involved will be 

preserved from public disclosure if the female has not consented to her identity being 

disclosed. If the female’s identity is to be 

shielded, the court shall issue an order sealing the record and excluding individuals 

from the courtroom to preserve her identity. 

(C) In the absence of the female’s written 

consent, anyone other than a public official 

who brings the action shall do so under a 

pseudonym. 

(3) RULE OF CONSTRUCTION.—Nothing in this 

subsection may be construed to conceal the 

identity of the plaintiff or of the witnesses 

from the defendant. 

(e) SEVERABILITY.—If any provision of this 

section requiring informed consent for abortions is found unconstitutional, the unconstitutional provision is severable and the 

other provisions of this section remain in effect. 

(f) PREEMPTION.—Nothing in this section 

shall prevent a State from enacting and enforcing additional requirements with respect 

to informed consent. 

TITLE VI—SERVICES TO PATIENTS RECEIVING POSITIVE TEST DIAGNOSIS OF 

DOWN SYNDROME OR OTHER PRENATALLY DIAGNOSED CONDITIONS 

SEC. 601. SERVICES TO PATIENTS RECEIVING 

POSITIVE TEST DIAGNOSIS FOR 

DOWN SYNDROME OR OTHER PRENATALLY DIAGNOSED CONDITIONS. 

(a) FINDINGS AND PURPOSES.— 

(1) FINDINGS.—The Congress finds as follows: 

(A) Pregnant women who choose to undergo prenatal genetic testing should have access to timely, scientific, and nondirective 

counseling about the conditions being tested 

for and the accuracy of such tests, from 

health care professionals qualified to provide 

and interpret these tests. Informed consent 

is a critical component of all genetic testing. 

(B) A recent, peer-reviewed study and two 

reports from the Centers for Disease Control 

and Prevention on prenatal testing found a 

deficiency in the data needed to understand 

the epidemiology of prenatally diagnosed 

conditions, to monitor trends accurately, 

and to increase the effectiveness of health 

intervention. 

(2) PURPOSES.—It is the purpose of this section, after the diagnosis of an unborn child 

with Down syndrome or other prenatally diagnosed conditions, to— 

(A) increase patient referrals to providers 

of key support services to assist parents in 

the care, or placement for adoption, of a 

child with Down syndrome, or other prenatally diagnosed conditions, as well as to 

provide up-to-date, science-based information about life-expectancy and development 

potential for a child born with Down syndrome or other prenatally diagnosed condition; 

(B) provide networks of support services 

described in subparagraph (A) through a Centers for Disease Control and Prevention patient and provider outreach program; 

(C) improve available data by incorporating information directly revealed by 

prenatal testing into existing State-based 

surveillance programs for birth defects and 

prenatally diagnosed conditions; and 

(D) ensure that patients receive up-to-date, 

scientific information about the accuracy of 

the test. 

(b) AMENDMENT TO THE PUBLIC HEALTH

SERVICE ACT.—Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.) 

is amended by adding at the end the following: 

‘‘SEC. 399U. SUPPORT FOR PATIENTS RECEIVING 

A POSITIVE TEST DIAGNOSIS OF 

DOWN SYNDROME OR OTHER PRENATALLY DIAGNOSED CONDITIONS. 

‘‘(a) DEFINITIONS.—In this section: 

‘‘(1) DOWN SYNDROME.—The term ‘Down 

syndrome’ refers to a chromosomal disorder 

caused by an error in cell division that results in the presence of an extra whole or 

partial copy of chromosome 21. 

‘‘(2) HEALTH CARE PROVIDER.—The term 

‘health care provider’ means any person or 

entity required by State or Federal law or 

regulation to be licensed, registered, or certified to provide health care services, and 

who is so licensed, registered, or certified. 

‘‘(3) PRENATALLY DIAGNOSED CONDITION.— 

The term ‘prenatally diagnosed condition’ 

means any fetal health condition identified 

by prenatal genetic testing or prenatal 

screening procedures. 

‘‘(4) PRENATAL TEST.—The term ‘prenatal 

test’ means diagnostic or screening tests offered to pregnant women seeking routine 

prenatal care that are administered by a 

health care provider based on medical history, family background, ethnic background, 

previous test results, or other risk factors. 

‘‘(5) SUPPORT.—The terms ‘support’ and 

‘supportive services’ mean services to assist 

parents to care for, and prepare to care for, 

a child with Down Syndrome or another prenatally diagnosed condition, and to facilitate the adoption of such children as appropriate. 

‘‘(b) INFORMATION AND SUPPORT SERVICES.— 

The Secretary, acting through the Director 

of the National Institutes of Health, the Director of the Centers for Disease Control and 

Prevention, or the Administrator of the 

Health Resources and Services Administration, may authorize and oversee certain activities, including the awarding of grants, 

contracts, or cooperative agreements, to— 

‘‘(1) collect, synthesize, and disseminate 

current scientific information relating to 

Down syndrome or other prenatally diagnosed conditions; 

‘‘(2) coordinate the provision of, and access 

to, new or existing supportive services for 

patients receiving a positive test diagnosis 

for Down syndrome or other prenatally diagnosed conditions, including— 

‘‘(A) the establishment of a resource telephone hotline and Internet Website accessible to patients receiving a positive test result; 

‘‘(B) the establishment of national and 

local peer-support programs; and 

‘‘(C) the establishment of a national registry, or network of local registries, of families willing to adopt newborns with Down 

syndrome or other prenatally diagnosed conditions, and links to adoption agencies willing to place babies with Down syndrome or 

other prenatally diagnosed conditions, with 

families willing to adopt; 

‘‘(3) establish a clearinghouse of information regarding the scientific facts, clinical 

course, life expectancy, and development potential relating to Down syndrome or other 

prenatally diagnosed conditions; and 

‘‘(4) establish awareness and education programs for health care providers who provide 


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the results of prenatal tests for Down syndrome or other prenatally diagnosed conditions, to patients, consistent with the purpose described in section 601(a)(2)(A) of the 

Pregnant Women Support Act. 

‘‘(c) DATA COLLECTION.— 

‘‘(1) PROVISION OF ASSISTANCE.—The Secretary, acting through the Director of the 

Centers for Disease Control and Prevention, 

shall provide assistance to State and local 

health departments to integrate the results 

of prenatal testing into State-based vital 

statistics and birth defects surveillance programs. 

‘‘(2) ACTIVITIES.—The Secretary shall ensure that activities carried out under paragraph (1) are sufficient to extract population-level data relating to national rates 

and results of prenatal testing. 

‘‘(d) PROVISION OF INFORMATION BY PROVIDERS.—Upon receipt of a positive test result from a prenatal test for Down syndrome 

or other prenatally diagnosed conditions performed on a patient, the health care provider 

involved (or his or her designee) shall provide the patient with the following: 

‘‘(1) Up-to-date, scientific, written information concerning the life expectancy, clinical course, and intellectual and functional 

development and treatment options for an 

unborn child diagnosed with or child born 

with Down syndrome or other prenatally diagnosed conditions. 

‘‘(2) Referral to supportive services providers, including information hotlines specific to Down syndrome or other prenatally 

diagnosed conditions, resource centers or 

clearinghouses, and other education and support programs described in subsection (b). 

‘‘(e) PRIVACY.— 

‘‘(1) IN GENERAL.—Notwithstanding subsections (c) and (d), nothing in this section 

shall be construed to permit or require the 

collection, maintenance, or transmission, 

without the health care provider obtaining 

the prior, written consent of the patient, of— 

‘‘(A) health information or data that identify a patient, or with respect to which there 

is a reasonable basis to believe the information could be used to identify the patient (including a patient’s name, address, healthcare 

provider, or hospital); and 

‘‘(B) data that are not related to the epidemiology of the condition being tested for. 

‘‘(2) GUIDANCE.—Not later than 180 days 

after the date of enactment of this section, 

the Secretary shall establish guidelines concerning the implementation of paragraph (1) 

and subsection (d). 

‘‘(f) REPORTS.— 

‘‘(1) IMPLEMENTATION REPORT.—Not later 

than 2 years after the date of enactment of 

this section, and every 2 years thereafter, 

the Secretary shall submit a report to Congress concerning the implementation of the 

guidelines described in subsection (e)(2). 

‘‘(2) GAO REPORT.—Not later than 1 year 

after the date of enactment of this section, 

the Government Accountability Office shall 

submit a report to Congress concerning the 

effectiveness of current healthcare and family support programs serving as resources for 

the families of children with disabilities. 

‘‘(g) AUTHORIZATION OF APPROPRIATIONS.— 

There is authorized to be appropriated to 

carry out this section $5,000,000 for each of 

the fiscal years 2010 through 2014.’’. 

TITLE VII—SUPPORT FOR PREGNANT AND 

PARENTING COLLEGE STUDENTS 

SEC. 701. SENSE OF CONGRESS. 

It is the sense of Congress that— 

(1) pregnant college students should not 

have to make a choice between keeping their 

baby and staying in school; 

(2) the pilot program under this title will 

help interested, eligible institutions of higher education establish pregnancy and parenting student services offices that will operate independent of Federal funding no 

later than 5 years after the date of the enactment of this title; and 

(3) amounts appropriated to carry out 

other Federal programs should be reduced to 

offset the costs of this title. 

SEC. 702. DEFINITIONS. 

In this title: 

(1) ELIGIBLE INSTITUTION OF HIGHER EDUCATION.—The term ‘‘eligible institution of 

higher education’’ means an institution of 

higher education (as such term is defined in 

section 101 of the Higher Education Act of 

1965 (20 U.S.C. 1001)) that has established and 

operates, or agrees to establish and operate 

upon the receipt of a grant under this title, 

a pregnant and parenting student services office described in section 706. 

(2) PARENT; PARENTING.—The terms ‘‘parent’’ and ‘‘parenting’’ refer to a parent or 

legal guardian of a minor. 

(3) SECRETARY.—The term ‘‘Secretary’’ 

means the Secretary of Education. 

SEC. 703. PREGNANT AND PARENTING STUDENT 

SERVICES PILOT PROGRAM. 

From amounts appropriated under section 

708 for a fiscal year, the Secretary shall establish a pilot program to award grants to 

eligible institutions of higher education to 

enable the eligible institutions to establish 

(or maintain) and operate pregnant and parenting student services offices in accordance 

with section 706. 

SEC. 704. APPLICATION; NUMBER OF GRANTS. 

(a) APPLICATION.—An eligible institution of 

higher education that desires to receive a 

grant under this title shall submit an application to the Secretary at such time, in such 

manner, and containing such information as 

the Secretary may require. 

(b) REQUESTS FOR ADDITIONAL INFORMATION.—The Secretary may require an eligible 

institution submitting an application under 

subsection (a) to provide additional information if the Secretary determines such information is necessary to process the application. 

(c) NUMBER OF GRANTS.—Subject to the 

availability of appropriations under section 

708, the Secretary shall award grants under 

this title to no more than 200 eligible institutions. 

SEC. 705. MATCHING REQUIREMENT. 

An eligible institution of higher education 

that receives a grant under this title shall 

contribute to the conduct of the pregnant 

and parenting student services office supported by the grant an amount from nonFederal funds equal to the amount of the 

grant. The non-Federal share may be in cash 

or in kind, fairly evaluated, including services, facilities, supplies, or equipment. 

SEC. 706. USE OF FUNDS. 

(a) IN GENERAL.—An eligible institution of 

higher education that receives a grant under 

this title shall use grant funds to establish 

(or maintain) and operate a pregnant and 

parenting student services office, located on 

the campus of the eligible institution, that 

carries out the following programs and activities: 

(1) Hosts an initial pregnancy and parenting resource forum— 

(A) to assess pregnancy and parenting resources, located on the campus or within the 

local community, that are available to meet 

the needs described in paragraph (2); and 

(B) to set goals for— 

(i) improving such resources for pregnant, 

parenting, and prospective parenting students; and 

(ii) improving access to such resources. 

(2) Annually assesses the performance of 

the eligible institution and the office in 

meeting the following needs of students enrolled in the eligible institution who are 

pregnant or are parents: 

(A) The inclusion of maternity coverage 

and the availability of riders for additional 

family members in student health care. 

(B) Family housing. 

(C) Child care. 

(D) Flexible or alternative academic scheduling, such as telecommuting programs. 

(E) Education to improve parenting skills 

for mothers and fathers and to strengthen 

marriages. 

(F) Maternity and baby clothing, baby food 

(including formula), baby furniture, and 

similar items to assist parents and prospective parents in meeting the material needs of 

their children. 

(G) Post-partum counseling and support 

groups. 

(3) Identifies public and private service 

providers, located on the campus of the eligible institution or within the local community, that are qualified to meet the needs described in paragraph (2), and establishes programs with qualified providers to meet such 

needs. 

(4) Assists pregnant and parenting students 

and their spouses in locating and obtaining 

services that meet the needs described in 

paragraph (2). 

(5) If appropriate, provides referrals for 

prenatal care and delivery, infant or foster 

care, or adoption, to a student who requests 

such information. An office shall make such 

referrals only to service providers that primarily serve the following types of individuals: 

(A) Parents. 

(B) Prospective parents awaiting adoption. 

(C) Women who are pregnant and plan on 

parenting or placing the child for adoption. 

(D) Parenting or prospective parenting 

couples who are married or who plan on 

marrying in order to provide a supportive environment for each other and their child. 

(b) EXPANDED SERVICES.—In carrying out 

the programs and activities described in subsection (a), an eligible institution of higher 

education receiving a grant under this title 

may choose to provide access to such programs and activities to a pregnant or parenting employee of the eligible institution, 

and the employee’s spouse. 

SEC. 707. REPORTING. 

(a) ANNUAL REPORT BY INSTITUTIONS.— 

(1) IN GENERAL.—For each fiscal year that 

an eligible institution of higher education 

receives a grant under this title, the eligible 

institution shall prepare and submit to the 

Secretary, by the date determined by the 

Secretary, a report that— 

(A) itemizes the pregnant and parenting 

student services office’s expenditures for the 

fiscal year; 

(B) contains a review and evaluation of the 

performance of the office in fulfilling the requirements of this title, using the specific 

performance criteria or standards established under paragraph (2)(A); and 

(C) describes the achievement of the office 

in meeting the needs listed in section 

706(a)(2) of the students served by the eligible institution, and the frequency of use of 

the office by such students. 

(2) PERFORMANCE CRITERIA.—Not later than 

180 days before the date the annual report 

described in paragraph (1) is submitted, the 

Secretary— 

(A) shall identify the specific performance 

criteria or standards that shall be used to 

prepare the report; and 

(B) may establish the form or format of the 

report. 

(3) ADDITIONAL INFORMATION.—After reviewing an annual report of an eligible institution of higher education, the Secretary 

may require that the eligible institution provide additional information if the Secretary 

determines that such additional information 

is necessary to evaluate the pilot program. 


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(b) REPORT BY SECRETARY.—The Secretary 

shall annually prepare and submit a report 

on the findings of the pilot program under 

this title, including the number of eligible 

institutions of higher education that were 

awarded grants and the number of students 

served by each pregnant and parenting student services office receiving funds under 

this title, to the appropriate committees of 

the Senate and the House of Representatives. 

SEC. 708. AUTHORIZATION OF APPROPRIATIONS. 

There is authorized to be appropriated to 

carry out this title not more than $10,000,000 

for each of the fiscal years 2010 through 2014. 

TITLE VIII—SUPPORT FOR PREGNANT 

AND PARENTING TEENS 

SEC. 801. GRANTS TO STATES. 

The Secretary shall make grants to States 

to allow early childhood education programs, including Head Start, to work with 

pregnant or parenting teens to complete 

high school and prepare for college or for vocational education. 

TITLE IX—IMPROVING SERVICES FOR 

PREGNANT WOMEN WHO ARE VICTIMS 

OF DOMESTIC VIOLENCE, DATING VIOLENCE, AND STALKING 

SEC. 901. FINDINGS. 

The Congress finds as follows: 

(1) Pregnant and recently pregnant women 

are more likely to be victims of homicide 

than to die of any other causes, and evidence 

exists that a significant proportion of all female homicide victims are killed by their intimate partners. 

(2) A 2001 study published by the Journal of 

the American Medical Association found 

that murder is the number one cause of 

death among pregnant women. 

(3) Research suggests that injury-related 

deaths, including homicide and suicide, account for approximately one-third of all maternal mortality cases, while medical reasons make up the rest. Homicide is the leading cause of death overall for pregnant 

women, followed by cancer, acute and chronic respiratory conditions, motor vehicle collisions and drug overdose, peripartum and 

postpartum cardiomyopthy, and suicide. 

SEC. 902. PROGRAM TO SUPPORT PREGNANT 

WOMEN WHO ARE VICTIMS OF DOMESTIC VIOLENCE. 

(a) IN GENERAL.—For fiscal year 2010 and 

each subsequent fiscal year, the Attorney 

General, through the Director of the Office 

on Violence Against Women, may award 

grants to States, to be used for any of the 

following purposes: 

(1) To assist States in providing intervention services, accompaniment, and supportive social services for eligible pregnant 

women who are victims of domestic violence, 

dating violence, or stalking. 

(2) To provide for technical assistance and 

training (as described in subsection (c)) relating to violence against eligible pregnant 

women to be made available to the following: 

(A) Federal, State, tribal, territorial, and 

local governments, law enforcement agencies, and courts. 

(B) Professionals working in legal, social 

service, and health care settings. 

(C) Nonprofit organizations. 

(D) Faith-based organizations. 

(b) STATE ELIGIBILITY.—To be eligible for a 

grant under subsection (a), a State shall— 

(1) submit to the Attorney General an application in such time and manner, and containing such information, as specified by the 

Attorney General; and 

(2) for a grant made for a fiscal year beginning on or after the date that is one year 

after the date of the enactment of this title, 

satisfy the requirement under section 903, relating to female homicide victim determinations and death certificates. 

(c) TECHNICAL ASSISTANCE AND TRAINING

DESCRIBED.—For purposes of subsection 

(a)(2), technical assistance and training is— 

(1) the identification of eligible pregnant 

women experiencing domestic violence, dating violence, or stalking; 

(2) the assessment of the immediate and 

short-term safety of such a pregnant woman, 

the evaluation of the impact of the violence 

or stalking on the pregnant woman’s health, 

and the assistance of the pregnant woman in 

developing a plan aimed at preventing further domestic violence, dating violence, or 

stalking, as appropriate; 

(3) the maintenance of complete medical or 

forensic records that include the documentation of any examination, treatment given, 

and referrals made, recording the location 

and nature of the pregnant woman’s injuries, 

and the establishment of mechanisms to ensure the privacy and confidentiality of those 

medical records; and 

(4) the identification and referral of the 

pregnant woman to appropriate public and 

private nonprofit entities that provide intervention services, accompaniment, and supportive social services. 

(d) DEFINITIONS.—For purposes of this title: 

(1) ACCOMPANIMENT.—The term ‘‘accompaniment’’ means assisting, representing, 

and accompanying a woman in seeking judicial relief for child support, child custody, 

restraining orders, and restitution for harm 

to persons and property, and in filing criminal charges, and may include the payment of 

court costs and reasonable attorney and witness fees associated therewith. 

(2) ELIGIBLE PREGNANT WOMAN.—The term 

‘‘eligible pregnant woman’’ means any 

woman who is pregnant on the date on which 

such woman becomes a victim of domestic 

violence, dating violence, or stalking or who 

was pregnant during the one-year period before such date. 

(3) INTERVENTION SERVICES.—The term 

‘‘intervention services’’ means, with respect 

to domestic violence, dating violence, or 

stalking, 24-hour telephone hotline services 

for police protection and referral to shelters. 

(4) STATE.—The term ‘‘State’’ includes the 

District of Columbia, any commonwealth, 

possession, or other territory of the United 

States, and any Indian tribe or reservation. 

(5) SUPPORTIVE SOCIAL SERVICES.—The term 

‘‘supportive social services’’ means transitional and permanent housing, vocational 

counseling, and individual and group counseling aimed at preventing domestic violence, dating violence, or stalking. 

(6) VIOLENCE.—The term ‘‘violence’’ means 

actual violence and the risk or threat of violence. 

(e) AUTHORIZATION OF APPROPRIATIONS.— 

For the purpose of making allotments under 

subsection (a), there are authorized to be appropriated $4,000,000 for each of the fiscal 

years 2010 through 2014. 

SEC. 903. HOMICIDE DEATH CERTIFICATES OF 

CERTAIN FEMALE VICTIMS. 

For purposes of section 902(b)(2), the requirement under this section is that not 

later than the date that is one year after the 

date of the enactment of this title, a State 

shall require, with respect to any homicide 

case initiated after such one-year date and in 

which the victim is a female of possible 

child-bearing age, each of the following: 

(1) A determination of which, if any, of the 

following categories, described the victim: 

(A) The victim was pregnant on the date of 

her death. 

(B) The victim was not pregnant on the 

date of her death, but had been pregnant during the 42-day period before such date. 

(C) The victim was not pregnant on the 

date of her death, but had been pregnant during the period beginning on the date that 

was one year before such date of her death 

and ending on the date that was 43 days before such date of her death. 

(D) The victim was not pregnant during 

the one-year period before the date of her 

death. 

(E) It could not be determined whether or 

not the victim had been pregnant during the 

one-year period before the date of her death. 

(2) The determination made under paragraph (1) shall be included in the death certificate of the victim. 

TITLE X—LIFE SUPPORT CENTERS FOR 

PREGNANT WOMEN, MOTHERS, AND 

CHILDREN 

SEC. 1001. LIFE SUPPORT CENTERS PILOT PROGRAM. 

(a) IN GENERAL.—The Secretary shall establish a pilot program to fund comprehensive and supportive services for pregnant 

women, mothers, and children. Such services 

may include— 

(1) child care for infants and toddlers to 

allow mothers to find jobs and finish their 

education; 

(2) relocation assistance to establish good 

and stable homes; 

(3) educational support, such as preparation for pregnant and parenting mothers for 

the recognized equivalent of a secondary 

school diploma; 

(4) counseling, including adoption counseling; 

(5) parenting classes; 

(6) business skills training; 

(7) emergency aid in times of crisis; 

(8) nutrition education and food assistance; 

and 

(9) outreach to seniors, many of whom volunteer to help with the children or who receive advice on helping raise their own 

grandchildren. 

(b) AUTHORIZATION OF APPROPRIATIONS.— 

There is authorized to be appropriated to 

carry out this section no more than 

$10,000,000 for each of the fiscal years 2010 

through 2014. 

TITLE XI—PROVIDING SUPPORT TO NEW 

PARENTS 

SEC. 1101. INCREASED SUPPORT FOR WIC PROGRAM. 

(a) FINDINGS.—Congress finds the following: 

(1) The special supplemental nutrition program for women, infants, and children (WIC) 

authorized in section 17 of the Child Nutrition Act of 1966 (42 U.S.C. 1786) served approximately 8,100,000 women, infants, and 

children per month in fiscal year 2006. 

(2) Half of all infants in the United States 

and 1 in 4 young children under age 5 get crucial health and nutrition benefits from the 

WIC Program. 

(3) It is estimated that every dollar spent 

on WIC results in between $1.92 and $4.21 in 

Medicaid savings for newborns and their 

mothers. 

(4) The WIC program has been proven to increase the number of women receiving prenatal care, reduce the incidence of low birth 

weight and fetal mortality, reduce anemia, 

and enhance the nutritional quality of the 

diet of mothers and children. 

(5) The WIC program’s essential, effective 

nutrition services include nutrition assessment, counseling and education, obesity prevention, breastfeeding support and promotion, prenatal and pediatric health care 

referrals and follow-up, spousal and child 

abuse referral, drug and alcohol abuse referral, immunization screening, assessment and 

referral, and a host of other services for 

mothers and children. 

(b) AUTHORIZATION OF APPROPRIATIONS.— 

For the purpose of carrying out the special 

supplemental nutrition program for women, 

infants, and children (WIC) authorized in section 17 of the Child Nutrition Act of 1966 (42 


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U.S.C. 1786), there is authorized to be appropriated such sums as may be necessary for 

each of fiscal years 2010 through 2014, of 

which— 

(1) there is authorized to be appropriated 

$15,000,000 for fiscal year 2010, and such sums 

as may be necessary for each of fiscal years 

2011 through 2014, for breast-feeding peer 

counselors; and 

(2) there is authorized to be appropriated 

$14,000,000 for fiscal year 2010, and such sums 

as may be necessary for each of fiscal years 

2011 through 2014, for infrastructure needs. 

SEC. 1102. NUTRITIONAL SUPPORT FOR LOW-INCOME PARENTS. 

Section 5(c)(2) of the Food and Nutrition 

Act of 2008 (7 U.S.C. 2014(c)(2)) is amended by 

striking ‘‘30 per centum’’ and inserting ‘‘85 

percent’’. 

SEC. 1103. INCREASED FUNDING FOR THE CHILD 

CARE AND DEVELOPMENT BLOCK 

GRANT PROGRAM. 

(a) AUTHORIZATION OF APPROPRIATIONS.— 

Section 658B of the Child Care and Development Block Grant Act of 1990 (42 U.S.C. 9858) 

is amended to read as follows: 

‘‘SEC. 658B. AUTHORIZATION OF APPROPRIATIONS. 

‘‘There are authorized to be appropriated 

to carry out this subchapter $2,350,000,000 for 

fiscal year 2010 and such sums as may be necessary for fiscal years 2011 through 2014.’’. 

(b) CONFORMING AMENDMENT.—Section 

658E(c)(3)(D) of the Child Care and Development Block Grant Act of 1990 (42 U.S.C. 

9858c(c)(3)(D)) is amended by striking ‘‘1997 

through 2002’’ and inserting ‘‘2010 through 

2014’’. 

SEC. 1104. TEENAGE OR FIRST-TIME MOTHERS; 

FREE HOME VISITS BY REGISTERED 

NURSES FOR EDUCATION ON 

HEALTH NEEDS OF INFANTS. 

(a) IN GENERAL.—The Secretary may make 

grants to local health departments to provide to eligible mothers, without charge, 

education on the health needs of their infants through visits to their homes by registered nurses. 

(b) ELIGIBLE MOTHER.— 

(1) IN GENERAL.—For purposes of subsection 

(a), a woman is an eligible mother if, subject 

to paragraph (2), the woman— 

(A) is the mother of an infant who is not 

more than 24 months of age; and 

(B)(i) the woman was under the age of 20 at 

the time of birth; or 

(ii) the infant referred to in subparagraph 

(A) is the first child of the woman. 

(2) ADDITIONAL REQUIREMENTS FOR CERTAIN

MOTHERS.—In the case of a woman described 

in paragraph (1)(B)(ii) who is 20 years of age 

or older, the woman is an eligible mother for 

purposes of subsection (a) only if the woman 

meets such standards in addition to the applicable standards under paragraph (1) as the 

local health department involved determines 

to be appropriate. 

(c) CERTAIN REQUIREMENTS.—A grant may 

be made under subsection (a) only if the applicant involved agrees as follows: 

(1) The program carried out under such 

subsection by the applicant will be designed 

to instill in eligible mothers confidence in 

their abilities to provide for the health needs 

of their newborns, including through— 

(A) providing information on child development; and 

(B) soliciting questions from the mothers. 

(2) The registered nurses who make home 

visits under subsection (a) will, as needed, 

provide referrals for health and social services to serve the needs of the newborns. 

(3) The period during which the visits will 

be available to an eligible mother will not be 

fewer than six months. 

(d) AUTHORIZED SERVICES.— 

(1) REQUIREMENTS.—A grant may be made 

under subsection (a) only if the applicant involved agrees that the following services will 

be provided by registered nurses in home visits under subsection (a): 

(A) Information on child health and development, including suggestions for child-developmental activities that are enjoyable for 

parents and children. 

(B) Advice on parenting, including information on how to develop a strong parentchild relationship. 

(C) Information on resources about parenting, including identifying books and videos that are available at local libraries. 

(D) Information on upcoming parenting 

workshops in the local region. 

(E) Information on programs that facilitate parent-to-parent support services. 

(F) In the case of an eligible mother who is 

a student, information on resources that 

may assist the mother in completing the 

educational courses involved. 

(2) ADDITIONAL SERVICES.—A grant under 

subsection (a) may be expended to provide 

services during home visits under such subsection in addition to the services specified 

in paragraph (1). 

(e) AUTHORIZATION OF APPROPRIATIONS.— 

For the purpose of carrying out this section, 

there are authorized to be appropriated 

$3,000,000 for fiscal year 2010, and such sums 

as may be necessary for each of fiscal years 

2011 through 2014. 

TITLE XII—COLLECTING AND REPORTING 

ABORTION DATA 

SEC. 1201. GRANTS FOR COLLECTION AND REPORTING OF ABORTION DATA. 

(a) GRANTS.—The Secretary, acting 

through the Director of the Centers for Disease Control and Prevention, may make 

grants to States for collecting and reporting 

abortion surveillance data. 

(b) REPORTING REQUIREMENT.— 

(1) IN GENERAL.—The Secretary may make 

a grant to a State under this section only if 

the State agrees to submit a report in each 

of fiscal years 2011 and 2013 on the State’s 

abortion surveillance data. 

(2) CONTENTS.—Each report submitted by a 

State under this subsection shall, with respect to the preceding 2 fiscal years, include— 

(A) the number and characteristics of 

women obtaining abortions in the State; and 

(B) the characteristics of these abortions, 

including the approximate gestational age of 

the unborn child, the abortion method, and 

any known physical or psychological complications. 

(3) PERSONAL INFORMATION.—A report submitted by a State under this subsection shall 

not contain the name of any woman obtaining or seeking to obtain an abortion, any 

common identifier (such as a social security 

number), or any other identifier (including 

statistical information) that would make it 

possible to identify in any manner or under 

any circumstances an individual who has obtained or seeks to obtain an abortion. 

(c) CONFIDENTIALITY.—The Secretary shall 

maintain the confidentiality of any individually identifiable information reported to 

the Secretary under this section. 

(d) REPORT TO CONGRESS.— 

(1) IN GENERAL.—Not later than the end of 

fiscal year 2013, the Secretary shall submit a 

report to the Congress on the abortion surveillance data reported to the Secretary 

under this section. 

(2) PERSONAL INFORMATION.—A report submitted by the Secretary to the Congress 

under this subsection shall not contain any 

name or other identifier described in subsection (b)(3). 

(e) AUTHORIZATION OF APPROPRIATIONS.—To 

carry out this section, there are authorized 

to be appropriated such sums as may be necessary for each of fiscal years 2010 through 

2014. 

By Mr. HARKIN: 

S. 272. A bill to amend the Commodity Exchange Act to ensure that 

all agreements, contracts, and transactions with respect to commodities 

are carried out on a regulated exchange, and for other purposes; to the 

Committee on Agriculture, Nutrition, 

and Forestry. 

Mr. HARKIN. Mr. President, today, I 

am reintroducing legislation—the Derivatives Trading Integrity Act—which 

calls for establishing stronger standards of openness, transparency and integrity in the trading of financial 

swaps and other over-the-counter derivative contracts as a critical step toward rebuilding and restoring confidence in the financial system. Over 

the years, the Commodity Futures 

Trading Commission and laws enacted 

by Congress have allowed instruments 

that are in form and function futures 

contracts to be privately negotiated 

without the safeguards provided 

through trading on exchanges regulated by the Commodity Futures Trading Commission, CFTC. 

The economic downturn in this country is forcing us to examine all contributing factors to the crisis in our financial markets. By restoring reasonable 

safeguards and regulation of swaps, including credit default swaps, along 

with all other futures contracts, this 

legislation will go a long way to restore confidence in the markets and reestablish soundness and integrity in 

the financial system. My bill will end 

the unregulated ‘‘casino capitalism’’ 

that has engendered great risks in 

swaps trading. And it will bring these 

transactions out into the sunlight 

where they can be monitored and appropriately and responsibly regulated. 

This legislation will establish authority and safeguards to ensure that parties can meet their obligations to manage and reduce danger and risk to the 

entire financial system and economy. 

Virtually all contracts now commonly referred to as swaps fall under 

the definition of futures contracts and 

function basically in the same manner 

as futures contracts. This bill amends 

the Commodity Exchange Act to eliminate the distinctions in the regulatory 

treatment of futures contracts among 

‘‘excluded’’ and ‘‘exempt’’ commodities, and the transactions in them, and 

regulated, exchange-traded commodities and transactions in them. Futures 

contracts for all commodities would be 

treated the same in the law and regulations. 

In addition, the bill eliminates the 

statutory exclusion of swap transactions from regulation, and it ends 

the Commodity Futures Trading Commission’s authority to exempt such 

transactions from the general requirement that a contract for the purchase 

or sale of a commodity for future delivery can only trade on a regulated board 

of trade. In effect, this proposed change 


jbell on PROD1PC69 with SENATE