I

105TH CONGRESS

2D SESSION S. 1722

IN THE HOUSE OF REPRESENTATIVES

OCTOBER 13, 1998

Referred to the Committee on Commerce

AN ACT

To amend the Public Health Service Act to revise and extend

certain program with respect to women’s health research

and prevention activities at the National Institutes of

Health and the Centers for Disease Control and Prevention.

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 ‘‘Women’s Health Re5 search and Prevention Amendments of 1998’’.
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1 TITLE I—PROVISIONS RELATING

2 TO WOMEN’S HEALTH RE3 SEARCH AT NATIONAL INSTI4 TUTES OF HEALTH

5 SEC. 101. RESEARCH ON DRUG DES; NATIONAL PROGRAM

6 OF EDUCATION.

7 (a) RESEARCH.—Section 403A(e) of the Public

8 Health Service Act (42 U.S.C. 283a(e)) is amended by

9 striking ‘‘1996’’ and inserting ‘‘2003’’.

10 (b) NATIONAL PROGRAM FOR EDUCATION OF

11 HEALTH PROFESSIONALS AND PUBLIC.—Title XVII of

12 the Public Health Service Act (42 U.S.C. 300u et seq.)

13 is amended by adding at the end the following:

14 ‘‘EDUCATION REGARDING DES

15 ‘‘SEC. 1710. (a) IN GENERAL.—The Secretary, act16 ing through the heads of the appropriate agencies of the

17 Public Health Service, shall carry out a national program

18 for the education of health professionals and the public

19 with respect to the drug diethylstilbestrol (commonly

20 known as DES). To the extent appropriate, such national

21 program shall use methodologies developed through the

22 education demonstration program carried out under sec23 tion 403A. In developing and carrying out the national

24 program, the Secretary shall consult closely with rep25 resentatives of nonprofit private entities that represent in-
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1 dividuals who have been exposed to DES and that have

2 expertise in community-based information campaigns for

3 the public and for health care providers. The implementa4 tion of the national program shall begin during fiscal year

5 1999.

6 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—For the

7 purpose of carrying out this section, there are authorized

8 to be appropriated such sums as may be necessary for

9 each of the fiscal years 1999 through 2003. The author10 ization of appropriations established in the preceding sen11 tence is in addition to any other authorization of appro12 priation that is available for such purpose.’’.

13 SEC. 102. RESEARCH ON OSTEOPOROSIS, PAGET’S DISEASE,

14 AND RELATED BONE DISORDERS.

15 Section 409A(d) of the Public Health Service Act (42

16 U.S.C. 284e(d)) is amended by striking ‘‘and 1996’’ and

17 inserting ‘‘through 2003’’.

18 SEC. 103. RESEARCH ON CANCER.

19 (a) RESEARCH ON BREAST CANCER.—Section

20 417B(b)(1) of the Public Health Service Act (42 U.S.C.

21 286a–8(b)(1)) is amended—

22 (1) in subparagraph (A), by striking ‘‘and

23 1996’’ and inserting ‘‘through 2003’’; and

24 (2) in subparagraph (B), by striking ‘‘and

25 1996’’ and inserting ‘‘through 2003’’.
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1 (b) RESEARCH ON OVARIAN AND RELATED CANCER

2 RESEARCH.—Section 417B(b)(2) of the Public Health

3 Service Act (42 U.S.C. 286a–8(b)(2)) is amended by strik4 ing ‘‘and 1996’’ and inserting ‘‘through 2003’’.

5 SEC. 104. RESEARCH ON HEART ATTACK, STROKE, AND

6 OTHER CARDIOVASCULAR DISEASES IN

7 WOMEN.

8 Subpart 2 of part C of title IV of the Public Health

9 Service Act (42 U.S.C. 285b et seq.) is amended by insert10 ing after section 424 the following:

11 ‘‘HEART ATTACK, STROKE, AND OTHER CARDIOVASCULAR

12 DISEASES IN WOMEN

13 ‘‘SEC. 424A. (a) IN GENERAL.—The Director of the

14 Institute shall expand, intensify, and coordinate research

15 and related activities of the Institute with respect to heart

16 attack, stroke, and other cardiovascular diseases in

17 women.

18 ‘‘(b) COORDINATION WITH OTHER INSTITUTES.—

19 The Director of the Institute shall coordinate activities

20 under subsection (a) with similar activities conducted by

21 the other national research institutes and agencies of the

22 National Institutes of Health to the extent that such Insti23 tutes and agencies have responsibilities that are related

24 to heart attack, stroke, and other cardiovascular diseases

25 in women.
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1 ‘‘(c) CERTAIN PROGRAMS.—In carrying out sub2 section (a), the Director of the Institute shall conduct or

3 support research to expand the understanding of the

4 causes of, and to develop methods for preventing, cardio5 vascular diseases in women. Activities under such sub6 section shall include conducting and supporting the follow7 ing:

8 ‘‘(1) Research to determine the reasons under9 lying the prevalence of heart attack, stroke, and

10 other cardiovascular diseases in women, including

11 African-American women and other women who are

12 members of racial or ethnic minority groups.

13 ‘‘(2) Basic research concerning the etiology and

14 causes of cardiovascular diseases in women.

15 ‘‘(3) Epidemiological studies to address the fre16 quency and natural history of such diseases and the

17 differences among men and women, and among ra18 cial and ethnic groups, with respect to such diseases.

19 ‘‘(4) The development of safe, efficient, and

20 cost-effective diagnostic approaches to evaluating

21 women with suspected ischemic heart disease.

22 ‘‘(5) Clinical research for the development and

23 evaluation of new treatments for women, including

24 rehabilitation.
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1 ‘‘(6) Studies to gain a better understanding of

2 methods of preventing cardiovascular diseases in

3 women, including applications of effective methods

4 for the control of blood pressure, lipids, and obesity.

5 ‘‘(7) Information and education programs for

6 patients and health care providers on risk factors as7 sociated with heart attack, stroke, and other cardio8 vascular diseases in women, and on the importance

9 of the prevention or control of such risk factors and

10 timely referral with appropriate diagnosis and treat11 ment. Such programs shall include information and

12 education on health-related behaviors that can im13 prove such important risk factors as smoking, obe14 sity, high blood cholesterol, and lack of exercise.

15 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the

16 purpose of carrying out this section, there are authorized

17 to be appropriated such sums as may be necessary for

18 each of the fiscal years 1999 through 2003. The author19 ization of appropriations established in the preceding sen20 tence is in addition to any other authorization of appro21 priation that is available for such purpose.’’.

22 SEC. 105. AGING PROCESSES REGARDING WOMEN.

23 Section 445H of the Public Health Service Act (42

24 U.S.C. 285e–10) is amended—
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1 (1) by striking ‘‘The Director’’ and inserting

2 ‘‘(a) The Director’’; and

3 (2) by adding at the end the following sub4 section:

5 ‘‘(b) For the purpose of carrying out this section,

6 there are authorized to be appropriated such sums as may

7 be necessary for each of the fiscal years 1999 through

8 2003. The authorization of appropriations established in

9 the preceding sentence is in addition to any other author10 ization of appropriation that is available for such pur11 pose.’’.

12 SEC. 106. OFFICE OF RESEARCH ON WOMEN’S HEALTH.

13 Section 486(d)(2) of the Public Health Service Act

14 (42 U.S.C. 287d(d)(2)) is amended by striking ‘‘Director

15 of the Office’’ and inserting ‘‘Director of NIH’’.

16 TITLE II—PROVISIONS RELAT17 ING TO WOMEN’S HEALTH AT

18 CENTERS FOR DISEASE CON19 TROL AND PREVENTION

20 SEC. 201. NATIONAL CENTER FOR HEALTH STATISTICS.

21 Section 306(n) of the Public Health Service Act (42

22 U.S.C. 242k(n)) is amended—

23 (1) in paragraph (1), by striking ‘‘through

24 1998’’ and inserting ‘‘through 2003’’; and
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1 (2) in paragraph (2), by striking ‘‘through

2 1998’’ and inserting ‘‘through 2003’’.

3 SEC. 202. NATIONAL PROGRAM OF CANCER REGISTRIES.

4 Section 399L(a) of the Public Health Service Act (42

5 U.S.C. 280e–4(a)) is amended by striking ‘‘through 1998’’

6 and inserting ‘‘through 2003’’.

7 SEC. 203. NATIONAL BREAST AND CERVICAL CANCER

8 EARLY DETECTION PROGRAM.

9 (a) SERVICES.—Section 1501(a)(2) of the Public

10 Health Service Act (42 U.S.C. 300k(a)(2)) is amended by

11 inserting before the semicolon the following: ‘‘and support

12 services such as case management’’.

13 (b) PROVIDERS OF SERVICES.—Section 1501(b) of

14 the Public Health Service Act (42 U.S.C. 300k(b)) is

15 amended—

16 (1) in paragraph (1), by striking ‘‘through

17 grants’’ and all that follows and inserting the follow18 ing: ‘‘through grants to public and nonprofit private

19 entities and through contracts with public and pri20 vate entities.’’; and

21 (2) by striking paragraph (2) and inserting the

22 following:

23 ‘‘(2) CERTAIN APPLICATIONS.—If a nonprofit

24 private entity and a private entity that is not a non25 profit entity both submit applications to a State to
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1 receive an award of a grant or contract pursuant to

2 paragraph (1), the State may give priority to the ap3 plication submitted by the nonprofit private entity in

4 any case in which the State determines that the

5 quality of such application is equivalent to the qual6 ity of the application submitted by the other private

7 entity.’’.

8 (c) AUTHORIZATIONS OF APPROPRIATIONS.—

9 (1) SUPPLEMENTAL GRANTS FOR ADDITIONAL

10 PREVENTIVE HEALTH SERVICES.—Section

11 1509(d)(1) of the Public Health Service Act (42

12 U.S.C. 300n–4a(d)(1)) is amended by striking

13 ‘‘through 1998’’ and inserting ‘‘through 2003’’.

14 (2) GENERAL PROGRAM.—Section 1510(a) of

15 the Public Health Service Act (42 U.S.C. 300n–

16 5(a)) is amended by striking ‘‘through 1998’’ and

17 inserting ‘‘through 2003’’.

18 SEC. 204. CENTERS FOR RESEARCH AND DEMONSTRATION

19 OF HEALTH PROMOTION.

20 Section 1706(e) of the Public Health Service Act (42

21 U.S.C. 300u–5(e)) is amended by striking ‘‘through

22 1998’’ and inserting ‘‘through 2003’’.

Passed the Senate October 12 (legislative day, October 2), 1998.

Attest: GARY SISCO,

Secretary.