II

105TH CONGRESS

2D SESSION S. 1722

To amend the Public Health Service Act to revise and extend certain programs with respect to women’s health research and prevention activities

at the National Institutes of Health and the Centers for Disease Control

and Prevention.

IN THE SENATE OF THE UNITED STATES

MARCH 6, 1998

Mr. FRIST (for himself, Mr. LOTT, Mr. JEFFORDS, Mr. KENNEDY, Mr.

GREGG, Mr. DODD, Mr. ENZI, Mr. HARKIN, Mr. HUTCHINSON, Ms. MIKULSKI, Ms. COLLINS, Mr. BINGAMAN, Mr. MCCONNELL, Mr.

WELLSTONE, Mrs. MURRAY, Mr. REED, Ms. SNOWE, Mr. NICKLES, Mr.

MACK, Mrs. BOXER, Mr. DASCHLE, Mr. CHAFEE, Mrs. FEINSTEIN, Mr.

ROTH, Mr. SPECTER, Mr. D’AMATO, Mr. DOMENICI, and Mr.

SANTORUM) introduced the following bill; which was read twice and referred to the Committee on Labor and Human Resources

A BILL

To amend the Public Health Service Act to revise and extend

certain programs 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,
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1 SECTION 1. SHORT TITLE.

2 This Act may be cited as the ‘‘Women’s Health Re3 search and Prevention Amendments of 1998’’.

4 TITLE I—PROVISIONS RELATING

5 TO WOMEN’S HEALTH RE6 SEARCH AT THE NATIONAL

7 INSTITUTES OF HEALTH

8 SEC. 101. EXTENSION OF PROGRAM FOR RESEARCH AND

9 AUTHORIZATION OF NATIONAL PROGRAM OF

10 EDUCATION REGARDING THE DRUG DES.

11 (a) IN GENERAL.—Section 403A(e) of the Public

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

13 striking ‘‘1996’’ and inserting ‘‘2001’’.

14 (b) NATIONAL PROGRAM FOR EDUCATION OF

15 HEALTH PROFESSIONALS AND PUBLIC.—From amounts

16 appropriated for carrying out section 403A of the Public

17 Health Service Act (42 U.S.C. 283a), the Secretary of

18 Health and Human Services, acting through the heads of

19 the appropriate agencies of the Public Health Service,

20 shall carry out a national program for the education of

21 health professionals and the public with respect to the

22 drug diethylstilbestrol (commonly known as DES). To the

23 extent appropriate, such national program shall use meth24 odologies developed through the education demonstration

25 program carried out under such section 403A. In develop26 ing and carrying out the national program, the Secretary
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1 shall consult closely with representatives of nonprofit pri2 vate entities that represent individuals who have been ex3 posed to DES and that have expertise in community-based

4 information campaigns for the public and for health care

5 providers. The implementation of the national program

6 shall begin during fiscal year 1999.

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

8 AND RELATED BONE DISORDERS.

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

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

11 inserting ‘‘through 2001’’.

12 SEC. 103. RESEARCH ON CANCER.

13 (a) IN GENERAL.—Section 417B(a) of the Public

14 Health Service Act (42 U.S.C. 286a–8(a)) is amended by

15 striking ‘‘and 1996’’ and inserting ‘‘through 2001’’.

16 (b) RESEARCH ON BREAST CANCER.—Section

17 417B(b)(1) of the Public Health Service Act (42 U.S.C.

18 286a–8(b)(1)) is amended—

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

20 1996’’ and inserting ‘‘through 2001’’; and

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

22 1996’’ and inserting ‘‘through 2001’’.

23 (c) RESEARCH ON OVARIAN AND RELATED CANCER

24 RESEARCH.—Section 417B(b)(2) of the Public Health
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1 Service Act (42 U.S.C. 286a–8(b)(2)) is amended by strik2 ing ‘‘and 1996’’ and inserting ‘‘through 2001’’.

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

4 OTHER CARDIOVASCULAR DISEASES IN

5 WOMEN.

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

7 Service Act (42 U.S.C. 285b et seq.) is amended by insert8 ing after section 424 the following:

9 ‘‘HEART ATTACK, STROKE, AND OTHER CARDIOVASCULAR

10 DISEASES IN WOMEN

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

12 Institute shall expand, intensify, and coordinate research

13 and related activities of the Institute with respect to heart

14 attack, stroke, and other cardiovascular diseases in

15 women.

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

17 The Director of the Institute shall coordinate activities

18 under subsection (a) with similar activities conducted by

19 the other national research institutes and agencies of the

20 National Institutes of Health to the extent that such Insti21 tutes and agencies have responsibilities that are related

22 to heart attack, stroke, and other cardiovascular diseases

23 in women.

24 ‘‘(c) CERTAIN PROGRAMS.—In carrying out sub25 section (a), the Director of the Institute shall conduct or

26 support research to expand the understanding of the
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1 causes of, and to develop methods for preventing, cardio2 vascular diseases in women. Activities under such sub3 section shall include conducting and supporting the follow4 ing:

5 ‘‘(1) Research to determine the reasons under6 lying the prevalence of heart attack, stroke, and

7 other cardiovascular diseases in women, including

8 African-American women and other women who are

9 members of racial or ethnic minority groups.

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

11 causes of cardiovascular diseases in women.

12 ‘‘(3) Epidemiological studies to address the fre13 quency and natural history of such diseases and the

14 differences among men and women, and among ra15 cial and ethnic groups, with respect to such diseases.

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

17 cost-effective diagnostic approaches to evaluating

18 women with suspected ischemic heart disease.

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

20 evaluation of new treatments for women, including

21 rehabilitation.

22 ‘‘(6) Studies to gain a better understanding of

23 methods of preventing cardiovascular diseases in

24 women, including applications of effective methods

25 for the control of blood pressure, lipids, and obesity.
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1 ‘‘(7) Information and education programs for

2 patients and health care providers on risk factors as3 sociated with heart attack, stroke, and other cardio4 vascular diseases in women, and on the importance

5 of the prevention or control of such risk factors and

6 timely referral with appropriate diagnosis and treat7 ment. Such programs shall include information and

8 education on health-related behaviors that can im9 prove such important risk factors as smoking, obe10 sity, high blood cholesterol, and lack of exercise.

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

12 purpose of carrying out this section, there is authorized

13 to be appropriated such sums as may be necessary for

14 each of the fiscal years 1999 through 2001. The author15 ization of appropriations established in the preceding sen16 tence is in addition to any other authorization of appro17 priation that is available for such purpose.’’.

18 SEC. 105. AGING PROCESSES REGARDING WOMEN.

19 Section 445I of the Public Health Service Act (42

20 U.S.C. 285e–11) is amended by striking ‘‘and 1996’’ and

21 inserting ‘‘through 2001’’.

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

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

24 (42 U.S.C. 287d(d)(2)) is amended by striking ‘‘Director
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1 of the Office’’ and inserting ‘‘Director of the National In2 stitutes of Health’’.

3 TITLE II—PROVISIONS RELAT4 ING TO WOMEN’S HEALTH AT

5 THE CENTERS FOR DISEASE

6 CONTROL AND PREVENTION

7 SEC. 201. NATIONAL CENTER FOR HEALTH STATISTICS.

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

9 U.S.C. 242k(n)) is amended—

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

11 1998’’ and inserting ‘‘through 2002’’; and

12 (2) in paragraph (2), by striking ‘‘through

13 1998’’ and inserting ‘‘through 2002’’.

14 SEC. 202. NATIONAL PROGRAM OF CANCER REGISTRIES.

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

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

17 and inserting ‘‘through 2002’’.

18 SEC. 203. NATIONAL BREAST AND CERVICAL CANCER

19 EARLY DETECTION PROGRAM.

20 (a) GRANTS.—Section 1501(b) of the Public Health

21 Service Act (42 U.S.C. 300k(b)) is amended—

22 (1) in paragraph (1), by striking ‘‘nonprofit’’;

23 and

24 (2) in paragraph (2), by striking ‘‘that are not

25 nonprofit entities’’.
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1 (b) PREVENTIVE HEALTH.—Section 1509(d) of the

2 Public Health Service Act (42 U.S.C. 300n–4a(d)(1)) is

3 amended by striking ‘‘through 1998’’ and inserting

4 ‘‘through 2002’’.

5 (c) GENERAL PROGRAM.—Section 1510(a) of the

6 Public Health Service Act (42 U.S.C. 300n–5(a)) is

7 amended by striking ‘‘through 1998’’ and inserting

8 ‘‘through 2002’’.

9 SEC. 204. CENTERS FOR RESEARCH AND DEMONSTRATION

10 OF HEALTH PROMOTION.

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

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

13 1998’’ and inserting ‘‘through 2002’’.

14 SEC. 205. COMMUNITY PROGRAMS ON DOMESTIC VIO15 LENCE.

16 Section 318(h)(2) of the Family Violence Prevention

17 and Services Act (42 U.S.C. 10418(h)(2)) is amended by

18 striking ‘‘fiscal year 1997’’ and inserting ‘‘for each of the

19 fiscal years 1997 through 2002’’.

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