II

106TH CONGRESS

2D SESSION S. 2635

To reduce health care costs and promote improved health by providing

supplemental grants for additional preventive health services for women.

IN THE SENATE OF THE UNITED STATES

MAY 25, 2000

Mr. FRIST (for himself, Mr. HARKIN, Mr. JEFFORDS, Mrs. MURRAY, Mr.

BINGAMAN, Ms. MIKULSKI, and Mr. REED) introduced the following bill;

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions

A BILL

To reduce health care costs and promote improved health

by providing supplemental grants for additional preventive health services for women.

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 ‘‘WISEWOMAN Ex5 pansion Act of 2000’’.

6 SEC. 2. FINDINGS.

7 Congress makes the following findings:

8 (1) Heart disease, stroke, and other cardio9 vascular diseases remain the leading cause of death
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1 among females in the United States, killing more

2 than 500,000 women each year.

3 (2) About 1 in 5 females have some form of

4 cardiovascular disease, killing more American women

5 than the next 14 causes of death combined.

6 (3) In women, cardiovascular disease is fre7 quently undetected and untreated until the disease

8 has become severe, causing 38 percent of women

9 who have heart attacks to die within 1 year.

10 (4) Obesity increases women’s risk for some of

11 the leading causes of death: heart disease, stroke, di12 abetes, and certain cancers.

13 (5) Better nutrition and lifestyle changes can

14 effectively prevent and treat obesity.

15 (6) Osteoporosis afflicts more than 20,000,000

16 American women.

(7) More than 1 17 ⁄2 of all women over 65 have

18 osteoporosis.

19 (8) One out of every 2 women over 50 will have

20 an osteoporosis-related fracture during her lifetime.

21 (9) The national annual costs associated with

22 osteoporosis are estimated at $14,000,000,000.

23 (10) Physical activity is necessary for bone ac24 quisition and maintenance throughout adulthood.
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1 (11) Muscular strengthen and balance may be

2 very significant in future risk reduction for

3 osteoporosis.

4 (12) There is consensus that adequate vitamin

5 D and calcium intakes are required for bone health.

6 (13) Research has demonstrated that—

7 (A) the uninsured often have significantly

8 poorer health than the insured; and

9 (B) being uninsured is an obstacle to re10 ceiving preventive health care services.

11 (14) The WISEWOMAN program has—

12 (A) provided one-stop shopping for preven13 tive health services such as cholesterol and

14 blood pressure screening for close to 8000

15 women and identified risk factors for heart dis16 ease such as obesity, high cholesterol, high

17 blood pressure, sedentary behavior and poor

18 diet; and

19 (B) found that many of the women

20 screened have returned for additional interven21 tions and follow-up, resulting in improved

22 weight management, lower blood pressure and

23 lower cholesterol.

24 (15) Expansion of the WISEWOMAN model

25 program to additional States would help reduce
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1 women’s risk of illness and death from heart disease

2 and other preventable diseases and provide further

3 insights into the feasibility and effectiveness of mak4 ing comprehensive, integrated preventive services

5 available to low-income and uninsured women.

6 SEC. 3. SUPPLEMENTAL GRANTS FOR ADDITIONAL PRE7 VENTIVE HEALTH SERVICES FOR WOMEN.

8 Section 1509 of the Public Health Service Act (42

9 U.S.C. 300n–4a) is amended to read as follows:

10 ‘‘SEC. 1509. ESTABLISHMENT OF PROGRAM FOR ADDI11 TIONAL PREVENTIVE HEALTH SERVICES.

12 ‘‘(a) IN GENERAL.—The Secretary, acting through

13 the Director of the Centers for Disease Control and Pre14 vention, may, through a competitive review process, award

15 grants to States that have received grants under section

16 1501 for a fiscal year, to enable such State to carry out

17 programs—

18 ‘‘(1) to provide preventive health services, in ad19 dition to the services authorized in such section

20 1501, for diseases such as cardiovascular diseases,

21 osteoporosis, and obesity;

22 ‘‘(2) to provide screenings, such as screening

23 for blood pressure, cholesterol, and osteoporosis, and

24 other services that the Secretary, acting through the
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1 Director of the Centers for Disease Control and Pre2 vention, determines to be appropriate and feasible;

3 ‘‘(3) for health education, counseling, and inter4 ventions for behavioral risk factors, such as physical

5 inactivity and poor nutrition, and diseases referred

6 to in paragraph (1);

7 ‘‘(4) to provide appropriate referrals for medical

8 treatment of women receiving services pursuant to

9 paragraph (1) through (3), and ensuring, to the ex10 tent practicable, the provision of appropriate follow11 up services; and

12 ‘‘(5) to evaluate the activities conducted under

13 paragraphs (1) through (4) through appropriate sur14 veillance, research, or program monitoring activities.

15 ‘‘(b) STATUS AS PARTICIPANT IN PROGRAM REGARD16 ING BREAST AND CERVICAL CANCER.—The Secretary

17 may not make a grant to a State under subsection (a)

18 unless the State involved agrees that services under the

19 grant will be provided in conjunction with entities that are

20 screening women for breast or cervical cancer pursuant

21 to a grant under section 1501.

22 ‘‘(c) APPLICABILITY OF PROVISIONS.—The provi23 sions of this title shall apply to a grant under subsection

24 (a) to the same extent and in the same manner as such

25 provisions apply to a grant under section 1501.
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1 ‘‘(d) FUNDING.—

2 ‘‘(1) IN GENERAL.—There is authorized to be

3 appropriate to carry out this section—

4 ‘‘(A) $15,000,000 for fiscal year 2001;

5 ‘‘(B) $20,000,000 for fiscal year 2002;

6 ‘‘(C) $25,000,000 for fiscal year 2003; and

7 ‘‘(D) such sums as may be necessary for

8 each subsequent fiscal year.

9 ‘‘(2) LIMITATION REGARDING FUNDING WITH

10 RESPECT TO BREAST AND CERVICAL CANCER.—No

11 additional resources shall be appropriated for a fis12 cal year under paragraph (1) unless the amount ap13 propriated under section 1510(a) for such fiscal year

14 is at least $158,000,000.’’.

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