II 

113TH CONGRESS 

1ST SESSION S. 237 

To amend the Public Health Service Act to reauthorize and extend the 

Fetal Alcohol Syndrome prevention and services program, and for other 

purposes. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 7, 2013 

Ms. MURKOWSKI (for herself, Mr. JOHNSON of South Dakota, and Mr. 

BEGICH) introduced the following bill; which was read twice and referred 

to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to reauthorize and 

extend the Fetal Alcohol Syndrome prevention and services program, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Advancing FASD Re5 search, Prevention, and Services Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 

8 (1) Fetal Alcohol Spectrum Disorders (FASD) 

9 are the spectrum of serious, life-long disorders 


TKELLEY on DSK3SPTVN1PROD with BILLS
2 

•S 237 IS

1 caused by prenatal exposure to alcohol, which in2 clude Fetal Alcohol Syndrome, Alcohol-Related 

3 Neurodevelopmental Disorder, and Alcohol-Related 

4 Birth Defects. 

5 (2) In the decades that have passed since Fetal 

6 Alcohol Syndrome was first recognized in the United 

7 States, this fully preventable condition has continued 

8 to affect American children and families. 

9 (3) Prenatal alcohol exposure can cause brain 

10 damage that produces cognitive and behavioral im11 pairments. Prenatal alcohol exposure can cause in12 tellectual disabilities or low IQ and difficulties with 

13 learning, memory, attention, and problem solving. It 

14 can also create problems with executive functioning 

15 and adaptive behavior that impairs mental health 

16 and social interaction. Prenatal alcohol exposure 

17 does not always result in below average IQ or visible 

18 birth defects, which makes Fetal Alcohol Spectrum 

19 Disorders difficult to identify, leading to improper 

20 treatment or denial of support services. 

21 (4) Prenatal alcohol exposure also can cause 

22 growth retardation, birth defects involving the heart, 

23 kidney, vision and hearing, and a characteristic pat24 tern of facial abnormalities. Prenatal alcohol expo25 sure can also result in secondary behavioral characVerDate Mar 15 2010 22:28 Feb 19, 2013 Jkt 029200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S237.IS S237

TKELLEY on DSK3SPTVN1PROD with BILLS
3 

•S 237 IS

1 teristics that may include mental health disorders 

2 and learning and behavioral problems resulting in 

3 disrupted school experience, trouble with the law, in4 carceration, inappropriate sexual behavior, alcohol or 

5 drug problems, dependent living, and problems with 

6 employment. 

7 (5) According to the Substance Abuse and Men8 tal Health Services Administration, more than 1 in 

9 5 women report drinking alcohol in the first tri10 mester of pregnancy, 1 in 14 in the second tri11 mester, and 1 in 20 in the third trimester, even 

12 though there is no known safe level of alcohol con13 sumption during pregnancy. 

14 (6) The incidence rate for all Fetal Alcohol 

15 Spectrum Disorders is estimated in a publication of 

16 the National Institute on Alcohol Abuse and Alco17 holism to be about 10 out of 1,000 births (1 percent 

18 of births) or 40,000 newborns each year. It is esti19 mated that as many as 2 per 1,000, or 20 percent 

20 of alcohol exposed newborns, have Fetal Alcohol 

21 Syndrome, the most serious and identifiable of the 

22 Fetal Alcohol Spectrum Disorders. 

23 (7) As measured by the Fetal Alcohol Syn24 drome Surveillance Network, a partnership between 

25 the Centers for Disease Control and Prevention and 


TKELLEY on DSK3SPTVN1PROD with BILLS
4 

•S 237 IS

1 5 different States, prevalence of Fetal Alcohol Spec2 trum Disorders can be even higher in certain popu3 lations, such as American Indians and Alaska Na4 tives, foster care children, adoptive children from the 

5 United States and from countries where alcohol con6 sumption is more prevalent, and in certain areas, 

7 such as those characterized by low socioeconomic 

8 status. 

9 (8) Fetal Alcohol Spectrum Disorders pose ex10 traordinary financial costs to the Nation, including 

11 the cost of specialized health care, education, foster 

12 care, incarceration, job training, and general support 

13 services for individuals affected by Fetal Alcohol 

14 Spectrum Disorders. 

15 (9) Lifetime health costs for an individual with 

16 Fetal Alcohol Syndrome ranges from $860,000 to 

17 $4,000,000. The cost of Fetal Alcohol Syndrome in 

18 the United States is estimated to be at least 

19 $6,000,000,000 in 2007. Total economic costs would 

20 be even higher for all Fetal Alcohol Spectrum Dis21 orders. 

22 (10) There is a great need for research, surveil23 lance, prevention, treatment, and support services 

24 for individuals with Fetal Alcohol Spectrum Dis25 orders and their families. 


TKELLEY on DSK3SPTVN1PROD with BILLS
5 

•S 237 IS

1 (11) The National Institutes of Health, in co2 ordination with other Federal agencies, the Inter3 agency Coordinating Committee on Fetal Alcohol 

4 Syndrome, and the National Task Force on Fetal 

5 Alcohol Syndrome and Fetal Alcohol Effect, has an 

6 opportunity to advance research on Fetal Alcohol 

7 Spectrum Disorders in many areas, including the 

8 following: 

9 (A) The identification of the mechanisms 

10 that produce the cognitive and behavioral prob11 lems associated with fetal alcohol exposure. 

12 (B) The identification of a neurocognitive 

13 and neurobehavioral phenotype for prenatal al14 cohol-related conditions other than Fetal Alco15 hol Syndrome. 

16 (C) The identification of biological markers 

17 that can be used to indicate fetal alcohol expo18 sure. 

19 (D) The identification of fetal and mater20 nal risk factors that increase susceptibility to 

21 Fetal Alcohol Spectrum Disorders. 

22 (E) The investigation of behavioral and 

23 pharmacotherapies for alcohol-dependent 

24 women to determine new approaches for sus25 taining recovery. 


TKELLEY on DSK3SPTVN1PROD with BILLS
6 

•S 237 IS

1 (F) The development of scientific-based 

2 pharmacologic and nutrient augmentation-based 

3 pre- and post-natal interventions to antagonize 

4 or mitigate the effects of prenatal alcohol expo5 sure. 

6 (G) The development of neurocognitive 

7 interventions to address deficits in 

8 neurocognitive function for individuals with 

9 Fetal Alcohol Spectrum Disorders. 

10 (H) The development of standards for 

11 measuring, reporting, and analyzing alcohol 

12 consumption patterns in pregnant women. 

13 (I) The development of enhanced techno14 logical approaches for the diagnosis of Fetal Al15 cohol Spectrum Disorders including investiga16 tion of prenatal ultrasound, non-invasive imag17 ing, three-dimensional facial feature imaging 

18 and their application in telemedicine to aid in 

19 remote diagnosis. 

20 (J) The evaluation of the role of alcohol in 

21 Sudden Infant Death Syndrome (SIDS), unex22 plained stillbirth, and premature birth. 

23 (K) The collection and banking of biomate24 rials for future analyses to aid in the identifica25 tion of genetic and other biological and environVerDate Mar 15 2010 22:28 Feb 19, 2013 Jkt 029200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S237.IS S237

TKELLEY on DSK3SPTVN1PROD with BILLS
7 

•S 237 IS

1 mental risk factors contributing in the develop2 ment of Fetal Alcohol Spectrum Disorders. 

3 (L) The identification of barriers to imple4 menting alcohol screening in primary care and 

5 obstetric practice, and explore the acceptability 

6 of new screening technologies, such as computer 

7 assisted interviewing. 

8 (M) The development of approaches for se9 lected and indicated prevention, to decrease the 

10 potential for FASD births among the women at 

11 greatest risk for these disorders. 

12 SEC. 3. PROGRAMS FOR FETAL ALCOHOL SPECTRUM DIS13 ORDERS. 

14 Section 399H of the Public Health Service Act (42 

15 U.S.C. 280f) is amended— 

16 (1) by striking the section heading and insert17 ing the following: ‘‘SEC. 399H. PROGRAMS FOR

18 FETAL ALCOHOL SPECTRUM DISORDERS.’’; 

19 (2) by redesignating subsections (a) through (d) 

20 as subsections (h) through (k), respectively; 

21 (3) by inserting after the section heading, the 

22 following: 

23 ‘‘(a) RESEARCH ON FAS AND RELATED DIS24 ORDERS.— 


TKELLEY on DSK3SPTVN1PROD with BILLS
8 

•S 237 IS

1 ‘‘(1) IN GENERAL.—The Secretary, acting 

2 through the Director of the National Institutes of 

3 Health and in coordination with the Interagency Co4 ordinating Committee on Fetal Alcohol Syndrome, 

5 shall— 

6 ‘‘(A) establish a research agenda for Fetal 

7 Alcohol Spectrum Disorders; and 

8 ‘‘(B) award grants, contracts, or coopera9 tive agreements to public or private nonprofit 

10 entities to pay all or part of carrying out re11 search under such agenda. 

12 ‘‘(2) TYPES OF RESEARCH.—In carrying out 

13 paragraph (1), the Secretary, acting through the Di14 rector of the National Institute of Alcohol Abuse and 

15 Alcoholism, shall continue to conduct and expand 

16 national and international research in coordination 

17 with other Federal agencies that includes— 

18 ‘‘(A) the most promising avenues of re19 search in Fetal Alcohol Spectrum Disorder di20 agnosis, intervention, and prevention; 

21 ‘‘(B) factors that may mitigate the effects 

22 of fetal alcohol exposure; and 

23 ‘‘(C) other research that the Director de24 termines to be appropriate. 


TKELLEY on DSK3SPTVN1PROD with BILLS
9 

•S 237 IS

1 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

2 There are authorized to be appropriated to carry out 

3 this subsection, such sums as may be necessary for 

4 each of fiscal years 2014 through 2018. 

5 ‘‘(b) SURVEILLANCE, PUBLIC HEALTH RESEARCH, 

6 AND PREVENTION ACTIVITIES.— 

7 ‘‘(1) IN GENERAL.—The Secretary, acting 

8 through the Director of the National Center on 

9 Birth Defects and Developmental Disabilities, shall 

10 facilitate surveillance, public health research, and 

11 prevention of Fetal Alcohol Spectrum Disorders as 

12 provided for in this subsection. 

13 ‘‘(2) SURVEILLANCE, PUBLIC HEALTH RE14 SEARCH, AND PREVENTION.—In carrying out this 

15 subsection, the Secretary shall— 

16 ‘‘(A) integrate into clinical practice the 

17 standard case definition for diagnosis of Fetal 

18 Alcohol Syndrome and, in collaboration with the 

19 National Institute on Alcohol Abuse and Alco20 holism, the Centers for Disease Control and 

21 Prevention, researchers, and experts in the 

22 field, develop a standard clinical case definition 

23 for diagnostic guidelines and criteria for pre24 natal alcohol-related conditions other than Fetal 

25 Alcohol Syndrome; 


TKELLEY on DSK3SPTVN1PROD with BILLS
10 

•S 237 IS

1 ‘‘(B) conduct applied public health preven2 tion research to identify evidence-based strate3 gies for reducing alcohol-exposed pregnancies in 

4 women at high risk for alcohol-exposed preg5 nancies; 

6 ‘‘(C) disseminate and provide the necessary 

7 training and support to implement evidence8 based strategies developed under subparagraph 

9 (A) to— 

10 ‘‘(i) hospitals, federally qualified 

11 health centers, outpatient programs, and 

12 other appropriate health care providers; 

13 ‘‘(ii) incarceration, detainment facili14 ties, and other judicial systems for juve15 niles and adults; 

16 ‘‘(iii) educational settings; 

17 ‘‘(iv) social work and child welfare of18 fices; 

19 ‘‘(v) foster care providers and adop20 tion agencies; 

21 ‘‘(vi) State offices and others pro22 viding services to individuals with disabil23 ities; 

24 ‘‘(vii) alcoholism treatment facilities; 

25 and 


TKELLEY on DSK3SPTVN1PROD with BILLS
11 

•S 237 IS

1 ‘‘(viii) other entities that the Sec2 retary determines to be appropriate; 

3 ‘‘(D) conduct activities related to risk fac4 tor surveillance including the biannual moni5 toring and reporting of alcohol consumption 

6 among pregnant women and women of child 

7 bearing age; and 

8 ‘‘(E) disseminate and evaluate brief behav9 ioral intervention strategies aimed at preventing 

10 alcohol-exposed pregnancies among women of 

11 childbearing age in special settings, including 

12 clinical primary health centers, outpatient clin13 ics, and jail and recovery campuses. 

14 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

15 There are authorized to be appropriated to carry out 

16 this subsection, such sums as may be necessary for 

17 each of fiscal years 2014 through 2018. 

18 ‘‘(c) BUILDING STATE FASD SYSTEMS.— 

19 ‘‘(1) IN GENERAL.—The Secretary, acting 

20 through the Administrator of the Substance Abuse 

21 and Mental Health Services Administration, shall 

22 award grants, contracts, or cooperative agreements 

23 to States for the purpose of establishing or expand24 ing statewide programs of surveillance, prevention, 


TKELLEY on DSK3SPTVN1PROD with BILLS
12 

•S 237 IS

1 and clinical intervention for individuals with Fetal 

2 Alcohol Spectrum Disorders. 

3 ‘‘(2) ELIGIBILITY.—To be eligible to receive a 

4 grant, contract, or cooperative agreement under 

5 paragraph (1) a State shall— 

6 ‘‘(A) prepare and submit to the Secretary 

7 an application at such time, in such manner, 

8 and containing such information as the Sec9 retary may reasonably require; 

10 ‘‘(B) develop and implement a statewide 

11 strategic plan for preventing Fetal Alcohol 

12 Spectrum Disorders and clinical intervention 

13 for individuals with Fetal Alcohol Spectrum 

14 Disorders; 

15 ‘‘(C) consult with public and private non16 profit entities with relevant expertise on Fetal 

17 Alcohol Spectrum Disorders within the State, 

18 including— 

19 ‘‘(i) parent-led groups and other orga20 nizations that support and advocate for in21 dividuals with Fetal Alcohol Spectrum Dis22 orders; and 

23 ‘‘(ii) Indian tribes and tribal organiza24 tions; and 


TKELLEY on DSK3SPTVN1PROD with BILLS
13 

•S 237 IS

1 ‘‘(D) designate an individual to serve as 

2 the coordinator of the State’s Fetal Alcohol 

3 Spectrum Disorders program. 

4 ‘‘(3) STRATEGIC PLAN.—The statewide stra5 tegic plan prepared under paragraph (2)(B) shall in6 clude— 

7 ‘‘(A) the identification of existing State 

8 programs and systems that could be used to 

9 identify and assist individuals with Fetal Alco10 hol Spectrum Disorders and prevent alcohol 

11 consumption during pregnancy, such as— 

12 ‘‘(i) programs for the developmentally 

13 disabled, the mentally ill, and individuals 

14 with alcohol dependency; 

15 ‘‘(ii) educational settings; 

16 ‘‘(iii) incarceration, detention centers, 

17 and judicial systems for juveniles and 

18 adults; 

19 ‘‘(iv) child welfare programs and so20 cial service programs; and 

21 ‘‘(v) other programs or systems the 

22 State determines to be appropriate; 

23 ‘‘(B) the identification of any barriers for 

24 individuals with Fetal Alcohol Spectrum Dis25 orders or women at risk for alcohol consumpVerDate Mar 15 2010 22:28 Feb 19, 2013 Jkt 029200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\S237.IS S237

TKELLEY on DSK3SPTVN1PROD with BILLS
14 

•S 237 IS

1 tion during pregnancy to access the programs 

2 identified under subparagraph (A); and 

3 ‘‘(C) proposals to eliminate barriers to pre4 vention and treatment programs and coordinate 

5 the activities of such programs. 

6 ‘‘(4) USE OF FUNDS.—Amounts received under 

7 a grant, contract, or cooperative agreement under 

8 paragraph (1) shall be used for 1 or more of the fol9 lowing activities: 

10 ‘‘(A) Establishing a statewide surveillance 

11 system. 

12 ‘‘(B) Collecting, analyzing, and inter13 preting data. 

14 ‘‘(C) Establishing a diagnostic center. 

15 ‘‘(D) Developing, implementing, and evalu16 ating population-based and targeted prevention 

17 programs for Fetal Alcohol Spectrum Dis18 orders, including public awareness campaigns. 

19 ‘‘(E) Referring individuals with Fetal Alco20 hol Spectrum Disorders to appropriate support 

21 services. 

22 ‘‘(F) Implementing recommendations from 

23 relevant agencies and organizations on the iden24 tification and prevention of Fetal Alcohol Spec25 trum Disorders, and clinical intervention for inVerDate Mar 15 2010 22:28 Feb 19, 2013 Jkt 029200 PO 00000 Frm 00014 Fmt 6652 Sfmt 6201 E:\BILLS\S237.IS S237

TKELLEY on DSK3SPTVN1PROD with BILLS
15 

•S 237 IS

1 dividuals with Fetal Alcohol Spectrum Dis2 orders. 

3 ‘‘(G) Providing training to health care pro4 viders on the prevention, identification, and 

5 treatment of Fetal Alcohol Spectrum Disorders. 

6 ‘‘(H) Disseminating information about 

7 Fetal Alcohol Spectrum Disorders and the 

8 availability of support services to families of in9 dividuals with Fetal Alcohol Spectrum Dis10 orders. 

11 ‘‘(I) Other activities determined appro12 priate by the Secretary. 

13 ‘‘(5) MULTI-STATE PROGRAMS.—The Secretary 

14 shall permit the formation of multi-State Fetal Alco15 hol Spectrum Disorders programs under this sub16 section. 

17 ‘‘(6) OTHER CONTRACTS AND AGREEMENTS.— 

18 A State may carry out activities under paragraph 

19 (4) through contracts or cooperative agreements 

20 with public and private non-profit entities with a 

21 demonstrated expertise in Fetal Alcohol Spectrum 

22 Disorders. 

23 ‘‘(7) AUTHORIZATION OF APPROPRIATIONS.— 

24 There are authorized to be appropriated to carry out 


TKELLEY on DSK3SPTVN1PROD with BILLS
16 

•S 237 IS

1 this subsection, such sums as may be necessary for 

2 fiscal years 2014 through 2018. 

3 ‘‘(d) PROMOTING COMMUNITY PARTNERSHIPS.— 

4 ‘‘(1) IN GENERAL.—The Secretary shall award 

5 grants, contracts, or cooperative agreements to eligi6 ble entities to enable such entities to establish, en7 hance, or improve community partnerships for the 

8 purpose of collaborating on common objectives and 

9 integrating the services available to individuals with 

10 Fetal Alcohol Spectrum Disorders, such as surveil11 lance, prevention, treatment, and provision of sup12 port services. 

13 ‘‘(2) ELIGIBLE ENTITIES.—To be eligible to re14 ceive a grant, contract, or cooperative agreement 

15 under paragraph (1), an entity shall— 

16 ‘‘(A) be a public or private nonprofit enti17 ty, including— 

18 ‘‘(i) a health care provider or health 

19 professional; 

20 ‘‘(ii) a primary or secondary school; 

21 ‘‘(iii) a social work or child welfare of22 fice; 

23 ‘‘(iv) an incarceration, detainment fa24 cility, or judicial systems for juveniles and 

25 adults; 


TKELLEY on DSK3SPTVN1PROD with BILLS
17 

•S 237 IS

1 ‘‘(v) a parent-led group or other orga2 nization that supports and advocates for 

3 individuals with Fetal Alcohol Spectrum 

4 Disorders; 

5 ‘‘(vi) an Indian tribe or tribal organi6 zation; 

7 ‘‘(vii) any other entity the Secretary 

8 determines to be appropriate; or 

9 ‘‘(viii) a consortium of any of the enti10 ties described in clauses (i) through (vii); 

11 and 

12 ‘‘(B) prepare and submit to the Secretary 

13 an application at such time, in such manner, 

14 and containing such information as the Sec15 retary may reasonably require, including assur16 ances that the entity submitting the application 

17 does, at the time of application, or will, within 

18 a reasonable amount of time from the date of 

19 application, include substantive participation of 

20 a broad range of entities that work with or pro21 vide services for individuals with Fetal Alcohol 

22 Spectrum Disorders. 

23 ‘‘(3) ACTIVITIES.—An eligible entity shall use 

24 amounts received under a grant, contract, or cooperVerDate Mar 15 2010 22:28 Feb 19, 2013 Jkt 029200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\S237.IS S237

TKELLEY on DSK3SPTVN1PROD with BILLS
18 

•S 237 IS

1 ative agreement under this subsection shall carry out 

2 1 or more of the following activities: 

3 ‘‘(A) Integrating Fetal Alcohol Spectrum 

4 Disorders services into existing programs and 

5 services available in the community. 

6 ‘‘(B) Conducting a needs assessment to 

7 identify services that are not available in a com8 munity. 

9 ‘‘(C) Developing and implementing com10 munity-based initiatives to prevent, diagnose, 

11 treat, and provide support services to individ12 uals with Fetal Alcohol Spectrum Disorders. 

13 ‘‘(D) Disseminating information about 

14 Fetal Alcohol Spectrum Disorders and the 

15 availability of support services. 

16 ‘‘(E) Developing and implementing a com17 munity-wide public awareness and outreach 

18 campaign focusing on the dangers of drinking 

19 alcohol while pregnant. 

20 ‘‘(F) Providing mentoring or other support 

21 to families of individuals with Fetal Alcohol 

22 Spectrum Disorders. 

23 ‘‘(G) Other activities determined appro24 priate by the Secretary. 


TKELLEY on DSK3SPTVN1PROD with BILLS
19 

•S 237 IS

1 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.— 

2 There are authorized to be appropriated to carry out 

3 this subsection, such sums as may be necessary for 

4 each of fiscal years 2014 through 2018. 

5 ‘‘(e) DEVELOPMENT OF BEST PRACTICES.— 

6 ‘‘(1) IN GENERAL.—The Secretary, in coordina7 tion with the Administrator of the Substance Abuse 

8 and Mental Health Services Administration, shall 

9 award grants to States, Indian tribes and tribal or10 ganizations, and nongovernmental organizations for 

11 the establishment of pilot projects to identify and 

12 implement best practices for— 

13 ‘‘(A) educating children with fetal alcohol 

14 spectrum disorders, including— 

15 ‘‘(i) activities and programs designed 

16 specifically for the identification, treat17 ment, and education of such children; and 

18 ‘‘(ii) curricula development and 

19 credentialing of teachers, administrators, 

20 and social workers who implement such 

21 programs; 

22 ‘‘(B) educating judges, attorneys, proba23 tion officers, child advocates, law enforcement 

24 officers, prison wardens, alternative incarcer25 ation administrators, and incarceration officials 


TKELLEY on DSK3SPTVN1PROD with BILLS
20 

•S 237 IS

1 on how to treat and support individuals suf2 fering from Fetal Alcohol Spectrum Disorders 

3 within the criminal justice system, including— 

4 ‘‘(i) programs designed specifically for 

5 the identification, treatment, and education 

6 of those with Fetal Alcohol Spectrum Dis7 orders; and 

8 ‘‘(ii) curricula development and 

9 credentialing within the justice system for 

10 individuals who implement such programs; 

11 and 

12 ‘‘(C) educating adoption or foster care 

13 agency officials about available and necessary 

14 services for children with Fetal Alcohol Spec15 trum Disorders, including— 

16 ‘‘(i) programs designed specifically for 

17 the identification, treatment, and education 

18 of those with Fetal Alcohol Spectrum Dis19 orders; and 

20 ‘‘(ii) education and training for poten21 tial parents of an adopted child with Fetal 

22 Alcohol Spectrum Disorders. 

23 ‘‘(2) APPLICATION.—To be eligible for a grant 

24 under paragraph (1), an entity shall prepare and 

25 submit to the Secretary an application at such time, 


TKELLEY on DSK3SPTVN1PROD with BILLS
21 

•S 237 IS

1 in such manner, and containing such information as 

2 the Secretary may reasonably require. 

3 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

4 There are authorized to be appropriated to carry out 

5 this subsection, such sums as may be necessary for 

6 each of fiscal years 2014 through 2018. 

7 ‘‘(f) TRANSITIONAL SERVICES.— 

8 ‘‘(1) IN GENERAL.—The Secretary shall award 

9 demonstration grants, contracts, and cooperative 

10 agreements to States, Indian tribes and tribal orga11 nizations, and nongovernmental organizations for 

12 the purpose of establishing integrated systems for 

13 providing transitional services for those affected by 

14 prenatal alcohol exposure and evaluating their effec15 tiveness. 

16 ‘‘(2) APPLICATION.—To be eligible for a grant, 

17 contract, or cooperative agreement under paragraph 

18 (1), an entity shall prepare and submit to the Sec19 retary an application at such time, in such manner, 

20 and containing such information as the Secretary 

21 may reasonably require, including specific creden22 tials relating to education, skills, training, and con23 tinuing educational requirements relating to Fetal 

24 Alcohol Spectrum Disorders. 


TKELLEY on DSK3SPTVN1PROD with BILLS
22 

•S 237 IS

1 ‘‘(3) ALLOWABLE USES.—An entity shall use 

2 amounts received under a grant, contract, or cooper3 ative agreement under paragraph (1) to— 

4 ‘‘(A) provide housing assistance to, or spe5 cialized housing for, adults with Fetal Alcohol 

6 Spectrum Disorders; 

7 ‘‘(B) provide vocational training and place8 ment services for adults with Fetal Alcohol 

9 Spectrum Disorders; 

10 ‘‘(C) provide medication monitoring serv11 ices for adults with Fetal Alcohol Spectrum 

12 Disorders; 

13 ‘‘(D) provide training and support to orga14 nizations providing family services or mental 

15 health programs and other organizations that 

16 work with adults with Fetal Alcohol Spectrum 

17 Disorders; and 

18 ‘‘(E) establish and evaluate housing models 

19 specially designed for adults with Fetal Alcohol 

20 Spectrum Disorders. 

21 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.— 

22 There are authorized to be appropriated to carry out 

23 this subsection, such sums as may be necessary for 

24 each of fiscal years 2014 through 2018. 


TKELLEY on DSK3SPTVN1PROD with BILLS
23 

•S 237 IS

1 ‘‘(g) FEDERALLY QUALIFIED HEALTH CENTER INI2 TIATIVE.— 

3 ‘‘(1) IN GENERAL.—The Secretary, acting 

4 through the Administrator of the Health Resources 

5 and Services Administration, shall award grants to 

6 federally qualified health centers acting in collabora7 tion with States, Indian tribes, tribal organizations, 

8 and nongovernmental organizations, for the estab9 lishment of a 5-year demonstration program to im10 plement and evaluate a program to increase the 

11 awareness and identification of Fetal Alcohol Spec12 trum Disorders in federally qualified health centers 

13 and to refer affected individuals to appropriate sup14 port services. 

15 ‘‘(2) APPLICATION.—To be eligible to receive a 

16 grant under paragraph (1), a federally qualified 

17 health center, or a State, Indian tribe, tribal organi18 zation, or nongovernment organization with a dem19 onstrated record of implementing Fetal Alcohol 

20 Spectrum Disorders programming in federally quali21 fied health centers, shall prepare and submit to the 

22 Administrator an application at such time, in such 

23 manner, and containing such information as the Ad24 ministrator may reasonably require. 


TKELLEY on DSK3SPTVN1PROD with BILLS
24 

•S 237 IS

1 ‘‘(3) ACTIVITIES.—A federally qualified health 

2 center, or other eligible entity, shall use amounts re3 ceived under a grant under paragraph (1) to— 

4 ‘‘(A) provide training for health care pro5 viders on identifying and educating women who 

6 are at risk for alcohol consumption during preg7 nancy; 

8 ‘‘(B) provide training for health care pro9 viders on screening children for Fetal Alcohol 

10 Spectrum Disorders; 

11 ‘‘(C) educate health care providers and 

12 other relevant federally qualified health center 

13 workers on the support services available for 

14 those with Fetal Alcohol Spectrum Disorders 

15 and treatment services available for women at 

16 risk for alcohol consumption during pregnancy; 

17 and 

18 ‘‘(D) implement a tracking system that 

19 can identify the rates of Fetal Alcohol Spec20 trum Disorders by racial, ethnic, and economic 

21 backgrounds. 

22 ‘‘(4) SELECTION OF PARTICIPANTS.—The Ad23 ministrator shall determine the number of federally 

24 qualified health centers that will participate in the 

25 demonstration program under this subsection and 


TKELLEY on DSK3SPTVN1PROD with BILLS
25 

•S 237 IS

1 shall select participants, to the extent practicable, 

2 that are located in different regions of the United 

3 States and that serve a racially and ethnically di4 verse population. 

5 ‘‘(5) AUTHORIZATION OF APPROPRIATIONS.— 

6 There are authorized to be appropriated to carry out 

7 this subsection, such sums as may be necessary for 

8 each of fiscal years 2014 through 2018. 

9 ‘‘(6) REPORT TO CONGRESS.—Not later than 1 

10 year after completion of the demonstration program 

11 under this subsection, the Administrator shall pre12 pare and submit to Congress a report on the results 

13 of the demonstration program, including— 

14 ‘‘(A) changes in the number of women 

15 screened for and identified as at risk for alcohol 

16 consumption during pregnancy; 

17 ‘‘(B) changes in the number of individuals 

18 identified as having a Fetal Alcohol Spectrum 

19 Disorder; and 

20 ‘‘(C) changes in the number of alcohol-con21 suming pregnant women and individuals with 

22 Fetal Alcohol Spectrum Disorders who were re23 ferred to appropriate services.’’; 

24 (4) in subsection (h)(1) (as so redesignated)— 


TKELLEY on DSK3SPTVN1PROD with BILLS
26 

•S 237 IS

1 (A) in subparagraph (C), by striking 

2 ‘‘and’’ after the semicolon; 

3 (B) in subparagraph (D), by adding ‘‘and’’ 

4 after the semicolon; and 

5 (C) by adding at the end the following: 

6 ‘‘(E) national public service announce7 ments to raise public awareness of the risks as8 sociated with alcohol consumption during preg9 nancy with the purpose of reducing the preva10 lence of Fetal Alcohol Spectrum Disorders, that 

11 shall— 

12 ‘‘(i) be developed, conducted, and 

13 evaluated prior to broadcast by relevant 

14 Federal agencies with the advice of the 

15 Interagency Coordinating Committee on 

16 Fetal Alcohol Syndrome taking into consid17 eration the expertise and experience of 

18 other relevant Federal agencies; 

19 ‘‘(ii) be broadcast through appropriate 

20 media outlets, including the Internet, tele21 vision or radio, in a manner intended to 

22 reach women at risk of alcohol consump23 tion during pregnancy; and 

24 ‘‘(iii) be measured prior to broadcast 

25 of the national public service announceVerDate Mar 15 2010 22:28 Feb 19, 2013 Jkt 029200 PO 00000 Frm 00026 Fmt 6652 Sfmt 6201 E:\BILLS\S237.IS S237

TKELLEY on DSK3SPTVN1PROD with BILLS
27 

•S 237 IS

1 ments to provide baseline data that will be 

2 used to evaluate the effectiveness of the 

3 announcements.’’; and 

4 (5) in subsection (k) (as so redesignated)— 

5 (A) in paragraph (1), by striking ‘‘Na6 tional Task Force on Fetal Alcohol Syndrome 

7 and Fetal Alcohol Effect’’ and inserting ‘‘Na8 tional Task Force on Fetal Alcohol Spectrum 

9 Disorders’’; 

10 (B) in paragraph (3)— 

11 (i) in subparagraph (B), by striking 

12 ‘‘and’’ after the semicolon; 

13 (ii) in subparagraph (C), by striking 

14 the period and inserting a semicolon; and 

15 (iii) by adding at the end the fol16 lowing: 

17 ‘‘(D) explore the feasibility of whether 

18 Fetal Alcohol Syndrome and other prenatal al19 cohol disorders, or a subset of these disorders, 

20 should be included in the Diagnostic and Sta21 tistic Manual of Mental Disorders; and 

22 ‘‘(E) in collaboration with the National In23 stitute on Alcohol Abuse and Alcoholism, the 

24 Centers for Disease Control and Prevention, re25 searchers, and experts in the field, develop a 


TKELLEY on DSK3SPTVN1PROD with BILLS
28 

•S 237 IS

1 standard clinical case definition for diagnostic 

2 guideline and criteria for prenatal alcohol-re3 lated conditions other than Fetal Alcohol Syn4 drome.’’; and 

5 (C) by striking ‘‘Fetal Alcohol Syndrome 

6 and Fetal Alcohol Effect’’ each place that such 

7 appears and inserting ‘‘Fetal Alcohol Spectrum 

8 Disorders’’. 

9 SEC. 4. COORDINATION AMONG FEDERAL ENTITIES. 

10 Part O of title III of the Public Health Service Act 

11 (42 U.S.C. 280f et seq.) is amended by adding at the end 

12 the following: 

13 ‘‘SEC. 399K–1. COORDINATION AMONG FEDERAL ENTITIES. 

14 ‘‘(a) INTERAGENCY COORDINATING COMMITTEE ON

15 FETAL ALCOHOL SYNDROME.—The Secretary, acting 

16 through the Director of the National Institute on Alcohol 

17 Abuse and Alcoholism, shall provide for the continuation 

18 of the Interagency Coordinating Committee on Fetal Alco19 hol Syndrome so that such Committee may— 

20 ‘‘(1) coordinate activities conducted by the Fed21 eral Government on Fetal Alcohol Spectrum Dis22 orders, including convening meetings, establishing 

23 work groups, sharing information, and facilitating 

24 and promoting collaborative projects among Federal 

25 agencies; and 


TKELLEY on DSK3SPTVN1PROD with BILLS
29 

•S 237 IS

1 ‘‘(2) develop, in consultation with the National 

2 Task Force on Fetal Alcohol Spectrum Disorders, 

3 priority areas for years 2013 through 2017 to guide 

4 Federal programs and activities related to Fetal Al5 cohol Spectrum Disorders. 

6 ‘‘(b) COORDINATION AMONG FEDERAL ENTITIES.— 

7 ‘‘(1) IN GENERAL.—The Comptroller General of 

8 the United States shall evaluate and make rec9 ommendations regarding the appropriate roles and 

10 responsibilities of Federal entities with respect to 

11 programs and activities related to Fetal Alcohol 

12 Spectrum Disorders. 

13 ‘‘(2) COVERED ENTITIES.—The Federal entities 

14 under paragraph (1) shall include entities within the 

15 National Institutes of Health, the Centers for Dis16 ease Control and Prevention, the Substance Abuse 

17 and Mental Health Services Administration, the 

18 Health Resources and Services Administration, the 

19 Indian Health Service, the Agency for Healthcare 

20 Research and Quality, the Interagency Coordinating 

21 Committee on Fetal Alcohol Syndrome, the National 

22 Task Force on Fetal Alcohol Spectrum Disorders, as 

23 well as the Office of Special Education and Rehabili24 tative Services in the Department of Education and 


TKELLEY on DSK3SPTVN1PROD with BILLS
30 

•S 237 IS

1 the Office of Juvenile Justice and Delinquency Pre2 vention in the Department of Justice. 

3 ‘‘(3) EVALUATION.—The evaluation conducted 

4 by the Comptroller General under paragraph (1) 

5 shall include— 

6 ‘‘(A) an assessment of the current roles 

7 and responsibilities of Federal entities with pro8 grams and activities related to Fetal Alcohol 

9 Spectrum Disorders; and 

10 ‘‘(B) an assessment of whether there is du11 plication in programs and activities, conflicting 

12 roles and responsibilities, or lack of coordina13 tion among Federal entities. 

14 ‘‘(4) RECOMMENDATION.—The Comptroller 

15 General shall provide recommendations on the ap16 propriate roles and responsibilities of the Federal 

17 entities described in paragraph (2) in order to maxi18 mize the effectiveness of Federal programs and ac19 tivities related to Fetal Alcohol Spectrum Disorders. 

20 ‘‘(5) COMPLETION.—Not later than 1 year after 

21 the date of enactment of the Advancing FASD Re22 search, Prevention, and Services Act, the Comp23 troller General shall complete the evaluation and 

24 submit to Congress a report on the findings and rec25 ommendations made as a result of the evaluation.’’. 


TKELLEY on DSK3SPTVN1PROD with BILLS
31 

•S 237 IS

1 SEC. 5. SERVICES FOR INDIVIDUALS WITH FETAL ALCOHOL 

2 SPECTRUM DISORDERS. 

3 Section 519C(b) of the Public Health Service Act (42 

4 U.S.C. 290bb–25c(b)) is amended— 

5 (1) in paragraph (11), by striking ‘‘and’’ after 

6 the semicolon; 

7 (2) by redesignating paragraph (12) as para8 graph (15); and 

9 (3) by inserting after paragraph (11), the fol10 lowing: 

11 ‘‘(12) provide respite care for caretakers of in12 dividuals with Fetal Alcohol Syndrome and other 

13 prenatal alcohol-related disorders; 

14 ‘‘(13) recruit and train mentors for individuals 

15 with Fetal Alcohol Syndrome and other prenatal al16 cohol-related disorders; 

17 ‘‘(14) provide educational and supportive serv18 ices to families of individuals with Fetal Alcohol 

19 Spectrum Disorders; and’’. 

20 SEC. 6. PREVENTION, INTERVENTION, AND SERVICES IN 

21 THE EDUCATION SYSTEM. 

22 (a) GENERAL RULE.—The Secretary of Education 

23 shall be the lead Federal official with responsibility over 

24 education-related issues with respect to children with 

25 Fetal Alcohol Spectrum Disorders. 


TKELLEY on DSK3SPTVN1PROD with BILLS
32 

•S 237 IS

1 (b) SPECIFIC RESPONSIBILITIES.—The Secretary of 

2 Education shall direct the Office of Special Education and 

3 Rehabilitative Services to— 

4 (1) conduct and disseminate training on a na5 tionwide Fetal Alcohol Spectrum Disorders surveil6 lance campaign to local education agencies and early 

7 childhood education providers in collaboration with 

8 the National Center on Birth Defects and Develop9 mental Disabilities under section 399H(b) of the 

10 Public Health Service Act (as added by this Act); 

11 (2) collect, collate, and disseminate (through 

12 the Internet Web site of the Department of Edu13 cation, at teacher-to-teacher workshops, and through 

14 other means) evidence-based practices that are effec15 tive in the education and support of children with 

16 Fetal Alcohol Syndrome Disorders, including any 

17 special techniques on how to assist children with 

18 Fetal Alcohol Spectrum Disorders, in both special 

19 and traditional educational settings, such practices 

20 to incorporate information concerning the identifica21 tion, behavioral supports, teaching, and learning as22 sociated with Fetal Alcohol Spectrum Disorders, 

23 to— 

24 (A) education groups such as the National 

25 Association of School Boards, the National 


TKELLEY on DSK3SPTVN1PROD with BILLS
33 

•S 237 IS

1 Education Association, the American Federa2 tion of Teachers, the National Association of 

3 Elementary School Principals, and the National 

4 Association of Secondary School Principals; 

5 (B) 21st Century Community Learning 

6 Center program grantees and other after school 

7 program personnel; and 

8 (C) Parent Teacher Associations, Parent 

9 Information and Training Centers, family aid 

10 programs, and other appropriate education or11 ganizations; 

12 (3) ensure that, in administering the Individ13 uals with Disabilities Education Act, parents, edu14 cators, and advocates for children with disabilities 

15 are aware that children with Fetal Alcohol Spectrum 

16 Disorders have the right to access general cur17 riculum under the least restrictive environment; 

18 (4) collaborate with other Federal agencies to 

19 include Fetal Alcohol Spectrum Disorders-related in20 formation or activities in programs related to mater21 nal health, health education, and sex education; 

22 (5) collaborate with the Secretary of Health 

23 and Human Services to ensure that Fetal Alcohol 

24 Spectrum Disorders prevention grants under section 

25 399H of the Public Health Service Act include eduVerDate Mar 15 2010 22:28 Feb 19, 2013 Jkt 029200 PO 00000 Frm 00033 Fmt 6652 Sfmt 6201 E:\BILLS\S237.IS S237

TKELLEY on DSK3SPTVN1PROD with BILLS
34 

•S 237 IS

1 cation concerning Fetal Alcohol Spectrum Disorders 

2 in the sexual and health education curricula of 

3 schools; and 

4 (6) support efforts by peer advisory networks of 

5 adolescents in schools organized to discourage the 

6 use of alcohol while pregnant or considering getting 

7 pregnant. 

8 SEC. 7. PREVENTION, INTERVENTION, AND SERVICES IN 

9 THE JUSTICE SYSTEM. 

10 The Attorney General shall direct the Office of Juve11 nile Justice and Delinquency Prevention to— 

12 (1) implement screening procedures and con13 duct training on a nationwide Fetal Alcohol Spec14 trum Disorders surveillance campaign for the De15 partment of Justice in collaboration with the efforts 

16 of the National Center on Birth Defects and Devel17 opmental Disabilities under section 399H(b) of the 

18 Public Health Service Act (as added by this Act); 

19 (2) introduce training curricula on how to most 

20 effectively identify and interact with individuals with 

21 Fetal Alcohol Spectrum Disorders in both the juve22 nile and adult justice systems, and investigate incor23 porating information about the identification, pre24 vention, and treatment of the disorders into justice 

25 professionals’ credentialing requirements; 


TKELLEY on DSK3SPTVN1PROD with BILLS
35 

•S 237 IS

1 (3) promote the tracking of individuals entering 

2 the juvenile justice system with at-risk backgrounds 

3 that indicates them as high probability for having a 

4 Fetal Alcohol Spectrum Disorder, especially those 

5 individuals whose mothers have a record of heavy or 

6 binge drinking during pregnancy as reported by the 

7 appropriate child protection agency; 

8 (4) educate judges, attorneys, probation offi9 cers, child advocates, law enforcement officers, pris10 on wardens, alternative incarceration administrators, 

11 and incarceration officials on how to treat and sup12 port individuals suffering from Fetal Alcohol Spec13 trum Disorders within the juvenile and adult justice 

14 systems, including— 

15 (A) programs designed specifically for the 

16 identification, treatment, and education of such 

17 children; and 

18 (B) curricula development and 

19 credentialing of teachers, administrators, and 

20 social workers who implement such programs; 

21 (5) conduct a study on the inadequacies of how 

22 the current system processes children with certain 

23 developmental delays and subsequently implement 

24 alternative methods of incarceration and treatment 


TKELLEY on DSK3SPTVN1PROD with BILLS
36 

•S 237 IS

1 that are more effective for youth offenders identified 

2 to have a Fetal Alcohol Spectrum Disorder; and 

3 (6) collaborate with Fetal Alcohol Spectrum 

4 Disorders professionals and implement transition 

5 programs for juveniles and adults with Fetal Alcohol 

6 Spectrum Disorders who are released from incarcer7 ation. 

8 SEC. 8. MISCELLANEOUS PROVISIONS. 

9 (a) AUTHORIZATION OF APPROPRIATIONS.—Section 

10 399J of the Public Health Service Act (42 U.S.C. 280f– 

11 2) is amended by striking ‘‘the part’’ and all that follows 

12 through the period and inserting ‘‘subsections (h) through 

13 (k) of section 399H, $27,000,000 for each of fiscal years 

14 2014 through 2018’’. 

15 (b) REPEAL OF SUNSET.—Section 399K of the Pub16 lic Health Service Act (42 U.S.C. 280f–3) is repealed. 

Æ 


TKELLEY on DSK3SPTVN1PROD with BILLS