```

[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4979 Introduced in House (IH)]

108th CONGRESS
  2d Session
                                H. R. 4979

   To amend the Public Health Service Act to provide for educational 
  activities and research with respect to women's pelvic floor health 
through the Centers for Disease Control and Prevention and the National 
                         Institutes of Health.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                             July 22, 2004

Mr. Nethercutt (for himself, Mrs. Davis of California, Mr. Gerlach, Mr. 
  Sessions, and Mr. Vitter) introduced the following bill; which was 
            referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL

 
   To amend the Public Health Service Act to provide for educational 
  activities and research with respect to women's pelvic floor health 
through the Centers for Disease Control and Prevention and the National 
                         Institutes of Health.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Women's Pelvic Floor Health 
Education and Awareness Act''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) Women's pelvic floor disorders are a group of common 
        conditions that cause considerable disability and pain.
            (2) Such disorders include bladder and bowel dysfunction, 
        including incontinence. Another such disorder is pelvic organ 
        prolapse, which involves a downward shift of uterine or vaginal 
        structures from their normal positions. Often these conditions 
        coexist.
            (3) Women's pelvic floor disorders are extremely common and 
        are barriers to healthy living.
            (4) Women often suffer from a broad overlap of all pelvic 
        floor disorders, usually experiencing several disorders 
        simultaneously.
            (5) Thirty percent of American women will suffer from a 
        form of urinary incontinence.
            (6) Eleven percent of women in the United States have 
        surgery for urinary incontinence or pelvic organ prolapse 
        during their lifetime, and close to one third will have a 
        second surgery. Many more women are treated with nonsurgical 
        techniques or remain untreated.
            (7) Of the 3 million vaginal deliveries that occur each 
        year in the United States, 900,000 women will develop 
        symptomatic urinary incontinence and a smaller number will 
        develop pelvic organ prolapse and bowel incontinence.
            (8) An estimated $26.3 billion is spent annually to either 
        treat or compensate for urinary incontinence.
            (9) Many health care providers are not prepared to evaluate 
        urinary pelvic floor disorders, including incontinence, and are 
        unaware of treatment options.
            (10) To address the public health threat posed by women's 
        pelvic floor disorders, there is a need for the establishment 
        of awareness and education programs directed at the public and 
        primary-care providers, including the authorization of research 
        focused on urinary incontinence and other pelvic floor 
        disorders. Such programs will greatly help promote better care 
        and treatment to those women afflicted with these disorders.

SEC. 3. EDUCATION REGARDING WOMEN'S PELVIC FLOOR DISORDERS.

    (a) In General.--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 section:

``SEC. 399O. EDUCATION REGARDING WOMEN'S PELVIC FLOOR DISORDERS.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Health Resources and Services Administration and the Director of 
the Centers for Disease Control and Prevention, shall carry out a 
program to provide education regarding bladder and bowel dysfunction 
(including incontinence), pelvic organ prolapse, and other pelvic floor 
disorders to health professionals and the general public. Activities 
under such program shall be carried out directly by the Secretary and 
through awards of grants or contracts to States, political subdivisions 
of States, and other public or nonprofit private entities.
    ``(b) Certain Information.--The Secretary shall ensure that 
education under subsection (a) includes, at a minimum--
            ``(1) information describing the prevalence of pelvic floor 
        disorders in women; and
            ``(2) information regarding treatment options for such 
        disorders.
    ``(c) Use of Internet.--The Secretary shall ensure that the means 
through which education under subsection (a) is provided includes the 
posting of information on the Internet site of the Centers for Disease 
Control and Prevention. The Secretary shall ensure that, in the case of 
health professionals, such means includes means in addition to the 
posting of information on such site.
    ``(d) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary for each of the fiscal years 2005 through 2009.''.
    (b) Sense of Congress.--It is the sense of the Congress that the 
Director of the Centers for Disease Control and Prevention should 
establish a national registry for surgical treatment of pelvic floor 
disorders, especially procedures using new technology.

SEC. 4. RESEARCH THROUGH NATIONAL INSTITUTES OF HEALTH.

    (a) In General.--Part B of title IV of the Public Health Service 
Act (42 U.S.C. 284 et seq.) is amended by adding at the end the 
following:

``SEC. 409J. WOMEN'S PELVIC FLOOR DISORDERS.

    ``(a) In General.--The Directors of the National Institute of 
Diabetes and Digestive and Kidney Diseases and the National Institute 
of Child Health and Human Development shall expand and intensify the 
activities of such Institutes with respect to women's pelvic floor 
disorders, including proposals for research on such disorders that are 
developed independently of solicitations by the National Institutes of 
Health for research proposals.
    ``(b) Networks.--
            ``(1) Urinary incontinence treatment network.--The Director 
        of the National Institute of Diabetes and Digestive and Kidney 
        Diseases, in consultation with the Director of the National 
        Institute of Child Health and Human Development, shall provide 
        for the continuing operation of the Urinary Incontinence 
        Treatment Network. The Network was established pursuant to 
        financial awards from such Institutes, and includes multiple 
        continence treatment centers and a single biostatistical 
        coordinating committee. The Director shall ensure that not 
        fewer than eight such treatment centers are in operation and 
        may provide for the establishment of additional treatment 
        centers, subject to appropriations Acts.
            ``(2) Clinical trials network for female pelvic 
        disorders.--The Director of the National Institute of Child 
        Health and Human Development, in consultation with the Director 
        of the National Institute of Diabetes and Digestive and Kidney 
        Diseases, shall provide for the continuing operation of the 
        Clinical Trials Network for Female Pelvic Disorders. The 
        Network was established pursuant to financial awards from such 
        Institutes, and includes multiple clinical sites and a single 
        data coordinating committee. The Director shall ensure that not 
        fewer than seven such clinical sites are in operation and may 
        provide for the establishment of additional clinical sites, 
        subject to appropriations Acts.
    ``(c) Peer Review.--With respect to technical and scientific peer 
review under section 492, the Director of NIH shall ensure that groups 
that review research proposals under this section include 
urogynecologists. ''.
    (b) Sense of Congress.--
            (1) In general.--The Congress commends--
                    (A) the National Institute of Diabetes and 
                Digestive and Kidney Diseases for its financial support 
                of the Urinary Incontinence Treatment Network;
                    (B) the National Institute of Child Health and 
                Human Development for its financial support of the 
                Clinical Trials Network for Female Pelvic Disorders;
                    (C) the successful collaboration of such Institutes 
                with respect to the Networks; and
                    (D) each of such Networks for the research it is 
                conducting toward improving women's pelvic health.
            (2) Certain activities.--It is the sense of the Congress 
        that the Directors of the National Institute of Diabetes and 
        Digestive and Kidney Diseases and the National Institute of 
        Child Health and Human Development should--
                    (A) increase the size, scope, number, and funding 
                for multidisciplinary research through centers and 
                clinical sites of the Networks referred to in paragraph 
                (1);
                    (B) encourage industry relationships in women's 
                pelvic floor health related research;
                    (C) recruit established scientists from other 
                relevant areas (such as cardiac or gastrointestinal 
                physiology, cell signaling, biomechanical engineering, 
                genomics, and proteomics) to apply their work to the 
                urinary tract and incontinence by encouraging 
                collaborative efforts between basic and clinical 
                scientists;
                    (D) increase research funding for studies that use 
                cellular and molecular techniques to examine the basic 
                mechanisms of bladder and urethral interactions that 
                create urinary continence and incontinence;
                    (E) support research to develop appropriate animal 
                models of urinary incontinence;
                    (F) develop novel techniques (both invasive and 
                noninvasive) for measuring neural, muscular (striated 
                and smooth), and vascular function relating to pelvic 
                floor health;
                    (G) identify risk factors for pelvic floor 
                disorders and urinary incontinence related to 
                childbirth and aging so that prevention measures and 
                improved disease-specific treatment can be developed;
                    (H) initiate research to develop preventive and 
                therapeutic approaches to urinary incontinence that are 
                sensitive to gender, race, and culture, and develop the 
                means of measuring outcomes for treatments in these 
                varied settings;
                    (I) develop a national data registry and tissue 
                bank of people suffering from incontinence to meet the 
                needs of researchers for well-characterized tissue 
                samples; and
                    (J) research the relationship between the anatomic 
                changes of pelvic organ prolapse and the functional 
                derangement's commonly seen in association with them, 
                including voiding dysfunction and incontinence.

SEC. 5. INCLUSION OF WOMEN'S PELVIC FLOOR HEALTH IN NATIONAL CHILDREN'S 
              STUDY.

    The Director of the National Institute of Child Health and Human 
Development shall include women's pelvic floor health as one of the 
matters studied in the prospective cohort study regarding child health 
and human development that is being conducted under section 1004(b) of 
the Children's Health Act of 2000 (Public Law 106-310; 114 Stat. 1130) 
and is known as the National Children's Study.

SEC. 6. CONSULTATION.

    In carrying out this Act, the Secretary of Health and Human 
Services shall consult with the American Urogynecologic Society and 
such other qualified professional and patient organizations as the 
Secretary determines to be appropriate.
                                 <all>
```