I
106TH CONGRESS
1ST SESSION
H. R. 2538
To amend the Public Health Service Act to provide for a national folic
acid education program to prevent birth defects, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
JULY 15, 1999
Ms. ROYBAL-ALLARD (for herself, Mrs. EMERSON, Mr. ABERCROMBIE, Mr.
ADERHOLT, Mr. BARCIA, Mr. BECERRA, Mr. BENTSEN, Ms. BERKLEY,
Ms. EDDIE BERNICE JOHNSON of Texas, Mr. BONILLA, Mr. BONIOR, Mr.
BOSWELL, Ms. BROWN of Florida, Mrs. CAPPS, Ms. CARSON, Mrs. CLAY-
TON, Mr. COX, Mr. CRAMER, Mr. CUMMINGS, Mr. CUNNINGHAM, Ms.
DANNER, Mr. DEFAZIO, Ms. DEGETTE, Ms. DELAURO, Mr. DICKEY, Mr.
DICKS, Mr. DIXON, Mr. DOOLEY of California, Mr. EDWARDS, Mr.
EVANS, Mr. FARR of California, Mr. FORBES, Mr. FRELINGHUYSEN, Mr.
FROST, Mr. GONZALEZ, Ms. GRANGER, Mr. GUTIERREZ, Mr. HASTINGS
of Florida, Mr. HINCHEY, Mr. HINOJOSA, Ms. NORTON, Ms. HOOLEY of
Oregon, Ms. JACKSON-LEE of Texas, Ms. KAPTUR, Mrs. KELLY, Mr.
KILDEE, Ms. KILPATRICK, Mr. KINGSTON, Mr. KNOLLENBERG, Mr. LAN-
TOS, Mr. LEWIS of Georgia, Mrs. MALONEY of New York, Mr. MALONEY
of Connecticut, Mr. MATSUI, Mrs. MCCARTHY of New York, Mr. MCGOV-
ERN, Ms. MCKINNEY, Mr. MENENDEZ, Ms. MILLENDER-MCDONALD, Mr.
MILLER of Florida, Mr. GEORGE MILLER of California, Mrs. MINK of
Hawaii, Mr. MORAN of Virginia, Mrs. MORELLA, Mrs. NAPOLITANO, Mr.
NEAL of Massachusetts, Mr. NETHERCUTT, Mrs. NORTHUP, Mr. ORTIZ,
Mr. PACKARD, Mr. PASTOR, Mr. PAYNE, Ms. PELOSI, Mr. PETERSON of
Pennsylvania, Mr. POMEROY, Mr. PRICE of North Carolina, Mr. REYES,
Ms. RIVERS, Mr. RODRIGUEZ, Mr. ROMERO-BARCELO´, Mr. RUSH, Ms.
SANCHEZ, Mr. SANDLIN, Mr. SCOTT, Mr. SERRANO, Mr. SHOWS, Mr.
SKELTON, Ms. SLAUGHTER, Ms. STABENOW, Mr. STARK, Mr. STUPAK,
Mrs. TAUSCHER, Mrs. THURMAN, Mr. TOWNS, Mrs. JONES of Ohio, Mr.
UDALL of New Mexico, Ms. VELA´ZQUEZ, Mr. WALSH, Ms. WATERS, Mr.
WAXMAN, Mr. WICKER, Mr. WISE, and Ms. WOOLSEY) introduced the
following bill; which was referred to the Committee on Commerce
A BILL
To amend the Public Health Service Act to provide for
a national folic acid education program to prevent birth
defects, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Folic Acid Promotion
and Birth Defects Prevention Act of 1999’’.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) Each year an estimated 2,500 infants are
born in the United States with serious birth defects
of the brain and spine, called neural tube defects.
(2) The most common neural tube defects are
spina bifida and anencephaly.
(3) Spina bifida, the incomplete closure of the
spinal column, is a leading cause of childhood paral-
ysis.
(4) Anencephaly is a fatal condition in which an
infant is born with a severely underdeveloped brain
and skull.
(5) As many as 70 percent of neural tube birth
defects could be prevented if all women of child-
bearing age consumed 400 micrograms of folic acid
daily, beginning before pregnancy.
(6) Folic acid is a B vitamin found naturally in
foods such as leafy green vegetables, beans, citrus
fruits, and juices.
(7) Since January 1, 1998, the Food and Drug
Administration has required that all foods con-
taining enriched flour, such as breads, pasta and
breakfast cereal, be fortified with folic acid.
(8) In addition to consuming a diet high in
folate rich foods, a daily multivitamin is one of the
most reliable sources of folic acid.
(9) A majority of women are not aware of this
prevention opportunity, nor are they consuming the
recommended daily amount.
(10) A national folic acid education campaign is
needed to urge women to take this simple step to
prevent neural tube defects.
SEC. 3. PROGRAM REGARDING EFFECTS OF FOLIC ACID IN
PREVENTION OF BIRTH DEFECTS.
Part B of title III of the Public Health Service Act
(42 U.S.C. 243 et seq.) is amended by inserting after sec-
tion 317G the following section:
‘‘EFFECTS OF FOLIC ACID IN PREVENTION OF BIRTH
DEFECTS
‘‘SEC. 317H. (a) IN GENERAL.—The Secretary, act-
ing through the Director of the Centers for Disease Con-
trol and Prevention, shall carry out a program (directly
or through grants or contracts) for the following purposes:
‘‘(1) To provide education and training for
health professionals and the general public for pur-
poses of explaining the effects of folic acid in pre-
venting birth defects and for purposes of encour-
aging each woman of reproductive capacity (whether
or not planning a pregnancy) to consume on a daily
basis a dietary supplement that provides an appro-
priate level of folic acid.
‘‘(2) To conduct research with respect to such
education and training, including identifying effec-
tive strategies for increasing the rate of consumption
of folic acid by women of reproductive capacity.
‘‘(3) To conduct research to increase the under-
standing of the effects of folic acid in preventing
birth defects, including understanding with respect
to cleft lip, cleft palate, and heart defects.
‘‘(4) To provide for appropriate epidemiological
activities regarding folic acid and birth defects, in-
cluding epidemiological activities regarding neural
tube defects.
‘‘(b) CONSULTATIONS WITH STATES AND PRIVATE
ENTITIES.—In carrying out subsection (a), the Secretary
shall consult with the States and with other appropriate
public or private entities, including national nonprofit pri-
vate organizations, health professionals, and providers of
health insurance and health plans.
‘‘(c) TECHNICAL ASSISTANCE.—The Secretary may
(directly or through grants or contracts) provide technical
assistance to public and nonprofit private entities in car-
rying out the activities described in subsection (a).
‘‘(d) EVALUATIONS.—The Secretary shall (directly or
through grants or contracts) provide for the evaluation of
activities under subsection (a) in order to determine the
extent to which such activities have been effective in car-
rying out the purposes of the program under such sub-
section, including the effects on various demographic pop-
ulations. Methods of evaluation under the preceding sen-
tence may include surveys of knowledge and attitudes on
the consumption of folic acid and on blood folate levels.
Such methods may include complete and timely moni-
toring of infants who are born with neural tube defects.
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there are authorized
to be appropriated $20,000,000 for fiscal year 2000, and
such sums as may be necessary for each of the fiscal years
2001 through 2004.’’.
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