H. R. 4365
One Hundred Sixth Congress
of the
United States of America
AT THE SECOND SESSION
Begun and held at the City of Washington on Monday,
the twenty-fourth day of January, two thousand
An Act
To amend the Public Health Service Act with respect to children’s 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 ‘‘Children’s Health Act of 2000’’.
SEC. 2. TABLE OF CONTENTS.
The table of contents for this Act is as follows:
Sec.1.Short title.
Sec.2.Table of contents.
DIVISION A—CHILDREN’S HEALTH
TITLE I—AUTISM
Sec.101.Expansion, intensification, and coordination of activities of National Insti-
tutes of Health with respect to research on autism.
Sec.102.Developmental disabilities surveillance and research programs.
Sec.103.Information and education.
Sec.104.Inter-agency Autism Coordinating Committee.
Sec.105.Report to Congress.
TITLE II—RESEARCH AND DEVELOPMENT REGARDING FRAGILE X
Sec.201.National Institute of Child Health and Human Development; research on
fragile X.
TITLE III—JUVENILE ARTHRITIS AND RELATED CONDITIONS
Sec.301.National Institute of Arthritis and Musculoskeletal and Skin Diseases;
research on juvenile arthritis and related conditions.
Sec.302.Information clearinghouse.
TITLE IV—REDUCING BURDEN OF DIABETES AMONG CHILDREN AND
YOUTH
Sec.401.Programs of Centers for Disease Control and Prevention.
Sec.402.Programs of National Institutes of Health.
TITLE V—ASTHMA SERVICES FOR CHILDREN
Subtitle A—Asthma Services
Sec.501.Grants for children’s asthma relief.
Sec.502.Technical and conforming amendments.
Subtitle B—Prevention Activities
Sec.511.Preventive health and health services block grant; systems for reducing
asthma-related illnesses through integrated pest management.
Subtitle C—Coordination of Federal Activities
Sec.521.Coordination through National Institutes of Health.
Subtitle D—Compilation of Data
Sec.531.Compilation of data by Centers for Disease Control and Prevention.
H. R. 4365—2
TITLE VI—BIRTH DEFECTS PREVENTION ACTIVITIES
Subtitle A—Folic Acid Promotion
Sec.601.Program regarding effects of folic acid in prevention of birth defects.
Subtitle B—National Center on Birth Defects and Developmental Disabilities
Sec.611.National Center on Birth Defects and Developmental Disabilities.
TITLE VII—EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING
HEARING LOSS IN INFANTS
Sec.701.Purposes.
Sec.702.Programs of Health Resources and Services Administration, Centers for
Disease Control and Prevention, and National Institutes of Health.
TITLE VIII—CHILDREN AND EPILEPSY
Sec.801.National public health campaign on epilepsy; seizure disorder demonstra-
tion projects in medically underserved areas.
TITLE IX—SAFE MOTHERHOOD; INFANT HEALTH PROMOTION
Subtitle A—Safe Motherhood Prevention Research
Sec.901.Prevention research and other activities.
Subtitle B—Pregnant Women and Infants Health Promotion
Sec.911.Programs regarding prenatal and postnatal health.
TITLE X—PEDIATRIC RESEARCH INITIATIVE
Sec.1001.Establishment of pediatric research initiative.
Sec.1002.Investment in tomorrow’s pediatric researchers.
Sec.1003.Review of regulations.
Sec.1004.Long-term child development study.
TITLE XI—CHILDHOOD MALIGNANCIES
Sec.1101.Programs of Centers for Disease Control and Prevention and National In-
stitutes of Health.
TITLE XII—ADOPTION AWARENESS
Subtitle A—Infant Adoption Awareness
Sec.1201.Grants regarding infant adoption awareness.
Subtitle B—Special Needs Adoption Awareness
Sec.1211.Special needs adoption programs; public awareness campaign and other
activities.
TITLE XIII—TRAUMATIC BRAIN INJURY
Sec.1301.Programs of Centers for Disease Control and Prevention.
Sec.1302.Study and monitor incidence and prevalence.
Sec.1303.Programs of National Institutes of Health.
Sec.1304.Programs of Health Resources and Services Administration.
Sec.1305.State grants for protection and advocacy services.
Sec.1306.Authorization of appropriations for certain programs.
TITLE XIV—CHILD CARE SAFETY AND HEALTH GRANTS
Sec.1401.Definitions.
Sec.1402.Authorization of appropriations.
Sec.1403.Programs.
Sec.1404.Amounts reserved; allotments.
Sec.1405.State applications.
Sec.1406.Use of funds.
Sec.1407.Reports.
TITLE XV—HEALTHY START INITIATIVE
Sec.1501.Continuation of healthy start program.
TITLE XVI—ORAL HEALTH PROMOTION AND DISEASE PREVENTION
Sec.1601.Identification of interventions that reduce the burden and transmission of
oral, dental, and craniofacial diseases in high risk populations; develop-
ment of approaches for pediatric oral and craniofacial assessment.
H. R. 4365—3
Sec.1602.Oral health promotion and disease prevention.
Sec.1603.Coordinated program to improve pediatric oral health.
TITLE XVII—VACCINE-RELATED PROGRAMS
Subtitle A—Vaccine Compensation Program
Sec.1701.Content of petitions.
Subtitle B—Childhood Immunizations
Sec.1711.Childhood immunizations.
TITLE XVIII—HEPATITIS C
Sec.1801.Surveillance and education regarding hepatitis C.
TITLE XIX—NIH INITIATIVE ON AUTOIMMUNE DISEASES
Sec.1901.Autoimmune diseases; initiative through Director of National Institutes of
Health.
TITLE XX—GRADUATE MEDICAL EDUCATION PROGRAMS IN CHILDREN’S
HOSPITALS
Sec.2001.Provisions to revise and extend program.
TITLE XXI—SPECIAL NEEDS OF CHILDREN REGARDING ORGAN
TRANSPLANTATION
Sec.2101.Organ Procurement and Transplantation Network; amendments regarding
needs of children.
TITLE XXII—MUSCULAR DYSTROPHY RESEARCH
Sec.2201.Muscular dystrophy research.
TITLE XXIII—CHILDREN AND TOURETTE SYNDROME AWARENESS
Sec.2301.Grants regarding Tourette Syndrome.
TITLE XXIV—CHILDHOOD OBESITY PREVENTION
Sec.2401.Programs operated through the Centers for Disease Control and
Prevention.
TITLE XXV—EARLY DETECTION AND TREATMENT REGARDING
CHILDHOOD LEAD POISONING
Sec.2501.Centers for Disease Control and Prevention efforts to combat childhood
lead poisoning.
Sec.2502.Grants for lead poisoning related activities.
Sec.2503.Training 
and 
reports 
by 
the 
Health 
Resources 
and 
Services
Administration.
Sec.2504.Screenings, referrals, and education regarding lead poisoning.
TITLE XXVI—SCREENING FOR HERITABLE DISORDERS
Sec.2601.Program to improve the ability of States to provide newborn and child
screening for heritable disorders.
TITLE XXVII—PEDIATRIC RESEARCH PROTECTIONS
Sec.2701.Requirement for additional protections for children involved in research.
TITLE XXVIII—MISCELLANEOUS PROVISIONS
Sec.2801.Report regarding research on rare diseases in children.
Sec.2802.Study on metabolic disorders.
TITLE XXIX—EFFECTIVE DATE
Sec.2901.Effective date.
DIVISION B—YOUTH DRUG AND MENTAL HEALTH SERVICES
Sec.3001.Short title.
TITLE XXXI—PROVISIONS RELATING TO SERVICES FOR CHILDREN AND
ADOLESCENTS
Sec.3101.Children and violence.
Sec.3102.Emergency response.
H. R. 4365—4
Sec.3103.High risk youth reauthorization.
Sec.3104.Substance abuse treatment services for children and adolescents.
Sec.3105.Comprehensive community services for children with serious emotional
disturbance.
Sec.3106.Services for children of substance abusers.
Sec.3107.Services for youth offenders.
Sec.3108.Grants for strengthening families through community partnerships.
Sec.3109.Programs to reduce underage drinking.
Sec.3110.Services for individuals with fetal alcohol syndrome.
Sec.3111.Suicide prevention.
Sec.3112.General provisions.
TITLE XXXII—PROVISIONS RELATING TO MENTAL HEALTH
Sec.3201.Priority mental health needs of regional and national significance.
Sec.3202.Grants for the benefit of homeless individuals.
Sec.3203.Projects for assistance in transition from homelessness.
Sec.3204.Community mental health services performance partnership block grant.
Sec.3205.Determination of allotment.
Sec.3206.Protection and Advocacy for Mentally Ill Individuals Act of 1986.
Sec.3207.Requirement relating to the rights of residents of certain facilities.
Sec.3208.Requirement relating to the rights of residents of certain non-medical,
community-based facilities for children and youth.
Sec.3209.Emergency mental health centers.
Sec.3210.Grants for jail diversion programs.
Sec.3211.Improving outcomes for children and adolescents through services integra-
tion between child welfare and mental health services.
Sec.3212.Grants for the integrated treatment of serious mental illness and
co-occurring substance abuse.
Sec.3213.Training grants.
TITLE XXXIII—PROVISIONS RELATING TO SUBSTANCE ABUSE
Sec.3301.Priority substance abuse treatment needs of regional and national
significance.
Sec.3302.Priority substance abuse prevention needs of regional and national
significance.
Sec.3303.Substance abuse prevention and treatment performance partnership block
grant.
Sec.3304.Determination of allotments.
Sec.3305.Nondiscrimination and institutional safeguards for religious providers.
Sec.3306.Alcohol and drug prevention or treatment services for Indians and
Native Alaskans.
Sec.3307.Establishment of commission.
TITLE XXXIV—PROVISIONS RELATING TO FLEXIBILITY AND
ACCOUNTABILITY
Sec.3401.General authorities and peer review.
Sec.3402.Advisory councils.
Sec.3403.General provisions for the performance partnership block grants.
Sec.3404.Data infrastructure projects.
Sec.3405.Repeal of obsolete addict referral provisions.
Sec.3406.Individuals with co-occurring disorders.
Sec.3407.Services for individuals with co-occurring disorders.
TITLE XXXV—WAIVER AUTHORITY FOR PHYSICIANS WHO DISPENSE OR
PRESCRIBE 
CERTAIN 
NARCOTIC 
DRUGS 
FOR 
MAINTENANCE
TREATMENT OR DETOXIFICATION TREATMENT
Sec.3501.Short title.
Sec.3502.Amendment to Controlled Substances Act.
TITLE XXXVI—METHAMPHETAMINE AND OTHER CONTROLLED
SUBSTANCES
Sec.3601.Short title.
Subtitle A—Methamphetamine Production, Trafficking, and Abuse
PART I—CRIMINAL PENALTIES
Sec.3611.Enhanced punishment of amphetamine laboratory operators.
Sec.3612.Enhanced punishment of amphetamine or methamphetamine laboratory
operators.
H. R. 4365—5
Sec.3613.Mandatory restitution for violations of Controlled Substances Act and Con-
trolled Substances Import and Export Act relating to amphetamine and
methamphetamine.
Sec.3614.Methamphetamine paraphernalia.
PART II—ENHANCED LAW ENFORCEMENT
Sec.3621.Environmental 
hazards 
associated 
with 
illegal 
manufacture 
of
amphetamine and methamphetamine.
Sec.3622.Reduction in retail sales transaction threshold for non-safe harbor
products containing pseudoephedrine or phenylpropanolamine.
Sec.3623.Training for Drug Enforcement Administration and State and local law
enforcement personnel relating to clandestine laboratories.
Sec.3624.Combating methamphetamine and amphetamine in high intensity drug
trafficking areas.
Sec.3625.Combating amphetamine and methamphetamine manufacturing and traf-
ficking.
PART III—ABUSE PREVENTION AND TREATMENT
Sec.3631.Expansion of methamphetamine research.
Sec.3632.Methamphetamine and amphetamine treatment initiative by Center for
Substance Abuse Treatment.
Sec.3633.Study of methamphetamine treatment.
PART IV—REPORTS
Sec.3641.Reports on consumption of methamphetamine and other illicit drugs in
rural areas, metropolitan areas, and consolidated metropolitan areas.
Sec.3642.Report on diversion of ordinary, over-the-counter pseudoephedrine and
phenylpropanolamine products.
Subtitle B—Controlled Substances Generally
Sec.3651.Enhanced punishment for trafficking in list I chemicals.
Sec.3652.Mail order requirements.
Sec.3653.Theft and transportation of anhydrous ammonia for purposes of illicit pro-
duction of controlled substances.
Subtitle C—Ecstasy Anti-Proliferation Act of 2000
Sec.3661.Short title.
Sec.3662.Findings.
Sec.3663.Enhanced punishment of Ecstasy traffickers.
Sec.3664.Emergency authority to United States Sentencing Commission.
Sec.3665.Expansion of Ecstasy and club drugs abuse prevention efforts.
Subtitle D—Miscellaneous
Sec.3671.Antidrug messages on Federal Government Internet websites.
Sec.3672.Reimbursement by Drug Enforcement Administration of expenses
incurred to remediate methamphetamine laboratories.
Sec.3673.Severability.
DIVISION A—CHILDREN’S HEALTH
TITLE I—AUTISM
SEC. 101. EXPANSION, INTENSIFICATION, AND COORDINATION OF
ACTIVITIES OF NATIONAL INSTITUTES OF HEALTH WITH
RESPECT TO RESEARCH ON AUTISM.
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 section:
‘‘EXPANSION, INTENSIFICATION, AND COORDINATION OF ACTIVITIES OF
NATIONAL INSTITUTES OF HEALTH WITH RESPECT TO RESEARCH ON
AUTISM
‘‘SEC. 409C. (a) IN GENERAL.—
‘‘(1) EXPANSION OF ACTIVITIES.—The Director of NIH (in
this section referred to as the ‘Director’) shall expand, intensify,
H. R. 4365—6
and coordinate the activities of the National Institutes of Health
with respect to research on autism.
‘‘(2) ADMINISTRATION OF PROGRAM; COLLABORATION AMONG
AGENCIES.—The Director shall carry out this section acting
through the Director of the National Institute of Mental Health
and in collaboration with any other agencies that the Director
determines appropriate.
‘‘(b) CENTERS OF EXCELLENCE.—
‘‘(1) IN
GENERAL.—The Director shall under subsection
(a)(1) make awards of grants and contracts to public or non-
profit private entities to pay all or part of the cost of planning,
establishing, improving, and providing basic operating support
for centers of excellence regarding research on autism.
‘‘(2) RESEARCH.—Each center under paragraph (1) shall
conduct basic and clinical research into autism. Such research
should include investigations into the cause, diagnosis, early
detection, prevention, control, and treatment of autism. The
centers, as a group, shall conduct research including the fields
of 
developmental 
neurobiology, 
genetics, 
and
psychopharmacology.
‘‘(3) SERVICES FOR PATIENTS.—
‘‘(A) IN GENERAL.—A center under paragraph (1) may
expend amounts provided under such paragraph to carry
out a program to make individuals aware of opportunities
to participate as subjects in research conducted by the
centers.
‘‘(B) 
REFERRALS
AND
COSTS.—A 
program 
under
subparagraph (A) may, in accordance with such criteria
as the Director may establish, provide to the subjects
described in such subparagraph, referrals for health and
other services, and such patient care costs as are required
for research.
‘‘(C) AVAILABILITY AND ACCESS.—The extent to which
a center can demonstrate availability and access to clinical
services shall be considered by the Director in decisions
about awarding grants to applicants which meet the sci-
entific criteria for funding under this section.
‘‘(4) COORDINATION OF CENTERS; REPORTS.—The Director
shall, as appropriate, provide for the coordination of information
among centers under paragraph (1) and ensure regular commu-
nication between such centers, and may require the periodic
preparation of reports on the activities of the centers and
the submission of the reports to the Director.
‘‘(5) ORGANIZATION OF CENTERS.—Each center under para-
graph (1) shall use the facilities of a single institution, or
be formed from a consortium of cooperating institutions,
meeting such requirements as may be prescribed by the
Director.
‘‘(6) NUMBER OF CENTERS; DURATION OF SUPPORT.—
‘‘(A) IN GENERAL.—The Director shall provide for the
establishment of not less than five centers under paragraph
(1).
‘‘(B) DURATION.—Support for a center established
under paragraph (1) may be provided under this section
for a period of not to exceed 5 years. Such period may
be extended for one or more additional periods not
exceeding 5 years if the operations of such center have
H. R. 4365—7
been reviewed by an appropriate technical and scientific
peer review group established by the Director and if such
group has recommended to the Director that such period
should be extended.
‘‘(c) FACILITATION OF RESEARCH.—The Director shall under sub-
section (a)(1) provide for a program under which samples of tissues
and genetic materials that are of use in research on autism are
donated, collected, preserved, and made available for such research.
The program shall be carried out in accordance with accepted
scientific and medical standards for the donation, collection, and
preservation of such samples.
‘‘(d) PUBLIC INPUT.—The Director shall under subsection (a)(1)
provide for means through which the public can obtain information
on the existing and planned programs and activities of the National
Institutes of Health with respect to autism and through which
the Director can receive comments from the public regarding such
programs and activities.
‘‘(e) FUNDING.—There are authorized to be appropriated such
sums as may be necessary to carry out this section. Amounts
appropriated under this subsection are in addition to any other
amounts appropriated for such purpose.’’.
SEC. 
102. 
DEVELOPMENTAL 
DISABILITIES 
SURVEILLANCE 
AND
RESEARCH PROGRAMS.
(a) NATIONAL AUTISM AND PERVASIVE DEVELOPMENTAL DISABIL-
ITIES SURVEILLANCE PROGRAM.—
(1) IN
GENERAL.—The Secretary of Health and Human
Services (in this section referred to as the ‘‘Secretary’’), acting
through the Director of the Centers for Disease Control and
Prevention, may make awards of grants and cooperative agree-
ments for the collection, analysis, and reporting of data on
autism and pervasive developmental disabilities. In making
such awards, the Secretary may provide direct technical assist-
ance in lieu of cash.
(2) ELIGIBILITY.—To be eligible to receive an award under
paragraph (1) an entity shall be a public or nonprofit private
entity (including health departments of States and political
subdivisions of States, and including universities and other
educational entities).
(b) CENTERS
OF
EXCELLENCE
IN
AUTISM
AND
PERVASIVE
DEVELOPMENTAL DISABILITIES EPIDEMIOLOGY.—
(1) IN
GENERAL.—The Secretary, acting through the
Director of the Centers for Disease Control and Prevention,
shall establish not less than three regional centers of excellence
in autism and pervasive developmental disabilities epidemi-
ology for the purpose of collecting and analyzing information
on the number, incidence, correlates, and causes of autism
and related developmental disabilities.
(2) RECIPIENTS OF AWARDS FOR ESTABLISHMENT OF CEN-
TERS.—Centers under paragraph (1) shall be established and
operated through the awarding of grants or cooperative agree-
ments to public or nonprofit private entities that conduct
research, including health departments of States and political
subdivisions of States, and including universities and other
educational entities.
(3) CERTAIN REQUIREMENTS.—An award for a center under
paragraph (1) may be made only if the entity involved submits
H. R. 4365—8
to the Secretary an application containing such agreements
and information as the Secretary may require, including an
agreement that the center involved will operate in accordance
with the following:
(A) The center will collect, analyze, and report autism
and pervasive developmental disabilities data according
to guidelines prescribed by the Director, after consultation
with relevant State and local public health officials, private
sector developmental disability researchers, and advocates
for those with developmental disabilities.
(B) The center will assist with the development and
coordination of State autism and pervasive developmental
disabilities surveillance efforts within a region.
(C) The center will identify eligible cases and controls
through its surveillance systems and conduct research into
factors which may cause autism and related developmental
disabilities.
(D) The center will develop or extend an area of special
research expertise (including genetics, environmental expo-
sure to contaminants, immunology, and other relevant
research specialty areas).
(c) CLEARINGHOUSE.—The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, shall
carry out the following:
(1) The Secretary shall establish a clearinghouse within
the Centers for Disease Control and Prevention for the collec-
tion and storage of data generated from the monitoring pro-
grams established by this title. Through the clearinghouse,
such Centers shall serve as the coordinating agency for autism
and pervasive developmental disabilities surveillance activities.
The functions of such a clearinghouse shall include facilitating
the coordination of research and policy development relating
to the epidemiology of autism and other pervasive develop-
mental disabilities.
(2) The Secretary shall coordinate the Federal response
to requests for assistance from State health department officials
regarding potential or alleged autism or developmental dis-
ability clusters.
(d) DEFINITION.—In this title, the term ‘‘State’’ means each
of the several States, the District of Columbia, the Commonwealth
of Puerto Rico, American Samoa, Guam, the Commonwealth of
the Northern Mariana Islands, the Virgin Islands, and the Trust
Territory of the Pacific Islands.
(e) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated such sums as may be necessary to carry out
this section.
SEC. 103. INFORMATION AND EDUCATION.
(a) IN GENERAL.—The Secretary shall establish and implement
a program to provide information and education on autism to health
professionals and the general public, including information and
education on advances in the diagnosis and treatment of autism
and training and continuing education through programs for sci-
entists, physicians, and other health professionals who provide care
for patients with autism.
H. R. 4365—9
(b) STIPENDS.—The Secretary may use amounts made available
under this section to provide stipends for health professionals who
are enrolled in training programs under this section.
(c) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated such sums as may be necessary to carry out
this section.
SEC. 104. INTER-AGENCY AUTISM COORDINATING COMMITTEE.
(a) ESTABLISHMENT.—The Secretary shall establish a committee
to be known as the ‘‘Autism Coordinating Committee’’ (in this
section referred to as the ‘‘Committee’’) to coordinate all efforts
within the Department of Health and Human Services concerning
autism, including activities carried out through the National
Institutes of Health and the Centers for Disease Control and
Prevention under this title (and the amendment made by this
title).
(b) MEMBERSHIP.—
(1) IN GENERAL.—The Committee shall be composed of the
Directors of such national research institutes, of the Centers
for Disease Control and Prevention, and of such other agencies
and such other officials as the Secretary determines appro-
priate.
(2) ADDITIONAL MEMBERS.—If determined appropriate by
the Secretary, the Secretary may appoint to the Committee—
(A) parents or legal guardians of individuals with
autism or other pervasive developmental disorders; and
(B) representatives of other governmental agencies that
serve children with autism such as the Department of
Education.
(c) ADMINISTRATIVE SUPPORT; TERMS OF SERVICE; OTHER PROVI-
SIONS.—The following shall apply with respect to the Committee:
(1) The Committee shall receive necessary and appropriate
administrative support from the Department of Health and
Human Services.
(2) Members of the Committee appointed under subsection
(b)(2)(A) shall serve for a term of 3 years, and may serve
for an unlimited number of terms if reappointed.
(3) The Committee shall meet not less than two times
each year.
SEC. 105. REPORT TO CONGRESS.
Not later than January 1, 2001, and each January 1 thereafter,
the Secretary shall prepare and submit to the appropriate commit-
tees of Congress, a report concerning the implementation of this
title and the amendments made by this title.
TITLE II—RESEARCH AND
DEVELOPMENT REGARDING FRAGILE X
SEC. 201. NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN
DEVELOPMENT; RESEARCH ON FRAGILE X.
Subpart 7 of part C of title IV of the Public Health Service
Act is amended by adding at the end the following section:
H. R. 4365—10
‘‘FRAGILE X
‘‘SEC. 452E. (a) EXPANSION AND COORDINATION OF RESEARCH
ACTIVITIES.—The Director of the Institute, after consultation with
the advisory council for the Institute, shall expand, intensify, and
coordinate the activities of the Institute with respect to research
on the disease known as fragile X.
‘‘(b) RESEARCH CENTERS.—
‘‘(1) IN GENERAL.—The Director of the Institute shall make
grants or enter into contracts for the development and operation
of centers to conduct research for the purposes of improving
the diagnosis and treatment of, and finding the cure for, fragile
X.
‘‘(2) NUMBER OF CENTERS.—
‘‘(A) IN GENERAL.—In carrying out paragraph (1), the
Director of the Institute shall, to the extent that amounts
are appropriated, and subject to subparagraph (B), provide
for the establishment of at least three fragile X research
centers.
‘‘(B) PEER REVIEW REQUIREMENT.—The Director of the
Institute shall make a grant to, or enter into a contract
with, an entity for purposes of establishing a center under
paragraph (1) only if the grant or contract has been rec-
ommended after technical and scientific peer review
required by regulations under section 492.
‘‘(3) ACTIVITIES.—The Director of the Institute, with the
assistance of centers established under paragraph (1), shall
conduct and support basic and biomedical research into the
detection and treatment of fragile X.
‘‘(4) COORDINATION AMONG CENTERS.—The Director of the
Institute shall, as appropriate, provide for the coordination
of the activities of the centers assisted under this section,
including providing for the exchange of information among
the centers.
‘‘(5) CERTAIN ADMINISTRATIVE REQUIREMENTS.—Each center
assisted under paragraph (1) shall use the facilities of a single
institution, or be formed from a consortium of cooperating
institutions, meeting such requirements as may be prescribed
by the Director of the Institute.
‘‘(6) DURATION OF SUPPORT.—Support may be provided to
a center under paragraph (1) for a period not exceeding 5
years. Such period may be extended for one or more additional
periods, each of which may not exceed 5 years, if the operations
of such center have been reviewed by an appropriate technical
and scientific peer review group established by the Director
and if such group has recommended to the Director that such
period be extended.
‘‘(7) AUTHORIZATION OF APPROPRIATIONS.—For the purpose
of carrying out this subsection, there are authorized to be
appropriated such sums as may be necessary for each of the
fiscal years 2001 through 2005.’’.
H. R. 4365—11
TITLE III—JUVENILE ARTHRITIS AND
RELATED CONDITIONS
SEC. 301. NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULO-
SKELETAL AND SKIN DISEASES; RESEARCH ON JUVENILE
ARTHRITIS AND RELATED CONDITIONS.
(a) IN GENERAL.—Subpart 4 of part C of title IV of the Public
Health Service Act (42 U.S.C. 285d et seq.) is amended by inserting
after section 442 the following section:
‘‘JUVENILE ARTHRITIS AND RELATED CONDITIONS
‘‘SEC. 442A. (a) EXPANSION AND COORDINATION OF ACTIVITIES.—
The Director of the Institute, in coordination with the Director
of the National Institute of Allergy and Infectious Diseases, shall
expand and intensify the programs of such Institutes with respect
to research and related activities concerning juvenile arthritis and
related conditions.
‘‘(b) COORDINATION.—The Directors referred to in subsection
(a) shall jointly coordinate the programs referred to in such sub-
section and consult with the Arthritis and Musculoskeletal Diseases
Interagency Coordinating Committee.
‘‘(c) 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 2001
through 2005.’’.
(b) PEDIATRIC RHEUMATOLOGY.—Subpart 1 of part E of title
VII of the Public Health Service Act (42 U.S.C. 294n et seq.)
is amended by adding at the end the following:
‘‘SEC. 763. PEDIATRIC RHEUMATOLOGY.
‘‘(a) IN GENERAL.—The Secretary, acting through the appro-
priate agencies, shall evaluate whether the number of pediatric
rheumatologists is sufficient to address the health care needs of
children with arthritis and related conditions, and if the Secretary
determines that the number is not sufficient, shall develop strate-
gies to help address the shortfall.
‘‘(b) REPORT TO CONGRESS.—Not later than October 1, 2001,
the Secretary shall submit to the Congress a report describing
the results of the evaluation under subsection (a), and as applicable,
the strategies developed under such subsection.
‘‘(c) 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 2001
through 2005.’’.
SEC. 302. INFORMATION CLEARINGHOUSE.
Section 438(b) of the Public Health Service Act (42 U.S.C.
285d–3(b)) is amended by inserting ‘‘, including juvenile arthritis
and related conditions,’’ after ‘‘diseases’’.
H. R. 4365—12
TITLE IV—REDUCING BURDEN OF DIA-
BETES AMONG CHILDREN AND YOUTH
SEC. 401. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND
PREVENTION.
Part B of title III of the Public Health Service Act (42 U.S.C.
243 et seq.) is amended by inserting after section 317G the following
section:
‘‘DIABETES IN CHILDREN AND YOUTH
‘‘SEC. 317H. (a) SURVEILLANCE ON JUVENILE DIABETES.—The
Secretary, acting through the Director of the Centers for Disease
Control and Prevention, shall develop a sentinel system to collect
data on juvenile diabetes, including with respect to incidence and
prevalence, and shall establish a national database for such data.
‘‘(b) TYPE 2 DIABETES IN YOUTH.—The Secretary shall imple-
ment a national public health effort to address type 2 diabetes
in youth, including—
‘‘(1) 
enhancing 
surveillance 
systems 
and 
expanding
research to better assess the prevalence and incidence of type
2 diabetes in youth and determine the extent to which type
2 diabetes is incorrectly diagnosed as type 1 diabetes among
children; and
‘‘(2) developing and improving laboratory methods to assist
in diagnosis, treatment, and prevention of diabetes including,
but not limited to, developing noninvasive ways to monitor
blood glucose to prevent hypoglycemia and improving existing
glucometers that measure blood glucose.
‘‘(c) 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 2001
through 2005.’’.
SEC. 402. PROGRAMS OF NATIONAL INSTITUTES OF HEALTH.
Subpart 3 of part C of title IV of the Public Health Service
Act (42 U.S.C. 285c et seq.) is amended by inserting after section
434 the following section:
‘‘JUVENILE DIABETES
‘‘SEC. 434A. (a) LONG-TERM
EPIDEMIOLOGY
STUDIES.—The
Director of the Institute shall conduct or support long-term epidemi-
ology studies in which individuals with or at risk for type 1, or
juvenile, diabetes are followed for 10 years or more. Such studies
shall investigate the causes and characteristics of the disease and
its complications.
‘‘(b) CLINICAL TRIAL INFRASTRUCTURE/INNOVATIVE TREATMENTS
FOR
JUVENILE
DIABETES.—The Secretary, acting through the
Director of the National Institutes of Health, shall support regional
clinical research centers for the prevention, detection, treatment,
and cure of juvenile diabetes.
‘‘(c) PREVENTION OF TYPE 1 DIABETES.—The Secretary, acting
through the appropriate agencies, shall provide for a national effort
to prevent type 1 diabetes. Such effort shall provide for a combina-
tion of increased efforts in research and development of prevention
strategies, including consideration of vaccine development, coupled
H. R. 4365—13
with appropriate ability to test the effectiveness of such strategies
in large clinical trials of children and young adults.
‘‘(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 2001
through 2005.’’.
TITLE V—ASTHMA SERVICES FOR
CHILDREN
Subtitle A—Asthma Services
SEC. 501. GRANTS FOR CHILDREN’S ASTHMA RELIEF.
Title III of the Public Health Service Act (42 U.S.C. 241 et
seq.) is amended by adding at the end the following part:
‘‘PART P—ADDITIONAL PROGRAMS
‘‘SEC. 399L. CHILDREN’S ASTHMA TREATMENT GRANTS PROGRAM.
‘‘(a) AUTHORITY TO MAKE GRANTS.—
‘‘(1) IN GENERAL.—In addition to any other payments made
under this Act or title V of the Social Security Act, the Secretary
shall award grants to eligible entities to carry out the following
purposes:
‘‘(A) To provide access to quality medical care for chil-
dren who live in areas that have a high prevalence of
asthma and who lack access to medical care.
‘‘(B) To provide on-site education to parents, children,
health care providers, and medical teams to recognize the
signs and symptoms of asthma, and to train them in the
use of medications to treat asthma and prevent its exacer-
bations.
‘‘(C) To decrease preventable trips to the emergency
room by making medication available to individuals who
have not previously had access to treatment or education
in the management of asthma.
‘‘(D) To provide other services, such as smoking ces-
sation programs, home modification, and other direct and
support services that ameliorate conditions that exacerbate
or induce asthma.
‘‘(2) CERTAIN
PROJECTS.—In making grants under para-
graph (1), the Secretary may make grants designed to develop
and expand the following projects:
‘‘(A) Projects to provide comprehensive asthma services
to children in accordance with the guidelines of the
National Asthma Education and Prevention Program
(through the National Heart, Lung and Blood Institute),
including access to care and treatment for asthma in a
community-based setting.
‘‘(B) Projects to fully equip mobile health care clinics
that provide preventive asthma care including diagnosis,
physical examinations, pharmacological therapy, skin
testing, peak flow meter testing, and other asthma-related
health care services.
H. R. 4365—14
‘‘(C) Projects to conduct validated asthma management
education programs for patients with asthma and their
families, including patient education regarding asthma
management, family education on asthma management,
and the distribution of materials, including displays and
videos, to reinforce concepts presented by medical teams.
‘‘(2) AWARD OF GRANTS.—
‘‘(A) APPLICATION.—
‘‘(i) IN GENERAL.—An eligible entity shall submit
an application to the Secretary for a grant under this
section in such form and manner as the Secretary
may require.
‘‘(ii) REQUIRED INFORMATION.—An application sub-
mitted under this subparagraph shall include a plan
for the use of funds awarded under the grant and
such other information as the Secretary may require.
‘‘(B) REQUIREMENT.—In awarding grants under this
section, the Secretary shall give preference to eligible enti-
ties that demonstrate that the activities to be carried out
under this section shall be in localities within areas of
known or suspected high prevalence of childhood asthma
or high asthma-related mortality or high rate of hospitaliza-
tion or emergency room visits for asthma (relative to the
average asthma prevalence rates and associated mortality
rates in the United States). Acceptable data sets to dem-
onstrate a high prevalence of childhood asthma or high
asthma-related mortality may include data from Federal,
State, or local vital statistics, claims data under title XIX
or XXI of the Social Security Act, other public health statis-
tics or surveys, or other data that the Secretary, in con-
sultation with the Director of the Centers for Disease Con-
trol and Prevention, deems appropriate.
‘‘(3) DEFINITION OF ELIGIBLE ENTITY.—For purposes of this
section, the term ‘eligible entity’ means a public or nonprofit
private entity (including a State or political subdivision of a
State), or a consortium of any of such entities.
‘‘(b) COORDINATION WITH OTHER CHILDREN’S PROGRAMS.—An
eligible entity shall identify in the plan submitted as part of an
application for a grant under this section how the entity will coordi-
nate operations and activities under the grant with—
‘‘(1) other programs operated in the State that serve chil-
dren with asthma, including any such programs operated under
title V, XIX, or XXI of the Social Security Act; and
‘‘(2) one or more of the following—
‘‘(A) the child welfare and foster care and adoption
assistance programs under parts B and E of title IV of
such Act;
‘‘(B) the head start program established under the
Head Start Act (42 U.S.C. 9831 et seq.);
‘‘(C) the program of assistance under the special supple-
mental nutrition program for women, infants and children
(WIC) under section 17 of the Child Nutrition Act of 1966
(42 U.S.C. 1786);
‘‘(D) local public and private elementary or secondary
schools; or
‘‘(E) public housing agencies, as defined in section 3
of the United States Housing Act of 1937 (42 U.S.C. 1437a).
H. R. 4365—15
‘‘(c) EVALUATION.—An eligible entity that receives a grant under
this section shall submit to the Secretary an evaluation of the
operations and activities carried out under the grant that includes—
‘‘(1) a description of the health status outcomes of children
assisted under the grant;
‘‘(2) an assessment of the utilization of asthma-related
health care services as a result of activities carried out under
the grant;
‘‘(3) the collection, analysis, and reporting of asthma data
according to guidelines prescribed by the Director of the Centers
for Disease Control and Prevention; and
‘‘(4) such other information as the Secretary may require.
‘‘(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 2001
through 2005.’’.
SEC. 502. TECHNICAL AND CONFORMING AMENDMENTS.
Title III of the Public Health Service Act (42 U.S.C. 241 et
seq.) is amended—
(1) in part L, by redesignating section 399D as section
399A;
(2) in part M—
(A) by redesignating sections 399H through 399L as
sections 399B through 399F, respectively;
(B) in section 399B (as so redesignated), in subsection
(e)—
(i) by striking ‘‘section 399K(b)’’ and inserting ‘‘sub-
section (b) of section 399E’’; and
(ii) by striking ‘‘section 399C’’ and inserting ‘‘such
section’’;
(C) in section 399E (as so redesignated), in subsection
(c), by striking ‘‘section 399H(a)’’ and inserting ‘‘section
399B(a)’’; and
(D) in section 399F (as so redesignated)—
(i) in subsection (a), by striking ‘‘section 399I’’ and
inserting ‘‘section 399C’’;
(ii) in subsection (a), by striking ‘‘subsection 399J’’
and inserting ‘‘section 399D’’; and
(iii) in subsection (b), by striking ‘‘subsection 399K’’
and inserting ‘‘section 399E’’;
(3) in part N, by redesignating section 399F as section
399G; and
(4) in part O—
(A) by redesignating sections 399G through 399J as
sections 399H through 399K, respectively;
(B) in section 399H (as so redesignated), in subsection
(b), by striking ‘‘section 399H’’ and inserting ‘‘section 399I’’;
(C) in section 399J (as so redesignated), in subsection
(b), by striking ‘‘section 399G(d)’’ and inserting ‘‘section
399H(d)’’; and
(D) in section 399K (as so redesignated), by striking
‘‘section 399G(d)(1)’’ and inserting ‘‘section 399H(d)(1)’’.
H. R. 4365—16
Subtitle B—Prevention Activities
SEC. 511. PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT;
SYSTEMS FOR REDUCING ASTHMA-RELATED ILLNESSES
THROUGH INTEGRATED PEST MANAGEMENT.
Section 1904(a)(1) of the Public Health Service Act (42 U.S.C.
300w–3(a)(1)) is amended—
(1) by redesignating subparagraphs (E) and (F) as subpara-
graphs (F) and (G), respectively;
(2) by adding a period at the end of subparagraph (G)
(as so redesignated);
(3) by inserting after subparagraph (D), the following:
‘‘(E) The establishment, operation, and coordination of effec-
tive and cost-efficient systems to reduce the prevalence of illness
due to asthma and asthma-related illnesses, especially among
children, by reducing the level of exposure to cockroach allergen
or other known asthma triggers through the use of integrated
pest management, as applied to cockroaches or other known
allergens. Amounts expended for such systems may include
the costs of building maintenance and the costs of programs
to promote community participation in the carrying out at
such sites of integrated pest management, as applied to cock-
roaches or other known allergens. For purposes of this subpara-
graph, the term ‘integrated pest management’ means an
approach to the management of pests in public facilities that
combines biological, cultural, physical, and chemical tools in
a way that minimizes economic, health, and environmental
risks.’’;
(4) in subparagraph (F) (as so redesignated), by striking
‘‘subparagraphs (A) through (D)’’ and inserting ‘‘subparagraphs
(A) through (E)’’; and
(5) in subparagraph (G) (as so redesignated), by striking
‘‘subparagraphs (A) through (E)’’ and inserting ‘‘subparagraphs
(A) through (F)’’.
Subtitle C—Coordination of Federal
Activities
SEC. 521. COORDINATION THROUGH NATIONAL INSTITUTES OF
HEALTH.
Subpart 2 of part C of title IV of the Public Health Service
Act (42 U.S.C. 285b et seq.) is amended by inserting after section
424A the following section:
‘‘COORDINATION OF FEDERAL ASTHMA ACTIVITIES
‘‘SEC. 424B (a) IN GENERAL.—The Director of Institute shall,
through the National Asthma Education Prevention Program
Coordinating Committee—
‘‘(1) identify all Federal programs that carry out asthma-
related activities;
‘‘(2) develop, in consultation with appropriate Federal agen-
cies and professional and voluntary health organizations, a
Federal plan for responding to asthma; and
H. R. 4365—17
‘‘(3) not later than 12 months after the date of the enact-
ment of the Children’s Health Act of 2000, submit recommenda-
tions to the appropriate committees of the Congress on ways
to strengthen and improve the coordination of asthma-related
activities of the Federal Government.
‘‘(b) REPRESENTATION OF THE DEPARTMENT OF HOUSING AND
URBAN DEVELOPMENT.—A representative of the Department of
Housing and Urban Development shall be included on the National
Asthma Education Prevention Program Coordinating Committee
for the purpose of performing the tasks described in subsection
(a).
‘‘(c) 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 2001
through 2005.’’.
Subtitle D—Compilation of Data
SEC. 531. COMPILATION OF DATA BY CENTERS FOR DISEASE CONTROL
AND PREVENTION.
Part B of title III of the Public Health Service Act, as amended
by section 401 of this Act, is amended by inserting after section
317H the following section:
‘‘COMPILATION OF DATA ON ASTHMA
‘‘SEC. 317I. (a) IN GENERAL.—The Secretary, acting through
the Director of the Centers for Disease Control and Prevention,
shall—
‘‘(1) conduct local asthma surveillance activities to collect
data on the prevalence and severity of asthma and the quality
of asthma management;
‘‘(2) compile and annually publish data on the prevalence
of children suffering from asthma in each State; and
‘‘(3) to the extent practicable, compile and publish data
on the childhood mortality rate associated with asthma nation-
ally.
‘‘(b) SURVEILLANCE ACTIVITIES.—The Director of the Centers
for Disease Control and Prevention, acting through the representa-
tive of the Director on the National Asthma Education Prevention
Program Coordinating Committee, shall, in carrying out subsection
(a), provide an update on surveillance activities at each Committee
meeting.
‘‘(c) COLLABORATIVE EFFORTS.—The activities described in sub-
section (a)(1) may be conducted in collaboration with eligible entities
awarded a grant under section 399L.
‘‘(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 2001
through 2005.’’.
H. R. 4365—18
TITLE VI—BIRTH DEFECTS
PREVENTION ACTIVITIES
Subtitle A—Folic Acid Promotion
SEC. 601. PROGRAM REGARDING EFFECTS OF FOLIC ACID IN PREVEN-
TION OF BIRTH DEFECTS.
Part B of title III of the Public Health Service Act, as amended
by section 531 of this Act, is amended by inserting after section
317I the following section:
‘‘EFFECTS OF FOLIC ACID IN PREVENTION OF BIRTH DEFECTS
‘‘SEC. 317J. (a) IN GENERAL.—The Secretary, acting through
the Director of the Centers for Disease Control and Prevention,
shall expand and intensify programs (directly or through grants
or contracts) for the following purposes:
‘‘(1) To provide education and training for health profes-
sionals and the general public for purposes of explaining the
effects of folic acid in preventing birth defects and for purposes
of encouraging each woman of reproductive capacity (whether
or not planning a pregnancy) to consume on a daily basis
a dietary supplement that provides an appropriate level of
folic acid.
‘‘(2) To conduct research with respect to such education
and training, including identifying effective strategies for
increasing the rate of consumption of folic acid by women
of reproductive capacity.
‘‘(3) To conduct research to increase the understanding
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, including 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 private organizations, health profes-
sionals, 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 carrying 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 carrying out the purposes of the
program under such subsection, including the effects on various
demographic populations. Methods of evaluation under the pre-
ceding sentence 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 monitoring 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
H. R. 4365—19
such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.
Subtitle B—National Center on Birth
Defects and Developmental Disabilities
SEC. 611. NATIONAL CENTER ON BIRTH DEFECTS AND DEVELOP-
MENTAL DISABILITIES.
Section 317C of the Public Health Service Act (42 U.S.C. 247b–
4) is amended—
(1) by striking the heading for the section and inserting
the following:
‘‘NATIONAL CENTER ON BIRTH DEFECTS AND DEVELOPMENTAL
DISABILITIES’’;
(2) by striking ‘‘SEC. 317C. (a)’’ and all that follows through
the end of subsection (a) and inserting the following:
‘‘SEC. 317C. (a) IN GENERAL.—
‘‘(1) NATIONAL CENTER.—There is established within the
Centers for Disease Control and Prevention a center to be
known as the National Center on Birth Defects and Develop-
mental Disabilities (referred to in this section as the ‘Center’),
which shall be headed by a director appointed by the Director
of the Centers for Disease Control and Prevention.
‘‘(2) GENERAL
DUTIES.—The Secretary shall carry out
programs—
‘‘(A) to collect, analyze, and make available data on
birth defects and developmental disabilities (in a manner
that facilitates compliance with subsection (d)(2)), including
data on the causes of such defects and disabilities and
on the incidence and prevalence of such defects and disabil-
ities;
‘‘(B) to operate regional centers for the conduct of
applied epidemiological research on the prevention of such
defects and disabilities; and
‘‘(C) to provide information and education to the public
on the prevention of such defects and disabilities.
‘‘(3) FOLIC
ACID.—The Secretary shall carry out section
317J through the Center.
‘‘(4) CERTAIN PROGRAMS.—
‘‘(A) TRANSFERS.—All programs and functions described
in subparagraph (B) are transferred to the Center, effective
upon the expiration of the 180-day period beginning on
the date of the enactment of the Children’s Health Act
of 2000.
‘‘(B) RELEVANT PROGRAMS.—The programs and func-
tions described in this subparagraph are all programs and
functions that—
‘‘(i) relate to birth defects; folic acid; cerebral palsy;
mental 
retardation; 
child 
development; 
newborn
screening; autism; fragile X syndrome; fetal alcohol
syndrome; 
pediatric 
genetic 
disorders; 
disability
prevention; or other relevant diseases, disorders, or
conditions as determined the Secretary; and
H. R. 4365—20
‘‘(ii) were carried out through the National Center
for Environmental Health as of the day before the
date of the enactment of the Act referred to in subpara-
graph (A).
‘‘(C) RELATED
TRANSFERS.—Personnel employed in
connection with the programs and functions specified in
subparagraph (B), and amounts available for carrying out
the programs and functions, are transferred to the Center,
effective upon the expiration of the 180-day period begin-
ning on the date of the enactment of the Act referred
to in subparagraph (A). Such transfer of amounts does
not affect the period of availability of the amounts, or
the availability of the amounts with respect to the purposes
for which the amounts may be expended.’’; and
(3) in subsection (b)(1), in the matter preceding subpara-
graph (A), by striking ‘‘(a)(1)’’ and inserting ‘‘(a)(2)(A)’’.
TITLE VII—EARLY DETECTION, DIAG-
NOSIS, AND TREATMENT REGARDING
HEARING LOSS IN INFANTS
SEC. 701. PURPOSES.
The purposes of this title are to clarify the authority within
the Public Health Service Act to authorize statewide newborn and
infant hearing screening, evaluation and intervention programs
and systems, technical assistance, a national applied research pro-
gram, and interagency and private sector collaboration for policy
development, in order to assist the States in making progress
toward the following goals:
(1) All babies born in hospitals in the United States and
its territories should have a hearing screening before leaving
the birthing facility. Babies born in other countries and residing
in the United States via immigration or adoption should have
a hearing screening as early as possible.
(2) All babies who are not born in hospitals in the United
States and its territories should have a hearing screening
within the first 3 months of life.
(3) Appropriate audiologic and medical evaluations should
be conducted by 3 months for all newborns and infants sus-
pected of having hearing loss to allow appropriate referral
and provisions for audiologic rehabilitation, medical and early
intervention before the age of 6 months.
(4) All newborn and infant hearing screening programs
and systems should include a component for audiologic
rehabilitation, medical and early intervention options that
ensures linkage to any new and existing state-wide systems
of intervention and rehabilitative services for newborns and
infants with hearing loss.
(5) Public policy in regard to newborn and infant hearing
screening and intervention should be based on applied research
and the recognition that newborns, infants, toddlers, and chil-
dren who are deaf or hard-of-hearing have unique language,
learning, and communication needs, and should be the result
of consultation with pertinent public and private sectors.
H. R. 4365—21
SEC. 702. PROGRAMS OF HEALTH RESOURCES AND SERVICES ADMINIS-
TRATION, 
CENTERS 
FOR 
DISEASE 
CONTROL 
AND
PREVENTION, AND NATIONAL INSTITUTES OF HEALTH.
Part P of title III of the Public Health Service Act, as added
by section 501 of this Act, is amended by adding at the end the
following section:
‘‘SEC. 
399M. 
EARLY 
DETECTION, 
DIAGNOSIS, 
AND 
TREATMENT
REGARDING HEARING LOSS IN INFANTS.
‘‘(a) STATEWIDE NEWBORN AND INFANT HEARING SCREENING,
EVALUATION AND INTERVENTION PROGRAMS AND SYSTEMS.—The Sec-
retary, acting through the Administrator of the Health Resources
and Services Administration, shall make awards of grants or
cooperative agreements to develop statewide newborn and infant
hearing screening, evaluation and intervention programs and sys-
tems for the following purposes:
‘‘(1) To develop and monitor the efficacy of state-wide new-
born and infant hearing screening, evaluation and intervention
programs and systems. Early intervention includes referral to
schools and agencies, including community, consumer, and
parent-based agencies and organizations and other programs
mandated by part C of the Individuals with Disabilities Edu-
cation Act, which offer programs specifically designed to meet
the unique language and communication needs of deaf and
hard of hearing newborns, infants, toddlers, and children.
‘‘(2) To collect data on statewide newborn and infant
hearing screening, evaluation and intervention programs and
systems that can be used for applied research, program evalua-
tion and policy development.
‘‘(b) TECHNICAL ASSISTANCE, DATA MANAGEMENT, AND APPLIED
RESEARCH.—
‘‘(1) CENTERS FOR DISEASE CONTROL AND PREVENTION.—
The Secretary, acting through the Director of the Centers for
Disease Control and Prevention, shall make awards of grants
or cooperative agreements to provide technical assistance to
State agencies to complement an intramural program and to
conduct applied research related to newborn and infant hearing
screening, evaluation and intervention programs and systems.
The program shall develop standardized procedures for data
management and program effectiveness and costs, such as—
‘‘(A) to ensure quality monitoring of newborn and infant
hearing loss screening, evaluation, and intervention pro-
grams and systems;
‘‘(B) to provide technical assistance on data collection
and management;
‘‘(C) to study the costs and effectiveness of newborn
and infant hearing screening, evaluation and intervention
programs and systems conducted by State-based programs
in order to answer issues of importance to State and
national policymakers;
‘‘(D) to identify the causes and risk factors for con-
genital hearing loss;
‘‘(E) to study the effectiveness of newborn and infant
hearing screening, audiologic and medical evaluations and
intervention programs and systems by assessing the health,
intellectual and social developmental, cognitive, and lan-
guage status of these children at school age; and
H. R. 4365—22
‘‘(F) to promote the sharing of data regarding early
hearing loss with State-based birth defects and develop-
mental disabilities monitoring programs for the purpose
of identifying previously unknown causes of hearing loss.
‘‘(2) NATIONAL INSTITUTES OF HEALTH.—The Director of the
National Institutes of Health, acting through the Director of
the National Institute on Deafness and Other Communication
Disorders, shall for purposes of this section, continue a program
of research and development on the efficacy of new screening
techniques and technology, including clinical studies of
screening methods, studies on efficacy of intervention, and
related research.
‘‘(c) COORDINATION AND COLLABORATION.—
‘‘(1) IN
GENERAL.—In carrying out programs under this
section, the Administrator of the Health Resources and Services
Administration, the Director of the Centers for Disease Control
and Prevention, and the Director of the National Institutes
of Health shall collaborate and consult with other Federal
agencies; State and local agencies, including those responsible
for early intervention services pursuant to title XIX of the
Social Security Act (Medicaid Early and Periodic Screening,
Diagnosis and Treatment Program); title XXI of the Social
Security Act (State Children’s Health Insurance Program); title
V of the Social Security Act (Maternal and Child Health Block
Grant Program); and part C of the Individuals with Disabilities
Education Act; consumer groups of and that serve individuals
who are deaf and hard-of-hearing and their families; appro-
priate national medical and other health and education spe-
cialty organizations; persons who are deaf and hard-of-hearing
and their families; other qualified professional personnel who
are proficient in deaf or hard-of-hearing children’s language
and who possess the specialized knowledge, skills, and
attributes needed to serve deaf and hard-of-hearing newborns,
infants, toddlers, children, and their families; third-party
payers and managed care organizations; and related commercial
industries.
‘‘(2) POLICY
DEVELOPMENT.—The Administrator of the
Health Resources and Services Administration, the Director
of the Centers for Disease Control and Prevention, and the
Director of the National Institutes of Health shall coordinate
and collaborate on recommendations for policy development
at the Federal and State levels and with the private sector,
including consumer, medical and other health and education
professional-based organizations, with respect to newborn and
infant hearing screening, evaluation and intervention programs
and systems.
‘‘(3) STATE EARLY DETECTION, DIAGNOSIS, AND INTERVENTION
PROGRAMS AND SYSTEMS; DATA COLLECTION.—The Administrator
of the Health Resources and Services Administration and the
Director of the Centers for Disease Control and Prevention
shall coordinate and collaborate in assisting States to establish
newborn and infant hearing screening, evaluation and interven-
tion programs and systems under subsection (a) and to develop
a data collection system under subsection (b).
‘‘(d) RULE OF CONSTRUCTION; RELIGIOUS ACCOMMODATION.—
Nothing in this section shall be construed to preempt or prohibit
any State law, including State laws which do not require the
H. R. 4365—23
screening for hearing loss of newborn infants or young children
of parents who object to the screening on the grounds that such
screening conflicts with the parents’ religious beliefs.
‘‘(e) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘audiologic evaluation’ refers to procedures
to assess the status of the auditory system; to establish the
site of the auditory disorder; the type and degree of hearing
loss, and the potential effects of hearing loss on communication;
and to identify appropriate treatment and referral options.
Referral options should include linkage to State coordinating
agencies under part C of the Individuals with Disabilities Edu-
cation Act or other appropriate agencies, medical evaluation,
hearing aid /sensory aid assessment, audiologic rehabilitation
treatment, national and local consumer, self-help, parent, and
education organizations, and other family-centered services.
‘‘(2) The terms ‘audiologic rehabilitation’ and ‘audiologic
intervention’ refer to procedures, techniques, and technologies
to facilitate the receptive and expressive communication abili-
ties of a child with hearing loss.
‘‘(3) The term ‘early intervention’ refers to providing appro-
priate services for the child with hearing loss, including non-
medical services, and ensuring that families of the child are
provided comprehensive, consumer-oriented information about
the full range of family support, training, information services,
communication options and are given the opportunity to con-
sider the full range of educational and program placements
and options for their child.
‘‘(4) The term ‘medical evaluation by a physician’ refers
to key components including history, examination, and medical
decision making focused on symptomatic and related body sys-
tems for the purpose of diagnosing the etiology of hearing
loss and related physical conditions, and for identifying appro-
priate treatment and referral options.
‘‘(5) The term ‘medical intervention’ refers to the process
by which a physician provides medical diagnosis and direction
for medical and /or surgical treatment options of hearing loss
and /or related medical disorder associated with hearing loss.
‘‘(6) The term ‘newborn and infant hearing screening’ refers
to objective physiologic procedures to detect possible hearing
loss and to identify newborns and infants who, after re-
screening, require further audiologic and medical evaluations.
‘‘(f ) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) STATEWIDE NEWBORN AND INFANT HEARING SCREENING,
EVALUATION AND INTERVENTION PROGRAMS AND SYSTEMS.—For
the purpose of carrying out subsection (a), there are authorized
to be appropriated to the Health Resources and Services
Administration such sums as may be necessary for fiscal year
2002.
‘‘(2) TECHNICAL
ASSISTANCE, 
DATA
MANAGEMENT, 
AND
APPLIED RESEARCH; CENTERS FOR DISEASE CONTROL AND PREVEN-
TION.—For the purpose of carrying out subsection (b)(1), there
are authorized to be appropriated to the Centers for Disease
Control and Prevention such sums as may be necessary for
fiscal year 2002.
‘‘(3) TECHNICAL
ASSISTANCE, 
DATA
MANAGEMENT, 
AND
APPLIED
RESEARCH; NATIONAL
INSTITUTE
ON
DEAFNESS
AND
H. R. 4365—24
OTHER COMMUNICATION DISORDERS.—For the purpose of car-
rying out subsection (b)(2), there are authorized to be appro-
priated to the National Institute on Deafness and Other
Communication Disorders such sums as may be necessary for
fiscal year 2002.’’.
TITLE VIII—CHILDREN AND EPILEPSY
SEC. 801. NATIONAL PUBLIC HEALTH CAMPAIGN ON EPILEPSY; SEI-
ZURE DISORDER DEMONSTRATION PROJECTS IN MEDI-
CALLY UNDERSERVED AREAS.
Subpart I of part D of title III of the Public Health Service
Act (42 U.S.C. 254b) is amended by adding at the end the following
section:
‘‘SEC. 330E. EPILEPSY; SEIZURE DISORDER.
‘‘(a) NATIONAL PUBLIC HEALTH CAMPAIGN.—
‘‘(1) IN GENERAL.—The Secretary shall develop and imple-
ment public health surveillance, education, research, and inter-
vention strategies to improve the lives of persons with epilepsy,
with a particular emphasis on children. Such projects may
be carried out by the Secretary directly and through awards
of grants or contracts to public or nonprofit private entities.
The Secretary may directly or through such awards provide
technical assistance with respect to the planning, development,
and operation of such projects.
‘‘(2) CERTAIN ACTIVITIES.—Activities under paragraph (1)
shall include—
‘‘(A) expanding current surveillance activities through
existing monitoring systems and improving registries that
maintain data on individuals with epilepsy, including chil-
dren;
‘‘(B) enhancing research activities on the diagnosis,
treatment, and management of epilepsy;
‘‘(C) implementing public and professional information
and education programs regarding epilepsy, including ini-
tiatives which promote effective management of the disease
through children’s programs which are targeted to parents,
schools, daycare providers, patients;
‘‘(D) undertaking educational efforts with the media,
providers of health care, schools and others regarding
stigmas and secondary disabilities related to epilepsy and
seizures, and its effects on youth;
‘‘(E) 
utilizing 
and 
expanding 
partnerships 
with
organizations with experience addressing the health and
related needs of people with disabilities; and
‘‘(F) other activities the Secretary deems appropriate.
‘‘(3) COORDINATION
OF
ACTIVITIES.—The Secretary shall
ensure that activities under this subsection are coordinated
as appropriate with other agencies of the Public Health Service
that carry out activities regarding epilepsy and seizure.
‘‘(b) SEIZURE DISORDER; DEMONSTRATION PROJECTS IN MEDI-
CALLY UNDERSERVED AREAS.—
H. R. 4365—25
‘‘(1) IN
GENERAL.—The Secretary, acting through the
Administrator of the Health Resources and Services Adminis-
tration, may make grants for the purpose of carrying out dem-
onstration projects to improve access to health and other serv-
ices regarding seizures to encourage early detection and treat-
ment in children and others residing in medically underserved
areas.
‘‘(2) APPLICATION FOR GRANT.—A grant may not be awarded
under paragraph (1) unless an application therefore is sub-
mitted to the Secretary and the Secretary approves such
application. Such application shall be submitted in such form
and manner and shall contain such information as the Secretary
may prescribe.
‘‘(c) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘epilepsy’ refers to a chronic and serious
neurological condition characterized by excessive electrical dis-
charges in the brain causing recurring seizures affecting all
life activities. The Secretary may revise the definition of such
term to the extent the Secretary determines necessary.
‘‘(2) The term ‘medically underserved’ has the meaning
applicable under section 799B(6).
‘‘(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 2001
through 2005.’’.
TITLE IX—SAFE MOTHERHOOD; INFANT
HEALTH PROMOTION
Subtitle A—Safe Motherhood Prevention
Research
SEC. 901. PREVENTION RESEARCH AND OTHER ACTIVITIES.
Part B of title III of the Public Health Service Act, as amended
by section 601 of this Act, is amended by inserting after section
317J the following section:
‘‘SAFE MOTHERHOOD
‘‘SEC. 317K. (a) SURVEILLANCE.—
‘‘(1) PURPOSE.—The purpose of this subsection is to develop
surveillance systems at the local, State, and national level
to better understand the burden of maternal complications
and mortality and to decrease the disparities among population
at risk of death and complications from pregnancy.
‘‘(2) ACTIVITIES.—For the purpose described in paragraph
(1), the Secretary, acting through the Director of the Centers
for Disease Control and Prevention, may carry out the following
activities:
‘‘(A) The Secretary may establish and implement a
national surveillance program to identify and promote the
investigation of deaths and severe complications that occur
during pregnancy.
H. R. 4365—26
‘‘(B) The Secretary may expand the Pregnancy Risk
Assessment Monitoring System to provide surveillance and
collect data in each State.
‘‘(C) The Secretary may expand the Maternal and Child
Health Epidemiology Program to provide technical support,
financial assistance, or the time-limited assignment of
senior epidemiologists to maternal and child health pro-
grams in each State.
‘‘(b) PREVENTION RESEARCH.—
‘‘(1) PURPOSE.—The purpose of this subsection is to provide
the Secretary with the authority to further expand research
concerning risk factors, prevention strategies, and the roles
of the family, health care providers and the community in
safe motherhood.
‘‘(2) RESEARCH.—The Secretary may carry out activities
to expand research relating to—
‘‘(A) encouraging preconception counseling, especially
for at risk populations such as diabetics;
‘‘(B) the identification of critical components of prenatal
delivery and postpartum care;
‘‘(C) the identification of outreach and support services,
such as folic acid education, that are available for pregnant
women;
‘‘(D) the identification of women who are at high risk
for complications;
‘‘(E) preventing preterm delivery;
‘‘(F) preventing urinary tract infections;
‘‘(G) preventing unnecessary caesarean sections;
‘‘(H) an examination of the higher rates of maternal
mortality among African American women;
‘‘(I) an examination of the relationship between
domestic violence and maternal complications and mor-
tality;
‘‘(J) preventing and reducing adverse health con-
sequences that may result from smoking, alcohol and illegal
drug use before, during and after pregnancy;
‘‘(K) preventing infections that cause maternal and
infant complications; and
‘‘(L) other areas determined appropriate by the Sec-
retary.
‘‘(c) PREVENTION PROGRAMS.—
‘‘(1) IN GENERAL.—The Secretary may carry out activities
to promote safe motherhood, including—
‘‘(A) public education campaigns on healthy preg-
nancies and the building of partnerships with outside
organizations concerned about safe motherhood;
‘‘(B) education programs for physicians, nurses and
other health care providers; and
‘‘(C) activities to promote community support services
for pregnant women.
‘‘(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 2001
through 2005.’’.
H. R. 4365—27
Subtitle B—Pregnant Women and Infants
Health Promotion
SEC. 
911. 
PROGRAMS 
REGARDING 
PRENATAL 
AND 
POSTNATAL
HEALTH.
Part B of title III of the Public Health Service Act, as amended
by section 901 of this Act, is amended by inserting after section
317K the following section:
‘‘PRENATAL AND POSTNATAL HEALTH
‘‘SEC. 317L. (a) IN GENERAL.—The Secretary, acting through
the Director of the Centers for Disease Control and Prevention,
shall carry out programs—
‘‘(1) to collect, analyze, and make available data on prenatal
smoking, alcohol and illegal drug use, including data on the
implications of such activities and on the incidence and preva-
lence of such activities and their implications;
‘‘(2) to conduct applied epidemiological research on the
prevention of prenatal and postnatal smoking, alcohol and
illegal drug use;
‘‘(3) to support, conduct, and evaluate the effectiveness
of educational and cessation programs; and
‘‘(4) to provide information and education to the public
on the prevention and implications of prenatal and postnatal
smoking, alcohol and illegal drug use.
‘‘(b) GRANTS.—In carrying out subsection (a), the Secretary
may award grants to and enter into contracts with States, local
governments, scientific and academic institutions, federally quali-
fied health centers, and other public and nonprofit entities, and
may provide technical and consultative assistance to such entities.
‘‘(c) 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 2001
through 2005.’’.
TITLE X— PEDIATRIC RESEARCH
INITIATIVE
SEC. 1001. ESTABLISHMENT OF PEDIATRIC RESEARCH INITIATIVE.
Part B of title IV of the Public Health Service Act, as amended
by section 101 of this Act, is amended by adding at the end the
following:
‘‘PEDIATRIC RESEARCH INITIATIVE
‘‘SEC. 409D. (a) ESTABLISHMENT.—The Secretary shall establish
within the Office of the Director of NIH a Pediatric Research
Initiative (referred to in this section as the ‘Initiative’) to conduct
and support research that is directly related to diseases, disorders,
and other conditions in children. The Initiative shall be headed
by the Director of NIH.
‘‘(b) PURPOSE.—The purpose of the Initiative is to provide funds
to enable the Director of NIH—
H. R. 4365—28
‘‘(1) to increase support for pediatric biomedical research
within the National Institutes of Health to realize the
expanding opportunities for advancement in scientific investiga-
tions and care for children;
‘‘(2) to enhance collaborative efforts among the Institutes
to conduct and support multidisciplinary research in the areas
that the Director deems most promising; and
‘‘(3) in coordination with the Food and Drug Administra-
tion, to increase the development of adequate pediatric clinical
trials and pediatric use information to promote the safer and
more effective use of prescription drugs in the pediatric popu-
lation.
‘‘(c) DUTIES.—In carrying out subsection (b), the Director of
NIH shall—
‘‘(1) consult with the Director of the National Institute
of Child Health and Human Development and the other
national research institutes, in considering their requests for
new or expanded pediatric research efforts, and consult with
the Administrator of the Health Resources and Services
Administration and other advisors as the Director determines
to be appropriate;
‘‘(2) have broad discretion in the allocation of any Initiative
assistance among the Institutes, among types of grants, and
between basic and clinical research so long as the assistance
is directly related to the illnesses and conditions of children;
and
‘‘(3) be responsible for the oversight of any newly appro-
priated Initiative funds and annually report to Congress and
the public on the extent of the total funds obligated to conduct
or support pediatric research across the National Institutes
of Health, including the specific support and research awards
allocated through the Initiative.
‘‘(d) AUTHORIZATION.—For the purpose of carrying out this sec-
tion, there are authorized to be appropriated $50,000,000 for fiscal
year 2001, and such sums as may be necessary for each of the
fiscal years 2002 through 2005.
‘‘(e) TRANSFER OF FUNDS.—The Director of NIH may transfer
amounts appropriated under this section to any of the Institutes
for a fiscal year to carry out the purposes of the Initiative under
this section.’’.
SEC. 1002. INVESTMENT IN TOMORROW’S PEDIATRIC RESEARCHERS.
(a) IN GENERAL.—Subpart 7 of part C of title IV of the Public
Health Service Act, as amended by section 921 of this Act, is
amended by adding at the end the following:
‘‘INVESTMENT IN TOMORROW’S PEDIATRIC RESEARCHERS
‘‘SEC. 452G. (a) ENHANCED SUPPORT.—In order to ensure the
future supply of researchers dedicated to the care and research
needs of children, the Director of the Institute, after consultation
with the Administrator of the Health Resources and Services
Administration, shall support activities to provide for—
‘‘(1) an increase in the number and size of institutional
training grants to institutions supporting pediatric training;
and
H. R. 4365—77
(c) SERVICES FOR AFFECTED FAMILIES.—Section 399D(c) of the
Public Health Service Act (42 U.S.C. 280d(c)) is amended—
(1) in paragraph (1)—
(A) in the matter preceding subparagraph (A), by
inserting before the colon the following: ‘‘, or by an entity,
where the professional or entity provides assurances that
the professional or entity is licensed or certified by the
State if required and is complying with applicable licensure
or certification requirements’’; and
(B) by adding at the end the following:
‘‘(D) Aggressive outreach to family members with sub-
stance abuse problems.
‘‘(E) Inclusion of consumer in the development,
implementation, and monitoring of Family Services Plan.’’;
(2) in paragraph (2)—
(A) by striking subparagraph (A) and inserting the
following:
‘‘(A) Alcohol and drug treatment services, including
screening and assessment, diagnosis, detoxification, indi-
vidual, group and family counseling, relapse prevention,
pharmacotherapy treatment, after-care services, and case
management.’’;
(B) in subparagraph (C), by striking ‘‘, including edu-
cational and career planning’’ and inserting ‘‘and counseling
on the human immunodeficiency virus and acquired
immune deficiency syndrome’’;
(C) in subparagraph (D), by striking ‘‘conflict and’’;
and
(D) in subparagraph (E), by striking ‘‘Remedial’’ and
inserting ‘‘Career planning and’’; and
(3) in paragraph (3)(D), by inserting ‘‘which include child
abuse and neglect prevention techniques’’ before the period.
(d) ELIGIBLE ENTITIES.—Section 399D(d) of the Public Health
Service Act (42 U.S.C. 280d(d)) is amended—
(1) by striking the matter preceding paragraph (1) and
inserting:
‘‘(d) ELIGIBLE ENTITIES.—The Secretary shall distribute the
grants through the following types of entities:’’;
(2) in paragraph (1), by striking ‘‘drug treatment’’ and
inserting ‘‘drug early intervention, prevention or treatment’’;
and
(3) in paragraph (2)—
(A) in subparagraph (A), by striking ‘‘; and’’ and
inserting ‘‘; or’’; and
(B) in subparagraph (B), by inserting ‘‘or pediatric
health or mental health providers and family mental health
providers’’ before the period.
(e) SUBMISSION OF INFORMATION.—Section 399D(h) of the Public
Health Service Act (42 U.S.C. 280d(h)) is amended—
(1) in paragraph (2)—
(A) by inserting ‘‘including maternal and child health’’
before ‘‘mental’’;
(B) by striking ‘‘treatment programs’’; and
(C) by striking ‘‘and the State agency responsible for
administering public maternal and child health services’’
and inserting ‘‘, the State agency responsible for admin-
istering alcohol and drug programs, the State lead agency,