H. R. 4365—58
‘‘TOURETTE SYNDROME
‘‘SEC. 1108. (a) IN GENERAL.—The Secretary shall develop and
implement outreach programs to educate the public, health care
providers, educators and community based organizations about the
etiology, symptoms, diagnosis and treatment of Tourette Syndrome,
with a particular emphasis on children with Tourette Syndrome.
Such programs may be carried out by the Secretary directly and
through awards of grants or contracts to public or nonprofit private
entities.
‘‘(b) CERTAIN ACTIVITIES.—Activities under subsection (a) shall
include—
‘‘(1) the production and translation of educational mate-
rials, including public service announcements;
‘‘(2) the development of training material for health care
providers, educators and community based organizations; and
‘‘(3) outreach efforts directed at the misdiagnosis and
underdiagnosis of Tourette Syndrome in children and in
minority groups.
‘‘(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 XXIV—CHILDHOOD OBESITY
PREVENTION
SEC. 2401. PROGRAMS OPERATED THROUGH THE CENTERS FOR DIS-
EASE CONTROL AND PREVENTION.
Title III of the Public Health Service Act (42 U.S.C. 241 et
seq.), as amended by section 1101 of this Act, is amended by
adding at the end the following part:
‘‘PART Q—PROGRAMS TO IMPROVE THE
HEALTH OF CHILDREN
‘‘SEC. 399W. GRANTS TO PROMOTE CHILDHOOD NUTRITION AND PHYS-
ICAL ACTIVITY.
‘‘(a) IN GENERAL.—The Secretary, acting though the Director
of the Centers for Disease Control and Prevention, shall award
competitive grants to States and political subdivisions of States
for the development and implementation of State and community-
based intervention programs to promote good nutrition and physical
activity in children and adolescents.
‘‘(b) ELIGIBILITY.—To be eligible to receive a grant under this
section a State or political subdivision of a State shall prepare
and submit to the Secretary an application at such time, in such
manner, and containing such information as the Secretary may
require, including a plan that describes—
‘‘(1) how the applicant proposes to develop a comprehensive
program of school- and community-based approaches to encour-
age and promote good nutrition and appropriate levels of phys-
ical activity with respect to children or adolescents in local
communities;
H. R. 4365—59
‘‘(2) the manner in which the applicant shall coordinate
with appropriate State and local authorities, such as State
and local school departments, State departments of health,
chronic disease directors, State directors of programs under
section 17 of the Child Nutrition Act of 1966, 5-a-day coordina-
tors, governors councils for physical activity and good nutrition,
and State and local parks and recreation departments; and
‘‘(3) the manner in which the applicant will evaluate the
effectiveness of the program carried out under this section.
‘‘(c) USE OF FUNDS.—A State or political subdivision of a State
shall use amount received under a grant under this section to—
‘‘(1) develop, implement, disseminate, and evaluate school-
and community-based strategies in States to reduce inactivity
and improve dietary choices among children and adolescents;
‘‘(2) expand opportunities for physical activity programs
in school- and community-based settings; and
‘‘(3) develop, implement, and evaluate programs that pro-
mote good eating habits and physical activity including
opportunities for children with cognitive and physical disabil-
ities.
‘‘(d) TECHNICAL ASSISTANCE.—The Secretary may set-aside an
amount not to exceed 10 percent of the amount appropriated for
a fiscal year under subsection (h) to permit the Director of the
Centers for Disease Control and Prevention to—
‘‘(1) provide States and political subdivisions of States with
technical support in the development and implementation of
programs under this section; and
‘‘(2) disseminate information about effective strategies and
interventions in preventing and treating obesity through the
promotion of good nutrition and physical activity.
‘‘(e) LIMITATION ON ADMINISTRATIVE COSTS.—Not to exceed 10
percent of the amount of a grant awarded to the State or political
subdivision under subsection (a) for a fiscal year may be used
by the State or political subdivision for administrative expenses.
‘‘(f ) TERM.—A grant awarded under subsection (a) shall be
for a term of 3 years.
‘‘(g) DEFINITION.—In this section, the term ‘children and adoles-
cents’ means individuals who do not exceed 18 years of age.
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section such sums as may
be necessary for each of the fiscal years 2001 through 2005.
‘‘SEC. 399X. APPLIED RESEARCH PROGRAM.
‘‘(a) IN GENERAL.—The Secretary, acting through the Centers
for Disease Control and Prevention and in consultation with the
Director of the National Institutes of Health, shall—
‘‘(1) conduct research to better understand the relationship
between physical activity, diet, and health and factors that
influence health-related behaviors;
‘‘(2) develop and evaluate strategies for the prevention and
treatment of obesity to be used in community-based interven-
tions and by health professionals;
‘‘(3) develop and evaluate strategies for the prevention and
treatment of eating disorders, such as anorexia and bulimia;
‘‘(4) conduct research to establish the prevalence, con-
sequences, and costs of childhood obesity and its effects in
adulthood;
H. R. 4365—60
‘‘(5) identify behaviors and risk factors that contribute to
obesity;
‘‘(6) evaluate materials and programs to provide nutrition
education to parents and teachers of children in child care
or pre-school and the food service staff of such child care
and pre-school entities; and
‘‘(7) evaluate materials and programs that are designed
to educate and encourage physical activity in child care and
pre-school facilities.
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section such sums as may
be necessary for each of the fiscal years 2001 through 2005.
‘‘SEC. 399Y. EDUCATION CAMPAIGN.
‘‘(a) IN GENERAL.—The Secretary, acting through the Director
of the Centers for Disease Control and Prevention, and in collabora-
tion with national, State, and local partners, physical activity
organizations, nutrition experts, and health professional organiza-
tions, shall develop a national public campaign to promote and
educate children and their parents concerning—
‘‘(1) the health risks associated with obesity, inactivity,
and poor nutrition;
‘‘(2) ways in which to incorporate physical activity into
daily living; and
‘‘(3) the benefits of good nutrition and strategies to improve
eating habits.
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section such sums as may
be necessary for each of the fiscal years 2001 through 2005.
‘‘SEC. 399Z. HEALTH PROFESSIONAL EDUCATION AND TRAINING.
‘‘(a) IN GENERAL.—The Secretary, acting through the Director
of the Centers for Disease Control and Prevention, in collaboration
with the Administrator of the Health Resources and Services
Administration and the heads of other agencies, and in consultation
with appropriate health professional associations, shall develop and
carry out a program to educate and train health professionals
in effective strategies to—
‘‘(1) better identify and assess patients with obesity or
an eating disorder or patients at-risk of becoming obese or
developing an eating disorder;
‘‘(2) counsel, refer, or treat patients with obesity or an
eating disorder; and
‘‘(3) educate patients and their families about effective
strategies to improve dietary habits and establish appropriate
levels of physical activity.
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section such sums as may
be necessary for each of the fiscal years 2001 through 2005.’’.
H. R. 4365—61
TITLE XXV—EARLY 
DETECTION 
AND
TREATMENT REGARDING CHILDHOOD
LEAD POISONING
SEC. 2501. CENTERS FOR DISEASE CONTROL AND PREVENTION
EFFORTS TO COMBAT CHILDHOOD LEAD POISONING.
(a) 
REQUIREMENTS
FOR
LEAD
POISONING
PREVENTION
GRANTEES.—Section 317A of the Public Health Service Act (42
U.S.C. 247b–1) is amended—
(1) in subsection (d)—
(A) by redesignating paragraph (7) as paragraph (8);
and
(B) by inserting after paragraph (6) the following:
‘‘(7) Assurances satisfactory to the Secretary that the
applicant will ensure complete and consistent reporting of all
blood lead test results from laboratories and health care pro-
viders to State and local health departments in accordance
with guidelines of the Centers for Disease Control and Preven-
tion for standardized reporting as described in subsection (m).’’;
and
(2) in subsection ( j)(2)—
(A) in subparagraph (F) by striking ‘‘(E)’’ and inserting
‘‘(F)’’;
(B) by redesignating subparagraph (F) as subparagraph
(G); and
(C) by inserting after subparagraph (E) the following:
‘‘(F) The number of grantees that have established
systems to ensure mandatory reporting of all blood lead
tests from laboratories and health care providers to State
and local health departments.’’.
(b) GUIDELINES FOR STANDARDIZED REPORTING.—Section 317A
of the Public Health Service Act (42 U.S.C. 247b–1) is amended
by adding at the end the following:
‘‘(m) GUIDELINES
FOR STANDARDIZED REPORTING.—The Sec-
retary, acting through the Director of the Centers for Disease Con-
trol and Prevention, shall develop national guidelines for the uni-
form reporting of all blood lead test results to State and local
health departments.’’.
(c) DEVELOPMENT AND IMPLEMENTATION OF EFFECTIVE DATA
MANAGEMENT BY THE CENTERS FOR DISEASE CONTROL AND PREVEN-
TION.—
(1) IN GENERAL.—The Director of the Centers for Disease
Control and Prevention shall—
(A) assist with the improvement of data linkages
between State and local health departments and between
State health departments and the Centers for Disease Con-
trol and Prevention;
(B) assist States with the development of flexible, com-
prehensive State-based data management systems for the
surveillance of children with lead poisoning that have the
capacity to contribute to a national data set;
(C) assist with the improvement of the ability of State-
based data management systems and federally-funded
means-tested public benefit programs (including the special
supplemental food program for women, infants and children
H. R. 4365—62
(WIC) under section 17 of the Child Nutrition Act of 1966
(42 U.S.C. 1786) and the early head start program under
section 645A of the Head Start Act (42 U.S.C. 9840a(h))
to respond to ad hoc inquiries and generate progress reports
regarding the lead blood level screening of children enrolled
in those programs;
(D) assist States with the establishment of a capacity
for assessing how many children enrolled in the Medicaid,
WIC, early head start, and other federally-funded means-
tested public benefit programs are being screened for lead
poisoning at age-appropriate intervals;
(E) use data obtained as result of activities under
this section to formulate or revise existing lead blood
screening and case management policies; and
(F) establish performance measures for evaluating
State and local implementation of the requirements and
improvements described in subparagraphs (A) through (E).
(2) AUTHORIZATION OF APPROPRIATIONS.—There are author-
ized to be appropriated to carry out this subsection such sums
as may be necessary for each the fiscal years 2001 through
2005.
(3) EFFECTIVE DATE.—This subsection takes effect on the
date of the enactment of this Act.
SEC. 2502. GRANTS FOR LEAD POISONING RELATED ACTIVITIES.
(a) IN GENERAL.—Part B of title III of the Public Health Service
Act (42 U.S.C. 243 et seq.), as amended by section 1801 of this
Act, is amended by inserting after section 317N the following sec-
tion:
‘‘GRANTS FOR LEAD POISONING RELATED ACTIVITIES
‘‘SEC. 317O. (a) AUTHORITY TO MAKE GRANTS.—
‘‘(1) IN
GENERAL.—The Secretary shall make grants to
States to support public health activities in States and localities
where data suggests that at least 5 percent of preschool-age
children have an elevated blood lead level through—
‘‘(A) effective, ongoing outreach and community edu-
cation targeted to families most likely to be at risk for
lead poisoning;
‘‘(B) individual family education activities that are
designed to reduce ongoing exposures to lead for children
with elevated blood lead levels, including through home
visits and coordination with other programs designed to
identify and treat children at risk for lead poisoning; and
‘‘(C) the development, coordination and implementation
of community-based approaches for comprehensive lead poi-
soning prevention from surveillance to lead hazard control.
‘‘(2) STATE
MATCH.—A State is not eligible for a grant
under this section unless the State agrees to expend (through
State or local funds) $1 for every $2 provided under the grant
to carry out the activities described in paragraph (1).
‘‘(3) APPLICATION.—To be eligible to receive a grant under
this section, a State shall submit an application to the Secretary
in such form and manner and containing such information
as the Secretary may require.
‘‘(b) COORDINATION WITH OTHER CHILDREN’S PROGRAMS.—A
State shall identify in the application for a grant under this section
H. R. 4365—63
how the State will coordinate operations and activities under the
grant with—
‘‘(1) other programs operated in the State that serve chil-
dren with elevated blood lead levels, including any such pro-
grams 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).
‘‘(c) PERFORMANCE MEASURES.—The Secretary shall establish
needs indicators and performance measures to evaluate the activi-
ties carried out under grants awarded under this section. Such
indicators shall be commensurate with national measures of
maternal and child health programs and shall be developed in
consultation with the Director of the Centers for Disease Control
and Prevention.
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section such sums as may
be necessary for each of the fiscal years 2001 through 2005.’’.
(b) CONFORMING AMENDMENT.—Section 340D(c)(1) of the Public
Health Service Act (42 U.S.C. 256d(c)(1)) is amended by striking
‘‘317E’’ and inserting ‘‘317F’’.
SEC. 2503. TRAINING AND REPORTS BY THE HEALTH RESOURCES AND
SERVICES ADMINISTRATION.
(a) TRAINING.—The Secretary of Health and Human Services,
acting through the Administrator of the Health Resources and
Services Administration and in collaboration with the Administrator
of the Health Care Financing Administration and the Director
of the Centers for Disease Control and Prevention, shall conduct
education and training programs for physicians and other health
care providers regarding childhood lead poisoning, current screening
and treatment recommendations and requirements, and the sci-
entific, medical, and public health basis for those policies.
(b) REPORT.—The Secretary of Health and Human Services,
acting through the Administrator of the Health Resources and
Services Administration, annually shall report to Congress on the
number of children who received services through health centers
established under section 330 of the Public Health Service Act
(42 U.S.C. 254b) and received a blood lead screening test during
the prior fiscal year, noting the percentage that such children
represent as compared to all children who received services through
such health centers.
(c) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section such sums as may
be necessary for each the fiscal years 2001 through 2005.
H. R. 4365—64
SEC. 2504. SCREENINGS, REFERRALS, AND EDUCATION REGARDING
LEAD POISONING.
Section 317A(l)(1) of the Public Health Service Act (42 U.S.C.
247b–1(l)(1)) is amended by striking ‘‘1994’’ and all that follows
and inserting ‘‘1994 through 2005.’’.
TITLE XXVI—SCREENING FOR
HERITABLE DISORDERS
SEC. 2601. PROGRAM TO IMPROVE THE ABILITY OF STATES TO PRO-
VIDE NEWBORN AND CHILD SCREENING FOR HERITABLE
DISORDERS.
Part A of title XI of the Public Health Service Act, as amended
by section 2301 of this Act, is amended by adding at the end
the following:
‘‘SEC. 1109. IMPROVED NEWBORN AND CHILD SCREENING FOR HERI-
TABLE DISORDERS.
‘‘(a) IN GENERAL.—The Secretary shall award grants to eligible
entities to enhance, improve or expand the ability of State and
local public health agencies to provide screening, counseling or
health care services to newborns and children having or at risk
for heritable disorders.
‘‘(b) USE OF FUNDS.—Amounts provided under a grant awarded
under subsection (a) shall be used to—
‘‘(1) establish, expand, or improve systems or programs
to provide screening, counseling, testing or specialty services
for newborns and children at risk for heritable disorders;
‘‘(2) establish, expand, or improve programs or services
to reduce mortality or morbidity from heritable disorders;
‘‘(3) establish, expand, or improve systems or programs
to provide information and counseling on available therapies
for newborns and children with heritable disorders;
‘‘(4) improve the access of medically underserved popu-
lations to screening, counseling, testing and specialty services
for newborns and children having or at risk for heritable dis-
orders; or
‘‘(5) conduct such other activities as may be necessary
to enable newborns and children having or at risk for heritable
disorders to receive screening, counseling, testing or specialty
services, regardless of income, race, color, religion, sex, national
origin, age, or disability.
‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive a grant under
subsection (a) an entity shall—
‘‘(1) be a State or political subdivision of a State, or a
consortium of two or more States or political subdivisions of
States; and
‘‘(2) prepare and submit to the Secretary an application
that includes—
‘‘(A) a plan to use amounts awarded under the grant
to meet specific health status goals and objectives relative
to heritable disorders, including attention to needs of medi-
cally underserved populations;
‘‘(B) a plan for the collection of outcome data or other
methods of evaluating the degree to which amounts
H. R. 4365—65
awarded under this grant will be used to achieve the goals
and objectives identified under subparagraph (A);
‘‘(C) a plan for monitoring and ensuring the quality
of services provided under the grant;
‘‘(D) an assurance that amounts awarded under the
grant will be used only to implement the approved plan
for the State;
‘‘(E) an assurance that the provision of services under
the plan is coordinated with services provided under pro-
grams implemented in the State under title V, XVIII, XIX,
XX, or XXI of the Social Security Act (subject to Federal
regulations applicable to such programs) so that the cov-
erage of services under such titles is not substantially
diminished by the use of granted funds; and
‘‘(F) such other information determined by the Sec-
retary to be necessary.
‘‘(d) LIMITATION.—An eligible entity may not use amounts
received under this section to—
‘‘(1) provide cash payments to or on behalf of affected
individuals;
‘‘(2) provide inpatient services;
‘‘(3) purchase land or make capital improvements to prop-
erty; or
‘‘(4) provide for proprietary research or training.
‘‘(e) VOLUNTARY PARTICIPATION.—The participation by any indi-
vidual in any program or portion thereof established or operated
with funds received under this section shall be wholly voluntary
and shall not be a prerequisite to eligibility for or receipt of any
other service or assistance from, or to participation in, another
Federal or State program.
‘‘(f ) SUPPLEMENT NOT SUPPLANT.—Funds appropriated under
this section shall be used to supplement and not supplant other
Federal, State, and local public funds provided for activities of
the type described in this section.
‘‘(g) PUBLICATION.—
‘‘(1) IN
GENERAL.—An application submitted under sub-
section (c)(2) shall be made public by the State in such a
manner as to facilitate comment from any person, including
through hearings and other methods used to facilitate com-
ments from the public.
‘‘(2) COMMENTS.—Comments received by the State after
the publication described in paragraph (1) shall be addressed
in the application submitted under subsection (c)(2).
‘‘(h) TECHNICAL ASSISTANCE.—The Secretary shall provide to
entities receiving grants under subsection (a) such technical assist-
ance as may be necessary to ensure the quality of programs con-
ducted under this section.
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section such sums as may
be necessary for each of the fiscal years 2001 through 2005.
‘‘SEC. 1110. EVALUATING THE EFFECTIVENESS OF NEWBORN AND
CHILD SCREENING PROGRAMS.
‘‘(a) IN GENERAL.—The Secretary shall award grants to eligible
entities to provide for the conduct of demonstration programs to
evaluate the effectiveness of screening, counseling or health care
H. R. 4365—66
services in reducing the morbidity and mortality caused by heritable
disorders in newborns and children.
‘‘(b) DEMONSTRATION PROGRAMS.—A demonstration program
conducted under a grant under this section shall be designed to
evaluate and assess, within the jurisdiction of the entity receiving
such grant—
‘‘(1) the effectiveness of screening, counseling, testing or
specialty services for newborns and children at risk for heritable
disorders in reducing the morbidity and mortality associated
with such disorders;
‘‘(2) the effectiveness of screening, counseling, testing or
specialty services in accurately and reliably diagnosing heri-
table disorders in newborns and children; or
‘‘(3) the availability of screening, counseling, testing or
specialty services for newborns and children at risk for heritable
disorders.
‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive a grant under
subsection (a) an entity shall be a State or political subdivision
of a State, or a consortium of two or more States or political
subdivisions of States.
‘‘SEC. 1111. ADVISORY COMMITTEE ON HERITABLE DISORDERS IN
NEWBORNS AND CHILDREN.
‘‘(a) ESTABLISHMENT.—The Secretary shall establish an advisory
committee to be known as the ‘Advisory Committee on Heritable
Disorders in Newborns and Children’ (referred to in this section
as the ‘Advisory Committee’).
‘‘(b) DUTIES.—The Advisory Committee shall—
‘‘(1) provide advice and recommendations to the Secretary
concerning grants and projects awarded or funded under section
1109;
‘‘(2) provide technical information to the Secretary for the
development of policies and priorities for the administration
of grants under section 1109; and
‘‘(3) provide such recommendations, advice or information
as may be necessary to enhance, expand or improve the ability
of the Secretary to reduce the mortality or morbidity from
heritable disorders.
‘‘(c) MEMBERSHIP.—
‘‘(1) IN GENERAL.—The Secretary shall appoint not to exceed
15 members to the Advisory Committee. In appointing such
members, the Secretary shall ensure that the total membership
of the Advisory Committee is an odd number.
‘‘(2) REQUIRED MEMBERS.—The Secretary shall appoint to
the Advisory Committee under paragraph (1)—
‘‘(A) the Administrator of the Health Resources and
Services Administration;
‘‘(B) the Director of the Centers for Disease Control
and Prevention;
‘‘(C) the Director of the National Institutes of Health;
‘‘(D) the Director of the Agency for Healthcare Research
and Quality;
‘‘(E) medical, technical, or scientific professionals with
special expertise in heritable disorders, or in providing
screening, counseling, testing or specialty services for
newborns and children at risk for heritable disorders;