I
105TH CONGRESS
2D SESSION
H. R. 4670
To establish a program of formula grants to the States for programs to
provide pregnant women with alternatives to abortion, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
OCTOBER 1, 1998
Mr. PITTS introduced the following bill; which was referred to the Committee
on Commerce
A BILL
To establish a program of formula grants to the States
for programs to provide pregnant women with alter-
natives to abortion, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Women and Children’s
Resources Act’’.
SEC. 2. FORMULA GRANTS TO STATES REGARDING ALTER-
NATIVES TO ABORTION.
In the case of each State that in accordance with sec-
tion 5 submits to the Secretary of Health and Human
Services an application for a fiscal year, the Secretary
shall make a grant to the State for the year for carrying
out the purposes authorized in section 3(a) (subject to
amounts being appropriated under section 10 for the
year). The grant shall consist of the allotment determined
for the State under section 6.
SEC. 3. OPERATION OF PROGRAMS TO PROVIDE ALTER-
NATIVES TO ABORTION; ADMINISTRATION OF
PROGRAMS THROUGH CONTRACTS WITH EN-
TITIES WITH NO ABORTION-RELATED HIS-
TORY.
(a) IN GENERAL.—A precondition for the receipt of
a grant under section 2 (in this Act referred to as a ‘‘grant
precondition’’ under such section) is that the State in-
volved agree that the grant will be expended only for pur-
poses of the establishment and operation of programs
(carried out pursuant to contracts under subsection (d))
that have the primary purpose of providing to eligible indi-
viduals under subsection (b) information, education, and
counseling on alternatives to abortion, and that in addition
make available to such individuals the following services:
(1) Information, education, and counseling on
maintaining abstinence from sexual activities.
(2) Testing for pregnancy, including follow-up
services.
(3) Prenatal and postpartum health care.
(4) Information and education on the following:
(A) Prenatal and postpartum health, in-
cluding fetal development and the health and
nutritional needs of pregnant and postpartum
women.
(B) Childbirth.
(C) Parenting.
(D) Pregnancy during adolescence.
(E) Substance abuse.
(F) Sexually transmitted diseases, includ-
ing infection with the human immunodeficiency
virus (commonly known as HIV).
(G) Adoption.
(5) Referrals for services, items, and assistance
regarding health, mental health, food, clothing,
housing, education, vocational training, and other
appropriate services, items, and assistance, including
under programs under title V of the Social Security
Act (relating to maternal and child health); section
17 of the Child Nutrition Act of 1966 (relating to
women, infants, and children); title XIX of the So-
cial Security Act (relating to the Medicaid program,
including the program for early and periodic screen-
ing, diagnostic, and treatment services described in
section 1905(r) of such Act); title IV of such Act
(relating to child and family services, foster care and
adoption, and job opportunities); and title XIX of
the Public Health Service Act (relating to public
health programs, mental health programs, and pro-
grams for the prevention and treatment of substance
abuse).
(b) ELIGIBLE INDIVIDUALS.—
(1) IN GENERAL.—Subject to paragraph (2), an
individual is an eligible individual for purposes of
subsection (a) if—
(A) the individual is pregnant (or has rea-
sonable grounds for believing she may be preg-
nant);
(B) the individual (male or female) is the
parent or legal guardian of an infant under 12
months of age; or
(C) the individual is the spouse or other
partner of an individual described in subpara-
graph (A) or (B).
(2) LIMITATION.—A grant precondition under
section 2 is that the State involved agree that pro-
grams under subsection (a) will expend the grant
under such section to provide the services of the pro-
gram to an individual only if the income of the indi-
vidual does not exceed an amount equal to 185 per-
cent of the official poverty line (as established by the
Director of the Office of Management and Budget
and revised by the Secretary in accordance with sec-
tion 673(2) of the Omnibus Budget Reconciliation
Act of 1981).
(c) ADDITIONAL
PROVISIONS
REGARDING
SERV-
ICES.—
(1) RESTRICTIONS REGARDING ABORTIONS.—A
grant precondition under section 2 is that the State
involved agree that programs under subsection (a)
will be operated in accordance with the following:
(A) The programs will not perform or
make referrals for abortions.
(B) The programs will not provide or make
referrals for information, education, or counsel-
ing that presents abortion as a pregnancy-man-
agement option;
(C) The programs will not provide contra-
ceptive services or contraceptive drugs or de-
vices, or recommend the use of contraceptives.
(2) SCOPE
OF
PRENATAL
AND
POSTPARTUM
HEALTH CARE.—The Secretary may establish limita-
tions on the expenditure of a grant under section 2
to provide prenatal and postpartum health care
under subsection (a)(3), including limitations on the
amount of the grant that may be expended for such
care and limitations on the type or extent of services
that may be provided with the grant.
(3) OTHER ASSISTANCE.—The Secretary may,
subject to subsection (b)(2), authorize a State to
permit programs under subsection (a) to expend the
grant under section 2 to provide food, clothing, and
furniture for infants of eligible individuals, subject
to the infants being under 12 months of age.
(d) ADMINISTRATION OF PROGRAMS THROUGH CON-
TRACTS WITH ENTITIES WITH NO ABORTION-RELATED
HISTORY; OTHER ABORTION-RELATED RESTRICTIONS.—
A grant precondition under section 2 is that the State in-
volved agree that programs under subsection (a) will be
operated in accordance with the following:
(1) The State will enter into contracts with one
or more nonprofit private entities under which such
entities have the principal responsibility for operat-
ing such programs and acting as prime contractors
on behalf of the State.
(2) An entity will not receive such a contract if,
during the five-year period preceding the date on
which the entity applies to receive the contract, the
entity performed or made referrals for abortions, or
provided or made referrals for information, edu-
cation, or counseling that presented abortion as a
pregnancy-management option.
(3) An entity will not receive such a contract
unless the entity is physically, legally, and financially
separate from entities that, during the five-year pe-
riod referred to in paragraph (2), performed or
made referrals for abortions, or provided or made re-
ferrals for information, education, or counseling that
presented abortion as a pregnancy-management op-
tion.
(4) The State will permit entities receiving such
contracts to carry out such programs directly and
through entering into contracts with subcontractors.
(5) Paragraphs (2) and (3) apply to a person
applying to serve as such a subcontractor to the
same extent and in the same manner as the para-
graphs apply to entities serving as the prime con-
tractors.
(6) A person will not receive a subcontract to
provide any service under such a program unless the
person has not less than one year of experience in
providing the service.
(e) MISCELLANEOUS PROVISIONS.—A grant pre-
condition under section 2 is that the State involved agree
that programs under subsection (a) will be operated in ac-
cordance with the following:
(1) The programs will provide information to
the public on the availability of the services of the
program, including providing information through
the establishment and operation of toll-free tele-
communications.
(2) With respect to the expenditure of the grant
pursuant to subsection (b)(2), the grant will not be
expended to make payment for a service of the pro-
gram that is provided to an eligible individual to the
extent that payment has been made, or can reason-
ably be expected to be made, with respect to the
service—
(A) under any State compensation pro-
gram, under an insurance policy, or under any
Federal or State health benefits program; or
(B) by an entity that provides health serv-
ices on a prepaid basis.
(3) For the fiscal year in which a program is
established and for the two subsequent fiscal years,
there will be no limit on the amount of the grant
that may be expended for administrative expenses.
For all other fiscal years, the program will not ex-
pend the grant for administrative expenses in excess
of an amount equal to 15 percent of the grant made
to the State for the fiscal year.
(4)(A) Providers of services in the program will
be reimbursed (as applicable) $10 for every 10 min-
utes of counseling for eligible individuals; $10 for
every 10 minutes of referral time spent on behalf of
such individuals; $20 per class per hour of instruc-
tion taught to such individuals; $10 for each self-ad-
ministered pregnancy test kit provided to such indi-
viduals; and $10 for every pantry visit where such
individuals receive free food, clothing, or furniture
for their infants.
(B) For fiscal year 2000 and subsequent fiscal
years, each of the dollar amounts specified in sub-
paragraph (A) will be adjusted to offset the effects
of inflation occurring after the beginning of fiscal
year 1999.
(5) The programs will not expend the grant—
(A) to provide inpatient hospital services;
(B) to makes cash payments to intended
recipients of services;
(C) to purchase or improve land, purchase,
construct, or permanently improve (other than
minor remodeling) any building or other facil-
ity; or
(D) to satisfy any requirement that non-
Federal funds be expended as a precondition of
the receipt of Federal funds.
SEC. 4. SERVICES PROVIDED BY RELIGIOUS ORGANIZA-
TIONS.
(a) IN GENERAL.—With respect to contracts under
section 3(d) (relating to entities that will carry out pro-
grams under section 3(a)), a State may award such con-
tracts to religious organizations that meet the criteria
under section 3(d) for receiving such awards.
(b) RELIGIOUS ORGANIZATIONS.—The purpose of
this section is to allow States to contract with religious
organizations under section 3(d) on the same basis as any
other nongovernmental provider without impairing the re-
ligious character of such organizations, and without di-
minishing the religious freedom of beneficiaries of assist-
ance funded under such program.
(c) NONDISCRIMINATION AGAINST RELIGIOUS ORGA-
NIZATIONS.—In the event a State exercises its authority
under subsection (a), religious organizations are eligible
for contracts under section 3(d) on the same basis as any
other nonprofit private entity as long as the programs are
implemented consistent with the Establishment Clause of
the United States Constitution. Except as provided in sub-
section (k), neither the Federal Government nor a State
receiving a grant under section 2 shall discriminate
against an organization that is or applies to be a contrac-
tor under section 3(d) on the basis that the organization
has a religious character.
(d) RELIGIOUS CHARACTER AND FREEDOM.—
(1) RELIGIOUS
ORGANIZATIONS.—A religious
organization receiving a contract under section 3(d)
shall retain its independence from Federal, State,
and local governments, including such organization’s
control over the definition, development, practice,
and expression of its religious beliefs.
(2) ADDITIONAL
SAFEGUARDS.—Neither the
Federal Government nor a State receiving a grant
under section 2 shall require a religious organiza-
tion—
(A) to alter its form of internal govern-
ance; or
(B) to remove religious art, icons, scrip-
ture, or other symbols;
in order to be eligible for a contract under section
3(d).
(e) RIGHTS OF BENEFICIARIES OF ASSISTANCE.—
(1) IN GENERAL.—If an individual described in
paragraph (2) has an objection to the religious char-
acter of the organization from which the individual
receives services pursuant to a contract under sec-
tion 3(d), a State receiving a grant under section 2
shall provide such individual (if an eligible individual
under section 3(b)), within a reasonable period of
time after the date of such objection, with services
from an alternative provider that is accessible to the
individual and the value of which is not less than the
value of the services that the individual would have
received from such organization.
(2) INDIVIDUAL DESCRIBED.—An individual de-
scribed in this paragraph is an individual who re-
ceives, applies for, or requests to apply for, services
under a program under section 3(a).
(f) EMPLOYMENT PRACTICES.—A religious organiza-
tion’s exemption provided under section 702 of the Civil
Rights Act of 1964 (42 U.S.C. 2000e–1a) regarding em-
ployment practices shall not be affected by the receipt of
a contract under section 3(d).
(g) 
NONDISCRIMINATION
AGAINST
BENE-
FICIARIES.—Except as otherwise provided in law, a reli-
gious organization shall not discriminate against an indi-
vidual in regard to providing services under section 3(a)
on the basis of religion, a religious belief, or refusal to
actively participate in a religious practice.
(h) FISCAL ACCOUNTABILITY.—
(1) IN GENERAL.—Except as provided in para-
graph (2), any religious organization receiving a con-
tract under section 3(d) shall be subject to the same
regulations as other contractors to account in accord
with generally accepted auditing principles for the
expenditure of a grant under section 2.
(2) LIMITED AUDIT.—If such organization seg-
regates funds received from a grant under section 2
into separate accounts, then only services provided
with such funds shall be subject to audit.
(i) COMPLIANCE.—Any party seeking to enforce its
rights under this section may commence a civil action for
injunctive relief exclusively in an appropriate State court
against the entity or agency that allegedly committed such
violation.
(j) LIMITATIONS ON USE OF FUNDS FOR CERTAIN
PURPOSES.—A grant under section 2 may not be ex-
pended for sectarian worship, instruction, or proselytiza-
tion.
(k) PREEMPTION.—Nothing in this section shall be
construed to preempt any provision of a State constitution
or State statute that prohibits or restricts the expenditure
of State funds in or by religious organizations.
(l) SUBCONTRACTORS.—This section applies to
awards under section 3(d) made by prime contractors to
subcontractors to the same extent and in the same manner
as this section applies to awards under such section by
States to prime contractors.
SEC. 5. STATE APPLICATION FOR GRANT.
For purposes of section 2, an application for a grant
under such section for a fiscal year is in accordance with
this section if—
(1) the State involved submits the application
not later than the date specified by the Secretary;
(2) the application demonstrates compliance
with the grant preconditions specified in section 3;
and
(3) the application is in such form, is made in
such manner, and contains such agreements, assur-
ances, and information as the Secretary determines
to be necessary to carry out this Act.
SEC. 6. DETERMINATION OF AMOUNT OF STATE ALLOT-
MENT.
For purposes of section 2, the allotment determined
under this section for a State for a fiscal year is the prod-
uct of—
(1) the amount available under section 10 for
the fiscal year; and
(2) the percentage constituted by the ratio of—
(A) a number equal to the sum of—
(i) the number of children born in the
State to women who were not married to
the fathers of the children at the time of
the births of the children; and
(ii) the number of abortions per-
formed in the State; to
(B) the sum of the respective numbers de-
termined under subparagraph (A) for all States.
SEC. 7. BIENNIAL REPORTS TO CONGRESS.
The Secretary shall submit to the Congress periodic
reports on the programs carried out under section 3(a).
The first report shall be submitted not later than Feb-
ruary 1, 2000, and subsequent reports shall be submitted
biennially thereafter.
SEC. 8. DEFINITIONS.
For purposes of this Act:
(1)(A) The term ‘‘administrative expenses’’,
with respect to programs under section 3(a), means
expenditures for costs associated with administering
such programs, including salaries, taxes, benefits,
job placement costs, postage and shipping costs,
travel and lodging, office, rent, telephone and fax
costs, insurance and office supplies, professional de-
velopment for staff and ongoing legal, accounting,
and computer consulting. Such term does not in-
clude expenditures for start-up costs or service costs.
(B) The term ‘‘service costs’’, with respect to
programs under section 3(a), includes the costs of
salaries for technical support, taxes, benefits, job
placement costs, professional development and ongo-
ing training, educational and informational material
for eligible individuals and counselors, program ad-
vertising costs, travel for technical support staff,
billing and database computer consulting, seminars
for counseling training, meetings for recurring pro-
gram training, minor equipment purchases for stor-
age of files regarding eligible individuals, new pro-
gram development, pregnancy test kit reimburse-
ment, counseling and referral time, and toll-free re-
ferral telephone operations.
(C) The term ‘‘start-up costs’’, with respect to
programs under section 3(a), means costs necessary
for establishing the programs, including the cost of
obtaining furniture, computers and accessories, copy
machines, consulting services, telephones, and other
office equipment and supplies.
(2) The term ‘‘grant precondition’’ has the
meaning indicated for such term in section 3(a).
(3) The term ‘‘Secretary’’ means the Secretary
of Health and Human Services.
(4) The term ‘‘State’’ means each of the several
States, the District of Columbia, and each of 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.
SEC. 9. REGULATIONS.
No head of a Federal department or agency other
than the Secretary may promulgate regulations to carry
out this Act.
SEC. 10. FUNDING.
For the purpose of carrying out this Act, there is au-
thorized to be appropriated $85,000,000 for each of the
fiscal years 1999 through 2003.
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