I 
111TH CONGRESS 
1ST SESSION H. R. 2107 
To direct the Secretary of Health and Human Services to conduct a public 
education campaign on umbilical cord blood stem cells, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 27, 2009 
Ms. SPEIER introduced the following bill; which was referred to the Committee 
on Energy and Commerce, and in addition to the Committee on Edu-
cation and Labor, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To direct the Secretary of Health and Human Services to 
conduct a public education campaign on umbilical cord 
blood stem cells, 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; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Cord Blood Education and Awareness Act of 2009’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Findings. 
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Sec. 3. Public education campaign. 
Sec. 4. Patient informed consent document. 
Sec. 5. Duty of certain professionals to disclose information to, and obtain in-
formed consent from, pregnant patients. 
Sec. 6. Professional education. 
Sec. 7. Targeted education grants. 
Sec. 8. Authorization of appropriations. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Every 10 minutes, another child or adult is 
expected to die from leukemia, lymphoma or 
myeloma. 
Leukemia, 
lymphoma, 
and 
myeloma 
caused the deaths of an estimated 52,910 people in 
the United States in 2007 and accounted for nearly 
9.4 percent of the deaths from cancer in 2008. In 
addition, leukemia causes more deaths than any 
other cancer among children and young adults under 
the age of 20. 
(2) As many as 16,000 leukemia patients diag-
nosed each year require a bone marrow transplant 
but have no matched relative or cannot find a match 
in the national bone marrow registry. There is a 1 
in 4 chance that an newborn baby’s cord blood cells 
would be a perfect match to a sibling that suffers 
from 1 of 70 blood diseases. 
(3) Umbilical cord blood stem cells (in this Act 
referred to as ‘‘cord blood cells’’) have effectively 
been used in the treatment of these conditions. To 
date, cord blood cells have been used in more than 
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14,000 transplants worldwide during the last 20 
years. 
(4) Cord blood cells, like marrow and blood, is 
a rich source of stem cells for allogeneic transplan-
tation, especially for children. Cord blood cells used 
in transplant result in a lower rate of graft versus 
host disease than bone marrow and are easier to 
match based on HLA typing. In addition, cord blood 
cells have also been used to treat effectively non-
malignant blood, immune, and metabolic disorders 
such as aplastic anemia, sickle cell anemia, severe 
combined immunodeficiencies, and leukodystrophies. 
(5) Researchers have found that in addition to 
blood cell precursors, cord blood cells contains many 
different types of stem cells—the building blocks of 
bones, the heart, liver, and nervous system. Further, 
cord blood cells have proven to be pluripotent, which 
means they have the ability to differentiate into 
every cell type in the human body. Cord blood cells 
have also been shown decrease inflammation and 
stimulate tissue repair. 
(6) Clinical research and experimental clinical 
use is underway to study the use of autologous cord 
blood cells to treat type 1 diabetes, brain injury, and 
cerebral palsy. In addition, preclinical research using 
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cord blood cells is showing promise in treating hear-
ing loss, renal failure, spinal cord injury, and con-
genital heart valve defects. 
(7) Of the more than 4,000,000 births in the 
United States each year, more than 90 percent of 
the cord blood cells are discarded as medical waste. 
Currently, less than one quarter of the States re-
quires that expectant parents receive information re-
garding their options to bank their baby’s cord blood 
in public or private blood banks. 
(8) In 2005, the Institute of Medicine sub-
mitted a report to Congress entitled ‘‘Establishing 
National Hematopoietic Stem Cell Bank Program’’, 
and recommended that ‘‘donors must be provided 
with clear information about their options’’, for cord 
blood cells and that ‘‘the information provided to a 
donor must include a balanced perspective on the 
different options for banking’’ cord blood cells. The 
Institute also recommended that ‘‘informed consent 
for the collection storage and use of cord blood 
should be obtained before labor and delivery, and 
after the adequate disclosure of information.’’. 
SEC. 3. PUBLIC EDUCATION CAMPAIGN. 
Not later than 1 year after the date of the enactment 
of this Act, the Secretary of Health and Human Services 
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(in this Act referred to as the ‘‘Secretary’’) shall develop 
and make publicly available, including by posting on the 
public website of the Department of Health and Human 
Services, a publication relating to umbilical cord blood 
that includes the following information: 
(1) An explanation of the potential value and 
uses of umbilical cord blood, including cord blood 
cells and stem cells, for individuals who are, as well 
as individuals who are not, biologically related to a 
mother or her newborn child. 
(2) An explanation of the differences between 
using one’s own cord blood cells (autologous) and 
using related or unrelated cord blood stem cells 
(allogeneic use) in the treatment of disease. 
(3) An explanation of the differences between 
public and private umbilical cord blood banking. 
(4) The options available to a mother relating 
to stem cells that are contained in the umbilical cord 
blood after the delivery of her newborn, including— 
(A) donating the stem cells to a public um-
bilical cord blood bank (where facilities are 
available); 
(B) storing the stem cells in a private fam-
ily umbilical cord blood bank for use by imme-
diate and extended family members; 
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(C) storing the stem cells for immediate or 
extended family members through a family or 
sibling donor banking program that provides 
free collection, processing, and storage where 
there is an existing medical need; and 
(D) discarding the stem cells. 
(5) The medical processes involved in the collec-
tion of cord blood. 
(6) Medical or family history criteria that can 
impact a family’s consideration of umbilical cord 
blood banking, including the likelihood of using a 
baby’s cord blood to serve as a match for a family 
member who has a medical condition. 
(7) Options for ownership and future use of do-
nated umbilical cord blood. 
(8) The average cost of public and private um-
bilical cord blood banking. 
(9) The availability of public and private cord 
blood banks, including— 
(A) a list of public cord blood banks within 
the United States and the hospitals served by 
such banks; 
(B) a list of private cord blood banks that 
are accredited, as determined by the Secretary; 
and 
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(C) the availability of free family banking 
and sibling donor programs where there is an 
existing medical need by a family member. 
(10) An explanation of which racial and ethnic 
groups are in particular need of publicly donated 
cord blood samples based upon medical data devel-
oped by the Health Resources and Services Adminis-
tration. 
SEC. 4. PATIENT INFORMED CONSENT DOCUMENT. 
(a) IN GENERAL.—Not later than 1 year after the 
date of the enactment of this Act, the Secretary shall de-
velop a written patient informed consent document relat-
ing to cord blood disposition to be presented and signed, 
to the extent feasible, by an expectant woman not later 
than 2 weeks before her estimated delivery date. 
(b) CONTENTS.—The document developed under sub-
section (a) shall include the following: 
(1) Information providing a balanced perspec-
tive on the different options for cord blood banking, 
including public donation, private banking, and dis-
posal. 
(2) Information on the medical value of cord 
blood stem cells in the treatment of disease. 
(3) A declaration, to be signed, of a woman’s 
chosen option for the disposition of a child’s cord 
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blood stem cells, whether public donation, private 
banking, or other disposal. 
SEC. 5. DUTY OF CERTAIN PROFESSIONALS TO DISCLOSE 
INFORMATION TO, AND OBTAIN INFORMED 
CONSENT FROM, PREGNANT PATIENTS. 
(a) DISCLOSURE
OF OPTIONS.—Effective 1 year 
after the date of the enactment of this Act, each physician 
or other health care professional who is primarily respon-
sible for the furnishing ambulatory prenatal care to a 
pregnant woman shall— 
(1) prior to the beginning of the third trimester 
of the pregnancy (or, if later, at the first visit of 
such pregnant woman to the provider), provide her 
with information developed under section 3 relating 
to the woman’s options with respect to umbilical 
cord blood banking; and 
(2) after providing such information and, to the 
extent feasible, not later than 2 weeks before the 
woman’s estimated date of delivery, obtain a written 
informed consent described in section 4 relating to 
the woman’s decision regarding disposition of cord 
blood stem cells or document that the provider 
sought such consent and the woman refused or de-
clined to provide it. 
(b) APPLICATION.— 
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(1) MEDICAID.— 
(A) Section 1902(a) of the Social Security 
Act (42 U.S.C. 1396b(a)) is amended— 
(i) by striking ‘‘and’’ at the end of 
paragraph (72); 
(ii) by striking the period at the end 
of paragraph (73) and inserting ‘‘; and’’; 
and 
(iii) by inserting after paragraph (73) 
the following new paragraph: 
‘‘(74) provide (A) that each physician or other 
health care professional who is primarily responsible 
for the furnishing ambulatory prenatal care to a 
pregnant woman and who is receiving funds under 
the plan for the furnishing of such care shall comply 
with the requirements of such section with respect to 
any pregnant woman to whom the provider furnishes 
such care; and (B) for a method to enforce such re-
quirements.’’. 
(B) Section 1903 of such Act (42 U.S.C. 
1396c) is amended by adding at the end the fol-
lowing new subsection: 
‘‘(aa) If the Secretary finds that a State has not com-
plied with the requirement of section 1902(a)(74)(B), the 
Secretary may provide for such reduction in payment oth-
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erwise made to the State under section 1902(a)(7) as may 
be appropriate, taking into account the costs the State 
would have incurred in complying with such require-
ment.’’. 
(2) CHIP.—Section 2107(e)(1) of such Act (42 
U.S.C. 1397hh(e)(1)) is amended by adding at the 
end the following new subparagraph: 
‘‘(M) Sections 1902(a)(74) and 1903(aa) 
(relating to informing pregnant women con-
cerning blood cord banking).’’. 
(3) EMPLOYER GROUP HEALTH PLANS UNDER 
ERISA.—Section 609 of the Employee Retirement 
Income Security Act of 1974 (29 U.S.C. 1169) is 
amended— 
(A) by redesignating subsection (e) as sub-
section (f); and 
(B) by inserting after subsection (d) the 
following new subsection: 
‘‘(e) INFORMING PREGNANT WOMEN CONCERNING 
BLOOD CORD BANKING.— 
‘‘(1) IN GENERAL.—A group health plan, and a 
health insurance issuer that offers group health in-
surance coverage, that provides benefits for ambula-
tory prenatal care for a pregnant woman through an 
agreement or arrangement with a physician or other 
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