I
106TH CONGRESS
1ST SESSION
H. R. 2471
To amend the Public Health Service Act to provide for screenings, referrals,
and education regarding osteoporosis.
IN THE HOUSE OF REPRESENTATIVES
JULY 12, 1999
Ms. EDDIE BERNICE JOHNSON of Texas (for herself, Mrs. KELLY, Mrs.
CAPPS, Ms. CARSON, Mrs. CHRISTENSEN, Mrs. CLAYTON, Ms. DANNER,
Mrs. JONES of Ohio, Mr. FROST, Mr. GREEN of Texas, Mr. GONZALEZ,
Mrs. LOWEY, Mrs. MCCARTHY of New York, Mrs. MEEK of Florida, Ms.
ESHOO, Ms. MCKINNEY, Ms. MILLENDER-MCDONALD, Ms. WATERS, Ms.
SLAUGHTER, Mr. BENTSEN, Ms. JACKSON-LEE of Texas, Mr. CONYERS,
Mr. CLAY, Mr. RANGEL, Mr. DIXON, Mr. OWENS, Mr. TOWNS, Mr.
LEWIS of Georgia, Mr. PAYNE, Ms. NORTON, Mr. JEFFERSON, Mr.
BISHOP, Mr. CLYBURN, Mr. HASTINGS of Florida, Mr. HILLIARD, Mr.
RUSH, Mr. SCOTT, Mr. WATT of North Carolina, Mr. WYNN, Mr.
THOMPSON of Mississippi, Mr. FATTAH, Mr. CUMMINGS, Mr. DAVIS of
Illinois, Mr. FORD, Mr. MEEKS of New York, Ms. LEE, and Ms. KIL-
PATRICK) introduced the following bill; which was referred to the Com-
mittee on Commerce
A BILL
To amend the Public Health Service Act to provide for
screenings, referrals, and education regarding osteoporosis.
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 ‘‘Public Health
Osteoporosis Screening, Diagnosis, and Treatment Act of
1999’’.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) Osteoporosis is a significant public health
risk affecting 28,000,000 Americans who either have
osteoporosis or are at risk of fractures due to low
bone mass.
(2) One out of two women and one in eight men
over age 50 will have an osteoporosis-related frac-
ture in their lifetime.
(3) Ten percent of African-American women
over age 50 will have an osteoporosis-related frac-
ture.
(4) While osteoporosis is often thought of as an
older person’s disease, it can strike at any age, in-
cluding in young women with eating disorders or
young men treated for asthma with steroids.
(5) Osteoporosis is responsible for 1,500,000
fractures annually, including 300,000 hip fractures,
700,000 vertebral fractures, 250,000 wrist fractures,
and 300,000 fractures at other sites.
(6) A woman’s risk of hip fracture is equal to
her combined risk of breast, uterine, and ovarian
cancer.
(7) The estimated national direct medical cost
of osteoporosis is $13,800,000,000 annually, which
is $38,000,000 each day, and the cost is rising.
(8) Osteoporosis is preventable in most people
if the right precautions are taken.
(9) Only 13 percent of teen girls get the cal-
cium necessary to build their bone to peak capacity.
(10) Most adult women are not aware of their
own risk factors for osteoporosis.
(11) Women can lose up to 20 percent of their
bone mass in the five to seven years following meno-
pause, making them susceptible to osteoporosis.
(12) Eighty percent of fractures in adult
women are osteoporosis related, yet most people pre-
senting 
with 
fractures 
are 
not 
assessed 
for
osteoporosis.
(13) Only 7 percent of people with osteoporosis
have been diagnosed.
(14) 
States 
are 
currently 
spending 
only
$4,000,000 
on 
educating 
the 
public 
about
osteoporosis prevention, diagnosis, and treatment.
SEC. 3. OSTEOPOROSIS SCREENING AS REQUIRED PRI-
MARY 
HEALTH 
SERVICE 
FOR 
FEDERAL
HEALTH CENTERS.
Section 330(b)(1)(A)(i)(III) of the Public Health
Service Act (42 U.S.C. 254b(b)(1)(A)(i)(III)) is amended
by amending item (ee) to read as follows:
‘‘(ee) screenings for elevated
blood lead levels, communicable
diseases, 
cholesterol, 
and
osteoporosis;’’.
SEC. 
4. 
EXPANSION 
OF 
STATE 
PROGRAMS 
FOR
SCREENINGS, REFERRALS, AND EDUCATION
REGARDING OSTEOPOROSIS.
Part B of title III of the Public Health Service Act
(42 U.S.C. 243 et seq.) is amended by inserting after sec-
tion 317G the following section:
‘‘SCREENINGS, REFERRALS, AND EDUCATION REGARDING
OSTEOPOROSIS
‘‘SEC. 317H. (a) IN GENERAL.—The Secretary, act-
ing through the Director of the Centers for Disease Con-
trol and Prevention, may make grants to States and polit-
ical subdivisions of States for the establishment and oper-
ation of programs (including the expansion of pro-
grams)—
‘‘(1) to screen individuals for osteoporosis;
‘‘(2) to provide referrals for treatment of the
disease; and
‘‘(3) to carry out activities to educate health
professionals and the public regarding the disease.
‘‘(b) REQUIREMENT OF MATCHING FUNDS.—
‘‘(1) IN GENERAL.—The Secretary may make a
grant under subsection (a) only if the applicant in-
volved agrees that, with respect to the costs to be in-
curred by the applicant in carrying out a program
under such subsection, the applicant will make avail-
able (directly or through donations from public or
private entities) non-Federal contributions toward
such costs in an amount that is not less than $1 for
each $1 of Federal funds provided in the grant.
‘‘(2) DETERMINATION
OF
AMOUNT
OF
NON-
FEDERAL
CONTRIBUTIONS.—Non-Federal contribu-
tions required in paragraph (1) may be in cash or
in kind, fairly evaluated, including plant, equipment,
or services. Amounts provided by the Federal Gov-
ernment, or services assisted or subsidized to any
significant extent by the Federal Government, may
not be included in determining the amount of such
non-Federal contributions.
‘‘(c) APPLICATION FOR GRANT.—The Secretary may
make a grant under subsection (a) only if an application
for the grant is submitted to the Secretary and the appli-
cation is in such form, is made in such manner, and con-
tains such agreements, assurances, and information as the
Secretary determines to be necessary to carry out this sec-
tion.
‘‘(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 2000 and 2001.’’.
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