I
106TH CONGRESS
1ST SESSION
H. R. 3301
To amend the Public Health Service Act with respect to children’s health.
IN THE HOUSE OF REPRESENTATIVES
NOVEMBER 10, 1999
Mr. BILIRAKIS (for himself, Mr. BROWN of Ohio, Mrs. EMERSON, Mr. TOWNS,
Mr. GREENWOOD, Mr. UPTON, Ms. DEGETTE, Mr. SMITH of New Jersey,
Mr. WAXMAN, and Mr. WALSH) introduced the following bill; which was
referred to the Committee on Commerce
A BILL
To amend the Public Health Service Act with respect to
children’s health.
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 ‘‘Children’s Health Re-
search and Prevention Amendments of 1999’’.
SEC. 2. TABLE OF CONTENTS.
The table of contents for this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
TITLE I—REVISION AND EXTENSION OF PROGRAMS
Subtitle A—Pediatric Research Initiative
Sec. 101. Short title.
Sec. 102. Establishment of a pediatric research initiative.
Sec. 103. Investment in tomorrow’s pediatric researchers.
Subtitle B—Other Programs
Sec. 111. Childhood immunizations.
Sec. 112. Screenings, referrals, and education regarding lead poisoning.
Sec. 113. Prevention and control of injuries; traumatic brain injury.
TITLE II—CHILDREN’S HEALTH RESEARCH AND PREVENTION
ACTIVITIES
Subtitle A—Early Detection, Diagnosis, and Treatment Regarding Hearing
Loss in Infants
Sec. 201. Short title.
Sec. 202. Early detection, diagnosis, and interventions for newborns and in-
fants with hearing loss.
Subtitle B—Autism
CHAPTER 1—SURVEILLANCE AND RESEARCH REGARDING PREVALENCE AND
PATTERN OF AUTISM
Sec. 211. Short title.
Sec. 212. Developmental disabilities surveillance and research programs.
Sec. 213. Clearinghouse.
Sec. 214. Advisory committee.
Sec. 215. Report to Congress.
Sec. 216. Definition.
Sec. 217. Authorization of appropriations.
CHAPTER 2—EXPANSION, INTENSIFICATION, AND COORDINATION OF ACTIVI-
TIES OF DEPARTMENT OF HEALTH AND HUMAN SERVICES WITH RESPECT
TO AUTISM
Sec. 218. Short title.
Sec. 218A. Expansion, intensification, and coordination of activities of National
Institutes of Health.
Sec. 219. Developmental disabilities surveillance and research programs.
Sec. 220. Information and education.
Sec. 220A. Interagency autism coordinating committee.
Sec. 220B. Report to Congress.
Subtitle C—Poison Control Center Enhancement and Awareness
Sec. 221. Short title.
Sec. 222. Definition.
Sec. 223. Establishment of a national toll-free number.
Sec. 224. Establishment of nationwide media campaign.
Sec. 225. Establishment of a grant program.
Subtitle D—Birth Defects Prevention Activities
CHAPTER 1—FOLIC ACID PROMOTION
Sec. 231. Short title.
Sec. 232. Program regarding effects of folic acid in prevention of birth defects.
CHAPTER 2—NATIONAL CENTER ON BIRTH DEFECTS AND DEVELOPMENTAL
DISABILITIES
Sec. 236. National Center on Birth Defects and Developmental Disabilities.
Subtitle E—Safe Motherhood Monitoring and Prevention Research
Sec. 241. Short title.
Sec. 242. Amendment to Public Health Service Act.
Subtitle F—Pregnant Mothers and Infants Health Promotion
Sec. 251. Short title.
Sec. 252. Establishment.
Subtitle G—Utilization of Preventive Health Services
Sec. 261. Grants regarding utilization of preventive health services.
Subtitle H—Research and Development Regarding Fragile X
Sec. 266. Short title.
Sec. 267. National Institute of Child Health and Human Development; re-
search on fragile X.
Sec. 268. National Institute of Child Health and Human Development; loan re-
payment program regarding research on fragile X.
Subtitle I—Children and Epilepsy
Sec. 271. Programs of the Centers for Disease Control and Prevention; national
public health campaign on epilepsy.
Sec. 272. Programs of Health Resources and Services Administration; State
and local grants for seizure disorder demonstration projects in
medically underserved areas.
Sec. 273. Definitions.
Subtitle J—Asthma Treatment Services for Children
Sec. 276. Short title.
Sec. 277. Children’s asthma relief.
Sec. 278. Incorporation of asthma prevention treatment and services into State
children’s health insurance programs.
Sec. 279. Preventive health and health services block grant; systems for reduc-
ing asthma and asthma-related illnesses through urban cock-
roach management.
Sec. 279A. Coordination of Federal activities to address asthma-related health
care needs.
Sec. 279B. Compilation of data by the Centers for Disease Control and Preven-
tion.
Subtitle K—Juvenile Arthritis and Related Conditions
Sec. 281. Research on juvenile arthritis and related conditions.
Subtitle L—Childhood Skeletal Malignancies
Sec. 286. Programs of Centers for Disease Control and Prevention.
Subtitle M—Reducing Burden of Diabetes Among Children and Youth
Sec. 291. Programs regarding diabetes in children and youth.
Subtitle N—Miscellaneous Provisions
Sec. 296. Report regarding research on rare diseases in children.
TITLE I—REVISION AND
EXTENSION OF PROGRAMS
Subtitle A—Pediatric Research
Initiative
SEC. 101. SHORT TITLE.
This subtitle may be cited as the ‘‘Pediatric Research
Initiative Act of 1999’’.
SEC. 102. ESTABLISHMENT OF A PEDIATRIC RESEARCH INI-
TIATIVE.
Part A of title IV of the Public Health Service Act
(42 U.S.C. 281 et seq.) is amended by adding at the end
the following:
‘‘SEC. 404F. PEDIATRIC RESEARCH INITIATIVE.
‘‘(a) ESTABLISHMENT.—The Secretary shall estab-
lish within the Office of the Director of NIH a Pediatric
Research Initiative (referred to in this section as the ‘Ini-
tiative’). 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 to
encourage—
‘‘(1) increased support for pediatric biomedical
research within the National Institutes of Health to
ensure that the expanding opportunities for advance-
ment in scientific investigations and care for chil-
dren are realized;
‘‘(2) enhanced collaborative efforts among the
Institutes to support multidisciplinary research in
the areas that the Director deems most promising;
and
‘‘(3) the development of adequate pediatric clin-
ical trials and pediatric use information to promote
the safer and more effective use of prescription
drugs in the pediatric population.
‘‘(c) DUTIES.—In carrying out subsection (b), the Di-
rector of NIH shall—
‘‘(1) consult with the Institute of Child Health
and Human Development and the other Institutes,
in considering their requests for new or expanded
pediatric research efforts, and consult with other ad-
visors as the Director determines appropriate;
‘‘(2) have broad discretion in the allocation of
any Initiative assistance among the Institutes,
among types of grants, and between basic and clin-
ical research so long as the—
‘‘(A) assistance is directly related to the ill-
nesses and conditions of children; and
‘‘(B) assistance is extramural in nature;
and
‘‘(3) be responsible for the oversight of any
newly appropriated Initiative funds and annually re-
port to Congress and the public on the extent of the
total extramural support for pediatric research
across the NIH, including the specific support and
research awards allocated through the Initiative.
‘‘(d) AUTHORIZATION.—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 through 2003.
‘‘(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 pur-
poses of the Initiative under this section.’’.
SEC. 
103. 
INVESTMENT 
IN 
TOMORROW’S 
PEDIATRIC
RESEARCHERS.
Subpart 7 of part C of title IV of the Public Health
Service Act (42 U.S.C. 285g et seq.) is amended by adding
at the end the following:
‘‘SEC. 452E. INVESTMENT IN TOMORROW’S PEDIATRIC
RESEARCHERS.
‘‘(a) IN GENERAL.—The Secretary shall make avail-
able within the National Institute of Child Health and
Human Development enhanced support for extramural ac-
tivities relating to the training and career development of
pediatric researchers.
‘‘(b) PURPOSE.—The purpose of support provided
under subsection (a) shall be to ensure the future supply
of researchers dedicated to the care and research needs
of children by providing for—
‘‘(1) an increase in the number and size of in-
stitutional training grants to medical school pedi-
atric departments and children’s hospitals; and
‘‘(2) an increase in the number of career devel-
opment awards for pediatricians building careers in
pediatric basic and clinical research.
‘‘(c) AUTHORIZATION.—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 through 2003.’’.
Subtitle B—Other Programs
SEC. 111. CHILDHOOD IMMUNIZATIONS.
Section 317(j)(1) of the Public Health Service Act
(42 U.S.C. 247b(j)(1)) is amended in the first sentence
by striking ‘‘1998’’ and all that follows and inserting
‘‘1998 through 2003.’’.
SEC. 112. 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 2003.’’.
SEC. 113. PREVENTION AND CONTROL OF INJURIES; TRAU-
MATIC BRAIN INJURY.
Section 394A of the Public Health Service Act (42
U.S.C. 280b–3) is amended by striking ‘‘and’’ after
‘‘1994’’ and by inserting before the period the following:
‘‘, and such sums as may be necessary for each of the
fiscal years 2000 through 2003.’’.
TITLE II—CHILDREN’S HEALTH
RESEARCH AND PREVENTION
ACTIVITIES
Subtitle A—Early Detection, Diag-
nosis, and Treatment Regarding
Hearing Loss in Infants
SEC. 201. SHORT TITLE.
This subtitle may be cited as the ‘‘Newborn and In-
fant Hearing Screening and Intervention Act of 1999’’.
SEC. 202. EARLY DETECTION, DIAGNOSIS, AND INTERVEN-
TIONS FOR NEWBORNS AND INFANTS WITH
HEARING LOSS.
(a) DEFINITIONS.—For the purposes of this subtitle
only, the following terms in this section are defined as fol-
lows:
(1) HEARING
SCREENING.—Newborn and in-
fant hearing screening consists of objective physio-
logic procedures to detect possible hearing loss and
to identify newborns and infants who, after re-
screening, require further audiologic and medical
evaluations.
(2) 
AUDIOLOGIC
EVALUATION.—Audiologic
evaluation consists of 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 treat-
ment and referral options. Referral options should
include linkage to state IDEA Part C coordinating
agencies or other appropriate agencies, medical eval-
uation, 
hearing 
aid/sensory 
aid 
assessment,
audiologic rehabilitation treatment, national and
local consumer, self-help, parent, and education or-
ganizations, and other family-centered services.
(3) MEDICAL EVALUATION.—Medical evaluation
by a physician consists of key components including
history, examination, and medical decision making
focused on symptomatic and related body systems
for the purpose of diagnosing the etiology of hearing
loss and related physical conditions, and for identi-
fying appropriate treatment and referral options.
(4) MEDICAL
INTERVENTION.—Medical inter-
vention is the process by which a physician provides
medical diagnosis and direction for medical and/or
surgical treatment options of hearing loss and/or re-
lated medical disorder associated with hearing loss.
(5) AUDIOLOGIC REHABILITATION.—Audiologic
rehabilitation (intervention) consists of procedures,
techniques, and technologies to facilitate the recep-
tive and expressive communication abilities of a child
with hearing loss.
(6) EARLY INTERVENTION.—Early intervention
(e.g., nonmedical) means providing appropriate serv-
ices for the child with hearing loss 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 oppor-
tunity to consider the full range of educational and
program placements and options for their child.
(b) PURPOSES.—The purposes of this subtitle are to
clarify the authority within the Public Health Service Act
to authorize statewide newborn and infant hearing screen-
ing, evaluation and intervention programs and systems,
technical assistance, a national applied research program,
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 evalua-
tions should be conducted by 3 months for all
newborns and infants suspected of having hearing
loss to allow appropriate referral and provisions for
audiologic rehabilitation, medical and early interven-
tion 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 inter-
vention options that ensures linkage to any new and
existing state-wide systems of intervention and reha-
bilitative services for newborns and infants with
hearing loss.
(5) Public policy in regard to newborn and in-
fant hearing screening and intervention should be
based on applied research and the recognition that
newborns, infants, toddlers, and children who are
deaf or hard-of-hearing have unique language, learn-
ing, and communication needs, and should be the re-
sult of consultation with pertinent public and private
sectors.
(c) STATEWIDE NEWBORN AND INFANT HEARING
SCREENING, EVALUATION
AND
INTERVENTION
PRO-
GRAMS
AND SYSTEMS.—The Secretary of Health and
Human Services (in this subtitle referred to as 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 systems for the following pur-
poses:
(1) To develop and monitor the efficacy of
state-wide newborn and infant hearing screening,
evaluation and intervention programs and systems.
Early intervention includes referral to schools and
agencies, including community, consumer, and par-
ent-based agencies and organizations and other pro-
grams mandated by Part C of the Individuals with
Disabilities Education Act, which offer programs
specifically designed to meet the unique language
and communication needs of deaf and hard of hear-
ing 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 evaluation and policy develop-
ment.
(d) TECHNICAL ASSISTANCE, DATA MANAGEMENT,
AND APPLIED RESEARCH.—
(1) CENTERS FOR DISEASE CONTROL AND PRE-
VENTION.—The Secretary, acting through the Direc-
tor of the Centers for Disease Control and Preven-
tion, 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 new-
born and infant hearing loss screening, evalua-
tion, and intervention programs 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, evalua-
tion and intervention programs and systems
conducted by State-based programs in order to
answer issues of importance to state and na-
tional policymakers;
(D) to identify the causes and risk factors
for congenital 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
(F) to promote the sharing of data regard-
ing early hearing loss with state-based birth de-
fects and developmental disabilities monitoring
programs for the purpose of identifying pre-
viously 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 clin-
ical studies of screening methods, studies on efficacy
of intervention, and related research.
(e) 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 Treat-
ment 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 In-
dividuals with Disabilities Education Act); consumer
groups of and that serve individuals who are deaf
and hard-of-hearing and their families; appropriate
national medical and other health and education spe-
cialty organizations; persons who are deaf and hard-
of-hearing and their families; other qualified profes-
sional 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 Adminis-
trator of the Health Resources and Services Admin-
istration, the Director of the Centers for Disease
Control and Prevention, and the Director of the Na-
tional Institutes of Health shall coordinate and col-
laborate 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 COL-
LECTION.—The Administrator of the Health Re-
sources and Services Administration and the Direc-
tor of the Centers for Disease Control and Preven-
tion shall coordinate and collaborate in assisting
States to establish newborn and infant hearing
screening, evaluation and intervention programs and
systems under subsection (c) and to develop a data
collection system under subsection (d).
(f) RULE OF CONSTRUCTION.—Nothing in this sub-
title shall be construed to preempt any State law.
(g) AUTHORIZATION OF APPROPRIATIONS.—
(1) STATEWIDE NEWBORN AND INFANT HEAR-
ING SCREENING, EVALUATION AND INTERVENTION
PROGRAMS AND SYSTEMS.—For the purpose of car-
rying out subsection (c), there are authorized to be
appropriated to the Health Resources and Services
Administration such sums as may be necessary for
each of the fiscal years 2000 through 2003.
(2) TECHNICAL
ASSISTANCE, DATA
MANAGE-
MENT, AND APPLIED RESEARCH; CENTERS FOR DIS-
EASE CONTROL AND PREVENTION.—For the purpose
of carrying out subsection (d)(1), there are author-
ized to be appropriated to the Centers for Disease
Control and Prevention such sums as may be nec-
essary for each of the fiscal years 2000 through
2003.
(3) TECHNICAL
ASSISTANCE, DATA
MANAGE-
MENT, AND APPLIED RESEARCH; NATIONAL INSTI-
TUTE ON DEAFNESS AND OTHER COMMUNICATION
DISORDERS.—For the purpose of carrying out sub-
section (d)(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 each of the fiscal years 2000
through 2003.
Subtitle B—Autism
CHAPTER 
1—SURVEILLANCE 
AND 
RE-
SEARCH 
REGARDING 
PREVALENCE
AND PATTERN OF AUTISM
SEC. 211. SHORT TITLE.
This chapter may be cited as the ‘‘Autism Statistics,
Surveillance, Research, and Epidemiology Act of 1999
(ASSURE)’’.
SEC. 212. DEVELOPMENTAL DISABILITIES SURVEILLANCE
AND RESEARCH PROGRAMS.
(a) NATIONAL AUTISM AND PERVASIVE DEVELOP-
MENTAL DISABILITIES SURVEILLANCE PROGRAM.—The
Secretary of Health and Human Services (in this chapter
referred to as the ‘‘Secretary’’), acting through the Direc-
tor of the Centers for Disease Control and Prevention,
may make awards of grants and cooperative agreements
for the collection, analysis, and reporting of data on au-
tism and pervasive developmental disabilities. An entity
may receive such an award only if the entity is a public
or nonprofit private entity (including health departments
of States and political subdivisions of States, and includ-
ing universities and other educational entities). In making
such awards, the Secretary may provide direct technical
assistance in lieu of cash.
(b) CENTERS OF EXCELLENCE IN AUTISM AND PER-
VASIVE
DEVELOPMENTAL
DISABILITIES
EPIDEMI-
OLOGY.—
(1) 
IN
GENERAL.—The 
Secretary, 
acting
through the Director of the Centers for Disease
Control and Prevention, shall (subject to the extent
of amounts made available in appropriations Acts)
establish not less than three, and not more than five,
regional centers of excellence in autism and perva-
sive developmental disabilities epidemiology for the
purpose of collecting and analyzing information on
the number, incidence, correlates, and causes of au-
tism and related developmental disabilities.
(2) RECIPIENTS OF AWARDS FOR ESTABLISH-
MENT OF CENTERS.—Centers under paragraph (1)
shall be established and operated through the award
of grants or cooperative agreements to public or
nonprofit private entities that conduct research, in-
cluding 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 to the Secretary an applica-
tion 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 re-
port autism and pervasive developmental dis-
abilities 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 disabil-
ities;
(B) The center will assist with the develop-
ment and coordination of State autism and per-
vasive developmental disabilities surveillance ef-
forts within a region;
(C) The center will provide education,
training, and clinical skills improvement for
health professionals aimed at better under-
standing and treatment of autism and related
developmental disabilities; and
(D) The center will identify eligible cases
and controls through its surveillance systems
and conduct research into factors which may
cause autism and related developmental disabil-
ities; each program will develop or extend an
area of special research expertise (including,
but not limited to, genetics, environmental ex-
posure to contaminants, immunology, and other
relevant research specialty areas).
SEC. 213. CLEARINGHOUSE.
The Secretary, acting through the Director of the
Centers for Disease Control and Prevention, shall carry
out the following:
(1) The Centers for Disease Control and Pre-
vention shall serve as the coordinating agency for
autism and pervasive developmental disabilities sur-
veillance activities through the establishment of a
clearinghouse for the collection and storage of data
generated from the monitoring programs created by
this chapter. 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 developmental disabil-
ities.
(2) The Secretary, acting through the Centers
for Disease Control and Prevention, shall coordinate
the Federal response to requests for assistance from
State health department officials regarding potential
or alleged autism or developmental disability clus-
ters.
SEC. 214. ADVISORY COMMITTEE.
(a) IN GENERAL.—The Secretary shall establish an
Advisory Committee for Autism and Pervasive Develop-
mental Disabilities Epidemiology Research (in this section
referred to as the ‘‘Committee’’). The Committee shall
provide advice and recommendations to the Director of the
Centers for Disease Control and Prevention on—
(1) the establishment of a national autism and
pervasive developmental disabilities surveillance pro-
gram;
(2) the establishment of centers of excellence in
autism and pervasive developmental disabilities epi-
demiology;
(3) methods and procedures to more effectively
coordinate government and non-government pro-
grams and research on autism and pervasive devel-
opmental disabilities epidemiology; and
(4) the effective operation of autism and perva-
sive developmental disabilities epidemiology research
activities.
(b) COMPOSITION.—
(1) IN
GENERAL.—The Committee shall be
composed of ex officio members in accordance with
paragraph (2) and 11 appointed members in accord-
ance with paragraph (3).
(2) EX OFFICIO MEMBERS.—The following offi-
cials shall serve as ex officio members of the Com-
mittee:
(A) The Director of the National Center
for Environmental Health.
(B) The Assistant Administrator of the
Agency for Toxic Substances and Disease Reg-
istry.
(C) The Director of the National Institute
of Child Health and Human Development.
(D) The Director of the National Institute
of Neurological Disorders and Stroke.
(3) APPOINTED
MEMBERS.—Appointments to
the Committee shall be made in accordance with the
following:
(A) Two members shall be research sci-
entists with demonstrated achievements in re-
search related to autism and related develop-
mental disabilities. The scientists shall be ap-
pointed by the Secretary in consultation with
the National Academy of Sciences.
(B) Five members shall be representatives
of the five national organizations whose primary
emphasis is on research into autism and other
pervasive developmental disabilities. One rep-
resentative from each of such organizations
shall be appointed by the Secretary in consulta-
tion with the National Academy of Sciences.
(C) Two members shall be clinicians whose
practice is primarily devoted to the treatment of
individuals with autism and other pervasive de-
velopmental disabilities. The clinicians shall be
appointed by the Secretary in consultation with
the Institute of Medicine and the National
Academy of Sciences.
(D) Two members shall be individuals who
are the parents or legal guardians of a person
or persons with autism or other pervasive devel-
opmental disabilities. The individuals shall be
appointed by the Secretary in consultation with
the ex officio members under paragraph (1) and
the five national organizations referred to in
subparagraph (B).
(c) ADMINISTRATIVE SUPPORT; TERMS OF SERVICE;
OTHER PROVISIONS.—The following apply with respect to
the Committee:
(1) The Committee shall receive necessary and
appropriate administrative support from the Depart-
ment of Health and Human Services.
(2) Members of the Committee shall be ap-
pointed for a term of three years, and may serve for
an unlimited number of terms if reappointed.
(3) The Committee shall meet no less than two
times per year.
(4) Members of the Committee shall not receive
additional compensation for their service. Such
members may receive reimbursement for appropriate
and additional expenses that are incurred through
service on the Committee which would not have in-
curred had they not been a member of the Com-
mittee.
SEC. 215. REPORT TO CONGRESS.
The Secretary shall prepare and submit to the Con-
gress, after consultation and comment by the Advisory
Committee, an annual report regarding the prevalence and
incidence of autism and other pervasive developmental dis-
orders, the results of research into the etiology of autism
and other pervasive developmental disorders, public health
responses to known or preventable causes of autism and
other pervasive developmental disorders, and the need for
additional research into promising lines of scientific in-
quiry.
SEC. 216. DEFINITION.
For purposes of this chapter, 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 Is-
lands.
SEC. 217. AUTHORIZATION OF APPROPRIATIONS.
For the purpose of carrying out this chapter, there
are authorized to be appropriated such sums as may be
necessary for each of the fiscal years 2000 through 2003.
CHAPTER 
2—EXPANSION, 
INTENSIFICA-
TION, AND COORDINATION OF ACTIVI-
TIES OF DEPARTMENT OF HEALTH
AND HUMAN SERVICES WITH RESPECT
TO AUTISM
SEC. 218. SHORT TITLE.
This Act may be cited as the ‘‘Advancement in Pedi-
atric Autism Research Act of 1999’’.
SEC. 218A. EXPANSION, INTENSIFICATION, AND COORDINA-
TION OF ACTIVITIES OF NATIONAL INSTI-
TUTES OF HEALTH.
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:
‘‘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, and coordinate the activities
of the National Institutes of Health with respect to
research on autism.
‘‘(2) ADMINISTRATION OF PROGRAM; COLLABO-
RATION AMONG AGENCIES.—The Director shall carry
out this section acting through the Director of the
National Institute of Mental Health and in collabo-
ration with any other agencies that the Director de-
termines appropriate.
‘‘(b) CENTERS OF EXCELLENCE.—
‘‘(1) IN GENERAL.—The Director shall under
subsection (a)(1) make awards of grants and con-
tracts to public or nonprofit private entities to pay
all or part of the cost of planning, establishing, im-
proving, and providing basic operating support for
centers of excellence regarding research on autism.
‘‘(2) RESEARCH.—Each center under para-
graph (1) shall conduct basic and clinical research
into autism. Such research should include investiga-
tions into the cause, diagnosis, early detection, pre-
vention, control, and treatment of autism. These
centers, as a group, shall conduct research including
but not limited to the fields of developmental
neurobiology, genetics, and psychopharmacology.
‘‘(3) SERVICES FOR PATIENTS.—A center under
paragraph (1) may expend amounts provided under
such paragraph to carry out a program to make in-
dividuals aware of opportunities to participate as
subjects in research conducted by the centers. The
program may, in accordance with such criteria as
the Director may establish, provide to such subjects
referrals for health and other services, and such pa-
tient care costs as are required for research. The ex-
tent to which the center can demonstrate availability
and access to clinical services shall be considered by
the Director in decisions about awarding the grants
to applicants which meet the scientific criteria for
funding.
‘‘(4) COORDINATION OF CENTERS; REPORTS.—
The Director shall, as appropriate, provide for the
coordination of information among centers under
paragraph (1) and ensure regular communication
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 cen-
ter 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.
‘‘(6) NUMBER OF CENTERS; DURATION OF SUP-
PORT.—The Director shall provide for the establish-
ment of not less than five centers under paragraph
(1). Support of such a center may be for a period
not exceeding 5 years. Such period may be extended
for one or more additional periods not exceeding 5
years if the operations of such center have been re-
viewed 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 subsection (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, pre-
served, and made available for such research. The pro-
gram shall be carried out in accordance with accepted sci-
entific and medical standards for the donation, collection,
and preservation of such samples.
‘‘(d) PUBLIC INPUT.—The Director shall under sub-
section (a)(1) provide for means through which the public
can obtain information on the existing and planned pro-
grams 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 pro-
grams and activities.
‘‘(e) FUNDING.—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
through 2003. Such authorizations of appropriations are
in addition to any other authorization of appropriations
that is available for such purpose.’’.
SEC. 219. DEVELOPMENTAL DISABILITIES SURVEILLANCE
AND RESEARCH PROGRAMS.
(a) NATIONAL AUTISM AND PERVASIVE DEVELOP-
MENTAL DISABILITIES SURVEILLANCE PROGRAM.—The
Secretary of Health and Human Services (in this chapter
referred to as the ‘‘Secretary’’), acting through the Direc-
tor of the Centers for Disease Control and Prevention,
may make awards of grants and cooperative agreements
for the collection, analysis, and reporting of data on au-
tism and pervasive developmental disabilities. An entity
may receive such an award only if the entity is a public
or nonprofit private entity (including health departments
of States and political subdivisions of States, and includ-
ing universities and other educational entities). In making
such awards, the Secretary may provide direct technical
assistance in lieu of cash.
(b) CENTERS OF EXCELLENCE IN AUTISM AND PER-
VASIVE
DEVELOPMENTAL
DISABILITIES
EPIDEMI-
OLOGY.—
(1) 
IN
GENERAL.—The 
Secretary, 
acting
through the Director of the Centers for Disease
Control and Prevention, shall establish not less than
3, regional centers of excellence in autism and perva-
sive developmental disabilities epidemiology for the
purpose of collecting and analyzing information on
the number, incidence, correlates, and causes of au-
tism and related developmental disabilities.
(2) RECIPIENTS OF AWARDS FOR ESTABLISH-
MENT OF CENTERS.—Centers under paragraph (1)
shall be established and operated through the award-
ing of grants or cooperative agreements to public or
nonprofit private entities that conduct research, in-
cluding 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 to the Secretary an applica-
tion 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 re-
port autism and pervasive developmental dis-
abilities 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 disabil-
ities.
(B) The center will assist with the develop-
ment and coordination of State autism and per-
vasive developmental disabilities surveillance ef-
forts 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 disabil-
ities. Each program will develop or extend an
area of special research expertise (including ge-
netics, environmental exposure to contaminants,
immunology, and other relevant research spe-
cialty 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 clearing-
house within the Centers for Disease Control and
Prevention for the collection and storage of data
generated from the monitoring programs created by
this chapter. Through the clearinghouse, such Cen-
ters shall serve as the coordinating agency for au-
tism and pervasive developmental disabilities surveil-
lance activities. The functions of such a clearing-
house shall include facilitating the coordination of
research and policy development relating to the epi-
demiology of autism and other pervasive develop-
mental disabilities.
(2) The Secretary, acting through the Centers
for Disease Control and Prevention, shall coordinate
the Federal response to requests for assistance from
State health department officials regarding potential
or alleged autism or developmental disability clus-
ters.
(d) DEFINITION.—In this chapter, 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 Is-
lands, the Virgin Islands, and the Trust Territory of the
Pacific Islands.
(e) 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 through 2003.
SEC. 220. INFORMATION AND EDUCATION.
(a) IN GENERAL.—The Secretary shall establish and
implement a program to provide information and edu-
cation 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 scientists, phy-
sicians, and other health professionals who provide care
for patients with autism.
(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.—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 through 2003.
SEC. 220A. INTERAGENCY AUTISM COORDINATING COM-
MITTEE.
(a) ESTABLISHMENT.—The Secretary shall establish
a committee to be known as the ‘‘Autism Coordinating
Committee’’ (in this section referred to as the ‘‘Com-
mittee’’) to coordinate all efforts within the Department
of Health and Human Services concerning autism, includ-
ing activities carried out through the National Institutes
of Health and the Centers for Disease Control and Pre-
vention under this chapter (and the amendment made by
this chapter).
(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 ap-
propriate by the Secretary, the Secretary may ap-
point to the Committee—
(A) parents or legal guardians of individ-
uals with autism or other pervasive develop-
mental 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 PROVISIONS.—The following shall apply with re-
spect to the Committee:
(1) The Committee shall receive necessary and
appropriate administrative support from the Depart-
ment 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 2
times per year.
SEC. 220B. REPORT TO CONGRESS.
Not later than January 1, 2000, and each January
1 thereafter, the Secretary shall prepare and submit to
the appropriate committees of Congress, a report con-
cerning the implementation of this chapter and the
amendments made by this chapter.
Subtitle C—Poison Control Center
Enhancement and Awareness
SEC. 221. SHORT TITLE.
This subtitle may be cited as the ‘‘Poison Control
Center Enhancement and Awareness Act’’.
SEC. 222. DEFINITION.
For purposes of this subtitle, the term ‘‘Secretary’’
means the Secretary of Health and Human Services.
SEC. 223. ESTABLISHMENT OF A NATIONAL TOLL-FREE
NUMBER.
(a) IN GENERAL.—The Secretary shall provide co-
ordination and assistance to regional poison control cen-
ters for the establishment of a nationwide toll-free phone
number to be used to access such centers.
(b) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed as prohibiting the establishment
or continued operation of any privately funded nationwide
toll-free phone number used to provide advice and other
assistance for poisonings or accidental exposures.
(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 2000 through 2003. Funds appro-
priated under this subsection shall not be used to fund
any toll-free phone number described in subsection (b).
SEC. 
224. 
ESTABLISHMENT 
OF 
NATIONWIDE 
MEDIA
CAMPAIGN.
(a) IN GENERAL.—The Secretary shall establish a
national media campaign to educate the public and health
care providers about poison prevention and the availability
of poison control resources in local communities and to
conduct advertising campaigns concerning the nationwide
toll-free number established under section 223.
(b) CONTRACT WITH ENTITY.—The Secretary may
carry out subsection (a) by entering into contracts with
1 or more nationally recognized media firms for the devel-
opment and distribution of monthly television, radio, and
newspaper public service announcements.
(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 2000 through 2003.
SEC. 225. ESTABLISHMENT OF A GRANT PROGRAM.
(a) REGIONAL POISON CONTROL CENTERS.—The
Secretary shall award grants to certified regional poison
control centers for the purposes of achieving the financial
stability of such centers, and for preventing and providing
treatment recommendations for poisonings.
(b) OTHER IMPROVEMENTS.—The Secretary shall
also use amounts received under this section to—
(1) develop standard education programs;
(2) develop standard patient management pro-
tocols for commonly encountered toxic exposures;
(3) improve and expand the poison control data
collection systems;
(4) improve national toxic exposure surveillance;
and
(5) expand the physician/medical toxicologist
supervision of poison control centers.
(c) CERTIFICATION.—Except as provided in sub-
section (d), the Secretary may make a grant to a center
under subsection (a) only if—
(1) the center has been certified by a profes-
sional organization in the field of poison control, and
the Secretary has approved the organization as hav-
ing in effect standards for certification that reason-
ably provide for the protection of the public health
with respect to poisoning; or
(2) the center has been certified by a State gov-
ernment, and the Secretary has approved the State
government as having in effect standards for certifi-
cation that reasonably provide for the protection of
the public health with respect to poisoning.
(d) WAIVER OF CERTIFICATION REQUIREMENTS.—
(1) IN GENERAL.—The Secretary may grant a
waiver of the certification requirement of subsection
(c) with respect to a noncertified poison control cen-
ter or a newly established center that applies for a
grant under this section if such center can reason-
ably demonstrate that the center will obtain such a
certification within a reasonable period of time as
determined appropriate by the Secretary.
(2) RENEWAL.—The Secretary may only renew
a waiver under paragraph (1) for a period of 3
years.
(e) SUPPLEMENT NOT SUPPLANT.—Amounts made
available to a poison control center under this section shall
be used to supplement and not supplant other Federal,
State, or local funds provided for such center.
(f) MAINTENANCE OF EFFORT.—A poison control
center, in utilizing the proceeds of a grant under this sec-
tion, shall maintain the expenditures of the center for ac-
tivities of the center at a level that is not less than the
level of such expenditures maintained by the center for
the fiscal year preceding the fiscal year for which the
grant is received.
(g) MATCHING REQUIREMENT.—The Secretary may
impose a matching requirement with respect to amounts
provided under a grant under this section if the Secretary
determines appropriate.
(h) 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 through 2003.
Subtitle D—Birth Defects
Prevention Activities
CHAPTER 1—FOLIC ACID
SEC. 231. SHORT TITLE.
This chapter may be cited as the ‘‘Folic Acid Pro-
motion and Birth Defects Prevention Act of 1999’’.
SEC. 232. PROGRAM REGARDING EFFECTS OF FOLIC ACID
IN PREVENTION OF BIRTH DEFECTS.
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:
‘‘EFFECTS OF FOLIC ACID IN PREVENTION OF BIRTH
DEFECTS
‘‘SEC. 317H. (a) IN GENERAL.—The Secretary, act-
ing through the Director of the Centers for Disease Con-
trol and Prevention, shall carry out a program (directly
or through grants or contracts) for the following purposes:
‘‘(1) To provide education and training for
health professionals and the general public for pur-
poses of explaining the effects of folic acid in pre-
venting birth defects and for purposes of encour-
aging each woman of reproductive capacity (whether
or not planning a pregnancy) to consume on a daily
basis a dietary supplement that provides an appro-
priate level of folic acid.
‘‘(2) To conduct research with respect to such
education and training, including identifying effec-
tive strategies for increasing the rate of consumption
of folic acid by women of reproductive capacity.
‘‘(3) To conduct research to increase the under-
standing 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, in-
cluding 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 pri-
vate organizations, health professionals, 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 car-
rying 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 car-
rying out the purposes of the program under such sub-
section, including the effects on various demographic pop-
ulations. Methods of evaluation under the preceding sen-
tence 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 moni-
toring 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 such sums as may be necessary for
each of the fiscal years 2000 through 2003.’’.
CHAPTER 
2—NATIONAL 
CENTER 
ON
BIRTH 
DEFECTS 
AND 
DEVELOP-
MENTAL DISABILITIES
SEC. 236. NATIONAL CENTER ON BIRTH DEFECTS AND
DEVELOPMENTAL DISABILITIES.
Title III of the Public Health Service Act (42 U.S.C.
241 et seq.) is amended—
(1) in part O—
(A) 
by 
redesignating 
sections 
399G
through 399J as sections 399M through 399P,
respectively;
(B) in section 399O(b) (as so redesig-
nated), by striking ‘‘section 399G(d)’’ and in-
serting ‘‘section 399M(d)’’; and
(C) in section 399P (as so redesignated),
by striking ‘‘section 399G(d)(1)’’ and inserting
‘‘section 399M(d)(1)’’; and
(2) by adding at the end the following part:
‘‘PART P—PEDIATRIC PUBLIC HEALTH PROMOTION
‘‘SEC. 399Q. NATIONAL CENTER ON BIRTH DEFECTS AND
DEVELOPMENTAL DISABILITIES.
‘‘(a) ESTABLISHMENT.—There is established within
the Centers for Disease Control and Prevention a center
to be known as the National Center on Birth Defects and
Developmental Disabilities.
‘‘(b) PURPOSE.—The general purpose of the National
Center established under subsection (a) shall be to—
‘‘(1) collect, analyze, and make available data
on birth defects, including data on the causes of
such defects and on the incidence and prevalence of
such defects;
‘‘(2) conduct applied epidemiological research
on the prevention of such defects; and
‘‘(3) provide information and education to the
public on the prevention of such defects.
‘‘(c) DIRECTOR.—The National Center established
under subsection (a) shall be headed by a director to be
appointed by the Secretary.
‘‘(d) TRANSFERS.—There shall be transferred to the
National Center established under subsection (a) all activi-
ties, budgets and personnel of the National Center for En-
vironmental Health that relate to birth defects, folic acid,
cerebral palsy, mental retardation, child development,
newborn screening, autism, fragile X syndrome, fetal alco-
hol syndrome, pediatric genetics, and disability prevention.
‘‘(e) 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 through 2003.’’.
Subtitle E—Safe Motherhood Moni-
toring and Prevention Research
SEC. 241. SHORT TITLE.
This subtitle may be cited as the ‘‘Safe Motherhood
Monitoring and Prevention Research Act’’.
SEC. 242. AMENDMENT TO PUBLIC HEALTH SERVICE ACT.
Title III of the Public Health Service Act, as amend-
ed by section 236 of this Act, is amended by adding at
the end the following part:
‘‘PART Q—SAFE MOTHERHOOD
‘‘SEC. 399R. SAFE MOTHERHOOD MONITORING.
‘‘(a) PURPOSE.—It is the purpose of this section to
develop monitoring systems at the local, State, and na-
tional 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.
‘‘(b) ACTIVITIES.—For the purpose described in sub-
section (a), the Secretary may carry out the following ac-
tivities:
‘‘(1) The Secretary may establish and imple-
ment a national monitoring and surveillance pro-
gram to identify and promote the investigation of
deaths and severe complications that occur during
pregnancy.
‘‘(2) The Secretary may expand the Pregnancy
Risk Assessment Monitoring System to provide sur-
veillance and collect data in each of the 50 States.
‘‘(3) 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 ma-
ternal and child health programs in each of the 50
States.
‘‘(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 2000 through 2003.’’.
‘‘SEC. 399S. PREVENTION RESEARCH TO ENSURE SAFE
MOTHERHOOD.
‘‘(a) PURPOSE.—It is the purpose of this section 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.
‘‘(b) RESEARCH.—The Secretary may carry out ac-
tivities to expand research relating to—
‘‘(1) encouraging preconception counseling, es-
pecially for at risk populations such as diabetics;
‘‘(2) the identification of critical components of
prenatal delivery and postpartum care;
‘‘(3) the identification of outreach and support
services, such as folic acid education, that are avail-
able for pregnant women;
‘‘(4) the identification of women who are at
high risk for complications;
‘‘(5) preventing preterm delivery;
‘‘(6) preventing urinary tract infections;
‘‘(7) preventing unnecessary caesarean sections;
‘‘(8) an examination of the higher rates of ma-
ternal mortality among African American women;
‘‘(9) an examination of the relationship between
domestic violence and maternal complications and
mortality;
‘‘(10) preventing smoking, alcohol and illegal
drug usage before, during and after pregnancy;
‘‘(11) preventing infections that cause maternal
and infant complications; and
‘‘(12) other areas determined appropriate by
the Secretary.
‘‘(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 2000 through 2003.
‘‘SEC. 399T. PREVENTION PROGRAMS TO ENSURE SAFE
MOTHERHOOD.
‘‘(a) IN GENERAL.—The Secretary may carry out ac-
tivities to promote safe motherhood, including—
‘‘(1) public education campaigns on healthy
pregnancies and the building of partnerships with
outside organizations concerned about safe mother-
hood;
‘‘(2) education programs for physicians, nurses
and other health care providers; and
‘‘(3) activities to promote community support
services for pregnant women.
‘‘(b) 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 through 2003.’’.
Subtitle F—Pregnant Mothers and
Infants Health Promotion
SEC. 251. SHORT TITLE.
This subtitle may be cited as the ‘‘Pregnant Mothers
and Infants Health Protection Act’’.
SEC. 252. ESTABLISHMENT.
Title III of the Public Health Service Act, as amend-
ed by section 242 of this Act, is amended by adding at
the end the following part:
‘‘PART R—ADDITIONAL PROGRAMS
‘‘SEC. 399U. PROGRAMS REGARDING PRENATAL AND POST-
NATAL HEALTH.
‘‘(a) IN GENERAL.—The Secretary shall carry out
programs—
‘‘(1) to collect, analyze, and make available data
on prenatal smoking, alcohol and illegal drug usage,
including data on the implications of such activities
and on the incidence and prevalence of such activi-
ties and their implications;
‘‘(2) to conduct applied epidemiological research
on the prevention of prenatal and postnatal smoking,
alcohol and illegal drug usage;
‘‘(3) to support, conduct, and evaluate the ef-
fectiveness of educational and cessation programs;
and
‘‘(4) to provide information and education to
the public on the prevention and implications of pre-
natal and postnatal smoking, alcohol and illegal drug
usage.
‘‘(b) GRANTS.—In carrying out subsection (a), the
Secretary may award grants to and enter into contracts
with States, local governments, scientific and academic in-
stitutions, Federally qualified 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 2000 through 2003.’’.
Subtitle G—Utilization of
Preventive Health Services
SEC. 261. GRANTS REGARDING UTILIZATION OF PREVEN-
TIVE HEALTH SERVICES.
Part D of title III of the Public Health Service Act
(42 U.S.C. 254b et seq.) is amended by adding at the end
the following section:
‘‘SEC. 330D. CENTERS FOR STRATEGIES ON FACILITATING
UTILIZATION OF PREVENTIVE HEALTH SERV-
ICES AMONG VARIOUS POPULATIONS.
‘‘(a) IN GENERAL.—The Secretary, acting through
the appropriate agencies of the Public Health Service,
shall make grants to public or nonprofit private entities
for the establishment and operation of regional centers
whose purpose is to identify particular populations of pa-
tients and facilitate the appropriate utilization of preven-
tive health services by patients in the populations through
developing and disseminating strategies to improve the
methods used by public and private health care programs
and providers in interacting with such patients.
‘‘(b) RESEARCH AND TRAINING.—The activities car-
ried out by a center under subsection (a) may include es-
tablishing programs of research and training with respect
to the purpose described in such subsection, including the
development of curricula for training individuals in imple-
menting the strategies developed under such subsection.
‘‘(c) QUALITY MANAGEMENT.—A condition for the
receipt of a grant under subsection (a) is that the appli-
cant involved agree that, in order to ensure that the strat-
egies developed under such subsection take into account
principles of quality management with respect to con-
sumer satisfaction, the applicant will make arrangements
with one or more private entities that have experience in
applying such principles.
‘‘(d) PRIORITY REGARDING INFANTS
AND CHIL-
DREN.—In carrying out the purpose described in sub-
section (a), the Secretary shall give priority to various
populations of infants, young children, and their mothers.
‘‘(e) EVALUATIONS.—The Secretary, acting through
the appropriate agencies of the Public Health Service,
shall (directly or through grants or contracts) provide for
the evaluation of strategies under subsection (a) in order
to determine the extent to which the strategies have been
effective in facilitating the appropriate utilization of pre-
ventive health services in the populations with respect to
which the strategies were developed.
‘‘(f) 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 through 2003.’’.
Subtitle H—Research and
Development Regarding Fragile X
SEC. 266. SHORT TITLE.
This subtitle may be cited as the ‘‘Fragile X Research
Breakthrough Act of 1999’’.
SEC. 267. NATIONAL INSTITUTE OF CHILD HEALTH AND
HUMAN DEVELOPMENT; RESEARCH ON FRAG-
ILE X.
Subpart 7 of part C of title IV of the Public Health
Service Act, as amended by section 103 of this Act, is
amended by adding at the end the following section:
‘‘FRAGILE X
‘‘SEC. 452F. (a) EXPANSION AND COORDINATION OF
RESEARCH ACTIVITIES.—The Director of the Institute,
after consultation with the advisory council for the Insti-
tute, 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 Insti-
tute, after consultation with the advisory council for
the Institute, shall make grants to, or enter into
contracts with, public or nonprofit private entities
for the development and operation of centers to con-
duct research for the purposes of improving the di-
agnosis and treatment of, and finding the cure for,
fragile X.
‘‘(2) NUMBER OF CENTERS.—In carrying out
paragraph (1), the Director of the Institute shall, to
the extent that amounts are appropriated, provide
for the establishment of at least three fragile X re-
search centers.
‘‘(3) ACTIVITIES.—
‘‘(A) IN GENERAL.—Each center assisted
under paragraph (1) shall, with respect to frag-
ile X—
‘‘(i) conduct basic and clinical re-
search, which may include clinical trials
of—
‘‘(I) new or improved diagnostic
methods; and
‘‘(II) drugs or other treatment
approaches; and
‘‘(ii) conduct research to find a cure.
‘‘(B) FEES.—A center may use funds pro-
vided under paragraph (1) to provide fees to in-
dividuals serving as subjects in clinical trials
conducted under subparagraph (A).
‘‘(4) COORDINATION
AMONG
CENTERS.—The
Director of the Institute shall, as appropriate, pro-
vide for the coordination of the activities of the cen-
ters assisted under this section, including providing
for the exchange of information among the centers.
‘‘(5) 
CERTAIN
ADMINISTRATIVE
REQUIRE-
MENTS.—Each center assisted under paragraph (1)
shall use the facilities of a single institution, or be
formed from a consortium of cooperating institu-
tions, meeting such requirements as may be pre-
scribed by the Director of the Institute.
‘‘(6) DURATION OF SUPPORT.—Support may be
provided to a center under paragraph (1) for a pe-
riod not exceeding 5 years. Such period may be ex-
tended 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
2000 through 2003.’’.
SEC. 268. NATIONAL INSTITUTE OF CHILD HEALTH AND
HUMAN DEVELOPMENT; LOAN REPAYMENT
PROGRAM REGARDING RESEARCH ON FRAG-
ILE X.
Part G of title IV of the Public Health Service Act
(42 U.S.C. 288 et seq.) is amended by inserting after sec-
tion 487E the following section:
‘‘LOAN REPAYMENT PROGRAM REGARDING RESEARCH ON
FRAGILE X
‘‘SEC. 487F. (a) IN GENERAL.—The Secretary, in
consultation with the Director of the National Institute
of Child Health and Human Development, shall establish
a program under which the Federal Government enters
into contracts with qualified health professionals (includ-
ing graduate students) who agree to conduct research re-
garding fragile X in consideration of the Federal Govern-
ment’s agreement to repay, for each year of such service,
not more than $35,000 of the principal and interest of
the educational loans owed by such health professionals.
‘‘(b) APPLICABILITY
OF CERTAIN PROVISIONS.—
With respect to the National Health Service Corps Loan
Repayment Program established in subpart III of part D
of title III, the provisions of such subpart (including sec-
tion 338B(g)(3)) shall, except as inconsistent with sub-
section (a) of this section, apply to the program estab-
lished in such subsection in the same manner and to the
same extent as such provisions apply to the National
Health Service Corps Loan Repayment Program estab-
lished in such subpart.
‘‘(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 2000 through 2003.’’.
Subtitle I—Children and Epilepsy
SEC. 271. PROGRAMS OF THE CENTERS FOR DISEASE CON-
TROL AND PREVENTION; NATIONAL PUBLIC
HEALTH CAMPAIGN ON EPILEPSY.
(a) IN GENERAL.—The Secretary of Health and
Human Services (in this subtitle referred to as the ‘‘Sec-
retary’’), acting through the Director of the Centers for
Disease Control and Prevention, shall develop and imple-
ment public health surveillance, education, research, and
intervention 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 non-
profit private entities. The Secretary may directly or
through such awards provide technical assistance with re-
spect to the planning, development, and operation of such
projects.
(b) CERTAIN
ACTIVITIES.—Activities under sub-
section (a) shall include—
(1) expanding current surveillance activities
through existing monitoring systems and improving
registries that maintain data on individuals with epi-
lepsy, including children;
(2) enhancing research activities on the man-
agement and control of epilepsy;
(3) implementing public and professional infor-
mation and education programs regarding epilepsy,
including initiatives which promote effective manage-
ment and control of the disease through children’s
programs which are targeted to parents, schools,
daycare providers, patients;
(4) undertaking educational efforts with the
media, providers of health care, schools and others
regarding stigmas and secondary disabilities related
to epilepsy and seizures, and also its affects on
youth;
(5) utilizing and expanding partnerships with
organizations with experience addressing the health
and related needs of people with disabilities; and
(6) other activities the Secretary deems appro-
priate.
(c) COORDINATION OF ACTIVITIES.—The Secretary
shall ensure that activities under this section are coordi-
nated as appropriate with other agencies of the Public
Health Service that carry out activities regarding epilepsy
and seizure.
(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 through 2003.
SEC. 272. PROGRAMS OF HEALTH RESOURCES AND SERV-
ICES ADMINISTRATION; STATE AND LOCAL
GRANTS 
FOR 
SEIZURE 
DISORDER 
DEM-
ONSTRATION PROJECTS IN MEDICALLY UN-
DERSERVED AREAS.
(a) IN GENERAL.—The Secretary, acting through the
Administrator of the Health Resources and Services Ad-
ministration, may make grants to States and local govern-
ments for the purpose of carrying out demonstration
projects to improve access to health and other services re-
garding seizures to encourage early detection and treat-
ment in children and others residing in medically under-
served areas.
(b) APPLICATION FOR GRANT.—The Secretary may
make a grant under subsection (a) only if the application
for the grant is submitted to the Secretary and the appli-
cation is in such form, is made in such matter, and con-
tains such agreements, assurances, and information as the
Secretary determines to be necessary to carry out this sec-
tion.
(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 2000 through 2003.
SEC. 273. DEFINITIONS.
For purposes of this subtitle:
(1) The term ‘‘epilepsy’’ refers to a chronic and
serious neurological condition which produces exces-
sive electrical discharges in the brain causing recur-
ring seizures affecting all life activities. The Sec-
retary may revise the definition of such term as the
Secretary.
(2) The term ‘‘medically underserved’’ has the
meaning applicable under section 799B(6) of the
Public Health Service Act.
Subtitle J—Asthma Treatment
Services for Children
SEC. 276. SHORT TITLE.
This subtitle may be cited as the ‘‘Children’s Asthma
Relief Act of 1999’’.
SEC. 277. CHILDREN’S ASTHMA RELIEF.
Title III of the Public Health Service Act, as amend-
ed by section 252 of this Act, is amended by adding at
the end the following:
‘‘PART S—CHILDREN’S ASTHMA RELIEF
‘‘SEC. 399V. ASTHMA TREATMENT GRANTS PROGRAM.
‘‘(a) PURPOSES.—The purposes of this section are as
follows:
‘‘(1) To provide access to quality medical care
for children who live in areas that have a high prev-
alence of asthma and who lack access to medical
care.
‘‘(2) 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 prevent and
treat asthma.
‘‘(3) To decrease preventable trips to the emer-
gency room by making medication available to indi-
viduals who have not previously had access to treat-
ment or education in the prevention of asthma.
‘‘(4) To provide other services, such as smoking
cessation programs, home modification, and other
direct and support services that ameliorate condi-
tions that exacerbate or induce asthma.
‘‘(b) AUTHORITY TO MAKE GRANTS.—
‘‘(1) IN GENERAL.—In addition to any other
payments made under this Act or title V of the So-
cial Security Act, the Secretary shall award grants
to eligible entities to carry out the purposes of this
section, including grants that are designed to de-
velop and expand projects to—
‘‘(A) provide comprehensive asthma serv-
ices to children, including access to care and
treatment for asthma in a community-based
setting;
‘‘(B) fully equip mobile health care clinics
that provide preventive asthma care including
diagnosis, 
physical 
examinations, 
pharma-
cological therapy, skin testing, peak flow meter
testing, and other asthma-related health care
services;
‘‘(C) conduct study validated asthma man-
agement education programs for patients with
asthma and their families, including patient
education regarding asthma management, fam-
ily education on asthma management, and the
distribution of materials, including displays and
videos, to reinforce concepts presented by med-
ical teams; and
age asthma incidence rates and associated mor-
tality rates in the United States). Acceptable
data sets to demonstrate a high prevalence of
childhood asthma or high asthma-related mor-
tality 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 statistics or surveys, or other data that
the Secretary, in consultation with the Director
of the Centers for Disease Control and Preven-
tion, deems appropriate.
‘‘(3) DEFINITION OF ELIGIBLE ENTITY.—For
purposes of this section, the term ‘eligible entity’
means a State agency or other entity receiving funds
under title V of the Social Security Act, a local com-
munity, a nonprofit children’s hospital or founda-
tion, or a nonprofit community-based organization.
‘‘(c) COORDINATION WITH OTHER CHILDREN’S PRO-
GRAMS.—An eligible entity shall identify in the plan sub-
mitted as part of an application for a grant under this
section how the entity will coordinate operations and ac-
tivities under the grant with—
‘‘(1) other programs operated in the State that
serve children with asthma, including any such pro-
grams operated under titles 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 supplemental nutrition program for
women, infants and children (WIC) under sec-
tion 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).
‘‘(d) 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.
‘‘(e) APPLICABILITY OF CERTAIN PROVISIONS.—The
following provisions of title V of the Social Security Act
shall apply to a grant made under this section to the same
extent and in the same manner as such provisions apply
to allotments made under section 502(c) of such Act:
‘‘(1) Section 504(b)(4) (relating to expenditures
of funds as a condition of receipt of Federal funds).
‘‘(2) Section 504(b)(6) (relating to prohibition
on payments to excluded individuals and entities).
‘‘(3) Section 506 (relating to reports and au-
dits, but only to the extent determined by the Sec-
retary to be appropriate for grants made under this
section).
‘‘(4) Section 508 (relating to nondiscrimina-
tion).
‘‘(f) 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 through 2003.’’.
SEC. 
278. 
INCORPORATION 
OF 
ASTHMA 
PREVENTION
TREATMENT 
AND 
SERVICES 
INTO 
STATE
CHILDREN’S 
HEALTH 
INSURANCE 
PRO-
GRAMS.
(a) IN GENERAL.—The Secretary of Health and
Human Services (in this section referred to as the ‘‘Sec-
retary’’) shall, in accordance with subsection (b), carry out
a program to encourage States to implement plans to
carry out activities to assist children with respect to asth-
ma in accordance with guidelines of the National Asthma
Education and Prevention Program (NAEPP) and the
National Heart, Lung and Blood Institute.
(b) RELATION TO CHILDREN’S HEALTH INSURANCE
PROGRAM.—
(1) IN GENERAL.—Subject to paragraph (2), if
a State child health plan under title XXI of the So-
cial Security Act (42 U.S.C. 1397aa et seq.) pro-
vides for activities described in subsection (a) to an
extent satisfactory to the Secretary, the Secretary
shall, with amounts appropriated under subsection
(c), make a grant to the State involved to assist the
State in carrying out such activities.
(2) CRITERIA
REGARDING
ELIGIBILITY
FOR
GRANT; RULE
OF
CONSTRUCTION
REGARDING
AU-
THORITY OF SECRETARY.—The Secretary shall pub-
lish in the Federal Register criteria describing the
circumstances in which the Secretary will consider a
State plan to be satisfactory for purposes of para-
graph (1), subject to the condition that this section
may not be construed as modifying (or authorizing
the Secretary to modify) any requirement or author-
ity established in or under title XXI of the Social
Security Act.
(3) REQUIREMENT OF MATCHING FUNDS.—
(A) IN
GENERAL.—With respect to the
costs of the activities to be carried out by a
State pursuant to paragraph (1), the Secretary
may make a grant under such paragraph only
if the State agrees to make available (directly
or through donations from public or private en-
tities) non-Federal contributions toward such
costs in an amount that is not less than 15 per-
cent of the costs.
(B) DETERMINATION
OF
AMOUNT
CON-
TRIBUTED.—Non-Federal 
contributions 
re-
quired in subparagraph (A) may be in cash or
in kind, fairly evaluated, including equipment or
services. Amounts provided by the Federal Gov-
ernment, or services assisted or subsidized to
any significant extent by the Federal Govern-
ment, may not be included in determining the
amount of such non-Federal contributions.
(4) TECHNICAL ASSISTANCE.—With respect to
State child health plans under title XXI of the So-
cial Security Act (42 U.S.C. 1397aa et seq.), the
Secretary, acting through the Director of the Cen-
ters for Disease Control and Prevention, in consulta-
tion with the heads of other Federal agencies in-
volved in asthma treatment and prevention, shall
make available to the States technical assistance in
developing the provision of such plans that will pro-
vide for activities pursuant to paragraph (1).
(c) FUNDING.—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
through 2003.
SEC. 279. PREVENTIVE HEALTH AND HEALTH SERVICES
BLOCK GRANT; SYSTEMS FOR REDUCING
ASTHMA AND ASTHMA-RELATED ILLNESSES
THROUGH 
URBAN 
COCKROACH 
MANAGE-
MENT.
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 subparagraphs (F) and (G), respectively;
(2) by adding a period at the end of subpara-
graph (G) (as so redesignated);
(3) by inserting after subparagraph (D), the
following:
‘‘(E) The establishment, operation, and coordi-
nation of effective and cost-efficient systems to re-
duce the prevalence of asthma and asthma-related
illnesses among urban populations, especially chil-
dren, by reducing the level of exposure to cockroach
allergen through the use of integrated pest manage-
ment, as applied to cockroaches. Amounts expended
for such systems may include the costs of structural
rehabilitation of housing, public schools, and other
public facilities to reduce cockroach infestation, the
costs of building maintenance, and the costs of pro-
grams to promote community participation in the
carrying out at such sites of integrated pest manage-
ment, as applied to cockroaches. For purposes of
this subparagraph, the term ‘integrated pest man-
agement’ 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)’’.
SEC. 279A. COORDINATION OF FEDERAL ACTIVITIES TO AD-
DRESS 
ASTHMA-RELATED 
HEALTH 
CARE
NEEDS.
(a) IN GENERAL.—The Director of the National
Heart, Lung, and Blood Institute shall, through the Na-
tional Asthma Education Prevention Program Coordi-
nating Committee—
(1) identify all Federal programs that carry out
asthma-related activities;
(2) develop, in consultation with appropriate
Federal agencies and professional and voluntary
health organizations, a Federal plan for responding
to asthma; and
(3) not later than 12 months after the date of
enactment of this Act, submit recommendations to
Congress on ways to strengthen and improve the co-
ordination 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 Pre-
vention 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 2000 through 2003.
SEC. 279B. COMPILATION OF DATA BY THE CENTERS FOR
DISEASE CONTROL AND PREVENTION.
(a) IN GENERAL.—The Director of the Centers for
Disease Control and Prevention, in consultation with the
National Asthma Education Prevention Program Coordi-
nating Committee, shall—
(1) conduct local asthma surveillance activities
to collect data on the prevalence and severity of
asthma and the quality of asthma management,
including—
(A) telephone surveys to collect sample
household data on the local burden of asthma;
and
(B) health care facility specific surveillance
to collect asthma data on the prevalence and se-
verity of asthma, and on the quality of asthma
care; and
(2) compile and annually publish data on—
(A) the prevalence of children suffering
from asthma in each State; and
(B) the childhood mortality rate associated
with asthma nationally and in each State.
(b) COLLABORATIVE EFFORTS.—The activities de-
scribed in subsection (a)(1) may be conducted in collabo-
ration with eligible entities awarded a grant under section
399V of the Public Health Service Act (as added by sec-
tion 277 of this Act).
Subtitle K—Juvenile Arthritis and
Related Conditions
SEC. 281. RESEARCH ON JUVENILE ARTHRITIS AND RE-
LATED CONDITIONS.
(a) ESTABLISHMENT.—The Directors of the National
Institute of Arthritis and Musculoskeletal and Skin Dis-
eases and 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 re-
ferred to in such subsection and consult with the Arthritis
and Musculoskeletal Diseases Interagency Coordinating
Committee.
(c) INFORMATION RESOURCE CENTER.—
(1) IN GENERAL.— In order to assist in car-
rying out the purpose described in subsection (a),
the Director of the National Institutes of Health
shall provide for the establishment of an information
resource center on arthritis and related conditions,
including juvenile arthritis, to facilitate and enhance
knowledge and understanding on the part of pa-
tients, health professionals, and the public through
the effective dissemination of information.
(2) ESTABLISHMENT THROUGH GRANT OR CON-
TRACT.—For the purpose of carrying out paragraph
(1), the Director of the National Institutes of Health
shall enter into a grant, cooperative agreement, or
contract with a national, nonprofit private entity in-
volved in activities regarding the prevention and con-
trol of arthritis and related conditions through the
National Arthritis Action Plan.
(c) PEDIATRIC RHEUMATOLOGY.—The Secretary of
Health and Human Services, acting through the Director
of the National Institutes of Health and the Administrator
of the Health Resources and Services Administration,
shall develop a coordinated effort to ensure that a national
infrastructure is in place to train and develop pediatric
rheumatologists to address the health care services re-
quirements of children with arthritis and related condi-
tions.
(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 through 2003.
Subtitle L—Childhood Skeletal
Malignancies
SEC. 286. PROGRAMS OF CENTERS FOR DISEASE CONTROL
AND PREVENTION.
(a) IN GENERAL.—The Secretary of Health and
Human Services (in this section referred to as the ‘‘Sec-
retary’’), acting through the Director of the Centers for
Disease Control and Prevention, shall study environmental
and other risk factors for childhood skeletal cancers, and
carry out projects to improve outcomes among children
with childhood skeletal cancers and resultant secondary
conditions, including limb loss. Such projects shall be car-
ried out by the Secretary directly and through awards of
grants or contracts to public or nonprofit entities.
(b) CERTAIN
ACTIVITIES.—Activities under sub-
section (a) include—
(1) the expansion of current demographic data
collection and population surveillance efforts to in-
clude childhood skeletal cancers nationally;
(2) the development of a uniform reporting sys-
tem under which treating physicians, hospitals, clin-
ics, and states report the diagnosis of childhood skel-
etal cancers, including relevant associated epidemio-
logical data; and
(3) support for the National Limb Loss Infor-
mation Center to address, in part, the primary and
secondary needs of persons who experience childhood
skeletal cancers in order to prevent or minimize the
disabling nature of these cancers.
(c) COORDINATION OF ACTIVITIES.—The Secretary
shall assure that activities under this section are coordi-
nated as appropriate with other agencies of the Public
Health Service that carry out activities focused on child-
hood cancers and limb loss.
(d) DEFINITION.—For purposes of this section, the
term ‘‘childhood skeletal cancer’’ refers to any malignancy
originating in the connective tissue of a person before skel-
etal maturity including the appendicular and axial skel-
eton. The Secretary may revise the definition of such term
as determined necessary to carry out the intent of this
effort.
(e) 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 through 2003.
Subtitle M—Reducing Burden of
Diabetes Among Children and
Youth
SEC. 291. PROGRAMS REGARDING DIABETES IN CHILDREN
AND YOUTH.
(a) NATIONAL REGISTRY ON JUVENILE DIABETES.—
The Secretary of Health and Human Services (in this sec-
tion referred to as the ‘‘Secretary’’), acting through the
Director of the Centers for Disease Control and Preven-
tion, shall develop a system to collect data on juvenile dia-
betes, including with respect to incidence and prevalence,
and shall establish a national database for such data.
(b) LONG-TERM EPIDEMIOLOGY STUDIES ON JUVE-
NILE DIABETES.—
(1) 
IN
GENERAL.—The 
Secretary, 
acting
through the Director of the National Institutes of
Health, shall conduct or support long-term epidemi-
ology studies in which individuals with type 1, or ju-
venile, diabetes are followed for 10 years or more.
Such studies shall, in order to provide a valuable re-
source for the purposes specified in paragraph (2),
provide for complete characterization of disease
manifestations, appropriate medical history, eluci-
dation of environmental factors, delineation of com-
plications, results of usual medical treatment and a
variety of other potential valuable (such as samples
of blood).
(2) PURPOSES.—The purposes referred to in
paragraph (1) with respect to type 1 diabetes are
the following:
(A) Delineation of potential environmental
triggers thought precipitating or causing type 1
diabetes.
(B) Delineation of those clinical character-
istics or lab measures associated with complica-
tions of the disease.
(C) Potential study population to enter
into clinical trials for prevention and treatment,
as well as genetic studies.
(c) TYPE 2 DIABETES IN YOUTH.—The Secretary,
acting through the Director of the Centers for Disease
Control and Prevention, shall implement a national public
health effort to address type 2 diabetes in youth,
including—
(1) enhancing surveillance systems and expand-
ing research to better assess the prevalence 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) assisting States in establishing coordinated
school health programs and physical activity and nu-
trition demonstration programs to control weight
and increase physical activity among youth.
(d) CLINICAL TRIAL INFRASTRUCTURE/INNOVATIVE
TREATMENTS FOR JUVENILE DIABETES.—The Secretary,
acting through the Director of the National Institutes of
Health, shall support regional clinical centers for the cure
of juvenile diabetes and shall through such centers provide
for—
(1) well-characterized population of children ap-
propriate for study;
(2) well-trained clinical scientists able to con-
duct such trials;
(3) appropriate clinical settings able to house
such studies; and
(4) appropriate statistical capability, data, safe-
ty and other monitoring capacity.
(e) DEVELOPMENT
OF VACCINE.—The Secretary,
acting through the appropriate agencies of the Public
Health Service, shall provide for a national effort to de-
velop a vaccine for type 1 diabetes. Such effort shall pro-
vide for a combination of increased efforts in research and
development of candidate vaccines, coupled with appro-
priate ability to conduct large clinical trials in children.
(f) 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 through 2003.
Subtitle N—Miscellaneous
Provisions
SEC. 296. REPORT REGARDING RESEARCH ON RARE DIS-
EASES IN CHILDREN.
Not later than 180 days after the date of the enact-
ment of this Act, the Director of the National Institutes
of Health shall submit to the Congress a report on—
(1) the activities that, during fiscal year 1999,
were conducted and supported by such Institutes
with respect to rare diseases in children, including
Friedreich’s ataxia; and
(2) the activities that are planned to be con-
ducted and supported by such Institutes with respect
to such diseases during the fiscal years 2000
through 2003.
Æ