106TH CONGRESS
2D SESSION
H. R. 4365
AN ACT
To amend the Public Health Service Act with
respect to children’s health.
106TH CONGRESS
2D SESSION
H. R. 4365
AN ACT
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,
Subtitle B—Prevention Activities
Sec. 521. Preventive health and health services block grant; systems for reduc-
ing asthma-related illnesses through urban cockroach manage-
ment.
Subtitle C—Coordination of Federal Activities
Sec. 531. Coordination through National Institutes of Health.
Subtitle D—Compilation of Data
Sec. 541. Compilation of data by Centers for Disease Control and Prevention.
TITLE VI—BIRTH DEFECTS PREVENTION ACTIVITIES
Subtitle A—Folic Acid Promotion
Sec. 601. Short title.
Sec. 602. Program regarding effects of folic acid in prevention of birth defects.
Subtitle B—National Center on Birth Defects and Developmental Disabilities
Sec. 611. National Center on Birth Defects and Developmental Disabilities.
TITLE VII—EARLY DETECTION, DIAGNOSIS, AND TREATMENT
REGARDING HEARING LOSS IN INFANTS
Sec. 701. Short title.
Sec. 702. Purposes.
Sec. 703. Programs of Health Resources and Services Administration, Centers
for Disease Control and Prevention, and National Institutes of
Health.
TITLE VIII—CHILDREN AND EPILEPSY
Sec. 801. National public health campaign on epilepsy; seizure disorder dem-
onstration projects in medically underserved areas.
TITLE IX—SAFE MOTHERHOOD; INFANT HEALTH PROMOTION
Subtitle A—Safe Motherhood Monitoring and Prevention Research
Sec. 901. Short title.
Sec. 902. Monitoring; prevention research and other activities.
Subtitle B—Pregnant Mothers and Infants Health Promotion
Sec. 911. Short title.
Sec. 912. Programs regarding prenatal and postnatal health.
TITLE X—REVISION AND EXTENSION OF CERTAIN PROGRAMS
Subtitle A—Pediatric Research Initiative
Sec. 1001. Short title.
Sec. 1002. Establishment of pediatric research initiative.
Sec. 1003. Investment in tomorrow’s pediatric researchers.
Subtitle B—Other Programs
Sec. 1011. Childhood immunizations.
Sec. 1012. Screenings, referrals, and education regarding lead poisoning.
TITLE XI—CHILDHOOD SKELETAL MALIGNANCIES
Sec. 1101. Programs of Centers for Disease Control and Prevention and Na-
tional Institutes of Health.
TITLE XII—ADOPTION AWARENESS
Subtitle A—Infant Adoption Awareness
Sec. 1201. Short title.
Sec. 1202. Grants regarding infant adoption awareness.
Subtitle B—Special Needs Adoption Awareness
Sec. 1211. Short title.
Sec. 1212. Special needs adoption programs; public awareness campaign and
other activities.
TITLE XIII—TRAUMATIC BRAIN INJURY
Sec. 1301. Short title.
Sec. 1302. Programs of Centers for Disease Control and Prevention.
Sec. 1303. Programs of National Institutes of Health.
Sec. 1304. Programs of Health Resources and Services Administration.
TITLE XIV—PREVENTION AND CONTROL OF INJURIES
Sec. 1401. Authorization of Appropriations for programs of Centers for Disease
Control and Prevention.
TITLE XV—HEALTHY START INITIATIVE
Sec. 1501. Short title.
Sec. 1502. Continuation of healthy start program.
TITLE XVI—ORAL HEALTH PROMOTION AND DISEASE
PREVENTION
Sec. 1601. Oral health promotion and disease prevention.
TITLE XVII—VACCINE COMPENSATION PROGRAM
Sec. 1701. Short title.
Sec. 1702. Content of petitions.
TITLE XVIII—HEPATITIS C
Sec. 1801. Short title.
Sec. 1802. Surveillance and education regarding hepatitis C.
TITLE XIX—NIH INITIATIVE ON AUTOIMMUNE DISEASES
Sec. 1901. Short title.
Sec. 1902. Juvenile diabetes, juvenile arthritis, lupus, multiple sclerosis, and
other autoimmune-diseases; initiative through Directior of Na-
tional Institutes of Health.
TITLE XX—GRADUATE MEDICAL EDUCATION PROGRAMS IN
CHILDREN’S HOSPITALS
Sec. 2001. Extension of authorization of appropriations.
TITLE XXI—SPECIAL NEEDS OF CHILDREN REGARDING ORGAN
TRANSPLANTATION
Sec. 2101. Short title.
Sec. 2102. Organ Procurement and Transplantation Network; amendments re-
garding needs of children.
TITLE XXII—MISCELLANEOUS PROVISIONS
Sec. 2201. Report regarding research on rare diseases in children.
TITLE XXIII—EFFECTIVE DATE
Sec. 2301. Effective date.
TITLE I—AUTISM
Subtitle A—Surveillance and Re-
search 
Regarding 
Prevalence
and Pattern of Autism
SEC. 101. SHORT TITLE.
This subtitle may be cited as the ‘‘Autism Statistics,
Surveillance, Research, and Epidemiology Act of 2000
(ASSURE)’’.
SEC. 102. SURVEILLANCE AND RESEARCH PROGRAMS;
CLEARINGHOUSE; ADVISORY COMMITTEE.
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:
‘‘SURVEILLANCE AND RESEARCH REGARDING AUTISM
AND PERVASIVE DEVELOPMENTAL DISORDERS
‘‘SEC. 317H. (a) IN GENERAL.—The Secretary , act-
ing through the Director of the Centers for Disease Con-
trol and Prevention, may make awards of grants and coop-
erative agreements for the collection, analysis, and report-
ing of data on autism and pervasive developmental dis-
orders. 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 including universities and other educational
entities). In making such awards, the Secretary may pro-
vide direct technical assistance in lieu of cash.
‘‘(b) CENTERS
OF EXCELLENCE
IN AUTISM
AND
PERVASIVE
DEVELOPMENTAL
DISORDERS
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 disorders epidemiology for the
purpose of collecting and analyzing information on
the number, incidence, correlates, and causes of au-
tism and related developmental disorders.
‘‘(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 ap-
plication containing such agreements and informa-
tion 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
report autism and pervasive developmental dis-
orders data according to guidelines prescribed
by the Director, after consultation with relevant
State and local public health officials, private
sector developmental disorder researchers, and
advocates for those with developmental dis-
orders;
‘‘(B) The center will assist with the devel-
opment and coordination of State autism and
pervasive developmental disorders surveillance
efforts 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 disorders; 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 dis-
orders; 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).
‘‘(c) 
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 disorders sur-
veillance activities through the establishment of a
clearinghouse for the collection and storage of data
generated from the monitoring programs created by
this section. The functions of such a clearinghouse
shall include facilitating the coordination of research
pervasive developmental disorders epidemiology;
and
‘‘(D) the effective operation of autism and
pervasive developmental disorders epidemiology
research activities.
‘‘(2) COMPOSITION.—
‘‘(A) IN GENERAL.—The Committee shall
be composed of ex officio members in accord-
ance with subparagraph (B) and 11 appointed
members in accordance with subparagraph (C).
‘‘(B) EX
OFFICIO
MEMBERS.—The fol-
lowing officials shall serve as ex officio members
of the Committee:
‘‘(i) The Director of the National
Center for Environmental Health.
‘‘(ii) The Assistant Administrator of
the Agency for Toxic Substances and Dis-
ease Registry.
‘‘(iii) The Director of the National In-
stitute of Child Health and Human Devel-
opment.
‘‘(iv) The Director of the National In-
stitute of Neurological Disorders and
Stroke.
‘‘(C) 
APPOINTED
MEMBERS.—Appoint-
ments to the Committee shall be made in ac-
cordance with the following:
‘‘(i) Two members shall be research
scientists with demonstrated achievements
in research related to autism and related
developmental disorders. The scientists
shall be appointed by the Secretary in con-
sultation with the National Academy of
Sciences.
‘‘(ii) Five members shall be represent-
atives of the five national organizations
whose primary emphasis is on research
into autism and other pervasive develop-
mental disorders. One representative from
each of such organizations shall be ap-
pointed by the Secretary in consultation
with the National Academy of Sciences.
‘‘(iii) Two members shall be clinicians
whose practice is primarily devoted to the
treatment of individuals with autism and
other pervasive developmental disorders.
The clinicians shall be appointed by the
Secretary in consultation with the Institute
of Medicine and the National Academy of
Sciences.
‘‘(iv) Two members shall be individ-
uals who are the parents or legal guardians
of a person or persons with autism or
other pervasive developmental disorders.
The individuals shall be appointed by the
Secretary in consultation with the ex offi-
cio members under subparagraph (B) and
the five national organizations referred to
in clause (ii).
‘‘(3) ADMINISTRATIVE
SUPPORT; TERMS
OF
SERVICE; OTHER PROVISIONS.—The following apply
with respect to the Committee:
‘‘(A) The Committee shall receive nec-
essary and appropriate administrative support
from the Department of Health and Human
Services.
‘‘(B) Members of the Committee shall be
appointed for a term of three years, and may
serve for an unlimited number of terms if re-
appointed.
‘‘(C) The Committee shall meet no less
than two times per year.
‘‘(D) Members of the Committee shall not
receive additional compensation for their serv-
ice. Such members may receive reimbursement
for appropriate and additional expenses that are
incurred through service on the Committee
which would not have incurred had they not
been a member of the Committee.
‘‘(e) REPORT TO CONGRESS.—The Secretary shall
prepare and submit to the Congress, after consultation
with and comment by the advisory committee under sub-
section (d), 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.
‘‘(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 2001 through 2005.’’.
Subtitle B—Expansion, Intensifica-
tion, and Coordination of Au-
tism Activities of National Insti-
tutes of Health With Respect to
Autism
SEC. 111. SHORT TITLE.
This subtitle may be cited as the ‘‘Advancement in
Pediatric Autism Research Act of 2000’’.
SEC. 112. EXPANSION, INTENSIFICATION, AND COORDINA-
TION; 
INFORMATION 
AND 
EDUCATION;
INTERAGENCY COORDINATING COMMITTEE.
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 (other than subsection (b)) acting
through the Director of the National Institute of
Mental Health and in collaboration with any other
agencies that the Director determines appropriate.
‘‘(b) INTERAGENCY COORDINATING COMMITTEE.—
‘‘(1) IN GENERAL.—The Secretary shall ensure
that there is in operation an interagency committee
to be known as the ‘Autism Coordinating Com-
mittee’ (referred to in this subsection as the ‘Com-
mittee’) to coordinate all efforts within the Depart-
ment of Health and Human Services concerning au-
tism, including activities carried out through the Na-
tional Institutes of Health under this section and ac-
tivities carried out through the Centers for Disease
Control and Prevention under section 317H.
‘‘(2) MEMBERSHIP.—The Committee shall be
composed of such directors of the national research
institutes, such directors of centers within the Cen-
ters for Disease Control and Prevention, and such
other officials within the Department of Health and
Human Services as the Secretary determines to be
appropriate. The Committee may include representa-
tives of other Federal agencies that serve children
with autism, such as the Department of Education.
‘‘(3) MEETINGS.—The Committee shall meet
not less than twice per year.
‘‘(c) 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), subject to the extent of amounts made available
in appropriations Acts. Support of such a center
may be for a period not exceeding 5 years. Such pe-
riod may be extended for one or more additional pe-
riods not exceeding 5 years if the operations of such
center have been reviewed by an appropriate tech-
nical and scientific peer review group established by
the Director and if such group has recommended to
the Director that such period should be extended.
‘‘(d) 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.
‘‘(e) INFORMATION AND EDUCATION.—
‘‘(1) IN GENERAL.—The Director shall establish
and implement a program to provide information
and education on autism to health professionals and
the general public, including information and edu-
cation on advances in the diagnosis and treatment of
autism and training and continuing education
through programs for scientists, physicians, and
other health professionals who provide care for pa-
tients with autism.
‘‘(2) 
STIPENDS.—The 
Director 
may 
use
amounts made available under this section to pro-
vide stipends for health professionals who are en-
rolled in training programs under this section.
‘‘(f) 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.
‘‘(g) ANNUAL REPORT TO CONGRESS.—The Director
shall prepare and submit to the appropriate committees
of the Congress reports regarding the activities carried out
under this section. The first report shall be submitted not
later than January 10, 2002, and subsequent reports shall
be submitted annually thereafter.
‘‘(h) 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 2001
through 2005. Such authorizations of appropriations are
in addition to any other authorizations of appropriations
that are available for such purpose.’’.
TITLE II—RESEARCH AND DE-
VELOPMENT 
REGARDING
FRAGILE X
SEC. 201. SHORT TITLE.
This title may be cited as the ‘‘Fragile X Research
Breakthrough Act of 2000’’.
SEC. 202. 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 is amended by adding at the end the following
section:
‘‘FRAGILE X
‘‘SEC. 452E. (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
2001 through 2005.’’.
SEC. 203. 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 2001 through 2005.’’.
TITLE III—JUVENILE ARTHRITIS
AND RELATED CONDITIONS
SEC. 301. NATIONAL INSTITUTE OF ARTHRITIS AND MUS-
CULOSKELETAL AND SKIN DISEASES; RE-
SEARCH ON JUVENILE ARTHRITIS AND RE-
LATED CONDITIONS.
Subpart 4 of part C of title IV of the Public Health
Service Act (42 U.S.C. 285d et seq.) is amended by insert-
ing after section 442 the following section:
‘‘JUVENILE ARTHRITIS AND RELATED CONDITIONS
‘‘SEC. 442A. (a) EXPANSION AND COORDINATION OF
ACTIVITIES.—The Director of the Institute, in coordina-
tion with the Director of 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) PEDIATRIC RHEUMATOLOGY.—The Secretary,
acting through the appropriate agencies of the Public
Health Service, shall develop a coordinated effort to help
ensure that a national infrastructure is in place to train
and develop pediatric rheumatologists to address the
health care services requirements of children with arthritis
and related conditions.
‘‘(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 2001 through 2005.’’.
SEC. 302. INFORMATION CLEARINGHOUSE.
Section 438(b) of the Public Health Service Act (42
U.S.C. 285d–3(b)) is amended by inserting ‘‘, including
juvenile arthritis and related conditions,’’ after ‘‘diseases’’.
TITLE IV—REDUCING BURDEN
OF DIABETES AMONG CHIL-
DREN AND YOUTH
SEC. 401. PROGRAMS OF CENTERS FOR DISEASE CONTROL
AND PREVENTION.
Part B of title III of the Public Health Service Act,
as amended by section 102 of this Act, is amended by in-
serting after section 317H the following section:
‘‘DIABETES IN CHILDREN AND YOUTH
‘‘SEC. 317I. (a) NATIONAL REGISTRY ON JUVENILE
DIABETES.—The Secretary , acting through the Director
of the Centers for Disease Control and Prevention, shall
develop a system to collect data on juvenile diabetes, in-
cluding with respect to incidence and prevalence, and shall
establish a national database for such data.
‘‘(b) TYPE 2 DIABETES IN YOUTH.—The Secretary,
acting through the Director of the Centers for Disease
Control and Prevention and in consultation with the Ad-
ministrator of the Health Resources and Services Admin-
istration, shall implement a national public health effort
to address type 2 diabetes in youth, including—
‘‘(1) enhancing surveillance systems and ex-
panding 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;
‘‘(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; and
‘‘(3) developing and improving laboratory meth-
ods to assist in diagnosis, treatment, and prevention
of diabetes including, but not limited to, developing
noninvasive ways to monitor blood glucose to prevent
hypoglycema and improving existing glucometers
that measure blood glucose.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there are authorized
to be appropriated such sums as may be necessary for
each of the fiscal years 2001 through 2005.’’.
SEC. 
402. 
PROGRAMS 
OF 
NATIONAL 
INSTITUTES 
OF
HEALTH.
Subpart 3 of part C of title IV of the Public Health
Service Act (42 U.S.C. 285c et seq.) is amended by insert-
ing after section 434 the following section:
‘‘JUVENILE DIABETES
‘‘SEC. 434A. (a) LONG-TERM EPIDEMIOLOGY STUD-
IES.—
‘‘(1) IN GENERAL.—The Director of the Insti-
tute shall conduct or support long-term epidemiology
studies in which individuals with type 1, or juvenile,
diabetes are followed for 10 years or more. Such
studies shall, in order to provide a valuable resource
for the purposes specified in paragraph (2), provide
for complete characterization of disease manifesta-
tions, appropriate medical history, elucidation of en-
vironmental factors, delineation of complications, re-
sults 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 environ-
mental triggers thought precipitating or causing
type 1 diabetes.
‘‘(B) Delineation of those clinical charac-
teristics or lab measures associated with com-
plications of the disease.
‘‘(C) Potential study population to enter
into clinical trials for prevention and treatment,
as well as genetic studies.
‘‘(b) 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
appropriate 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,
safety and other monitoring capacity.
‘‘(c) 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.
‘‘(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 2001 through 2005.’’.
TITLE V—ASTHMA TREATMENT
SERVICES FOR CHILDREN
SEC. 501. SHORT TITLE.
This title may be cited as the ‘‘Children’s Asthma Re-
lief Act of 2000’’.
Subtitle A—Treatment
SEC. 511. GRANTS FOR CHILDREN’S ASTHMA RELIEF.
Title III of the Public Health Service Act (42 U.S.C.
241 et seq.) is amended by adding at the end the following
part:
‘‘PART P—ADDITIONAL PROGRAMS
‘‘SEC. 399L. CHILDREN’S ASTHMA TREATMENT GRANTS
PROGRAM.
‘‘(a) 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 following pur-
poses:
‘‘(A) To provide access to quality medical
care for children who live in areas that have a
high prevalence of asthma and who lack access
to medical care.
‘‘(B) To provide on-site education to par-
ents, children, health care providers, and med-
ical teams to recognize the signs and symptoms
of asthma, and to train them in the use of
medications to treat asthma and prevent its ex-
acerbations.
‘‘(C) To decrease preventable trips to the
emergency room by making medication available
to individuals who have not previously had ac-
cess to treatment or education in the manage-
ment of asthma.
‘‘(D) To provide other services, such as
smoking cessation programs, home modifica-
tion, and other direct and support services that
ameliorate conditions that exacerbate or induce
asthma.
‘‘(2) CERTAIN
PROJECTS.—In making grants
under paragraph (1), the Secretary may make
grants designed to develop and expand the following
projects:
‘‘(A) Projects to provide comprehensive
asthma services to children in accordance with
the guidelines of the National Asthma Edu-
cation and Prevention Program (through the
National Heart, Lung and Blood Institute), in-
cluding access to care and treatment for asth-
ma in a community-based setting;
‘‘(B) Projects to demonstrate mobile health
care clinics that in accordance with such guide-
lines provide preventive asthma care. Such
projects shall be evaluated and reports describ-
ing the findings of the evaluations shall be sub-
mitted to the Congress.
‘‘(C) Projects to conduct validated asthma
management education programs for patients
with asthma and their families, including pa-
tient education regarding asthma management,
family education on asthma management, and
the distribution of materials, including displays
and videos, to reinforce concepts presented by
medical teams.
‘‘(2) AWARD OF GRANTS.—
‘‘(A) APPLICATION.—
‘‘(i) IN GENERAL.—An eligible entity
shall submit an application to the Sec-
retary for a grant under this section in
such form and manner as the Secretary
may require.
‘‘(ii) REQUIRED
INFORMATION.—An
application submitted under this subpara-
graph shall include a plan for the use of
funds awarded under the grant and such
other information as the Secretary may re-
quire.
‘‘(B) REQUIREMENT.—In awarding grants
under this section, the Secretary shall give pref-
erence to eligible entities that demonstrate that
the activities to be carried out under this sec-
tion shall be in localities within areas of known
or suspected high prevalence of childhood asth-
ma or high asthma-related mortality (relative to
the average asthma prevalence rates and associ-
ated mortality rates in the United States). Ac-
ceptable data sets to demonstrate a high preva-
lence of childhood asthma or high asthma-re-
lated mortality 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 Prevention, 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.
‘‘(b) 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).
‘‘(c) 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.
‘‘(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 2001 through 2005.’’.
SEC. 512. TECHNICAL AND CONFORMING AMENDMENTS.
Title III of the Public Health Service Act (42 U.S.C.
241 et seq.) is amended—
(1) in part L, by redesignating section 399D as
section 399A;
(2) in part M—
(A) 
by 
redesignating 
sections 
399H
through 399L as sections 399B through 399F,
respectively;
(B) in section 399B (as so redesignated),
in subsection (e)—
(i) by striking ‘‘section 399K(b)’’ and
inserting ‘‘subsection (b) of section 399E’’;
and
(ii) by striking ‘‘section 399C’’ and in-
serting ‘‘such section’’;
(C) in section 399E (as so redesignated),
in subsection (c), by striking ‘‘section 399H(a)’’
and inserting ‘‘section 399B(a)’’; and
(D) in section 399F (as so redesignated)—
(i) in subsection (a), by striking ‘‘sec-
tion 399I’’ and inserting ‘‘section 399C’’;
(ii) in subsection (a), by striking
‘‘subsection 399J’’ and inserting ‘‘section
399D’’; and
(iii) in subsection (b), by striking
‘‘subsection 399K’’ and inserting ‘‘section
399E’’;
(3) in part N, by redesignating section 399F as
section 399G; and
(4) in part O—
(A) 
by 
redesignating 
sections 
399G
through 399J as sections 399H through 399K,
respectively;
(B) in section 399H (as so redesignated),
in subsection (b), by striking ‘‘section 399H’’
and inserting ‘‘section 399I’’;
(C) in section 399J (as so redesignated),
in subsection (b), by striking ‘‘section 399G(d)’’
and inserting ‘‘section 399H(d)’’; and
(D) in section 399K (as so redesignated),
by striking ‘‘section 399G(d)(1)’’ and inserting
‘‘section 399H(d)(1)’’.
Subtitle B—Prevention Activities
SEC. 521. PREVENTIVE HEALTH AND HEALTH SERVICES
BLOCK GRANT; SYSTEMS FOR REDUCING
ASTHMA-RELATED 
ILLNESSES 
THROUGH
URBAN COCKROACH MANAGEMENT.
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 building
maintenance and the costs of programs to promote
community participation in the carrying out at such
sites of integrated pest management, as applied to
cockroaches. For purposes of this subparagraph, the
term ‘integrated pest management’ means an ap-
proach to the management of pests in public facili-
ties 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)’’.
Subtitle C—Coordination of
Federal Activities
SEC. 531. COORDINATION THROUGH NATIONAL INSTITUTES
OF HEALTH.
Subpart 2 of part C of title IV of the Public Health
Service Act (42 U.S.C. 285b et seq.) is amended by insert-
ing after section 424A the following section:
‘‘COORDINATION OF FEDERAL ASTHMA ACTIVITIES
‘‘SEC. 424B (a) IN GENERAL.—The Director of In-
stitute shall, through the National Asthma Education Pre-
vention Program Coordinating 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
the enactment of the Children’s Health Act of 2000,
submit recommendations to the appropriate commit-
tees of the Congress on ways to strengthen and im-
prove the coordination 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 2001 through 2005.’’.
Subtitle D—Compilation of Data
SEC. 541. COMPILATION OF DATA BY CENTERS FOR DIS-
EASE CONTROL AND PREVENTION.
Part B of title III of the Public Health Service Act,
as amended by section 401 of this Act, is amended by in-
serting after section 317I the following section:
‘‘COMPILATION OF DATA ON ASTHMA
‘‘SEC. 317J. (a) IN GENERAL.—The Secretary, act-
ing through the Director of the Centers for Disease Con-
trol and Prevention and in consultation with the Director
of the National Heart, Lung, and Blood Institute, shall—
‘‘(1) conduct local asthma surveillance activities
to collect data on the prevalence and severity of
asthma and the quality of asthma management;
‘‘(2) compile and annually publish data on the
prevalence of children suffering from asthma in each
State; and
‘‘(3) to the extent practicable, compile and pub-
lish data on the childhood mortality rate associated
with asthma nationally.
‘‘(b) NATIONAL COORDINATING COMMITTEE.—The
Director of the National Heart, Lung, and Blood Institute
shall in carrying out subsection (a) consult with the Na-
tional Asthma Education Prevention Program Coordi-
nating Committee.
‘‘(c) COLLABORATIVE EFFORTS.—The activities de-
scribed in subsection (a)(1) may be conducted in collabo-
ration with eligible entities awarded a grant under section
399L.’’.
TITLE VI—BIRTH DEFECTS
PREVENTION ACTIVITIES
Subtitle A—Folic Acid
SEC. 601. SHORT TITLE.
This subtitle may be cited as the ‘‘Folic Acid Pro-
motion and Birth Defects Prevention Act of 2000’’.
SEC. 602. PROGRAM REGARDING EFFECTS OF FOLIC ACID
IN PREVENTION OF BIRTH DEFECTS.
Part B of title III of the Public Health Service Act,
as amended by section 541 of this Act, is amended by in-
serting after section 317J the following section:
‘‘EFFECTS OF FOLIC ACID IN PREVENTION OF BIRTH
DEFECTS
‘‘SEC. 317K. (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 2001 through 2005.’’.
Subtitle 
B—National 
Center 
on
Birth 
Defects 
and 
Develop-
mental Disabilities
SEC. 611. NATIONAL CENTER ON BIRTH DEFECTS AND
DEVELOPMENTAL DISABILITIES.
Section 317C of the Public Health Service Act (42
U.S.C. 247b–4) is amended—
(1) by striking the heading for the section and
inserting the following:
‘‘NATIONAL CENTER ON BIRTH DEFECTS AND
DEVELOPMENTAL DISABILITIES’’;
(2) by striking ‘‘SEC. 317C. (a)’’ and all that
follows through the end of subsection (a) and insert-
ing the following:
‘‘SEC. 317C. (a) IN GENERAL.—
‘‘(1) NATIONAL CENTER.—There is established
within the Centers for Disease Control and Preven-
tion a center to be known as the National Center on
Birth Defects and Developmental Disabilities (re-
ferred to in this section as the ‘Center’), which shall
be headed by a director appointed by the Director of
the Centers for Disease Control and Prevention.
‘‘(2) GENERAL
DUTIES.—The Secretary shall
carry out programs—
(A) to collect, analyze, and make available
data on birth defects (in a manner that facili-
tates compliance with subsection (d)(2)), includ-
ing data on the causes of such defects and on
the incidence and prevalence of such defects;
(B) to operate regional centers for the con-
duct of applied epidemiological research on the
prevention of such defects; and
(C) to provide information and education
to the public on the prevention of such defects.
‘‘(3) FOLIC ACID.—The Secretary shall carry
out section 317K through the Center.
‘‘(4) CERTAIN PROGRAMS.—
‘‘(A) 
TRANSFERS.—All 
programs 
and
functions described in subparagraph (B) are
transferred to the Center, effective on the date
of the enactment of the Children’s Health Act
of 2000.
‘‘(B) RELEVANT
PROGRAMS.—The pro-
grams and functions described in this subpara-
graph are all programs and functions that—
‘‘(i) relate to birth defects, folic acid,
cerebral palsy, mental retardation, child
development, newborn screening, autism,
fragile X syndrome, fetal alcohol syndrome,
pediatric genetics, or disability prevention;
and
‘‘(ii) were carried out through the Na-
tional Center for Environmental Health as
of the day before the date of the enactment
of the Act referred to in subparagraph (A).
‘‘(C) RELATED
TRANSFERS.—Personnel
employed in connection with the programs and
functions specified in subparagraph (B), and
amounts available for carrying out the pro-
grams and functions, are transferred to the
Center, effective on the date of the enactment
of the Act referred to in subparagraph (A).
Such transfer of amounts does not affect the
period of availability of the amounts, or the
availability of the amounts with respect to the
purposes for which the amounts may be ex-
pended.’’; and
(3) in subsection (b)(1), in the matter pre-
ceding subparagraph (A), by striking ‘‘(a)(1)’’ and
inserting ‘‘(a)(2)(A)’’.
TITLE VII—EARLY DETECTION,
DIAGNOSIS, AND TREATMENT
REGARDING HEARING LOSS
IN INFANTS
SEC. 701. SHORT TITLE.
This title may be cited as the ‘‘Newborn and Infant
Hearing Screening and Intervention Act of 2000’’.
SEC. 702. PURPOSES.
The purposes of this title are to clarify the authority
within the Public Health Service Act to authorize state-
wide newborn and infant hearing screening, evaluation
and intervention programs and systems, technical assist-
ance, a national applied research program, and inter-
agency and private sector collaboration for policy develop-
ment, in order to assist the States in making progress to-
ward 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.
SEC. 703. PROGRAMS OF HEALTH RESOURCES AND SERV-
ICES ADMINISTRATION, CENTERS FOR DIS-
EASE CONTROL AND PREVENTION, AND NA-
TIONAL INSTITUTES OF HEALTH.
Part P of title III of the Public Health Service Act,
as added by section 511 of this Act, is amended by adding
at the end the following section:
‘‘SEC. 399M. EARLY DETECTION, DIAGNOSIS, AND TREAT-
MENT REGARDING HEARING LOSS IN IN-
FANTS.
‘‘(a) STATEWIDE NEWBORN AND INFANT HEARING
SCREENING, EVALUATION
AND
INTERVENTION
PRO-
GRAMS AND SYSTEMS.—The Secretary, acting through the
Administrator of the Health Resources and Services Ad-
ministration, shall make awards of grants or cooperative
agreements to develop statewide newborn and infant hear-
ing screening, evaluation and intervention programs and
systems for the following purposes:
‘‘(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.
‘‘(b) TECHNICAL ASSISTANCE, DATA MANAGEMENT,
AND APPLIED RESEARCH.—
‘‘(1) CENTERS
FOR
DISEASE
CONTROL
AND
PREVENTION.—The Secretary, acting through the
Director of the Centers for Disease Control and Pre-
vention, 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 re-
garding early hearing loss with State-based
birth defects and developmental disabilities
monitoring programs for the purpose of identi-
fying previously 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.
‘‘(c) 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
COLLECTION.—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 (a) and to develop a data
collection system under subsection (b).
‘‘(d) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to preempt any State law.
‘‘(e) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘audiologic evaluation’ refers to
procedures to assess the status of the auditory sys-
tem; to establish the site of the auditory disorder;
the type and degree of hearing loss, and the poten-
tial effects of hearing loss on communication; and to
identify appropriate treatment and referral options.
Referral options should include linkage to State co-
ordinating agencies under part C of the Individuals
with Disabilities Education Act or other appropriate
agencies, medical evaluation, hearing aid/sensory aid
assessment, audiologic rehabilitation treatment, na-
tional and local consumer, self-help, parent, and
education organizations, and other family-centered
services.
‘‘(2) The terms ‘audiologic rehabilitation’ and
‘audiologic intervention’ refer to procedures, tech-
niques, and technologies to facilitate the receptive
and expressive communication abilities of a child
with hearing loss.
‘‘(3) The term ‘early intervention’ refers to pro-
viding appropriate services for the child with hearing
loss, including nonmedical services, and ensuring
that families of the child are provided comprehen-
sive, consumer-oriented information about the full
range of family support, training, information serv-
ices, communication options and are given the op-
portunity to consider the full range of educational
and program placements and options for their child.
‘‘(4) The term ‘medical evaluation by a physi-
cian’ refers to key components including history, ex-
amination, and medical decision making focused on
symptomatic and related body systems for the pur-
pose of diagnosing the etiology of hearing loss and
related physical conditions, and for identifying ap-
propriate treatment and referral options.
‘‘(5) The term ‘medical intervention’ refers to
the process by which a physician provides medical
diagnosis and direction for medical and/or surgical
treatment options of hearing loss and/or related
medical disorder associated with hearing loss.
‘‘(6) The term ‘newborn and infant hearing
screening’ refers to objective physiologic procedures
to detect possible hearing loss and to identify
newborns and infants who, after rescreening, require
further audiologic and medical evaluations.
‘‘(f) 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 (a), 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 2001 through 2005.
‘‘(2) TECHNICAL ASSISTANCE, DATA MANAGE-
MENT, AND APPLIED RESEARCH; CENTERS FOR DIS-
EASE CONTROL AND PREVENTION.—For the purpose
of carrying out subsection (b)(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 2001 through
2005.
‘‘(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 (b)(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 2001
through 2005.’’.
TITLE VIII—CHILDREN AND
EPILEPSY
SEC. 801. NATIONAL PUBLIC HEALTH CAMPAIGN ON EPI-
LEPSY; SEIZURE DISORDER DEMONSTRATION
PROJECTS 
IN 
MEDICALLY 
UNDERSERVED
AREAS.
Subpart I of part D of title III of the Public Health
Service Act (42 U.S.C. 254b) is amended by adding at
the end the following section:
‘‘SEC. 330E. EPILEPSY; SEIZURE DISORDER.
‘‘(a) NATIONAL PUBLIC HEALTH CAMPAIGN.—
‘‘(1) IN GENERAL.—The Secretary shall develop
and implement public health surveillance, education,
research, and intervention strategies to improve the
lives of persons with epilepsy, with a particular em-
phasis on children. Such projects may be carried out
by the Secretary directly and through awards of
grants or contracts to public or nonprofit private en-
tities. The Secretary may directly or through such
awards provide technical assistance with respect to
the planning, development, and operation of such
projects.
‘‘(2) CERTAIN
ACTIVITIES.—Activities under
paragraph (1) shall include—
‘‘(A) expanding current surveillance activi-
ties through existing monitoring systems and
improving registries that maintain data on indi-
viduals with epilepsy, including children;
‘‘(B) enhancing research activities on pa-
tient management and control of epilepsy;
‘‘(C) implementing public and professional
information and education programs regarding
epilepsy, including initiatives which promote ef-
fective management and control of the disease
through children’s programs which are targeted
to parents, schools, daycare providers, patients;
‘‘(D) undertaking educational efforts with
the media, providers of health care, schools and
others regarding stigmas and secondary disabil-
ities related to epilepsy and seizures, and also
its affects on youth;
‘‘(E) utilizing and expanding partnerships
with organizations with experience addressing
the health and related needs of people with dis-
abilities; and
‘‘(F) other activities the Secretary deems
appropriate.
‘‘(3) COORDINATION OF ACTIVITIES.—The Sec-
retary shall ensure that activities under this sub-
section are coordinated as appropriate with other
agencies of the Public Health Service that carry out
activities regarding epilepsy and seizure.
‘‘(b) 
SEIZURE
DISORDER; 
DEMONSTRATION
PROJECTS IN MEDICALLY UNDERSERVED AREAS.—
‘‘(1) IN
GENERAL.—The Secretary, acting
through the Administrator of the Health Resources
and Services Administration, may make grants to
States and local governments for the purpose of car-
rying out demonstration projects to improve access
to health and other services regarding seizures to en-
courage early detection and treatment in children
and others residing in medically underserved areas.
‘‘(2) APPLICATION FOR GRANT.—The Secretary
may make a grant under paragraph (1) only if the
application for the grant is submitted to the Sec-
retary and the application is in such form, is made
in such matter, and contains such agreements, as-
surances, and information as the Secretary deter-
mines to be necessary to carry out this subsection.
‘‘(c) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘‘epilepsy’’ refers to a chronic
and serious neurological condition which produces
excessive electrical discharges in the brain causing
recurring seizures affecting all life activities. The
Secretary may revise the definition of such term as
the Secretary.
‘‘(2) The term ‘‘medically underserved’’ has the
meaning applicable under section 799B(6).
‘‘(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 2001 through 2005.’’.
TITLE IX—SAFE MOTHERHOOD;
INFANT HEALTH PROMOTION
Subtitle A—Safe Motherhood Moni-
toring and Prevention Research
SEC. 901. SHORT TITLE.
This title may be cited as the ‘‘Safe Motherhood Mon-
itoring and Prevention Research Act’’.
SEC. 902. MONITORING; PREVENTION RESEARCH AND
OTHER ACTIVITIES.
Part B of title III of the Public Health Service Act,
as amended by section 602 of this Act, is amended by in-
serting after section 317K the following section:
‘‘SAFE MOTHERHOOD
‘‘SEC. 317L. (a) MONITORING.—
‘‘(1) PURPOSE.—The purpose of this subsection
is to develop monitoring systems at the local, State,
and national level to better understand the burden
of maternal complications and mortality and to de-
crease the disparities among population at risk of
death and complications from pregnancy.
‘‘(2) ACTIVITIES.—For the purpose described in
paragraph (1), the Secretary may carry out the fol-
lowing activities:
‘‘(A) the Secretary may establish and im-
plement a national monitoring and surveillance
program to identify and promote the investiga-
tion of deaths and severe complications that
occur during pregnancy.
‘‘(B) The Secretary may expand the Preg-
nancy Risk Assessment Monitoring System to
provide surveillance and collect data in each of
the 50 States.
‘‘(C) The Secretary may expand the Ma-
ternal and Child Health Epidemiology Program
to provide technical support, financial assist-
ance, or the time-limited assignment of senior
epidemiologists to maternal and child health
programs in each of the 50 States.
‘‘(b) PREVENTION RESEARCH.—
‘‘(1) PURPOSE.—The purpose of this subsection
is to provide the Secretary with the authority to fur-
ther expand research concerning risk factors, pre-
vention strategies, and the roles of the family, health
care providers and the community in safe mother-
hood.
‘‘(2) RESEARCH.—The Secretary may carry out
activities to expand research relating to—
‘‘(A) 
encouraging 
preconception 
coun-
seling, especially for at risk populations such as
diabetics;
‘‘(B) the identification of critical compo-
nents of prenatal delivery and postpartum care;
‘‘(C) the identification of outreach and
support services, such as folic acid education,
that are available for pregnant women;
‘‘(D) the identification of women who are
at high risk for complications;
‘‘(E) preventing preterm delivery;
‘‘(F) preventing urinary tract infections;
‘‘(G) preventing unnecessary caesarean
sections;
‘‘(H) an examination of the higher rates of
maternal mortality among African American
women;
‘‘(I) an examination of the relationship be-
tween domestic violence and maternal complica-
tions and mortality;
‘‘(J) preventing smoking, alcohol and ille-
gal drug usage before, during and after preg-
nancy;
‘‘(K) preventing infections that cause ma-
ternal and infant complications; and
‘‘(L) other areas determined appropriate
by the Secretary.
‘‘(c) PREVENTION PROGRAMS.—
‘‘(1) IN GENERAL.—The Secretary may carry
out 
activities 
to 
promote 
safe 
motherhood,
including—
‘‘(A) 
public 
education 
campaigns 
on
healthy pregnancies and the building of part-
nerships with outside organizations concerned
about safe motherhood;
‘‘(B) education programs for physicians,
nurses and other health care providers; and
‘‘(C) activities to promote community sup-
port services for pregnant women.
‘‘(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 2001 through 2005.’’.
Subtitle B—Pregnant Mothers and
Infants Health Promotion
SEC. 911. SHORT TITLE.
This subtitle may be cited as the ‘‘Pregnant Mothers
and Infants Health Protection Act’’.
SEC. 912. PROGRAMS REGARDING PRENATAL AND POST-
NATAL HEALTH.
Part B of title III of the Public Health Service Act,
as amended by section 902 of this Act, is amended by in-
serting after section 317L the following section:
‘‘PRENATAL AND POSTNATAL HEALTH
‘‘SEC. 317M. (a) IN GENERAL.—The Secretary, act-
ing through the Director of the Centers for Disease Con-
trol and Prevention, 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 2001 through 2005.’’.
TITLE X—REVISION AND
EXTENSION OF PROGRAMS
Subtitle A—Pediatric Research
Initiative
SEC. 1001. SHORT TITLE.
This subtitle may be cited as the ‘‘Pediatric Research
Initiative Act of 2000’’.
SEC. 1002. ESTABLISHMENT OF PEDIATRIC RESEARCH
INITIATIVE.
Part B of title IV of the Public Health Service Act,
as amended by section 112 of this Act, is amended by add-
ing at the end the following:
‘‘PEDIATRIC RESEARCH INITIATIVE
‘‘SEC. 409D. (a) ESTABLISHMENT.—The Secretary
shall establish within the Office of the Director of NIH
a Pediatric Research Initiative (referred to in this section
as the ‘Initiative’). 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 provide—
‘‘(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 Director of the National
Institute of Child Health and Human Development
and the Directors of the other national research in-
stitutes, in considering their requests for new or ex-
panded pediatric research efforts, and consult with
the Administrator of the Health Resources and Serv-
ices Administration and other advisors as the Direc-
tor determines to be 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
2001 through 2005.
‘‘(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. 
1003. 
INVESTMENT 
IN 
TOMORROW’S 
PEDIATRIC
RESEARCHERS.
Subpart 7 of part C of title IV of the Public Health
Service Act, as amended by section 921 of this Act, is
amended by adding at the end the following:
‘‘INVESTMENT IN TOMORROW’S PEDIATRIC RESEARCHERS
‘‘SEC. 452G. (a) IN GENERAL.—In order to ensure
the future supply of researchers dedicated to the care and
research needs of children, the Director of the Institute,
after consultation with the Administrator of the Health
Resources and Services Administration, shall support ac-
tivities to provide for—
‘‘(1) an increase in the number and size of in-
stitutional training grants to pediatric departments
of medical schools and to children’s hospitals; and
‘‘(2) an increase in the number of career devel-
opment awards for health professionals who are in
pediatric specialties or subspecialties and intend to
build careers in pediatric basic and clinical research.
‘‘(b) 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
2001 through 2005.’’.
Subtitle B—Other Programs
SEC. 1011. 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. 1012. SCREENINGS, REFERRALS, AND EDUCATION RE-
GARDING 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.’’.
TITLE XI—CHILDHOOD
SKELETAL MALIGNANCIES
SEC. 1101. PROGRAMS OF CENTERS FOR DISEASE CONTROL
AND PREVENTION AND NATIONAL INSTI-
TUTES OF HEALTH.
Part P of title III of the Public Health Service Act,
as amended by section 703 of this Act, is amended by add-
ing at the end the following section:
‘‘SEC. 399N. CHILDHOOD SKELETAL MALIGNANCIES.
‘‘(a) IN GENERAL.—The Secretary, acting as appro-
priate through the Director of the Centers for Disease
Control and Prevention and the Director of the National
Institutes of Health, shall study environmental and other
risk factors for childhood skeletal cancers, and carry out
projects to improve outcomes among children with child-
hood skeletal cancers and resultant secondary conditions,
including limb loss. Such projects shall be carried 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
system under which treating physicians, hospitals,
clinics, and states report the diagnosis of childhood
skeletal cancers, including relevant associated epide-
miological 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 for purposes of this section revise
the definition of such term to the extent determined by
the Secretary to be appropriate.
‘‘(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 2001 through 2005.’’.
TITLE XII—ADOPTION
AWARENESS
Subtitle A—Infant Adoption
Awareness
SEC. 1201. SHORT TITLE.
This subtitle may be cited as the ‘‘Infant Adoption
Awareness Act of 2000’’.
SEC. 1202. GRANTS REGARDING INFANT ADOPTION AWARE-
NESS.
Subpart I of part D of title III of the Public Health
Service Act, as amended by section 801 of this Act, is
amended by adding at the end the following section:
‘‘SEC. 330F. CERTAIN SERVICES FOR PREGNANT WOMEN.
‘‘(a) INFANT ADOPTION AWARENESS.—
‘‘(1) IN GENERAL.—The Secretary shall make
grants to national, regional, or local adoption organi-
zations for the purpose of developing and imple-
menting programs to train the designated staff of el-
igible health centers in providing adoption informa-
tion and referrals to pregnant women on an equal
basis with all other courses of action included in
nondirective counseling.
‘‘(2) BEST-PRACTICES GUIDELINES.—
‘‘(A) IN GENERAL.—A condition for the re-
ceipt of a grant under paragraph (1) is that the
adoption organization involved agree that, in
providing training under such paragraph, the
organization will follow the guidelines developed
under subparagraph (B).
‘‘(B) PROCESS
FOR
DEVELOPMENT
OF
GUIDELINES.—
‘‘(i) IN
GENERAL.—The Secretary
shall establish and supervise a process de-
scribed in clause (ii) in which the partici-
pants are—
‘‘(I) an appropriate number and
variety of adoption organizations that,
as a group, have expertise in all mod-
els of adoption practice and that rep-
resent all members of the adoption
triad (birth mother, infant, and adop-
tive parent); and
‘‘(II) affected public health enti-
ties.
‘‘(ii) DESCRIPTION OF PROCESS.—The
process referred to in clause (i) is a proc-
ess in which the participants described in
such clause collaborate to develop best-
practices guidelines on the provision of
adoption information and referrals to preg-
nant women on an equal basis with all
other courses of action included in non-
directive counseling.
‘‘(iii) DATE CERTAIN FOR DEVELOP-
MENT.—The Secretary shall ensure that
the guidelines described in clause (ii) are
developed not later than 180 days after the
date of the enactment of the Children’s
Health Act of 2000.
‘‘(C) 
RELATION
TO
AUTHORITY
FOR
GRANTS.—The Secretary may not make any
grant under paragraph (1) before the date on
which the guidelines under subparagraph (B)
are developed.
‘‘(3) USE OF GRANT.—
‘‘(A) IN
GENERAL.—With respect to a
grant under paragraph (1)—
‘‘(i) an adoption organization may ex-
pend the grant to carry out the programs
directly or through grants to or contracts
with other adoption organizations;
‘‘(ii) the purposes for which the adop-
tion organization expends the grant may
include the development of a training cur-
riculum, consistent with the guidelines de-
veloped under paragraph (2)(B); and
‘‘(iii) a condition for the receipt of the
grant is that the adoption organization
agree that, in providing training for the
designated staff of eligible health centers,
such organization will make reasonable ef-
forts to ensure that the individuals who
provide the training are individuals who
are knowledgeable on the process for
adopting a child and are experienced in
providing adoption information and refer-
rals in the geographic areas in which the
eligible health centers are located, and that
the designated staff receive the training in
such areas.
‘‘(B) RULE OF CONSTRUCTION REGARDING
TRAINING OF TRAINERS.—With respect to indi-
viduals who under a grant under paragraph (1)
provide training for the designated staff of eli-
gible health centers (referred to in this subpara-
graph as ‘trainers’), subparagraph (A)(iii) may
not be construed as establishing any limitation
regarding the geographic area in which the
trainers receive instruction in being such train-
ers. A trainer may receive such instruction in a
different geographic area than the area in
which the trainer trains (or will train) the des-
ignated staff of eligible health centers.
‘‘(4) 
ADOPTION
ORGANIZATIONS; 
ELIGIBLE
HEALTH CENTERS; OTHER DEFINITIONS.—For pur-
poses of this section:
‘‘(A) The term ‘adoption organization’
means 
a 
national, 
regional, 
or 
local
organization—
‘‘(i) among whose primary purposes
are adoption;
‘‘(ii) that is knowledgeable on the
process for adopting a child and on pro-
viding adoption information and referrals
to pregnant women; and
‘‘(iii) that is a nonprofit private enti-
ty.
‘‘(B) The term ‘designated staff’, with re-
spect to an eligible health center, means staff of
the center who provide pregnancy or adoption
information and referrals (or will provide such
information and referrals after receiving train-
ing under a grant under paragraph (1)).
‘‘(C) The term ‘eligible health centers’
means public and nonprofit private entities that
provide health-related services to pregnant
women.
‘‘(5) 
TRAINING
FOR
CERTAIN
ELIGIBLE
HEALTH CENTERS.—A condition for the receipt of a
grant under paragraph (1) is that the adoption orga-
nization involved agree to make reasonable efforts to
ensure that the eligible health centers with respect
to which training under the grant is provided
include—
‘‘(A) eligible health centers that receive
grants under section 1001 (relating to vol-
untary family planning projects);
‘‘(B) eligible health centers that receive
grants under section 330 (relating to commu-
nity health centers, migrant health centers, and
centers regarding homeless individuals and resi-
dents of public housing); and
‘‘(C) eligible health centers that receive
grants under this Act for the provision of serv-
ices in schools.
‘‘(6) PARTICIPATION
OF
CERTAIN
ELIGIBLE
HEALTH CLINICS.—In the case of eligible health cen-
ters that receive grants under section 330 or 1001:
‘‘(A) Within a reasonable period after the
Secretary begins making grants under para-
graph (1), the Secretary shall provide eligible
health centers with complete information about
the training available from organizations receiv-
ing grants under such paragraph. The Sec-
retary shall make reasonable efforts to encour-
age eligible health centers to arrange for des-
ignated staff to participate in such training.
‘‘(B) All costs of such centers in obtaining
the training shall be reimbursed by the organi-
zation that provides the training, using grants
under paragraph (1).
‘‘(C) Not later than one year after the date
of the enactment the Children’s Health Act of
2000, the Secretary shall submit to the appro-
priate committees of the Congress a report eval-
uating the extent to which adoption informa-
tion, and referral upon request, is provided by
eligible health centers. Within a reasonable time
after training under this section is initiated, the
Secretary shall submit to the appropriate com-
mittees of the Congress a report evaluating the
extent to which adoption information, and refer-
ral upon request, is provided by eligible health
centers in order to determine the effectiveness
of such training. In preparing the reports re-
quired by this subparagraph, the Secretary
shall in no respect interpret the provisions of
this section to allow any interference in the pro-
vider-patient relationship, any breach of patient
confidentiality, or any monitoring or auditing of
the counseling process or patient records which
breaches patient confidentiality or reveals pa-
tient identity.
‘‘(b) 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.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there are authorized
to be appropriated such sums as may be necessary for
each of the fiscal years 2001 through 2005.’’.
Subtitle B—Special Needs Adoption
Awareness
SEC. 1211. SPECIAL NEEDS ADOPTION PROGRAMS; PUBLIC
AWARENESS CAMPAIGN AND OTHER ACTIVI-
TIES.
Subpart I of part D of title III of the Public Health
Service Act, as amended by section 1202 of this Act, is
amended by adding at the end the following section:
‘‘SEC. 330G. SPECIAL NEEDS ADOPTION PROGRAMS; PUBLIC
AWARENESS CAMPAIGN AND OTHER ACTIVI-
TIES.
‘‘(a) SPECIAL NEEDS ADOPTION AWARENESS CAM-
PAIGN.—
‘‘(1) 
IN
GENERAL.—The 
Secretary 
shall,
through making grants to nonprofit private entities,
provide for the planning, development, and carrying
out of a national campaign to provide information to
the public regarding the adoption of children with
special needs.
‘‘(2) INPUT
ON
PLANNING
AND
DEVELOP-
MENT.—In providing for the planning and develop-
ment of the national campaign under paragraph (1),
the Secretary shall provide for input from a number
and variety of adoption organizations throughout the
States in order that the full national diversity of in-
terests among adoption organizations is represented
in the planning and development of the campaign.
‘‘(3) CERTAIN FEATURES.—With respect to the
national campaign under paragraph (1):
‘‘(A) The campaign shall be directed at
various populations, taking into account as ap-
propriate differences among geographic regions,
and shall be carried out in the language and
cultural context that is most appropriate to the
population involved.
‘‘(B) The means through which the cam-
paign may be carried out include—
‘‘(i) placing public service announce-
ments on television, radio, and billboards;
and
‘‘(ii) providing information through
means that the Secretary determines will
reach individuals who are most likely to
adopt children with special needs.
‘‘(C) The campaign shall provide informa-
tion on the subsidies and supports that are
available to individuals regarding the adoption
of children with special needs.
‘‘(D) The Secretary may provide that the
placement of public service announcements, and
the dissemination of brochures and other mate-
rials, is subject to review by the Secretary.
‘‘(4) MATCHING REQUIREMENT.—
‘‘(A) IN GENERAL.—With respect to the
costs of the activities to be carried out by an
entity pursuant to paragraph (1), a condition
for the receipt of a grant under such paragraph
is that the entity agree to make available (di-
rectly or through donations from public or pri-
vate entities) non-Federal contributions toward
such costs in an amount that is not less than
25 percent of such costs.
‘‘(B) DETERMINATION
OF
AMOUNT
CON-
TRIBUTED.—Non-Federal contributions under
subparagraph (A) 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 Govern-
ment, may not be included in determining the
amount of such contributions.
‘‘(b) NATIONAL RESOURCES PROGRAM.—The Sec-
retary shall (directly or through grant or contract) carry
out a program that, through toll-free telecommunications,
makes available to the public information regarding the
adoption of children with special needs. Such information
shall include the following:
‘‘(1) A list of national, State, and regional or-
ganizations that provide services regarding such
adoptions, including exchanges and other informa-
tion on communicating with the organizations. The
list shall represent the full national diversity of
adoption organizations.
‘‘(2) Information beneficial to individuals who
adopt such children, including lists of support
groups for adoptive parents and other postadoptive
services.
‘‘(c) OTHER PROGRAMS.—With respect to the adop-
tion of children with special needs, the Secretary shall
make grants—
‘‘(1) to provide assistance to support groups for
adoptive parents, adopted children, and siblings of
adopted children; and
‘‘(2) to carry out studies to identify the reasons
for adoption disruptions.
‘‘(d) APPLICATION FOR GRANT.—The Secretary may
make an award of a grant or contract under this section
only if an application for the award is submitted to the
Secretary and the application is in such form, is made in
such manner, and contains such agreements, assurances,
and information as the Secretary determines to be nec-
essary to carry out this section.
‘‘(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 2001
through 2005.’’.
TITLE XIII—TRAUMATIC BRAIN
INJURY
SEC. 1301. SHORT TITLE.
This title may be cited as the ‘‘Traumatic Brain In-
jury Act Amendments of 2000’’.
SEC. 1302. PROGRAMS OF CENTERS FOR DISEASE CONTROL
AND PREVENTION.
(a) IN GENERAL.—Section 393A of the Public
Health Service Act (42 U.S.C. 280b–1b) is amended—
(1) in subsection (b)—
(A) in paragraph (1), by striking ‘‘and’’ at
the end;
(B) in paragraph (2), by striking the pe-
riod and inserting ‘‘; and’’; and
(C) by adding at the end the following:
‘‘(3) the implementation of a national education
and awareness campaign regarding such injury (in
conjunction with the program of the Secretary re-
garding health-status goals for 2010, commonly re-
ferred to as Healthy People 2010), including the na-
tional dissemination of information on—
‘‘(A) incidence and prevalence;
‘‘(B) secondary conditions arising from
traumatic brain injury upon discharge from
hospitals and trauma centers.’’;
(2) in subsection (d)—
(A) in the second sentence, by striking
‘‘anoxia due to near drowning.’’ and inserting
‘‘anoxia.’’; and
(B) in the third sentence, by inserting be-
fore the period the following: ‘‘, after consulta-
tion with States and other appropriate public or
nonprofit private entities’’.
(b) NATIONAL REGISTRY.—Part J of title III of the
Public Health Service Act (42 U.S.C. 280b et seq.) is
amended by inserting after section 393A the following sec-
tion:
‘‘NATIONAL PROGRAM FOR TRAUMATIC BRAIN INJURY
REGISTRIES
‘‘SEC. 393B. (a) IN GENERAL.—The Secretary, act-
ing through the Director of the Centers for Disease Con-
trol and Prevention, may make grants to States or their
designees to operate the State’s traumatic brain injury
registry, and to academic institutions to conduct applied
research that will support the development of such reg-
istries, to collect data concerning—
‘‘(1) demographic information about each trau-
matic brain injury;
‘‘(2) information about the circumstances sur-
rounding the injury event associated with each trau-
matic brain injury;
‘‘(3) administrative information about the
source of the collected information, dates of hos-
pitalization and treatment, and the date of injury;
and
‘‘(4) information characterizing the clinical as-
pects of the traumatic brain injury, including the se-
verity of the injury, the types of treatments received,
and the types of services utilized.’’.
SEC. 1303. PROGRAMS OF NATIONAL INSTITUTES OF
HEALTH.
(a) INTERAGENCY PROGRAM.—Section 1261(d)(4) of
the Public Health Service Act (42 U.S.C. 300d–61(d)(4))
is amended—
(1) in subparagraph (A), by striking ‘‘degree of
injury’’ and inserting ‘‘degree of brain injury’’;
(2) in subparagraph (B), by striking ‘‘acute in-
jury’’ and inserting ‘‘acute brain injury’’; and
(3) in subparagraph (D), by striking ‘‘injury
treatment’’ and inserting ‘‘brain injury treatment’’.
(b) DEFINITION.—Section 1261(h)(4) of the Public
Health Service Act (42 U.S.C. 300d–61(h)(4)) is
amended—
(1) in the second sentence, by striking ‘‘anoxia
due to near drowning.’’ and inserting ‘‘anoxia.’’; and
(2) in the third sentence, by inserting before
the period the following: ‘‘, after consultation with
States and other appropriate public or nonprofit pri-
vate entities’’.
(c) AUTHORIZATION OF APPROPRIATIONS.—Section
1261 of the Public Health Service Act (42 U.S.C. 300d–
61) is amended by adding at the end the following:
‘‘(i) 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 2004.’’.
SEC. 1304. PROGRAMS OF HEALTH RESOURCES AND SERV-
ICES ADMINISTRATION.
Section 1252 of the Public Health Service Act (42
U.S.C. 300d–51) is amended—
(1) in subsection (b)(3)—
(A) in subparagraph (A)(iv), by striking
‘‘representing traumatic brain injury survivors’’
and inserting ‘‘representing individuals with
traumatic brain injury’’; and
(B) in subparagraph (B), by striking ‘‘who
are survivors of’’ and inserting ‘‘with’’;
(2) in subsection (c)—
(A) in paragraph (1), by striking ‘‘, in
cash,’’; and
(B) in paragraph (2), by amending the
paragraph to read as follows:
‘‘(2) DETERMINATION
OF
AMOUNT
CONTRIB-
UTED.—Non-Federal contributions under paragraph
(1) may be in cash or in kind, fairly evaluated, in-
cluding plant, equipment, or services. Amounts pro-
vided by the Federal Government, or services as-
sisted or subsidized to any significant extent by the
Federal Government, may not be included in deter-
mining the amount of such contributions.’’;
(3) by designating subsections (e) through (h)
as subsections (g) through (j), respectively; and
(4) by inserting after subsection (d) the fol-
lowing subsections:
‘‘(e) CONTINUATION
OF
PREVIOUSLY
AWARDED
DEMONSTRATION PROJECTS.—A State that received a
grant under this section prior to the date of the enactment
of the Children’s Health Act of 2000 may compete for new
project grants under this section after such date of enact-
ment.
‘‘(f) USE OF STATE GRANTS.—
‘‘(1) COMMUNITY SERVICES AND SUPPORTS.—A
State shall (directly or through awards of contracts
to nonprofit private entities) use amounts received
under a grant under this section for the following:
‘‘(A) To develop, change, or enhance com-
munity-based service delivery systems that in-
clude timely access to comprehensive appro-
priate services and supports. Such service and
supports—
‘‘(i) shall promote full participation by
individuals with brain injury and their
families in decision making regarding the
services and supports; and
‘‘(ii) shall be designed for children
and other individuals with traumatic brain
injury.
‘‘(B) To focus on outreach to underserved
and inappropriately served individuals, such as
individuals in institutional settings, individuals
with low socioeconomic resources, individuals in
rural communities, and individuals in culturally
and linguistically diverse communities.
‘‘(C) To award contracts to nonprofit enti-
ties for consumer or family service access train-
ing, consumer support, peer mentoring, and
parent to parent programs.
‘‘(D) To provide individual and family
service coordination or case management sys-
tems.
‘‘(E) To support other needs identified by
the advisory board under subsection (b) for the
State involved.
‘‘(2) BEST PRACTICES.—
‘‘(A) IN
GENERAL.—State services and
supports provided under a grant under this sec-
tion shall reflect the best practices in the field
of traumatic brain injury, shall be in compli-
ance with title II of the Americans with Disabil-
ities Act of 1990, and shall be supported by
quality assurance measures as well as state-of-
the-art health care and integrated community
supports, regardless of the severity of injury.
‘‘(B) DEMONSTRATION
BY
STATE
AGEN-
CY.—The State agency responsible for admin-
istering amounts received under a grant under
this section shall demonstrate or express a will-
ingness to obtain expertise and knowledge of
traumatic brain injury and the unique needs as-
sociated with traumatic brain injury.
‘‘(3) STATE CAPACITY BUILDING.—A State may
use amounts received under a grant under this sec-
tion to—
‘‘(A) educate consumers and families;
‘‘(B) train professionals in public and pri-
vate sector financing (such as third party pay-
ers, State agencies, community-based providers,
schools, and educators);
‘‘(C) develop or improve case management
or service coordination systems;
‘‘(D) develop best practices in areas such
as family or consumer support, return to work,
housing or supportive living personal assistance
services, assistive technology and devices, be-
havioral health services, substance abuse serv-
ices, and traumatic brain injury treatment and
rehabilitation;
‘‘(E) tailor existing State systems to pro-
vide accommodations to the needs of individuals
with brain injury (including systems adminis-
tered by the State departments responsible for
health, mental health, labor, education, mental
retardation/developmental disorders, transpor-
tation, and correctional systems);
‘‘(F) improve data sets coordinated across
systems and other needs identified by a State
plan supported by its advisory council; and
‘‘(G) develop capacity within targeted com-
munities.’’;
(5) in subsection (g) (as so redesignated), by
striking ‘‘agencies of the Public Health Service’’ and
inserting ‘‘Federal agencies’’;
(6) in subsection (i) (as redesignated by para-
graph (3))—
(A) in the second sentence, by striking
‘‘anoxia due to near drowning.’’ and inserting
‘‘anoxia.’’; and
(B) in the third sentence, by inserting be-
fore the period the following: ‘‘, after consulta-
tion with States and other appropriate public or
nonprofit private entities’’; and
(7) in subsection (j) (as so redesignated), by
amending the subsection to read as follows:
‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there are authorized
to be appropriated such sums as may be necessary for
each of the fiscal years 2001 through 2005.’’.
TITLE XIV—PREVENTION AND
CONTROL OF INJURIES
SEC. 1401. AUTHORIZATION OF APPROPRIATIONS FOR PRO-
GRAMS OF CENTERS FOR DISEASE CONTROL
AND PREVENTION.
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 2001 through 2005.’’.
TITLE XV—HEALTHY START
INITIATIVE
SEC. 1501. SHORT TITLE.
This title may be cited as the ‘‘Healthy Start Initia-
tive Continuation Act’’.
SEC. 1502. CONTINUATION OF HEALTHY START PROGRAM.
Subpart I of part D of title III of the Public Health
Service Act, as amended by section 1203 of this Act, is
amended by adding at the end the following section:
‘‘SEC. 330H. HEALTHY START FOR INFANTS.
‘‘(a) IN GENERAL.—
‘‘(1) CONTINUATION AND EXPANSION OF PRO-
GRAM.—The Secretary, acting through the Adminis-
trator of the Health Resources and Services Admin-
istration, Maternal and Child Health Bureau, shall
under authority of this section continue in effect the
Healthy Start Initiative and may, during fiscal year
2001 and subsequent years, carry out such program
on a national basis.
‘‘(2) DEFINITION.—For purposes of paragraph
(1), the term ‘Healthy Start Initiative’ is a reference
to the program that, as an initiative to reduce the
rate of infant mortality and improve perinatal out-
comes, makes grants for project areas with high an-
nual rates of infant mortality and that, prior to the
effective date of this section, was a demonstration
program carried out under section 301.
‘‘(3) ADDITIONAL GRANTS.— Effective upon in-
creased funding beyond fiscal year 1999 for such
Initiative, additional grants may be made to States
to assist communities with technical assistance, rep-
lication of successful projects, and State policy for-
mation to reduce infant and maternal mortality and
morbidity.
‘‘(b) REQUIREMENTS
FOR MAKING GRANTS.—In
making grants under subsection (a), the Secretary shall
require that applicants (in addition to meeting all eligi-
bility criteria established by the Secretary) establish, for
project areas under such subsection, community-based
consortia of individuals and organizations (including agen-
cies responsible for administering block grant programs
under title V of the Social Security Act, consumers of
project services, public health departments, hospitals,
health centers under section 330, and other significant
sources of health care services) that are appropriate for
participation in projects under subsection (a).
‘‘(c) COORDINATION.—Recipients of grants under
subsection (a) shall coordinate their services and activities
with the State agency or agencies that administer block
grant programs under title V of the Social Security Act
in order to promote cooperation, integrity, and dissemina-
tion of information with Statewide systems and with other
community services funded under the Maternal and Child
Health Block Grant.
‘‘(d) RULE OF CONSTRUCTION.—Except to the extent
inconsistent with this section, this section may not be con-
strued as affecting the authority of the Secretary to make
modifications in the program carried out under subsection
(a).
‘‘(e) MEDICALLY APPROPRIATE ULTRASOUND SERV-
ICES; MEDICALLY APPROPRIATE SERVICES FOR AT-RISK
MOTHERS AND INFANTS.—
‘‘(1) IN GENERAL.—The Secretary may make
grants to health care entities to provide—
‘‘(A) for pregnant women, ultrasound serv-
ices provided by qualified health care profes-
sionals upon medical indication and referral
from health care professionals who provide com-
prehensive prenatal services; and
‘‘(B) for pregnant women or infants, other
health services (including prenatal care, genetic
counseling, and fetal and other surgery) that—
‘‘(i) are determined by a qualified
treating health care professional to be
medically appropriate in order to prevent
or mitigate congenital defects (including
but not limited to spina bifida and
hydrocephaly) or other serious obstetric
complications (including but not limited to
placenta previa, premature rupture of
membranes, or preeclampsia); and
‘‘(ii) are provided during pregnancy or
during the first year after birth.
‘‘(2) ELIGIBLE PROJECT AREA.—The Secretary
may make a grant under paragraph (1) only if the
geographic area in which services under the grant
will be provided is a geographic area in which a
project under subsection (a) is being carried out,
and if the Secretary determines that the grant will
add to or expand the level of health services avail-
able in such area to pregnant women and infants.
‘‘(3) TRANSPORTATION AND SUBSISTENCE EX-
PENSES FOR CERTAIN PATIENTS.—The purposes for
which a grant under paragraph (1)(B) may be ex-
pended include paying, on behalf of a pregnant
woman who is in need of the health services de-
scribed in such paragraph, transportation and sub-
sistence expenses to assist the pregnant woman in
obtaining such health services from the grantee in-
volved. The Secretary may establish such restrictions
regarding payments under the preceding sentence as
the Secretary determines to be appropriate.
‘‘(4) CERTAIN
CONDITIONS.—A condition for
the receipt of a grant under paragraph (1) is that
the applicant for the grant agree as follows:
‘‘(A) In the case of a grant under para-
graph (1)(A), if ultrasound services indicate
that there is a fetal anomaly or other serious
obstetric complication, the applicant will refer
the pregnant woman involved for appropriate
medical services, including, as appropriate, for
health services described in paragraph (1)(B)
provided by grantees under such paragraph.
‘‘(B) If the applicant provides nondirective
pregnancy counseling to patients and is not
subject to the condition under section 330F(b),
such counseling provided by the applicant to pa-
tients will include (but is not limited to) the
provision of adoption information and referrals.
‘‘(5) RELATIONSHIP
TO
PAYMENTS
UNDER
OTHER PROGRAMS.—A grant may be made under
paragraph (1) only if the applicant involved agrees
that the grant will not be expended to pay the ex-
penses of providing any service under such para-
graph to a pregnant woman to the extent that pay-
ment has been made, or can reasonably be expected
to be made, with respect to such expenses—
‘‘(A) under any State compensation pro-
gram, under an insurance policy, or under any
Federal or State health benefits program; or
‘‘(B) by an entity that provides health
services on a prepaid basis.
‘‘(6) EVALUATION
BY
GENERAL
ACCOUNTING
OFFICE.—
‘‘(A) IN
GENERAL.—During fiscal year
2004, the Comptroller General of the United
States shall conduct an evaluation of activities
under grants under paragraph (1) in order to
determine whether the activities have been ef-
fective in serving the needs of pregnant women
with respect to ultrasound services and the
other health services described in paragraph
(1)(B). The evaluation shall include an analysis
of whether such activities have been effective in
reducing the disparity in health status between
the general population and individuals who are
members of racial or ethnic minority groups.
Not later than January 10, 2005, the Comp-
troller General shall submit to the Committee
on Commerce in the House of Representatives,
and to the Committee on Health, Education,
Labor, and Pensions in the Senate, a report de-
scribing the findings of the evaluation.
‘‘(B) RELATION
TO
GRANTS
REGARDING
MEDICALLY
APPROPRIATE
SERVICES
FOR
AT-
RISK MOTHERS AND INFANTS.—Before the date
on which the evaluation under subparagraph
(A) is submitted in accordance with such
subparagraph—
‘‘(i) the Secretary shall ensure that
there are not more than three grantees
under paragraph (1)(B); and
‘‘(ii) an entity is not eligible to receive
grants under such paragraph unless the
entity has substantial experience in pro-
viding the health services described in such
paragraph.
‘‘(e) FUNDING.—
‘‘(1) GENERAL PROGRAM.—
‘‘(A) 
AUTHORIZATION
OF
APPROPRIA-
TIONS.—For the purpose of carrying out this
section (other than subsection (e)), there are
authorized to be appropriated such sums as
may be necessary for each of the fiscal years
2001 through 2005.
‘‘(B) ALLOCATIONS.—
‘‘(i) PROGRAM ADMINISTRATION.—Of
the amounts appropriated under subpara-
graph (A) for a fiscal year, the Secretary
may reserve up to 5 percent for coordina-
tion, dissemination, technical assistance,
and data activities that are determined by
the Secretary to be appropriate for car-
rying out the program under this section.
‘‘(ii) EVALUATION.—Of the amounts
appropriated under subparagraph (A) for a
fiscal year, the Secretary may reserve up
100
to 1 percent for evaluations of projects car-
ried out under subsection (a). Each such
evaluation shall include a determination of
whether such projects have been effective
in reducing the disparity in health status
between the general population and indi-
viduals who are members of racial or eth-
nic minority groups.
‘‘(2) MEDICALLY
APPROPRIATE
ULTRASOUND
SERVICES; MEDICALLY APPROPRIATE SERVICES FOR
AT-RISK MOTHERS AND INFANTS.—
‘‘(A) 
AUTHORIZATION
OF
APPROPRIA-
TIONS.—For the purpose of carrying out sub-
section (e), there are authorized to be appro-
priated such sums as may be necessary for each
of the fiscal years 2001 through 2005.
‘‘(B) ALLOCATION.—Of the amounts ap-
propriated under subparagraph (A) for a fiscal
year, the Secretary shall make available not less
than 10 percent for providing ultrasound serv-
ices under subsection (d)(1)(A) (provided by
qualified health care professionals upon medical
indication and referral from health care profes-
sionals who provide comprehensive prenatal
services) through visits by mobile units to com-
101
munities that are eligible for services under
subsection (a).’’.
TITLE XVI—ORAL HEALTH PRO-
MOTION AND DISEASE PRE-
VENTION
SEC. 1601. ORAL HEALTH PROMOTION AND DISEASE
PREVENTION.
Part B of title III of the Public Health Service Act,
as amended by section 912 of this Act, is amended by in-
serting after section 317M the following section:
‘‘ORAL HEALTH PROMOTION AND DISEASE PREVENTION
‘‘SEC. 317N. (a) GRANTS TO INCREASE RESOURCES
FOR COMMUNITY WATER FLUORIDATION.—
‘‘(1) IN
GENERAL.—The Secretary, acting
through the Director of the Centers for Disease
Control and Prevention, may make grants to States
and Indian tribes for the purpose of increasing the
resources available for community water fluorida-
tion.
‘‘(2) USE
OF
FUNDS.—A State shall use
amounts provided under a grant under paragraph
(1)—
‘‘(A) to purchase fluoridation equipment;
‘‘(B) to train fluoridation engineers;
‘‘(C) to develop educational materials on
the benefits of fluoridation; or
102
‘‘(D) to support the infrastructure nec-
essary to monitor and maintain the quality of
water fluoridation.
‘‘(b) COMMUNITY WATER FLUORIDATION.—
‘‘(1) IN
GENERAL.—The Secretary, acting
through the Director of the Centers for Disease
Control and Prevention and in collaboration with the
Director of the Indian Health Service, shall establish
a demonstration project that is designed to assist
rural water systems in successfully implementing the
water fluoridation guidelines of the Centers for Dis-
ease Control and Prevention that are entitled ‘‘Engi-
neering and Administrative Recommendations for
Water Fluoridation, 1995’’ (referred to in this sub-
section as the ‘EARWF’).
‘‘(2) REQUIREMENTS.—
‘‘(A) COLLABORATION.—In collaborating
under paragraph (1), the Directors referred to
in such paragraph shall ensure that technical
assistance and training are provided to tribal
programs located in each of the 12 areas of the
Indian Health Service. The Director of the In-
dian Health Service shall provide coordination
and administrative support to tribes under this
section.
103
‘‘(B) GENERAL USE OF FUNDS.—Amounts
made available under paragraph (1) shall be
used to assist small water systems in improving
the effectiveness of water fluoridation and to
meet the recommendations of the EARWF.
‘‘(C) FLUORIDATION SPECIALISTS.—
‘‘(i) IN
GENERAL.—In carrying out
this subsection, the Secretary shall provide
for the establishment of fluoridation spe-
cialist engineering positions in each of the
Dental Clinical and Preventive Support
Centers through which technical assistance
and training will be provided to tribal
water operators, tribal utility operators
and other Indian Health Service personnel
working directly with fluoridation projects.
‘‘(ii) LIAISON.—A fluoridation spe-
cialist shall serve as the principal technical
liaison between the Indian Health Service
and the Centers for Disease Control and
Prevention with respect to engineering and
fluoridation issues.
‘‘(iii) CDC.—The Director of the Cen-
ters for Disease Control and Prevention
104
shall appoint individuals to serve as the
fluoridation specialists.
‘‘(D) IMPLEMENTATION.—The project es-
tablished 
under 
this 
subsection 
shall 
be
planned, implemented and evaluated over the 5-
year period beginning on the date on which
funds are appropriated under this section and
shall be designed to serve as a model for im-
proving the effectiveness of water fluoridation
systems of small rural communities.
‘‘(3) EVALUATION.—In conducting the ongoing
evaluation as provided for in paragraph (2)(D), the
Secretary 
shall 
ensure 
that 
such 
evaluation
includes—
‘‘(A) the measurement of changes in water
fluoridation compliance levels resulting from as-
sistance provided under this section;
‘‘(B) the identification of the administra-
tive, technical and operational challenges that
are unique to the fluoridation of small water
systems;
‘‘(C) the development of a practical model
that may be easily utilized by other tribal, state,
county or local governments in improving the
105
quality of water fluoridation with emphasis on
small water systems; and
‘‘(D) the measurement of any increased
percentage of Native Americans or Alaskan Na-
tives who receive the benefits of optimally fluo-
ridated water.
‘‘(c) SCHOOL-BASED DENTAL SEALANT PROGRAM.—
‘‘(1) IN
GENERAL.—The Secretary, acting
through the Director of the Centers for Disease
Control and Prevention and in collaboration with the
Administrator of the Health Resources and Services
Administration, may award grants to States and In-
dian tribes to provide for the development of school-
based dental sealant programs to improve the access
of children to sealants.
‘‘(2) USE
OF
FUNDS.—A State shall use
amounts received under a grant under paragraph (1)
to provide funds to eligible school-based entities or
to public elementary or secondary schools to enable
such entities or schools to provide children in second
and sixth grades with access to dental care and den-
tal sealant services. Such services shall be provided
by licensed dental health professionals in accordance
with State practice licensing laws.
106
‘‘(3) ELIGIBILITY.—To be eligible to receive
funds under paragraph (1), an entity shall—
‘‘(A) prepare and submit to the State an
application at such time, in such manner and
containing such information as the state may
require; and
‘‘(B) be a public elementary or secondary
school—
‘‘(i) that is located in an urban area
in which and more than 50 percent of the
student population is participating in fed-
eral or state free or reduced meal pro-
grams; or
‘‘(ii) that is located in a rural area
and, with respect to the school district in
which the school is located, the district in-
volved has a median income that is at or
below 235 percent of the poverty line, as
defined in section 673(2) of the Commu-
nity Services Block Grant Act (42 U.S.C.
9902(2)).
‘‘(d) DEFINITIONS.—For purposes of this section, the
term ‘Indian tribe’ means an Indian tribe or tribal organi-
zation as defined in section 4(b) and section 4(c) of the
Indian Self-Determination and Education Assistance Act.
107
‘‘(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 2001 through 2005.’’.
TITLE XVII—VACCINE
COMPENSATION PROGRAM
SEC. 1701. SHORT TITLE.
This title may be cited as the ‘‘Vaccine Injury Com-
pensation Program Amendments of 2000.’’.
SEC. 1702. CONTENT OF PETITIONS.
(a) IN GENERAL.—Section 2111(c)(1)(D) of the
Public Health Service Act (42 U.S.C. 300aa–11(c)(1)(D))
is amended by striking ‘‘and’’ at the end and inserting
‘‘or (iii) suffered such illness, disability, injury, or condi-
tion from the vaccine which resulted in inpatient hos-
pitalization and surgical intervention, and’’.
(b) EFFECTIVE DATE.—The amendment made by
subsection (a) takes effect upon the date of the enactment
of this Act, including with respect to petitions under sec-
tion 2111 of the Public Health Service Act that are pend-
ing on such date.
TITLE XVIII—HEPATITIS C
SEC. 1801. SHORT TITLE.
This title may be cited as the ‘‘Hepatitis C and Chil-
dren Act of 2000’’.
108
SEC. 1802. SURVEILLANCE AND EDUCATION REGARDING
HEPATITIS C.
Part B of title III of the Public Health Service Act,
as amended by section 1601 of this Act, is amended by
inserting after section 317N the following section:
‘‘SURVEILLANCE AND EDUCATION REGARDING HEPATITIS
C VIRUS
‘‘SEC. 317O. (a) IN GENERAL.—The Secretary, act-
ing through the Director of the Centers for Disease Con-
trol and Prevention, may (directly and through grants to
public and nonprofit private entities) provide for programs
to carry out the following:
‘‘(1) To cooperate with the States in imple-
menting a national system to determine the inci-
dence and prevalence of cases of infection with hepa-
titis C virus, including the reporting of chronic hepa-
titis C cases.
‘‘(2) To identify and contact individuals who
became infected with such virus as a result of receiv-
ing blood transfusions prior to July 1992 when the
individuals were infants, small children, or adoles-
cents.
‘‘(3) To provide appropriate referrals for coun-
seling, testing, and medical treatment of individuals
identified under paragraph (2) and to ensure, to the
109
extent practicable, the provision of appropriate fol-
low-up services.
‘‘(4) To develop and disseminate public infor-
mation and education programs for the detection
and control of hepatitis C, with priority given to re-
cipients of blood transfusions; women who gave birth
by caesarean section; children who were high-risk
neonates; veterans of the Armed Forces; and health
professionals.
‘‘(5) To improve the education, training, and
skills of health professionals in the detection and
control of cases of infection with hepatitis C, with
priority given to pediatricians and other primary
care physicians.
‘‘(b) LABORATORY
PROCEDURES.—The Secretary
may (directly and through grants to public and nonprofit
private entities) carry out programs to provide for im-
provements in the quality of clinical-laboratory procedures
regarding hepatitis C, including reducing variability in
laboratory results on hepatitis C antibody and PCR test-
ing.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there are authorized
to be appropriated such sums as may be necessary for
each of the fiscal years 2001 through 2005.’’.
110
TITLE XIX—NIH INITIATIVE ON
AUTOIMMUNE DISEASES
SEC. 1901. SHORT TITLE.
This title may be cited as the ‘‘NIH Autoimmune
Diseases Initiative Act of 2000’’.
SEC. 1902. JUVENILE DIABETES, JUVENILE ARTHRITIS,
LUPUS, MULTIPLE SCLEROSIS, AND OTHER
AUTOIMMUNE-DISEASES; 
INITIATIVE
THROUGH DIRECTOR OF NATIONAL INSTI-
TUTES OF HEALTH.
Part B of title IV of the Public Health Service Act,
as amended by section 1002 of this Act, is amended by
adding at the end the following:
‘‘AUTOIMMUNE DISEASES
‘‘SEC. 409E. (a) EXPANSION, INTENSIFICATION, AND
COORDINATION OF ACTIVITIES.—
‘‘(1) IN GENERAL.—The Director of NIH shall
expand, intensify, and coordinate research and other
activities of the National Institutes of Health with
respect to juvenile-onset diabetes, rheumatoid arthri-
tis, systemic lupus erthematosus, multiple sclerosis,
Sjo¨gren’s syndrome, scleroderma, chronic fatigue
syndrome, Crohn’s disease and colitis (in this section
referred to as ‘autoimmune diseases’).
111
‘‘(2) ALLOCATIONS
BY
DIRECTOR
OF
NIH.—
With respect to amounts appropriated to carry out
this section for a fiscal year, the Director of NIH
shall allocate the amounts among the national re-
search institutes that are carrying out paragraph
(1).
‘‘(3) ADDITIONAL DISEASES OR DISORDERS.—
In addition to the diseases or disorders specified in
paragraph (1), the term ‘autoimmune disease’ in-
cludes for purposes of this section such other dis-
eases or disorders as the Secretary determines to be
appropriate.
‘‘(b) COORDINATING COMMITTEE.—
‘‘(1) IN GENERAL.—The Secretary shall estab-
lish a committee to be known as Autoimmune Dis-
eases Coordinating Committee (referred to in this
subsection as the ‘Coordinating Committee’).
‘‘(2) DUTIES.—The Coordinating Committee
shall, with respect to autoimmune diseases—
‘‘(A) provide for the coordination of the ac-
tivities of the national research institutes; and
‘‘(B) coordinate the aspects of all Federal
health programs and activities relating to such
diseases in order to assure the adequacy and
technical soundness of such programs and ac-
112
tivities and in order to provide for the full com-
munication and exchange of information nec-
essary to maintain adequate coordination of
such programs and activities.
‘‘(3) COMPOSITION.—The Coordinating Com-
mittee shall be composed of the directors of each of
the national research institutes involved in research
with respect to autoimmune diseases and representa-
tives of all other Federal departments and agencies
whose programs involve health functions or respon-
sibilities relevant to such diseases, including the
Centers for Disease Control and Prevention and the
Food and Drug Administration.
‘‘(4) CHAIR.—From among the members of the
Coordinating Committee, the Committee shall des-
ignate an individual to serve as the chair of the
Committee. With respect to autoimmune diseases,
the Chair shall serve as the principal advisor to the
Secretary, the Assistant Secretary for Health, and
the Director of NIH, and shall provide advice to the
Director of the Centers for Disease Control and Pre-
vention, the Commissioner of Food and Drugs, and
other relevant agencies.
‘‘(5) FULL-TIME STAFF.—The Secretary shall
ensure that the Coordinating Committee is staffed
113
and supported by not fewer than three scientists or
health professionals for whom such service is a full-
time Federal position. The Secretary shall in addi-
tion ensure that the Committee is provided with
such administrative staff and support as may be
necessary to carry out the duties of the Committee.
‘‘(c) ADVISORY COUNCIL.—
‘‘(1) IN GENERAL.—The Secretary shall estab-
lish an advisory council to be known as the Auto-
immune Diseases Public Advisory Council (referred
to in this subsection as the ‘Advisory Council’).
‘‘(2) DUTIES.—The Advisory Council shall pro-
vide to the Director of NIH and the Coordinating
Committee under subsection (b) recommendations on
carrying out this section, including the plan under
subsection (d).
‘‘(3) COMPOSITION.—The Advisory Council
shall be composed exclusively of not more than 18
members appointed to the Council by the Secretary
from among individuals who are not officers or em-
ployees of the United States. The Secretary shall en-
sure that the membership of the Advisory Council
includes—
114
‘‘(A) scientists or health professionals who
are knowledgeable with respect to autoimmune
diseases;
‘‘(B) representatives of autoimmune dis-
ease patient advocacy organizations, including
organizations advocating on behalf of diseases
affecting small patient populations; and
‘‘(C) patients and parents of children with
such diseases, including autoimmune diseases
affecting small patient populations.
‘‘(d) PLAN FOR NIH ACTIVITIES.—
‘‘(1) IN
GENERAL.—The Coordinating Com-
mittee shall develop a plan for conducting and sup-
porting research and education on autoimmune dis-
eases through the national research institutes, shall
review the plan not less frequently than once each
fiscal year, and shall revise the plan as appropriate.
The plan shall—
‘‘(A) provide for a broad range of research
and education activities relating to biomedical,
psychosocial, and rehabilitative issues, including
studies of the disproportionate impact of such
diseases on women; and
115
‘‘(B) establish priorities among the pro-
grams and activities of the National Institutes
of Health regarding such diseases.
‘‘(2) CERTAIN ELEMENTS OF PLAN.—The plan
under paragraph (1) shall, with respect to auto-
immune diseases, provide for the following:
‘‘(A) Research to determine the reasons
underlying the incidence and prevalence of the
diseases.
‘‘(B) Basic research concerning the eti-
ology and causes of the diseases.
‘‘(C) Epidemiological studies to address
the frequency and natural history of the dis-
eases, including any differences among the
sexes and among racial and ethnic groups.
‘‘(D) The development of improved screen-
ing techniques.
‘‘(E) Clinical research for the development
and evaluation of new treatments, including
new biological agents.
‘‘(F) Information and education programs
for health care professionals and the public.
‘‘(3) RECOMMENDATIONS OF ADVISORY COUN-
CIL.—In developing the plan under paragraph (1),
and reviewing and revising the plan, the Coordi-
116
nating Committee shall consider the recommenda-
tions of the Advisory Council regarding the plan.
‘‘(4) IMPLEMENTATION OF PLAN.—The Direc-
tor of NIH shall ensure that programs and activities
of the National Institutes of Health regarding auto-
immune diseases are implemented in accordance
with the plan under paragraph (1).
‘‘(e) REPORTS
TO CONGRESS.—The Coordinating
Committee under subsection (b)(1) shall annually submit
to the Committee on Commerce of the House of Rep-
resentatives, and the Committee on Health, Education,
Labor and Pensions of the Senate, a report that describes
the research, education, and other activities on auto-
immune diseases being conducted or supported through
the national research institutes, and that in addition in-
cludes the following:
‘‘(1) The plan under subsection (d)(1) (or revi-
sions to the plan, as the case may be).
‘‘(2) The recommendations of the advisory
council under subsection (c) regarding the plan (or
revisions, as the case may be).
‘‘(3) Provisions specifying the amounts ex-
pended by the National Institutes of Health with re-
spect to each of the autoimmune diseases included in
the plan.
117
‘‘(4) Provisions identifying particular projects
or types of projects that should in the future be con-
ducted or supported by the national research insti-
tutes or other entities in the field of research on
autoimmune diseases.
‘‘(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 2001 through 2005. The author-
ization of appropriations established in the preceding sen-
tence is in addition to any other authorization of appro-
priations that is available for conducting or supporting
through the National Institutes of Health research and
other activities with respect to autoimmune diseases.’’.
TITLE XX—GRADUATE MEDICAL
EDUCATION 
PROGRAMS 
IN
CHILDREN’S HOSPITALS
SEC. 2001. EXTENSION OF AUTHORIZATION OF APPROPRIA-
TIONS.
Section 340E(f) of the Public Health Service Act (42
U.S.C. 256e(f)) is amended—
(1) in paragraph (1)(A)—
(A) in clause (i), by striking ‘‘and’’ at the
end;
118
(B) in clause (ii), by striking the period
and inserting ‘‘; and’’; and
(C) by adding at the end the following:
‘‘(iii) for each of the fiscal years 2002
through 2005, such sums as may be nec-
essary.’’; and
(2) in paragraph (2)—
(A) in subparagraph (A), by striking
‘‘and’’ at the end;
(B) in subparagraph (B), by striking the
period and inserting ‘‘; and’’; and
(C) by adding at the end the following:
‘‘(C) for each of the fiscal years 2002
through 2005, such sums as may be nec-
essary.’’.
TITLE XXI—SPECIAL NEEDS OF
CHILDREN 
REGARDING
ORGAN TRANSPLANTATION
SEC. 2101. SHORT TITLE.
This title may be cited as the ‘‘Pediatric Organ
Transplantation Improvement Act of 2000’’.
119
SEC. 2102. ORGAN PROCUREMENT AND TRANSPLANTATION
NETWORK; AMENDMENTS REGARDING NEEDS
OF CHILDREN.
(a) IN GENERAL.—Section 372(b)(2) of the Public
Health Service Act (42 U.S.C. 274(b)(2)) is amended—
(1) in subparagraph (J), by striking ‘‘and’’ at
the end;
(2) in each of subparagraphs (K) and (L), by
striking the period and inserting a comma; and
(3) by adding at the end the following subpara-
graphs:
‘‘(M) recognize the differences in health
and in organ transplantation issues between
children and adults throughout the system and
adopt criteria, polices, and procedures that ad-
dress the unique health care needs of children,
‘‘(N) carry out studies and demonstration
projects for the purpose of improving proce-
dures for organ donation procurement and allo-
cation, including but not limited to projects to
examine and attempt to increase transplan-
tation among populations with special needs, in-
cluding children and individuals who are mem-
bers of racial or ethnic minority groups, and
among populations with limited access to trans-
portation, and
120
‘‘(O) provide that for purposes of this
paragraph, the term ‘children’ refers to individ-
uals who are under the age of 18.’’.
(b) 
STUDY
REGARDING
IMMUNOSUPPRESSIVE
DRUGS.—
(1) IN GENERAL.—The Secretary of Health and
Human Services (referred to in this subsection as
the ‘‘Secretary’’) shall provide for a study to deter-
mine the costs of immunosuppressive drugs that are
provided to children pursuant to organ transplants
and to determine the extent to which health plans
and health insurance cover such costs. The Sec-
retary may carry out the study directly or through
a grant to the Institute of Medicine (or other public
or nonprofit private entity).
(2) RECOMMENDATIONS
REGARDING
CERTAIN
ISSUES.—The Secretary shall ensure that, in addi-
tion to making determinations under paragraph (1),
the study under such paragraph makes recommenda-
tions regarding the following issues:
(A) The costs of immunosuppressive drugs
that are provided to children pursuant to organ
transplants and to determine the extent to
which health plans, health insurance and gov-
ernment programs cover such costs.
121
(B) The extent of denial of organs to be
released for transplant by coroners and medical
examiners.
(C) The special growth and developmental
issues that children have pre- and post- organ
transplantation.
(D) Other issues that are particular to the
special health and transplantation needs of chil-
dren.
(3) REPORT.—The Secretary shall ensure that,
not later than December 31, 2000, the study under
paragraph (1) is completed and a report describing
the findings of the study is submitted to the Con-
gress.
TITLE XXII—MISCELLANEOUS
PROVISIONS
SEC. 2201. 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 2000,
were conducted and supported by such Institutes
with respect to rare diseases in children, including
Friedreich’s ataxia; and
122
(2) the activities that are planned to be con-
ducted and supported by such Institutes with respect
to such diseases during the fiscal years 2001
through 2005.
TITLE XXIII—EFFECTIVE DATE
SEC. 2301. EFFECTIVE DATE.
This Act and the amendments made by this Act take
effect October 1, 2000, or upon the date of the enactment
of this Act, whichever occurs later.
Passed the House of Representatives May 9, 2000.
Attest:
Clerk.