I 
108TH CONGRESS 
1ST SESSION H. R. 1470
To reduce health care costs and promote improved health by providing 
supplemental grants for additional preventive health services for women. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 27, 2003
Ms. DELAURO (for herself, Mr. LEACH, Mr. DOYLE, Mr. KILDEE, Mr. MEE-
HAN, Mr. CROWLEY, Mr. LANTOS, Mr. GRIJALVA, Mr. CONYERS, Ms. 
JACKSON-LEE
of 
Texas, 
Mr. 
HINCHEY, 
Mr. 
ETHERIDGE, 
Ms. 
MILLENDER-MCDONALD, Ms. LEE, Mr. MENENDEZ, Mrs. LOWEY, Mr. 
FROST, Mr. UDALL of New Mexico, Mr. SERRANO, Mr. MCNULTY, Mr. 
GREEN of Texas, Mr. KENNEDY of Rhode Island, Mr. OWENS, Ms. 
LINDA T. SA´NCHEZ of California, Mr. SCHIFF, Mr. MICHAUD, Mr. NAD-
LER, Ms. WOOLSEY, Mr. STARK, Mr. DAVIS of Tennessee, Mr. STRICK-
LAND, Mr. LARSEN of Washington, Mr. INSLEE, Mr. BOSWELL, Mr. 
BERMAN, Mr. EMANUEL, Mr. MORAN of Virginia, Mrs. MALONEY, Mrs. 
CAPPS, and Ms. MCCOLLUM) introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce 
A BILL 
To reduce health care costs and promote improved health 
by providing supplemental grants for additional preven-
tive health services for women.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘WISEWOMAN Ex-
pansion Act of 2003’’.
SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) Heart disease, stroke, and other cardio-
vascular diseases remain the leading cause of death 
among females in the United States, killing more 
than 500,000 women each year. 
(2) About 1 in 5 females have some form of 
cardiovascular disease, killing more American women 
than the next 14 causes of death combined. 
(3) In women, cardiovascular disease is fre-
quently undetected and untreated until the disease 
has become severe, causing 38 percent of women 
who have heart attacks to die within 1 year. 
(4) Obesity increases women’s risk for some of 
the leading causes of death: heart disease, stroke, di-
abetes, and certain cancers. 
(5) Better nutrition and lifestyle changes can 
effectively prevent and treat obesity. 
(6) Osteoporosis afflicts more than 20,000,000 
American women. 
(7) More than 1⁄2 of all women over 65 have 
osteoporosis. 
(8) One out of every 2 women over 50 will have 
an osteoporosis-related fracture during her lifetime. 
(9) The national annual costs associated with 
osteoporosis are estimated at $14,000,000,000.
(10) Physical activity is necessary for bone ac-
quisition and maintenance throughout adulthood. 
(11) Muscular strength and balance may be 
very significant in future risk reduction for 
osteoporosis. 
(12) There is consensus that adequate vitamin 
D and calcium intakes are required for bone health. 
(13) Seventeen million Americans have diabe-
tes, and over 200,000 people die each year from re-
lated complications. Among U.S. adults, diabetes in-
creased 61 percent from 1990 to 2001. Diabetes is 
the sixth leading cause of death in America. 
(14) Approximately 8.9 percent of all women 
over the age of 20 in the United States have diabe-
tes, but about 1⁄3 of them are unaware of it. 
(15) The risk for cardiovascular disease, the 
most common complication attributable to diabetes, 
is more serious among women than men. Deaths 
from heart disease in women with diabetes have in-
creased 23 percent over the past 30 years. 
(16) The direct and indirect costs of diabetes 
are over $130 billion a year. 
(17) Better nutrition, physical activity, control 
of blood glucose levels, and access to services can 
delay the progression of diabetes. In fact, recent
findings show that modest, consistent physical activ-
ity and a healthy diet can cut a person’s risk for de-
veloping type 2 diabetes by nearly 60 percent. 
(18) Research has demonstrated that—
(A) the uninsured often have significantly 
poorer health than the insured; and 
(B) being uninsured is an obstacle to re-
ceiving preventive health care services. 
(19) The WISEWOMAN program has—
(A) provided one-stop shopping for preven-
tive health services such as cholesterol and 
blood pressure screening for more than 10,000 
women and identified risk factors for heart dis-
ease such as obesity, high cholesterol, high 
blood pressure, sedentary behavior and poor 
diet; and 
(B) found that many of the women 
screened have returned for additional interven-
tions and follow-up, resulting in improved 
weight management, lower blood pressure and 
lower cholesterol. 
(20) Expansion of the WISEWOMAN model 
program to additional States would help reduce 
women’s risk of illness and death from heart disease, 
diabetes, and other preventable diseases and provide
further insights into the feasibility and effectiveness 
of making comprehensive, integrated preventive serv-
ices available to low-income and uninsured women. 
SEC. 3. SUPPLEMENTAL GRANTS FOR ADDITIONAL PRE-
VENTIVE HEALTH SERVICES FOR WOMEN. 
Section 1509 of the Public Health Service Act (42 
U.S.C. 300n–4a) is amended to read as follows: 
‘‘SEC. 1509. ESTABLISHMENT OF PROGRAM FOR ADDI-
TIONAL PREVENTIVE HEALTH SERVICES. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, may, through a competitive review process, award 
grants to States that have received grants under section 
1501 for a fiscal year, to enable such State to carry out 
programs—
‘‘(1) to provide preventive health services, in ad-
dition to the services authorized in such section 
1501, for diseases such as cardiovascular diseases, 
diabetes, osteoporosis, and obesity; 
‘‘(2) to provide screenings, such as screening 
for blood pressure, cholesterol, osteoporosis, and dia-
betes, and other services that the Secretary deter-
mines to be appropriate and feasible; 
‘‘(3) for health education, counseling, and inter-
ventions for behavioral risk factors, such as physical
inactivity and poor nutrition, and diseases such as 
cardiovascular diseases, diabetes, osteoporosis, and 
obesity; 
‘‘(4) to provide appropriate referrals for medical 
treatment of women receiving services pursuant to 
paragraph (1) through (3), and ensuring, to the ex-
tent practicable, the provision of appropriate follow-
up services; and 
‘‘(5) to evaluate the activities conducted under 
paragraphs (1) through (4) through appropriate sur-
veillance, research, or program monitoring activities. 
‘‘(b) STATUS AS PARTICIPANT IN PROGRAM REGARD-
ING BREAST
AND CERVICAL CANCER.—The Secretary 
may not make a grant to a State under subsection (a) 
unless the State involved agrees that services under the 
grant will be provided in conjunction with entities that are 
screening women for breast or cervical cancer pursuant 
to a grant under section 1501. 
‘‘(c) APPLICABILITY
OF PROVISIONS.—The provi-
sions of this title shall apply to a grant under subsection 
(a) to the same extent and in the same manner as such 
provisions apply to a grant under section 1501. 
‘‘(d) FUNDING.—
‘‘(1) IN GENERAL.—There is authorized to be 
appropriated to carry out this section—
‘‘(A) $20,000,000 for fiscal year 2004; 
‘‘(B) $25,000,000 for fiscal year 2005; 
‘‘(C) $30,000,000 for fiscal year 2006; and 
‘‘(D) such sums as may be necessary for 
each subsequent fiscal year. 
‘‘(2) LIMITATION REGARDING FUNDING WITH 
RESPECT TO BREAST AND CERVICAL CANCER.—No 
additional resources shall be appropriated for a fis-
cal year under paragraph (1) unless the amount ap-
propriated under section 1510(a) for such fiscal year 
is at least $173,920,000.’’.
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