I
106TH CONGRESS
2D SESSION
H. R. 4426
To amend the Public Health Service Act with respect to testing pregnant
women and newborn infants for infection with the human immuno-
deficiency virus.
IN THE HOUSE OF REPRESENTATIVES
MAY 11, 2000
Mr. ACKERMAN (for himself and Mr. COBURN) introduced the following bill;
which was referred to the Committee on Commerce
A BILL
To amend the Public Health Service Act with respect to
testing pregnant women and newborn infants for infec-
tion with the human immunodeficiency virus.
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 ‘‘Women and Children’s
HIV Protection Act of 2000’’.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) Perinatal transmission is the leading cause
of pediatric cases of acquired immune deficiency
syndrome (commonly known as AIDS).
(2) The Centers for Disease Control and Pre-
vention (CDC) estimates that nearly 7,000 HIV-in-
fected women give birth in the United States each
year and as many as 400 babies continue to be born
with HIV infection each year.
(3) Medical advances have made it possible to
nearly eliminate perinatal HIV transmission.
(4) Research studies have demonstrated that
the administration of antiviral medication during
pregnancy, during labor, and immediately following
birth can significantly reduce the transmission of the
human immunodeficiency virus (commonly known as
HIV) from an infected mother to her baby. Cesarean
section further reduces the risk of transmission.
(5) Even if treatment begins shortly after birth,
antiretroviral therapy can substantially reduce the
chance that an HIV-exposed child will become in-
fected.
(6) Breastfeeding by HIV-infected mothers
poses additional significant risk of infection to ba-
bies.
(7) The Institute of Medicine (IOM) has rec-
ommended the adoption of a national policy of uni-
versal HIV testing, with patient notification, as a
routine component of prenatal care. However, 15
percent of HIV-infected pregnant women receive no
prenatal care according to the IOM.
(8) The American Medical Association rec-
ommends mandatory HIV testing of all pregnant
women and newborns with counseling and rec-
ommendations for appropriate treatment.
(9) Testing newborns whose mothers’ status is
unknown ensures that every child at risk for HIV is
identified.
(10) The provision of testing of pregnant
women and newborns with appropriate counseling
and treatment can significantly reduce the number
of pediatric cases of acquired immune deficiency
syndrome, can improve access to and medical care
for the woman and children, and can provide oppor-
tunities to further reduce transmission among
adults.
(11) The provision of such testing, counseling,
and treatment can reduce the overall cost of pedi-
atric cases of AIDS.
(12) For the reasons specified in paragraphs
(1) through (7)—
(A) universal routine HIV testing of preg-
nant women and newborns should be the stand-
ard of care; and
(B) the relevant medical organizations, as
well as public health officials, should issue
guidelines making such testing, counseling, and
treatment the standard of care.
SEC. 3. ADDITIONAL REQUIREMENT FOR CERTAIN GRANTS.
Subpart I of part B of title XXVI of the Public
Health Service Act (42 U.S.C. 300ff–21 et seq.) is amend-
ed by inserting after section 2616 the following section:
‘‘SEC. 2616A. ADDITIONAL REQUIREMENT FOR CERTAIN
GRANTS.
‘‘For fiscal year 2002 and subsequent fiscal years,
the Secretary shall not make a grant to a State under
this part unless the State demonstrates that the law or
regulations of the State are in accordance with the fol-
lowing:
‘‘(1) That all pregnant women receiving pre-
natal care in the State be offered counseling and
testing regarding HIV disease.
‘‘(2) In the case of prenatal testing for such
disease that is conducted in the State, that the re-
sults of such testing be promptly disclosed to the
pregnant woman involved.
‘‘(3) In the case of newborn infants who are
born in the State and whose biological mothers have
not undergone prenatal testing for HIV disease, that
each such infant undergo testing for such disease.
‘‘(4) That the results of such testing of a new-
born infant be promptly disclosed in accordance with
the following, as applicable to the infant involved:
‘‘(A) To the biological mother of the infant
(without regard to whether she is the legal
guardian of the infant).
‘‘(B) If the State is the legal guardian of
the infant:
‘‘(i) To the appropriate official of the
State agency with responsibility for the
care of the infant.
‘‘(ii) To the appropriate official of
each authorized agency providing assist-
ance in the placement of the infant.
‘‘(iii) If the authorized agency is giv-
ing significant consideration to approving
an individual as a foster parent of the in-
fant, to the prospective foster parent.
‘‘(iv) If the authorized agency is giv-
ing significant consideration to approving
an individual as an adoptive parent of the
infant, to the prospective adoptive parent.
‘‘(C) If neither the biological mother nor
the State is the legal guardian of the infant, to
another legal guardian of the infant.
‘‘(D) To the child’s health care provider.
‘‘(5) That, in disclosing the test results to an
individual under paragraph (2) or (4), appropriate
counseling on HIV disease and appropriate referrals
for health care be offered to the individual (except
in the case of a disclosure to an official of a State
or an authorized agency, or to a health care pro-
vider).’’.
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