I
103D CONGRESS
2D SESSION
H. R. 3783
To amend the Public Health Service Act to provide a comprehensive program
for the prevention of Fetal Alcohol Syndrome, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
FEBRUARY 2, 1994
Mr. RICHARDSON (for himself, Mr. KENNEDY, Mrs. MORELLA, Mr. SYNAR,
Mr. BEREUTER, and Mr. MORAN) introduced the following bill; which was
referred to the Committee on Energy and Commerce
A BILL
To amend the Public Health Service Act to provide a com-
prehensive program for the prevention of Fetal Alcohol
Syndrome, and for other purposes.
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 ‘‘Comprehensive Fetal
Alcohol Syndrome Prevention Act’’.
SEC. 2. FINDINGS.
Congress finds that—
(1) Fetal Alcohol Syndrome is the leading
known cause of mental retardation, and it is 100
percent preventable;
(2) each year, more than 5,000 infants are born
in the United States with Fetal Alcohol Syndrome,
suffering irreversible physical and mental damage;
(3) 50,000 more infants are born each year
with lesser, though still serious, alcohol-related birth
defects, known as Fetal Alcohol Effects;
(4) Fetal Alcohol Syndrome is a national prob-
lem, it can impact any child, family, or community,
but its threat to American Indians and Alaska Na-
tives is especially alarming;
(5) in some American Indian communities,
where alcohol dependency rates reach 50 percent
and above, the chances of a newborn suffering Fetal
Alcohol Syndrome or Fetal Alcohol Effects are 30
times greater than national averages;
(6) researchers have determined that the possi-
bility of giving birth to a baby with Fetal Alcohol
Syndrome or Fetal Alcohol Effects increases in pro-
portion to the amount and frequency of alcohol
consumed by a pregnant woman, and that stopping
alcohol consumption at any point in the pregnancy
reduces the risks and the emotional, physical, and
mental consequences of alcohol exposure to the baby;
(7) in addition to the immeasurable toll on
Fetal Alcohol Syndrome and Fetal Alcohol Effects
children and their families, Fetal Alcohol Syndrome
and Fetal Alcohol Effects pose extraordinary finan-
cial costs to the Nation, including the costs of health
care, education, foster care, job training, and gen-
eral support services for affected individuals;
(8) as a reliable comparison, delivery and care
costs are four times greater for infants who were ex-
posed to illicit substances than for infants with no
indication of substance exposure, and over a lifetime,
health care costs for one Fetal Alcohol Syndrome
child are estimated, to be at least $1,400,000; and
(9) we know of no safe dose of alcohol during
pregnancy, or of any safe time to drink during preg-
nancy, thus, it is in the best interest of the Nation
for the Federal Government to take an active role in
encouraging all women to abstain from alcohol con-
sumption during pregnancy.
Alcoholism and Alcohol Abuse to establish a pro-
gram that shall conduct and support basic research
targeted to developing data to improve prevention
and treatment of Fetal Alcohol Syndrome and Fetal
Alcohol Effects;
‘‘(4) develop a plan to disseminate diagnostic
criteria to health care and social services providers
and carry out that plan; and
‘‘(5) establish an Inter-Agency Task Force on
Fetal Alcohol Syndrome and Fetal Alcohol Effects,
which shall be chaired by the Associate Adminis-
trator for Alcohol Prevention and Treatment of the
Substance Abuse and Mental Health Services Ad-
ministration, and which shall include representatives
from all relevant agencies and offices within the De-
partment of Health and Human Services (including
the Indian Health Service and the Centers for Dis-
ease Control and Prevention), Department of Agri-
culture, Department of Education, Department of
Defense, Department of the Interior (including the
Bureau of Indian Affairs), Department of Justice,
Bureau of Alcohol, Tobacco, and Firearms, Federal
Trade Commission, and any other relevant Federal
Agency.
‘‘SEC. 520F. EDUCATION AND PUBLIC AWARENESS.
‘‘The Secretary shall direct the Substance Abuse and
Mental Health Services Administration to—
‘‘(1) support, conduct and evaluate the effec-
tiveness of—
‘‘(A) training programs for health care
providers, educators, school-based health care
providers, social workers, child welfare workers
and family members concerning the prevention,
diagnosis, and treatment of Fetal Alcohol Syn-
drome and Fetal Alcohol Effects;
‘‘(B) prevention and education programs,
including health education, and school-based
clinic programs, for school-age children with re-
spect to Fetal Alcohol Syndrome and Fetal Al-
cohol Effects; and
‘‘(C) public and community awareness pro-
grams concerning Fetal Alcohol Syndrome and
Fetal Alcohol Effects;
‘‘(2) provide technical and consultative assist-
ance to States, Indian tribal governments, local gov-
ernments, school-based health care providers, sci-
entific and academic institutions, and non-profit or-
ganizations concerning the programs referred to in
paragraph (1); and
‘‘(3) award grants to and enter into cooperative
agreements and contracts with States, Indian tribal
governments, local governments, scientific and aca-
demic institutions, entities that fund school-based
clinics, and non-profit organizations for the purpose
of—
‘‘(A) enabling such entities to evaluate the
effectiveness, with particular emphasis on the
cultural sensitivity and age-appropriateness, of
the prevention, education and community-based
public awareness programs referred to in para-
graph (1);
‘‘(B) enabling such entities to provide
training to health care providers, school nurses
and other school health care providers, includ-
ing school-based clinic health care providers,
educators, family members, social workers, child
welfare workers, and others in the prevention,
diagnosis and treatment of Fetal Alcohol Syn-
drome and Fetal Alcohol Effects;
‘‘(C) educating children and youth, includ-
ing pregnant and high-risk youth, concerning
such syndrome and effects with priority given to
those programs that are part of a sequential,
comprehensive school health education program;
and
‘‘(D) increasing public and community
awareness concerning Fetal Alcohol Syndrome
and Fetal Alcohol Effects through culturally
sensitive projects, programs, and campaigns,
and improving the understanding of the general
public and targeted groups concerning the most
effective methods for intervening with friends
and family to prevent fetal exposure to alcohol.
‘‘SEC. 520G. APPLIED EPIDEMIOLOGIC RESEARCH AND PRE-
VENTION PROGRAM.
‘‘The Secretary shall direct the Centers for Disease
Control and Prevention and other appropriate agencies
within the Department of Health and Human Services
to—
‘‘(1) conduct and support research on the
causes, mechanisms, diagnostic methods, and treat-
ment and prevention of Fetal Alcohol Syndrome and
Fetal Alcohol Effects;
‘‘(2) provide technical and consultative assist-
ance and training to States, Indian tribal govern-
ments, local governments, other public entities, sci-
entific and academic institutions, and non-profit or-
ganizations engaged in the conduct of—
‘‘(A) Fetal Alcohol Syndrome prevention
and early intervention programs; and
‘‘(B) research relating to the causes, mech-
anisms, diagnosis methods, treatment and pre-
vention, of Fetal Alcohol Syndrome and Fetal
Alcohol Effects; and
‘‘(3) award grants to, and enter into coopera-
tive agreements and contracts with States, Indian
tribal governments, local governments, other public
entities, scientific and academic institutions, and
non-profit organizations to—
‘‘(A) assist such entities in conducting in-
novative demonstration and evaluation projects
designed to determine effective strategies, in-
cluding community-based prevention programs
and multi-cultural education campaigns, for
preventing and intervening in fetal exposure to
alcohol;
‘‘(B) improve and coordinate the surveil-
lance and ongoing assessment methods imple-
mented by such entities and the Federal Gov-
ernment, with respect to Fetal Alcohol Syn-
drome and Fetal Alcohol Effects for the pur-
pose of—
‘‘(i) tracking progress toward achiev-
ing relevant Year 2000 Prevention Objec-
tives, set forth by the Public Health Serv-
ice in the Healthy People 2000: National
Health Promotion and Disease Prevention
Objectives;
‘‘(ii) identifying successful, culturally
sensitive prevention efforts; and
‘‘(iii) identifying children who have
symptoms of Fetal Alcohol Syndrome and
Fetal Alcohol Effects and may need special
health, education, and support services;
‘‘(C) develop and evaluate effective age-ap-
propriate and culturally-sensitive prevention
programs for infants, children, adolescents, and
adults identified as being at-risk of becoming
chemically dependent on alcohol and associated
with or developing Fetal Alcohol Syndrome and
Fetal Alcohol Effects; and
‘‘(D) facilitate coordination and collabora-
tion among Federal, State, Tribal, and local
Fetal Alcohol Syndrome prevention programs.
‘‘SEC. 520H. BASIC RESEARCH PROGRAM.
‘‘The Director of the National Institutes of Health
shall direct the National Institute on Alcoholism and Alco-
hol Abuse to conduct and support research on services re-
search and effective prevention treatments and interven-
tions for pregnant alcohol dependent women and individ-
uals with Fetal Alcohol Syndrome and Fetal Alcohol
Effects.
‘‘SEC. 520I. DIAGNOSTIC CRITERIA FOR FETAL ALCOHOL
SYNDROME AND FETAL ALCOHOL EFFECTS.
‘‘Not later than 90 days after the date of enactment
of this subpart, the Secretary shall direct the appropriate
agencies within the Department of Health and Human
Services to—
‘‘(1) develop a plan for widely-disseminating the
Fetal Alcohol Syndrome/Fetal Alcohol Effects diag-
nostic criteria developed by the Department of
Health and Human Services under the ADAMHA
Reorganization Act (Public Law 102–321) to health
care providers, educators, social workers, child wel-
fare workers, and other individuals within 16
months of such date of enactment; and
‘‘(2) disseminate the criteria described in para-
graph (1) in accordance with the plan developed
under paragraph (1).
‘‘SEC. 520J. INTER-AGENCY TASK FORCE ON FETAL ALCO-
HOL SYNDROME AND FETAL ALCOHOL EF-
FECTS.
‘‘(a) ESTABLISHMENT.—Not later than 30 days after
the date of enactment of this subpart, the Secretary shall
establish an Inter-Agency Task Force on Fetal Alcohol
Syndrome and Fetal Alcohol Effects to foster coordination
among all Federal agencies that conduct or support Fetal
Alcohol Syndrome and Fetal Alcohol Effects research, pro-
grams, and surveillance and otherwise meet the general
needs of populations actually or potentially impacted by
Fetal Alcohol Syndrome and Fetal Alcohol Effects.
‘‘(b) MEMBERSHIP.—The Task Force established
under subsection (a) shall—
‘‘(1) be chaired by the Associate Administrator
for Alcohol Prevention and Treatment of the Sub-
stance Abuse and Mental Health Services Adminis-
tration and staffed by the Administration; and
‘‘(2) include representatives from all relevant
agencies and offices within the Department of
Health and Human Services, Department of Agri-
culture, Department of Education, Department of
Defense, Department of Interior, Department of
Justice, Bureau of Alcohol, Tobacco and Firearms,
Federal Trade Commission, and any other relevant
Federal agency.
‘‘(c) FUNCTIONS.—The Task Force established under
subsection (a) shall—
‘‘(1) coordinate all Federal programs and re-
search concerning Fetal Alcohol Syndrome, Fetal Al-
cohol Effects, and other forms of maternal substance
abuse, including those programs—
‘‘(A) targeting individuals, families, and
populations identified as being at risk of acquir-
ing Fetal Alcohol Syndrome, Fetal Alcohol Ef-
fects, or other maternal substance abuse; and
‘‘(B) providing health, education, treat-
ment, and social services to infants, children,
and adults with Fetal Alcohol Syndrome, Fetal
Alcohol Effects, and other drug exposures and
their families; and
‘‘(2) coordinate its efforts with existing Depart-
ment of Health and Human Services task forces on
substance abuse prevention and maternal and child
health;
‘‘(3) report on an annual basis to the Secretary
and relevant Committees of Congress on the current
and planned activities of the participating agencies.
‘‘SEC. 520K. ADMINISTRATIVE PROVISIONS WITH RESPECT
TO 
GRANTS, 
COOPERATIVE 
AGREEMENTS
AND CONTRACTS.
‘‘(a) ELIGIBILITY.—To be eligible to receive a grant,
cooperative agreement or contract under this subpart, an
entity shall—
‘‘(1) be a State, Indian tribal government, local
government, entity that funds a school-based health
clinic scientific or academic institution or non-profit
organization;
‘‘(2) prepare and submit to the Secretary an
application at such time, in such manner, and con-
taining such information as the Secretary may pre-
scribe, including a description of the activities that
the entity intends to carry out using amounts re-
ceived under a grant, cooperative agreement, or con-
tract; and
‘‘(3) provide assurances that amounts received
under such grants, cooperative agreements or con-
tracts will be used in accordance with this subpart.
‘‘(b) MAINTENANCE OF EFFORT.—No grant, cooper-
ative agreement, or contract may be awarded to an entity
under this subpart unless the entity agrees to maintain
the expenditures of the entity for activities of the type for
which the amounts to be received under a grant, coopera-
tive agreement, or contract are to be used, at a level equal
to not less than the level of such expenditures maintained
by the entity for the fiscal year preceding the fiscal year
for which the entity is applying to receive the grant, coop-
erative agreement or contract.
‘‘(c) AMOUNTS IN LIEU OF CASH.—At the request
of a recipient of a grant, cooperative agreement, or con-
tract under this subpart, the Secretary may reduce the
amount provided under such grant, agreement, or contract
by—
‘‘(1) an amount equal to the fair market value
of any supplies or equipment furnished the recipient;
and
‘‘(2) an amount equal to the amount of the pay,
allowances, and travel expenses of any officer or em-
ployee of the Federal Government which was de-
tailed to the recipient and the amount of any other
cost incurred in connection with the detail of such
officer or employee.
‘‘SEC. 520L. AUTHORIZATION OF APPROPRIATIONS.
‘‘There are authorized to be appropriated to carry out
this subpart, such sums as are necessary for each of the
fiscal years 1994 through 1997.’’.
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