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Q: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Women's Health Research and
Prevention Amendments of 1998''.

TITLE I--PROVISIONS RELATING TO WOMEN'S HEALTH RESEARCH AT NATIONAL
INSTITUTES OF HEALTH

SEC. 101. RESEARCH ON DRUG DES; NATIONAL PROGRAM OF EDUCATION.
(a) Research.--Section 403A(e) of the Public Health Service Act (42
U.S.C. 283a(e)) is amended by striking ''1996'' and inserting ''2003''.
(b) National Program for Education of Health Professionals and
Public.--Title XVII of the Public Health Service Act (42 U.S.C. 300u et
seq.) is amended by adding at the end the following:

''education regarding des

''Sec. 1710. (a) In General.--The Secretary, acting through the
heads of the appropriate agencies of the Public Health Service, shall
carry out a national program for the education of health professionals
and the public with respect to the drug diethylstilbestrol (commonly
known as DES). To the extent appropriate, such national program shall
use methodologies developed through the education demonstration program
carried out under section 403A. In developing and carrying out the
national program, the Secretary shall consult closely with
representatives of nonprofit private entities that represent
individuals who have been exposed to DES and that have expertise in
community-based information campaigns for the public and for health
care providers. The implementation of the national program shall begin
during fiscal year 1999.
''(b) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 1999 through 2003. The
authorization of appropriations established in the preceding sentence
is in addition to any other authorization of appropriation that is
available for such purpose.''.
SEC. 102. RESEARCH ON OSTEOPOROSIS, PAGET'S DISEASE, AND RELATED
BONE DISORDERS.
Section 409A(d) of the Public Health Service Act (42 U.S.C.
284e(d)) is amended by striking ''and 1996'' and inserting ''through
2003''.

SEC. 103. RESEARCH ON CANCER.

(a) Research on Breast Cancer.--Section 417B(b)(1) of the Public
Health Service Act (42 U.S.C. 286a-8(b)(1)) is amended--
(1) in subparagraph (A), by striking ''and 1996'' and inserting
''through 2003''; and
(2) in subparagraph (B), by striking ''and 1996'' and inserting
''through 2003''.
(b) Research on Ovarian and Related Cancer Research.--Section
417B(b)(2) of the Public Health Service Act (42 U.S.C. 286a-8(b)(2)) is
amended by striking ''and 1996'' and inserting ''through 2003''.
SEC. 104. RESEARCH ON HEART ATTACK, STROKE, AND OTHER
CARDIOVASCULAR DISEASES IN WOMEN.
Subpart 2 of part C of title IV of the Public Health Service Act
(42 U.S.C. 285b et seq.) is amended by inserting after section 424 the
following:

''heart attack, stroke, and other cardiovascular diseases in women

''Sec. 424A. (a) In General.--The Director of the Institute shall
expand, intensify, and coordinate research and related activities of
the Institute with respect to heart attack, stroke, and other
cardiovascular diseases in women.
''(b) Coordination With Other Institutes.--The Director of the
Institute shall coordinate activities under subsection (a) with similar
activities conducted by the other national research institutes and
agencies of the National Institutes of Health to the extent that such
Institutes and agencies have responsibilities that are related to heart
attack, stroke, and other cardiovascular diseases in women.
''(c) Certain Programs.--In carrying out subsection (a), the
Director of the Institute shall conduct or support research to expand
the understanding of the causes of, and to develop methods for
preventing, cardiovascular diseases in women. Activities under such
subsection shall include conducting and supporting the following:
''(1) Research to determine the reasons underlying the
prevalence of heart attack, stroke, and other cardiovascular
diseases in women, including African-American women and other women
who are members of racial or ethnic minority groups.
''(2) Basic research concerning the etiology and causes of
cardiovascular diseases in women.
''(3) Epidemiological studies to address the frequency and
natural history of such diseases and the differences among men and
women, and among racial and ethnic groups, with respect to such
diseases.
''(4) The development of safe, efficient, and cost-effective
diagnostic approaches to evaluating women with suspected ischemic
heart disease.
''(5) Clinical research for the development and evaluation of
new treatments for women, including rehabilitation.
''(6) Studies to gain a better understanding of methods of
preventing cardiovascular diseases in women, including applications
of effective methods for the control of blood pressure, lipids, and
obesity.
''(7) Information and education programs for patients and
health care providers on risk factors associated with heart attack,
stroke, and other cardiovascular diseases in women, and on the
importance of the prevention or control of such risk factors and
timely referral with appropriate diagnosis and treatment. Such
programs shall include information and education on health-related
behaviors that can improve such important risk factors as smoking,
obesity, high blood cholesterol, and lack of exercise.
''(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 1999 through 2003. The
authorization of appropriations established in the preceding sentence
is in addition to any other authorization of appropriation that is
available for such purpose.''.

SEC. 105. AGING PROCESSES REGARDING WOMEN.

Section 445H of the Public Health Service Act (42 U.S.C. 285e-10)
is amended--
(1) by striking ''The Director'' and inserting ''(a) The
Director''; and
(2) by adding at the end the following subsection:
''(b) 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 1999 through 2003. The authorization of appropriations
established in the preceding sentence is in addition to any other
authorization of appropriation that is available for such purpose.''.

SEC. 106. OFFICE OF RESEARCH ON WOMEN'S HEALTH.

Section 486(d)(2) of the Public Health Service Act (42 U.S.C.
287d(d)(2)) is amended by striking ''Director of the Office'' and
inserting ''Director of NIH''.

TITLE II--PROVISIONS RELATING TO WOMEN'S HEALTH AT CENTERS FOR DISEASE
CONTROL AND PREVENTION

SEC. 201. NATIONAL CENTER FOR HEALTH STATISTICS.

Section 306(n) of the Public Health Service Act (42 U.S.C. 242k(n))
is amended--
(1) in paragraph (1), by striking ''through 1998'' and
inserting ''through 2003''; and
(2) in paragraph (2), by striking ''through 1998'' and
inserting ''through 2003''.

SEC. 202. NATIONAL PROGRAM OF CANCER REGISTRIES.

Section 399L(a) of the Public Health Service Act (42 U.S.C. 280e-
4(a)) is amended by striking ''through 1998'' and inserting ''through
2003''.
SEC. 203. NATIONAL BREAST AND CERVICAL CANCER EARLY DETECTION
PROGRAM.
(a) Services.--Section 1501(a)(2) of the Public Health Service Act
(42 U.S.C. 300k(a)(2)) is amended by inserting before the semicolon the
following: ''and support services such as case management''.
(b) Providers of Services.--Section 1501(b) of the Public Health
Service Act (42 U.S.C. 300k(b)) is amended--
(1) in paragraph (1), by striking ''through grants'' and all
that follows and inserting the following: ''through grants to
public and nonprofit private entities and through contracts with
public and private entities.''; and
(2) by striking paragraph (2) and inserting the following:
''(2) Certain applications.--If a nonprofit private entity and
a private entity that is not a nonprofit entity both submit
applications to a State to receive an award of a grant or contract
pursuant to paragraph (1), the State may give priority to the
application submitted by the nonprofit private entity in any case
in which the State determines that the quality of such application
is equivalent to the quality of the application submitted by the
other private entity.''.
(c) Authorizations of Appropriations.--
(1) Supplemental grants for additional preventive health
services.--Section 1509(d)(1) of the Public Health Service Act (42
U.S.C. 300n-4a(d)(1)) is amended by striking ''through 1998'' and
inserting ''through 2003''.
(2) General program.--Section 1510(a) of the Public Health
Service Act (42 U.S.C. 300n-5(a)) is amended by striking ''through
1998'' and inserting ''through 2003''.
SEC. 204. CENTERS FOR RESEARCH AND DEMONSTRATION OF HEALTH
PROMOTION.
Section 1706(e) of the Public Health Service Act (42 U.S.C. 300u-
5(e)) is amended by striking ''through 1998'' and inserting ''through
2003''.

Speaker of the House of Representatives.

Vice President of the United States and
President of the Senate.
A:
TABLE OF CONTENTS:
Title I: Provisions Relating to Women's Health Research at
National Institutes of Health
Title II: Provisions Relating to Women's Health at Centers
for Disease Control and Prevention
Women's Health Research and Prevention Amendments of 1998 -
Title I: Provisions Relating to Women's Health Research at National Institutes of Health
- Amends the Public Health Service Act to extend the authorization of appropriations for programs regarding diethylstilbestrol (DES).
Mandates a program of education of health professionals and the public concerning DES. Authorizes appropriations.
(Sec. 102) Extends the authorizations of appropriations for: (1) research on osteoporosis, Paget's disease, and related bone disorders; (2) breast cancer programs; and (3) programs on ovarian and other cancers of the reproductive system of women.
(Sec. 104) Mandates expansion, intensification, and coordination of research and related activities of the National Heart, Lung, and Blood Institute regarding heart attack, stroke, and other cardiovascular diseases in women. Authorizes appropriations.
(Sec. 105) Extends the authorization of appropriations for research on the aging processes of women.
(Sec. 106) Requires that the Director of the National Institutes of Health (currently, the Director of the Office of Research on Women's Health) appoint members of the Advisory Committee on Women's Health.
Title II: Provisions Relating to Women's Health at Centers for Disease Control and Prevention
- Extends the authorization of appropriations for the National Center for Health Statistics and the National Program of Cancer Registries.
(Sec. 203) Authorizes grants to States to ensure the provision to women screened for breast or cervical cancer of support services such as case management. Allows certain breast and cervical cancer programs to be carried out through grants to public and nonprofit private entities and contracts with public or private entities (currently, through grants and contracts with public or nonprofit private entities). Allows a State to give priority to a nonprofit entity over an entity that is not a nonprofit if the quality of the entities' applications are equivalent. Extends authorizations of appropriations for: (1) annual evaluations of programs relating to preventive health measures regarding breast and cervical cancers; and (2) various breast and cervical cancer preventive health measures.
(Sec. 204) Extends the authorization of appropriations for centers for research and demonstration regarding health promotion and disease prevention.