102d CONGRESS
1st Session
H. R. 3635
AMENDMENT
HR 3635 EAS
In the Senate of the United States,
November 27 (legislative day, November 23), 1991.
Resolved, That the bill from the House of Representatives (H.R. 3635)
entitled `An Act to amend the Public Health Service Act to revise and
extend the program of block grants for preventive health and health
services, and for other purposes' do pass with the following
AMENDMENT:
Strike out all after the enacting clause and insert:

3b03303cbc6af4997a0605900c01a79435856627a3b2390093e7fab9ea4121ab

(a) SHORT TITLE- This Act may be cited as the `Health Promotion and Disease
Prevention Act of 1991'.
(b) TABLE OF CONTENTS- The table of contents is as follows:

3ba10db9bcd54dae7d19b1fb974d5bdf42cc5c93fa37b7ac6fb5cde5ba0ff56c

Subtitle A--Preventive Health and Health Services Block Grant

33437d5cd8894881aaaf4ce3753ac6ccb3c460c502dd6f46b7390ca726007701

TITLE I

-HEALTH PROMOTION AND DISEASE PREVENTION ASSISTANCE

and disease prevention related to women's health.

d0b89e5ef4f939435be7a6c4cf997eb15f1470f5ceb82b1f54fd1405bd758f5a

Subtitle B--National Health Objectives Project Grants to States

71711446ed37cae1bd083377f7f0afd720cf4965732c91512086f306589a112d

8cccaca11db35c1d22dc442a50a811706bd565c015677defa46e1c64b7c8cb2b

818765d19802f804e47b56d86d44743a8b5dbdfa61a79aa9c0b1b6f782b89cda

infertility arising as result of sexually transmitted diseases.

a62b35aabd3281256a60d9c8345d5998002327984f2df7129837badb64bc92d7

TITLE III

-PREVENTABLE CASES OF INFERTILITY

509211dc9b28e66de990f4e1e0f71d1d3fb4af1a8547ab3718d3d40b68a4abb8

TITLE IV

-COMPREHENSIVE MATERNAL AND EARLY CHILDHOOD HEALTH CARE

35fc67613ba87fef436e53b16e720b332db0b08679d1bae32ad1b1174ce97a19

TITLE V

MISCELLANEOUS

79636a6fcbc021df3b5399cc160588eb14f20afb6a5c2ac85a009942b704eeeb

9dadad7be8fb596af71afa9ea713c1bcd12d4ad33d050b69dc1596681936fb6b

c2fd1e5f7e1d88b708c389d5e711fd4605720cc974d37c7df7ea7a90bc74d6ea

Except as otherwise provided, whenever in this Act an amendment or repeal
is expressed in terms of an amendment to, or repeal of, a section or other
provision, the reference shall be considered to be made to a section or
other provision of the Public Health Service Act (42 U.S.C. 201 et seq.).

b1a3960761b7fbb97427d823b7f17ed38dac53fbb237c746449ff82fdd8244c4

This title may be cited as the `Health Promotion and Disease Prevention
Assistance Act of 1991'.
Subtitle A--Preventive Health and Health Services Block Grant

e3c52651a1e93621a969f2ec2a3eca742c82ce1d6c21ed2a3424de7755388069

Section 1901 (42 U.S.C. 300-w) is amended--
(1) in subsection (a), by striking out `$95,000,000' and all that follows
through the end thereof and inserting the following: `$275,000,000 for
fiscal year 1992, and such sums as may be necessary for each of the fiscal
years 1993 through 1996.';
(2) in subsection (b), by striking out `at least $3,500,000' and inserting
in lieu thereof `at least $7,000,000'; and
(3) by adding at the end thereof the following new subsection:
`(c) Notwithstanding any other provision of this subtitle and subject to
the provisions of subsection (b), if amounts appropriated under subsection
(a) for any fiscal year exceed $150,000,000 all of such amounts shall be
used to carry out subpart 2 for such fiscal year.'.

c4929a3331e58bdf6b992b988fc90768d64d91b7e7352731709349beaadc99ce

(a) ANNUAL REPORTS- Subsection (a) of section 1906 (42 U.S.C. 300w-5(a))
shall be amended to read as follows:
`(a)(1) Each State receiving an allotment, and each entity receiving a
grant, under this part shall prepare and submit to the Secretary an annual
report concerning the activities carried out by such State or grantee
with amounts received under this part. Such reports shall describe the
services provided using such amounts in accordance with subsections (a)
and (e) of section 1904.
`(2) The Secretary, acting through the Centers for Disease Control and
Prevention and in consultation with the States and the National Health
Objectives Advisory Committee, shall develop uniform data items and data
formats for the annual reports required under paragraph (1). Such uniform
data items and formats shall constitute the minimum requirements that
States must meet in submitting annual reports under paragraph (1).
`(3) In addition to complying with the uniform data item and format
requirements of paragraph (2), an annual report submitted under paragraph
(1) shall specifically provide if readily available--
`(A) the number of individuals provided with services in the service areas
designated under subsections (a) and (e) of section 1904;
`(B) the percentage of minorities and disadvantaged individuals served
within each of the service areas described in subparagraph (A); and
`(C) any other demographic information that the Secretary, after consultation
with the States, determines appropriate.'.
(b) INVESTIGATIONS- Subsection (d) of section 1906 (42 U.S.C. 300w-5(d))
is amended to read as follows:
`(d) The Secretary, in consultation with the States and the National Health
Objectives Advisory Committee, shall periodically update a set of priority
national health status indicators, to be used to evaluate and monitor the
overall health of the United States and of selected subgroups within the
United States.'.
(c) HEALTH STATUS REPORTS- Section 1906 (42 U.S.C. 300w-5) is amended by
adding at the end thereof the following new subsection:
`(e)(1) The Secretary shall determine the capability of each State to
evaluate and submit a report, in a uniform format, concerning the health
status of the State as measured in terms of the health objectives parameters
as described in subsection (d).
`(2)(A) Except as provided in subparagraph (B), with respect to a State
that is determined by the Secretary under paragraph (1) to be unable to
adequately evaluate its health status, such State shall be required to
utilize not more than 10 percent of the amounts paid to the State under
section 1903 for a fiscal year to develop the capacity to make such an
evaluation. Amounts under section 1903 shall be so utilized until such
time as the Secretary determines that such capacity has been achieved by
the State.
`(B) The Secretary may waive the requirement of subparagraph (A) in the
case of a State, territory or Indian tribe that is determined by the
Secretary to be unable to develop the capacity required under paragraph
(1) through the utilization of the funds required under such subparagraph.
`(3) With respect to entities that are eligible to receive grants under this
part, that apply for such grants, and that the Secretary determines do not
have the resources to efficiently establish the capacity for evaluating
their health status as provided for in paragraph (1), the Secretary, in
consultation with the State agencies, may provide technical assistance to
enable such entities to make such evaluations and such entities shall be
exempt from the requirements of paragraph (1).
`(4) An entity described in paragraph (3) shall indicate in the annual
report submitted by such entity under subsection (a) the status of such
entity under such paragraph and the Secretary shall review such status
once during every 3-year period.'.
(d) REPORT TO CONGRESS- Section 1906 (42 U.S.C. 300w-5(b)) (as amended by
subsection (a)) is amended--
(1) by striking out paragraph (6) of subsection (b); and
(2) by adding at the end thereof the following new subsection:
`(f) Not later than 3 years after the date of enactment of this subsection,
and every 3 years thereafter, the Secretary shall prepare and submit a report
to Congress concerning the activities of the States that have received
funds under this part. Such report shall include State compilations of
the information contained in the reports prepared under subsection (a),
and any recommendations for appropriate changes in legislation necessary
to facilitate improvement in the health status indicators described in
subsection (d), facilitate the implementation of the State plans described
in subsection (a)(3)(A) and ensure compliance with section 1905(c)(8),
and to facilitate other changes determined appropriate by the Secretary
under this part.'.
(e) APPLICATION- Section 1905 (42 U.S.C. 300w-4) is amended--
(1) in subsection (c)--
(A) by striking out `and' at the end of paragraph (6);
(B) by striking out the period at the end of paragraph (7) and inserting
in lieu thereof `; and'; and
(C) by adding at the end thereof the following new paragraph:
`(8) agrees that continuing education credits in the utilization of
universal precautions, and infection control procedures for the prevention
of bloodborne disease transmission, shall be required as part of those
credits required for health professional relicensure.'; and
(2) in subsection (d), by striking out the last sentence and inserting in
lieu thereof the following new sentences: `The description shall include,
a summary of the manner in which the funds will be allocated under section
1904(a)(1), and which health status indicators (as described in section
1906(d)) such allocations are intended to address. The description shall also
include prior year information concerning the State's health status according
to the health status indicators (as described in section 1906(d)).'.

430c94a58cfbb7b0e2a9967a60cd0f4aac7eb99dd03c0e2ccdd85e43a6e8ffd5

AND DISEASE PREVENTION RELATED TO WOMEN'S HEALTH.
Section 1904 (42 U.S.C. 300w-3) is further amended by adding at the end
thereof the following new subsection:
`(e) Each State that receives payments under section 1903 shall demonstrate
that a portion of such payments are being utilized in each fiscal year for
health promotion and disease prevention activities related to women's health
problems, such as osteoporosis, physical abuse, diabetes and tobacco use.'.

e360c21b3f0bc3916c393b598dab4704c321ec3cab3c1bd2781dc466ad522517

Section 7 of the Year 2000 Health Objectives Planning Act (Public Law
101-582) is amended to read as follows:
`SEC. 7. AUTHORIZATION OF APPROPRIATIONS.
`For the purpose of carrying out this Act and for the establishment and
operation of State Health Objectives Advisory Committees under section
1910I(b) of the Public Health Service Act, there are authorized to be
appropriated $10,000,000 for fiscal year 1992, and such sums as may be
necessary for each of the fiscal years 1993 through 1996.'.

c8c1d7e1c4e5b068272927db38a2c0c918c0808b62d4f72cb6b728aeb2132756

Section 1706(e) (42 U.S.C. 300u-5(e)) is amended by striking out `$3,000,000'
and all that follows through the end thereof and inserting `$10,000,000
for fiscal year 1992, and such sums as may be necessary for each of the
fiscal years 1993 through 1996.'.

715c7366e6b92529b64aa87326ba204e118edece8d4e650c067a19646f0dbeeb

Section 1904(a)(1) (42 U.S.C. 300w-4(a)(1)) is amended in the matter
preceding subparagraph (A) by striking out `and (c)' and inserting in lieu
thereof `(c), (e), and (f)'.

625c59393132743f9c70cbad41cc8aaaac8003c5c68622a16d31636a9e5f6e94

Part A of title XIX (42 U.S.C. 300w et seq.) is amended by adding at the
end thereof the following new section:
`SEC. 1910A. TRAINING.
`(a) IN GENERAL- The Secretary, acting through the Director of the Centers
for Disease Control and Prevention, shall, to the extent appropriations
are available, provide assistance for the professional training of public
health personnel, including--
`(1) the identification of new knowledge bases and skills for State and
local public health personnel that are reasonably necessary and appropriate
to permit the States to achieve the national health priorities; and
`(2) encouraging the training and education of appropriate numbers of
such personnel, including racial and ethnic minority personnel, in such
knowledge bases and skills, including cross cultural skills, by establishing
cooperative agreements with schools of public health, schools of nursing,
schools of medicine, and other institutions that train and educate such
personnel; and
`(b) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be appropriated
to carry out this section, $10,000,000 for fiscal year 1992, and such sums
as may be necessary for each of the fiscal years 1993 through 1996.'.
Subtitle B--National Health Objectives Project Grants to States

d057fb02fd8b9931bef69518825a020609da551aaf01ac07e642d59da88fd331

da662c7f81c19b1591ad68c90267e253cde02f3ec1ef7526ef9cfb666ee8b5bf

Section 317(k) (42 U.S.C. 247b(k)) is amended--
(1) by redesignating paragraphs (4) and (5) as paragraphs (5) and (6),
respectively; and
(2) by inserting after paragraph (3) the following new paragraph:
`(4)(A) The Secretary shall award grants to States, and in consultation
with State health agencies, to political subdivisions of States, community
based organizations, and other public and nonprofit private entities for--
`(i) the establishment of demonstration projects for the prevention of
conditions or diseases that adversely affect women;
`(ii) the establishment of demonstration projects for the promotion of
women's health; and
`(iii) the development and dissemination of information for health promotion
and disease prevention related to issues of women's health.
`(B) The projects and activities carried out under this subsection shall
have an emphasis on, but not be restricted to the prevention or control
of osteoporosis, coronary heart disease, diabetes, obesity and tobacco use.
`(C) There are authorized to be appropriated to carry out this paragraph,
$10,000,000 for fiscal year 1992, and such sums as may be necessary for
each of the fiscal years 1993 through 1996.'.

4cd9781cb994341a2ee9f3549349ddb5fe2a1a3faf06194581906f163f957fb4

(a) INJURY CONTROL ACTIVITIES- Section 392 (42 U.S.C. 280b-1) is amended
by adding at the end thereof the following new subsections:
`(c) The Secretary, acting through the Director of the Centers for Disease
Control and Prevention, may establish a national information clearinghouse
to facilitate the exchange and dissemination of information concerning the
prevention and control of injuries in homes, schools, public buildings and
other such locations not otherwise covered by the Occupational Safety and
Health Act of 1970.
`(d) The Secretary, acting through the Director of the Centers for Disease
Control and Prevention, may award grants to, or enter into contracts with,
State departments of health and education, and in consultation with
State authorities, to local departments of health and education, for
the purposes of helping public schools to implement effective programs
to prevent injuries and behaviors associated with unnecessary risks for
injuries. As a condition of awarding a grant under this subsection to a
State or local department of education, the Secretary shall require that
such department of education coordinate with the relevant department of
health in utilizing amounts received under such grant.
`(e)(1) The Secretary, acting through the Director of the Centers for Disease
Control and Prevention, shall award grants to States, and in consultation
with State health agencies, to political subdivisions of States, community
based organizations, and other public and nonprofit private entities for the
establishment of 10 demonstration projects for the prevention and control
of injuries in homes, schools, public buildings and other such locations
not otherwise covered by the Occupational Safety and Health Act of 1970.
`(2)(A) Not more than 50 percent the amount appropriated under section 394
for fiscal year 1993 that exceeds $30,000,000, but in no event in excess
of $2,000,000, shall be used to establish five demonstration projects
under paragraph (1) in such fiscal year.
`(B) Not more than 50 percent of the amount appropriated under section
394 for fiscal year 1994 that exceeds the amount appropriated under such
section for fiscal year 1993, but in no event in excess of $2,000,000,
shall be used to establish the remaining five demonstration projects
required under paragraph (1) in such fiscal year. Additional projects may
be established under such paragraph if appropriations remain available.
`(3) The projects and activities carried out under this subsection shall
place an emphasis on, but not be restricted to, childhood injuries,
particularly injuries to children under five years of age, prevention of
motor vehicle injuries, violence and falls.'.
(b) REPORT AND RECOMMENDATIONS- Section 393 (42 U.S.C. 280b-2) is amended--
(1) in the section heading to read as follows:
`REPORT AND RECOMMENDATIONS';
(2) by inserting `(a)' after the section designation; and
(3) by adding at the end thereof the following new subsection:
`(b) The Director of the Centers for Disease Control and Prevention
shall biennially prepare and submit to the Secretary a report, together
with recommendations and guidelines, concerning new technologies and
practices based on established research findings of efficacy for injury
prevention and control. The Secretary shall consider such recommendations
and guidelines in determining whether to approve the purchase or lease of
equipment, including vehicles, for use by the Department of Health and Human
Services. The Secretary shall forward such recommendations and guidelines
to the Congress, the Director of the General Services Administration,
and any other agency head or State Governor that requests a copy of such
recommendations and guidelines.'.
(c) AUTHORIZATION OF APPROPRIATIONS- Section 394 (42 U.S.C. 280b-3)
is amended--
(1) by striking out `$10,000,000' and all that follows and inserting
`$40,000,000 for fiscal year 1992, and such sums as may be necessary for
each of the fiscal years 1993 through 1996.';
(2) by inserting `(a)' after the section designation; and
(3) by adding at the end thereof the following new subsection:
`(b) The Secretary shall only make grants under section 392(e) for a fiscal
year if amounts appropriated under subsection (a) for such fiscal year are in
excess of the amount appropriated under this section for fiscal year 1991.'.

1375ebe8e7b6274318d06bcf442f58dfa1e96f0824be9fe08ceb36b810b1826f

Title III (42 U.S.C. 241 et seq.) is amended by adding at the end thereof
the following new part:
`Part M--Adolescent Health
`SEC. 399F. OFFICE OF ADOLESCENT HEALTH.
`(a) ESTABLISHMENT- The Secretary shall establish an Office of Adolescent
Health (hereafter referred to in this part as the `Office') and provide
administrative support and support services to the Director of such Office.
`(b) DIRECTOR- The Office shall be headed by a Director (hereafter referred
to in this part as the `Director') who shall be appointed by the Secretary.
`(c) PURPOSE AND DUTIES- It shall be the purpose of the Office to ensure
the sufficiency of the efforts of the Federal government to improve the
health status of adolescents. The Office shall--
`(1) coordinate all activities within the Department that relate to the
monitoring of trends in the health status of adolescents through data
collection;
`(2) coordinate all activities (including research) within the Department
concerning the design of, support for, and evaluation of, adolescent
health services;
`(3) establish a national information clearinghouse to facilitate the
exchange of information concerning all Federal research activities and
initiatives as such relates to adolescent health and to facilitate access
to such information;
`(4) oversee multidisciplinary disease, injury, and disability prevention
research projects concerning conditions and diseases unique to, more
prevalent in, or neglected in adolescents;
`(5) coordinate the training of health providers who work with adolescents,
particularly nurse practitioners, physician assistants, social workers;
`(6) establish within the Office an advisory committee under section 399H
to be known as the National Advisory Committee on Adolescent Health;
`(7) provide advice to Congress concerning adolescent health issues; and
`(8) in collaboration with the National Adolescent Health Advisory
Commission, develop a national strategic plan to access adolescent health
issues.
`SEC. 399G. ADOLESCENT HEALTH INITIATIVES.
`(a) GRANTS- The Secretary, acting through the Office of Adolescent Health,
shall award grants to, or enter into contract with, State health agencies
and other eligible applicants to assist such applicant in funding activities
authorized under an application approved under section (d).
`(b) USE OF AMOUNTS- Amounts provided under a grant or contract under
subsection (a) shall be used by the recipients of such amounts to fund
multidisciplinary projects based on established research findings of
efficacy that are designed to--
`(1) use new and innovative methods to train health care practitioners to
provide services to adolescents; and
`(2) demonstrate and evaluate innovative multidisciplinary methods and
models designed to prevent adolescent violence.
`(c) ELIGIBLE APPLICANTS- To be eligible to receive a grant or contract
under this section an entity shall be a State or local health department,
nonprofit organization and public or nonprofit college, university or
school of, or program that specializes in, adolescent medicine, nursing,
medicine, osteopathy, social work, psychology, public health, and programs
that train physician assistants and shall prepare and submit to the Secretary
for approval an application under subsection (d). Eligible entities shall
not include for-profit entities, either directly or through a subcontract
or subgrant.
`(d) APPLICATIONS-
`(1) SUBMISSION- To be eligible to receive a grant or contract under
subsection (a) an entity shall prepare and submit an application to the
Secretary at such time, in such form, and containing such information as
the Secretary shall require.
`(2) REQUIREMENTS- Applications submitted under this subsection shall--
`(A) be submitted by a coalition or consortium of at least three eligible
applicants with the express purpose of establishing long-term collaborative
relationships with adolescent health care providers; and
`(B) provide any additional information required by the Secretary.
`(e) PEER REVIEW-
`(1) IN GENERAL- Each application for a grant or contract under this section
shall be submitted to a peer review group for an evaluation of the merits
of the proposals made in the application.
`(2) ESTABLISHMENT- The Secretary shall establish such peer review groups
as may be necessary to carry out paragraph (1). The Secretary shall make
appointments to the peer review groups from among appropriately qualified
persons who are not officers or employees of the United States.
`(3) REPORT OF FINDINGS- With respect to applications referred to in
paragraph (1), a peer review group established pursuant to such paragraph
shall report its finding and recommendations to the Secretary. The
Secretary may not approve such an application unless a peer review group
has recommended the application for approval, and awards should be made
in the order of priority from the peer review process.
`(4) ADMINISTRATION- This paragraph shall be carried out by the Secretary.
`(f) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be appropriated
to carry out this section, $10,000,000 for fiscal year 1992, and such sums
as may be necessary for each of the fiscal years 1993 through 1996.
`SEC. 399H. NATIONAL ADOLESCENT HEALTH ADVISORY COMMISSION.
`(a) COMPOSITION- The Advisory Commission (hereafter referred to in this
section as the `Commission') established under section 399F(c)(6) shall
be composed of--
`(1) the Assistant Secretary of Health;
`(2) the Assistant Secretary of Education for Elementary and Secondary
Schools;
`(3) a representative of the Health Resources and Services Administration
to be appointed by the Secretary;
`(4) a representative of the Centers for Disease Control and Prevention
to be appointed by the Secretary;
`(5) a representative of the National Institute of Health to be appointed
by the Secretary;
`(6) five individuals appointed by the Secretary from among physicians,
practitioners, scientists, and other health professionals whose clinical
practice and research specialization focus on adolescent health; and
`(7) a parent of an adolescent to be appointed by the Secretary.
`(b) APPOINTMENTS- Not later than April 1, 1992, the Secretary shall
appoint the members of the Commission in accordance with subsection (a).
`(c) MEETINGS- The Commission shall meet not less than twice annually
to provide advice and make recommendations to the Secretary and to the
Committee on Labor and Human Resources of the Senate and the Committee on
Energy and Commerce of the House of Representatives, with respect to--
`(1) priority research needs;
`(2) appropriate research activities to be supported by the Office;
`(3) deficiencies and needs for improvements in existing data bases
concerning adolescent health status and steps that should be taken to
eliminate such deficiencies; and
`(4) identify problems in adolescent health and make recommendations for
the resolution of such problems.
`(d) REPORTS-
`(1) INTERIM REPORTS- Not later than 1 year and 3 years after the date on
which the initial meeting of the Commission is held, the Commission shall
prepare and submit to the individual and entities described in subsection
(c) a progress report concerning the activities of the Commission.
`(2) FINAL REPORT- Not later than April 1, 1996, the Commission shall
prepare and submit to the individuals and entities described in subsection
(c) a final report concerning its activities.
`(e)  STAFF SUPPORT FOR THE ADVISORY COMMISSION- The Director of the Centers
for Disease Control and Prevention, acting through the Division of Adolescent
and School Health, shall provide the staff support for the Commission.'.

77f96431a4079d0caba2413ef4dddc2dc31802543c2afdeb64890b18f706a50c

(a) AUTHORITY FOR GRANTS-
(1) IN GENERAL- Section 317A(a) (42 U.S.C. 247b-1(a)) is amended to read
as follows:
`(a) AUTHORITY FOR GRANTS-
`(1) IN GENERAL- The Secretary, acting through the Director of the Centers
for Disease Control and Prevention, may make grants to public and nonprofit
private entities (including States and political subdivisions of States)
for the initiation and expansion of community programs designed--
`(A) to provide, for infants and children--
`(i) screening for elevated blood-lead levels;
`(ii) referral for treatment of such levels; and
`(iii) referral for environmental intervention associated with such
levels; and
`(B) to provide education about childhood lead poisoning.
`(2) PROVISION OF ALL SERVICES AND ACTIVITIES THROUGH EACH GRANTEE- In
making grants under paragraph (1), the Secretary shall ensure that each
of the services and activities described in such paragraph is provided
through each grantee under such paragraph. The Secretary may authorize
such a grantee to provide the services and activities directly, or through
arrangements with other providers.'; and
(2) CONFORMING AMENDMENTS- Section 317A (42 U.S.C. 247b-1) is amended--
(A) by redesignating subsections (b) through (j) as subsections (d) through
(l), respectively;
(B) in subsection (h) (as so redesignated)--
(i) in paragraph (1), by striking the comma after `recipient' and inserting
a semicolon; and
(ii) in paragraph (2), by striking the comma at the end and inserting a
semicolon; and
(C) by inserting before subsection (d) (as so redesignated) the following:
`(c) PRIORITY IN MAKING GRANTS- In making grants under subsection (a),
the Secretary shall give priority to applications for programs that will
serve areas with a high incidence of elevated blood-lead levels in infants
and children.'.
(b) ESTABLISHMENT OF REQUIREMENT REGARDING STATUS AS MEDICAID PROVIDER-
Section 317A, as amended by subsection (a)(2)(A), is further amended by
inserting after subsection (a) the following new subsection:
`(b) STATUS AS MEDICAID PROVIDER-
`(1) IN GENERAL- Subject to paragraph (2), the Secretary may not make a
grant under subsection (a) unless, in the case of any service described in
such subsection that is made available pursuant to the State plan approved
under title XIX of the Social Security Act for the State involved--
`(A) the applicant for the grant will provide the service directly, and
the applicant has entered into a participation agreement under the State
plan and is qualified to receive payments under such plan; or
`(B) the applicant will enter into an agreement with a provider under which
the provider will provide the service, and the provider has entered into
such a participation agreement and is qualified to receive such payments.
`(2) WAIVER REGARDING CERTAIN SECONDARY AGREEMENTS-
`(A) In the case of a provider making an agreement pursuant to paragraph
(1)(B) regarding the provision of services, the requirement established in
such paragraph regarding a participation agreement shall be waived by the
Secretary if the provider does not, in providing health care services,
impose a charge or accept reimbursement available from any third-party
payor, including reimbursement under any insurance policy or under any
Federal or State health benefits plan.
`(B) A determination by the Secretary of whether a provider referred to in
subparagraph (A) meets the criteria for a waiver under such subparagraph
shall be made without regard to whether the provider accepts voluntary
donations regarding the provision of services to the public.'.
(c) GRANT APPLICATION-
(1) COORDINATION- Section 317A, as amended by subsection (a)(2)(A), is
further amended--
(A) by striking out subsection (f); and
(B) in subsection (d)(1)--
(i) by inserting `, including the sources of lead exposure, the immediate
risk of lead-based paints, other sources of lead including drinking water
and soil, the potential dangers of lead exposure during home renovations,
the importance of screening young children for lead, and the preventive
steps that parents can take in reducing the risk for lead poisoning,'
after `infants and children' in subparagraph (B);
(ii) by redesignating subparagraph (E) as subparagraph (F); and
(iii) by inserting after subparagraph (D) the following new subparagraph:
`(E) Assurances satisfactory to the Secretary that the program to be
provided under the grant applied for will include educational programs
designed to communicate to health professionals and paraprofessionals updated
knowledge concerning lead poisoning and research, the health consequences,
if any, of low-level lead burden, the prevalence of lead poisoning among
all socioeconomic groupings, the benefits of expanded lead screening, and
the therapeutic and other interventions available to prevent and combat
lead poisoning in affected children and families.'.
(2) REPORT- Section 317A(d)(2), as redesignated by subsection (a)(2)(A),
is amended to read as follows:
`(2) ANNUAL REPORT- Not later than February 1 of each year, the Secretary
shall submit to Congress, a report on the effectiveness during the
preceding fiscal year of programs carried out with grants under subsection
(a) and of any programs that are carried out by the Secretary pursuant
to subsection (l)(2). Such reports shall, include in addition to any
other information that the Secretary shall require a description of the
number of individuals screened, age distribution of individuals screened,
minority representation of the screened population, number of screening
sites, percentage of children screened with blood levels greater than 10
micrograms per deciliter, and prior years information for these categories
where available. Recipients of grants under this section that are required
to report equivalent information to the Secretary under other sections of
this Act shall be exempt from the requirements of this subsection.'.
(3) TECHNICAL AND CONFORMING AMENDMENTS- Section 317A(d)(1), as redesignated
by subsection (a)(2)(A) and amended by subsection (c)(1)(B)(i), is further
amended--
(A) by striking out `(d) GRANT' and all that follows through `No grant'
and inserting the following:
`(d) GRANT APPLICATION-
`(1) IN GENERAL- No grant';
(B) by moving each of subparagraphs (A) through (F) 2 ems to the right; and
(C) in subparagraph (C), by striking out `effectiveness' and all that
follows and inserting in lieu thereof `effectiveness.'.
(d) ESTABLISHMENT OF PROVISION REGARDING RELATIONSHIP TO ITEMS AND SERVICES
UNDER OTHER PROGRAMS- Section 317A, as amended by subsection (c)(1)(A),
is further amended by inserting after subsection (e) the following new
subsection:
`(f) RELATIONSHIP TO SERVICES AND ACTIVITIES UNDER OTHER PROGRAMS-
`(1) IN GENERAL- A recipient of a grant under subsection (a) may not
make payments from the grant for any service or activity to the extent
that payment has been made, or can reasonably be expected to be made,
with respect to such service or activity--
`(A) under any State compensation program, 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.
`(2) APPLICABILITY TO CERTAIN SECONDARY AGREEMENTS FOR PROVISION OF SERVICES-
Paragraph (1) shall not apply in the case of a provider through which a
grantee under subsection (a) provides services under such subsection if
the Secretary has provided a waiver under subsection (b)(2) regarding
the provider.'.
(e) AUTHORIZATION OF APPROPRIATIONS- Section 317A(l), as redesignated by
subsection (a)(2)(A), is further amended--
(1) by striking out `There are' and all that follows through `not more than'
and inserting in lieu thereof the following: `For the purpose of carrying
out this section, there are authorized to be appropriated';
(2) by striking `and' after `1990,'; and
(3) by inserting before the period the following: `, $40,000,000 for fiscal
year 1992, and such sums as may be necessary for each of the fiscal years
1993 through 1996.'.
(f)  NATIONAL EDUCATION PROGRAM- Title III is amended by inserting after
section 317A (42 U.S.C. 247b-1) the following new section:
`SEC. 317B. NATIONAL LEAD POISONING PREVENTION EDUCATION PROGRAM.
`The Secretary, acting through the Director of the Centers for Disease
Control and Prevention, shall establish and implement a national program
designed to educate health professionals and paraprofessionals and the
general public concerning lead poisoning. As part of such educational program
the Secretary shall ensure that such individuals have access to information
concerning the health effects of low-level lead toxicity, the most serious
causes of lead poisoning, and the primary and secondary preventive measures
that may be taken to combat the problem of lead poisoning.'.
(g) RESEARCH AND DEVELOPMENT- Title III (as amended by subsection (f)
is further amended by inserting after section 317B the following new section:
`SEC. 317C. NATIONAL LEAD POISONING TECHNOLOGY ASSESSMENT AND EPIDEMIOLOGY
PROGRAM.
`The Secretary, acting through the Director of the Centers for Disease
Control and Prevention, shall establish and implement a concerted technology
assessment and epidemiology program to--
`(1) develop improved testing measures that may be administered to children
to detect lead toxicity using methods that are sufficiently reliable,
sensitive, applicable and cost-effective;
`(2) more accurately assess the prevalence of lead poisoning by State,
socioeconomic grouping, and health care insurance status; and
`(3) conduct any applied research necessary to improve the effectiveness
of childhood lead poisoning prevention programs.'.
(h) TASK FORCE TO COORDINATE EFFORTS TO PREVENT LEAD POISONING- Title III
(as amended by subsections (f) and (g) is further amended by inserting
after section 317C the following new section:
`SEC. 317D. INTERAGENCY TASK FORCE ON THE PREVENTION OF LEAD POISONING.
`(a) ESTABLISHMENT- Not later than 6 months after the date of enactment of
this Act, the Secretary shall establish a task force, to be known as the
`Interagency Task Force on the Prevention of Lead Poisoning', to coordinate
the efforts of Federal agencies to prevent lead poisoning.
`(b) COMPOSITION- The task force established under subsection (a) shall
be composed of--
`(1) the Secretary, who shall serve as the chairperson of the task force;
`(2) the Secretary of Housing and Urban Development;
`(3) the Administrator of the Environmental Protection Agency; and
`(4) senior staff selected by the Secretary of Health and Human Services,
Secretary of Housing and Urban Development and Administrator of the
Environmental Protection Agency.
`(c) DUTIES- The task force established under subsection (a) shall--
`(1) review, evaluate and coordinate current strategies and plans formulated
by the Department of Health and Human Services (including the Strategic Plan
for the Elimination of Lead Poisoning of February 21, 1991), the Department
of Housing and Urban Development (including the Comprehensive and Workable
Plan for the Abatement of Lead-Based Paint in Privately Owned Housing of
December 7, 1990) and the Environmental Protection Agency (including the
Strategy for Reducing Lead Exposures of February 21, 1991) and develop
a unified implementation plan for programs related to the prevention of
lead poisoning that receive assistance from the Federal Government;
`(2) establish a mechanism for sharing and disseminating information among
and to agencies participating in the task force;
`(3) identify the most promising areas of research and education concerning
lead poisoning;
`(4) identify the practical and technological constraints to expanding
lead poisoning prevention;
`(5) annually carry out a comprehensive review of Federal programs providing
assistance to prevent lead poisoning, and prepare and submit not later
than May 1 of each year to the Committee on Labor and Human Resources and
the Committee on the Environment and Public Works of the Senate and the
Committee on Energy and Commerce of the House of Representatives, a report
that summarizes the review conducted under this paragraph and contains
any program, policy and budgetary recommendations of the task force; and
`(6) annually review and coordinate departmental and agency budgetary
requests with respect to all lead poisoning prevention activities of the
Federal Government.'.
(i) EFFECTIVE DATE- The amendments made by this section shall take effect
October 1, 1991, or upon the date of the enactment of this Act, whichever
occurs later.

6bb492aec0a64614ef5372e761fb53eec041c1d1e9b5bfbba0a0731455b69a27

Title III is amended by inserting after Section 318 (42 U.S.C. 247c)
the following new section:
`SEC. 318A. PROSTATE CANCER SCREENING AND EARLY DETECTION.
`(a) IN GENERAL- The Secretary, acting through the Director of the Centers
for Disease Control and Prevention, may make grants to States, academic
medical centers, or other public or nonprofit private entities--
`(1) to determine the prevalence, incidence and mortality rates and stage
at diagnosis of prostate cancer, nationally, within regions and within
subgroups of the population; and
`(2) to determine the state of current practices for the screening and
diagnosis of prostate cancer and the effectiveness of such practices in
reducing mortality.
Such grants shall be awarded on the basis of an established competitive
review process.
`(b) COORDINATION WITH THE NATIONAL INSTITUTES OF HEALTH- The Director of
the Centers of Disease Control and Prevention shall coordinate with the
Director of the National Institutes of Health to--
`(1) evaluate existing methods for the screening and diagnosis of prostate
cancer in order to develop more sensitive and specific, less expensive
screening and diagnostic methods;
`(2) evaluate and improve reporting of surveillance data relative to
prostate cancer;
`(3) disseminate information concerning such methods to health professionals;
and
`(4) collaborate to expedite the review of research and development of
technologies that insure early detection of prostate cancer.
`(c) APPLICATION REQUIREMENTS- The Secretary may not make a grant under
subsection (a) unless an application for such grant is submitted to the
Secretary. Such application shall be in such form, submitted at such time,
and contain such information as the Secretary determines to be appropriate
to carry out this section, including a description of the activities,
as described in subsection (a), that the applicant intends to use the
amounts received under such grant to carry out.
`(d) DESCRIPTION OF INTENDED USE OF GRANTS- The Secretary may not make a
grant under subsection (a) unless the applicant for such grant submits
to the Secretary a description of the purposes for which the applicant
intends to expend the amounts received under the grant that--
`(1) identifies the populations, areas and locations to be assessed under
the grant; and
`(2) provides assurances that the grant funds will be used in the most
cost-effective manner practicable.
`(e) TECHNICAL ASSISTANCE- The Secretary may provide training and technical
assistance with respect to the planning, development and operation of
activities carried out under grants awarded under this section.
`(f) REPORTS- Not later than 18 months after the awarding of grants under
this section, and annually thereafter, the Secretary shall prepare and
submit to the Committee on Labor and Human Resources of the Senate and
the Committee on Energy and Commerce in the House of Representatives,
a report that contains--
`(1) a summary of the findings derived from the activities carried out
under grants awarded under this section during the preceding fiscal year; and
`(2) recommendations for administrative and legislative initiatives to
improve the public health based upon the findings described in paragraph
(1) that the Secretary determines to be appropriate.
`(g) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be appropriated
to carry out this section, $10,000,000 for fiscal year 1992, and such sums
as may be necessary for each of the fiscal years 1993 through 1996.'.

782c131dbf190eea9e8d413cbf6056b1c2ca78fe4121bd485fa389830014fb1b

HEALTH PROMOTION AND DISEASE PREVENTION.
Title XVII (42 U.S.C. 300u) is amended by adding at the end thereof the
following new section:
`SEC. 1708. SPECIAL REGIONAL AND NATIONAL DEMONSTRATION PROJECTS FOR MINORITY
HEALTH PROMOTION AND DISEASE PREVENTION.
`(a)  GRANTS- The Secretary, acting through the Assistant Secretary of
Health, shall award grants to States, political subdivisions of States,
public or nonprofit community-based organizations, and other public and
nonprofit private entities for the establishment of demonstration projects
for the prevention of diseases that disproportionately affect minorities.
`(b) PRIORITY- In awarding grants for projects under subsection (a), the
Secretary shall give priority to projects that are designed to address the
leading causes of death, disease and disability in minority populations,
including cancer, cardiovascular disease, diabetes, violence, homicide,
and tobacco use.
`(c) APPLICATION- To be eligible to receive a grant under this section,
an entity of the type described in subsection (a) shall prepare and submit
to the Secretary an application, at such time, in such form, and containing
such information as the Secretary determines appropriate.
`(d) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be appropriated
to carry out this section, $10,000,000 for fiscal year 1992, and such sums
as may be necessary for each of the fiscal years 1993 through 1996.'.

1c7929b4e64eb2878dcfb26057573d88a37d365d258a97926753da61d714a7f7

This title may be cited as the `Health Promotion and Disease Prevention
Coordination Act of 1991'.

d0f8e74aeeff5776ab59022544a49c2aa01b6088c3f6133a9004223fb1905e14

TITLE II

-COORDINATION OF HEALTH PROMOTION AND DISEASE PREVENTION ACTIVITIES

(a) OFFICE OF DISEASE PREVENTION AND HEALTH PROMOTION- Paragraph (11)
of section 1701(a) (42 U.S.C. 300u(a)(11)) is amended to read as follows:
`(11) establish in the Office of the Assistant Secretary for Health an
Office of Disease Prevention and Health Promotion, to be headed by a
director appointed by the Secretary, that shall--
`(A) ensure interagency and interdepartmental coordination of all activities
related to health promotion and disease prevention, specifically including
nutrition, physical fitness, children and school health, worksite health
promotion, health promotion for special populations at risk for preventable
disease and disability, and other matters that involve various agencies of
the Department or collaboration with other Federal departments and agencies;
`(B) coordinate Federal activities of the type described in subparagraph (A)
with similar activities conducted by the private sector and encourage the
establishment of additional activities of this type in the private sector;
`(C) establish a national information clearinghouse to--
`(i) facilitate the exchange of information concerning matters relating
to health information and health promotion, preventive health services,
and education in the appropriate use of health care;
`(ii) facilitate the access of health care providers, other providers of
health information, and health care consumers to such information; and
`(iii) facilitate and assist entities in the access of such information
and the analysis of issues and problems relating to such matters;
`(D) support projects, conduct research, and disseminate information
relating to health promotion, disease prevention, preventive medicine and
physical fitness and exercise;
`(E) coordinate, in collaboration with agencies within the Department and
other Federal Departments and agencies, a national effort to promote health
and prevent disease through the enhancement of health related behavior,
improve access to preventive health services, and health information,
communication and education with respect to the appropriate use of health
care; and
`(F) report to the public, through the publication of a short,
easy-to-understand annual report on key Healthy People 2000 objective
indicators and on progress made toward achieving the Healthy People 2000
objectives, to--
`(i) focus attention on an easily identifiable and understandable set of
core health objective indicators;
`(ii) highlight national, State, and individual health status indicators
and cite specific examples;
`(iii) stress quality of life indicators;
`(iv) maximize the use of the print and electronic media to promote the
health status of the United States and the Healthy People 2000 objectives;
`(v) highlight priority areas where additional efforts are needed, either
at the national, State, or individual level, to attain specific Healthy
People 2000 objectives; and
`(vi) report on the current ranking of the United States with respect to
the infant mortality and life expectancy rates.'.
(b) AUTHORIZATION OF APPROPRIATIONS- Subsection (b) of section 1701 (42
U.S.C. 300u(b)) is amended to read as follows--
`(b) For the purpose of carrying out this section and sections 1702 through
1705, there are authorized to be appropriated $10,000,000 for fiscal year
1992, and such sums as may be necessary for each of the fiscal years 1993
through 1996.'.
(c) TARGET POPULATIONS- Section 1701 (42 U.S.C. 300u) is amended by adding
at the end thereof the following new subsection:
`(d) With respect to activities carried out with amounts appropriated under
this title, particular emphasis shall be placed on the target populations
under each grant, contract or other activity under this title to ensure
that appropriate priority is provided to populations and groups with
documented historically poor health.'.
(d) LITERACY REQUIREMENTS- Section 1701(a)(3) (42 U.S.C. 300u(a)(3))
is amended--
(1) in subparagraph (B), by striking out `and' at the end thereof;
(2) in subparagraph (C), by adding `and' after the semicolon; and
(3) by adding at the end thereof the following new subparagraph:
`(D) ensure that, after January 1, 1992, at least one-half of all new or
revised health education and promotion materials developed or funded by the
Department is in a form that does not exceed a level of functional literacy,
as defined in the National Literacy Act of 1991 (Public Law 102-73);'.

7eb07bad4bce285083e45b9adc987170094251bd301309ac18df025d22b785b1

Section 1701 (42 U.S.C. 300u) (as amended by section 202(c)) is further
amended by adding at the end thereof the following new subsection:
`(e)(1) The Secretary, in consultation with the Secretary of Education,
shall establish an interdepartmental group for coordinating activities and
fostering cooperation with respect to programs concerning multidimensional
school health programs, including school health education. Multidimensional
school health programs may include--
`(A) school health education;
`(B) school-linked or school based health services designed to prevent,
detect and address health problems;
`(C) programs to create a healthy and safe school environment;
`(D) physical education;
`(E) healthful school food services;
`(F) psychological assessment and counseling to promote child development
and emotional health;
`(G) schoolsite health promotion for faculty and staff; and
`(H) integrated school and community disease prevention and health
promotion efforts.
`(2) The group established under paragraph (1) shall foster cooperation
in linking national health objectives established by the Secretary with
national education goals established by the Secretary of Education, and
promote the establishment of multidimensional school health programs,
particularly comprehensive school education, to improve the health of
American youth.
`(3) The Secretary and the Secretary of Education, shall serve as
co-chairpersons of the group established under paragraph (1). The Secretary
shall appoint individuals to serve as a members of the group from among
representatives of appropriate components of the Department of Health
and Human Services and the Department of Education. The co-chairpersons
may solicit appropriate representation from other Federal departments
and agencies. The Public Health Service shall provide staff support for
convening the group established under paragraph (1).'.

14250081e82e40d690688a90b2de296087fba8b4667b888c9d132dc7fe657c54

(a) RESEARCH- Section 1702(a) (42 U.S.C. 300u-1(a)) is amended--
(1) in the matter preceding paragraph (1), by striking out `health
information and';
(2) striking out paragraph (2);
(3) redesignating paragraphs (3) through (6) as paragraphs (2) through
(5), respectively; and
(4) in paragraph (5) (as so redesignated), by striking out `paragraph (5)'
and inserting in lieu thereof `paragraph (4)'.
(b) INFORMATION- Section 1704 (42 U.S.C. 300u-3) is amended by adding at
the end thereof the following new paragraph:
`(6) A determination of the most effective methods of disseminating
information concerning personal health behavior, preventive health services
and the appropriate use of health care and of affecting behavior so that
such information is applied to maintain and improve health, and prevent
disease, reduce risk, or modify its course or severity.'.

043aea0b9ccf008e619f2c7b245a0a66ef2caf2598a9f9969da88440ba05b2f0

Subsection (a) of section 1705 (42 U.S.C. 300u-4(a)) is amended to read
as follows:
`(a) The Secretary shall annually prepare and submit to the President,
for subsequent transmittal to the appropriate committees of Congress,
a report concerning the status of the nation's health. Each such report
shall include--
`(1) a description of the activities carried out under this title for the
period for which the report is being submitted and the extent to which
each such activity achieves the purpose of the title;
`(2) a description of the goals and strategy formulated pursuant to section
1701(a)(1), the model standards developed under this title, and the results
of the study conducted under subsection (b) of this section;
`(3) an analysis of the manner in which the health status of the nation
has changed since during the period for which the report is submitted,
including information concerning the nation's health status according to
the national health status indicators developed under section 5 of the
Year 2000 National Health Objectives Planning Act (Public Law 101-582); and
`(4) such recommendations as the Secretary considers appropriate for
legislation with respect to health promotion, disease prevention, health
information, preventive health services, and education in the appropriate
use of health care, including recommendations for revisions and extensions
of this title.'.

20464366c2cb46d518261b7da27ad6cf2b2112fdd0aa22202fc7c391cc460b89

Section 1707(b)(6) (42 U.S.C. 300u-6(b)(6)) is amended--
(1) by striking out `and' at the end of subparagraph (D);
(2) by adding `and' after the semicolon in subparagraph (E);
(3) by adding at the end thereof the following new subparagraph:
`(F) the development of model curricula and programs for health information
and education for use in community and workplace settings.'.

0c4f597dd11653e92c9ccb6e1e0700c3635e4ee9c57393b13d996303275069f7

Title XVII (42 U.S.C. 300u et seq.) is amended by adding at the end thereof
the following new section:
`SEC. 1709. GRANTS TO STATES FOR OPERATION OF OFFICES OF MINORITY HEALTH.
`(a) IN GENERAL- The Secretary, acting through the Deputy Assistant
Secretary for Minority health (as established under section 1707), may
make grants to States for the purpose of improving the health status in
minority communities, through the operation of State offices of minority
health established to monitor and facilitate the achievement of the Health
Objectives for the Year 2000 as they affect minority populations.
`(b) Certain Requirement for States-
`(1) MINIMUM QUALIFICATIONS- The Secretary may not make a grant to a State
under subsection (a) unless such State receives, under any provision of this
Act other than subsection (a), one or more grants, cooperative agreements,
or contracts for the fiscal year for which the State is applying pursuant
to subsection (g) to receive a grant under subsection (a).
`(2) ADMINISTRATION OF PROGRAM- The Secretary may not make a grant to
a State under subsection (a) unless such State agrees that the program
carried out by the State with amounts received under the grant will be
administered directly by a single State agency.
`(c) CERTAIN REQUIRED ACTIVITIES- The Secretary may not make a grant to
a State under subsection (a) unless such State agrees that activities
carried out by an office operated under the grant received pursuant to
such subsection will--
`(1) establish and maintain within the State a clearinghouse for collecting
and disseminating information on--
`(A) minority health care issues;
`(B) research findings relating to minority health care; and
`(C) innovative approaches to the delivery of health care and social
services in minority communities;
`(2) coordinate the activities carried out in the State that relate to
minority health care, including providing coordination for the purpose of
avoiding redundancy in such activities; and
`(3) identify Federal and State programs regarding minority health, and
providing technical assistance to public and non-profit entities regarding
participation in such program.
`(d) REQUIREMENT REGARDING ANNUAL BUDGET FOR OFFICE- The Secretary may not
make a grant to a State under subsection (a) unless such State agrees that,
for any fiscal year for which the State receives such a grant, the office
operated under such grant will be provided with an annual budget of not
less than $50,000.
`(e) Certain Uses of Funds-
`(1) RESTRICTIONS- The Secretary may not make a grant to a State under
subsection (a) unless such State agrees that--
`(A) if research with respect to minority health is conducted pursuant to
the grant, not more than 10 percent of the amount receive under the grant
will be expended for such research; and
`(B) amounts provided under the grant will not be expended--
`(i) to provide health care (including providing cash payments regarding
such care);
`(ii) to conduct activities for which Federal funds are expended--
`(I) within the state to provide technical and other non-financial assistance
under subsection (m) of section 340A;
`(II) under a memorandum of agreement entered into with the State under
subsection (h) of such section;
`(III) under a grant under section 388I;
`(iii) to purchase medical equipment, to purchase ambulances, aircraft,
or other vehicles, or to purchase major communications equipment;
`(iv) to purchase or improve real property; or
`(v) to carry out any activity regarding a certificate of need.
`(2) AUTHORITIES- Activities for which a State may expend amounts received
under a grant under subsection (a) include--
`(A) paying the costs of establishing an office of minority health for
purposes of subsection (a);
`(B) subject to paragraph (1)(B)(ii)(III), paying the costs of any activity
carried out with respect to recruiting and retaining health professionals
to serve in minority communities in the State; and
`(C) providing grants and contracts to public and non-profit private
entities to carry out activities authorized in this section.
`(f) REPORTS- The Secretary may not make a grant to a State under subsection
(a) unless such State agrees--
`(1) to submit to the Secretary reports containing such information as the
Secretary may require regarding activities carried out under this section
by the State; and
`(2) to submit such a report not later than January 10 of each fiscal year
immediately following any fiscal year for which the State has received
such a grant.
`(g) REQUIREMENT OF APPLICATION- The Secretary may not make a grant to a
State under subsection (a) unless an application for the grant is submitted
to the Secretary and the application in such form, is made in such manner,
and contains such agreements, assurances, and information as the Secretary
determines to be necessary to carry out such subsection.
`(h) NONCOMPLIANCE- The Secretary may not make payments under subsection
(a) to a State for any fiscal year subsequent to the first fiscal year of
such payments unless the Secretary determines that, for the immediately
preceding fiscal year, the State has complied with each of the agreements
made by the State under this section.
`(i) DEFINITIONS- For purposes of making grants under subsection (a)
there are authorized to be appropriated $3,000,000 for fiscal year 1992,
$4,000,000 for fiscal year 1993, $3,000,000 for fiscal year 1994, and such
sums as may be necessary for each of the fiscal years 1995 through 1996.
`(2) AVAILABILITY- Amounts appropriated under paragraph (1) shall remain
available until expended.
`(k) TERMINATION OF PROGRAM- No grant may be made under this section after
the aggregate amounts appropriated under subsection (j)(1) are equal to
$10,000,000.'.

c033b44efea4e8258b404ef112ee4eb72e47d2f0a4f4a4351d027b0c9bd166ed

INFERTILITY ARISING AS RESULT OF SEXUALLY TRANSMITTED DISEASES.
Title III (42 U.S.C. 241 et seq.) (as amended by sections 133 and 302),
is further amended by adding at the end the following new part:
`PART O--PREVENTABLE CASES OF INFERTILITY
`SEC. 399N. INFERTILITY ARISING AS RESULT OF SEXUALLY TRANSMITTED DISEASES.
`(a) GRANTS- The Secretary may make grants to States, political subdivisions
of States, and any other public or nonprofit private entities for the purpose
of carrying out the activities described in subsection (c) regarding any
treatable sexually transmitted disease that can cause infertility in women
if treatment is not received for the disease. The Secretary shall carry
out this section acting through the Director of the Centers for Disease
Control and Prevention.
`(b) SPECIFICATION OF RELEVANT DISEASES-
`(1) IN GENERAL- For each fiscal year, the Secretary shall make
a determination specifying all sexually transmitted diseases that are
diseases described in subsection (a).
`(2) DISEASES APPLICABLE WITH RESPECT TO GRANTEE INVOLVED- In making a
grant under subsection (a) to an applicant for the grant, the Secretary
shall make a determination in order to select, from among the diseases
specified for purposes of paragraph (1) for the fiscal year involved, the
particular diseases with respect to which the grant is to be made to the
applicant. The Secretary may select, for purposes of the determination, any
or all of the diseases so specified. The Secretary may not make such a grant
unless the applicant agrees to carry out this section only with respect to
the disease or diseases selected for the applicant through the determination.
`(c) AUTHORIZED ACTIVITIES- With respect to any sexually transmitted
disease described in subsection (a), the activities referred to in such
subsection are--
`(1) providing counseling to women on the prevention and control of the
disease, including, in the case of a woman with the disease, counseling on
the benefits of locating and providing such counseling to any individual
from whom the woman may have contracted the disease and any individual
whom the woman may have exposed to the disease;
`(2) screening women for the disease and for secondary conditions resulting
from the disease;
`(3) providing treatment to women for the disease;
`(4) providing for the provision of necessary medical services to women
screened pursuant to paragraph (2), and referrals for evaluation and
treatment regarding acquired immune deficiency syndrome and other sexually
transmitted diseases;
`(5) providing follow-up services to determine the outcomes of medical
services;
`(6) in the case of any woman receiving services pursuant to any of
paragraphs (1) through (5), providing to the partner of the woman the
services described in such paragraphs, as appropriate;
`(7) providing outreach services to inform women of the fact that the
services described in paragraphs (1) through (6) are available from the
grantee involved;
`(8) providing to the public information and education on the prevention
and control of the disease, including disseminating such information;
`(9) providing training to health care providers in carrying out the
counseling and screenings described in paragraphs (1) and (2);
`(10) in the case of services and activities described in this subsection,
coordinating the services and activities in accordance with subsection
(g); and
`(11) collecting, in accordance with subsection (k), data on the incidence
and prevalence of the disease in order to assist in carrying out activities
for the prevention and control of the disease, including activities to
educate the public regarding the disease.
`(d) REQUIREMENT OF AVAILABILITY OF ALL SERVICES THROUGH EACH GRANTEE- The
Secretary may not make a grant under subsection (a) unless the applicant
involved agrees that each authorized service will be available through the
applicant. With respect to compliance with such agreement, the applicant
may expend the grant to provide any of the services directly, and may
expend the grant to enter into agreements with other public or nonprofit
private entities under which the entities provide the services.
`(e) REQUIRED PROVIDERS REGARDING CERTAIN SERVICES- The Secretary may not
make a grant under subsection (a) unless the applicant involved agrees that,
in expending the grant to provide authorized services, the services described
in paragraphs (1) through (7) of subsection (c) will be provided only through
entities that are State or local health departments, grantees under section
329, 330, or 1001 or are other public or nonprofit private entities that
provide health services to a significant number of low-income women.
`(f) QUALITY ASSURANCE REGARDING SCREENING FOR DISEASES- For purposes
of this section, the Secretary shall establish criteria for ensuring
the quality of screening procedures for diseases described in subsection
(a). The Secretary may not make a grant under such subsection unless the
applicant involved agrees, with respect to any disease selected in the
determination made under subsection (b)(2) for the applicant, to carry
out screenings for the disease in accordance with such criteria.
`(g) COORDINATION OF SERVICES- The Secretary may not make a grant under
subsection (a) unless the applicant involved agrees to coordinate all
authorized services provided through the applicant for the purpose of
ensuring efficiency in the provision of the services.
`(h) CONFIDENTIALITY- The Secretary may not make a grant under subsection
(a) unless the applicant involved agrees to maintain the confidentiality
of information on individuals regarding screenings of the individuals for
sexually transmitted diseases, subject to complying with applicable law.
`(i) LIMITATION ON IMPOSITION OF FEES FOR SERVICES- The Secretary may not
make a grant under subsection (a) unless the applicant involved agrees
that, if a charge is imposed for the provision of services or activities
under the grant, such charge--
`(1) will be made according to a schedule of charges that is made available
to the public;
`(2) will be adjusted to reflect the income of the individual involved; and
`(3) will not be imposed on any individual with an income of less than 150
percent of the official poverty line, as established by the Director of the
Office of Management and Budget and revised by the Secretary in accordance
with section 673(2) of the Omnibus Budget Reconciliation Act of 1981.
`(j) LIMITATIONS ON CERTAIN EXPENDITURES- The Secretary may not make a
grant under subsection (a) unless the applicant for the grant agrees that--
`(1) in the case of the first fiscal year for which the applicant receives
payments under the grant, not more than 20 percent of the grant will
be expended for the purpose of carrying out paragraphs (8) through (11)
and subsection (c); and
`(2) in the case of any subsequent fiscal year for which the applicant
receives payments under any grant under subsection (a), not more than 15
percent of the grant will be expended for such purpose.
`(k) REPORTS TO SECRETARY-
`(1) COLLECTION OF DATA- The Secretary may not make a grant under subsection
(a) unless the applicant for the grant agrees, with respect to any disease
selected in the determination made under subsection (b)(2) for the applicant,
to submit to the Secretary, for each fiscal year for which the applicant
receives such a grant, a report providing--
`(A) the incidence of the disease among the population of individuals
served by the applicant;
`(B) the number and demographic characteristics of individuals in such
population;
`(C) the types of interventions and treatments provided by the applicant,
and the health conditions with respect to which referrals have been made
pursuant to subsection (c)(4);
`(D) an estimate by the applicant of the effect of the services provided
under the grant on the community in which the services have been provided;
and
`(E) providing such other information as is available to the applicant
and determined by the Secretary to be relevant regarding the prevention
and control of the disease.
`(2) UTILITY AND COMPARABILITY OF DATA- The Secretary shall carry out
activities for the purpose of ensuring the utility and comparability of data
collected pursuant to paragraph (1). The Secretary may not make a grant
under subsection (a) unless the applicant involved makes such agreements
as the Secretary determines to be necessary for such purpose.
`(l) MAINTENANCE OF EFFORT-
`(1) IN GENERAL- With respect to activities for which a grant under
subsection (a) is authorized to be expended, the Secretary may not,
subject to paragraph (2), make such a grant for any fiscal year unless the
applicant agrees to maintain expenditures of non-Federal amounts for such
activities at a level that is not less than the level of such expenditures
maintained by the entity for the fiscal year preceding the first fiscal
year for which the entity receives such a grant.
`(2) APPLICABILITY TO PRIVATE ENTITIES- In the case of a nonprofit private
entity making an agreement under paragraph (1), the Secretary may require
the entity to comply with the agreement only to the extent of the amount
of non-Federal amounts that are available to the entity for the activities
to which the agreement applies.
`(m) SUBMISSION OF PLAN FOR PROGRAM OF GRANTEE-
`(1) IN GENERAL- The Secretary may not make a grant under subsection (a)
unless the applicant involved submits to the Secretary a plan describing
the manner in which the applicant will comply with the agreements required
as a condition of receiving such a grant, including a specification of
the entities through which authorized services will be provided and a
specification of the manner in which such services will be coordinated
for purposes of subsection (g).
`(2) PARTICIPATION OF CERTAIN ENTITIES- The Secretary may not make a grant
under subsection (a) unless the applicant provides assurances satisfactory
to the Secretary that the plan submitted under paragraph (1) has been
prepared in consultation with an appropriate number and variety of--
`(A) representatives of entities in the geographic area involved that
provide services for the prevention and control of sexually transmitted
diseases, including programs to provide to the public information and
education regarding such diseases; and
`(B) representatives of entities in such area that provide family planning
services.
`(n) REQUIREMENT OF APPLICATION- The Secretary may not make a grant under
subsection (a) unless an application for the grant is submitted to the
Secretary, the application contains the plan required in subsection (m),
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 necessary to carry out this section.
`(o) DURATION OF GRANT- The period during which payments are made to an
entity from a grant under subsection (a) may not exceed 3 years. The
provision of such payments shall be subject to annual approval by the
Secretary of the payments and subject to the availability of appropriations
for the fiscal year involved to make the payments in such year. The
preceding sentence may not be construed to establish a limitation on the
number of grants under such subsection that may be made to an entity.
`(p) TECHNICAL ASSISTANCE, AND SUPPLIES AND SERVICES IN LIEU OF GRANT FUNDS-
`(1) TECHNICAL ASSISTANCE- The Secretary may provide training and technical
assistance to grantees under subsection (a) with respect to the planning,
development, and operation of any program or service carried out under such
subsection. The Secretary may provide such technical assistance directly
or through grants or contracts.
`(2) SUPPLIES AND SERVICES IN LIEU OF GRANT FUNDS-
`(A) Upon the request of a grantee under subsection (a), the Secretary may,
subject to subparagraph (B), provide supplies, equipment, and services for
the purpose of aiding the grantee in carrying out such subsection and,
for such purpose, may detail to the grantee any officer or employee of
the Department of Health and Human Services.
`(B) With respect to a request described in subparagraph (A), the Secretary
shall reduce the amount of the grant to the grantee involved by an amount
equal to the costs of detailing personnel and the fair market value of any
supplies, equipment, or services provided by the Secretary. The Secretary
shall, for the payment of expenses incurred in complying with such request,
expend the amounts withheld.
`(q) EVALUATIONS AND REPORTS BY SECRETARY-
`(1) EVALUATIONS- The Secretary shall, directly or through contracts with
public or private entities, provide for annual evaluations of programs
carried out pursuant to subsection (a) in order to determine the quality
and effectiveness of the programs.
`(2) REPORT TO CONGRESS- Not later than 1 year after the date on which
amounts are first appropriated pursuant to subsection (t), and annually
thereafter, the Secretary shall submit to the Committee on Energy and
Commerce of the House of Representatives, and to the Committee on Labor
and Human Resources of the Senate, a report--
`(A) summarizing the information provided to the Secretary in reports
made pursuant to subsection (k), including information on the incidence
of sexually transmitted diseases described in subsection (a); and
`(B) summarizing evaluations carried out pursuant to paragraph (1) during
the preceding fiscal year.
`(r) COORDINATION OF FEDERAL PROGRAMS- The Secretary shall coordinate the
activities carried out under the program established in this section with
any similar activities regarding sexually transmitted diseases that are
carried out under other programs administered by the Secretary, including
the coordination of such activities of the Director of the Centers for
Disease Control and Prevention with such activities of the Director of
the National Institutes of Health.
`(s) DEFINITIONS- For purposes of this section, the term `authorized service'
means any service or activity described in subsection (c).
`(t) AUTHORIZATION OF APPROPRIATIONS- For the purpose of carrying out this
section, other than subsections (q) and (u), there are authorized to be
appropriated $50,000,000 for each of the fiscal years 1992 through 1996.
`(u) SEPARATE GRANTS FOR RESEARCH ON DELIVERY OF SERVICES-
`(1) IN GENERAL- The Secretary may make grants for the purpose of conducting
research on the manner in which the delivery of services under subsection
(a) may be improved. The Secretary may make such grants only to grantees
under such subsection and to public and nonprofit private entities that
are carrying out projects substantially similar to projects carried out
under such subsection.
`(2) AUTHORIZATION OF APPROPRIATIONS- For the purpose of carrying out
paragraph (1), there are authorized to be appropriated such sums as may
be necessary for each of the fiscal years 1992 through 1996.'.

c8f2b15a40fb82139c71473865674e9772f85f1792f0e8a26831f2b9d6bfe4bd

This title may be cited as the `Comprehensive Maternal and Early Childhood
Health Care Act'.

56338f7eb82797767a85cf0be7a3094d09ff0e76ff786a12ae8488d6b087612e

COMPREHENSIVE MATERNAL AND EARLY CHILDHOOD HEALTH CARE

(a) MIGRANT HEALTH CENTERS- Paragraph (2) of subsection (h) of section 329
(42 U.S.C. 254b(g)) is amended to read as follows:
`(2)(A) For purposes of subparagraph (B), from the amounts appropriated
in each fiscal year under paragraph (1)(A), that are in excess of the
amounts necessary to maintain the level of services provided with amounts
appropriated under such paragraph in the year preceding the year for which
such amounts are appropriated, the Secretary shall utilize, in each of the
fiscal years 1992 through 1994, such sums as may be necessary in each such
fiscal year for the development and operation of new Comprehensive Perinatal
and Early Childhood Health Programs in medically underserved areas where
such programs do not exist, and expand the capacity of services provided for
pregnant women and children up to the age of three, in medically underserved
areas where Migrant Health Centers are currently operating Comprehensive
Perinatal Care Programs. The Secretary shall utilize such amounts to
supplement and not supplant amounts expended on the date of enactment of
this paragraph for Comprehensive Perinatal Care Programs under this section.
`(B) The Secretary shall make grants to Migrant Health Centers to assist
such Centers in the development and operation of Comprehensive Perinatal
and Early Childhood Health Programs. Such Programs shall be designed to
provide coordinated health care and support services to pregnant women and
young children to increase positive birth outcomes, reduce infant mortality,
and support healthy child development. Such services shall include--
`(i) public information, outreach and case finding services provided through
the use of media, community canvassing (using volunteer and paraprofessional
personnel), referrals, or other methods targeted to reach women at high-risk
of receiving inadequate health care;
`(ii) individualized risk assessment and case management services for
pregnant women, infants, and children to ensure early, continuous, and
comprehensive health care and support services including--
`(I) health care (including prenatal health care, nutrition counseling,
and smoking cessation interventions), and health education concerning the
risks of smoking, alcohol, substance abuse, and inadequate nutrition; and
`(II) perinatal care, primary and preventive health care for infants and
children (including screening for vision, hearing, dental conditions,
developmental delay, nutritional status, and lead poisoning), timely
provision of immunizations, and referral for specialized early periodic
screening diagnostic treatment services, services under part H of the
Individuals with Disabilities Education Act, and other necessary health
and support services;
`(iii) substance abuse screening, outpatient substance abuse counseling
services, and referral to and as necessary for the purchase of
community-based residential substance abuse treatment services for women
with substance abuse problems;
`(iv) parenting skill training and child development education (including
services stressing the importance of regular health screenings, adequate
nutrition, child safety measures and basic growth patterns and expectations)
through both center based counseling and through distribution of the
Maternal Child Health Handbooks as available;
`(v) necessary support services, including counseling, child care,
transportation, translation services, benefit eligibility determination,
and housing assistance, either provided directly or through referral with
appropriate follow-up; and
`(vi) collaboration with other community-based health and support service
providers, hospitals, clinics, recipients of grants under title V of the
Social Security Act, State and local health and social service departments,
alcohol and drug treatment programs, State and local special supplemental
food programs for women, infants and children under section 17 of the
Child Nutrition Act of 1966, Medicaid offices, and other organizations
providing services to women, infants, children, and families.
`(C) To the maximum extent practicable, comprehensive health and support
services under this paragraph should be delivered on site at the health
center (including services delivered by outposted Medicaid workers in
accordance with section 1902 of the Social Security Act (42 U.S.C. 1396a),
by workers eligible to provide services under section 17 of the Child
Nutrition Act of 1966 (42 U.S.C. 1786), by drug treatment service providers
and through others) to ensure access and coordination.'.
(b) COMMUNITY HEALTH CENTERS- Subsection (g) of section 330 (42
U.S.C. 254c(g)) is amended:
(1) in paragraph (1) by adding at the end thereof the following new
subparagraph:
`(C) Of the amounts appropriated under subparagraph (A), that are in excess
of the amounts necessary to maintain the level of services provided with
amounts appropriated under such subparagraph in the year preceding the year
for which such amounts are appropriated, the Secretary shall utilize, in
each of the fiscal years 1992 through 1994, such sums as may be necessary
in each such fiscal year to make grants under subsections (c) and (d)
for the planning and development of health centers to serve medically
underserved populations. New community health centers shall be equitably
distributed between underserved urban and rural areas with satellite models
used where appropriate.'; and
(2) in paragraph (2) to read as follows:
`(2)(A) For purposes of subparagraph (B), from the amounts appropriated
in each fiscal year under paragraph (1)(A), that are in excess of the
amounts necessary to maintain the level of services provided with amounts
appropriated under such paragraph in the year preceding the year for which
such amounts are appropriated, the Secretary shall utilize, in each of the
fiscal years 1992 through 1994, such sums as may be necessary in each such
fiscal year for--
`(i) the development and operation of new Comprehensive Perinatal and
Early Childhood Health Programs in medically underserved areas where such
programs do not exist; and
`(ii) expanding the capacity of services provided for pregnant women and
children up to the age of three, in medically underserved areas where
community health centers are currently operating Comprehensive Perinatal
Care Programs in areas with high infant mortality.
The Secretary shall utilize such amounts to supplement and not supplant
amounts expended on the date of enactment of this paragraph for Comprehensive
Perinatal Care Programs under this section.
`(B) The Secretary shall make grants to Community Health Centers to assist
such Centers in the development and operation of Comprehensive Perinatal
and Early Childhood Health Programs. Such programs shall be designed to
provide coordinated health care and support services to pregnant women and
young children to increase positive birth outcomes, reduce infant mortality,
and support healthy child development. Such services shall include--
`(i) public information, outreach and case finding services provided through
the use of media, community canvassing (using volunteer and paraprofessional
personnel), referrals, or other methods targeted to reach women at high-risk
of receiving inadequate health care;
`(ii) individualized risk assessment and case management services for
pregnant women, infants, and children to ensure early, continuous, and
comprehensive health care and support services including--
`(I) health care (including prenatal health care, nutrition counseling,
and smoking cessation interventions), and health education concerning the
risks of smoking, alcohol, substance abuse, and inadequate nutrition; and
`(II) perinatal care, primary and preventive health care for infants and
children (including screening for vision, hearing, dental conditions,
developmental delay, nutritional status, and lead poisoning), timely
provision of immunizations, and referral for specialized early periodic
screening diagnostic treatment services, services under part H of the
Individuals with Disabilities Education Act, and other necessary health
and support services;
`(iii) substance abuse screening, outpatient substance abuse counseling
services, and referral to and as necessary the purchase of community-based
residential substance abuse treatment services for women with substance
abuse problems;
`(iv) parenting skill training and child development education (including
services stressing the importance of regular health screenings, adequate
nutrition, child safety measures and basic growth patterns and expectations)
through both center-based counseling and through distribution of the
Maternal Child Health Handbooks as available;
`(v) necessary support services, including counseling, child care,
transportation, translation services, benefit eligibility determination,
and housing assistance, either provided directly or through referral with
appropriate follow-up; and
`(vi) collaboration with other community-based health and support service
providers, hospitals, clinics, recipients of grants under title V of the
Social Security Act, State and local health and social service departments,
alcohol and drug treatment programs, State and local special supplemental
food programs for women, infants and children under section 17 of the
Child Nutrition Act of 1966, Medicaid offices, and other organizations
providing services to women, infants, children, and families.
`(C) To the maximum extent practicable, comprehensive health and support
services under this paragraph should be delivered on site at the health
center, (including services delivered by outposted Medicaid workers in
accordance with section 1902 of the Social Security Act (42 U.S.C. 1396a),
by workers eligible to provide services under section 17 of the Child
Nutrition Act of 1966 (42 U.S.C. 1786), by drug treatment service providers
and by others) to ensure access and coordination.'.
(c) PROGRAMS FOR THE BENEFIT OF HOMELESS INDIVIDUALS- Subsection (q) of
section 340 (42 U.S.C. 256(q)) is amended by adding at the end thereof
the following new paragraph:
`(3)(A) For purposes of subparagraph (B), from the amounts appropriated
in each fiscal year under paragraph (1)(A), that are in excess of the
amounts necessary to maintain the level of services provided with amounts
appropriated under such paragraph in the year preceding the year for which
such amounts are appropriated, the Secretary shall utilize, in each of the
fiscal years 1992 through 1994, such sums as may be necessary in each such
fiscal year for--
`(i) the development and operation of new Comprehensive Perinatal and
Early Childhood Health Programs in medically underserved areas where such
programs do not exist; and
`(ii) expanding the capacity of services provided for pregnant women
and children up to the age of three, in medically underserved areas where
grantees under this section are currently operating Comprehensive Perinatal
Care Programs.
The Secretary shall utilize such amounts to supplement and not supplant
amounts expended on the date of enactment of this paragraph for Comprehensive
Perinatal Care Programs under this section.
`(B) The Secretary shall make grants to grantees under this section to assist
such grantees in the development and operation of Comprehensive Perinatal
and Early Childhood Health Programs. Such Programs shall be designed to
provide coordinated health care and support services to pregnant women and
young children to increase positive birth outcomes, reduce infant mortality,
and support healthy child development. Such services should include--
`(i) public information, outreach and case finding services provided through
the use of media, community canvassing (using volunteer and paraprofessional
personnel), referrals, or other methods targeted to reach women at high-risk
of receiving inadequate health care;
`(ii) individualized risk assessment and case management services for
pregnant women, infants, and children to ensure early, continuous, and
comprehensive health care and support services including--
`(I) health care (including prenatal health care, nutrition counseling,
and smoking cessation interventions), and health education concerning the
risks of smoking, alcohol, substance abuse, and inadequate nutrition; and
`(II) perinatal care, primary and preventive health care for infants and
children (including screening for vision, hearing, dental conditions,
developmental delay, nutritional status, and lead poisoning), timely
provision of immunizations, and referral for specialized early periodic
screening diagnostic treatment services, services under part H of the
Individuals with Disabilities Education Act, and other necessary health
and support services;
`(iii) substance abuse screening, outpatient substance abuse counseling
services, and referral to and as necessary the purchase of community-based
residential substance abuse treatment services for women with substance
abuse problems;
`(iv) parenting skill training and child development education (including
services stressing the importance of regular health screenings, adequate
nutrition, child safety measures and basic growth patterns and expectations)
through both center-based counseling and through distribution of the
Maternal Child Health Handbooks as available;
`(v) necessary support services, including counseling, child care,
transportation, translation services, benefit eligibility determination,
and housing assistance, either provided directly or through referral with
appropriate follow-up; and
`(vi) collaboration with other community-based health and support service
providers, hospitals, clinics, recipients of grants under title V of the
Social Security Act, State and local health and social service departments,
alcohol and drug treatment programs, State and local special supplemental
food programs for women, infants and children under section 17 of the
Child Nutrition Act of 1966, Medicaid offices, and other organizations
providing services to women, infants, children, and families.
`(C) To the maximum extent practicable, comprehensive health and support
services under this paragraph should be delivered on site at a health center,
(including services delivered by outposted Medicaid workers in accordance
with section 1902 of the Social Security Act (42 U.S.C. 1396a), by workers
eligible to provide services under section 17 of the Child Nutrition Act of
1966 (42 U.S.C. 1786), by drug treatment service providers and by others)
to ensure access and coordination.'.

d936c62c5ca2ef43d6e5d90f75fec96e7771dad733c3d520b59a975a7196e1d1

(a) VACCINE BULK PURCHASE PROGRAM- Part B of title III (as amended by
section 134) is further amended by adding after section 317D the following
new section:
`SEC. 317E . VACCINE BULK PURCHASE PROGRAM.
`(a) IN GENERAL- The Secretary acting through the Director of the Centers
for Disease Control and in accordance with the preventative health grant
provisions of subsections (a) and (j)(1)(B) of section 317, shall provide
to the health department of each State or large city that is operating an
immunization project, vaccines for immunization purposes.
`(b) DISTRIBUTION- Vaccines provided to grantees with existing immunization
projects under subsection (a) shall be made available for distribution
and immunization services through the public health departments of such
States or cities, recipients of grants under section 329, 330, and 340
in the State or city, Federally qualified health centers under section
1905(l)(2)(B) of the Social Security Act operating in the State or city,
and public health professionals.
`(c) QUANTITY- In determining the quantity of vaccine that is needed by a
grantee under subsection (a), the Administrator of the Health Resources and
Services Administration shall make available to the Director of the Centers
for Disease Control data from annual reports submitted by recipients of
grants under section 329, 330, and 340 and from entities certified as
Federally qualified health centers under section 1905(l)(2)(B) of the
Social Security Act. The Director of such Centers shall direct the health
department of the State, county or city to equitably allocate vaccines made
available under the bulk purchase program among those recipients described
in subsection (b) who are providing immunization services to children,
except that the amounts received by each provider on the date of enactment
of this section shall not be diminished relative to the population served,
and that grantees shall receive not less than the amount such grantees
received under their bulk vaccine allotment as of January 1, 1991.
`(d) MAINTENANCE OF SUPPLY- The provisions of this section shall be
effective only to the extent to which the Secretary, acting through the
Director of the Centers for Disease Control, provides assurances that the
implementation of this section will not result in a reduction in the supply
of vaccines available to grantees receiving vaccine allotments under the
bulk purchasing programs as of January 1, 1991.'.
(b) IMMUNIZATION DEMONSTRATION PROJECTS FOR OUTREACH PROGRAMS- Subsection
(b) of section 2 of the Vaccine and Immunization Amendments of 1990
(Public Law 101-502) is amended to read as follows:
`(b) DEMONSTRATION PROJECTS FOR OUTREACH PROGRAMS-
`(1) IN GENERAL- The Secretary of Health and Human Services, acting through
the Director of the Centers for Disease Control, may make grants to States
for the purpose of carrying out demonstration projects--
`(A) to provide, without administrative charge, immunizations for vaccine
preventable diseases to children not more than 2 years of age who reside
in communities whose population includes a significant number of low
income individuals, increasing the capacity of public health departments
to deliver vaccines and facilitating outreach activities to improve the
percentage of fully immunized children;
`(B) to expand the capacity of public health departments, recipients
of grants under sections 329, 330, and 340 of the Public Health Service
Act, and other health provider entities that are co-located with centers
providing services under section 17 of the Child Nutrition Act of 1966 in
order to provide immunizations to participants in the program established
under such section 17 during regular hours, and to enable State health
departments working through State directors of the program established
under such section 17 to make available to such centers vaccines and
adequate funds to administer immunizations; and
`(C) to maintain private provider participation in the provision of
immunization services and to encourage private physicians to provide such
services to infants and children enrolled for benefits under title XIX of
the Social Security Act.
`(2) AUTHORIZATION OF APPROPRIATIONS- For the purposes of carrying out
paragraph (1), there are authorized to be appropriated $25,000,000 in fiscal
year 1992, and such sums as may be necessary for each of the fiscal years
1993 through 1995.'.

3f369d192add5ae44a0073d8f5ca5e8475111129b20ab21d52ac9873fc0efb35

CARE SERVICES.
Section 314 (42 U.S.C. 246) is amended by adding at the end thereof the
following new subsection:
`(g)(1) The Secretary is authorized to award grants to eligible entities
for the development and operation of Comprehensive Perinatal and Early
Childhood Health Programs, to provide coordinated health care and support
services to pregnant women and young children to increase positive birth
outcomes, reduce infant mortality, and support healthy child development.
`(2)(A) To be eligible to receive a grant under this subsection, an entity
shall be a public health department or public or private nonprofit health
entity that--
`(i) does not receive assistance under section 329 or 330;
`(ii) is located in a medically underserved or health professional shortage
area not served by an entity receiving funds under section 329 or 330; and
`(iii) has demonstrated a commitment to serving low income and uninsured
individuals and families.
`(B) Notwithstanding subparagraph (A), entities located in areas served by
grantees under section 329 or 330 may apply for and receive a grant under
this subsection, if such 329 or 330 grantees do not intend to apply for
expanded funding for prenatal and early childhood health care services,
and if such entities can demonstrate that--
`(i) the women and children to be served, or the services to be provided,
using funds provided under the grant are in addition to those populations
served and services offered by such existing section 329 or 330 grantees; and
`(ii) the entity will not use funds provided under this subsection to
supplant State expenditures.
`(3) Services to be provided with funds under a grant awarded under this
subsection shall be delivered in a culturally sensitive manner and made
accessible to the population to be served. Such services shall include--
`(A) public information, outreach, or case finding services provided
through the use of media, community canvassing (including the use of
volunteer and paraprofessional personnel), referrals, or other methods
targeted to reach women at high-risk of receiving inadequate health care;
`(B) individualized risk assessment and case management services for
pregnant women, infants, and children to ensure early, continuous, and
comprehensive health care and support services including--
`(i) health care (including prenatal health care, nutrition counseling,
and smoking cessation interventions), and health education concerning the
risks of smoking, alcohol, substance abuse, and inadequate nutrition; and
`(ii) perinatal care, primary and preventive health care for infants and
children (including screening for vision, hearing, dental conditions,
developmental delay, nutritional status, and lead poisoning), timely
immunizations, and referral for specialized early periodic screening
diagnostic treatment services, services under part H of the Individuals with
Disabilities Education Act, and other necessary health and support services;
`(C) collaboration with other community-based health and support service
providers, hospitals, clinics, recipients of grants under title V of the
Social Security Act, State and local health and social service departments,
alcohol and drug treatment programs, State and local special supplemental
food programs for women, infants and children under section 17 of the
Child Nutrition Act of 1966, Medicaid offices, and other organizations
providing services to women, infants, children and families;
`(D) substance abuse screening, outpatient substance abuse counseling
services, or referral to substance abuse treatment services for women with
substance abuse problems;
`(E) necessary support services, including counseling, child care,
transportation, translation services, benefit eligibility determination,
and housing assistance, either provided directly or through referral with
appropriate follow-up; and
`(F) parenting skill training and child development education (including
services stressing the importance of regular health screenings, adequate
nutrition, child safety measures and basic growth patterns and expectations)
through both counseling provided directly by the grantee, and through
distribution of the Maternal Child Health Handbooks as available.
Services described in subparagraphs (D), (E) and (F) shall be provided by
grantees under this subsection to the maximum extent practicable.
`(4) To the maximum extent practicable, services provided under this
subsection shall be delivered in a single location by the grantee, except
that such may include multiple sites if mobile health care provider units
are utilized (including services delivered by outposted Medicaid workers
in accordance with section 1902 of the Social Security Act, by workers
eligible to provide services under section 17 of the Child Nutrition Act
of 1966, by drug treatment service providers, and by others) to ensure
access and coordination.
`(5) The Secretary may not award a grant under this subsection unless--
`(A) the applicant for the grant has entered into, or will enter into,
a participation agreement within 180 days of the date of the grant award
with the State agency administering funds under title XIX of the Social
Security Act and is qualified to receive such payments for services provided;
`(B) the applicant for the grant has prepared a schedule of fees or payments
for the provision of services under paragraph (3) consistent with locally
prevailing rates or charges, and has prepared a corresponding schedule
of discounts to be applied to the payment of such fees or payments, such
discounts to be adjusted on the basis of the patient's ability to pay;
`(C) the applicant for the grant provides assurances that every reasonable
effort will be made to secure from patients and third party reimbursement
entities, including any State compensation program, health insurance entity,
any entity providing health services on a prepaid basis, or any Federal
or State health benefits program, full payment for the services provided
under paragraph (3).
Amounts awarded under this subsection shall be used as the payment source
of last resort for services provided.
`(6) In addition to providing the services required under paragraph (3),
a grantee may use amounts provided under the grant for minor remodeling
and rehabilitation of the facilities needed to support the delivery of
such services. No funds may be used for the construction of new buildings
or the acquisition of properties.
`(7) A grantee shall not use in excess of 5 percent of the amounts received
under a grant awarded under this subsection for administration, accounting,
reporting and program oversight functions.
`(8) To be eligible to receive a grant under this subsection, an entity,
in addition to meeting the requirements of paragraph (2), shall prepare
and submit to the Secretary an application at such time, in such form,
and containing such information as the Secretary shall require, including
assurances adequate to ensure--
`(A) that funds received under a grant awarded under this subsection will
be utilized to supplement not supplant State funds made available to the
entity for the provision of maternal and child health and social services,
with identification of funding received from other sources for such purposes;
`(B) that prenatal and early childhood health care will be provided under
a case management model, that continuity of care will be provided for all
individuals, and that services to be provided are accessible to the target
population to be served;
`(C) that the entity will serve low income women and children in the
service delivery area, and have a plan for outreach to those at risk of
inadequate health care services;
`(D) that the entity has outlined a needs assessment of the health
care delivery system in the service delivery area, to include health
status indicators for women of childbearing age and young children, and
identification of other health care provider groups in the area;
`(E) that the entity has reviewed the application for a grant under this
section with the State agency administering amounts received under title
V of the Social Security Act and the local health department,  and that
such application is consistent with the State plan for the delivery of
maternal and child health services; and
`(F) that the entity will submit a report to the Secretary and to the
State and relevant local health departments that will include demographic
data on the number of individuals served and those services provided with
funds provided under this subsection, and a description of the manner in
which services provided by the entity are integrated with those services
provided by other health care agencies or provider groups in the service
delivery area.
`(9) In awarding grants under this subsection, the Secretary should give
priority to--
`(A) those applications submitted by entities that are an association
of one or more public, and one or more nonprofit private health care and
social service providers, except that in areas where such an association
would not be possible as a result of the absence of more than one provider
entity, no such priority shall be given; and
`(B) those applications providing evidence of local investment (such as
State, health care provider, local charity, and volunteer organization
contributions) in maternal and child health initiatives, through a 10
percent local contribution to match Federal funds, in cash or in kind,
fairly evaluated, not including any portion of any service subsidized by
the Federal Government or other copayments under paragraph (5).
Grants under this subsection shall be awarded on an equitable basis among
eligible rural and urban applicants.
`(10) Not later than 30 months after the date of enactment of this
subsection, the Secretary shall prepare and submit, to the Senate Committee
on Labor and Human Resources, the Senate Finance Committee, and the House
Committee on Energy and Commerce, an evaluation of the program established
under this subsection, that shall include--
`(A) an analysis of the manner in which funds provided under this subsection
have been used by grantees, with a review of the services provided;
`(B) the infant mortality rates and immunization rates in the communities
served by grantees prior to the receipt of such a grant and at the time
such evaluation is prepared, and an assessment of the impact of enhanced
services on such rates;
`(C) an analysis of the manner in which entities receiving grants under
this subsection have integrated the services provided under such grants
with other available health and social service providers in the service
delivery area; and
`(D) recommendations concerning any modifications necessary to improve
program effectiveness in reaching the stated goals of the program in a
cost-effective manner.
`(11) There are authorized to be appropriated for each of the fiscal
years 1992 through 1994, such sums as may be necessary to carry out this
subsection.'.

2b2aa10668b841f7c86ccb8c70cb404b894f0c7e21418354d6b718a2e4af517e

Part B of title III (42 U.S.C. 243 et seq.) (as amended by section 403) is
further amended by inserting after section 317E, the following new section:
`SEC. 317F. COORDINATION OF BIRTH DEFECTS SURVEILLANCE AND EPIDEMIOLOGY
RESEARCH PROGRAMS.
`(a) FINDINGS- Congress finds that--
`(1) birth defects are the leading cause of infant mortality, directly
responsible for one out every five infant deaths;
`(2) thousands of the 250,000 infants born with a birth defect annually
face a lifetime of chronic disability and illness; and
`(3) there is no national effort to record birth defect data and perform
epidemiologic surveillance even though such data would aid research efforts
to understand and reduce the incidence of preventable birth defects.
`(b) PLAN FOR IMPLEMENTING A NATIONAL BIRTH DEFECTS MONITORING SYSTEM AND
SURVEILLANCE PROGRAM-
`(1) DEVELOPMENT- The Secretary, acting through the Centers for Disease
Control, shall develop a plan to establish regional birth defects monitoring
programs to serve all States for the purpose of collecting and analyzing
data on the incidence of birth defects with relevant epidemiologic data. Such
plan shall specify how collaborative efforts between the Centers for Disease
Control and responsible State agencies will be carried out, and may include
the provision of grants or cooperative agreements, and technical assistance.
`(2) CLEARINGHOUSE- The Centers for Disease Control shall develop a program
plan to serve as the national clearinghouse of the collection and storage
of data and information generated from birth defects monitoring programs
developed under paragraph (1). Functions of the clearinghouse will include
facilitating the coordination of birth defects research.
`(3) REPORT- The Secretary shall prepare and submit to the Committee on
Labor and Human Resources of the Senate and the Committee on Energy and
Commerce of the House of Representatives a report containing the plan
required under paragraph (1), together with recommendations to facilitate
the immediate implementation of such plan, on or before July 1, 1993.
`(c) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be appropriated
to carry out this section, $5,000,000 for fiscal year 1992, and such sums
as may be necessary for each of the fiscal years 1993 and 1994.'.

f3494ed4e9a2793548732c8c8c953a8ffac93f37def19b98a0b28fa8e2ea4130

DISEASE PREVENTION.
Title XVII (42 U.S.C. 300u et seq.) (as amended by sections 137 and 207)
is further amended by adding at the end thereof the following new section:
`SEC. 1710 . SECRETARY'S ADVISORY COUNCIL.
`(a) IN GENERAL- The Secretary shall establish an advisory council on
health promotion and disease prevention to be known as the Secretary's
Advisory Council on Health Promotion and Disease Prevention (hereafter
referred to in this section as the `Council').
`(b) COMPOSITION- The Council shall be composed of--
`(1) the Secretary;
`(2) recognized leaders in health promotion, academia, industry, non-profit
private organizations and representatives of health care consumer groups,
to be appointed by the Secretary;
`(3) ex officio members who shall include representatives of--
`(A) the Department of Health and Human Services as designated by the
Secretary;
`(B) the Departments of Education;
`(C) the Department of Agriculture;
`(D) the Office of Science and Technology Policy;
`(E) the Surgeon Generals of all of the uniformed services; and
`(F) the chief medical officer of the Department of Veterans Affairs; and
`(4) the members of the National Health Objectives Advisory Committee
established under section 1910K.
`(c) DUTIES- The Council shall provide advice and recommendations to the
Secretary concerning the goals and priorities of the Department relating
to health promotion, disease prevention, preventive health services and
the objectives established by the Secretary for the health status of the
population of the United States under to section 1906(d). The Council may
also direct that recommendations for changes in priorities or programs be
prepared and submitted to the Congress and the President.
`(d) FUNDING- The Secretary is authorized to transfer not to exceed one
percent of any appropriation authorized under this Act to provide the funds
necessary for the operation of the Council. The total amount transferred
under this subsection shall not exceed $400,000 for each fiscal year.'.

48fe3a69c01767208156199c9b9acdf1bc2e4c79bcc36805eae866db585e560b

-MISCELLANEOUS

PROMOTION AND DISEASE PREVENTION.
Section 204 (42 U.S.C. 205) is amended--
(1) by inserting `(a)' after the section designation; and
(2) by adding at the end thereof the following new subsection:
`(b) The Surgeon General shall notify all active members of the Commissioned
Corps concerning any guidelines and recommendations for clinical practice
that are developed or issued by the Public Health Service. The Surgeon
General shall also ensure that members of the Commissioned Corps who are
engaged in clinical practice are properly utilizing such guidelines and
recommendations.'.

8c3cf59baabf2f93beca42151746232d2253ec6a0d8832f4f33c11b2508b3164

AND RECOMMENDATIONS.
Title XVII (42 U.S.C. 300u) (as amended by sections 137, 207 and 501)
is further amended by adding at the end thereof the following new section:
`SEC. 1711. DISSEMINATION OF PREVENTION RECOMMENDATIONS.
`The Secretary, in consultation with the Assistant Secretary for Health,
the Director of the Office of Disease Prevention and Health Promotion,
the Surgeon General of the Public Health Service, and the Director of
the Agency for Health Care Policy and Research, shall inform the Surgeon
Generals of all the uniformed services, the Secretary of Veterans Affairs,
and the Administrator of the Office of Personnel Management concerning any
guidelines or recommendations for clinical practice that are developed by
the Public Health Service. The Secretary shall annually prepare and submit
to the appropriate committees of Congress, a report describing all such
recommendations transmitted under this section.'.

b37f893fbf2c7eea419828f25c7cde31159c348a13b82b393144e4b95019358d

(a) COMPREHENSIVE SMOKING EDUCATION ACT- Section 3(b)(1)(A) of the
Comprehensive Smoking Education Act (15 U.S.C. 1341(b)(1)(A)) is amended
by striking out `Centers for Disease Control' and inserting in lieu thereof
`Centers for Disease Control and Prevention'.
(b) EDUCATION AMENDMENTS OF 1978- Section 1121(b)(2) of the Education
Amendments of 1978 is amended by striking out `Federal Center for Disease
Control' and inserting in lieu thereof `Centers for Disease Control and
Prevention'.
(c) VETERANS' BENEFITS AND SERVICES ACT OF 1988- Section 123(b)(1) of the
Veterans' Benefits and Services Act of 1988 (38 U.S.C. 210 note) is amended
by striking out `Centers for Disease Control' and inserting in lieu thereof
`Centers for Disease Control and Prevention'.
(d) PUBLIC HEALTH SERVICE ACT- The Public Health Service Act is amended--
(1) in section 227 (42 U.S.C. 236) by striking out `Centers for Disease
Control' each place that such occurs and inserting in lieu thereof `Centers
for Disease Control and Prevention';
(2) in section 317A(a) (42 U.S.C. 247b-1(a)) by striking out `Centers
for Disease Control' and inserting in lieu thereof `Centers for Disease
Control and Prevention';
(3) in section 319(a) (42 U.S.C. 247d(a)) by striking out `Centers for
Disease Control' and inserting in lieu thereof `Centers for Disease Control
and Prevention';
(4) in section 391 (42 U.S.C. 280b) by striking out `Centers for Disease
Control' each place that such occurs and inserting in lieu thereof `Centers
for Disease Control and Prevention';
(5) in section 392 (42 U.S.C. 280b-1) by striking out `Centers for Disease
Control' each place that such occurs and inserting in lieu thereof `Centers
for Disease Control and Prevention';
(6) in section 393 (42 U.S.C. 280b-2) by striking out `Centers for Disease
Control' and inserting in lieu thereof `Centers for Disease Control and
Prevention';
(7) in section 430(b)(2)(A)(i) (42 U.S.C. 285c-4(b)(2)(A)(i)) by striking
out `Centers for Disease Control' and inserting in lieu thereof `Centers
for Disease Control and Prevention';
(8) in section 442(b)(2)(A) (42 U.S.C. 285d-7(b)(2)(A)) by striking out
`Centers for Disease Control' and inserting in lieu thereof `Centers for
Disease Control and Prevention';
(9) in section 464D(b)(2)(A) (42 U.S.C. 285m-4(b)(2)(A)) by striking out
`Centers for Disease Control' and inserting in lieu thereof `Centers for
Disease Control and Prevention';
(10) in section 494(a) (42 U.S.C. 289c(a)) by striking out `Centers for
Disease Control' and inserting in lieu thereof `Centers for Disease Control
and Prevention';
(11) in section 508(b)(6) (42 U.S.C. 290aa-6(b)(6)) by striking out
`Centers for Disease Control' and inserting in lieu thereof `Centers for
Disease Control and Prevention';
(12) in section 509B(a) (42 U.S.C. 290aa-9(a)) by striking out `Centers
for Disease Control' and inserting in lieu thereof `Centers for Disease
Control and Prevention';
(13) in section 1706(c)(2)(B) (42 U.S.C. 300u-5(c)(2)(B)) by striking out
`Centers for Disease Control' and inserting in lieu thereof `Centers for
Disease Control and Prevention';
(14) in section 2102 (42 U.S.C. 300aa-2) by striking out `Centers for
Disease Control' each place that such occurs and inserting in lieu thereof
`Centers for Disease Control and Prevention';
(15) in section 2119(a)(2) (42 U.S.C. 300aa-19(a)(2)) by striking out
`Centers for Disease Control' and inserting in lieu thereof `Centers for
Disease Control and Prevention';
(16) in section 2126(b)(2) (42 U.S.C. 300aa-26(b)(2)) by striking out
`Centers for Disease Control' and inserting in lieu thereof `Centers for
Disease Control and Prevention';
(17) in section 2301(b)(4) (42 U.S.C. 300cc(b)(4)) by striking out `Centers
for Disease Control' and inserting in lieu thereof `Centers for Disease
Control and Prevention';
(18) in section 2303 (42 U.S.C. 300cc-2) by striking out `Centers for
Disease Control' each place that such occurs and inserting in lieu thereof
`Centers for Disease Control and Prevention';
(19) in section 2315(b) (42 U.S.C. 300cc-15(b)) by striking out `Centers
for Disease Control' and inserting in lieu thereof `Centers for Disease
Control and Prevention';
(20) in section 2317 (42 U.S.C. 300cc-17) by striking out `Centers for
Disease Control' each place that such occurs and inserting in lieu thereof
`Centers for Disease Control and Prevention';
(21) in section 2320 (42 U.S.C. 300cc-20) by striking out `Centers for
Disease Control' each place that such occurs and inserting in lieu thereof
`Centers for Disease Control and Prevention';
(22) in section 2341(a) (42 U.S.C. 300cc-31(a)) by striking out `Centers
for Disease Control' and inserting in lieu thereof `Centers for Disease
Control and Prevention';
(23) in section 2521 (42 U.S.C. 300ee-31) by striking out `Centers for
Disease Control' each place that such occurs and inserting in lieu thereof
`Centers for Disease Control and Prevention';
(24) in section 2522(a) (42 U.S.C. 300ee-32(a)) by striking out `Centers
for Disease Control' and inserting in lieu thereof `Centers for Disease
Control and Prevention';
(25) in section 2524(b)(2) (42 U.S.C. 300ee-34(b)(2)) by striking out
`Centers for Disease Control' and inserting in lieu thereof `Centers for
Disease Control and Prevention';
(26) in section 2601 by striking out `Centers for Disease Control' each
place that such occurs and inserting in lieu thereof `Centers for Disease
Control and Prevention';
(27) in section 2602(a)(1) by striking out `Centers for Disease Control'
and inserting in lieu thereof `Centers for Disease Control and Prevention';
(28) in section 2603(a)(3)(B)(i) by striking out `Centers for Disease
Control' and inserting in lieu thereof `Centers for Disease Control and
Prevention';
(29) in section 2607(2) by striking out `Centers for Disease Control'
and inserting in lieu thereof `Centers for Disease Control and Prevention';
(30) in section 2617(d)(3)(A) by striking out `Centers for Disease Control'
and inserting in lieu thereof `Centers for Disease Control and Prevention';
(31) in section 2618(c)(1) by striking out `Centers for Disease Control'
and inserting in lieu thereof `Centers for Disease Control and Prevention';
(32) in section 2641(a) by striking out `Centers for Disease Control'
and inserting in lieu thereof `Centers for Disease Control and Prevention';
(33) in section 2643(c)(1)(A) by striking out `Centers for Disease Control'
and inserting in lieu thereof `Centers for Disease Control and Prevention';
(34) in section 2649 by striking out `Centers for Disease Control' each
place that such occurs and inserting in lieu thereof `Centers for Disease
Control and Prevention'; and
(35) in section 2675(a) by striking out `Centers for Disease Control'
each place that such occurs and inserting in lieu thereof `Centers for
Disease Control and Prevention'.
(e) HEALTH OMNIBUS PROGRAMS EXTENSION OF 1988- The Health Omnibus Programs
Extension of 1988 is amended--
(1) in section 161 (42 U.S.C. 241 note) by striking out `Centers for
Disease Control' each place that such occurs and inserting in lieu thereof
`Centers for Disease Control and Prevention';
(2) in section 252 (42 U.S.C. 300ee-1) by striking out `Centers for Disease
Control' and inserting in lieu thereof `Centers for Disease Control and
Prevention'; and
(3) in section 253 (42 U.S.C. 300ee-2) by striking out `Centers for Disease
Control' each place that such occurs and inserting in lieu thereof `Centers
for Disease Control and Prevention'.
(f) HEALTH RESEARCH EXTENSION ACT OF 1985- Section 5(b)(1)(G) of the
Health Research Extension Act of 1985 (42 U.S.C. 281 note) is amended by
striking out `Centers for Disease Control' and inserting in lieu thereof
`Centers for Disease Control and Prevention'.
(g) PAINT POISONING PREVENTION- Section 501(3)(B)(i) of Public Law 91-695 (42
U.S.C. 4841(3)(B)(i)) is amended by striking out `Center for Disease Control'
and inserting in lieu thereof `Centers for Disease Control and Prevention'.
(h) COMPREHENSIVE ENVIRONMENTAL RESPONSE, COMPENSATION AND LIABILITY
ACT OF 1980- Section 104 of the Comprehensive Environmental Response,
Compensation and Liability Act of 1980 (42 U.S.C. 9604) is amended by
striking out `Centers for Disease Control' each place that such occurs
and inserting in lieu thereof `Centers for Disease Control and Prevention'.

874f7a433321d960ea5991ea28ade689fa0b174d107000b20b9765a67f50a652

TRANSMISSION.
(a) STUDY- The Secretary of Health and Human Services shall request the
National Academy of Sciences, acting through the Institute of Medicine, to
conduct a study concerning surgical technique, including oral surgery, and
medical device innovation to further reduce the risk of bloodborne disease
transmission in the health care setting. The study shall review techniques
and medical devices used in performing various surgical and dental procedures
that present a risk of percutaneous injury and examine mechanisms, such
as improvements in technique and product design modification, to enhance
injury prevention during such procedures to further reduce the risk of
bloodborne disease transmission.
(b) REPORT- Not later than 2 years after the date of enactment of this Act,
the Secretary of Health and Human Services shall prepare and submit to the
Committee on Energy and Commerce of the House of Representatives and the
Committee on Labor and Human Resources of the Senate, a report concerning
the results of the study conducted under subsection (a).
Attest:
Secretary.
HR 3635 EAS----2
HR 3635 EAS----3
HR 3635 EAS----4
HR 3635 EAS----5
HR 3635 EAS----6
HR 3635 EAS----7
HR 3635 EAS----8
HR 3635 EAS----9
HR 3635 EAS----10
HR 3635 EAS----11

a2159c25af5b24806e5115195462a388770f4a6526a41219958830ea024e62de

Health Promotion and Disease Prevention Act of 1991 — HR. 3635

Other Sections

TITLE I

TITLE III

TITLE IV

TITLE V

TITLE II

TITLE IV

TITLE V

Want the full experience?