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Congress Clears Children’s Health Bill

As the end of the 106th Congress draws near, the House and Senate cleared legislation (H.R. 4365) that would authorize research on children’s health. Originally approved by the House on May 9 (see The Source, 5/12/00, p. 2), the Senate on September 22 amended and passed the bill by unanimous consent. On September 27, the House agreed, 394-25, to the Senate amendments, clearing the measure for the President’s signature. The bill is sponsored by Rep. Michael Bilirakis (R-FL).

H.R. 4365 would establish a pediatric research initiative at the National Institutes of Health (NIH) aimed at increasing support for pediatric biomedical research. The bill also would authorize research and prevention activities dealing with hearing loss in infants, autism, folic acid and birth defects, safe motherhood, drug, alcohol, and smoking prevention and cessation for pregnant mothers, Fragile X, juvenile diabetes, juvenile arthritis, asthma, traumatic brain injury, epilepsy, Healthy Start, oral health, Hepatitis C, and rare diseases.

The bill includes the Safe Motherhood Monitoring and Prevention Research Act (H.R. 2316), sponsored by Reps. Jo Ann Emerson (R-MO) and Nita Lowey (D-NY). H.R. 2316 would establish a national surveillance and monitoring program at the Centers for Disease Control and Prevention (CDC) to investigate deaths and severe complications from pregnancy. Additionally, the bill would expand the Pregnancy Risk Assessment Monitoring System and the Health Epidemiology Program to all 50 states. The CDC also would be authorized to expand research on risk factors and prevention strategies relating to safe motherhood and to implement a public education campaign to promote safe motherhood.

H.R. 4365 also includes an autoimmune diseases initiative at the NIH. Under the provision, the NIH Director would be required to expand, intensify, and coordinate research on autoimmune diseases at the NIH. The provision would require the NIH to report to Congress biennially on research, education, and other activities on autoimmune diseases being conducted or supported at the NIH. Reps. Henry Waxman (D-CA) and Connie Morella (R-MD) and Sen. Joseph Biden (D-DE) have sponsored similar bills (H.R. 2573/S. 1897) that would actually establish an Office of Autoimmune Diseases at the NIH.

The bill includes compromise language dealing with adoption training at Title X clinics and community health centers. The provision would authorize the Secretary of Health and Human Services to make grants to adoption organizations to develop and implement programs to train staff of Title X clinics and community health centers in providing adoption information and referrals. While eligible health centers are not required to participate in the training, under the provision the Secretary should “make reasonable efforts to encourage eligible health centers to arrange for designated staff to participate in such training.” The Secretary of Health and Human Services also would be required to report to Congress on the extent to which adoption information and referrals are provided at eligible health centers, as well as on the extent to which adoption information and referrals are provided by eligible health centers to determine “the effectiveness of such training.” The language is a compromise version of a bill (H.R. 2511) sponsored by Rep. Jim DeMint (R-SC).

During Senate consideration of the bill, several unrelated bills were added to H.R. 4365. One such bill (S. 976) would reauthorize the Substance Abuse and Mental Health Services Administration (SAMHSA). Congress created SAMHSA in 1992 to assist states in preventing and treating substance abuse and mental illness. Funds are provided to states for drug and alcohol abuse prevention and treatment programs and mental health services through two block grants—the Substance Abuse Prevention and Treatment Block Grant and the Community Mental Health Services Block Grant.

S. 976 would authorize $2 billion in FY2000 for the substance abuse block grant and $450 million for the mental health block grant, while making a number of technical changes aimed at giving states more flexibility in how they may spend the funds.

The Senate also amended H.R.4365 to include bills (H.R. 4750/S. 2236) sponsored by Rep. Ed Bryant (R-TN) and Sen. Bill Frist (R-TN). The measure would authorize $200 million in state grants for programs to improve the health and safety of children in child care. “We are experiencing a national child care crisis. In 1997, 31,000 children ages 4 and younger were treated in hospital emergency rooms for injuries sustained in child care facilities,” stated Rep. Carolyn McCarthy (D-NY), adding that the bill will “give our parents the peace of mind of where they are going to send their child is offering the best services possible.”