[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 707 Introduced in Senate (IS)]
109th CONGRESS
1st Session
S. 707
To reduce preterm labor and delivery and the risk of pregnancy-related
deaths and complications due to pregnancy, and to reduce infant
mortality caused by prematurity.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
April 5, 2005
Mr. Alexander (for himself and Mr. Dodd) introduced the following bill;
which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To reduce preterm labor and delivery and the risk of pregnancy-related
deaths and complications due to pregnancy, and to reduce infant
mortality caused by prematurity.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Prematurity Research Expansion and
Education for Mothers who deliver Infants Early Act'' or the ``PREEMIE
Act''.
SEC. 2. FINDINGS AND PURPOSE.
(a) Findings.--Congress makes the following findings:
(1) Premature birth is a serious and growing problem. The
rate of preterm birth increased 27 percent between 1982 and
2002 (from 9.4 percent to 11.9 percent). In 2001, more than
480,000 babies were born prematurely in the United States.
(2) Preterm birth accounts for 24 percent of deaths in the
first month of life.
(3) Premature infants are 14 times more likely to die in
the first year of life.
(4) Premature babies who survive may suffer lifelong
consequences, including cerebral palsy, mental retardation,
chronic lung disease, and vision and hearing loss.
(5) Preterm and low birthweight birth is a significant
financial burden in health care. The estimated charges for
hospital stays for infants with any diagnosis of prematurity/
low birthweight were $15,500,000,000 in 2002. The average
lifetime medical costs of a premature baby are conservatively
estimated at $500,000.
(6) The proportion of preterm infants born to African-
American mothers (17.3 percent) was significantly higher
compared to the rate of infants born to white mothers (10.6
percent). Prematurity or low birthweight is the leading cause
of death for African-American infants.
(7) The cause of approximately half of all premature births
is unknown.
(8) Women who smoke during pregnancy are twice as likely as
nonsmokers to give birth to a low birthweight baby. Babies born
to smokers weigh, on average, 200 grams less than nonsmokers'
babies.
(9) To reduce the rates of preterm labor and delivery more
research is needed on the underlying causes of preterm
delivery, the development of treatments for prevention of
preterm birth, and treatments improving outcomes for infants
born preterm.
(b) Purposes.--It the purpose of this Act to--
(1) reduce rates of preterm labor and delivery;
(2) work toward an evidence-based standard of care for
pregnant women at risk of preterm labor or other serious
complications, and for infants born preterm and at a low
birthweight; and
(3) reduce infant mortality and disabilities caused by
prematurity.
SEC. 3. RESEARCH RELATING TO PRETERM LABOR AND DELIVERY AND THE CARE,
TREATMENT, AND OUTCOMES OF PRETERM AND LOW BIRTHWEIGHT
INFANTS.
(a) General Expansion of NIH Research.--Part B of title IV of the
Public Health Service Act (42 U.S.C. 284 et seq.) is amended by adding
at the end the following:
``SEC. 409J. EXPANSION AND COORDINATION OF RESEARCH RELATING TO PRETERM
LABOR AND DELIVERY AND INFANT MORTALITY.
``(a) In General.--The Director of NIH shall expand, intensify, and
coordinate the activities of the National Institutes of Health with
respect to research on the causes of preterm labor and delivery, infant
mortality, and improving the care and treatment of preterm and low
birthweight infants.
``(b) Authorization of Research Networks.--There shall be
established within the National Institutes of Health a Maternal-Fetal
Medicine Units Network and a Neonatal Research Units Network. In
complying with this subsection, the Director of NIH shall utilize
existing networks.
``(c) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2005 through 2009.''.
(b) General Expansion of CDC Research.--Section 301 of the Public
Health Service Act (42 U.S.C. 241 et seq.) is amended by adding at the
end the following:
``(e) The Director of the Centers for Disease Control and
Prevention shall expand, intensify, and coordinate the activities of
the Centers for Disease Control and Prevention with respect to preterm
labor and delivery and infant mortality.''.
(c) Study on Assisted Reproduction Technologies.--Section 1004(c)
of the Children's Health Act of 2000 (Public Law 106-310) is amended--
(1) in paragraph (2), by striking ``and'' at the end;
(2) in paragraph (3), by striking the period and inserting
``; and''; and
(3) by adding at the end the following:
``(4) consider the impact of assisted reproduction
technologies on the mother's and children's health and
development.''.
(d) Study on Relationship Between Prematurity and Birth Defects.--
(1) In general.--The Director of the Centers for Disease
Control and Prevention shall conduct a study on the
relationship between prematurity, birth defects, and
developmental disabilities.
(2) Report.--Not later than 2 years after the date of
enactment of this Act, the Director of the Centers for Disease
Control and Prevention shall submit to the appropriate
committees of Congress a report concerning the results of the
study conducted under paragraph (1).
(e) Review of Pregnancy Risk Assessment Monitoring Survey.--The
Director of the Centers for Disease Control and Prevention shall
conduct a review of the Pregnancy Risk Assessment Monitoring Survey to
ensure that the Survey includes information relative to medical care
and intervention received, in order to track pregnancy outcomes and
reduce instances of preterm birth.
(f) Study on the Health and Economic Consequences of Preterm
Birth.--
(1) In general.--The Director of the National Institutes of
Health in conjunction with the Director of the Centers for
Disease Control and Prevention shall enter into a contract with
the Institute of Medicine of the National Academy of Sciences
for the conduct of a study to define and address the health and
economic consequences of preterm birth. In conducting the
study, the Institute of Medicine shall--
(A) review and assess the epidemiology of premature
birth and low birthweight, and the associated maternal
and child health effects in the United States, with
attention paid to categories of gestational age,
plurality, maternal age, and racial or ethnic
disparities;
(B) review and describe the spectrum of short and
long-term disability and health-related quality of life
associated with premature births and the impact on
maternal health, health care and quality of life,
family employment, caregiver issues, and other social
and financial burdens;
(C) assess the direct and indirect costs associated
with premature birth, including morbidity, disability,
and mortality;
(D) identify gaps and provide recommendations for
feasible systems of monitoring and assessing associated
economic and quality of life burdens associated with
prematurity;
(E) explore the implications of the burden of
premature births for national health policy;
(F) identify community outreach models that are
effective in decreasing prematurity rates in
communities;
(G) consider options for addressing, as
appropriate, the allocation of public funds to
biomedical and behavioral research, the costs and
benefits of preventive interventions, public health,
and access to health care; and
(H) provide recommendations on best practices and
interventions to prevent premature birth, as well as
the most promising areas of research to further
prevention efforts.
(2) Report.--Not later than 1 year after the date on which
the contract is entered into under paragraph (1), the Institute
of Medicine shall submit to the Director of the National
Institutes of Health, the Director of the Centers for Disease
Control and Prevention, and the appropriate committees of
Congress a report concerning the results of the study conducted
under such paragraph.
(g) Evaluation of National Core Performance Measures.--
(1) In general.--The Administrator of the Health Resources
and Services Administration shall conduct an assessment of the
current national core performance measures and national core
outcome measures utilized under the Maternal and Child Health
Block Grant under title V of the Social Security Act (42 U.S.C.
701 et seq.) for purposes of expanding such measures to include
some of the known risk factors of low birthweight and
prematurity, including the percentage of infants born to
pregnant women who smoked during pregnancy.
(2) Report.--Not later than 1 year after the date of
enactment of this Act, the Administrator of the Health
Resources and Services Administration shall submit to the
appropriate committees of Congress a report concerning the
results of the evaluation conducted under paragraph (1).
SEC. 4. PUBLIC AND HEALTH CARE PROVIDER EDUCATION AND SUPPORT SERVICES.
Part P of title III of the Public Health Service Act (42 U.S.C.
280g et seq.) is amended by adding at the end the following:
``SEC. 399O. PUBLIC AND HEALTH CARE PROVIDER EDUCATION AND SUPPORT
SERVICES.
``(a) In General.--The Secretary, directly or through the awarding
of grants to public or private nonprofit entities, shall conduct a
demonstration project to improve the provision of information on
prematurity to health professionals and other health care providers and
the public.
``(b) Activities.--Activities to be carried out under the
demonstration project under subsection (a) shall include the
establishment of programs--
``(1) to provide information and education to health
professionals, other health care providers, and the public
concerning--
``(A) the signs of preterm labor, updated as new
research results become available;
``(B) the screening for and the treating of
infections;
``(C) counseling on optimal weight and good
nutrition, including folic acid;
``(D) smoking cessation education and counseling;
and
``(E) stress management; and
``(2) to improve the treatment and outcomes for babies born
premature, including the use of evidence-based standards of
care by health care professionals for pregnant women at risk of
preterm labor or other serious complications and for infants
born preterm and at a low birthweight.
``(c) Requirement.--Any program or activity funded under this
section shall be evidence-based.
``(d) NICU Family Support Programs.--The Secretary shall conduct,
through the awarding of grants to public and nonprofit private
entities, projects to respond to the emotional and informational needs
of families during the stay of an infant in a neonatal intensive care
unit, during the transition of the infant to the home, and in the event
of a newborn death. Activities under such projects may include
providing books and videos to families that provide information about
the neonatal intensive care unit experience, and providing direct
services that provide emotional support within the neonatal intensive
care unit setting.
``(e) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2005 through 2009.''.
SEC. 5. INTERAGENCY COORDINATING COUNCIL ON PREMATURITY AND LOW
BIRTHWEIGHT.
(a) Purpose.--It is the purpose of this section to stimulate
multidisciplinary research, scientific exchange, and collaboration
among the agencies of the Department of Health and Human Services and
to assist the Department in targeting efforts to achieve the greatest
advances toward the goal of reducing prematurity and low birthweight.
(b) Establishment.--The Secretary of Health and Human Services
shall establish an Interagency Coordinating Council on Prematurity and
Low Birthweight (referred to in this section as the Council) to carry
out the purpose of this section.
(c) Composition.--The Council shall be composed of members to be
appointed by the Secretary, including representatives of--
(1) the agencies of the Department of Health and Human
Services; and
(2) voluntary health care organizations, including
grassroots advocacy organizations, providers of specialty
obstetrical and pediatric care, and researcher organizations.
(d) Activities.--The Council shall--
(1) annually report to the Secretary of Health and Human
Services on current Departmental activities relating to
prematurity and low birthweight;
(2) plan and hold a conference on prematurity and low
birthweight under the sponsorship of the Surgeon General;
(3) establish a consensus research plan for the Department
of Health and Human Services on prematurity and low
birthweight;
(4) report to the Secretary of Health and Human Services
and the appropriate committees of Congress on recommendations
derived from the conference held under paragraph (2) and on the
status of Departmental research activities concerning
prematurity and low birthweight;
(5) carry out other activities determined appropriate by
the Secretary of Health and Human Services; and
(6) oversee the coordination of the implementation of this
Act.
SEC. 6. AUTHORIZATION OF APPROPRIATIONS.
There are authorized to be appropriated to carry out this Act, such
sums as may be necessary for each of fiscal years 2005 through 2009.
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