[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 4246 Introduced in Senate (IS)]
<DOC>
118th CONGRESS
2d Session
S. 4246
To improve menopause care and mid-life women's health, and for other
purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 2, 2024
Mrs. Murray (for herself, Ms. Murkowski, Ms. Baldwin, Ms. Collins, Ms.
Klobuchar, Mrs. Capito, Ms. Cantwell, Ms. Cortez Masto, Ms. Duckworth,
Mrs. Gillibrand, Ms. Hassan, Ms. Hirono, Ms. Rosen, Mrs. Shaheen, Ms.
Sinema, Ms. Smith, and Ms. Stabenow) introduced the following bill;
which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To improve menopause care and mid-life women's health, and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Advancing
Menopause Care and Mid-Life Women's Health Act''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Research with respect to menopause and mid-life women's health.
Sec. 3. Public health promotion and prevention.
Sec. 4. Public health awareness, education, and outreach program on
menopause and mid-life women's health.
Sec. 5. Training programs to improve care and treatment of menopausal
symptoms.
Sec. 6. Centers of excellence in menopause cause and mid-life women's
health.
Sec. 7. Reporting requirement.
Sec. 8. Coordination.
SEC. 2. RESEARCH WITH RESPECT TO MENOPAUSE AND MID-LIFE WOMEN'S HEALTH.
(a) NIH Research.--Part A of title IV of the Public Health Service
Act (42 U.S.C. 281 et seq.) is amended by adding at the end the
following:
``SEC. 404P. RESEARCH WITH RESPECT TO MENOPAUSE AND MID-LIFE WOMEN'S
HEALTH.
``(a) Research and Innovation.--
``(1) In general.--The Director of NIH, acting through the
Director of the Office of Research on Women's Health, shall
coordinate and expand research activities conducted by all
institutes, centers, and offices of the National Institutes of
Health to develop and implement Federal research programs with
respect to--
``(A) the impact of the symptoms and trajectories
of changes across the menopausal transition and the
postmenopausal period on women's physical, mental,
behavioral, and cognitive health; and
``(B) the prevention of related adverse health
outcomes among women during the menopausal transition
and the postmenopausal period.
``(2) Grants.--In carrying out paragraph (1), the Director
of NIH shall award grants to eligible entities to support--
``(A) biomedical and public health research and
innovation in the development of new treatments and
diagnostic testing services for perimenopause and acute
and chronic menopausal symptoms; and
``(B) researchers and clinicians engaged in
clinical and translational research on menopause and
mid-life women's health.
``(3) Eligible entities.--To be eligible to receive a grant
under subsection (b), an entity shall meet such criteria as the
Director of NIH may establish, and shall be--
``(A) an accredited entity that offers education to
students in various health professions, such as_
``(i) a teaching hospital;
``(ii) an accredited school of medicine,
osteopathic medicine, nursing, or pharmacy, or
a physician assistant training program,
including a historically Black college or
university (as defined by the term `part B
institution' in section 322 of the Higher
Education Act of 1965 or described in section
326(e)(1) of the Higher Education Act of 1965)
or other minority-serving institutions (as
described in section 371(a) of the Higher
Education Act of 1965));
``(iii) a certified behavioral health
clinic with an accredited medical or nursing
residency program;
``(iv) an accredited public or nonprofit
private hospital with an accredited medical or
nursing residency program;
``(v) an accredited nurse practitioner
residency program that includes and accredited
nursing residency program; or
``(vi) a related accredited program engaged
in the care, treatment, or management of
menopausal symptoms;
``(B) an academic research institution or other
nonprofit research institution;
``(C) a small business; or
``(D) such other entity as the Director of NIH may
determine appropriate.
``(b) Research, Condition, and Disease Categorization.--The
Director of NIH shall designate, in the Research, Condition, and
Disease Categorization, new categories for chronic or debilitating
conditions among women, to analyze and coordinate current and future
research on menopause, menopausal symptoms, and short-term and long-
term effects of such symptoms on mid-life women's health.
``(c) Coordination.--The Director of the NIH shall coordinate and
expand Federal research programs and activities to study acute and
chronic menopausal symptoms, including--
``(1) vasomotor symptoms;
``(2) osteoporosis;
``(3) sarcopenia;
``(4) temporomandibular disorders;
``(5) joint and nerve pain;
``(6) trauma, anxiety, depression, mood disorders, and
related mental and behavioral health conditions;
``(7) short-term memory loss;
``(8) genitourinary conditions;
``(9) alopecia;
``(10) vision or hearing impairments;
``(11) digestive and metabolic disorders;
``(12) chronic sleep deficiency, insomnia, and related
sleep disorders; and
``(13) other menopausal symptoms and related conditions, as
the Director of NIH determines appropriate.
``(d) Translational Research.--The Secretary shall expand
translational research activities to accelerate translation of Federal
research on perimenopause and menopausal symptoms and facilitate
equitable delivery of perimenopause and menopause care and related mid-
life women's health services.
``(e) Outreach and Engagement.--The Secretary shall expand outreach
and engagement activities with accredited schools of medicine,
institutions of higher education, and research institutions to support
Federal research activities with respect to menopausal symptoms.''.
(b) Public Health Research and Data Reporting Activities.--Part A
of title III of the Public Health Service Act (42 U.S.C. 241 et seq.)
is amended by adding at the end the following:
``SEC. 310C. RESEARCH RELATING TO MID-LIFE WOMEN'S HEALTH.
``(a) Public Health Research.--The Secretary shall expand research
activities with respect to the severity and duration of menopausal
symptoms and related chronic conditions affecting mid-life health
outcomes among women, including mental and behavioral health outcomes.
In carrying out activities under this section, the Secretary shall
coordinate with existing programs and activities of the Department of
Health and Human Services.
``(b) Health Care Quality Research.--The Secretary shall expand
research, program evaluation, and quality improvement activities to
improve health care delivery for the care, treatment, or management of
perimenopause and menopausal symptoms and related chronic conditions,
including data collection with respect to preventive services that
support mid-life health outcomes among women and barriers to care.
``(c) Dashboard.--The Secretary shall establish and maintain a
dashboard for the reporting of data on menopausal symptoms and mid-life
health outcomes among women gathered through public health surveillance
activities with respect to screening, testing, treatment, and
prevention services, and the impact of this section and section 404P on
such efforts.
``(d) Occupational Health Research.--The Secretary shall conduct
research activities and expand data collection with respect to
workplace stressors related to severe acute or chronic menopausal
symptoms, physical injury, or other adverse health outcomes among
women, including traumatic stress, anxiety, depression, and related
mental and behavioral health conditions. The Secretary shall review
existing evidence, identify gaps in services, and develop evidence-
informed recommendations for related public health interventions and
support services.
``(e) Interagency Coordination.--The Secretary shall develop and
implement new interagency research initiatives or programs to address
menopausal symptoms.''.
(c) Authorization of Appropriations.--For the purpose of carrying
out sections 404P and 310C of the Public Health Service Act, as added
by subsections (a) and (b), respectively, there are authorized to be
appropriated $25,000,000 for each of fiscal years 2025 through 2029.
SEC. 3. PUBLIC HEALTH PROMOTION AND PREVENTION.
Title III of the Public Health Service Act (42 U.S.C. 241 et seq.)
is amended by adding at the end the following:
``PART W--ACTIVITIES TO PROMOTE MID-LIFE WOMEN'S HEALTH
``SEC. 399OO. PUBLIC HEALTH PROMOTION ACTIVITIES.
``(a) Chronic Conditions and Public Health Promotion.--The
Secretary shall expand public health promotion and prevention
activities with respect to mid-life women's health and chronic
conditions, including diabetes, hypertension, heart disease, iron-
deficiency anemia, inflammation, fibroids, endometriosis, and other
related conditions and adverse health outcomes, at the discretion of
the Secretary.
``(b) Early Detection, Diagnosis, and Treatment.--
``(1) In general.--The Secretary shall award grants to
eligible entities to improve the early detection, diagnosis,
and treatment of perimenopause and menopausal symptoms and
support public health activities to expand access to quality
care services and improve mid-life health outcomes among women.
``(2) Eligible entities.--To be eligible to receive a grant
under paragraph (1), an entity shall_
``(A) be--
``(i) a State, local, Tribal, or
territorial public health department;
``(ii) an accredited entity that offers
education to students in various health
professions; or
``(iii) such other type of entity, as the
Secretary determines appropriate; and
``(B) submit an application to the Secretary at
such time, in such manner, and containing such
information as the Secretary may require.
``(c) Care Coordination.--The Secretary shall award grants to
eligible entities described in subsection (b)(2) to support care
coordination and care planning activities, including such activities
otherwise supported under this Act, and expand access to quality
primary care and specialty care services to improve--
``(1) mid-life women's health, including activities to
support the integration of primary care and specialty care;
``(2) bone health and muscle loss;
``(3) mental and behavioral health care services;
``(4) joint, nerve, and muscle pain prevention services;
``(5) digestive and metabolic health;
``(6) prevention and management of multiple chronic
conditions;
``(7) physical therapy and injury prevention support
services for populations affected by acute and chronic
menopausal symptoms; and
``(8) other services that address acute and chronic
conditions that affect women's health in perimenopause and
menopause.
``(d) Mental Health and Substance Use Prevention.--The Secretary
shall develop recommendations and best practices to--
``(1) increase access to mental and behavioral health care
services and substance use disorder prevention services for
women experiencing perimenopause or menopausal symptoms; and
``(2) expand substance use disorder treatment, recovery,
and support services for women experiencing perimenopause,
early menopause, premature menopause, and related conditions.
``(e) Health Care Delivery.--The Secretary shall develop
recommendations and best practices for--
``(1) reducing disparities in the management of menopausal
symptoms;
``(2) improving access to perimenopause and menopause
health care services; and
``(3) providing patient-centered perimenopause and
menopause counseling and treatment.
``(f) Safety and Effectiveness.--The Secretary shall carry out and
support--
``(1) outreach and engagement activities of the Food and
Drug Administration with health care providers on perimenopause
and menopause and mid-life women's health;
``(2) oversight efforts to assess the safety and
effectiveness of new diagnostic tools for perimenopause or
menopausal symptoms, including devices that use artificial
intelligence; and
``(3) support existing activities of the Department of
Health and Human Services to enforce privacy protections for
patients.
``(g) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $10,000,000 for each of fiscal
years 2025 through 2029.''.
SEC. 4. PUBLIC HEALTH AWARENESS, EDUCATION, AND OUTREACH PROGRAM ON
MENOPAUSE AND MID-LIFE WOMEN'S HEALTH.
Part W of title III of the Public Health Service Act (42 U.S.C. 241
et seq.), as added by section 3, is amended by adding at the end the
following:
``SEC. 399OO-1. PUBLIC HEALTH AWARENESS, EDUCATION, AND OUTREACH
PROGRAM ON MENOPAUSE AND MID-LIFE WOMEN'S HEALTH.
``(a) In General.--The Secretary shall develop and carry out a
national awareness, education, and outreach program relating to
menopausal symptoms, mid-life women's health, and related care,
treatment, and preventive services directed at patients, health care
providers, first responders (such as emergency medical service
providers), and related stakeholders. Such awareness, education, and
outreach program shall--
``(1) disseminate educational materials and provide
technical assistance for health care providers and patients to
support engagement about perimenopause and menopause care and
treatment options for menopausal symptoms;
``(2) help such providers to identify risk factors and
prevent injury among women with menopausal symptoms; and
``(3) address barriers to related care and treatment
services for women.
``(b) Outreach.--In carrying out this section, the Secretary
shall--
``(1) conduct outreach and education activities related to
perimenopause and menopause and mid-life women's health that--
``(A) include evidence-based information; and
``(B) are culturally appropriate, in the case of
such outreach and education activities for Indian
Tribes;
``(2) provide opportunities for State, local, Tribal, and
territorial public health departments to customize public
health awareness, education, and outreach materials for their
populations; and
``(3) prioritize populations in areas affected by barriers
to care, including rural and underserved areas.
``(c) Coordination.--In carrying out this section, the Secretary
shall coordinate with existing awareness, education, and outreach
programs and activities of the Department of Health and Human Services.
``(d) Online Resources.--The Secretary shall develop, operate, and
maintain a website to provide educational materials in accessible
formats for health care providers, patients, and caregivers, regarding
perimenopause, menopause, and mid-life women's health. Such educational
materials may include--
``(1) webinars, continuing education modules, videos, fact
sheets, infographics, stakeholder toolkits, or other materials
in formats as appropriate and applicable; and
``(2) tailored for health care providers, patients,
caregivers, and other audiences, as the Secretary determines
appropriate.
``(e) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $10,000,000 for each of fiscal
years 2025 through 2029.''.
SEC. 5. TRAINING PROGRAMS TO IMPROVE CARE AND TREATMENT OF MENOPAUSAL
SYMPTOMS.
Part D of title VII of the Public Health Service Act (42 U.S.C. 294
et seq.) is amended by inserting after section 757 (42 U.S.C. 294f) the
following:
``SEC. 758. TRAINING PROGRAMS TO IMPROVE CARE AND TREATMENT OF
MENOPAUSAL SYMPTOMS.
``(a) Grants To Train Health Professionals.--
``(1) In general.--The Secretary shall award grants to
eligible entities for the purpose described in paragraph (2).
``(2) Use of funds.--A grant awarded under this subsection
shall be used to develop, establish, or expand training
programs (including accredited residency programs, fellowships,
or other related clinical training) for physicians, registered
nurses, nurse practitioners, physician assistants, pharmacists,
other health care providers, and students and trainees to
improve care, treatment, or management services for
perimenopause, menopausal symptoms, and related chronic
conditions.
``(3) Eligibility.--To be eligible to receive a grant under
this subsection, an entity shall--
``(A) be--
``(i) an accredited school of medicine or
osteopathic medicine;
``(ii) an accredited nursing school;
``(iii) an accredited school of pharmacy;
``(iv) an accredited public or nonprofit
private hospital;
``(v) an accredited medical residency
program;
``(vi) an accredited nurse practitioner
residency program; or
``(vii) a related training program for
clinicians, allied health professionals, or
social workers that interface with affected
populations, which may include hospitals and
research institutions, as determined by the
Secretary; and
``(B) submit an application to the Secretary at
such time, in such manner, and containing such
information as the Secretary may require.
``(b) Training Opportunities.--The Secretary shall expand outreach
activities to support and expand training programs, fellowships, and
other opportunities for students, faculty, and trainees (including
continuing medical education) or establish new training opportunities
to address barriers to access to--
``(1) primary and specialty care services to support mid-
life women's health; and
``(2) early detection, diagnosis, treatment, and care
services for perimenopause, menopausal symptoms, and related
chronic conditions.
``(c) Coordination.--In carrying out this section, the Secretary
shall coordinate with existing awareness, education, and outreach
programs and activities of the Department of Health and Human Services.
``(d) Authorization of Appropriations.--To carry out this section
there are authorized to be appropriated $10,000,000 for each of fiscal
years 2025 through 2029.''.
SEC. 6. CENTERS OF EXCELLENCE IN MENOPAUSE CAUSE AND MID-LIFE WOMEN'S
HEALTH.
Part W of title III of the Public Health Service Act (42 U.S.C. 241
et seq.), as amended by section 4, is further amended by adding at the
end the following:
``SEC. 399OO-2. CENTERS OF EXCELLENCE IN MENOPAUSE CARE AND MID-LIFE
WOMEN'S HEALTH.
``(a) In General.--The Secretary shall designate eligible entities
as Centers of Excellence in Menopause and Mid-Life Women's Health, and
award grants to such entities, for purposes of improving professional
training resources for health care providers on mid-life women's health
with respect to the care, treatment, and management of perimenopause
and menopausal symptoms, and related support services.
``(b) Eligibility.--To be eligible to receive a designation and
grant under subsection (a), an entity shall_
``(1) be an accredited entity that offers education to
students in various health professions, or such other type of
entity, as the Secretary determines appropriate;
``(2) demonstrate community engagement and partnerships
with community stakeholders, including entities that train
health professionals, social workers, community health centers,
health systems administrators, certified behavioral health
clinics, and research institutions; and
``(3) submit to the Secretary an application at such time,
in such manner, and containing such information as the
Secretary may require.
``(c) Activities.--An entity receiving an award under subsection
(a) shall develop and distribute evidence-based resources to health
care providers, patients, and public health departments regarding the
care, treatment, and management of perimenopause and menopausal
symptoms. Such resources may include information on--
``(1) advancements in the treatment or management of
perimenopause and acute or chronic menopausal symptoms;
``(2) the prevention and treatment of related chronic
conditions across different patient populations to support mid-
life women's health; and
``(3) other topic areas that are relevant to the objectives
described in subsection (a).
``(d) Geographic Distribution.--In awarding grants under subsection
(a), the Secretary shall take into account regional differences among
eligible entities and ensure equitable geographic distribution.
``(e) Priority.--In awarding grants under subsection (a), the
Secretary shall prioritize eligible entities that provide services in a
health professional shortage area designated under section 332 or to
medically underserved populations, as defined in section 330(b)(3).
``(f) Evaluation.--Each entity receiving an award under subsection
(a) shall submit an annual report to the Secretary on the activities
carried out using such award. The Secretary shall evaluate each project
carried out by an entity receiving an award under this section and
shall report the findings with respect to each such evaluation to
appropriate Federal agencies and public and private entities.
``(g) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated such sums as may be necessary
for each of fiscal years 2025 through 2029.''.
SEC. 7. REPORTING REQUIREMENT.
(a) Report on Activities Carried Out Under This Act.--Not later
than 2 years after the date of enactment of this Act, and every year
thereafter, the Secretary of Health and Human Services shall submit to
the Committee on Appropriations, the Committee on Health, Education,
Labor, and Pensions, the Committee on Finance, the Committee on
Homeland Security and Government Affairs, the Committee on Indian
Affairs, the Committee on Veterans' Affairs, and the Special Committee
on Aging of the Senate and the Committee on Appropriations, the
Committee on Energy and Commerce, the Committee on Ways and Means, the
Committee on Education and the Workforce, the Committee on Veterans'
Affairs, the Committee on Natural Resources, and the Committee on
Oversight and Accountability of the House of Representatives a report
describing the progress of activities carried out under this Act and
the amendments made by this Act. Each such report shall contain--
(1) information with respect to Federal research activities
related to perimenopause and menopause and mid-life women's
health, including information related public health awareness,
education, and outreach activities, including--
(A) data and knowledge gaps, or other barriers,
related to research, diagnostic testing, and treatments
with respect to perimenopause, menopause, menopausal
symptoms, and related health outcomes;
(B) data or information related to barriers to
health care and support services among women
experiencing perimenopause or menopausal symptoms in
rural and underserved areas; and
(C) data or information related to barriers to
training opportunities and resources for health care
providers serving women experiencing perimenopause or
menopausal symptoms in rural and underserved areas;
(2) recommendations and best practices for health care
providers and public health departments to expand access to
care and increase public awareness and understanding of
menopausal symptoms and related chronic conditions; and
(3) information about related Federal activities, as the
Secretary determines appropriate.
(b) Report on Access to Care and Treatment.--Not later than 2 years
after the date of enactment of this Act, the Secretary shall release a
report on barriers to access to care and treatment services for
perimenopause and menopausal symptoms, and recommendations to reduce
any such barriers.
(c) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated such sums as may be necessary
for each of fiscal years 2025 through 2029.
SEC. 8. COORDINATION.
The Secretary of Health and Human Services shall coordinate
activities carried out under this Act (including the amendments made by
this Act) with other existing Federal efforts relating to menopausal
symptoms, mid-life women's health, aging, or public health promotion
carried out by the Department of Veterans Affairs, the Department of
Defense, and other Federal departments and agencies, as appropriate.
<all>