Text: H.R.4543 — 108th Congress (2003-2004)All Bill Information (Except Text)

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Introduced in House (06/09/2004)

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[Congressional Bills 108th Congress]
[From the U.S. Government Printing Office]
[H.R. 4543 Introduced in House (IH)]

  2d Session
                                H. R. 4543

  To provide for research on, and services for individuals with, post-
                   abortion depression and psychosis.



                              June 9, 2004

 Mr. Pitts (for himself and Mrs. Jo Ann Davis of Virginia) introduced 
 the following bill; which was referred to the Committee on Energy and 


                                 A BILL

  To provide for research on, and services for individuals with, post-
                   abortion depression and psychosis.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,


    This Act may be cited as the ``Post-Abortion Depression Research 
and Care Act''.


    The Congress finds as follows:
            (1) About 3,000,000 women per year in the United States 
        have an unplanned or unwanted pregnancy, and approximately 
        1,186,000 of these pregnancies end in elective abortion.
            (2) Abortion can have severe and long-term effects on the 
        mental and emotional well-being of women. Women often 
        experience sadness and guilt following abortions with no one to 
        console them. They may have difficulty in bonding with new 
        babies, become overprotective parents or develop problems in 
        their relationship with their spouses. Problems such as eating 
        disorders, depression and suicide attempts have also been 
        traced to past abortions.
            (3) The symptoms of post-abortion depression include bouts 
        of crying, guilt, intense grief or sadness, emotional numbness, 
        eating disorders, drug and alcohol abuse, suicidal urges, 
        anxiety and panic attacks, anger/rage, sexual problems or 
        promiscuity, lowered self esteem, nightmares and sleep 
        disturbance, flashbacks, and difficulty with relationships.
            (4) Women who aborted a first pregnancy are four times more 
        likely to report substance abuse compared to those who suffered 
        a natural loss of their first pregnancy, and they are five 
        times more likely to report subsequent substance abuse than 
        women who carried to term.
            (5) Greater thought suppression is associated with 
        experiencing more intrusive thoughts of the abortion. Both 
        suppression and intrusive thoughts, in turn, are positively 
        related to increases in psychological distress over time.
            (6) Women who experience decision-making difficulties and 
        may lack social support may experience more negative emotional 
        consequences to induced abortion.
            (7) Post-abortion depression often relates to the lack of 
        understanding in society and the medical community of the 
        complexity of post-abortion depression, and economic pressures 
        placed on hospitals and providers are contributing factors.
            (8) Social pressure to have an abortion can be directly 
        related to higher levels of immediate regret and more mental 
        undoing over subsequent years.
            (9) Post-abortion depression is a treatable disorder if 
        promptly diagnosed by a trained provider and attended to with a 
        personalized regimen of care including social support, therapy, 
        medication, and when necessary hospitalization.
            (10) While there have been many studies regarding the 
        emotional aftermath of abortion, very little research has been 
        sponsored by the National Institutes of Health.



    (a) In General.--The Secretary of Health and Human Services, acting 
through the Director of NIH and the Director of the National Institute 
of Mental Health (in this section referred to as the ``Institute''), 
shall expand and intensify research and related activities of the 
Institute with respect to post-abortion depression and post-abortion 
psychosis (in this section referred to as ``post-abortion 
    (b) Coordination With Other Institutes.--The Director of the 
Institute shall coordinate the activities of the Director under 
subsection (a) with similar activities conducted by the other national 
research institutes and agencies of the National Institutes of Health 
to the extent that such Institutes and agencies have responsibilities 
that are related to post-abortion conditions.
    (c) Programs for Post-Abortion Conditions.--In carrying out 
subsection (a), the Director of the Institute shall conduct or support 
research to expand the understanding of the causes of, and to find a 
cure for, post-abortion conditions. Activities under such subsection 
shall include conducting and supporting the following:
            (1) Basic research concerning the etiology and causes of 
        the conditions.
            (2) Epidemiological studies to address the frequency and 
        natural history of the conditions and the differences among 
        racial and ethnic groups with respect to the conditions.
            (3) The development of improved diagnostic techniques.
            (4) Clinical research for the development and evaluation of 
        new treatments, including new biological agents.
            (5) Information and education programs for health care 
        professionals and the public.
    (d) Longitudinal Study.--
            (1) In general.--The Director of the Institute shall 
        conduct a national longitudinal study to determine the 
        incidence and prevalence of cases of post-abortion conditions, 
        and the symptoms, severity, and duration of such cases, toward 
        the goal of more fully identifying the characteristics of such 
        cases and developing diagnostic techniques.
            (2) Report.--Beginning not later than 3 years after the 
        date of the enactment of this Act, and periodically thereafter 
        for the duration of the study under paragraph (1), the Director 
        of the Institute shall prepare and submit to the Congress 
        reports on the findings of the study.
    (e) Authorization of Appropriations.--For the purpose of carrying 
out this section, there is authorized to be appropriated $3,000,000 for 
each of the fiscal years 2005 through 2009.



    (a) In General.--The Secretary of Health and Human Services (in 
this title referred to as the ``Secretary'') shall in accordance with 
this title make grants to provide for projects for the establishment, 
operation, and coordination of effective and cost-efficient systems for 
the delivery of essential services to individuals with post-abortion 
depression or post-abortion psychosis (referred to in this section as a 
``post-abortion condition) and their families.
    (b) Recipients of Grants.--A grant under subsection (a) may be made 
to an entity only if the entity--
            (1) is a public or nonprofit private entity, which may 
        include a State or local government; a public or nonprofit 
        private hospital, community-based organization, hospice, 
        ambulatory care facility, community health center, migrant 
        health center, or homeless health center; or other appropriate 
        public or nonprofit private entity; and
            (2) had experience in providing the services described in 
        subsection (a) before the date of the enactment of this Act.
    (c) Certain Activities.--To the extent practicable and appropriate, 
the Secretary shall ensure that projects under subsection (a) provide 
services for the diagnosis and management of post-abortion conditions. 
Activities that the Secretary may authorize for such projects may also 
include the following:
            (1) Delivering or enhancing outpatient and home-based 
        health and support services, including case management, 
        screening and comprehensive treatment services for individuals 
        with or at risk for post-abortion conditions; and delivering or 
        enhancing support services for their families.
            (2) Delivering or enhancing inpatient care management 
        services that ensure the well being of the mother and family 
        and the future development of the infant.
            (3) Improving the quality, availability, and organization 
        of health care and support services (including transportation 
        services, attendant care, homemaker services, day or respite 
        care, and providing counseling on financial assistance and 
        insurance) for individuals with post-abortion conditions and 
        support services for their families.
    (d) Integration With Other Programs.--To the extent practicable and 
appropriate, the Secretary shall integrate the program under this title 
with other grant programs carried out by the Secretary, including the 
program under section 330 of the Public Health Service Act.
    (e) Limitation on Amount of Grants.--A grant under subsection (a) 
may not for any fiscal year be made in an amount exceeding $100,000.


    A grant may be made under section 201 only if the applicant 
involved makes the following agreements:
            (1) Not more than 5 percent of the grant will be used for 
        administration, accounting, reporting, and program oversight 
            (2) The grant will be used to supplement and not supplant 
        funds from other sources related to the treatment of post-
        abortion conditions.
            (3) The applicant will abide by any limitations deemed 
        appropriate by the Secretary on any charges to individuals 
        receiving services pursuant to the grant. As deemed appropriate 
        by the Secretary, such limitations on charges may vary based on 
        the financial circumstances of the individual receiving 
            (4) The grant will not be expended to make payment for 
        services authorized under section 201(a) to the extent that 
        payment has been made, or can reasonably be expected to be 
        made, with respect to such services--
                    (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.
            (5) The applicant will, at each site at which the applicant 
        provides services under section 201(a), post a conspicuous 
        notice informing individuals who receive the services of any 
        Federal policies that apply to the applicant with respect to 
        the imposition of charges on such individuals.


    The Secretary may provide technical assistance to assist entities 
in complying with the requirements of this title in order to make such 
entities eligible to receive grants under section 201.


    For the purpose of carrying out this title, there is authorized to 
be appropriated $300,000 for each of the fiscal years 2005 through