S 2635 IS

To reduce health care costs and promote improved health by providing supplemental grants for additional preventive health services for women.

May 25, 2000

Mr. FRIST (for himself, Mr. HARKIN, Mr. JEFFORDS, Mrs. MURRAY, Mr. BINGAMAN, Ms. MIKULSKI, and Mr. REED) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions

To reduce health care costs and promote improved health by providing supplemental grants for additional preventive health services for women.

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 `WISEWOMAN Expansion Act of 2000'.

SEC. 2. FINDINGS.

Congress makes the following findings:

(1) Heart disease, stroke, and other cardiovascular diseases remain the leading cause of death among females in the United States, killing more than 500,000 women each year.

(2) About 1 in 5 females have some form of cardiovascular disease, killing more American women than the next 14 causes of death combined.

(3) In women, cardiovascular disease is frequently undetected and untreated until the disease has become severe, causing 38 percent of women who have heart attacks to die within 1 year.

(4) Obesity increases women's risk for some of the leading causes of death: heart disease, stroke, diabetes, and certain cancers.

(5) Better nutrition and lifestyle changes can effectively prevent and treat obesity.

(6) Osteoporosis afflicts more than 20,000,000 American women.

(7) More than 1/2 of all women over 65 have osteoporosis.

(8) One out of every 2 women over 50 will have an osteoporosis-related fracture during her lifetime.

(9) The national annual costs associated with osteoporosis are estimated at $14,000,000,000.

(10) Physical activity is necessary for bone acquisition and maintenance throughout adulthood.

(11) Muscular strengthen and balance may be very significant in future risk reduction for osteoporosis.

(12) There is consensus that adequate vitamin D and calcium intakes are required for bone health.

(13) Research has demonstrated that--

(A) the uninsured often have significantly poorer health than the insured; and

(B) being uninsured is an obstacle to receiving preventive health care services.

(14) The WISEWOMAN program has--

(A) provided one-stop shopping for preventive health services such as cholesterol and blood pressure screening for close to 8000 women and identified risk factors for heart disease such as obesity, high cholesterol, high blood pressure, sedentary behavior and poor diet; and

(B) found that many of the women screened have returned for additional interventions and follow-up, resulting in improved weight management, lower blood pressure and lower cholesterol.

(15) Expansion of the WISEWOMAN model program to additional States would help reduce women's risk of illness and death from heart disease and other preventable diseases and provide further insights into the feasibility and effectiveness of making comprehensive, integrated preventive services available to low-income and uninsured women.

SEC. 3. SUPPLEMENTAL GRANTS FOR ADDITIONAL PREVENTIVE HEALTH SERVICES FOR WOMEN.

Section 1509 of the Public Health Service Act (42 U.S.C. 300n-4a) is amended to read as follows:

`SEC. 1509. ESTABLISHMENT OF PROGRAM FOR ADDITIONAL PREVENTIVE HEALTH SERVICES.

`(a) IN GENERAL- The Secretary, acting through the Director of the Centers for Disease Control and Prevention, may, through a competitive review process, award grants to States that have received grants under section 1501 for a fiscal year, to enable such State to carry out programs--

`(1) to provide preventive health services, in addition to the services authorized in such section 1501, for diseases such as cardiovascular diseases, osteoporosis, and obesity;

`(2) to provide screenings, such as screening for blood pressure, cholesterol, and osteoporosis, and other services that the Secretary, acting through the Director of the Centers for Disease Control and Prevention, determines to be appropriate and feasible;

`(3) for health education, counseling, and interventions for behavioral risk factors, such as physical inactivity and poor nutrition, and diseases referred to in paragraph (1);

`(4) to provide appropriate referrals for medical treatment of women receiving services pursuant to paragraph (1) through (3), and ensuring, to the extent practicable, the provision of appropriate follow-up services; and

`(5) to evaluate the activities conducted under paragraphs (1) through (4) through appropriate surveillance, research, or program monitoring activities.

`(b) STATUS AS PARTICIPANT IN PROGRAM REGARDING BREAST AND CERVICAL CANCER- The Secretary may not make a grant to a State under subsection (a) unless the State involved agrees that services under the grant will be provided in conjunction with entities that are screening women for breast or cervical cancer pursuant to a grant under section 1501.

`(c) APPLICABILITY OF PROVISIONS- The provisions of this title shall apply to a grant under subsection (a) to the same extent and in the same manner as such provisions apply to a grant under section 1501.

`(d) FUNDING-

`(1) IN GENERAL- There is authorized to be appropriate to carry out this section--

`(A) $15,000,000 for fiscal year 2001;

`(B) $20,000,000 for fiscal year 2002;

`(C) $25,000,000 for fiscal year 2003; and

`(D) such sums as may be necessary for each subsequent fiscal year.

`(2) LIMITATION REGARDING FUNDING WITH RESPECT TO BREAST AND CERVICAL CANCER- No additional resources shall be appropriated for a fiscal year under paragraph (1) unless the amount appropriated under section 1510(a) for such fiscal year is at least $158,000,000.'.

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