[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[S. 887 Introduced in Senate (IS)]
103d CONGRESS
1st Session
S. 887
To amend the Public Health Service Act to improve immunization rates
among children through the establishment of data registries and
educational programs, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 4 (legislative day, April 19), 1993
Mr. Danforth (for himself, Mrs. Kassebaum, Mr. Durenberger, Mr. Gregg,
and Mr. Bond) introduced the following bill; which was read twice and
referred to the Committee on Finance
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to improve immunization rates
among children through the establishment of data registries and
educational programs, 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.
This Act may be cited as the ``National Immunization Improvement
Act of 1993''.
SEC. 2. FINDINGS AND PURPOSE.
(a) Findings.--Congress finds that--
(1) 90 percent of all children under the age of 2 receive
at least one vaccination yet only 40 to 60 percent of these
children receive a complete set of vaccinations;
(2) the low immunization rate for children stems from
inadequate immunization delivery systems and a lack of public
education concerning the risks related to the nonimmunization
of children; and
(3) government health care programs must coordinate their
activities in order to increase immunization rates.
(b) Purpose.--It is the purpose of this Act to--
(1) assist the States in developing State systems to
monitor the immunization status of children in order to ensure
that these children are provided with the recommended number of
vaccinations;
(2) in cooperation with the States, improve the
immunization delivery system and expand outreach and awareness
efforts to ensure that every child under 2 years of age is
properly immunized;
(3) provide for increased coordination among Federal
programs in order to improve immunization rates;
(4) encourage increased coordination among Federal, State
and private programs to improve immunization rates; and
(5) make certain revisions with respect to the Vaccine
Injury Compensation Program.
SEC. 3. AMENDMENT TO PUBLIC HEALTH SERVICE ACT.
(a) Improved Immunization.--Subtitle 2 of title XXI of the Public
Health Service Act (42 U.S.C. 300aa-1 et seq.) is amended--
(1) by redesignating part D as part E;
(2) by redesignating sections 2131 through 2134 as sections
2151 through 2154, respectively; and
(3) by inserting after part C, the following new part:
``Part D--Improved Immunization Efforts
``SEC. 2131. VOLUNTARY STATE REGISTRY GRANT PROGRAM.
``(a) In General.--Not later than 1 year after the date of
enactment of this part, the Secretary shall establish a program under
which the Secretary may award grants to States to enable such States to
develop and operate computerized State registries to collect, track and
monitor immunization data with respect to children residing within such
States as described in subsection (c).
``(b) Application.--To be eligible to receive a grant under
subsection (a), a State shall prepare and submit to the Secretary an
application at such time, in such manner, and containing such
information as the Secretary may require. Such application shall
include a plan to ensure that necessary immunization information is
provided to the State registry.
``(c) Data.--
``(1) Data set and standards.--The Secretary shall develop
a minimum uniform data set and data standards applicable to
State registries developed under this section, in order to
allow compatibility between States.
``(2) Design.--A State immunization tracking and
surveillance registry established under subsection (a) shall be
designed to collect immunization information on each child
residing within the State from the time that each such child is
born, and track the immunization records of each such child as
they grow older. The registry shall contain at least the
following information with respect to each child residing
within the State:
``(A) The name, address and date of birth of the
child.
``(B) The complete immunization history of the
child.
``(C) The type and lot numbers of each vaccine
provided to the child.
``(D) The name and address of each health care
provider providing a vaccination to the child.
``(E) Identifying data that is sufficient to enable
the registry to locate the child for purposes of
conducting immunization notification activities
concerning the child.
``(F) Information designed to monitor the safety
and effectiveness of vaccines by linking vaccine dosage
information with adverse events reporting and disease
outbreak patterns, including events reported by
petitioners under parts A or B.
``(d) Technical Assistance.--The Secretary shall provide technical
assistance to States for the development of State registries under this
section.
``(e) Reporting.--Each State that receives a grant under this
section shall annually prepare and submit to the Secretary a report
concerning the progress made by the State in operating a State registry
under the grant.
``(f) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, $150,000,000 for fiscal year
1995, and such sums as may be necessary for each of the fiscal years
1995 through 1999.
``SEC. 2132. IMPROVED IMMUNIZATION DELIVERY, OUTREACH AND EDUCATION.
``(a) Required Activities.--The Secretary, acting through the
Centers for Disease Control and Prevention and in conjunction with
State health officials and other appropriate public and private
organizations, shall conduct the following activities to improve
Federal, State and local vaccines delivery systems and immunization
outreach and education efforts:
``(1) Immunization educational materials for providers.--
Not later than 1 year after the date of enactment of this part,
the Secretary, in conjunction with State health officials and
other appropriate public and private organizations, shall
develop and disseminate standard immunization educational
materials for providers, including--
``(A) a list of basic recommended vaccines and the
schedules for immunizing children with such vaccines;
``(B) recommended criteria for the administration
of vaccines;
``(C) recommended criteria for determining when
vaccines should not be administered;
``(D) recommended criteria for the screening of
children prior to immunization;
``(E) informed consent materials consistent with
those required under section 2126(c); and
``(F) any other information determined appropriate
by the Secretary.
``(2) National public awareness campaign.--
``(A) In general.--The Secretary, in conjunction
with State health officials and other appropriate
public and private organizations, shall develop and
implement a National Immunization Public Awareness
Campaign to assist parents (through bilingual means if
necessary) of children under the age of 2 years, and
expectant parents, in obtaining knowledge concerning
the importance of having their children immunized and
in identifying the vaccines, schedules for
immunization, and vaccine provider locations,
appropriate with respect to their children.
``(B) Implementation.--In implementing the Campaign
under subparagraph (A), the Secretary shall ensure
that--
``(i) new and innovative methods are
developed and utilized to publicly advertise
the need to have children immunized in a timely
manner;
``(ii) print, radio and television media
are utilized to convey immunization information
to the public; and
``(iii) with respect to immunization
information, efforts are made to target
pregnant women and the parents of children
under the age of 2.
``(3) Interagency committee on immunization.--The
Secretary, in conjunction with the Secretary of Agriculture,
the Secretary of Housing and Urban Development, and the
Secretary of Education, shall carry out activities through the
Interagency Committee on Immunization to incorporate
immunization status assessments and referral services as an
integral part of the process by which individuals apply for
assistance under--
``(A) the food stamp program under the Food Stamp
Act of 1977;
``(B) section 17 of the Child Nutrition Act of
1966;
``(C) the Head Start Act;
``(D) part A of title IV of the Social Security
Act;
``(E) title XIX of the Social Security Act;
``(F) any of the housing assistance laws of the
United States; and
``(G) other programs determined appropriate by any
of the Secretaries described in this paragraph.
``(4) Outreach activities.--The Secretary shall conduct
immunization outreach activities, including--
``(A) conducting research concerning alternative
delivery systems (such as mobile immunization clinics);
``(B) utilization of National Health Service Corps
members and other measures to conduct immunization
outreach activities in medically underserved areas and
for medically underserved populations;
``(C) conducting research concerning the
implementation of innovative methods to--
``(i) contact parents or legal guardians
concerning their children's immunization
status;
``(ii) refer such parents or legal
guardians to immunization providers; and
``(iii) conduct follow-up activities
concerning the immunization status of children
affected by the activities conducted under this
subparagraph;
``(D) the coordination of vaccine outreach and
education activities with other Federal, State and
local programs to encourage parents to have their
children immunized; and
``(E) any other activities determined appropriate
by the Secretary.
``(b) Immunization Action Plans.--
``(1) Grants.--
``(A) In general.--The Secretary may award grants
to States to enable such State to develop, revise and
implement immunization action plans as described in
paragraph (2).
``(B) Application.--To be eligible to receive a
grant under subparagraph (A), a State shall prepare and
submit to the Secretary an application at such time, in
such manner, and containing such information as the
Secretary may require.
``(2) Design.--A State immunization action plan shall be
designed to improve immunization delivery, outreach, education
and coordination within the State. Such plan shall provide for
the creation of--
``(A) a vaccine provider education campaign under
which standard immunization criteria developed under
subsection (a)(1), and any other materials determined
to be appropriate by State health officials, will be
distributed to immunization providers--
``(i) to enable such providers to make the
best use of vaccination opportunities; and
``(ii) to educate such providers concerning
their obligation to report immunization
information with respect to their patients to
State registries;
``(B) expanded immunization delivery through--
``(i) increasing the number or type of
facilities through which vaccines may be made
available;
``(ii) developing alternative methods of
delivering vaccines, such as mobile health
clinics or through programs of the type
described in subsection (a)(5); or
``(iii) increasing the number of hours
during which vaccines are made available by
providers within the State;
except that, the Secretary may waive the requirements
of this subparagraph if the Secretary determines that
State immunization delivery efforts are sufficient;
``(C) population-based assessment criteria through
which the State is able to assess the effectiveness of
immunization activities in the State;
``(D) a public awareness campaign, in conjunction
with the National Campaign established under subsection
(a)(2), to provide parents with information concerning
the types and schedules for the administration of
vaccines, and the locations of vaccines providers;
``(E) coordination of outreach activities with
other public or private health programs to encourage
parents to have their children immunized; and
``(F) significant collaboration with private
entities in achieving the goals of the plan.
``(3) Immunization action plan approval.--
``(A) Goals.--As part of the immunization action
plan of a State, the State shall establish immunization
rate goals for children residing within the State.
``(B) Approval.--The immunization action plan
developed by a State under this subsection shall be
submitted to the Secretary for approval prior to the
distribution of grant funds to the States under this
subsection. The Secretary shall periodically review the
progress that the State has made under such plan in
achieving the goals established under subparagraph (A).
``(C) Reporting.--A State shall annually prepare
and submit to the Director of the Centers for Disease
Control and Prevention a report concerning the
implementation of the State immunization action plan.
If the Director or the Secretary, in reviewing the
reports submitted under this subparagraph determine
that the State has not made sufficient progress towards
achieving the goals established under subparagraph (A),
the Secretary may reduce the State's grant funds.
``SEC. 2133. AUTHORIZATION OF APPROPRIATIONS.
``There are authorized to be appropriated to carry out 2132(b),
$200,000,000 for fiscal year 1994, and such sums as may be necessary
for each of the fiscal years 1995 through 1999.''.
(b) Simplification of Informed Consent Materials.--Section 2126(c)
of the Public Health Service Act (42 U.S.C. 300aa-26(c)) is amended--
(A) in the matter preceding paragraph (1), by
inserting ``shall be based on available data and
information,'' after ``such materials''; and
(B) by striking out ``include--'' and all that
follows through the paragraph (10) and inserting in
lieu thereof ``include a concise description of the
benefits and the risks of the vaccines and a statement
of the availability of the National Vaccine Injury
Compensation Fund.''.
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