[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[S. 1440 Introduced in Senate (IS)]
112th CONGRESS
1st Session
S. 1440
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
July 28, 2011
Mr. Alexander (for himself and Mr. Bennet) 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 Reauthorization Act''
or the ``PREEMIE Reauthorization Act''.
SEC. 2. PURPOSES.
It is the purpose of this Act to--
(1) help reduce preterm birth, associated disabilities of
preterm birth, and deaths of babies born preterm;
(2) expand research into the causes of preterm birth; and
(3) promote the development, availability, and use of
evidence-based practices of care for pregnant women at risk of
preterm labor or other serious pregnancy-related complications
and for infants born preterm.
SEC. 3. RESEARCH AND ACTIVITIES AT THE NATIONAL INSTITUTES OF HEALTH.
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. 409K. EXPANSION AND COORDINATION OF RESEARCH RELATING TO PRETERM
LABOR AND DELIVERY AND INFANT MORTALITY.
``(a) In General.--The Secretary, acting through the Director of
NIH, shall, subject to the availability of appropriations, expand,
intensify, and coordinate the activities of the National Institutes of
Health with respect to research on the causes of preterm labor and
delivery, tools to detect, prevent, or reduce prevalence of preterm
labor and delivery, and the care and treatment of preterm infants.
``(b) Authorization of Clinical Research Networks.--There shall be
established within the National Institutes of Health a multi-center
clinical program (that shall be initially established utilizing
existing networks) designed to--
``(1) investigate problems in clinical obstetrics,
particularly those related to prevention of low birth weight,
prematurity, and medical problems of pregnancy;
``(2) improve the care and outcomes of neonates, especially
very-low-birth weight infants; and
``(3) enhance the understanding of DNA and proteins as they
relate to the underlying processes that lead to preterm birth
to aid in formulating more effective interventions to prevent
preterm birth.
``(c) Trans-Disciplinary Centers for Preterm Birth Research.--
``(1) In general.--The Director of NIH shall, subject to
appropriations made available to carry out this subsection,
award grants and contracts to public and nonprofit private
entities to pay all or part of the cost of planning,
establishing, improving, and providing basic operating support
for trans-disciplinary research centers for prematurity.
Research supported under this subsection shall integrate
clinical, public health, basic, and behavioral and social
science disciplines together with bioinformatics, engineering,
mathematical, and computer sciences to address the causes of
preterm labor and delivery collaboratively.
``(2) Eligibility.--To be eligible to receive a grant or
contract under paragraph (1), an entity shall submit to the
Director an application at such time, in such manner, and
containing such information as the Director may require,
including, if appropriate, an assurance that the entity will
coordinate with clinical research networks authorized in
subsection (b).
``(3) Report.--The Director of NIH shall include in the
report under section 402A(c) information on the activities of
the trans-disciplinary research centers for prematurity under
this subsection.
``(d) National Educational Campaign.--
``(1) Establishment.--The Secretary, acting through the
Surgeon General of the Public Health Service and in
consultation with the Director of the Eunice Kennedy Shriver
National Institute on Child Health and Human Development, shall
establish and implement a national science-based provider and
consumer education campaign on promoting healthy pregnancies
and preventing preterm birth.
``(2) Targeting.--The campaign established under paragraph
(1) shall target women of childbearing age, high risk
populations, ethnic and minority groups, individuals with a low
socioeconomic status, obstetricians and gynecologists, nurse
practitioners, certified nurse-midwives, certified midwives,
and other health care providers.''.
SEC. 4. RESEARCH AND ACTIVITIES AT THE CENTERS FOR DISEASE CONTROL AND
PREVENTION.
(a) Epidemiological Studies.--Section 3 of the Prematurity Research
Expansion and Education for Mothers who deliver Infants Early Act (42
U.S.C. 247b-4f) is amended by striking subsection (b) and inserting the
following:
``(b) Studies and Activities on Preterm Birth.--
``(1) In general.--The Secretary of Health and Human
Services, acting through the Director of the Centers for
Disease Control and Prevention, shall, subject to the
availability of appropriations--
``(A) conduct ongoing epidemiological studies on
the clinical, biological, social, environmental,
genetic, and behavioral factors relating to
prematurity;
``(B) conduct activities to improve national data
to facilitate tracking the burden of preterm birth;
``(C) develop, implement, and evaluate novel
methods for prevention to better understand the growing
problem of late preterm birth;
``(D) conduct etiologic and epidemiologic studies
of preterm birth;
``(E) expand research on racial and ethnic
disparities as they relate to preterm birth; and
``(F) conduct ongoing epidemiological studies on
the effectiveness of community based interventions.
``(2) Report.--Not later than 2 years after the date of
enactment of the PREEMIE Reauthorization Act, and every 2 years
thereafter, the Secretary of Health and Human Services, acting
through the Director of the Centers for Disease Control and
Prevention, shall submit to the appropriate committees of
Congress reports concerning the progress and any results of
studies conducted under paragraph (1).''.
(b) Reauthorization.--Section 3(e) of the Prematurity Research
Expansion and Education for Mothers who deliver Infants Early Act (42
U.S.C. 247b-4f(e)) is amended by striking ``2011'' and inserting
``2016''.
SEC. 5. RESEARCH AND ACTIVITIES AT THE HEALTH RESOURCES AND SERVICES
ADMINISTRATION.
(a) Telemedicine Demonstration Project on High Risk Pregnancies.--
Section 330I of the Public Health Service Act (42 U.S.C. 254c-14) is
amended--
(1) by redesignating subsections (q) through (s) as
subsections (r) through (t), respectively;
(2) by inserting after subsection (p), the following:
``(q) Telemedicine Demonstration Project on High Risk
Pregnancies.--
``(1) In general.--The Director shall award grants under
this section to eligible entities to establish demonstration
projects for--
``(A) the provision of preconception, antepartum,
intrapartum, and obstetric services to high risk women
of child bearing age remotely by obstetricians and
gynecologists, nurse practitioners, certified nurse-
midwives, certified midwives, or other health care
providers using telehealth; and
``(B) for the conduct of educational activities
regarding risk factors for preterm birth.
``(2) Eligibility.--To be eligible to receive a grant under
paragraph (1), an entity shall submit an application to the
Director at such time, in such manner, and containing such
information as the Director my require.''; and
(3) in subsection (t) (as so redesignated)--
(A) in paragraph (1), by striking ``and'' at the
end;
(B) in paragraph (2), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(3) for grants under subsection (q), $1,000,000 for each
of fiscal years 2012 through 2016.''.
(b) Public and Health Care Provider Education.--Section 399Q of the
Public Health Service Act (42 U.S.C. 280g-5) is amended--
(1) in subsection (b)--
(A) in paragraph (1), by striking subparagraphs (A)
through (F) and inserting the following:
``(A) the core risk factors for preterm labor;
``(B) medically indicated deliveries before 39
weeks;
``(C) outcomes for infants born before 39 weeks;
``(D) risk factors for preterm delivery;
``(E) the importance of preconception- and prenatal
care;
``(F) smoking cessation, hypertension, and weight
maintenance;
``(G) treatments and outcomes for babies born
premature;
``(H) the informational needs of families during
the stay of an infant in a neonatal intensive care
unit;
``(I) preventable birth injuries if evidence-based
strategies had been utilized;
``(J) depression; and
``(K) the use of progesterone;''; and
(B) by striking paragraph (2) and by redesignating
paragraphs (3) and (4) as paragraphs (2) and (3),
respectively;
(2) by redesignating subsection (c) as subsection (d) and
by inserting after subsection (b) the following new subsection:
``(c) Pilot Program.--
``(1) In general.--The Secretary, acting through the
Administrator of the Health Resources and Services
Administration and the heads of other appropriate agencies,
shall conduct (and report on) research studies and
demonstration projects that test maternity care models that are
designed to reduce the rate of preterm birth.
``(2) Grants.--The Secretary may carry out this subsection
through the awarding of grants to eligible entities.
``(3) Eligibility.--To be eligible to receive a grant under
this section an entity shall--
``(A) be--
``(i) a hospital or hospital systems that
utilizes evidence-based best practices; or
``(ii) a public or private nonprofit
entity; and
``(B) submit to the Secretary an application at
such time, in such manner, and containing such
information as the Secretary may require.
``(4) Targeting.--In awarding grants under this subsection,
the Secretary shall give priority to projects in geographic
areas with a demonstrated persistent high rate of preterm birth
based on data from the National Center on Health Statistics.'';
and
(3) in subsection (d), as redesignated by paragraph (2), by
striking ``2011'' and inserting ``2016''.
SEC. 6. OTHER ACTIVITIES.
(a) Advisory Committee on Infant Mortality.--
(1) Establishment.--The Secretary shall establish an
advisory committee known as the ``Advisory Committee on Infant
Mortality'' (referred to in this section as the ``Advisory
Committee'').
(2) Duties.--The Advisory Committee shall provide advice
and recommendations to the Secretary concerning the following
activities:
(A) Programs of the Department of Health and Human
Services that are directed at reducing infant mortality
and improving the health status of pregnant women and
infants.
(B) Factors affecting the continuum of care with
respect to maternal and child health care, including
outcomes following childbirth and specifically preterm
birth.
(C) Strategies to coordinate the various Federal,
State, local, and private programs and efforts that are
designed to deal with the health and social problems
impacting infant mortality.
(D) Implementation of the Healthy Start program
under section 330H of the Public Health Service Act (42
U.S.C. 254c-8) and Healthy People 2020 infant mortality
objectives.
(E) Strategies to promote the collection of
improved linked maternal and infant perinatal data.
(F) Strategies to reduce preterm birth rates
through research, programs, and education.
(3) Plan for hhs preterm birth activities.--Not later than
1 year after the date of enactment of this section, the
Advisory Committee shall develop a plan for conducting and
supporting research education and programs on preterm birth
through the Department of Health and Human Services and shall
periodically review and revise the plan. The plan shall--
(A) provide for a broad range of research and
educational activities relating to biomedical,
epidemiological, psychosocial, translational, and
clinical activities, including studies on racial and
ethnic disparities in preterm birth rates;
(B) identify priorities among the programs and
activities of the Department of Health and Human
Services regarding preterm birth; and
(C) reflect input from a broad range of scientists,
patients, and advocacy groups.
(4) Membership.--The Secretary shall ensure that the
membership of the Advisory Committee includes the following:
(A) Representatives provided for in the original
charter of the Advisory Committee.
(B) A representative of the National Center for
Health Statistics.
(b) Patient Safety Study and Report.--
(1) In general.--The Secretary shall designate an
appropriate agency within the Department of Health and Human
Services to conduct a study on hospital readmissions of preterm
infants. Findings and recommendations resulting from such study
shall be based on data collected to address the following
questions and such other related questions which the Secretary
and such designated agency deem important:
(A) By State and by health care system, what is the
number and rate of inpatient readmission for infants
born preterm?
(B) What are the leading diagnoses at the time of
inpatient readmission for preterm infants?
(C) What is the average cost of treatment for
preterm infant readmissions by diagnosis, by health
care system, and by State?
(D) What percentage of readmissions are preventable
if evidence-based strategies had been utilized?
(E) What percentage of treatment cost is
attributable to preventable readmissions?
(F) What is the source of health insurance coverage
for preterm infants who are readmitted, such as through
publicly funded programs (including the Medicaid
program under title XIX of the Social Security Act and
the Children's Health Insurance Program under title XXI
of such Act), private health insurance, and self
payments of uninsured individuals?
(G) What evidence-based interventions are effective
in preventing readmission of preterm infants, including
measuring and reporting on quality of care and
outcomes?
(2) Report to secretary and congress.--Not later than 1
year after the date of the enactment of this Act, the agency
designated under paragraph (1) shall submit to the Secretary
and to Congress a report containing the findings and
recommendations resulting from the study conducted under such
subparagraph, including recommendations for hospital discharge
and follow-up procedures designed to reduce rates of
preventable hospital readmissions for preterm infants.
(3) Authorization of appropriations.--There is authorized
to be appropriated to carry out this subsection, $1,000,000 for
fiscal year 2012.
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