On September 14, the House Energy and Commerce Subcommittee on Health held a hearing to examine several public health bills, including the Heart Disease, Education, Analysis Research, and Treatment (HEART) for Women Act (H.R. 1032), Gynecological Cancer Education and Awareness Act (H.R. 2941), Birth Defects Prevention, Risk Reduction, and Awareness Act (H.R. 5462), the Gestational Diabetes (GEDI) Act (H.R. 5354), and the Methamphetamine Education, Treatment, and Hope Act (H.R. 2818).
On September 15, the subcommittee approved the bills separately by voice vote, after also adopting substitute amendments for each bill, also by voice vote.
Subcommittee Mark-Up
HEART for Women Act
As amended, H.R. 1032, sponsored by Rep. Lois Capps (D-CA), would require the Government Accountability Office (GAO) to study the extent to which applications for licenses for new drugs and devices, as well as sponsors of clinical studies, comply with Food and Drug Administration (FDA) guidelines with regard to sex, race, and age. The GAO would be required to submit the report to Congress within one year of the bill’s enactment; HHS would be required to respond to the report as well.
The bill would require the Department of Health and Human Services (HHS) to report to Congress on the access women with cardiovascular disease have to quality care.
The substitute amendment also changes the authorizations for the WISEWOMAN program, a program administered by the CDC to prevent cardiovascular diseases in women. The program would receive $23 million in FY2012, $25.3 million in FY2013, $27.8 million in FY2014, $30.8 million n FY2015, and $34 million in FY2016.
Gynecological Cancer Education and Awareness
Sponsored by Rep. Rosa DeLauro (D-CT), the Gynecological Cancer Education and Awareness Act (H.R. 2941), as amended, would authorize $18 million annually for FY2012-2014 for CDC programs to provide education about gynecologic cancers to women and health care providers. Also known as Johanna’s Law, the bill would require the secretary of HHS to collaborate with nonprofit organizations to determine “best practices” to educate populations about gynecological cancers.
The bill also would award grants to nonprofit organizations to test outreach and education strategies to raise awareness of such cancers.
Birth Defects Prevention and Awareness
Also sponsored by Rep. DeLauro, the Birth Defects Prevention, Risk Reduction, and Awareness Act (H.R. 5462) would require the secretary of HHS to establish a birth defects prevention and public awareness program. The program would establish grants to organizations to increase awareness about pregnancy and breastfeeding information services.
As amended, the bill would authorize $4.5 million in FY2011, $5.5 million in FY2012, $6.5 million in FY2013, $7.5 million in FY2014, and $8.5 million in FY2015.
Gestational Diabetes
As amended, the Gestational Diabetes (GEDI) Act (H.R. 5354), sponsored by Rep. Eliot Engel (D-NY), would authorize $5 million annually from FY2012-2016 to develop “a multisite, gestational diabetes research project within the CDC’s diabetes program to expand and enhance surveillance data and public health research on gestational diabetes,” including developing and testing approaches for improving postpartum diabetes testing and on the epidemiological, socio-economic, behavioral, and other factors that influence the risk of developing gestational diabetes.
Nonprofit organizations would be eligible to receive federal grants for demonstration projects aimed at building, implementing, and evaluating evidence-based interventions to reduce gestational diabetes, its recurrence, and to prevent type-2 diabetes after pregnancy.
Methamphetamine Treatment
As amended, the Methamphetamine Education, Treatment, and Hope Act, sponsored by Rep. Jerry McNerney (D-CA), would authorize the Substance Abuse and Mental Health Services Administration (SAMHSA) to provide residential substance abuse treatment services for pregnant and parenting women addicted to methamphetamine. Such services would be available to low-income pregnant and parenting women and those in health disparity populations.
The measure would give priority to programs in rural areas and those facing a shortage of health professionals or family-based substance abuse treatment options.
Subcommittee Hearing
Dr. Ileana Arias, principal deputy director at the Centers for Disease Control and Prevention (CDC) Agency for Toxic Substances and Disease Registry, detailed one of the six “Winnable Battles” the CDC is waging in the area of teen pregnancy. Dr. Arias noted that “Teen pregnancy rates in the United States are the highest of any industrialized nation, and 82 percent of these pregnancies are unintended. Moreover, although teen birth rates declined from 1991 to 2005, they rose for the next two years before declining again in 2008. Teen pregnancy is a significant public health concern not only because it perpetuates the cycle of poverty – a significant socioeconomic determinant of health – but also because babies born to teen mothers are more likely to die, to have low birth weights, or to be born prematurely. The CDC is working with its partners to deter teen pregnancy through science based approaches.”
Dr. Arias also identified global health as one of five strategic priorities to help the CDC achieve its public health goals. She said, “Global public health investments have a direct benefit on U.S. public health and national security. Programs, such as the President’s Emergency Plan for AIDS Relief (PEPFAR), the President’s Malaria Initiative (PMI), and the international pandemic influenza preparedness plans have improved health systems throughout the world and strengthened our outbreak response. CDC has created a new Global Health Center to enhance our efforts to build capacity at ministries of health; strengthen disease detection, surveillance, response, and laboratory capacity; and improve sustainability of public health programs.”
Dr. Marcia Brand, deputy administrator of the Health Resources and Services Administration (HRSA), also described programs in place at HRSA to improve public health. In describing the Title V Maternal and Child Health (MCH) Services Block Grant program, Dr. Brand said, “The purpose of the Title V MCH Block Grant is to improve the health of all mothers and children consistent with the applicable health status goals and national objectives, and to provide and assure mothers and children (in particular those with low income or with limited availability of health services) access to quality maternal and child health services.” She described one program within Title V, saying, “The Affordable Care Act [P.L. 111-148] provided $100 million in FY2010 for grants to states and tribes to provide evidence-based home visitation services to improve outcomes for children and families who reside in at-risk communities. Through the Maternal, Infant, and Early Childhood Home Visiting Program, nurses, social workers, or other professionals meet with at-risk families in their homes, evaluate the families’ circumstances, and connect families to the kinds of help that can make a real difference in a child’s health, development, and ability to learn – such as health care, developmental services for children, early education, parenting skills, child abuse prevention, and nutrition education or assistance. Home visiting is a strategy that has been used by public health and human services programs to foster child development and address such problems as infant mortality. HRSA and ACF [Administration for Children and Families] are working collaboratively on this program.”
