109th CONGRESS
2d Session
H. R. 6067
To provide for programs that reduce the number of unplanned pregnancies,
reduce the need for abortion, help women bear healthy children, and support
new parents.
IN THE HOUSE OF REPRESENTATIVES
September 13, 2006
Mr. RYAN of Ohio (for himself, Mr. LANGEVIN, Ms. KAPTUR, Ms. DELAURO, Ms.
HERSETH, Mr. EMANUEL, Mr. LARSON of Connecticut, Mr. CLYBURN, Mr. STRICKLAND,
Mr. FORD, Mr. OBEY, and Ms. ESHOO) introduced the following bill; which
was referred to the Committee on Energy and Commerce, and in addition to
the Committees on Education and the Workforce and Ways and Means, for a
period to be subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee concerned
A BILL
To provide for programs that reduce the number of unplanned pregnancies,
reduce the need for abortion, help women bear healthy children, and support
new parents.
Be it enacted by the Senate and House of Representatives of the United
States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title- This Act may be cited as the `Reducing the Need for Abortion
and Supporting Parents Act'.
(b) Table of Contents- The table of contents for this Act is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings; purpose.
Sec. 4. Eligibility of Indian tribes for awards.
TITLE I--EDUCATION PROGRAMS FOR PREVENTING TEEN PREGNANCIES
Sec. 102. Education programs for preventing teen pregnancies.
TITLE II--REAUTHORIZATION OF CERTAIN AFTER-SCHOOL PROGRAMS
Sec. 202. Reauthorization of certain after-school programs.
TITLE III--TEEN PREGNANCY PREVENTION INCENTIVE GRANTS
Sec. 301. Teen pregnancy prevention incentive grants.
Sec. 302. Establishing national goal to prevent teen pregnancy.
TITLE IV--DEMONSTRATION GRANTS TO ENCOURAGE CREATIVE APPROACHES TO TEEN
PREGNANCY PREVENTION
Sec. 401. Demonstration grants to encourage creative approaches to teen
pregnancy prevention.
TITLE V--NATIONAL CAMPAIGN TO ENLIST PARENTS IN PREVENTING TEEN PREGNANCY
Sec. 502. Establishment of a national center for parents of adolescents;
provision of challenge grants for State and local programs.
TITLE VI--CLARIFICATION OF CONTINUED MEDICAID COVERAGE OF FAMILY PLANNING
SERVICES
Sec. 601. Clarification of continued Medicaid coverage of family planning
services.
TITLE VII--EXPANDED MEDICAID ELIGIBILITY FOR FAMILY PLANNING SERVICES
Sec. 701. Expanded Medicaid eligibility for family planning services.
TITLE VIII--DISCLOSURE OF INFORMATION FOR ABORTION SERVICES
Sec. 801. Disclosure of information for abortion services.
TITLE IX--MEDICAID AND SCHIP COVERAGE OF PREGNANT WOMEN
Sec. 901. State option to expand or add coverage of certain pregnant women
under medicaid and SCHIP.
Sec. 902. Coordination with the maternal and child health program.
Sec. 903. Increase in SCHIP income eligibility.
Sec. 904. Outreach program to encourage those eligible for services to
enroll.
TITLE X--TITLE X OF PUBLIC HEALTH SERVICE ACT
Sec. 1002. Authorization of appropriations.
TITLE XI--PREGNANCY AS PREEXISTING CONDITION
Sec. 1101. Removal of pregnancy as a preexisting condition under individual
health insurance coverage.
TITLE XII--INCREASING WOMEN'S KNOWLEDGE ABOUT THEIR PREGNANCY
Sec. 1201. Grants to health centers for purchase of ultrasound equipment.
Sec. 1202. Services to patients receiving positive test diagnosis for
down syndrome or other prenatally diagnosed condition.
TITLE XIII--PREVENTING DOMESTIC VIOLENCE AND SEXUAL ASSAULT
Sec. 1301. Separate program to identify and treat pregnant women and new
mothers who are victims of domestic violence, dating violence, sexual
assault, or stalking.
Sec. 1302. Additional authorization of appropriations for public campaign
to increase public awareness.
TITLE XIV--SUPPORT FOR PREGNANT AND PARENTING STUDENTS
Sec. 1401. Support services for students of institutions of higher education.
Sec. 1402. Child care access means parents in school program.
TITLE XV--FEDERALLY-FUNDED HOMES FOR PREGNANT AND PARENTING WOMEN
Sec. 1501. Counseling requirements.
Sec. 1502. Treatment of pregnant and parenting women.
TITLE XVI--EXPANSION OF ADOPTION CREDIT AND ADOPTION ASSISTANCE PROGRAMS
Sec. 1601. Expansion of adoption credit and adoption assistance programs.
TITLE XVII--PROVIDING SUPPORT TO NEW PARENTS
Sec. 1701. Increased support for WIC program.
Sec. 1702. Nutritional support for low-income parents.
Sec. 1703. Increased funding for the Child Care and Development Block
Grant program.
Sec. 1704. Teenage or first-time mothers; free home visits by registered
nurses for education on health needs of infants.
Sec. 1705. Grants for increasing public awareness of resources available
to women preparing for child birth.
TITLE XVIII--COLLECTING AND REPORTING ABORTION SURVEILLANCE DATA
Sec. 1801. Grants for collection and reporting of abortion surveillance
data.
Sec. 1802. Report on reasons why women choose to have an abortion.
SEC. 2. FINDINGS; PURPOSE.
(a) Findings- Congress makes the following findings:
(1) There are 1,290,000 abortions annually in America and one in five
pregnancies ends in abortion.
(2) 49 percent of all pregnancies in America are unintended. Excluding
miscarriages, 54 percent of unintended pregnancies end in abortion.
(3) 57 percent of women who have abortions have incomes below 200 percent
of the poverty level.
(4) Rates of unintended pregnancy in the United States increased by nearly
30 percent among low-income women between 1994 and 2001, and a low-income
woman today is about 4 times as likely to have an unintended pregnancy
as her higher income counterpart.
(5) Levels of contraceptive use among low-income women at risk of unintended
pregnancy declined significantly between 1994 and 2001, from 92 percent
to 86 percent.
(6) By helping couples avoid unintended pregnancy, Medicaid-funded and
Title X contraceptive services are highly cost-effective, and every public
dollar spent on family planning saves $3 in the cost of pregnancy-related
care alone.
(7) Abortion rates decreased among higher income women but increased among
low income women between 1994 and 2001, and a low income woman is more
than 4 times as likely to have an abortion as her higher income counterpart.
(8) `Cannot afford a baby' is the second most frequently cited reason
women choose to have an abortion; 73 percent of women having abortions
cited this reason as a contributing factor.
(b) Purpose- The purpose of this Act is to provide a comprehensive initiative
to--
(1) reduce the abortion rate by reducing the number of unintended pregnancies
and supporting women facing unplanned pregnancies;
(2) prevent unintended pregnancies from occurring in the first place--
(A) by reducing teen pregnancy through education, after-school and other
programs, and involving parents; and
(B) by extending Medicaid family planning services to more low-income
women; and
(3) support pregnant women, new parents, and their children, through measures
that address domestic violence and sexual assault, provide health care
services, information about pregnancy, and other supportive services for
pregnant women, and provide supportive services for new parents.
SEC. 3. DEFINITIONS.
For purposes of this Act:
(1) The term `Secretary' means the Secretary of Health and Human Services.
(2) The term `State' includes the 50 States, the District of Columbia,
the Commonwealth of Puerto Rico, the Commonwealth of the Northern Mariana
Islands, American Samoa, Guam, the Virgin Islands, and any other territory
or possession of the United States.
SEC. 4. ELIGIBILITY OF INDIAN TRIBES FOR AWARDS.
(a) In General- In the case of programs carried out pursuant to this Act
that make awards of grants, cooperative agreements, or contracts, Indian
tribes are eligible for awards under the programs in accordance with such
criteria as the Secretary may establish.
(b) Definitions- For purposes of this Act, the term `Indian tribe' has the
meaning given such term in section 4 of the Indian Self-Determination and
Education Assistance Act.
TITLE I--EDUCATION PROGRAMS FOR PREVENTING TEEN PREGNANCIES
SEC. 101. FINDINGS.
The Congress finds as follows:
(1) The United States has the highest teen pregnancy rate and teen birth
rate among comparable countries, costing the United States at least $7,000,000,000
annually.
(2) About one out of three young women in America become pregnant before
they reach the age of 20.
(3) Teenagers account for nearly one of every five abortions.
(4) Teen pregnancy has serious consequences for young women, their children,
and communities as a whole. Too-early childbearing increases the likelihood
that a young woman will drop out of high school and that she and her child
will live in poverty.
(5) Statistically, the sons of teen mothers are more likely to end up
in prison. The daughters of teen mothers are more likely to end up teen
mothers too.
(6) Teens that grow up in disadvantaged economic, social, and family circumstances
are more likely to engage in risky behavior and have a child during adolescence.
(7) Eight in 10 girls and six in 10 boys report that they wish they had
waited until they were older to have sex.
SEC. 102. EDUCATION PROGRAMS FOR PREVENTING TEEN PREGNANCIES.
(a) In General- The Secretary shall make grants to local educational agencies,
State and local public health agencies, and nonprofit private entities for
the purpose of carrying out projects to provide education on preventing
teen pregnancies.
(b) Preference in Making Grants- In making grants under subsection (a),
the Secretary shall give preference to applicants that will carry out the
projects under such subsection in communities for which the rate of teen
pregnancy is significantly above the average rate of such pregnancies.
(c) Certain Requirements- A grant may be made under subsection (a) only
if the applicant for the grant meets the following conditions with respect
to the project involved:
(1) The applicant agrees that information provided by the project on pregnancy
prevention will be age-appropriate, factually and medically accurate and
complete, and scientifically-based.
(2) The applicant agrees that the project will prevent teen pregnancies
by--
(A) encouraging teens to delay sexual activity and providing educational
services and interventions, including information about contraception
for sexually active teens or teens at risk of becoming sexually active
that meets the requirements of paragraph (1);
(B) educating both young men and women about the responsibilities and
pressures that come along with parenting;
(C) helping parents communicate with teens about sexuality; or
(D) teaching young people responsible decision-making.
(1) IN GENERAL- With respect to the costs of the project to be carried
out under subsection (a) by an applicant, a grant may be made under such
subsection only if the applicant agrees to make available (directly or
through donations from public or private entities) non-Federal contributions
toward such costs in an amount that is not less than 25 percent of such
costs ($1 for each $3 of Federal funds provided in the grant).
(2) DETERMINATION OF AMOUNT CONTRIBUTED- Non-Federal contributions required
in paragraph (1) may be in cash or in kind, fairly evaluated, including
plant, equipment, or services. Amounts provided by the Federal Government,
or services assisted or subsidized to any significant extent by the Federal
Government, may not be included in determining the amount of such non-Federal
contributions.
(e) Supplementation of Funds- An applicant to which a grant is made under
subsection (a) for a fiscal year shall use the grant to supplement and not
supplant funds that would otherwise be available to the applicant for carrying
out the purpose described in such subsection.
(f) Evaluation of Projects- The Secretary shall establish criteria for the
evaluation of projects under subsection (a). A grant may be made under such
subsection only if the applicant involved--
(1) agrees to conduct evaluations of the project in accordance with such
criteria;
(2) agrees to submit to the Secretary such reports describing the results
of the evaluations as the Secretary determines to be appropriate; and
(3) submits to the Secretary, in the application under subsection (g),
a plan for conducting the evaluations.
(g) Application for Grant- A grant may be made under subsection (a) only
if an application for the grant is submitted to the Secretary and the application
is in such form, is made in such manner, and contains such agreements, assurances,
and information, including the agreements under subsections (c) through
(f) and the plan under subsection (f)(3), as the Secretary determines to
be necessary to carry out this section.
(h) Report to Congress- Not later than April 1, 2012, the Secretary shall
submit to the Congress a report describing the extent to which projects
under subsection (a) have been successful in reducing the rate of teen pregnancies
in the communities in which the projects have been carried out.
(i) Definitions- For purposes of this section:
(1) The term `age-appropriate', with respect to the information in pregnancy
prevention, means topics, messages, and teaching methods suitable to particular
ages or age groups of children and adolescents, based on developing cognitive,
emotional, and behavioral capacity typical for the age or age group.
(2) The term `factually and medically accurate and complete' means verified
or supported by the weight of research conducted in compliance with accepted
scientific methods and--
(A) published in peer-reviewed journals, where applicable; or
(B) comprising information that leading professional organizations and
agencies with relevant expertise in the field recognize as accurate,
objective, and complete.
(3) The term `local educational agency' has the meaning given such term
in section 9101 of the Elementary and Secondary Education Act of 1965.
(j) Authorization of Appropriations- For the purpose of carrying out this
section, there is authorized to be appropriated $20,000,000 for each of
the fiscal years 2007 through 2011.
TITLE II--REAUTHORIZATION OF CERTAIN AFTER-SCHOOL PROGRAMS
SEC. 201. FINDINGS.
The Congress finds as follows:
(1) The likelihood of teens having sex for the first time increases with
the number of unsupervised hours teens have during a week.
(2) After-school programs can reduce teen risky behavior. Teenage girls
who play sports, for instance, are more likely to delay sex and have fewer
partners and less likely to become pregnant.
(3) After-school programs can help prevent teen pregnancy by advancing
good decision-making skills and providing teens with health education
and positive role models in a supervised setting.
SEC. 202. REAUTHORIZATION OF CERTAIN AFTER-SCHOOL PROGRAMS.
(a) 21st Century Community Learning Centers- Section 4206 of the Elementary
and Secondary Education Act of 1965 (20 U.S.C. 7176) is amended--
(1) in paragraph (5), by striking `$2,250,000,000' and inserting `$2,500,000,000';
and
(2) in paragraph (6), by striking `$2,500,000,000' and inserting `$2,750,000,000'.
(b) Carol M. White Physical Education Program- Section 5401 of the Elementary
and Secondary Education Act of 1965 (20 U.S.C. 7241) is amended--
(1) by striking `there are' and inserting `(a) In General- There are';
and
(2) by adding at the end the following:
`(b) Physical Education- In addition to the amounts authorized to be appropriated
$80,000,000 for each of fiscal years 2007 and 2008 to carry out subpart
10.'.
(c) Federal TRIO Programs- Section 402A(f) of the Higher Education Act of
1965 (20 U.S.C. 1070a-11(f)) is amended by striking `$700,000,000 for fiscal
year 1999, and such sums as may be necessary for each of the 4 succeeding
fiscal years' and inserting `$883,000,000 for fiscal year 2007 and such
sums as may be necessary for each of the 5 succeeding fiscal years'.
(d) Gearup- Section 404H of the Higher Education Act of 1965 (20 U.S.C.
1070a-28) is amended by striking `$200,000,000 for fiscal year 1999 and
such sums as may be necessary for each of the 4 succeeding fiscal years'
and inserting `$350,000,000 for fiscal year 2007 and such sums as may be
necessary for each of the 5 succeeding fiscal years'.
TITLE III--TEEN PREGNANCY PREVENTION INCENTIVE GRANTS
SEC. 301. TEEN PREGNANCY PREVENTION INCENTIVE GRANTS.
Section 403(a)(2) of the Social Security Act (42 U.S.C. 603(a)(2)) is amended
to read as follows:
`(2) INCENTIVE GRANTS TO PREVENT TEEN PREGNANCY-
`(A) GRANTS TO ELIGIBLE STATES-
`(I) FISCAL YEAR 2007; GRANTS TO STATES WITH COMPLIANT PLANS- For
fiscal year 2007, each State that meets the requirements of clause
(ii) shall be eligible to receive from the Secretary for such year
a grant in an amount determined under subparagraph (B)(i)(I).
`(II) SUBSEQUENT FISCAL YEARS; GRANTS TO HIGH-ACHIEVING STATES WITH
COMPLIANT PLANS- For each of the fiscal years 2008 through 2011,
each high-achieving State that meets the requirements of clause
(ii) shall be eligible to receive from the Secretary for such year
a grant in an amount determined under subparagraph (B)(i)(II).
`(III) HIGH-ACHIEVING STATE- For purposes of this paragraph, the
term `high-achieving State', with respect to a year, means a State
that has achieved an annual decline in the teen pregnancy rate for
the State as compared to the preceding year (or the most recent
year for which data is available) which exceeds the national average
rate of decline.
`(ii) SUBMISSION OF PLAN; REQUIREMENTS- A plan meets the requirements
of this clause if the plan describes--
`(I) the State's numerical goal for reducing teen pregnancy and
teen births;
`(II) the strategies to be used to achieve such goal;
`(III) the efforts the State will make to involve young men, as
well as young women, in delaying pregnancy and parenting;
`(IV) efforts to involve parents and other caretakers; and
`(V) efforts to reach communities or populations experiencing rates
of teen pregnancy above the State average.
`(iii) SET-ASIDE FOR GRANTS TO INDIAN TRIBES- An amount equal to 1.5
percent of the amount appropriated in subparagraph (G) for a fiscal
year shall be reserved for awarding grants to Indian tribes under
this paragraph in such manner, and subject to such requirements, as
the Secretary, in consultation with such tribes, determines appropriate.
`(iv) STATE- The term `State' means each of the several States of
the United States, the District of Columbia, the Commonwealth of Puerto
Rico, the United States Virgin Islands, Guam, American Samoa, and
the Commonwealth of the Northern Mariana Islands.
`(i) IN GENERAL- The amount of a grant under subparagraph (A)(i) to
an eligible State for a fiscal year shall be the following amount,
as applicable:
`(I) For fiscal year 2007, the amount that bears the same ratio
to the amount appropriated in subparagraph (G) for such fiscal year
as the proportion of births in the State to teens under age 20 bears
to the number of such births in all eligible States in the most
recent year for which data is available.
`(II) For each of fiscal years 2008 through 2011, the amount that
bears the same ratio to the amount appropriated in subparagraph
(G) for such fiscal year as the proportion of teens under age 20
in the State bears to the number of such teens in all eligible States
in the most recent year for which data is available.
`(ii) DETERMINATION OF TEEN PREGNANCY RATES- For purposes of this
paragraph, the teen pregnancy rate for a State shall be determined
on the basis of the teen pregnancy rate per 1,000 women, ages 15 through
19, who reside in the State. Where teen pregnancy data is not available
in a particular State, the Secretary may identify alternative sources
of data.
`(i) IN GENERAL- A State or Indian tribe shall use funds provided
under a grant under this paragraph to implement teen pregnancy prevention
strategies that meet the following requirements:
`(I) The strategies replicate or substantially incorporate the elements
of one or more teen pregnancy prevention programs that have been
proven effective (on the basis of rigorous scientific research)
to--
`(aa) delay or decrease sexual intercourse or sexual activity;
`(bb) increase contraceptive use among sexually active teens;
or
`(cc) reduce teenage pregnancy.
`(II) The strategies incorporate one or more of the following strategies
for preventing teenage pregnancy:
`(aa) Encouraging teenagers to delay sexual activity.
`(bb) Sex and HIV education.
`(cc) Preventive health services.
`(dd) Youth development programs.
`(ee) Service learning programs.
`(ff) Helping parents communicate with teens.
`(gg) Outreach or media programs.
`(III) The strategies provide information that is age-appropriate,
factually and medically accurate and complete, and scientifically-based.
`(D) SUBGRANT OR CONTRACT RECIPIENTS- A State to which a grant is made
under this paragraph for a fiscal year may award subgrants or contracts
to--
`(i) State or local nonprofit coalitions or organizations working
to prevent teenage pregnancy;
`(ii) State, local, or tribal agencies;
`(iv) entities that provide after-school programs;
`(v) nonprofit community or faith-based organizations; or
`(vi) other organizations designated by the State.
`(E) SUPPLEMENTATION OF FUNDS- A State to which a grant is made under
this paragraph for a fiscal year shall use funds provided under the
grant to supplement and not supplant funds that would otherwise be available
to the State for preventing teen pregnancy.
`(F) DATA REPORTING- A State to which a grant is made under this paragraph
for a fiscal year shall cooperate with the Secretary to collect information
and report on outcomes of programs funded under the grant, as specified
by the Secretary.
`(G) APPROPRIATION- Out of any money in the Treasury of the United States
not otherwise appropriated, there are appropriated for making grants
under this paragraph $20,000,000 for each of the fiscal years 2007 through
2011.
`(i) IN GENERAL- The Secretary shall, by grant or contract, gather
and disseminate information on effective practices, programs, and
strategies for reducing teen pregnancy rates that are used by States
that receive grants under this paragraph in order to allow other States,
and leaders in the area of teen pregnancy prevention, to learn from
the experiences of successful States. The Secretary shall publish
an interim and final report summarizing and synthesizing outcomes
and lessons learned pursuant to such grants.
`(ii) APPROPRIATION- Out of any money in the Treasury of the United
States not otherwise appropriated, there is appropriated to the Secretary
for the purpose of carrying out clause (i) $2,000,000 for fiscal year
2007, to remain available through fiscal year 2012.'.
SEC. 302. ESTABLISHING NATIONAL GOAL TO PREVENT TEEN PREGNANCY.
Section 905 of the Personal Responsibility and Work Opportunity Reconciliation
Act of 1996 (42 U.S.C. 710 note) is amended to read as follows:
`SEC. 905. ESTABLISHING NATIONAL GOAL TO PREVENT TEEN PREGNANCY.
`(a) In General- Not later than 90 days after the date of the enactment
of this Act, the Secretary of Health and Human Services shall establish
a national goal of reducing teen pregnancy by at least one-third over the
subsequent ten years.
`(b) Report- Not later than 12 months after the date of the enactment of
this Act, and annually thereafter, the Secretary of Health and Human Services
shall report to Congress with respect to the progress that has been made
in meeting the national goal established under subsection (a) and with respect
to State-level progress on reducing teen pregnancy.'.
TITLE IV--DEMONSTRATION GRANTS TO ENCOURAGE CREATIVE APPROACHES TO TEEN
PREGNANCY PREVENTION
SEC. 401. DEMONSTRATION GRANTS TO ENCOURAGE CREATIVE APPROACHES TO TEEN
PREGNANCY PREVENTION.
(a) In General- The Secretary may make grants to several public or nonprofit
private entities for the purpose of assisting the entities in demonstrating
innovative approaches to prevent teen pregnancies.
(b) Certain Approaches- Approaches under subsection (a) may include approaches
such as the following:
(1) Encouraging teen-driven approaches to pregnancy prevention.
(2) Exposing teens to realistic simulations of the physical, emotional,
and financial consequences of pregnancy and parenting.
(3) Facilitating communication between parents and children, especially
using programs that have been evaluated and proven effective.
(1) IN GENERAL- With respect to the costs of the project to be carried
out under subsection (a) by an applicant, a grant may be made under such
subsection only if the applicant agrees to make available (directly or
through donations from public or private entities) non-Federal contributions
toward such costs in an amount that is not less than 25 percent of such
costs ($1 for each $3 of Federal funds provided in the grant).
(2) DETERMINATION OF AMOUNT CONTRIBUTED- Non-Federal contributions required
in paragraph (1) may be in cash or in kind, fairly evaluated, including
plant, equipment, or services. Amounts provided by the Federal Government,
or services assisted or subsidized to any significant extent by the Federal
Government, may not be included in determining the amount of such non-Federal
contributions.
(d) Evaluation of Projects- The Secretary shall establish criteria for the
evaluation of projects under subsection (a). A grant may be made under such
subsection only if the applicant involved--
(1) agrees to conduct evaluations of the project in accordance with such
criteria;
(2) agrees to submit to the Secretary such reports describing the results
of the evaluations as the Secretary determines to be appropriate; and
(3) submits to the Secretary, in the application under subsection (e),
a plan for conducting the evaluations.
(e) Application for Grant- A grant may be made under subsection (a) only
if an application for the grant is submitted to the Secretary and the application
is in such form, is made in such manner, and contains such agreements, assurances,
and information, including the agreements under subsections (c) and (d)
and the plan under subsection (d)(3), as the Secretary determines to be
necessary to carry out this section.
(f) Report to Congress- Not later than April 1, 2012, the Secretary shall
submit to the Congress a report describing the extent to which projects
under subsection (a) have been successful in reducing the rate of teen pregnancies
in the communities in which the projects have been carried out. Such reports
shall describe the various approaches used under subsection (a) and the
effectiveness of each of the approaches.
(g) Authorization of Appropriations- For the purpose of carrying out this
section, there is authorized to be appropriated $10,000,000 for each of
the fiscal years 2007 through 2011.
TITLE V--NATIONAL CAMPAIGN TO ENLIST PARENTS IN PREVENTING TEEN PREGNANCY
SEC. 501. FINDINGS.
The Congress finds as follows:
(1) Teens with strong emotional attachments to their parents are more
likely to delay becoming sexually active. Seven out of ten teens say that
they are prepared to listen to things parents thought the teens were not
ready to hear.
(2) Ninety percent of parents of teens report that they know they should
talk to their kids about sex but often don't know what to say, how to
say it, or when to start the conversations.
SEC. 502. ESTABLISHMENT OF A NATIONAL CENTER FOR PARENTS OF ADOLESCENTS;
PROVISION OF CHALLENGE GRANTS FOR STATE AND LOCAL PROGRAMS.
(a) Grant- The Secretary shall make one grant to a nationally recognized
nonpartisan, nonprofit organization that meets the requirements of this
section to establish and operate a national center for parents of adolescents
to carry out the purposes and activities described in subsections (b) and
(c) (referred to in this section as the `Center').
(b) Requirements- The Secretary may make a grant under this section only
if--
(1) the organization focuses exclusively on preventing teen pregnancy
and has at least 10 years of experience in working with diverse sectors
of society to reduce teen pregnancy;
(2) the organization has a demonstrated ability to work with and provide
assistance to a broad range of individuals and entities, including teens,
parents, the entertainment and news media, State, tribal, and local organizations,
networks of teen pregnancy prevention practitioners, businesses, faith
and community leaders, and researchers;
(3) the organization is research-based and has capabilities in scientific
analysis and evaluation; and
(4) the organization has comprehensive knowledge and data about teen pregnancy
prevention strategies.
(c) Purposes- The purposes of the Center are to--
(1) support parents in their essential role in preventing teen pregnancy
by equipping them with information and resources to promote and strengthen
communication with their children about sex, values, and healthy relationships;
(2) develop and implement media campaigns to promote positive information
and messages for parents about how they can help address teen pregnancy;
and
(3) provide challenge grants to States to promote parent education and
involvement.
(d) Activities- The Center shall carry out the purposes described in subsection
(c) through the following activities:
(1) Providing resources for parents and other adults (such as other family
members, teachers, coaches, mentors, and faith leaders) that help to foster
strong connections with children, including--
(A) online access to current research;
(B) user-friendly guides for parents;
(C) practical tips and advice from experts;
(D) alerts about new trends among teens;
(E) suggestions for how to use the entertainment media as a discussion-starter;
and
(F) information about the rapidly-changing media environment of teens.
In order to efficiently reach and support parents, information shall be
provided primarily through technological means, including the Internet.
(2) Using a portion of the funds available through this section to develop
and implement media campaigns directly or through grants, contracts, or
cooperative agreements with other entities. They may include the production
and distribution of printed materials and messages for print media, television,
and radio broadcast media, the Internet, or such other new technology
as may be appropriate for reaching large numbers of parents and other
adults involved in the lives of teens. Special efforts shall be made to
develop messages that are effective in reaching fathers as well as mothers.
To the extent possible, funds used to develop and implement media campaigns
under this subsection shall be matched with non-Federal resources, including
in-kind contributions, from public and private entities. In addition,
the Center shall provide consultation and serve as a source of factual
information to individuals and organizations in the entertainment industry
on issues related to teen pregnancy prevention that highlights the role
of parents.
(3) Awarding challenge grants on a competitive basis to States and Indian
tribes. Applicants shall submit a plan for how they would involve parents
and other caregivers (such as grandparents, foster parents and other guardians)
in helping to reduce teen pregnancy through activities such as--
(A) workshops and town hall meetings;
(B) providing information through employers, civic associations, community
and faith-based organizations, parent-teacher organizations, and other
organizations that reach large numbers of parents; and
(C) innovative ways to provide education and support for parents through
online communities and neighborhood-based activities.
(e) Authorization of Appropriations-
(1) IN GENERAL- For the purpose of carrying out this section, there is
authorized to be appropriated $15,000,000 for each of fiscal years 2007
through 2011.
(2) CHALLENGE GRANTS- Of the amount appropriated under paragraph (1) for
a fiscal year, not less than $5,000,000 shall be made available for challenge
grants under subsection (d)(3).
TITLE VI--CLARIFICATION OF CONTINUED MEDICAID COVERAGE OF FAMILY PLANNING
SERVICES
SEC. 601. CLARIFICATION OF CONTINUED MEDICAID COVERAGE OF FAMILY PLANNING
SERVICES.
(a) In General- Section 1937(a)(1) of the Social Security Act (42 U.S.C.
1396u-7(a)(1)) is amended by adding at the end the following new subparagraph:
`(E) COVERAGE OF FAMILY PLANNING SERVICES- The State may only exercise
the option under subparagraph (A) with respect to an individual if the
State provides the individual, through the benchmark coverage, benchmark
equivalent coverage, or directly under its State plan, medical assistance
for family planning services and supplies (described in section 1905(a)(4)(C))
in at least the same amount, duration, and scope as would be provided
if this section did not apply.'.
(b) Effective Date- The amendment made by subsection (a) shall apply as
of the first day of the first month that begins more than 30 days after
the date of the enactment of this Act.
TITLE VII--EXPANDED MEDICAID ELIGIBILITY FOR FAMILY PLANNING SERVICES
SEC. 701. EXPANDED MEDICAID ELIGIBILITY FOR FAMILY PLANNING SERVICES.
(a) Coverage as Mandatory Categorically Needy Group-
(1) IN GENERAL- Section 1902(a)(10)(A)(i) of the Social Security Act (42
U.S.C. 1396a(a)(10)(A)(i)) is amended--
(A) in subclause (VI), by striking `or' at the end;
(B) in subclause (VII), by adding `or' at the end; and
(C) by adding at the end the following new subclause:
`(VIII) subject to subsection (dd)(3), who are described in subsection
(dd) (relating to individuals who meet the income standards for
pregnant women);'.
(2) GROUP DESCRIBED- Section 1902 of the Social Security Act (42 U.S.C.
1396a) is amended by adding at the end the following new subsection:
`(dd)(1) Individuals described in this subsection are individuals who--
`(A) meet at least the income eligibility standards established under
the State plan as of May 1, 2006, for pregnant women or such higher income
eligibility standard for such women as the State may establish; and
`(2) At the option of a State, individuals described in this subsection
may include individuals who are determined to meet the income eligibility
standards referred to in paragraph (1)(A) under the terms and conditions
applicable to making eligibility determinations for medical assistance under
this title under a waiver to provide the benefits described in clause (XV)
of the matter following subparagraph (G) of section 1902(a)(10) granted
to the State under section 1115 as of May 1, 2006.'.
(3) LIMITATION ON BENEFITS- Section 1902(a)(10) of the Social Security
Act (42 U.S.C. 1396a(a)(10)) is amended in the matter following subparagraph
(G)--
(A) by striking `and (XIV)' and inserting `(XIV)'; and
(B) by inserting `, and (XV) the medical assistance made available to
an individual described in subsection (dd) who is eligible for medical
assistance only because of subparagraph (A)(10)(i)(VIII) shall be limited
to family planning services and supplies described in 1905(a)(4)(C)
and, at the State's option, medical diagnosis or treatment services
that are provided in conjunction with a family planning service in a
family planning setting provided during the period in which such an
individual is eligible;' after `cervical cancer'.
(4) CONFORMING AMENDMENTS- Section 1905(a) of the Social Security Act
(42 U.S.C. 1396d(a)) is amended in the matter preceding paragraph (1)--
(A) in clause (xii), by striking `or' at the end;
(B) in clause (xii), by adding `or' at the end; and
(C) by inserting after clause (xiii) the following:
`(xiv) individuals described in section 1902(dd),'.
(b) Presumptive Eligibility-
(1) IN GENERAL- Title XIX of the Social Security Act (42 U.S.C. 1396 et
seq.) is amended by inserting after section 1920B the following:
`PRESUMPTIVE ELIGIBILITY FOR FAMILY PLANNING SERVICES
`Sec. 1920C. (a) State Option- A State plan approved under section 1902
may provide for making medical assistance available to an individual described
in section 1902(dd) (relating to individuals who meet the income eligibility
standard for pregnant women in the State) during a presumptive eligibility
period. In the case of an individual described in section 1902(dd) who is
eligible for medical assistance only because of subparagraph (A)(10)(i)(VIII),
such medical assistance may be limited to family planning services and supplies
described in 1905(a)(4)(C) and, at the State's option, medical diagnosis
or treatment services that are provided in conjunction with a family planning
service in a family planning setting provided during the period in which
such an individual is eligible.
`(b) Definitions- For purposes of this section:
`(1) PRESUMPTIVE ELIGIBILITY PERIOD- The term `presumptive eligibility
period' means, with respect to an individual described in subsection (a),
the period that--
`(A) begins with the date on which a qualified entity determines, on
the basis of preliminary information, that the individual is described
in section 1902(dd); and
`(B) ends with (and includes) the earlier of--
`(i) the day on which a determination is made with respect to the
eligibility of such individual for services under the State plan;
or
`(ii) in the case of such an individual who does not file an application
by the last day of the month following the month during which the
entity makes the determination referred to in subparagraph (A), such
last day.
`(A) IN GENERAL- Subject to subparagraph (B), the term `qualified entity'
means any entity that--
`(i) is eligible for payments under a State plan approved under this
title; and
`(ii) is determined by the State agency to be capable of making determinations
of the type described in paragraph (1)(A).
`(B) REGULATIONS- The Secretary may issue regulations further limiting
those entities that may become qualified entities in order to prevent
fraud and abuse and for other reasons.
`(C) RULE OF CONSTRUCTION- Nothing in this paragraph shall be construed
as preventing a State from limiting the classes of entities that may
become qualified entities, consistent with any limitations imposed under
subparagraph (B).
`(1) IN GENERAL- The State agency shall provide qualified entities with--
`(A) such forms as are necessary for an application to be made by an
individual described in subsection (a) for medical assistance under
the State plan; and
`(B) information on how to assist such individuals in completing and
filing such forms.
`(2) NOTIFICATION REQUIREMENTS- A qualified entity that determines under
subsection (b)(1)(A) that an individual described in subsection (a) is
presumptively eligible for medical assistance under a State plan shall--
`(A) notify the State agency of the determination within 5 working days
after the date on which determination is made; and
`(B) inform such individual at the time the determination is made that
an application for medical assistance is required to be made by not
later than the last day of the month following the month during which
the determination is made.
`(3) APPLICATION FOR MEDICAL ASSISTANCE- In the case of an individual
described in subsection (a) who is determined by a qualified entity to
be presumptively eligible for medical assistance under a State plan, the
individual shall apply for medical assistance by not later than the last
day of the month following the month during which the determination is
made.
`(d) Payment- Notwithstanding any other provision of this title, medical
assistance that--
`(1) is furnished to an individual described in subsection (a)--
`(A) during a presumptive eligibility period;
`(B) by a entity that is eligible for payments under the State plan;
and
`(2) is included in the care and services covered by the State plan, shall
be treated as medical assistance provided by such plan for purposes of
clause (4) of the first sentence of section 1905(b).'.
(2) CONFORMING AMENDMENTS-
(A) Section 1902(a)(47) of the Social Security Act (42 U.S.C. 1396a(a)(47))
is amended by inserting before the semicolon at the end the following:
`and provide for making medical assistance available to individuals
described in subsection (a) of section 1920C during a presumptive eligibility
period in accordance with such section.'.
(B) Section 1903(u)(1)(D)(v) of such Act (42 U.S.C. 1396b(u)(1)(D)(v))
is amended--
(i) by striking `or for' and inserting `, for'; and
(ii) by inserting before the period the following: `, or for medical
assistance provided to an individual described in subsection (a) of
section 1920C during a presumptive eligibility period under such section'.
(1) IN GENERAL- Except as provided in paragraph (2), the amendments made
by this section shall apply as of the first day of the first month that
begins more than 30 days after the date of the enactment of this Act.
(2) EXTENSION OF EFFECTIVE DATE FOR STATE LAW AMENDMENT- In the case of
a State plan under title XIX of the Social Security Act (42 U.S.C. 1396
et seq.) which the Secretary of Health and Human Services determines requires
State legislation in order for the plan to meet the additional requirements
imposed by the amendments made by this section, the State plan shall not
be regarded as failing to comply with the requirements of such title solely
on the basis of its failure to meet these additional requirements before
the first day of the first calendar quarter beginning after the close
of the first regular session of the State legislature that begins after
the date of enactment of this Act. For purposes of the previous sentence,
in the case of a State that has a 2-year legislative session, each year
of the session is considered to be a separate regular session of the State
legislature.
TITLE VIII--DISCLOSURE OF INFORMATION FOR ABORTION SERVICES
SEC. 801. DISCLOSURE OF INFORMATION FOR ABORTION SERVICES.
(a) In General- Primary care clinics that receive Federal financial assistance
and provide abortion services shall obtain informed consent from the pregnant
woman seeking to have the abortion.
(b) Informed Consent- Informed consent shall include:
(1) Medically and factually accurate information on the following:
(A) How the abortion procedure is performed.
(B) Possible risks and complications of the procedure to be performed
versus carrying the pregnancy to term.
(2) At the woman's request, information regarding alternatives to abortion
including adoption and information concerning public and private agencies
that may provide the woman with economic and other assistance to carry
her pregnancy to term.
(c) Prevention- Information about family planning services and supplies
shall also be offered.
(d) Treatment of Patients- Primary care clinics receiving Federal financial
assistance shall ensure that all patients are treated in a nonjudgmental
manner and are not subjected to indignity, humiliation, or breaches of confidentiality.
(e) Definition- For purposes of this section, the term `medically and factually
accurate', with respect to information, means the information is--
(1) verified or supported by the weight of research conducted in compliance
with accepted scientific methods; and
(2)(A) published in peer-reviewed journals where applicable; or
(B) information that leading professional organizations and agencies with
relevant expertise in the field, such as the American College of Obstetricians
and Gynecologists, recognize as accurate and objective.
TITLE IX--MEDICAID AND SCHIP COVERAGE OF PREGNANT WOMEN
SEC. 901. STATE OPTION TO EXPAND OR ADD COVERAGE OF CERTAIN PREGNANT WOMEN
UNDER MEDICAID AND SCHIP.
(1) AUTHORITY TO EXPAND COVERAGE- Section 1902(l)(2)(A)(i) of the Social
Security Act (42 U.S.C. 1396a(l)(2)(A)(i)) is amended by inserting `(or
such higher percent as the State may elect for purposes of expenditures
for medical assistance for pregnant women described in section 1905(u)(4)(A))'
after `185 percent'.
(2) ENHANCED MATCHING FUNDS AVAILABLE IF CERTAIN CONDITIONS MET- Section
1905 of the Social Security Act (42 U.S.C. 1396d) is amended--
(A) in the fourth sentence of subsection (b), by striking `or subsection
(u)(3)' and inserting `, (u)(3), or (u)(4)'; and
(i) by redesignating paragraph (4) as paragraph (5); and
(ii) by inserting after paragraph (3) the following:
`(4) For purposes of the fourth sentence of subsection (b) and section
2105(a), the expenditures described in this paragraph are the following:
`(A) CERTAIN PREGNANT WOMEN- If the conditions described in subparagraph
(B) are met, expenditures for medical assistance for pregnant women
described in subsection (n) or under section 1902(l)(1)(A) in a family
the income of which exceeds the effective income level (expressed as
a percent of the poverty line and considering applicable income disregards)
that has been specified under subsection (a)(10)(A)(i)(III) or (l)(2)(A)
of section 1902, as of January 1, 2007, but does not exceed the income
eligibility level established under title XXI for a targeted low-income
child.
`(B) CONDITIONS- The conditions described in this subparagraph are the
following:
`(i) The State plans under this title and title XXI do not provide
coverage for pregnant women described in subparagraph (A) with higher
family income without covering such pregnant women with a lower family
income.
`(ii) The State does not apply an effective income level for pregnant
women that is lower than the effective income level (expressed as
a percent of the poverty line and considering applicable income disregards)
that has been specified under the State plan under subsection (a)(10)(A)(i)(III)
or (l)(2)(A) of section 1902, as of January 1, 2007, to be eligible
for medical assistance as a pregnant woman.
`(C) DEFINITION OF POVERTY LINE- In this subsection, the term `poverty
line' has the meaning given such term in section 2110(c)(5).'.
(3) PAYMENT FROM TITLE XXI ALLOTMENT FOR MEDICAID EXPANSION COSTS; ELIMINATION
OF COUNTING MEDICAID CHILD PRESUMPTIVE ELIGIBILITY COSTS AGAINST TITLE
XXI ALLOTMENT- Section 2105(a)(1) of the Social Security Act (42 U.S.C.
1397ee(a)(1)) is amended--
(A) in the matter preceding subparagraph (A), by striking `(or, in the
case of expenditures described in subparagraph (B), the Federal medical
assistance percentage (as defined in the first sentence of section 1905(b)))';
and
(B) by striking subparagraph (B) and inserting the following:
`(B) for the provision of medical assistance that is attributable to
expenditures described in section 1905(u)(4)(A);'.
(4) ADDITIONAL AMENDMENTS TO MEDICAID-
(A) ELIGIBILITY OF A NEWBORN- Section 1902(e)(4) of the Social Security
Act (42 U.S.C. 1396a(e)(4)) is amended in the first sentence by striking
`so long as the child is a member of the woman's household and the woman
remains (or would remain if pregnant) eligible for such assistance'.
(B) APPLICATION OF QUALIFIED ENTITIES TO PRESUMPTIVE ELIGIBILITY FOR
PREGNANT WOMEN UNDER MEDICAID- Section 1920(b) of the Social Security
Act (42 U.S.C. 1396r-1(b)) is amended by adding at the end after and
below paragraph (2) the following flush sentence:
`The term `qualified provider' includes a qualified entity as defined in
section 1920A(b)(3).'.
(1) COVERAGE- Title XXI of the Social Security Act (42 U.S.C. 1397aa et
seq.) is amended by adding at the end the following:
`SEC. 2111. OPTIONAL COVERAGE OF TARGETED LOW-INCOME PREGNANT WOMEN.
`(a) Optional Coverage- Notwithstanding any other provision of this title,
a State may provide for coverage, through an amendment to its State child
health plan under section 2102, of pregnancy-related assistance for targeted
low-income pregnant women in accordance with this section, but only if the
State meets the conditions described in section 1905(u)(4)(B).
`(b) Definitions- For purposes of this title:
`(1) PREGNANCY-RELATED ASSISTANCE- The term `pregnancy-related assistance'
has the meaning given the term child health assistance in section 2110(a)
as if any reference to targeted low-income children were a reference to
targeted low-income pregnant women, except that the assistance shall be
limited to services related to pregnancy (which include prenatal, delivery,
and postpartum services and services described in section 1905(a)(4)(C))
and to other conditions that may complicate pregnancy.
`(2) TARGETED LOW-INCOME PREGNANT WOMAN- The term `targeted low-income
pregnant woman' means a woman
`(A) during pregnancy and through the end of the month in which the
60-day period (beginning on the last day of her pregnancy) ends;
`(B) whose family income exceeds the effective income level (expressed
as a percent of the poverty line and considering applicable income disregards)
that has been specified under subsection (a)(10)(A)(i)(III) or (l)(2)(A)
of section 1902, as of January 1, 2007, to be eligible for medical assistance
as a pregnant woman under title XIX but does not exceed the income eligibility
level established under the State child health plan under this title
for a targeted low income child; and
`(C) who satisfies the requirements of paragraphs (1)(A), (1)(C), (2),
and (3) of section 2110(b).
`(c) References to Terms and Special Rules- In the case of, and with respect
to, a State providing for coverage of pregnancy-related assistance to targeted
low-income pregnant women under subsection (a), the following special rules
apply:
`(1) Any reference in this title (other than in subsection (b)) to a targeted
low-income child is deemed to include a reference to a targeted low-income
pregnant woman.
`(2) Any such reference to child health assistance with respect to such
women is deemed a reference to pregnancy-related assistance.
`(3) Any such reference to a child is deemed a reference to a woman during
pregnancy and the period described in subsection (b)(2)(A).
`(4) In applying section 2102(b)(3)(B), any reference to children found
through screening to be eligible for medical assistance under the State
Medicaid plan under title XIX is deemed a reference to pregnant women.
`(5) There shall be no exclusion of benefits for services described in
subsection (b)(1) based on any preexisting condition and no waiting period
(including any waiting period imposed to carry out section 2102(b)(3)(C))
shall apply.
`(6) Subsection (a) of section 2103 (relating to required scope of health
insurance coverage) shall not apply insofar as a State limits coverage
to services described in subsection (b)(1) and the reference to such section
in section 2105(a)(1)(C) is deemed not to require, in such case, compliance
with the requirements of section 2103(a).
`(7) In applying section 2103(e)(3)(B) in the case of a pregnant woman
provided coverage under this section, the limitation on total annual aggregate
cost-sharing shall be applied to the entire family of such pregnant woman.
`(d) Automatic Enrollment for Children Born to Women Receiving Pregnancy-Related
Assistance- If a child is born to a targeted low-income pregnant woman who
was receiving pregnancy-related assistance under this section on the date
of the child's birth, the child shall be deemed to have applied for child
health assistance under the State child health plan and to have been found
eligible for such assistance under such plan or to have applied for medical
assistance under title XIX and to have been found eligible for such assistance
under such title, as appropriate, on the date of such birth and to remain
eligible for such assistance until the child attains 1 year of age. During
the period in which a child is deemed under the preceding sentence to be
eligible for child health or medical assistance, the child health or medical
assistance eligibility identification number of the mother shall also serve
as the identification number of the child, and all claims shall be submitted
and paid under such number (unless the State issues a separate identification
number for the child before such period expires).'.
(2) ADDITIONAL ALLOTMENTS FOR PROVIDING COVERAGE OF PREGNANT WOMEN-
(A) IN GENERAL- Section 2104 of the Social Security Act (42 U.S.C. 1397dd)
is amended by inserting after subsection (c) the following:
`(d) Additional Allotments for Providing Coverage of Pregnant Women-
`(1) APPROPRIATION; TOTAL ALLOTMENT- For the purpose of providing additional
allotments to States under this title, there is appropriated, out of any
money in the Treasury not otherwise appropriated, for each of fiscal years
2007 and 2008, $200,000,000.
`(2) STATE AND TERRITORIAL ALLOTMENTS- In addition to the allotments provided
under subsections (b) and (c), subject to paragraphs (3) and (4), of the
amount available for the additional allotments under paragraph (1) for
a fiscal year, the Secretary shall allot to each State with a State child
health plan approved under this title--
`(A) in the case of such a State other than a commonwealth or territory
described in subparagraph (B),the same proportion as the proportion
of the State's allotment under subsection (b) (determined without regard
to subsection (f)) to the total amount of the allotments under subsection
(b) for such States eligible for an allotment under this paragraph for
such fiscal year; and
`(B) in the case of a commonwealth or territory described in subsection
(c)(3), the same proportion as the proportion of the commonwealth's
or territory's allotment under subsection (c) (determined without regard
to subsection (f)) to the total amount of the allotments under subsection
(c) for commonwealths and territories eligible for an allotment under
this paragraph for such fiscal year.
`(3) USE OF ADDITIONAL ALLOTMENT- Additional allotments provided under
this subsection are not available for amounts expended before October
1, 2006. Such amounts are available for amounts expended on or after such
date for child health assistance for targeted low-income children, as
well as for pregnancy-related assistance for targeted low-income pregnant
women.
`(4) NO PAYMENTS UNLESS ELECTION TO EXPAND COVERAGE OF PREGNANT WOMEN-
No payments may be made to a State under this title from an allotment
provided under this subsection unless the State provides pregnancy-related
assistance for targeted low-income pregnant women under this title, or
provides medical assistance for pregnant women under title XIX, whose
family income exceeds the effective income level applicable under subsection
(a)(10)(A)(i)(III) or (l)(2)(A) of section 1902 to a family of the size
involved as of January 1, 2007.'.
(B) CONFORMING AMENDMENTS- Section 2104 of the Social Security Act (42
U.S.C. 1397dd) is amended--
(i) in subsection (a), in the matter preceding paragraph (1), by inserting
`subject to subsection (d),' after `under this section,';
(ii) in subsection (b)(1), by inserting `and subsection (d)' after
`Subject to paragraph (4)'; and
(iii) in subsection (c)(1), by inserting `subject to subsection (d),'
after `for a fiscal year,'.
(3) PRESUMPTIVE ELIGIBILITY UNDER TITLE XXI-
(A) APPLICATION TO PREGNANT WOMEN- Section 2107(e)(1)(D) of the Social
Security Act (42 U.S.C. 1397gg(e)(1)) is amended to read as follows:
`(D) Sections 1920 and 1920A (relating to presumptive eligibility).'.
(B) EXCEPTION FROM LIMITATION ON ADMINISTRATIVE EXPENSES- Section 2105(c)(2)
of the Social Security Act (42 U.S.C. 1397ee(c)(2)) is amended by adding
at the end the following new subparagraph:
`(C) EXCEPTION FOR PRESUMPTIVE ELIGIBILITY EXPENDITURES- The limitation
under subparagraph (A) on expenditures shall not apply to expenditures
attributable to the application of section 1920 or 1920A (pursuant to
section 2107(e)(1)(D)), regardless of whether the child or pregnant
woman is determined to be ineligible for the program under this title
or title XIX.'.
(4) ADDITIONAL AMENDMENTS TO TITLE XXI-
(A) NO COST-SHARING FOR PREGNANCY RELATED SERVICES- Section 2103(e)(2)
of the Social Security Act (42 U.S.C. 1397cc(e)(2)) is amended--
(i) in the heading, by inserting `OR PREGNANCY-RELATED SERVICES' after
`PREVENTIVE SERVICES'; and
(ii) by inserting before the period at the end the following: `or
for pregnancy related services'.
(B) NO WAITING PERIOD- Section 2102(b)(1)(B) of the Social Security
Act (42 U.S.C. 1397bb(b)(1)(B)) is amended--
(i) by striking `, and' at the end of clause (i) and inserting a semicolon;
(ii) by striking the period at the end of clause (ii) and inserting
`; and'; and
(iii) by adding at the end the following:
`(iii) may not apply a waiting period (including a waiting period
to carry out paragraph (3)(C)) in the case of a targeted low-income
pregnant woman.'.
(c) Effective Date- The amendments made by this section apply to items and
services furnished on or after October 1, 2006, without regard to whether
regulations implementing such amendments have been promulgated.
(d) Construction- Nothing in this Act shall be construed as affecting the
regulation promulgated at Federal Register 61956 (October 2, 2002), relating
to eligibility for prenatal care and other health services for unborn children
under SCHIP.
SEC. 902. COORDINATION WITH THE MATERNAL AND CHILD HEALTH PROGRAM.
(a) In General- Section 2102(b)(3) of the Social Security Act (42 U.S.C.
1397bb(b)(3)) is amended--
(1) in subparagraph (D), by striking `and' at the end;
(2) in subparagraph (E), by striking the period and inserting `; and';
and
(3) by adding at the end the following new subparagraph:
`(F) that operations and activities under this title are developed and
implemented in consultation and coordination with the program operated
by the State under title V in areas including outreach and enrollment,
benefits and services, service delivery standards, public health and
social service agency relationships, and quality assurance and data
reporting.'.
(b) Conforming Medicaid Amendment- Section 1902(a)(11) of such Act (42 U.S.C.
1396a(a)(11)) is amended--
(1) by striking `and' before `(C)'; and
(2) by inserting before the semicolon at the end the following: `, and
(D) provide that operations and activities under this title are developed
and implemented in consultation and coordination with the program operated
by the State under title V in areas including outreach and enrollment,
benefits and services, service delivery standards, public health and social
service agency relationships, and quality assurance and data reporting'.
(c) Effective Date- The amendments made by this section take effect on January
1, 2007.
SEC. 903. INCREASE IN SCHIP INCOME ELIGIBILITY.
(a) Definition of Low-Income Child- Section 2110(c)(4) of the Social Security
Act (42 U.S.C. 42 U.S.C. 1397jj(c)(4)) is amended by striking `200' and
inserting `250'.
(b) Effective Date- The amendment made by subsection (a) applies to child
health assistance provided and allotments determined under section 2104
of the Social Security Act (42 U.S.C. 1397dd) for fiscal years beginning
with fiscal year 2007.
SEC. 904. OUTREACH PROGRAM TO ENCOURAGE THOSE ELIGIBLE FOR SERVICES TO
ENROLL.
The Secretary shall make such funds available as may be necessary to encourage
eligible pregnant women to enroll for services under this title.
TITLE X--TITLE X OF PUBLIC HEALTH SERVICE ACT
SEC. 1001. SHORT TITLE.
This title may be cited as the `Title X Family Planning Services Act of
2006'.
SEC. 1002. AUTHORIZATION OF APPROPRIATIONS.
For the purpose of making grants and contracts under section 1001 of the
Public Health Service Act, there are authorized to be appropriated $643,000,000
for fiscal year 2007, and such sums as may be necessary for each subsequent
fiscal year.
TITLE XI--PREGNANCY AS PREEXISTING CONDITION
SEC. 1101. REMOVAL OF PREGNANCY AS A PREEXISTING CONDITION UNDER INDIVIDUAL
HEALTH INSURANCE COVERAGE.
(a) In General- Title XXVII of the Public Health Service Act is amended
by inserting after section 2752 the following new section:
`SEC. 2753. PREEXISTING CONDITION EXCLUSION NOT APPLICABLE TO PREGNANCY.
`Individual health insurance coverage, and a health insurance issuer offering
individual health insurance coverage, may not impose any preexisting condition
exclusion relating to pregnancy as a preexisting condition.'.
(b) Effective Date- The amendment made by subsection (a) shall apply to
coverage provided on or after January 1, 2007.
TITLE XII--INCREASING WOMEN'S KNOWLEDGE ABOUT THEIR PREGNANCY
SEC. 1201. GRANTS TO HEALTH CENTERS FOR PURCHASE OF ULTRASOUND EQUIPMENT.
Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.)
is amended by inserting after section 317L the following:
`SEC. 317L-1. GRANTS FOR THE PURCHASE OR UPGRADE OF ULTRASOUND EQUIPMENT.
`(a) In General- The Secretary may make grants for the purchase of ultrasound
equipment. Such ultrasound equipment shall be used by the recipients of
such grants to provide ultrasound examinations to pregnant women consenting
to such services.
`(b) Eligibility Requirements- An entity may receive a grant under subsection
(a) only if the entity meets the following conditions:
`(1) The entity is a health center eligible to receive a grant under section
330 of the Public Health Service Act (relating to community health centers,
migrant health centers, homeless health centers, and public-housing health
centers).
`(2) The entity agrees to comply with the following medical procedures:
`(A) Each pregnant woman upon whom the ultrasound equipment is used
will be given the option of viewing the visual image of the fetus from
the ultrasound examination and will be given the option of hearing a
general anatomical and physiological description of the characteristics
of the fetus.
`(B) Each pregnant woman upon whom the ultrasound equipment is used
will be given the option of learning, according to the best medical
judgment of the health professional performing the ultrasound examination,
the approximate age of the embryo or fetus considering the number of
weeks elapsed from the probable time of the conception of the embryo
or fetus, based upon the information provided by the client as to the
time of her last menstrual period, her medical history, a physical examination,
or appropriate laboratory tests.
`(C) The ultrasound examinations will be performed by a health professional
authorized under the law of the State involved to perform such examinations.
`(c) Application for Grant- A grant may be made under subsection (a) only
if an application for the grant is submitted to the Secretary and the application
is in such form, is made in such manner, and contains such agreements, assurances,
and information as the Secretary determines to be necessary to carry out
this section.
`(d) Annual Report to Secretary- A grant may be made under subsection (a)
only if the applicant for the grant agrees to report on an annual basis
to the Secretary, in such form and manner as the Secretary may require,
on the ongoing compliance of the applicant with the eligibility conditions
established in subsection (b).
`(e) Authorization of Appropriations- For the purpose of carrying out this
section, there are authorized to be appropriated $3,000,000 for fiscal year
2007, and such sums as may be necessary for each of the fiscal years 2008
through 2010.'.
SEC. 1202. SERVICES TO PATIENTS RECEIVING POSITIVE TEST DIAGNOSIS FOR
DOWN SYNDROME OR OTHER PRENATALLY DIAGNOSED CONDITION.
(a) Findings and Purposes-
(1) FINDINGS- The Congress finds as follows:
(A) Pregnant women who choose to undergo prenatal genetic testing should
have access to timely, scientific, and nondirective counseling about
the conditions being tested for and the accuracy of such tests, from
health care professionals qualified to provide and interpret these tests.
Informed consent is a critical component of all genetic testing.
(B) A recent, peer-reviewed study and two reports from the Centers for
Disease Control and Prevention on prenatal testing found a deficiency
in the data needed to understand the epidemiology of prenatally diagnosed
conditions, to monitor trends accurately, and to increase the effectiveness
of health intervention.
(2) PURPOSES- It is the purpose of this section, after the diagnosis of
a fetus with Down syndrome or other prenatally diagnosed conditions, to--
(A) increase patient referrals to providers of key support services
for women who have received a positive test diagnosis for Down syndrome,
or other prenatally diagnosed conditions, as well as to provide up-to-date,
science-based information about life-expectancy, development potential,
and quality of life for a child born with Down syndrome or other prenatally
diagnosed condition;
(B) provide networks of support through a Centers for Disease Control
and Prevention patient and provider outreach program;
(C) improve available data by incorporating information directly revealed
by prenatal testing into existing State-based surveillance programs
for birth defects and prenatally diagnosed conditions; and
(D) ensure that patients receive up-to-date, scientific information
about the accuracy of the test.
(b) Amendment to the Public Health Service Act- Part P of title III of the
Public Health Service Act (42 U.S.C. 280g et seq.) is amended by adding
at the end the following:
`SEC. 399P. SUPPORT FOR PATIENTS RECEIVING A POSITIVE TEST DIAGNOSIS OF
DOWN SYNDROME OR OTHER PRENATALLY DIAGNOSED CONDITIONS.
`(a) Definitions- In this section:
`(1) DOWN SYNDROME- The term `Down syndrome' refers to a chromosomal disorder
caused by an error in cell division that results in the presence of an
extra whole or partial copy of chromosome 21.
`(2) HEALTH CARE PROVIDER- The term `health care provider' means any person
or entity required by State or Federal law or regulation to be licensed,
registered, or certified to provide health care services, and who is so
licensed, registered, or certified.
`(3) PRENATALLY DIAGNOSED CONDITION- The term `prenatally diagnosed condition'
means any fetal health condition identified by prenatal genetic testing
or prenatal screening procedures.
`(4) PRENATAL TEST- The term `prenatal test' means diagnostic or screening
tests offered to pregnant women seeking routine prenatal care that are
administered on a required or recommended basis by a health care provider
based on medical history, family background, ethnic background, previous
test results, or other risk factors.
`(b) Information and Support Services- The Secretary, acting through the
Director of the National Institutes of Health, the Director of the Centers
for Disease Control and Prevention, or the Administrator of the Health Resources
and Services Administration, may authorize and oversee certain activities,
including the awarding of grants, contracts or cooperative agreements, to--
`(1) collect, synthesize, and disseminate current scientific information
relating to Down syndrome or other prenatally diagnosed conditions; and
`(2) coordinate the provision of, and access to, new or existing supportive
services for patients receiving a positive test diagnosis for Down syndrome
or other prenatally diagnosed conditions, including--
`(A) the establishment of a resource telephone hotline and Internet
Website accessible to patients receiving a positive test result;
`(B) the establishment of a clearinghouse of scientific information,
including clinical course, life expectancy, development potential, and
quality of life relating to Down syndrome or other prenatally diagnosed
conditions;
`(C) the establishment of national and local peer-support programs;
`(D) the establishment of a national registry, or network of local registries,
of families willing to adopt newborns with Down syndrome or other prenatally
diagnosed conditions, and links to adoption agencies willing to place
babies with Down syndrome or other prenatally diagnosed conditions,
with families willing to adopt; and
`(E) the establishment of awareness and education programs for health
care providers who provide the results of prenatal tests for Down syndrome
or other prenatally diagnosed conditions, to patients, consistent with
the purpose described in section 2(b)(1) of the Prenatal Diagnosis Support
Act.
`(1) PROVISION OF ASSISTANCE- The Secretary, acting through the Director
of the Centers for Disease Control and Prevention, shall provide assistance
to State and local health departments to integrate the results of prenatal
testing into State-based vital statistics and birth defects surveillance
programs.
`(2) ACTIVITIES- The Secretary shall ensure that activities carried out
under paragraph (1) are sufficient to extract population-level data relating
to national rates and results of prenatal testing.
`(d) Provision of Information by Providers- Upon receipt of a positive test
result from a prenatal test for Down syndrome or other prenatally diagnosed
conditions performed on a patient, the health care provider involved (or
his or her designee) shall provide the patient with the following:
`(1) Up-to-date, scientific, written information concerning the life expectancy,
clinical course, and intellectual and functional development and treatment
options for a fetus diagnosed with or child born with Down syndrome or
other prenatally diagnosed conditions.
`(2) Referral to supportive services providers, including information
hotlines specific to Down syndrome or other prenatally diagnosed conditions,
resource centers or clearinghouses, and other education and support programs
as described in subsection (b)(2).
`(1) IN GENERAL- Notwithstanding subsections (c) and (d), nothing in this
section shall be construed to have any effect on laws or policies that
protect the confidentiality of medical information on a patient. Notwithstanding
such subsections, nothing in this section shall be construed to permit
or require the collection, maintenance, or transmission, without the health
care provider obtaining the prior, written consent of the patient, of--
`(A) health information or data that identify a patient, or with respect
to which there is a reasonable basis to believe the information could
be used to identify the patient (including a patient's name, address,
healthcare provider, or hospital); and
`(B) data that are not related to the epidemiology of the condition
being tested for.
`(2) GUIDANCE- Not later than 180 days after the date of enactment of
this section, the Secretary shall establish guidelines concerning the
implementation of paragraph (1) and subsection (d).
`(1) IMPLEMENTATION REPORT- Not later than 2 years after the date of enactment
of this section, and every 2 years thereafter, the Secretary shall submit
a report to Congress concerning the implementation of the guidelines described
in subsection (e)(2).
`(2) GAO REPORT- Not later than 1 year after the date of enactment of
this section, the Government Accountability Office shall submit a report
to Congress concerning the effectiveness of current healthcare and family
support programs serving as resources for the families of children with
disabilities.
`(g) Authorization of Appropriations- There is authorized to be appropriated
to carry out this section $5,000,000 for each of the fiscal years 2007 through
2011.'.
TITLE XIII--PREVENTING DOMESTIC VIOLENCE AND SEXUAL ASSAULT
SEC. 1301. SEPARATE PROGRAM TO IDENTIFY AND TREAT PREGNANT WOMEN AND NEW
MOTHERS WHO ARE VICTIMS OF DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT,
OR STALKING.
(a) Allotments- For the purpose described in subsection (b), the Secretary
shall, for fiscal year 2007 and each subsequent fiscal year, allot to each
State that has transmitted an application for the fiscal year under section
505(a) of the Social Security Act an amount equal to the product of--
(1) the amount appropriated under subsection (d) for the fiscal year;
and
(2) the percentage determined for the State under section 502(c)(1)(B)(ii)
of such Act.
(b) Purpose- The purpose of an allotment under subsection (a) with respect
to a State is to enable the State to better identify and treat pregnant
women and mothers of children up to one year old who are victims of domestic
violence, dating violence, sexual assault, or stalking through training
health care professionals and behavioral and public health staff how to
identify, assess, treat, and refer such women. Such training shall include--
(1) identifying patients of clients experiencing domestic violence, dating
violence sexual assault, or stalking;
(2) assessing the immediate and short-term safety of the patient or client,
the impact of the abuse on the health of the patient, and assisting the
patient in developing a plan to promote his or her safety;
(3) examining and treating such patients or clients within the scope of
the health professional's discipline, training, and practice (including
providing medical advice regarding the dynamics and nature of domestic
violence, dating violence sexual assault, or stalking);
(4) maintaining complete medical or forensic records that include the
documentation of the examination, treatment given, and referrals made,
and recording the location and nature of the victim's injuries, and establishing
mechanisms to ensure the privacy and confidentiality of those medical
records;
(5) referring the patient or client to public and private nonprofit entities
that provide services for such victims; and
(6) ensuring that all services are provided in a linguistically and culturally
relevant manner.
(c) Application of Provisions-
(1) IN GENERAL- Sections 503, 507, and 508 of the Social Security Act
apply to allotments under subsection (a) to the same extent and in the
same manner as such sections apply to allotments under section 502(c)
of such Act.
(2) SECRETARIAL DISCRETION- Sections 505 and 506 of the Social Security
Act apply to allotments under subsection (a) to the extent determined
by the Secretary to be appropriate.
(d) Authorization of Appropriations- For the purpose of making allotments
under subsection (a), there is authorized to be appropriated $4,000,000
for each of the fiscal years 2007 through 2011.
SEC. 1302. ADDITIONAL AUTHORIZATION OF APPROPRIATIONS FOR PUBLIC CAMPAIGN
TO INCREASE PUBLIC AWARENESS.
Section 403(b) of Public Law 109-162 (119 Stat. 3023) is amended by striking
`such sums' and all that follows and inserting the following: `$5,000,000
for fiscal year 2007, and such sums as may be necessary for each of the
fiscal years 2008 through 2011.'.
TITLE XIV--SUPPORT FOR PREGNANT AND PARENTING STUDENTS
SEC. 1401. SUPPORT SERVICES FOR STUDENTS OF INSTITUTIONS OF HIGHER EDUCATION.
(a) In General- The Secretary may make grants to public institutions of
higher education to carry out demonstration projects for the purpose of
providing services to assist both students who have decided to carry their
pregnancies to term, including those anticipating adoption, and parenting
students in continuing their studies and graduating.
(b) Certain Requirements for Grantees- A grant may be made under subsection
(a) only if the institution of higher education involved agrees that the
institution--
(1) will provide the services through on-campus facilities; and
(2) will submit to the Secretary, for each fiscal year for which the grant
is provided, a report describing the activities carried out under the
grant and the effects of the activities on the students involved.
(c) Application for Grant- A grant may be made under subsection (a) only
if an application for the grant is submitted to the Secretary and the application
is in such form, is made in such manner, and contains such agreements, assurances,
and information as the Secretary determines to be necessary to carry out
this section.
(d) Limitations on Amount of Grant- A grant under subsection (a) for a fiscal
year may not be made in an amount exceeding $25,000.
(e) Authorization of Appropriations- For the purpose of carrying out this
section, there are authorized to be appropriated $500,000 for each of the
fiscal years 2007 through 2011.
SEC. 1402. CHILD CARE ACCESS MEANS PARENTS IN SCHOOL PROGRAM.
(a) Minimum Grant- Section 419N(b)(2)(B) of the Higher Education Act of
1965 (20 U.S.C. 1070e(b)(2)(B)) is amended by striking `$10,000' and inserting
`$30,000'.
(b) Definition of Low-Income Student- Section 419N(b)(7) of such Act is
amended to read as follows:
`(7) DEFINITION OF LOW-INCOME STUDENT- For the purpose of this section,
the term
131`low-income student' means a student who--
`(A) is eligible to receive a Federal Pell Grant for the fiscal year
for which the determination is made; or
`(B) would otherwise be eligible to receive a Federal Pell Grant for
the fiscal year for which the determination is made, except that the
student fails to meet the requirements of--
`(i) section 401(c)(1) because the student is enrolled in a graduate
or first professional course of study; or
`(ii) section 484(a)(5) because the student is in the United States
for a temporary purpose.'.'.
(c) Authorization of Appropriations- Section 419N(g) of such Act is amended
by striking `$45,000,000 for fiscal year 1999' and inserting `$75,000,000
for fiscal year 2007'.
TITLE XV--FEDERALLY-FUNDED HOMES FOR PREGNANT AND PARENTING WOMEN
SEC. 1501. COUNSELING REQUIREMENTS.
With respect to any program of grants that is administered by the Secretary
and whose purposes include providing funds for group homes for pregnant
and parenting women, the Secretary shall require as a condition of making
such grants that the entities operating the group homes provide to such
women, upon request--
(1) adoption counseling; and
(2) counseling on parenting skills.
SEC. 1502. TREATMENT OF PREGNANT AND PARENTING WOMEN.
Organizations that provide group homes for pregnant and parenting women
and receive Federal financial assistance shall ensure that all residents
are treated in a nonjudgmental manner and are not subject to indignity and
humiliation.
TITLE XVI--EXPANSION OF ADOPTION CREDIT AND ADOPTION ASSISTANCE PROGRAMS
SEC. 1601. EXPANSION OF ADOPTION CREDIT AND ADOPTION ASSISTANCE PROGRAMS.
(a) Increase in Dollar Limitation-
(A) IN GENERAL- Paragraph (1) of section 23(b) of the Internal Revenue
Code of 1986 (relating to dollar limitation) is amended by striking
`$10,000' and inserting `$15,000'.
(B) CHILD WITH SPECIAL NEEDS- Paragraph (3) of section 23(a) of such
Code (relating to $10,000 credit for adoption of child with special
needs regardless of expenses) is amended
