Healthy Start Reauthorization Act of 2019

II Calendar No. 288 116TH CONGRESS 1ST SESSION S. 2619 To amend the Public Health Service Act to reauthorize the Healthy Start program. IN THE SENATE OF THE UNITED STATES OCTOBER 17, 2019 Mr. BROWN (for himself, Mr. BURR, Ms. STABENOW, Ms. ERNST, and Ms. BALDWIN) introduced the following bill; which was read twice and re- ferred to the Committee on Health, Education, Labor, and Pensions NOVEMBER 5, 2019 Reported by Mr. ALEXANDER, with an amendment [Strike out all after the enacting clause and insert the part printed in italic] A BILL To amend the Public Health Service Act to reauthorize the Healthy Start program. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Heathy Start Reau- 4 thorization Act of 2019’’. 5 VerDate Sep 11 2014 21:40 Nov 05, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6401 E:\BILLS\S2619.RS S2619 kjohnson on DSK79L0C42 with BILLS 2 •S 2619 RS SEC. 2. REAUTHORIZATION OF HEALTHY START PROGRAM. 1 Section 330H of the Public Health Service Act (42 2 U.S.C. 254c–8) is amended— 3 (1) in subsection (a)— 4 (A) in paragraph (1), by striking ‘‘, during 5 fiscal year 2001 and subsequent years,’’; and 6 (B) in paragraph (2), by inserting ‘‘or in- 7 creasing above the national average’’ after 8 ‘‘areas with high’’; 9 (2) in subsection (b)— 10 (A) in paragraph (1), by striking ‘‘con- 11 sumers of project services, public health depart- 12 ments, hospitals, health centers under section 13 330’’ and inserting ‘‘participants and former 14 participants of project services, public health 15 departments, hospitals, health centers under 16 section 330, State substance abuse agencies’’; 17 and 18 (B) in paragraph (2)— 19 (i) in subparagraph (A), by striking 20 ‘‘such as low birthweight’’ and inserting 21 ‘‘including poor birth outcomes (such as 22 low birthweight and preterm birth) and so- 23 cial determinants of health’’; 24 (ii) by redesignating subparagraph 25 (B) as subparagraph (C); 26 VerDate Sep 11 2014 21:40 Nov 05, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6401 E:\BILLS\S2619.RS S2619 kjohnson on DSK79L0C42 with BILLS 3 •S 2619 RS (iii) by inserting after subparagraph 1 (A), the following: 2 ‘‘(B) Communities with— 3 ‘‘(i) high rates of infant mortality or 4 poor perinatal outcomes; or 5 ‘‘(ii) high rates of infant mortality or 6 poor perinatal outcomes in specific sub- 7 populations within the community.’’; and 8 (iv) in subparagraph (C) (as so redes- 9 ignated)— 10 (I) by redesignating clauses (i) 11 and (ii) as clauses (ii) and (iii), re- 12 spectively; 13 (II) by inserting before clause (ii) 14 (as so redesignated) the following: 15 ‘‘(i) collaboration with the local com- 16 munity in the development of the project;’’; 17 (III) in clause (ii) (as so redesig- 18 nated), by striking ‘‘and’’ at the end; 19 (IV) in clause (iii) (as so redesig- 20 nated), by striking the period and in- 21 serting ‘‘; and’’; and 22 (V) by adding at the end the fol- 23 lowing: 24 VerDate Sep 11 2014 21:40 Nov 05, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6401 E:\BILLS\S2619.RS S2619 kjohnson on DSK79L0C42 with BILLS 4 •S 2619 RS ‘‘(iv) the use and collection of data 1 demonstrating the effectiveness of such 2 program in decreasing infant mortality 3 rates and improving perinatal outcomes, as 4 applicable, or the process by which new ap- 5 plicants plan to collect this data.’’; 6 (3) in subsection (c)— 7 (A) by striking ‘‘Recipients of grants’’ and 8 inserting the following: 9 ‘‘(1) IN GENERAL.—Recipients of grants’’; and 10 (B) by adding at the end the following: 11 ‘‘(2) OTHER PROGRAMS.—The Secretary shall 12 ensure coordination of the program carried out pur- 13 suant to this section with other programs and activi- 14 ties related to the reduction of the rate of infant 15 mortality and improved perinatal and infant health 16 outcomes supported by the Department.’’; 17 (4) in subsection (e)— 18 (A) in paragraph (1), by striking ‘‘appro- 19 priated—’’ and all that follows through the end 20 and inserting ‘‘appropriated $122,500,000 for 21 each of fiscal years 2020 through 2024.’’; and 22 (B) in paragraph (2)(B), by adding at the 23 end the following: ‘‘Evaluations may also in- 24 VerDate Sep 11 2014 21:40 Nov 05, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6401 E:\BILLS\S2619.RS S2619 kjohnson on DSK79L0C42 with BILLS 5 •S 2619 RS clude, to the extent practicable, information re- 1 lated to— 2 ‘‘(i) progress toward achieving any 3 grant metrics or outcomes related to re- 4 ducing infant mortality rates, improving 5 perinatal outcomes, or reducing the dis- 6 parity in health status; 7 ‘‘(ii) recommendations on potential 8 improvements that may assist with ad- 9 dressing gaps, as applicable and appro- 10 priate; and 11 ‘‘(iii) the extent to which the grantee 12 coordinated with the community in which 13 the grantee is located in the development 14 of the project and delivery of services, in- 15 cluding with respect to technical assistance 16 and mentorship programs.’’; and 17 (5) by adding at the end the following: 18 ‘‘(f) GAO REPORT.— 19 ‘‘(1) IN GENERAL.—Not later than 4 years 20 after the date of the enactment of this subsection, 21 the Comptroller General of the United States shall 22 conduct an independent evaluation, and submit to 23 the appropriate Committees of Congress a report, 24 VerDate Sep 11 2014 21:40 Nov 05, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6401 E:\BILLS\S2619.RS S2619 kjohnson on DSK79L0C42 with BILLS 6 •S 2619 RS concerning the Healthy Start program under this 1 section. 2 ‘‘(2) EVALUATION.—In conducting the evalua- 3 tion under paragraph (1), the Comptroller General 4 shall consider, as applicable and appropriate, infor- 5 mation from the evaluations under subsection 6 (e)(2)(B). 7 ‘‘(3) REPORT.—The report described in para- 8 graph (1) shall review, assess, and provide rec- 9 ommendations, as appropriate, on the following: 10 ‘‘(A) The allocation of Healthy Start pro- 11 gram grants by the Health Resources and Serv- 12 ices Administration, including considerations 13 made by such Administration regarding dispari- 14 ties in infant mortality or perinatal outcomes 15 among urban and rural areas in making such 16 awards. 17 ‘‘(B) Trends in the progress made toward 18 meeting the evaluation criteria pursuant to sub- 19 section (e)(2)(B), including programs which de- 20 crease infant mortality rates and improve 21 perinatal outcomes, programs that have not de- 22 creased infant mortality rates or improved 23 perinatal outcomes, and programs that have 24 VerDate Sep 11 2014 21:40 Nov 05, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6401 E:\BILLS\S2619.RS S2619 kjohnson on DSK79L0C42 with BILLS 7 •S 2619 RS made an impact on disparities in infant mor- 1 tality or perinatal outcomes. 2 ‘‘(C) The ability of grantees to improve 3 health outcomes for project participants, pro- 4 mote the awareness of the Healthy Start pro- 5 gram services, incorporate and promote family 6 participation, facilitate coordination with the 7 community in which the grantee is located, and 8 increase grantee accountability through quality 9 improvement, performance monitoring, evalua- 10 tion, and the effect such metrics may have to- 11 ward decreasing the rate of infant mortality 12 and improve perinatal outcomes. 13 ‘‘(D) The extent to which such Federal 14 programs are coordinated across agencies and 15 the identification of opportunities for improved 16 coordination in such Federal programs and ac- 17 tivities.’’. 18 SECTION 1. SHORT TITLE. 19 This Act may be cited as the ‘‘Healthy Start Reauthor- 20 ization Act of 2019’’. 21 SEC. 2. REAUTHORIZATION OF HEALTHY START PROGRAM. 22 Section 330H of the Public Health Service Act (42 23 U.S.C. 254c–8) is amended— 24 (1) in subsection (a)— 25 VerDate Sep 11 2014 21:40 Nov 05, 2019 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6203 E:\BILLS\S2619.RS S2619 kjohnson on DSK79L0C42 with BILLS 8 •S 2619 RS (A) in paragraph (1), by striking ‘‘, during 1 fiscal year 2001 and subsequent years,’’; and 2 (B) in paragraph (2), by inserting ‘‘or in- 3 creasing above the national average’’ after ‘‘areas 4 with high’’; 5 (2) in subsection (b)— 6 (A) in paragraph (1), by striking ‘‘con- 7 sumers of project services, public health depart- 8 ments, hospitals, health centers under section 9 330’’ and inserting ‘‘participants and former 10 participants of project services, public health de- 11 partments, hospitals, health centers under section 12 330, State substance abuse agencies’’; and 13 (B) in paragraph (2)— 14 (i) in subparagraph (A), by striking 15 ‘‘such as low birthweight’’ and inserting 16 ‘‘including poor birth outcomes (such as low 17 birthweight and preterm birth) and social 18 determinants of health’’; 19 (ii) by redesignating subparagraph (B) 20 as subparagraph (C); 21 (iii) by inserting after subparagraph 22 (A), the following: 23 ‘‘(B) Communities with— 24 VerDate Sep 11 2014 21:40 Nov 05, 2019 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6203 E:\BILLS\S2619.RS S2619 kjohnson on DSK79L0C42 with BILLS 9 •S 2619 RS ‘‘(i) high rates of infant mortality or 1 poor perinatal outcomes; or 2 ‘‘(ii) high rates of infant mortality or 3 poor perinatal outcomes in specific sub- 4 populations within the community.’’; and 5 (iv) in subparagraph (C) (as so redes- 6 ignated)— 7 (I) by redesignating clauses (i) 8 and (ii) as clauses (ii) and (iii), re- 9 spectively; 10 (II) by inserting before clause (ii) 11 (as so redesignated) the following: 12 ‘‘(i) collaboration with the local com- 13 munity in the development of the project;’’; 14 (III) in clause (ii) (as so redesig- 15 nated), by striking ‘‘and’’ at the end; 16 (IV) in clause (iii) (as so redesig- 17 nated), by striking the period and in- 18 serting ‘‘; and’’; and 19 (V) by adding at the end the fol- 20 lowing: 21 ‘‘(iv) the use and collection of data 22 demonstrating the effectiveness of such pro- 23 gram in decreasing infant mortality rates 24 and improving perinatal outcomes, as ap- 25 VerDate Sep 11 2014 21:40 Nov 05, 2019 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6203 E:\BILLS\S2619.RS S2619 kjohnson on DSK79L0C42 with BILLS 10 •S 2619 RS plicable, or the process by which new appli- 1 cants plan to collect this data.’’; 2 (3) in subsection (c)— 3 (A) by striking ‘‘Recipients of grants’’ and 4 inserting the following: 5 ‘‘(1) IN GENERAL.—Recipients of grants’’; and 6 (B) by adding at the end the following: 7 ‘‘(2) OTHER PROGRAMS.—The Secretary shall 8 ensure coordination of the program carried out pur- 9 suant to this section with other programs and activi- 10 ties related to the reduction of the rate of infant mor- 11 tality and improved perinatal and infant health out- 12 comes supported by the Department.’’; 13 (4) in subsection (e)— 14 (A) in paragraph (1), by striking ‘‘appro- 15 priated—’’ and all that follows through the end 16 and inserting ‘‘appropriated $122,500,000 for 17 each of fiscal years 2020 through 2024.’’; and 18 (B) in paragraph (2)(B), by adding at the 19 end the following: ‘‘Evaluations may also in- 20 clude, to the extent practicable, information re- 21 lated to— 22 ‘‘(i) progress toward achieving any 23 grant metrics or outcomes related to reduc- 24 ing infant mortality rates, improving 25 VerDate Sep 11 2014 21:40 Nov 05, 2019 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6203 E:\BILLS\S2619.RS S2619 kjohnson on DSK79L0C42 with BILLS 11 •S 2619 RS perinatal outcomes, or reducing the dis- 1 parity in health status; 2 ‘‘(ii) recommendations on potential 3 improvements that may assist with address- 4 ing gaps, as applicable and appropriate; 5 and 6 ‘‘(iii) the extent to which the grantee 7 coordinated with the community in which 8 the grantee is located in the development of 9 the project and delivery of services, includ- 10 ing with respect to technical assistance and 11 mentorship programs.’’; and 12 (5) by adding at the end the following: 13 ‘‘(f) GAO REPORT.— 14 ‘‘(1) IN GENERAL.—Not later than 4 years after 15 the date of the enactment of this subsection, the 16 Comptroller General of the United States shall con- 17 duct an independent evaluation, and submit to the 18 appropriate Committees of Congress a report, con- 19 cerning the Healthy Start program under this section. 20 ‘‘(2) EVALUATION.—In conducting the evaluation 21 under paragraph (1), the Comptroller General shall 22 consider, as applicable and appropriate, information 23 from the evaluations under subsection (e)(2)(B). 24 VerDate Sep 11 2014 21:40 Nov 05, 2019 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6203 E:\BILLS\S2619.RS S2619 kjohnson on DSK79L0C42 with BILLS 12 •S 2619 RS ‘‘(3) REPORT.—The report described in para- 1 graph (1) shall review, assess, and provide rec- 2 ommendations, as appropriate, on the following: 3 ‘‘(A) The allocation of Healthy Start pro- 4 gram grants by the Health Resources and Serv- 5 ices Administration, including considerations 6 made by such Administration regarding dispari- 7 ties in infant mortality or perinatal outcomes 8 among urban and rural areas in making such 9 awards. 10 ‘‘(B) Trends in the progress made toward 11 meeting the evaluation criteria pursuant to sub- 12 section (e)(2)(B), including programs which de- 13 crease infant mortality rates and improve 14 perinatal outcomes, programs that have not de- 15 creased infant mortality rates or improved 16 perinatal outcomes, and programs that have 17 made an impact on disparities in infant mor- 18 tality or perinatal outcomes. 19 ‘‘(C) The ability of grantees to improve 20 health outcomes for project participants, promote 21 the awareness of the Healthy Start program 22 services, incorporate and promote family partici- 23 pation, facilitate coordination with the commu- 24 nity in which the grantee is located, and in- 25 VerDate Sep 11 2014 21:40 Nov 05, 2019 Jkt 099200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6203 E:\BILLS\S2619.RS S2619 kjohnson on DSK79L0C42 with BILLS 13 •S 2619 RS crease grantee accountability through quality 1 improvement, performance monitoring, evalua- 2 tion, and the effect such metrics may have to- 3 ward decreasing the rate of infant mortality and 4 improving perinatal outcomes. 5 ‘‘(D) The extent to which such Federal pro- 6 grams are coordinated across agencies and the 7 identification of opportunities for improved co- 8 ordination in such Federal programs and activi- 9 ties.’’. 10 VerDate Sep 11 2014 21:40 Nov 05, 2019 Jkt 099200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6203 E:\BILLS\S2619.RS S2619 kjohnson on DSK79L0C42 with BILLS Calendar No. 288 116TH CONGRESS 1ST SESSION S. 2619 A BILL To amend the Public Health Service Act to reauthorize the Healthy Sta [Text truncated for display. Full text available on Congress.gov.]