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