,,ii #aahth ,,congress #b;d ,session ,s4 #dbdf ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #b1 #bjbd,mrs4 ,murray 7for herself1 ,ms4 ,murkowski1 ,ms4 ,baldwin1 ,ms4 ,collins1 ,ms4 ,klobuchar1 ,mrs4 ,capito1 ,ms4 ,cantwell1 ,ms4 ,cortez ,masto1 ,ms4 ,duckworth1 ,mrs4 ,gillibrand1 ,ms4 ,hassan1 ,ms4 ,hirono1 ,ms4 ,rosen1 ,mrs4 ,shaheen1 ,ms4 ,sinema1 ,ms4 ,smith1 and ,ms4 ,stabenow7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to improve menopause care and mid-life women's health1 and for other purposes4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,advancing ,menopause ,care and ,mid-,life ,women's ,health ,act4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4,sec4 #b4 ,research with respect to menopause and mid-life women's health4,sec4 #c4 ,public health promotion and prevention4,sec4 #d4 ,public health awareness1 education1 and outreach program on menopause and mid-life women's health4,sec4 #e4 ,training programs to improve care and treatment of menopausal symptoms4,sec4 #f4 ,centers of excellence in menopause cause and mid-life women's health4,sec4 #g4 ,reporting requirement4,sec4 #h4 ,coordination4 #b4 ,research with respect to menopause and mid-life women's health 7a7 ,,nih research ,part ,a of title ,,iv of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bha et seq47 is amended by adding at the end the following3 #djd,p4 ,research with respect to menopause and mid-life women's health 7a7 ,research and innovation 7#a7 ,in general ,the ,director of ,,nih1 acting through the ,director of the ,office of ,research on ,women's ,health1 shall coordinate and expand research activities conducted by all institutes1 centers1 and offices of the ,national ,institutes of ,health to develop and implement ,federal research programs with respect to-- 7,a7 the impact of the symptoms and trajectories of changes across the menopausal transition and the postmenopausal period on women's physical1 mental1 behavioral1 and cognitive health2 and 7,b7 the prevention of related adverse health outcomes among women during the menopausal transition and the postmenopausal period4 7#b7 ,grants ,in carrying out paragraph 7#a71 the ,director of ,,nih shall award grants to eligible entities to support-- 7,a7 biomedical and public health research and innovation in the development of new treatments and diagnostic testing services for perimenopause and acute and chronic menopausal symptoms2 and 7,b7 researchers and clinicians engaged in clinical and translational research on menopause and mid-life women's health4 7#c7 ,eligible entities ,to be eligible to receive a grant under subsection 7b71 an entity shall meet such criteria as the ,director of ,,nih may establish1 and shall be-- 7,a7 an accredited entity that offers education to students in various health professions1 such as 7i7 a teaching hospital2 7ii7 an accredited school of medicine1 osteopathic medicine1 nursing1 or pharmacy1 or a physician assistant training program1 including a historically ,black college or university 7as defined by the term part ,b institution in section #cbb of the ,higher ,education ,act of #aife or described in section #cbf7;e77#a7 of the ,higher ,education ,act of #aife7 or other minority-serving institutions 7as described in section #cga7;a7 of the ,higher ,education ,act of #aife772 7iii7 a certified behavioral health clinic with an accredited medical or nursing residency program2 7iv7 an accredited public or nonprofit private hospital with an accredited medical or nursing residency program2 7v7 an accredited nurse practitioner residency program that includes and accredited nursing residency program2 or 7vi7 a related accredited program engaged in the care1 treatment1 or management of menopausal symptoms2 7,b7 an academic research institution or other nonprofit research institution2 7,c7 a small business2 or 7,d7 such other entity as the ,director of ,,nih may determine appropriate4 7b7 ,research1 condition1 and disease categorization ,the ,director of ,,nih shall designate1 in the ,research1 ,condition1 and ,disease ,categorization1 new categories for chronic or debilitating conditions among women1 to analyze and coordinate current and future research on menopause1 menopausal symptoms1 and short-term and long-term effects of such symptoms on mid-life women's health4 7c7 ,coordination ,the ,director of the ,,nih shall coordinate and expand ,federal research programs and activities to study acute and chronic menopausal symptoms1 including-- 7#a7 vasomotor symptoms2 7#b7 osteoporosis2 7#c7 sarcopenia2 7#d7 temporomandibular disorders2 7#e7 joint and nerve pain2 7#f7 trauma1 anxiety1 depression1 mood disorders1 and related mental and behavioral health conditions2 7#g7 short-term memory loss2 7#h7 genitourinary conditions2 7#i7 alopecia2 7#aj7 vision or hearing impairments2 7#aa7 digestive and metabolic disorders2 7#ab7 chronic sleep deficiency1 insomnia1 and related sleep disorders2 and 7#ac7 other menopausal symptoms and related conditions1 as the ,director of ,,nih determines appropriate4 7d7 ,translational research ,the ,secretary shall expand translational research activities to accelerate translation of ,federal research on perimenopause and menopausal symptoms and facilitate equitable delivery of perimenopause and menopause care and related mid-life women's health services4 7e7 ,outreach and engagement ,the ,secretary shall expand outreach and engagement activities with accredited schools of medicine1 institutions of higher education1 and research institutions to support ,federal research activities with respect to menopausal symptoms4 4 7b7 ,public health research and data reporting activities ,part ,a of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bda et seq47 is amended by adding at the end the following3 #caj;,c4 ,research relating to mid-life women's health 7a7 ,public health research ,the ,secretary shall expand research activities with respect to the severity and duration of menopausal symptoms and related chronic conditions affecting mid-life health outcomes among women1 including mental and behavioral health outcomes4 ,in carrying out activities under this section1 the ,secretary shall coordinate with existing programs and activities of the ,department of ,health and ,human ,services4 7b7 ,health care quality research ,the ,secretary shall expand research1 program evaluation1 and quality improvement activities to improve health care delivery for the care1 treatment1 or management of perimenopause and menopausal symptoms and related chronic conditions1 including data collection with respect to preventive services that support mid-life health outcomes among women and barriers to care4 7c7 ,dashboard ,the ,secretary shall establish and maintain a dashboard for the reporting of data on menopausal symptoms and mid-life health outcomes among women gathered through public health surveillance activities with respect to screening1 testing1 treatment1 and prevention services1 and the impact of this section and section #djd,p on such efforts4 7d7 ,occupational health research ,the ,secretary shall conduct research activities and expand data collection with respect to workplace stressors related to severe acute or chronic menopausal symptoms1 physical injury1 or other adverse health outcomes among women1 including traumatic stress1 anxiety1 depression1 and related mental and behavioral health conditions4 ,the ,secretary shall review existing evidence1 identify gaps in services1 and develop evidence-informed recommendations for related public health interventions and support services4 7e7 ,interagency coordination ,the ,secretary shall develop and implement new interagency research initiatives or programs to address menopausal symptoms4 4 7c7 ,authorization of appropriations ,for the purpose of carrying out sections #djd,p and #caj;,c of the ,public ,health ,service ,act1 as added by subsections 7a7 and 7b71 respectively1 there are authorized to be appropriated #be1jjj1jjj for each of fiscal years #bjbe through #bjbi4 #c4 ,public health promotion and prevention ,title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bda et seq47 is amended by adding at the end the following3 ,w ,activities to promote mid-life women's health #cii,,oo4 ,public health promotion activities 7a7 ,chronic conditions and public health promotion ,the ,secretary shall expand public health promotion and prevention activities with respect to mid-life women's health and chronic conditions1 including diabetes1 hypertension1 heart disease1 iron-deficiency anemia1 inflammation1 fibroids1 endometriosis1 and other related conditions and adverse health outcomes1 at the discretion of the ,secretary4 7b7 ,early detection1 diagnosis1 and treatment 7#a7 ,in general ,the ,secretary shall award grants to eligible entities to improve the early detection1 diagnosis1 and treatment of perimenopause and menopausal symptoms and support public health activities to expand access to quality care services and improve mid-life health outcomes among women4 7#b7 ,eligible entities ,to be eligible to receive a grant under paragraph 7#a71 an entity shall 7,a7 be-- 7i7 a ,state1 local1 ,tribal1 or territorial public health department2 7ii7 an accredited entity that offers education to students in various health professions2 or 7iii7 such other type of entity1 as the ,secretary determines appropriate2 and 7,b7 submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may require4 7c7 ,care coordination ,the ,secretary shall award grants to eligible entities described in subsection 7b77#b7 to support care coordination and care planning activities1 including such activities otherwise supported under this ,act1 and expand access to quality primary care and specialty care services to improve-- 7#a7 mid-life women's health1 including activities to support the integration of primary care and specialty care2 7#b7 bone health and muscle loss2 7#c7 mental and behavioral health care services2 7#d7 joint1 nerve1 and muscle pain prevention services2 7#e7 digestive and metabolic health2 7#f7 prevention and management of multiple chronic conditions2 7#g7 physical therapy and injury prevention support services for populations affected by acute and chronic menopausal symptoms2 and 7#h7 other services that address acute and chronic conditions that affect women's health in perimenopause and menopause4 7d7 ,mental health and substance use prevention ,the ,secretary shall develop recommendations and best practices to-- 7#a7 increase access to mental and behavioral health care services and substance use disorder prevention services for women experiencing perimenopause or menopausal symptoms2 and 7#b7 expand substance use disorder treatment1 recovery1 and support services for women experiencing perimenopause1 early menopause1 premature menopause1 and related conditions4 7e7 ,health care delivery ,the ,secretary shall develop recommendations and best practices for-- 7#a7 reducing disparities in the management of menopausal symptoms2 7#b7 improving access to perimenopause and menopause health care services2 and 7#c7 providing patient-centered perimenopause and menopause counseling and treatment4 7f7 ,safety and effectiveness ,the ,secretary shall carry out and support-- 7#a7 outreach and engagement activities of the ,food and ,drug ,administration with health care providers on perimenopause and menopause and mid-life women's health2 7#b7 oversight efforts to assess the safety and effectiveness of new diagnostic tools for perimenopause or menopausal symptoms1 including devices that use artificial intelligence2 and 7#c7 support existing activities of the ,department of ,health and ,human ,services to enforce privacy protections for patients4 7g7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated #aj1jjj1jjj for each of fiscal years #bjbe through #bjbi4 4 #d4 ,public health awareness1 education1 and outreach program on menopause and mid-life women's health ,part ,w of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bda et seq471 as added by section #c1 is amended by adding at the end the following3 #cii,,oo-#a4 ,public health awareness1 education1 and outreach program on menopause and mid-life women's health 7a7 ,in general ,the ,secretary shall develop and carry out a national awareness1 education1 and outreach program relating to menopausal symptoms1 mid-life women's health1 and related care1 treatment1 and preventive services directed at patients1 health care providers1 first responders 7such as emergency medical service providers71 and related stakeholders4 ,such awareness1 education1 and outreach program shall-- 7#a7 disseminate educational materials and provide technical assistance for health care providers and patients to support engagement about perimenopause and menopause care and treatment options for menopausal symptoms2 7#b7 help such providers to identify risk factors and prevent injury among women with menopausal symptoms2 and 7#c7 address barriers to related care and treatment services for women4 7b7 ,outreach ,in carrying out this section1 the ,secretary shall-- 7#a7 conduct outreach and education activities related to perimenopause and menopause and mid-life women's health that-- 7,a7 include evidence-based information2 and 7,b7 are culturally appropriate1 in the case of such outreach and education activities for ,indian ,tribes2 7#b7 provide opportunities for ,state1 local1 ,tribal1 and territorial public health departments to customize public health awareness1 education1 and outreach materials for their populations2 and 7#c7 prioritize populations in areas affected by barriers to care1 including rural and underserved areas4 7c7 ,coordination ,in carrying out this section1 the ,secretary shall coordinate with existing awareness1 education1 and outreach programs and activities of the ,department of ,health and ,human ,services4 7d7 ,online resources ,the ,secretary shall develop1 operate1 and maintain a website to provide educational materials in accessible formats for health care providers1 patients1 and caregivers1 regarding perimenopause1 menopause1 and mid-life women's health4 ,such educational materials may include-- 7#a7 webinars1 continuing education modules1 videos1 fact sheets1 infographics1 stakeholder toolkits1 or other materials in formats as appropriate and applicable2 and 7#b7 tailored for health care providers1 patients1 caregivers1 and other audiences1 as the ,secretary determines appropriate4 7e7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated #aj1jjj1jjj for each of fiscal years #bjbe through #bjbi4 4 #e4 ,training programs to improve care and treatment of menopausal symptoms ,part ,d of title ,,vii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bid et seq47 is amended by inserting after section #geg 7#db ,u4,s4,c4 #bid;f7 the following3 #geh4 ,training programs to improve care and treatment of menopausal symptoms 7a7 ,grants ,to train health professionals 7#a7 ,in general ,the ,secretary shall award grants to eligible entities for the purpose described in paragraph 7#b74 7#b7 ,use of funds ,a grant awarded under this subsection shall be used to develop1 establish1 or expand training programs 7including accredited residency programs1 fellowships1 or other related clinical training7 for physicians1 registered nurses1 nurse practitioners1 physician assistants1 pharmacists1 other health care providers1 and students and trainees to improve care1 treatment1 or management services for perimenopause1 menopausal symptoms1 and related chronic conditions4 7#c7 ,eligibility ,to be eligible to receive a grant under this subsection1 an entity shall-- 7,a7 be-- 7i7 an accredited school of medicine or osteopathic medicine2 7ii7 an accredited nursing school2 7iii7 an accredited school of pharmacy2 7iv7 an accredited public or nonprofit private hospital2 7v7 an accredited medical residency program2 7vi7 an accredited nurse practitioner residency program2 or 7vii7 a related training program for clinicians1 allied health professionals1 or social workers that interface with affected populations1 which may include hospitals and research institutions1 as determined by the ,secretary2 and 7,b7 submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may require4 7b7 ,training opportunities ,the ,secretary shall expand outreach activities to support and expand training programs1 fellowships1 and other opportunities for students1 faculty1 and trainees 7including continuing medical education7 or establish new training opportunities to address barriers to access to-- 7#a7 primary and specialty care services to support mid-life women's health2 and 7#b7 early detection1 diagnosis1 treatment1 and care services for perimenopause1 menopausal symptoms1 and related chronic conditions4 7c7 ,coordination ,in carrying out this section1 the ,secretary shall coordinate with existing awareness1 education1 and outreach programs and activities of the ,department of ,health and ,human ,services4 7d7 ,authorization of appropriations ,to carry out this section there are authorized to be appropriated #aj1jjj1jjj for each of fiscal years #bjbe through #bjbi4 4 #f4 ,centers of excellence in menopause cause and mid-life women's health ,part ,w of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bda et seq471 as amended by section #d1 is further amended by adding at the end the following3 #cii,,oo-#b4 ,centers of excellence in menopause care and mid-life women's health 7a7 ,in general ,the ,secretary shall designate eligible entities as ,centers of ,excellence in ,menopause and ,mid-,life ,women's ,health1 and award grants to such entities1 for purposes of improving professional training resources for health care providers on mid-life women's health with respect to the care1 treatment1 and management of perimenopause and menopausal symptoms1 and related support services4 7b7 ,eligibility ,to be eligible to receive a designation and grant under subsection 7a71 an entity shall 7#a7 be an accredited entity that offers education to students in various health professions1 or such other type of entity1 as the ,secretary determines appropriate2 7#b7 demonstrate community engagement and partnerships with community stakeholders1 including entities that train health professionals1 social workers1 community health centers1 health systems administrators1 certified behavioral health clinics1 and research institutions2 and 7#c7 submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7c7 ,activities ,an entity receiving an award under subsection 7a7 shall develop and distribute evidence-based resources to health care providers1 patients1 and public health departments regarding the care1 treatment1 and management of perimenopause and menopausal symptoms4 ,such resources may include information on-- 7#a7 advancements in the treatment or management of perimenopause and acute or chronic menopausal symptoms2 7#b7 the prevention and treatment of related chronic conditions across different patient populations to support mid-life women's health2 and 7#c7 other topic areas that are relevant to the objectives described in subsection 7a74 7d7 ,geographic distribution ,in awarding grants under subsection 7a71 the ,secretary shall take into account regional differences among eligible entities and ensure equitable geographic distribution4 7e7 ,priority ,in awarding grants under subsection 7a71 the ,secretary shall prioritize eligible entities that provide services in a health professional shortage area designated under section #ccb or to medically underserved populations1 as defined in section #ccj7;b77#c74 7f7 ,evaluation ,each entity receiving an award under subsection 7a7 shall submit an annual report to the ,secretary on the activities carried out using such award4 ,the ,secretary shall evaluate each project carried out by an entity receiving an award under this section and shall report the findings with respect to each such evaluation to appropriate ,federal agencies and public and private entities4 7g7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated such sums as may be necessary for each of fiscal years #bjbe through #bjbi4 4 #g4 ,reporting requirement 7a7 ,report on activities carried out under this ,act ,not later than #b years after the date of enactment of this ,act1 and every year thereafter1 the ,secretary of ,health and ,human ,services shall submit to the ,committee on ,appropriations1 the ,committee on ,health1 ,education1 ,labor1 and ,pensions1 the ,committee on ,finance1 the ,committee on ,homeland ,security and ,government ,affairs1 the ,committee on ,indian ,affairs1 the ,committee on ,veterans' ,affairs1 and the ,special ,committee on ,aging of the ,senate and the ,committee on ,appropriations1 the ,committee on ,energy and ,commerce1 the ,committee on ,ways and ,means1 the ,committee on ,education and the ,workforce1 the ,committee on ,veterans' ,affairs1 the ,committee on ,natural ,resources1 and the ,committee on ,oversight and ,accountability of the ,house of ,representatives a report describing the progress of activities carried out under this ,act and the amendments made by this ,act4 ,each such report shall contain-- 7#a7 information with respect to ,federal research activities related to perimenopause and menopause and mid-life women's health1 including information related public health awareness1 education1 and outreach activities1 including-- 7,a7 data and knowledge gaps1 or other barriers1 related to research1 diagnostic testing1 and treatments with respect to perimenopause1 menopause1 menopausal symptoms1 and related health outcomes2 7,b7 data or information related to barriers to health care and support services among women experiencing perimenopause or menopausal symptoms in rural and underserved areas2 and 7,c7 data or information related to barriers to training opportunities and resources for health care providers serving women experiencing perimenopause or menopausal symptoms in rural and underserved areas2 7#b7 recommendations and best practices for health care providers and public health departments to expand access to care and increase public awareness and understanding of menopausal symptoms and related chronic conditions2 and 7#c7 information about related ,federal activities1 as the ,secretary determines appropriate4 7b7 ,report on access to care and treatment ,not later than #b years after the date of enactment of this ,act1 the ,secretary shall release a report on barriers to access to care and treatment services for perimenopause and menopausal symptoms1 and recommendations to reduce any such barriers4 7c7 ,authorization of appropriations ,to carry out this section1 there are authorized to be appropriated such sums as may be necessary for each of fiscal years #bjbe through #bjbi4 #h4 ,coordination ,the ,secretary of ,health and ,human ,services shall coordinate activities carried out under this ,act 7including the amendments made by this ,act7 with other existing ,federal efforts relating to menopausal symptoms1 mid-life women's health1 aging1 or public health promotion carried out by the ,department of ,veterans ,affairs1 the ,department of ,defense1 and other ,federal departments and agencies1 as appropriate4