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( ~ S 788Q . ~ CONGRESSIONAL RECORD -SFNA TE May 19;: 79'78 -.M ~ .. ' .. . . . .. tess thee rightt of thee membersof~ the af ad(atlonal'fundsl needed was not tnowna report't from theCbmptraller General Public Groups'.toPt'omote Obcervanceof'unta early ln: 1978. . andd theCommittee. oa.. pf ~U~~y., Ststes,. Ml.: E)mer Staats,. theHe)sinklAgreementinthe17.S.SR. $'rl°eauawdmmfstmuoa~udaotrecetvetn>s oapro fnformattoa uat11 dHSy 3: 1978.. PasCd "sunset"-1eglslatioa: At the.e to pursue their Iawlul.activities aad urg- Th e eaect off defeating conswerationn of': commitlt®e hearing an A'prll 19„ Mr. . 1ng: the Presidpntto continue to'.exPress:- the adattlonsl authorltatton womd beto~ Staats was asked.d to study' the various IInitedStatesopposition:to: theimprison- iurther delay construction, thereby addmg: Proposalsthat have beenn madee ta: hn, .' mentof Group, members.. . . to the total eeet of.compienag the:propect. ' Prove congressional aversight and to'.in.--~ and'puttu~g additloual pressae mnthe Ll- corporate their best features in aa pro-' .. F: brary of Congrese to: carry out the: miaslons... Mr. Staatswass asked too study S. . -. SE~hYTD': RESOLUTION 458-ORIOI--asstgnea too tt:hy tne:Coagreee: pas8l. -. 2, the Program Evaluation' Act. of 1977, . - NAL RESOLVPIONREPORTEDTO: The desired authoriza.tionn will not havem sponsored by Senator 39vs1xi; and PAY A.GRATIIITY': the egect.of'delaying the approprtatione: . - Prooass; 1t:wm need to be accommadsted ln a othe2s:'. S. 1244., theFederal Spenrling ' ~)19r:.' PELL, from the COmmittee: An supplementEl apprapriat9on. .... : , Contrai' Act af 1977, sponsored by SeIDa- -- .., Rules. end An.,,+*a=tration, reportedthe:- -This author)zation tss suffitfenety aman tor Bmsn:; the work done in this area by.followingoriglilak resolutk)n.whichwas': that:lt wiunotslgnlaeanty afrect tha can-the:.GAO~for. Senator Laalrv.; Pi.R.. 10421. - placed.aa theca[eudar:, , - gmetonal budget. Howevez.it will result:in. the' Legislative Oversight' Act' of 1978;,. a gas, 468. comptetton of a proJect which7sbaaly needed introduced in the House of Represeata- _Se+oived;.7'hetthe Secretary ot the senate- m o'TIBrto meet the changing and expand- ttves~ by'Representatlve. BB'rtza~ Drnerexhersbp Is auworlaedd and directed to Pay, ing''°poneibnluea of the Library of Con-- and others; and the resolution proposed .from:the.contingent.tund of:the senate,.to ~°.' ., _.. -_-bythestaSy working group on S.2- .. ..., Arthur a:.. lvckery wtdowe3' of ifaryyf. .. .. .. .. .. and. S. 1244 In tts: report, to the Rules. '.. Tucker, an: employee uf the 8enatee at: the -~AMENDlIwrS! BTTBhII'1'I'En. FOR '`Comalittee. . ttme.ofherdeath, s.eumequal to one yeara' :- - PRII4TI5,IG--A)so' echedilled . to testify on June g. - compensatton.at, the rate she wasrecefMng ' ',. _ ' .. wllli be wltnessess representing the A;FIr -'. by law abthe time of herdeath:r eatdd sum to -' T,AROR~ LAW . REFORM ACT OF' C'IOand the Americaa: Society for Pub-be cousidere¢ lnelusive nf' fuaerel ezpenees 197:g-HR: 8410 Ik Admtnistradon:n aaa sn otlier aucwanaee. . . - ; ' 7 - , The coauaitteew)ll then meet at' 10 ,. _ .. ~-..rQroaarrc:NOe. f9fT'SmmIIaB raaa. .~a.m:on: Wednesday. JUne-14, it1 roomSEN'ATE: RESOLSOTION 459-ORIGI- '- (Orderedd to be printed and to: lieon 301„ to consider commititeeaction: on the ~ MAL RESOLLITION REPORTEDTO thetab)e.)._. -_ ... . .......,. - proposals.0 ' -PAYA.GRATViTY-.. •bIa HATCH submlttedl.six amend- ._..,. . . .:.... ..::. -Mx.. PELL;, from the Committee on meats. lhtended to beDroDOSed~' by him . - ADDITIONA'L STATEMENTS ~-. . Rules and Adminiatratlon,reportedj the to the bi)I. (HR. 8410) to amend the Na- ,. imllowingorlgiust' zesalutioa.. which was tional Latior Relatiaas Act to strengthen ~~ pgO:RO~ ~ ~; f. ... " placed onthe,..calendar-.... _the:.remediea-andexpedtte:theproce- _,_.. ..,- . '..:-s. itts 459=. . _ .~ duresvadersuch a8t. ."... . .,.: . . ... 'rMr. EAGLEPON. D6t'. Presldent., the '.._.'"'. . - .- . . . . .. - ~ xeaorved-;:z7,at the secnets~y of the senate agony Al$o Moro suffered through hffi 54 -. . .. - , . days in eaptivtty ended with his tragic' - herebyfs authorized-andd dfreatedd to pay, ;NOTICES-OF 11p`arMGS death, but the horror andgl'ief of c1vi1- . Lrom:'thecontingentflindoftheSenate:..to , a9ecoxlar~n.aaoxreneau:errMOma..Ized~DOOPIeeVerywhCEe.at:thL5m08L.IE- - sa sthel.n~ emPlo}me o1 nesener,. the wtdew 8enate ofR at the lchards';. tlme amsner, .,a,cru.v..,no..oeaw: aovmixeesrr ..:'cent, most d~pl0able: act of terrorism . . bb h1a - .. .. `. . _ _. aeatn, a sum equal to-one yea.e~comp~ 02 Drtr• CH7LE5: Mr_Presidentr the Sub- continuesi " moa.atthe.rate.ne.waareemvingnytewat--committee:oa.FederaASpeadlagPr•sa- ~•'TheassassfnatlaaofAldo.Morowesan . the tlme of' hisdeath,s eaidd sum-c to., be con- tices:and.Open Government willbe hold- act of desperation..coaimltted by a fringe . -atderedtnclusllveoffvaerai' enxnsesands all ylg.an oversighthearingontheGovera- of socletywhoseonly'hope ])esfn.the. ' otherallowancee: - -..-. . ,. . menkia the SunshtneAct (Public Law violent disruptioa of civilization. Row- ' on' Wednesday:. June:7,1978, at `ever, theRed.Brigades':won.notiiing fiom. BENATE' RESOLUTION 460-ORi GI- 10~ a.m:, in" room. 3302.' Dirksen Office this barbarous act:..If:theysought sym- NAL "RESOLU'TIONREPORT[s'D BuiIdL51g. pattly from the oppressed whom-t2fey. WAIPII'1GCONGRESSIONAL B017G, °' Fur further informatton regarding the c)aimm to represent, they failed! If they. LT A= : _ hearin6plesse contacL Mr. Ronald A. soughA to.advance:thecauseof theirob- . - Chindo. chief counsel affi staS'dlrector sourepolitYcalldeology„they faiie(L Pub- . Mr,. PETL froPt the~Committ:eon ofthesubcommittee.t' ," - lie outrage at their brutal actlvities' Rules and Adminlstration, reported the shows that there Is no aonsensus.tor their .. following original resolutions which was . .`_ . ., ~'. , cause, '"referred to the Committee on the- s, Mr. RTBICOFF. Mr.. President, the - Onfortunately, thds d'oes not signal.the. Committeee on. Oovermmenta[ Af[atrs. Sudget: . ,_.. demiseolthe.RedBrlgadea.and.theirilk.. . . :g, a:a.4e0.., ~-. willl hold a business meeting on 3[onday, They are-stilI.at work nlltaly: tetxoriztng, ..Reselved,..thaepursuant to 8eatian 4oa(c)'May22„ 1978, to consider S':. 2460, the at random, wielding the:only'power theyofthe:congresetonalBudgetAct:of1974,.theCivllService: Reform Act of 1978. The--ae.n grasp. It does, however, signal a. .. p:rovieionc of Sectlon.4o'z(a). ofsuchACt are meeting will be he)dd at-• 10::30 a.m.in ~mg awareness that terrorism 1s a. watved wtth.reapect to:tae:conslderatton.of- room 3302,' IDirksen. SenateOfOce force to be defeated, and that we must'. & 3113', abtll toamendo the. Act of Oato-- Bullding,E.- .. _ . .,. '. be prepared t(4dea1 with lt on both ana--' ber 19;.19agi,autaonzmg conatructfon of:the- e sato, eeqi.memmesntxx, sasvsae. .xw •. Lbraryof'CongreesJames-Madison'llemorial . p~axeercrneev2emoN sxm '..c.vs:.ecT'os 1978 tlanel~ and an',InteRlatlanallBVe6. Eummhg. waivertn.nscaf. year1978 of Sec. tton 4o2 (a) >8 neceseary r.> anow for an ln- 0 ,~,~WSIS.7A'MS;.hlr,,,Pres)dent;.I wLsh ~President Leone01'~ Italy made this : . . compelling statement after he )earned.of " ere®e1a the fundingauthorfzation for con- toanaou:nce that the Senate: Committee ydo'Moro's death:: - - etruCtion of the btnlding_. . . -'-.. on Human Resources will hold Its first Aldo: Mom hasbeen: pitnesely and horrify- S. 8. 3t13 would laerease the authorization d9yof hearingson S. 2910.. the. 9doles. (hglyslaln.The.besst whotried to.covee the . . for construction fundss by: s10;000,000; from- cent' Health, Services, andPregnaney kidnapping wit:ha political and Ideological i123.000,000:toi138,000;Q00:The.amountpre- Preveatlon, and Care Act of 1978, on cioahfailed tolUten to the cry from the "viously authorized uinadequate to cover June,14„at 9:30 a.m.., )n'room 4232 of the whoie of manltind that this maa txe spared. - the coste of aeceasary changes 1n.the building Dirksen Senate:Office Building. Withhis death, barbarity neems to want not ` . resulting from Congreseional3ymandated es- . to k171 a nlan, but thfnking aad mteingence - pansion of.lte fuactions, conetruction' delaye, For-further tLformatHOn oathi6': mat- ~d nberty. Yetwhne thisdeatn appalle" and _' and ]n9atihn: . ter, please contact'Ms.. Patricia :13arkey dYatvrbs, itwill~neversucceed m:defeatmg:ua. CompIIaneew[th eection 4'02(a)of- theSt 224-0324.F... .:. ... . In that wsy. atraglo error has been com. -Cangresslonal Butlget. desof 1974 waa not "stnssrr, nzcnn~noa ' "~=" mltted by'these wretched beirs.of the most ' : poasltilebythaafay 25, 1977, deadline, be- GMr:.PELL. Mr. President, on Thursday, bsrbarona. assasslaa: that manhmd has - eauaetheArchtteet.of:the capttol~diduot.June8, at 10~ a.ae,tbe, Committee on kn'p°ra` (~'~~(~~~y~1~ become:awareoTtheimetequacyofthe:au-...Rules.'andAdhlinistration-willmeethlIn,otherwot'dYtRf,Y~1A14h R6vibtioryby - 301f th hid1 . thortrattoa, until late 1a.a977..7he: amoun; room• oeRusse)T..Buildingtoeatr the Red, Brgaeas Illusory, because -.

~. lkletv' 19"„ 1978 CCQNGItESSIONr1I. RECC7RII)=AAdTE ; .S 7801 nish province of'North S.areha,.a~broadl.~ nutrlt3onalilmpribationsof'the~~.foods~they~ centrall role, they will have to~~ strike out - new progxammatic directions: They rogram reduced consume tian d . uaa p e -based health. k4 s-thetncidenee of heart attack by 40per- ur h: MFoposes. a~ compre-~ will haveto maintain: thetraditional . cmt. henslveantismokmg mtiativeaimed athealth protection activities of State gov- ;'+: ~'- The incorporatfon of sound preventive reducmg the burden of smoking-related.. Xernment--sanitary protection, food- u4 i heaith practice is already having. a na- illbessm our seei - afetymonitoring, maintenance of. State ., .. .«+..,mIn. ,aA~i in this countrv. From ge er. Mr. President. theselabs, and so on-and..reach beyond them. I decline Is at least in part attributable: for.healthpromotlonr and disease.pre-.of newprograms inthe.area.of commu- 11 197otn 1975 death rates from stroke malorinitiativesformacoordihated-and. Theywillhave:toaddtotraditlonalpub- ~I dropped 18percent.. Expertss feel thisflexibles program. of, Federal supportliohealth. activitiesan innovativearray ~. ~Heart;~Lung;andBloodInstitutehas~~un-. ~.Nevertheless,.Iunderstandithatmany~ to, take.on.this~challenge.ifwe~give.them Education Campaign at: theNational dlseseand',disabilityamong'our peopl'e: I thihk Stategovernments.are ready ; '1973 the National HlighBloodi Preasuree bytheircanmzon aim: the prevention ofnutritionalf education, among others. to: improvedi health habits among Amer. ventlon.n activities ih thiseountry.s aicatibns, health education, occupational Seans:andto.themore:widespread!tk•eat=- Though ttleproposals cover a broad,healtnprotectSon, smokmgand, hyper- . ment of high blood pressure. Started in range of issues,..I feel they are unifled tension control; accident.protectfon, and infectious diseases some1'50 yearss ago., fortns;. First asas single piece of Iegisla-- ta theStates$5Smillion it. 1980, $150 In theearly1800's; longbefore: bacteriation: andsecond: aaa paekagee of! three . million in 1981', $175 millfom in 1982, . atage we reachedd in the investigation af-- Health Promotion Act. of. 1978 in. two , proposed formula' grant. woul'd allocate 'compllvhment. -. : some of:. these proposalaa but not.ail of: talentandt to bulld an infrastructtue for We now fmd.ourselves„Mr. President,. - them. Forthatr reason. I will.introduee: . prevention.activitfesat.the 9tateand.lo- at-a point in history very sihnilar toa, the. National Disease Preventton._and. cal.level. To provide this support, our ~-doubtedly contributed tothiso last ao- - of a'Lyeolleaguesmay wish to support . the resources they need. to attract new. • were di5covered, enterprisingg citiaenss bills. The firstbill-ih the latter package. .$200 million in..1983', and $200.mfllion.in prevented choleraa epidemics by Guavan- would'consist off tttle I and II... The see- 1984- Though. these figures may sound ': tiningconte.minatedg pumps.. SimllarlF,ond piece ofthepaelcagewould ineludesubstantial, they-amount too a mere- 50 at.theturnofthecenturp,publio.health titl'eIII.onI,P-Andthethirdpartofthe. centspercapitain.thesecond.year-less -espertss were- able, by' eradicating mos-package- would constst of title Iv;, the than the cost of aa pack-of cigarettes m quitos,. to preventt yellow fever long be- ~ anti-smokiag leglslation I welcome my manyareas-and rise to less than $1 fore they had isolated the. yellowfever colleaguesto Joih with me.ine cosponsor- per capitaa by' the fourthyear- And --vlrus or developed a vaccihe.. -'mgthe> total aet. orr an,yparts off thee that increeseiss contingent an matching .. - The-lesson iselear. We, . donot: have corresponding disease: prevention pack- in¢enttve contributions.faom the States. -. to-: understand every facet of a di5ease - age. - - ''Though~ we-attempt to. provide Staces -tocontrol-it. We.aowfiadw ourselves ca- Mr. President. I'would now like to. -maximum flexibility in. initiatingttteir pable of making huge: Inroads intiathe describee brle5ythecontents.of each of ownprograms,wealsoseekto.protectthe :prevalenceofourNadon'S:mostdevastat:-thetitlesofthislegtslation.- -1 Federal interest by providing for ac:- .g ing k1llers, even though our understand-Tltle. I of theNatlonal Disease Pre- countatillity in the useof Federal moneys. ~' 1ng.& of the causes?of'those,.dlseasese la-.in:- . vention . and Health- would provide. . Under thee proposed program,. States •complete.If.we selzethe ehance; we-may moneysandi authority for the secretary -would have-to•usetheirformulafunds- - be'e able: to accomplish.h with ehroniedis- -ta support:preventive'healthserviee.s. SA for progcams- aimed, at. combating one ease what weaceomplished-with infec- substantial,part of those funds would be - or.more of the five leading. causesof tious diseases_over the lastcentury. -'. - authorized'for the: support of formula death- within theirr boundaries.. They-• -T'heNattonaliDlsease Prevention andd grantstoStates.fortheestablishmentof .couldaise;.attheirowninitiative:,launch _.HealthPromoffion Act of.1978will: in health~ promotional programs within..programs7 aimedat:reducingtheburden myopinien,enabSeus-to.take.advantagetheirown.boundaries. .-ofillnessassuciated.with.one:ormoreof of: this. tremendous opportunit,v. It will II am~ convinced that ifdlsease:preven- 'theEve leading causee of d7sability reiaforceeaistinghealthpromotional'ae-tion programsaretawork„they must among their populations. Moneyscould tivlties atFederali State,.and Ioeal.levels.l be: based Erml,v_ in-.the communiti:es. of be used only forprogra.ms of primary or And it will.launch usmtonew programs Eimerlca- They-must mvolveState, and secondaryprevention. Stateswouldhave ~ that hold great. potentiai, promise. local govemmant,. labor andl Industry; _ to make Q•uantitativee statements of their ~.Theactham fourtitlea., -, votiuntary-groups, schoollsystems„physi'- -programs:goals..andwcullihaveto, build .. ~Flrst. Title L provides. grants for the _ eians;. hoapital§, health centers, and in- la an evabiation component. The formula _ supportof'preventive health services. dfviduals.in.their places, of work and tn grantwouldbesuthorized for 5 years In Thesem include formula..grants to the their homes. Health promotional pro-. ea+dertoprovlde.the:Statessufficienttlme States to assistt them inn destgning.g pror grams~ cannot workk if they are imposed . to get'their programs up'andl running to , gzamsaimed:atpreventingthefivelead-fzom: above. They must be nurtured at . ing causes of death and the five leadingtheg level of'thecommunity.: They must °. causesof di3abilitywithintheir. State makesense to people. seem relevant too b oundaries. The- grant program also,their needs. and.desires, and grow: in.theIncludespro7ect grantss to public andd direetlonswhich each" community prtvate: entites for thesupporte of health ehaoses. •- promottonaI. programsof proveweffec--- The. Federat Government has an Im- tlVenessand high.h natinnall prtority:, portentt role in supporting'sueh commu- F7mmpies are hypertensionn and, im-- nitq programs but tothe:extent Govern- ... munixationservioes. -ment provides coordination and guidance - Second: TitleII provideslorthe.crea-forcommunity-based prevention efforts., ~tibn of'a Prevention Resources program that help must.be odered at a ievel closer. which will. provid'e technica[i assistance tothepeople. I',.believe that Stat'ee gov- .. to: State and locail health promotion ernmeats working closely with local' gav- efforts, andd willl support research andd ernments are ideally situated to provide .-_d'ata collection necessary to perfectna-_ leadershipp and..coordinationd m the de- .. tional, State, and local.preventive health velopment of diseaseprevention andpro- activlties. - . motion programs in this country:. For Third: Titie. 1'II', amends the. Food, Drug, and Cosmetic Act for-the purpose .,.of: revibingfoodg labeling statutes.. The amendments would require nutritional labeling:ofall food (to the:extent prac- .. tieal)„ so that eonsumerss can bave, Im-. . -•proved.lnformationatiout.thehealthand. that reason,, thee act provides maJorr new resources to: these governmental entitiesbaseds prevention programss havee made for thepurposese of planning flexible, ac- auccessful~ use of'f the print andd electronic countable;, and locally responsivee pro--- media m motivating people to engagee in -grams~ of healthpromot'don and diseasee more.heafthy behavCoror to seekaccess prevention. .. : to preventive :aealth services. No pre-~ IS St t t ' a egovernmen a are to play thiss vention program w 1 ects the ase ' 594 reach.h their State. programm objectives. The first yearr of the program would, be -an obligatory planning- year for all -,-TheformulA. grant program has one unique feature, which deserves special mention. Thereiera separate set-aside allowing 10~0 celtts aperson per State for the developmentt of: a health communica- tions program: Thiss set-aside recognizes the unique potential of:themassmedia for informing;.the publioc of the health . consequences aftheir behavior. Xmer1:- cans currentlyspend on an average the equivalent- of 1 day a week watching television, , Thee average American willl havespent9 years of his life watching= television by the- age of 85. Growing numbers of experiments in communitv-

; S788'4' ., r~, ;-' ;, CONORESSIONAL RBCORA- 1VA~E May 19; 1978' I tua3lyall the ageiicies of the Puhlic.- spoken advocates ofpreventive-health forr andi 1nA meeting the costa of providing Health S_ervice.. and ma8ing' these ese bu- progrnm•4 on ourr committee, and hee has. (througli such states aad through 8?ants or . . ._ ..- _. .. a _.__.... . •.. _. . ..nMr1a n. M.M m1N6 .wv.•. ~-. ..._ .. lG6 .:aoua.. cuu w. wp..w.r... taoritles'. Of . -.-.ccnstitute a.maior ehallenge.,Properly roletheSt'atesmust: DlayfIItheforma• Polltlcsl.subdialeibaa or the Stetes,r other public entities, cr' private ea- .. 9taHed~ and euPDOnfed the ©fflee Of tioa aad administYatiaa of such preven-~ tlrties). Dreventfve health eervfcee.. -° , 'Health.Iaformatlon and Health Promo- tivehealthpxograms. .. ••(b) No grant shau be made under sub-! : ctfon, (a)~) unlese an application therefor - tion mi6ht aceompllsh thistaslc Certain- . ASr.. President,, it enaeted. II think.k the ee .. ly, the Secretary will need'some adminis- National Disease'.Preeentlon and ELealthh bell , beeasubmitted to. and.approved; by. the: _ ~ trativeentitywhlche sits. atopalTp thePromotlonActof 1978 wouldputlnplace- 36c1eL"y' Such an application shall be InHEW agetiaiea tb'.serve asliis'.[lght; arm p[oBramsthat promise toreduee8Ub- aach tbrm and be submltted in such manner: ae" the. Secretary..shan.y bgy regulatlon pn. -la~.forghig a'coordinatedAreventloa.Pro-- ata~ntial~ the burden of111neas among ecribe and ehan provide (otherthanla an.. $tam. -.-~J, : ' .. -. ; -: .. our Pe4ple:, Th19ik81slattort can ProYlda: apphcatton.fara. plannmg grant)-- . • i&d: _-At this titrle: L do'not i'ntend too pre- something whiclh:nati'onaihealth lnsur-°(1)~ for a'- detailed pfann of a ptngnm' judHe thesee management issues, But I ance. ImPOrtBnt.as-It is, oannot. Healtli designed to: reduoe; throv8h.the'.prlmary or.r e%pectatlon ..tnmiranre may-Improve..ollr access to, second az'yndaz'y preventloaaf cbu9atltre eondi-' wouldll7ceto, makeclearm y -:.thatthe'Depart'menti will came forth. Care:itmayyhelyeontainonatslit.may' tlons,themoreautyratesibroaeortnoreaf' Wlth concrete 8dmh11stratAVe DroPDea7H make onFhealth'eeJesystem more eqliit-- ine flve.leatl3ng cauaesof death latheState:: . . - 1oDde8Aa6 w(th.d19ea9e prevention and. "Abk- End lighten the: bultien of Cata' "(2) the amount af 8ederal. Btatal and other funds obllgatedby the State In 1ta .. health Promotion'as a natConsli priority. strophic medioat.ezpense: But it wiII not- iptMSt annual aecnunung perlod.for taepro- ..I also espect the'Department's.proposals- make us a healthier and Inorelong-lived.e vwan of each program, described ln paca. ' wllfdeal.with.thefuture off,the'0fficeof . PeOpleunlesgltls:comtiinedwittia.com- gnph• (I): a deecetptloa or thepreventtve Health.Itlformattan and HealthPromo- - prehensl4estl9tegy for: reducing death; health.eervlceg Provhled.bythe State m each. . tlon. . .:... , .-. ., ~.. _. - . ...antk dtsabillty_thron811 preventi'o1r. Our. each programm such.perlod„ theamount or -- • II wouldalso li'ke to: note, Mr: Presf- :nMghbors- in. Canada are aiready leala-- r A~ ~g needed eyr~ 8a .r hum dent, that the National.Disease. Preves-~ th13kssorL After thep enacted thelr prognm: tff taa statscomprehensive national health insurance. prepaees abansa m - t10n and Health' PromoUva A6t'of 1'97&& the Pravlston' of the.eervlcee.3a any encn, Pro- ..: eatendsL for 3yea:s sectlon 314(d) of the System. theY autckly discovered'that they gram, the Prloratfee of such plvpoeed~ PubiteHealth3erviceAct•.'Thig.Program'hadaolved.onlvenehalfof.theirhealth ehanges::tha.res.omtoreuchehangesc'and,Bl1DDO[ta.. CtlmPrehenSloe Dtlbllc'c health care~Drob1PA[:TheyWEDeabletotakeearetheamovnt.of 8ederaLfunde needed bFtha-r servlce•formnla arantato~ 8tatca..Wlitle Of peoDle oootrtheygot s1cY•. But they Stata m maweeuch changee: ... ,. .-'Imt strictly relevant tbcur . Drevellt(vehad.donenoLbingto.keeD them well.. .:: ~~) ~~'a eopttoa ot tha stata a da. _ . health serviceproDosalk, the 314(d) an-~. ~e C°^^ "e^• ara•nav:undertakfig;. throu ptlva~eantlrtm tya. Progxsm.deafsned m : reduoe.-_thoidtyis', iadireotS,y relevant ia' a. num-- a-natlonwidee8:ort in thee area of health ~' Dnman or eecondary prevention - M~oauaasaa, Lhaaurdea.of 1Dasee bet oi 1mDOrtaIIL way6 ..:. . . -Dremetlaan and disease D[CYCa61on•. Mi? aeeodaten with the flw lesding.. eavaae of .... .... Fhat, the'progFamprovides. general Presddeatt wecaa IeaPix.firom their ex- .morbtuty In,me er.ts:, . .. . .. :-:supportt for'State-heal.th departments, patience:' and froErt the smlllar experl.. •~~) ihathe da o~~t of aeaen4etate: snd .. ,.. and'.tiilss support~,has beea vital inn main-enaes of: the maag Weatera EnroDasn by tns-etata In lte : an8. petJOd for tEe'pro- - eoontri'es:wltli aattonal' health.fasuraace- latest anauLL s - tafaibzg: the:. intearttp aad: stI•ength of ..yrogrnm3:: We can-move now too folanl-. 91eIOM ot e.cu. Pragramm described la. parc- .~. ~esareasing o~le ln the: Provisloa- e~- _lataa national strategy Sorhealth~ pro=' ~m(e3er~.IcaedpluvlGea ny the 8taa m etach~ . nentflve-healRh: se[vicesr it is..essentiah._Inottoa:aaII.disee~aeprevention.C?ur.allll--~~p~,lasuchperlod:.the:amountof. m dahlldrea, mdahlldrea wLLl.lPve longer. : pyderal~ funda needed tit ehe . etate to, coa-. .. that. their inirastructure aad.theirL ca- ..drern, and ~ - esoh euch: ._Daatt9for mana8ement be maintained 8ud~hetterll'veeifcvedo: alavs proamng esscII ae.+laee m : andenhanced.. 7f6[::. President, the Subcommittee on-program: u thastatepraPosesmanges in the:.. -:. 8econd..iaany Ststegs use 314(dT itmds- Heaith andSCientifloResearch will hold p1O9len~ wfeecvtcm m snpeoehpmgrama. hearin8s- onthe:. National DL9CSBe- Pl'e-, •.ehs such prap?seA changee: tae. for provtdfngPreventiveseruicea' ot var-~ venttoar, and Heaith~ Piromation. AaE. of1eseDae''~ ~ohangee: aad, the amouat' louskind®. For that reason.. there.- are . 19788 on'.. MaY:24 and.25 and on. Juae7'. ot.7eees•at imm needed by tna State to, me,Ye suah Important areas of. overlaptietween.p the n x . mm~ .r. . .. .~ , eh.ages: . . , , ...01.tS1ese:eTlstiIIgfnnd3.andthepo9- -aad8.'711~Q~;° . (3) that Tho-plaoedexrl6ed ln para- uses . d18CU8810a OfOm'Sntl 4mok'ms lydtiative,: '~tis (i)q am~ (3),•~- . . a161e uses ofthe: formvla grant fo[Pre-. (A) eban1 6eaafae scomP'a•aheasive:prd-. - . ventive services proposed iu title:I of the -~of the propasad legislatlon- :... .. ....ventton ptogfam vhichatufza, to tbe ertena . -.bllL Wlu1e we do notfatend, fhese.new -.- bEr Phesldent.I askunanimous aon-. Pr'm'1ts~°'au~ relevant proreedaaai macl ~ moneys So substltlitefor existing pre-- . sent. that tl'~ bills lio- PI'lIDtsd In the': , p~°'' . ..~.: 'vent(on actlvlties,. it Isesaential.that', the -(e)) may..at the.optfon of the 9tatb, de- _. .. P[o8r'amaflmded v¢Iderr t3e9e- two~. . ~caaP. •-,:- - ..". .•' .. tcrltie aPr~'am' orPrograms that ara ~ eourcea.of:fum~Lss brclbselyooordYnated. --Tl'Ierebeineno~.obieatloa.thebdlLawere' .~a?setedtowatae aParacular ega gmup:. .. Ordered to bee prlnted iM'the ItLCOND4 . as. ..,. (e') aha11 aae forth quantitatively thecur- ` .. We . ProDase; M[C.:.Pra9ident. thaL.the, - .. ,. 7. ._ reatrelevant rates of mortaltty aad, where ": fOlloSFa:_ •-apyroprlate. of. mortlldtt _ - . _ -TIn the Brate: - . fundtng..suthorityfor314(d) tiemod ..fied slightly and lnereaaed. First ofall. Ha'.!t aT6cted 6P the Serate 6ad Rouee o '~" (n) shaLL set forth the 9uantlmtlve goeln "• we slr$geat 6' matChilII8..lncentiVe grant r txreductioaW1 the rel9venti ra[ee, or mor- ": , .&apresentai[oee'ol fhe Untted Smtea. altahtyaud..wharoeDRroprlate; olmoxbidltytn -. . . ~formula'wfiiahwllleacauragethe3tates. Amerres..ty C`mpreae aue+eaud, that tn1ss taestate;- -. . .: ` _ -.4oaddo their ftandstoFederalfunds..ia Act may be cited ae..the:^IDisease Freventfan: '•(g) shall 1~ve a eeparate health commu-.µ~ -the-suppm't of publlcc health act(5dtle6'.s end Health Promotlon Act of~ 1978'••. ,.. . nicattuaeM component 1nths r .~ .. wltliln Stategoveanmentsi- 8econdiwe:. Tr1ZLr= r-PONMahA , ANI) 'P1taiECi' P o8ram or pro '.: .. g+ama which shall include, butnot be limited r~ ...suggrstanincreaseiuthe3l't(d)'author- .. 6serm'a. FOR artEVSrnzvs >eFar2'S:. to,.adeearlptionofnowtaecommnmcatlone- , i'ty irom, $07 mlllloiln in 1978to $125 .- S&ItvICEB .. ..,. .-.'. :.- '. media, including the-electrontc medla,, wtul million In 1988,.$140 million in 1981 and - Saa: 1o1.:wthenever in thle tltle aa amend- ~>'dntnlzed to' eIIectaatethe purpoees of'the'. ' $1500 milionin 1982:. These: inereasess are faa~taor prravfemn~ne, retsrE "p 1~ alI toen - . intended to compensate for the faet that m a sect tlfym epeclLC lnetltuttomal .~ aDPropriat(onss levels under the 314(d) . eaaeshalr be considered too bemade to a.eec-tur1 st9CCOmhtethatg will be nee{wnstble .tlonor other'provillonofYhe Pubflc Heslth. PLSal'ag. through contractewlth`. euthoritylia9e~"been SHed' atthe $90 seyyfce Acy. .. _ ;. prfmate entitles: and Other means thee re- ~' mlllion SCvel aince 1971. - ~ - -qutrementb ofparagraph: (E); aad. - -_' raeMVta,cadNra ra9 P9avi2TTrvE SQw2B'. -.. Mr:.President,I~wouidHketocomme ndwouidHketocommen dtocommend (({) S1SalI Contabyeueh, otaer lafarmatlan. .I9Te; ttefe IIIa°~e Becretarg maf by regulation pre- . ` _ my colleague...Senator CnA'nrE; for the '. gm „ Iga .ECect[va Octaber I aaribe: • . leaddngrolehehasPlayedlaerel{3ng'our .faameadedbyadding;afteraecetoa314the.~ tor'sseuraucea:eatfe[actcryto theSec- - . . revislon of the, 314(d) antherity: and for fallowing'. nevrseotion and headtngg thereto: ~ --...his valD6ble=a4sPstance in helping .~yaesroaa osaxas m arexae noa raavenrna ~-°.rbh w[tbeproviaea ~the i~Uhayer s. ., ahaDeourpre8ram'.offormuPaBrantatP-.: - ... , . '•ffincrssnvxss .. -- ; .: .' grant'undersubsectton (a) 1>albe,prawlded } . , mamanaeranneletentwfththeStatbhealtS ~ .-8tates.forpreveIItlve"serVicee..$enator" "8ac.318. (a) 17ie:-Hecretar yahalrmate_ , . ~E.`SdHESha8 been one of the most out- . sranta tostates toaeetet them in planning Dfau m saeet.underseotton 18?4(c): ..Ji

c;. fS 7868: ~•. CONGRESSIONAL, RECORD -SENATE' May 19, 1978 of the popnlation of the IIotted States and :.•(H) the percentage per serving of pPtela,. Permttfed in any enclDeed area open- too the ~. the relationship between these:eletetlmmen/S fat:, angar:. atarch, and alcohol. m: term6of ': puhllb m.n any FEderal.l facllit7 or in any.. .of health and.the 1nGdenee and prevalence calorlcoontent,aadi stalrscayelevatnr,hallway;conveyance,walt., .. of preventable eausea 6f death and desa- "(C)thegramsper'serving'nf'.protein:.sat-- fngroom, reception room, conference room. '. _.bflltp;',and . ..... ....ucated fat, unmturatedd fat. eugar„ etarrb„ or hearing room.ih..anysuch.facLlity. ,(4)') the behavioral dete[mlaantsof:heaTtIIt alcohol, eGd1nID: chole9terol, and any other.. (D) Smokemahall be effeetfvely'separated ' ..of thePopulatfon of, the. United Stateas la- mg*•de^+s . ass the. 3ecret®ry by regulation from, non-smnkera. Ln any res4aurant , aafe« ' ' eluding. but notllmited to; emokhag, nutri- preocrlbea. .. _. ' • .. terie, anackbar, other dining. fAc111ty. recrea. '_ -ffional.and.dfetaryhablta,.erercise.andaico- -'"(2)'DDe Secretary is autlioriredl where: Slon.roomor.lbungeLn.anyPedemlifaclSty: "' ... hol eonmumptlbn, and thee relattonshipbe- appropr•iate, to.preocrlbe by regulation aeys- (c); Each Lastrumentslityx of the IImted. .. tween these determlaantaof healthand ttie--tem. of symbmis, figures, or other' devicea States shall uae reamnatlle eHorrs: that.t do: ...fnetdence, and prevalence- of pcerentable whhh wilC.eaatile eoneumera to readily oom-.not result.la excessive cost orr admliuistrative ~.. causasaf'deathand Nbabllity. ., ... -prebend tha nutrition Lnformation, requfi'edi' dtsrnptionA to. effectlvely separatethe vmrk- `..(b) Iapreparing the proflle: required by to be placed an labela by pacagraph. (1):.. places af lts.employeeawho, do not smoke ~ ~nubsectlon (a):. the Secretary!,., autlag. °(S) Tothee:tentttaacompllaacewlth, andlwho.wisti.tnbeso~separsiedifromthe: ; through the National Center for Health Sta- - t1iee requuementa of subparagraphs(1). and workpiace® of Its employeee..who: do amoke:. ~' . tPatSeas or its eqmvalent, shalP comply with (2) ' ia Lmpra.eticable,. theSeeretary ahalf.by (d)'InPlatming: designing. purchasing,. .. , all relevant provisions of' sectlona._ 3086 and tegutationn prescribe ezemptions- from such, leaam& or otherwlse.obralning,new fstc311t1es„ 308 of' the public Health Service Act. requirements.". . . .. ... ,,.. eech tMStrumeatalty of' the United Statea . 2TII3. DI-AMENDEIIENTS TO M?OD ehaP:to:-the maa]mum extent practitab)e:. .. , PHOUISICNSOP TRIBEID6ILAL P'OOD, SDC. 303:. Chapter IV Is amendedby adding- iMS°re the eHective separation of smoking ~. DRIIG.ADID~COSMEliC.ACT TO: POS'l1rRr after sectiDn 411 the following new aectlnn:' d nonrmoktngg emploAeea In such fat11- HEALTH PRIOMOTIOX iilea:- - . ' . Sae..301:. WIIenever'Ln thls ttt]w an emeud- . . "aa:~ ~~ a~'r~m'c snaosnio" aroxs-. " ' .. ment:Paenpt®edLattrms.c[anamendment gW_ 412 (s) Enoap~t~asMPtovided.Sn.sub-- SDa4a2lneveryarea.Ln:anyPedemlfa-. .toa.seotloaor.othes'Pro°ision•thereierenceo sectEon(b):no~Stata;or..pouacalaubdivisioa cilItywheresmaking.isprohihlted.midersec--.shallbeeooxederedto:bemadetoaaectionor' ofa3tatemaFeatabLaharcontinue,meHecG tiOn .401,.'No.Smoktng"slgnashallbeclearly otherpt'mdsion:of tho--PederaL POod,. Dnt& . andconsplcuously posted in anmoteat..num-aadCO®etlcAct. .p,-. -. . . a labalmgg requlremeati applloabletoaay ..bara.and ominence to - fmd wmch Ia,dlIIermt from or fa addition w. Pr . glvee notice m:.any. - xorammr urroawx¢mr uan-ormsox caast.at0. any labeling xeq„r e-.,t.applicatiletoanch. P&oun eateting or accupytng~ such areathsc. l l Moo1 m 1 pmb b tedlnauchares ag~ P -feadunder'aactaan-303. . .. . .; -Stc: 301.(a)~(S) Seerion401 isameaded by - ^(b) ppoa appltr•atfaa.n of a State ar a : atnkingoutthe.fourth.sentencetbm'eof.. ':politYcai~subdtv7ebn thereof, the Senretazy' See.403: (a)'The~ezecutivehee.d'.orchlef ' admtala4stive officer of - (3) '. Seetlon.4059(H) 1s.ameDaed to.zead.as,. -may„ by vegulatba'atter notfee and uppor-.eachanatr¢mental-f follows: . .... tuaityfoaan.oraLfieerlng;.ezemptfromuub-ityofttie.UnttedStatea•shallbereapanetble any. U it purports.~ia.Da..or ia repreamted. aeotton-(al,. vndersutlt.aondlwonase may 6eSor enfareiag' aecttona 401 and'4D2 m.y _ ssa.foodfbrwhlchew deSattton.andstandard.' pras:ribed! m:sedh regamtlon„alabelmg're-7ed"at eacint4lnwhtchauch,lnatrumental- ".:of.ltleniity'haYe been '-preacritied byy regula-- q¢tremeat o1: such State or political sub-. fry'maintafm of7cea.. .. .. .' . _: ttona.as provided byaection401•.unlesa (l),. ft. dlvlsfon It. the Sae2etary.det •,,,r^^" that the: (b) Hot later thar ninetydaysy after the. d t f - a e o enactmentof thiaPart,.the.eucntlve. .. oonformsto:sueh deitnitlon, and.etaadard: requirement ia zeqalredd by coampellinglocalg ' f and. (7) tte: latiel, bears.the: name of'the food! condlttona.andi ¢omPlianoe wlth it would natt bead.d or'dhie admmistrattve omcsr of each.. -specifiedinsuchdeIInltionand:s4endard.':':. .•ewee.eTOod.tobe-mviolatlomof:.rzeqnise-inetr®entaaty of', the IImted-Statesaha:l (b) (1)Sectlon 403(1)t Is amended to read ,meat.mtdersactian 403."_. pu'bLahia the Pedetal Register regulations, as follows:: _ . . .,:.. accvaocre ss.aucao- , . for" the enfercemeat'. ofsactldm 401. and 402 "(1)Dnless:2ta label-beara- Sac, 304. Section 201(f (1)') ie amended to.~uding: but hotIhaltedt to, apptoprtate '. ."(lLin.the ceae Gf foed whiCh L aUt sub- ) saacElona.for noaeomPliance w1tth euen a!c- ')ecY. to pstsgraph (8) of' ffida eecCton,the read as follows: "(1) articles tieed (A) for -tiOm COMParable tosaaotlone.forfellme to.o rammon.or uaaal nsme-(tray)~. ofahe food: food foc.man or otherantmals, and (B) sa. comPly nLth:an7 ather applicable.regulatton snd . ...... ~_.. .,.--_. _driniG for' rna6 or atbeL anlmala: iaciadmgeffeeting the healCh,. saieYy, or well:-bMng o0 "(2) In case Ytt ia fab[ecslef 4.'ota: two oi dffitllled epirib... vAnea, and maT6 bevatages,•• thee public or the work: force... - _ mDle.mgredieaTa- . :. . ......_- .., - .. ,...., O'DLCIIVlnA1Sl _.~ ,.;......~....DZ(ntQ.mNe ' .. "(A) the ce®aonorra¢sl neme of.eaeh : Snc• SOB. The e:mndmeata madebT 'sac- - 8as:. 46LFbm'Lbspurpoaesol WlapscL; .. each,ingredtenkm.tDCOrderof Sts-peedorat- . tlons302.-308; and'304•aDail apply wlth.m- ,.(a)) theterm "amuking" means.the amek-. .nanee: escept.that any sPiceaor'flavortngaspect:to.foodwmch,hlntmducedar.dellvered ,y8,o[paaeaaatonefaLghted..dgarattei.aigar:, which are not aotdd as-sueh anad be, deeig- Sor lntroduetion. into..interstate commerceor PtPe: awntamingg a tobacco pr<tlnct;aad, aatedseartffieiaisplcesorastmxiapYtessnd~ atterone:yearaSt,e<'thedate of the enacc.- (b) theterm"•eaecttvel se '. ' artiEetali 9avoringssor-ns.tmal. Havortags• as . meat of this title:. .... .. y _ Paratad" maaas the- caaemaYbe, without rmmtng..eart snea.. xa'rmcx2ma.so.axm.auwar sr 't•ra rIDa+D~permittad and Ln _ which smoking Iaot~ er.- mgredieat, unless the8ecrerat9 reqqh® by . .. . tsanacoa®etas+nx_. '' . mfYted in r manner which minimlzee, tn the. . ' regulstlan taat:the•comraon ornanal-nama -..8~308: (a)~ The:Secretarpof 8ealta..8d... ezkeaY ptactlcsble..LhardrllY.ot smoketYOm~ . of sa apfcaor [Ia9orlvg'De aa the'~1NIel farLae.veatlonr snd Weifateatlall nottfy . the' Ped-- the amoriag:area.lnto the nonsmo ' ptetpose of'f provlding•.•health imlaematiea~ toking. arsa. eonsumers.: . . ~. .' .: ~ esal'~'LZ'a~COmmlaeim of, eae:nutrltional.ln.. _ (e)) the term "lnatrlxmeatall'ty aL tDS. .. "($) adeeMratlo'aeftho-pcaeatsgenf-sayformatton'thac ]a'.requ4ed.te be.Placed on IIn1Y068iatsa"mearu-. . . , apeMae6 tngredteat Yother than e.spl4s ord feod ]abeb purauant to.sectlon 4'OSlgl.and (1) an ezeautlva agency,. u deftnad la: - flasating)' 1ftLS8eeRmrydetermfaee:bTreg- -~ mW the. Commisalbnn whlcli.. (iL: axYma.lOb-of.tltLb$ IInitedStateS~.COde: '.. nlatton that snea 3ageedleat hees algatIIcant an,y) ) of such Lnformationn shW ld berequired -, (2) tCeIImted Statee Poetai Servlce:'. ., . .besrhl(;aatheqvalStp.nutritton.acceptabil-.bytheComm7s5ionnndertllePedersl'ITada. (S) Ytie.Congreae:,- . _ .'.l'ty, ar- cast of'.suchfood, and .. .•: . . ommussion Act to beaDeluded In the ad-.. (4/ the courts of.the United States; and "(C) a. eymbol ea pteeeribed' D7 uLO SeDte- T~ffimg,of suchfood•' f . .,.... (5) ttlegevernmentsof theterrlturlea and. ...YarpDytegnisttna.toaigptfy'ttiePreeenceol (ti): The Chstrmaa of the Commisemn. PosaPSeSOaaob.the.IImtedStates:. . . an artisetal flsvor er color.: . . shall report annua¢y to. Congxeas on (1) any.-(d0 the tetm '1"ederal . fbdllty" meaea- -- mommrndattone msde to. the Commission. -(1) aay building• InatallhtlDn, . ot fae111tq . Tntae extent that eompRamewit9rahe re---by'the 9eeretery mider subsection (1). . (3) . - owned-by. theIImted States, eacepting, prl-q ofsnDP~4taPi>`4~)--iatmPraoti-Ln'those: aLtcstlana-where the CommLSaionn vareresldencl2a,.or: .-cebleor would. rnult: tn dwepttoa' or unlairaeeepted a recommendation, s deecripmn .. (2) any part of'f any other. Uulldltg. Lnstal',-e cea[petnio¢, the Sec[atary shall by ieg~sia-of_ anr actton: taken to Implement such rec- lation, or facility, which part lsawned or . t1o¢PresalDezaemptianaEVmanrh.raqahe-.n ommeadatSon; and-(3p in thosesttustlons: leased by the United Statsa•, ercepting'.pr1':- ^ Meate ~' '~~ 1 nt .. ojhere tne-Comml.w]om failedd to, accept. Ia, vae: residencies. nq (Q) :These~ondsente~eofaeeKoa40g(k)wha]eorm.part,.a.reeommendatLon,ade-- ... irre¢}~~i}{i~""'O+ - . Sr~ 405. 'ThtsPart shall take eIIec[ ainety ) 3ectioa408 ias.meaded byaddfag atter (c. ParagraPa(P)ehelDLlowlagnewparagxaPh:-PROGRAri15 DESIG"ED~TOyaafterthe.dateafenaetmentof'~thla.part. PROH2OTE HEALTB: THROIIGSi. SEIIOE-'-(q)li)~IfiSteafoodforDUmaaeaamtmP- INGn~,r,p ~ Puat HI-Sez'aat.rsaa¢tar os a Hcaa Pao-. . . .. . . .. a. T.- . . - Desnpuch.nnaittaa-lIIformation reiatmg' PacA-R.toarraom:orS4ounra,nrr'e"ssau..'Sq.408: (a) Subsection (b):'of'xection. ...-to the food as.:thei Seerctary byiagulatlon . . _' Pecn•rTSS -. .- -' .. - 5701 of:.the iaternal Revanue Cbde'of-196L j.. preserfbeas to'p[ovideo health Lnformattaa to '- sraxatcnoNa- oes®eesaNanr r>mm0e. (relatmg, too the rate of: taz on, cigarettes) ... .>consumata including at leaat thee foRowmg: r.~ . . .. . .. -'>m. CMWn(ftd to readd sa. ftlllown: . - . . ~ - (b) ClgaretDSS : sa481 (a)LftiddD td '(A) the totall number o calories anc..~xcepaa<proveIxt sueec«..,-- .. •. .. . . grame per.servtng,. . . ... . tlon. (b)', (c)~ and (d), emokfng shall not be"(1)1lsrosrrmx or sez.-There ebali be~ . 60'

c Mau 19."1978 - .>• - CONGRBSSIONAL 1RECOBD-SE1,`~LA'TE l _,; b :7869 lmpoeed,on everyelgarette manufactured Ih tb.e.Pederal Clgarette tebeling. and'Adhertfa. tlom and.d evaluatlona underr pargaraph arlhiported mto:the IInlted.Btates, regard- Ing Act (Pttbllc I.aw g9-02) Se amended to. (a).(7)s thare:ara.authorfaad.to. be sppropri- " ' (i tlie ffacayearendmg . R. '--leee'otwelght,whichcontams- .. readasfbllowe: ated i10,000',000 for ...•(A)i 1rom10 to.199 tonc unlta„ a healtli "Sse., 4(a).. It shall ba unlawful toe' any8eptember 30, 1980, 430j000:000 for the flecal -~rs: .. protectton tax of:80.0025: - . pataoato manufacture., Smport, or paekage: . yasr endmg'September 30.1981, and a10,000: +br{,..• «•(B), froml0 to,29.9 taalcumtv, a hesitlt for saleor dlstributlann wlth1n, the IIntted' 000 forthe:llecal,year ending September 30, c•:• . protectlontaaof.80.007b; 8t++heeanyclgat'ettea- * ,1983. . . (C) from 30 m39.9 toxic un3ts/ a health (1) If'.the package for which fails to bear (3) Pbr the purpose of making paymente r,qs.y . protectlon taa. of' $0.015; and .. thee tar' and: nicotine eoatent of such clga-- forgrante under. psragraph (a) (a), there , aGiL- "(D). 40 or meree tosle.unlta,. a.health Pro- rettee stated 1n m1l11grems, and areauthor3zed tbbe appropriated $10,000,000 be e 3 St' th § f hS h f 11 t 0 ° ) epac age or w C s s o: s . a . forthe asoal,yearendmg Septem8er 304 198 ( ,:1`;'_ , .. . tecUon tax ofS0i0S5._-. t f l t ol bwtng:eta emeID e: a10,000:000:for the Oscs1 year ending 9ep- . "(9) Daramnosr.orxoxtc mvtie:-Fbrths aaeof, tha Vrplxee of' subeectlon (b) (1) above, the "(A)~, CANCER MAYB.FSIILT FROM CIOA-, tember 30, 19g1„and 810,000,000:for the fiscal . D ., REPl'ESMO8IDIR7: esr endln tember g0,:1985:a'~at~-:: avmberof'toanunita'meansthesum~of- - 9 g'.SeP •• ('B):. CANCER OP T8E LIING9i 1t9OUTH.. . P.ex m~amm~. es He.anxa Hneas. Asae" '.. . ..•n..~ en.........lur nf, mfllemsms~ M'~ ,f.r': p~ - .. . . , _ ~u.L .m.a.,e.~.l mmi a..o,l vLl r.ww ..a ~y.y.m, Wira St[ca:IIrto Crasaal•rea or .. -: ~~. ..._......., u .v . u .u.~~_..., . HHITHSMOffi'IR3'. . .. . ~ ... . ~ ,....- ..._ ... :-geams of'aiootma'. which are aonta(ned m. ..l'u1: nr~+vi a+a6Aila. ytaa. Wtva. s~eranera Cosnrrox~.e AnDea ~ ~ 3bfOHING: ••.-t1 ~ -suchotgantte" -~ . ..: . . FROM CIO - - ~ ro Co~s M.xnraeream. Crc- =S: ' .- °G3) Daraxmaenoer or Tes uva~. ntcorare °(D)~ CIOA v.`+"v° SMOKIIfG~LdAY HORT~ ~ eyC1,r~ - . .._ .... .: -.. . . . YODR.~HEARTf . . . . °(A): Testing by Federal Trade Commis- ($)' EMPHYSEM.1 AND CHROITIC SRON-.'_ - gra. 410.. (a) The Secretary ofHealth: Edu- '. tl d W lf d L hall a4.an . e ars s roa ue , or.arrange . . elan.-The Fcderal TradeCommleslon: (here-' ~$' ~A~ ~~•TFROM CIGAB.EITEaa r ..laatterraiecradtoeathe'COmmlasioa')~shall SMOKIIiG:._:. - fmrLhecoaducf~ol.sstudyorrtudlas.of(1) _ ' the rel'stlve health: rlsks. eaeoclsted'Wlth 87T8 8M0ffiNGDDRIItC} P CIGAR " . . ) ( a ' from tlme m-ttme (but at Ieest.oacs eac lavelaof tar em°k1a6 cigarettes of°u}?lag.f PREOHANCY: MMY DAbfAGE TH6 IIHBORN oalendar year) determine Or cause to be determined the-Lar and nicotine content .CBD.Dt. = ' and.nicatme.nd.(2) tHe.hesithrlaks:aseod- -'•(G), YOD OWB' YOUR BODY SOME R8- . ated wttbM ataokmg ctgarattea ooutautiag any ' gssme per clgaratte) of (eslavlated Sn m178 - SPECI'-DONT S3iO8S: eubstsnua'cammonly' added toCommerCl9lty each brand of dgarettee manufactured ta manuteatured clgarattea. .. or, hnported':1ato the IImted Statee.. Thee aon- (H) SMOKERS COUGH IS A1F- EAHI.Y '-dltlmm,., methndai, andd proeedurees far eon-SKIN OFLUNO DAMAGE; (b)i Within two years of-.the date of enact- dveting' such daterminaCann. eha¢ 6ee pro- "(I)' yP YOD. MDST SMOHE: 219 aae maat of th1c.Part, the Seeretary'shall'repart t th C th lt f th d ' o e ongreses ee resu es o e etu y ~ mulgated bP the COmmisslon la. tegulatlona., ISOHTLY-TBIS MAY REDUCE THEM38H8, or Ieeued.by It.for purposes ofthia.paragraph. TOYODRHEALTH: studfea: candacted pursuani toanbsecnun , ~y 'Linttl sueh time se,.suc11 regulstlons.arearst -"'(J) DOlrr SMOKE CIQARST284 TO(e•) and anyreaommendatiooa.for legislative leened, theconditltons,e methods, and pro- THEEIPD-THISNiAYHSDDCW1'HE'Bd$H3'.i^pr.admlaisixatlvesctlo n. ceduresfor conducting such determinations TO'YO'CRHFiALTH.".. .. . ~i+~ miseton . - S.. 3118' .. . . db th Cc hall b h e m s e L oea aPDrove y . the (b) Thee ststementa requlred'by suhaeb- fm formal ~ tment which '. Be It enaeted by t8.eSenate and Hov.< oj dateofthe nace of are: thls m effeet aa 'aubsectlaa. L1nn (a) ahsll W:located m ecanepiwousBM~eatfaes oJ the IJnfredStates a/ - plece-on every ofgsrette Packsge end.sbsli America fn.Con9ress easembled:. '(B): Certification tbthe Se¢etary. Dur- appear in conspicuous aad legible type m' - 1ng,the last mlenaar Quarter, of each calendar aontraett bytypagjaphy, Iayout,I and color -aaoas.. m7a: amaaxra :o wcr .. . :. year: the Cbattman of'the Commisetan shr11 wlth other~prlnLed matter on thePackage. - 8carmRI. Thle Aat may' be cited, as the -_amRftyto theBeaetary'the tar and ni'catiae.(c) Clgaretts, shall: be packaged 1kt eale. "Pormulsa.nd Projectb.Granta for Preventlve content.of each brandof afgarettes.msnu-- or. Eintnbutlon.ln: suph a-manner so that Health 8ervicee: and. R,eaources for D7sease - - faatttredla'or lmported- mto-tlie United. each of tlYastatemeam zequlred' by Psra_ FrevenRion md Health Promotion Act; of .. - Btstea~ Suchcertmcattons ahsu.be used by.. graph.(a) (2) appeeeaon 10'percentum of a8_. 1948'• .. - _ ,~. . . . ~ the Secretary todetermineo the rate of tax: cigarette packagea . . .. .- T1TL8 L,-POR'MOGA -dND, . PRO,Ta'CT ' to be Smpoaed on algarattes. for the period. PaBT D-SersaussruaaiPr oT Paoaaaer .vo.': GR.ANTB~.FU$: PR.EPELTyiQ6 HEALTH b g!*•^g with the drst day.y of tha calandsr .. Da'lm.Sasasaro Artoao Csm.aaur eem SMoICH9',- .. . : yesr tib+~e;~~~ ~~~~~ afterr sucb: certtflcatton ls. .. ' .. '. made, and during suoh calendar year.. Sac.. 1'01. Whenever m this tttlee an amend~-. '. .. °(O). The: Commisslan aad'.theSBCretary-' .Sac.409. (e.) The.Seoretaryof Health, Fdu- mentla expressed m.termsof an'amendment shall Promulgatee reguSatlons.s forr tliepur-& catlan,.tud. Welfare, atter cansultatfan wlth to a section or other ProvteLm, the reference poses of teetlag;eertlfying, and haposing'g appropriate:publ6c and private entltle9„ahsll ahall' be considered Co' be madeto a. aectmn . . taxes under thia': subsectlon onn new' beande ' otsbllsh a comprehenslve program designed ~ A~ pruvLUon.of the Pubhe Health Sezv- .. ' Af~clgarntteamLroduoadforsale:•': .-to.detersmokmg.among.chihtrenandsdolCa- . ... (b) The amendments made bysubsectton cents:SUchaprogrsmsballInclude-".. roaarm.i'.oa.trrs roa.esavstartvs metza! - (a)') shall apply to elgaretteewhich the maa-. . (1)' the undertskingor aupport (through ufacturer or.importer of such cigarettes re-grants or contracts or.both~) of bmmedlos0 -^ See. 102.~ELeetlve October 1,.1879; tftleIII movEe. (Wlthln themeaning GI section 57012 and behavloralreseareh~deslgnedto increase fe smended' byaddingefter sectiop 314 the ` ,' .(k)ofsuch Code}wlthln 120.days;.after the>- vadarstandtng of thee biological and be- fuilowing9 new semlon and.heading:thereta: -dste of eaactment of thie part+--" .'. )lavloral determPnantaof' smoking among --,yasacur..: osnmra ro sr.axa. roa~ reavauaave l i d h f Th - e t (a) e Coutm ae on .sn t e S ary o .: ahlldren and! adolescents, tvith' special am- - - cre - the Tteaeuryor n1s delegate shall promm-phaels on children aged,l3' or balow: ~ •.~:'.. sravtccv ... - e'f01(b) of. LISe.Iatemal Beveaue Cadea1 ~~ g,i yn y33 or contracts orboth)r of demanstra~ fD to 9te.tes.to asefstthem m pisIl°1°g the emta..s of. for anQ 1a roatdm . meatm - p g . .. 2954 wit]nn. 00 dayn after ths dateof- Llla tfona and evaluations oftamprehenslve com- g, enactment at tbls.part-._.. . .. :' munity and..schaal:-baaed programs designed '~ntxecty~ arbothwltn Pubttlenealth: s~thorc .. Sac..409. There are authorized tobe.'ap- todeter~oktagamong:.chtidren,and.g.doles- lttee of:pollticai..subdtvlstona of the.staces, proprlated for the fiscal. yeats ending Sep- : ceats;'and. - . tember30, 1981, Beptembar:30,1982: Septem- (g)i granta, to: States: or politlcai aubdivl- other-publla e3tittas.. or prlvete entlMeal . ber 30, 1983;. and'~ 9eptember 30', 1984,o thoae: alons of.States to saslst them in meeting the Pr°vbatlve.aealth servicea amount!' determined by the 9eeretatY'of tneoosts of. operating comprehensive coolmuL secthvn r(a) ~aas an application Eheretor .. Treasury to, be equivalent to vhe: tases re- mty orr schaol-based~ pragtamss designed to hae been submitted to, e.nd' approved', by. the af` tha Iaternal ReveauedCOds eaofa 1954 (for deter smokmgamong ehlldten:. snd.d adole6. Secretaiy. Such an applleatlon.n shall bee m thepurpoeeofmaking.edditlonaf.paymeateeoata'. - -suchformandbeeubmlttedmeuchmsmer . to the States toasslst.them.ln meeting the (b). Wlthrespeet to.o graatn underparar esthe.Secretary.sha8 by regulation preeerfbe costs off provldingg preventive health sercieesgmPn' (a) (3)'.. tae Secretaryand each grant and shall provide (other than man applica- . a lloanL and Yacl la t t l lth Pp p u mus Camp yw Llan far s planalag gfant)- uader'seetfon.315,nt ttiePublic Health Serv- ' IcaAet: The: amount of payments kYo the' the provlsloaa afbubsectluna (ib), (a), (d):, "(1)r for a detailed plan of a program States shall be determffied, on aa perr capita (e), (f), (g), and. (h) o1f section 317. " designed m: reduce, through the prlmaryor basis provided that only those 5tstee who- (c)(1) : For thee purpose of makfngg pay; eaeondsry preventlon uf causat7ve condltione• ' are recelvblg,granta Ynder sectloR 335(1) (2p mentator taa undlrtaking ot 4upport of re- the mortality nste fbr one or moCeot the of'the: Public Health BertM1ce Act shall beaearchunderpazag<aph.(a) (',1)„thereare sn- IIva leading'esueea of death mn the State, . -' (2): the amount of Pederati, State, and . eligible to receive paymenteunder'thlseub-morized, to, be appropriated a10;000;000 for -sxilom ' . . the Oecsl year endmg..September 30, 19806 otherr funda ob11'gsted by the State m tta-. . • 000 for the tlscel yesr'w ending Sep latest'annuai eccounttngpiod fon P+ux C-CasrraaaS ar L.aat.ara roa. r'•=...+.•.+ $10,000...-ern the pr- .. ~sem. .. .. tember 30, 19B1„end 110,000:000 for the: flaral vleioa:. of esonn program described In pars- . , year endlag eeptember30,.1981 . __ gesph, (1): s-dearstptlon= of the preventive ' Bea• 408-(a) ffieeLCre one year aftar, ttle: (g): Por the puapoeeaf making payments . health eervhxe provided by the State in dateofenactmentof:thbparE,..Sectloa4.a( fmtheundertakmgessupporCafdemonatra•..aachiuab.p[agrsm ..laeuchperlotl:the - q (~p~~.~a,.vQM1/iFi~ VJ ..::~' .. " .-. .. _ . .. ._._..._. . ~. ..~17!'r.~~~~~.~'.. . /l

May 1s; Z9x8 .. CONGRESSIONAL R,ECORD'-SENA'TE s.7ss3 tlon program untL'we complete our re- deaths,lneluding 20 percent of- all can-rettes..inhale them more deepl,y,., hold, ..vision oL the Health Manpower Aet-. cer deaths-. Itt found that cigarettee the smoke . fn ttteir Imigs longer_ and ."' 'rllethlrtftitle:of:tlte.act.isa.proposal' what the National Disease Preventtoa bythey eontinued recommendation. of 1ts: mtd-pointL andshoul& be completed be nearJA lhcomprehensible: Shepcal!i- cigarettes tendto develop lung cancer ~.-. tp the end of thiacal'endar.Year_ ~~ for. dramatte: and flnm aetion... That iss and'd heart disease less freauently,, and lBteaeftgures.are so staggering astoIogQc data showing thatuserso£ ter ~ thei7nttedStates.That,reviewis.now at. i"eal,research and.its role insupportmg a ity_.It,noted thstl~S15~billion was spent~_ may not be altered through removal of natdonafl prerention progiam until l the~- in 1977 on smoking-related.9llness, near-.- tar and~nicot3ae. .. ..: ... -.. . . ~- ,..,., sulicommfttee.e completes Its review of: 1F~ 30 petcentt of~f totaI, personal health. -. Whlle.recogniahig~these uncertainties;. biomedical and behaviorall researelhh inn expendltures: ... -~ ~.. . .~ I am•• still impressed' bY' the~~e eptdemio- fll ' -~4 Wehave~deferreddealfagwfth'~bfomedi-~ lies,:and~maternai'~and.neonatal~mortal-~ ard.assoclated wlth~ these eonstituents~~ ~~ - ~;...3econd; it does not deall with thepo- -smokiagg caasex3U'.desths:perhour, onee smoke them closer to theend-.There is, tential contribution of- biomedical' re-'ifeath every 2mfimtes..It concluded that aigo growing evidence that othercon- ..sear7h to pedecting.our skillss forpre-ct$arette smoking ia a malor cause off stttuents of snmke, besld'e..tar ant nlco- Rventing disease andd promoting, bealth: low-birth wefghtinfants„ birth anoma- ttae may be.har^^ol, and that the:baz- `-" formodiflcattons.in the Food. Drug..and and.HealthPromotlon Actof-,1978'pro-the. American Cancer Soefety' that'con- A,n.ric.,, consumer has the informatfonn antismoldngg esmpaign composed ofthe: rettes low iu tar andd nieotine: It seemsheneeds to pian a healthydiet consiat-folllowingkey efements:. - :. too me;, therefore, that encouragingg the. '. Casmetie.Actafined at msm•ingthat:theg poses. SPeclfl¢atly, theact suggests: am _sumers.be encauraged to smokeciga- . lndfvidual neerlsands tastes., P1rsGAnmSorPederalimtfati7eaimed •O^s,•n+ptfon of. "less hazardoua"ciea- his ~ 'c: ent with _ . : .We expect ttiat manir Statess will Provide at . the prevention off smok4ig_ among.g rettea is. a. ressanablee and viable short- . urtfthihfldStfltfAmer thte6y For thelonae term we .~':-natritfoaeducatfonaspaoercom-.. cren-..eveny-veperceao-erm sa.. . _. +~'-4"'-- prehensibe prevention plans. But- such. oans etartsmoAing tieforettieage~ of need to raPidlyfucrease ourknowCedge•. education is of littlebeneflt if.consnm-. 2L Saroking. amon8 teenage- girls, has of the health.rlsks assoiyatedwith amok- . a'`;'' ,eeaeannotiearattienutritSonal'.contentreachedeptdemicPraWrttOna.ThePer- ingcigarettesloa¢iatarand.nicotine. ofithefoodstheY commonlFPurchase. -centageofe smoltuig has doubled since.It is for that reasdn: that we ask the r•cai:.Z,. .. The Natfonal DL4ease. Prevention..and . I98& .. ... -- ._ -> BecrctarS to.lannch. an Intensive Inves- HealthPromotion.Actproposesthatcur-Seconit.Zheibstttutioa.ofa,revolving: tigattoa oftheIawtar and nlcatine._ ~-ren4foodlawbemodi+e.+torequfrethat Iabeltcteplace..thecurrentwarmmn4onl strategy and to report back within. 2 •all~foods.td.theestentfeasible,.display..cigarettepaclmges-Theactwonld.spell~ yearsWtheCo . theirrvntent of certain maior nutritionall. outI0. new labe]a one of which would~ Scliss elementx.,These would.fnclude,at.a:mfh-haveto.be afHsad.on-a.random.basls to.theNational Disease Prevention ana imum. protefn, sugar, carbohydrates,.fat each cigarette paclage. 7R1e rationale.. Health.Promotfan Act.of I978,, SIr..Prea- (in.*.niro cholesterol and saturated: basedone=perfenceinWesternEUropean ident, L would like to~ make one impor- .. TuAeti anA eslk. Thia information.would corm'FaiACi6that':more'informatlon:call tant nointconeerfdng the admi1115tr8-. ~ have to, be displaYedd in easiiF~ under- beconveyed if the labelws change . andd tfon off tms~ faw: 'iwo years~s agv; u.e atandabl'e:grapform,and:labeLswould , that~.eansumerrwill~noticethem.~more. ~ConBrrss enacted Publie~.Imw 94-317,,. aIDegatforL Thoogh.the tobaccomdustry.._tu-uapoliuted mdoor_air. The: Federall Weare.notrepealfng.Pabliclyaw94-317 theafngl'e greatest preventatile.threat to~ beProtected. ag,ainstn the isritatloan and'ventionpol'keY. -_ '.. . ... .. .. .: our.Nation's.health-Iwill'notelaborate..Potentlal.barm.asaociated.withe~iosure. ' I.hopethelawyrearepropostngtodaP onn thesdentdfic underpSnnings:oftbis-n too cigarette smoke- Theyhavea right will end that situation once and fur alt. ..donotthink2eaaggerste,.Mr.Prestdent, children.. . -._. . ..-.... .' -:;. tendedrote;andtheFederalGwernment whenTsaFthat.cigarette-: smoklhir is. Secand_ nonsmokers.have a right tocontinuea to.Iack any meanmgtnlpi,:- ~flgtloIv o8 ourbfilL Mr. President,, thehabit'e is imtiated, we propose target- tton and HealthPromotluaz , has never f contains our antismoking proposaLs.I mg. on preventing' Smoking'amongg been permittedd to function in itam- the groundwork-. for whatt we are taday' Flrst,our primary publlb. policy ohlec- - Congrese hass never allocsted, more than Droposmg,, and I commend h1m forr his tive mnst betoprevent smoking. Since-'asmall fraction of what was authorized. ~}({~at„ rNe -.~ - - deterrence Is most easillr achieved before Asa result,t the Office,of Health' Informa- ' aiycosponsorship-His'worklaidmnet.o£restis as tlie.follownig.basic princtple: istratlon has never reqnested:, and.d the ., theFoodAmendmentsActof 1978. whfch....thebases for these Proposals, Mr. Pres1- Ia,er 94-317...Themoneysauthorized'.un- .';. was.Introduced liySenator Rrcorrwithv deat. 'Yhe act'santi9moltlng-, Initiativee dertheIawwere.paltry, and the admfn- : I)rvg Adtriinlstrationn authority over thee cigarettes in Praliortion totheir tar: and•HSic! -laheltn8ofafcoholicbeverages. .. nfcotlnecontent;decreasirigtliecurrent ThenewO'IDeewaafntendedtoserveas. ' I:shouldpatlntout,194t.President.that: Fedesaltaa.forelgarettesverylowtntarl afocal.pofnt:forhealthPromottonalac- these_foodlabelitigproposalsareinmany_ -andnkwtine: and increa4ingthe taa.for ttvities:m the Federal Government. IIn- ..respects:.merely amodlfieatonand.ea-a thosevershighci'nthesecoastituents_.-.e fortunateix, a series of' problemsm has. - tenslon•:of ceatain, provlsions ofS. 254% . -.. . t: willl make just aa few-w pofnfs aboutt frustrated the imp>ementationn of Public , well ass thee qiiantTtyfn- gsanvss of eaci>: In: Intastatee transportation set aside- eral authority' to, msGttutemany of tbe eonstltuent contained in such asetving. - armswhere: nonsmokers ee.n avoides- programs we aremlW'Proposing. It also The act. also - proposes cartaia minor posure to cigarette smoke if theychose: created an OIDcee of I{calth Information modtflcatlonsiningredfentsIabefingptro-. Pourth: Theinstitutionof-a.Federal'and Health Promotion fm.the,Office off andwould give the Food and health Protectian taa which would'taatheAssistant BecretarT of Health in vistons ;. eaeh:ofthese.element'seontributestothe 'Yhird: A.reqimement fen: Federal lawmationw andHealthPromotiorr Aet of ; totall calories iaan average serving; as thataliPederatbuildingsandallcarriers1976. That law gave the SecretaryGen- `-- have todlsplaF~ the~~. Percentage~e which if~theircontent varies: ~ ----~ the National Conamaer~ Health Infor- . -mnttnuee--against alll the.evidence--to -Govemmentt shouldd make sure that:. because its mandate to~ the.. Secretary n -1 :. thtssuHfect was conduoted.d bytheablV-meffectivey the. Federal Govern- However, that feavesunclear the fate of '-Amerleaa Cancer Society's National.-ment has everyrlght to decrease: thee the. Office of Health Information and .- The most recenti sclentittc review of Ing' wool@ be Inappropriate and-prob- tion and HealthPramotion Act of~ 1978: argue the safetyof cigarette smoking, withfn.lts lurvsdic_tion, this right 1ss pro- provides an.n approBriatee prasmnin, Sor few;if any,: self-respectiag•scientistsr ortccted- - -- much of what: we Iiopeto accomplish phvsiciansinthiscountryagree. . 7'hirdlthough.banningcigarettesmok- throughthe.National DiseasePreven- :. vaareL.ted in 1977 to.m.orethan_320,00o aumers may smoke- more of tiiese ciga- Oa'c pmpeeed propaa.tawltp,ap,s3r Commt unn on. SmokingJ and puYlic heaSth haracds of smokmgbyusmgtasHealth Promotion. .. ,-. :.. Polir,y. which reported ht.Januarp 1978. . Inceatives too encourage smokers too use. Mr.. Prayfdent, we have specifScally~ '..-.'Fhe Commission found that "cfgarette, eigaretteslessiikeZytoharmttlelrhealth.s avoldedaddreeamgtheadminlstrativels. ; smoking remains the, ]argest.t singleLamawazetlnGthereissomedtspute snesrel'evantto.emttvganatlonatpre- nnnecesaMyr andpreventatilecauseofoverwhetherlow!tarand.nlcotinecig- ventfoaprvgrans eothattheSecretary .. 1Bhess and early deathi'•. The Commfs- -aretLeas aret'wly lessharmfuL Some might enfoymeidmmn fle=ibility ih ap- .R slau concinned t}ate!¢arette. smokiag'laborator9 eridence Indicates that con- proachingtLedt®m ttprrobtemoinvolved.

S787q ~" CONGRESSIONAL RECORD-SENA'TM - May 19, 19 78. ~ amolmt of Federal funds needed bythe State- Statee with an. approved applicattbn und'erwith thisseeEtbn as:the amount apperopt3ated' ; ~ to continue provlding. auch egvtwm saah -subseetlon. (b)) to determine If the prugram-under subaectioa (1) bean to the amount ', sudEprogram:'.Iftne.State.Propoees cbaages' or erogramss are operatlag, effectlvelytoy needed too make grsnta'.ln aecordance wttp in the Provfston.of'.the aervtoea.maay such.. e.ehteve their atated puryoses., and It't thethlssaetionfor.aueh.8sca1 yearto.all States. _ . :: program,. the ytlorltieaof suda. Ptbposed Statecompaed with the saeurancee'.provitled"(e) Eachh grant under sobsectloa. (a) -" changes;, the neasonsM for such ehangea, and,: - with the application. The Secretarp ghall. yhall be made for tvats for preventive healthh the amount of:Federal funds needed bythenoty approve an application submitted underservlces Sn theone-year'period beginning on ~' State to makesachchaniges: . .. subsectien.. (b)unlese the Secretary deter- the fle'stt day of the&ste monthh beglnnlag .~ -"(3)) foi, at the optloa,of the. State, s de.-minev'-. . .. . after the mouth Ia.whlch'the:graatte made:. '. tatled plan of a: programdestgaed to reduce„ .. °(A) that the program or. progranm. are. Paymeatss under such grants may' be made. -- thxevghe the pdmaryor'secoadhryprevea-operatmge8ectivelyto aohleaethelr stated! m advance onn thee basis of estimates or by ttoan of causative conditions, the burdenn of' pur . ... . Sllnese e.tmnclated wlth the aveIeaGL'ag.causes ~ g1 ~ that the State prlor _ a thee way of relmbutsement, wteh necessary . . . ed. ~ assur_~)ustmenta aa eccouatt of underpayments of morbltlf .~ ty in.the 9tate; ~~ 'provided.wlth, a Dp overpaymeate. aad In.. suca. Instatlmeate ` .'(#)) the amount of Pedetal. State, and- _mittad under subaecaon. (tl) , and aa3. on eachh terms'sad' conditions us the. ~. ~'otller funds obligated bp the. Srab'mIta '•(C) that he.la.amurad that theStare. wIIl.. SeoretsrYy ande: necessary ta..earrpout the•'. - lateetsaaval accouatiag Perlod'forthe.pro-eomply with the easursnceaProvlded-w1thpurpasea of such grants. .. .1' .....Ia;. vision ofeaeh, program dticrlbed in Para- LheaPpllratloaundercoavlderatlon: .. '°(e) The Secretary. at the request of graph (3)y; a deecrlptlon_of the preventlqe ` "(O) W,baaever the SeevetarY:,after rea:wn-' State which Ssa recipient of a grant under '. health serrieees provided by theStata In each able notice and'' opportunity tor:a ]veacmg te, subaectlon (a).,, may reduce the amount of. ,_ . snd1. ProgramIn anah- pmod: the. atnouat the.State, Hadswlthsespcot tnfunds:pald to. auah gre.nt by-- . --of Fedetall funds nEadM bythe. Seatetb . it under a: grarlt-undes subsection (a),.that', - ••(1) thefaire market vaSue:of anpenPpuea. ~' aontSnue prondtng,audrxxYfum bi eaeh the program or programs arer-mot.operating-:or eqmpment.PUtmsIIed theState, and. . - ,..sueh.pcvgc®m:h if the Statepmpoeas..changes effactively toachleveo their stated Purposes". "(a)the) smovat of the Pay, allowances,. .. in the provision of'f the servlem. fan any ettch ' ar that tCere is faHUrbto, comply eubstan-- and.travel' expenses of aay omeer ord emPtoyee . : program,-the prlorities.s of aueflh proposed tiellpwlth, assurances provSded ander sub- of-the aovernmenE. whea detaIIed' to the . ehanges:..tho-reasuns.foreuub.aLSngea:s.ntl, sactlna(b} with respectto.tlfe reoelpti of' Stateandthe.amouat.of'anyothercosts.fn-.. ' t+he emount of', Federalftmde needed bythe auchgrant, theSacretary shall notGfT the curred 1h- connection wf.ththe_ detalt of. . State to make.e such..ehsbgea; , -Smtethat furCharpayments - willt not be, auch e[6cer or. emPloyee., (5)that the: Pians. dascrlhad. Sa- para- made:o.1t'undersuch gran9(or In hffis db- wDen the, f,•^^/-_~"leg ofauch euppllea, . or. . ,.geaphe(l)'.and(9)- : _.metloa tllatftn•ther.paymente.wlllt be re-...equlpmentor the detall.of such:.an omean ... (A) sliall dasetlbe. a..MT~r,T *~~e* pro-- dttead), nntlLbe:ls.satllsIIed thsuthapreqramt or employee Se'.far the convemance-ol and at' ..: ventloa Program.wlti:ch utlllaea, to.theez-.o or.prograuu will operate eHectlveiFor theretherequestof.euchStateandfortbepurpose- ,-e tentpractlrable.aRrelevsntprofeeafonsi.dls- yillimlanger.besuohafauure.IIntllhetsao . of.pl8amagp r esrryingout a.program with. ' dpllnes: - . .. . _: ._ satisfled. the Scrzetary aWll malce, no psy- respect toahlcho the State grant undersub-.. . (8), may, atrtheopLione of the State:, de- ment. or: in htsdlsetetios reduce Peyments eecttaa (a): la made_.'Eae amountt by whlch. }..;ecribeaProgrsm'ocprogramsthetare.tar-'tothe.Stste.fromsuchgrante anFSUCh.grsat'1sso~reducedshal~l.beavall-. .. geteditoward a Par.tlcvinrr age group: .. .. able.e for payment by the Secretary of' the . . `(C)shall set fotth quantltatively the "(d):ClJTha. total emounL.t oC grautss n-. eoeta mcuaed in n...,i_ F er.,s the eupplleeor. ' eurrent relevantratesof mortality and: where oelved.d bya. State undersubseotton (a) to equlpment, ur.ln detailing the peraonnel',n oa. - appropriate, ofmormdlty, tb-the Sffite: aavat, States-in plaanLtg" for preventive which tbe.reductlon of euoh, .. . "(DY, shall seE~forth.the quantitative goals healthseralcee'for the.Lseal year.ending Sep- and:aUCh smovat sISBLL betl Mtae yeTtof. .forreduction.inthelelevantzatee-ofmorta4.tember39,.1980sball.be, determinedbyithe thegrantand.abalUbedeemed'tohave.beea ,, ity affi,. wlieree approprlsfe;-oLmarbldltg in. Secretary; errepc:that it may hot beles thaa -psm tq the. Stata. ` - ,. _ rifesLafe: the.product.oi~aao and thepapulatJoaof.the . _ • . -; - '('S)ahall) have a- sepamts. Leslth-com- . Stete:. _ . __ . .. . - _ . ,. ~"(g)(1) ) .. unde'r sobseettoa, (a) snaLLAkeet_ munlcatlans ccmponent in ttie.prageamor . "(a)Thetotal amovat.of gtautsrecelveµ Fmt p' ..pcogtame whirhshall lhdude, butt not be by a: State under subsection. (a) to aaust recortls as the Secretergehallby xegulation ... limited to, a description of.bow the com- States.m.provldmgpreventlve.healtaaervlcea Prescram,lncllmmg.tycord3wh:ich.fullydL- . :' mumcatlons: medls, indudmg the. eledromc for any asral year sliall be determined by, the cloee' =ae amount and dlaposttion by such. 9tate:of the proceedbof euch gtant,, tbe.total.. .....medls.w111.beutlllsedto.eEeatu8tet1ltrpur--Secretary.excePtthaEat-' . :..yoeeeotthepsogysms:, -.. :. . . . . •~(A),maynateaceedttle.lemtero[- . ... cost oi the undart•k~^^..ut conne¢tlon wlth'(F) ahall idantify a spaclHc lnstituttoaal "jl) the product of.8.75and.ttie population ef t~by~~ ~E was mede' and the:amount~ ~~ Rortlon eatity Inn thwr8tete that . at will bereePomllile of the,State, or - . . , ot the oosE of: th9 undertak-. ' for enoamp't~...=e~ ^~~ througllh matzaera- with - .. : . ` . ' . ~"- - ~g supplied bFOther . aourcee, sad auch other "(h) in '. . thee case af tha. Eeaal-year ending records as willl fadllYate an effective andlt. privata eatltles andi other means the- re- . _.SePEamber30.1083.5-perceat af'the amaunt "(a). The Secretary atW the Camptrallerr qulramtntes of P%ragraPn' (E);; and. . ~ of, State aod_lbcal espendtpuee, for preven- Cexn} of.thaIIatted Statea,, or any of tllalr.. .-...' •(C1)) ahall rnntain.suChn other tnfcema-- tlre. health servloaT. nupportathy grants -duly' antlwrf2ed~ repre6cntatUea, sas11 have . tloa, aa.EneSecretarymaF6yzagulatlonpre- nnder subsecttoa (a), witaln the Stata. 1a . accereler.tae'parPosaof:andlt.and'.essto+=d- '-sentla:: .. .. .. the, Stata's, Sacal year which endad.. oa or f1oan manp baalo,:. documenrs. Papen: aad. - -.(8): for emuranaea.sat7stsntorT to, the'beforeJuly1.1981:.anthe-case.ofthe8anl .racardeol'each.Statewhlbhlsaredpientof', .. ' Secretary that thepreventlve health serv- : year endingSeptember. 30.'.1983,.7+/i percent a grant under_subeectlon. (a), that', are per- .- icea mhiohmtll be provtderl wlthfuads ua- nf taee amount af sueh eapendlturess ln the tlneut to.auchgr.nt, - der a grant under subsection (a): wtlli be pro- State:'s.fisral year wlilch.eaGed. ea er, before ..•. "(h) dll Information obtained about any . vtded.m a.manneroonolatent with theSte.te ?ulY' 1, 1082; and, mthe caseof the fiscal ..IadlvlduaL.under any Prograbtthat 14 betng, .. - Ilealthptan.m.ef[ectuaelerseettoa.1534(c):: year.endivg.9eptembet30,1989, 10:pereeat oyrrtedout.wlthageant:made.undersubsec- -(7). for assurances satlsfactory to tae of the amount of sueb, espendlturess m the . tfon. (a) 9ha11 not. wtthout such mdlvtdtul's ~-Secetary'that'the, Statewlll Proalde for -State's9seal yearwhlch ended on.ex-befora couaent, be disclosedi ercept: that. (1) auch. .. enoh,LSeaI:control and fund accounting pro- JulE 11 1983; and - - lnfotmstiun maT bedlsclased. without such - ceduree ae: the SecretarYby regulation pre- "(8)~ may nott be lesa thaa~ theproduct aonsent iftheplsclueure SS necessarytopro- . " 'acribestoav.suretheproperdlsburaemaatof off.50iand,the•populatlon'of't1leState-. vtdaservim tu9uehindisldual.orls.required . ' and accounting for funds zeceived under '.(3)'. TheLtotarr amount'i of grantereoelved by a law of a State-or political subdivlslon, . .. . grantsunder subseotion (a): by-a. State'e under snbsection'. (a) to aseist of a.State,. and (2) Snformatlon: derived from . . "(8) for assurancea satlSfHetoryto theStetes.In-meetingthe eoate of operating, the any such.program may bedlsclosed- Seeret.arythat the State 9P111 IDakesuob. re, health commumcaLlons Component Of their "(A} m' summary. etatlstlcal, or other ports (in suchh form andcontalning such preventive:.health services programs.foneay ..fbrm,.or . .. ' Sn:tormatlonn ass the~ Secretary may.byreg- 9acal.yaaishall.be determined! by tSeSecre- "(g) for clihlcal or research purposee,. ul'atien preaerlbe)as:the Secretary may rea, tary:.esceptl that it may not be Iesa.than.s the but oaly tf fndlvldually ldeatdIIable taonel .'amaahly reqvueaad..lieepsuch records and product af'.IL10, and.the population of the pe , . aHord.such-ateess ttheeto.as.the Se¢etarp -State:.. ._datacfanysuchlndtvldualla..notdlscloeed.. map 8ndd necessarp. W assure the maect- p7otwlthstaadlag' paragraphs (1/. (z), end "(d)NotmngIn this eection-ehall:limit or ... a9seof, aad to verlfP., suc11h reporv:: "(3). 1f forr anyy aseal: year2he' amount ap- otheratse rastrMttne use.of fuadswhlchare~ ' "(9) Sor aesurancea: satisfactory to the proprlated' fortLat fiscal yearr under eub- ~nted t¢ a 3tate ar to an ageacp or a poIIL--. Secretary thattheState wI1L'L aomply wltn -section (1)) is leae than the amouat:aeeded ..~~ ~bdlvlsWn.of a-State. under pmm. . .. any ather condltionsimposed bT th1s. see- - to make grantsfor that fiscal year In aceald- - of Federal law (other than this'.sectton)s and - .tloawlth.respeet'.to.gCantt:and . - ancawlthsuehparagr9pastoalf3tstes',the whibh.ailavailableforthecanductof'.pL'e- °(10)~ for suchother Snfotnmtlow aa the -'tbtai amount of grants 1bi that fiscal year ventive health service programa from befng' Secretary may t/yreguffitloa preecrlbe: -. ..fora Stateshali...avt.beleee:than.auamount uaeC...in connectionn with progxamsassl8ted, . .•Le):(1) The. 9ectetaryrshall, xMear'an- whlch, bearethe:enme:tstib, tothe amounts throughgrantsundersubeactlon (a).. . ....nms a..: ...«,.w... w~ce„ w. ....w dwtwn.an.a' in+ c..eh 41ub. Sb_ aerrrdance "S3A The. Secretary lhall anbmlttot the - vapvabV;fr

S 7$74 `' CO3~IGRESSTONAL R~CS7~17'-S'~NATB May 19; 19~'8 tiee,..each'.lnstrtmentality of the~~IInitetl. .,: -(8) 10'. tnnea the number~ at.~the m1111~ AND THBOAT MAY R.FSUY.T E4lOM' Cif3- Y:, States shelh to. tae maamum.. estent prao-. ' grama of ~'nlooEme~' wmch arQ. oontamed in AR.ErTE SMOB:eN(3: ~ .. ttcable, insure the~ eIIectlve, separation of~ such'ctgarette.. .. ~~ ^(C) HEABT DISEASE~ MAY RFBIILT~ .. .. ~~ smokbagandnon-smokmg~~.employeeslneuch'. "(3) Da•rsaatulszlox' ar .Feonwa 'IIaesa ~~FBAMCIOAF.'FIi1'E.SbfOB~Nq; :. ... . '+; -'. faeflMfes.. ' - ~~ .Coa[Mraerax..-The: Federal 1iYade Commis- ~"(D) CIGARE7-TE S1;fO81NG b1AY 8@RT~~' • "tm: suoaarc^ smrm -~ - -' "'' ataa (herelnsfter referred to as the 'COm- YO17R IDr1RT.. - ~~ '1: ~~~~ 9ac.~9 In~ev ~ mise]om °' - ery aia8: la:anyFOderel feelltty. least onee eaoh~ alom~ e ta~. t1me. Cbut at "(E) E~HYSESIA AND CHftONDC B80N ~:ti _.~. where emoring; le prohtblted natler section. . yesr) aatermme or ~ C17M'IB~~ MAF: B.ESIILT PROEC CIGAF9fTE; t. ~ 401.. "NO'Smokmg" edgns~ahalt:he dearly'aaa osuee.to be,detetauned.ilia tar aad mcotma. BATOSIIPG: ~ ~. eonspicuously~ p~ m.. sumclent numbers ~tent. (calculatea. in mllllgrama. per eiga-~ "(F) CIGAFk:TTE SMOE3N0' DIIRLYG~ ~' ' and. prominenee.to.. glve notloe~to aay petson' rette)'. of~~ each brand. of: clgarestes maaufae- PB.EGNANCY 3QAY DAbti1G8 THE ONBOICN ., ~ entermg~. ar occupying auch area that emok- . tured, ln or imported,mto. the:IInited Statee., CHII;D:~.. .- '~`~: - fag~.1a prohlb_ited insuch~area. _ ~~ Theeondltfons: methods,.aad procedures for~ -~ "(G) YOII~ OWE YOIIR BODY SOME R8 ~~. .. ~a~r. '".~ ~~. conduct'!ng such determinatlone. shall be SFECT-DONT S82OEE: . 1~ ~ ~promulgated by~the Commisaon Ih.regula- "(H) SMOEEe:'S'~. COAOH I9. AN EA$LY ~ -.. •~ ~ Ssc.' 4: (a) The~ eseautive head or ehief. . ttona fseued by lt_f~ purpoees'. of this pazs- SIGN OF LIING DAMAGB: - - .,'::n ~ WmlTdetiatl9eOmCerofeachlnetrualeatallty~ 6rapb. IIntll euca time~ae euch regulatlane: "(I) II+ YOII M17ST SMOE$', rNRar.e'. '. ~ ofthe.Omted~.Sratee:shall.beresponslble~for ara~flrat.lseued„thecondittons;,mettiode~,and~ LIGHTLY-'1~ISMr1YR1~IICE'DHERIgES~ ~ . eaforeing sectlons 2~and S m~ any Federal... praeedurea for oonducting euoh determlm- TO~~FOUB. HEALTH:. , ~.+°`.. . factlityin'whteh~suoh~instrumentaatymam-. tdone..shallbe.those~approved~.by~theCam- ~ . . . . talm'.omoes. . . .. ~ ~ - mfesioa forfbrmat tebtmg which are In.el- ' ~~(~) DONTSE¢OB.ECIGARE3TF9TOT88. ~~. (b)''. Not later~~ than nlhety days'. after'the~ fect. on the date of' the enactment of'this . ENI~T'HSli MnY B,EDIICE TEE RSSB:8 TO - _ - dbte of enactment of~ th13.. Act, the~~ e&ecntive~~ 9ubsectioni. ~ - ~ ~ ~. .: YOIIR HEALTB.". .. -. . ~ .,. ., head or e111ef~admianlstrative~amcerof each~ "(B) Caaxaaearmx ro~ r~ Sacaeaear.-~ ~(b)'Theetatementsrequtred''bysubsactlan: ~~ ` lnstntmentalitF of the IImted States ehall~ Duriag the last. calender 9uarter. of each •(a)~. ehall. be located. bs a conspicuous~Plhee~ - ~ publlsh 1h the ~~ Federal Itegfster tegulatlons calentlar. year„ the ~ Chaltman -Of the Com- on every clgarette ~package and ehali appear~. - ~~~"' for tbe~enfbtcement of sections 2 and.3~~ in- mis:sion shall certify to the Seeretary the~ tar m coaspleuous. and.leg(ble type in eontrast ' eluding butnutlbnltedto~,aPBropriatesaau- snd.nfcotCae eamtent:of each.brand of ciga- by typograpb: layout, and eolor wLth other. .~' tfona. for noncompllaace of auch. sectlons~ rEttea manufactureri m~ or. imported'i mto~.. tnr~ Prlnted matter'on the package.: -. .. . . eomparable to~~ ennetions'. for failure. to com- IInited~ States: Such~ cerd4eatibna. shaB. be `(C). Cigprettea soall be packsged'for ssle. -. ply with any otHer apPllcebleregulatton. af- ~ed' by the 3ecretary tu~determine~ the rate or d'latllbuuon m each a manaer so~.that each~ . fect3ng the health,. safety, or~ well-being~.of~ of ta>:~. to~3e imposeed'~ on cigarettee for•the of the etatemenre requlred by~Paragraph (a)'. :. thepublla~orthe'~workforee. -:'-~ponod beginalhg wlth the ffi~st day of'~. U1e (2) appesls oa.10. Percent ot. all cigarette ~ .. ~ ~ '-oessxrtmxs.~ ' calendm•~yearbeglaningafter each certlf(ca_ p~ka8'~!. .. . . ~ Ser; S. Fur the Purposea~ oL thls Aat:. ~ ttoa Ls'matle, and durmg'sueh~ ealeadar yeer. vresanxrsrxr. o~paoeea'se~ ro~eata eYOa:aro. .(a')~. the term "amoklag"~.means the~emok. .~~(C)~ Tae Commission and'~. the Secrete:ry : raroxo ~a.u.aanv axo'.noarscrars~ .. ~' `lag ur posseasloa~of a ughtea clgsrette,.. e1k~ shau promulgate regulatlbns:~for the pur- Erc. 10!. (a) The•Bebretary ee'~ Health, Etlu-.. '. or pipe. oontalnl,ng a~ tobaoco~ produet;: and~ ~ea uadert~thgg~~ evbc e~ectf~omg on now brsndn`catloa. sad Walfare. a[tar~conaultatloa wlth' .. (b) the term "ef/ectlvelyseparatedl' means~ m, clgarettea mtroduceeioe sale: ". ~ aPpropriate publle and private entltiee, ehail'~. .. the separation of.. areas m~ whleh smaking L. -~ eetabaeh a' compreheastve: prognm.. desi(~ed. .. - permltted andin.which smoking:)e~not Per- (b)~~ The~~amendments made'~by subsection to deter emokmg. among~~ chiltlren and.ado- . raitt<d in a IDsaner whlch '^~~~m~°"; to.the (sy sha11 apply-to clgarettes whloh the raaII- gy,.eats. Such:aprogr'.nt'. shall mclude--.. . .. satent pract6cabte; t11e~ drtft at smak. fram -.ufeoturer~or importer of'eueh. clgarettes~re- 1 g .. pport. (thruugh' ~-: . the smukm ~.. ares lnte~ the. nonamokmg arr'a'•, wes (wlthm: the~ meaning oI'~ eectlon 5702 -()'. the~ underLa?^ or au g gnu2e. or aontracte~~ ~ both) ot blomadl¢a['~. ~ . ~(c)" the~ term~. "SVSttumentauty' oL Laa ~(k) of'eneh~. Cadel wlthla I20 daya attar tne ~ and'bebanloraLresearch daetgned tb~mcre.ee'. ~~'IInited'States" narans- . . ... . ... ~.dateafenectmentof.thlsAet. ~ '-- ~.~ understandmg. of' the blologtcal and~ be- ~~~ (1)~ an erecutive agency; as~deaned ln sac*- ~(c): The:CommLSion and the 9eeretaayof havlosal- determmante of amokiag among ~ tton10Sof'tttle:S,IInitedStateaCode::~ . -.-~theTleaet¢y er'hfs delegateehaB.PtOmul- ehIIdrenanaadoleacanta,wlthepeeialempha- .:._'(9)~ the TTnited~ States Pnstsl Sentce:. `: gate-regulatioas for the purpoees of eeetlon ~ e~ anehltdren agad 1ZOr~below: ~ . . , (8j.. ~e ~~: . . . ._ 8701(bD.- of the. Internal 8evenue Cotle~. oe ~ . .~.: (4). the~ courts of tlie IInlted States: and 1964: wlthm 60: dsya after.. the~~ data of-the.- '~ (2)'~the andertakmg or eupport. (through . (6). the governmente~.of the terrltortes and enectment of tlilBACt, - ~ -. -:.~graa or'euatraete or both) nf demonetta- ~. poeeeeelona af tlie.elmted'S~atm: .~~.- ''. - Sxc. 8. There are autharized tu be apPro- tlona:aad avaNrattoos ef oomprehennve enm- -~ ~ Id) tae term.,•Fedetal Saclllty" meane.-~ .. prlsted fos the 9xs{ years eatling Septem. '_ munlty and scaool-besed programa: dbl~ed . ber 30. 1981', September 30, 1989, SeDtem- --to. deter smoldng amoag~: children aad' ado- '~ ~(1)~ aay building; tnstallattan. er~factlitg ber 30;.1983~: and tember~ 30, 1984:.tb0ee. ~ecaatq-and' ~ - . . ,~ ovaed by the~IInlted States\ euePtmg'prl+ ..amounts determtn~ by tbe Secretary of the -~ (3)'. granta te'~ Statee or politlcal'subdrai- . . 'tate reeldencles,. or, . . -. . _ . .. (2)'~~ any part of any otherbu0.dltrtg.~ lnstal'- Tresaury to be. equlsaleat to the tasee~ re. . afone of Sta.tea ta aaalst thetn ih~~ meeting~. tlle - -:~Iatton., or 1aeBity, w91ch.. part lg.. owned. or ~oeived~ns tae'lYeesuryundersect1oa67ol(b) aoatn~of oparaCngcomPrebeasloeeommunity ~ leeeed try the IInlted States: ezcepting prlvate.. ~ theSnternai:Reveaue Code oY'~ 1g64 for the or actiool-baeed' Programa'. des/gned. to tleter .... ~ re941enofe9.. .. .-.. . Aur'Pae6 of: maklYlg addltional~ PaymeMa~to .emokiag amOng~,caLdzen aaa adbleateniL~ ~ , . . . ~~~~~ _ ... .~ the Statea~~ to~ aelsf~ them~ Ia meetang tbw (b)'. Wlth~ reepect to granu under pera- ~- ~ seTvfees grapa~.(a)(3)..theSacretsryandeaehgraat . -~~ Src.8.7La .ceete~oLproviding~preventlvehealth ptnvlidona.ofttilsACt.slialltake undersect1on316~~ofthePubllc.HeelLh.Serv- applicrat aad reciPient must oomply with .,. ~eIIectninetydaysafterthe:dateofenactment. ioe-Act- The~amount of~ payments~ta tae~ tGe proalelons~ot~.subieetlons (b), (~), (d). . - . ~' ~ ~. - - . - ~.. States.shal3 be determmed. on. a~ per- caplta - (e). 4t)!, (g)I. and (h)~ of eeatlon 317_ ~ ~ - iersasnafma'e oa e IDur,rs.reas®crmx :~ tiasls. provided~that only thoae~. etatee who :(a). (1) Fnr the pvrpoae~of makiag pay- - Sec..7:(a)~.SUbsectlon(b)'~of.sectlora670L. arerearlvmg~grantsundersectien316(1)(2)~, rnents.for~theundermkiag.oreupportof'.re- ... ae~the~InternslRevenue~,Codeof:1964 (relat-. of tl1e. Public Health~ Servlce Act shall be seareh under paragraph (a)(1).-tbere are 1mg~- to~ the~~ rate of tax on cigarettee) ie~- ellgihle to receive payrtnents under ttiJs sub~ sutbarized to-be aPpluupl'iated e10,000,000'~far - . ~emendedto~~readasfollbws:. : ~.section:: . .. - ... .. - . . ~the IIeeal yearepdtng`. September 30i 1980, . "(b)~ Clgarette8.- '.: . ~' ~~ ~~- ~~~ Oaerroasar~a6am.nra aoa oroeatrre rneaeeas~ ~p0.000:000:forthellaeal year ending Septem- . ~ '(1) ~ Iameaarox. or Twmm-There shah be~ ~ gyp, 9.. (sh ffiectlve. one year atter the date ' ber 30; 1981, and 810,000,000 fbr tbe Oscsi .. lmposeaoa~every'cigarette'manufactured.ia~ uf enactment of this~Act,. Seetion 4~of the-~ Yearending9eptember30„1982. . ~~ . ~ or'haportea'.)nto the~..Unlted,States, regard~- ~ F~yeral Cigarette Labeting and. Adv'ertismg. .~ (9): For the-Purpoae~of mskmg Psyments ~ lem~ of wefght„whlah contBaLs-~- ~ Act (Pub19e Law~ 89~2) ls~ amended to. read far the. ~a~»'L +ng or support of aemonstra- - "(A):trom~10tu19.9:tosicumts,a,health. v~foLLbwa:,. . . ... -. -tlbneandevaluatlons~underparagraph(a) .- peotection tas Of 80.002.~ -- - ~ "Sm 4(a).. It. sha11: be unlawfut for any ('). tbere are-authorlmd to be~approprlated (B)•from..a0 to.29:9.toale-unite, a~~health~ #~on to maaufacture. import( ar package~ i10,000~,000'~forthe~OScalyearendtngSeptem- protectioa tar of 80:0078: for. sale: or dlstnbution witala. the IInited.' ber 30; 1980) e10.000,000 mr the IIscal year . (C)~ from..30 to:39!O:toz16 unlts, a.health.'StetesanyclgareY-" eading September 30• 1981~,. and.810,000,000 protectlontac~off0'.016: and ~~ . "(1)'~. it the package. forwtich falla to~bear' for the~.ascal.yearending September 30~ 19g2. (D)~ 40 or more taric~umta a~heaith ro-~ - P '~ ' - the~tar and nlcotnae eontent of:such ciga.~ (3) For the purpose~of~making payments teatioa taz of ~g0.026. _ . . ~ rettes stated In m~nre.a.,,. ' .. "(2)i DwnamaxroF zoan'.~~vxrte.-For the ~ 2): lltthe ao ~ _ for 6rehts uader pa*agraph (s) (3~). tb0re ue ( P kage~forwalch.falU~to:bmr suthorized. to be aPP'rapriatea. fI0~000A00 '~ psayoe~~of aubaertlon (b).(I) abova..the- one~.of:tliefbllowmgerstemente:':. . ~YOrtheLacal~year~enalbgSeptem4er30,1980( ~: numbar of 'Walc uafta' meoae Llle.aum.ot~. •(A): CANOER:MiAY RESIILT FB,OM. CIG- i10~'.000.000 tor Lhe.Eacel' year eatllag 9eDtem~. ' '(A), tha~number ~of +*fnl~^'~ a!: `tarr: ABSPDE SMO~70: • ber 30: 1981i. and' 710.000:0g0.for the~ becal plln .. . . . -. -' . .. Y . ..-;.,~~ ` , ,!'GB)I CANCE6' OF 1ffiE-LIINOS,.IgiD'G'I$_ Yearending'.September30,-I984.-.,.~.- -;;., . .... .. - .. I . . .. .. . . . . v.. - .

lY1ay 19, 1978 Cc7NUM5LVivn>L . Presldent forsubmisslan tothe:Congresa on. '"(1) for sa detailed plan of th support ~prcve~n heg th'servlces [ntheone-yesr : January 1, 1981. and4 on Janusry 1 off each Sor which the appllcaat fs seeking month be ~' after tHe~mo¢th 1'n which succeeding year a report on'tbe eztent.of the, nnder subaecnon (s):;ginnm6 problems presentedd bythe'.dlseasasaad coa-other) fnnthe ds.ob geted bytLee pricantm tts grantsmay be made In advan e on the Deala - dltGons:referrad to' 1n parsgcaphs. (1) and (3) . lstest'.a¢nual acco~mting period.for the pro- of esqmates or by the wayof reimburaement, of eulYSectloa. (D); on the amount. off fundas vnionn of each proglsm.m referradd to In per6+ with necessary adJuatlmeats on account of . obligated Vader greatc,vader suboectlba (a). -...,«.M.gr%Ph(~l); a description of thee prewentlve naderpayme¢te or evenpaymenie; and 1¢ such States.ia operatmg programs te:.pravent the. euch program lasueh pertod the amou¢t of tlom se theSeecetary i<ndknece.saryao carry lt~, yseases:and.condlttonsrefermdto.in.P~ Federal funds needed by'the appli®nt tb outtllepurpesee.of'such.grents. graphs, (1) and (9) of subsection (b): audi opatthue.pro.idffig such services in.n each '"(a). 4'heSecretary,.. at thetequest of' a `~ 'on.the effective¢ess of'.the programa assllst®dl suoh program; if tbe'e applicant proposm tecepient of a gnnt't undez subsectlon (a), .,,,.... s..r~ nntlar subsection (s) m Pre- chances. tn the erovtrtan of theseraleee in mav redueee the amount of euchRrant by- .g venting such.diseasesaaa connmamn.. - - any anen program, rae pnorates. or sucn .--l+./taa..aeu. meracv vnwe v. s,+r =uve••~- tt e ' ' v andd other preven faragi'aphs(1) proposed ehanges; thereasons forsuc¢ (mctuding~ vaceines -^(k).(1) For ptu'poses: op-.: . and (3)) of subsection.(b:), theterm'prtmat9' changes; and, tliee amouat-of Federal.frmds agents)) or equipment furnished the grant preaentmn.a of causative- conditlens" means needed. by the applicant_ tomake such reefpient, and . ;. the preventioa of'thedevelopment, ofthe -ahyangesp. '- (2p the amount. of the pay,, allowe.nces, conditlons 1hn hesCthy' mN.Mdusla. ''(3)'. for.assurances satisfactary to the Sec-- and travelienpenses of any officer or employee ''•(2)For putposes of paragraphs (1)'and retar3' that thee preveatlte', health services of the. Cievernment when detalledd to the ofsubseetlon. (b)'..'secoadsay Preventlon which'. will be ptnvldedi with funds under a grant.recipientl and the amount.of any other tlo lth the detail i t m d tn t tl b t ded coe s eurre a connac n w . un er su vrtlll be prov seo " off causattve: eondlttons• meaas +Ae early de- gran lon. (a). '' teetfoaof the ceaditfoaem asymPmmatLe ' inamannerconetetent_wlth,theStateDealth o[suebo®eeroremployee, - _ plan in.effect under sectlon.1524(c) end.m- 'wheu the'e furnishingg of' such, supplies Or . 1adlaldu616.:.. . ' ~ .-thoe9rsees wDere: the.applleaat is a State. ul ment or the detall, ef such an officer tEe(Stecmr'StstaaendflocaleaPh (d)~(1)(Bo)i. _tbat auchservicee.wlli be provlded, where ~ ePloyee le'.for the coaventenee.ot and - pnveative.healtli seMces'mes~m es~peadi-gppro~u" m' a. manner, consistent'wlt¢ stthoxequeetoOsueDgrantreelptentandfCr tutas by Stated and lacal. Public health au- any Plans in aSecE under Pa'ae+'p--~`(b) (1) the purposeof'' carrying ont arprognm with a¢d(b)(3).ofsection:315; respect.towhlchthe.grs.nt'undersubsectlan thorttles.Sor prehalt~a (s),.~ . 1•(4) fbr sasuraneessatfsfaotnry.to the Sec. (a) ie:made, The amount'.by which any such - ported byg~~ emder but tretary thatt theapplice.nte wtIl provide Ibr grant is so.reduced shall be available for - emludesezpendituree by such authorttlesT-. such.fixsI:control'and Iundsecountlhg Wo• the Secrotary of,the ceata 1'ncurrel . xg 1~sw sas~e eo~adltlan to tlle.raceipt-0f'FBtd- ~°resas. the Secretary by regulation pre- en furnishing the supplies ore9uipment, to . ' eeribee.to as®urethe properdivbursement of or 1¢detaflingthe personnel, oa whicch.Ehe eral IIhancial,asslstanw, or and aceounting for f1mCe's received under 8)) for operating mpatlent care fae111tiee: ~~ty. under subsectten (a)',; trodneLlo¢of such grant bbaeed, and such "( construction,. or me¢tall health programa.. _-(gl, tor assura¢ees. satLVfacto to tlle 36c. ~~t shall be deemed ea part. of the grant ^(4)For purposes of'subsectton~ (d).. poPu^ retarythatthe ~ and shsll be deemed. toaavR lleeapakl, m ~ latilons shall be: deteemt¢ed.ond the basis ot' applicant will make such re. the great recipient. .. .p porte. (in such Imm and containing such ln- . '(I) (1) Hb.ch tectpieat' of a granE. a¢der - the latest figures sveliablairom the I1eParc- formation as. thu Seeretazymay byregnia- sobeeatioa(s) eDallkeep such.recorde estlle meat.ol commerca. '•tiea pr'seetaeY ea the. Secretary msyresson- .Secretar.y.y shall by regulation preecrtbq, la- ,. °(I) (1) Fdr thee purpose '.. of maklog' pay- abty raqofre, sad'd keep such reoordss and af- _cluoing eeeorda which tully' dlee{ose Zne 'meatss under grants uader this sactian..to ea- ford such accese.thereto ass the 8eoretary may amov¢t and disposition tiy such rectpleat'el - .. elst StaOes m..plaaningforpreventlve.heaith' -gnd necessary too saure the correctnese.. of, the proceeds of'such granC, the total~ corG of .earalces... there are authorl8ed to beaPpm-'andtovertty; such.repnrts-.' Ebe undentaking. mconnectlon.withn whlbh -. . prfatsd E55A00.OO0:.Sen the 9aea1 yearendinj ••(6) '. for aseuraaaee satisfactoryte.the Sea- adcp, grent waes made, andd the smouafr of September30,1980.. -.. .•: . -ratarYthat4.theappliemt.mlllicomBlywlth ,jLat.portfonofthe.costaf.theuadertsHng ... ."(2)'Pbr. the punpose.. of: msking: Paynients.s sny otfter eondltlons,'impoeed 7y thias seetion supplied by other soureee;, andd such athec nndergrantB under thia: seCtion too ass7st ..with2eepecttogrants;andi . ' records as.will- facilirhte sn.e3ectlveaudi9:. .. Statastnmeetingthe.costs.ofprovidingpce'. . (7).foreuehothnrl:nfocrostienae.We9w- - '(2), Tlie-Seoretary and.theCOmptroaa• vxative health serelees.: there aree authorized xetary may: by regulation proecrlbe. . . Qeneral of the United . Statee, or any of their to.besppraprlsted i168,000,g00 fnr the BaeaL.(e)'(1) 1he Seeretat9 shall revlevr saan- duly awtnoalzedd mPreeentatrvos= shall'. Dnve` .. maar ending September 30,1981, d175,000,000~ elly theactlvStlea'undertaken byeachrecip!- stoees Ior the purpose of audltt and' eam4- ~ fortbe:asealyearaading5eptember30,.1982'. oncofa.grantundersubsectian.(s) tode-'nattonto'.anybooks,-da.•^~^•^«-,.papars,.aad - y200,000,000for the. Dseal yea[r ending' Sep_ trsmtne IL thee program aselsted. by enehh a- records of, the recipient mgraa4under sub- tember30, 1288, andS400,000A0ofm tDe-¢aml granE: i6.operating effsilvaIy to achleve: 1t6 _eot,on (sk that:arePertlaa¢t tpeutli.grante. .. year aatnng Se.ptembecSO. 1994... ...... ...atstedi pucposes-and..lf tliee grant recipient .(g.)yL 1Mormatlon oltbined about any: ... "(3ypor eha puxposeof makmg:additannsl_ complled with the assurances provided wleh tadlvtdusia under any Drogeamm tlmtt is betng. psymantg undar grsara undsr" thlss aection the appitcatlon: 77se. Secietary'shalT not ap- caraYed out wlth a grant made:under subeee- . 'to:eeefat steiram.meating Lhe.oae~ o[ op- p+'ove.an appacatlon'submitted,under sub- tlon(a) shall not, vXthout.sucii mdlYldiWB- sectlon(b):unlesethe.Secretarydotermines-N consent beerao,..n - ersting' the-heLLth cdmMunlcattona o001- ., except ttlaE. 4I) euaD .. ponent off their preventive health services "WLhatW the pmgram, fa operattng9 esec- . tnfonmatfon may be. e~^l.,sed 'without aueh ' ~.programs, thece areauthorized, to, be. ap- , idaelyy to achleve..its stated purposes. I ~~ consent If'the dsecioeure ta:nacesearY to pre- - propriated:625,000,0e0-fortheflscalyear.'and -.°M' .that:theapplicantcomplled.withm- videisarvaxto:aueh.mdiv7dualorlk:eequtred -. ing September 3o,1991;.736900;OOd for the sura_ras, previdedwlth a prlcr application by a l.w of a Stste~ or polltiwf snbdtvtam¢. .. Ifseaiyear ending September 30i-1982 648,- undersubsectlon (b),and. . . . of' a.State., and (2)) information derlved, ' . . .000,000fatthe¢scai.year'entling9eptwmber ..l(CFtAat:he.ls~suredthat':theapplicant fzomanysuchprogrammaybe.dfeclcaed- ' ~ -- . .. ) tnsummary oe btaei (+ti) 983d E859000e0 foahn4eea19oar 30. 1, an,.r..veompy weaeauranceB provide. statistical,r Alllith tlld ending", September 30,. 1984:"- ~ •. ... . _with:.L¢e application vade~bmideratioa. ..form, or ... aoascrc..xrsssoasa¢vi¢arivsffiecxs. .'. "(2) -Whenever the. Semetary„ after fea- '. ••(B)'i forcllnAcal or reseamh', purpose~ ' . / ,. savrms - ..wnable. notice and•opportunity.d tara heu- but only ifindl<ddnally identlLableperaonal . 19799 sea mgto a geantrectplent, finds wlth respect to - data.o[ anysucD Individual tsnot.dlaelosed., (e.) E6ectlceOatoberl 8u:10g , .. - tioa 317 and the. Deedlhg thereto are funds:pamtosuchrecipient,thattIIe.pro-. "(h)~Nothing'mthissectlon.sha¢'llmitoe'amended torea.d 8e follows: ' BF'am is not opetatmg'ef(ectltvely toaehieve otherwise restrict the use, of' fuadn whlca. 'Sxoosca cserru rosssmamlziv: ar+srs' =a stated purposes or that there Is afallvre are grantedi to a State or to an.n agency or- a too tomply su¢atanitallF Weth aeauraneee pre- political subdit+i5loni of' a. State under pro- affiv[C62aooss.mms.vlded'. undec subeection-(b) with respect ec vWnos of: Federal law (ather than this. sec- °SaC. 317: (&) Tlie: Secretary maF make . ttioreoeipt of such grant,the Secretary shalll tton)~ and which are available for the gs7ntato States; pout1cal subdtvisiona: of notlfythegrant.reclpient.that Iurther pay- conduct of preventive Deaith service.pro-Stater. ather publlc.entittes, o[ priYate e¢. mentss will not be madeto Stt under suoh. $ramefronti being used in ccnneetion wlth. tttlesto asust them in meetmg.g the:castae of g,gnt, (or in hia-: discretion that.Iurther pay- programs assisted througDgrants under sub- providing preveativee health earvieee pm-- menta wll1l be reduced), unt11 he Issatis8ed section (a)'- gramsas set forth in.subeeot,ion ())L that the program wiil.operate.effectivelyor "(t) The Secretary shall submit to the-"(b)',.No-gpant mayy be made under subeec- there will: no longerr be such a-faLLute: IIatll Frestden4fcr submissionn tu the Congress, oan tEbn (s/ unlessan applleatlon' theretor bae •]heJe.so.satisfled, the'Secretary shall make no -Jaauary 1„ 1981,. andi on. January 1 of each been submitted to,, and'd approved by the payment or,, mn hU: dlscretlon,., reduce pay- succeedingyeQ a repdrt-oathe.estent of.the~ " Secretary. Suchh an application shall'bel ln meats to the grant recipient, prablems.presented by nsee diseeees.and con-euchform and be submitted 1n.eueh manasr "(d)~ 171e0 amount of agrantunder sub- dltfons referred.to-in subsection (J); on the'..ss.theSecretaryshallbyregnlaticmpreacr/be sectlon(a):shall'bedetermiaedbytheSebte- emeuntoC~fundkobllgatedundergesntsun-andsDallprovldo-. ..aary,Eac&s7[cilgraatsasll.bemedefbscosb dersubsectlan(a)~1'athe.prcedmgLanl. 03603604 .

Dday, 19,; 1978 C CONGRESSIONAL RECIJRD -SEftATE : 5 786'a - '1`%'(7)for assur~ancea..sattsfactory to.o the..tlacal'yeasvhichendidonor-tlefore July16 -alduaS'a eement„beNacloaed'.:e:raptl that 8eaefary t1YaL tDS Siata w1tS provide for sueh1983: and ... . ... ...' ( I) auch lntarmatien may be disclosed wlth- nYCU soatrol and' fttnd aecnunriag Pra .".(B}y may aot be lees than the product of out such eoosant 11 .. the dfaelosare Is neeee- -5pdueea:as the Seeretary byregulatlon pre- 3:50 and the population of the.Stata - esry to~ Provldeserateeto, such mdlvtduai.or `•srribes.toasnuretheproperdisbursement.of "I3).'1'hetotalamnuntofgxantsreceived Is.reQufredbyalawofs.State.orpolltloal asn,•: .nd aceountingg for funds received.d underr bg a. Stateunder suDsectton. (a)l toasaist subdivision ef a. State, and: (2), Snfortmtton t"<-• grantsunder.suL.eatlon.(a)G . - Siateam meatingthecnslacf operattng the derlved'from anysuehl program..may. be dls- •., :. ••(8)forasauraacesaatlsfactorytot.heSec- bealth.¢ummnnic9tfun8componentof their closed- ._ . . ,. . ' •' .-aetarythattheStste.wili makesuch, reportss preventive.health servlees programa for any (A). )n. aunneler,T rtat/ktfcal, or other Sam suN'a form and aontalaingeudL lnfo=- flacsiyear shallbe'.determined.bythe.Secre- form, or . :.matloa as the S.ecretary tosy byy regulation iary.exeapt.that Stmaynot.be Tess than the °(B) for atlnncal orreseamh.purposes, prescriDe) as the Sacretarymsy reaeonaDiiy product of8,10. snd the papulation of the but only if individually Sdentffiable.personsl require. andl teep...suchreomds, and afford Stwia_ data of' any aual! lndiv(dna! 1snot disclosed. enahaneeas.thereto.aatheSecretarytnaYand NotwlLDataedin8Paragralba (1)... (2), and. I '(1)'Nothing.ln.thlasesttonshall.lilnlt.or neoaesary toassuie the correctness of., andi (8), if.for aay fliaal year theamount appro- otherwise restrlct phee tae off funda wDich to verify; such nporte; .' _ -. prlated for tbaL' flseal year under eubsec- are granted . to a Stateoe'ta aa agency Or a "(9) for. aseuraacea satisfactory too thee tlbn (A)I .le. iesa.than-the amount needed to poLLtieal suhdlvlafonl of a..State under pro- Secbterythatthe.State.wtil.compiywitbany matag,rsntafor that.Lec6lyear:la aacord., laIa1onSof YedeaC faw . (otlfes than this saC- othereondltlonslmposedbythlsseotloawith sace vlth.suohparagrapba tn. sB. Statee: tion), and.whlchareavnlablefor the con- jeepect.to gtants7: and-. . - the total amouat of'graata foer that fiscal ductt of preventive heelth serrlce programa .•(10) forr suchh other Information, as the, year for.r a Statee shall nottb less than an ftamm bemg. uaed. 1na co®ecConn with pro- Secretary tnay byy regl11at1on preeCilbe:. dnlUUat whiah tiea[Sn the same ratloo to the glame. aJSIBted . tyoag4 pa.nta. under sub- ~.. -(el'..('1'') The Secretary ahatil revieww aa-- amounta determtned for such State~.e i'n ac- eectloti (a):, ~. . .. ,... ~.-. ~ avally the~~ activlttes.s undertaken byrr eaehh aordance~ w1tD. thla section a€ the amouat •'(IY. •rhe~ Seeeretsy ahall eubmit to the State wlth aa approved application underapproprlatad.uader subeectton (1) bee.n to i+revldentfoesnbmlealea tothe.Congresa,on - subsection (8) to determineif the pzagram.. tne atwonntneeded tomaEa gcaata. ffi se. January y. 1981, snQoa January tL of each Or . programa aree operating' effectively ta' oordance with this aeoslon.forauchfiseal- succeemngyearareparcoathe.extentof'the achieve thetr:stated purposes, and..If-the.yeaetsafiStsw:. ' . . . . . problemepe®ntedbytaedleeasesandcon- c:. Stata somplled wltlt, t5e.aseurancaspra--.. "(a), ffia1t-gtant under subsectton (a). .dltfonseefersedti"ihrpaes8rsphs(1).and'(3) -vlded wtth the applicatlon.,The Searersryshallbemadeforeostafor.preventSveheallth of subsection (b); on theamotmt of funda . '.shsilnot.aPprove.an.appl(catfunsubmltted'. servleea..lntheone-yeerperiodbeglnntng obllgatedundergrnnteundersubsectlon(a) -' . under. mtbaeet]oa (b) unleaa the Seecetary' _ on the flrsf.' dsyof the first monthh begin- ,bn the: preeedhrg, flacaF year teW aselat the .. ..determhsca-....- ning otter the month. tn whtcn thegtant Statee in operntmg pto8mma to' prevent the .. .^(A), that the programor. p=ograms are,. le mads_ Pa.ymenta undersuchr g5%nts ouy - dieeeses andcuntlftions referred to in pars- - opeestGng.eSectively- tio.aahlevetheirstat:edo be medein.advanee,.. ae the basis ofestl- g=pha (1)'.'end (3) of snbsectton fb}:: and purponC9mates. ar by the.wayofreimbursement,e with on the eSeetiaenea of the rnms asaisted ro g . "(B) thatthe.Stete..com Ifed wltri.assur-h n~T>~nta.on account of under- p .'aneesprovldedwitb.a.prlorPapplicatlbn.sz<b. paPments oravetpaymentaw and. m such Sh.. ~ndy.,~n ~,ryaea=es and eoadittoru, ~e eitted.under subsection (D)„aad.; . : stalbnenta-andon such tkrma sad condl:- ••(C)that he ls.assured that the.State:wilt ' tionss as theSeeretary IInds necessary to... anQ (3i1 of'anDeaetim (ti , the paragraphs 'prf~ ly wit3 the sesurancesrovtfled wlth ~~euttheparpoeea..afauch3rants. LLapa IleaLlon under consideratioa, •. (f) 7Ee Secmtary;, at the reqvest of" a' msry Premeatbn of' osassttve" coadltlons' . •`(2PpVRhenever.theSecretary,afterrea.son• StatewhichIeareciplento[agtanEunder meena:thepreoentoa..oftEedevclopmeatof -~able notice and opportumtyforn.hearingtoy eubsectim (a).may reducee theamount of the condltloaa in healthy Individuals. ., orPm4ossofParagnPhs(1) and ... "(2J'1^ - h tD . .. .. .. grrn y- : •-theState,IIndswithrespeettofUnds':paldto suc tt under a grant,undkr subaeotion(s) tDat '-Ilry~ 7De ffitr market value off anA: sup- (31 of sat:eeation (Dl:'seoendary Prereatlba •. thepraagfsam.oe programs are net'o pltes.ar eq1taimieaL+furnSshed theState. bad ot canSattPe'condtttons• meamthe eariy de- aIIeetlvelP toecDleratheir stated pu or. .°(2) thee amaunt- of the.e paY, allawanees,, tectian of the' aeaditlcmIn asymptumatln tDae there 1sr s faaure. to...complysuDetea- and travell erpenees of'aaF oIDaeror em- Individuala - . .. LfaBy with.asurancesh p3'ovtded. under.r auMp)oyee of ttieCovernment, when detailed to '~••(3) H'or.pttrPOSeaofparegraph (d),(1) (IL), 'seaiton. (D} wICD, respect fotaereca/ t of. the3tateandtheamountaf.anyethereosrs the term'Stateaad.IoaaL erpenElturesfor eueh gtant, the: S p -i^^"•"^'t: Iu: connection w1tL the detail of preventirehealttie services' means expendt.- ecfetary sball', notify the auoh omcer oi empmyae... -. ... '.. -: Stste LDat further payments will not be mada tnres by State and torBI. PuDllc health Gu- " tb tt under." suehh grant-(orm hla dlserettoa whesr tDe' fua^k^ .,^aof suoheuppaes or thorttlea forr preventi:eheatth servlces sup- thatftlether.payamentawAL'.beredtveed).un. equipmenaarthadetall.of'suchanofeeeror ported.byganteundersabsecnoa(a) but ... ta he ls eatisded that the pmgam arr peo-: emPloypo- la fnethe conveniencee of. nndd at excludes erpendltures by suehl anthodtlsa.- ~ grame'.w(ll.operate effectlveiy or therawlll, tha requast of.snch 8tate, and for the pur- .. ••W . speclflcallyrequfred bylelderaletatv- '.aoloagtrbesucha..Iafiure::IIntllheIaso-'poeesof:planning.orcurytngoutapragram tory law ae a eondttton to the.recelptof ~,-...eaLtadedl.theSect•etaryshatL.msldeno 'dth, reepeettn-wDich.theStateg,rantunder?ede.al8nanelaTaslstanee:or . . . _w'.. tnmtor, Ialiis dlecretion;.reducepaymente °mb"WOU, (Rl lamade. Thee amount bY •°(H) for operatiag~invsttent~carnfac111- ~' tathe8tate:from~such.grant. .. wD1a.b.aqysu=hnarm r'lssoreducedshsRbe tfes, constructioa, armentsfhenl'tlf pro- - - - Payment by the Secretary of grams. . _ .- .. , - , :, .:_ . .,.' . "(d)'(1) The tota4amotmt of avWlahla foc esived '®Stace under subsectioa~~ ~, tDe, coste mrnaed lnn furnlthingthe sup- .. (4)' Por Pa>rP~eea~Lsubeectlon(d)y. ~ bT (aY to-.ph~m_~~~nt.ortn detallla the pert ulattons shaR be. determined an the beeP aesiet Sbtee fn. Plannin8 me Preaantiva. s . such aaaltheavtaeaforthe escdN.l earendih 9e ~, aa mhicD the reduction of grant ot thelatestSgnren.efal7sWefMm the De- ~: SemberSOt 1986sDa11 be aeLSrmineQ by the LS ' bal anttsucG aatouffishati be deemed py=tinent of Commeras ...,.: .:,1 ' ' BeeteLoy, Claepti.tbatftmaynotbe lasthan an , pact of the gFant anII sDaLL be: daemed'to- ~(Iki1} Pet fbs purn®e o[' msRfng Pay^ -thepxodneLet/30-andthe.popalatloao[, hav'eheenPaldtatDeStaie. ,_.. . ......mente.andergrantevndRqllasactton,toae- •• ' - (L)BacIIStsta!xhichtsa.Peclp/entoL a1aLStateslhphunmg'forpreeenttvehenkh (g) ...t11e3oate_ .•1 .. ,.- -. . . . . ... "(2) The totall amount of.' grants received f gtantuades srbeeetlbn (s}. shaB~ keep'. such serviata taeie are anthorfaed ta.be appropri- hg aState under subeection (a)~ tu ssalat, recordaas:tha3ecretary shall by regulation e.tYd 885,000Ad0~ ~for the t/scsl year ending Siates in providing prevenuve Deatth~ aerw-P=~bn including recordawD16h fully ~- SeptemDer30, I9&D. . . . -. .:. ~ s -kes for any /tacaL,yearsDallbe determined close the amount and dfsposltion bP aueh . (2.': For the - Statsofthe,.proceedaofsuah t ttatotsl ) FntTPaseofmsYingpaymecte ~n bytheSeetnttDttt ..erry,.eacePa.r . under Brantw nader th1Sl eection to: sas7st . caat of the:nn3anlaking Sn connecttba.with ."(A)'. maX nat eaceedthe leseer of-- whlch sueh.wautvnamade,aad the amount Staten ia meetbt4 tae eaetr of providing `^(t)thepraduutaf8:75anGtbepupulatian ofthstportlonofthecostoftheundertak!ng P"e°ant've Deatth aerr~as:, there are nn-- ' M.the Stat>, ur - . supptledl blret7ler soorcealand euch attier thor3zad taW be eppreprlatad. $I50:000.000foF •'(l1)fa the caee.ofthe nwl', yearendiogre[orda a4.wt11 fac111tate an eaectlve audtt tbe ag`'al year mtllag; September 306 1985, September30:1982,..5perceatof'theamount:°(2).TheSe¢etaryandthe.COmptroller $17SAOR000'fortheflal vearendlhgSeP- of State sadd localerpendlturea for preven-_CM.ral of the tTaited States, or any of their tembee 30, . 1983, e700:000:000 for tb& 05<al LtVe healthservlces aupported' Dpgraats duly antborlrsd represeatatives, shallbave 'yeat' end)ngSmtember 30.. 1983, and a200.- under snbsectlea (a) witmn the State in the aceese for the pueposee of audit and esamF 00O.OOOioc tDe-elesk.year Mding. September __State'B Lseal yearwhlcD caded on' or before, nation to nny boo8n, doenments, papers, and 30:1984: " - . ... Jnly-1,. 1981;: inn tlle' eme of the 9scaI'l year records of each State-. which is a rsGpfent.of -°(S) Yor tLepurposeaf mnting additional aadfng September 30, I983, 7*g' percent of the a grant tmder sutieectioa (A)" that are . pert[- Wymeeta tmdec grant aader tDfe seetion amotmtofaaaherpenditnres.inaheStates•nenttosuch.grant, -. .to.aesletStatesiasoeetlngthecosteofop- flo* year vhfen ended'on or beforeSvly 1,. •(h) All mformatioal obtalned about any ersemg thm heaNtb e®mmteattonscompo. - 1882• and, Inn theesse of'.the f/ecal.year end+ 1adlsldnaYnnderanY program that Is being nent ffi1LC1r peeeeatYee hesith sRVibes pro- ~ mg September 30:1984', 10'peraent of' theearrled'aut wltha a grant made under sub- krama; thas sa antharlseQto be Appro- ' amount of eactreapentlitures Ian theStata'e section (s)l ehall not„ wlthoua sncD. Indt- printed $28;000,008 fer the fiscal year ending - • . .59~- Q36~3l

S 7878 _`CONGi2E5SIOAIAL RECORD-SENATE May 19, 1'978 ._ 1ag.., appropriate rlak aseasmentl mtoo their . wLll bave to- makefar mocee decfelons about tack victims, operations often done uaelessly .. . prepald' aeresystenm.. - - Who aha11 live and Who. ePall be allowed toO now, according to.. atvdiea, . . , . Lappreetatethe opportunity tn contribute d1e, avehealth leadenagreed here this week:. (ymena baeked...such.teattng.~but said the' . today to your consuterstton of:newdtrectiona. , They spoke at a news eonfeeencee at thee are..,hu..m•.....- opposea the Kennedy and for health haaard'& apPratsayL andi I look.for-Amerteaa As.aclatfoa for the Advancement H,oge,sblllsbe®use ma.ny' euchstepe.are al- ~. vsrdto.thepape[sanddlseusstonaesstonsof' ofSctenretounvel3amatorhealthlssVe,out ready beingMten. . . ''tflemaetfng.'Dbank.you.: -tiaaay;, of the aesociattonta' noted weekty HIatC.xeplledthat.theHsrvard'..School.of-., . . . yOUrNoT11a; . :-. . .7nmml8cf®ee_ Public Hea1tII't'. Center for Analysis of . -I nIel:cnde.. Mero;-'bperstioa Ltfeatyle:' Dr. YhiL Abelsan, Sclence's editor and Resatis pnenheadoftheCaraeglerastitutlen.ofWashing- ~ch eea uoet--cenudeend the leeding . . Nna Cancrpts. in Heeirh., FraaeeNaga's of the am uffiteffitfea-asa been ton, wams tnaa mtroductloa tothe Lcsue' censiscenel l . -PraepecttvMediclnMe,~Ocgtober B4SacSetp' foe that curreat Pumaal reseerch aad care mayP far federal suppea~t bruedealte e~tadt'.a. •IILah, 1vaa. Yed7calNemestis:'. The &2pr~ bae focused.d too. strongiyy oa Prolonging:. ..Yet: he ssW, ^Maapann~eat: Practtaes in 'yrlbt4on of H'eaith. Fantheon. Hooks, 197e. . meanlbgiemeyt4acea" at huge; coet; medtcme sad snrgerP havee not tieenn evalu- . •Prlatleon. Sltot.. Dacrorheq Tdperhea- A' But the gtoming problem. of. "ehoshail' ated. Rameat maateetam)"-lemovtng the .. Study of ~feasian, Sac4aF CoxiZrot. New ~- °d~ sftectt msay more penona than preastandadlacent. st:netures-"remamsYarY, >il®evter,197S': - . ,.tbe vergllI wIIOee.ltvesmapseem meaiilngr7 the nwat ooramoaly, prmcticed pro«dure for •Carteon, HlclL The 8nd' of JfedianG 1Q8B' satd De. Homsrd' Hlstt,' deau of thebreast' naeQ. Laoogp', there Ie no pereus- .. -RArvardSchool at.PnaiSaHealtlL IieWYort, Wlley. 1975. . ,. Heranee astther the government nor ln- alveevidence.tIIfyitta.better.thaaaefmpler .•eba,. RenaeC.'"Ihe Medlcatizatlon aad svsennnr Indte11f0a1s mat te.able.to pay for ~~~otudlIectoodes Are, . beolag done lese fre.~ . -'. Demedlcall2salon of Americaa. Society.'" An 'thet8fagadnetasare..learning:toda,"We•.. Daadaircr.Witrter 1977.9-22: - fnevitably sball be aNdng,'whtch af our citt-" q°entl)y butoneoy still seriously questloa': .. .. •8obbiae, Lewls and 8a1f. Jatlk Haor to- yeas, must bedeprivede of Lfe-savmgg mess-theaeed forr close, to amllaon aa year: Last Practiee• Prospeeiine. M'ediciae. IndlanapolLsl, ureaY ^ IDatt es9d.. T am coavlnced wecan- 'ees over g0.fq0 Amerlons had eoronary sur-_ . . Ltdlana,. Metaodfat Heepttsl'of Iadla.na,.1970: aet evade thfs fesas.^ .. BerY stt a cast 1n ezcem af $1, bllllaa." 81att . •Heet, J. tl. and. Steffy, IL--.L "SmoMng. '~It'sgomPF on, now."said'ltobert Ball. ~d. ,. Modification Feoeedlarea'PaIIored.to Snbtect foemen federal8ocfal esromlty, 2ommleslaner: - ffi8Acoets meke it neeeeaary for us-tc .. GRaraetertsttae,'•. Behavior 1'RempF;. 2:$, 3Tb-- noer senior achnlsr at the Idstltute of Medl- . eet prlvrYttea~ aad we need morefaderel eup- ..91,Apr1F187L.. .. .. .. . -.. .,.- afficaf,tIle National Academy of'Sdeneee. I>4rt foa•'the.needed e.amstlbn.,1'he cost of,•Fra~f published reports by the Natlonaf' -"DOCt~prs .24 decfdmg against eztrsordl~- ~~dertetmgsaeh research will be great- , centerforHealth3tatlesfea..US.Department yry~epstobeeppnrsoasallve.Crwhether K~sn~~~~~,. . CfHeatttr, Dlurstfon, and Welfare. PtrbHC ornot.togMthlsorthat Petnon,an orgaa. & . Mr. SMM=Xp_ . pqp- President. L. HeaFGhService,:HealthRSSnutr.esAdmmistra.Itlotmatets.donethan:lsevermadeformai."' ~m tOdgP Sfliaitl4 w16h>~yCOlleBgtieS imn: ~ . . . . -. . . .- -- - .. SuoD: deriatane'sre made °ottea" end, sre •Statement.bySecretaryof Healtli.Educa- aIIecting..ms7fEnnr, eald Dr:. Plaest se.ward;. Ole the S176COtIDO01t0eC nafiBalth: and! tfaa, and. WeHare: beforee the. Subcommittee ptofesanr o[.easlat mediefae at theCinlvereityScieat18C ReseaLt'h 1n gpoflsOPlIIg' a'a b1)ai .on.Healthand,..Eavfronment:Commlttee:on. ofSoruastar:. toa.mendthePAfhltc'HealthServlce'Mt' . : Lutvstat4and Foreign Commerce,. Septenr- This..la bamasethere is "r.tmamg•" of care to IlaprOve0lli ab111tyt0 DroRaete health-. ber 9, 1977. (¢'abrn' fxome data complled.bP'.d parrJ9 by'ehobes..scrosto dnctorsand who ful' beba'Vlor- and.prevent.dfaeaee. - 'theNat6onal'.Centee f~ Hxslth-Stsalettm. esa.pa7w baesM:,'RRmessmpl'e, blacks..only- IamPlea9edtosDaasorthtsbillwhich .. Difenv-Y . .: . . ..~.' . ....-:-gethiprepleeenrnteperattonsai.mne-tentn. seekstoenhaucethero0ealprevenrdoa. .. eeetye Hans. 'Stresaf WftAout Htstreu-. the rate of. Wbftrs, butt tbey have just ass inourhealt]'1 Ceresystli M1:.PresidefLt,. ,. NeerYors, J. $ f.tPpiacot Co... 197~1. '.'-:. ., -toaay'mp.p•oblems: I think 40 or 50 mlllion. 1t'.. is IIICiCdlbleihaLe the'. Onited States %ata SidneY eraf.. The:Eftects of Can~. people areuaderseved by the health syetem tlnuea Care. SLB.' Department of Health- becauae.tdeP don'thavethe meane:' -sDends under 2 percent ofi ff8 healtFi' care „- Mucation, aad'Welfare.: National Center foc - - Coanpared to other agegroups„ the elderly doIIa15on dlseflae prevention and health - Health SeevfeasHesearote and.Develapment... sndeaelPadoleurntsareunderserved.addedd promotion. C1eYrly. tl'if818IDOLley'that December 1972 (I6H8W, pubilcatioa No.Dr.IDSvidHamhaighesd''of'theInstituteaf. reDre9ettte-tSe9oU11de3t.hkY09tIDent we.. ( 7 ) ~ IMd, .: ., . Laf.onde. . .-: -ThentstaaointbmsoIIend'~6y'~. . .. . ~... . caltIDakeiII ihe'16eatthlleFd thexspeak-: .ipydelstrpportalltheefementsof'th1s. r•H[ealornv. Leater and- SomeM Anns R..t ers aad. Hh: O$bert.Omenn„ aseietaut dl'reC- pragr3m~ I wUttld Lke tC, restilct IDy!. '2ifetimeHeaitaMnnltesGng:'APrnctteatAp` torofPeesidentCarteYSOmee.ofSclenee.and proach ta Revcntlve- Medldne"' Mno. 6nq-- '3laanotogy Follcy, arx pnweatloni natfonal.l reL]ar$etO those 11evr or eipaIIded! Dre: .. .. lmid: 7oorrwl' oJ Medicine; 296:11;, eo1-008, -.heaCth-msmsaee:. costt ecatrot and aesese-~graII1A- that'ale't eatabllahed by' thLS' act. -. March 17;.1977: -. .,.. . :.. -.. ,:ment of IIevrmedicst methods to-ellmtnate, . AalOngtheCategOrlcal'PrdlCetgi'at1t5 for .. ~"'IIS. Department of' Health. E'ducatfon„- the.uselese and..wastefu4 . .... . prerentYve healthserYleeBh theaeW or .. :: and': Weltare: Bealth.: - CaitedStaYes~ 1975: . Saward.ceAed the search for'more eBective- expanded prOgrNnsarehypertensioR.. ..-Publ¢o Health, Seralce National Center foe. wayg toPrecent ttlnese: and! accldents.'Yhe'. environmental health and, physical fltr. .. Health Statlwtlra, H.ockvil7e. Maryland.:I975.. queatoftIleneIItdeeade.'• .. .. : .. ...IIess, Hfpert24StOR Is a dL9ease, th8tt u Maeon; Thomas J'~ et't at. Atda.ss of Caneem ' BsFf oelled aatfonsl1 health ~ Insureace Xarpalify for IIB-Ceunties-'1950'-1984.' V.S. esseattsF. and.. esld' it. wu. •'fmportant' Lo- a8e0ts'approbIDBteIy35IDflltoa Alaert-. .~. 3Tepartment of.HealEh, 8ducatlan., andWei- keep~aaR means test ta theabaolute• mlal- can9 anrlOlle wGfCltt$ame3labteh to'.eD11- . fare: Public aeettbservtca. xstionsl Instt-- mm beeavse:M'avery: very dlfficu7t to maln-trol.if- detected'. and the. Patiellt. L2 be- . 'tntes of Healtli,. 1975 (DREW Publication Ift taahJgn9nalfty eertQaefor all ia, aay'pIan gllrton'tIlerapy. 'Ih' t$b511Wou1d double .. (NIBI 75-780)'.. •. . .- -. .... : thst atngles unt taspoor Deople".In asepa.- the budget a72tharity' for: Sh/Sprogram'.. "... e Par4uhar, John W; of at ."Commualty rata . category:'l1ketnday's• Medlcaid whrch,, and extend tt9 author1ea11v1n for 3 years. Edumtlon for : Cardf'ovaaeular Health." . The.. Msold'. aacoti¢uges."Medleala; m117s." . In . edditloID,: bf eeG9CSth1g the: program - ... . Zaaeet- I:8083~:, 1192-d5, June.4. 1977. .. .:. ." ~trol Control of ofaoete; aelwlaes.' he.tbst 14 eaid.'w83-caatrot te0.ufra.,- to. a Pro14'ct we will ail bwaLly the most - .. . Rt3ree.n:,Lawlence.vV."DSlfuatonandAdop- . over AddiDg mefitartotlsD'r06IS01S to be SnDPOrtedl ' tbDaf Innovat3ona'. Related to Cardthvas- . ~y buiitltngs and equlpmeat and , .: -eulaa:8iak Behavior in tlie.PUiN2o.".L Y.Eae- - the. averase of expensive medlcaV specisl-.. htirtherlROre'e iff splltow8 the Statess to~ 1'aw; J. ALan, and J: Headereoa (Eda)-d¢ypjy- I8t8"' choose whether or not theg wish to'o sup. 'img: BehaeioratSclenee to Cardiooaarralar` For etample..be said,.. "the.scope~e off per- porritheSeprOgrBtltt. Biaiw NewYar14 Ameriran Heart AsaaUatlon,. °Onat Preveatlve eervlcaqcovered at the tie-IaCTNagfng(p we ai8learD]IIgof health' .. .E4-t9g, 197s . glnmagPuf e.& aew, nattonalhealth plsn haaattSaIn the a3V We.bteakbe,the w8ter .. ~•Brownell,E:.~D: ..etui.The_Eeato~ ~~tbe:narroW.but'aapectalbaaracautQ.we.drfllk.thefoad'weeBE,andthehouses'. .' Couplea Traisiay and Spoate. Cooperattoet be `~°~a0ahedd to. a.pprove aaatttbnsl serv- welive.. III. The paogcaaxWou1f1 enable. 1tea.for aoverage after ttep have been testedtwasnrtreBehaviorsuTreatmentoJOaeaitg_ And .evaluated,- . - stabestodeslglLDrogramstoddeatifYaadPeqerpeeeentedat the Annual Meeting of tbeHiatt-summariziag an artiCle by Dr. How- preventt huIDan Illness caused by theseAseoclation. for: theAdvancement. of. Be-ard' FraZler and hlmself-urgedd rlgorouss env11'olil9eIIta1 he'atth:prObTela9.h hatfor'1'herapy, . Atlants,. Qeorg7a, 19a7. .- evaluctfoauf~. all medical and surgicat pro-. Physical HtmeSsshOWds be a goal for - xrbld;.Farquhar,.Joha.t4.etat. -ceduresand use only of: those that pass.s alL. AIDerfesma. This aieg. will Provide . . ~ - - me5ter m: beaeecial'l and cost-effecttve.. . grants to. argiAlEe tli• erleoursgeo thede- IFiom the~ Washington Past„ May 19, 19791 He urged GbngresctoPass ablllipruposeda yejoDaieat 01' Cd>'a~ffiIDS1Ve. Dh9s1Ca1 .. Henr.tn aoem'8sva DeeetE oNWuo Sasv.. tiTSCO-Ed°OardM. Semedy (B-Masc)-ors $taPSS DrOgialat TII[i' S$Ollld 1Llerease. L.m,Warr Snetr, f)Q ., samCRllat tes eumpretlensiNe" bill' byHep. ~, a„~naW niP Of tlleJE 19C]11tSC4 [ar at(~ . (8'7~atm'Coha). ', eenterealtb.servicee~renearcha.ItlWould. ~BrtC8D3. _ ~'iLenstlonb hesltlk bill larleing so fasttkasaee tests of nes maasines.. far example, -Reallzlhg' the. tuvermw aIIQi$theg ffiat. lt_tehaetening. the.e dayWhea doctars-eastty coroaaryartery surgeryfor'heartat- BtBtee.theforIDlllagraIItDrogramla.thls

8dag 19, 1978 ' + CONGRESSZ()NeYI. REC©RD-SE1UTE ; ,`S 7,1459 the roleofe the- front-11ue states: Is' like markets., We-are alread',yez{ierieneingy aNowever. it- has.became apparent that more Chamberlain's, legltimlzation of Hitler'a seriousdecline l:n our share of' the~worid additmnal storage space: Will berequlred " rnle in the Munich settlement. market--a& dechnefrorm 50-60 yercent than' envisaged during apprauu and pro- "-. eot Th ~ ld d th v .. e newprocesa- i ed for un er e prol -.-Butthe:IInlted'Stat~:aotoalyaccePta oalva.decadeagoto, 33.PememttodaFfis iug line wut ooeupv almost svncee the so- _"- -their role;, butsingles ou$'t a country like Flue-cured.d tabacco,, forr example:: More- tlcipared erea, the haaeatripping pracess.has '%', . Tanzania..f'or speciaL.honor and favor, overs.thereare:A other ominous market -hadto,be:tranereaedtoa.storagearea•aaa "ya - even whean it goes. directly contrary to signs~ that.are.well understood.by United the temporary shedsw111.nat remaln.servlae- '~ the pocketbookInterests'. af U.S. citizens. States and North CaroIina groweis. The - able after 1980; aawwas enought at. the time - .-. The leader of Tanzania isJules . S'obaeoo Division of: the U.B. Department of appralsac ... . .~•y,`: Nyerere, the self-proc]aimed!promoter of of Agrtculturehas-prepared statistles's at Despite the failures created by doctri- ."Africansocialism."' It i,kdimcult to see: my request which tell the' whole story. .-naire socialism•and'vlolations of human ,rhowPreddentCartef°can.squarehisp>ro- ...The - failure.e of Fresident.Nyerere'9r18ht5, Tanzania now seeks a third loan ' ,- mottonn of . humam rightss withh his's praise policies- ih Tanzania are~ detailedd in. aOf $14 mtill'on: Tbis '.money wouldd be used "~ .t-ofPresSdent.Nyerere. :-.. • . :. ...: :.stafE aPPraisaIl report Prepated for the to purchase plastic bags and bagging • ' i: In ptomotian of, African socialism. tyorldBamk. Actually, the proposed $14- eauipment.set.upgrading centers: build ~~ President. Nyerere has uprooted halfof millioa:.loaa wouldbe the third World. storage buildings with concretefloors. -~ .~-- his people:frome theiY'traditYonall settle- . Banklban made to Increase tobacco pro- and buy tractors and trucks.. , . ,: -ments. tisfng hiss arnLy to drive them out.._ duction, w1th uttle Wshow forlt because Mr. President, here 1s thepeint: We burning their homes, and: forcing: them-of T,_ry,.e=i,., micma^ vement. The two have a State: Department and and ad- : intocollective farms' often at great dis- pr,evious. Ioans were for $9 million andd ministration that lseager to doleuut the ,, tanceas from their, home'e areas. Iaek: of $g..million- ::.:_.. . --. ..... .. . -. American taxpayers' money to Com- ~. ... Planndng, lackk of orgsnlzing: basic serv- .- The language of the staff reportt is sur- munists and Marxists tohelp them un- , ices, tti,e choice:of poor farming.land, and.d prismgly- : h=h; consideringtheeSort - demut~ our ownn tobacco Production, and .. inade9uatettansportation,haveaddedto.international -os•ganiaations make-.to -destroy the Jebs- of North Carolina ...' ,....:. thehardships..:. :' .... :... ......: ..avoiddisturbing Third.World sensibil- farrners.TheTan3anianProlectwasde- . . Presiulent Nyerere-runa a one-party Ities: Spealtin&, of the- emfamed! collec- signed d by the World 8ank to: create to- . ' att Allf th newspers areowned ba fepothot ..ae.. o:eeaps, tivization.. thereport says: ... --.,...: _._.-ccoorar--as a cas crp-no , bythe-:Governmentorbythe'.pat•ty.The. ... galyperformanc> has beenn mlzaa, witn for domestic consumption in Tanzania. ., President 1s the'e editor in chief of. the . ~~eem maome~ reglooa aemoaaaattag.n aa Afterr the. original loans's were made. II.S. me;}oraewspaPers. He has between, 3,000 tmprmivep aburtyy tor mobulze-iccal eupport Praducexs" thought that theY had re-. .- d9000litSlis IJ]]s far fofi lftid tht th Wld an., poca Pronersn.a.r theconstruction osocalareeructun ceve! assurancraaeor Bank , more thanSouth Africa..On a:descendiag. -(such: aa schoots): orproductlve. Infxaetruc- would make nomore such loatis. ' - .. acaleofl-7..FreedomH'ouse-_rsakaTan- ture(euch.as:vivagegsain'andinputetoree). Thereare.32Statesinthiscountry :Zania as 6:C onl}r astepaliove ceuntriea- whilst ctherr villages have shown uttle~sbu- whlch:raioetobaccowandhave:an:intexeat sadists suehas Uganda itytay efcectivelymobuiseresouroesy vu- ih seein m that theiTf ownfarmersn do not ' run b9inaane - g , _, - and E4tiatorial' ~Gu1ne8_,. _ _ iagl~tlDna aaa . brought w1th -ftt probiema have'to flubeldlu' Unfair tompetition - -' whlch are lncreaefnglybeing felt m Tenaanla ., . , . with their tax money_ We:Oluste puta -- Yet.PPPBidentCarter allows PreSidentrn,ecme-arem ofhlgh populatton denslty . Nyerereta dictate: ourPolicy towardd maeglastton.has Iedd to.overgrammg and de- stop to this sort of'thing. . Rhodesi'a, andchosehimas the:8rst planon of aon fertuity., mother areas..there ~' Mr. President: today I am tntrpducAng Afrlcan.leadertovlsltthe-WhiteHouse:'n aresubstantiatd:meconomles.lnthatvniagere- -sbill!whichwouldhelptodoJustthat` .. :.-. ihi Augl7st.197T.,ThePresident haiied t11emust. now travel' further toculttvate delde. Lfdder that bill,., theIIB.. Executive Di- .~Ta.,~nian leadee, as.."a man ofmodesty' cunecteueiwood• and draw potable watsr. ~'-rectors ofiaternationalflnancial tn- .. would have to consider the _. and. greatt aohuevementwhot fu~m my- Moreover„the--socfallst argicultural~..stltnttnna'L oplnion.- holds the key to the- futureof' marketiingsystem has also taken Its toil:extenE towhlth such ]bans'; would have .•peece.e and equalityof treatment and oP:-.. .-The.mutetmg system ies often character_ an adverse effect onindustry and! agrf- ~ .. ;:. por'tunlty andd freedom in:. Africa as.. load bylsct or aompemtwn,.,nigiti marketmgg culture inthe; United States:. Moreover. dearlyaadaselbselyasanypersonallve:"y aoets:poorservnce., and s'iow...paymenta to, an economic Impact statement.t would :'-NOtsia71r1g1rtgly, the Tamzanlsan ecoa-, rarmers'-manT parestatalshave been Provea haveto be'.Prepared' showmgthe.g effect - .-.omrp haa falledto r~pondto*the.e8orts, too beinemcleat wlth-ezcesefroe uverhead of such aeafstance'om II.S. iitdustry and. . ooete. Overallk operattonsemcteney has not Joba. . . ... : - of enforced! callectivization: The dectrl--improved overfnepmtaecaae, and map even .. Mr.. President. II have-gone into the .. naireaPproachtd.agrieultureta.mat:chede have deelfned: ia.somen uaee. a+cesaInem. . '--. by similar misnnaaagement of: other ciencies have resulted mmmeseed trrdmg ¢ase hlstary o[: ibLs. Tanzanlaa loann at sectors; of the econom'i,y. The abridgment marglns,, whihh ]n turn lead to:hlgner, con- some length. becauseit shows in det811 .. of fundamental human' rlghte,, partlcn.- "umor pnces's and/orr lower. producerr pricea, the absurttity andr harm.causedm by for- " Iarl'y hrn the area. ofeeonomlc freedom... Theee, protileme, . haVe Ifeen exacerbated by "e1gII assistaneee toihdustrie8 that will ,: has worked_ considerable hardshipson.- the ehanges outtiaed abava-. compete with, ours.. Butt above and be- -. .. a, eountry - that .. alreadR . has.., poor -The: tobacco-growtag sector was par.- ycndthat, it demonstrates that unsound -performaace_..... ....:. .,.:,..:. : tibularL4 Ihard ltit by t2iechaages: 'Ihe and dangerousforeigaaoliciess policies . ~'1Peverthelesa:;A•esident Carter. ,co,?--»t World Bank loan, oI $9 mi7llon, was that will aHeotmtllione throughout the . _,," worldSOrthe worst,.also have a aegatlve : ~tlnues his .endomement::of, '1"• - _., imtended for llhe.fomed.resettlementrof-,impacton:.ourowmeitlzensathome.0ur polideH At-this very mument, the- V:9.. 15,000 : tobaccogrowers. The World.Bank African Policies are heading tnward , . representative to.the World Banklsspre- Reportsay+s: .. -.. .. ... .-.' = disaster ~ Af3):ca;.; and.ifd that happens paring to support- a, $14, millloa, duRar' The project quickly encountered dimcul'--~ the eonsstiuences wi11 in the ksng run .. loan to balll out . the Tanzaniaan tobacco: tres. The-settlement of fasmers reu'W behina- affect: the : Linited States. Butit eveanaw. ..'~' . industry. As: the single largest contribu- sohedulee as areslrit of government preseurea d er to~ettrryYavor with Marsists, and torr to.the Worid Baak,k the'IInited-6tates. . on, farmemto ,mdertakecoliecttve tobaccw . or ( 'O'PIESid mm'un1et8111Afliba t C ' ' v ea arter cul tivatlanandcnrmg.... ~ ._ .-: eanrlesa weight of endorsement that.goes~. Tobsceoo production. Iromt the'PmJect ln" seems wi111ng to saerifleethelmmediatg ~ , , beyond the Weighted'votiag sYstem. Itt ia.. 1976/TI'laestlmated at anly3o percent cf the- . ]nterests of V.S:. taSpayers. These.polie9ea . hard- too beIIevethatthe WorldBank revised estlmates sud.ls only aaout 10 per- are tiemg. Pushed without regardd to the e ' wo ld tu d ml l T • _ rnn own. a u an¢a ana proPOSa cent of totali Tsaaanian nne-ciaed tbbaccoa eonsequences, based upon some strange : aftertheglowing.trttiutesthathavebeenr production, .ratherthaathec7percentan- ldeological-compuLvion..Bydemonstrat- .paid to Nyerereby President Carter• See-ticipated ... ., thesmount ot-tobaccoso far. iag theimmediate harm these Policies retary, Vance, - and Ambassadar: -Ypung-- . growa.ls,dfesppomting...,.. _ . .: bring;I hope to help my colleaguess to _ Yet the purpose- of this loan isto In- The second loan~ of $S mlIllon, .ap-- understand'd the long-term consequences. ._ cceaseTanz ras_ in*, tobaccaproduction for• provedin 3eptember 1976; . hasaLvoa pro-. Mr. President, IX ask unanimous con= ...exportsales;..competingditectlywlthII.$r. duced fewresults:-- sent that:the text of:f my"bill be Printed .....Aenlm TI.aTn....•..,/n..1.. ....~~.. ' . - m:G1Ve 1n lBprUaryi "" '- lneludes bath: Siue.curedd and hurley._ a#7v. moat conttactes for prolect equtpment ~There being:. ao ob}ection•, the bill was -Theirmarkets-are-the.samre.markets-at hameaawadF been awardea.. and.-macniaery ordered to be printed ia theRScoan...aa - I . F ,3t Glarketa--aad as:NorthCarollaa. Inetsllatton:commeneedn fa. Novembee 1977: followa:. _.

S 7872 .. z~ .. ' CONGRESSIONAI. RECORl? -SE ATE Bfia'2( 19.. t 97R -": Aear forr each.of: the Drov.rams ilsted.in eub-. m the oase of:theLecan ve.e endfne ua i.. of ..,ee~ ..H..,.... ,., _....____.. .. r e u a ee (7).( ) r paymen . an or ore July 1, 1979. m the.case of the amended by (L) strlking"'a Stste's. a11bt:~ grante,under subaseot1oID. (a)) for:establishmg: Lacall yearr endmg. September 30, 1981, 75~j ment;'. m clause (A) and. lnserEfngg in 1)eu snd malntalningprograms Ior the screening, percent of'f the amount of such.eryendltures thereof "thesa:ounti recelved",. (g) atrlking detecnon, dlagnosts, prevention,.referral for m the'..State.'s flsoal.year whlch.ended-on or •'of & State's allotment" in el6use (B)(i) traatment, and follbw.up oncompllance with before. July, 1. 1980, and In theeaseof the and Inserthag m.lieun thereof "received under treatment of', hypertension, there are author- Hacalyear ending September 30,.198R;.10 per- paragraph(4)^ . and (3)etriktn "Stat' ( ) g e ve pu s a es ee ns llc heelth. servleesarithm the meats:. , ,.. .. ' conditions. -State: )n the State's ffeca) year whloh ended (b). Paragraph (6) of sectlon 314(d) Ib ' 1 Pb ffi t ' unde b f St t aetlvltles aeslsted under grants under sub- oE. Stateand.locai.e eapendltures.for compre- any previous everpaymente or.. untlerpay- ~' ctlon aln tontrollm ueb dlae e 6nd il b i ... . IJJ. «+ aeyuunu.,r.:w, sov, e.a perceni or tae amcunt menreas appropriatewlth adjustments for . , tlen oE the..8tate., er Under granta under paragraph (T) oa the (L) msy ante[luto- arrsngementa with ra- . .•• (i) ': may not ezc,eed-the ieeeer.of-.. partment of: Commeree. .. 8ecretery may by regulation prescribe. 1"'(I)i the prodm;tof 61.00: and'.theapopubt- ''(8)The-Sttaetary may makepayments .-^(c)' Centerss asslated. mrder this eectfon i a gg st thee endthereof the follovnng new - . for the:8ecal yearand)ng September 30;.1982. g . .°(3)Par mymentas vaderr subeeetlon(a)~ nseal. year In accordance withv such clause p~%gJ'aph:. . . .. foe.establishfagandmelntaining:aommunity' ~'all State health and mentalhealtl'r-au- ••(C)~ Of.theamount'sppropriated under .. andi echool.based'IIouridanon programa, thorlttea wlth- approved applications; the subparagraPp (A') for anyfiscal ynar the . "- tllere~'are authorized to be spproprleted -total amount of'grants for that fiscal year mr . Semepry slfaLL'U obllgate noct more then - 86,000,000 for the flsast year ending; Sep~ State: health andd mentaU health authorl. 81,000;000 foc the unlform, natlonsf, health . ties shall nat.beLeeg than an amolmt whlch. p re ortm .: en ~~d1ng'SePtember.30I981,fanG88,000,000bears.the eamerr.tio.to theamounta deter- p ~ h(Z1(C)g1l)~~m. referred to lis ... tlle.eacal year ending 9eptember 3q 19@2 for m)nedforsueit authorltfes.- In aecardance.,B..II-~~~CE4FQR DISEASE PRE- . '~. Por paymenta. under aubseetlon (a)' anns suchclause as the amount aPproprf- . ~~ON AND~ . ated under such. paragraph tleare to the - lII^AI•TH PBAM0120N. .'. forr establ)ehing' and. maiata.tmagprogramsamuJunt neededd to make 8tanta, . Sa accord- '~. t>s+rara roa ffiwnra norrormN~ ` .. designed to: prevent flineess esued by fectors'anoe wlth such clause,for such 6sca1 year to Sec. 201. TSt1'eDI of the Publlc, Health Imm pla such ss..oca)IUM.erpoeure.nW toxic sub- _ aII~ State health.and mentall health authorl- Service Act Is amended byy adding after sec- .- erwnces, and'd lmproperstorage ofablld vreatae ueawiRh approvedappBratLLOhs.. .., tion 316 (added by section 109' of ttita Act) and Iueis, Glere sre tuthorlud.to'd besppro-, ,•(B) '. The.. Semetary;at the:, request of tha following newsectlonand beaCing p'r)4ted 812:000,o00'for.the.flecsl yeer.endlhgState health.and,mental healthauthorltles; thereto:: . .' . ... :. September 30i 1980, p12;000:000 for the flacaly may reduae" the: amovaC at the gr ...ants.to1t •t'ansrs roa~7ra. nosrort0ar year ending'. September 30;1981,atml underpamgraph..(1),.by- .. . .. ,.°Sae..318.(a) PbcLne .ofwlaY-'.. ' i19.000.000 tortJle 8ecal. Aear ending.9ep- ..~(i)', thefolr market value of any-suP^ yye.. m P~~eea . tember. S0, 19o: ..' -._ - plies or equipment furnished ench authorl- Ing 8eQ°tarA carrying out sections 315 . ..'°(5) Por. paymeafa tmder'suhscctlon .(a) t8x,aad .. . . .- . . . _. .and 317: providfag such technical and oon- .. fa eetabliahlhg:g and.. mslnminmg ptoga'ams' (h)') the emount off the pay,. allowancee, suYting aestetance aas reelpleMw: of: grants tnprevent diseases Dorae by rodente;M thenand travel expenses of any omcer or em. ~°Qr auch.sectlom msy Srom.tlme to time are.authorffied to be-approprfated.814,000,000'e ployes of the Oovernment'whendetafled,. to re9vire: conducting reaaarch,. etudles and -- forther flsesl year'enAing Septembar 30,.198Q; " the Smte health or mental health authority 0°~~ (Including eaet-eIIecnveneea analy- t14,000i000YOrthe8scalAaar endingSeptem-. and theamount.of anyother costs incurred ~ dQ4entlve hesltn.servlcapeoB~s: .' ber 30. 198I, snd'~ 814.000:000 for the8scal' )n connection wiLh thedeta.tl of'such o0cu PmgapProschee, methodologfee, . aram lo .. . pollefee: and stlantlarda for delivering. p,re-- r yeat'eading8eptember30„1983: , - - - p ye0. _ •..'':.I venttaehealth services, the Secretary etiall .. (6)(A) TheSeeretaryShallestsblleh, afYer" When the rvrni.i„e"of such. suppl100 or by graub assfatpublle orpnvate nunproGt :. eoneultatlonwiththe' Presldent's Council on- eQulPment: or thee detail of such sa omcer eatltlm )a meatmg the coeos. of'plannmg and Physical y7tnms: standardefor comprehen-or employee la& for the convenience of aaddevelopmgnew- oenters, and operathrgg eziat- eive physical Htnem programa. .... . ... at thee request ef the Stete health. or: mentsl ingand new bentem, for multidlsc1p11nary _ `(8)Por payments under.sulieectlon(h)r hesith authority and forther purpose of healthpromotlon. To.theextentpraccGeatlle, - fpr eetabllehingandg matatslnling. comPre-'oarrytug- outt a program' withh respect too the Sersetary shall provide emistanceunder hemivee physical 1ltoees progrsms that are. whlehltsgrant'under pangtaph: (i) la this section so that at leaet',ffve:euch eenters '; consistent wlththestandardeestabDshedmade. The amount bywhlch any suoh..grant .w)]l be'm.operatlon by October.1. 1981. -_ ptasuent.toparagrtph. (A):,. there are_an- la'so redueed.stiaB' be'avallable for payment ..(b),(1) No grant may bemade under this . . thorlred to be appropriated' $10.000.000 for by the--Seeretary of' ths' costs Incurred fa tlb~ tloesl year endlag: SePtemtier 30, 1880; fmafshingthe supDliesor equlpment,, or fn section forplanningbr developing a,center 817,000:000 ter the fiscal year ending: Sep- detalBngthe:personnel,.onwhlchthe.reduo- Unless the8ecxethrydeea'aLnes.thatwhealt . -., -. tember 30, 1981,.and 818;000;000 for ttie.8sca1e tion of such grant.ls bseedij and sueh amount Ls opera2loml it wW'. meet the requirements year ending' 9ePtember 30, 1999:". ..- s11s11- be- dcemedl ea part of'.the . and .~ted.m psragraph (2) and bee ablato pre- - (b) Section 503(a) of Publie. Law 91-e9E'- ymD, be deemed. to have been: palgrd grant the ~~ ~ISoeande dissemination of lh- ' (telanng to authorization forr lead.beaed: 3tate healtH, o[. mmtal health authaMty., formanunn to recipients of grsnte, under eeo- .. -. pstht polsoning- preventioa. Programs) 7s' -(C) For purpoaess of subparagraph (A)i tisoaa316 and 317 ss..provided la.aubaectlbns and Under amended he end t~ereof:e't, 8 4,0before 00.OO0 the tlisftseal 4t).(II).. the. term 'State and local eapentllL thfa section)for operatlomHOf aecentMereumese t ear ending. Septemtier30; 3980, . 814,000,000 ~es:for eemDreLenslwe publle.health,aerv- tbe center meetesuchrequirementiand is y Soss' meana.eapendltures tly SLe.ta-and lacal-atile-~ prcvide.suchaesfstance and..diesemi- . fos the8seal.year.endmgSeptember 301, 1961, . public'health and mcntalhealth authorities '- and 8/.4,000,0000 for the 8aea1 yeerw ending, ~ public heslth' services desfgnated.by the nation of informs.tfe¢ . : September 30: 1983-• -Secretarp but excludes expenditures by such ~(7) Theeequiremenra.ceferred tuln para- ezransmN or ceeril9io axarrs roa ccauM- authorLties- - - gtaph (1) ere as..toBows: >vavsava avsnrc awsa seavmm'. •(i)specl9cally'requlredby Federal statn. -(A)Thero shall be. a: foll-tfinee director . Sse. 104. (a) Paragrapha (4)) aad'(5) of tory law aea.condinon.totherece/ptof Hed1 of'theCenter who posseseee a.demonstrated seenon' 314'(d) areamended toread, as fol-eral ansnclaliaesistance, or capacity for substantial accompll'shment and lows: '(If):) for operatmg. )mpatlent care facilL+-- leadershlp' in hgalthh pramonon, andi there '•(4){A) The tob31. smount of~f grants re= ties, censtructlbn, or mental healthh pro- shall'be euan additional'l profeeslonal staff . eelved by State:.hesithe and mental.healt7ll grsms. -' - , aas:may.beapproprfate: . . authorltiee.undec'Paragrsph (1)foreqyfe-,. "(D) For purposes of eubparagraph (A)' . -(B)~. Thesta6'of the Center shall repre- . calyeershallbe.determtned.by.the.Secretary. populstGonsshall.bedetermined'.onthebasfe WantadlversityofrelevantdlactpLLhee. . . ,: eacept.thatit- -- - of thelateet.flgl¢ea available from.the De•- "(C) Such'additional requlrements'.ae the _-, , her30,. 1981, and..840,000.000 for the Hscal :.,, °(I!), may:notbelesethanthe.greaterof- (e) Sectmn 314(d)(7)(A): I, amended by. ,: year ending.. September30, 1982.. .- -- "(I) thetotai: amount of' grants received striking "s.nd" after '•197R," and Inserting .. (9) phr peyments'under sulisectioa (a)~ by such. authorities under paragraph (1) for before thepertod thereof:. ", 8107,000,000,for for.r establlshing.and.maintafning programs5 the. Qscal year ending September 30; 1979, the Qscat yearenEing, September 306 . 1979, ... to Immunlma chimrenagalnst diseases ()a- or .- . •. . . 8125,000,0000 for the Hscall year.w ending Stlp_ 'tludingg meesles,, rubella, pollomyelltls, diph- '•(11): the:w product of 8.50and the popula- tember 30, 1980;.. 8140,000;000 for the8scal therbs,, pestussta. tetanus; andl mttmpe),, tion of:theState: year ending.September'3 1981, and s150,000,. them are authorized tn be appropriated 836'. Notvrithstsndmgg olause ()1): iff for any ts.- 000 for the ftscsl-yeatL ending September 30, 000;000 for- the Bscal year ending eeptem.. C81 year'the amount a I983'; .. ber30;1980„ 635,000,000 forthew Qaval A~r~~ . PProprlsted forr that .- •endingSeptember 30, 1981. and135,000p,000y~ under P~6+'aph (7), Is leea, tbaa' (d)9ection 314(d) (7) Isameaded'by add. the amouat naetled to maketar th renta t 1h "laad to be appropriated 830;000:000 for the oent ofthe: amount of such, erpendf.turesm almtment" ih clause (8) (lt)'and ingsertfng:f:n - fiscal year ending'9eptember 30. 1980,. $35, the. State'ss fiscall year which ended' on Or Iteu thereof: "amount received under pen- '~ 000;0e0'W for the Hscali year ending 9eptem- before July 1. 1282: : and - graph' (4)" . _ ~ . . . . .. '.. . . . ~ . . ,- .. . _. , - . . . ~ ~ V.JVV.J.6Q!i '~'~~-

-61ay 19, 1978 CONOItBSSIONAP.' RECORD=-SE ATE ~ S!7873 ..avooass or- sastts stsss essocreet'so:wrra-Mr:. President,I' fully support the'articleand'.paper,TllusI..askunanimous ._'- ercoamn asasesrrra eP veazava r.wa oe major Droviaions.ofthis.disease prevea- consent that "Health Hasard.ADprattal: .. ex ,ru sn srsnraca axa wms scas: c® tion package. Iam extremelyy pleased to. Its. Limitat'lons: and. New' Directions for r eoececoenzeea® m eaaraaacreu.uz erx~- seee it Presentedd as a comprehensive ap-~ lttsk A'aseszment,'•" and "Heaith. Costs •~m nm"a:aTSe - a : _.Proach to the promotion of good health~~ Spur Debataoa Who Slaall'~ ISva, Who ~,: s.c, tI, (ap •rhesecretary of Hesatn, adu- for the Nation: I hope my'coileagues will-6hall Die."' be printed fn the Rzcoan. a - d t uc , ar . cetlon,.. and Welfare saau. coa r studies reuge for the conduct of, a study er agree tthatt thesee pl'oDosals ftlLl a major There being noo objection, thee ma- '. . . oi. (I) the relauaeheaithr1sks manatatad. gap 1n ourr health DCannlh8 and delivery terlalwasorderedao heDrimted.ln the with amoktngcigarettes of varying levels of systems„ and that these bills will gather . Rxcoaal as follows: ~-.tar andd nicotine, and (d) the health rlsks the,e strongg support they deserve.R.;Hesczs H-- . s~.: Ira. Iasrreaanns aseoctated with ®oking cig%lettee conntam- * .. Mr. MeQ3OVERN:.. Mr. President, II a+a Nrw Dacccmars:aoa Raaa easzsennrr., mg any substancm cbmmonlyadtled to.com- want to~o take this o to eom-In consld erin tae- broad msndata of P:L Oitunit g pD Y . merciany manofaccsuad cigarrettes- H lth ShaNeLloaBl Coaeume a1Z ' s4 Ia ea • , r - . ' (b) Withm two years of.the date~ot'en:- meZld. SetlBtorSxPNEUYand the staff tormanon and-Heatth.Plomotlom Acc ef 1678,' . antmenti of this part, the Bacretary sEall re- . of the.3ubeommittee on Healthand:3c1- lt beas been.clearto me tnat pexeGn risk as- ort tothe Ooagress theresuitsf the study entifla Research for the development and p. o' nr studies conducted pursuant to subsection _fntrodnetion.n today of . the National eB~ent Ir one of the nawett potent and '(a)i aad any reCnmmenaanoas. for leglsla- Disease Prevention and. HealthPromo- prnwning-alnett embrrooic-tecan/quea bt t d a o:a vaace the statua ot preven- . '~~tecor.admlalbcrsttveactton: L ava9s tion Act of 1978. L8[e 8. 1191, the Na-'..tton,preventive esratcae, tealth.h promotion, _ & Mr. IEGLE. Mr:.President-SenatOr tional Preventive Medicille,. Health health-eduoation, health.lnformatton, and 'S&uN b-TT-MM'I are todayintroducingu Pt•nmohion.Act of,197T, a.bill somee of my the myriad of nther macthms mnndated by . with additional cosponsors, a- full=scale ootleaguesand I introduced principaqv' this important piece of legi,latlon- ... -... .. . prevention. Package designedd to: develop -to address'needed eAangesIn.biomedical alslc, esaeeement; often uemg,.healur nsa« st . t t n l m l ' °ro appr sa ac n ques, vo vee the .. anatibnal strategy to prev,entil}nessand research, this bill is another potentfal. e eom- disability among Americans. This pack- step in the mostt eriticai'~l processofre'- ~a r sn.tyve off tnee pmbebutty ofreduced age-presented In. one comprehensivvediessmge the balance, betweenn eurative°~m°ey~e or dasthh la the next- ten yeara, poeed by the partlnlnar• oonateuettca . bill and In three component proposals- and Dreventivemedleme.-Jvst.tilia ot risk tactara m.sa mdivldueL.It hes.gmc .. utilizes State and.Faderal.resources„ re- morning in:n ttle Washington Post• the. -potenteal for promoting concepts:of weuness search;; and' edueationl experimenYetion importance af altering our current over- and risk tscwrr x.ductton' through chsgea ,. and' proven programs, all: designed to emphasis on-ctlrative medicinewas.high.-s to ilfestyle,: but.1s currently hampered by ,. -reduce theincidence`ofe disease In this- "lighted in.an article ttledl. "Health IIeveralimportant dehctenctee. I sincerely °-I wul not: break Lae dract rula or a hd . p " countrF_ h;oste Spur. Debate on Who Shall Live: . . . : .- . good speaker this morning'by Irritating.or - . Perhaps the most significant part -of: Who.3hall.Dle.." .. . . ... .. .. ... ' i..n„id.± g.. atore than So%',% of the audience. the National Disease PSeventionand. -A%chairm%n'of the:Nutrition Subeom- I: do not want you tothtnt that I bellew _. HealtliPremotionAct.of.1978'~isthe.food. mittee.Iamencouraged..thatoneofthe. I'navedtecovered.mcetofthe.tesues lwih isbeling and nutrition'informatlonsec-n bill•s five key, elements revises the foodl diacustodaF. °-...,. ~-tion, whlch,is based m' large part on the Iabelmgstatutesin order for consumersAS I see tt,. the problem.sre:e witnh hearch his "rdI eppr°lae`t- [anl within four enerat ~ provisions of'S.2540.whlch Imtrodueed. - to'be able tnmake2ully informed choices - g . carles:. -. -, b t th f d th h au e: oo eF Durc ase: on Feb 10ith th cospnsorship a ,ruary' we.eo ~... - :.-WheOalnltaow - ~~ 4.~ ~.~ : ofSenators. S,anraDY, w*rrr.*R'. and. Ialso-note.thatm0!distinguishedicol- :..Wmt•emtmitnow•. . . ,.. _; '-#lacxvaoN.. Senator'SZIaNzDr' and I feei, leaguasfro.n Maseaehusettsemphasized -.Whatlt can do now. - ~ fn.hiv..flmirntatnm,nntth,•n~w.a:vwt'nn-.....Wlvtitr.ouldda ._:. <.:.~. -~ thnt.nane. nn,rtanamf~C~..956ncfinFhnA~~. '`.Amendhlenta Act- of: 1979, deserve aw realized'.potentib.l of.the Office of Health: :..°:a'= •< ovn.r.sconoaaxa< -:-. . ~'promihentmsilionin~anFeomprehensive.Information:and'HealthPromotion',and~Ihave.severaf.overattconc ernewmch.re .' dfseasepreventfon package, and Irthank: -hisexpectatioas that at>,V'-concrete- ad- relevant ta health hazard appnaeal.. .... . the Senator for including many of'these.m1nL5trative proposalh for deallng:.with- Moralism: Aw I:revlewmost of tns(iltarv -~. provisions. At the same time, I:would like disease: prevention and"health address' mre concernmg prevention, heelthpromo- h the Senate: to know that I amcontmufng' the futureof- that office. Iwoulld amplify tian, and wenneae. Ihesr tones of the mw to, work' toward adoption off additional . fils: point by sayingg thatt theDepart-' rengton. Usre l.ai.ande'a talk )aet year epit- .measures d'esignerltoassure that Amer-ment'a- failure to aggressively developcnusas, fa many waye; eucm.marallsm.Wnne ' deeortbmg Important innovative eaorta. m " ican consumersracefve full:aad adeqnate.that affice: to. roatchh the mandate seY. . ee.nads.to implemene.tne operatton Lifestyle . Information concerningthemgredients forth.ih the Nationall:COnsumer Health ptogrem, bemakeq frequent referenaeeto and nutritional.l valueofthefoods: they' -Information' and.Health. Promotion Act. "bad" and."tarproper•r• lifeetyles..and -arong '• '• ° ' and abuse oflifestytet'rhiskind .. buy.andthatthe.Pbod '.and DrugAdmin- of1978.has:impeded.progresaitl..alllareass cnolcea istrationwiQlhavesufficientauthoritytoofdfsease.preventlon-and.health.pro-ofmorallam.haa3ong.beena.p roblem~mpub--combat food contamination and Prevent motionl Furthermore',; in light of such Ub health whsG the where-we publlc eften .hould du. feel we."knonv bet- -' . . consumer deception and^ooffivsfon "-AaDers aa: "Health' Hazard ~p~~~: ter . Failura to Atknowtedge:.Disertng mdlvtd" I alsolodnwith Senator. BxxxxnY m. Its.. Limitations and NewDireetions. for uat values: Acorotlay -to thu.s moreusmn is. ' proposing the- othereomponents of this- Hitir Assassment,:' whiclrwasdevelopeda our frequent fauure~ to acknowledge that _ ~'dlxeaseprevention package.. I am eu-byMS'-JufterFutie.rton. EaterimDirector;. healthfa.not sn end in tteeiff,, but ameans .. thusfastic.about.theopportunity'tobar-c the.Iost.opportu,nitytoobtainvitalpolieytouvlag..the-kln.d af ilfe.one:desrres. Not ness the energy and resources of' ourdtrectionr from the©ffice of Health In-~ ~ eeeryene aalueehealthaadi long llre m the--.. State governments to combat high--formation and'Health Promotion does 'eame way. In partlcuoar, peoplee havn.wldelF .... mortality diseases, utilizing both state- nott appearr to rest with. _t'hee verysmail sarYtng, vatueo- *bout nsk... eome- of- us am - ':avlnl0 and community-basede8orts.. 7a, sBafl.of~._t1ult office'e who have labored ~~Frlak aversi. wmte others sra:not'.so -coaeeraed sCOUt risk, ead virtually nom, ot . additibn: I feel- iC-iS essential. that LDe~ underr aa sevare'e budget constraint.. ._ . us, fas conslatentt acrbeaaa areae, aaaatages. Federal Government expand its own role. MII•., president„ the development of -of b,ir iises In our vatues about.rist and our -in'the- prevention of.f tllsease, both health maihtenanceand promotion as "'°illingness, to maxe ohangeas and' chofces re- _through research aridthrough publle. a.-national', priorityreqaifes.y that both :lated to.rlsk.. We.need'..to tnclude: indivldual- ~ education programs: Andit fs:longpas 4,'ongress and the aflmlaistrationn takepBrcBpdbne ofriskand tudlviGuai values t m eme thne, In this respect,.for the Federal:C.ov- an active role... Thee introduction of'thta about rlak. We muatt recogatze that to so peoPlee tt Un eimplF not "ororth tY' to make ernment to~ put.itsefforts.stronglyon theblllis another indication of the Semate's. - drasttce changess tn iiteetyteoathe basUs of side ofprevent5hg cancer- through per-interest in. proceed'h]g, as - S8Senator . available probab6lity datt. - suasive',eHorta to reduce the incidenceof. SsNNZoz'sreference:toproposed& addi-oyenmedteluzatioa 6 of Prevention and cigarette smoking:. Every American.n tionallegislation,on~biomedlcalresearch, Risk Assessment: s2ost modern. preventibn, shouldd have the. right too smoke, but't the health, manpower and health Insuranee mn my vlew,. ia not: ^memcu,e•• nt an. at least , , -Government should.takebtrong, positive- As we pursue our goal of'incorporatfng-notlnsnywual.eenaeor*astterm..aatnar„ ~ volvee: com- . . actionto reducetheihaideneeof smok- disease: prevention sudd health promo-- yiaz prevention and lnteraatlons risk among reduction m mdivldNals, aoclety "imB-ralated. illness, and-. to ssaurer khat tim ih oyr natloa&1 health Dolicy. I bee .and eoclu. vuuee, andd basith-prcAStonaia-, ~ _aonsmokecs.have.therigpttutireatheair -liever It:would.beuseful to consider the. ~'.free of cigarettee smok.e-In public piaces pointe'. raised in the'above-mentfoned. I~iotaotei~at end of articta .2 .

.Mffy 19, 1973 biIIU aIIows each State• to•focva its efforta orpaneof lts•.fiNereadiTtg cauaesof death:Inaddtiont.lve provide fonds forthede-• '_ celopment of a- 9tatecommuaicateons l. program so~ that~ the. State~maS~ utiLSZe mvdern~~mase.medfa•techni'ques:to•aidin . ... .. - headth prnmotfouanddiseasepreventiom ~ S'z879 reet•: bu'(ti~ theSenateCbmmlttee otr the tooverhaui and': improve e theflaanciai:. Diatrictof COliimbia:deferred acttoa mr management. and.f(scal aceomitabilffy of:f tfl.thecityhadassursnces:thataprihste theNatontaCapital.I consider none, developerwAuldfi)1lgutiII7stfiesite_De- ®ote. fmportaatthaaP.L9i1'-399:1a1975:. tail'edplsnsfoctheproJeet; hauebeenap- ThatlBw createdthe:•L2mporaxy-Finaa-. Pr°ced by lora1 guae~•r+man nak Iand P1ao` e1aT Qversight Commisvion ta imlRoee . . nthg bodies;." oppositiomhaa; beem.eE mauagementt and fiscall systems so, the piBssed.atnamerouspubliemeetings,andfhst,totalaudiL.oftheDistdct's:flnanciaf. heatings; anrladeveloperis prepared to posit,ion caa bee completed in. 1001 and.d commence construotioa this-year.others:ca¢becanri-t nannuaUythere-Th"s Ieglsiattoa:involves no expense to: "after. I chair the Comnnsaioa and it al-y theFederalGnvorament,andmerel3:wt11ready has madeeobsiderableeprogress in :+ theseefforts?wecan.learnr.which- st4aEe- clear a cloud on.tb.eSanrLthathasIin-. est^btish+ng sound 'recnrdkeepdng and . gless ataeHective<•andwhich should be gered fon more than. three °uacters.of a other aecesearyproeedutie&, tlut 1t,t has'. Dursued'.natlonall3. -.. : :-• . ..centa.Lg...Ori¢fa^Lg. theIand was dssia- fnm(d that:tsamreLstfaelq~'minar chaagrs. "'Rsthe: Subcommittee oaHda{th~aad nateda for PubIla.stseets. but, under the In the 1975, act wi1L clazifglts:auth°ritY.. - ScientifieResearefr, on•whioh-tamthe TLTM- Statio.ntAOfaoE1901.and:19a3,.theands will peru>Lt.more eapedittousand: - .... ranltlnB$eputilleau,psaeeedsto.constder.stredsFwerrdoaevfandatiaadoned.andcost-efficientimes:ns.ofac nievln¢tlle;goal., . •. Ta better undetstand how all tAe• eie- :' menteof a.headtlrPromotlon-p'ogramaa- :'« teract in a speeift¢ c°mmuaity, thisa bill `:: woulld establish five commmllty` demom- ~• strattoa•. Programs.. F hopethat- from tcorJCwith us teimprovethepreventYon- Phia, Baltlmore& Washington RaiI- cally.tllechangeawouldpermiatheComN, this=biIL=uPgealFconeerned citfzenstos the land:',wae grantedto, tticPhtiadeL•°fiannuataudits:for the:District.SPeciS- ..of dlseaseandpromotfonoflYeaFth•hrthee road. Co:c andtothe BBItd-more & Ohio.nm*+**-: fixst,, toa negotiate certaiia. :. The PRESIDZNG. OFFICHIR.. Withoutt tha. sitie•- as UcCeax R•enewal Plsa for Settatoa, fr.om Wtashington. (Mr. 7acic-. 'sel£andothers; tuacreatrpragt•mmato.. ThelaadwasbsedprimarilyforswitchCommitteeonGovernentaiAHairs.t ` promote healtB) tmrougfi smekiifg, deter• traclis,. IoadingK docBs,. andd open air stor- - :. rence: belomtlrreferred tetHeCommit-. a&e: As rarl traffle• dirmnished' at mid- ' tees on.Environment and Public~SPMBst; century, the city began considering the •ADDSIZONALCOSPONSORS - . ,. Pinance,: Commerce; Science;, and Tran.c- stte for urbagreaevaal: Ia 1959- theSlis. ... . . . e_sus..I. ,. . . .._portation;andHumaa.Resoorces- .. : ..trictBbardolCoumusat°aers, designated . AL.thereque'st:of:MrBaercorn.the• Mb RABEIL'I•Cr'B4TgA..44Y. Presfdent„ for the perpetusi use°, of the railmads: mentsT with- theDistrdctroa Partieular F ask nna,.+*.oua~ consent that a bil:i~ia- and- in eachange.. they gave more. cen- eontracts_ TBeehsnges atr essentally ttod'nced earlierr bP the-Sena:tor from.._..traAiy-PoeatedproaerGiesto theFederal! r.,,x~ and.IwouldeapectthelegslaR • Massachusetts(DSi•. Swxenr),,.foahim- Government.:- s - tion will be swiftlgconsideredy b8the . . .VnitedStates.. - ~ ... anrJi~.to-theTemnnat.CO:~~.'lhelandwas~i eontraetsaadsecond:~~.to•enter~into-agree- aa nee ~" . tfie: District.of C°Iumbia,,.a.critdcaL pr1-~ -nationaF cooperattbatocombat inter•Ia1900'theDistrictPaid:thePenasylFnat7onai`.tertorism .,.i ~ltyy iss`ea the sasion oz the IocaltasL * _ propertyof the Chfted SYates to.the DIS.at'flrst heliectnr any rnmaa pntn>.Federal'~ ~cyy=°x),.the Semator faam Minnesota .trictofColumbis:.RedevelbPmentISnd titlecouidtiecoaveyed, adn~istrativel,yr (y~,y,H~ssal,andtheSenatonfrom. .~. Agency:. to the- Committee on. Governt under tho' Closed Street~ Act of 1932. PeansgLvanla (Mt:. Hsma). wereadded as ~mentalAgaits. ; - - . . . -. . ..foundbareTegaltttleremalnedunderthe~ponsmsol°..~2236~,.a.btlL'tastn'ngthea. . • Mz EdGLETON. Mr- Ptesidovt•~ for oTiE II~m Stattom Acts and that wm--~;erab.polYciee..and Progtamsand mter+ esaionat aati®i w ded . . .. Sy Mr_ EXGLETOR::' . . . their rights and interests Nmax),. the: Senator isomTennessea (YIr:. ,.5`3tT9-AbilLt°transfetcerYa{areal Asthepro]ectmnvedfonward,the.citY. S/usssa) the:SenatorfiflmMlssourl.(Mr t~ww:wvu,.,u,~s.r.,ruereo=. _. Ar 1982;Pald$r.52h025fathrrailroad§aor sox) ) nne ~_sot: nnmr umo ama. _ ..Gr.am¢),.the Senatna.fxom.Georgla;.6ildz , PrSVate.constructlon_SeLGrellanceshould. , andlim 1973;.it. pa1d:$3A.milIioa for.sa~ At the reauest of Mr.. ANnessoN., the-e hean essentfaLcompanioaoLHOmeRUle ~~ ~ehouse•psoperth tn. com- Senator fromCaIIfornla (Mr. Csnxsxox) .CIearlv...increased- capaeitpbycthe.Dkr plete thesitee bninging too a.totsloC$5. ..~'.added asacosponsoroTS:238®:the. .;tr7cttcrafscits.a~arxra¢enurn•.~¢ilSmeau 37a.9241.it.has-paidto:seeure.thesitr_ ...DUtch.EIm.DiseasrCCntroFRetiol do.•naa..i T9~F7., -. •.. r a~ ; m v . ; oni $ - t - s $ ' hase.througTithe.developmentotneeded . . .• csaea . .. ... . . . earflaterestfae.the~41.000, squarefeet. . . , p snl Rn i l ad 4 xl 3aaf t rJ ht ti le r .. ~ drpe, o„re.. on the: Federal zws„v ,.n .r,v.e.t,.e ... .we. ie...,~~ .r.e. 4 ~ .. • ~ ~ svrs ~ ~ - eg, s a at on. ~.w9Ihit.anuniatentional, roads paid.over~the years,. it.was~the.~-~ProvementACtot197&. ' im edfin nt f l a es acons ra on ana. ou r of the Zc P 1 ' sightly andidlelandwithffithe. ~Dlatslbt. use- ~ .. .t,vn. G. -~ It 1s ~ to: this ~~ end that ~ today I iatrodnce ~~~t to ~ use' tbe paecels.. in Southwest.. fferrn¢aT wss addedl aa. a~. cosponsar of 4• Washmgtonn and'~ of the tasess the~ rai1- S.. 2~475',. the Pubiic Grazmg• I.ands...Ito:.., l ..t l ti~ th , cans s re . o n e r e q mxaca; the., thr°ugh_thedevelopmentof:Presentiyv:r ( Senatorfroax M St t l ide t tt fo C u~..~;~~.•n~s,car,.oesc.oe.aemeuea ..,s,: t n.. d d At the-r ue t fer t of M e d -'th II it C p e c s mng ago FedA.naL land opinionn of the Gbverument's appratsera, s. ssxe . title.thatstands:f¢the.way ofalmosttWC, - ~ . I • . , or.rrocr..an the Sena- A )d ~ mSouthwest.Waslimgton: 3I20: A ~~bilito~enhancetheflexi61T~ty -~ tor~lrom New York~ (1FlY~, M'©.~rms~a )s~a) een Fourthh and Si~ffih Streets, at CC mentto,the,deveTopmentotwhatisnowSenatorfrom West Vlrginia (3Cr. Rosr Street, and is needed' by the Redevelop- a- wastelandd of railroad: tracks ean ~=.C. Bxao)., the SenatorliomF:rkansas-~ ment-Land. eTgenCy oL:theDistrlct to. speedii',}rmave•forwar[&*. - (Ddr: Bussras).,, thesenatorfivm. Ar1- .complete.asitefnrtTie.constructfoaofa zena(IDII-DaCbxcnsr)•,.the8enatorfi•om. .. $40.to~85a.miltioahoteland o~ce~cent'es: ~rylr EAG3' FPSOfC` .. l~lssouri'(Mr E ~ - r ee s m ee aDaarm~)., were added as cosponsor•s~ of - vep, 41:000•s4uarefeetof7and theFederaL. _ft the ratIroad. . .. . P e e .. GOV~~~~~OV~Y°'~`~~' ItiellevethattttIetothe.4'1,OOOsquare: $2~6`~~~'RicesSarvtv°r ~. -raiiroads. at the turn. of the: centurybut- teet shoufd'be comeyed to•, the, Dlstniet ~' P~~eatm Actoi 1978. inmhlch.itstllLretainsabare2egaLtiLle:n saRthatanypeioodonthelandmay;once. ~ ~ 3Ga~G1,'t~'. The4r00Psquarafeet.tvroaghlgtie- andlbs, alCberemavedand, aayfmPOd& ..At.therequestoL.744r..Harsaca t5e, • -- meicisraompT~.Spa^:^^~•.w^",.lt'.w1lIeon.- ~readFhad~patdthe•.eqbivalentvalueof I : ~.~atos from.Nece Hampshlre.~(DGi. the Iandhad th f i - t1tI 6 ~ theDist¢•icL atcrfromPermontSMt SraBroan)', and . develbFoldrathoadvroPertyfntoaeoni-om. 99W hr T975,,.that ottlYe~hem fagsia theHouse. - At the~~reLuest~of b1r..MOxcnx...the~Ben~ -- ~~ ~ d'eeades- of effbrt by tlie Distriot ta~.reu at. ' ; needed'n.,000sq~uarefeetwasconveyed rary!COmmfssmruomE4nanciatOversight bilTto•amenaFtkre:TR•adeActof'1974:V~ ~... Eevoihtion- 39'I: but. at. tha. time, Plansmittee on Governmentai ASa.'ssc c y V~ -~.-•4 Y V..~ V~_.L s~ . 5adnotheeadev - AhtherequestoL Mr. Psts, theSena-. ,. lect sadt~the:4'1•.OOo~p~fosaspectBGpro-• Mr: F,eYGyicTipp= ir4k Presir3ent; ass tor from+ Maryland (bIL Zt~L_*was- 1nd~uded.: 4uarettet:wem mt rhnlm.mn oE the• Senate Committee, on addedtasacosponsorof Senate, Concur~ •the•Dlstribtot.COliimtita( nmwaStiheom. rent Reaalnttba.8g, expresstngthe sense. .. ILi18Z5.theEiouse.ln.8R_ 995SvotedmitteeoSGovesnmentap8gafia:2.have~ otrthe.Conor-w ..thatthePTelsihld 8mat. • -~te transfer Wtief tli 'EO e. ' or: oOSe{par a4 introduced:a~II~ ...,.onoIDt.mesauxu PICGasweIIssinTernatrnm.nra~~,9,..

C CONGRESSIONAL RECORD = SENATE S'786i' - . '•• (6) (A)~ 7.he Secratary shall.l establlbh, ' empLoyee:is for the convenience of and at:the_ the Secretary shalln provide assista.ncae under the Pre5ldent'e requeet of the State health or mmta:lliealtU Lli1a seatloa aa. that aE le9af, flve an¢71 ¢eatere. -- ith . . . after' Wnaultatlon w ' Council: aU Fhyslnal' Bttness, standacde . for authorlty and for tae purpoee of rarrying ottt will be in operation by October 1,. 1981. rehenslve phy?icst'.fftnesaprogramsl a program with respect to which.lts gnn4 "(b)(1) No~grantrmybemadeunder.this 'aom ur: l in e d p eve op g ae n : The amount eectlon tnr Plsnning or .. ede ..n~•YXr:-e~", "(B) Fta• payments under subsectloa(a). nader paragrsph` (1) Is m for eetsbllehing and. malntalningcompre.bywhlchmy sudi graat.fe so:reduced.ahall unless the Searetazy detarmines that when.lt henaivephyaleal Otnesaprogramss that are, be.avallable for payment.by the Seeretary of isopemtionalIt will meet the requiremears ....eonsistent with the standards establisaed, thecosta mcurred.ln furnishing the supplles.. listed inn paragnPh(3) and be able topro- autplor-thePersonael', videasslstaaceaaddi.....,:.,=tionoflnfbrms-. lndetailing or o*equipment taereare A a , . . ):, ( y, .yvravanttoDm'agraP . NM ': biad ta be s.PPropriatsn 810;00O.OOD for thee on~ wmoli Ehe,reductfoi oL sudi grant 1stlon toreclPLente of grants under eecttonss p l ,. " flacal~ 9pr ending Septamber 30. I98(li: 813.' tima~be madaeunder this deemed m Ua aand ~cJ. No graa h ll be d s ~ Of the grsat sa s 1. D00,OW for the fiscal year ending Septem- ald to thaState healthh oe meatell asction for operation of a eeaterr unless the th pscell b f - e aen p or 39g1 andilSOW;000 b 30 ,'sr.,._,. :. : ... 1 - . . ' ceaurmeetasuchrequn2meatnaadLSaelem t ' • hea[thauthord yearr ending September 30, 1983: y., . (ti) Sectioa 303(s) of Public Law 91-895' ••(C) For pnrposes of subparagraph (A) provide:suchamietance and dissemination of (ralstrngg too authortrettons for lesd-bsaed! (1)'.(II).. theterm''State and.loasl erpmdl• informatioa. .. rohensive publmhealth aerv-"(3) The requlr_ements referred to mpara- - I ama)isI t rea for oom ro p p gf u isoning Praventloa paint po amended by m.serting before theperiod'at-- ices'meatu ezpendituresby' State~ md, lbcsl graph (1) are ae fo[laara:'' . the endtJUreof: `„ 814,00p,000 for'theflscal' public health and mental heaSth, authoritles'. °(A). Thereshell be afull-time.direcmr of' asted tlythet11eCenter who paeemsse a demonstrated desi i ' g ces Stb 30 1980 p14000;000 0 forblic health serv yesrw endingepemer.,,, pu for.theflacsl.yearendingSeptember30,1981,: Secretary'butexeludes'erpendlturesbysuch capacidy'forsubetanaatiaceompllahmentandy an,i 814•000,000 for' the Oscal year ending: authorities- . "leadershlp Sn heelth promotion, and there. .September30;.1982".. "(1)apecifleallyrequtredbyFederalststu«elmubesuunh.aQdltlonal,proteselonalataHea. sirsxsroxofEaaesro, srwxzsrva.coa0?aa- tarylawesa,eonditbn.tothereceiptoLFed-7 maybe.approprla:tm . . ffixarvr royao »yy.r>H sesrress. .-. , eralli 8aanclall assistance, or" .. "(B):. Thestaft of trie: Center ehalCrepre-. ...'. 8ee, 106. (a)''. Paragrapil+. (4) and (5)- of. "11i) for operating mpatSmtearefactlltlea:,- Sent a diveretty of relevmtrdlseipliaea:.. () _ congttvctlon,.or mental'health pragrams. "(C) Suah addltionatrequlrementsae theea¢tton,314 dsro ameaded to [ead eaw tol .. oees of subP~gFaph• (A)~ ~'etary may by regulation prescribe. ' Py ' (D) rPur P ..~e: . .. poputatibns shali be determined on the bae]s: •I('~ Centers aeslsted' under this eeeUOn .. aeaole-frum theDe~. ()' yenteriatoarraagemmtswithreclpl- ..°(4)(~A): The total amount oi granG.re' f igures av of tae latest ' ceiven by Stste health, aad.d mental health. -eata of, granta under aectlons 315 and 317. e .. ' ~ ~ rce.. . Comm t of . for Lne~e provlslaa. af apProPriate~.. 6nd aeces- .. lUtlloritlee under paragrsPh' (1) fbr. my'9a-. Partmeat ~'l5) The 9acretar9 may ~epaymeat° eati year easll be determlaed by theSecreta.ry. s~ technlcal aslstance. and (9)) shall ae- . aieepLLliatlt- . :. ... . VmlargranLeilaaerpflrglaPh.(I)¢altileb9allVelopanddleeemnUltetnau¢hreciPientsap- ..'(t) may not esoeed the lesser of- ,:.. oE', euch estimateamd m aueh tastauments. Proe.cnee: metaodoi ea, aolee..and etand: .. •('~ ttie-pruduct.af 81.00 and the popula.. m.aPproPrtaU xlth adjustments for myDre.. ~ds for denveringprovoai va health sarvlces:. .- vmus overpaymenta ot underpeymeats.". ~ ...(d), Fm the .of_maCin a tion~of the State, or purpose g P ym<nta . (ti)' ~TaBraDh(8) 00 sacpon.. 914(d) 1s puxaumt to grants uadersubsecUon (a) di ° . „ ng casaof the as¢al year ea _. (a) 1m.tlle. £eptemtier 30..1080:, 5 percent. of the amounti. amended by (1)) striking 's. Stata's allof~ there are autaorlb<d'' to be - appropriated - ment^-eianae (A) and lasertfag m. lieu Ih ' , 0io ,000,000 for the escal year mdingSep- . ei.. 8tate, andd local .xpendStureas for. com. (2) et21k1ng. ~eamouat recatved" ~ •' t , ym.:ber' 30, 1980;. 810.U00,000 fbr' thefleeaL . bm plellenelre public healtaserviCes withln the Statb in theState'e daeal year whlch.ended. "off a State's allotment" -la clause (8) (I) year myng September 30;, 1981, and. 110, . md Inserting Ln iteu thereof "received under .0006000 . mr the fL+ca11w year eadm Se tem- t-th . g p e Laecese o . on or before Ju1F1n 1979,., m. - flecsl year ending September 30;. 1981,-7+h'. . Paragraph (54F',.and (3) str181ng:••9tate'e at- bw gp: 1987 ^i . . .. . .. . . lotment••' (8) (11) and-lnaert7ng m ¢lause m . .ro~~~ abm.. aeseoxe~nanoxs arnr.. .. pereeat of the emount..of:suell erpendltures, ttisreot: 'amooatraceteed under pars- f . .. ea. , vZN!rXVr PERAaM SxRrtcxS in the State's HseaLyear which ended.on acI ... before July 1„ 198U;I ma m me ca5e m wa. BrC. ROR. (s) 173eSametety of Health, BdU- ;. Oewl year mding:.September:30. 1882• 10 per-(e) Section 314(d) (7)(A): is amended by' ation..md V7anare ahall uadertska or au - "Ip77°'and lnaerting d" ft " - an a er tf'htf'h in atriYing .cea:o.te amounosuc expenditures,... rc throu ts or eeatracte orr tlot) n . .' 000 for Po ( Bh 6>~ " . , 4107,000. the State's fiscal year which eaded on.or be-before tae perlod~ thereof: fore:JUly.l, 1981; and . ` . tasOscaU year endingSeptember: 30;, 1979, five mtenslve.aud comprehenatve:¢ommunltq .. "(Il) msynotbelesa:thmthegreaterof-8135.0011:000 forr the' Oscal year ending' based proglame for the purpose of Qeman. , [l.xtzatm8 and evaluating optimal methods G1 000f 40 000 , , or 0 , "(1) the-totala amount of' granta recelved~ September 30, 2980; i1 :. bysueh authoritieauader paragraph (1)' for ecail yearendtngSeptamber' 80; 1981,. aad.d fbr orgpmzmg md delllvering comprehensive eervM1CesLo detlaedpopu- _ - PF~mtSVe healta~ : year endlag: - the Oscall year ending September 30, 1979. or. 3150;000;0001 fottheo-Secal` : 1982` ~ ...- . . . . . latlona. : • ..: , . . ., . . . . rber3V t S em ep •(II) flie-Product of4d0 md the PaPUIA_.. , tloa,ofSaeState- . (Q) 8ecttann.314(C) ('I}'isamendedbyadd--(b) Rhe. Seeretsryehs1Iy aubmlt to the „ Notwlthstanding clauee.(U)ifforany~lmg' att the end..tilereof the following aew'- Committeem Humm,ReaoUmea.aiF.lie Baa- . . . ate md the: Committee on~ Interstate and . yesr: Lhe: amount appraPriated'tor that flscal- P~a~'aPa: -- -- Forelgm Commeree of' the House of' Sepre'- . year under peregrsph. (7) islesas thann the "(C). Of the amount appropriated undersants.ttvea on January'1', 1981, and oa.Jmu. ' : smount needed ta.makngrautsfartbat ascel subparagrsph. (A) forany . eecsl year thee ary 1 of every seeaad year thereafter a report .. year In., accardanG, with. audi Clsvsetoe all Sscretary: ahslI o1111ge~ao lth h u •. es national Stt hlthdl hlth 000000' for the ,•^ . ~er.eueecoa.~acungunmm« dhtt(Lldi bt tll ae .eah an mentaea authorities, „ withapp'aoved applications, the total amounE pragrsmraPantmg:aysffim referred W la Par-lted ta:. & detaUedd description and fiuavam- of grante~~for~tLat fiscal year for State healtll graph (2) (O)~.(7fY67.. .. .. . . . ation of'tae~. effectiveness oD each, such pro-d and mental healthh authorities etlall~ not be TrZ7m II-x.BSODg;Cy.9~~ FO[t DL4RA8$ PB.E- gram, .....- . . ~~ ~ leq~tbanaa~~amountwmelvbears.the.same -..pMMON~AND'HEAL'1'8':PB.OldOTION ~,.(c) For thapurpoee'of...undbrtaking_oe .. ratlu to:.theemouatsdetermined for auctiL ;. ca+.ros ros. ~xs rr.osaortow aupParnng: demonatrationss mdd evahratlone Such clause Pumusnt toeubeacttoa -(a) tliere are eu- _ , lt!! '' . aeLhe amount app[uprlaiedunder euCll para- t;ec. 201. 21tlrIII of' thaPublie Hea•. tassmmded b7 sdaiagaftersec- A i S ~ 8 erv ce c •hb tthtdd tk 9ttl 30: glapescaoe amoun neeeo mae ee o.+.e.acayearaenngepemer :.. hth OAdi Act) 102 Oi' th1s b tl : yaec on. grsata laaaardance wLthh such: clause for' tton 315 (added : 1980, 9eptemtler30i 1981, September 30; 1982, . such fiscal year toa]3 State health and tnen- the-following now. secttoa and headlag:ttlero-Sepffimbcr 30, 1988, and September 30,. 1984'C tai.health authorities with approved aBphca+ tot- "caarr®a ro4 xsaxoxu, nrasses rasv~rrorr nsA veoras ppyg• . ~, . -- .,..>IIelrrarsontotaoar i . '(B)_The S.cretary, at.the.request of.Stata- "Sac 318:. (a) For the Purposess off aesist- Ssc.703. (a) The Secretar,y, acting through . Iag titie.Secretary'facarryingout sectlbns 915'5 thNatianat Center for Health. Stattatlceor health and mental h lth th itl ea au or esn may , .. reduce the ataounr.of the grants toW it:under and 317:. Pzovidmgg suaa, tecaatcail andd con- 1ta.eqylvalmts shall aubmft tor Caagcaea oa . paragraph (1). by- amting.esafarance.as recipients ofgrmra va- January1..1'981. and on Jmuary1 of every dersueh sectlonsmays from~ tane.to time re-- third year thereafter„ anatlonsl dieeaae pre- i " ) the falr, merket value of any . l supplies oCder toprovldea ' oreqvlpmentfurmshedettchsathotittes,.aad q~' conducting research. studtes' and, -ventlan data Droale m ~.: -^(ii) the smovatt of'thef pay, allowan~s; amiyses. (ineluding coet-efreatlveness amly- data base for thee effective implemmtation r?sndtravel expenses .. of any amcer or em eae) of~preventlve:Lealtll'aervicePTog+'s®;: -of:tnUActandtoinmeasepubllcawarenesss , of' tha. f3oaernmentl when . detailed tolpt~e andd developing aPpraaches; methodologies, of.theprevalmee; Incidenee. aad:my''~ds -. _. $t+te healthh or mental . heslth: authoxSt poucies;.and standards for dellvermg.preven~ m' the preventable uusees of death and dle- { 7 a¢d tlve health services, the Secretary ahsli by ability ln the Dnlted States. Such proEle r. e. .. tYe amounE: ot.mq-other costs mcurred In' glyata aseist.publtc or private nonprofit en-.- shal11ac1udeatamin3mum- -_ -eonnecttoa with the detail. of' such of8eer or tlties Sn meetnlg the eostsof planning, and ,(1) mortality rates fbrpreveatable dlYesees: ' . l oyea : .. ....:!!vmP . . .:. ... . . ... .. .. .. developing new eenters,.and aPerattng: ebat-: . (2) marblidlty rates asaoclatedd rit'h pre= .. whea the m.,.,fxe t„s. of. euch enPPltes.GE - Ing and new ¢enters. for multidisciplinary rentabl'e dl8eaeen; . •.. ...- :: eQWpmant or thedetall of such an aff/eer orw heaTth'promotloa.,1'o the eztentpractlcable;, -(3) the. physfcal- determinants ot health

: dF..... . - . .~ ~-; . ~... C /,"' ' . . . . lll f CbNGRESSZ©NALItECORD -SENlI'<TE 1{?ay 19, .237.8 _ S 7860 .' g siis.. •mmore'tlian.4'.000+ hOspftaLF~% despite our ,_ Some of~ the~.moet ucamLsdnr devetm- .. ~°FaeitenactestgAae.senaraand-EOUae.of- 360~.000phvsfetans,despitemedicareandmentsia~the.aresofpreventio=ncoacern ;~~menta4nronoressasrexnb 47yatcne medicaideaPendituresoly65billionffiis thellnkbetweenlifestYte:andlllness.,and vee.r.wehavefnathis tountrvnonatfonal Zwwidliketa.sharzTrn•..P~ddonr w,,,,e r-. ..1'rastarn' amt+~- n°a ~•" --m.° .'sm3tegpfortnepreventtonofIIlnese-ana oz >ag pprgonal, earltemeab ever recent .~.;.. ecvuva.Dlreotoro-.of ulr In&ernatio»al: Bank dlsabilitFamong our people. E IInd this breaYthxonghs.ln this.ares'.... : . - mentti the ihseto p l . for Remnstruatfua and. ~. rateraauonri Devsiopment. • ei«^n.. In-:.oveidight asticundi:ng: Surely, the pre- .In.theI950'sand early 1980's;thrnugh , ternati.onat. atnanne 6orporatioa.the. mter- ventibnof'1Ilness, and'- the-maintenance the work of 4VFnderaad others; we came American Development Sanlr,.and theAslan of.goodhealthi9thewises~: moeS.COit- fhstt to unde.33tand the' cel3t'ial: role of -' Devetnpmevt saak; and! the.naecutiveDUec-.. effective and:most humanei approach to- clgacetter amokinr in the development tor tetresenaak me'=t@a' seat°: st the reducint;ther bunten- of~ fIlnese. m- this of lung canoer ALevf<yemislater,:thiou8h :. Atrtcanr nesNOemen4PUnd:,liz oetrging aut.. ea„atrv- Fet-: we find that- the=IIhited acork' donein', the edtw nl, Pnaxninohwn:. tn r..i~;tnrirdunee.*a-rnus>m5,gt,atesspend3.feMthatx.Z:perCentoi:.its mpowa Stateoi'.Massaehusetta:.epide-;;f,i,:: .ap ioea c+eeir. or curee utiuz.twa.of the . health dollsas on preventive health. pro- mioiogLSts began to see thee close 1irJrs y..:,•.'nmaaor""°.` grams;and F31at: the FederaL Govern- between eholesterol levels~ highblood. edvenee eeeet ob indratxlee~ incauding- agri- . .' cuiture:, rna omployme~ ta the- unned mentt has no. coordiaated.sttategr for Pressure;'. oand.the.development _ dH^naner mc'gords' LakingadvaatBgE afthem6lt,Qnew Elreak- of ooronal disease. and stroke. [edueing e b ita t q s . es. e . sta . yrodueed in the: vvited. etatea or bs ifterew- ' throughs: ocearrin4 in- this. 8eld- .... The implications of these IIndings were . ' ma tmporm to far untted statee. 'rocarrp : E am tutroducing; ' om behalf of myself .nnciea.r..If stnokinV was, correlated: with.. .. wt tnr playorea ofttne-ACec.f ms.Unlfed andt Senators. Wn'.esnas: CBar>S. A.tx- llmg•eancerand. other disease states,. .. etstmssecusivsrnrectovot eech ema la. oai.rH, Pstit, Cwuvsxox:. Rrssz,. Savms, that: did aotmesn that ending the habit . ::'sutuuon atraa re4peat..a.>sd , thm-t7cued_ SMWEBUM &nrvroe>r Henr wouldproteetagainstthedevelo ' 1KCGOVSm. Pment of . ,: ., .amtermumrtiolsst'BadacoT^~•.'~-sbaii ". +a .+:.,. Fi t t Cancer Or h ~ t dL A d 1t l a r ag m ea r .Etbmkwill seeae n andIlannr; e evated. ,,:, 'iurntsb, a..repon ase4snmgtbe.ticrtF.impact .:~ ~ 1• w . rf such icsnaos owec.emnctat or trcanlcu filZ this inezcosable; ttapin our national oholesterols+and, elevated, blood-.tlresaures sweerece.ontnavetdea-mdemptnxmeatia heall~:poL4egan3:ourna.tionsLhea]th werecorrelated.withtisart-diseasesnd. struktwe- sMlll could not be• sure that -~ s t 2'h :vatt 2 DL rtl P -r' ps em e Sease roves oaa oa lteaasatea the Ttn:. .. . .. ...... . - -_..aia....i>.. A.w..w..._.....r..w .nne..-.... Ynmsanonhnlocf .r m. lwmhtn.. 1.1~i ' - fievelbped witii tha, wise: aseistanee of Preastn•e would proteeta8alnstthe de- l~sr- . )~Y Sfor hiin5elf. OS di .... gg velo ment a di l ' ' ~ ~~ ~ p r sease: c ovarcu ar _ n... .>T..... mr. r~a~,e_aisr - of my colleeattex.L think it pro- . .._I/ . RamoLpg.mr- Ps.....Mr.Rntczz, Aviae3tneessenctal:eiemenworaPn)gram ' tsutotQeptaemtologies-and•dllnicians.. Mr McGovaeM.. Mr_ Haax„ and I which cas dramat7ea.llg reduce through deveTOped' evidence on these Points- as .] . ' ntrr.r.a,s.vs- diseasap=eventfon..thetiurdeboLillnesswetltItbecame.clearthatwhessmokers' S. 3515,. A. bi11 to,estabiLUaa.compre- .. y.~t+r.wunt.ay.: - . . .. .tuw, w.eu' nsx oraeveiapmg cancer ana. disease-Preventiiom.and. health .., Mn.President-wecauprevent.the~dia--heart diseasedecreased- rapidf$:. Slmi- hensive• . .~: penniotioa program intheIInited:States: easer whicis: ki1L most Americans-We larlp;, it tiecame clear ttuvugir studfess tothe Committee on, Htmssa: Resources. have: the means, orwillU shortlFdevelop d'one: bp' the. Veterens" Adinirrlattratton~ ' BPMr- >MNNED'Y (for himself. them. BY1tiI~ reeentl;pwecould not make andelsewhere that treating high bl:ood , Nr_oya`.•,•+r=..Mr_C13nrsa.Mc.. this elaPia. But let nsnow lookattfie Pr~ eouid dramattcallgreducey the. ' gyyoozrs„ Ms- ..y+syi,. yfrr facts I .. '..-. . . ":.-fncidenceofstrokeamong-hFpertensives. Mr:. Raers.. 30i: .. 'Onahundrediyeaa.ago. infectitus. dIs-_ While noo one haa' conclusivelp- demon- ~ Casnsxasa. , . 3evrrs. . nir:. Scavatiataa.150'. eweawerethe:mastTiurdensome'filnmses strated' that Iowering cholesterol levels _- ._ ; S,rarzaao:.. Mr_. McGoanas;, y[r.. in this country, but that'is nolonger the- wilI'pQeventcasdfovascalardlsease: manp-Hsax;and.Mr-.Z.eaaq):-. ~case.,`NehavelearnecFhowtaprevent of our coentrv'x Ieadng', cardiologists. .. 5_ 1116, . Ex bill tor amend.the Public ..manYof the~~inteeCious-d7seasesthrough PredietthatwiIIbethecase:. - Health 3erviceActtoprovideasslatance ItnmunizatYon;, and'titrough- improved IYew evidence Is constantly emergingthmughformnl'a.and.proleet.graatsfnr- saaitatioiratnt nutritionr and wa havw thatlYfrstple ciianges^ca¢adectmorbid- .. preventioa, heaNln. Pragisms. aad fm .-lea.med: hot.v tnheat manxot: the com- ftT andmori.alitp:'B8 recent study demon--...i~#r,~.•.r.other.PUxPOses to the_COmanitteteoa mimicablaedlseases.thraugb.the.use:of- stratedttistmegwha~eaaaiseregularly' - HumanResources:. . ..-- . .. antlbiatiasand.athetmediiations.Norc,.6 and^vigDlvtlsLFredhceLheirrlsk.ofheart " . . Hy. Mr_ 11LECiNEDF @for himself. ehrOmfe disease and violenee atg the-attacgbyrno`perteat:.-: :;. .... 1dsPR'aan~..114r.lneea Bd,i.. leadingkiliersandserippiers'inoursoci-, EYnallY.sstudgby'BeIloaandsBresiow..., Beanoar>£:Mr-Pau.Dfz.Rac>:a, ety::.IS2971F chroalis^affiictionsandvie- demonstated•i¢theeadqi946'sthatIm- It,llW)1firm:and Tence~ accounted• for 833 percent of'all pravedlifestglemightHe-ailletrn~ertend ~ EtR[iav>trm~ .. . . . deaths hr the Ohited States:'. • :. > - Il1tr: eapeetarrcy by' anywhere franx T to ..•. '~S: 3I1R. A . btIIto amend the Ptiod. ~~ 'Heart: disease alone accauated for 38:-.EI Aears IDtug: andCoametie Aet brrCqah,:• ,nuttrl'- Percent of' aRdeaths. Heart disease Pl.us' 'RLW Me unk' in~ the• chaixr was still. .. : , '.t .~: -'Wonad.labelia& of aSfoadsf and for other stroke and other CardiovascuIax diseases misting: Evea, if we knew that redudng Pumosees•;:: tathe• Cbmmtttee:, oa Com- aceotmtedfor• 5P perceat of deaths. cholesterol leveLs,, or cessatYOn of smn - ~...4-.}r.~,. eardiov~cvlardfseaserplus~cancerfor• {JiC.~treatment.of~ure;. . merar. SCfeaeei and 'h~ , ' sportattoa: a: astounding; TP Pereent. Add efrrhasis.-. could reduce hhe.lnctdence of cancer and e d _ o c: arograma. e- dfabetes. erphyscrem andrenal dsrase, hem-'t disease; it was not clear that we~sfgnsd t¢ pmmote heaIth through ercent oE: allcouL3flndacceptabiewafstodndacepeo-. -d t for 78 a O , we cc tm P ~~6.. smoldng.deterrence; totlte Cbmmittee.on deliths. Aecidents. homicide and sulcidePle..to stntrs&Dkine. taget thelthFper-' r S~ Commerce,.SCience..and:Ttansoortation rdwmstr t4c,~.. . a.: / andlhe Com,,,tttee'on Ht=anRCsources, /Inthe`Mite3Statas_y-•~-LL~ theirm diets- ia wags that would_ reduce T !"Jomtlg, by llnanlmnus consen;t- 1 me.V..nr h,l1o n. A.r~~,t rr,e rantnw- tberchotestemL IeveLt 3Zl?..SEIV.•75D'SF;Hn Presideat:: despite.. Yactors whichyunderlie:. thesn.WBUt. re- Citing experlments. tn~receat timesW tLLa~ its size and sophisticatlorr:. o= hea[th- r~eativ.becauseofeoidemiolo¢icaL.break- Iast'Guest'Conu behtganswered: and'the ,~...:._„. . caresystem haamang failivgs_Ztis, ex- throughs.weihaveidentided'.some:of'.theinformation 1s indeed encouragJng... In ,..cessivel4 costRy_ It 1s poorl7c Planned-Zt. hnportant cauaatfve factors• und'erIging C•elifornia, an experimentttiadld by'the. provides: ourpeople unevea' ..qualitg. oP someoftheseconditions We:havebegun.NatHonal! Heart. Lung;,and'. BIood Thsti-C carei It averemPhaeizea. prorisianrof spe- to see the reiatiemship' of involuntaryy tute-haxdemonstrated that an intensive. .,, -- .. elaltycare:Ztgives.insufficientweightto.eaposures-tn the eavironment andd the educational Campaign ttsing the mass. .- .: the-provisibn:ofprimacgcare: . -..-workplaee~to• the developmentot dis-medter and individttai: counseling could. :: -- --. Haweuer:.bfe. President nOnee of tiiese ease. And we have alsoe begtm: tQ see, the reduce chOresterorIevels by 39 to 40- shortcomings Ls more serioos•than the.7mportanceofllfestyleandhealthhablts pereeut,.substantiallylhcreasethenma- . - one:I: rise taaddims today: IIespitethe in causing the- diseases: wtttr,kraccomit•- berof peopLe- gettingtreated• for high - 3I8tT:.btIIfoa: wewllp spend"on persanaYforthe malor-burderrof illnCsa'in ourbloodpreseure, and reduce'tSlenombera. . . health services this year, desptte oorsocietY . . .. . . . .... .. .. ,._ -. smofdng::IIr a simlfarstady (a the'Fhi- . - _ G3603`59~ : _ .

May 19;, 19'78 C CONGItESSIONAL RECORD-SERATE -' S 7877 '-ponentss of the population who are hott mea tton and individual conneeling" ere reoom'. As one erample,, esercisa . emerged aa a par- . effluent, highly educated, and Insurable. Wee mended~ as needed. .. tlcularly important'subetitutet behavlorr in need more intormatlon on.n rlskss to women. Geographic Differences and tKher Non- smoking cessation, dlbtaryrchanges, weight lorr ezample, oneof', the prlnclpal reasonss indivimual: Factors in. Health: T71ehealth management, and strese reduction,. and en- '} that oxerahBH..mortalttyrateafinm.cmcer' haasyd appnaiaa4 dopnot copslder geo- banced thee impact of: counseling and other have not declined 1a the rapid rise in.lung graphic:` variations In healtlr,. which, for laterventions.'The Stanford Progranda]so ln- , cancer, espeClally' among woan:n; but most eiample; as shown in the "Atlae of' Cancer cresaed theeHecttveneas of'.Its mterventions - of our risk data and public edueatlonanaung Mortality for II.B. Countrlee,^ v raa point by emphasizfng, short-termm bene8ts, suchas aancer conttnuee to focus'. on men. We a]soout dtatnatlc differences in mortality. Lates betteramelIingbreath and iacreased.lungra- -know too little and Include.too Bttlem ourIrom this disease. And while. we do not.fulIy paelty foreserolse,.ln addition too reduced'- -~riek asmsameataof thespeclsl rleksof ml-know- the tesaona'e for these diHerencea. !n risk of premature coroaary heart. disease norttles or the poor; soI am pleeaed to see moat casaswe do, knowithettheyoccur coa, snddeath: . a.paper being presented here on.raefal and slatently md.shouldd therefore; be lncurpo. 8ociat cB'matee andd other social supports - ethnic dlIIeiencee in, mortality Ih Hawatl. rated' mpcedlctions af' dlsease. md life ax- play an: lmportant rolb'. m Influencing health _. Factors MotivatUng Young. People:', Moae pectancy. The cnl'y inputeemployed in the promo2ingbehavior; Thai conatructlve par- -r.+~.n attention needs to be given. In riskasseea- health: haurd appzafssl ace: those qumtiII- ticipatloan of spoueein Intermeation efrorta ment to motivatiagfactors.for Foung:peopie- able mortality ratios which ean be.e readily has shownpromlaing resuite lnn obeslty man- Heaeueh on.attltudestoward agingreveSlD, eomputed mto risk facLors. If this were not agemCnt.in work done by Dr. B:elly. Brown- ~r l ude 3075vould5 th thEltl i . that mmypeopener ag-e: caee.e numerca- outpu, appraisal eliv now att the. Dniversityof PennnFvanla, littldthd drop desd: gldtil Bt prefer tove ua, 45 anenpge, woue meaningem:u to aseess a Another promising technique in social sup- - pf:f conrse, thls vievr. often chmges ae. One . peraon'ss health statue= as accurate[y as. poeslL porte is eontingmcyeontractmgwhich hae . approaches 20, but the..tllusloa, af immor- blo; wemuwst beoognif®nt af the fact that bad a: sigomcant adlunct.eSect IncoatroL-n taBty among tae young,highltghts theneed aainy leas'bell qumtiaed md, quantlmable imgblood'preesurn. . . . for'moro slwrt-term and mtermedYSte.goaia faccEorsereof'tromendousslgniIIcanceee.weB'. I amoptimistic about theabllltyof the ' In addit'lonn to reduced mortality,. it health. Dt Is also imperative-e to' dlstrnguish, which general. publia to underatmd. concepis of hsaard appralsal.is.l to become mureusafu4 ot'the fa.etorsaIIectrng health.and health rlNr-beneIIt'.andtheprobabinatic.thlnkingln for a broader agermge of the papulation, Asetstus are primarily seclally and environ. general. If we get:away fromareme imguagv M'aro Lsi.onde oftea. saye, we: need not onlF mentally relatedd md.d whlah. sre.a primarlly and emphaelae the evaryday, rrisk ludgmenta to.bell peoplethate good sez.is healtuF, but smanablb- to lndlvidual actlon. 1'hee healthh that people ma.ke all'the tlme, Ilknetappiag al§o that good health. is;sesyY The-preven- harard apprsUal, dars, verp; welll with theoSnubs,IfeelconIIdbatthatwecaaconvey tlonotpreroatureaging.mdprematurephysl-latter,m but:...does.vistuitly nothing about tlleeecunceptetothepubllc.A.eeriousleeus -cat"deteriorationrepresent promising aP- developLng:soma.,peispectlve.lnthemtllvld- hereis.wbether,weere;,lafact„ssklmg'People ~. proa.OheeM mdd heree the. "appraisal agef•W eon-um about-thosesociaL mdd mvlronmenta6 to.accept wur vsluee.. or to, develop their ewn - ., cept, already' an•. Inisgral.. part: of' health factorss whtchh affect h1m/her. Lt wmrld- be risk lltdgmentt on the baele of better inter- haeard~ appraisal• could ba expsnded toyelpfulif lnterpretatfonsofappraisals could matiem: . '...".. ... . - youngar people. B'ew 25:yearoldawould like . canveythey idea that. somee people are at to thlu[: of thearselvee'se Davingg the,.body higher: rfskbecause offaotors outside their. _:.•bfteDmy discussion of all these isauee md - and.'riakof a.3O or 35 year Old controlmd tbat' the»fore tme ma want ou tbat h t i assure y p ` , y as en n aancecns let ,.. Ma[bldlty:'Ihe mdlLioa olf morb[dity datw.. to payspec.tal attentlmn to developing ~'- I dnd the healthhasnrd appraisal and other• avlllob. taoaes ofttle Wplca.to-tie0onattd at - iateditothoee risk factces Ceamon tbe tm ide e t ~ t t h i ev ne re a g en e rlsk assessmen ec n ques . - .. thla.meering„ wol%'d represaM: a. ma]or. ad which the menbw to enhsn<a - can inLuence ttiemselves develo 8ow- most's romi5in y . p g p .. vsnce ffi e:pandingg the uaatulnea ot heakth !t is nott eaou merelFtoy eaorGpeepla haeeN appraiaal, for: the- populatiunn as s ever. Bh - public understmding. of personal rlak amd whole. The-earliest IdentllLCat7on of-rlet to'ehange theirdletaryprrctlcm It they do pomlbnlneaforpereanal sceloa:.It iseeem- s t]ie Korean PSbt Nam not ksaethe: foodd opefooe, the money, octial too advamce.tme embryonic atete-of-the- aad h 6 t a euc oLS- .. ac .Was autbpsy fladlhgs of, slguiflcmt azterm-: eawantlal snefai supporta md:refntaraemente.' art of'riak ~eeosnseaS' ard to erpmd Its uae--ealerosiatn 7Pr9: servicemen aged 1g-31, ortheAlaa It wlll-be,:aBur comfort to, . people... to- fulaeae ufFrevention.md:hesleh promotion. '"Hnow: Your BodF'•progr'am of tha . Amar-' leern,that they can raduce.theirriak otf pre-- for a wlderrmgeof the populatfon.. .,. . lo>n 8ealth. 8oundatlon; Wmch:. Souaa oaac matora desthbYdrtving fewer mtlea;.l1 tluy . T'he. Office of.. HASith .Intormailom affi-d or moeeoeronery hesrt~disesae riek..llactors.. onnot rHord ta.Bve elosar tothelecwork. HealtmPromotionhae.deveWpedprellminacy' -. !a'3S°6..o1 ehlldren, aged 11-14---lmdbrllnes.. -Also, the Ig?yreductlon in: traf7a tatslltles plam.to help adtlresasomeof theee-preeaing ' tlie . Impeetance., of finding, matiFatlonat. . ft°m 1p73-7.t: resoltedd from': a& set nff sealsl- issues Sn risk aeeoeement. We pim to oemm/e- atesfog[m.fas.7lfmtyle.change.'.very early.Itt detlsionsto.:enacta Nattonal.S6mph:speed. aLemerateof-tha-artpapers.andtavlewworlr- ;. Ilfa .. . 3imfY: wbichh itself accounted for the.e single ahopato develop aad-al......h.te Cmeemws Poaltlve Valuee:: Wellueee.. hlgh teve/a a1' largestt reduction in any' year In aiortallt7(- on therelativeeAcacy of. prevmti.rofater- 'en.ugy'md produemvlty, md lncreased senee^ from asingte.causeia this century. ' veatlons for.various. caUgories: of rlbk.. Dn. ' of.eontrot over one'e 11fe are-Importaat fao- Whnt tt caw dorwur ~ .:e?aluatlon,t tt takestlme=.to.s aeetheshort, mtermedtate.mdloag-LermeHecre; It'wen- t ard tl tb f health ]isz .. ls t la t d ' e goa o o .. ars re : e . s : 8ealtll3farard:appralseL nowrePreaenfe appxelmL ~'hesa: fsotoxa.s retnte to braadac. - quire effectiveaases data too earlp In am..mter- '.m md. marepostilve goalb. Lllantmat of. Juatsummus too action, with. aatlenn dependent vmtlbmm we maydleeard goedd mterventionareadfnese.o[ the individuat to~act sndan on i t t . hterven premyturelyor accept cos ly .. delaying.mortallty:.Brmlow, md.e0mars:out- ions. 11ned eumples af such' guals:In their'"Llfe-the avallsbili.ty of eaective.mterventiona--_ .. that w11I not aabievee long.-teem obJbetlvee. . tAme BeatW1-Manltoring Program,•v, ~s... What_4t dould do: Premtse: )ar,the- firtureAnother important aspeat of such evahLS- ' health assessmentwhile not complete (h: -Health hsaaM apprateal-represeatsl an Sm- tlons, that ehouldd be-borne.in, arknd'. is that ' iteelf elther-le eombined..withd preventive portent cornerstone in our eHorts..toedueate: seculartrenda may obecure Important rlek measured prngrsmmed- to promote optimal. . tliee pubiluc abomt pereonala rlst% asemment analyses: and make It'.partlcularly diffioult.to health. md. development-botht' physlealiynas, one: rnoHVatloa ton action. Much, moseprodum statlstttany signmbmt Dndtmga even .: md emottonauy,, nor' eaeh, age group, goats', needs to be done, however. to. Includb m- when absolute changes can bedocumented,e are. outllned-.which petbam to thehealta, dWidual values aboutt risk md.ttadlnees tofor erample, where oveLallpopuiatton, levels .needsofthat.partt0ularcohortfollowed.by actmto.the.appalsalconcept.. . - ,..ot.serumcliolestarot'.apPaseto.bedeclmlagf reeommendatioae's of apeelHc professionat. 'idore:.poeitiva terminology would help-the-.. Tnese state-of'-the-art. aeeessmenRa. of tbe ,:.. servicestos aocomplLwh: these goals. These-e yealth.haeard appreisalmovemeat. I tlke the relative e®caeytot interventlona should es- ktablish a_basell'ne toadvaacea eommon' meaeuceaueuallF'iavolvetestsfon-commonly f " •• " r e healtll ProaPect9 better thm term occurring problems and preveatlve md-vnderstaadmg o1: the ceebeIIeettveaess-ot_ _ ' reduttion."' butothers: prefec "wettaess^ mdd various approechee toteventlon and risk prVmoLlonal. F age grou: Por example. fa, ..~g1t1Ve healtll:' AB Lhese moro hopeful~ reductioa. Blbk.aaaeasmeatek will.l be essential ehedg'. to 24 ear P;.6oatb arer tarms.ahould'~halp to capltatlze onn the.grow- g the P Prlate intensity 'TO tac111tate-trsnslWOn I[omdepandent: ~ excitement of:.the.CubB¢ about eoncepta ~' determimn a pro . and adolascenca, to mature mdepeadeatt admt-olhealth romotmn. cost of. mterventennsIf we expect to have eood with maximumphyalcal: mental md.. P -- -'_ preventive Satervaatlboa covered by eureant emotloaal resovrers- .(andl to sehleve' The 3tanford. Heart Disease Proaantlon - health insurance ptogaameer la. omr deveI-- useiuli empieyarentt and- maslmum oapsoity Progrsm'° embodied concepts waichcould opmgg aetional health insurance proposals. . for a haalthy marrlege,.PetentaooU md'sa.nelp develop health hasardd apprafsal tech- -We intend to emphselze, tnteraetlne risks ctal relatlons,•• v nlquee. Thiss program tied cho rnncept oi and lnteracttve mterventlons, as I have uead The:seCvicee related toithe9e goals include:. Interactive risk toresulta aChleved with m- those termetodaF, in our educational' eacrta . forr the healthy adultt mn annual physicfam twactive mterventlons. It,builton the bmt with the publlc as wall as with health profee- ,- vlslt with tetanusboeeterr, if nxa.arF. teate, , mowledge.e of.f learatngtheory, communlca, alonals.. I urge: the Society os Prospeetive . for veneiealidieeaee, nutritlonal status:.blood- tionss and media reaeerr,h, and_ developmg.. Medicine to.encoursge..others to, thlak probe- ' presaure. and choleaterol.levels, and "medtcal.-. e4aluation. Whiehh shows that multl-facetedd billstlcally about Ita awnn activities, andd to " and betiavlbral hlstory- -,.. ,.8ealth. edirea. - healtheducation Programsare much more.- work with health maintenance orgmisatlons ' eHectlve thsn single modsllty intervrcntionsi aad other'setttngs toenconrage more than .: H1x.Lartess at ead of'artiele.,. regardless of aperson'b readiness to, act.L*-, lipp servlcewhealth maintenance by adapt- ~9 ---~~-~

S 7$7&. 'as- COAiGItFSSIE)Nl.L RE[O~'RD'-SETNeLTE . 1j4aY 19',: 1978 , and' experts of: many' types. Overmedcalisa- yolloming ' the,.same PrecePts. I. ralsem thi® ax- Lavmral meesrch. teilaM us that raising lte : tlaaas s new termderlved from the radtml- ampie only to rernforcemy concern: and to. spectre la likely to prodnceresiatance: and ".worRof anehpeople sa Ivan'IBleh,'Prted-remind ue, alI' that tt' is3 not only the publfcc bloeking: It 7a'often.tht casetbat we mesa- "~ eoa;" and: Carleon.• aruld receatly the tougtlt- whoEan betame confimed.about the 1nabld/ty utewhat wee eea ^+ ^'t ea911y(<.g...Ilke ~.1 flf Nt Lt•hthrf t thiyLlYiitt tmtaht) . -useeayonee+a, wc.eersooe: to app PaoaA concepsoo speeec mory. aad taen- like ecnnumists, try : ln¢easingg tendencyy to deane.wTthft.p.e ma- mdivLdwla to Perauad® People.that what.we caa meaa. - ususi..t or aaerraat as lllnesa or~diseasn tobeaLange m B,S1t Pactocsover.T(me: Rtsk:k uree fa rhat brtmpamnt. . .. , ,teeated hy.nsdbdn._ , ,.. . fattars ehangeover'tlme in populaclons,.as And what about'the elderiyt Is risk s tel- OQermedicaliSStbnbas' at least two. lm- walt. aa 1n lndtviduals, and this notlon of event noneept: paet mMdle age? f.lte, ex- -= ' and! Uak: asaeasment: overemphasis on the hazard appratsal and,lato public edhcatioa centmq,aa ooattaated to dramatlc cnaages-.; .'.toleofUfe..paAsleianeadivaGaxeatlmaChfg aboutrbC aneardbablfag--la.lftemeee[aneyatblrth!:~ . .. tSx role of Ute'tadhMdnal. person mhosetlek .. Pwr Training of gealtly profemlona.L4 In Wae need . faaooaUVe eoaeeptefor the elder- '~>, 1 S •'-- + : .. + 1c of whom some actloaIs Preventiaa:: Pact of mpy eoncern about the Y as weN sa as t aad S the yomlg to promote whst ._..r..- . . .. • prea+7teqn#ed: Aaerample oLplac orermedtosu+ew .. of Pvetioadk everlevehrof:wemiese uel+oatlbla ~a ,_.-.~n.-renn..n ris:. :. ; Yng undnee...,,na.c.,.on the phyaleian'a m[e redueiton, etema fram: the. poortra[ning' of The Llterstore: The literature on health ~ -. .3'¢ the praveatlvie.pracessaPPasrsht the most health, ptofes.lnnala~d and particularly .p(tp-_hazsrd appraisal IrI1kethc' literature of '. -neeent edlUoa of Iris. Botbius': aad 8aB's aicfane- ihepidemieIDgp;.n bfostatlsUCa, and much ofhealth edacattoa,. elmost' ercIU- ~ '8oz-to PracUee Peospectime. Medicare.^t taeaan-medieal'e determtnantss ofhealtl,- siveiy desertpttve reporta.of suceesatoeles. ~; . 2t mentlona thephyetclan's aoceptaaceof that Ia. 2he very knowledge aad. Concepts.. We needd much moma eaafQaUUn and follow-1'espoIIDkbtlliA 'YOe the total rCsk off an in- whlchaaderBOrleic asSReament and pre- -up aver time, lfwe axe to ieaaethe eQecttve-.. '. ~ dNldual." bnt.lgaares.the: person who hae vennea rfsk reduction. In' addltlon toim- ~~ou~ess and health :, to do, the: changing:The simple truth'.Is. proved.txatelagm theeeHelds,forphystdans ~ promotion. - that't moUrated' People: caa. PracttcePrimary aad' Mses tradittona4-healthprofeselonals, .: .Wkaf...4 aot tatt uaa '•, .. Preventloawlthout health hasard appratsaL§ liealtla.nla..n..a. represent another key tar-- _Socloeeenumia Statne_ Such non-he4th '.. . aad, lntleed, wlthoatt phyplclans. 9n', B:BA get graup f0ranCh training. Determ(naUOn -:parametera u laoomq edueatlon., eex- and - .; . lkof llttla valuee waea'n used to aesesas thosa at approprlate'e national, regtonal. and local rac]aP,. cultural or etbnlecharacteastlca are ... wffio will not act toattempt to aaprove riealthgoals aredependent on an. under- tlgnSgcanUy aseoofated with or-erltical de- h heaith ptaepecfs.. Ptequeai.reparts of poor standln3 of tIIefnll'e range of fectors: which termmanta', of Ilea1W: Phr eaample, receat . '4omptian<W retes, ofIesethan 30: percent. -determme.or retate to..health., . .. . analysls ladieatee that twiceae-manT chil- . ..~.-wlUa Physfr.ffanpreacripttoasdemonstrate -' 871ttem: lfnstheatth,haaardappral+alsanddren In s..,ni.. .. °tth tDe- dlvergenceof phystaian.ss andd patient alak saeemmeatnara aow ueed only ia.popn- will de .-~omesnndM .AS.o00 VerepeeUv~ Tke, popularity of the term 1gUoaswLlcit ere:more affiuent, morehigpl9 veiop etlrnmlr:ieaat dfaeese as those . w(th' fam13A ln®mae nf aa};Ueb: or more: and "ocmplfeaeer Itealf characterizes the. passive . educated and moUrated, w1t11h tha: leisure omldsea ua tonn Umas as.litNA• to have poor eoncepivailmUOa of'the patient's eolela the Ume to devote to fiealth promotion. 74aY or falrr kealt7r lfthelt family mwme le under . pDpsltianJRatfent earnnnter. This 14s espe- lsaaerakesserlooaqnestfcas about the gsa-Q,OqOp: ,.. .. :.. ._ .. .. . ehlllyinapproprlatelnedortatoaHectchange enlhatlon af health hazard appraisal and .. M,.4yUaa/DFet 1n, geiaUonto Health:-.. ,1acomplex: behavior. Physlleiansa7eariT do the esbapotatloBn of' daLs from.m the current $ealth Ilayerdapprebsle rarel7 aaveee an- _ -bave a roleto play f.'n prevention, but not useoi'.thesa~teehniqnes ,- .... -~'tnttematatatosand.awtde.rsnge of.dletary - the prlmary.oney ih tlie prevenfion, process axecisnez.au~svgcvn~.: s,rsrnassassarext praeUees, atthengh Ireigpt foa height and . .Yteelf.. _ . . - .. ._ : . ... • .._. , '.: _...: WRnifsin it:nom~. .. ' ' ,. ahesttlp" la' atlsyt' meaaWed tietanee lt IS , _ Btfectivenese _of Interventions: Bnother easy to.meamreeempared to other sepects.of ttnublesome, t of current, reventioa- ~~~' A systEm' fs only ae good as tta in- - ~pBO p ~formetton., hut a.ellable-dats fat'rlsk aaaf- autriUamLetatvs and dIK MA. preperetloa and r1bksssesement lstheaerT poor success for the Seeond..D[CerruUOna[ Obesttyr Coa- _ rates ofmcat available interventlons: Beme~ h°° °' a®~ aIInoasyatemariR errors. _ . proportlon of people-perhaps 26:30'0 pervent. ~r'eautrulbak from mhase eaparlence ~ me'that me do aoe ~October vr sgwork- . ofthe.poPUiatlon-canandwlR',chan theirmu<h ¢vreeat>tisk, data 1sgeaerated, are not.. - Lfestye: "cold':tutkey,,~'d with mformaU a and ~aractartsUeof thegeneral Posulatlon,l3ey tng deLatUOn oII'abesity, mnch lesea decent .. efttiartstfoas sa tae om . stlmulus'tos ac« tend to be mora's affiuent., more male, more ~~_ ng efrleks related mo obesity. ..~_ Uon. Is hea[th hasardl appralsal, a complete' .~ . ty~,are IBieiyto be at ]oweri~rls athan ~tet to~men, mhlle:BD-66 peaaentof those- . progvestic and moUvaUonsl.meehanbml per' the genrra7:..Population on many factors and mmrmal, trsatmeat progeamsara women. ', ..se:.ur ls':lt.really onlya.flrst step ior.mosthi Idfa BLteealLlfe OD9nge: Very ImPortant ..people?~ It 1a..not teaaeonatile toW eapect in. P~~_ ~t aa otber ffictors : 8fnca the - work: baa been done m receat years based:oa . jprmarlorc atone to changes the mal4rity of ~y used eadsU¢dled. Ehese same: charactee~ the sanriaal wmY of ffins Setye,?e' blghltghting -~ tdlosa at high rlek-.Otherlntersentlons are.-Lmtlmnoerepeescntattveof'tliageneralPopn'- -Melmpurtanceof thecumnlatlve hnpectof .. .- .needed;anlres,aifstodata.wtth.sristatttedr Iattun,whatIsttie.baslstar:ertrapolatlonof -Itfe ahaugee--paeltive or negatlve--aa pre- ' I[Jesty7c change havtrbtm genetsily abysnW:- demT Et-a'apola:UOn errors can work In eitherr cursors otl>mees`and death.. While more wark _Wa.have:Ln.canaidereerlouslywhatwehaae& d'Jrectbaaepeadbagoa-the:sourceofthedatafaneeda'drto~aBdaiatne~ilyona7lfacaanga.. - - toofierpeoplwwhen weatnnulate them aseesement Kalea, thlab addttlont moultl add .-. enirlsltt. rlek' aseessmanm from the geuerall., tbchange;especiallymllglitofresearch.that popppttkaamwtQOVextwtlmatemoctailtyrltr. aalmporraret poteattai toLha.eduratlomi .. 1aW<atea that prealous.Iallnrea at beruvtar' , totAeearreat apeclalhealth haxsrd apprala-.. andA motlvatfnnai Impect. ef heaithLazard ~; ehango, oorrelate wltnh future Iatlures in _ yLpopulatlon, whereas exLCa.polat1on ai cur-_ aPpraLmL -' . ... behsvarr chaaga-` .. . - -.: renthealth'heasrdappralsalilatatothe'gen.. '. Warkplace/'WOtt Bttem*. Ctu'ient asecss-. . Overstatement an EzsggeraUOn of BeneIIte ~en[ Popnlatton monld tend:to underestlmatas ment Instruments raee4y elncidatr important ::.4emPlfeecqletmangeeMany'of'theprasent -aAeraIIrfsk.PfearwearaIaa~sltvattoamuuh BBPettaafaerYeitaat[one.+ne+^^"^gesposure ' f41t reductloa pcagrams may mislead-d psr-_ l6ES tEat of' health mamtenanees mrganres_.. teoocapatioaal paeartle:ofboth'pliyslologtcsL . .-' tfmpam8aboutthe beneats'of.rlak.redhetioas tLana; WncIDU hana.. aleo been' implemented +nd psTChola&at'M character-. which ace aig- .-„ ~ aadthe dtmcukty of chavgh+g comples life- prEmanly amang:.relativelymura arfluent.. Pmcant rSekk faetora, per ee: or mteractt to aipre aehsalms.Islvould haeteato: add thatl eooployed, and lnformed partlelpaati,, and. . increase the lmpaet of athec rbdclactorsk such .' am . a believer- in thebeneflclal. Impact of- - about which data' ate equaltiy dlmcultt to ex-- as. smokfn&. .. : . - .. taltmgg more: centro[ averane's lffe, andmd trapolate tn'.the tatal' population. PYtnees: C@rapE appralgal instrumente efforb to try too tmprove oae's risk status, --Crnnpts:. Our general system for assesstng. -Plsea an andue emphasls oa:forma6 exercise .. and.I try to practice these principles myseelf' rlsk.ta grasslp Inadequate, and I.am' pfeeaedd an@ sports, wfrbnotenoug}t attention.to ez- . mkeephtg with thehtgh v®lue'r plaee on to sea that a at~ber of papers win be pre« . erd'seievelas tn settvlUes oi dally ltvmg..I am 3.elth.Imosry,, however, about some Par•sented here nn improving therisk.predletlone im?~d mLtb tlie potenUal of: the concept .. UeWar: <3 yaac-aid man who may believe technlquea ofhealth haaard appraisat Oor' of'fur^-im+^g statua'.' a developed toassese.. If he stope smoktng,, changesbis dYetaryaml deflolencLees aze- gseatesG when Ltcomes to: the.elderly more rea]faticaily than dlagnoses eaeaeLae patterns, that'.he will not havea: assessinglnteeactive or compeUti4erisks-fora alone Permit:: You could knuw that a person heart att9ek. ae dlettngefshed from uader-. esxmpie,mfti smokmg~g and accupattonal. =y have dlabetes, arthrttia, techemtcheart'. _. standing that- he would be hnprovibghls^a°"°` .Io-atldtttoa, I am troubled by the: dlsease- and reeptratory;: vEdtoa and hcaring' risk category. I reter youhere tothebitter.o wsA emaentrbasesesaments treat alcohol, Impsfrmeatw and. yet know virtually nothing letters m M'odern. PKediclnewrltten by itas coafturnptbon-ffiIICalt 1sclear'thatthere'ts aa about bDw we[I that peraan ts able to, .func- . _ edrtor aws reaomnedcardtologtst, Izving,Page:, ble dlaesenee between' consuming seven ttoa, edbing: 'Yanetleningstatus" aVese- .. t+nrmg bta heepitallzatfon' ftom a.myocardiak& allass 'lbr meek at. a mte, of. one eaeh.h day. . menta of' phyateal and peyehologlcal perform.-- hrfarcdon- after having followed.for manp and:rons;...,essvenaf.onca. .. ... anea could eahance and reSaforee the'rlsk ' yeaasalD:ofthePrlnclpleefoirreducia~ g'ooro-., Sfortalltytmly::Thaezgluslveen..pl,aaison reductioa potenUai of health haaardi .: ... , r ,. . . . .. mryr heart dlhease risk aad' having 6kreat- martatldp arime leavesa~ Iott to be desired . aPPrWs"- .encd.hbPatleatsatthe.Clnveland.,.Cllaluihto...slanedeath}anof.nprlmarymottvattngforce Repreeantatfon uf Tatat Populatlou:Not. . ,- .... formaasApeoph,.partlaalarly'Ehetiyoang;lh en<mghrtskdaiats.menrporated.lncurrent .', Pootnotes at end of artlclR addittaa~whese fear of death is-.hlgh, be- bealtb: Lezsrd sppraleals envarioue oam-. 0.36.036U~

•' . .. . . . .. ' i ~1 ;, S 7866 • . 1VGRESSIONAL RECORD'-;SEN fH Mlpx~ Z9~.Y978 September 30: 1981, 830'AOO.000 fortheflscal' •"(A) that the programte operattagg eHec- -- "(g) ,Ahinformltion obtained' about any - year endlag September 30, 1883, Bfl3.000•000l tively to echfeve. lts stated purPoses,- .. ' indlndual under, any program that fe, bemgg toe the fLUal year ending:September 30:.1983,.. : '(B) that theapplloant', eomphed with carried' out with. aA grant made I under eub- and..835.000,000 fur, the:flscaL.year.endYng' assurances provided with a prior application eeetlon.(a)sball~not, without sueh indlvld- September 30. 1®84:", ....,. .. under eubeectlon (b),, and val•e eonsent,l be:' dfecloeedl. except: that (1) rwtrcr oserrrs roa saxvcnarw >vecra .-: °(C) : that ho-ls..aseul thatthe appllcant 'suchintermation may be disclosed without .. .. _-amvrpw .w111 comply'.vrtth the. ase.urencee'. Proslded auch conaeat if the disclosure~ is.neossssry with 1g3. (a)ffieatlve October i', 1979, aec- ~ the appileatioa unAer-oonsie®ration. . to provide serviee'e to such. ]hdlvldual'or Ia "(2) Whanever the atter'rea- -raqulredbp e lasr' 9bcretary ot a9tate or ol[ttcal' b- , p su ". tlon'91Tend the aeeefngthereto aro ammd- .edLOreadsafollower -. sonablenotice.and.opportunltqforsheanng'division'ot aState,'ayd'(9) Informatton '' to a grant recipient. nnda wlth, respeat too derivedfromany euch program may tie:die-: "veo.iscr cuN•mrors rl~ >uacrn - . funds paid to such reclpient,, that thee pro- closed- .- ' -. . . ,,. . . . . ...smar® raaaseasa . '-: gramIs.. notoperatlag eSectlvelyto achieve. "(A)l fn aummary. 'etatlatlaaL orr other . "'Sst•. 31T. (a) The Seeret,ary,May make.1ts eteted purpoeess or that there Is a fall- form. or -.. ' .. ~ ' •~ grants to -States., politieai aubdivLslonas of ureto.eomply subatantlally with assur. :"(B). foT clinical orresearch, purpoees; • .: Statee, other pubitceatitles.orpnvste enti-.: ances pmvrded undar eabeectlea(b)_vrtth, but.omy if Indlvmtmlly.ldentiflable personal .. ..m tles. to. eesiaf, . themm in meeting tlle' coste of respect't to the recelpt of eueh grant, the: data of:any such mdlvldual'..1s not't d(ecloeed. ' .._provlding preventlvehealthe aervicees pro-. Secretary shall not4fy' the grant reeiplent: . "(h) Nothing in.this sectmn shall limit or . - ; grama aaaet farthllh subesetton (j).. . .-that.further paymentswEll not hemade toW oth®rwlee:reetnettheuseof'.funde.whtch arv , - - "(b):No•grantmaybemadeundersutisec- lt under sueh,gmnt.(or 1nn biag disCletton . granted.to a State orr to an agency-oL a ' ti ()f thatt fut'ther paymentYs willl be: reduaed) Politica[ subdriiotSttd .ona uniess an.applieaton.therefor: hae..s,.vsn oa.ae uner provt- ..been. suAmltted to„ andapproved. by, the..e until he ie satisaedd that the: program will slons of H'edersl law (other thann this eec- Secretany:,Such anapplleatlon sha1l be..in operate. eHectively or therewill.: no longer' tfon) andwhicharaavallablefortheeoaduct . .. ,: suchh form, and be eubmlttedl in auch maa- be auch..a.. faSUre. Untllhe I$ se satls8ed..theof'preventive health seraiceprograme, . from . . ...- m. thn A.nterxnv-aTnn ha wn„ruHnn ..... Secretary aball, make no~o payment. or 1n hiss being u]edm eonnection, with e[Ol eerlbeandahallprovfde-- . meacevo4: rzuuwpar+ueuww cue yrunuaaavwu6 cmollgn gnmrJ. ~tnder' sunaeCaon -.. •. . : ~ '(I) for.adetatledplanof theprogrsmSor recipSeae. . ~~ . . .-. . . is)' ... . .'nhtch.the:apphcantfeseekingsupportunder ~~(1).'1Leamountofa.grantundersub- ••(1) The Secretary'stlall'submit to the. subaeetlon (a).pI section.(a7 shall bedetermmed by'theSec+ Ptesldent.ror submiselon,to, the Congrese on '(7) theamount ok Pederaq State. and~d rotary, Sachsuch, .gront-ahall.be made for'Janusrp1, 1981, and on.JanuarpI of each'other fundsabllgated by thee appheant'Sa, costs-for prevenl health servlcaa in thesuooeedlag yeer a'reporto¢the eztentof ths _Ita latest annuaL accountrng: periodfor thee ona-yesn-period begkonmg' on, the Enst.day probteme presented by the dlseeaee andd con- .. ~ prevlston:ofeaehprogramreierredito(n.par-.-.of.the-tirst.month.beglnafng after the dlttonsreferredto, (naubsectton.(1);anthe' ' agra'aph (1); a. deseription. of: the preventlvee moath-Inh wmchtbe gcsnt ix made.. Pay-. amountot funds obligated under grants un- llcantinh meatsunder.smnhgrantsmayt)emadelnado dereubsection (a)in..the'preceding'flecal .. bealthservlces.provided~bytheap p . .'. weIIprogram.ln aueh penod:'.Lhe. amovnt -rance.on: thebaslae of eetlmatea or bytheyear for each of the. Programe'.lnted ih.sub-. ^'of Federal fuude needed.by the.gpplloantto way of retmGmaemeat, with necessary' ad-sectfoh (J); and on the effectiveness of'taa .. eontiaueprovlding, aueh services. in' eaeh~lustmeath ow account of: undbrpsymenm or ectlerttleseaselated, under^grante underr euh-. on such terme and' condltlonssathe Saore- condYtions. ..' enenges Ih the pmvlelon. Of the servicea'la. any such progesm, the priorities of such pre. tary ends. neceeeary to,earaT out the pur. ."()) (I) ybr payments to States under:.. +' . . . '_ paead.caangee; tiia~ras.omaoressch cnsnges: pO°e8'alsuch granta. -- . :- - grante u.nderr aubesotton. (a)~.-tor eetabuan-. `and:'the amount of'Federal funds needed.by.. '"(e) 'LheSerzetery. at the.request af d L4 andmaintaintng progntms for the. - dWgaoela Rrerontlon: ~°°°III8'• detectlonl - . . reclpientt of a grant under subsection. (a)... Lha~applleantto make suoh ohanges: `"('3) for assursnem satlstactory tm the may reducs theamount of aueh gleat by--referral fortteatmenWr and:d follbw-up on ' °~ppBea rompliancr'withtteamtentofhyperteneion. thefalrmarYetvalue~ofaa7 (1) 8 ' . euretary Lhst.theprevsntlveheal CliaenM1Oes.. . . whloh w1II' bs P~?ded.. wltheunda under a flnuLUding.'vsaciaea aad: othar Prevaativee tkus are authorleed to 1SSaPPropnatedl ..grant under euesectlon (a): wlll bepro_ . agenm)or aquSpment furnished the grant. 830.000:000 for theBeeal year endtng, Sep+..tlded.in amanner consietent with the State- reclptent.. andd tember 30, 1980. {85.0OO,OW'.forl the. Lacal -. .health.pl'an in-eSectundert seetton:1534(c). "('7) the amoun4 of the paY.allowances,. ~Oo0 for endm'g: the tlxsl 8eptember30,. 1081. and'860:-,Bud in those caees wheree theapplicant-1s and. travelexpensee ofany omceror em-9eu endnl8..3eptembei.. ...-... -aStste, that auch alrvlGee wtll be . leyee ofthe: Government when detailed to~. -.30Y 19g2. papmente undec eubaeotiou~ (al ~• (d) ~'r, . . hegrant recipient andd the amount ot' any' _ ~~Mhere aPProprlate.. In a manner conaletanC't b ngand matntalning' programs tt a with th i .. i ~ n n coaaec o ncurred wltheny plans' in efftdiarh otherweM n e,ec unr-pagraps:. . to~hmimlzscnlld ren (b) (D) and (b).(3) of eecdon 318; < detail of such.omcsr or amployee.. -. : a8atnet dleeeeea' (In'elud7ng measles, rulfella,. Ponompeutb: Alpb... . ,•.(4i for sesuna¢see utlsfaetoryr to the° wbenn ttiee furalsbfng' of suah eupplfbn or tbsns, pertueele, tataaus., and mumpa) ~ tbere.. Secretary thatt the:.appnuant wm DrovlA, -equspmentt or tho--deteAL o1' auah'aa oteeen' are.anthorized,.to beapproprlated e38,00u,000. - for euch nxall eonttol.endl fund aacouattngcl empleyee Istorthaeonvenleaea off and forrohe Beml year endng..BePtember 30, 19g0:. _ proceduresae. We. Beaetaryby regulation at the request of auch~ grant recipient and yg6,000.006for the 0scal,yearenQing Septemrl prescrlbms m, essure theproperdlsbune- forr the purpose of carrying out a pragram be!-30. 19811U and', i38•000,000'0 torLhe Hacel. . meat off and aecouat/ng' for fundareonved °rlsn respect too which the grant underr sub- year.r ending Sep4mber 30, 1982. ' nnder Btanta uader auneectloa: aection (a) ismade: Ttis,-emouat Hy-whtcn .••(3) For payments undar subsection (a): . .'(4) for aesuraaem estlsfactorytothe aaysuoh'granVteso.reduoed.shalibeavall- forestabllshfngand.malntalningcommunit~- _SeeretarythattheappBcantwlllmake:sach abte for paymentby the Secretary ofths' end atnool-baeedi Buoradatlon plograms•. _. reporra (in euch form andeontamrng.sueh~ eoerelncurled In fb+'++naiegg tha. supplisa or -there are authorlmd~ to be. approprb.ted (ufermatlonastheSbcretarymay by re~ea- ~~pment: or In deta)Rhg'.the peraanaeL ~.OO0,OO0,forthe.aeCal..year ending Saptem- -.. latlon preaenbe) ae.the Secretary'mayr on wmahh the tednlctioa of' auah gnnt 1a: ber. 3p,. 1p8e..88,g00,000for.the aeoaU year ®ed.sonably require. and~. keep sucll-recoeds: sad~ ®ed. and such amouat eball be daemed asendmg September 30..1981, end {e,00oA00 for. . .. bs • afferd sueh acr,eee.s tbereto. saS the part of the graat. aad sha11', be deemedi to, . thee nsea( yser ending September 30. 1989'. . SeQetary- havsbeen pald.to, the grant reelplaat • ••(;) for payme>~ts under atlbaectfon (a)- maFElnd.hecesesry'toesurttkecorrecthesa-.,(Q)(1):. Each reoipfentt ofa.grant under for-estabhabfng sulf-maiatalningt programa ' ofNandto.vanfy;suahreporta;.~:- 'aubsectiom. (a)shaW keep such recares. asdesigaed to, Prevept illheee.e caused by fac• ..~ (6) for.asaueanceesat26factorptothe..Sec-r the Secretsry'shall' by regulationprescrnbe: tors in the Immedlate iiving:envlronment of .. .. retary that theepplYcant wlll':.complpwlthfneludmg^ recorda, which fullytllselose the: peopla aueh as' [ocanzed, expoeure: to tonc . any' other contlitlonss imposedd byttlfa, sec- amount and d)spmitlon.by such recipient ofsubstances, and- Improper atoragee of: solid lth '. tl t t on:w respec og[anta;; and thcdfhrt th ttlost ofd fle tSre are autnorfaed t b ..e pmees,osuc.gaaseoa c waste anue,eoe^(7) fersuchr other information.ea~ the the undertakmg Ih. connectlon with which' . approprlated: 812.000.000' for: the. Lscal yearFiecretary: mayr by-regulatlon, presCEibe; such grant wesmadeS and the amount'of ending yeptamber 30, 1980;. 512;000.0001 for '"(c) (1)The: Secr,etary shalll review an. that portion ot thee eastof the undertaking, the 8sca1 year' endtngSeptember30, 19g1;, nusRy the setivitfeal undertakel by eaeasuppued by otherr sourres, and suchother.and'. 812:000.000 forr the fiscal year ending, reclpOSnt:.of a:grsnt undersubeeotion (a)) to, . uco('da-as. vri11 faeillmtean. effective audit. September 30; 1982. ." .' detm•mine:If the program assisted.by so:ch a-"(Z) 73e Secretary and the Comptroller "(5) For payments under subeectloa (a)) grant lo- operating enectlvely t'oar.hieve. tte. Qieneral of the United States.. or any eff foreetaibllahing and mamtaiWagProgramsetated purpmeiand:lf.'the grant reciPientthelnduly'autnorized representatives. shalll to.prevent diseases borne by rodentar there. . eempLLed:wlth.theasetranEes:p[ovlded-wlth haee. accmn forr the purpoee.of audit andi" areauthorized.toheaPproPnstAd814.000,000 the. applicatton:.TheSecretaryrshall. not ap= , enm[nation to any books.- documeuts,, for:the Slecal.year ending Beptember30,.19801 . prove an,applmation, submitted' under ebb- papera, and reeords.. ot thereeip(ent of granta. f14.000.000 forr the Eseal! year endlagSep- eeetlbn (b~)unleaa. the Secrstary- deter- ~rndes-subeeet.fon (a)._that.are.partlnent) m: tember 30'. 1981, and 814.000.000 for the-BecY ... .- .

tVl ay 19, 1978 CONGRESSIONAJi," Itff.C.OlIy7 =SENATI = S 7873 ..~.;. .'eipieate'of granta.under sectlons 313end (b) Whenever-in 'th)stitle'sn:amendment. 'cawrc eno. cocsn'.oon tsea.ara ar.qutsm- • 317"for the provision of appropriate: and' te espreesediih terme-of'aaamendmentto.d" '- " ' aasnTa '- 's,i" neeesesrytechnlealiaesisteace: end (2), shalll seotion.orotberprovislon,the:referenceshalll .."Sac:,412::(a) 8tcept:aaprocdded m, sub- " develop, aad.dmaeminatb meneh, reclplenta beaonsidtred'tobemsde'toaeectionorother. sectioa.(b), no Stateor:polltleal,subdlvtsion approachee, methedolog)es,;, poltcles,. -and prov)slonofthe Federal Food, Drug.and Coe- of',a State may establLvh or'contlnue meffent . standards for dellvering' preventkve- health` mete Aet. -- "'- a:labelmg requirement spplicablee to any food ~"services. '- Nuran+iorr ncroamwnoxr exv: or>aa ~a wmch..isdiffereat fromor In addition'to auy ••(d) Por the purpose of making Payments labeling requirement applicable to such food -- i ' . .. . on suant to grantas under subsect (r): ®dereatton 403 , pur: g.c. 2s.(al.(1) SecLinn 401 Is amended 6Y' s. - • tliere are authorized to be approprlatedAlO,- ylng out the fourthsentenceh thereot ''/b)'. IIpon~ application of a State or a po- . 000'.0000 for the flbml yearendmgSeptem. . 2;(ectioa' 403ig1 Is amended to read a3 ~cal'subdtvlsto nsubdtvlston thereof, the Secretary may, . ber. 30,. 19g0, 810,000,0000 forther flacsU year bilaw c . byregµlatlbn after notice and: opportunity s - •ending: September 30,..1981',. and $20.000.000 „(g), HIt purports V~ be or h.s represented for an orat hearing, esemptt from subsection ~ for the fiscal'year ending SepoemCer 306. . mefood • taxwluchadeanitlonandstanflard (a)., under suc3condltionnaamaybe pre- . . _ of ld hasebeen reserlbedb[egttls- ecrlbedd m such regulatioa. s.lebeling tt- . coneXm+n•t anem naermes'faAnoraS on .'tbons-be provided by saetloa 401'. ualese (1)., quirement ofsuch.Smte or pollth•8l subd191- ' determmas thaL the . ~ lf the Secetar atudmg. but.notlimited to:, amoktnB, atrbi-~brlaconten4aad _: tions (b),.(e) satp. (d.1. smnkmgshall'~not be • .. ttoaaland dietaog hablts:.; essclse: and ii- , Q. t,ye: grams pan seraln af te Her'mitted m ' any encloeed'aread open to the ;. eehol eoneum nl and',thexelationshnp be-. '( ) 8 1?n° m• . tween: these determmaats of:n.ea1th aad thee aatm'ated fat, unssturated.fat, sugac„atareh, pubLLe.fn any Pedeml facility or'in any stslr- . . mcidenex and prevatenae. of preaantalflee albohol,. sodium. chbinsterol,. aad any other r~. B4e~ion room. co~ ence room. .. waeeeofdeatLanddlsabluty: ingredients._as8 the Secretary by regulatloa oom, recPC . .. . (b) In preparing thee profilee zeqtillred by' prescrtbes•. _. hearing room m anyieueh fscillty. wbsecrdon.(a), cae8eeretary...actlng through. "(2) •lheSecretaryis authorized, where 6 (b) Smokera shallbe eSeCtlvely separated - the Natfonal Ceater for Healtb.Statlseics'. approprlate,. to prescribe by regulation' a sys- tromnon:-emokeis (hn anyy eestaurm.t• rste- 'oritv'equlvalent, ahall'mmply wlth an xele- tem of'f aymboW, flgges, or otherr devices teria, soackasr, other dming fac111ty:, recrea- vent provfalons, of sectmm 306 end'~ 3p8 of which will' enable.consumers to.readYly com- t~ room or louagee in aay Fedaral, facility. -thepublicSIesltaServ3eeAnt. . .. ,prehead taenutrltion Information required (c) Hach Instrumentality of the: IIalted _to.be:placed.onlabels by paragcaph.(1). -Btatee. shs111 use reeaonable eHOtts.that', do . 8.. Sill7 - '°(3)i TO the extent tffit. compliance with not result m ercesslbe cost or adminl5nm- - .: Be tt: enactedby.Y,he 8anata.and, Housa the requirementsof subparagraphs (1) snd tdve dLsruptionn to effectdvely separate the aj Representat•EUCS'o)''the Rnite6~:.Statee: of (2) ~'impcsetloable:,the Secretary shall~ by workplaces ot Srs employeeawho: do nat _.-.. America in C _ _ xegulatibnpreecribe esempt(oaH from such smoke andd wbo-wlsh to be so-aeparated from . onprmsasmm8i~. -requirsmeate:'.- . tho workplaces.. of lte employeea. who~, do .. .. -anoar xatt, maaszmi xo sca- Stcnosr I,. (sy Th)s.ACt'maybe clted. aa See. 3. Chapter IV 1.s ameaded'by' ad3YV8' (d)' m planamg, designing., purchasing. the "Nutrltionsi Labeling.Act of'1978": after'sectlon.411 the.followmgnewsectlon: leaslag: or otherwL•/e obtaining aeW faaill- .:(2) mortilliitpratesy assoeleted`vAth. pn.> "(4).(1)' Ef lt. lesfood: for human roa-- - . S..3118:: . --. .•. - aeatebledlsesees; `- - `- sumpttom and m psekage' form„ unlees its Se'.1t' enaatedby the Senatee and House ~o/ .. .(8) tae-physles4 determinauts of'tiedlth' label beera eachnutntloah informatlon re- -8epreae•ntatiseao/ tl/a United- States-. aj - of'the.-poptdsttan,of She IInlted8tatee-and Ifidng'to the faod, aa_the 8ecretazry-by tega- Amerirn-in-Conpressa asaembied, T,bat this the relaffionshlp between theee.determmanl9 1911on.preaeLibea to PrOAfde health 1Gforme- Act may be. cited eae me. "Smoking. Deter- o0health and the Incidence aad'prevaleacs Han toconaumers melum'ag at least the rence Act of' 1978". of.f prlvaatible cames- of delta and' dlsabll- tolloWtag: '. ..- ,. ., .- ar:an'Laltblt or ' errb¢am aP M9lAa rArt- . - 1tyd: aa& .. . - . .-».(A). Shetotal 'nnmbeh of . celorlea and . y.~:essrLrCrrors. o¢v eaaoa LKrmasL .. . ~s: . .. . . .. . . .. ' (4) the belfaatorsl der icu~.of aeatfh ~ grsma~er serving: . . •. . _ : of: the popalatloa of'the Bntted, Statea Sa- .. (B)) the Petuentageper-serving:oi pcuteln, .. fat augar starch and alcohol m terme of -~ Sac: 2. (a) ,Except sa pzovlded ln subaec- . : 1980, September 30;.1981,.September 30, 1992. „ Havoringl .iG the Secretary determmea by mend'to the: ComnUaelon'whtch (if any)i of September30;.1988..anQSeptemtier3041984''. ragu7at(on.ttiatsuch..tugr'edlent'has.aeig' such(nfor¢nationshouldbe.requiredbythe ' rrarfoaac rose:asn nsavnvrsaN n~soara ni8cantt bearing' oa the quality, , nntritfon, Cammfasfon„uader the Pederal. TraQe, Com. Ssc. 208..(a): TbaSeoretarY: actmg-tluoughg acceptabillty;-or'cost of such food,. and mtesloa, Actto be mcluded in, the advertfs- : th> Natmnal- Ceater for HeallelL Statlstla', ~ bp re~ •~an to.y ~theyp~ presence of mg ofsucK Iood:. ...', .:' ..or Ite- equivalenG eha¢' submit m , Congce9s~. . . (b) The-Chaittman of the-COinmisilon ahall on -January4 1981, sad on-Jhanat•y 1 of~.f sa.artlflclal.9avoror eolor:. . report annuslly to Congress on (4) any ree= esery third yesrw thereafter;, a national d1a-. _ Too the ertent- that compllance wlththe re- ommendationa nudeo to the Comml9sion.n by ease prevention data{)roffie in ordertopru-qu(remeata of subparagrapa (2) Is tmprac« the Seccetary under subeection. (a):... (9)' in vhtea databa6efbi.tae..edemlvelmplemea ._tteable:orwould.resmtmdeeeptlonornnfsie those situattons'where the:COmmiselaa ab tatlon- of this Actand. ta'increa.se public . eomPettt(om. theSeerethryshall' byregula-.y cepted' a'.reconuaendation,, a-de9arlptionn of ' awareness of the prevalenae,, wa+daum . and. tfon preeerlbeeaemptioes feom.such require- any aetlon.n takentoimplementn such.recom- any trends in the pEeventable:- aaussee of nfeats."_ . . .-'.' . . ." .- .:. -. .. _ mendatma.aad (2) (n.thueesltuat(ona.where death and' dlssbilitym: the IIntted' Sigtn. X2)'2he seeond ,seatencerofsectlon>SOS'('k)) the Commission failed to eacept„ m.wholen or - Stleh' profile sha6include:at.a IDtatmam-. "te~T9peeled, Sn.parti e- CIi_ndatioa,.a descrlptionof (1) mortsltLy rstesfor prevenZabledffi-- '- (s)'8eetloa403:'leamendedbyaddmgs3!Lae thereaeons.forsuch.mtlure:: eeeeq, .Y+ragrarph'.(p)the.followmg,newparngraph:.- . /eport on the programs,undertakea or snp.nated- es aetitlciel sptces or, aatural spr¢ee. . I ar naalSlavoriags; yp6r aftier the dste of the enactment of this ported' underr subsection (a)'. mcluding: but and at138ciak aavormge tur .sG-maybe..wit.houtnamnlg.each..AaE. _ '_ .. .not.llmitedtoiadetaneddeseription.andaa ae the Ca evaluation ot-theeftectivenese, ot'.each sueh_ etch ingrement;, unless, the Secretary re- rtomrcai•roNio~.arm: srsoai ar f2rX nmemwc program. qufreas by regulationta5t'the, common or . . . rLAnL cotsatmelox . . . (o) For the putpnse afundertaYdng Or saP- tmusna(I nama af aapicear'flavormg be ~.. ~Sea. B. (al •IheSecretsry of Healtti;.Sduce- ': port(ag' demons(astlons. and -evaluatlona the labell for the:purpose of'provrding health -rloa, and. Welfare shall notify the Federal . ' pursuant tosubeeetlon (a),there arean- fnfo>mation.to.consumes, .g•ede e- -• ..m~..~~a. -•..m~..~~a of'the nutritional infor- . ' thoriaed. to: be appropriated 330i000,A0p0 far. _.. »(S)'. s daeloratioa of.thepercaatageot anY mation:-tbaBis required to: be placed:en food ..,. each of'the nscal years.ending September 30b speciaedd ingredient (otherthan a spirw or~ labels.p•,•.,•rnt to..aectioa,403(q) and recem•- - . ... . . .ave.mteastveand ccmpxEhenslveoommunityp ja,..tolloWs_.s ment tlnde[ sectton 4032. .. . . .. . ~8or.m'.estom.aes. . . ' based programs for thee purPose. of demon- c^(1): Unless Its label beazs- • . etrating'and evaluatYng;optlmal methods for-. ~(1)m thecase of fbod which'.ls.notsub« ' ~c. 4<' ~8ectton 301(R) (1)~ lss amended to . organlatng aad deliveringcomprehensive jeCt to pareg•aph. (g)'Y of this eectlon: the-raad asfollows: "(I)artleles used. (A) for preventive health.servlaes todefined: pupa- . coarmoaor'usuaL.name-(Ifany)iof thefoad:', food forman orotber anlmale, and.(IIl. se - IetlbnSand- _ . drlnk for [oan or.r other aatmale, mcludmg . (b) The Secrrtary' shall submlt tn- the ..»(3) m . ose It. Is fabricated flnm- two ar distilled splrits.. wmee, and malt'.beversges,^. ,. Committee on.HUman:Hasoarcrs:of the-Sen- more mgredlears- - . . ...' a.EE(rrIVg yiy " . . ateaad!-tbe: Commitn!e+'on. Intesetate, aud -."(A)thecommon or usual name of each .• . '.IWrelgnCommerce of', the House of Repro- sutlllegcedlent m the;orderof-1ra predoml- .~~5. The ameo.dmenta'made.by asctfons .. sentsttaee bn. Jaanary-1i 1981' aad'oM Jan- , nmce;, except that anp,',splces or.. Havonvga 2. 3, and 4ahail. applywith respect'to food nary 1,, of every' second year thereatter a.- whlrh-- ereaot sold ae sucb:. shall be deelg._ whlch,l9 mtroduced or dellveced for intro- ductiom. into: mterstate commerce after one an y s) s a e cauon• andIWelfareshall undertake or sup'.speelHedLm such de0nitwn aad standard'.":.. OUndltloae.md.cumpllance.wlthlt would no0 _ port (th:ough' grants or contracts or aoth.). (b) (11. Sectfon:.403{1N isamended.tnread, rause a fooditobe In:.vlolaxion.ot e requlre- , . par.vz . ... it.conrbnms to surh de5n.rlon and sEandard; utremeat. 4 ulred by'compelLng laasl ofHeatth:E du..- linesm the name of thefood req ml TheSecretar l b S 202 d 2lt ~~ 03603604:- . - y smvac® .. eavzxH rrrva

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