[House Report 111-638]
[From the U.S. Government Publishing Office]
111th Congress } { Report
2d Session } HOUSE OF REPRESENTATIVES { 111-638
=======================================================================
ARTHRITIS PREVENTION, CONTROL, AND CURE ACT OF 2010
_______
September 28, 2010.--Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
_______
Mr. Waxman, from the Committee on Energy and Commerce,
submitted the following
R E P O R T
[To accompany H.R. 1210]
[Including cost estimate of the Congressional Budget Office]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 1210) to amend the Public Health Service Act to
provide for arthritis research and public health, and for other
purposes, having considered the same, report favorably thereon
with an amendment and recommend that the bill as amended do
pass.
CONTENTS
Page
Amendment........................................................ 1
Purpose and Summary.............................................. 4
Background and Need for Legislation.............................. 4
Committee Consideration.......................................... 4
Committee Votes.................................................. 5
Committee Oversight Findings and Recommendations................. 5
New Budget Authority, Entitlement Authority, and Tax Expenditures 5
Statement of General Performance Goals and Objectives............ 5
Constitutional Authority Statement............................... 5
Earmarks and Tax and Tariff Benefits............................. 5
Federal Advisory Committee Statement............................. 5
Applicability of Law to the Legislative Branch................... 5
Federal Mandates Statement....................................... 6
Committee Cost Estimate.......................................... 6
Congressional Budget Office Cost Estimate........................ 6
Section-by-Section Analysis of the Legislation................... 7
Explanation of Amendment......................................... 8
Changes in Existing Law Made by the Bill, as Reported............ 8
Amendment
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Arthritis Prevention, Control, and
Cure Act of 2010''.
SEC. 2. ENHANCING PUBLIC HEALTH ACTIVITIES RELATED TO ARTHRITIS THROUGH
THE NATIONAL ARTHRITIS ACTION PLAN.
Part B of title III of the Public Health Service Act (42 U.S.C. 243
et seq.) is amended by inserting after section 314 the following:
``SEC. 315. NATIONAL ARTHRITIS ACTION PLAN.
``(a) Establishment of Plan.--The Secretary may develop and implement
a National Arthritis Action Plan (in this section referred to as the
`Plan') consistent with this section.
``(b) Control, Prevention, and Surveillance.--
``(1) In general.--Under the Plan, the Secretary may,
directly or through competitive grants to eligible entities,
conduct, support, and promote the coordination of research,
investigations, demonstrations, training, and studies relating
to the control, prevention, and surveillance of arthritis and
other rheumatic diseases.
``(2) Training and technical assistance.--
``(A) Provision.--Upon the request of an applicant
receiving a grant under paragraph (1), the Secretary
may, subject to subparagraph (B), provide training,
technical assistance, supplies, equipment, or services
for the purpose of aiding the applicant in carrying out
grant activities and, for such purpose, may detail to
the applicant any officer or employee of the Department
of Health and Human Services.
``(B) Corresponding reduction in payments.--With
respect to a request described in subparagraph (A), the
Secretary shall reduce the amount of payments under the
grant under paragraph (1) to the applicant involved by
an amount equal to the costs of detailing personnel
(including pay, allowances, and travel expenses) and
the fair market value of any supplies, equipment, or
services provided by the Secretary.
``(3) Arthritis prevention research at the centers for
disease control and prevention.--The Secretary may provide
additional grant support under this subsection to encourage the
expansion of research related to the prevention and management
of arthritis at the Centers for Disease Control and Prevention.
``(4) Eligible entity.--For purposes of this subsection, the
term `eligible entity' means a public or private nonprofit
entity that demonstrates to the satisfaction of the Secretary,
in the application described in subsection (e), the ability of
the entity to carry out the activities described in paragraph
(1).
``(c) Education and Outreach.--
``(1) In general.--Under the Plan, the Secretary may
coordinate and carry out national education and outreach
activities, directly or through the provision of grants to
eligible entities, to support, develop, and implement education
initiatives and outreach strategies appropriate for arthritis
and other rheumatic diseases.
``(2) Initiatives and strategies.--Initiatives and strategies
implemented under paragraph (1) may include public awareness
campaigns, public service announcements, and community
partnership workshops, as well as programs targeted to
businesses and employers, managed care organizations, and
health care providers.
``(3) Priority.--In carrying out paragraph (1), the
Secretary--
``(A) may emphasize prevention, early diagnosis, and
appropriate management of arthritis, and opportunities
for effective patient self-management; and
``(B) may give priority to reaching high-risk or
underserved populations.
``(4) Collaboration.--In carrying out this subsection, the
Secretary shall consult and collaborate with stakeholders from
the public, private, and nonprofit sectors with expertise
relating to arthritis control, prevention, and treatment.
``(5) Eligible entity.--For purposes of this subsection, the
term `eligible entity' means a public or private nonprofit
entity that demonstrates to the satisfaction of the Secretary,
in the application described in subsection (e), the ability of
the entity to carry out the activities described in paragraph
(1).
``(d) Comprehensive State Grants.--
``(1) In general.--Under the Plan, the Secretary may award
grants to eligible entities to provide support for
comprehensive arthritis control and prevention programs and to
enable such entities to provide public health surveillance,
prevention, and control activities related to arthritis and
other rheumatic diseases.
``(2) Application.--The Secretary may only award a grant
under this subsection to an eligible entity that submits to the
Secretary an application at such time, in such manner, and
containing such agreements, assurances, and information as the
Secretary may require, including a comprehensive arthritis
control and prevention plan that--
``(A) is developed with the advice of stakeholders
from the public, private, and nonprofit sectors that
have expertise relating to arthritis control,
prevention, and treatment that increase the quality of
life and decrease the level of disability;
``(B) is intended to reduce the morbidity of
arthritis, with priority on preventing and controlling
arthritis in at-risk populations and reducing
disparities in arthritis prevention, diagnosis,
management, and quality of care in underserved
populations;
``(C) describes the arthritis-related services and
activities to be undertaken or supported by the entity;
and
``(D) demonstrates the relationship the entity has
with the community and local entities and how the
entity plans to involve such community and local
entities in carrying out the activities described in
paragraph (1).
``(3) Use of funds.--An eligible entity may use amounts
received under a grant awarded under this subsection to
conduct, in a manner consistent with the comprehensive
arthritis control and prevention plan submitted by the entity
in the application under paragraph (2)--
``(A) public health surveillance and epidemiological
activities relating to the prevalence of arthritis and
assessment of disparities in arthritis prevention,
diagnosis, management, and care;
``(B) public information and education programs; and
``(C) education, training, and clinical skills
improvement activities for health professionals,
including allied health personnel.
``(4) Eligible entity.--For purposes of this subsection, the
term `eligible entity' means a State or an Indian tribe.
``(e) General Application.--The Secretary may only award a grant
under subsection (b) or (c) to an entity that submits to the Secretary
an application at such time, in such manner, and containing such
agreements, assurances, and information as the Secretary may require,
including a description of how funds received under a grant awarded
under such subsection will supplement or fulfill unmet needs identified
in a comprehensive arthritis control and prevention plan of the entity.
``(f) Definitions.--For purposes of this section:
``(1) Indian tribe.--The term `Indian tribe' has the meaning
given such term in section 4(e) of the Indian Self-
Determination and Education Assistance Act.
``(2) State.--The term `State' means any of the 50 States,
the District of Columbia, the Commonwealth of Puerto Rico, the
Virgin Islands, American Samoa, Guam, and the Northern Mariana
Islands.
``(g) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section--
``(1) for fiscal year 2012, $14,600,000;
``(2) for fiscal year 2013, $16,000,000;
``(3) for fiscal year 2014, $17,700,000;
``(4) for fiscal year 2015, $19,400,000; and
``(5) for fiscal year 2016, $21,400,000.''.
SEC. 3. ACTIVITIES OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES WITH
RESPECT TO JUVENILE ARTHRITIS AND RELATED
CONDITIONS.
Part B of title IV of the Public Health Service Act (42 U.S.C. 284 et
seq.) is amended by adding at the end the following:
``SEC. 409K. JUVENILE ARTHRITIS AND RELATED CONDITIONS.
``(a) In General.--The Secretary, in coordination with the Director
of NIH, may expand and intensify programs of the National Institutes of
Health with respect to research and related activities designed to
improve the outcomes and quality of life for children with arthritis
and other rheumatic diseases.
``(b) Coordination.--The Director of NIH may coordinate the programs
referred to in subsection (a) and consult with additional Federal
officials, voluntary health associations, medical professional
societies, and private entities, as appropriate.''.
SEC. 4. INVESTMENT IN TOMORROW'S PEDIATRIC RHEUMATOLOGISTS.
Subpart I of part C of title VII of the Public Health Service Act (42
U.S.C. 293k et seq.) is amended by adding at the end the following:
``SEC. 749A-1. PEDIATRIC RHEUMATOLOGISTS.
``In order to ensure an adequate future supply of pediatric
rheumatologists, the Secretary, in consultation with the Administrator
of the Health Resources and Services Administration, may award
institutional training grants to institutions to support pediatric
rheumatology training.''.
Purpose and Summary
H.R. 1210, the ``Arthritis Prevention, Control, and Cure
Act'', was introduced on February 26, 2009, by Representative
Anna G. Eshoo (D-CA), and referred to the Committee on Energy
and Commerce.
The goal of H.R. 1210 is to provide for arthritis public
health efforts, enhance juvenile arthritis research, and
increase the number of pediatric rheumatology professionals.
Background and Need for Legislation
Arthritis encompasses more than 100 diseases and conditions
that affect joints, the surrounding tissues, and other
connective tissues. Arthritis affects nearly one of every six
Americans and it is the leading cause of disability in this
nation.\1\
---------------------------------------------------------------------------
\1\Arthritis Foundation, Association of State and Territorial
Health Officials, and the Centers for Disease Control and Prevention,
National Arthritis Action Plan: A Public Health Strategy (1999).
---------------------------------------------------------------------------
The arthritis program at the Centers for Disease Control
and Prevention (CDC) supports programs to implement the 1999
National Arthritis Action Plan, but these activities are not
specifically authorized.
A 2007 report by the Health Resources and Services
Administration (HRSA) concluded that there is a shortage of
pediatric rheumatologists and that a 75% increase in such
physicians is needed.\2\ Under the Patient Protections and
Affordable Care Act (Public Law 111-148), HRSA is authorized to
create loan repayment programs for pediatric subspecialists,
which includes pediatric rheumatologists, but is unclear
whether any authority currently exists under which HRSA could
provide institutional training grants for pediatric
rheumatologists.
---------------------------------------------------------------------------
\2\Health Resources and Services Administration, Report to
Congress: The Pediatric Rheumatology Workforce: A Study of the Supply
and Demand for Pediatric Rheumatologists (Feb. 2007).
---------------------------------------------------------------------------
Committee Consideration
H.R. 1210, the ``Arthritis Prevention, Control, and Cure
Act'', was introduced by Ms. Eshoo of California on February
26, 2009, and referred to the Committee on Energy and Commerce.
The bill was subsequently referred to the Subcommittee on
Health on March 2, 2009. On September 15, 2010, the
Subcommittee held a legislative hearing on the bill. There was
no Subcommittee markup held on the legislation.
On September 23, 2010, the Committee on Energy and Commerce
met in open markup session and discharged H.R. 1210 from the
Subcommittee on Health in order to consider the bill in full
Committee. Ms. Eshoo of California offered an amendment in the
nature of a substitute (manager's amendment) to H.R. 1210,
which was adopted by a voice vote. Subsequently the Committee
ordered H.R. 1210 favorably reported to the House, amended, by
a voice vote.
Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list each record vote
on the motion to report legislation and amendments thereto. A
motion by Mr. Pallone ordering H.R. 1210 reported to the House,
amended, was approved by a voice vote. There were no record
votes taken during consideration of this bill.
Committee Oversight Findings and Recommendations
In compliance with clause 3(c)(1) of rule XIII and clause
2(b)(1) of rule X of the Rules of the House of Representatives,
the oversight findings and recommendations of the House are
reflected in the descriptive portions of this report, including
the finding that there is a shortage of pediatric
rheumatologists and that an increase in such physicians is
needed.
New Budget Authority, Entitlement Authority, and Tax Expenditures
Regarding compliance with clause 3(c)(2) of rule XIII of
the Rules of the House of Representatives, the Committee finds
that H.R. 1210 would result in no new budget authority,
entitlement authority, or tax expenditures or revenues.
Statement of General Performance Goals and Objectives
In accordance with clause 3(c)(4) of rule XIII of the Rules
of the House of Representatives, the performance goals and
objectives of the Committee are reflected in the descriptive
portions of this report, including the goal of providing for
arthritis public health efforts, enhancing juvenile arthritis
research, and increasing the number of pediatric rheumatology
professionals.
Constitutional Authority Statement
Pursuant to clause 3(d)(1) of rule XIII of the Rules of the
House of Representatives, the Committee finds that the
constitutional authority for H.R. 1210 is provided under
article I, section 8, clauses 3 and 18 of the Constitution of
the United States.
Earmarks and Tax and Tariff Benefits
H.R. 1210 does not contain any congressional earmarks,
limited tax benefits, or limited tariff benefits as defined in
clause 9 of rule XXI of the Rules of the House of
Representatives.
Federal Advisory Committee Statement
The Committee finds that the legislation does not establish
or authorize the establishment of an advisory committee within
the definition of 5 U.S.C. App., section 5(b) of the Federal
Advisory Committee Act.
Applicability of Law to the Legislative Branch
Section 102(b)(3) of Public Law 104-1 requires a
description of the application of this bill to the legislative
branch where the bill relates to terms and conditions of
employment or access to public services and accommodations.
H.R. 1210 contains no such provisions.
Federal Mandates Statement
Section 423 of the Congressional Budget and Impoundment
Control Act of 1974 (as amended by section 101(a)(2) of the
Unfunded Mandates Reform Act, Public Law 104-4) requires a
statement on whether the provisions of the report include
unfunded mandates. In compliance with this requirement the
Committee adopts as its own the analysis of federal mandates
prepared by the Director of the Congressional Budget Office
regarding H.R. 1210.
Committee Cost Estimate
Pursuant to clause 3(d)(2) of rule XIII of the Rules of the
House of Representatives, the Committee adopts as its own the
cost estimate of H.R. 1210 prepared by the Director of the
Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974.
Congressional Budget Office Cost Estimate
With respect to the requirements of clause 3(c)(3) of rule
XIII of the Rules of the House of Representatives and section
402 of the Congressional Budget Act of 1974, the Committee has
received the following cost estimate for H.R. 1210 from the
Director of Congressional Budget Office:
U.S. Congress,
Congressional Budget Office,
Washington, DC, September 27, 2010.
Hon. Henry A. Waxman,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 1210, the
Arthritis Prevention, Control, and Cure Act of 2010.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Mindy Cohen.
Sincerely,
Douglas W. Elmendorf,
Director.
Enclosure.
H.R. 1210--Arthritis Prevention, Control, and Cure Act of 2010
Summary: H.R. 1210 would authorize the Secretary of Health
and Human Services to fund activities relating to the control,
prevention, and surveillance of arthritis and other rheumatic
diseases. Assuming appropriation of the specified amounts, CBO
estimates that implementing H.R. 1210 would cost $52 million
over the 2011-2015 period. Enacting H.R. 1210 would not affect
direct spending or revenues; therefore, pay-as-you-go
procedures do not apply.
H.R. 1210 contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act (UMRA).
Estimated cost to the Federal Government: The estimated
budgetary impact of H.R. 1210 is shown in the following table.
The costs of this legislation fall within budget function 550
(health).
----------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
------------------------------------------------------------
2011 2012 2013 2014 2015 2011-2015
----------------------------------------------------------------------------------------------------------------
CHANGES IN SPENDING SUBJECT TO APPROPRIATIONAuthorization Level................................ 0 15 16 18 19 68
Estimated Outlays.................................. 0 5 13 16 18 52
----------------------------------------------------------------------------------------------------------------
Basis of estimate: H.R. 1210 would authorize the Secretary
of Health and Human Services, in coordination with the Center
for Disease Control and Prevention, to award grants to public
or private nonprofit entities for research, training, and other
activities relating to the control, prevention, and
surveillance of arthritis and other rheumatic diseases. The
bill also would authorize the Director of the National
Institutes of Health to expand and intensify programs designed
to improve the outcome and quality of life for children with
arthritis. In addition, the bill would authorize the Health
Resources and Services Administration to award training grants
to institutions to support pediatric rheumatology training.
H.R. 1210 would authorize the appropriation of $68 million
for fiscal years 2012 through 2015 and an additional $21
million for fiscal year 2016. Based on historical spending
patterns for similar activities, and assuming appropriation of
the specified amounts, CBO estimates that implementing H.R.
1210 would cost $52 million over the 2011-2015 period and an
additional $37 million after 2015.
Pay-As-You-Go considerations: None.
Intergovernmental and private-sector impact: H.R. 1210
contains no intergovernmental or private-sector mandates as
defined in UMRA. Grant activities authorized in the bill would
benefit state, local, and tribal governments.
Estimate prepared by: Federal Costs: Mindy Cohen; Impact on
State, Local, and Tribal Governments: Lisa Ramirez-Branum;
Impact on the Private Sector: Sarah Axeen.
Estimate approved by: Holly Harvey, Deputy Assistant
Director for Budget Analysis.
Section-by-Section Analysis of the Legislation
Section 1. Short title
Section 1 designates that this Act may be cited as the
``Arthritis Prevention, Control, and Cure Act of 2010''.
Section 2. Enhancing public health activities related to arthritis
through the National Arthritis Action Plan
Section 2 authorizes the Secretary of Health and Human
Services (Secretary) to develop and implement a National
Arthritis Action Plan, at a level of $14.6 million in FY2012,
rising to $21.4 million in FY2016. Such Plan would support
arthritis control, prevention, surveillance, research,
education, and outreach activities, through grants and direct
support to public or private non-profit entities and states.
Section 3. Activities of the Department of Health and Human Services
with respect to juvenile arthritis and related conditions
Section 3 authorizes the Secretary to expand and intensify
programs of the National Institutes of Health (NIH) with
respect to research and related activities concerning various
forms of juvenile arthritis and related conditions.
Section 4. Investment in tomorrow's pediatric rheumatologists
Section 4 authorizes the Secretary to provide grants to
training institutions in order to support pediatric
rheumatology training.
Explanation of Amendment
During full Committee consideration of H.R. 1210, Ms. Eshoo
of California offered an amendment in the nature of a
substitute (manager's amendment), which was adopted by a voice
vote. The substance of the substitute amendment is reflected in
the section-by-section analysis contained in this report.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (new matter is
printed in italic and existing law in which no change is
proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE
* * * * * * *
Part B--Federal-State Cooperation
* * * * * * *
SEC. 315. NATIONAL ARTHRITIS ACTION PLAN.
(a) Establishment of Plan.--The Secretary may develop and
implement a National Arthritis Action Plan (in this section
referred to as the ``Plan'') consistent with this section.
(b) Control, Prevention, and Surveillance.--
(1) In general.--Under the Plan, the Secretary may,
directly or through competitive grants to eligible
entities, conduct, support, and promote the
coordination of research, investigations,
demonstrations, training, and studies relating to the
control, prevention, and surveillance of arthritis and
other rheumatic diseases.
(2) Training and technical assistance.--
(A) Provision.--Upon the request of an
applicant receiving a grant under paragraph
(1), the Secretary may, subject to subparagraph
(B), provide training, technical assistance,
supplies, equipment, or services for the
purpose of aiding the applicant in carrying out
grant activities and, for such purpose, may
detail to the applicant any officer or employee
of the Department of Health and Human Services.
(B) Corresponding reduction in payments.--
With respect to a request described in
subparagraph (A), the Secretary shall reduce
the amount of payments under the grant under
paragraph (1) to the applicant involved by an
amount equal to the costs of detailing
personnel (including pay, allowances, and
travel expenses) and the fair market value of
any supplies, equipment, or services provided
by the Secretary.
(3) Arthritis prevention research at the centers for
disease control and prevention.--The Secretary may
provide additional grant support under this subsection
to encourage the expansion of research related to the
prevention and management of arthritis at the Centers
for Disease Control and Prevention.
(4) Eligible entity.--For purposes of this
subsection, the term ``eligible entity'' means a public
or private nonprofit entity that demonstrates to the
satisfaction of the Secretary, in the application
described in subsection (e), the ability of the entity
to carry out the activities described in paragraph (1).
(c) Education and Outreach.--
(1) In general.--Under the Plan, the Secretary may
coordinate and carry out national education and
outreach activities, directly or through the provision
of grants to eligible entities, to support, develop,
and implement education initiatives and outreach
strategies appropriate for arthritis and other
rheumatic diseases.
(2) Initiatives and strategies.--Initiatives and
strategies implemented under paragraph (1) may include
public awareness campaigns, public service
announcements, and community partnership workshops, as
well as programs targeted to businesses and employers,
managed care organizations, and health care providers.
(3) Priority.--In carrying out paragraph (1), the
Secretary--
(A) may emphasize prevention, early
diagnosis, and appropriate management of
arthritis, and opportunities for effective
patient self-management; and
(B) may give priority to reaching high-risk
or underserved populations.
(4) Collaboration.--In carrying out this subsection,
the Secretary shall consult and collaborate with
stakeholders from the public, private, and nonprofit
sectors with expertise relating to arthritis control,
prevention, and treatment.
(5) Eligible entity.--For purposes of this
subsection, the term ``eligible entity'' means a public
or private nonprofit entity that demonstrates to the
satisfaction of the Secretary, in the application
described in subsection (e), the ability of the entity
to carry out the activities described in paragraph (1).
(d) Comprehensive State Grants.--
(1) In general.--Under the Plan, the Secretary may
award grants to eligible entities to provide support
for comprehensive arthritis control and prevention
programs and to enable such entities to provide public
health surveillance, prevention, and control activities
related to arthritis and other rheumatic diseases.
(2) Application.--The Secretary may only award a
grant under this subsection to an eligible entity that
submits to the Secretary an application at such time,
in such manner, and containing such agreements,
assurances, and information as the Secretary may
require, including a comprehensive arthritis control
and prevention plan that--
(A) is developed with the advice of
stakeholders from the public, private, and
nonprofit sectors that have expertise relating
to arthritis control, prevention, and treatment
that increase the quality of life and decrease
the level of disability;
(B) is intended to reduce the morbidity of
arthritis, with priority on preventing and
controlling arthritis in at-risk populations
and reducing disparities in arthritis
prevention, diagnosis, management, and quality
of care in underserved populations;
(C) describes the arthritis-related services
and activities to be undertaken or supported by
the entity; and
(D) demonstrates the relationship the entity
has with the community and local entities and
how the entity plans to involve such community
and local entities in carrying out the
activities described in paragraph (1).
(3) Use of funds.--An eligible entity may use amounts
received under a grant awarded under this subsection to
conduct, in a manner consistent with the comprehensive
arthritis control and prevention plan submitted by the
entity in the application under paragraph (2)--
(A) public health surveillance and
epidemiological activities relating to the
prevalence of arthritis and assessment of
disparities in arthritis prevention, diagnosis,
management, and care;
(B) public information and education
programs; and
(C) education, training, and clinical skills
improvement activities for health
professionals, including allied health
personnel.
(4) Eligible entity.--For purposes of this
subsection, the term ``eligible entity'' means a State
or an Indian tribe.
(e) General Application.--The Secretary may only award a
grant under subsection (b) or (c) to an entity that submits to
the Secretary an application at such time, in such manner, and
containing such agreements, assurances, and information as the
Secretary may require, including a description of how funds
received under a grant awarded under such subsection will
supplement or fulfill unmet needs identified in a comprehensive
arthritis control and prevention plan of the entity.
(f) Definitions.--For purposes of this section:
(1) Indian tribe.--The term ``Indian tribe'' has the
meaning given such term in section 4(e) of the Indian
Self-Determination and Education Assistance Act.
(2) State.--The term ``State'' means any of the 50
States, the District of Columbia, the Commonwealth of
Puerto Rico, the Virgin Islands, American Samoa, Guam,
and the Northern Mariana Islands.
(g) Authorization of Appropriations.--There are authorized to
be appropriated to carry out this section--
(1) for fiscal year 2012, $14,600,000;
(2) for fiscal year 2013, $16,000,000;
(3) for fiscal year 2014, $17,700,000;
(4) for fiscal year 2015, $19,400,000; and
(5) for fiscal year 2016, $21,400,000.
* * * * * * *
TITLE IV--NATIONAL RESEARCH INSTITUTES
* * * * * * *
Part B--General Provisions Respecting National Research Institutes
* * * * * * *
SEC. 409K. JUVENILE ARTHRITIS AND RELATED CONDITIONS.
(a) In General.--The Secretary, in coordination with the
Director of NIH, may expand and intensify programs of the
National Institutes of Health with respect to research and
related activities designed to improve the outcomes and quality
of life for children with arthritis and other rheumatic
diseases.
(b) Coordination.--The Director of NIH may coordinate the
programs referred to in subsection (a) and consult with
additional Federal officials, voluntary health associations,
medical professional societies, and private entities, as
appropriate.
* * * * * * *
TITLE VII--HEALTH PROFESSIONS EDUCATION
* * * * * * *
PART C--TRAINING IN FAMILY MEDICINE, GENERAL INTERNAL MEDICINE, GENERAL
PEDIATRICS, PHYSICIAN ASSISTANTS, GENERAL DENTISTRY, AND PEDIATRIC
DENTISTRY
Subpart I--Medical Training Generally
* * * * * * *
SEC. 749A-1. PEDIATRIC RHEUMATOLOGISTS.
In order to ensure an adequate future supply of pediatric
rheumatologists, the Secretary, in consultation with the
Administrator of the Health Resources and Services
Administration, may award institutional training grants to
institutions to support pediatric rheumatology training.
* * * * * * *