[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 2983 Introduced in Senate (IS)]
110th CONGRESS
2d Session
S. 2983
To amend the Public Health Service Act to prevent and cure diabetes and
to promote and improve the care of individuals with diabetes for the
reduction of health disparities within racial and ethnic minority
groups, including the African-American, Hispanic American, Asian
American and Pacific Islander, and American Indian and Alaskan Native
communities.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 6, 2008
Mr. Lautenberg (for himself, Mr. Isakson, and Ms. Stabenow) introduced
the following bill; which was read twice and referred to the Committee
on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to prevent and cure diabetes and
to promote and improve the care of individuals with diabetes for the
reduction of health disparities within racial and ethnic minority
groups, including the African-American, Hispanic American, Asian
American and Pacific Islander, and American Indian and Alaskan Native
communities.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Diabetes Prevention Access and Care
Act of 2008''.
TITLE I--NATIONAL INSTITUTES OF HEALTH
SEC. 101. RESEARCH, TREATMENT, AND EDUCATION.
(a) In General.--Subpart 3 of part C of title IV of the Public
Health Service Act (42 U.S.C. 285c et seq.) is amended by adding at the
end the following new section:
``SEC. 434B. DIABETES IN MINORITY POPULATIONS.
``(a) In General.--The Director of the National Institutes of
Health shall expand, intensify, conduct, coordinate, and support
research and other activities with respect to pre-diabetes and
diabetes, particularly type 2, in minority populations, including
research to identify clinical, socioeconomic, geographical, cultural,
and organizational factors that contribute to type 2 diabetes in such
populations.
``(b) Certain Activities.--Activities under subsection (a)
regarding type 2 diabetes in minority populations shall include the
following:
``(1) Research on behavior and obesity, including research
through the obesity research center that is sponsored by the
National Institutes of Health.
``(2) Research on environmental factors that may contribute
to the increase in type 2 diabetes, which shall be conducted or
supported through the National Institute of Environmental
Health Sciences and the National Human Genome Research
Institute.
``(3) Support for new methods to identify environmental
triggers and genetic interactions that lead to the development
of type 1 and type 2 diabetes in minority newborns with a high
genetic susceptibility to the disease. Such research should
follow the newborns through puberty, which is a high-risk
period for developing type 1 diabetes, and--increasingly--type
2 diabetes.
``(4) Research to identify genes that predispose
individuals to the onset of developing type 1 and type 2
diabetes and to develop complications.
``(5) Research to prevent complications in individuals who
have already developed diabetes, such as attempting to identify
the genes that predispose individuals with diabetes to the
development of complications, as well as methods and
alternative therapies to control blood glucose.
``(6) The support of ongoing research efforts examining the
level of glycemia at which adverse outcomes develop during
pregnancy and to address the many clinical issues associated
with minority mothers and fetuses during diabetic and
gestational diabetic pregnancies.
``(c) Treatment.--
``(1) In general.--The Director of the National Institutes
of Health shall conduct and support programs to treat diabetes
in minority populations.
``(2) Certain activities.--Activities under paragraph (1)
regarding the treatment of diabetes in minority populations
shall include recommending and disseminating, through the
National Center on Minority Health and Health Disparities, the
guidelines of the American Diabetes Association for nutrition
exercise and diet for diabetes treatment and prevention.
``(d) Education.--The Director of the National Institutes of Health
shall--
``(1) through the National Center on Minority Health and
Health Disparities--
``(A) make grants to programs funded under section
485F (relating to centers of excellence) for the
purpose of establishing a mentoring program for health
care professionals to be more involved in weight
counseling, obesity research, and nutrition; and
``(B) provide for the participation of minority
health professionals in diabetes-focused research
programs; and
``(2) make grants for programs to establish a pipeline from
high school to professional school that will increase minority
representation in diabetes-focused health fields by expanding
Minority Access to Research Careers (MARC) program internships
and mentoring opportunities for recruitment.
``(e) Definition.--For purposes of this section, the term `minority
populations' means racial and ethnic minority groups within the meaning
of section 1707.
``(f) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for fiscal year 2009 and each subsequent fiscal
year.''.
(b) Diabetes Mellitus Interagency Coordinating Committee.--Section
429 of the Public Health Service Act (42 U.S.C. 285c-3) is amended by
adding at the end the following subsection:
``(c)(1) In addition to other duties established in this section
for the Diabetes Mellitus Interagency Coordinating Committee, such
Committee shall--
``(A) assess the current activities of all current Federal
health programs to determine their adequacy as a systemic
method of addressing the impact of diabetes mellitus on
minority populations;
``(B) undertake strategic planning activities to develop an
effective and comprehensive Federal plan to address diabetes
mellitus within communities of color which will involve all
appropriate Federal health programs; and
``(C) conduct the implementation of such a plan throughout
all Federal health programs.
``(2) The Federal plan under paragraph (1)(B) shall--
``(A) include steps to address issues including, but not
limited to, type 1 and type 2 diabetes in children and the
disproportionate impact of diabetes mellitus on minority
populations; and
``(B) remain consistent with the programs and activities
identified in section 399O, as well as remaining consistent
with the intent of the Diabetes Prevention Access and Care Act
of 2008.
``(3) For purposes of this subsection, the term `minority
populations' means racial and ethnic minority groups within the meaning
of section 1707.
``(4) For the purpose of carrying out this subsection, there are
authorized to be appropriated such sums as may be necessary for fiscal
year 2009 and each subsequent fiscal year.''.
TITLE II--CENTERS FOR DISEASE CONTROL AND PREVENTION
SEC. 201. RESEARCH, EDUCATION, AND OTHER ACTIVITIES.
(a) In General.--Part B of title III of the Public Health Service
Act (42 U.S.C. 243 et seq.) is amended by inserting after section 317S
the following section:
``SEC. 317T. DIABETES IN MINORITY POPULATIONS.
``(a) Research and Other Activities.--
``(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention,
shall conduct and support research and other activities with
respect to diabetes in minority populations.
``(2) Certain activities.--Activities under paragraph (1)
regarding diabetes in minority populations shall include the
following:
``(A) Expanding the National Diabetes Laboratory
for translational research, and the identification of
genetic and immunological risk factors associated with
diabetes.
``(B) Enhancing the National Health and Nutrition
Examination Survey on eating and dietary habits, with a
focus, including cultural and socioeconomic factors, on
Hispanic American, African-American, American Indian
and Alaskan Native, and Asian American and Pacific
Islander communities.
``(C) Further enhancing the National Health and
Nutrition Examination Survey by over-sampling Asian
American and Pacific Islanders in appropriate
geographic areas to better determine the prevalence of
diabetes in these populations as well as to improve the
data collection of diabetes penetration disaggregated
into major ethnic groups within this population.
``(D) Within the Division of Diabetes Translation,
providing for prevention research to better understand
how to influence health care systems changes to improve
quality of care being delivered to such populations,
and within the Division of Diabetes Translation,
carrying out model demonstration projects to design,
implement, and evaluate effective diabetes prevention
and control intervention for these populations.
``(E) Through the Division of Diabetes Translation,
carrying out culturally appropriate community-based
interventions designed to address issues and problems
experienced by these populations.
``(F) Conducting applied research within the
Division of Diabetes Translation to reduce health
disparities within these populations with diabetes.
``(G) Conducting applied research on primary
prevention within the Division of Diabetes Translation
to specifically focus on these populations with pre-
diabetes.
``(b) Education.--
``(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention,
shall direct the Division of Diabetes Translation to conduct
and support programs to educate the public on the causes and
effects of diabetes in minority populations.
``(2) Certain activities.--Activities under paragraph (1)
regarding education on diabetes in minority populations shall
include the following:
``(A) Making grants for diabetes-focused education
classes or training programs on cultural sensitivity
and patient care within such populations for health
care providers.
``(B) Carrying out public awareness campaigns
directed toward such populations to aggressively
emphasize the importance and impact of physical
activity and diet in regard to diabetes and diabetes-
related complications.
``(c) Diabetes; Health Promotion, Prevention Activities, and
Access.--
``(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention,
shall carry out culturally appropriate diabetes health
promotion and prevention programs for minority populations.
``(2) Certain activities.--Activities under paragraph (1)
regarding culturally appropriate diabetes health promotion and
prevention programs for minority populations shall include the
following:
``(A) Expanding the Diabetes Prevention and Control
Program (currently existing in all the States and
territories).
``(B) Providing funds for the Diabetes Today
program to adapt community planning tools within such
populations.
``(C) Providing funds for Racial and Ethnic
Approaches to Community Health (REACH 2010) grants to
develop and evaluate diabetes prevention and control
community programs focused on such populations.
``(D) Providing funds to community health centers
for a monthly diabetes week program of diabetes
services, including screenings.
``(E) Providing funds for education and community
outreach on diabetes.
``(F) Providing funds for the United States and
Mexico Border Diabetes project to develop culturally
appropriate diabetes prevention and control
interventions for minority populations in the border
region.
``(G) Providing funds for an aggressive prevention
campaign that focuses on physical inactivity and diet
and its relation to type 2 diabetes within such
populations.
``(H) Providing funds for surveillance systems and
strategies for strengthening existing systems to
improve the quality, accuracy, and timelines of
morbidity and mortality diabetes data for such
populations.
``(d) Definition.--For purposes of this section, the term `minority
populations' means racial and ethnic minority groups within the meaning
of section 1707.
``(e) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for fiscal year 2009 and each subsequent fiscal
year.''.
TITLE III--ADDITIONAL PROGRAMS
SEC. 301. RESEARCH, EDUCATION, AND OTHER ACTIVITIES.
Part P of title III of the Public Health Service Act (42 U.S.C.
280g et seq.) is amended by inserting after section 399N the following
section:
``SEC. 399O. RESEARCH, EDUCATION, AND OTHER ACTIVITIES REGARDING
DIABETES IN MINORITY POPULATIONS.
``(a) Research and Other Activities.--
``(1) In general.--In addition to activities under sections
317T and 434B, the Secretary shall conduct and support research
and other activities with respect to diabetes within minority
populations.
``(2) Certain activities.--Activities under paragraph (1)
regarding diabetes in minority populations shall include the
following:
``(A) Expanding the National Diabetes Education
Program.
``(B) Through the National Center on Minority
Health and Health Disparities, the Office of Minority
Health under section 1707, the Health Resources and
Services Administration, the Centers for Disease
Control and Prevention, and the Indian Health Service,
establishing partnerships within minority populations
to conduct studies on cultural, familial, and social
factors that may influence health promotion, diabetes
management, and prevention.
``(C) Through the Indian Health Service, in
collaboration with other appropriate Federal agencies,
conducting research on ethnic and culturally
appropriate diabetes treatment, care, prevention, and
services by health care professionals to the American
Indian population.
``(3) Programs relating to clinical research.--
``(A) Education regarding clinical trials.--The
Secretary shall carry out education and awareness
programs designed to increase participation of minority
populations in clinical trials.
``(B) Minority researchers.--The Secretary shall
carry out mentorship programs for minority researchers
who are conducting or intend to conduct research on
diabetes in minority populations.
``(C) Supplementing clinical research regarding
children.--The Secretary shall make grants to
supplement clinical research programs to assist such
programs in obtaining the services of health
professionals and other resources to provide
specialized care for children with type 1 and type 2
diabetes.
``(b) Education.--
``(1) In general.--The Secretary shall conduct and support
programs to educate the public on the causes of effects of
diabetes in minority populations.
``(2) Health resources and services administration.--With
respect to the Health Resources and Services Administration,
activities under paragraph (1) regarding education on diabetes
in minority populations shall include the following:
``(A) Providing additional funds for the Health
Careers Opportunity Program, Centers for Excellence,
and the Minority Faculty Fellowship Program to partner
with the Office of Minority Health under section 1707
and the National Institutes of Health to strengthen
programs for career opportunities within minority
populations focused on diabetes treatment and care.
``(B) In partnership with the Health Resources and
Services Administration, develop a diabetes focus
within, and provide additional funds for, the National
Health Service Corps Scholarship program to place
individuals in areas that are disproportionately
affected by diabetes, to provide health care services.
``(C) Establishing a diabetes ambassador program
for recruitment efforts to increase the number of
underrepresented minorities currently serving in
student, faculty, or administrative positions in
institutions of higher learning, hospitals, and
community health centers.
``(D) Establishing a loan repayment program that
focuses on diabetes care and prevention.
``(3) Additional programs.--Activities under paragraph (1)
regarding education on diabetes in minority populations shall
include the following:
``(A) Through collaboration between the Health
Resources and Services Administration and the Indian
Health Service, establishing a joint scholarship and
loan-repayment program for American Indians health
profession students.
``(B) Providing funds for new and existing
diabetes-focused education grants and programs for
present and future students and clinicians in the
medical field from minority populations, including the
following:
``(i) Federal and State loan repayment
programs for health profession students within
communities of color.
``(ii) Providing funds to the Office of
Minority Health under section 1707 for training
health profession students to focus on diabetes
within such populations.
``(iii) Providing funds to State and local
entities to establish diabetes awareness week
or day every month in schools, nursing homes,
and colleges through partnerships with the
Office of Minority Health under section 1707
and the Health Resources and Services
Administration.
``(c) Definition.--For purposes of this section, the term `minority
populations' means racial and ethnic minority groups within the meaning
of section 1707.
``(d) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for fiscal year 2009 and each subsequent fiscal
year.''.
TITLE IV--STUDIES
SEC. 401. STUDIES.
(a) Institute of Medicine.--The Secretary of Health and Human
Services (referred to in this section as the ``Secretary'') shall
request the Institute of Medicine to conduct a study to determine the
extent and impact of the shortage of adult and pediatric
endocrinologists specializing in diabetes, and to submit a report
describing the findings of the study to the Secretary, to the Committee
on Energy and Commerce of the House of Representatives, and to the
Committee on Health, Education, Labor, and Pensions of the Senate. The
Secretary shall ensure that the report includes recommendations on
changes in Federal policies that would increase the number of adult and
pediatric endocrinologists specializing in diabetes.
(b) Agency for Healthcare Research and Quality.--The Secretary,
acting through the Director of the Agency for Healthcare Research and
Quality, shall conduct a study to determine whether minority children
with diabetes have better or worse outcomes than nonminority children.
The study shall include a determination of the extent to which minority
children have access to and participate in disease management programs,
and have access to and use medical devices such as continuous glucose
monitoring systems, insulin pumps, and artificial pancreas.
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