[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4378 Introduced in House (IH)]
113th CONGRESS
2d Session
H. R. 4378
To require the Secretary of Health and Human Services to issue to
Federal agencies guidelines for developing procedures and requirements
relating to certain primary care Federal health professionals
completing continuing medical education on nutrition and to require
Federal agencies to submit annual reports relating to such guidelines,
and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 2, 2014
Mr. Grijalva (for himself and Mr. Ryan of Ohio) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
_______________________________________________________________________
A BILL
To require the Secretary of Health and Human Services to issue to
Federal agencies guidelines for developing procedures and requirements
relating to certain primary care Federal health professionals
completing continuing medical education on nutrition and to require
Federal agencies to submit annual reports relating to such guidelines,
and for other purposes.
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 ``Education and Training for Health
Act of 2014'' or the ``EAT for Health Act of 2014''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) In 2012, United States health care spending was
approximately $8,233 per resident and accounted for 17.6
percent of the Nation's gross domestic product. This is among
the highest of all industrialized countries.
(2) Expenditures in the United States on health care
surpassed $2.6 trillion in 2011, more than three times the $714
billion spent in 1990, and over eight times the $253 billion
spent in 1980.
(3) Estimates of health care costs attribute over 75
percent of national health expenditures to treatment for
chronic diseases.
(4) A March 2003 report from the World Health Organization
concluded diet was a major cause of chronic diseases.
(5) Seven out of 10 deaths among people in the United
States each year are from chronic diseases such as
cardiovascular disease, obesity, diabetes, and cancer.
(6) Approximately 81.1 million American adults in the
United States have at least one form of cardiovascular disease.
Approximately 2,300 American adults in the United States die
every day from cardiovascular disease. In 2010, cardiovascular
disease cost American taxpayers $189.4 billion. The American
Heart Association estimates that, by 2030, direct costs related
to cardiovascular disease will triple to around $818 billion.
(7) Research has shown that following a healthful diet can
not only reduce symptoms related to cardiovascular disease but
also actually reverse damage done to the arteries.
(8) Two-thirds of adults in the United States are currently
overweight, and half of those overweight individuals are obese.
One in three children are now overweight, and one-fifth of
children are obese. In 2008, direct medical costs associated
with obesity totaled $147 billion.
(9) An estimated 25.8 million people in the United States
have diabetes. Another 79 million American adults in the United
States have prediabetes. The Centers for Disease Control and
Prevention predict that one in three children born in 2000 will
develop diabetes at some point in their lives. Total estimated
costs of diagnosed diabetes have increased 41 percent, to $245
billion in 2012 from $174 billion in 2007. Research shows that
reducing fat in the diet can reverse the symptoms of type 2
diabetes, not just ``manage'' the symptoms.
(10) Cancer kills approximately 570,000 Americans each
year, accounting for one in four deaths. More than 1.5 million
new cancer cases are diagnosed annually. In 2010, the direct
costs of cancer were $102.8 billion. Estimates expect that
number to rise to $172 billion by 2020.
(11) According to the Journal of the American College of
Nutrition, physicians feel inadequately trained to provide
proper nutrition advice. Ninety-four percent feel nutrition
counseling should be included during primary care visits, but
only 14 percent felt adequately trained to provide such
counseling.
(12) A 1985 National Academy of Sciences report recommended
that all medical schools require at least 25 contact hours of
nutrition education. In 2004, only 38 percent of medical
schools met these minimum standards by requiring 25 hours of
nutrition education as part of their general curricula. By
2010, that number had shrunk to 27 percent.
(13) In 2004, 30 percent of United States medical schools
required a dedicated nutrition course. In 2010, only 25 percent
of such schools required such a course.
(14) According to a 2009 national survey of medical
colleges published in Academic Medicine, more than half of
graduating medical students feel their nutrition education is
insufficient.
SEC. 3. DEPARTMENT OF HEALTH AND HUMAN SERVICES GUIDELINES, AND FEDERAL
AGENCIES ANNUAL REPORTS, RELATING TO CERTAIN PRIMARY CARE
FEDERAL HEALTH PROFESSIONALS COMPLETING CONTINUING
MEDICAL EDUCATION ON NUTRITION.
(a) Guidelines.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Health and Human Services shall
issue guidelines to Federal agencies for developing procedures and
requirements to ensure that every primary care health professional
employed full-time for such agencies have at least 6 credits of
continuing medical education courses relating to nutrition (as
described in subsection (c)).
(b) Annual Reports.--For 2016 and each subsequent year, the head of
each Federal agency that employs full-time primary care health
professionals shall submit to Congress a report attesting, in a form
and manner specified by the Secretary of Health and Human Services, to
the extent to which the agency has adopted and enforced the guidelines
issued under subsection (a) with respect to such professionals employed
by such agency during any portion of the previous year. If the agency,
with respect to such previous year, did not fully adopt and enforce
such guidelines with respect to such professionals, the head of the
agency shall include in the report for the year the percentage of such
professionals employed by such agency to furnish primary care services
who during such previous year completed 6 credits of continuing medical
education courses relating to nutrition (as described in subsection
(c)).
(c) Continuing Medical Education Relating to Nutrition.--For
purposes of subsections (a) and (b), continuing medical education
courses relating to nutrition shall include at least courses on the
role of nutrition in the prevention, management, and, as possible,
reversal of obesity, cardiovascular disease, diabetes, and cancer.
(d) Definitions.--For purposes of this Act:
(1) Primary care health professional.--The term ``primary
care health professional'' means a physician or nurse
practitioner who furnishes primary care services.
(2) Nurse practitioner.--The term ``nurse practitioner''
has the meaning given such term in section 1861(aa)(5) of the
Social Security Act (42 U.S.C. 1395x(aa)(5)).
(3) Physician.--The term ``physician'' has the meaning
given such term in section 1861(r)(1) of the Social Security
Act (42 U.S.C. 1395x(r)(1)).
(4) Primary care services.--The term ``primary care
services'' has the meaning given such term in section
1842(i)(4) of the Social Security Act (42 U.S.C. 1395u(i)(4)),
but shall include such services furnished by a nurse
practitioner as would otherwise be included if furnished by a
physician.
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