National Pain Care Policy Act of 2008

        [Congressional Bills 110th Congress]
[From the U.S. Government Printing Office]
[H.R. 2994 Referred in Senate (RFS)]

2d Session
H. R. 2994

_______________________________________________________________________

IN THE SENATE OF THE UNITED STATES

September 25 (legislative day, September 17), 2008

Received

October 2 (legislative day, September 17), 2008

Read twice and referred to the Committee on Health, Education, Labor,
and Pensions

_______________________________________________________________________

AN ACT

To amend the Public Health Service Act with respect to pain care.

Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) Short Title.--This Act may be cited as the ``National Pain Care
Policy Act of 2008''.
(b) Table of Contents.--The table of contents of this Act is as
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Institute of Medicine Conference on Pain.
Sec. 3. Pain research at National Institutes of Health.
Sec. 4. Pain care education and training.
Sec. 5. Public awareness campaign on pain management.

SEC. 2. INSTITUTE OF MEDICINE CONFERENCE ON PAIN.

(a) Convening.--Not later than June 30, 2009, the Secretary of
Health and Human Services shall seek to enter into an agreement with
the Institute of Medicine of the National Academies to convene a
Conference on Pain (in this section referred to as ``the Conference'').
(b) Purposes.--The purposes of the Conference shall be to--
(1) increase the recognition of pain as a significant
public health problem in the United States;
(2) evaluate the adequacy of assessment, diagnosis,
treatment, and management of acute and chronic pain in the
general population, and in identified racial, ethnic, gender,
age, and other demographic groups that may be
disproportionately affected by inadequacies in the assessment,
diagnosis, treatment, and management of pain;
(3) identify barriers to appropriate pain care, including--
(A) lack of understanding and education among
employers, patients, health care providers, regulators,
and third-party payors;
(B) barriers to access to care at the primary,
specialty, and tertiary care levels, including
barriers--
(i) specific to those populations that are
disproportionately undertreated for pain;
(ii) related to physician concerns over
regulatory and law enforcement policies
applicable to some pain therapies; and
(iii) attributable to benefit, coverage,
and payment policies in both the public and
private sectors; and
(C) gaps in basic and clinical research on the
symptoms and causes of pain, and potential assessment
methods and new treatments to improve pain care; and
(4) establish an agenda for action in both the public and
private sectors that will reduce such barriers and
significantly improve the state of pain care research,
education, and clinical care in the United States.
(c) Other Appropriate Entity.--If the Institute of Medicine
declines to enter into an agreement under subsection (a), the Secretary
of Health and Human Services may enter into such agreement with another
appropriate entity.
(d) Report.--A report summarizing the Conference's findings and
recommendations shall be submitted to the Congress not later than June
30, 2010.
(e) Authorization of Appropriations.--For the purpose of carrying
out this section, there is authorized to be appropriated $500,000 for
each of fiscal years 2009 and 2010.

SEC. 3. PAIN RESEARCH AT NATIONAL INSTITUTES OF HEALTH.

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. 409J. PAIN RESEARCH.

``(a) Research Initiatives.--
``(1) In general.--The Director of NIH is encouraged to
continue and expand, through the Pain Consortium, an aggressive
program of basic and clinical research on the causes of and
potential treatments for pain.
``(2) Annual recommendations.--Not less than annually, the
Pain Consortium, in consultation with the Division of Program
Coordination, Planning, and Strategic Initiatives, shall
develop and submit to the Director of NIH recommendations on
appropriate pain research initiatives that could be undertaken
with funds reserved under section 402A(c)(1) for the Common
Fund or otherwise available for such initiatives.
``(3) Definition.--In this subsection, the term `Pain
Consortium' means the Pain Consortium of the National
Institutes of Health or a similar trans-National Institutes of
Health coordinating entity designated by the Secretary for
purposes of this subsection.
``(b) Interagency Pain Research Coordinating Committee.--
``(1) Establishment.--The Secretary shall establish not
later than 1 year after the date of the enactment of this
section and as necessary maintain a committee, to be known as
the Interagency Pain Research Coordinating Committee (in this
section referred to as the `Committee'), to coordinate all
efforts within the Department of Health and Human Services and
other Federal agencies that relate to pain research.
``(2) Membership.--
``(A) In general.--The Committee shall be composed
of the following voting members:
``(i) Not more than 7 voting Federal
representatives as follows:
``(I) The Director of the Centers
for Disease Control and Prevention.
``(II) The Director of the National
Institutes of Health and the directors
of such national research institutes
and national centers as the Secretary
determines appropriate.
``(III) The heads of such other
agencies of the Department of Health
and Human Services as the Secretary
determines appropriate.
``(IV) Representatives of other
Federal agencies that conduct or
support pain care research and
treatment, including the Department of
Defense and the Department of Veterans
Affairs.
``(ii) 12 additional voting members
appointed under subparagraph (B).
``(B) Additional members.--The Committee shall
include additional voting members appointed by the
Secretary as follows:
``(i) 6 members shall be appointed from
among scientists, physicians, and other health
professionals, who--
``(I) are not officers or employees
of the United States;
``(II) represent multiple
disciplines, including clinical, basic,
and public health sciences;
``(III) represent different
geographical regions of the United
States; and
``(IV) are from practice settings,
academia, manufacturers or other
research settings; and
``(ii) 6 members shall be appointed from
members of the general public, who are
representatives of leading research, advocacy,
and service organizations for individuals with
pain-related conditions
``(C) Nonvoting members.--The Committee shall
include such nonvoting members as the Secretary
determines to be appropriate.
``(3) Chairperson.--The voting members of the Committee
shall select a chairperson from among such members. The
selection of a chairperson shall be subject to the approval of
the Director of NIH.
``(4) Meetings.--The Committee shall meet at the call of
the chairperson of the Committee or upon the request of the
Director of NIH, but in no case less often than once each year.
``(5) Duties.--The Committee shall--
``(A) develop a summary of advances in pain care
research supported or conducted by the Federal agencies
relevant to the diagnosis, prevention, and treatment of
pain and diseases and disorders associated with pain;
``(B) identify critical gaps in basic and clinical
research on the symptoms and causes of pain;
``(C) make recommendations to ensure that the
activities of the National Institutes of Health and
other Federal agencies, including the Department of
Defense and the Department of Veteran Affairs, are free
of unnecessary duplication of effort;
``(D) make recommendations on how best to
disseminate information on pain care; and
``(E) make recommendations on how to expand
partnerships between public entities, including Federal
agencies, and private entities to expand collaborative,
cross-cutting research.
``(6) Review.--The Secretary shall review the necessity of
the Committee at least once every 2 years.''.

SEC. 4. PAIN CARE EDUCATION AND TRAINING.

(a) Pain Care Education and Training.--Part D of title VII of the
Public Health Service Act (42 U.S.C. 294 et seq.) is amended--
(1) by redesignating sections 754 through 758 as sections
755 through 759, respectively; and
(2) by inserting after section 753 the following:

``SEC. 754. PROGRAM FOR EDUCATION AND TRAINING IN PAIN CARE.

``(a) In General.--The Secretary may make awards of grants,
cooperative agreements, and contracts to health professions schools,
hospices, and other public and private entities for the development and
implementation of programs to provide education and training to health
care professionals in pain care.
``(b) Priorities.--In making awards under subsection (a), the
Secretary shall give priority to awards for the implementation of
programs under such subsection.
``(c) Certain Topics.--An award may be made under subsection (a)
only if the applicant for the award agrees that the program carried out
with the award will include information and education on--
``(1) recognized means for assessing, diagnosing, treating,
and managing pain and related signs and symptoms, including the
medically appropriate use of controlled substances;
``(2) applicable laws, regulations, rules, and policies on
controlled substances, including the degree to which
misconceptions and concerns regarding such laws, regulations,
rules, and policies, or the enforcement thereof, may create
barriers to patient access to appropriate and effective pain
care;
``(3) interdisciplinary approaches to the delivery of pain
care, including delivery through specialized centers providing
comprehensive pain care treatment expertise;
``(4) cultural, linguistic, literacy, geographic, and other
barriers to care in underserved populations; and
``(5) recent findings, developments, and improvements in
the provision of pain care.
``(d) Program Sites.--Education and training under subsection (a)
may be provided at or through health professions schools, residency
training programs, and other graduate programs in the health
professions; entities that provide continuing education in medicine,
pain management, dentistry, psychology, social work, nursing, and
pharmacy; hospices; and such other programs or sites as the Secretary
determines to be appropriate.
``(e) Evaluation of Programs.--The Secretary shall (directly or
through grants or contracts) provide for the evaluation of programs
implemented under subsection (a) in order to determine the effect of
such programs on knowledge and practice of pain care.
``(f) Peer Review Groups.--In carrying out section 799(f) with
respect to this section, the Secretary shall ensure that the membership
of each peer review group involved includes individuals with expertise
and experience in pain care.
``(g) Definitions.--For purposes of this section the term `pain
care' means the assessment, diagnosis, treatment, or management of
acute or chronic pain regardless of causation or body location.''.
(b) Authorization of Appropriations.--Section 758(b)(1) of the
Public Health Service Act (as redesignated by subsection (a)(1) of this
section) is amended--
(1) by striking ``and'' at the end of subparagraph (B);
(2) by striking the period at the end of subparagraph (C)
and inserting ``; and''; and
(3) by inserting after subparagraph (C) the following:
``(D) not less than $5,000,000 for awards of
grants, cooperative agreements, and contracts under
sections 754.''.
(c) Technical Amendments.--Title VII of the Public Health Service
Act (42 U.S.C. 292 et seq.) is amended--
(1) in paragraph (2) of section 757(b) (as redesignated by
subsection (a)(1)), by striking ``754(3)(A), and 755(b)'' and
inserting ``755(3)(A), and 756(b)''; and
(2) in subparagraph (C) of section 758(b)(1) (as
redesignated by subsection (a)(1)), by striking ``754, and
755'' and inserting ``755, and 756''.

SEC. 5. PUBLIC AWARENESS CAMPAIGN ON PAIN MANAGEMENT.

Part B of title II of the Public Health Service Act (42 U.S.C. 238
et seq.) is amended by adding at the end the following:

``SEC. 249. NATIONAL EDUCATION OUTREACH AND AWARENESS CAMPAIGN ON PAIN
MANAGEMENT.

``(a) Establishment.--Not later than June 30, 2009, the Secretary
shall establish and implement a national pain care education outreach
and awareness campaign described in subsection (b).
``(b) Requirements.--The Secretary shall design the public
awareness campaign under this section to educate consumers, patients,
their families, and other caregivers with respect to--
``(1) the incidence and importance of pain as a national
public health problem;
``(2) the adverse physical, psychological, emotional,
societal, and financial consequences that can result if pain is
not appropriately assessed, diagnosed, treated, or managed;
``(3) the availability, benefits, and risks of all pain
treatment and management options;
``(4) having pain promptly assessed, appropriately
diagnosed, treated, and managed, and regularly reassessed with
treatment adjusted as needed;
``(5) the role of credentialed pain management specialists
and subspecialists, and of comprehensive interdisciplinary
centers of treatment expertise;
``(6) the availability in the public, nonprofit, and
private sectors of pain management-related information,
services, and resources for consumers, employers, third-party
payors, patients, their families, and caregivers, including
information on--
``(A) appropriate assessment, diagnosis, treatment,
and management options for all types of pain and pain-
related symptoms; and
``(B) conditions for which no treatment options are
yet recognized; and
``(7) other issues the Secretary deems appropriate.
``(c) Consultation.--In designing and implementing the public
awareness campaign required by this section, the Secretary shall
consult with organizations representing patients in pain and other
consumers, employers, physicians including physicians specializing in
pain care, other pain management professionals, medical device
manufacturers, and pharmaceutical companies.
``(d) Coordination.--
``(1) Lead official.--The Secretary shall designate one
official in the Department of Health and Human Services to
oversee the campaign established under this section.
``(2) Agency coordination.--The Secretary shall ensure the
involvement in the public awareness campaign under this section
of the Surgeon General of the Public Health Service, the
Director of the Centers for Disease Control and Prevention, and
such other representatives of offices and agencies of the
Department of Health and Human Services as the Secretary
determines appropriate.
``(e) Underserved Areas and Populations.--In designing the public
awareness campaign under this section, the Secretary shall--
``(1) take into account the special needs of geographic
areas and racial, ethnic, gender, age, and other demographic
groups that are currently underserved; and
``(2) provide resources that will reduce disparities in
access to appropriate diagnosis, assessment, and treatment.
``(f) Grants and Contracts.--The Secretary may make awards of
grants, cooperative agreements, and contracts to public agencies and
private nonprofit organizations to assist with the development and
implementation of the public awareness campaign under this section.
``(g) Evaluation and Report.--Not later than the end of fiscal year
2011, the Secretary shall prepare and submit to the Congress a report
evaluating the effectiveness of the public awareness campaign under
this section in educating the general public with respect to the
matters described in subsection (b).
``(h) Authorization of Appropriations.--For purposes of carrying
out this section, there are authorized to be appropriated $2,000,000
for fiscal year 2009 and $4,000,000 for each of fiscal years 2010 and
2011.''.

Passed the House of Representatives September 24, 2008.

Attest:

LORRAINE C. MILLER,

Clerk.