II
111th CONGRESS
1st Session
S. 984
IN THE SENATE OF THE UNITED STATES
May 6, 2009
Mrs. Boxer (for herself, Mr. Bond, and Mr. Kennedy) 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 provide for arthritis research and public health, and for other purposes.
Short title
This Act may be cited as the
Arthritis Prevention, Control, and
Cure Act of 2009
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Enhancing the public Health activities related to arthritis of the Centers for Disease Control and Prevention 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:
Implementation of the National Arthritis Action Plan
The Secretary shall develop and implement a National Arthritis Action Plan that consists of—
the Federal arthritis prevention and control activities, as described in section 315A;
the State arthritis control and prevention programs, as described in section 315B;
the comprehensive arthritis action grant program, as described in section 315C; and
a national arthritis education and outreach program, as described in section 315D.
Federal arthritis prevention and control activities
In General
The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall, directly, or through a grant to an eligible entity, 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.
Duties of Secretary
The activities of the Secretary under subsection (a) shall include—
the collection, publication, and analysis of data on the prevalence and incidence of arthritis and other rheumatic diseases;
the development of uniform data sets for public health surveillance and clinical quality improvement activities;
the identification of evidence-based and cost-effective best practices for the prevention, diagnosis, management, and care of arthritis and other rheumatic diseases;
research, including research on behavioral interventions to prevent arthritis and on other evidence-based best practices relating to arthritis prevention, diagnosis, management, and care; and
demonstration projects, including community-based and patient self-management programs of arthritis control, prevention, and care, and similar collaborations with academic institutions, hospitals, health insurers, researchers, health professionals, and nonprofit organizations.
Training and Technical Assistance
With respect to the planning, development, and operation of any activity carried out under subsection (a), the Secretary may provide training, technical assistance, supplies, equipment, or services, and may assign any officer or employee of the Department of Health and Human Services to a State or local health agency, or to any public or nonprofit entity designated by a State health agency, in lieu of providing grant funds under this section.
Arthritis Prevention Research at the Centers for Disease Control and Prevention Centers
The Secretary shall provide additional grant support for research projects at the Centers for Prevention Research by the Centers for Disease Control and Prevention to encourage the expansion of research portfolios at the Centers for Prevention Research to include arthritis-specific research activities related to the prevention and management of arthritis.
Authorization of Appropriations
There are authorized to be appropriated to carry out this section—
$8,000,000 for fiscal year 2010;
$10,000,000 for fiscal year 2011;
$12,000,000 for fiscal year 2012;
$14,000,000 for fiscal year 2013; and
$16,000,000 for fiscal year 2014.
State arthritis control and prevention programs
In General
The Secretary shall 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.
Eligibility
To be eligible to receive a grant under this section, an entity shall be a State or Indian tribe.
Application
To be eligible to receive a grant under this section, an entity shall submit 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—
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;
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;
describes the arthritis-related services and activities to be undertaken or supported by the entity; and
is developed in a manner that is consistent with the National Arthritis Action Plan or a subsequent strategic plan designated by the Secretary.
Use of Funds
An eligible entity shall use amounts received under a grant awarded under subsection (a) to conduct, in a manner consistent with the comprehensive arthritis control and prevention plan submitted by the entity in the application under subsection (c)—
public health surveillance and epidemiological activities relating to the prevalence of arthritis and assessment of disparities in arthritis prevention, diagnosis, management, and care;
public information and education programs; and
education, training, and clinical skills improvement activities for health professionals, including allied health personnel.
Authorization of Appropriations
There are authorized to be appropriated to carry out this section—
$12,000,000 for fiscal year 2010;
$17,000,000 for fiscal year 2011;
$22,000,000 for fiscal year 2012;
$27,000,000 for fiscal year 2013; and
$32,000,000 for fiscal year 2014.
Comprehensive arthritis action grants
In General
The Secretary shall award grants on a competitive basis to eligible entities to enable such eligible entities to assist in the implementation of a national strategy for arthritis control and prevention.
Eligibility
To be eligible to receive a grant under this section, an entity shall be a national public or private nonprofit entity.
Application
To be eligible to receive a grant under this section, an entity shall submit 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 this section will—
supplement or fulfill unmet needs identified in the comprehensive arthritis control and prevention plan of a State or Indian tribe; and
otherwise help achieve the goals of the National Arthritis Action Plan or a subsequent strategic plan designated by the Secretary.
Priority
In awarding grants under this section, the Secretary shall give priority to eligible entities submitting applications proposing to carry out programs for controlling and preventing arthritis in at-risk populations or reducing disparities in underserved populations.
Use of Funds
An eligible entity shall use amounts received under a grant awarded under subsection (a) for 1 or more of the following purposes:
To expand the availability of physical activity programs designed specifically for people with arthritis.
To provide awareness education to patients, family members, and health care providers, to help such individuals recognize the signs and symptoms of arthritis, and to address the control and prevention of arthritis.
To decrease long-term consequences of arthritis by making information available to individuals with regard to the self-management of arthritis.
To provide information on nutrition education programs with regard to preventing or mitigating the impact of arthritis.
Evaluation
An eligible entity that receives a grant under this section shall submit to the Secretary an evaluation of the operations and activities carried out under such grant that includes an analysis of increased utilization and benefit of public health programs relevant to the activities described in the appropriate provisions of subsection (e).
Authorization of Appropriations
There are authorized to be appropriated to carry out this section—
$2,000,000 for fiscal year 2010;
$2,500,000 for fiscal year 2011;
$3,000,000 for fiscal year 2012;
$3,500,000 for fiscal year 2013; and
$4,000,000 for fiscal year 2014.
National arthritis education and outreach
In General
The Secretary shall coordinate a national education and outreach program to support, develop, and implement education initiatives and outreach strategies appropriate for arthritis and other rheumatic diseases.
Initiatives and Strategies
Initiatives and strategies implemented under the program described in paragraph (1) may include public awareness campaigns, public service announcements, and community partnership workshops, as well as programs targeted at businesses and employers, managed care organizations, and health care providers.
Priority
In carrying out subsection (a), the Secretary—
may emphasize prevention, early diagnosis, and appropriate management of arthritis, and opportunities for effective patient self-management; and
shall give priority to reaching high-risk or underserved populations.
Collaboration
In carrying out this section, the Secretary shall consult and collaborate with stake-holders from the public, private, and nonprofit sectors with expertise relating to arthritis control, prevention, and treatment.
Authorization of Appropriations
There are authorized to be appropriated to carry out this section—
$10,000,000 for fiscal year 2010;
$15,000,000 for fiscal year 2011;
$20,000,000 for fiscal year 2012;
$20,000,000 for fiscal year 2013; and
$20,000,000 for fiscal year 2014.
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Expansion and coordination of activities of the National Institutes of Health with respect to research on arthritis
Title IV of the Public Health Service Act (42 U.S.C. 281 et seq.) is amended by inserting after section 439 the following:
Arthritis and Rheumatic Diseases Interagency Coordinating Committee
In General
Establishment
The Secretary shall establish an Arthritis and Rheumatic Diseases Interagency Coordinating Committee (referred to in this section as the Coordinating Committee).
Duties
The coordinating committee established under paragraph (1) shall—
provide for the improved coordination of the research activities of all the national research institutes relating to arthritis and rheumatic diseases; and
provide for full and regular communication and exchange of information necessary to maintain adequate coordination across all Federal health programs and activities related to arthritis and rheumatic diseases.
Arthritis and Rheumatic Diseases Interagency Coordinating Committee
Composition
The Coordinating Committee shall consist of members, appointed by the Secretary, of which—
2/3 of such members shall represent governmental agencies, including—
the directors of each of the national research institutes and divisions involved in research regarding arthritis and rheumatic diseases (or the directors’ respective designees); and
representatives of other Federal departments and agencies (as determined appropriate by the Secretary) whose programs involve health functions or responsibilities relevant to arthritis and rheumatic diseases, including the Centers for Disease Control and Prevention, the Health Resources and Services Administration, and the Food and Drug Administration; and
1/3 of such members shall be public members, including a broad cross section of persons affected by arthritis, researchers, clinicians, and representatives of voluntary health agencies, who—
shall serve for a term of 3 years; and
may serve for an unlimited number of terms if reappointed.
Chairperson
Appointment
The Chairperson of the Coordinating Committee (referred to in this subsection as the Chairperson) shall be appointed by and be directly responsible to the Secretary.
Duties
The Chairperson shall—
serve as the principal advisor to the Secretary, the Assistant Secretary for Health, and the Director of NIH on matters relating to arthritis and rheumatic diseases; and
provide advice to the Director of the Centers for Disease Control and Prevention, the Commissioner of Food and Drugs, and the heads of other relevant Federal agencies, on matters relating to arthritis and rheumatic diseases.
Administrative support; meetings
Administrative support
The Secretary shall provide necessary and appropriate administrative support to the Coordinating Committee.
Meetings
The Coordinating Committee shall meet on a regular basis as determined by the Secretary, in consultation with the Chairperson.
Arthritis and Rheumatic Diseases Summit
In general
Not later than 1 year after the date of enactment of the Arthritis Prevention, Control, and Cure Act of 2009, the Coordinating Committee shall convene a summit of researchers, public health professionals, representatives of voluntary health agencies, representatives of academic institutions, and Federal and State policymakers, to provide a detailed overview of current research activities at the National Institutes of Health, as well as to discuss and solicit input related to potential areas of collaboration between the National Institutes of Health and other Federal health agencies, including the Centers for Disease Control and Prevention, the Agency for Healthcare Research and Quality, and the Health Resources and Services Administration, related to research, prevention, and treatment of arthritis and rheumatic diseases.
Summit details
The summit developed under paragraph (1) shall focus on—
a broad range of research activities relating to biomedical, epidemiological, psychosocial, and rehabilitative issues, including studies of the impact of the diseases described in paragraph (1) in rural and underserved communities;
clinical research for the development and evaluation of new treatments, including new biological agents;
translational research on evidence-based and cost-effective best practices in the treatment, prevention, and management of the disease;
information and education programs for health care professionals and the public;
priorities among the programs and activities of the various Federal agencies regarding such diseases; and
challenges and opportunities for scientists, clinicians, patients, and voluntary organizations.
Report to Congress
Not later than 180 days after the convening of the Arthritis and Rheumatic Diseases Summit under subsection (c)(1), the Director of NIH shall prepare and submit a report to Congress that includes proceedings from the summit and a description of arthritis research, education, and other activities that are conducted or supported through the national research institutes.
Public Information
The Coordinating Committee shall make readily available to the public information about the research, education, and other activities relating to arthritis and other rheumatic diseases, conducted or supported by the National Institutes of Health.
Authorization of Appropriations
There are authorized to be appropriated to carry out this section $1,000,000 for each of fiscal years 2010 through 2014.
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Expansion, intensification, and innovation of research and public Health activities related to juvenile arthritis
Juvenile Arthritis Initiative Through the Director of the National Institutes of Health
Part A of title IV of the Public Health Service Act (42 U.S.C. 281 et seq.) is amended by adding at the end the following:
Juvenile arthritis initiative through the director of the National Institutes of Health
Expansion and Intensification of Activities
In general
The Director of NIH, in coordination with the Director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, and the directors of the other national research institutes, as appropriate, shall expand and intensify programs of the National Institutes of Health with respect to research and related activities concerning various forms of juvenile arthritis.
Coordination
The directors referred to in paragraph (1) shall jointly coordinate the programs referred to in such paragraph and consult with additional Federal officials, voluntary health associations, medical professional societies, and private entities as appropriate.
Planning Grants and Contracts for Innovative Research in Juvenile Arthritis
In general
In carrying out subsection (a)(1) the Director of NIH shall award planning grants or contracts for the establishment of new research programs, or enhancement of existing research programs, that focus on juvenile arthritis.
Research
Types of research
In carrying out this subsection, the Secretary shall encourage research that focus on genetics, on the development of biomarkers, and on pharmacological and other therapies.
Priority
In awarding planning grants or contracts under paragraph (1), the Director of NIH may give priority to collaborative partnerships, which may include academic health centers, private sector entities, and nonprofit organizations.
Authorization of Appropriations
In general
There are authorized to be appropriated to carry out this section—
$12,000,000 for fiscal year 2010;
$14,000,000 for fiscal year 2011;
$16,000,000 for fiscal year 2012;
$18,000,000 for fiscal year 2013; and
$20,000,000 for fiscal year 2014.
Supplement not supplant
Such authorization shall be in addition to any authorization of appropriations under any other provision of law to carry out juvenile arthritis activities or other arthritis-related research.
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Public Health and Surveillance Activities Related to Juvenile Arthritis at the Centers for Disease Control and Prevention
Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by inserting after section 320A the following:
Surveillance and research regarding juvenile arthritis
In General
The Secretary, acting through the Director of the Centers for Disease Control and Prevention, may award grants to and enter into cooperative agreements with public or nonprofit private entities for the collection, analysis, and reporting of data on juvenile arthritis.
Technical Assistance
In awarding grants and entering into agreements under subsection (a), the Secretary may provide direct technical assistance in lieu of cash.
Coordination With NIH
The Secretary shall ensure that epidemiological and other types of information obtained under subsection (a) is made available to the National Institutes of Health.
Creation of a National Juvenile Arthritis Patient Registry
The Secretary, acting through the Director of the Centers for Disease Control and Prevention and in collaboration with a national voluntary health organization with experience serving the juvenile arthritis population as well as the full spectrum of arthritis-related conditions, shall support the development of a National Juvenile Arthritis Patient Registry to collect specific data for follow-up studies regarding the prevalence and incidence of juvenile arthritis, as well as capturing information on evidence-based health outcomes related to specific therapies and interventions.
Authorization of Appropriations
There are authorized to be appropriated to carry out this section $40,000,000 for each of fiscal years 2010 through 2014.
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Investment in tomorrow’s pediatric rheumatologists
In General
Part Q of title III of the Public Health Service Act (42 U.S.C. 280h et seq.) is amended by adding at the end the following:
Investment in tomorrow’s pediatric rheumatologists
Enhanced Support
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, shall support activities that provide for—
an increase in the number and size of institutional training grants awarded to institutions to support pediatric rheumatology training; and
an expansion of public-private partnerships to encourage academic institutions, private sector entities, and health agencies to promote educational training and fellowship opportunities for pediatric rheumatologists.
Authorization
There are authorized to be appropriated to carry out this section $4,000,000 for each of fiscal years 2010 through 2014.
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Pediatric Loan Repayment Program
Part Q of title III of the Public Health Service Act (42 U.S.C. 280h et seq.), as amended by subsection (a), is further amended by adding at the end the following:
Pediatric rheumatology loan repayment program
In General
The Secretary, in consultation with the Administrator of the Health Resources and Services Administration, may establish a pediatric rheumatology loan repayment program.
Program Administration
Through the program established under subsection (a), the Secretary shall—
enter into contracts with qualified health professionals who are pediatric rheumatologists under which—
such professionals agree to provide health care in an area with a shortage of pediatric rheumatologists; and
the Federal Government agrees to repay, for each year of such service, not more than $25,000 of the principal and interest of the educational loans of such professionals; and
in addition to making payments under paragraph (1) on behalf of an individual, make payments to the individual for the purpose of providing reimbursement for tax liability resulting from the payments made under paragraph (1), in an amount equal to 39 percent of the total amount of the payments made for the taxable year involved.
Authorization of Appropriations
There are authorized to be appropriated to carry out this section—
$3,500,000 for fiscal year 2010;
$4,000,000 for fiscal year 2011;
$4,500,000 for fiscal year 2012;
$5,000,000 for fiscal year 2013; and
$5,500,000 for fiscal year 2014.
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Career development awards in pediatric rheumatology
Part G of title IV of the Public Health Service Act (42 U.S.C. 288 et seq.) is amended—
by redesignating section 487F (as added by Public Law 106–310) as section 487G;
by inserting after section 487G (as so redesignated) the following:
Career development awards in pediatric rheumatology
In General
The Secretary, in consultation with the Director of NIH, may establish a program to increase the number of career development awards for health professionals who intend to build careers in clinical and translational research relating to pediatric rheumatology.
Authorization of Appropriations
There are authorized to be appropriated to carry out this section—
$900,000 for fiscal year 2010;
$1,400,000 for fiscal year 2011;
$1,900,000 for fiscal year 2012;
$2,400,000 for fiscal year 2013; and
$2,900,000 for fiscal year 2014.
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General accounting office study of arthritis and the workplace
Study and Report
Not later than 3 years after the date of enactment of this Act, the Comptroller General of the United States shall conduct a study on the economic impact of arthritis in the workplace, and submit a report to the appropriate committees of Congress containing the results of the study.
Authorization of Appropriations
There are authorized to be appropriated such sums as may be necessary to carry out this section.