[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2697 Introduced in House (IH)]







105th CONGRESS
  1st Session
                                H. R. 2697

To amend the Public Health Service Act to expand and intensify programs 
   of the National Institutes of Health with respect to research and 
 related activities concerning osteoporosis and related bone diseases.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 22, 1997

 Ms. Eddie Bernice Johnson of Texas (for herself, Mrs. Maloney of New 
  York, Mrs. Morella, Ms. Woolsey, Mr. Pascrell, Mr. Dellums, and Mr. 
   Dingell) introduced the following bill; which was referred to the 
                         Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
To amend the Public Health Service Act to expand and intensify programs 
   of the National Institutes of Health with respect to research and 
 related activities concerning osteoporosis and related bone diseases.

    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 ``Osteoporosis and Related Bone 
Diseases Research Act of 1997''.

SEC. 2. FINDINGS.

    The Congress finds that--
            (1) osteoporosis, or porous bone, is a condition 
        characterized by an excessive loss of bone tissue and an 
        increased susceptibility to fractures of the hip, spine, and 
        wrist;
            (2) osteoporosis is a threat to an estimated 28,000,000 
        Americans, 80 percent of whom are women, many of whose cases go 
        undiagnosed because the condition develops without symptoms 
        until a strain, bump, or fall causes a fracture;
            (3) between 3 and 4 million Americans have Paget's disease, 
        osteogenesis imperfecta, hyperparathyroidism, and other related 
        metabolic bone diseases;
            (4) osteoporosis is responsible for 1,500,000 bone 
        fractures annually, including more than 300,000 hip fractures, 
        700,000 vertebral fractures, 200,000 fractures of the wrist, 
        and the remaining fractures at other sites;
            (5) 1 of every 2 women and 1 of every 8 men over age 50 
        will develop fractures associated with osteoporosis in their 
        lifetimes;
            (6) direct medical costs of osteoporosis are estimated to 
        be $13,800,000,000 annually for the United States, not 
        including the costs of family care and lost work for 
        caregivers;
            (7) direct medical costs of osteoporosis are expected to 
        increase precipitously because the proportion of the population 
        comprised of older persons is expanding and each generation of 
        older persons tends to have a higher incidence of osteoporosis 
        than preceding generations;
            (8) technology now exists, and new technology is 
        developing, that will permit early diagnosis and prevention of 
        osteoporosis as well as management of the condition once it has 
        developed;
            (9) funding for research on osteoporosis and related bone 
        diseases is severely constrained at key research institutes, 
        including the National Institute of Arthritis and 
        Musculoskeletal and Skin Diseases, the National Institute on 
        Aging, the National Institute of Diabetes and Digestive and 
        Kidney Diseases, the National Institute of Dental Research, and 
        the National Institute of Child Health and Human Development;
            (10) further research is needed to improve medical 
        knowledge concerning--
                    (A) cellular mechanisms related to the processes of 
                bone resorption and bone formation, and the effect of 
                different agents on bone remodeling;
                    (B) risk factors for osteoporosis, including newly 
                discovered risk factors, risk factors related to groups 
                not ordinarily studied (such as men and minorities), 
                risk factors related to genes that help to control 
                skeletal metabolism, and risk factors relating to the 
                relationship of aging processes to the development of 
                osteoporosis;
                    (C) bone mass measurement technology, including 
                more widespread and cost-effective techniques for 
                making more precise measurements and for interpreting 
                measurements;
                    (D) calcium (including bioavailability, intake 
                requirements, and the role of calcium in building 
                heavier and denser skeletons), and vitamin D and its 
                role as an essential vitamin in adults;
                    (E) prevention and treatment, including the 
                efficacy of current therapies, alternative drug 
                therapies for prevention and treatment, and the role of 
                exercise; and
                    (F) rehabilitation; and
            (11) further educational efforts are needed to increase 
        public and professional knowledge of the causes of, methods for 
        avoiding, and treatment of osteoporosis.

SEC. 3. OSTEOPOROSIS RESEARCH.

    Subpart 4 of part C of title IV of the Public Health Service Act 
(42 U.S.C. 285d et seq.) is amended by adding at the end the following 
new section:

            ``research on osteoporosis and related diseases

    ``Sec. 442A. (a) Expansion of Research.--The Director of the 
Institute, the Director of the National Institute on Aging, the 
Director of the National Institute of Diabetes and Digestive and Kidney 
Diseases, the Director of the National Institute of Dental Research, 
and the Director of the National Institute of Child Health and Human 
Development shall expand and intensify research on osteoporosis and 
related bone diseases. The research shall be in addition to research 
that is authorized under any other provision of law.
    ``(b) Mechanisms for Expansion of Research.--Each of the Directors 
specified in subsection (a) shall, in carrying out such subsection, 
provide for one or more of the following:
            ``(1) Investigator-initiated research.
            ``(2) Funding for investigators beginning their research 
        careers.
            ``(3) Mentorship research grants.
    ``(c) Specialized Centers of Research.--
            ``(1) In general.--The Director of the Institute, after 
        consultation with the advisory council for the Institute, shall 
        make grants to, or enter into contracts with, public or 
        nonprofit private entities for the development and operation of 
        centers to conduct research on osteoporosis and related bone 
        diseases. Subject to the extent of amounts made available in 
        appropriations Acts, the Director shall provide for not less 
        than three such centers.
            ``(2) Activities.--Each center assisted under this 
        subsection--
                    ``(A) shall, with respect to osteoporosis and 
                related bone diseases--
                            ``(i) conduct basic and clinical research;
                            ``(ii) develop protocols for training 
                        physicians, scientists, nurses, and other 
                        health and allied health professionals;
                            ``(iii) conduct training programs for such 
                        individuals;
                            ``(iv) develop model continuing education 
                        programs for such professionals; and
                            ``(v) disseminate information to such 
                        professionals and the public;
                    ``(B) may use the funds to provide stipends for 
                health and allied health professionals enrolled in 
                training programs described in subparagraph (A)(iii); 
                and
                    ``(C) shall use the facilities of a single 
                institution, or be formed from a consortium of 
                cooperating institutions, meeting such requirements as 
                may be prescribed by the Director of the Institute.
            ``(3) Duration of support.--Support of a center under this 
        subsection may be for a period not exceeding 5 years. Such 
        period may be extended for one or more additional periods not 
        exceeding 5 years if the operations of such center have been 
        reviewed by an appropriate technical and scientific peer review 
        group established by the Director and if such group has 
        recommended to the Director that such period should be 
        extended.
    ``(d) Definition of Related Bone Diseases.--For purposes of this 
section, the term `related bone diseases' includes--
            ``(1) Paget's disease, a bone disease characterized by 
        enlargement and loss of density with bowing and deformity of 
        the bones;
            ``(2) osteogenesis imperfecta, a familial disease marked by 
        extreme brittleness of the long bones;
            ``(3) hyperparathyroidism, a condition characterized by the 
        presence of excess parathormone in the body resulting in 
        disturbance of calcium metabolism with loss of calcium from 
        bone and renal damage;
            ``(4) hypoparathyroidism, a condition characterized by the 
        absence of parathormone resulting in disturbances of calcium 
        metabolism;
            ``(5) renal bone disease, a disease characterized by 
        metabolic disturbances from dialysis, renal transplants, or 
        other renal disturbances;
            ``(6) primary or postmenopausal osteoporosis and secondary 
        osteoporosis, such as that induced by corticosteroids; and
            ``(7) other general diseases of bone and mineral metabolism 
        including abnormalities of vitamin D.
    ``(e) Authorizations of Appropriations.--
            ``(1) National institute of arthritis and musculoskeletal 
        and skin diseases.--For the purpose of carrying out this 
        section through the National Institute of Arthritis and 
        Musculoskeletal and Skin Diseases, there are authorized to be 
        appropriated $17,000,000 for each of the fiscal years 1999 
        through 2001, and such sums as may be necessary for each 
        subsequent fiscal year.
            ``(2) National institute on aging.--For the purpose of 
        carrying out this section through the National Institute on 
        Aging, there are authorized to be appropriated $10,000,000 for 
        each of the fiscal years 1999 through 2001, and such sums as 
        may be necessary for each subsequent fiscal year.
            ``(3) National institute of diabetes and digestive and 
        kidney diseases.--For the purpose of carrying out this section 
        through the National Institute of Diabetes and Digestive and 
        Kidney Diseases, there are authorized to be appropriated 
        $10,000,000 for each of the fiscal years 1999 through 2001, and 
        such sums as may be necessary for each subsequent fiscal year.
            ``(4) National institute of dental research.--For the 
        purpose of carrying out this section through the National 
        Institute of Dental Research, there are authorized to be 
        appropriated $5,000,000 for each of the fiscal years 1999 
        through 2001, and such sums as may be necessary for each 
        subsequent fiscal year.
            ``(5) National institute of child health and human 
        development.--For the purpose of carrying out this section 
        through the National Institute of Child Health and Human 
        Development, there are authorized to be appropriated $5,000,000 
        for each of the fiscal years 1999 through 2001, and such sums 
        as may be necessary for each subsequent fiscal year.
            ``(6) Specialized centers of research.--For the purpose of 
        carrying out subsection (c), there are authorized to be 
        appropriated $3,000,000 for each of the fiscal years 1999 
        through 2001, and such sums as may be necessary for each 
        subsequent fiscal year.
            ``(7) Relation to other provisions.--Authorizations of 
        appropriations under this subsection are in addition to amounts 
        authorized to be appropriated for biomedical research relating 
        to osteoporosis and related bone diseases under any other 
        provision of law.''.
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