[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3793 Introduced in House (IH)]







107th CONGRESS
  2d Session
                                H. R. 3793

    To educate health professionals concerning substance abuse and 
                               addiction.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 26, 2002

 Mr. Kennedy of Rhode Island introduced the following bill; which was 
            referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
    To educate health professionals concerning substance abuse and 
                               addiction.

    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 ``Health Professionals Substance Abuse 
Education Act''.

SEC. 2. FINDINGS AND PURPOSE.

    (a) Findings.--Congress makes the following findings:
            (1) Illegal drugs and alcohol are responsible for thousands 
        of deaths each year, and they fuel the spread of a number of 
        communicable diseases, including AIDS and Hepatitis C, as well 
        as some of the worst social problems in the United States, 
        including child abuse, domestic violence, and sexual assault.
            (2) There are an estimated 14,800,000 current drug users in 
        America, more than 4,000,000 of whom are addicts. An estimated 
        14,000,000 Americans abuse alcohol or are alcoholic.
            (3) There is a significant treatment gap in the United 
        States. Nearly 4,000,000 drug users who are in need of 
        immediate treatment are not receiving it. This includes more 
        than 1,200,000 children ages 12 to 25. These numbers do not 
        take into account the number of alcoholics in need of 
        treatment.
            (4) There are more than 28,000,000 children of alcoholics 
        in America, almost 11,000,000 of whom are under 18 years of 
        age. Countless other children are affected by substance abusing 
        parents or other caretakers. Health professionals are uniquely 
        positioned to help reduce or prevent alcohol and other drug-
        related impairment by identifying affected families and youth 
        and by providing early intervention.
            (5) Drug addiction is a chronic relapsing disease. As with 
        other chronic relapsing diseases (such as diabetes, 
        hypertension and asthma), there is no cure, although a number 
        of treatments can effectively control the disease. According to 
        an article published in the Journal of the American Medical 
        Association, treatment for addiction works just as well as 
        treatment for other chronic relapsing diseases.
            (6) Drug treatment is cost effective, even when compared 
        with residential treatment, the most expensive type of 
        treatment. Residential treatment for cocaine addiction costs 
        between $15,000 and $20,000 a year, a substantial savings 
        compared to incarceration (costing nearly $40,000 a year), or 
        untreated addiction (costing more than $43,000 a year). Also, 
        in 1998, substance abuse and addiction accounted for 
        approximately $10,000,000,000 in Federal, State, and local 
        government spending simply to maintain the child welfare 
        system. The economic costs associated with fetal alcohol 
        syndrome were estimated at $1,900,000,000 for 1992.
            (7) Many doctors and other health professionals are 
        unprepared to recognize substance abuse in their patients or 
        their families and intervene in an appropriate manner. Only 56 
        percent of residency programs have a required curriculum in 
        preventing or treating substance abuse.
            (8) Fewer than 1 in 5 doctors (only 19 percent) feel 
        confident about diagnosing alcoholism, and only 17 percent feel 
        qualified to identify illegal drug use.
            (9) Most doctors who are in a position to make a diagnosis 
        of alcoholism or drug addiction do not believe that treatment 
        works (less than 4 percent for alcoholism and only 2 percent 
        for drugs).
            (10) According to a survey by the National Center on 
        Addiction and Substance Abuse at Columbia University (referred 
        to in this section as ``CASA''), 94 percent of primary care 
        physicians and 40 percent of pediatricians presented with a 
        classic description of an alcoholic or drug addict, 
        respectively, failed to properly recognize the problem.
            (11) Another CASA report revealed that fewer than 1 percent 
        of doctors presented with the classic profile of an alcoholic 
        older woman could diagnose it properly. Eighty-two percent 
misdiagnosed it as depression, some treatments for which are dangerous 
when taken with alcohol.
            (12) Training can greatly increase the degree to which 
        medical and other health professionals screen patients for 
        substance abuse. It can also increase the manner by which such 
        professionals screen children and youth who may be impacted by 
        the addiction of a parent or other primary caretaker. Boston 
        University Medical School researchers designed and conducted a 
        seminar on detection and brief intervention of substance abuse 
        for doctors, nurses, physician's assistants, social workers and 
        psychologists. Follow-up studies reveal that 91 percent of 
        those who participated in the seminar report that they are 
        still using the techniques up to 5 years later.
            (13) According to the National Clearinghouse for Alcohol 
        and Drug Information, drug and alcohol abuse account for more 
        than $400,000,000,000 in health care costs each year. Arming 
        health care professionals with the information they need in 
        order to intervene and prevent further substance abuse could 
        lead to a significant cost savings.
            (14) A study conducted by doctors at the University of 
        Wisconsin found a $947 net savings patient in health care, 
        accident, and criminal justice costs for each individual 
        screened and, if appropriate, for whom intervention was made, 
        with respect to alcohol problems.
    (b) Purpose.--It is the purpose of this Act to--
            (1) improve the ability of health care professionals to 
        identify and assist their patients with substance abuse;
            (2) improve the ability of health care professionals to 
        identify and assist children and youth affected by substance 
        abuse in their families; and
            (3) help establish an infrastructure to train health care 
        professionals about substance abuse issues.

SEC. 3. HEALTH PROFESSION EDUCATION.

    (a) Secretary of Health and Human Services.--The Secretary of 
Health and Human Services may enter into interagency agreements with 
the Health Resources Services Administration or the Substance Abuse and 
Mental Health Services Administration to enable each such 
Administration to carry out activities to train health professionals 
(who are generalists and not already specialists in substance abuse) so 
that they are competent to--
            (1) recognize substance abuse in their patients or the 
        family members of their patients;
            (2) intervene, treat, or refer for treatment those 
        individuals who are affected by substance abuse;
            (3) identify and assist children of substance abusing 
        parents; and
            (4) serve as advocates and resources for community-based 
        substance abuse prevention programs.
    (b) Use of Funds.--Amounts received under an interagency agreement 
under this section shall be used--
            (1) with respect to the Health Resources and Services 
        Administration, to support the Association for Medical 
        Education and Research in Substance Abuse (AMERSA) 
        Interdisciplinary Project; and
            (2) with respect to the Substance Abuse and Mental Health 
        Services Administration, to support the Addiction Technology 
        Transfer Centers counselor training programs to train other 
        health professionals.
    (c) Collaboration.--To be eligible to enter into an interagency 
agreement under this section the Health Resources and Services 
Administration or the Substance Abuse and Mental Health Services 
Administration shall demonstrate that such Administration will 
participate in interdisciplinary collaboration and collaborate with 
other nongovernmental organizations with respect to activities carried 
out under this section.
    (d) Evaluations.--The Health Resources and Services Administration 
and the Substance Abuse and Mental Health Services Administration shall 
conduct a process and outcome evaluation of the programs and activities 
carried out with funds received under this section, and shall provide 
semi-annual reports to the Secretary of Health Human Services and the 
Director of the Office of National Drug Control Policy.
    (e) Definitions.--In this section--
            (1) the term ``health professional'' means a doctor, nurse, 
        physician assistant, nurse practitioner, social worker, 
        psychologist, pharmacist, osteopath, or other individual who is 
        licensed, accredited, or certified under State law to provide 
        specified health care services and who is operating within the 
        scope of such licensure, accreditation, or certification; and
            (2) the terms ``doctor'', ``nurse'', ``physician 
        assistant'', ``nurse practitioner'', ``social worker'', 
        ``psychologist'', ``pharmacist'', and ``osteopath'' shall have 
        the meanings given such terms for purposes of titles VII and 
        VIII of the Public Health Service Act (42 U.S.C. 292 et seq and 
        296 et seq.).
    (f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $5,500,000 for each of fiscal 
years 2002 through 2006, of which $1,000,000 in each such fiscal year 
shall be made available to the Substance Abuse and Mental Health 
Services Administration and $4,500,000 in each such fiscal year shall 
be made available to the Health Resources and Services Administration, 
to carry out this section. Amounts made available under this subsection 
shall be used to supplement and not supplant amounts being used on the 
date of enactment of this Act for activities of the types described in 
this section.

SEC. 4. SUBSTANCE ABUSE FACULTY FELLOWSHIP.

    (a) Establishment.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary'') shall establish and 
administer a substance abuse faculty fellowship program under which the 
Secretary shall provide assistance to eligible institutions to enable 
such institutions to employ individuals to serve as faculty and provide 
substance abuse training in a multi-discipline manner.
    (b) Eligibility.--
            (1) Institutions.--To be eligible to receive assistance 
        under this section, an institution shall--
                    (A) be an accredited medical school or nursing 
                school, or be an institution of higher education that 
                offers one or more of the following--
                            (i) an accredited physician assistant 
                        program;
                            (ii) an accredited nurse practitioner 
                        program;
                            (iii) a graduate program in pharmacy;
                            (iv) a graduate program in public health;
                            (v) a graduate program in social work; or
                            (vi) a graduate program in psychology; and
                    (B) prepare and submit to the Secretary an 
                application at such time, in such manner, and 
                containing such information as the Secretary may 
                require.
            (2) Individuals.--To be eligible to receive a fellowship 
        from an eligible institution under this section, an individual 
        shall prepare and submit to the institution an application at 
        such time, in such manner, and containing such information as 
        the institution may require.
    (c) Use of Funds.--
            (1) In general.--An eligible institution shall utilize 
        assistance received under this section to provide one or more 
        fellowships to eligible individuals. Such assistance shall be 
        used to pay not to exceed 50 percent of the annual salary of 
        the individual under such a fellowship for a 5-year period.
            (2) Fellowships.--Under a fellowship under paragraph (1), 
        an individual shall--
                    (A) devote a substantial number of teaching hours 
                to substance abuse issues (as part of both required and 
                elective courses) at the institution involved during 
                the period of the fellowship; and
                    (B) attempt to incorporate substance abuse issues 
                into the required curriculum of the institution in a 
                manner that is likely to be sustained after the period 
                of the fellowship ends.
        Courses described in this paragraph should by taught as part of 
        several different health care training programs at the 
        institution involved.
            (3) Evaluations.--The Secretary shall conduct a process and 
        outcome evaluation of the programs and activities carried out 
        with amounts appropriated under this section and shall provide 
        semi-annual reports to the Director of the Office of National 
        Drug Control Policy and the Secretary of Health and Human 
        Services.
    (d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $3,500,000 for each of the 
fiscal years 2002 through 2006. Amounts made available under this 
subsection shall be used to supplement and not supplant amounts being 
used on the date of enactment of this Act for activities of the types 
described in this section.

SEC. 5. OVERSIGHT COMMITTEE.

    (a) In General.--The Director of the Office of National Drug 
Control Policy shall convene an interagency oversight committee, 
composed of representatives of the Health Resources and Services 
Administration, as well as the National Institute on Drug Abuse, the 
National Institute on Alcohol Abuse and Alcoholism, the Substance Abuse 
and Mental Health Services Administration, and the National Institute 
on Mental Health, and non-governmental organizations determined to be 
experts in the field of substance abuse, to receive updates concerning 
and coordinate the Federal activities funded under this Act and the 
activities of various Federal agencies, toward the goal of educating 
health professionals about substance abuse.
    (b) Meetings.--The interagency oversight committee established 
under subsection (a) shall meet at least twice each year at the call of 
the Director of the Office of National Drug Control Policy.
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