[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5482 Introduced in House (IH)]







107th CONGRESS
  2d Session
                                H. R. 5482

  To prevent and cure diabetes and to promote and improve the care of 
   individuals with diabetes for the reduction of health disparities 
    within racial and ethnic minority groups, including the African-
 American, Hispanic American, Asian American and Pacific Islander, and 
            American Indian and Alaskan Native communities.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 26, 2002

      Ms. DeGette (for herself, Mr. Nethercutt, Mr. Bonilla, Mrs. 
   Christensen, Mr. Reyes, Ms. Millender-McDonald, Mr. Hayworth, Mr. 
   Rodriguez, Mr. Underwood, Mr. Jackson of Illinois, Mr. Weldon of 
Pennsylvania, Mr. Lewis of Georgia, Mr. Green of Texas, Ms. Norton, and 
Mr. Hinojosa) introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
  To prevent and cure diabetes and to promote and improve the care of 
   individuals with diabetes for the reduction of health disparities 
    within racial and ethnic minority groups, including the African-
 American, Hispanic American, Asian American and Pacific Islander, and 
            American Indian and Alaskan Native communities.

    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 ``Diabetes Prevention Access and Care 
Act''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) Hispanic Americans, African-Americans, Asian Americans 
        and Pacific Islanders, and American Indians and Alaskan Native 
        populations suffer from the highest incidence of diabetes and 
        from the highest rates of diabetes complications, and these 
        rates are steadily increasing to epidemic proportions.
            (2) Within the United States, diabetes increased from 6.9 
        percent to 7.3 percent during the period 1999 to 2000, 
        affecting every age group and socioeconomic level.
            (3) Type 2 diabetes accounts for 90 to 95 percent of 
        diagnosed diabetes cases among these populations.
            (4) Another 16,000,000 individuals in the United States 
        have a condition known as ``pre-diabetes,'' or Impaired Glucose 
        Tolerance (IGT). Unless treated, pre-diabetes dramatically 
        increases the risk for developing type 2 diabetes and increases 
        the risk of heart disease by nearly 50 percent. As with 
        diabetes, this condition also disproportionately affects 
        minority populations.
            (5) Physical inactivity and obesity are the main 
        contributing risk factors to the rising numbers of diabetes 
        cases within these racial and ethnic minority populations.
            (6) Critical facets of daily living that can contribute to 
        diabetes risk can be modified including poor diet, lack of 
        recess and physical education for children, specific eating 
        habits for families and adults that may be culturally 
        indicative to the minority group, and psychological factors 
        that may interfere with proper meal planning and dietary 
        education.
            (7) For certain socioeconomic groups, unhealthy food is the 
        only nutritional source available within the community, such as 
        fast food in poor areas. Additionally, there are limited 
        options for physical activity within certain neighborhoods, 
        communities, or geographical areas.
            (8) Type 2 diabetes is also being increasingly diagnosed in 
        adolescents in high numbers within these populations. This is 
        partly due to nonnutritional diets and a lack of physical 
        activity.
            (9) The most effective prevention and control strategies 
        include: increased physical activity, improved nutrition, 
        quality diabetes care, and improved self-management practice.
            (10) Multiple acute and chronic complications result from 
        poor diabetes diagnosis, care, and management. There is a need 
        for prevention strategies and measures in order to educate 
        individuals about diabetes and its complications, and to 
        decrease current numbers within these populations.
            (11) Recent discoveries regarding disparities in health 
        care among these populations have identified a need for 
        culturally sensitive modes of treatment that are conducive to 
        the lifestyle of the patient: Patients and consumers should be 
        guaranteed effective, understandable, and respectful care that 
        is provided in a manner that properly addresses their cultural 
        health beliefs, practices, and preferred language.
            (12) Effective communication, cultural conflict resolution, 
        and cultural differences on health promotion and disease 
        prevention should be addressed.

                           TITLE I--RESEARCH

SEC. 101. RESEARCH.

    Part P of title III of the Public Health Service Act (42 U.S.C. 
280g et seq.) is amended by inserting after section 399N the following 
section:

``SEC. 399O. DIABETES; MINORITY HEALTH AND HEALTH DISPARITIES RESEARCH.

    ``(a) National Institutes of Health.--
            ``(1) In general.--The Director of the National Institutes 
        of Health shall expand, intensify, conduct, coordinate, and 
        support research and other activities with respect to pre-
        diabetes and diabetes, particularly type 2, in minority 
        populations, including research to identify clinical, 
        socioeconomic, geographical, cultural, and organizational 
        factors that contribute to type 2 diabetes in such populations.
            ``(2) Certain activities.--Activities under paragraph (1) 
        regarding type 2 diabetes in minority populations shall include 
        the following:
                    ``(A) Research on behavior and obesity, including 
                research through the obesity research center that is 
                sponsored by the National Institutes of Health.
                    ``(B) Research on the causes and effects of health 
                care access disparities and racial discrimination, 
                including research to identify the following:
                            ``(i) Linguistic difficulties and language 
                        barriers of diabetes diagnosis, treatment, and 
                        care within these populations.
                            ``(ii) Environmental barriers in accessing 
                        transportation to health centers and health 
                        care providers.
                            ``(iii) Financial difficulties of health 
                        care financing and delivery to receive 
                        treatment.
                            ``(iv) Diabetes care and treatment 
                        discrimination against individuals with 
                        diabetes in prisons, the workplace, and 
                        schools.
                            ``(v) The manner in which racial 
                        stereotypes evolve, persist, shape 
                        expectations, and affect interpersonal 
                        interactions with diabetes diagnosis, 
                        treatment, and education.
                            ``(vi) The manner in which patient and 
                        provider relationships can be strengthened by 
                        greater diversity in the health professions for 
                        diabetes care.
                    ``(C) Research on environmental factors that may 
                contribute to the increase in type 2 diabetes, which 
                shall be conducted or supported through the National 
                Institute of Environmental Health Sciences and the 
                National Human Genome Research Institute.
                    ``(D) Support for new methods to identify 
                environmental triggers and genetic interactions that 
                lead to the development of type 1 and type 2 diabetes 
                in minority newborns with a high genetic susceptibility 
                to the disease. Such research should follow the 
                newborns through puberty, which is a high-risk period 
                for developing type 1 diabetes, and--increasingly--type 
                2 diabetes.
                    ``(E) Research to identify genes that predispose 
                individuals to the onset of developing type 1 and type 
                2 diabetes and to develop complications with the goal 
                of developing improved prevention and treatment 
                strategies.
                    ``(F) Research to prevent complications in 
                individuals who have already developed diabetes, such 
                as attempting to identify the genes that predispose 
                individuals with diabetes to the development of 
                complications, as well as methods and alternative 
                therapies to control blood glucose.
                    ``(G) The support of ongoing research efforts 
                examining the level of glycemia at which adverse 
                outcomes develop during pregnancy and to address the 
                many clinical issues associated with minority mothers 
                and fetuses during diabetic and gestational diabetic 
                pregnancies.
    ``(b) Centers for Disease Control and Prevention.--
            ``(1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and Prevention, 
        shall conduct and support research and other activities with 
        respect to diabetes in minority populations.
            ``(2) Certain activities.--Activities under paragraph (1) 
        regarding diabetes in minority populations shall include the 
        following:
                    ``(A) Expanding the National Diabetes Laboratory 
                for translational research, and the identification of 
                genetic and immunological risk factors associated with 
                diabetes.
                    ``(B) Enhancing the National Health and Nutrition 
                Examination Survey on eating and dietary habits, with a 
                focus, including cultural and socioeconomic factors, on 
                Hispanic American, African-American, American Indian 
                and Alaskan Native, and Asian American and Pacific 
                Islander communities.
                    ``(C) Establishing and implementing model 
                demonstration projects to design, implement,  and 
evaluate effective diabetes prevention and control interventions.
                    ``(D) Increased funding for the Translating 
                Research Into Action for Diabetes study to conduct 
                interventions for improving the quality of diabetes 
                care received by these populations in managed care 
                settings.
                    ``(E) Prevention research within the Division of 
                Diabetes Translation to better understand how to 
                influence healthcare systems changes to improve quality 
                of care being delivered to such populations.
                    ``(F) Within the Division of Diabetes Translation, 
                carrying out model demonstration projects to design, 
                implement, and evaluate effective diabetes prevention 
                and control intervention for these populations.
                    ``(G) Carrying out culturally appropriate 
                community-based interventions within the Division of 
                Diabetes Translation designed to address issues and 
                problems experienced by these populations.
                    ``(H) Conducting applied research within the 
                Division of Diabetes Translation on health systems, 
                community, and communication interventions to reduce 
                those barriers of discrimination, and reduce health 
                disparities within these populations with diabetes.
                    ``(I) Conducting applied research on primary 
                prevention within the Division of Diabetes Translation 
                to reduce those barriers within various arenas of 
                discrimination, and reduce diabetes-related health 
                disparities within these populations with diabetes.
    ``(c) Additional Programs.--
            ``(1) In general.--In addition to activities under 
        subsections (a) and (b), the Secretary shall conduct and 
        support research and other activities with respect to diabetes 
        within minority populations.
            ``(2) Certain activities.--Activities under paragraph (1) 
        regarding diabetes in minority populations shall include the 
        following:
                    ``(A) Through the National Institutes of Health and 
                the Centers for Disease Control and Prevention, 
                identifying culturally sensitive approaches to 
                research, including the clinical, cultural, 
                socioeconomic, and organizational factors that 
                contribute to high levels of diabetes within such 
                populations.
                    ``(B) Expanding the National Diabetes Education 
                Program.
                    ``(C) Through the National Center on Minority 
                Health and Health Disparities, the Office of Minority 
                Health under section 1707, the Health Resources and 
                Service Administration, the Centers for Disease Control 
                and Prevention, and the Indian Health Service, 
                establishing partnerships within minority populations 
                to conduct studies on cultural, familial, and social 
                factors that may influence health promotion, diabetes 
                management, and prevention.
                    ``(D) Through the Indian Health Service, in 
                collaboration with other appropriate Federal agencies, 
                conducting research on ethnic and culturally 
                appropriate diabetes treatment, care, prevention, and 
                services by health care professionals to the American 
                Indian population.
    ``(d) Definition.--For purposes of this section, the term `minority 
populations' means racial and ethnic minority groups within the meaning 
of section 1707.
    ``(e) Authorization of Appropriations.--
            ``(1) National institutes of health.--For the purpose of 
        carrying out subsection (a), there are authorized to be 
        appropriated such sums as may be necessary for fiscal year 2003 
        and each subsequent fiscal year.
            ``(2) Centers for disease control and prevention.--For the 
        purpose of carrying out subsection (b), there are authorized to 
        be appropriated such sums as may be necessary for fiscal year 
        2003 and each subsequent fiscal year.
            ``(3) Additional programs.--For the purpose of carrying out 
        subsection (c), there are authorized to be appropriated such 
        sums as may be necessary for fiscal year 2003 and each 
        subsequent fiscal year.''.

SEC. 102. DIABETES MELLITUS INTERAGENCY COORDINATING COMMITTEE.

    Section 429 of the Public Health Service Act (42 U.S.C. 285c-3) is 
amended by adding at the end the following subsection:
    ``(d)(1) In addition to other duties established in this section 
for the Diabetes Mellitus Interagency Coordinating Committee, such 
Committee shall--
            ``(A) assess the current activities of all current Federal 
        health programs to determine their adequacy as a systemic 
        method of addressing the impact of diabetes mellitus on 
        minority populations;
            ``(B) undertake strategic planning activities to develop an 
        effective and comprehensive Federal plan to address diabetes 
        mellitus within communities of color which will involve all 
        appropriate Federal health programs; and
            ``(C) conduct the implementation of such a plan throughout 
        all Federal health programs.
    ``(2) The Federal plan under paragraph (1)(B) shall--
            ``(A) include steps to address issues including, but not 
        limited to, type 1 and type 2 diabetes in children and the 
        disproportionate impact of diabetes mellitus on minority 
        populations; and
            ``(B) remain consistent with the programs and activities 
        identified in sections 399O through 399R, as well as remaining 
        consistent with the intent of the Diabetes Prevention Access 
        and Care Act.
    ``(3) For purposes of this subsection, the term `minority 
populations' means racial and ethnic minority groups within the meaning 
of section 1707.
    ``(4) For the purpose of carrying out this subsection, there are 
authorized to be appropriated such sums as may be necessary for fiscal 
year 2003 and each subsequent fiscal year.''.

                          TITLE II--TREATMENT

SEC. 201. TREATMENT.

    Part P of title III of the Public Health Service Act, as amended by 
section 101 of this Act, is amended by inserting after section 399O the 
following section:

``SEC. 399P. DIABETES; TREATMENT FOR MINORITY POPULATIONS.

    ``(a) In General.--The Secretary shall conduct and support programs 
to treat diabetes in minority populations.
    ``(b) National Institutes of Health.--With respect to the National 
Institutes of Health, activities under subsection (a) regarding the 
treatment of diabetes in minority populations shall include the 
following:
            ``(1) Through the National Institute of Mental Health, 
        providing for comprehensive mental health services and 
        treatment for individuals within such populations who 
        experience mental barriers to proper diabetes care.
            ``(2) Through the National Center on Minority Health and 
        Health Disparities, recommending and disseminating the 
        guidelines of the American Diabetes Association for nutrition 
        exercise and diet for diabetes treatment and prevention.
    ``(c) Other Agencies.--Activities under subsection (a) regarding 
the treatment of diabetes in minority populations shall include the 
following:
            ``(1) Through the Substance Abuse and Mental Health 
        Services Administration and the National Institute of Mental 
        Health, providing for comprehensive mental health services and 
        treatment for minorities who experience mental barriers to 
        proper diabetes care.
            ``(2) Promoting early detection as a cost-saving mechanism, 
        including making grants to community health centers and clinics 
        to specifically treat type 2 diabetes and complications, 
        including eye disease, kidney failure, heart disease and 
        stroke, nerve damage, and limb amputations.
            ``(3) Through the Health Resources and Services 
        Administration and the Centers for Disease Control and 
        Prevention, carrying out a collaborative program to encourage 
        preventive care. Such program shall not be limited to primary 
        prevention, and shall include secondary and tertiary 
        prevention. Such program shall include the award of grants to 
        community health centers and clinics to specifically treat 
        diabetes, with an emphasis on type 2 diabetes, and diabetic 
        complications, including eye disease, kidney failure, heart 
        disease and stroke, nerve damage, and limb amputation.
    ``(d) Definition.--For purposes of this section, the term `minority 
populations' means racial and ethnic minority groups within the meaning 
of section 1707.
    ``(e) Authorization of Appropriations.--
            ``(1) In general.--For the purpose of carrying out 
        subsections (a) and (c), there are authorized to be 
        appropriated such sums as may be necessary for fiscal year 2003 
        and each subsequent fiscal year.
            ``(2) National institutes of health.--For the purpose of 
        carrying out subsection (b), there are authorized to be 
        appropriated such sums as may be necessary for fiscal year 2003 
        and each subsequent fiscal year.''.

                          TITLE III--EDUCATION

SEC. 301. EDUCATION.

    Part P of title III of the Public Health Service Act, as amended by 
section 201 of this Act, is amended by inserting after section 399P the 
following section:

``SEC. 399Q. DIABETES; EDUCATION REGARDING MINORITY POPULATIONS.

    ``(a) In General.--The Secretary shall conduct and support programs 
to educate the public on the causes of effects of diabetes in minority 
populations.
    ``(b) National Institutes of Health.--With respect to the National 
Institutes of Health, activities under subsection (a) regarding 
education on diabetes in minority populations shall include the 
following:
            ``(1) Through the National Center on Minority Health and 
        Health Disparities--
                    ``(A) making grants to programs funded under 
                section 485F (relating to centers of excellence) for 
                the purpose of establishing a mentoring program for 
                health care professionals to be more involved in weight 
                counseling, obesity research, and nutrition;
                    ``(B) providing for the participation of minority 
                health professionals in diabetes-focused research 
                programs; and
                    ``(C) providing for the participation of minority 
                health professionals in diabetes-focused research 
                programs.
            ``(2) Making grants for programs to establish a pipeline 
        from high school to professional school that will increase 
        minority representation in diabetes-focused health fields by 
        expanding Minority Access to Research Careers (MARC) program 
        internships and mentoring opportunities for recruitment.
    ``(c) Centers for Disease Control and Prevention.--With respect to 
the Centers for Disease Control and Prevention, activities under 
subsection (a) regarding education on diabetes in minority populations 
shall include the following:
            ``(1) Making grants for diabetes-focused education classes 
        or training programs on cultural sensitivity and patient care 
        within such populations for health care providers.
            ``(2) Carrying out public awareness campaigns directed 
        toward such populations to aggressively emphasize the 
        importance and impact of physical activity and diet in regard 
        to diabetes and diabetes-related complications.
    ``(d) Health Resources and Services Administration.--With respect 
to the Health Resources and Services Administration, activities under 
subsection (a) regarding education on diabetes in minority populations 
shall include the following:
            ``(1) Providing additional funds for the Health Careers 
        Opportunity Program, Centers for Excellence, and the Minority 
        Faculty Fellowship Program to partner with the Office of 
Minority Health under section 1707 and the National Institutes of 
Health to strengthen programs for career opportunities within minority 
populations focused on diabetes treatment and care.
            ``(2) In partnership with the Health Resources and Services 
        Administration, develop a diabetes focus within, and provide 
        additional funds for, the National Health Service Corps 
        Scholarship program to place individuals in areas that are 
        disproportionately affected by diabetes, to provide health care 
        services.
            ``(3) Establishing a diabetes ambassador program for 
        recruitment efforts to increase the number of underrepresented 
        minorities currently serving in student, faculty, or 
        administrative positions in institutions of higher learning, 
        hospitals, and community health centers.
            ``(4) Establishing a loan repayment program that focuses on 
        diabetes care and prevention.
    ``(e) Additional Programs.--Activities under subsection (a) 
regarding education on diabetes in minority populations shall include 
the following:
            ``(1) Through collaboration between the Health Resources 
        and Services Administration and the Indian Health Service, 
        establishing a joint scholarship and loan-repayment program for 
        American Indians health profession students.
            ``(2) Providing funds for new and existing diabetes-focused 
        education grants and programs for present and future students 
        and clinicians in the medical field from minority populations, 
        including the following:
                    ``(A) Federal and State loan repayment programs for 
                health profession students within communities of color.
                    ``(B) Providing funds to the Office of Minority 
                Health under section 1707 for training health 
                profession students to focus on diabetes within such 
                populations.
                    ``(C) Providing funds to State and local entities 
                to establish diabetes awareness week or day every month 
                in schools, nursing homes, and colleges through 
                partnerships with the Office of Minority Health under 
                section 1707 and the Health Resources and Services 
                Administration.
    ``(f) Definition.--For purposes of this section, the term `minority 
populations' means racial and ethnic minority groups within the meaning 
of section 1707.
    ``(g) Authorization of Appropriations.--
            ``(1) In general.--For the purpose of carrying out 
        subsections (a) and (e), there are authorized to be 
        appropriated such sums as may be necessary for fiscal year 2003 
        and each subsequent fiscal year.
            ``(2) National institutes of health.--For the purpose of 
        carrying out subsection (b), there are authorized to be 
        appropriated such sums as may be necessary for fiscal year 2003 
        and each subsequent fiscal year.
            ``(3) Centers for disease control and prevention.--For the 
        purpose of carrying out subsection (c), there are authorized to 
        be appropriated such sums as may be necessary for fiscal year 
        2003 and each subsequent fiscal year.
            ``(4) Health resources and services administration.--For 
        the purpose of carrying out subsection (c), there are 
        authorized to be appropriated such sums as may be necessary for 
        fiscal year 2003 and each subsequent fiscal year.''.

     TITLE IV--HEALTH PROMOTION, PREVENTION ACTIVITIES, AND ACCESS

SEC. 401. HEALTH PROMOTION, PREVENTION ACTIVITIES, AND ACCESS.

    Part P of title III of the Public Health Service Act, as amended by 
section 301 of this Act, is amended by inserting after section 399Q the 
following section:

``SEC. 399R. DIABETES; HEALTH PROMOTION, PREVENTION ACTIVITIES, AND 
              ACCESS REGARDING MINORITY POPULATIONS.

    ``(a) National Institutes of Health.
            ``(1) In general.--The Secretary, acting through the 
        Director of the National Institutes of Health, shall provide 
        access to proper care of diabetes for minority populations.
            ``(2) Certain activities.--Activities under paragraph (1) 
        regarding proper care of diabetes in minority populations shall 
        include the following:
                    ``(A) Providing funds for research to assess and 
                identify the number of individuals affected by 
                socioeconomic and environmental barriers to diabetes 
                health care access, including research regarding 
                language, transportation, daily routine, lifestyle, and 
                housing.
                    ``(B) Through the National Center on Minority 
                Health and Health Disparities, identifying the manner 
                in which health care providers, community health 
                centers, and hospitals provide proper options and 
                education on available services for diabetes care, 
                management, and prevention, including identifying the 
                effects of differences in the cultures of staff and 
                patients on clinical and other workforce encounters.
    ``(b) Centers for Disease Control and Prevention.
            ``(1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and Prevention, 
        shall carry out culturally appropriate diabetes health 
        promotion and prevention programs for minority populations.
            ``(2) Certain activities.--Activities under paragraph (1) 
        regarding culturally appropriate diabetes health promotion and 
        prevention programs for minority populations shall include the 
        following:
                    ``(A) Expanding the Diabetes Control Program 
                (currently existing in all the States and territories).
                    ``(B) Providing funds for the Diabetes Today 
                program to adapt community planning tools within such 
                populations.
                    ``(C) Providing funds for Racial and Ethnic 
                Approaches to Community Health (REACH 2010) grants to 
                develop and evaluate diabetes prevention and control 
                community programs focused on such populations.
                    ``(D) Providing funds to community health centers 
                for a monthly diabetes week program of diabetes 
                services, including screenings.
                    ``(E) Providing funds for free diabetes self-
                management education classes in hospitals, clinics, and 
                community health centers.
                    ``(F) Providing funds for education and community 
                outreach on diabetes.
                    ``(G) Providing funds for the United States and 
                Mexico Border Diabetes project to develop culturally 
                appropriate diabetes prevention and control 
                interventions for Minority populations in the border 
                region.
                    ``(H) Providing funds for an aggressive prevention 
                campaign that focuses on physical inactivity and diet 
                and its relation to type 2 diabetes within such 
                populations.
                    ``(I) Providing funds for surveillance systems and 
                strategies for strengthening existing systems to 
                improve the quality, accuracy, and timelines of 
                morbidity and mortality diabetes data for such 
                populations.
    ``(c) Definition.--For purposes of this section, the term `minority 
populations' means racial and ethnic minority groups within the meaning 
of section 1707.
    ``(d) Authorization of Appropriations.--
            ``(1) National institutes of health.--For the purpose of 
        carrying out subsection (b), there are authorized to be 
        appropriated such sums as may be necessary for fiscal year 2003 
        and each subsequent fiscal year.
            ``(2) Centers for disease control and prevention.--For the 
        purpose of carrying out subsection (c), there are authorized to 
        be appropriated such sums as may be necessary for fiscal year 
        2003 and each subsequent fiscal year.''.

                      TITLE V--ADDITIONAL PROGRAMS

SEC. 501. ADDITIONAL PROGRAMS.

    (a) Education Regarding Clinical Trials.--The Secretary of Health 
and Human Services (referred to in this section as the ``Secretary'') 
shall carry out education and awareness programs designed to increase 
participation of minority populations in clinical trials.
    (b) Minority Researchers.--The Secretary shall carry out mentorship 
programs for minority researchers who are conducting or intend to 
conduct research on diabetes in minority populations.
    (c) Supplementing Clinical Research Regarding Children.--The 
Secretary shall make grants to supplement clinical research programs to 
assist such programs in obtaining the services of health professionals 
and other resources to provide specialized care for children with type 
1 and type 2 diabetes.
    (d) Definition.--For purposes of this section, the term ``minority 
populations'' means racial and ethnic minority groups within the 
meaning of section 1707 of the Public Health Service Act.
    (e) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary for fiscal year 2003 and each subsequent fiscal year.

                           TITLE VI--STUDIES

SEC. 601. STUDIES.

    (a) Institute of Medicine.--The Secretary of Health and Human 
Services (referred to in this section as the ``Secretary'') shall 
request the Institute of Medicine to conduct a study to determine the 
extent and impact of the shortage of adult and pediatric 
endocrinologists specializing in diabetes, and to submit a report 
describing the findings of the study to the Secretary, to the Committee 
on Energy and Commerce of the House of Representatives, and to the 
Committee on Health, Education, Labor, and Pensions of the Senate. The 
Secretary shall ensure that the report includes recommendations on 
changes in Federal policies that would increase the number of adult and 
pediatric endocrinologists specializing in diabetes.
    (b) Agency for Healthcare Research and Quality.--The Secretary, 
acting through the Director of the Agency for Healthcare Research and 
Quality, shall conduct a study to determine whether minority children 
with diabetes have better or worse outcomes than nonminority children. 
The study shall include a determination of the extent to which minority 
children have access to and participate in disease management programs, 
and have access to and use medical devices such as continuous glucose 
monitoring systems, insulin pumps, and artificial pancreas.
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