[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3203 Introduced in House (IH)]






108th CONGRESS
  1st Session
                                H. R. 3203

    To amend the Public Health Service Act to authorize grants for 
    education, screening, and treatment with the goal of preventing 
 diabetic foot complications and lower extremity amputations, and for 
                            other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 30, 2003

  Mr. Baker (for himself, Mr. McCrery, Mr. John, Mr. Nethercutt, Mr. 
Jefferson, Mrs. McCarthy of New York, and Mr. Faleomavaega) introduced 
 the following bill; which was referred to the Committee on Energy and 
                                Commerce

_______________________________________________________________________

                                 A BILL


 
    To amend the Public Health Service Act to authorize grants for 
    education, screening, and treatment with the goal of preventing 
 diabetic foot complications and lower extremity amputations, and for 
                            other purposes.

    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 ``Diabetic Foot Complication and Lower 
Extremity Amputation Reduction Act of 2003''.

SEC. 2. FINDINGS.

    The Congress finds the following:
            (1) It is estimated that there are 17,000,000 patients with 
        diabetes in the United States and that diabetes costs the 
        United States $132,000,000,000 each year.
            (2) There has been a 61 percent increase in the number of 
        Americans with diabetes since 1990.
            (3) Fifteen percent of people with diabetes will experience 
        a foot ulcer, and between 14 and 24 percent of those with a 
        foot ulcer will require an amputation.
            (4) The increased incidence of diabetes has resulted in 
        more lower extremity amputations. From 1980 to 1996, the number 
        of diabetes-related hospital discharges with lower extremity 
        amputations increased from 36,000 to 86,000 per year.
            (5) The Medicare costs for diabetes patients with foot 
        ulcers is 3 times higher than for diabetes patients in general, 
        and inpatient care accounts for 74 percent of diabetic ulcer-
        related costs. Therefore, cost effective ulcer prevention and 
        treatment interventions will reduce Medicare costs.
            (6) Lower extremity amputations are devastating to the 
        patient, and with an average cost of $60,000, these procedures 
        are a costly burden on the health system.
            (7) Research shows that a multidisciplinary approach, 
        including preventive strategies, patient and staff education, 
        and treatment of foot ulcers, has been reported to reduce 
        amputation rates by more than 50 percent at a fraction of the 
        cost.

SEC. 3. GRANTS FOR EDUCATION, SCREENING, AND TREATMENT REGARDING 
              DIABETIC FOOT COMPLICATIONS.

    Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) 
is amended by inserting after section 330K the following:

``SEC. 330L. GRANTS FOR EDUCATION, SCREENING, AND TREATMENT REGARDING 
              DIABETIC FOOT COMPLICATIONS.

    ``(a) Grants.--Subject to subsection (b), the Secretary shall award 
grants to eligible entities for the following:
            ``(1) Providing a high-risk, underserved population with 
        screening, education, and evidence-based medical treatment 
        regarding diabetic foot complications that may lead to lower 
        extremity amputations.
            ``(2) Evaluating the quality, cost effectiveness, parity, 
        and patient satisfaction of medical interventions in the 
        prevention of diabetic foot complications and lower extremity 
        amputations.
    ``(b) Restriction.--A grant under this section may be used to pay 
for a treatment only if the treatment is preventive in nature or is 
part of comprehensive outpatient care.
    ``(c) Eligible Entities.--For purposes of this section, the term 
`eligible entity' means a multidisciplinary health care program, which 
may be university-based, that demonstrates to the Secretary's 
satisfaction the following:
            ``(1) An ability to provide high-quality, cost-effective, 
        and accessible treatment to a patient population that has a 
        high incidence of diabetes relative to the national average and 
        a general inability to access diabetic foot treatment programs.
            ``(2) An ability to successfully educate patients and 
        health care providers about preventive health care measures and 
        treatment methods for diabetic foot complications.
            ``(3) An ability to analyze and compile the results of 
        research on diabetic foot complications and conduct additional 
        research on diabetic foot complications.
    ``(d) Criteria.--The Secretary, in consultation with appropriate 
professional organizations, shall develop criteria for carrying out the 
grant program under this section and for collecting data to evaluate 
the effectiveness of the grant program. These criteria shall ensure the 
following:
            ``(1) The establishment of an authoritative, collaborative, 
        multi-center study on the impact of comprehensive prevention 
        and treatment of diabetic foot complications in high-risk, 
        underserved populations, upon which future determinations can 
        be based.
            ``(2) The establishment, in coordination with grant 
        recipients, of evidence-based guidelines and standardized 
        measurement outcomes that may be used to evaluate the overall 
        results of projects under this section.
            ``(3) The provision to grant recipients of the necessary 
        resources to develop programs that effectively treat patients.
    ``(e) Application.--To seek a grant under this section, an eligible 
entity must submit an application to the Secretary in such form, in 
such manner, and containing such information as the Secretary may 
require.
    ``(f) Evaluations.--The Secretary may not award a grant to an 
eligible entity under this section unless the entity agrees to submit 
to the Secretary a yearly evaluation of the entity's operations and 
activities carried out under the grant.
    ``(g) Study; Report.--Annually, the Secretary--
            ``(1) shall conduct an authoritative study on the results 
        of grants under this section, for the purpose of better 
        informing future determinations regarding education, screening, 
        and treatment of diabetic foot complications; and
            ``(2) shall submit a report on the findings and conclusions 
        of the study to the Congress.
    ``(h) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated $25,000,000 
for fiscal year 2004 and such sums as may be necessary for each of 
fiscal years 2005 through 2008.''.
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