[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2241 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 2241

 To amend the Public Health Service Act with respect to prevention and 
             treatment of diabetes, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 9, 2007

Mr. Engel (for himself, Mr. Fossella, Mr. Gene Green of Texas, and Ms. 
   DeGette) introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To amend the Public Health Service Act with respect to prevention and 
             treatment of diabetes, 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 ``Diabetes Treatment and Prevention 
Act of 2007''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) According to the Centers for Disease Control and 
        Prevention, the prevalence of diabetes in the United States has 
        more than doubled in the past quarter-century.
            (2) The American Diabetes Association reports that there 
        are now more than 20,000,000 people in the United States living 
        with diabetes, with 6,000,000 of these cases not yet diagnosed. 
        Another 54,000,000 people in the United States have ``pre-
        diabetes'', which means that they have higher than normal blood 
        glucose levels, and are at increased risk of developing 
        diabetes.
            (3) In 2002, the landmark Diabetes Prevention Program study 
        found that lifestyle changes, such as diet and exercise, can 
        prevent or delay the onset of type 2 diabetes, and that 
        participants who made such lifestyle changes reduced their risk 
        of getting type 2 diabetes by 58 percent.
            (4) The New York Times has reported that lifestyle-based 
        interventions to control diabetes have resulted in positive 
        outcomes for patients, yet despite these successes, such 
        interventions were often unsustainable. While insurance 
        companies cover the treatments of complications of unchecked 
        diabetes, they tend not to cover the cheaper interventions to 
        prevent such complications.
            (5) According to the American Diabetes Association, in 
        2002, direct medical expenditures for diabetes totaled 
        $91,800,000,000, including $23,200,000,000 for diabetes care, 
        and $24,600,000,000 for chronic complications attributable to 
        diabetes. In that year, approximately 1 out of every 10 health 
        care dollars was directed to diabetes.
            (6) There is a need to increase the availability of 
        effective community-based lifestyle programs for diabetes 
        prevention and the ability of health care providers to refer 
        patients for enrollment in such programs to prevent diabetes, 
        reduce complications, and lower the costs associated with 
        diabetes treatment in the United States, and the Federal 
        government should encourage efforts to replicate the results of 
        the Diabetes Prevention Program on a wider scale.

SEC. 3. CENTERS FOR DISEASE CONTROL AND PREVENTION DIVISION OF DIABETES 
              TRANSLATION; DIABETES DEMONSTRATION PROJECTS.

    Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) 
is amended by inserting after section 317S the following:

``SEC. 317T. CENTERS FOR DISEASE CONTROL AND PREVENTION DIVISION OF 
              DIABETES TRANSLATION.

    ``(a) In General.--The Director of the Centers for Disease Control 
and Prevention shall establish within such Centers a Division of 
Diabetes Translation to eliminate the preventable burden of diabetes.
    ``(b) Office.--The Division of Diabetes Translation shall carry out 
the following activities:
            ``(1) Supporting and carrying out diabetes surveillance.
            ``(2) Conducting applied translational research, including 
        research that will improve early detection, prevention, and 
        access to quality care with respect to diabetes.
            ``(3) Working with States to establish and improve diabetes 
        control and prevention programs.
            ``(4) Coordinating the National Diabetes Education Program 
        in conjunction with the National Institutes of Health.
            ``(5) Increasing education and awareness of diabetes.
            ``(6) Promoting greater awareness of the health effects of 
        uncontrolled diabetes.
            ``(7) Other activities as deemed appropriate by the 
        Director.
    ``(c) Appropriations.--There are authorized to be appropriated to 
carry out the activities of the Division of Diabetes Translation under 
this section $90,000,000 for fiscal year 2008, and such sums as may be 
necessary for each subsequent fiscal year.

``SEC. 317U. DEMONSTRATION PROJECTS FOR THE IDENTIFICATION AND 
              TREATMENT FOR PERSONS DIAGNOSED WITH OR AT HIGH RISK FOR 
              DIABETES.

    ``(a) Identification and Prevention Demonstration Projects for 
Persons at High Risk for Type 2 Diabetes.--
            ``(1) In general.--
                    ``(A) Development.--The Director of the Centers for 
                Disease Control and Prevention (referred to in this 
                section as the `Director'), in consultation with the 
                Division of Diabetes Translation and academic centers, 
                shall develop a set of pilot demonstration projects to 
                evaluate various approaches to--
                            ``(i) screening and identifying persons 
                        with pre-diabetes and undiagnosed diabetes; and
                            ``(ii) providing identified persons with 
                        access to appropriate lifestyle interventions.
                    ``(B) Linkage to diabetes prevention program.--Such 
                pilot projects shall be carried out with the goal of 
                translating, using lifestyle interventions available in 
                the community, the Diabetes Prevention Program clinical 
                trial into interventions to reduce the incidence of 
                type 2 diabetes and its related complications in the 
                United States population.
            ``(2) Cooperative agreements.--
                    ``(A) In general.--The Director shall provide 
                cooperative agreements and technical assistance to not 
                more than 10 academic centers partnered with State or 
                local public health departments to implement, monitor, 
                and evaluate such pilot projects.
                    ``(B) Application.--Applicants shall submit to the 
                Director an application, at such time, in such manner, 
                and containing such information as the Director may 
                require, including--
                            ``(i) information documenting the risk of 
                        the populations to be targeted by this 
                        intervention; and
                            ``(ii) information regarding the methods 
                        that shall be used to identify and screen these 
                        populations.
            ``(3) Duration.--The cooperative agreements awarded under 
        this subsection shall be awarded for a 2-year period, with the 
        Director having the option to extend cooperative agreements for 
        an additional 2-year period.
            ``(4) Evaluation.--Not later than 4 years after the date of 
        the enactment of the Diabetes Treatment and Prevention Act of 
        2007, the Director shall submit to the Committee on Energy and 
        Commerce of the House of Representatives and the Committee on 
        Health, Education, Labor, and Pensions of the Senate a report 
        evaluating the effectiveness of the program under this 
        subsection and shall make such report publicly available.
            ``(5) Authorization of appropriations.--There are 
        authorized to be appropriated $10,000,000 to carry out this 
        subsection for each of fiscal years 2008 through 2012.
    ``(b) State Partnerships for Surveillance and Education.--
            ``(1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and Prevention, 
        shall engage in partnerships with State and local health 
        departments to carry out the following activities:
                    ``(A) National, State, and local (to the degree 
                determined by the Secretary) surveillance of the 
                following items:
                            ``(i) The number of individuals and 
                        percentage of the population at risk for 
                        developing diabetes.
                            ``(ii) The number of individuals and 
                        percentage of the population who have received 
                        diabetes and high blood glucose screenings.
                            ``(iii) Among those individuals who have 
                        been identified with pre-diabetes, the 
                        proportion that have been enrolled into 
                        lifestyle programs.
                            ``(iv) The availability of interventions to 
                        prevent diabetes, and the access of the 
                        population to such interventions.
                            ``(v) The number of individuals and 
                        percentage of population with both newly-
                        diagnosed cases of diabetes and existing cases 
                        of diabetes, as well as the rates of increase 
                        or decrease in newly-diagnosed diabetes.
                            ``(vi) Other relevant factors as determined 
                        by the Secretary.
                    ``(B) Education and information campaigns to 
                increase awareness among populations at high risk for 
                diabetes, health care providers, and the general 
                public, about the importance of primary prevention, 
                ways to assess personal risk, and how to locate and 
                access diabetes prevention programs.
            ``(2) Authorization of appropriations.--There are 
        authorized to be appropriated $10,000,000 to carry out this 
        subsection for each of the fiscal years 2008 through 2012.
    ``(c) Treatment Demonstration Projects for Co-Occurring Chronic 
Conditions.--
            ``(1) In general.--The Director, acting through the 
        Division of Diabetes Translation, shall develop a pilot program 
        to improve treatment for individuals with diabetes and other 
        co-occurring chronic conditions, such as mental illness, high 
        blood pressure, or cardiovascular disease, for which treatment 
        may complicate the treatment for diabetes.
            ``(2) Cooperative agreements.--
                    ``(A) In general.--The Director shall provide 
                cooperative agreements and technical assistance to not 
                more than 10 academic centers, in partnership with 
                State and local health departments, to implement, 
                monitor, and evaluate programs designed to improve 
                health outcomes in individuals with diabetes and other 
                co-occurring chronic conditions.
                    ``(B) Application.--Applicants shall submit to the 
                Director an application, at such time, in such manner, 
                and containing such information as the Director may 
                require, including information regarding the co-
                occurring conditions that shall be the subject of 
                study.
                    ``(C) Preference.--In awarding the cooperative 
                agreements under this subsection, the Director shall 
                give preference for research that focuses on conditions 
                which have a high prevalence among individuals with 
                diabetes, or for which the treatment involved has the 
                potential to impact adherence to diabetes treatment 
                regimens and that builds upon existing work designed to 
                improve the quality of care for patients with diabetes.
            ``(3) Duration.--The cooperative agreements awarded under 
        this subsection shall be awarded for a 2-year period, with the 
        Director having the option to extend cooperative agreements for 
        an additional 2-year period.
            ``(4) Evaluation.--Not later than 4 years after the date of 
        the enactment of the Diabetes Treatment and Prevention Act of 
        2007, the Director shall submit to the Committee on Energy and 
        Commerce of the House of Representatives and the Committee on 
        Health, Education, Labor, and Pensions of the Senate a report 
        evaluating the effectiveness of the program under this 
        subsection in improving the health care outcomes for 
        individuals with diabetes and other co-occurring chronic 
        conditions and shall make such report publicly available.
            ``(5) Appropriations.--There are authorized to be 
        appropriated $10,000,000 to carry out this subsection for each 
        of the fiscal years 2008 through 2012.''.
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