[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2994 Reported in House (RH)]






                                                 Union Calendar No. 567
110th CONGRESS
  2d Session
                                H. R. 2994

                          [Report No. 110-871]

   To amend the Public Health Service Act with respect to pain care.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 11, 2007

  Mrs. Capps (for herself and Mr. Rogers of Michigan) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

                           September 23, 2008

Additional sponsors: Ms. Baldwin, Mr. Boucher, Mr. Stupak, Mr. Kennedy, 
 Mr. Walberg, Mr. Upton, Ms. Schakowsky, Mr. Gordon of Tennessee, Mr. 
Hinchey, Mr. Marshall, Ms. Zoe Lofgren of California, Mr. Gene Green of 
Texas, Mr. Rush, Mr. Kildee, Mr. Deal of Georgia, Mr. Butterfield, Mr. 
Markey, Mr. Grijalva, Mr. Gonzalez, Mr. Platts, Mr. Murtha, Mr. Rahall, 
Mr. Berman, Mr. Towns, Ms. Solis, Ms. DeGette, Mr. Tiberi, Mr. Latham, 
Mr. Allen, Mr. Gilchrest, Mr. Wynn, Mr. Rothman, Mr. Ross, Ms. Hooley, 
 Mr. Wexler, Ms. Shea-Porter, Mr. LaTourette, Mr. Carson, Mr. Welch of 
  Vermont, Mr. McGovern, Mr. McCotter, Mr. Farr, Mr. Wamp, Mr. David 
 Davis of Tennessee, Mr. Altmire, Mr. Walsh of New York, Mr. Doggett, 
Mr. Kuhl of New York, Mr. Ryan of Ohio, Mr. Loebsack, Ms. Eddie Bernice 
 Johnson of Texas, Mr. Sestak, Mrs. Davis of California, Mrs. Myrick, 
                             and Mr. Waxman

                           September 23, 2008

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]
 [For text of introduced bill, see copy of bill as introduced on July 
                               11, 2007]

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act with respect to pain care.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``National Pain Care 
Policy Act of 2008''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Institute of Medicine Conference on Pain.
Sec. 3. Pain research at National Institutes of Health.
Sec. 4. Pain care education and training.
Sec. 5. Public awareness campaign on pain management.

SEC. 2. INSTITUTE OF MEDICINE CONFERENCE ON PAIN.

    (a) Convening.--Not later than June 30, 2009, the Secretary of 
Health and Human Services shall seek to enter into an agreement with 
the Institute of Medicine of the National Academies to convene a 
Conference on Pain (in this section referred to as ``the Conference'').
    (b) Purposes.--The purposes of the Conference shall be to--
            (1) increase the recognition of pain as a significant 
        public health problem in the United States;
            (2) evaluate the adequacy of assessment, diagnosis, 
        treatment, and management of acute and chronic pain in the 
        general population, and in identified racial, ethnic, gender, 
        age, and other demographic groups that may be 
        disproportionately affected by inadequacies in the assessment, 
        diagnosis, treatment, and management of pain;
            (3) identify barriers to appropriate pain care, including--
                    (A) lack of understanding and education among 
                employers, patients, health care providers, regulators, 
                and third-party payors;
                    (B) barriers to access to care at the primary, 
                specialty, and tertiary care levels, including 
                barriers--
                            (i) specific to those populations that are 
                        disproportionately undertreated for pain;
                            (ii) related to physician concerns over 
                        regulatory and law enforcement policies 
                        applicable to some pain therapies; and
                            (iii) attributable to benefit, coverage, 
                        and payment policies in both the public and 
                        private sectors; and
                    (C) gaps in basic and clinical research on the 
                symptoms and causes of pain, and potential assessment 
                methods and new treatments to improve pain care; and
            (4) establish an agenda for action in both the public and 
        private sectors that will reduce such barriers and 
        significantly improve the state of pain care research, 
        education, and clinical care in the United States.
    (c) Other Appropriate Entity.--If the Institute of Medicine 
declines to enter into an agreement under subsection (a), the Secretary 
of Health and Human Services may enter into such agreement with another 
appropriate entity.
    (d) Report.--A report summarizing the Conference's findings and 
recommendations shall be submitted to the Congress not later than June 
30, 2010.
    (e) Authorization of Appropriations.--For the purpose of carrying 
out this section, there is authorized to be appropriated $500,000 for 
each of fiscal years 2009 and 2010.

SEC. 3. PAIN RESEARCH AT NATIONAL INSTITUTES OF HEALTH.

    Part B of title IV of the Public Health Service Act (42 U.S.C. 284 
et seq.) is amended by adding at the end the following:

``SEC. 409J. PAIN RESEARCH.

    ``(a) Research Initiatives.--
            ``(1) In general.--The Director of NIH is encouraged to 
        continue and expand, through the Pain Consortium, an aggressive 
        program of basic and clinical research on the causes of and 
        potential treatments for pain.
            ``(2) Annual recommendations.--Not less than annually, the 
        Pain Consortium, in consultation with the Division of Program 
        Coordination, Planning, and Strategic Initiatives, shall 
        develop and submit to the Director of NIH recommendations on 
        appropriate pain research initiatives that could be undertaken 
        with funds reserved under section 402A(c)(1) for the Common 
        Fund or otherwise available for such initiatives.
            ``(3) Definition.--In this subsection, the term `Pain 
        Consortium' means the Pain Consortium of the National 
        Institutes of Health or a similar trans-National Institutes of 
        Health coordinating entity designated by the Secretary for 
        purposes of this subsection.
    ``(b) Interagency Pain Research Coordinating Committee.--
            ``(1) Establishment.--The Secretary shall establish not 
        later than 1 year after the date of the enactment of this 
        section and as necessary maintain a committee, to be known as 
        the Interagency Pain Research Coordinating Committee (in this 
        section referred to as the `Committee'), to coordinate all 
        efforts within the Department of Health and Human Services and 
        other Federal agencies that relate to pain research.
            ``(2) Membership.--
                    ``(A) In general.--The Committee shall be composed 
                of the following voting members:
                            ``(i) Not more than 7 voting Federal 
                        representatives as follows:
                                    ``(I) The Director of the Centers 
                                for Disease Control and Prevention.
                                    ``(II) The Director of the National 
                                Institutes of Health and the directors 
                                of such national research institutes 
                                and national centers as the Secretary 
                                determines appropriate.
                                    ``(III) The heads of such other 
                                agencies of the Department of Health 
                                and Human Services as the Secretary 
                                determines appropriate.
                                    ``(IV) Representatives of other 
                                Federal agencies that conduct or 
                                support pain care research and 
                                treatment, including the Department of 
                                Defense and the Department of Veterans 
                                Affairs.
                            ``(ii) 12 additional voting members 
                        appointed under subparagraph (B).
                    ``(B) Additional members.--The Committee shall 
                include additional voting members appointed by the 
                Secretary as follows:
                            ``(i) 6 members shall be appointed from 
                        among scientists, physicians, and other health 
                        professionals, who--
                                    ``(I) are not officers or employees 
                                of the United States;
                                    ``(II) represent multiple 
                                disciplines, including clinical, basic, 
                                and public health sciences;
                                    ``(III) represent different 
                                geographical regions of the United 
                                States; and
                                    ``(IV) are from practice settings, 
                                academia, manufacturers or other 
                                research settings; and
                            ``(ii) 6 members shall be appointed from 
                        members of the general public, who are 
                        representatives of leading research, advocacy, 
                        and service organizations for individuals with 
                        pain-related conditions
                    ``(C) Nonvoting members.--The Committee shall 
                include such nonvoting members as the Secretary 
                determines to be appropriate.
            ``(3) Chairperson.--The voting members of the Committee 
        shall select a chairperson from among such members. The 
        selection of a chairperson shall be subject to the approval of 
        the Director of NIH.
            ``(4) Meetings.--The Committee shall meet at the call of 
        the chairperson of the Committee or upon the request of the 
        Director of NIH, but in no case less often than once each year.
            ``(5) Duties.--The Committee shall--
                    ``(A) develop a summary of advances in pain care 
                research supported or conducted by the Federal agencies 
                relevant to the diagnosis, prevention, and treatment of 
                pain and diseases and disorders associated with pain;
                    ``(B) identify critical gaps in basic and clinical 
                research on the symptoms and causes of pain;
                    ``(C) make recommendations to ensure that the 
                activities of the National Institutes of Health and 
                other Federal agencies, including the Department of 
                Defense and the Department of Veteran Affairs, are free 
                of unnecessary duplication of effort;
                    ``(D) make recommendations on how best to 
                disseminate information on pain care; and
                    ``(E) make recommendations on how to expand 
                partnerships between public entities, including Federal 
                agencies, and private entities to expand collaborative, 
                cross-cutting research.
            ``(6) Review.--The Secretary shall review the necessity of 
        the Committee at least once every 2 years.''.

SEC. 4. PAIN CARE EDUCATION AND TRAINING.

    (a) Pain Care Education and Training.--Part D of title VII of the 
Public Health Service Act (42 U.S.C. 294 et seq.) is amended--
            (1) by redesignating sections 754 through 758 as sections 
        755 through 759, respectively; and
            (2) by inserting after section 753 the following:

``SEC. 754. PROGRAM FOR EDUCATION AND TRAINING IN PAIN CARE.

    ``(a) In General.--The Secretary may make awards of grants, 
cooperative agreements, and contracts to health professions schools, 
hospices, and other public and private entities for the development and 
implementation of programs to provide education and training to health 
care professionals in pain care.
    ``(b) Priorities.--In making awards under subsection (a), the 
Secretary shall give priority to awards for the implementation of 
programs under such subsection.
    ``(c) Certain Topics.--An award may be made under subsection (a) 
only if the applicant for the award agrees that the program carried out 
with the award will include information and education on--
            ``(1) recognized means for assessing, diagnosing, treating, 
        and managing pain and related signs and symptoms, including the 
        medically appropriate use of controlled substances;
            ``(2) applicable laws, regulations, rules, and policies on 
        controlled substances, including the degree to which 
        misconceptions and concerns regarding such laws, regulations, 
        rules, and policies, or the enforcement thereof, may create 
        barriers to patient access to appropriate and effective pain 
        care;
            ``(3) interdisciplinary approaches to the delivery of pain 
        care, including delivery through specialized centers providing 
        comprehensive pain care treatment expertise;
            ``(4) cultural, linguistic, literacy, geographic, and other 
        barriers to care in underserved populations; and
            ``(5) recent findings, developments, and improvements in 
        the provision of pain care.
    ``(d) Program Sites.--Education and training under subsection (a) 
may be provided at or through health professions schools, residency 
training programs, and other graduate programs in the health 
professions; entities that provide continuing education in medicine, 
pain management, dentistry, psychology, social work, nursing, and 
pharmacy; hospices; and such other programs or sites as the Secretary 
determines to be appropriate.
    ``(e) Evaluation of Programs.--The Secretary shall (directly or 
through grants or contracts) provide for the evaluation of programs 
implemented under subsection (a) in order to determine the effect of 
such programs on knowledge and practice of pain care.
    ``(f) Peer Review Groups.--In carrying out section 799(f) with 
respect to this section, the Secretary shall ensure that the membership 
of each peer review group involved includes individuals with expertise 
and experience in pain care.
    ``(g) Definitions.--For purposes of this section the term `pain 
care' means the assessment, diagnosis, treatment, or management of 
acute or chronic pain regardless of causation or body location.''.
    (b) Authorization of Appropriations.--Section 758(b)(1) of the 
Public Health Service Act (as redesignated by subsection (a)(1) of this 
section) is amended--
            (1) by striking ``and'' at the end of subparagraph (B);
            (2) by striking the period at the end of subparagraph (C) 
        and inserting ``; and''; and
            (3) by inserting after subparagraph (C) the following:
                    ``(D) not less than $5,000,000 for awards of 
                grants, cooperative agreements, and contracts under 
                sections 754.''.
    (c) Technical Amendments.--Title VII of the Public Health Service 
Act (42 U.S.C. 292 et seq.) is amended--
            (1) in paragraph (2) of section 757(b) (as redesignated by 
        subsection (a)(1)), by striking ``754(3)(A), and 755(b)'' and 
        inserting ``755(3)(A), and 756(b)''; and
            (2) in subparagraph (C) of section 758(b)(1) (as 
        redesignated by subsection (a)(1)), by striking ``754, and 
        755'' and inserting ``755, and 756''.

SEC. 5. PUBLIC AWARENESS CAMPAIGN ON PAIN MANAGEMENT.

    Part B of title II of the Public Health Service Act (42 U.S.C. 238 
et seq.) is amended by adding at the end the following:

``SEC. 249. NATIONAL EDUCATION OUTREACH AND AWARENESS CAMPAIGN ON PAIN 
              MANAGEMENT.

    ``(a) Establishment.--Not later than June 30, 2009, the Secretary 
shall establish and implement a national pain care education outreach 
and awareness campaign described in subsection (b).
    ``(b) Requirements.--The Secretary shall design the public 
awareness campaign under this section to educate consumers, patients, 
their families, and other caregivers with respect to--
            ``(1) the incidence and importance of pain as a national 
        public health problem;
            ``(2) the adverse physical, psychological, emotional, 
        societal, and financial consequences that can result if pain is 
        not appropriately assessed, diagnosed, treated, or managed;
            ``(3) the availability, benefits, and risks of all pain 
        treatment and management options;
            ``(4) having pain promptly assessed, appropriately 
        diagnosed, treated, and managed, and regularly reassessed with 
        treatment adjusted as needed;
            ``(5) the role of credentialed pain management specialists 
        and subspecialists, and of comprehensive interdisciplinary 
        centers of treatment expertise;
            ``(6) the availability in the public, nonprofit, and 
        private sectors of pain management-related information, 
        services, and resources for consumers, employers, third-party 
        payors, patients, their families, and caregivers, including 
        information on--
                    ``(A) appropriate assessment, diagnosis, treatment, 
                and management options for all types of pain and pain-
                related symptoms; and
                    ``(B) conditions for which no treatment options are 
                yet recognized; and
            ``(7) other issues the Secretary deems appropriate.
    ``(c) Consultation.--In designing and implementing the public 
awareness campaign required by this section, the Secretary shall 
consult with organizations representing patients in pain and other 
consumers, employers, physicians including physicians specializing in 
pain care, other pain management professionals, medical device 
manufacturers, and pharmaceutical companies.
    ``(d) Coordination.--
            ``(1) Lead official.--The Secretary shall designate one 
        official in the Department of Health and Human Services to 
        oversee the campaign established under this section.
            ``(2) Agency coordination.--The Secretary shall ensure the 
        involvement in the public awareness campaign under this section 
        of the Surgeon General of the Public Health Service, the 
        Director of the Centers for Disease Control and Prevention, and 
        such other representatives of offices and agencies of the 
        Department of Health and Human Services as the Secretary 
        determines appropriate.
    ``(e) Underserved Areas and Populations.--In designing the public 
awareness campaign under this section, the Secretary shall--
            ``(1) take into account the special needs of geographic 
        areas and racial, ethnic, gender, age, and other demographic 
        groups that are currently underserved; and
            ``(2) provide resources that will reduce disparities in 
        access to appropriate diagnosis, assessment, and treatment.
    ``(f) Grants and Contracts.--The Secretary may make awards of 
grants, cooperative agreements, and contracts to public agencies and 
private nonprofit organizations to assist with the development and 
implementation of the public awareness campaign under this section.
    ``(g) Evaluation and Report.--Not later than the end of fiscal year 
2011, the Secretary shall prepare and submit to the Congress a report 
evaluating the effectiveness of the public awareness campaign under 
this section in educating the general public with respect to the 
matters described in subsection (b).
    ``(h) Authorization of Appropriations.--For purposes of carrying 
out this section, there are authorized to be appropriated $2,000,000 
for fiscal year 2009 and $4,000,000 for each of fiscal years 2010 and 
2011.''.
                                                 Union Calendar No. 567

110th CONGRESS

  2d Session

                               H. R. 2994

                          [Report No. 110-871]

_______________________________________________________________________

                                 A BILL

   To amend the Public Health Service Act with respect to pain care.

_______________________________________________________________________

                           September 23, 2008

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed