[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 2983 Introduced in Senate (IS)]







110th CONGRESS
  2d Session
                                S. 2983

To amend the Public Health Service Act 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 SENATE OF THE UNITED STATES

                              May 6, 2008

Mr. Lautenberg (for himself, Mr. Isakson, and Ms. Stabenow) introduced 
the following bill; which was read twice and referred to the Committee 
               on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To amend the Public Health Service Act 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 of 2008''.

                 TITLE I--NATIONAL INSTITUTES OF HEALTH

SEC. 101. RESEARCH, TREATMENT, AND EDUCATION.

    (a) In General.--Subpart 3 of part C of title IV of the Public 
Health Service Act (42 U.S.C. 285c et seq.) is amended by adding at the 
end the following new section:

``SEC. 434B. DIABETES IN MINORITY POPULATIONS.

    ``(a) 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.
    ``(b) Certain Activities.--Activities under subsection (a) 
regarding type 2 diabetes in minority populations shall include the 
following:
            ``(1) Research on behavior and obesity, including research 
        through the obesity research center that is sponsored by the 
        National Institutes of Health.
            ``(2) 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.
            ``(3) 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.
            ``(4) Research to identify genes that predispose 
        individuals to the onset of developing type 1 and type 2 
        diabetes and to develop complications.
            ``(5) 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.
            ``(6) 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.
    ``(c) Treatment.--
            ``(1) In general.--The Director of the National Institutes 
        of Health shall conduct and support programs to treat diabetes 
        in minority populations.
            ``(2) Certain activities.--Activities under paragraph (1) 
        regarding the treatment of diabetes in minority populations 
        shall include recommending and disseminating, through the 
        National Center on Minority Health and Health Disparities, the 
        guidelines of the American Diabetes Association for nutrition 
        exercise and diet for diabetes treatment and prevention.
    ``(d) Education.--The Director of the National Institutes of Health 
shall--
            ``(1) through the National Center on Minority Health and 
        Health Disparities--
                    ``(A) make 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; and
                    ``(B) provide for the participation of minority 
                health professionals in diabetes-focused research 
                programs; and
            ``(2) make 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.
    ``(e) Definition.--For purposes of this section, the term `minority 
populations' means racial and ethnic minority groups within the meaning 
of section 1707.
    ``(f) 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 2009 and each subsequent fiscal 
year.''.
    (b) 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:
    ``(c)(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 section 399O, as well as remaining consistent 
        with the intent of the Diabetes Prevention Access and Care Act 
        of 2008.
    ``(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 2009 and each subsequent fiscal year.''.

          TITLE II--CENTERS FOR DISEASE CONTROL AND PREVENTION

SEC. 201. RESEARCH, EDUCATION, AND OTHER ACTIVITIES.

    (a) In General.--Part B of title III of the Public Health Service 
Act (42 U.S.C. 243 et seq.) is amended by inserting after section 317S 
the following section:

``SEC. 317T. DIABETES IN MINORITY POPULATIONS.

    ``(a) Research and Other Activities.--
            ``(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) Further enhancing the National Health and 
                Nutrition Examination Survey by over-sampling Asian 
                American and Pacific Islanders in appropriate 
                geographic areas to better determine the prevalence of 
                diabetes in these populations as well as to improve the 
                data collection of diabetes penetration disaggregated 
                into major ethnic groups within this population.
                    ``(D) Within the Division of Diabetes Translation, 
                providing for prevention research to better understand 
                how to influence health care systems changes to improve 
                quality of care being delivered to such populations, 
                and 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.
                    ``(E) Through the Division of Diabetes Translation, 
                carrying out culturally appropriate community-based 
                interventions designed to address issues and problems 
                experienced by these populations.
                    ``(F) Conducting applied research within the 
                Division of Diabetes Translation to reduce health 
                disparities within these populations with diabetes.
                    ``(G) Conducting applied research on primary 
                prevention within the Division of Diabetes Translation 
                to specifically focus on these populations with pre-
                diabetes.
    ``(b) Education.--
            ``(1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and Prevention, 
        shall direct the Division of Diabetes Translation to conduct 
        and support programs to educate the public on the causes and 
        effects of diabetes in minority populations.
            ``(2) Certain activities.--Activities under paragraph (1) 
        regarding education on diabetes in minority populations shall 
        include the following:
                    ``(A) Making grants for diabetes-focused education 
                classes or training programs on cultural sensitivity 
                and patient care within such populations for health 
                care providers.
                    ``(B) 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.
    ``(c) Diabetes; Health Promotion, Prevention Activities, and 
Access.--
            ``(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 Prevention and 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 education and community 
                outreach on diabetes.
                    ``(F) 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.
                    ``(G) Providing funds for an aggressive prevention 
                campaign that focuses on physical inactivity and diet 
                and its relation to type 2 diabetes within such 
                populations.
                    ``(H) 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.
    ``(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.--For the purpose of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary for fiscal year 2009 and each subsequent fiscal 
year.''.

                     TITLE III--ADDITIONAL PROGRAMS

SEC. 301. RESEARCH, EDUCATION, AND OTHER ACTIVITIES.

    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. RESEARCH, EDUCATION, AND OTHER ACTIVITIES REGARDING 
              DIABETES IN MINORITY POPULATIONS.

    ``(a) Research and Other Activities.--
            ``(1) In general.--In addition to activities under sections 
        317T and 434B, 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) Expanding the National Diabetes Education 
                Program.
                    ``(B) Through the National Center on Minority 
                Health and Health Disparities, the Office of Minority 
                Health under section 1707, the Health Resources and 
                Services 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.
                    ``(C) 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.
            ``(3) Programs relating to clinical research.--
                    ``(A) Education regarding clinical trials.--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.
    ``(b) Education.--
            ``(1) In general.--The Secretary shall conduct and support 
        programs to educate the public on the causes of effects of 
        diabetes in minority populations.
            ``(2) Health resources and services administration.--With 
        respect to the Health Resources and Services Administration, 
        activities under paragraph (1) regarding education on diabetes 
        in minority populations shall include the following:
                    ``(A) 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.
                    ``(B) 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.
                    ``(C) 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.
                    ``(D) Establishing a loan repayment program that 
                focuses on diabetes care and prevention.
            ``(3) Additional programs.--Activities under paragraph (1) 
        regarding education on diabetes in minority populations shall 
        include the following:
                    ``(A) 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.
                    ``(B) 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:
                            ``(i) Federal and State loan repayment 
                        programs for health profession students within 
                        communities of color.
                            ``(ii) Providing funds to the Office of 
                        Minority Health under section 1707 for training 
                        health profession students to focus on diabetes 
                        within such populations.
                            ``(iii) 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.
    ``(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.--For the purpose of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary for fiscal year 2009 and each subsequent fiscal 
year.''.

                           TITLE IV--STUDIES

SEC. 401. 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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