[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 1473 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                S. 1473

To catalyze change in the care and treatment of diabetes in the United 
                                States.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 20, 2009

Mrs. Hagan (for herself and Mr. Cornyn) introduced the following bill; 
     which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To catalyze change in the care and treatment of diabetes in the United 
                                States.

    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; FINDINGS.

    (a) Short Title.--This Act may be cited as the ``Catalyst to Better 
Diabetes Care Act of 2009''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents; findings.
Sec. 2. Diabetes screening collaboration and outreach program.
Sec. 3. Advisory group regarding employee wellness and disease 
                            management best practices.
Sec. 4. National Diabetes Report Card.
Sec. 5. Improvement of vital statistics collection.
Sec. 6. Study on appropriate level of diabetes medical education.
    (c) Findings.--The Congress finds as follows:
            (1) Diabetes is a chronic public health problem in the 
        United States that is getting worse.
            (2) According to the Centers for Disease Control and 
        Prevention:
                    (A) One in 3 Americans born in 2000 will get 
                diabetes.
                    (B) One in 2 Hispanic females born in 2000 will get 
                diabetes.
                    (C) 1,500,000 new cases of diabetes were diagnosed 
                in adults in 2005.
                    (D) In 2007, 23,600,000 Americans had diabetes, 
                which is 7.8 percent of the population of the United 
                States.
                    (E) 5,700,000 Americans are currently undiagnosed.
                    (F) African-Americans are nearly twice as likely as 
                whites to have diabetes.
                    (G) Nearly 13 percent of American Indians and 
                Alaska Natives over 20 years old have diagnosed 
                diabetes.
                    (H) In States with significant Asian populations, 
                Asians were 1.5 to 2 times as likely as whites to have 
                diagnosed diabetes.
            (3) Diabetes carries staggering costs:
                    (A) In 2007, the total amount of the direct and 
                indirect costs of diabetes was estimated at 
                $174,000,000,000.
                    (B) 18 percent of the Medicare population has 
                diabetes but spending on this group consumes 32 percent 
                of the Medicare budget.
            (4) Diabetes is deadly. According to the Centers for 
        Disease Control and Prevention:
                    (A) In 2007, according to death certificate 
                numbers, diabetes contributed to 284,000 deaths.
                    (B) Diabetes is likely to be seriously 
                underreported as studies have found that only 35 
                percent to 40 percent of decedents with diabetes had it 
                listed anywhere on the death certificate and only about 
                10 percent to 15 percent had it listed as the 
                underlying cause of death.
            (5) Diabetes complications carry staggering economic and 
        human costs for our country and health system:
                    (A) Diabetes contributes to over 224,000 deaths a 
                year.
                    (B) The risk for stroke is 2 to 4 times higher 
                among people with diabetes.
                    (C) Diabetes is the leading cause of new blindness 
                in America, causing approximately 12,000 to 24,000 new 
                cases of blindness each year.
                    (D) Diabetes is the leading cause of kidney failure 
                in America, accounting for 44 percent of new cases in 
                2005.
                    (E) In 2002, 44,400 Americans with diabetes began 
                treatment for end-stage kidney disease and a total of 
                153,730 were living on chronic dialysis or with a 
                kidney transplant as a result of their diabetes.
                    (F) In 2004, approximately 71,000 amputations were 
                performed on Americans with diabetes.
                    (G) Poorly controlled diabetes in women before 
                conceiving and during the first trimester of pregnancy 
                can cause major birth defects in 5 percent to 10 
                percent of pregnancies and spontaneous abortions in 15 
                percent to 20 percent of pregnancies.
            (6) Diabetes is unique because many of its complications 
        and tremendous costs are largely preventable through early 
        detection, better education on diabetes self-management, and 
        improved delivery of available medical treatment:
                    (A) According to the Agency for Healthcare Research 
                and Quality, appropriate primary care for diabetes 
                complications could have saved the Medicare and 
                Medicaid programs $2,500,000,000 in hospital costs in 
                2001 alone.
                    (B) According to the Diabetes Prevention Project 
                sponsored by the National Institutes of Health, 
                lifestyle interventions such as diet and moderate 
                physical activity for those with prediabetes reduced 
                the development of diabetes by 58 percent; among 
                Americans aged 60 and over, lifestyle interventions 
                reduced diabetes by 71 percent.
                    (C) Research shows detecting and treating diabetic 
                eye disease can reduce the development of severe vision 
                loss by 50 percent to 60 percent.
                    (D) Research shows comprehensive foot care programs 
                can reduce amputation rates by 45 percent to 85 
                percent.
                    (E) Detecting and treating early diabetic kidney 
                disease by lowering blood pressure can reduce the 
                decline in kidney function by 30 percent.
            (7) Research shows that diabetes self-management training 
        programs, involving a health team that includes certified 
        diabetes educators, not only significantly reduce overall 
        health costs but also improve health outcomes.

SEC. 2. DIABETES SCREENING COLLABORATION AND OUTREACH PROGRAM.

    (a) Establishment.--With respect to diabetes screening tests and 
for the purposes of reducing the number of undiagnosed seniors with 
diabetes or prediabetes, the Secretary of Health and Human Services 
(referred to in this Act as the ``Secretary''), in collaboration with 
the Director of the Centers for Disease Control and Prevention 
(referred to in this section as the ``Director''), shall--
            (1) review uptake and utilization of diabetes screening 
        benefits to identify and address any existing problems with 
        regard to utilization and data collection mechanisms;
            (2) establish an outreach program to identify existing 
        efforts by agencies and by the private and nonprofit sectors to 
        increase awareness among seniors and providers of diabetes 
        screening benefits; and
            (3) maximize cost effectiveness in increasing utilization 
        of diabetes screening benefits.
    (b) Consultation.--In carrying out this section, the Secretary and 
the Director shall consult with--
            (1) various units of the Federal Government, including the 
        Centers for Medicare & Medicaid Services, the Surgeon General 
        of the Public Health Service, the Agency for Healthcare 
        Research and Quality, the Health Resources and Services 
        Administration, and the National Institutes of Health; and
            (2) entities with an interest in diabetes, including 
        industry, voluntary health organizations, trade associations, 
        and professional societies.

SEC. 3. ADVISORY GROUP REGARDING EMPLOYEE WELLNESS AND DISEASE 
              MANAGEMENT BEST PRACTICES.

    (a) Establishment.--The Secretary shall establish an advisory group 
consisting of representatives of the public and private sector. The 
advisory group shall include--
            (1) representatives of the Department of Health and Human 
        Services;
            (2) representatives of the Department of Commerce; and
            (3) members of the public, representatives of the private 
        sector, and representatives of the small business community, 
        who have experience with diabetes or in administering and 
        operating employee wellness and disease management programs.
    (b) Duties.--The advisory group established under subsection (a) 
shall examine and make recommendations of best practices of employee 
wellness and disease management programs in order to--
            (1) provide public and private sector entities with 
        improved information in assessing the role of employee wellness 
        and disease management programs in saving money and improving 
        quality of life for patients with chronic illnesses; and
            (2) encourage the adoption of effective employee wellness 
        and disease management programs.
    (c) Report.--Not later than 1 year after the date of the enactment 
of this Act, the advisory group established under subsection (a) shall 
submit to the Secretary the results of the examination under subsection 
(b)(1).

SEC. 4. NATIONAL DIABETES REPORT CARD.

    (a) In General.--The Secretary, in collaboration with the Director 
of the Centers for Disease Control and Prevention (referred to in this 
section as the ``Director''), shall prepare on a biennial basis a 
national diabetes report card (referred to in this section as a 
``Report Card'') and, to the extent possible, for each State.
    (b) Contents.--
            (1) In general.--Each Report Card shall include aggregate 
        health outcomes related to individuals diagnosed with diabetes 
        and prediabetes including--
                    (A) preventative care practices and quality of 
                care;
                    (B) risk factors; and
                    (C) outcomes.
            (2) Updated reports.--Each Report Card that is prepared 
        after the initial Report Card shall include trend analysis for 
        the Nation and, to the extent possible, for each State, for the 
        purpose of--
                    (A) tracking progress in meeting established 
                national goals and objectives for improving diabetes 
                care, costs, and prevalence (including Healthy People 
                2010); and
                    (B) informing policy and program development.
    (c) Availability.--The Secretary, in collaboration with the 
Director, shall make each Report Card publicly available, including by 
posting the Report Card on the Internet.

SEC. 5. IMPROVEMENT OF VITAL STATISTICS COLLECTION.

    (a) In General.--The Secretary, acting through the Director of the 
Centers for Disease Control and Prevention and in collaboration with 
appropriate agencies and States, shall--
            (1) promote the education and training of physicians on the 
        importance of birth and death certificate data and how to 
        properly complete these documents, including the collection of 
        such data for diabetes and other chronic diseases;
            (2) encourage State adoption of the latest standard 
        revisions of birth and death certificates; and
            (3) work with States to re-engineer their vital statistics 
        systems in order to provide cost-effective, timely, and 
        accurate vital systems data.
    (b) Death Certificate Additional Language.--In carrying out this 
section, the Secretary may promote improvements to the collection of 
diabetes mortality data, including the addition of a question for the 
individual certifying the cause of death regarding whether the deceased 
had diabetes.

SEC. 6. STUDY ON APPROPRIATE LEVEL OF DIABETES MEDICAL EDUCATION.

    (a) In General.--The Secretary shall, in collaboration with the 
Institute of Medicine and appropriate associations and councils, 
conduct a study of the impact of diabetes on the practice of medicine 
in the United States and the appropriateness of the level of diabetes 
medical education that should be required prior to licensure, board 
certification, and board recertification.
    (b) Report.--Not later than 2 years after the date of the enactment 
of this Act, the Secretary shall submit a report on the study under 
subsection (a) to the Committees on Ways and Means and Energy and 
Commerce of the House of Representatives and the Committees on Finance 
and Health, Education, Labor, and Pensions of the Senate.

SEC. 7. AUTHORIZATION OF APPROPRIATIONS.

    There are authorized to be appropriated to carry out this Act such 
sums as may be necessary.
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