1.Short title; table of
contents; findings
(a)This Act may be cited
as the Catalyst to Better Diabetes
Care Act of 2009
.
(b)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)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.
2.Diabetes
screening collaboration and outreach program
(a)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)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.
3.Advisory group
regarding employee wellness and disease management best practices
(a)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)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)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).
4.National Diabetes
Report Card
(a)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)
(1)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)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)The
Secretary, in collaboration with the Director, shall make each Report Card
publicly available, including by posting the Report Card on the
Internet.
5.Improvement of
vital statistics collection
(a)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 languageIn 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.
6.Study on
appropriate level of diabetes medical education
(a)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)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.
7.Authorization of
appropriationsThere are
authorized to be appropriated to carry out this Act such sums as may be
necessary.