1.This Act may be cited as the
Bone Health Promotion and Research Act
of 2011
.
2.Congress makes the following
findings:
(1)Bone health is
critical to the overall health and quality of life of Americans. Bone provides
mobility, support, and protection for the body and acts as a storehouse for
essential minerals.
(2)Osteoporosis is a
condition in which the bones become weak and can break from a minor fall or, in
serious cases, from simple actions such as sneezing. An estimated 34,000,000
Americans have low bone mass or osteopenia, which puts them at risk for
osteoporosis and bone fractures. In addition, 10,000,000 Americans have
osteoporosis.
(3)Eight million of
those with osteoporosis are women, and an estimated 2,000,000 American men have
osteoporosis. The United States Surgeon General says that by 2020 one in two
Americans over age 50 is expected to have or to be at risk of developing
osteoporosis of the hip; even more will be at risk of developing osteoporosis
at any site in the skeleton.
(4)According to
estimated figures, osteoporosis was responsible for more than 2,000,000
fractures in 2005, including hip, spine, wrist, and other fractures. The number
of fractures due to osteoporosis is expected to rise to more than 3,000,000 by
2025. Approximately 1 in 2 women and up to 1 in 4 men over age 50 will break a
bone because of osteoporosis.
(5)An
average of 24 percent of hip fracture patients age 50 and older die in the year
following their fracture.
(6)Osteoporosis costs
our health care system an estimated $19,000,000,000 each year. By 2025, experts
predict that osteoporosis will account for $25,300,000,000 in costs.
(7)Individuals with
certain diseases are at higher risk of developing osteoporosis. For example,
diabetes patients are at increased risk for developing an osteoporosis-related
fracture. Cancer patients are also at increased risk because many cancer
therapies, such as chemotherapy and corticosteroids, have direct negative
effects on bone. Also, certain cancers, including prostate and breast cancer,
may be treated with hormonal therapy, which can cause bone loss.
(8)Osteogenesis
imperfecta is characterized by fragile bones and frequent fractures. It is
estimated to afflict an estimated 40,000 people.
(9)Paget’s disease of
the bone, a geriatric disorder that results in enlarged and deformed bones in
one or more parts of the body, afflicts an estimated 700,000 Americans over the
age of 60.
(10)Lifestyle factors
can affect bone health. For example, the chemicals in cigarette smoke are
harmful to bone cells and smoking may make it harder to absorb calcium. Heavy
drinking can reduce bone formation and may also affect the body’s calcium
supply.
(11)The 2004 Surgeon
General’s Report, Bone Health and Osteoporosis: A Report of the Surgeon
General
, said that Americans must be encouraged to: get enough calcium
and vitamin D; engage in regular weight-bearing and muscle-strengthening
exercise; avoid smoking and excessive alcohol; and talk to their healthcare
providers about bone health.
(12)The Nation’s
annual direct and indirect costs for bone and joint health are
$849,000,000,000—7.7 percent of the United States gross domestic
product.
(13)Greater efforts
and commitments are needed from Congress, the States, providers, and patients
to lessen the burden of osteoporosis and related bone diseases on
Americans.
3.National bone
health programPart B of title
III of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by
inserting after section 314 the following:
315.National bone
health program
(a)The Secretary may develop and implement a National Bone
Health Program (in this section referred to as the Program
)
consistent with this section.
(b)Control,
Prevention, and Surveillance
(1)Under the Program, the Secretary, acting through the
Director of the Centers for Disease Control and Prevention, may, directly or
through competitive grants to eligible entities, conduct, support, and promote
the coordination of research, investigations, demonstrations, training, and
studies relating to the control, prevention, and surveillance of osteoporosis
and related bone diseases.
(2)Training and
technical assistanceWith respect to the planning, development,
and operation of any activity carried out under paragraph (1), the Secretary
may provide training, technical assistance, supplies, equipment, or services,
and may assign any officer or employee of the Department of Health and Human
Services to a State or local health agency, or to any public or nonprofit
entity designated by a State health agency, in lieu of providing grant funds
under this subsection.
(3)Osteoporosis and
related bone disease prevention research at the Centers for Disease Control and
PreventionThe Secretary may provide additional grant support
under this subsection to encourage the expansion of research related to the
prevention and management of osteoporosis and related bone diseases at the
Centers for Disease Control and Prevention.
(4)For purposes of this subsection, the term eligible
entity
means a national public or private nonprofit entity that
demonstrates to the satisfaction of the Secretary, in the application described
in subsection (e), the ability of the entity to carry out the activities
described in paragraph (1).
(c)
(1)Under the Program, the Secretary may coordinate and carry
out national education and outreach activities, directly or through the
provision of grants to eligible entities, to support, develop, and implement
education initiatives and outreach strategies appropriate for osteoporosis and
related bone diseases.
(2)Initiatives and
strategiesInitiatives and strategies implemented under paragraph
(1) may include public awareness campaigns, public service announcements, and
community partnership workshops, as well as programs targeted at businesses and
employers, managed care organizations, and health care providers.
(3)In
carrying out paragraph (1), the Secretary—
(A)may emphasize
prevention, early diagnosis, and appropriate management of osteoporosis and
related bone disease, and opportunities for effective patient self-management;
and
(B)may give priority
to reaching high-risk or underserved populations.
(4)In
carrying out this subsection, the Secretary shall consult and collaborate with
the Advisory Committee established in subsection (g).
(5)For purposes of this subsection, the term eligible
entity
means a national public or private nonprofit entity that
demonstrates to the satisfaction of the Secretary, in the application described
in subsection (e), the ability of the entity to carry out the activities
described in paragraph (1).
(d)Comprehensive
State Grants
(1)Under the Program, the Secretary may award grants to
eligible entities to provide support for comprehensive osteoporosis and related
bone disease control and prevention programs and to enable such entities to
provide public health surveillance, prevention, and control activities related
to osteoporosis and related bone diseases.
(2)To
be eligible to receive a grant under this subsection, an entity shall be a
State or Indian tribe.
(3)To
be eligible to receive a grant under this subsection, an entity shall submit to
the Secretary an application at such time, in such manner, and containing such
agreements, assurances, and information as the Secretary may require, including
a comprehensive osteoporosis and related bone disease control and prevention
plan that—
(A)is developed with
the advice of stakeholders from the public, private, and nonprofit sectors that
have expertise relating to osteoporosis and related bone disease control,
prevention, and treatment that increase the quality of life and decrease the
level of disability;
(B)is intended to
reduce the morbidity of osteoporosis and related bone diseases, with priority
on preventing and controlling osteoporosis and related bone diseases in at-risk
populations and reducing disparities in osteoporosis and related bone disease
prevention, diagnosis, management, and quality of care in underserved
populations;
(C)describes the
osteoporosis and related bone disease services and activities to be undertaken
or supported by the entity; and
(D)demonstrates the
relationship the entity has with the community and local entities and how the
entity plans to involve such community and local entities in carrying out the
activities described in paragraph (1).
(4)An eligible entity may use amounts received under a grant
awarded under this subsection to conduct, in a manner consistent with the
comprehensive osteoporosis and related bone disease control and prevention plan
submitted by the entity in the application under paragraph (3)—
(A)public health
surveillance and epidemiological activities relating to the prevalence of
osteoporosis and related bone disease and assessment of disparities in
osteoporosis and related bone disease prevention, diagnosis, management, and
care;
(B)public information
and education programs; and
(C)education,
training, and clinical skills improvement activities for health professionals,
including allied health personnel.
(e)To be eligible to receive a grant under this section,
except under subsection (d), an entity shall submit to the Secretary an
application at such time, in such manner, and containing such agreements,
assurances, and information as the Secretary may require, including a
description of how funds received under a grant awarded under this section will
supplement or fulfill unmet needs identified in a comprehensive osteoporosis
and related bone disease control and prevention plan of the entity.
(f)For
purposes of this section:
(1)The term Indian tribe
has the meaning given
such term in section 4(e) of the Indian Self-Determination and Education
Assistance Act.
(2)The
term State
means any State of the United States, the District of
Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, American Samoa,
Guam, and the Northern Mariana Islands.
(g)
(1)Not
later than 90 days after the date of the enactment of this section, the
Secretary, acting through the Director of the Centers for Disease Control and
Prevention, shall establish a committee to be known as the Osteoporosis and
Related Bone Disease Advisory Committee (referred to in this section as the
Advisory Committee
). The Advisory Committee shall be composed of
at least one member, to be appointed by the Secretary, acting through the
Director of the Centers for Disease Control and Prevention, representing each
of the following:
(A)National voluntary
health organizations that focus on issues relating to osteoporosis or other
bone diseases.
(B)Professional
societies that focus on issues relating to osteoporosis or other bone
diseases.
(C)The Centers for
Disease Control and Prevention, to include, upon the recommendation of the
Director of the Centers, representatives of the Coordinating Center for Health
Promotion, the Coordinating Center for Health Information and Service, and the
Coordinating Center for Environmental Health and Injury Prevention.
(D)State public
health departments.
(E)The National
Institutes of Health, to include, upon the recommendation of the Director of
the National Institutes of Health, representatives of the National Institute of
Arthritis and Musculoskeletal and Skin Diseases, the National Cancer Institute,
the National Institute of Biomedical Imaging and Bioengineering, the National
Institute of Child Health and Human Development, the National Institute of
Dental and Craniofacial Research, the National Institute of Diabetes and
Digestive and Kidney Diseases, the National Institute on Aging, the Office of
Dietary Supplements, the Office of Rare Diseases, and the Office of Research on
Women’s Health.
(F)Patients with
osteoporosis or related bone diseases or their family members.
(G)The Office on
Women’s Health in the Department of Health and Human Services.
(H)Clinicians with
expertise on osteoporosis or related bone diseases.
(I)Other stakeholders
from the public, private, and nonprofit sectors with expertise relating to
osteoporosis or other bone disease control, prevention, and treatment.
(2)The
Advisory Committee shall advise the Secretary and the Assistant Secretary for
Health regarding the manner in which such officials can—
(A)ensure interagency
coordination and communication and minimize overlap regarding efforts to
address osteoporosis and related bone diseases;
(B)conduct and
support national education and outreach activities;
(C)identify
opportunities to coordinate efforts with other Federal and State agencies and
private organizations addressing such diseases;
(D)ensure that public
health policy decisions and information disseminated to the public and
physicians are evidence-based and population-focused;
(E)advise relevant
Federal agencies on priorities related to osteoporosis and related bone
diseases;
(F)conduct
surveillance and data collection and disseminate epidemiological information in
accordance with section 32OB; and
(G)expand and
intensify research on osteoporosis and related bone diseases in accordance with
section 404I.
(h)Authorization of
AppropriationsThere are authorized to be appropriated to carry
out this section $22,000,000 for each of fiscal years 2011 through
2013.
.
4.HHS
research activities with respect to osteoporosis and related bone
diseasesPart A of title IV of
the Public Health Service Act (42 U.S.C. 281 et seq.) is amended by adding at
the end the following:
404I.
(a)Expansion and
Intensification of Activities
(1)The Director of NIH shall expand and intensify programs
of the National Institutes of Health with respect to research and related
activities concerning osteoporosis and related bone diseases, including
osteogenesis imperfecta, Paget’s disease of bone, and rare bone
diseases.
(2)Coordination;
consultationThe Director of NIH shall carry out paragraph
(1)—
(A)in coordination
with the directors of the National Institute of Arthritis and Musculoskeletal
and Skin Diseases, the National Cancer Institute, the National Institute of
Biomedical Imaging and Bioengineering, the National Institute of Child Health
and Human Development, the National Institute of Dental and Craniofacial
Research, the National Institute of Diabetes and Digestive and Kidney Diseases,
the National Institute on Aging, the Office of Rare Diseases, the Office of
Research on Women’s Health, and any other national research institutes or
offices, as appropriate; and
(B)in consultation
with additional Federal officials, the advisory committee established under
section 315(g), and any national voluntary health organizations, professional
societies, and private entities, as appropriate.
(b)Planning Grants
and Contracts for Innovative Research in Osteoporosis and Related Bone
Diseases
(1)In carrying out subsection (a)(1), the Director of NIH
shall award planning grants or contracts for the establishment of new research
programs, or enhancement of existing research programs, that focus on
osteoporosis and related bone diseases, including osteogenesis imperfecta,
Paget’s disease of bone, and rare bone diseases.
(2)
(A)In carrying out this subsection, the Secretary shall
encourage basic, clinical, and translational research that focuses on
osteoporosis and related bone diseases, including osteogenesis imperfecta,
Paget’s disease of bone, and rare bone diseases.
(B)In
awarding planning grants or contracts under paragraph (1), the Director of NIH
may give priority to collaborative partnerships, which may include academic
health centers, private sector entities, and nonprofit organizations.
(C)New and early
stage investigatorsThe Director of NIH shall make an effort to
fund research by new and early stage investigators under paragraph (1).
(c)Authorization of
AppropriationsFor the purpose of carrying out this section,
there is authorized to be appropriated $250,000,000 for each of fiscal years
2011 through 2013. Such authorization shall be in addition to any authorization
of appropriations under any other provision of law to carry out research
activities on osteoporosis or related bone
diseases.
.
5.Surveillance
activities related to bone diseases at the centers for disease control and
preventionPart B of title III
of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by
inserting after section 320A the following:
320B.Surveillance
regarding osteoporosis and related bone diseases
(a)The Secretary, acting through the Director of the Centers
for Disease Control and Prevention, may award grants to and enter into
cooperative agreements with public or nonprofit private entities for the
collection, analysis, and reporting of data on osteoporosis and related bone
diseases, including osteogenesis imperfecta and Paget’s disease of bone.
(b)In awarding grants and entering into agreements under
subsection (a), the Secretary may provide direct technical assistance in lieu
of cash.
(c)Coordination
with Advisory Committee and NIHThe Secretary shall ensure that
epidemiological and other types of information obtained under subsection (a) is
made available to the National Institutes of Health. The advisory committee
established under section 315(g) shall advise the Secretary in the coordination
of epidemiological efforts and in the expansion and intensification of programs
for conducting surveillance and data collection activities under this
section.
(d)Authorization of
AppropriationsFor the purpose of carrying out this section,
there is authorized to be appropriated $25,000,000 for each of fiscal years
2011 through
2015.
.