[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 586 Introduced in Senate (IS)]

114th CONGRESS
  1st Session
                                 S. 586

    To amend the Public Health Service Act to foster more effective 
 implementation and coordination of clinical care for people with pre-
diabetes, diabetes, and the chronic diseases and conditions that result 
                             from diabetes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           February 26, 2015

  Mrs. Shaheen (for herself, Ms. Collins, Mr. Brown, Mr. Markey, Mr. 
Kirk, Ms. Ayotte, Mrs. Boxer, Mr. Nelson, Mr. Donnelly, Mr. Carper, Mr. 
 Booker, Mr. Grassley, and Mr. Peters) 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 foster more effective 
 implementation and coordination of clinical care for people with pre-
diabetes, diabetes, and the chronic diseases and conditions that result 
                             from diabetes.

    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 ``National Diabetes Clinical Care 
Commission Act''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) The Centers for Disease Control and Prevention report 
        that nearly 29,000,000 Americans have diabetes in addition to 
        an estimated 86,000,000 American adults that have pre-diabetes, 
        an increase of 3,000,000 Americans with diabetes and 7,000,000 
        American adults with pre-diabetes since 2011.
            (2) Diabetes affects 9.3 percent of Americans of all ages 
        and 12.3 percent of adults age 20 and older. Adults age 20 and 
        older of racial and ethnic minorities continue to have higher 
        rates of diabetes than individuals not of such minorities, as 
        demonstrated by the following: 15.9 percent of all adult 
        American Indians and Alaskan Natives have diabetes; 13.2 
        percent of all adult African-Americans have diabetes; 12.8 
        percent of all adult Hispanics have diabetes; and 9.0 percent 
        of all adult Asian-Americans have diabetes, while 7.6 percent 
        of all non-Hispanic Whites have diabetes.
            (3) Diabetes is the seventh leading cause of death in the 
        United States.
            (4) People with diabetes are more likely than people 
        without diabetes to also have chronic diseases and conditions 
        that are complications of diabetes, including cardiovascular 
        disease, strokes, high blood pressure, kidney disease, 
        including dialysis, blindness, neuropathy, and leg and feet 
        amputations.
            (5) Adults with diabetes have an elevated risk of heart 
        disease and stroke. Adults with diabetes have death rates from 
        heart disease that are nearly twice as high as adults without 
        the disease.
            (6) Diabetes is the leading cause of kidney failure. Each 
        year, nearly 100,000 individuals in the United States are 
        diagnosed with kidney failure, and diabetes accounts for 44 
        percent of these new cases.
            (7) Diabetic neuropathies are a family of nerve disorders 
        caused by diabetes and are prevalent in nearly 60 to 70 percent 
        of individuals with diabetes.
            (8) Diabetes is the leading cause of new cases of blindness 
        among adults aged 20 to 74.
            (9) About 60 percent of all non-traumatic lower limb 
        amputations in the United States occur in individuals with 
        diabetes.
            (10) Total national costs associated with diabetes in 2012 
        exceeded $245,000,000,000, according to the Centers for Disease 
        Control and Prevention.
            (11) One in three Medicare dollars is currently spent on 
        people with diabetes.
            (12) The Centers for Disease Control and Prevention 
        projects that as many as 1 in 3 American adults could have 
        diabetes by 2050 if current trends continue.
            (13) There are 35 Federal departments, agencies, and 
        offices involved in the implementation of Federal diabetes 
        activities.

SEC. 3. ESTABLISHMENT OF THE NATIONAL DIABETES CLINICAL CARE 
              COMMISSION.

    Part P of title III of the Public Health Service Act (42 U.S.C. 
280g et seq.) is amended by adding at the end the following new 
section:

``SEC. 399V-6. NATIONAL DIABETES CLINICAL CARE COMMISSION.

    ``(a) Establishment.--There is hereby established within the 
Department of Health and Human Services a National Diabetes Clinical 
Care Commission (in this section referred to as the `Commission') to 
evaluate and recommend solutions regarding better coordination and the 
leveraging of programs within the Department of Health and Human 
Services and other Federal agencies that relate in any way to 
supporting appropriate clinical care (such as any interactions between 
physicians and other health care providers and their patients) related 
to the treatment and care management for people with pre-diabetes, 
diabetes, and the chronic diseases and conditions that are 
complications of or caused by diabetes.
    ``(b) Membership.--
            ``(1) In general.--The Commission shall be composed of the 
        following voting members:
                    ``(A) The heads (or their designees) of the 
                following Federal agencies and departments that conduct 
                programs that could impact the clinical care of people 
                with pre-diabetes, diabetes, and the chronic diseases 
                and conditions that are complications of or caused by 
                diabetes:
                            ``(i) The Centers for Medicare and Medicaid 
                        Services.
                            ``(ii) The Agency for Healthcare Research 
                        and Quality.
                            ``(iii) The Centers for Disease Control and 
                        Prevention.
                            ``(iv) The Indian Health Service.
                            ``(v) The Department of Veterans Affairs.
                            ``(vi) The National Institutes of Health.
                            ``(vii) The Food and Drug Administration.
                            ``(viii) The Health Resources and Services 
                        Administration.
                            ``(ix) The Department of Defense.
                            ``(x) Other governmental or nongovernmental 
                        agency heads, at the discretion of the agency, 
                        that impact clinical care of individuals with 
                        pre-diabetes and diabetes.
                    ``(B) Twelve additional voting members appointed 
                under paragraph (2).
            ``(2) Additional members.--The Commission shall include 
        additional voting members appointed by the Comptroller General 
        of the United States, in consultation with national medical 
        societies and patient advocate organizations with expertise in 
        diabetes and the care of patients with diabetes and the 
        diseases it causes, including one or more from each of the 
        following categories:
                    ``(A) Clinical endocrinologists.
                    ``(B) Physician specialties (other than as 
                described in subparagraph (A)) that play a role in 
                diabetes care, such as cardiologists, nephrologists, 
                and eye care professionals.
                    ``(C) Primary care physicians.
                    ``(D) Non-physician health care professionals, such 
                as certified diabetes educators, registered dieticians 
                and nutrition professionals, nurses, nurse 
                practitioners, and physician assistants.
                    ``(E) Patient advocates.
                    ``(F) National experts in the duties listed under 
                subsection (c).
            ``(3) Chairperson.--The voting members of the Commission 
        shall select a chairperson from the members described in 
        paragraph (2)(A).
            ``(4) Meetings.--The Commission shall meet at least twice, 
        and not more than 4 times, a year.
            ``(5) Board terms.--Members of the Commission, including 
        the chairperson, shall serve for a 3-year term. A vacancy on 
        the Commission shall be filled in the same manner as the 
        original appointments.
    ``(c) Duties.--The Commission shall--
            ``(1) evaluate programs of the Department of Health and 
        Human Services regarding the utilization of diabetes screening 
        benefits, annual wellness visits, and other preventive health 
        benefits that may reduce the risk of diabetes and the chronic 
        diseases and conditions that are complications of diabetes, 
        addressing any existing problems regarding such utilization and 
        related data collection mechanisms;
            ``(2) identify current activities and critical gaps in 
        Federal efforts to support clinicians in providing integrated, 
        high-quality care to people with pre-diabetes, diabetes, and 
        the chronic diseases and conditions that are complications of 
        diabetes;
            ``(3) make recommendations regarding the coordination of 
        clinically based activities that are being supported by the 
        Federal Government;
            ``(4) make recommendations regarding the development and 
        coordination of federally funded clinical practice support 
        tools for physicians and other health care professionals in 
        caring for and managing the care of people with pre-diabetes, 
        diabetes, and the chronic diseases and conditions that are 
        complications of diabetes, specifically with regard to the 
        implementation of new treatments and technologies;
            ``(5) evaluate programs in existence as of the date of the 
        enactment of this section and determine if such programs are 
        meeting the needs identified in paragraph (2) and, if such 
        programs are determined to not be meeting such needs, recommend 
        programs that would be more appropriate;
            ``(6) recommend clinical pathways for new technologies and 
        treatments, including future data collection activities, and 
        how they may be developed and then used to evaluate and develop 
        various care models and methods and the impact of such models 
        and methods on quality of care and diabetes management as 
        measured by appropriate care parameters (such as A1C, blood 
        pressure, and cholesterol levels);
            ``(7) evaluate and expand education and awareness to 
        physicians and other health care professionals regarding 
        clinical practices for the prevention of diabetes and the 
        chronic diseases and conditions that are complications of 
        diabetes;
            ``(8) review and recommend appropriate methods for outreach 
        and dissemination of educational resources that regard diabetes 
        prevention and treatments, are funded by the Federal 
        Government, and are intended for health care professionals and 
        the public; and
            ``(9) include other activities, such as those relating to 
        the areas of public health and nutrition, that the Commission 
        deems appropriate.
    ``(d) Operating Plan.--
            ``(1) Initial plan.--Not later than 90 days after its first 
        meeting, the Commission shall submit to the Secretary and the 
        Congress an operating plan for carrying out the activities of 
        the Commission as described in subsection (c). Such operating 
        plan may include--
                    ``(A) a list of specific activities that the 
                Commission plans to conduct for purposes of carrying 
                out the duties described in each of the paragraphs in 
                subsection (c);
                    ``(B) a plan for completing the activities;
                    ``(C) a list of members of the Commission and other 
                individuals who are not members of the Commission who 
                will need to be involved to conduct such activities;
                    ``(D) an explanation of Federal agency involvement 
                and coordination needed to conduct such activities;
                    ``(E) a budget for conducting such activities;
                    ``(F) a plan for evaluating the value and potential 
                impact of the Commission's work and recommendations, 
                including the possible continuation of the Commission 
                for the purposes of overseeing their implementation; 
                and
                    ``(G) other information that the Commission deems 
                appropriate.
            ``(2) Updates.--The Commission shall periodically update 
        the operating plan under paragraph (1) and submit such updates 
        to the Secretary and the Congress.
    ``(e) Final Report and Sunset of the Commission.--By not later than 
3 years after the date of the Commission's first meeting, the 
Commission shall submit a report containing all of the findings and 
recommended actions of the Commission to the Secretary and Congress. 
Not later than 120 days after the submission of the final report, the 
Secretary shall review the evaluation required under subsection 
(d)(1)(F) to determine the continuation of the Commission.
    ``(f) Authorization of Appropriations.--Appropriations are 
authorized to be made available to the Commission for each of fiscal 
years 2016, 2017, and 2018, from amounts otherwise made available to 
the Department of Health and Human Services for such fiscal years, to 
carry out this section.''.
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