[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1634 Introduced in House (IH)]

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115th CONGRESS
  1st Session
                                H. R. 1634

   To require the Secretary of Health and Human Services to issue to 
Federal agencies guidelines for developing procedures and requirements 
     relating to certain primary care Federal health professionals 
  completing continuing medical education on nutrition and to require 
Federal agencies to submit annual reports relating to such guidelines, 
                        and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 20, 2017

 Mr. Grijalva (for himself, Mr. Garamendi, Ms. Jackson Lee, Ms. Roybal-
Allard, and Mr. Ryan of Ohio) introduced the following bill; which was 
            referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
   To require the Secretary of Health and Human Services to issue to 
Federal agencies guidelines for developing procedures and requirements 
     relating to certain primary care Federal health professionals 
  completing continuing medical education on nutrition and to require 
Federal agencies to submit annual reports relating to such guidelines, 
                        and for other purposes.

    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 ``Education and Training for Health 
Act of 2017'' or the ``EAT for Health Act of 2017''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) According to 2013 national health expenditure data, 
        United States health care spending increased 3.6 percent to 
        reach $2.9 trillion, or $9,255 per person, and accounted for 
        17.4 percent of Gross Domestic Product (GDP).
            (2) According to the Institute of Medicine, in 2012 
        estimates of health care costs attributed over 75 percent of 
        national health expenditures to treatment for chronic diseases.
            (3) A March 2003 report from the World Health Organization 
        concluded diet was a major cause of chronic diseases.
            (4) Seven out of 10 deaths among people in the United 
        States each year are from chronic diseases such as 
        cardiovascular disease, obesity, diabetes, and cancer.
            (5) According to the Centers for Disease Control and 
        Prevention, in 2013 heart disease was the leading cause of 
        death for American adults. Approximately 600,000 American 
        adults die each year from cardiovascular disease. Coronary 
        heart disease alone costs American taxpayers $108.9 billion 
        each year.
            (6) Research has shown that following a healthful diet can 
        not only reduce symptoms related to cardiovascular disease but 
        can also actually reverse damage done to the arteries.
            (7) According to the Journal of the American Medical 
        Association, two-thirds of adults in the United States are 
        currently overweight, and half of those overweight individuals 
        are obese. One in three children are overweight, and one-fifth 
        of children are obese. The United States spends about $147 to 
        $210 billion a year on obesity related diseases, including type 
        2 diabetes, hypertension, heart disease, and arthritis.
            (8) An estimated 29.1 million people in the United States 
        have diabetes. Another 86 million American adults have 
        prediabetes. The Centers for Disease Control and Prevention 
        predicts that one in three children born in 2000 will develop 
        diabetes at some point in their lives. Total estimated costs of 
        diagnosed diabetes have increased 41 percent, to $245 billion 
        in 2012 from $174 billion in 2007.
            (9) According to the American Cancer Society, there will be 
        an estimated 1,658,370 new cancer cases diagnosed and 589,430 
        cancer deaths in the United States in 2015. That is equivalent 
        to about 1,620 deaths per day and accounts for nearly 1 of 
        every 4 deaths. The Agency for Healthcare Research and Quality 
        (AHRQ) estimates that the direct medical costs for cancer in 
        the United States in 2011 were $88.7 billion.
            (10) According to the Journal of the American College of 
        Nutrition, in 2008 physicians felt inadequately trained to 
        provide proper nutrition advice. Ninety-four percent felt 
        nutrition counseling should be included during primary care 
        visits, but only 14 percent felt adequately trained to provide 
        such counseling.
            (11) A 1985 National Academy of Sciences report recommended 
        that all medical schools require at least 25 contact hours of 
        nutrition education. According to a 2009 national survey of 
        medical colleges published in Academic Medicine, only 38 
        percent of medical schools met these minimum standards by 
        requiring 25 hours of nutrition education as part of their 
        general curricula in 2004. By 2010, that number had shrunk to 
        27 percent. In addition, 30 percent of United States medical 
        schools required a dedicated nutrition course in 2004. Most 
        recently, only 25 percent of such schools required such a 
        course in 2010.
            (12) According to the Journal of Nutrition in Clinical 
        Practice in 2010, more than half of graduating medical students 
        felt their nutrition education was insufficient.
            (13) Recognizing the importance of nutrition, Healthy 
        People 2020--the Federal Government's framework for a healthier 
        Nation--includes a goal (NWS-6) to increase the proportion of 
        physician office visits that include counseling or education 
        related to nutrition or weight. According to Healthy People 
        2020, only 13.8 percent of physician office visits included 
        counseling about nutrition or diet (2010 latest year 
        available).
            (14) According to Mission: Readiness, one in four Americans 
        cannot serve in the military due to weight. For those serving, 
        the military discharged 4,300 active-duty personnel due to 
        weight problems in 2012.
            (15) According to the Journal of American Health Promotion, 
        the military spends well over $1 billion a year to treat 
        weight-related health problems such as heart disease and 
        diabetes through its TRICARE health insurance for active duty 
        personnel, reservists, retirees and their families.
            (16) According to the Centers for Disease Control and 
        Prevention, American Indian or Alaska Native adults are 60 
        percent more likely to be obese and over twice as likely as to 
        have diabetes compared to White adults.
            (17) According to the Centers for Disease Control and 
        Prevention, American Indian or Alaska Native adults have the 
        highest rate of diabetes among all minority groups at 15.9 
        percent.

SEC. 3. DEPARTMENT OF HEALTH AND HUMAN SERVICES GUIDELINES, AND FEDERAL 
              AGENCIES ANNUAL REPORTS, RELATING TO CERTAIN PRIMARY CARE 
              FEDERAL HEALTH PROFESSIONALS COMPLETING CONTINUING 
              MEDICAL EDUCATION ON NUTRITION.

    (a) Guidelines.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Health and Human Services shall 
issue guidelines to Federal agencies for developing procedures and 
requirements to ensure that every primary care health professional 
employed full-time for such agencies have continuing education courses 
relating to nutrition (as described in subsection (c)).
    (b) Biannual Reports.--Not later than 18 months after the date of 
the enactment of this Act and each subsequent year, the head of each 
Federal agency that employs full-time primary care health professionals 
shall submit to Congress a report attesting, in a form and manner 
specified by the Secretary of Health and Human Services, to the extent 
to which the agency has adopted and encouraged the guidelines issued 
under subsection (a) with respect to such professionals employed by 
such agency during any portion of the previous year. If the agency, 
with respect to such previous year, did not fully adopt and encourage 
such guidelines with respect to such professionals, the head of the 
agency shall include in the report for the year the percentage of such 
professionals employed by such agency to furnish primary care services 
who completed continuing education courses relating to nutrition (as 
described in subsection (c)).
    (c) Continuing Education Relating to Nutrition.--For purposes of 
subsections (a) and (b), continuing education courses relating to 
nutrition shall include at least content on the role of nutrition in 
the prevention, management, and, as possible, reversal of obesity, 
cardiovascular disease, diabetes, or cancer.
    (d) Definitions.--For purposes of this Act:
            (1) Continuing education.--The term ``continuing 
        education'' is defined as courses that meet requirements for 
        Continuing Medical Education (CME) or Continuing Education (CE) 
        by medical or nurse practitioner professional organizations or 
        certified accrediting bodies.
            (2) Nurse practitioner.--The term ``nurse practitioner'' 
        has the meaning given such term in section 1861(aa)(5) of the 
        Social Security Act (42 U.S.C. 1395x(aa)(5)).
            (3) Physician.--The term ``physician'' has the meaning 
        given such term in section 1861(r)(1) of the Social Security 
        Act (42 U.S.C. 1395x(r)(1)).
            (4) Primary care health professional.--The term ``primary 
        care health professional'' means a physician or nurse 
        practitioner who furnishes primary care services.
            (5) Primary care services.--The term ``primary care 
        services'' has the meaning given such term in section 
        1842(i)(4) of the Social Security Act (42 U.S.C. 1395u(i)(4)), 
        but shall include such services furnished by a nurse 
        practitioner as would otherwise be included if furnished by a 
        physician.
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