[Congressional Record Volume 153, Number 55 (Thursday, March 29, 2007)]
[Senate]
[Pages S4182-S4184]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. HARKIN:
  S. 1050. A bill to amend the Rehabilitation Act of 1973 and the 
Public Health Service Act to set standards for medical diagnostic 
equipment and to establish a program for promoting good health, disease 
prevention, and wellness and for the prevention of secondary conditions 
for individuals with disabilities, and for other purposes; to

[[Page S4183]]

the Committee on Health, Education, Labor, and Pensions.
  Mr. HARKIN. Mr. President, today I introduce the Promoting Wellness 
for Individuals with Disabilities Act. This important legislation will 
help ensure that people with disabilities have the same health and 
wellness opportunities as everyone else--through increasing access to 
accessible medical equipment, creating a health and wellness grant 
program, and improving the competency of medical professionals in 
providing care to patients with disabilities.
  The health and wellness of America's citizens has long been one of my 
top priorities. Too often, many Americans don't know about or lack 
access to health screenings and preventive services. As Ben Franklin 
said, ``An ounce of prevention is worth a pound of cure.''
  However, it is often difficult for many people with disabilities to 
access this ounce of prevention. Visits to physicians' offices often do 
not include accessible examination and diagnostic equipment, such as 
accessible examination tables, weight scales, and mammography machines 
for people with mobility or balance issues. The presence of these 
physical barriers can reduce the likelihood that persons with 
disabilities will receive timely and appropriate medical services.
  For example, one woman--a physician herself--told me that she has not 
had a complete physical examination since her spinal cord injury more 
than a decade ago because the tables are too high for her to get onto. 
She has not had a mammogram or colonoscopy because, as she puts it, it 
seems like such an effort to have to explain to the technicians her 
needs, to get them to lift her, and so on. These issues, which many of 
us take for granted, represent significant barriers to people with 
disabilities.
  Further, health and wellness programs on topics such as smoking 
cessation, weight control, nutrition, or fitness may not focus on the 
unique challenges faced by individuals with disabilities. And it may be 
difficult for persons with particular disabilities, such as those with 
intellectual disabilities, to find physicians or dentists who are 
willing to take them on as patients. All of these factors can also 
increase the incidence of secondary conditions for people with 
disabilities.
  I believe that the ``Promoting Wellness for Individuals with 
Disabilities Act'' is a good first step toward addressing these 
problems. The bill would: authorize the U.S. Access Board to establish 
accessibility standards for medical diagnostic equipment--including 
examination tables, examination chairs, weight scales, and mammography 
equipment, x-ray machines, and other radiological equipment commonly 
used for diagnostic purposes by medical professionals; establish a 
national wellness grant program that will help fund programs or 
activities for smoking cessation, weight control, nutrition or fitness 
that focus on the unique challenges faced by individuals with 
disabilities; preventive health screening programs for individuals with 
disabilities to reduce the incidence of secondary conditions; and 
athletic, exercise, or sports programs that provide individuals with 
disabilities an opportunity to increase their physical activity; and 
improve education and training of physicians and dentists by requiring 
that medical schools, dental schools, and their residency programs 
provide training to improve competency and clinical skills in providing 
care to patients with disabilities, including those with intellectual 
disabilities.
  I invite my fellow Members to join me in support of this legislation. 
Together, we can make certain that people with disabilities are not 
limited in their access to quality medical care, or in their 
opportunities for health and wellness.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1050

       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 ``Promoting Wellness for 
     Individuals with Disabilities Act of 2007''.

     SEC. 2. ESTABLISHMENT OF STANDARDS FOR ACCESSIBLE MEDICAL 
                   DIAGNOSTIC EQUIPMENT.

       Title V of the Rehabilitation Act of 1973 (29 U.S.C. 791 et 
     seq.) is amended by adding at the end of the following:

     ``SEC. 510. ESTABLISHMENT OF STANDARDS FOR ACCESSIBLE MEDICAL 
                   DIAGNOSTIC EQUIPMENT.

       ``(a) Standards.--Not later than 9 months after the date of 
     enactment of the Promoting Wellness for Individuals with 
     Disabilities Act of 2007, the Architectural and 
     Transportation Barriers Compliance Board shall issue 
     (including publishing) standards setting forth the minimum 
     technical criteria for medical diagnostic equipment used in 
     (or in conjunction with) physician's offices, clinics, 
     emergency rooms, hospitals, and other medical settings. The 
     standards shall ensure that such equipment is accessible to, 
     and usable by, individuals with disabilities, and shall allow 
     independent entry to, use of, and exit from the equipment by 
     such individuals to the maximum extent possible.
       ``(b) Medical Diagnostic Equipment Covered.--The standards 
     issued under subsection (a) for medical diagnostic equipment 
     shall apply to equipment that includes examination tables, 
     examination chairs (including chairs used for eye 
     examinations or procedures, and dental examinations or 
     procedures), weight scales, mammography equipment, x-ray 
     machines, and other radiological equipment commonly used for 
     diagnostic purposes by health professionals.
       ``(c) Interim Standards.--Until the date that the standards 
     described under subsection (a) are in effect, purchases of 
     examination tables, weight scales, and mammography equipment 
     made after January 1, 2008, and used in (or in conjunction 
     with) medical settings as described in subsection (a), shall 
     meet the following interim accessibility requirements:
       ``(1) Examination tables shall be height-adjustable between 
     a range of at least 18 inches to 37 inches.
       ``(2) Weight scales shall be capable of weighing 
     individuals who remain seated in a wheelchair or other 
     personal mobility aid.
       ``(3) Mammography machines and equipment shall be capable 
     of being used by individuals in a standing, seated, or 
     recumbent position, including individuals who remain seated 
     in a wheelchair or other personal mobility aid.
       ``(d) Review and Amendment.--The Architectural and 
     Transportation Barriers Compliance Board shall periodically 
     review and, as appropriate, amend the standards.''.

     SEC. 3. WELLNESS GRANT PROGRAM FOR INDIVIDUALS WITH 
                   DISABILITIES.

       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. 399R. ESTABLISHMENT OF WELLNESS GRANT PROGRAM FOR 
                   INDIVIDUALS WITH DISABILITIES.

       ``(a) In General.--
       ``(1) Individual with a disability defined.--For purposes 
     of this section, the term `individual with a disability' has 
     the meaning given the term in section 7(20) of the 
     Rehabilitation Act of 1973 (29 U.S.C. 705(20)), for purposes 
     of title V of such Act (29 U.S.C. 791 et seq.).
       ``(2) Wellness grant program for individuals with 
     disabilities.--The Secretary, in collaboration with the 
     National Advisory Committee on Wellness for Individuals With 
     Disabilities, may make grants on a competitive basis to 
     public and nonprofit private entities for the purpose of 
     carrying out programs for promoting good health, disease 
     prevention, and wellness for individuals with disabilities, 
     and preventing secondary conditions in such individuals.
       ``(b) Requirement of Application.--To be eligible to 
     receive a grant under subsection (a), a public or nonprofit 
     private entity shall submit to the Secretary an application 
     at such time, in such manner, and containing such agreements, 
     assurances, and information as the Secretary determines to be 
     necessary to carry out this section.
       ``(c) Authorized Activities.--With respect to promoting 
     good health and wellness for individuals with disabilities 
     described in subsection (a), activities for which the 
     Secretary may make a grant under such subsection include--
       ``(1) programs or activities for smoking cessation, weight 
     control, nutrition, or fitness that focus on the unique 
     challenges faced by individuals with disabilities regarding 
     these issues;
       ``(2) preventive health screening programs for individuals 
     with disabilities to reduce the incidence of secondary 
     conditions; and
       ``(3) athletic, exercise, or sports programs that provide 
     individuals with disabilities (including children with 
     disabilities) an opportunity to increase their physical 
     activity in a dedicated or adaptive recreational environment.
       ``(d) Priorities.--
       ``(1) Advisory committee.--The Secretary shall establish a 
     National Advisory Committee on Wellness for Individuals With 
     Disabilities that shall set priorities to carry out this 
     section, review grant proposals, and make recommendations for 
     funding, and annually evaluate the progress of the program 
     under this section in implementing the priorities.
       ``(2) Representation.--The Advisory Committee established 
     under paragraph (1) shall include representation by the 
     Department of Health and Human Services Office on Disability, 
     the United States Surgeon General

[[Page S4184]]

     or his designee, the Centers for Disease Control and 
     Prevention, private nonprofit organizations that represent 
     the civil rights and interests of individuals with 
     disabilities, and individuals with disabilities or their 
     family members.
       ``(e) Dissemination of Information.--The Secretary shall, 
     in addition to the usual methods of the Secretary, 
     disseminate information about the availability of grants 
     under the Wellness Grant Program for Individuals with 
     Disabilities in a manner designed to reach public entities 
     and nonprofit private organizations that are dedicated to 
     providing outreach, advocacy, or independent living services 
     to individuals with disabilities.
       ``(f) Reports to Congress.--The Secretary shall, not later 
     than 180 days after the date of the enactment of the 
     Promoting Wellness for Individuals with Disabilities Act of 
     2007, and annually thereafter, submit to Congress a report 
     summarizing activities, findings, outcomes, and 
     recommendations resulting from the grant projects funded 
     under this section during the preceding fiscal year.
       ``(g) Authorization of Appropriations.--For the purpose of 
     making grants under this section, there are authorized to be 
     appropriated such sums as may be necessary.''.

     SEC. 4. IMPROVING EDUCATION AND TRAINING TO PROVIDE MEDICAL 
                   SERVICES TO INDIVIDUALS WITH DISABILITIES.

       (a) Coordinated Program To Improve Pediatric Oral Health.--
     Section 320A(b) of the Public Health Service Act (42 U.S.C. 
     247d-8(b)) is amended by--
       (1) striking ``, or to increase'' and inserting ``, to 
     increase''; and
       (2) striking the period and inserting the following ``, or 
     to provide training to improve competency and clinical skills 
     in providing oral health services to, and communicating with, 
     patients with disabilities (including those with intellectual 
     disabilities) through training integrated into the core 
     curriculum and patient interaction in community-based 
     settings.''.
       (b) Children's Hospitals That Operate Graduate Medical 
     Education Programs.--Section 340E of the Public Health 
     Service Act (42 U.S.C. 256e) is amended by adding at the end 
     the following:
       ``(h) Requirement To Provide Training.--To be eligible to 
     receive a payment under this section, a children's hospital 
     shall provide training to improve competency and clinical 
     skills in providing health care to, and communicating with, 
     patients with disabilities, including those with intellectual 
     disabilities, as part of any approved graduate medical 
     residency training program provided by the hospital. Such 
     training shall include treating patients with disabilities in 
     community-based settings, as part of the usual training or 
     residency placement.''.
       (c) Centers of Excellence.--Section 736(b) of the Public 
     Health Service Act (42 U.S.C. 293(b)) is amended--
       (1) in paragraph (6)(B), by striking ``; and'' and 
     inserting a semicolon;
       (2) by redesignating paragraph (7) as paragraph (8); and
       (3) by inserting after paragraph (6) the following:
       ``(7) to carry out a program to improve competency and 
     clinical skills of students in providing health services to, 
     and communicating with, patients with disabilities, including 
     those with intellectual disabilities; and''.
       (d) Family Medicine, General Internal Medicine, General 
     Pediatrics, General Dentistry, Pediatric Dentistry, and 
     Physician Assistants.--Section 747(a) of the Public Health 
     Service Act (42 U.S.C. 293k(a)) is amended--
       (1) in paragraph (5), by striking ``; and'' and inserting a 
     semicolon;
       (2) in paragraph (6), by striking ``pediatric dentistry.'' 
     and inserting the following: ``pediatric dentistry; and
       ``(7) to plan, develop, and operate a program for the 
     training of physicians or dentists, or medical or dental 
     residents, to improve competency and clinical skills of 
     physicians and dentists in providing services to, and 
     communicating with, patients with disabilities, including 
     those with intellectual disabilities.''; and
       (3) by inserting at the end the following: ``The training 
     described in paragraph (7) shall include training integrated 
     into the core curriculum, as well as patient interaction with 
     individuals with disabilities in community-based settings, as 
     part of the usual training or residency placement.''.
       (e) Advisory Council on Graduate Medical Education.--
     Section 762(a)(1) of the Public Health Service Act (42 U.S.C. 
     294o(a)(1)) is amended--
       (1) in subparagraph (E), by striking ``; and'' and 
     inserting a semicolon;
       (2) by adding at the end the following:
       ``(G) appropriate efforts to be carried out by hospitals, 
     schools of medicine, schools of osteopathic medicine, schools 
     of dentistry, and accrediting bodies with respect to changes 
     in undergraduate and graduate medical training to improve 
     competency and clinical skills of physicians in providing 
     health care services to, and communicating with, patients 
     with disabilities, including those with intellectual 
     disabilities; and''.
       (f) Medicare Graduate Medical Education Programs.--Section 
     1886(h) of the Social Security Act (42 U.S.C. 1395ww(h)) is 
     amended by adding at the end the following:
       ``(8) Requirement to provide training.--To be eligible to 
     receive a payment under this subsection, a hospital shall 
     provide training to improve competency and clinical skills in 
     providing health care to, and communicating with, patients 
     with disabilities, including those with intellectual 
     disabilities, as part of any approved medical residency 
     training program provided by the hospital. Such training 
     shall include treating patients with disabilities in 
     community-based settings, as part of the usual training or 
     residency placement.''.
       (g) Effective Date.--The amendments made by subsections 
     (b), (c), and (f) shall take effect 180 days after the date 
     of enactment of this Act.
                                 ______