[Congressional Record Volume 153, Number 86 (Thursday, May 24, 2007)]
[Senate]
[Pages S6863-S6864]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DOMENICI (for himself, Mr. Dorgan, Mr. Inouye, Mr. Baucus, 
        Ms. Collins, Mrs. Lincoln, Mr. Hatch, Mr. Bingaman, Ms. 
        Stabenow, Mr. Schumer, and Mr. Durbin):
  S. 1494. A bill to amend the Public Health Service Act to reauthorize 
the special diabetes programs for Type I diabetes and Indians under 
that Act; to the Committee on Health, Education, Labor, and Pensions.
  Mr. DOMENICI. Mr. President, I rise today with my colleague, Senator 
Dorgan, to introduce a bill to reauthorize and expand two very 
important public health programs created by the Balanced Budget Act of 
1997; The Special Diabetes Program for Indians and the Special Funding 
Program for Type I Diabetes Research. I want to thank my colleagues, 
Senator Inouye, Senator Baucus, Senator Collins, Senator Lincoln, 
Senator Hatch, and Senator Bingaman for joining us as original 
cosponsors of this bill. This type of bipartisan support clearly shows 
that addressing this disease and its consequences is an important 
health priority for our Nation.
  Diabetes is one of the most serious and devastating health problems 
of our time. The American Diabetes Association estimates that 20.8 
million Americans have diabetes; more than 7 percent of our population. 
The number of U.S. adults with diagnosed diabetes has increased by more 
than 60 percent since 1991 and is projected to more than double by 
2050. It ranks as the sixth leading cause of death in America. This has 
serious national implications; it is overwhelming health systems in the 
states and the Nation.
  Although diabetes occurs in people of all ethnicities, the diabetes 
epidemic is particularly acute in our Native American populations. 
Among some tribes, as many as 50 percent of the adult population have 
the disease. That is why during the negotiations on the 1997 Balanced 
Budget Act, I helped craft an agreement to finance diabetes programs of 
the Indian Health Service and help raise the profile of tribal health 
programs. The Special Diabetes Program for Indians began with funding 
of $30 million annually for 5 years and was later expanded to $150 
million a year. This funding has been used widely in Indian country, 
including among the Navajo Nation and the 19 Pueblos in New Mexico.
  Federally supported treatment and prevention programs are showing 
real results in the Native American populations. The current funding 
has established almost 400 new diabetes treatment and prevention 
programs in Native communities. It has helped to provide critical 
resources such as medications and therapies, clinical exams, 
screenings, and resources to prevent complications. It has provided 
primary prevention activities such as physical fitness programs, 
medical nutrition therapy, wellness activities, and programs that 
target children and youth. The experiences of these programs have 
provided many important lessons learned that will benefit other 
minority communities and all people affected by diabetes.
  Despite all the positive results we have seen from these efforts, 
there is still much more work to be done. I have traveled extensively 
on the Navajo reservation and other parts of Indian country and seen 
those who still need help. I have visited the dialysis centers and met 
with those who are suffering from the effects of this disease. Due to 
the prevalence of this problem, it will take years for us to achieve 
our ultimate goal of reducing and eliminating diabetes and its 
complications. But, unless Congress reauthorizes and expands this 
program, the funding for these efforts and activities will end next 
year. We can't let that happen. The Special Diabetes Program for 
Indians has made an enormous and substantial impact on the problem of 
diabetes in Indian communities. The loss of funding now would be 
devastating. We must continue to focus specific resources to address 
the epidemic of diabetes in the Native American communities. That is 
why the bill we are introducing today will reauthorize the Special 
Diabetes Program for Indians for an additional 5 years and increase the 
funding from $150 million to $200 million each year. This will provide 
a billion dollars over the next 5 years for this program, $250 million 
more than we are currently authorized to spend. Reauthorization of this 
vital program will help save lives. It is the right thing to do and it 
is a smart investment of our health care dollars.
  In addition to the reauthorization of the Special Diabetes Program 
for Indians, this bill will also reauthorize another important tool in 
our battle against diabetes, the Special Funding Program for Type I 
Diabetes Research. Like the Indian program, this program is set to 
expire next year, and this bill will provide an authorization for an 
additional 5 years and increase the funding from $150 million to $200 
million each year.
  The Type I Diabetes research program which was also created in 1997 
Balanced Budget Act has allowed the Federal Government to make dramatic 
advances in research and treatment since its inception. This funding 
has helped support research into the identification of genes that 
increase susceptibility to diabetes. It has helped with the development 
of therapies that have helped slow the progression and in some cases 
even reverse the progression of this disease. And it has helped develop 
tools and methods that help people manage the disease long term.
  Again though, there is still much more work to be done. Continued 
investment in this program will help to maintain support for research 
that is truly helping those who are living with diabetes and help 
prevent the onset of diabetes in others. The Federal investment in 
research has produced tangible

[[Page S6864]]

results that I believe justify its continued support. Diabetes is 
taking too heavy a toll on too many Americans and their families. 
Continued funding is vital to the continuation of our fight against 
diabetes.
  The prevention and treatment of diabetes has improved greatly over 
the past decade and I believe it is in large part due to the funding 
and research accomplished through these two programs. Complications of 
diabetes can be prevented and the costs of this disease to our society 
can be contained. Research, early detection and treatment, however, are 
the keys. I hope that Congress will join together to reauthorize these 
programs and also provide to them the increase in funding that they 
need to keep making advances.
  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. 1494

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. REAUTHORIZATION OF SPECIAL DIABETES PROGRAMS FOR 
                   TYPE I DIABETES AND INDIANS.

       (a) Special Diabetes Programs for Type I Diabetes.--Section 
     330B(b)(2) of the Public Health Service Act (42 U.S.C. 254c-
     2(b)(2)) is amended--
       (1) in subparagraph (B), by striking ``and'' at the end;
       (2) in subparagraph (C), by striking the period at the end 
     and inserting ``; and''; and
       (3) by adding at the end the following:
       ``(D) $200,000,000 for each of fiscal years 2009 through 
     2013.''.
       (b) Special Diabetes Programs for Indians.--Section 
     330C(c)(2) of the Public Health Service Act (42 U.S.C. 254c-
     3(c)(2)) is amended--
       (1) in subparagraph (B), by striking ``and'' at the end;
       (2) in subparagraph (C), by striking the period at the end 
     and inserting ``; and''; and
       (3) by adding at the end the following:
       ``(D) $200,000,000 for each of fiscal years 2009 through 
     2013.''.
  Mr. DORGAN. Mr. President, I am pleased today to join my colleague 
from New Mexico in introducing legislation to reauthorize two very 
important efforts to address diabetes prevention and treatment and 
research: the Special Diabetes Program for Indians, which is 
administered by the Indian Health Service's Division of Diabetes 
Treatment and Prevention, and the Special Diabetes Programs for 
Children with Type I Diabetes Research, which is administered by the 
National Institutes of Health.
  The Indian Affairs Committee held an oversight hearing on diabetes in 
Indian country this past February. Diabetes is an illness that afflicts 
Native Americans more than any other ethnic/racial group in the United 
States, and some tribes have the onerous distinction of having the 
highest diabetes rate in the world. Indian people are 318 percent more 
likely to die from diabetes than the general population.
  The Special Diabetes Program for Indians is recognized as the most 
comprehensive rural system of care for diabetes in the United States. 
Grants under this program have been awarded by the Indian Health 
Service to nearly 400 IHS, tribal and urban Indian programs within the 
12 IHS Areas in 35 States. The program serves approximately 116,000 
Native American people with various prevention and treatment services.
  While each of the Special Diabetes Program grants reflects the unique 
tribal community that conducts the program, here are some examples of 
the kinds of activities the program provides: teaching Indians living 
with diabetes how to examine and take care of their feet; helping young 
mothers learn how to eat healthy using commodity foods issued under the 
USDA's Food Distribution Program on Indian reservations, and how to 
learn the value of breastfeeding their babies to reduce the incidence 
of diabetes as the children grow older; enabling diabetics to have 
access to regular eye screening exams; helping Native Americans know 
the connection between eating healthy and preventing diabetes by 
adapting materials of the National Institutes of Health-funded clinical 
trial, called the Diabetes Prevention Program, to be culturally-
appropriate; promoting physical activity in the reservation 
environment, such as building walking trails and displaying signs that 
say, ``Walk, don't take the elevator;'' and enabling Indian Health 
Service, tribal and urban Indian health programs to offer new 
medications for diabetes, such as glitazone, which helps increase 
insulin sensitivity.
  Reauthorization of the Special Diabetes Program for Indians is both a 
legislative and a medical priority for Indian country. I urge my 
colleagues to support the measure that we are introducing today.
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