[Congressional Record Volume 154, Number 155 (Saturday, September 27, 2008)]
[House]
[Pages H10165-H10169]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          ARTHRITIS PREVENTION, CONTROL, AND CURE ACT OF 2008

  Mr. PALLONE. Mr. Speaker, I ask unanimous consent that the Committee 
on Energy and Commerce be discharged from further consideration of the 
bill (H.R. 1283) to amend the Public Health Service Act to provide for 
arthritis research and public health, and for other purposes, and ask 
for its immediate consideration in the House.
  The Clerk read the title of the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  The text of the bill is as follows:

                               H.R. 1283

       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 ``Arthritis Prevention, 
     Control, and Cure Act of 2007''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) Arthritis and other rheumatic diseases are among the 
     most common chronic conditions in the United States. There 
     are more than 100 different forms of arthritis, which affect 
     joints, the tissues which surround the joint, and other 
     connective tissue. Two of the most common forms are 
     osteoarthritis, which affects approximately 21,000,000 
     Americans, and rheumatoid arthritis.
       (2) Arthritis and other rheumatic diseases cause severe and 
     chronic pain, swollen tissue, ligament and joint destruction, 
     deformities, permanent disability, and death. Arthritis and 
     other rheumatic diseases erode patients' quality of life and 
     can diminish their mental health, impose significant 
     limitations on their daily activities, and disrupt the lives 
     of their family members and caregivers.
       (3) One out of every 5 or 46 million adults in the United 
     States suffers from arthritis. The number of individuals in 
     the United States with arthritis will grow as the number of 
     older Americans continues to increase dramatically in the 
     next few decades.
       (4) By 2030, nearly 67,000,000 or 25 percent of the 
     projected United States adult population will have arthritis, 
     and arthritis will limit the daily activities of nearly 
     25,000,000 individuals. These estimates may be conservative 
     as they do not account for the current trends in obesity, 
     which may contribute to future cases of osteoarthritis.
       (5) According to the Centers for Disease Control and 
     Prevention, the total costs attributable to arthritis and 
     other rheumatic conditions in the United States in 2003 was 
     approximately $128,000,000,000. This equaled 1.2 percent of 
     the 2003 United States gross domestic product. 
     $80,800,000,000 of such costs consisted of direct costs for 
     medical care, and $47,000,000,000 consisted of indirect costs 
     for lost earnings. National medical costs attributable to 
     arthritis grew by 24 percent between 1997 and 2003. This rise 
     in medical costs resulted from an increase in the number of 
     people with arthritis and other rheumatic conditions.
       (6) Arthritis and other rheumatic diseases affect all types 
     of people of the United States, not just older individuals. 
     Arthritis and other rheumatic diseases disproportionately 
     affect women in the United States. 8,700,000 young adults 
     ages 18 through 44 have arthritis, and millions of others are 
     at risk for developing the disease.
       (7) Nearly 300,000 children in the United States, or 3 
     children out of every 1,000, have some form of arthritis or 
     other rheumatic disease. It is the sense of the Congress that 
     the substantial morbidity associated with pediatric arthritis 
     warrants a greater Federal investment in research to identify 
     new and more effective treatments for these diseases.
       (8) Arthritis and other rheumatic diseases are the leading 
     cause of disability among adults in the United States. Over 
     40 percent, or nearly 19,000,000, adults with arthritis are 
     limited in their activities because of their arthritis. In 
     addition to activity limitations, 31 percent or 8,200,000 of 
     working age adults with arthritis report being limited in 
     work activities due to arthritis.
       (9) Obese adults are up to 4 times more likely to develop 
     knee osteoarthritis than normal weight adults. Excess body 
     weight is also associated with worse progression of 
     arthritis, contributing to functional limitation, mobility 
     problems, and disability. About 35 percent of adults with 
     arthritis are obese compared to only 21 percent of those 
     without arthritis.
       (10) Arthritis results in 744,000 hospitalizations and 
     36,500,000 outpatient care visits every year.
       (11) In 1975, the National Arthritis Act of 1974 (Public 
     Law 93-640) was enacted to promote basic and clinical 
     arthritis research, establish multipurpose arthritis centers, 
     and expand clinical knowledge in the field of arthritis. The 
     Act was successfully implemented, and continued funding of 
     arthritis-related research has led to important advances in 
     arthritis control, treatment, and prevention.
       (12) Early diagnosis, treatment, and appropriate management 
     of arthritis can control symptoms and improve quality of 
     life. Weight control and exercise can demonstrably lower 
     health risks from arthritis, as can other forms of patient 
     education, training, and self-management. The genetics of 
     arthritis are being actively investigated. New, innovative, 
     and increasingly effective drug therapies, joint 
     replacements, and other therapeutic options are being 
     developed.
       (13) While research has identified many effective 
     interventions against arthritis, such interventions are 
     broadly underutilized. That underutilization leads to 
     unnecessary loss of life, health, and quality of life, as 
     well as avoidable or unnecessarily high health care costs. 
     Increasing physical activity, losing excess weight, and 
     participating in self-management education classes have been 
     shown to reduce pain, improve functional limitations and 
     mental health, and reduce disability among persons with 
     arthritis. Some self-management programs have been proven to 
     reduce arthritis pain by 20 percent and physician visits by 
     40 percent. Despite this fact, less than 1 percent of the 
     people in the United States with arthritis participate in 
     such programs, and self-management courses are not offered in 
     all areas of the United States.
       (14) Rheumatologists are internists or pediatric sub-
     specialists who are uniquely qualified by an additional 2 to 
     4 years of training and experience in the diagnosis and 
     treatment of rheumatic conditions. Typically, rheumatologists 
     act as consultants, but also often act as managers, relying 
     on the help of many skilled professionals, including nurses, 
     physical and occupational therapists, psychologists, and 
     social workers. Many rheumatologists conduct research to 
     determine the cause and effective treatment of disabling and 
     sometimes fatal rheumatic diseases.
       (15) Recognizing that the Nation requires a public health 
     approach to arthritis, the Department of Health and Human 
     Services established important national goals related to 
     arthritis in its Healthy People 2010 initiative. Moreover, 
     various Federal and non-Federal stakeholders have worked 
     cooperatively to develop a comprehensive National Arthritis 
     Action Plan: A Public Health Strategy.
       (16) Greater efforts and commitments are needed from 
     Congress, the States, providers, and patients to achieve the 
     goals of Healthy People 2010, implement a national public 
     health strategy consistent with the National Arthritis Action 
     Plan, and lessen the burden of arthritis on citizens of the 
     United States.

[[Page H10166]]

     SEC. 3. ENHANCING THE PUBLIC HEALTH ACTIVITIES RELATED TO 
                   ARTHRITIS OF THE CENTERS FOR DISEASE CONTROL 
                   AND PREVENTION THROUGH THE NATIONAL ARTHRITIS 
                   ACTION PLAN.

       Part 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:

     ``SEC. 315. IMPLEMENTATION OF THE NATIONAL ARTHRITIS ACTION 
                   PLAN.

       ``The Secretary shall develop and implement a National 
     Arthritis Action Plan that consists of--
       ``(1) the Federal arthritis prevention and control 
     activities, as described in section 315A;
       ``(2) the State arthritis control and prevention programs, 
     as described in section 315B;
       ``(3) the comprehensive arthritis action grant program, as 
     described in section 315C; and
       ``(4) a national arthritis education and outreach program, 
     as described in section 315D.

     ``SEC. 315A. FEDERAL ARTHRITIS PREVENTION AND CONTROL 
                   ACTIVITIES.

       ``(a) In General.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     shall, directly, or through a grant to an eligible entity, 
     conduct, support, and promote the coordination of research, 
     investigations, demonstrations, training, and studies 
     relating to the control, prevention, and surveillance of 
     arthritis and other rheumatic diseases.
       ``(b) Duties of Secretary.--The activities of the Secretary 
     under subsection (a) shall include--
       ``(1) the collection, publication, and analysis of data on 
     the prevalence and incidence of arthritis and other rheumatic 
     diseases;
       ``(2) the development of uniform data sets for public 
     health surveillance and clinical quality improvement 
     activities;
       ``(3) the identification of evidence-based and cost-
     effective best practices for the prevention, diagnosis, 
     management, and care of arthritis and other rheumatic 
     diseases;
       ``(4) research, including research on behavioral 
     interventions to prevent arthritis and on other evidence-
     based best practices relating to arthritis prevention, 
     diagnosis, management, and care; and
       ``(5) demonstration projects, including community-based and 
     patient self-management programs of arthritis control, 
     prevention, and care, and similar collaborations with 
     academic institutions, hospitals, health insurers, 
     researchers, health professionals, and nonprofit 
     organizations.
       ``(c) Training and Technical Assistance.--With respect to 
     the planning, development, and operation of any activity 
     carried out under subsection (a), 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 section.
       ``(d) Arthritis Prevention Research at the Centers for 
     Disease Control and Prevention Centers.--The Secretary shall 
     provide additional grant support for research projects at the 
     Centers for Prevention Research by the Centers for Disease 
     Control and Prevention to encourage the expansion of research 
     portfolios at the Centers for Prevention Research to include 
     arthritis-specific research activities related to the 
     prevention and management of arthritis.
       ``(e) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section such 
     sums as may be necessary for each of fiscal years 2008 
     through 2012.

     ``SEC. 315B. STATE ARTHRITIS CONTROL AND PREVENTION PROGRAMS.

       ``(a) In General.--The Secretary shall award grants to 
     eligible entities to provide support for comprehensive 
     arthritis control and prevention programs and to enable such 
     entities to provide public health surveillance, prevention, 
     and control activities related to arthritis and other 
     rheumatic diseases.
       ``(b) Eligibility.--To be eligible to receive a grant under 
     this section, an entity shall be a State or Indian tribe.
       ``(c) Application.--To be eligible to receive a grant under 
     this section, 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 arthritis control and 
     prevention plan that--
       ``(1) is developed with the advice of stakeholders from the 
     public, private, and nonprofit sectors that have expertise 
     relating to arthritis control, prevention, and treatment that 
     increase the quality of life and decrease the level of 
     disability;
       ``(2) is intended to reduce the morbidity of arthritis, 
     with priority on preventing and controlling arthritis in at-
     risk populations and reducing disparities in arthritis 
     prevention, diagnosis, management, and quality of care in 
     underserved populations;
       ``(3) describes the arthritis-related services and 
     activities to be undertaken or supported by the entity; and
       ``(4) is developed in a manner that is consistent with the 
     National Arthritis Action Plan or a subsequent strategic plan 
     designated by the Secretary.
       ``(d) Use of Funds.--An eligible entity shall use amounts 
     received under a grant awarded under subsection (a) to 
     conduct, in a manner consistent with the comprehensive 
     arthritis control and prevention plan submitted by the entity 
     in the application under subsection (c)--
       ``(1) public health surveillance and epidemiological 
     activities relating to the prevalence of arthritis and 
     assessment of disparities in arthritis prevention, diagnosis, 
     management, and care;
       ``(2) public information and education programs; and
       ``(3) education, training, and clinical skills improvement 
     activities for health professionals, including allied health 
     personnel.
       ``(e) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section such 
     sums as may be necessary for each of fiscal years 2008 
     through 2012.

     ``SEC. 315C. COMPREHENSIVE ARTHRITIS ACTION GRANTS.

       ``(a) In General.--The Secretary shall award grants on a 
     competitive basis to eligible entities to enable such 
     eligible entities to assist in the implementation of a 
     national strategy for arthritis control and prevention.
       ``(b) Eligibility.--To be eligible to receive a grant under 
     this section, an entity shall be a national public or private 
     nonprofit entity.
       ``(c) Application.--To be eligible to receive a grant under 
     this section, 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--
       ``(1) supplement or fulfill unmet needs identified in the 
     comprehensive arthritis control and prevention plan of a 
     State or Indian tribe; and
       ``(2) otherwise help achieve the goals of the National 
     Arthritis Action Plan or a subsequent strategic plan 
     designated by the Secretary.
       ``(d) Priority.--In awarding grants under this section, the 
     Secretary shall give priority to eligible entities submitting 
     applications proposing to carry out programs for controlling 
     and preventing arthritis in at-risk populations or reducing 
     disparities in underserved populations.
       ``(e) Use of Funds.--An eligible entity shall use amounts 
     received under a grant awarded under subsection (a) for 1 or 
     more of the following purposes:
       ``(1) To expand the availability of physical activity 
     programs designed specifically for people with arthritis.
       ``(2) To provide awareness education to patients, family 
     members, and health care providers, to help such individuals 
     recognize the signs and symptoms of arthritis, and to address 
     the control and prevention of arthritis.
       ``(3) To decrease long-term consequences of arthritis by 
     making information available to individuals with regard to 
     the self-management of arthritis.
       ``(4) To provide information on nutrition education 
     programs with regard to preventing or mitigating the impact 
     of arthritis.
       ``(f) Evaluation.--An eligible entity that receives a grant 
     under this section shall submit to the Secretary an 
     evaluation of the operations and activities carried out under 
     such grant that includes an analysis of increased utilization 
     and benefit of public health programs relevant to the 
     activities described in the appropriate provisions of 
     subsection (e).
       ``(g) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section such 
     sums as may be necessary for each of fiscal years 2008 
     through 2012.

     ``SEC. 315D. NATIONAL ARTHRITIS EDUCATION AND OUTREACH.

       ``(a) In General.--The Secretary shall coordinate a 
     national education and outreach program to support, develop, 
     and implement education initiatives and outreach strategies 
     appropriate for arthritis and other rheumatic diseases.
       ``(b) Initiatives and Strategies.--Initiatives and 
     strategies implemented under the program described in 
     subsection (a) 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.
       ``(c) Priority.--In carrying out subsection (a), the 
     Secretary--
       ``(1) may emphasize prevention, early diagnosis, and 
     appropriate management of arthritis, and opportunities for 
     effective patient self-management; and
       ``(2) shall give priority to reaching high-risk or 
     underserved populations.
       ``(d) Collaboration.--In carrying out this section, the 
     Secretary shall consult and collaborate with stake-holders 
     from the public, private, and nonprofit sectors with 
     expertise relating to arthritis control, prevention, and 
     treatment.
       ``(e) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section such 
     sums as may be necessary for each of fiscal years 2008 
     through 2012.''.

     SEC. 4. EXPANSION AND COORDINATION OF ACTIVITIES OF THE 
                   NATIONAL INSTITUTES OF HEALTH WITH RESPECT TO 
                   RESEARCH ON ARTHRITIS.

       Title IV of the Public Health Service Act (42 U.S.C. 281 et 
     seq.) is amended by inserting after section 439 the 
     following:

     ``SEC. 439A. ARTHRITIS AND RHEUMATIC DISEASES INTERAGENCY 
                   COORDINATING COMMITTEE.

       ``(a) In General.--

[[Page H10167]]

       ``(1) Establishment.--The Secretary shall establish an 
     Arthritis and Rheumatic Diseases Interagency Coordinating 
     Committee (referred to in this section as the `Coordinating 
     Committee').
       ``(2) Duties.--The coordinating committee established under 
     paragraph (1) shall--
       ``(A) provide for the improved coordination of the research 
     activities of all the national research institutes relating 
     to arthritis and rheumatic diseases; and
       ``(B) provide for full and regular communication and 
     exchange of information necessary to maintain adequate 
     coordination across all Federal health programs and 
     activities related to arthritis and rheumatic diseases.
       ``(b) Arthritis and Rheumatic Diseases Interagency 
     Coordinating Committee.--
       ``(1) Composition.--The Coordinating Committee shall 
     consist of members, appointed by the Secretary, of which--
       ``(A) \2/3\ of such members shall represent governmental 
     agencies, including--
       ``(i) the directors of each of the national research 
     institutes and divisions involved in research regarding 
     arthritis and rheumatic diseases (or the directors' 
     respective designees); and
       ``(ii) representatives of other Federal departments and 
     agencies (as determined appropriate by the Secretary) whose 
     programs involve health functions or responsibilities 
     relevant to arthritis and rheumatic diseases, including the 
     Centers for Disease Control and Prevention, the Health 
     Resources and Services Administration, and the Food and Drug 
     Administration; and
       ``(B) \1/3\ of such members shall be public members, 
     including a broad cross section of persons affected by 
     arthritis, researchers, clinicians, and representatives of 
     voluntary health agencies, who--
       ``(i) shall serve for a term of 3 years; and
       ``(ii) may serve for an unlimited number of terms if 
     reappointed.
       ``(2) Chairperson.--
       ``(A) Appointment.--The Chairperson of the Coordinating 
     Committee (referred to in this subsection as the 
     `Chairperson') shall be appointed by and be directly 
     responsible to the Secretary.
       ``(B) Duties.--The Chairperson shall--
       ``(i) serve as the principal advisor to the Secretary, the 
     Assistant Secretary for Health, and the Director of NIH on 
     matters relating to arthritis and rheumatic diseases; and
       ``(ii) provide advice to the Director of the Centers for 
     Disease Control and Prevention, the Commissioner of Food and 
     Drugs, and the heads of other relevant Federal agencies, on 
     matters relating to arthritis and rheumatic diseases.
       ``(3) Administrative support; meetings.--
       ``(A) Administrative support.--The Secretary shall provide 
     necessary and appropriate administrative support to the 
     Coordinating Committee.
       ``(B) Meetings.--The Coordinating Committee shall meet on a 
     regular basis as determined by the Secretary, in consultation 
     with the Chairperson.
       ``(c) Arthritis and Rheumatic Diseases Summit.--
       ``(1) In general.--Not later than 1 year after the date of 
     enactment of the Arthritis Prevention, Control, and Cure Act 
     of 2007, the Coordinating Committee shall convene a summit of 
     researchers, public health professionals, representatives of 
     voluntary health agencies, representatives of academic 
     institutions, and Federal and State policymakers, to provide 
     a detailed overview of current research activities at the 
     National Institutes of Health, as well as to discuss and 
     solicit input related to potential areas of collaboration 
     between the National Institutes of Health and other Federal 
     health agencies, including the Centers for Disease Control 
     and Prevention, the Agency for Healthcare Research and 
     Quality, and the Health Resources and Services 
     Administration, related to research, prevention, and 
     treatment of arthritis and rheumatic diseases.
       ``(2) Summit details.--The summit developed under paragraph 
     (1) shall focus on--
       ``(A) a broad range of research activities relating to 
     biomedical, epidemiological, psychosocial, and rehabilitative 
     issues, including studies of the impact of the diseases 
     described in paragraph (1) in rural and underserved 
     communities;
       ``(B) clinical research for the development and evaluation 
     of new treatments, including new biological agents;
       ``(C) translational research on evidence-based and cost-
     effective best practices in the treatment, prevention, and 
     management of the disease;
       ``(D) information and education programs for health care 
     professionals and the public;
       ``(E) priorities among the programs and activities of the 
     various Federal agencies regarding such diseases; and
       ``(F) challenges and opportunities for scientists, 
     clinicians, patients, and voluntary organizations.
       ``(d) Report to Congress.--Not later than 180 days after 
     the convening of the Arthritis and Rheumatic Diseases Summit 
     under subsection (c)(1), the Director of NIH shall prepare 
     and submit a report to Congress that includes proceedings 
     from the summit and a description of arthritis research, 
     education, and other activities that are conducted or 
     supported through the national research institutes.
       ``(e) Public Information.--The Coordinating Committee shall 
     make readily available to the public information about the 
     research, education, and other activities relating to 
     arthritis and other rheumatic diseases, conducted or 
     supported by the National Institutes of Health.
       ``(f) Authorization of Appropriations.--There are 
     authorized to be appropriated such sums as may be necessary 
     for each of fiscal years 2008 through 2012 to carry out this 
     section.''.

     SEC. 5. EXPANSION, INTENSIFICATION, AND INNOVATION OF 
                   RESEARCH AND PUBLIC HEALTH ACTIVITIES RELATED 
                   TO JUVENILE ARTHRITIS.

       (a) Juvenile Arthritis Initiative Through the Director of 
     the National Institutes of Health.--Part 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:

     ``SEC. 404I. JUVENILE ARTHRITIS INITIATIVE THROUGH THE 
                   DIRECTOR OF THE NATIONAL INSTITUTES OF HEALTH.

       ``(a) Expansion and Intensification of Activities.--
       ``(1) In general.--The Director of NIH, in coordination 
     with the Director of the National Institute of Arthritis and 
     Musculoskeletal and Skin Diseases, and the directors of the 
     other national research institutes, as appropriate, shall 
     expand and intensify programs of the National Institutes of 
     Health with respect to research and related activities 
     concerning various forms of juvenile arthritis.
       ``(2) Coordination.--The directors referred to in paragraph 
     (1) shall jointly coordinate the programs referred to in such 
     paragraph and consult with additional Federal officials, 
     voluntary health associations, medical professional 
     societies, and private entities as appropriate.
       ``(b) Planning Grants and Contracts for Innovative Research 
     in Juvenile Arthritis.--
       ``(1) In general.--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 juvenile arthritis.
       ``(2) Research.--
       ``(A) Types of research.--In carrying out this subsection, 
     the Secretary shall encourage research that focuses on 
     genetics, on the development of biomarkers, and on 
     pharmacological and other therapies.
       ``(B) Priority.--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) Authorization of Appropriations.--There are 
     authorized to be appropriated such sums as may be necessary 
     for each of fiscal years 2008 through 2012 to carry out this 
     section. Such authorization shall be in addition to any 
     authorization of appropriations under any other provision of 
     law to carry out juvenile arthritis activities or other 
     arthritis-related research.''.
       (b) Public Health and Surveillance Activities Related to 
     Juvenile Arthritis at the Centers for Disease Control and 
     Prevention.--Part 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:

     ``SEC. 320B. SURVEILLANCE AND RESEARCH REGARDING JUVENILE 
                   ARTHRITIS.

       ``(a) In General.--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 juvenile arthritis.
       ``(b) Technical Assistance.--In awarding grants and 
     entering into agreements under subsection (a), the Secretary 
     may provide direct technical assistance in lieu of cash.
       ``(c) Coordination With NIH.--The Secretary shall ensure 
     that epidemiological and other types of information obtained 
     under subsection (a) is made available to the National 
     Institutes of Health.
       ``(d) Creation of a National Juvenile Arthritis Patient 
     Registry.--The Secretary, acting through the Director of the 
     Centers for Disease Control and Prevention and in 
     collaboration with a national voluntary health organization 
     with experience serving the juvenile arthritis population as 
     well as the full spectrum of arthritis-related conditions, 
     shall support the development of a National Juvenile 
     Arthritis Patient Registry to collect specific data for 
     follow-up studies regarding the prevalence and incidence of 
     juvenile arthritis, as well as capturing information on 
     evidence-based health outcomes related to specific therapies 
     and interventions.
       ``(e) Authorization of Appropriations.--There are 
     authorized to be appropriated such sums as may be necessary 
     to carry out this section.''.

     SEC. 6. INVESTMENT IN TOMORROW'S PEDIATRIC RHEUMATOLOGISTS.

       (a) In General.--Part Q of title III of the Public Health 
     Service Act (42 U.S.C. 280h et seq.) is amended by adding at 
     the end the following:

     ``SEC. 399Z-1. INVESTMENT IN TOMORROW'S PEDIATRIC 
                   RHEUMATOLOGISTS.

       ``(a) Enhanced Support.--In order to ensure an adequate 
     future supply of pediatric rheumatologists, the Secretary, in 
     consultation with the Administrator of the Health Resources 
     and Services Administration, shall support activities that 
     provide for--
       ``(1) an increase in the number and size of institutional 
     training grants awarded to institutions to support pediatric 
     rheumatology training; and

[[Page H10168]]

       ``(2) an expansion of public-private partnerships to 
     encourage academic institutions, private sector entities, and 
     health agencies to promote educational training and 
     fellowship opportunities for pediatric rheumatologists.
       ``(b) Authorization.--There are authorized to be 
     appropriated such sums as may be necessary for each of fiscal 
     years 2008 through 2012 to carry out this section.''.
       (b) Pediatric Loan Repayment Program.--Part Q of title III 
     of the Public Health Service Act (42 U.S.C. 280h et seq.), as 
     amended by subsection (a), is further amended by adding at 
     the end the following:

     ``SEC. 399Z-2. PEDIATRIC RHEUMATOLOGY LOAN REPAYMENT PROGRAM.

       ``(a) In General.--The Secretary, in consultation with the 
     Administrator of the Health Resources and Services 
     Administration, may establish a pediatric rheumatology loan 
     repayment program.
       ``(b) Program Administration.--Through the program 
     established under subsection (a), the Secretary shall--
       ``(1) enter into contracts with qualified health 
     professionals who are pediatric rheumatologists under which--
       ``(A) such professionals agree to provide health care in an 
     area with a shortage of pediatric rheumatologists; and
       ``(B) the Federal Government agrees to repay, for each year 
     of such service, not more than $25,000 of the principal and 
     interest of the educational loans of such professionals; and
       ``(2) in addition to making payments under paragraph (1) on 
     behalf of an individual, make payments to the individual for 
     the purpose of providing reimbursement for tax liability 
     resulting from the payments made under paragraph (1), in an 
     amount equal to 39 percent of the total amount of the 
     payments made for the taxable year involved.
       ``(c) Funding.--
       ``(1) In general.--For the purpose of carrying out this 
     section, the Secretary may reserve, from amounts appropriated 
     for the Health Resources and Services Administration for the 
     fiscal year involved, such amounts as the Secretary 
     determines to be appropriate.
       ``(2) Availability of funds.--Amounts made available to 
     carry out this section shall remain available until the 
     expiration of the second fiscal year beginning after the 
     fiscal year for which such amounts were made available.''.

     SEC. 7. CAREER DEVELOPMENT AWARDS IN PEDIATRIC RHEUMATOLOGY.

       Part G of title IV of the Public Health Service Act (42 
     U.S.C. 288 et seq.) is amended--
       (1) by redesignating the second section 487F (relating to a 
     pediatric research loan repayment program) as section 487G;
       (2) by inserting after section 487G (as so redesignated) 
     the following:

     ``SEC. 487H. CAREER DEVELOPMENT AWARDS IN PEDIATRIC 
                   RHEUMATOLOGY.

       ``(a) In General.--The Secretary, in consultation with the 
     Director of NIH, may establish a program to increase the 
     number of career development awards for health professionals 
     who intend to build careers in clinical and translational 
     research relating to pediatric rheumatology.
       ``(b) Authorization of Appropriations.--There are 
     authorized to be appropriated such sums as may be necessary 
     to carry out this section.''.

     SEC. 8. GENERAL ACCOUNTING OFFICE STUDY OF ARTHRITIS AND THE 
                   WORKPLACE.

       (a) Study and Report.--Not later than 3 years after the 
     date of enactment of this Act, the Comptroller General of the 
     United States shall conduct a study on the economic impact of 
     arthritis in the workplace, and submit a report to the 
     appropriate committees of Congress containing the results of 
     the study.
       (b) Authorization of Appropriations.--There are authorized 
     to be appropriated such sums as may be necessary to carry out 
     this section.

                    Amendment Offered by Mr. Pallone

  Mr. PALLONE. Mr. Speaker, I have an amendment in the nature of a 
substitute at the desk.
  The Clerk read as follows:

       Amendment offered by Mr. Pallone:
       Strike all after the enacting clause and insert the 
     following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Arthritis Prevention, 
     Control, and Cure Act of 2008''.

     SEC. 2. ENHANCING THE PUBLIC HEALTH ACTIVITIES RELATED TO 
                   ARTHRITIS OF THE CENTERS FOR DISEASE CONTROL 
                   AND PREVENTION THROUGH THE NATIONAL ARTHRITIS 
                   ACTION PLAN.

       Part 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:

     ``SEC. 315. IMPLEMENTATION OF THE NATIONAL ARTHRITIS ACTION 
                   PROGRAM.

       ``(a) Establishment of Program.--The Secretary may develop 
     and implement a National Arthritis Action Program (in this 
     section referred to as the `Program') consistent with this 
     section.
       ``(b) Control, Prevention, and Surveillance.--
       ``(1) In general.--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 arthritis and other rheumatic diseases.
       ``(2) Training and technical assistance.--With 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) Arthritis prevention research at the centers for 
     disease control and prevention centers.--The Secretary may 
     provide additional grant support under this subsection to 
     encourage the expansion of research related to the prevention 
     and management of arthritis at the Centers for Disease 
     Control and Prevention.
       ``(4) Eligible entity.--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) Education and Outreach.--
       ``(1) In general.--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 
     arthritis and other rheumatic diseases.
       ``(2) Initiatives and strategies.--Initiatives 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) Priority.--In carrying out paragraph (1), the 
     Secretary--
       ``(A) may emphasize prevention, early diagnosis, and 
     appropriate management of arthritis, and opportunities for 
     effective patient self-management; and
       ``(B) may give priority to reaching high-risk or 
     underserved populations.
       ``(4) Collaboration.--In carrying out this subsection, the 
     Secretary shall consult and collaborate with stake-holders 
     from the public, private, and nonprofit sectors with 
     expertise relating to arthritis control, prevention, and 
     treatment.
       ``(5) Eligible entity.--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) In general.--Under the Program, the Secretary may 
     award grants to eligible entities to provide support for 
     comprehensive arthritis control and prevention programs and 
     to enable such entities to provide public health 
     surveillance, prevention, and control activities related to 
     arthritis and other rheumatic diseases.
       ``(2) Eligibility.--To be eligible to receive a grant under 
     this subsection, an entity shall be a State or Indian tribe.
       ``(3) Application.--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 arthritis 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 arthritis control, prevention, and treatment that 
     increase the quality of life and decrease the level of 
     disability;
       ``(B) is intended to reduce the morbidity of arthritis, 
     with priority on preventing and controlling arthritis in at-
     risk populations and reducing disparities in arthritis 
     prevention, diagnosis, management, and quality of care in 
     underserved populations;
       ``(C) describes the arthritis-related 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) Use of funds.--An eligible entity may use amounts 
     received under a grant awarded under this subsection to 
     conduct, in a manner consistent with the comprehensive 
     arthritis 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 arthritis and 
     assessment of disparities in arthritis 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) General Application.--To be eligible to receive a 
     grant under this section, except under subsection (d), an 
     entity shall submit

[[Page H10169]]

     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 arthritis control and prevention plan of the 
     entity.
       ``(f) Definitions.--For purposes of this section:
       ``(1) Indian tribe.--The term `Indian tribe' has the 
     meaning given such term in section 4(e) of the Indian Self-
     Determination and Education Assistance Act (25 U.S.C. 
     450b(e)).
       ``(2) State.--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) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section--
       ``(1) for fiscal year 2009, $32,000,000;
       ``(2) for fiscal year 2010, $34,000,000;
       ``(3) for fiscal year 2011, $36,000,000;
       ``(4) for fiscal year 2012, $38,000,000; and
       ``(5) for fiscal year 2013, $40,000,000.''.

     SEC. 3. ACTIVITIES OF THE DEPARTMENT OF HEALTH AND HUMAN 
                   SERVICES WITH RESPECT TO JUVENILE ARTHRITIS AND 
                   RELATED CONDITIONS.

       (a) In General.--The Secretary of Health and Human 
     Services, in coordination with the Director of the National 
     Institutes of Health, may expand and intensify programs of 
     the National Institutes of Health with respect to research 
     and related activities concerning various forms of juvenile 
     arthritis and related conditions.
       (b) Coordination.--The Director of the National Institutes 
     of Health may coordinate the programs referred to in 
     subsection (a) and consult with additional Federal officials, 
     voluntary health associations, medical professional 
     societies, and private entities as appropriate.

     SEC. 4. PUBLIC HEALTH AND SURVEILLANCE ACTIVITIES RELATED TO 
                   JUVENILE ARTHRITIS AT THE CENTERS FOR DISEASE 
                   CONTROL AND PREVENTION.

       Part 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:

     ``SEC. 320B. SURVEILLANCE AND RESEARCH REGARDING JUVENILE 
                   ARTHRITIS.

       ``(a) In General.--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 juvenile arthritis.
       ``(b) Technical Assistance.--In awarding grants and 
     entering into agreements under subsection (a), the Secretary 
     may provide direct technical assistance in lieu of cash.
       ``(c) Coordination With NIH.--The Secretary shall ensure 
     that epidemiological and other types of information obtained 
     under subsection (a) is made available to the National 
     Institutes of Health.
       ``(d) Creation of a National Juvenile Arthritis Population-
     Based Database.--The Secretary, acting through the Director 
     of the Centers for Disease Control and Prevention and in 
     collaboration with a national voluntary health organization 
     with experience serving the juvenile arthritis population as 
     well as the full spectrum of arthritis-related conditions, 
     may support the development of a national juvenile arthritis 
     population-based database to collect specific data for 
     follow-up studies regarding the prevalence and incidence of 
     juvenile arthritis, as well as capturing information on 
     evidence-based health outcomes related to specific therapies 
     and interventions.
       ``(e) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there is authorized to be 
     appropriated $25,000,000 for each of fiscal years 2009 
     through 2013.''

     SEC. 5. INVESTMENT IN TOMORROW'S PEDIATRIC RHEUMATOLOGISTS.

       (a) Enhanced Support.--
       (1) In general.--In order to ensure an adequate future 
     supply of pediatric rheumatologists, the Secretary of Health 
     and Human Services, in consultation with the Administrator of 
     the Health Resources and Services Administration, shall 
     support activities that provide for--
       (A) an increase in the number and size of institutional 
     training grants awarded to institutions to support pediatric 
     rheumatology training; and
       (B) an expansion of public-private partnerships to 
     encourage academic institutions, private sector entities, and 
     health agencies to promote educational training and 
     fellowship opportunities for pediatric rheumatologists.
       (2) Authorization of appropriations.--There are authorized 
     to be appropriated to carry out this subsection $3,750,000 
     for each of the fiscal years 2009 through 2013.
       (b) Pediatric Loan Repayment Program.--
       (1) In general.--The Secretary of Health and Human 
     Services, in consultation with the Administrator of the 
     Health Resources and Services Administration, shall establish 
     and, subject to the determination under paragraph (3), carry 
     out a pediatric rheumatology loan repayment program.
       (2) Program administration.--Through the program 
     established under this subsection, the Secretary shall--
       (A) enter into contracts with qualified health 
     professionals who are pediatric rheumatologists under which--
       (i) such professionals agree to provide health care in an 
     area with a shortage of pediatric rheumatologists and that 
     has the capacity to support pediatric rheumatology, as 
     determined by the Secretary of Health and Human Services; and
       (ii) the Federal Government agrees to repay, for each year 
     of such service, not more than $25,000 of the principal and 
     interest of the educational loans of such professionals; and
       (B) in addition to making payments under paragraph (1) on 
     behalf of an individual, make payments to the individual for 
     the purpose of providing reimbursement for tax liability 
     resulting from the payments made under paragraph (1), in an 
     amount equal to 39 percent of the total amount of the 
     payments made for the taxable year involved.
       (3) Determination of shortage areas.--For purposes of this 
     subsection, an area shall be determined to be an area with a 
     shortage of pediatric rheumatologists based on the ratio of 
     the number of children who reside in such area who are in 
     need of services of a pediatric rheumatologist to the number 
     of pediatric rheumatologists who furnish services within 100 
     miles of the area.
       (4) Periodic assessments.--
       (A) In general.--The Secretary of Health and Human Services 
     shall periodically assess--
       (i) the extent to which the loan repayment program under 
     this section is needed; and
       (ii) the extent to which the program is effective in 
     increasing the number of pediatric rheumatologists nationally 
     and the number of pediatric rheumatologists in areas with a 
     shortage of pediatric rheumatologists.
     In the case that the Secretary determines, pursuant to an 
     assessment under this subparagraph, that there is no longer a 
     need for the loan repayment program, such program shall be 
     terminated as of a date specified by the Secretary.
       (B) Annual reports.--The Secretary of Health and Human 
     Services shall annually report to Congress on the periodic 
     assessments conducted under subparagraph (A).
       (5) Funding.--
       (A) In general.--For the purpose of carrying out this 
     subsection, the Secretary of Health and Human Services may 
     reserve, from amounts appropriated for the Health Resources 
     and Services Administration for the fiscal year involved, 
     such amounts as the Secretary determines to be appropriate.
       (B) Availability of funds.--Amounts made available to carry 
     out this section shall remain available until the expiration 
     of the second fiscal year beginning after the fiscal year for 
     which such amounts were made available.

  Mr. PALLONE (during the reading). Mr. Speaker, I ask unanimous 
consent to dispense with the reading of the amendment.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  The amendment was agreed to.
  Ms. ESHOO. Mr. Speaker, I rise today in strong support of my 
legislation, H.R. 1283, the Arthritis Prevention, Control, and Cure 
Act. I have fought long and hard for this bill, along with the 
Arthritis Foundation, the American College of Rheumatology, and the 
thousands of advocates across the country that understand the need for 
this legislation.
  With 1 out of 5 adults suffering from arthritis, this debilitating 
condition is the most common cause of disability in the United States. 
More than 300,000 children suffer from juvenile arthritis--more than 
the number of children with juvenile diabetes yet we have a severe 
shortage of pediatric rheumatologists in our country with only 239 
nationwide and 11 states without even one. Early diagnosis for this 
disease is crucial and without it, thousands of children go undiagnosed 
because they don't have access to the right doctor.
  This bill addresses the shortage through loan reimbursements for 
doctors who go into pediatric rheumatology, an increase in research of 
juvenile arthritis, and State grants for comprehensive arthritis 
programs and public health outreach.
  I'm very proud to see the Arthritis Prevention, Control, and Cure Act 
on the floor today and I look forward to seeing the Senate companion, 
sponsored by my dear friend Senator Kennedy, pass the other body as 
well.
  The bill was ordered to be engrossed and read a third time, was read 
the third time, and passed, and a motion to reconsider was laid on the 
table.

                          ____________________