[Congressional Record (Bound Edition), Volume 155 (2009), Part 7]
[House]
[Pages 9074-9077]
[From the U.S. Government Publishing Office, www.gpo.gov]




                 NATIONAL PAIN CARE POLICY ACT OF 2009

  Mr. PALLONE. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 756) to amend the Public Health Service Act with respect to 
pain care, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                H.R. 756

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

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``National 
     Pain Care Policy Act of 2009''.
       (b) Table of Contents.--The table of contents of this Act 
     is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. Institute of Medicine Conference on Pain.
Sec. 3. Pain research at National Institutes of Health.
Sec. 4. Pain care education and training.
Sec. 5. Public awareness campaign on pain management.

     SEC. 2. INSTITUTE OF MEDICINE CONFERENCE ON PAIN.

       (a) Convening.--Not later than June 30, 2010, the Secretary 
     of Health and Human Services shall seek to enter into an 
     agreement with the Institute of Medicine of the National 
     Academies to convene a Conference on Pain (in this section 
     referred to as ``the Conference'').
       (b) Purposes.--The purposes of the Conference shall be to--
       (1) increase the recognition of pain as a significant 
     public health problem in the United States;
       (2) evaluate the adequacy of assessment, diagnosis, 
     treatment, and management of acute and chronic pain in the 
     general population, and in identified racial, ethnic, gender, 
     age, and other demographic groups that may be 
     disproportionately affected by inadequacies in the 
     assessment, diagnosis, treatment, and management of pain;
       (3) identify barriers to appropriate pain care, including--
       (A) lack of understanding and education among employers, 
     patients, health care providers, regulators, and third-party 
     payors;
       (B) barriers to access to care at the primary, specialty, 
     and tertiary care levels, including barriers--
       (i) specific to those populations that are 
     disproportionately undertreated for pain;
       (ii) related to physician concerns over regulatory and law 
     enforcement policies applicable to some pain therapies; and
       (iii) attributable to benefit, coverage, and payment 
     policies in both the public and private sectors; and

[[Page 9075]]

       (C) gaps in basic and clinical research on the symptoms and 
     causes of pain, and potential assessment methods and new 
     treatments to improve pain care; and
       (4) establish an agenda for action in both the public and 
     private sectors that will reduce such barriers and 
     significantly improve the state of pain care research, 
     education, and clinical care in the United States.
       (c) Other Appropriate Entity.--If the Institute of Medicine 
     declines to enter into an agreement under subsection (a), the 
     Secretary of Health and Human Services may enter into such 
     agreement with another appropriate entity.
       (d) Report.--A report summarizing the Conference's findings 
     and recommendations shall be submitted to the Congress not 
     later than June 30, 2011.
       (e) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there is authorized to be 
     appropriated $500,000 for each of fiscal years 2010 and 2011.

     SEC. 3. PAIN RESEARCH AT NATIONAL INSTITUTES OF HEALTH.

       Part B of title IV of the Public Health Service Act (42 
     U.S.C. 284 et seq.) is amended by adding at the end the 
     following:

     ``SEC. 409J. PAIN RESEARCH.

       ``(a) Research Initiatives.--
       ``(1) In general.--The Director of NIH is encouraged to 
     continue and expand, through the Pain Consortium, an 
     aggressive program of basic and clinical research on the 
     causes of and potential treatments for pain.
       ``(2) Annual recommendations.--Not less than annually, the 
     Pain Consortium, in consultation with the Division of Program 
     Coordination, Planning, and Strategic Initiatives, shall 
     develop and submit to the Director of NIH recommendations on 
     appropriate pain research initiatives that could be 
     undertaken with funds reserved under section 402A(c)(1) for 
     the Common Fund or otherwise available for such initiatives.
       ``(3) Definition.--In this subsection, the term `Pain 
     Consortium' means the Pain Consortium of the National 
     Institutes of Health or a similar trans-National Institutes 
     of Health coordinating entity designated by the Secretary for 
     purposes of this subsection.
       ``(b) Interagency Pain Research Coordinating Committee.--
       ``(1) Establishment.--The Secretary shall establish not 
     later than 1 year after the date of the enactment of this 
     section and as necessary maintain a committee, to be known as 
     the Interagency Pain Research Coordinating Committee (in this 
     section referred to as the `Committee'), to coordinate all 
     efforts within the Department of Health and Human Services 
     and other Federal agencies that relate to pain research.
       ``(2) Membership.--
       ``(A) In general.--The Committee shall be composed of the 
     following voting members:
       ``(i) Not more than 7 voting Federal representatives as 
     follows:

       ``(I) The Director of the Centers for Disease Control and 
     Prevention.
       ``(II) The Director of the National Institutes of Health 
     and the directors of such national research institutes and 
     national centers as the Secretary determines appropriate.
       ``(III) The heads of such other agencies of the Department 
     of Health and Human Services as the Secretary determines 
     appropriate.
       ``(IV) Representatives of other Federal agencies that 
     conduct or support pain care research and treatment, 
     including the Department of Defense and the Department of 
     Veterans Affairs.

       ``(ii) 12 additional voting members appointed under 
     subparagraph (B).
       ``(B) Additional members.--The Committee shall include 
     additional voting members appointed by the Secretary as 
     follows:
       ``(i) 6 members shall be appointed from among scientists, 
     physicians, and other health professionals, who--

       ``(I) are not officers or employees of the United States;
       ``(II) represent multiple disciplines, including clinical, 
     basic, and public health sciences;
       ``(III) represent different geographical regions of the 
     United States; and
       ``(IV) are from practice settings, academia, manufacturers 
     or other research settings; and

       ``(ii) 6 members shall be appointed from members of the 
     general public, who are representatives of leading research, 
     advocacy, and service organizations for individuals with 
     pain-related conditions.
       ``(C) Nonvoting members.--The Committee shall include such 
     nonvoting members as the Secretary determines to be 
     appropriate.
       ``(3) Chairperson.--The voting members of the Committee 
     shall select a chairperson from among such members. The 
     selection of a chairperson shall be subject to the approval 
     of the Director of NIH.
       ``(4) Meetings.--The Committee shall meet at the call of 
     the chairperson of the Committee or upon the request of the 
     Director of NIH, but in no case less often than once each 
     year.
       ``(5) Duties.--The Committee shall--
       ``(A) develop a summary of advances in pain care research 
     supported or conducted by the Federal agencies relevant to 
     the diagnosis, prevention, and treatment of pain and diseases 
     and disorders associated with pain;
       ``(B) identify critical gaps in basic and clinical research 
     on the symptoms and causes of pain;
       ``(C) make recommendations to ensure that the activities of 
     the National Institutes of Health and other Federal agencies, 
     including the Department of Defense and the Department of 
     Veteran Affairs, are free of unnecessary duplication of 
     effort;
       ``(D) make recommendations on how best to disseminate 
     information on pain care; and
       ``(E) make recommendations on how to expand partnerships 
     between public entities, including Federal agencies, and 
     private entities to expand collaborative, cross-cutting 
     research.
       ``(6) Review.--The Secretary shall review the necessity of 
     the Committee at least once every 2 years.''.

     SEC. 4. PAIN CARE EDUCATION AND TRAINING.

       Part D of title VII of the Public Health Service Act (42 
     U.S.C. 294 et seq.) is amended by adding at the end the 
     following new section:

     ``SEC. 759. PROGRAM FOR EDUCATION AND TRAINING IN PAIN CARE.

       ``(a) In General.--The Secretary may make awards of grants, 
     cooperative agreements, and contracts to health professions 
     schools, hospices, and other public and private entities for 
     the development and implementation of programs to provide 
     education and training to health care professionals in pain 
     care.
       ``(b) Priorities.--In making awards under subsection (a), 
     the Secretary shall give priority to awards for the 
     implementation of programs under such subsection.
       ``(c) Certain Topics.--An award may be made under 
     subsection (a) only if the applicant for the award agrees 
     that the program carried out with the award will include 
     information and education on--
       ``(1) recognized means for assessing, diagnosing, treating, 
     and managing pain and related signs and symptoms, including 
     the medically appropriate use of controlled substances;
       ``(2) applicable laws, regulations, rules, and policies on 
     controlled substances, including the degree to which 
     misconceptions and concerns regarding such laws, regulations, 
     rules, and policies, or the enforcement thereof, may create 
     barriers to patient access to appropriate and effective pain 
     care;
       ``(3) interdisciplinary approaches to the delivery of pain 
     care, including delivery through specialized centers 
     providing comprehensive pain care treatment expertise;
       ``(4) cultural, linguistic, literacy, geographic, and other 
     barriers to care in underserved populations; and
       ``(5) recent findings, developments, and improvements in 
     the provision of pain care.
       ``(d) Program Sites.--Education and training under 
     subsection (a) may be provided at or through health 
     professions schools, residency training programs, and other 
     graduate programs in the health professions; entities that 
     provide continuing education in medicine, pain management, 
     dentistry, psychology, social work, nursing, and pharmacy; 
     hospices; and such other programs or sites as the Secretary 
     determines to be appropriate.
       ``(e) Evaluation of Programs.--The Secretary shall 
     (directly or through grants or contracts) provide for the 
     evaluation of programs implemented under subsection (a) in 
     order to determine the effect of such programs on knowledge 
     and practice of pain care.
       ``(f) Peer Review Groups.--In carrying out section 799(f) 
     with respect to this section, the Secretary shall ensure that 
     the membership of each peer review group involved includes 
     individuals with expertise and experience in pain care.
       ``(g) Pain Care Defined.--For purposes of this section the 
     term `pain care' means the assessment, diagnosis, treatment, 
     or management of acute or chronic pain regardless of 
     causation or body location.
       ``(h) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, $5,000,000 for 
     each of the fiscal years 2010 through 2012. Amounts 
     appropriated under this subsection shall remain available 
     until expended.''.

     SEC. 5. PUBLIC AWARENESS CAMPAIGN ON PAIN MANAGEMENT.

       Part B of title II of the Public Health Service Act (42 
     U.S.C. 238 et seq.) is amended by adding at the end the 
     following:

     ``SEC. 249. NATIONAL EDUCATION OUTREACH AND AWARENESS 
                   CAMPAIGN ON PAIN MANAGEMENT.

       ``(a) Establishment.--Not later than June 30, 2010, the 
     Secretary shall establish and implement a national pain care 
     education outreach and awareness campaign described in 
     subsection (b).
       ``(b) Requirements.--The Secretary shall design the public 
     awareness campaign under this section to educate consumers, 
     patients, their families, and other caregivers with respect 
     to--
       ``(1) the incidence and importance of pain as a national 
     public health problem;
       ``(2) the adverse physical, psychological, emotional, 
     societal, and financial consequences that can result if pain 
     is not appropriately assessed, diagnosed, treated, or 
     managed;
       ``(3) the availability, benefits, and risks of all pain 
     treatment and management options;
       ``(4) having pain promptly assessed, appropriately 
     diagnosed, treated, and managed,

[[Page 9076]]

     and regularly reassessed with treatment adjusted as needed;
       ``(5) the role of credentialed pain management specialists 
     and subspecialists, and of comprehensive interdisciplinary 
     centers of treatment expertise;
       ``(6) the availability in the public, nonprofit, and 
     private sectors of pain management-related information, 
     services, and resources for consumers, employers, third-party 
     payors, patients, their families, and caregivers, including 
     information on--
       ``(A) appropriate assessment, diagnosis, treatment, and 
     management options for all types of pain and pain-related 
     symptoms; and
       ``(B) conditions for which no treatment options are yet 
     recognized; and
       ``(7) other issues the Secretary deems appropriate.
       ``(c) Consultation.--In designing and implementing the 
     public awareness campaign required by this section, the 
     Secretary shall consult with organizations representing 
     patients in pain and other consumers, employers, physicians 
     including physicians specializing in pain care, other pain 
     management professionals, medical device manufacturers, and 
     pharmaceutical companies.
       ``(d) Coordination.--
       ``(1) Lead official.--The Secretary shall designate one 
     official in the Department of Health and Human Services to 
     oversee the campaign established under this section.
       ``(2) Agency coordination.--The Secretary shall ensure the 
     involvement in the public awareness campaign under this 
     section of the Surgeon General of the Public Health Service, 
     the Director of the Centers for Disease Control and 
     Prevention, and such other representatives of offices and 
     agencies of the Department of Health and Human Services as 
     the Secretary determines appropriate.
       ``(e) Underserved Areas and Populations.--In designing the 
     public awareness campaign under this section, the Secretary 
     shall--
       ``(1) take into account the special needs of geographic 
     areas and racial, ethnic, gender, age, and other demographic 
     groups that are currently underserved; and
       ``(2) provide resources that will reduce disparities in 
     access to appropriate diagnosis, assessment, and treatment.
       ``(f) Grants and Contracts.--The Secretary may make awards 
     of grants, cooperative agreements, and contracts to public 
     agencies and private nonprofit organizations to assist with 
     the development and implementation of the public awareness 
     campaign under this section.
       ``(g) Evaluation and Report.--Not later than the end of 
     fiscal year 2012, the Secretary shall prepare and submit to 
     the Congress a report evaluating the effectiveness of the 
     public awareness campaign under this section in educating the 
     general public with respect to the matters described in 
     subsection (b).
       ``(h) Authorization of Appropriations.--For purposes of 
     carrying out this section, there are authorized to be 
     appropriated $2,000,000 for fiscal year 2010 and $4,000,000 
     for each of fiscal years 2011 and 2012.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
Jersey (Mr. Pallone) and the gentleman from Louisiana (Mr. Scalise) 
each will control 20 minutes.
  The Chair recognizes the gentleman from New Jersey.


                             General Leave

  Mr. PALLONE. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their 
remarks.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. PALLONE. I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of H.R. 756, the National Pain Care 
Policy Act of 2009.
  Pain is the most common reason Americans access the health care 
system and is a leading cause of disability. It is also a major 
contributor to health care costs. National Center for Health Statistics 
estimates that 76.2 million, or one in four, Americans have suffered 
from pain that lasts longer than 24 hours. Millions more Americans 
suffer from acute pain. While untreated pain can seriously impact every 
aspect of daily living, most painful conditions can be relieved through 
treatment.
  This bill will expand research on the causes and treatments of pain, 
award grants for pain care education and training programs for health 
professionals, and establish and implement a national pain care 
education outreach and awareness campaign.
  Once again, I'd like to thank my colleague, Representative Capps, for 
sponsoring this bill and for her hard work on the bill. I urge my 
colleagues to pass this very important bill.
  I reserve the balance of my time.
  Mr. SCALISE. Mr. Speaker, I rise in support of H.R. 756, the National 
Pain Care Policy Act of 2009. I want to commend Congresswoman Lois 
Capps and Congressman Mike Rogers for their bipartisan work on this 
bill.
  The National Center for Health Statistics estimates that 76.2 million 
Americans have suffered pain that lasts longer than 24 hours. Most 
painful conditions can be relieved with proper treatment and adequate 
pain management. This bill creates an interagency coordinating 
committee to coordinate all efforts within HHS and other Federal 
agencies related to pain research. This effort, along with efforts at 
the NIH via the pain consortium, will go a long way towards increasing 
research and awareness of chronic pain.
  Mr. Speaker, I urge Members to support this legislation.
  I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, once again, I yield 3 minutes to the 
gentlewoman from California (Mrs. Capps), the sponsor of the 
legislation.
  Mrs. CAPPS. Mr. Speaker, again, I thank our chairman of our 
subcommittee for giving me this time to speak in strong support of H.R. 
756, the National Pain Care Policy Act.
  I want to thank our colleague from Michigan, Mike Rogers, for his 
tireless advocacy on behalf of pain care. It's been several years that 
we've been working together, and we have a great deal of gratitude for 
the vast coalition of organizations who have been supporting this 
legislation and working so hard on behalf of people with pain who 
suffer every single day.
  Most Americans would be surprised if they understood that the leading 
cause of disability in the United States is pain and that its treatment 
and management is straining our health care system. Americans suffering 
from chronic pain, or from pain as a symptom of another illness, face 
so many barriers to achieving relief. Fortunately, we don't have to 
remain debilitated by pain because we can take several steps in this 
legislation to improve the way we research, diagnose, and treat pain.
  This legislation takes a multifaceted approach to addressing pain. 
First, it calls on the Institute of Medicine to convene a conference on 
pain. The bill will also enable coordination and improvement of pain 
research at the National Institutes of Health.

                              {time}  1530

  This information will then be disseminated to the health community. 
H.R. 756 will also create a grant program in order to improve training 
for health professionals in recognizing and treating pain effectively.
  Finally, through this legislation we will initiate a public health 
awareness campaign so that patients know they do not need to suffer 
from pain, but rather they can seek available treatment options.
  It is my hope that passage of this bill in the House today will spur 
the Senate to act soon so we can see this bill signed into law before 
the end of the year.
  Most of us have either suffered from pain ourselves--and chronic 
pain, as our colleague from the other side said, is pain that doesn't 
go away for at least 24 hours. That's awfully miserable. Either we have 
experienced that ourselves or we have some family member or loved one 
that we can think of who would be very much affected in a positive way 
by passing this legislation.
  So the sooner we get to work on improving pain care, the sooner we 
can see relief for the millions of Americans who are suffering from 
pain every day.
  Again, I urge my colleagues to vote ``yes'' on H.R. 756.
  Mr. SCALISE. I yield back the balance of my time.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, I rise today in strong support 
of H.R. 756, the ``National Pain Care Policy Act of 2009.'' I would 
like to thank Congresswoman Lois Capps from California for this 
important health care legislation.


                               background

  This legislation requires the Secretary of Health and Human Services 
to seek an agreement with the Institute of Medicine to convene a 
Conference on Pain that:
  (1) Increases the recognition of pain as a significant public health 
problem in the United States;

[[Page 9077]]

  (2) Evaluates the adequacy of assessment, diagnosis, treatment, and 
management of acute and chronic pain;
  (3) Identifies barriers to appropriate pain care; and
  (4) Establishes an agenda to reduce such barriers and significantly 
improve the state of pain care research, education, and clinical care 
in the United States by allowing the Secretary to enter into an 
agreement with another appropriate entity if the Institute of Medicine 
declines.
  This legislation will also amend the Public Health Service Act to 
require the Director of the National Institutes of Health (NIH) to 
continue and expand, through the Pain Consortium, an aggressive program 
of basic and clinical research on the causes of and potential 
treatments for pain.
  The Secretary will be required to establish the Interagency Pain 
Research Coordinating Committee to:
  (1) Develop a summary of advances in federal pain care research 
relevant to the diagnosis, prevention, and treatment of pain and 
diseases and disorders associated with pain; and
  (2) Identify critical gaps in basic and clinical research on the 
symptoms and causes of pain.
  Most importantly, it allows the Secretary to provide for education 
and training to health care professionals in pain care including the 
requirement to establish and implement a national pain care education 
outreach and awareness campaign to educate consumers, patients, their 
families, and other caregivers.


                                general

  The American Pain Foundation provides its members and the public with 
several tips to dealing with pain relief, they advise pain sufferers to 
be active in their pain management.
  Sufferers should not be afraid to speak up. Only you know the extent 
of your pain and how it affects your quality of life.
  Knowledge is power. There are a variety of drug and non-drug 
therapies (e.g., physical therapy, yoga, meditation) available to 
effectively control pain; these are typically used in combination. 
People need to ask their healthcare providers about ways to relax and 
cope with pain.
  Tell your provider what over-the-counter medications, vitamins and 
supplements you take, at what dose and how often. Also let him or her 
know about other personal health habits (e.g., smoking tobacco, alcohol 
use), which can interfere with some pain treatments and increase pain 
levels.
  Write down questions you have before each appointment, and tell your 
provider(s) if there is something you don't understand and bring a 
relative or friend to the appointments for support.
  It is often the little things that make all the difference in pain 
management. I urge my colleagues to remember that everyday persistent 
pain can interfere with people's enjoyment of life. It can make it hard 
to sleep, work, socialize with friends and family and accomplish 
everyday tasks. When your ability to function is limited, you may 
become less productive. People find themselves avoiding hobbies and 
other activities that normally bring them happiness in order to prevent 
further injury or pain. Ongoing pain can cause you to lose your 
appetite, feel weak and depressed. This legislation provides more 
resources to manage their pain and reclaim their life.
  Mr. PALLONE. Mr. Speaker, I urge passage of this bill and yield back 
the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from New Jersey (Mr. Pallone) that the House suspend the 
rules and pass the bill, H.R. 756, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________