[Congressional Record (Bound Edition), Volume 162 (2016), Part 10]
[House]
[Pages 14094-14096]
[From the U.S. Government Publishing Office, www.gpo.gov]




                 NATIONAL CLINICAL CARE COMMISSION ACT

  Mr. BURGESS. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 1192) to amend the Public Health Service Act to foster more 
effective implementation and coordination of clinical care for people 
with pre-diabetes, diabetes, and the chronic diseases and conditions 
that result from diabetes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 1192

       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 ``National Clinical Care 
     Commission Act''.

     SEC. 2. ESTABLISHMENT OF THE NATIONAL CLINICAL CARE 
                   COMMISSION.

       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. 399V-7. NATIONAL CLINICAL CARE COMMISSION.

       ``(a) Establishment.--There is hereby established, within 
     the Department of Health and Human Services, a National 
     Clinical Care Commission (in this section referred to as the 
     `Commission') to evaluate, and recommend solutions regarding 
     better coordination and leveraging of, programs within the 
     Department and other Federal agencies that relate in any way 
     to supporting appropriate clinical care (such as any 
     interactions between physicians and other health care 
     providers and their patients related to treatment and care 
     management) for individuals with--
       ``(1) a complex metabolic or autoimmune disease;
       ``(2) a disease resulting from insulin deficiency or 
     insulin resistance; or
       ``(3) complications caused by any such disease.
       ``(b) Membership.--
       ``(1) In general.--The Commission shall be composed of the 
     following voting members:
       ``(A) The heads (or their designees) of the following 
     Federal agencies and departments:
       ``(i) The Centers for Medicare & Medicaid Services.
       ``(ii) The Agency for Healthcare Research and Quality.
       ``(iii) The Centers for Disease Control and Prevention.
       ``(iv) The Indian Health Service.
       ``(v) The Department of Veterans Affairs.
       ``(vi) The National Institutes of Health.
       ``(vii) The Food and Drug Administration.
       ``(viii) The Health Resources and Services Administration.
       ``(ix) The Department of Defense.
       ``(B) Twelve additional voting members appointed under 
     paragraph (2).
       ``(C) Such additional voting members as may be appointed by 
     the Secretary, at the Secretary's discretion, from among the 
     heads (or their designees) of governmental or nongovernmental 
     entities that impact clinical care of individuals with any of 
     the diseases and complications described in subsection (a).
       ``(2) Additional members.--The Commission shall include 
     additional voting members appointed by the Secretary, in 
     consultation with national medical societies and patient 
     advocacy organizations with expertise in the care and 
     epidemiology of any of the diseases and complications 
     described in subsection (a), including one or more such 
     members from each of the following categories:
       ``(A) Clinical endocrinologists.
       ``(B) Physician specialties (other than as described in 
     subparagraph (A)) that play a role in diseases and 
     complications described in subsection (a), such as 
     cardiologists, nephrologists, and eye care professionals.
       ``(C) Primary care physicians.
       ``(D) Non-physician health care professionals, such as 
     certified diabetes educators, registered dieticians and 
     nutrition professionals, nurses, nurse practitioners, and 
     physician assistants.
       ``(E) Patient advocates.
       ``(F) National experts in the duties listed under 
     subsection (c).
       ``(G) Health care providers furnishing services to a 
     patient population that consists of a high percentage (as 
     specified by the Secretary) of individuals who are enrolled 
     in a State plan under title XIX of the Social Security Act or 
     who are not covered under a health plan or health insurance 
     coverage.
       ``(3) Chairperson.--The voting members of the Commission 
     shall select a chairperson from the members appointed under 
     paragraph (2) from the category under paragraph (2)(A).
       ``(4) Meetings.--The Commission shall meet at least twice, 
     and not more than 4 times, a year.
       ``(5) Board terms.--Members of the Commission appointed 
     pursuant to subparagraph (B) or (C) of paragraph (1), 
     including the chairperson, shall serve for a 3-year term. A 
     vacancy on the Commission shall be filled in the same manner 
     as the original appointments.
       ``(c) Duties.--The Commission shall--
       ``(1) evaluate programs of the Department of Health and 
     Human Services regarding the utilization of diabetes 
     screening benefits, annual wellness visits, and other 
     preventive health benefits that may reduce the incidence of 
     the diseases and complications described in subsection (a), 
     including explaining problems regarding such utilization and 
     related data collection mechanisms;
       ``(2) identify current activities and critical gaps in 
     Federal efforts to support clinicians in providing 
     integrated, high-quality care to individuals with any of the 
     diseases and complications described in subsection (a);
       ``(3) make recommendations regarding the coordination of 
     clinically-based activities that are being supported by the 
     Federal Government with respect to the diseases and 
     complications described in subsection (a);
       ``(4) make recommendations regarding the development and 
     coordination of federally funded clinical practice support 
     tools for physicians and other health care professionals in 
     caring for and managing the care of individuals with any of 
     the diseases and complications described in subsection (a), 
     specifically with regard to implementation of new treatments 
     and technologies;
       ``(5) evaluate programs described in subsection (a) that 
     are in existence as of the date of the enactment of this 
     section and determine if such programs are meeting the needs 
     identified in

[[Page 14095]]

     paragraph (2) and, if such programs are determined as not 
     meeting such needs, recommend programs that would be more 
     appropriate;
       ``(6) recommend, with respect to the diseases and 
     complications described in subsection (a), clinical pathways 
     for new technologies and treatments, including future data 
     collection activities, that may be developed and then used to 
     evaluate--
       ``(A) various care models and methods; and
       ``(B) the impact of such models and methods on quality of 
     care as measured by appropriate care parameters (such as A1C, 
     blood pressure, and cholesterol levels);
       ``(7) evaluate and expand education and awareness 
     activities provided to physicians and other health care 
     professionals regarding clinical practices for the prevention 
     of the diseases and complications described in subsection 
     (a);
       ``(8) review and recommend appropriate methods for outreach 
     and dissemination of educational resources that--
       ``(A) regard the diseases and complications described in 
     subsection (a);
       ``(B) are funded by the Federal Government; and
       ``(C) are intended for health care professionals and the 
     public; and
       ``(9) carry out other activities, such as activities 
     relating to the areas of public health and nutrition, that 
     the Commission deems appropriate with respect to the diseases 
     and complications described in subsection (a).
       ``(d) Operating Plan.--
       ``(1) Initial plan.--Not later than 90 days after its first 
     meeting, the Commission shall submit to the Secretary and the 
     Congress an operating plan for carrying out the activities of 
     the Commission as described in subsection (c). Such operating 
     plan may include--
       ``(A) a list of specific activities that the Commission 
     plans to conduct for purposes of carrying out the duties 
     described in each of the paragraphs in subsection (c);
       ``(B) a plan for completing the activities;
       ``(C) a list of members of the Commission and other 
     individuals who are not members of the Commission who will 
     need to be involved to conduct such activities;
       ``(D) an explanation of Federal agency involvement and 
     coordination needed to conduct such activities;
       ``(E) a budget for conducting such activities;
       ``(F) a plan for evaluating the value and potential impact 
     of the Commission's work and recommendations, including the 
     possible continuation of the Commission for the purposes of 
     overseeing their implementation; and
       ``(G) other information that the Commission deems 
     appropriate.
       ``(2) Updates.--The Commission shall periodically update 
     the operating plan under paragraph (1) and submit such 
     updates to the Secretary and the Congress.
       ``(e) Final Report.--By not later than 3 years after the 
     date of the Commission's first meeting, the Commission shall 
     submit to the Secretary and the Congress a final report 
     containing all of the findings and recommendations required 
     by this section. Not later than 120 days after the submission 
     of the final report, the Secretary shall review the plan 
     required by subsection (d)(1)(F) and submit to the Congress a 
     recommendation on whether the Commission should be 
     reauthorized to operate after fiscal year 2019.
       ``(f) Sunset.--The Commission shall terminate at the end of 
     fiscal year 2019.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Texas (Mr. Burgess) and the gentlewoman from Illinois (Ms. Schakowsky) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Texas.


                             General Leave

  Mr. BURGESS. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and insert extraneous materials into the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of H.R. 1192, the National 
Clinical Care Commission Act, introduced by my friend and colleague 
from Texas, Representative Pete Olson. It has been supported by 229 
cosponsors.
  H.R. 1192 establishes a clinical care commission to evaluate and 
recommend solutions regarding better coordinating and leveraging 
Federal programs that relate to complex metabolic or autoimmune 
disorders, such as diabetes. Metabolic disorders take a large toll on 
many Americans each year, and complications from these disorders can 
lead to catastrophic health outcomes.
  Currently, there are various programs across the Federal Government 
that touch on metabolic disorders, some focusing on prevention, others 
focusing on treatment, but they lack coordination. Improving 
coordination of such efforts provides an opportunity to reduce costs 
while improving health outcomes.
  This legislation received broad support from the Energy and Commerce 
Committee, passing through a full committee markup by voice vote. H.R. 
1192 provides for no new spending by utilizing only existing funds at 
the Department of Health and Human Services.
  Mr. Speaker, I urge my colleagues to support this legislation.
  I reserve the balance of my time.
  Ms. SCHAKOWSKY. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I want to thank the sponsors of the bill, Congressman 
Olson and Congressman Loebsack, for introducing this legislation. I am 
very proud to be one of the many cosponsors of the bill.
  H.R. 1192 would help to improve Federal efforts to treat and prevent 
metabolic disorders, autoimmune diseases, and diseases resulting from 
insulin deficiency or insulin resistance.
  The most common metabolic disorder in the United States, of course, 
is diabetes, which affects more than 29 million Americans. Another 86 
million Americans have prediabetes, a condition associated with an 
increased risk of developing type 2 diabetes and heart disease.
  Unfortunately, all too often, diabetes leads, as my colleague said, 
to avoidable complications such as blindness, limb amputation, and 
kidney failure, and it costs our healthcare system an avoidable 
billions of dollars each year. That is why it is important to improve 
Federal efforts to prevent avoidable cases of these conditions and to 
ensure that Americans have the treatment and management services 
necessary to successfully manage them.
  I am pleased that we were able to work together to pass this 
legislation. I urge all of my colleagues to vote ``yes'' on H.R. 1192.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield 5 minutes to the gentleman from 
Texas (Mr. Olson), the author of the bill.
  Mr. OLSON. Mr. Speaker, I thank my friend from Texas.
  Mr. Speaker, I rise today in support of my bill, H.R. 1192, the 
National Clinical Care Commission Act, a bipartisan bill which is 
cosponsored by over half of my House colleagues. It has this level of 
support because this Nation faces an epidemic. Diabetes or prediabetes 
affects over 100 million Americans. Nearly one in three of our 
neighbors are affected. Dr. Phil has diabetes. We met, and he is a 
strong proponent of this bill. This is in addition to all of the other 
Americans who have diseases that fall under complex metabolic, 
autoimmune, or insulin resistant diseases.
  When I first came to Congress in 2009, it was crystal clear that we 
had a big problem. The benefits of all the Federal research dollars 
going into these diseases were simply not making their way to patients. 
The researchers at the NIH, the CDC, and even the EPA weren't sharing 
diabetes research. It was clear to me in 2009, and it is clear to me in 
2016. We need a laser-like focus on improving patient care by pursuing 
a strong Federal focus on research.
  My bill accomplishes that goal through the establishment of a 
national clinical care commission made up of doctors with specialties, 
such as endocrinologists, and other healthcare providers who work 
directly with patients and pharmacists.
  This commission will have 3 years to strengthen the partnership 
between Federal stakeholders and health professionals who will bring 
hands-on, clinical experience to improve care. This is not a new, 
unending bureaucracy. After 3 years, this commission will sunset. In 3 
years, it will be gone.
  We have made a huge investment of taxpayer dollars in research. It is 
time for us to leverage that investment and translate that into 
meaningful prevention and effective treatment options.
  So today, on World Diabetes Day, I ask my colleagues to vote for H.R. 
1192 and help all those who suffer from diabetes and other complex 
metabolic and autoimmune disorders.
  Ms. SCHAKOWSKY. Mr. Speaker, the truth is, in this country, if we 
were

[[Page 14096]]

able to actually get some control of diabetes--which, as the author of 
this bill said, affects over 100 million Americans--prediabetes or 
diabetes, we would be able to really get control of all healthcare 
costs. It is one of the biggest drivers of healthcare costs in our 
country.
  So while this is a commission--and let's hope that the commission 
does its good work--we have to stay focused, as he said, on the issue 
of diabetes.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield 3 minutes to the gentleman from 
Georgia (Mr. Carter), who is in support of the bill.
  Mr. CARTER of Georgia. Mr. Speaker, I thank the gentleman for 
yielding.
  Mr. Speaker, I rise today in support of H.R. 1192, the National 
Clinical Care Commission Act, which establishes within the Department 
of Health and Human Services the National Diabetes Clinical Care 
Commission.
  The commission will look into the dissemination of information and 
resources to clinicians on best practices for delivering high quality 
care and how best to effectively deploy new and emerging treatment and 
technologies.
  As a pharmacist, I played an important role in diabetes care by 
screening patients who had a high risk for diabetes and educated 
patients to empower them to take better care of themselves.
  I believe all of my colleagues would agree that making government 
work to help evaluate and recommend solutions regarding diabetes is 
important. The American Diabetes Association reports that there are 
almost 30 million people living with this disease.
  With better coordination and leveraging of Federal programs that 
relate to clinical care for people with prediabetes, diabetes, and the 
chronic diseases and conditions caused by diabetes, we will begin to 
stem the tide of this awful disease.
  Mr. Speaker, this legislation should be a priority for our country, 
and I urge my colleagues to support this bill.
  Ms. SCHAKOWSKY. Mr. Speaker, I yield back the balance of my time.
  Mr. BURGESS. Mr. Speaker, this is an important bill that we are 
acting on today. I would remind the body that it passed on a strong 
vote through the full committee on a voice vote, and there are many 
things to recommend this bill. I urge an ``aye'' vote.
  Mr. Speaker, I yield back the balance of my time.
  Ms. DeGETTE. Mr. Speaker, I rise today to commemorate World Diabetes 
Day and to urge the passage of the National Diabetes Clinical Care 
Commission Act (H.R. 1192), which would authorize a committee of 
experts to improve care for people with diabetes and associated 
conditions. I'd like to thank the original co-sponsors of the bill, Mr. 
Olson and Mr. Loebsack, as well as Chairman Upton and Ranking Member 
Pallone, for all your hard work in making sure this important 
legislation gets the attention it deserves.
  World Diabetes Day helps raise awareness of the scope of this 
disease. In that spirit, I'd like to note for all our colleagues that 
the human and economic impact of diabetes in the United States is 
mammoth. More than 29 million people in the United States from all 
walks of life have diabetes. The Centers for Disease Control estimates 
as many as 86 million Americans have pre-diabetes.
  This disease is a life-long reality that patients and their families 
must grapple with every day. As the mother of a child with type 1 
diabetes, I know the toll it can take. But I'm also in awe of the 
bravery and strength exhibited by people who live with diabetes. For 
them, we must continue to support innovative and thoughtful solutions 
that address awareness, prevention and cures.
  For health care problems of this magnitude, coordination is 
essential. Increased communication and planning between the many 
different federal agencies working to prevent and treat diabetes will 
make a difference for patients and help us spend taxpayer dollars in a 
more cost-effective way. The National Clinical Care Commission Act 
would help jump-start these efforts by facilitating dialogue and 
coordination between leaders in the federal government and experts from 
the field. The Commission would be tasked with reviewing the many 
different ways the government currently spends money on diabetes and 
coming up with a strategic plan on how to move forward effectively and 
efficiently.
  I have no doubt that the House will pass H.R. 1192 today. I encourage 
the Senate to vote on this commonsense bill as soon as possible. Thank 
you.
  Ms. JACKSON LEE. Mr. Speaker, I rise in strong support of H.R. 1192, 
the ``National Diabetes Clinical Care Commission Act,'' which amends 
the Public Health Service Act to establish the National Diabetes 
Clinical Care Commission.
  This bill directs the Commission to evaluate and recommend solutions 
regarding better coordination and leverage of federal programs that 
relate to supporting appropriate clinical care for people afflicted 
with pre-diabetes, diabetes, and the resulting chronic diseases and 
conditions arising from these diseases.
  As a member of the Congressional Diabetes Caucus, I understand the 
importance of diabetes prevention and care of patients.
  We must address the devastating impact of diabetes as the seventh 
leading cause of death in the United States, affecting nearly 
29,000,000 Americans.
  Since 2011, 3 million Americans have been diagnosed with the disease 
and more than twice that, 7 million Americans, have been diagnosed as 
pre-diabetic.
  In my home state of Texas, the numbers are even more worrisome.
  According to a study performed by the Texas Department of State 
Health Services in 2013, 11 percent of adults in Texas suffer from 
diabetes and 8.1 percent of adults have pre-diabetes.
  Of these percentages, minorities had the highest level of diabetes 
and pre-diabetes occurrences:
  In Black adults, 12.9 percent had diabetes and 9.6 percent had pre-
diabetes.
  In Hispanic adults, 12.7 percent had diabetes and 6.2 percent had 
pre-diabetes.
  In 2014 in Harris county, 8.5 percent of adults were diagnosed with 
diabetes.
  A 2012 Centers for Disease Control study estimated diabetic medical 
treatments cost patients throughout the country an estimated $245 
billion.
  The direct medical costs associated with diabetes diagnoses totaled 
$176 billion.
  These numbers are incredibly high, but I am encouraged by the 
commendable efforts of the National Diabetes Clinical Care Commission 
Act.
  H.R. 1192 takes a critical step in the direction of preventive 
medicine, shifting the focus of diabetes management from reactive to 
proactive by encouraging prevention.
  Additionally, the establishment of the National Diabetes Clinical 
Care Commission within the Department of Health and Human Services 
would allow greater collaboration in research in the area of diabetes, 
pre-diabetes, and the health outcomes.
  I urge my colleagues to join me in supporting H.R. 1192, the 
``National Diabetes Clinical Care Commission Act.''
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Texas (Mr. Burgess) that the House suspend the rules and 
pass the bill, H.R. 1192, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  The title of the bill was amended so as to read: ``A bill to amend 
the Public Health Service Act to foster more effective implementation 
and coordination of clinical care for people with a complex metabolic 
or autoimmune disease, a disease resulting from insulin deficiency or 
insulin resistance, or complications caused by such a disease, and for 
other purposes.''.
  A motion to reconsider was laid on the table.

                          ____________________