[House Report 111-47]
[From the U.S. Government Publishing Office]



111th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 1st Session                                                     111-47
======================================================================
 
                 NATIONAL PAIN CARE POLICY ACT OF 2009

                                _______
                                

 March 23, 2009.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

 Mr. Waxman, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 756]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 756) to amend the Public Health Service Act with 
respect to pain care, having considered the same, report 
favorably thereon without amendment and recommend that the bill 
do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     1
Background and Need for Legislation..............................     2
Hearings.........................................................     2
Committee Consideration..........................................     2
Committee Votes..................................................     2
Committee Oversight Findings.....................................     2
Statement of General Performance Goals and Objectives............     2
New Budget Authority, Entitlement Authority, and Tax Expenditures     3
Earmarks and Tax and Tariff Benefits.............................     3
Committee Cost Estimate..........................................     3
Congressional Budget Office Estimate.............................     3
Federal Mandates Statement.......................................     5
Advisory Committee Statement.....................................     5
Constitutional Authority Statement...............................     5
Applicability to Legislative Branch..............................     5
Section-by-Section Analysis of the Legislation...................     6
Change in Existing Law Made by the Bill, As Reported.............     8

                          Purpose and Summary

    The purpose of H.R. 756, the ``National Pain Care Policy 
Act of 2009'', is to amend the Public Health Service Act with 
respect to pain care. The bill authorizes the Secretary of 
Health and Human Services to contract with the Institute of 
Medicine to convene a national conference on pain; authorizes 
the Secretary to support programs to educate and train health 
professionals in pain care; and directs the Secretary to 
implement a national pain care education, outreach, and 
awareness campaign. The bill authorizes the appropriation of 
various amounts for each of these purposes for fiscal years 
2010 through 2012.

                  Background and Need for Legislation

    Pain is the most common reason Americans access the health 
care system and is a leading cause of disability and major 
contributor to health care costs. The National Center for 
Health Statistics estimates that 76.2 million, or one in every 
four Americans, have suffered from pain that lasts longer than 
24 hours and millions more suffer from acute pain.
    Most painful conditions can be relieved with proper 
treatment, and providing adequate pain management is a crucial 
component of improving and maintaining quality of life for 
patients, survivors, and their loved ones. People in pain, 
however, often face significant barriers that can prevent 
proper assessment, diagnosis, treatment, and management of 
their pain. Left untreated, pain can decrease the quality of 
life and affect every aspect of daily living, including work, 
sleep, and social relations.

                                Hearings

    The Committee on Energy and Commerce did not hold hearings 
on the legislation.

                        Committee Consideration

    The Committee on Energy and Commerce met in open markup 
session on Wednesday, March 4, 2009, and, pursuant to a motion 
by Mr. Waxman, agreed by unanimous consent to consider and 
approve H.R. 756 and several other bills en bloc. H.R. 756 was 
ordered favorably reported to the House by a voice vote. No 
amendments were offered during full Committee consideration of 
H.R. 756.

                            Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list the record votes 
on the motion to report legislation and amendments thereto. 
There were no recorded votes taken during consideration or 
ordering H.R. 756 reported to the House.

                      Committee Oversight Findings

    Regarding clause 3(c)(1) of rule XIII of the Rules of the 
House of Representatives, the oversight findings of the 
Committee are reflected in this report.

         Statement of General Performance Goals and Objectives

    The objective of H.R. 756 is to amend the Public Health 
Service Act to (1) encourage the Secretary of Health and Human 
Services (HHS) to enter into an agreement with the Institute of 
Medicine (IOM) of the National Academies to convene a 
Conference on Pain; (2) encourage the Director of the National 
Institutes of Health (NIH) to continue to expand, through the 
Pain Consortium, an aggressive program of basic and clinical 
research on the causes of and potential treatments for pain; 
(3) establish an Interagency Pain Research Coordinating 
Committee within HHS; (4) allow the Secretary to award 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; and (5) require the Secretary to establish and implement 
a national pain care education outreach and awareness campaign.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    Regarding compliance with clause 3(c)(2) of rule XIII of 
the Rules of the House of Representatives, the Committee finds 
that H.R. 756 would result in no new or increased budget 
authority, entitlement authority, or tax expenditures or 
revenues.

                  Earmarks and Tax and Tariff Benefits

    In compliance with clause 9 of rule XXI of the Rules of the 
House of Representatives, H.R. 756 does not contain any 
congressional earmarks, limited tax benefits, or limited tariff 
benefits as defined in clause 9(d), 9(e), or 9(f) of rule XXI.

                        Committee Cost Estimate

    The Committee adopts as its own the cost estimate on H.R. 
756 prepared by the Director of the Congressional Budget Office 
pursuant to section 402 of the Congressional Budget Act of 
1974.

                  Congressional Budget Office Estimate

    Pursuant to clause 3(c)(3) of rule XIII of the Rules of the 
House of Representatives, the following is the cost estimate on 
H.R. 756 provided by the Congressional Budget Office pursuant 
to section 402 of the Congressional Budget Act of 1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                    Washington, DC, March 20, 2009.
Hon. Henry A. Waxman,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 756, the National 
Pain Care Policy Act of 2009.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Stephanie 
Cameron.
            Sincerely,
                                      Douglas W. Elmendorf,
                                                          Director.
    Enclosure.

H.R. 1246--Early Hearing Detection and Intervention Act of 2009

    Summary: H.R. 1246 would amend the Public Health Service 
Act to authorize and expand research and public health 
activities related to the early detection, diagnosis, and 
treatment of hearing loss in newborns and infants. CBO 
estimates that implementing the bill would cost $151 million 
over the 2010-2014 period, assuming appropriation of the 
necessary amounts. Enacting H.R. 1246 would not affect direct 
spending or revenues.
    H.R. 1246 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act (UMRA).
    Estimated cost to the Federal Government: The estimated 
budgetary impact of H.R. 1246 is shown in the following table. 
The costs of this legislation fall within budget function 550 
(health).

----------------------------------------------------------------------------------------------------------------
                                                                    By fiscal year, in millions of dollars--
                                                              --------------------------------------------------
                                                                2010    2011    2012    2013    2014   2010-2014
----------------------------------------------------------------------------------------------------------------
                                  CHANGES IN SPENDING SUBJECT TO APPROPRIATION

HRSA:
    Estimated Authorization Level............................      12      12      12      12      12        61
    Estimated Outlays........................................       6      11      12      12      12        53
CDC:
    Estimated Authorization Level............................      11      11      11      11      11        55
    Estimated Outlays........................................       4       9      11      11      11        46
NIH:
    Estimated Authorization Level............................      13      13      13      13      13        64
    Estimated Outlays........................................       3      11      12      13      13        51
Total Changes:
    Estimated Authorization Level............................      36      36      36      36      36       180
    Estimated Outlays........................................      14      30      35      36      36      151
----------------------------------------------------------------------------------------------------------------
Note:CDC = Centers for Disease Control and Prevention. HRSA = Health Resources and Services Administration. NIH
  = National Institutes of Health.

    Basis of estimate: H.R. 1246 would authorize funding for 
early hearing loss detection and intervention activities at the 
Health Resources and Services Administration (HRSA), the 
Centers for Disease Control and Prevention (CDC), and the 
National Institutes of Health (NIH) for fiscal years 2010 
through 2015. It also would require the Director of the 
National Institutes of Health to establish a postdoctoral 
research program to foster research and development in the area 
of early hearing detection and intervention. CBO estimates that 
those activities would require the appropriation of $180 
million over the 2010-2014 period. Based on historical spending 
patterns for similar activities and assuming the appropriation 
of necessary amounts, CBO estimates that implementing H.R. 1246 
would cost $151 million over the 2010-2014 period.
    HRSA administers the Universal Newborn Screening program, 
which makes grants to states to support testing of infants 
prior to hospital discharge, audiologic evaluation by three 
months of age, and early intervention activities. CBO estimates 
that those activities would require the appropriation of $61 
million over the 2010-2014 period. Assuming the appropriation 
of the necessary amounts, CBO estimates that implementing that 
grant program would cost $53 million over the 2010-2014 period.
    H.R. 1246 would authorize CDC to make grants to states and 
provide technical assistance to states to promote screening, 
surveillance, and research into the causes of hearing loss 
among newborns and infants. To fund that grant program, CBO 
estimates that the CDC would require the appropriation of $55 
million over the 2010-2014 period. Assuming the appropriation 
of the necessary amounts, CBO estimates that implementing the 
program would cost $46 million over the 2010-2014 period.
    H.R. 1246 would authorize the NIH to conduct research on 
early detection and treatment of hearing loss. The bill would 
direct the NIH to establish a postdoctoral fellowship program 
to train researchers in the field of detecting and intervening 
in early hearing loss. Based on information provided by the 
NIH, CBO expects that the new postdoctoral program would fund 
three postdoctoral fellows at an annual cost of approximately 
$120,000 per fellow. Based on that information, historical 
program expenditures at NIH, and adjustments for inflation, CBO 
estimates that NIH would require the appropriation of $64 
million over the 2010-2014 period. CBO estimates that 
implementing those programs would cost $51 million over the 
2010-2014 period, assuming appropriation of the necessary 
amounts.
    Intergovernmental and private-sector impact: H.R. 1246 
contains no intergovernmental or private-sector mandates as 
defined in UMRA. States that participate in programs to detect, 
diagnose, and treat hearing loss in newborns and infants would 
benefit from activities and grants authorized in the bill.
    Estimate prepared by: Federal Costs: Jamease Kowalczyk, 
Stephanie Cameron, and Lisa Ramirez-Branum; Impact on State, 
Local, and Tribal Governments: Lisa Ramirez-Branum; Impact on 
Private Sector: Patrick Bernhardt.
    Estimate approved by: Peter H. Fontaine, Assistant Director 
for Budget Analysis.

                       Federal Mandates Statement

    The Committee adopts as its own the estimate of federal 
mandates regarding H.R. 756 prepared by the Director of the 
Congressional Budget Office pursuant to section 423 of the 
Unfunded Mandates Reform Act.

                      Advisory Committee Statement

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act were created by H.R. 756.

                   Constitutional Authority Statement

    Pursuant to clause 3(d)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee finds that the 
constitutional authority for H.R. 756 is provided in the 
provisions of Article I, section 8, clause 1, that relate to 
expending funds to provide for the general welfare of the 
United States.

                  Applicability to Legislative Branch

    The Committee finds that H.R. 756 does not relate to the 
terms and conditions of employment or access to public services 
or accommodations within the meaning of section 102(b)(3) of 
the Congressional Accountability Act of 1995.

             Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 establishes the short title of the bill as the 
``National Pain Care Policy Act of 2009'' and lists the table 
of contents.

Section 2. Institute of Medicine Conference on Pain

    Section 2 states that, no later than June 30, 2010, the 
Secretary must seek to enter into an agreement with the IOM of 
the National Academies to convene a conference on pain. The 
purpose of the conference shall be to increase the recognition 
of pain as a significant public health problem in the United 
States; evaluate the adequacy of assessment, diagnosis, 
treatment, and management of acute and chronic pain in the 
general population; identify racial, ethnic, gender, age, and 
other demographic groups that may be disproportionately 
affected by inadequacies in the system; identify barriers to 
appropriate pain care; and 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.
    If the Institute of Medicine declines to enter into this 
agreement, the Secretary may enter into such agreement with 
another appropriate entity.
    Section 2 requires that a report summarizing the 
conference's findings shall be submitted to Congress no later 
than June 30, 2011.
    For the purpose of carrying out section 2, this legislation 
authorizes to be appropriated $500,000 for each of fiscal years 
2010 and 2011.

Section 3. Pain research at National Institutes of Health

    Section 3 amends part B of title IV of the Public Health 
Service Act (42 U.S.C. 284 et seq.) by adding a new section, 
section 409J.
            Section 409J. Pain research
    Section 409J encourages the NIH Director 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. At least once a year, the pain consortium, 
in consultation with the Division of Program Coordination, 
Planning, and Strategic Initiatives, shall develop and submit 
to the NIH Director recommendations on appropriate pain 
research initiatives that could be undertaken with funds 
reserved for the common fund or otherwise available for such 
initiatives.
    Section 409J defines the term ``pain consortium'' to mean 
the pain consortium of NIH or a similar trans-NIH coordinating 
entity designated by the Secretary.
    Section 409J directs the Secretary to establish an 
interagency pain research coordinating committee, charged with 
coordinating all efforts within HHS and other federal agencies 
that relate to pain research. This section establishes the 
composition of the coordinating committee and requires that the 
committee meet at the call of the chairperson, or upon the 
request of the NIH Director, but in no case less often than 
once per year.
    Section 409J establishes the duties of the coordinating 
committee and requires the committee to develop a summary of 
advances in pain care research supported or conducted by the 
federal agencies relevant to the diagnosis, treatment, and 
prevention of pain, and diseases and disorders associated with 
pain; identify critical gaps in basic and clinical research on 
the symptoms and causes of pain; and make recommendations. The 
Secretary shall review the necessity of the committee at least 
once every two years.

Section 4. Pain care education and training

    Section 4 amends part D of title VII of the Public Health 
Service Act (42 U.S.C. 294 et seq.) by adding a new section, 
section 754, and redesignating sections 754 through 758 as 
sections 755 through 759, respectively.
            Section 754. Program for education and training in pain 
                    care
    Section 754 states that the Secretary may award 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.
    Section 754 states that an award may be made only if the 
applicant for the award agrees that the program carried out 
with the award will include information and education on 
recognized means for assessing, diagnosing, treating, and 
managing pain and related signs and symptoms, including the 
medically appropriate use of controlled substances. In 
addition, programs carried out must include information and 
education on applicable laws, regulations, rules, and policies 
on controlled substances; interdisciplinary approaches to the 
delivery of pain care; cultural, linguistic, literacy, 
geographic, and other barriers to care in underserved 
populations; and recent findings, developments, and 
improvements in the provision of pain care. This section 
requires the Secretary to provide for the evaluation of these 
programs in order to determine the effect of such programs on 
the knowledge and practice of pain care.
    Section 754 defines the term ``pain care'' to mean the 
assessment, diagnosis, treatment, or management of acute or 
chronic pain regardless of causation or body location.
    Section 754 updates the existing authorization of 
appropriations to require that, of the amounts appropriated for 
a fiscal year, the Secretary shall make available not less than 
$5,000,000 for awards of grants, cooperative agreements, and 
contracts under this section. Section 754 also makes conforming 
amendments to sections 757(b) and 758(b)(1).

Section 5. Public awareness campaign on pain management

    Section 5 amends part B of title II of the Public Health 
Service Act (42 U.S.C. 238 et seq.) by adding a new section, 
Section 249.
            Section 249. National education outreach and awareness 
                    campaign on pain management
    Section 249 requires that, no later than June 30, 2010, the 
Secretary shall establish and implement a national pain care 
education outreach and awareness campaign. Amongst other 
things, the public awareness campaign shall be designed to 
educate consumers, patients, their families, and other 
caregivers with respect to the incidence and importance of pain 
as a national public health problem. In designing and 
implementing the public awareness campaign, the Secretary shall 
consult with organizations representing patients in pain and 
other consumers, employers, physicians, other pain management 
professionals, medical device manufacturers, and pharmaceutical 
companies.
    Section 249 requires the Secretary to designate one 
official in HHS to oversee the public awareness campaign and to 
ensure the involvement of the Surgeon General of the Public 
Health Service, the Director of the Centers for Disease Control 
and Prevention, and other such representatives of offices and 
agencies of HHS as the Secretary determines appropriate.
    Section 249 requires that, in designing the public 
awareness campaign, the Secretary shall take into account the 
special needs of geographic areas and racial, ethnic, gender, 
age, and other demographic groups that are currently 
underserved and provide resources that will reduce disparities 
in access to appropriate diagnosis, assessment, and treatment.
    Under this section, the Secretary has discretionary 
authority to 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. In addition, the Secretary 
shall prepare and submit a report to Congress evaluating the 
effectiveness of the public awareness campaign in educating the 
general public.
    For purposes of carrying out section 249, there is 
authorized to be appropriated $2,000,000 for fiscal year 2010 
and $4,000,000 for each of fiscal years 2011 and 2012.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, existing law in which no change is 
proposed is shown in roman):

                       PUBLIC HEALTH SERVICE ACT




           *       *       *       *       *       *       *
TITLE II--ADMINISTRATION AND MISCELLANEOUS PROVISIONS

           *       *       *       *       *       *       *



Part B--Miscellaneous Provisions

           *       *       *       *       *       *       *



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, 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.

           *       *       *       *       *       *       *


TITLE IV--NATIONAL RESEARCH INSTITUTES

           *       *       *       *       *       *       *


Part B--General Provisions Respecting National Research Institutes

           *       *       *       *       *       *       *


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.

           *       *       *       *       *       *       *


TITLE VII--HEALTH PROFESSIONS EDUCATION

           *       *       *       *       *       *       *


PART D--INTERDISCIPLINARY, COMMUNITY-BASED LINKAGES

           *       *       *       *       *       *       *


SEC. 754. 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) Definitions.--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.

SEC. [754.] 755. QUENTIN N. BURDICK PROGRAM FOR RURAL INTERDISCIPLINARY 
                    TRAINING.

  (a) * * *

           *       *       *       *       *       *       *


SEC. [755.] 756. ALLIED HEALTH AND OTHER DISCIPLINES.

  (a) * * *

           *       *       *       *       *       *       *


SEC. [756.] 757. ADVISORY COMMITTEE ON INTERDISCIPLINARY, COMMUNITY-
                    BASED LINKAGES.

  (a) * * *
  (b) Composition.--
          (1) * * *
          (2) Appointment.--Not later than 90 days after the 
        date of enactment of this Act, the Secretary shall 
        appoint the members of the Advisory Committee from 
        among individuals who are health professionals from 
        schools of the types described in sections 
        751(a)(1)(A), 751(a)(1)(B), 753(b), [754(3)(A), and 
        755(b)] 755(3)(A), and 756(b). In making such 
        appointments, the Secretary shall ensure a fair balance 
        between the health professions, that at least 75 
        percent of the members of the Advisory Committee are 
        health professionals, a broad geographic representation 
        of members and a balance between urban and rural 
        members. Members shall be appointed based on their 
        competence, interest, and knowledge of the mission of 
        the profession involved.

           *       *       *       *       *       *       *


SEC. [757.] 758. AUTHORIZATION OF APPROPRIATIONS.

  (a) * * *
  (b) Allocation.--
          (1) In general.--Of the amounts appropriated under 
        subsection (a) for a fiscal year, the Secretary shall 
        make available--
                  (A) * * *
                  (B) not less than $3,765,000 for awards of 
                grants and contracts under section 752, of 
                which not less than 50 percent of such amount 
                shall be made available for centers described 
                in subsection (a)(1) of such section; [and]
                  (C) not less than $22,631,000 for awards of 
                grants and contracts under sections 753, [754, 
                and 755.] 755, and 756; and
                  (D) not less than $5,000,000 for awards of 
                grants, cooperative agreements, and contracts 
                under sections 754.

           *       *       *       *       *       *       *


SEC. [758.] 759. INTERDISCIPLINARY TRAINING AND EDUCATION ON DOMESTIC 
                    VIOLENCE AND OTHER TYPES OF VIOLENCE AND ABUSE.

  (a) * * *

           *       *       *       *       *       *       *


                                  
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