Home > 106th Congressional Bills > H.R. 4611 (ih) To strengthen the authority of the Federal Government to protect individuals from certain acts and practices in the sale and purchase of Social Security numbers and Social Security account numbers, and for other purposes. [Introduced in Hou...

H.R. 4611 (ih) To strengthen the authority of the Federal Government to protect individuals from certain acts and practices in the sale and purchase of Social Security numbers and Social Security account numbers, and for other purposes. [Introduced in Hou...


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108th CONGRESS
  2d Session
                                H. R. 4610

    To amend the Public Health Service Act to provide for arthritis 
          research and public health, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 17, 2004

  Mr. Pickering (for himself and Ms. Eshoo) introduced the following 
    bill; which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
    To amend the Public Health Service Act to provide for arthritis 
          research and public health, and for other purposes.

    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 2004''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Arthritis and other rheumatic diseases are among the 
        most common conditions in the United States. There are more 
        than 100 different forms of arthritis, of which the 2 most 
        common forms are osteoarthritis 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 3, or nearly 70,000,000, adults in the 
        United States suffer from arthritis or chronic joint symptoms. 
        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) 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, and nearly 3 of every 5 
        individuals with arthritis are younger than 65 years of age. 
        Today, 8,400,000 young adults ages 18 through 44 have arthritis 
        and millions of others are at risk for developing the disease.
            (5) Arthritis and other rheumatic diseases are the leading 
        cause of disability among adults in the United States. More 
        than 8,000,000 people in the United States are disabled by 
        arthritis and other rheumatic diseases. By 2020, arthritis will 
        limit the daily activities of nearly 12,000,000 individuals.
            (6) Nearly 60 percent of people of the United States with 
        arthritis are of working age. In general, people with arthritis 
        have a low rate of participation in the workforce. Arthritis is 
        exceeded only by heart disease as a cause of work disability.
            (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 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 results in 750,000 hospitalizations, 
        44,000,000 outpatient visits, and 4,000,000 days of hospital 
        care every year, according to the Centers for Disease Control 
        and Prevention.
            (9) The Centers for Disease Control and Prevention estimate 
        that the annual cost of medical care for arthritis is 
        $51,000,000, and the estimated annual total cost of arthritis 
        to the United States, including lost productivity, exceeds 
        $86,000,000.
            (10) 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.
            (11) 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.
            (12) 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. Arthritis self-management 
        can reduce both patient pain and health care costs, with some 
        self-management programs reducing arthritis pain by 20 percent 
        and physician visits by 40 percent. Yet less than 1 percent of 
        the 49,000,000 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.
            (13) Rheumatologists are internists or pediatric sub-
        specialists that 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.
            (14) 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.
            (15) 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.

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 2005 through 2009.

``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 2005 through 2009.

``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;
            ``(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 

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