S 2479
110th CONGRESS
1st Session
S. 2479
To catalyze change in the care and treatment of diabetes in
the United States.
IN THE SENATE OF THE UNITED STATES
December 13, 2007
Mr. BROWN (for himself and Mr. CORNYN) introduced the following bill;
which was read twice and referred to the Committee on Health, Education,
Labor, and Pensions
A BILL
To catalyze change in the care and treatment of diabetes in
the United States.
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; FINDINGS.
(a) Short Title- This Act may be cited as the `Catalyst to Better Diabetes
Care Act of 2007'.
(b) Table of Contents- The table of contents of this Act is as follows:
Sec. 1. Short title; table of contents; findings.
Sec. 2. Diabetes screening collaboration and outreach program.
Sec. 3. Advisory group regarding employee wellness and disease management
best practices.
Sec. 4. National Diabetes Report Card.
Sec. 5. Improvement of vital statistics collection.
Sec. 6. Study on appropriate level of diabetes medical education.
(c) Findings- The Congress finds as follows:
(1) Diabetes is a chronic public health problem in the United States
that is getting worse.
(2) According to the Centers for Disease Control and Prevention:
(A) One in 3 Americans born in 2000 will get diabetes.
(B) One in 2 Hispanic females born in 2000 will get diabetes.
(C) 1,500,000 new cases of diabetes were diagnosed in adults in
2005.
(D) In 2005, 20,800,000 Americans had diabetes, which is 7 percent
of the population of the United States.
(E) 6,200,000 Americans are currently undiagnosed.
(F) African-Americans are nearly twice as likely as whites to have
diabetes.
(G) Nearly 13 percent of American Indians and Alaska Natives over
20 years old have diagnosed diabetes.
(H) In States with significant Asian populations, Asians were 1.5
to 2 times as likely as whites to have diagnosed diabetes.
(3) Diabetes carries staggering costs:
(A) In 2002, the total amount of the direct and indirect costs of
diabetes was estimated at $132,000,000,000.
(B) 18 percent of the Medicare population has diabetes but spending
on this group consumes 32 percent of the Medicare budget.
(4) Diabetes is deadly. According to the Centers for Disease Control
and Prevention:
(A) In 2002, diabetes contributed to 224,092 deaths.
(B) Diabetes is likely to be seriously underreported as studies
have found that only 35 percent to 40 percent of decedents with
diabetes had it listed anywhere on the death certificate and only
about 10 percent to 15 percent had it listed as the underlying cause
of death.
(5) Diabetes complications carry staggering economic and human costs
for our country and health system:
(A) Diabetes contributes to over 224,000 deaths a year.
(B) The risk for stroke is 2 to 4 times higher among people with
diabetes.
(C) Diabetes is the leading cause of new blindness in America, causing
approximately 18,000 new cases of blindness each year.
(D) Diabetes is the leading cause of kidney failure in America,
accounting for 44 percent of new cases in 2002.
(E) In 2002, 44,400 Americans with diabetes began treatment for
end-stage kidney disease and a total of 153,730 were living on chronic
dialysis or with a kidney transplant as a result of their diabetes.
(F) In 2002, approximately 82,000 amputations were performed on
Americans with diabetes.
(G) Poorly controlled diabetes before conception and during the
first trimester of pregnancy can cause major birth defects in 5
percent to 10 percent of pregnancies and spontaneous abortions in
15 percent to 20 percent of pregnancies.
(6) Diabetes is unique because many of its complications and tremendous
costs are largely preventable through early detection, better education
on diabetes self-management, and improved delivery of available medical
treatment:
(A) According to the Agency for Healthcare Research and Quality,
appropriate primary care for diabetes complications could have saved
the Medicare and Medicaid programs $2,500,000,000 in hospital costs
in 2001 alone.
(B) According to the Diabetes Prevention Project sponsored by the
National Institutes of Health, lifestyle interventions such as diet
and moderate physical activity for those with prediabetes reduced
the development of diabetes by 58 percent; among Americans aged
60 and over, lifestyle interventions reduced diabetes by 71 percent.
(C) Research shows detecting and treating diabetic eye disease can
reduce the development of severe vision loss by 50 percent to 60
percent.
(D) Research shows comprehensive foot care programs can reduce amputation
rates by 45 percent to 85 percent.
(E) Detecting and treating early diabetic kidney disease by lowering
blood pressure can reduce the decline in kidney function by 30 percent.
SEC. 2. DIABETES SCREENING COLLABORATION AND OUTREACH PROGRAM.
(a) Establishment- With respect to diabetes screening tests and for
the purposes of reducing the number of undiagnosed seniors with diabetes
or prediabetes, the Secretary of Health and Human Services (referred
to in this section as the `Secretary'), in collaboration with the Director
of the Centers for Disease Control and Prevention (referred to in this
section as the `Director'), shall--
(1) review uptake and utilization of diabetes screening benefits to
identify and address any existing problems with regard to utilization
and data collection mechanisms;
(2) establish an outreach program to identify existing efforts by
agencies and by the private and nonprofit sectors to increase awareness
among seniors and providers of diabetes screening benefits; and
(3) maximize cost effectiveness in increasing utilization of diabetes
screening benefits.
(b) Consultation- In carrying out this section, the Secretary and the
Director shall consult with--
(1) various units of the Federal Government, including the Centers
for Medicare & Medicaid Services, the Surgeon General of the Public
Health Service, the Agency for Healthcare Research and Quality, the
Health Resources and Services Administration, and the National Institutes
of Health; and
(2) entities with an interest in diabetes, including industry, voluntary
health organizations, trade associations, and professional societies.
SEC. 3. ADVISORY GROUP REGARDING EMPLOYEE WELLNESS AND DISEASE MANAGEMENT
BEST PRACTICES.
(a) Establishment- The Secretary of Health and Human Services shall
establish an advisory group consisting of representatives of the public
and private sector. The advisory group shall include representatives
from the Department of Commerce, the Department of Health and Human
Services, the Small Business Administration, and public and private
sector entities with experience in administering and operating employee
wellness and disease management programs.
(b) Duties- The advisory group established under subsection (a) shall
examine and make recommendations of best practices of employee wellness
and disease management programs in order to--
(1) provide public and private sector entities with improved information
in assessing the role of employee wellness and disease management
programs in saving money and improving quality of life for patients
with chronic illnesses; and
(2) encourage the adoption of effective employee wellness and disease
management programs.
(c) Report- Not later than 1 year after the date of the enactment of
this Act, the advisory group established under subsection (a) shall
submit to the Secretary of Health and Human Services the results of
the examination under subsection (b)(1).
SEC. 4. NATIONAL DIABETES REPORT CARD.
(a) In General- The Secretary of Health and Human Services (referred
to in this section as the `Secretary'), in collaboration with the Director
of the Centers for Disease Control and Prevention (referred to in this
section as the `Director'), shall prepare on a biennial basis a national
diabetes report card (referred to in this section as a `Report Card')
and, to the extent possible, for each State.
(1) IN GENERAL- Each Report Card shall include aggregate health outcomes
related to individuals diagnosed with diabetes and prediabetes including--
(A) preventative care practices and quality of care;
(2) UPDATED REPORTS- Each Report Card that is prepared after the initial
Report Card shall include trend analysis for the Nation and, to the
extent possible, for each State, for the purpose of--
(A) tracking progress in meeting established national goals and
objectives for improving diabetes care, costs, and prevalence (including
Healthy People 2010); and
(B) informing policy and program development.
(c) Availability- The Secretary, in collaboration with the Director,
shall make each Report Card publicly available, including by posting
the Report Card on the Internet.
SEC. 5. IMPROVEMENT OF VITAL STATISTICS COLLECTION.
(a) In General- The Secretary of Health and Human Services (referred
to in this section as the `Secretary'), acting through the Director
of the Centers for Disease Control and Prevention and in collaboration
with appropriate agencies and States, shall--
(1) promote the education and training of physicians on the importance
of birth and death certificate data and how to properly complete these
documents, including the collection of such data for diabetes and
other chronic diseases;
(2) encourage State adoption of the latest standard revisions of birth
and death certificates; and
(3) work with States to re-engineer their vital statistics systems
in order to provide cost-effective, timely, and accurate vital systems
data.
(b) Death Certificate Additional Language- In carrying out this section,
the Secretary may promote improvements to the collection of diabetes
mortality data, including the addition of a question for the individual
certifying the cause of death regarding whether the deceased had diabetes.
SEC. 6. STUDY ON APPROPRIATE LEVEL OF DIABETES MEDICAL EDUCATION.
(a) In General- The Secretary of Health and Human Services (referred
to in this section as the `Secretary') shall, in collaboration with
the Institute of Medicine and appropriate associations and councils,
conduct a study of the impact of diabetes on the practice of medicine
in the United States and the appropriateness of the level of diabetes
medical education that should be required prior to licensure, board
certification, and board recertification.
(b) Report- Not later than 2 years after the date of the enactment of
this Act, the Secretary shall submit a report on the study under subsection
(a) to the Committees on Ways and Means and Energy and Commerce of the
House of Representatives and the Committees on Finance and Health, Education,
Labor, and Pensions of the Senate.
END
