110th CONGRESS
1st Session
S. 626
To amend the Public Health Service Act to provide for arthritis
research and public health, and for other purposes.
IN THE SENATE OF THE UNITED STATES
February 15, 2007
Mr. KENNEDY (for himself, Mr. BOND, Mr. AKAKA, Mr. LEAHY, Mr. MENENDEZ,
Mr. CRAIG, and Mr. SHELBY) introduced the following bill; which was read
twice and referred to the Committee on Health, Education, Labor, and Pensions
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 2007'.
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,
which affects joints, the tissues which surround the joint, and other
connective tissue. Two of the most common forms are osteoarthritis, which
affects approximately 21,000,000 Americans, 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 5, or nearly 46,000,000, adults in the United States
suffers from arthritis. 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) By 2030, nearly 67,000,000, or 25 percent, of the projected United
States adult population will have arthritis, and arthritis will limit
the daily activities of nearly 25,000,000 individuals. These estimates
may be conservative as they do not account for the current trends in obesity,
which may contribute to future cases of osteoarthritis.
(5) According to the Centers for Disease Control and Prevention, the total
costs attributable to arthritis and other rheumatic conditions in the
United States in 2003 was approximately $128,000,000,000. This equaled
1.2 percent of the 2003 United States gross domestic product. $80,800,000,000
were direct costs for medical care and $47,000,000,000 were indirect costs
for lost earnings. National medical costs attributable to arthritis grew
by 24 percent between 1997 and 2003. This rise in medical costs resulted
from an increase in the number of people with arthritis and other rheumatic
conditions.
(6) 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.
8,700,000 young adults ages 18 through 44 have arthritis and millions
of others are at risk for developing the disease.
(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 and other rheumatic diseases are the leading cause of disability
among adults in the United States. Over 40 percent, or nearly 19,000,000,
adults with arthritis are limited in their activities because of their
arthritis.
(9) Obese adults are up to 4 times more likely to develop knee osteoarthritis
than normal weight adults. Excess body weight is also associated with
worse progression of arthritis, contributing to functional limitations,
mobility problems and disability. About 35 percent of adults with arthritis
are obese compared to only 21 percent of those without arthritis.
(10) Arthritis results in 744,000 hospitalizations and 36,500,000 outpatient
care visits every year.
(11) 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 lead to important advances in arthritis control, treatment,
and prevention.
(12) 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.
(13) 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. Increasing physical
activity, losing excess weight, and participating in self-management education
classes have been shown to reduce pain, improve functional limitations
and mental health, and reduce disability among persons with arthritis.
Some self-management programs have been proven to reduce arthritis pain
by 20 percent and physician visits by 40 percent. Despite this fact, less
than 1 percent of the 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.
(14) 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.
(15) 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.
(16) 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 2008 through 2012.
`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 2008 through 2012.
`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 appropriated
to carry out this section such sums as may be necessary for each of fiscal
years 2008 through 2012.
`SEC. 315D. NATIONAL ARTHRITIS EDUCATION AND OUTREACH.
`(a) In General- The Secretary shall coordinate a national education and
outreach program to support, develop, and implement education initiatives
and outreach strategies appropriate for arthritis and other rheumatic diseases.
`(b) Initiatives and Strategies- Initiatives and strategies implemented
under the program described in paragraph (1) may include public awareness
campaigns, public service announcements, and community partnership workshops,
as well as programs targeted at businesses and employers, managed care organizations,
and health care providers.
`(c) Priority- In carrying out subsection (a), the Secretary--
`(1) may emphasize prevention, early diagnosis, and appropriate management
of arthritis, and opportunities for effective patient self-management;
and
`(2) shall give priority to reaching high-risk or underserved populations.
`(d) Collaboration- In carrying out this section, the Secretary shall consult
and collaborate with stake-holders from the public, private, and nonprofit
sectors with expertise relating to arthritis control, prevention, and treatment.
`(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 2008 through 2012.'.
SEC. 4. EXPANSION AND COORDINATION OF ACTIVITIES OF THE NATIONAL INSTITUTES
OF HEALTH WITH RESPECT TO RESEARCH ON ARTHRITIS.
Title IV of the Public Health Service Act (42 U.S.C. 281 et seq.) is amended
by inserting after section 439 the following:
`SEC. 439A. ARTHRITIS AND RHEUMATIC DISEASES INTERAGENCY COORDINATING
COMMITTEE.
`(1) ESTABLISHMENT- The Secretary shall establish an Arthritis and Rheumatic
Diseases Interagency Coordinating Committee (referred to in this section
as the `Coordinating Committee').
`(2) DUTIES- The coordinating committee established under paragraph (1)
shall--
`(A) provide for the improved coordination of the research activities
of all the national research institutes relating to arthritis and rheumatic
diseases; and
`(B) provide for full and regular communication and exchange of information
necessary to maintain adequate coordination across all Federal health
programs and activities related to arthritis and rheumatic diseases.
`(b) Arthritis and Rheumatic Diseases Interagency Coordinating Committee-
`(1) COMPOSITION- The Coordinating Committee shall consist of members,
appointed by the Secretary, of which--
`(A) 2/3 of such members shall represent governmental agencies, including--
`(i) the directors of each of the national research institutes and
divisions involved in research regarding arthritis and rheumatic diseases
(or the directors' respective designees); and
`(ii) representatives of other Federal departments and agencies (as
determined appropriate by the Secretary) whose programs involve health
functions or responsibilities relevant to arthritis and rheumatic
diseases, including the Centers for Disease Control and Prevention,
the Health Resources and Services Administration, and the Food and
Drug Administration; and
`(B) 1/3 of such members shall be public members, including a broad
cross section of persons affected by arthritis, researchers, clinicians,
and representatives of voluntary health agencies, who--
`(i) shall serve for a term of 3 years; and
`(ii) may serve for an unlimited number of terms if reappointed.
`(A) APPOINTMENT- The Chairperson of the Coordinating Committee (referred
to in this subsection as the `Chairperson') shall be appointed by and
be directly responsible to the Secretary.
`(B) DUTIES- The Chairperson shall--
`(i) serve as the principal advisor to the Secretary, the Assistant
Secretary for Health, and the Director of NIH on matters relating
to arthritis and rheumatic diseases; and
`(ii) provide advice to the Director of the Centers for Disease Control
and Prevention, the Commissioner of Food and Drugs, and the heads
of other relevant Federal agencies, on matters relating to arthritis
and rheumatic diseases.
`(3) ADMINISTRATIVE SUPPORT; MEETINGS-
`(A) ADMINISTRATIVE SUPPORT- The Secretary shall provide necessary and
appropriate administrative support to the Coordinating Committee.
`(B) MEETINGS- The Coordinating Committee shall meet on a regular basis
as determined by the Secretary, in consultation with the Chairperson.
`(c) Arthritis and Rheumatic Diseases Summit-
`(1) IN GENERAL- Not later than 1 year after the date of enactment of
the Arthritis Prevention, Control, and Cure Act of 2007, the Coordinating
Committee shall convene a summit of researchers, public health professionals,
representatives of voluntary health agencies, representatives of academic
institutions, and Federal and State policymakers, to provide a detailed
overview of current research activities at the National Institutes of
Health, as well as to discuss and solicit input related to potential areas
of collaboration between the National Institutes of Health and other Federal
health agencies, including the Centers for Disease Control and Prevention,
the Agency for Healthcare Research and Quality, and the Health Resources
and Services Administration, related to research, prevention, and treatment
of arthritis and rheumatic diseases.
`(2) SUMMIT DETAILS- The summit developed under paragraph (1) shall focus
on--
`(A) a broad range of research activities relating to biomedical, epidemiological,
psychosocial, and rehabilitative issues, including studies of the impact
of the diseases described in paragraph (1) in rural and underserved
communities;
`(B) clinical research for the development and evaluation of new treatments,
including new biological agents;
`(C) translational research on evidence-based and cost-effective best
practices in the treatment, prevention, and management of the disease;
`(D) information and education programs for health care professionals
and the public;
`(E) priorities among the programs and activities of the various Federal
agencies regarding such diseases; and
`(F) challenges and opportunities for scientists, clinicians, patients,
and voluntary organizations.
`(d) Report to Congress- Not later than 180 days after the convening of
the Arthritis and Rheumatic Diseases Summit under subsection (c)(1), the
Director of NIH shall prepare and submit a report to Congress that includes
proceedings from the summit and a description of arthritis research, education,
and other activities that are conducted or supported through the national
research institutes.
`(e) Public Information- The Coordinating Committee shall make readily available
to the public information about the research, education, and other activities
relating to arthritis and other rheumatic diseases, conducted or supported
by the National Institutes of Health.
`(f) Authorization of Appropriations- There are authorized to be appropriated
such sums as may be necessary for each of fiscal years 2008 through 2012
to carry out this section.'.
SEC. 5. EXPANSION, INTENSIFICATION, AND INNOVATION OF RESEARCH AND PUBLIC
HEALTH ACTIVITIES RELATED TO JUVENILE ARTHRITIS.
(a) Juvenile Arthritis Initiative Through the Director of the National Institutes
of Health- Part A of title IV of the Public Health Service Act (42 U.S.C.
281 et seq.) is amended by adding at the end the following:
`SEC. 404H. JUVENILE ARTHRITIS INITIATIVE THROUGH THE DIRECTOR OF THE
NATIONAL INSTITUTES OF HEALTH.
`(a) Expansion and Intensification of Activities-
`(1) IN GENERAL- The Director of NIH, in coordination with the Director
of the National Institute of Arthritis and Musculoskeletal and Skin Diseases,
and the directors of the other national research institutes, as appropriate,
shall expand and intensify programs of the National Institutes of Health
with respect to research and related activities concerning various forms
of juvenile arthritis.
`(2) COORDINATION- The directors referred to in paragraph (1) shall jointly
coordinate the programs referred to in such paragraph and consult with
additional Federal officials, voluntary health associations, medical professional
societies, and private entities as appropriate.
`(b) Planning Grants and Contracts for Innovative Research in Juvenile Arthritis-
`(1) IN GENERAL- In carrying out subsection (a)(1) the Director of NIH
shall award planning grants or contracts for the establishment of new
research programs, or enhancement of existing research programs, that
focus on juvenile arthritis.
`(A) TYPES OF RESEARCH- In carrying out this subsection, the Secretary
shall encourage research that focus on genetics, on the development
of biomarkers, and on pharmacological and other therapies.
`(B) PRIORITY- In awarding planning grants or contracts under paragraph
(1), the Director of NIH may give priority to collaborative partnerships,
which may include academic health centers, private sector entities,
and nonprofit organizations.
`(c) Authorization of Appropriations- There are authorized to be appropriated
such sums as may be necessary for each of fiscal years 2008 through 2012
to carry out this section. Such authorization shall be in addition to any
authorization of appropriations under any other provision of law to carry
out juvenile arthritis activities or other arthritis-related research.'.
(b) Public Health and Surveillance Activities Related to Juvenile Arthritis
at the Centers for Disease Control and Prevention- Part B of title III of
the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by inserting
after section 320A the following:
`SEC. 320B. SURVEILLANCE AND RESEARCH REGARDING JUVENILE ARTHRITIS.
`(a) In General- The Secretary, acting through the Director of the Centers
for Disease Control and Prevention, may award grants to and enter into cooperative
agreements with public or nonprofit private entities for the collection,
analysis, and reporting of data on juvenile arthritis.
`(b) Technical Assistance- In awarding grants and entering into agreements
under subsection (a), the Secretary may provide direct technical assistance
in lieu of cash.
`(c) Coordination With NIH- The Secretary shall ensure that epidemiological
and other types of information obtained under subsection (a) is made available
to the National Institutes of Health.
`(d) Creation of a National Juvenile Arthritis Patient Registry- The Secretary,
acting through the Director of the Centers for Disease Control and Prevention
and in collaboration with a national voluntary health organization with
experience serving the juvenile arthritis population as well as the full
spectrum of arthritis-related conditions, shall support the development
of a National Juvenile Arthritis Patient Registry to collect specific data
for follow-up studies regarding the prevalence and incidence of juvenile
arthritis, as well as capturing information on evidence-based health outcomes
related to specific therapies and interventions.
`(e) Authorization of Appropriations- There are authorized to be appropriated
such sums as may be necessary to carry out this section.'.
SEC. 6. INVESTMENT IN TOMORROW'S PEDIATRIC RHEUMATOLOGISTS.
(a) In General- Part Q of title III of the Public Health Service Act (42
U.S.C. 280h et seq.) is amended by adding at the end the following:
`SEC. 399Z-1. INVESTMENT IN TOMORROW'S PEDIATRIC RHEUMATOLOGISTS.
`(a) Enhanced Support- In order to ensure an adequate future supply of pediatric
rheumatologists, the Secretary, in consultation with the Administrator of
the Health Resources and Services Administration, shall support activities
that provide for--
`(1) an increase in the number and size of institutional training grants
awarded to institutions to support pediatric rheumatology training; and
`(2) an expansion of public-private partnerships to encourage academic
institutions, private sector entities, and health agencies to promote
educational training and fellowship opportunities for pediatric rheumatologists.
`(b) Authorization- There are authorized to be appropriated such sums as
may be necessary for each of fiscal years 2008 through 2012 to carry out
this section.'.
(b) Pediatric Loan Repayment Program- Part Q of title III of the Public
Health Service Act (42 U.S.C. 280h et seq.), as amended by subsection (a),
is further amended by adding at the end the following:
`SEC. 399Z-2. PEDIATRIC RHEUMATOLOGY LOAN REPAYMENT PROGRAM.
`(a) In General- The Secretary, in consultation with the Administrator of
the Health Resources and Services Administration, may establish a pediatric
rheumatology loan repayment program.
`(b) Program Administration- Through the program established under subsection
(a), the Secretary shall--
`(1) enter into contracts with qualified health professionals who are
pediatric rheumatologists under which--
`(A) such professionals agree to provide health care in an area with
a shortage of pediatric rheumatologists; and
`(B) the Federal Government agrees to repay, for each year of such service,
not more than $25,000 of the principal and interest of the educational
loans of such professionals; and
`(2) in addition to making payments under paragraph (1) on behalf of an
individual, make payments to the individual for the purpose of providing
reimbursement for tax liability resulting from the payments made under
paragraph (1), in an amount equal to 39 percent of the total amount of
the payments made for the taxable year involved.
`(1) IN GENERAL- For the purpose of carrying out this section, the Secretary
may reserve, from amounts appropriated for the Health Resources and Services
Administration for the fiscal year involved, such amounts as the Secretary
determines to be appropriate.
`(2) AVAILABILITY OF FUNDS- Amounts made available to carry out this section
shall remain available until the expiration of the second fiscal year
beginning after the fiscal year for which such amounts were made available.'.
SEC. 7. CAREER DEVELOPMENT AWARDS IN PEDIATRIC RHEUMATOLOGY.
Part G of title IV of the Public Health Service Act (42 U.S.C. 288 et seq.)
is amended--
(1) by redesignating section 487F (as added by Public Law 106-310) as
section 487G;
(2) by inserting after section 487G (as so redesignated) the following:
`SEC. 487H. CAREER DEVELOPMENT AWARDS IN PEDIATRIC RHEUMATOLOGY.
`(a) In General- The Secretary, in consultation with the Director of NIH,
may establish a program to increase the number of career development awards
for health professionals who intend to build careers in clinical and translational
research relating to pediatric rheumatology.
`(b) Authorization of Appropriations- There are appropriated such sums as
may be necessary to carry out this section.'.
SEC. 8. GENERAL ACCOUNTING OFFICE STUDY OF ARTHRITIS AND THE WORKPLACE.
(a) Study and Report- Not later than 3 years after the date of enactment
of this Act, the Comptroller General of the United States shall conduct
a study on the economic impact of arthritis in the workplace, and submit
a report to the appropriate committees of Congress containing the results
of the study.
(b) Authorization of Appropriations- There are authorized to be appropriated
such sums as may be necessary to carry out this section.
END
