I 

108TH CONGRESS 

1ST SESSION H. R. 1916

To prevent and cure diabetes and to promote and improve the care of 

individuals with diabetes for the reduction of health disparities within 

racial and ethnic minority groups, including the African-American, Hispanic American, Asian American and Pacific Islander, and American 

Indian and Alaskan Native communities. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 1, 2003

Ms. DEGETTE (for herself, Mr. NETHERCUTT, Mr. WELDON of Pennsylvania, 

Mr. BECERRA, Ms. SOLIS, Mrs. CHRISTENSEN, Mr. WU, Mr. HONDA, Mr. 

KILDEE, Mr. BONILLA, Mr. DOYLE, Mr. KENNEDY of Rhode Island, Mr. 

GREEN of Texas, Mr. HINOJOSA, Ms. NORTON, Mr. LEWIS of Georgia, 

Mr. HOEFFEL, Mr. GUTIERREZ, Mr. JACKSON of Illinois, Mr. DAVIS of 

Illinois, Mr. REYES, Mr. CARSON of Oklahoma, Mr. RODRIGUEZ, Mr. 

STENHOLM, Mr. SCOTT of Georgia, Mr. WYNN, Ms. LEE, Mr. KIND, Mr. 

LYNCH, Mr. PRICE of North Carolina, Mr. CROWLEY, Mrs. CAPPS, Ms. 

SCHAKOWSKY, Ms. WOOLSEY, Mr. MCINTYRE, Mr. HILL, Mr. BERMAN, 

Mr. BELL, Ms. KILPATRICK, Mr. PASTOR, Ms. WATSON, Ms. WATERS, 

Mr. LAMPSON, Mr. DEUTSCH, Mr. OLVER, Mr. POMEROY, Ms. MAJETTE, 

Mr. SERRANO, Mr. MCDERMOTT, Mr. FILNER, Ms. KAPTUR, Mr. 

CUMMINGS, Mr. MOLLOHAN, Mr. KANJORSKI, Ms. DELAURO, Mr. 

KUCINICH, Mr. TOWNS, Mr. ETHERIDGE, Mr. FERGUSON, Mr. MEEKS of 

New York, Mr. THOMPSON of Mississippi, Mr. FORD, Mr. MURTHA, Mr. 

LEVIN, Mr. BISHOP of New York, and Mr. PALLONE) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL

To prevent and cure diabetes and to promote and improve 

the care of individuals with diabetes for the reduction 

of health disparities within racial and ethnic minority 
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groups, including the African-American, Hispanic American, Asian American and Pacific Islander, and American 

Indian and Alaskan Native communities.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Diabetes Prevention 

5 Access and Care Act’’. 

6 SEC. 2. FINDINGS. 

7 The Congress finds as follows: 

8 (1) Hispanic Americans, African-Americans, 

9 Asian Americans and Pacific Islanders, and Amer10 ican Indians and Alaskan Native populations suffer 

11 from the highest incidence of diabetes and from the 

12 highest rates of diabetes complications, and these 

13 rates are steadily increasing to epidemic proportions. 

14 (2) Within the United States, diabetes in15 creased from 6.9 percent to 7.3 percent during the 

16 period 1999 to 2000, affecting every age group and 

17 socioeconomic level. 

18 (3) Type 2 diabetes accounts for 90 to 95 per19 cent of diagnosed diabetes cases among these popu20 lations. 

21 (4) Another 16,000,000 individuals in the 

22 United States have a condition known as ‘‘pre-diabe23 tes,’’ or Impaired Glucose Tolerance (IGT). Unless 
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1 treated, pre-diabetes dramatically increases the risk 

2 for developing type 2 diabetes and increases the risk 

3 of heart disease by nearly 50 percent. As with diabe4 tes, this condition also disproportionately affects mi5 nority populations. 

6 (5) Physical inactivity and obesity are the main 

7 contributing risk factors to the rising numbers of di8 abetes cases within these racial and ethnic minority 

9 populations. 

10 (6) Critical facets of daily living that can con11 tribute to diabetes risk can be modified including 

12 poor diet, lack of recess and physical education for 

13 children, specific eating habits for families and 

14 adults that may be culturally indicative to the mi15 nority group, and psychological factors that may 

16 interfere with proper meal planning and dietary edu17 cation. 

18 (7) For certain socioeconomic groups, unhealthy 

19 food is the only nutritional source available within 

20 the community, such as fast food in poor areas. Ad21 ditionally, there are limited options for physical ac22 tivity within certain neighborhoods, communities, or 

23 geographical areas. 

24 (8) Type 2 diabetes is also being increasingly 

25 diagnosed in adolescents in high numbers within 
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1 these populations. This is partly due to nonnutri2 tional diets and a lack of physical activity. 

3 (9) The most effective prevention and control 

4 strategies include: increased physical activity, im5 proved nutrition, quality diabetes care, and improved 

6 self-management practice. 

7 (10) Multiple acute and chronic complications 

8 result from poor diabetes diagnosis, care, and man9 agement. There is a need for prevention strategies 

10 and measures in order to educate individuals about 

11 diabetes and its complications, and to decrease cur12 rent numbers within these populations. 

13 (11) Recent discoveries regarding disparities in 

14 health care among these populations have identified 

15 a need for culturally sensitive modes of treatment 

16 that are conducive to the lifestyle of the patient: Pa17 tients and consumers should be guaranteed effective, 

18 understandable, and respectful care that is provided 

19 in a manner that properly addresses their cultural 

20 health beliefs, practices, and preferred language. 

21 (12) Effective communication, cultural conflict 

22 resolution, and cultural differences on health pro23 motion and disease prevention should be addressed. 
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1 TITLE I—RESEARCH 

2 SEC. 101. RESEARCH. 

3 Part P of title III of the Public Health Service Act 

4 (42 U.S.C. 280g et seq.) is amended by inserting after 

5 section 399N the following section:

6 ‘‘SEC. 399O. DIABETES; MINORITY HEALTH AND HEALTH 

7 DISPARITIES RESEARCH. 

8 ‘‘(a) NATIONAL INSTITUTES OF HEALTH.—

9 ‘‘(1) IN GENERAL.—The Director of the Na10 tional Institutes of Health shall expand, intensify, 

11 conduct, coordinate, and support research and other 

12 activities with respect to pre-diabetes and diabetes, 

13 particularly type 2, in minority populations, includ14 ing research to identify clinical, socioeconomic, geo15 graphical, cultural, and organizational factors that 

16 contribute to type 2 diabetes in such populations. 

17 ‘‘(2) CERTAIN ACTIVITIES.—Activities under 

18 paragraph (1) regarding type 2 diabetes in minority 

19 populations shall include the following: 

20 ‘‘(A) Research on behavior and obesity, in21 cluding research through the obesity research 

22 center that is sponsored by the National Insti23 tutes of Health. 

24 ‘‘(B) Research on the causes and effects of 

25 health care access disparities and racial dis-
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1 crimination, including research to identify the 

2 following: 

3 ‘‘(i) Linguistic difficulties and lan4 guage barriers of diabetes diagnosis, treat5 ment, and care within these populations. 

6 ‘‘(ii) Environmental barriers in access7 ing transportation to health centers and 

8 health care providers. 

9 ‘‘(iii) Financial difficulties of health 

10 care financing and delivery to receive treat11 ment. 

12 ‘‘(iv) Diabetes care and treatment dis13 crimination against individuals with diabe14 tes in prisons, the workplace, and schools. 

15 ‘‘(v) The manner in which racial 

16 stereotypes evolve, persist, shape expecta17 tions, and affect interpersonal interactions 

18 with diabetes diagnosis, treatment, and 

19 education. 

20 ‘‘(vi) The manner in which patient 

21 and provider relationships can be strength22 ened by greater diversity in the health pro23 fessions for diabetes care. 

24 ‘‘(C) Research on environmental factors 

25 that may contribute to the increase in type 2 
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1 diabetes, which shall be conducted or supported 

2 through the National Institute of Environ3 mental Health Sciences and the National 

4 Human Genome Research Institute. 

5 ‘‘(D) Support for new methods to identify 

6 environmental triggers and genetic interactions 

7 that lead to the development of type 1 and type 

8 2 diabetes in minority newborns with a high ge9 netic susceptibility to the disease. Such research 

10 should follow the newborns through puberty, 

11 which is a high-risk period for developing type 

12 1 diabetes, and—increasingly—type 2 diabetes. 

13 ‘‘(E) Research to identify genes that pre14 dispose individuals to the onset of developing 

15 type 1 and type 2 diabetes and to develop com16 plications with the goal of developing improved 

17 prevention and treatment strategies. 

18 ‘‘(F) Research to prevent complications in 

19 individuals who have already developed diabe20 tes, such as attempting to identify the genes 

21 that predispose individuals with diabetes to the 

22 development of complications, as well as meth23 ods and alternative therapies to control blood 

24 glucose. 
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1 ‘‘(G) The support of ongoing research ef2 forts examining the level of glycemia at which 

3 adverse outcomes develop during pregnancy and 

4 to address the many clinical issues associated 

5 with minority mothers and fetuses during dia6 betic and gestational diabetic pregnancies. 

7 ‘‘(b) CENTERS FOR DISEASE CONTROL AND PREVEN8 TION.—

9 ‘‘(1) IN GENERAL.—The Secretary, acting 

10 through the Director of the Centers for Disease 

11 Control and Prevention, shall conduct and support 

12 research and other activities with respect to diabetes 

13 in minority populations. 

14 ‘‘(2) CERTAIN ACTIVITIES.—Activities under 

15 paragraph (1) regarding diabetes in minority popu16 lations shall include the following: 

17 ‘‘(A) Expanding the National Diabetes 

18 Laboratory for translational research, and the 

19 identification of genetic and immunological risk 

20 factors associated with diabetes. 

21 ‘‘(B) Enhancing the National Health and 

22 Nutrition Examination Survey on eating and di23 etary habits, with a focus, including cultural 

24 and socioeconomic factors, on Hispanic Amer25 ican, African-American, American Indian and 
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1 Alaskan Native, and Asian American and Pa2 cific Islander communities. 

3 ‘‘(C) Establishing and implementing model 

4 demonstration projects to design, implement,

5 and evaluate effective diabetes prevention and 

6 control interventions. 

7 ‘‘(D) Increased funding for the Translating 

8 Research Into Action for Diabetes study to con9 duct interventions for improving the quality of 

10 diabetes care received by these populations in 

11 managed care settings. 

12 ‘‘(E) Prevention research within the Divi13 sion of Diabetes Translation to better under14 stand how to influence healthcare systems 

15 changes to improve quality of care being deliv16 ered to such populations. 

17 ‘‘(F) Within the Division of Diabetes 

18 Translation, carrying out model demonstration 

19 projects to design, implement, and evaluate ef20 fective diabetes prevention and control interven21 tion for these populations. 

22 ‘‘(G) Carrying out culturally appropriate 

23 community-based interventions within the Divi24 sion of Diabetes Translation designed to ad-
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1 dress issues and problems experienced by these 

2 populations. 

3 ‘‘(H) Conducting applied research within 

4 the Division of Diabetes Translation on health 

5 systems, community, and communication inter6 ventions to reduce those barriers of discrimina7 tion, and reduce health disparities within these 

8 populations with diabetes. 

9 ‘‘(I) Conducting applied research on pri10 mary prevention within the Division of Diabetes 

11 Translation to reduce those barriers within var12 ious arenas of discrimination, and reduce diabe13 tes-related health disparities within these popu14 lations with diabetes. 

15 ‘‘(c) ADDITIONAL PROGRAMS.—

16 ‘‘(1) IN GENERAL.—In addition to activities 

17 under subsections (a) and (b), the Secretary shall 

18 conduct and support research and other activities 

19 with respect to diabetes within minority populations. 

20 ‘‘(2) CERTAIN ACTIVITIES.—Activities under 

21 paragraph (1) regarding diabetes in minority popu22 lations shall include the following: 

23 ‘‘(A) Through the National Institutes of 

24 Health and the Centers for Disease Control and 

25 Prevention, identifying culturally sensitive ap-
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1 proaches to research, including the clinical, cul2 tural, socioeconomic, and organizational factors 

3 that contribute to high levels of diabetes within 

4 such populations.

5 ‘‘(B) Expanding the National Diabetes 

6 Education Program. 

7 ‘‘(C) Through the National Center on Mi8 nority Health and Health Disparities, the Office 

9 of Minority Health under section 1707, the 

10 Health Resources and Service Administration, 

11 the Centers for Disease Control and Prevention, 

12 and the Indian Health Service, establishing 

13 partnerships within minority populations to 

14 conduct studies on cultural, familial, and social 

15 factors that may influence health promotion, di16 abetes management, and prevention. 

17 ‘‘(D) Through the Indian Health Service, 

18 in collaboration with other appropriate Federal 

19 agencies, conducting research on ethnic and cul20 turally appropriate diabetes treatment, care, 

21 prevention, and services by health care profes22 sionals to the American Indian population. 

23 ‘‘(d) DEFINITION.—For purposes of this section, the 

24 term ‘minority populations’ means racial and ethnic mi25 nority groups within the meaning of section 1707. 
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1 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—

2 ‘‘(1) NATIONAL INSTITUTES OF HEALTH.—For 

3 the purpose of carrying out subsection (a), there are 

4 authorized to be appropriated such sums as may be 

5 necessary for fiscal year 2004 and each subsequent 

6 fiscal year. 

7 ‘‘(2) CENTERS FOR DISEASE CONTROL AND

8 PREVENTION.—For the purpose of carrying out sub9 section (b), there are authorized to be appropriated 

10 such sums as may be necessary for fiscal year 2004 

11 and each subsequent fiscal year. 

12 ‘‘(3) ADDITIONAL PROGRAMS.—For the purpose 

13 of carrying out subsection (c), there are authorized 

14 to be appropriated such sums as may be necessary 

15 for fiscal year 2004 and each subsequent fiscal 

16 year.’’. 

17 SEC. 102. DIABETES MELLITUS INTERAGENCY COORDI18 NATING COMMITTEE. 

19 Section 429 of the Public Health Service Act (42 

20 U.S.C. 285c–3) is amended by adding at the end the fol21 lowing subsection: 

22 ‘‘(d)(1) In addition to other duties established in this 

23 section for the Diabetes Mellitus Interagency Coordinating 

24 Committee, such Committee shall—
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1 ‘‘(A) assess the current activities of all current 

2 Federal health programs to determine their ade3 quacy as a systemic method of addressing the im4 pact of diabetes mellitus on minority populations; 

5 ‘‘(B) undertake strategic planning activities to 

6 develop an effective and comprehensive Federal plan 

7 to address diabetes mellitus within communities of 

8 color which will involve all appropriate Federal 

9 health programs; and 

10 ‘‘(C) conduct the implementation of such a plan 

11 throughout all Federal health programs. 

12 ‘‘(2) The Federal plan under paragraph (1)(B) 

13 shall—

14 ‘‘(A) include steps to address issues including, 

15 but not limited to, type 1 and type 2 diabetes in 

16 children and the disproportionate impact of diabetes 

17 mellitus on minority populations; and 

18 ‘‘(B) remain consistent with the programs and 

19 activities identified in sections 399O through 399R, 

20 as well as remaining consistent with the intent of 

21 the Diabetes Prevention Access and Care Act. 

22 ‘‘(3) For purposes of this subsection, the term ‘mi23 nority populations’ means racial and ethnic minority 

24 groups within the meaning of section 1707. 
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1 ‘‘(4) For the purpose of carrying out this subsection, 

2 there are authorized to be appropriated such sums as may 

3 be necessary for fiscal year 2004 and each subsequent fis4 cal year.’’.

5 TITLE II—TREATMENT 

6 SEC. 201. TREATMENT. 

7 Part P of title III of the Public Health Service Act, 

8 as amended by section 101 of this Act, is amended by in9 serting after section 399O the following section: 

10 ‘‘SEC. 399P. DIABETES; TREATMENT FOR MINORITY POPU11 LATIONS. 

12 ‘‘(a) IN GENERAL.—The Secretary shall conduct and 

13 support programs to treat diabetes in minority popu14 lations. 

15 ‘‘(b) NATIONAL INSTITUTES OF HEALTH.—With re16 spect to the National Institutes of Health, activities under 

17 subsection (a) regarding the treatment of diabetes in mi18 nority populations shall include the following: 

19 ‘‘(1) Through the National Institute of Mental 

20 Health, providing for comprehensive mental health 

21 services and treatment for individuals within such 

22 populations who experience mental barriers to prop23 er diabetes care. 

24 ‘‘(2) Through the National Center on Minority 

25 Health and Health Disparities, recommending and 
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1 disseminating the guidelines of the American Diabe2 tes Association for nutrition exercise and diet for di3 abetes treatment and prevention. 

4 ‘‘(c) OTHER AGENCIES.—Activities under subsection 

5 (a) regarding the treatment of diabetes in minority popu6 lations shall include the following: 

7 ‘‘(1) Through the Substance Abuse and Mental 

8 Health Services Administration and the National In9 stitute of Mental Health, providing for comprehen10 sive mental health services and treatment for minori11 ties who experience mental barriers to proper diabe12 tes care. 

13 ‘‘(2) Promoting early detection as a cost-saving 

14 mechanism, including making grants to community 

15 health centers and clinics to specifically treat type 2 

16 diabetes and complications, including eye disease, 

17 kidney failure, heart disease and stroke, nerve dam18 age, and limb amputations. 

19 ‘‘(3) Through the Health Resources and Serv20 ices Administration and the Centers for Disease 

21 Control and Prevention, carrying out a collaborative 

22 program to encourage preventive care. Such pro23 gram shall not be limited to primary prevention, and 

24 shall include secondary and tertiary prevention. Such 

25 program shall include the award of grants to com-
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1 munity health centers and clinics to specifically treat 

2 diabetes, with an emphasis on type 2 diabetes, and 

3 diabetic complications, including eye disease, kidney

4 failure, heart disease and stroke, nerve damage, and 

5 limb amputation. 

6 ‘‘(d) DEFINITION.—For purposes of this section, the 

7 term ‘minority populations’ means racial and ethnic mi8 nority groups within the meaning of section 1707. 

9 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—

10 ‘‘(1) IN GENERAL.—For the purpose of car11 rying out subsections (a) and (c), there are author12 ized to be appropriated such sums as may be nec13 essary for fiscal year 2004 and each subsequent fis14 cal year. 

15 ‘‘(2) NATIONAL INSTITUTES OF HEALTH.—For 

16 the purpose of carrying out subsection (b), there are 

17 authorized to be appropriated such sums as may be 

18 necessary for fiscal year 2004 and each subsequent 

19 fiscal year.’’. 

20 TITLE III—EDUCATION 

21 SEC. 301. EDUCATION. 

22 Part P of title III of the Public Health Service Act, 

23 as amended by section 201 of this Act, is amended by in24 serting after section 399P the following section: 
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1 ‘‘SEC. 399Q. DIABETES; EDUCATION REGARDING MINORITY 

2 POPULATIONS. 

3 ‘‘(a) IN GENERAL.—The Secretary shall conduct and 

4 support programs to educate the public on the causes of 

5 effects of diabetes in minority populations. 

6 ‘‘(b) NATIONAL INSTITUTES OF HEALTH.—With re7 spect to the National Institutes of Health, activities under 

8 subsection (a) regarding education on diabetes in minority 

9 populations shall include the following: 

10 ‘‘(1) Through the National Center on Minority 

11 Health and Health Disparities—

12 ‘‘(A) making grants to programs funded 

13 under section 485F (relating to centers of ex14 cellence) for the purpose of establishing a men15 toring program for health care professionals to 

16 be more involved in weight counseling, obesity 

17 research, and nutrition; 

18 ‘‘(B) providing for the participation of mi19 nority health professionals in diabetes-focused 

20 research programs; and 

21 ‘‘(C) providing for the participation of mi22 nority health professionals in diabetes-focused 

23 research programs. 

24 ‘‘(2) Making grants for programs to establish a 

25 pipeline from high school to professional school that 

26 will increase minority representation in diabetes-fo-
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1 cused health fields by expanding Minority Access to 

2 Research Careers (MARC) program internships and 

3 mentoring opportunities for recruitment. 

4 ‘‘(c) CENTERS FOR DISEASE CONTROL AND PREVEN5 TION.—With respect to the Centers for Disease Control 

6 and Prevention, activities under subsection (a) regarding 

7 education on diabetes in minority populations shall include 

8 the following: 

9 ‘‘(1) Making grants for diabetes-focused edu10 cation classes or training programs on cultural sen11 sitivity and patient care within such populations for 

12 health care providers. 

13 ‘‘(2) Carrying out public awareness campaigns 

14 directed toward such populations to aggressively em15 phasize the importance and impact of physical activ16 ity and diet in regard to diabetes and diabetes-re17 lated complications. 

18 ‘‘(d) HEALTH RESOURCES AND SERVICES ADMINIS19 TRATION.—With respect to the Health Resources and 

20 Services Administration, activities under subsection (a) re21 garding education on diabetes in minority populations 

22 shall include the following: 

23 ‘‘(1) Providing additional funds for the Health 

24 Careers Opportunity Program, Centers for Excel25 lence, and the Minority Faculty Fellowship Program
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1 to partner with the Office of Minority Health under 

2 section 1707 and the National Institutes of Health 

3 to strengthen programs for career opportunities 

4 within minority populations focused on diabetes 

5 treatment and care. 

6 ‘‘(2) In partnership with the Health Resources 

7 and Services Administration, develop a diabetes 

8 focus within, and provide additional funds for, the 

9 National Health Service Corps Scholarship program 

10 to place individuals in areas that are disproportion11 ately affected by diabetes, to provide health care 

12 services. 

13 ‘‘(3) Establishing a diabetes ambassador pro14 gram for recruitment efforts to increase the number 

15 of underrepresented minorities currently serving in 

16 student, faculty, or administrative positions in insti17 tutions of higher learning, hospitals, and community 

18 health centers. 

19 ‘‘(4) Establishing a loan repayment program 

20 that focuses on diabetes care and prevention. 

21 ‘‘(e) ADDITIONAL PROGRAMS.—Activities under sub22 section (a) regarding education on diabetes in minority 

23 populations shall include the following: 

24 ‘‘(1) Through collaboration between the Health 

25 Resources and Services Administration and the In-
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1 dian Health Service, establishing a joint scholarship 

2 and loan-repayment program for American Indians 

3 health profession students. 

4 ‘‘(2) Providing funds for new and existing dia5 betes-focused education grants and programs for 

6 present and future students and clinicians in the 

7 medical field from minority populations, including 

8 the following: 

9 ‘‘(A) Federal and State loan repayment 

10 programs for health profession students within 

11 communities of color. 

12 ‘‘(B) Providing funds to the Office of Mi13 nority Health under section 1707 for training 

14 health profession students to focus on diabetes 

15 within such populations. 

16 ‘‘(C) Providing funds to State and local 

17 entities to establish diabetes awareness week or 

18 day every month in schools, nursing homes, and 

19 colleges through partnerships with the Office of 

20 Minority Health under section 1707 and the 

21 Health Resources and Services Administration. 

22 ‘‘(f) DEFINITION.—For purposes of this section, the 

23 term ‘minority populations’ means racial and ethnic mi24 nority groups within the meaning of section 1707. 

25 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—
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1 ‘‘(1) IN GENERAL.—For the purpose of car2 rying out subsections (a) and (e), there are author3 ized to be appropriated such sums as may be nec4 essary for fiscal year 2004 and each subsequent fis5 cal year. 

6 ‘‘(2) NATIONAL INSTITUTES OF HEALTH.—For 

7 the purpose of carrying out subsection (b), there are 

8 authorized to be appropriated such sums as may be 

9 necessary for fiscal year 2004 and each subsequent 

10 fiscal year. 

11 ‘‘(3) CENTERS FOR DISEASE CONTROL AND

12 PREVENTION.—For the purpose of carrying out sub13 section (c), there are authorized to be appropriated 

14 such sums as may be necessary for fiscal year 2004 

15 and each subsequent fiscal year. 

16 ‘‘(4) HEALTH RESOURCES AND SERVICES AD17 MINISTRATION.—For the purpose of carrying out 

18 subsection (c), there are authorized to be appro19 priated such sums as may be necessary for fiscal 

20 year 2004 and each subsequent fiscal year.’’. 
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1 TITLE IV—HEALTH PROMOTION, 

2 PREVENTION ACTIVITIES, 

3 AND ACCESS 

4 SEC. 401. HEALTH PROMOTION, PREVENTION ACTIVITIES, 

5 AND ACCESS. 

6 Part P of title III of the Public Health Service Act, 

7 as amended by section 301 of this Act, is amended by in8 serting after section 399Q the following section: 

9 ‘‘SEC. 399R. DIABETES; HEALTH PROMOTION, PREVENTION 

10 ACTIVITIES, AND ACCESS REGARDING MI11 NORITY POPULATIONS. 

12 ‘‘(a) NATIONAL INSTITUTES OF HEALTH. 

13 ‘‘(1) IN GENERAL.—The Secretary, acting 

14 through the Director of the National Institutes of 

15 Health, shall provide access to proper care of diabe16 tes for minority populations. 

17 ‘‘(2) CERTAIN ACTIVITIES.—Activities under 

18 paragraph (1) regarding proper care of diabetes in 

19 minority populations shall include the following: 

20 ‘‘(A) Providing funds for research to as21 sess and identify the number of individuals af22 fected by socioeconomic and environmental bar23 riers to diabetes health care access, including 

24 research regarding language, transportation, 

25 daily routine, lifestyle, and housing.
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1 ‘‘(B) Through the National Center on Mi2 nority Health and Health Disparities, identi3 fying the manner in which health care pro4 viders, community health centers, and hospitals 

5 provide proper options and education on avail6 able services for diabetes care, management, 

7 and prevention, including identifying the effects 

8 of differences in the cultures of staff and pa9 tients on clinical and other workforce encoun10 ters. 

11 ‘‘(b) CENTERS FOR DISEASE CONTROL AND PREVEN12 TION. 

13 ‘‘(1) IN GENERAL.—The Secretary, acting 

14 through the Director of the Centers for Disease 

15 Control and Prevention, shall carry out culturally 

16 appropriate diabetes health promotion and preven17 tion programs for minority populations. 

18 ‘‘(2) CERTAIN ACTIVITIES.—Activities under 

19 paragraph (1) regarding culturally appropriate dia20 betes health promotion and prevention programs for 

21 minority populations shall include the following: 

22 ‘‘(A) Expanding the Diabetes Control Pro23 gram (currently existing in all the States and 

24 territories). 
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1 ‘‘(B) Providing funds for the Diabetes 

2 Today program to adapt community planning 

3 tools within such populations. 

4 ‘‘(C) Providing funds for Racial and Eth5 nic Approaches to Community Health (REACH 

6 2010) grants to develop and evaluate diabetes 

7 prevention and control community programs fo8 cused on such populations. 

9 ‘‘(D) Providing funds to community health 

10 centers for a monthly diabetes week program of 

11 diabetes services, including screenings. 

12 ‘‘(E) Providing funds for free diabetes self13 management education classes in hospitals, clin14 ics, and community health centers. 

15 ‘‘(F) Providing funds for education and 

16 community outreach on diabetes. 

17 ‘‘(G) Providing funds for the United States 

18 and Mexico Border Diabetes project to develop 

19 culturally appropriate diabetes prevention and 

20 control interventions for Minority populations in 

21 the border region. 

22 ‘‘(H) Providing funds for an aggressive 

23 prevention campaign that focuses on physical 

24 inactivity and diet and its relation to type 2 di25 abetes within such populations.
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1 ‘‘(I) Providing funds for surveillance sys2 tems and strategies for strengthening existing 

3 systems to improve the quality, accuracy, and 

4 timelines of morbidity and mortality diabetes 

5 data for such populations. 

6 ‘‘(c) DEFINITION.—For purposes of this section, the 

7 term ‘minority populations’ means racial and ethnic mi8 nority groups within the meaning of section 1707. 

9 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—

10 ‘‘(1) NATIONAL INSTITUTES OF HEALTH.—For 

11 the purpose of carrying out subsection (b), there are 

12 authorized to be appropriated such sums as may be 

13 necessary for fiscal year 2004 and each subsequent 

14 fiscal year. 

15 ‘‘(2) CENTERS FOR DISEASE CONTROL AND

16 PREVENTION.—For the purpose of carrying out sub17 section (c), there are authorized to be appropriated 

18 such sums as may be necessary for fiscal year 2004 

19 and each subsequent fiscal year.’’. 

20 TITLE V—ADDITIONAL 

21 PROGRAMS 

22 SEC. 501. ADDITIONAL PROGRAMS. 

23 (a) EDUCATION REGARDING CLINICAL TRIALS.—The 

24 Secretary of Health and Human Services (referred to in 

25 this section as the ‘‘Secretary’’) shall carry out education 
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1 and awareness programs designed to increase participa2 tion of minority populations in clinical trials. 

3 (b) MINORITY RESEARCHERS.—The Secretary shall 

4 carry out mentorship programs for minority researchers 

5 who are conducting or intend to conduct research on dia6 betes in minority populations. 

7 (c) SUPPLEMENTING CLINICAL RESEARCH REGARD8 ING CHILDREN.—The Secretary shall make grants to sup9 plement clinical research programs to assist such pro10 grams in obtaining the services of health professionals and 

11 other resources to provide specialized care for children 

12 with type 1 and type 2 diabetes. 

13 (d) DEFINITION.—For purposes of this section, the 

14 term ‘‘minority populations’’ means racial and ethnic mi15 nority groups within the meaning of section 1707 of the 

16 Public Health Service Act. 

17 (e) AUTHORIZATION OF APPROPRIATIONS.—For the 

18 purpose of carrying out this section, there are authorized 

19 to be appropriated such sums as may be necessary for fis20 cal year 2004 and each subsequent fiscal year. 

21 TITLE VI—STUDIES 

22 SEC. 601. STUDIES. 

23 (a) INSTITUTE OF MEDICINE.—The Secretary of 

24 Health and Human Services (referred to in this section 

25 as the ‘‘Secretary’’) shall request the Institute of Medicine 
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1 to conduct a study to determine the extent and impact 

2 of the shortage of adult and pediatric endocrinologists spe3 cializing in diabetes, and to submit a report describing the 

4 findings of the study to the Secretary, to the Committee 

5 on Energy and Commerce of the House of Representa6 tives, and to the Committee on Health, Education, Labor, 

7 and Pensions of the Senate. The Secretary shall ensure 

8 that the report includes recommendations on changes in 

9 Federal policies that would increase the number of adult 

10 and pediatric endocrinologists specializing in diabetes. 

11 (b) AGENCY FOR HEALTHCARE RESEARCH AND

12 QUALITY.—The Secretary, acting through the Director of 

13 the Agency for Healthcare Research and Quality, shall 

14 conduct a study to determine whether minority children 

15 with diabetes have better or worse outcomes than non16 minority children. The study shall include a determination 

17 of the extent to which minority children have access to 

18 and participate in disease management programs, and 

19 have access to and use medical devices such as continuous 

20 glucose monitoring systems, insulin pumps, and artificial 

21 pancreas.

Æ