I 

110TH CONGRESS 

1ST SESSION H. R. 2241 

To amend the Public Health Service Act with respect to prevention and 

treatment of diabetes, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 9, 2007 

Mr. ENGEL (for himself, Mr. FOSSELLA, Mr. GENE GREEN of Texas, and Ms. 

DEGETTE) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act with respect to 

prevention and treatment of diabetes, and for other purposes. 

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 Treatment 

5 and Prevention Act of 2007’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 

8 (1) According to the Centers for Disease Con9 trol and Prevention, the prevalence of diabetes in the 


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1 United States has more than doubled in the past 

2 quarter-century. 

3 (2) The American Diabetes Association reports 

4 that there are now more than 20,000,000 people in 

5 the United States living with diabetes, with 

6 6,000,000 of these cases not yet diagnosed. Another 

7 54,000,000 people in the United States have ‘‘pre8 diabetes’’, which means that they have higher than 

9 normal blood glucose levels, and are at increased 

10 risk of developing diabetes. 

11 (3) In 2002, the landmark Diabetes Prevention 

12 Program study found that lifestyle changes, such as 

13 diet and exercise, can prevent or delay the onset of 

14 type 2 diabetes, and that participants who made 

15 such lifestyle changes reduced their risk of getting 

16 type 2 diabetes by 58 percent. 

17 (4) The New York Times has reported that life18 style-based interventions to control diabetes have re19 sulted in positive outcomes for patients, yet despite 

20 these successes, such interventions were often 

21 unsustainable. While insurance companies cover the 

22 treatments of complications of unchecked diabetes, 

23 they tend not to cover the cheaper interventions to 

24 prevent such complications. 


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1 (5) According to the American Diabetes Asso2 ciation, in 2002, direct medical expenditures for dia3 betes totaled $91,800,000,000, including 

4 $23,200,000,000 for diabetes care, and 

5 $24,600,000,000 for chronic complications attrib6 utable to diabetes. In that year, approximately 1 out 

7 of every 10 health care dollars was directed to diabe8 tes. 

9 (6) There is a need to increase the availability 

10 of effective community-based lifestyle programs for 

11 diabetes prevention and the ability of health care 

12 providers to refer patients for enrollment in such 

13 programs to prevent diabetes, reduce complications, 

14 and lower the costs associated with diabetes treat15 ment in the United States, and the Federal govern16 ment should encourage efforts to replicate the re17 sults of the Diabetes Prevention Program on a wider 

18 scale. 

19 SEC. 3. CENTERS FOR DISEASE CONTROL AND PREVEN20 TION DIVISION OF DIABETES TRANSLATION; 

21 DIABETES DEMONSTRATION PROJECTS. 

22 Title III of the Public Health Service Act (42 U.S.C. 

23 241 et seq.) is amended by inserting after section 317S 

24 the following: 


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1 ‘‘SEC. 317T. CENTERS FOR DISEASE CONTROL AND PREVEN2 TION DIVISION OF DIABETES TRANSLATION. 

3 ‘‘(a) IN GENERAL.—The Director of the Centers for 

4 Disease Control and Prevention shall establish within such 

5 Centers a Division of Diabetes Translation to eliminate 

6 the preventable burden of diabetes. 

7 ‘‘(b) OFFICE.—The Division of Diabetes Translation 

8 shall carry out the following activities: 

9 ‘‘(1) Supporting and carrying out diabetes sur10 veillance. 

11 ‘‘(2) Conducting applied translational research, 

12 including research that will improve early detection, 

13 prevention, and access to quality care with respect to 

14 diabetes. 

15 ‘‘(3) Working with States to establish and im16 prove diabetes control and prevention programs. 

17 ‘‘(4) Coordinating the National Diabetes Edu18 cation Program in conjunction with the National In19 stitutes of Health. 

20 ‘‘(5) Increasing education and awareness of dia21 betes. 

22 ‘‘(6) Promoting greater awareness of the health 

23 effects of uncontrolled diabetes. 

24 ‘‘(7) Other activities as deemed appropriate by 

25 the Director. 


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1 ‘‘(c) APPROPRIATIONS.—There are authorized to be 

2 appropriated to carry out the activities of the Division of 

3 Diabetes Translation under this section $90,000,000 for 

4 fiscal year 2008, and such sums as may be necessary for 

5 each subsequent fiscal year. 

6 ‘‘SEC. 317U. DEMONSTRATION PROJECTS FOR THE IDENTI7 FICATION AND TREATMENT FOR PERSONS DI8 AGNOSED WITH OR AT HIGH RISK FOR DIABE9 TES. 

10 ‘‘(a) IDENTIFICATION AND PREVENTION DEM11 ONSTRATION PROJECTS FOR PERSONS AT HIGH RISK FOR

12 TYPE 2 DIABETES.— 

13 ‘‘(1) IN GENERAL.— 

14 ‘‘(A) DEVELOPMENT.—The Director of the 

15 Centers for Disease Control and Prevention (re16 ferred to in this section as the ‘Director’), in 

17 consultation with the Division of Diabetes 

18 Translation and academic centers, shall develop 

19 a set of pilot demonstration projects to evaluate 

20 various approaches to— 

21 ‘‘(i) screening and identifying persons 

22 with pre-diabetes and undiagnosed diabe23 tes; and 


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1 ‘‘(ii) providing identified persons with 

2 access to appropriate lifestyle interven3 tions. 

4 ‘‘(B) LINKAGE TO DIABETES PREVENTION

5 PROGRAM.—Such pilot projects shall be carried 

6 out with the goal of translating, using lifestyle 

7 interventions available in the community, the 

8 Diabetes Prevention Program clinical trial into 

9 interventions to reduce the incidence of type 2 

10 diabetes and its related complications in the 

11 United States population. 

12 ‘‘(2) COOPERATIVE AGREEMENTS.— 

13 ‘‘(A) IN GENERAL.—The Director shall 

14 provide cooperative agreements and technical 

15 assistance to not more than 10 academic cen16 ters partnered with State or local public health 

17 departments to implement, monitor, and evalu18 ate such pilot projects. 

19 ‘‘(B) APPLICATION.—Applicants shall sub20 mit to the Director an application, at such time, 

21 in such manner, and containing such informa22 tion as the Director may require, including— 

23 ‘‘(i) information documenting the risk 

24 of the populations to be targeted by this 

25 intervention; and 


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1 ‘‘(ii) information regarding the meth2 ods that shall be used to identify and 

3 screen these populations. 

4 ‘‘(3) DURATION.—The cooperative agreements 

5 awarded under this subsection shall be awarded for 

6 a 2-year period, with the Director having the option 

7 to extend cooperative agreements for an additional 

8 2-year period. 

9 ‘‘(4) EVALUATION.—Not later than 4 years 

10 after the date of the enactment of the Diabetes 

11 Treatment and Prevention Act of 2007, the Director 

12 shall submit to the Committee on Energy and Com13 merce of the House of Representatives and the Com14 mittee on Health, Education, Labor, and Pensions 

15 of the Senate a report evaluating the effectiveness of 

16 the program under this subsection and shall make 

17 such report publicly available. 

18 ‘‘(5) AUTHORIZATION OF APPROPRIATIONS.— 

19 There are authorized to be appropriated 

20 $10,000,000 to carry out this subsection for each of 

21 fiscal years 2008 through 2012. 

22 ‘‘(b) STATE PARTNERSHIPS FOR SURVEILLANCE AND

23 EDUCATION.— 

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

25 through the Director of the Centers for Disease 


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1 Control and Prevention, shall engage in partnerships 

2 with State and local health departments to carry out 

3 the following activities: 

4 ‘‘(A) National, State, and local (to the de5 gree determined by the Secretary) surveillance 

6 of the following items: 

7 ‘‘(i) The number of individuals and 

8 percentage of the population at risk for de9 veloping diabetes. 

10 ‘‘(ii) The number of individuals and 

11 percentage of the population who have re12 ceived diabetes and high blood glucose 

13 screenings. 

14 ‘‘(iii) Among those individuals who 

15 have been identified with pre-diabetes, the 

16 proportion that have been enrolled into 

17 lifestyle programs. 

18 ‘‘(iv) The availability of interventions 

19 to prevent diabetes, and the access of the 

20 population to such interventions. 

21 ‘‘(v) The number of individuals and 

22 percentage of population with both newly23 diagnosed cases of diabetes and existing 

24 cases of diabetes, as well as the rates of inVerDate Aug 31 2005 21:27 May 10, 2007 Jkt 059200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2241.IH H2241

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1 crease or decrease in newly-diagnosed dia2 betes. 

3 ‘‘(vi) Other relevant factors as deter4 mined by the Secretary. 

5 ‘‘(B) Education and information cam6 paigns to increase awareness among populations 

7 at high risk for diabetes, health care providers, 

8 and the general public, about the importance of 

9 primary prevention, ways to assess personal 

10 risk, and how to locate and access diabetes pre11 vention programs. 

12 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

13 There are authorized to be appropriated 

14 $10,000,000 to carry out this subsection for each of 

15 the fiscal years 2008 through 2012. 

16 ‘‘(c) TREATMENT DEMONSTRATION PROJECTS FOR

17 CO-OCCURRING CHRONIC CONDITIONS.— 

18 ‘‘(1) IN GENERAL.—The Director, acting 

19 through the Division of Diabetes Translation, shall 

20 develop a pilot program to improve treatment for in21 dividuals with diabetes and other co-occurring chron22 ic conditions, such as mental illness, high blood pres23 sure, or cardiovascular disease, for which treatment 

24 may complicate the treatment for diabetes. 

25 ‘‘(2) COOPERATIVE AGREEMENTS.— 


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1 ‘‘(A) IN GENERAL.—The Director shall 

2 provide cooperative agreements and technical 

3 assistance to not more than 10 academic cen4 ters, in partnership with State and local health 

5 departments, to implement, monitor, and evalu6 ate programs designed to improve health out7 comes in individuals with diabetes and other co8 occurring chronic conditions. 

9 ‘‘(B) APPLICATION.—Applicants shall sub10 mit to the Director an application, at such time, 

11 in such manner, and containing such informa12 tion as the Director may require, including in13 formation regarding the co-occurring conditions 

14 that shall be the subject of study. 

15 ‘‘(C) PREFERENCE.—In awarding the co16 operative agreements under this subsection, the 

17 Director shall give preference for research that 

18 focuses on conditions which have a high preva19 lence among individuals with diabetes, or for 

20 which the treatment involved has the potential 

21 to impact adherence to diabetes treatment regi22 mens and that builds upon existing work de23 signed to improve the quality of care for pa24 tients with diabetes. 


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1 ‘‘(3) DURATION.—The cooperative agreements 

2 awarded under this subsection shall be awarded for 

3 a 2-year period, with the Director having the option 

4 to extend cooperative agreements for an additional 

5 2-year period. 

6 ‘‘(4) EVALUATION.—Not later than 4 years 

7 after the date of the enactment of the Diabetes 

8 Treatment and Prevention Act of 2007, the Director 

9 shall submit to the Committee on Energy and Com10 merce of the House of Representatives and the Com11 mittee on Health, Education, Labor, and Pensions 

12 of the Senate a report evaluating the effectiveness of 

13 the program under this subsection in improving the 

14 health care outcomes for individuals with diabetes 

15 and other co-occurring chronic conditions and shall 

16 make such report publicly available. 

17 ‘‘(5) APPROPRIATIONS.—There are authorized 

18 to be appropriated $10,000,000 to carry out this 

19 subsection for each of the fiscal years 2008 through 

20 2012.’’. 

Æ 


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