I 

108TH CONGRESS 

1ST SESSION H. R. 3359

To increase awareness of and research on autoimmune diseases, such as 

lupus, multiple sclerosis, rheumatoid arthritis, and fibromyalgia, and 

for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 21, 2003

Mr. KENNEDY of Rhode Island (for himself and Mr. UPTON) introduced the 

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

A BILL

To increase awareness of and research on autoimmune diseases, such as lupus, multiple sclerosis, rheumatoid arthritis, and fibromyalgia, 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 ‘‘Prevention, Awareness, 

5 and Research Auto-Immune Disease Act’’. 

6 SEC. 2. FINDINGS. 

7 The Congress finds as follows: 

8 (1) The Lupus Foundation of America esti9 mates that at least 1.5 million Americans have a 
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1 form of lupus, 9 out of 10 of these Americans are 

2 women, and 80 percent of all newly diagnosed cases 

3 of lupus are among women of childbearing age. 

4 (2) According to a Lupus Foundation of Amer5 ica survey, more than half of the people with lupus 

6 suffered for 4 or more years and visited 3 or more 

7 doctors before obtaining a diagnosis of lupus. 

8 (3) Early diagnosis of and commencement of 

9 treatment for lupus can prevent or reduce serious 

10 organ damage, disability, and death. 

11 (4) About 1 out of 5 lupus sufferers receives 

12 disability payments, costing the Government several 

13 billion dollars each year for social security disability 

14 benefits, lost taxes, and medical care provided 

15 through Medicare and Medicaid. 

16 (5) The average annual cost of medical treat17 ment for an individual with lupus is $6,000 to 

18 $10,000; for some people, medical costs may exceed 

19 several thousand dollars every month. 

20 (6) Despite the prevalence of lupus, public 

21 awareness and understanding of lupus remains low. 

22 According to a Lupus Foundation of America sur23 vey, only 1 out of 5 Americans can provide even 

24 basic information about lupus. 
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1 (7) Awareness of lupus is lowest among adults 

2 ages 18 to 34, the age group most likely to develop 

3 symptoms of lupus. 

4 (8) Multiple sclerosis is a chronic and often dis5 abling disease of the central nervous system which 

6 often first appears in people who are 20 to 50 years 

7 of age, with lifelong physical and emotional effects. 

8 (9) Multiple sclerosis is twice as common in 

9 women as in men. 

10 (10) An estimated 250,000 to 400,000 individ11 uals have multiple sclerosis nationally. 

12 (11) The average annual cost of multiple scle13 rosis to each affected individual is approximately 

14 $50,000, and the total cost can exceed $3,000,000 

15 over an individual’s lifetime. 

16 (12) The annual cost of treating all people who 

17 suffer from multiple sclerosis in the United States is 

18 approximately $20,000,000,000. 

19 (13) Symptoms of multiple sclerosis can be mild 

20 (such as numbness in the limbs) or severe (such as 

21 paralysis or loss of vision). 

22 (14) The progress, severity, and specific symp23 toms of multiple sclerosis in any one individual can24 not yet be predicted. 
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1 (15) Arthritis is the number one cause of dis2 ability in the United States. 

3 (16) Among the 2,100,000 people with rheu4 matoid arthritis in the United States, women out5 number men 3 to 1. 

6 (17) The total direct costs of rheumatoid ar7 thritis, including money spent on treatments, hos8 pitalizations, medications, transportation, and spe9 cialist aids, is approximately $1,200,000,000 each 

10 year. 

11 (18) The average medical care expenditures 

12 over the course of a rheumatoid arthritis patient’s 

13 lifetime is $225,000 to $370,000. 

14 (19) Fibromyalgia is believed to affect approxi15 mately 3,700,000 people (approximately 2 percent of 

16 the United States population) and occurs more com17 monly in women than men. 

18 (20) The exact cause of fibromyalgia is un19 known, but may be triggered by stress, trauma, or 

20 possibly an infectious agent in susceptible people.

21 SEC. 3. GRANTS TO INCREASE AWARENESS OF AUTO22 IMMUNE DISEASES. 

23 (a) PURPOSE.—The purpose of this section is to in24 crease awareness of autoimmune diseases, such as lupus, 

25 multiple sclerosis, rheumatoid arthritis, and fibromyalgia, 
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1 in order to provide to the public a more complete under2 standing of these diseases, which affect 5 to 10 percent 

3 of the people in the United States. 

4 (b) AMENDMENTS.—Title III of the Public Health 

5 Service Act (42 U.S.C. 241 et seq.) is amended—

6 (1) by moving section 317R so that such sec7 tion follows section 317Q; and 

8 (2) by inserting after section 317R (as so 

9 moved) the following: 

10 ‘‘SEC. 317S. (a) GRANTS TO INCREASE AWARENESS

11 OF AUTOIMMUNE DISEASES.—The Secretary, acting 

12 through the Director of the Centers for Disease Control 

13 and Prevention, shall award grants to eligible entities to 

14 conduct public and professional awareness activities re15 garding autoimmune diseases, such as lupus, multiple scle16 rosis, rheumatoid arthritis, and fibromyalgia. 

17 ‘‘(b) USE OF FUNDS.—In conducting public and pro18 fessional awareness activities with a grant under this sec19 tion, an eligible entity may do any of the following: 

20 ‘‘(1) Promote increased awareness of early 

21 intervention and treatment so as to significantly im22 prove the quality of life for people with autoimmune 

23 diseases, such as lupus, multiple sclerosis, rheu24 matoid arthritis, and fibromyalgia. 
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1 ‘‘(2) Target minority communities that may be 

2 underserved or disproportionately affected by auto3 immune diseases, such as lupus, multiple sclerosis, 

4 rheumatoid arthritis, and fibromyalgia. 

5 ‘‘(3) Target women (who are disproportionately 

6 affected by autoimmune diseases, such as lupus, 

7 multiple sclerosis, rheumatoid arthritis, and 

8 fibromyalgia) so as to help reduce the amount of 

9 time taken for correct diagnosis of such diseases, 

10 which often takes more than 1 year. 

11 ‘‘(c) ELIGIBLE ENTITY.—For purposes of this sec12 tion, the term ‘eligible entity’ means a nonprofit organiza13 tion, a consumer group, an institution of higher education 

14 (as defined in section 101 of the Higher Education Act 

15 of 1965 (20 U.S.C. 1001)), a Federal, State, or local gov16 ernmental agency, or a media organization. 

17 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 

18 are authorized to be appropriated to carry out this section 

19 $18,000,000 for each of fiscal years 2004 and 2005.’’. 

20 SEC. 4. GRANTS FOR EDUCATION ON RELATIONSHIP BE21 TWEEN AUTOIMMUNE DISEASES AND MEN22 TAL ILLNESSES. 

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

24 241 et seq.), as amended by section 3 of this Act, is 

25 amended by inserting after section 317S the following: 
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1 ‘‘SEC. 317T. (a) GRANTS FOR EDUCATION ON RELA2 TIONSHIP BETWEEN AUTOIMMUNE DISEASES AND MEN3 TAL ILLNESSES.—The Secretary, acting through the Ad4 ministrator of the Health Resources and Services Admin5 istration, shall award grants to eligible entities for the 

6 education of health care providers on potential links be7 tween autoimmune diseases, such as lupus, multiple scle8 rosis, rheumatoid arthritis, and fibromyalgia, and cog9 nitive and mood disorders, such as depression. 

10 ‘‘(b) ELIGIBLE ENTITY.—For purposes of this sec11 tion, the term ‘eligible entity’ means a nonprofit organiza12 tion, a consumer group, an institution of higher education 

13 (as defined in section 101 of the Higher Education Act 

14 of 1965 (20 U.S.C. 1001)), a Federal, State, or local gov15 ernmental agency, or a media organization. 

16 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 

17 are authorized to be appropriated to carry out this section 

18 $5,000,000 for each of fiscal years 2004 and 2005.’’. 

19 SEC. 5. LOAN REPAYMENT PROGRAM REGARDING PHYSI20 CIAN RESEARCH ON AUTOIMMUNE DISEASES. 

21 Title IV of the Public Health Service Act (42 U.S.C. 

22 281 et seq.) is amended—

23 (1) by redesignating the second section 487F as 

24 section 487G; and 
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1 (2) by inserting after section 487G (as so re2 designated) the following: 

3 ‘‘SEC. 487H. LOAN REPAYMENT PROGRAM REGARDING PHY4 SICIAN RESEARCH ON AUTOIMMUNE DIS5 EASES. 

6 ‘‘(a) ESTABLISHMENT.—To the extent and in the 

7 amounts provided in advance in appropriations Acts, the 

8 Secretary, acting through the Administrator of the Health 

9 Resources and Services Administration, shall establish a 

10 program to enter into contracts with qualified physicians 

11 under which such qualified physicians agree to conduct re12 search for a period of at least 3 years regarding auto13 immune diseases, such as lupus, multiple sclerosis, rheu14 matoid arthritis, and fibromyalgia, in consideration of the 

15 Federal Government agreeing to repay, for each year of 

16 service conducting such research, not more than $35,000 

17 of the principal and interest of the educational loans of 

18 such qualified physicians. 

19 ‘‘(b) APPLICATION OF PROVISIONS.—Except as in20 consistent with this section, the provisions of sections 

21 338B, 338C, and 338E shall apply to the program estab22 lished under this section to the same extent and in the 

23 same manner as such provisions apply to the National 

24 Health Service Corps Loan Repayment Program estab25 lished in subpart III of part D of title III. 
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1 ‘‘(c) QUALIFIED PHYSICIAN.—For purposes of this 

2 section, the term ‘qualified physician’ means any indi3 vidual who has received, or will have received by the time 

4 of the research to be conducted under this section, a de5 gree of doctor of medicine or its equivalent and is licensed 

6 to practice medicine in the United States. 

7 ‘‘(d) FUNDING.—

8 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—

9 For the purpose of carrying out this section, there 

10 are authorized to be appropriated such sums as may 

11 be necessary for each fiscal year. 

12 ‘‘(2) AVAILABILITY.—Amounts appropriated for 

13 carrying out this section shall remain available until 

14 the expiration of the second fiscal year beginning 

15 after the fiscal year for which the amounts were 

16 made available.’’.

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