I 

111TH CONGRESS 

1ST SESSION H. R. 2084 

To increase awareness of and research on autoimmune diseases, which are 

a major women’s health problem, affect as many as 23.5 million Americans, and encompass more than 100 interrelated diseases, such as lupus, 

multiple sclerosis, rheumatoid arthritis, Sjogren’s syndrome, polymyositis, 

pemphigus, myasthenia gravis, Wegener’s granulomatosis, psoriasis, celiac 

disease, autoimmune platelet disorders, scleroderma, alopecia areata, vitiligo, autoimmune thyroid disease, and sarcoidosis, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 23, 2009 

Mr. KENNEDY (for himself, Mr. STEARNS, and Mr. MCGOVERN) 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, which are a major women’s health problem, affect 

as many as 23.5 million Americans, and encompass more 

than 100 interrelated diseases, such as lupus, multiple 

sclerosis, rheumatoid arthritis, Sjogren’s syndrome, polymyositis, pemphigus, myasthenia gravis, Wegener’s granulomatosis, psoriasis, celiac disease, autoimmune platelet 

disorders, scleroderma, alopecia areata, vitiligo, autoimmune thyroid disease, and sarcoidosis, and for other 

purposes. 


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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 of Autoimmune Diseases Act of 2009’’. 

6 SEC. 2. FINDINGS. 

7 The Congress finds as follows: 

8 (1) The National Institutes of Health estimates 

9 that between 14 and 23.5 million Americans have an 

10 autoimmune disease and the prevalence is rising. 

11 Seventy-five percent of those afflicted are women 

12 with most cases occurring during the childbearing 

13 years. 

14 (2) Researchers have identified more than 100 

15 autoimmune diseases and suspect at least 40 addi16 tional disorders of having an autoimmune basis. 

17 (3) Autoimmune diseases are chronic and can 

18 be life-threatening, ranking in the top 10 causes of 

19 death in children and women in all age groups up 

20 to 64 years of age. 

21 (4) Early diagnosis of and commencement of 

22 treatment for autoimmune diseases can prevent or 

23 reduce serious organ damage, disability, and death. 

24 According to a study conducted by the American 

25 Autoimmune Related Diseases Association, more 


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1 than half of those with an autoimmune disease suf2 fered for 4 years and visited 4 doctors before obtain3 ing a diagnosis, and 44.6 percent of women were 

4 told they were chronic complainers or too concerned 

5 with their health prior to being diagnosed. 

6 (5) A close genetic relationship exists among 

7 autoimmune diseases, explaining clustering in indi8 viduals and families as well as common pathways for 

9 disease development. 

10 (6) The rapidly evolving field of epigenetics has 

11 shown that environmental factors can cause genes to 

12 be ‘‘turned on’’ or ‘‘turned off’’. Differing exposures 

13 to environmental factors can result in differing pat14 terns of autoimmune expression. 

15 (7) Frequently used immunosuppressant treat16 ments lead to devastating long-term side effects. 

17 Those with autoimmune diseases lack effective treat18 ments. 

19 (8) The Institute of Medicine reports that the 

20 United States is behind other countries in research 

21 into immune system self-recognition, the process in22 volved in autoimmune diseases. 

23 (9) Understanding how to modulate immune 

24 system activity will benefit transplant recipients, 


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1 cancer patients, AIDS patients, and infectious dis2 ease patients. 

3 (10) The National Institutes of Health esti4 mates that annual direct health care costs for auto5 immune disease are in the range of 

6 $100,000,000,000. 

7 (11) Lack of awareness on the part of the pub8 lic and health care professionals contributes to pa9 tients’ extreme difficulty in obtaining a correct diag10 nosis, and lack of effective treatments. Despite the 

11 prevalence of autoimmune diseases, public awareness 

12 remains low. According to a Roper study, only 5.5 

13 percent of Americans can even name an autoimmune 

14 disease and 29 percent incorrectly identify AIDS as 

15 an autoimmune disease. Awareness is lowest among 

16 adults ages 18 to 34, the age group most likely to 

17 develop an autoimmune disease. 

18 (12) Examples of autoimmune diseases include 

19 lupus, multiple sclerosis, rheumatoid arthritis, 

20 Sjo ̈gren’s syndrome, polymyositis, pemphigus, myas21 thenia gravis, Wegener’s granulomatosis, psoriasis, 

22 celiac disease, autoimmune platelet disorders, 

23 scleroderma, alopecia areata, vitiligo, autoimmune 

24 thyroid disease, and sarcoidosis. 


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1 (13) Lupus can affect many parts of the body, 

2 including joints, skin, kidneys, heart, lungs, blood 

3 vessels, and brain. At least 1,500,000 Americans 

4 have a form of lupus, 9 out of 10 of these Americans 

5 are women, and 80 percent of all newly diagnosed 

6 cases of lupus are among women of childbearing age. 

7 According to a Lupus Foundation of America sur8 vey, more than half of the people with lupus suffered 

9 for 4 or more years and visited 3 or more doctors 

10 before obtaining a diagnosis of lupus. About 1 out 

11 of 5 lupus sufferers receives disability payments, 

12 costing the Government several billion dollars each 

13 year for Social Security disability benefits, lost 

14 taxes, and medical care provided through Medicare 

15 and Medicaid. The average annual cost of medical 

16 treatment for an individual with lupus is $6,000 to 

17 $10,000; for some people, medical costs may exceed 

18 several thousand dollars every month. Early diag19 nosis of and commencement of treatment for lupus 

20 can prevent or reduce serious organ damage, dis21 ability, and death. 

22 (14) In multiple sclerosis (MS), the immune 

23 system attacks the protective coating around the 

24 nerves. The damage affects the brain or spinal cord 

25 and interferes with the nerve pathways, causing 


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1 muscular weakness, loss of coordination, and visual 

2 and speech problem. Multiple sclerosis is a chronic 

3 and often disabling disease of the central nervous 

4 system which often first appears in people who are 

5 20 to 50 years of age, with lifelong physical and 

6 emotional effects. Multiple sclerosis is twice as com7 mon in women as in men. An estimated 400,000 in8 dividuals have multiple sclerosis nationally. Accord9 ing to the Multiple Sclerosis Society, the average an10 nual cost of multiple sclerosis to each affected indi11 vidual is approximately $57,000, and the total cost 

12 can exceed $3,000,000 over an individual’s lifetime. 

13 The annual cost of treating all people who suffer 

14 from multiple sclerosis in the United States is ap15 proximately $20,000,000,000. 

16 (15) Four million Americans suffer from 

17 Sjo ̈gren’s syndrome, a serious autoimmune disease. 

18 Ninety percent of those with Sjo ̈gren’s syndrome are 

19 women. Sjo ̈gren’s affects all races and ethnic groups. 

20 Hallmark symptoms of Sjo ̈gren’s include dry eyes 

21 and dry mouth, which can lead to corneal abrasions 

22 and blindness and loss of teeth if not recognized and 

23 treated and affect a persons’ ability to eat, swallow, 

24 and digest food. Sjo ̈gren’s syndrome is a systemic 

25 disease that can affect any body organ or system, 


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1 cause extreme fatigue and pain, and lead to develop2 ment of non-Hodgkin’s B-cell lymphoma and heart 

3 block in babies born to mothers with Sjo ̈gren’s syn4 drome. Sjo ̈gren’s syndrome is frequently 

5 misdiagnosed because of lack of recognition and phy6 sician education. According to the Sjo ̈gren’s Syn7 drome Foundation, the average time for those who 

8 do obtain a correct diagnosis is 6.3 years after the 

9 onset of symptoms and active attempt to obtain a di10 agnosis. 

11 (16) In rheumatoid arthritis, the immune sys12 tem attacks the linings of the joints resulting in 

13 joint pain, stiffness, swelling, and destruction. 

14 Among the 2,100,000 people with rheumatoid arthri15 tis in the United States, women outnumber men 3 

16 to 1. According to the Arthritis Foundation, total di17 rect costs of rheumatoid arthritis, including money 

18 spent on treatments, hospitalizations, medications, 

19 transportation, and specialist aids, are approxi20 mately $1,200,000,000 each year. The average med21 ical care expenditures over the course of a rheu22 matoid arthritis patient’s lifetime is $225,000 to 

23 $370,000. 

24 (17) Systemic sclerosis affects approximately 

25 240 individuals per million, and an estimated 


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1 300,000 are affected by all forms of scleroderma in 

2 the United States. Scleroderma strikes more women 

3 than men, with an overall ratio of approximately 4 

4 to 1. Scleroderma is a chronic, often progressive 

5 autoimmune disease. The disease, which literally 

6 means ‘‘hard skin’’, can cause thickening and tight7 ening of the skin, as well as fibrosis of the internal 

8 organs, including the lungs, heart, kidneys, and gas9 trointestinal tract. Scleroderma can be life threat10 ening. The Scleroderma Foundation estimates the 

11 direct and indirect costs of systematic sclerosis in 

12 the United States to be $1,500,000,000, the value of 

13 lifetime earnings lost to be $300,000 per systemic 

14 sclerosis death, and direct costs at $4,731 per pa15 tient annually. 

16 (18) Myasthenia gravis is an autoimmune neu17 romuscular disease which affects the skeletal mus18 cles and is characterized by muscular weakness 

19 which is the result of a disturbance of the neuro20 muscular transmission. Certain muscles are more 

21 frequently involved, and these include the muscles 

22 that control eye movement, eyelids, chewing, swal23 lowing, coughing, and facial expression. Muscles that 

24 control breathing and movement of the arms and 

25 legs may also be affected. Approximately 40 to 50 


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1 percent of individuals with myasthenia gravis experi2 ence vision problems at the time of diagnosis, and 

3 up to 90 percent experience such problems in the 

4 disease’s lifetime. About 40 to 50 percent of patients 

5 experience generalized myasthenia gravis affecting 

6 the muscles of the trunk or limbs, which may result 

7 in impaired breathing. The prevalence of myasthenia 

8 gravis in the Untied States is estimated at approxi9 mately 36,000 cases. However, myasthenia gravis is 

10 probably underdiagnosed, and the prevalence is 

11 probably higher. Previous studies have shown that 

12 women are more often affected than men; however, 

13 now it seems that males over 50 are more often af14 fected. The most common age at onset is before age 

15 40 in women and after age 50 in men. Treatment 

16 for myasthenia gravis can cost up to $524 per 

17 month per prescription. Various surgeries can cost 

18 up to $6,000. 

19 (19) Wegener’s granulomatosis (WG) strikes 1 

20 in every 20,000 to 30,000 people. The disease can 

21 occur at any age, although peak occurrence is in the 

22 4th or 5th decade of life. Males and females are af23 fected equally. Wegener’s granulomatosis is a rare 

24 form of vasculitis, a disease characterized by inflam25 mation of blood vessel walls which can damage vital 


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1 organs by restricting blood flow. Wegener’s granu2 lomatosis primarily affects the respiratory tract 

3 (sinus, nose, trachea, and lungs) and the kidneys 

4 and may involve the joints, eyes, and skin. According 

5 to the Wegener’s Granulomatosus Association, pa6 tients experience a 26 percent reduction in income 

7 within the first year of diagnosis, or $9,700,000 per 

8 year in lost income total for all Wegener’s patients. 

9 A 1998 survey of Wegener’s patients showed costs 

10 of $33,517 per patient per year. 

11 (20) In immune thrombocytopenic purpura 

12 (ITP), the body mounts an autoimmune attack 

13 against platelets, particles in the blood essential for 

14 clotting. People with immune thrombocytopenic pur15 pura are prone to spontaneous hemorrhages, poten16 tially in the brain and other vital organs. According 

17 to the Platelet Disorders Support Association, treat18 ing immune thrombocytopenic purpura costs from 

19 several thousand to hundreds of thousands of dollars 

20 per year, depending on the severity of the case and 

21 response to treatments. Immune thrombocytopenic 

22 purpura is a diagnosis of exclusion. Many other dis23 eases and conditions present with low platelets and 

24 can be confused with immune thrombocytopenic pur25 pura. 


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1 (21) According to the National Alopecia Areata 

2 Foundation, over 4,500,000 Americans have alopecia 

3 areata, alopecia totalis, or alopecia universalis, or 

4 1.7 percent of any given population. While children 

5 are affected most frequently, alopecia areata occurs 

6 in all ages and ethnicities and in males and females. 

7 Alopecia areata results in hair loss, with many peo8 ple losing all hair over their entire body, including 

9 eyebrows and eyelashes and the hair on their head. 

10 This leads to loss of self-esteem and filtering protec11 tion from the elements and cold. Denting and strip12 ping of nails can also occur along with complete nail 

13 loss. Since no approved treatments exist for alopecia 

14 areata, insurance companies fail to recognize its se15 riousness and do not cover treatments that could af16 fect the disease’s course. Treatments are often paid 

17 for by patients or not administered. Diagnosis is dif18 ficult because of lack of knowledge, especially among 

19 pediatricians and general practitioners who would 

20 refer patients to specialists. The International 

21 Pemphigus Foundation estimates the incidence of 

22 pemphigus and pemphigoid as between 1 and 5 peo23 ple per hundred thousand. These diseases affect all 

24 races and ethnic groups. Pemphigus and pemphigoid 

25 are a group of chronic, rare autoimmune blistering 


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1 diseases of the skin or mucous membranes. They are 

2 characterized by painful, burn-like blisters or lesions 

3 covering much of the body that do not heal, and 

4 they can cause serious infection, difficulty swal5 lowing, and, with cicatricial pemphigoid (CP), blind6 ness. If untreated, pemphigus is usually fatal. 

7 (22) Polymyositis is an autoimmune disease 

8 that causes inflammation of the small and medium9 sized arteries and leads to problems in the muscles, 

10 joints, intestines, nerves, kidney, and skin. Myositis 

11 is a neuromuscular autoimmune disease affecting 

12 about 50,000 Americans. Because it is rare and not 

13 easily detectable, individuals with myositis are often 

14 misdiagnosed. It is common for those with myositis 

15 to go either undiagnosed or misdiagnosed for several 

16 years before getting a correct diagnosis. The efficacy 

17 of treatment is diminished by delayed diagnoses and 

18 the resulting medications required and costs in19 curred are substantially higher. 

20 (23) More than 5,000,000 people in the United 

21 States have been diagnosed with psoriasis or psori22 atic arthritis, including children. Psoriasis is a life23 long skin disease that occurs when faulty signals in 

24 the immune system cause skin cells to regenerate too 

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1 face forming red, flaky, scaly lesions that can itch, 

2 crack, bleed, and be extremely painful. Psoriasis 

3 generally appears on the joints, limbs, and scalp, but 

4 it can appear anywhere, covering some people from 

5 head to toe. The National Psoriasis Foundation esti6 mates the cost of psoriasis care in the United States 

7 ranges from $650,000,000 a year to $4,300,000,000 

8 a year. A recent study estimates that Americans 

9 with psoriasis lose about 56 million hours of work 

10 and spend $2 to $3 billion to treat the disease each 

11 year. 

12 (24) Sarcoidosis results in small growths of 

13 blood vessels, cells, and connective tissue and leads 

14 to problems in the skin, lungs, eyes, joints, and mus15 cles. Sarcoidosis is a disease due to inflammation 

16 that can attack any organ in the body in any loca17 tion. The disease is characterized by the presence of 

18 granulomas, small areas of inflamed cells. They can 

19 be either inside the body or on the body’s exterior, 

20 appearing as sores on the face or shins. Sarcoidosis 

21 is most frequently found in the lungs. There are 

22 about 25,000 cases of sarcoidosis in the United 

23 States. African-Americans have a higher risk for 

24 sarcoidosis than do other Americans. However, the 

25 disease occurs in every race in the United States and 


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1 throughout the world, including in individuals of Eu2 ropean ancestry. Sarcoidosis occurs predominantly 

3 between the ages of 20 and 40 years of age. 

4 (25) Vitiligo affects 1 to 2 percent of the popu5 lation, or about 3 to 6 million Americans, and af6 fects every nationality, race, and gender equally. Vit7 iligo is an autoimmune disease in which the immune 

8 system mistakenly attacks the pigment cells in the 

9 skin. It appears as milky white patches and can 

10 occur anywhere on the body. Usually progressive, it 

11 can have a devastating impact on a patient’s mental 

12 state, especially in those with darker skin. Cost var13 ies by treatment. Treatment can cost up to $150 a 

14 month for topical medications, $2,000 to $3,000 for 

15 a home unit for phototherapy, and up to $30 per 

16 doctor’s office visit 2 to 3 times per week. Laser 

17 treatments can cost $100 to $200 per treatment per 

18 area. Diagnosis can be extremely difficult, as loss of 

19 pigment occurs in several other conditions, and phy20 sician education is lacking. It can take several 

21 months or trips to several different dermatologists 

22 for a definitive diagnosis. 


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1 SEC. 3. RESEARCH ON ENVIRONMENTAL TRIGGERS OF 

2 AUTOIMMUNE DISEASES. 

3 Subpart 12 of part C of title IV of the Public Health 

4 Service Act (42 U.S.C. 285l et seq.) is amended by adding 

5 at the end the following: 

6 ‘‘SEC. 463C. RESEARCH ON ENVIRONMENTAL TRIGGERS OF 

7 AUTOIMMUNE DISEASES. 

8 ‘‘(a) AUTHORITY.—The Secretary, acting through 

9 the Director of the Institute and in collaboration with the 

10 directors of such other national research institutes as the 

11 Secretary deems appropriate, shall award not less than 2 

12 grants to eligible entities for the conduct or support of 

13 research on environmental triggers, such as heavy metals, 

14 fluorescent lighting, phthalates, post traumatic stress, 

15 and pharmaceuticals, that can cause the initiation of auto16 immune diseases in genetically predisposed individuals. 

17 ‘‘(b) GRANT PERIOD.—Each grant under this section 

18 shall be for a period of 5 years. 

19 ‘‘(c) DEFINITION.—In this section, the term ‘eligible 

20 entity’ means— 

21 ‘‘(1) a nonprofit organization; 

22 ‘‘(2) an institution of higher education (as de23 fined in section 101 of the Higher Education Act of 

24 1965); or 

25 ‘‘(3) a Federal, State, or local agency. 


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

2 is authorized to be appropriated to carry out this section 

3 $10,000,000 for each of fiscal years 2010 and 2011.’’. 

4 SEC. 4. GRANTS TO INCREASE AWARENESS OF AUTO5 IMMUNE DISEASES. 

6 (a) PURPOSE.—The purpose of this section is to in7 crease awareness of autoimmune diseases in order to pro8 vide to the public a more complete understanding of these 

9 diseases, which affect 5 to 10 percent of the people in the 

10 United States. 

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

12 Service Act (42 U.S.C. 241 et seq.) is amended by insert13 ing after section 317T the following: 

14 ‘‘SEC. 317U. GRANTS TO INCREASE AWARENESS OF AUTO15 IMMUNE DISEASES. 

16 ‘‘(a) GRANTS.—The Secretary, acting through the 

17 Director of the Centers for Disease Control and Preven18 tion, shall award grants to eligible entities to conduct pub19 lic and professional awareness activities regarding auto20 immune diseases. 

21 ‘‘(b) USE OF FUNDS.—In conducting public and pro22 fessional awareness activities with a grant under this sec23 tion, an eligible entity may do any of the following: 

24 ‘‘(1) Promote increased awareness of early 

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1 prove the quality of life for people with autoimmune 

2 diseases. 

3 ‘‘(2) Target minority communities that may be 

4 underserved or disproportionately affected by auto5 immune diseases. 

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

7 affected by autoimmune diseases) so as to help re8 duce the amount of time taken for correct diagnosis 

9 of such diseases, which often takes more than 1 

10 year. 

11 ‘‘(c) ELIGIBLE ENTITY.—For purposes of this sec12 tion, the term ‘eligible entity’ means a nonprofit organiza13 tion, an institution of higher education (as defined in sec14 tion 101 of the Higher Education Act of 1965), a Federal, 

15 State, or local governmental agency, or a media organiza16 tion. 

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

18 is authorized to be appropriated to carry out this section 

19 $18,000,000 for each of fiscal years 2010 and 2011.’’. 

20 SEC. 5. 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 4, is amended by in25 serting after section 317U the following: 


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1 ‘‘SEC. 317V. GRANTS FOR EDUCATION ON RELATIONSHIP 

2 BETWEEN AUTOIMMUNE DISEASES AND MEN3 TAL ILLNESSES. 

4 ‘‘(a) GRANTS.—The Secretary, acting through the 

5 Administrator of the Health Resources and Services Ad6 ministration, shall award grants to eligible entities for the 

7 education of health care providers on potential links be8 tween autoimmune diseases and cognitive and mood dis9 orders, such as depression. 

10 ‘‘(b) ELIGIBLE ENTITY.—For purposes of this sec11 tion, the term ‘eligible entity’ means a nonprofit organiza12 tion, an institution of higher education (as defined in sec13 tion 101 of the Higher Education Act of 1965), a Federal, 

14 State, or local governmental agency, or a media organiza15 tion. 

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

17 is authorized to be appropriated to carry out this section 

18 $5,000,000 for each of fiscal years 2010 and 2011.’’. 

19 SEC. 6. 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 

25 (2) by inserting after section 487G (as so re26 designated) the following: 


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1 ‘‘SEC. 487H. LOAN REPAYMENT PROGRAM REGARDING PHY2 SICIAN RESEARCH ON AUTOIMMUNE DIS3 EASES. 

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

5 amounts provided in advance in appropriations Acts, the 

6 Secretary, acting through the Administrator of the Health 

7 Resources and Services Administration, shall establish a 

8 program to enter into contracts with qualified physicians 

9 under which such qualified physicians agree to conduct re10 search for a period of at least 3 years regarding auto11 immune diseases in consideration of the Federal Govern12 ment agreeing to repay, for each year of service con13 ducting such research, not more than $35,000 of the prin14 cipal and interest of the educational loans of such qualified 

15 physicians. 

16 ‘‘(b) APPLICATION OF PROVISIONS.—Except as in17 consistent with this section, the provisions of sections 

18 338B, 338C, and 338E shall apply to the program estab19 lished under this section to the same extent and in the 

20 same manner as such provisions apply to the National 

21 Health Service Corps Loan Repayment Program estab22 lished in subpart III of part D of title III. 

23 ‘‘(c) QUALIFIED PHYSICIAN.—For purposes of this 

24 section, the term ‘qualified physician’ means an individual 

25 who has received, or will have received by the time of the 

26 research to be conducted under this section, a degree of 


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1 doctor of medicine or its equivalent and is licensed to prac2 tice medicine in the United States.’’. 

3 SEC. 7. RESEARCH AND DATABASE ON BIOMARKERS OF 

4 AUTOIMMUNE DISEASES. 

5 Subpart 4 of part C of title IV of the Public Health 

6 Service Act (42 U.S.C. 285d et seq.) is amended by adding 

7 at the end the following: 

8 ‘‘SEC. 442B. BIOMARKERS OF AUTOIMMUNE DISEASES. 

9 ‘‘(a) RESEARCH.—The Director of the Institute shall 

10 conduct or support research on biomarkers of autoimmune 

11 diseases for the purpose of— 

12 ‘‘(1) preventing such diseases; and 

13 ‘‘(2) making dramatic improvements in the di14 agnosis, treatment, and monitoring of such diseases. 

15 ‘‘(b) DATABASE.—The Director of the Institute shall 

16 establish and maintain a database on biomarkers of auto17 immune diseases for the purpose of facilitating research 

18 on, and understanding of, the relationship between such 

19 biomarkers and the development and severity of auto20 immune diseases. 

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

22 is authorized to be appropriated to carry out this section 

23 $10,000,000 for each of fiscal years 2010 and 2011.’’. 

Æ 


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