I 

113TH CONGRESS 

1ST SESSION H. R. 3322 

To amend the Public Health Service Act to prevent and treat diabetes, 

to promote and improve the care of individuals with diabetes, and to 

reduce health disparities, relating to diabetes, within racial and ethnic 

minority groups, including the African-American, Hispanic American, 

Asian American, Native Hawaiian and Other Pacific Islander, and American Indian and Alaskan Native communities. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 23, 2013 

Ms. DEGETTE (for herself, Mr. WHITFIELD, Mr. HINOJOSA, Ms. CHU, and 

Ms. FUDGE) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act to prevent and 

treat diabetes, to promote and improve the care of individuals with diabetes, and to reduce health disparities, 

relating to diabetes, within racial and ethnic minority 

groups, including the African-American, Hispanic American, Asian American, Native Hawaiian and Other 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, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Eliminating Dispari3 ties in Diabetes Prevention, Access, and Care Act of 

4 2013’’. 

5 TITLE I—NATIONAL INSTITUTES 

6 OF HEALTH 

7 SEC. 101. RESEARCH, TREATMENT, AND EDUCATION. 

8 (a) IN GENERAL.—Subpart 3 of part C of title IV 

9 of the Public Health Service Act (42 U.S.C. 285c et seq.) 

10 is amended by adding at the end the following new section: 

11 ‘‘SEC. 434B. DIABETES IN MINORITY POPULATIONS. 

12 ‘‘(a) IN GENERAL.—The Director of NIH shall ex13 pand, intensify, and support ongoing research and other 

14 activities with respect to prediabetes and diabetes, particu15 larly type 2, in minority populations. 

16 ‘‘(b) RESEARCH.— 

17 ‘‘(1) DESCRIPTION.—Research under subsection 

18 (a) shall include investigation into— 

19 ‘‘(A) the causes of diabetes, including so20 cioeconomic, geographic, clinical, environmental, 

21 genetic, and other factors that may contribute 

22 to increased rates of diabetes in minority popu23 lations; and 

24 ‘‘(B) the causes of increased incidence of 

25 diabetes complications in minority populations, 


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1 and possible interventions to decrease such inci2 dence. 

3 ‘‘(2) INCLUSION OF MINORITY PARTICIPANTS.— 

4 In conducting and supporting research described in 

5 subsection (a), the Director of NIH shall seek to in6 clude minority participants as study subjects in clin7 ical trials. 

8 ‘‘(c) REPORT; COMPREHENSIVE PLAN.— 

9 ‘‘(1) IN GENERAL.—The Diabetes Mellitus 

10 Interagency Coordinating Committee shall— 

11 ‘‘(A) prepare and submit to the Congress, 

12 not later than 6 months after the date of enact13 ment of this section, a report on Federal re14 search and public health activities with respect 

15 to prediabetes and diabetes in minority popu16 lations; and 

17 ‘‘(B) develop and submit to the Congress, 

18 not later than 1 year after the date of enact19 ment of this section, an effective and com20 prehensive Federal plan (including all appro21 priate Federal health programs) to address 

22 prediabetes and diabetes in minority popu23 lations. 


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1 ‘‘(2) CONTENTS.—The report under paragraph 

2 (1)(A) shall at minimum address each of the fol3 lowing: 

4 ‘‘(A) Research on diabetes and prediabetes 

5 in minority populations, including such research 

6 on— 

7 ‘‘(i) genetic, behavioral, and environ8 mental factors; and 

9 ‘‘(ii) prevention and complications 

10 among individuals within these populations 

11 who have already developed diabetes. 

12 ‘‘(B) Surveillance and data collection on 

13 diabetes and prediabetes in minority popu14 lations, including with respect to— 

15 ‘‘(i) efforts to better determine the 

16 prevalence of diabetes among Asian Amer17 ican and Pacific Islander subgroups; and 

18 ‘‘(ii) efforts to coordinate data collec19 tion on the American Indian population. 

20 ‘‘(C) Community-based interventions to ad21 dress diabetes and prediabetes targeting minor22 ity populations, including— 

23 ‘‘(i) the evidence base for such inter24 ventions; 


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1 ‘‘(ii) the cultural appropriateness of 

2 such interventions; and 

3 ‘‘(iii) efforts to educate the public on 

4 the causes and consequences of diabetes. 

5 ‘‘(D) Education and training programs for 

6 health professionals (including community 

7 health workers) on the prevention and manage8 ment of diabetes and its related complications 

9 that is supported by the Health Resources and 

10 Services Administration, including such pro11 grams supported by— 

12 ‘‘(i) the National Health Service 

13 Corps; or 

14 ‘‘(ii) the community health centers 

15 program under section 330. 

16 ‘‘(d) EDUCATION.—The Director of NIH shall— 

17 ‘‘(1) through the National Institute on Minority 

18 Health and Health Disparities and the National Di19 abetes Education Program— 

20 ‘‘(A) make grants to programs funded 

21 under section 464z–4 (relating to centers of ex22 cellence) for the purpose of establishing a men23 toring program for health care professionals to 

24 be more involved in weight counseling, obesity 

25 research, and nutrition; and 


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1 ‘‘(B) provide for the participation of mi2 nority health professionals in diabetes-focused 

3 research programs; and 

4 ‘‘(2) make grants for programs to establish a 

5 pipeline from high school to professional school that 

6 will increase minority representation in diabetes-fo7 cused health fields by expanding Minority Access to 

8 Research Careers (MARC) program internships and 

9 mentoring opportunities for recruitment. 

10 ‘‘(e) DEFINITIONS.—For purposes of this section: 

11 ‘‘(1) The ‘Diabetes Mellitus Interagency Coordi12 nating Committee’ means the Diabetes Mellitus 

13 Interagency Coordinating Committee established 

14 under section 429. 

15 ‘‘(2) The term ‘minority population’ means a 

16 racial and ethnic minority group, as defined in sec17 tion 1707.’’. 

18 TITLE II—CENTERS FOR DIS19 EASE CONTROL AND PREVEN20 TION 

21 SEC. 201. RESEARCH, EDUCATION, AND OTHER ACTIVITIES. 

22 Part B of title III of the Public Health Service Act 

23 (42 U.S.C. 243 et seq.) is amended by inserting after sec24 tion 317T the following section: 


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1 ‘‘SEC. 317U. DIABETES IN MINORITY POPULATIONS. 

2 ‘‘(a) RESEARCH AND OTHER ACTIVITIES.— 

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

4 through the Director of the Centers for Disease 

5 Control and Prevention, shall conduct and support 

6 research and public health activities with respect to 

7 diabetes in minority populations. 

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

9 paragraph (1) regarding diabetes in minority popu10 lations shall include the following: 

11 ‘‘(A) Further enhancing the National 

12 Health and Nutrition Examination Survey by 

13 over-sampling Asian American, Native Hawai14 ian, and Other Pacific Islanders in appropriate 

15 geographic areas to better determine the preva16 lence of diabetes in such populations as well as 

17 to improve the data collection of diabetes pene18 tration disaggregated into major ethnic groups 

19 within such populations. The Secretary shall en20 sure that any such oversampling does not re21 duce the oversampling of other minority popu22 lations including African-American and Latino 

23 populations. 

24 ‘‘(B) Through the Division of Diabetes 

25 Translation— 


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1 ‘‘(i) providing for prevention research 

2 to better understand how to influence 

3 health care systems changes to improve 

4 quality of care being delivered to such pop5 ulations; 

6 ‘‘(ii) carrying out model demonstra7 tion projects to design, implement, and 

8 evaluate effective diabetes prevention and 

9 control interventions for minority popu10 lations, including culturally appropriate 

11 community-based interventions; 

12 ‘‘(iii) developing and implementing a 

13 strategic plan to reduce diabetes in minor14 ity populations through applied research to 

15 reduce disparities and culturally and lin16 guistically appropriate community-based 

17 interventions; 

18 ‘‘(iv) supporting, through the national 

19 diabetes prevention program under section 

20 399V–3, diabetes prevention program sites 

21 in underserved regions highly impacted by 

22 diabetes; and 

23 ‘‘(v) implementing, through the na24 tional diabetes prevention program under 

25 section 399V–3, a demonstration program 


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1 developing new metrics measuring health 

2 outcomes related to diabetes that can be 

3 stratified by specific minority populations. 

4 ‘‘(b) EDUCATION.—The Secretary, acting through 

5 the Director of the Centers for Disease Control and Pre6 vention, shall direct the Division of Diabetes Translation 

7 to conduct and support both programs to educate the pub8 lic on diabetes in minority populations and programs to 

9 educate minority populations about the causes and effects 

10 of diabetes. 

11 ‘‘(c) DIABETES; HEALTH PROMOTION, PREVENTION

12 ACTIVITIES, AND ACCESS.—The Secretary, acting through 

13 the Director of the Centers for Disease Control and Pre14 vention and the National Diabetes Education Program, 

15 shall conduct and support programs to educate specific 

16 minority populations through culturally appropriate and 

17 linguistically appropriate information campaigns about 

18 prevention of, and managing, diabetes. 

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

20 term ‘minority population’ means a racial and ethnic mi21 nority group, as defined in section 1707.’’. 


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1 TITLE III—HEALTH RESOURCES 

2 AND SERVICES ADMINISTRA3 TION 

4 SEC. 301. RESEARCH, EDUCATION, AND OTHER ACTIVITIES. 

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

6 (42 U.S.C. 280g et seq.) is amended by adding at the end 

7 the following new section: 

8 ‘‘SEC. 399V–6. PROGRAMS TO EDUCATE HEALTH PRO9 VIDERS ON THE CAUSES AND EFFECTS OF DI10 ABETES IN MINORITY POPULATIONS. 

11 ‘‘(a) IN GENERAL.—The Secretary, acting through 

12 the Director of the Health Resources and Services Admin13 istration, shall conduct and support programs described 

14 in subsection (b) to educate health professionals on the 

15 causes and effects of diabetes in minority populations. 

16 ‘‘(b) PROGRAMS.—Programs described in this sub17 section, with respect to education on diabetes in minority 

18 populations, shall include the following: 

19 ‘‘(1) Giving priority, under the primary care 

20 training and enhancement program under section 

21 747— 

22 ‘‘(A) to awarding grants to focus on or ad23 dress diabetes; and 


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1 ‘‘(B) adding minority populations to the 

2 list of vulnerable populations that should be 

3 served by such grants. 

4 ‘‘(2) Providing additional funds for the Health 

5 Careers Opportunity Program, Centers for Excel6 lence, and the Minority Faculty Fellowship Program 

7 to partner with the Office of Minority Health under 

8 section 1707 and the National Institutes of Health 

9 to strengthen programs for career opportunities fo10 cused on diabetes treatment and care within under11 served regions highly impacted by diabetes. 

12 ‘‘(3) Developing a diabetes focus within, and 

13 providing additional funds for, the National Health 

14 Service Corps Scholarship Program— 

15 ‘‘(A) to place individuals in areas that are 

16 disproportionately affected by diabetes and to 

17 provide diabetes treatment and care in such 

18 areas; and 

19 ‘‘(B) to provide such individuals continuing 

20 medical education specific to diabetes care.’’. 

21 TITLE IV—INDIAN HEALTH 

22 SERVICE 

23 SEC. 401. RESEARCH, EDUCATION, AND OTHER ACTIVITIES. 

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

25 (42 U.S.C. 280g et seq.), as amended by section 301, is 


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1 further amended by adding at the end the following sec2 tion: 

3 ‘‘SEC. 399V–7. RESEARCH, EDUCATION, AND OTHER ACTIVI4 TIES REGARDING DIABETES IN AMERICAN IN5 DIAN POPULATIONS. 

6 ‘‘In addition to activities under sections 317V–6 and 

7 434B, the Secretary, acting through the Indian Health 

8 Service and in collaboration with other appropriate Fed9 eral agencies, shall— 

10 ‘‘(1) conduct and support research and other 

11 activities with respect to diabetes; and 

12 ‘‘(2) coordinate the collection of data on clini13 cally and culturally appropriate diabetes treatment, 

14 care, prevention, and services by health care profes15 sionals to the American Indian population.’’. 

16 TITLE V—INSTITUTE OF 

17 MEDICINE REPORT 

18 SEC. 501. UPDATED REPORT ON HEALTH DISPARITIES. 

19 The Secretary of Health and Human Services shall 

20 seek to enter into an arrangement with the Institute of 

21 Medicine under which the Institute will— 

22 (1) not later than 1 year after the date of en23 actment of this Act, submit to the Congress an up24 dated version of the Institute’s 2002 report entitled 


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1 ‘‘Unequal Treatment: Confronting Racial and Ethnic 

2 Disparities in Health Care’’; and 

3 (2) in such updated version, address how racial 

4 and ethnic health disparities have changed since the 

5 publication of the original report. 

Æ 


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