I 

111TH CONGRESS 

1ST SESSION H. R. 1210 

To amend the Public Health Service Act to provide for arthritis research 

and public health, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 26, 2009 

Ms. ESHOO (for herself, Mr. UPTON, Ms. SCHAKOWSKY, Mr. VAN HOLLEN, 

Ms. BORDALLO, Mr. LANGEVIN, Mr. KLEIN of Florida, Mr. 

MCDERMOTT, Mr. WU, Mr. BURTON of Indiana, Mr. KING of New York, 

Ms. BALDWIN, Mr. SARBANES, Mr. BISHOP of Georgia, Mr. YARMUTH, 

Mr. KENNEDY, Mr. RUSH, Mrs. CAPPS, Ms. HARMAN, Mr. MORAN of 

Virginia, Mr. MURPHY of Connecticut, Mr. BISHOP of New York, Mr. 

SENSENBRENNER, Mr. MURTHA, Mr. BERMAN, Mr. FRELINGHUYSEN, 

Mr. ISRAEL, Mr. MATHESON, Mr. SESSIONS, Mrs. EMERSON, Mr. 

PASCRELL, Ms. NORTON, Ms. MATSUI, Mr. TERRY, Mr. MCHUGH, Mr. 

GENE GREEN of Texas, Mr. HOLT, Ms. CASTOR of Florida, Mr. RAHALL, 

Mr. BOUCHER, Mr. NEAL of Massachusetts, Mr. FRANK of Massachusetts, Ms. DELAURO, Mr. SESTAK, Mr. MOORE of Kansas, Mrs. 

SCHMIDT, Ms. BERKLEY, and Mr. MORAN of Kansas) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act to provide for 

arthritis research and public health, 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, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Arthritis Prevention, 

3 Control, and Cure Act of 2009’’. 

4 SEC. 2. ENHANCING THE PUBLIC HEALTH ACTIVITIES RE5 LATED TO ARTHRITIS OF THE CENTERS FOR 

6 DISEASE CONTROL AND PREVENTION 

7 THROUGH THE NATIONAL ARTHRITIS ACTION 

8 PLAN. 

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

10 (42 U.S.C. 243 et seq.) is amended by inserting after sec11 tion 314 the following: 

12 ‘‘SEC. 315. IMPLEMENTATION OF THE NATIONAL ARTHRITIS 

13 ACTION PROGRAM. 

14 ‘‘(a) ESTABLISHMENT OF PROGRAM.—The Secretary 

15 may develop and implement a National Arthritis Action 

16 Program (in this section referred to as the ‘Program’) con17 sistent with this section. 

18 ‘‘(b) CONTROL, PREVENTION, AND SURVEIL19 LANCE.— 

20 ‘‘(1) IN GENERAL.—Under the Program, the 

21 Secretary, acting through the Director of the Cen22 ters for Disease Control and Prevention, may, di23 rectly or through competitive grants to eligible enti24 ties, conduct, support, and promote the coordination 

25 of research, investigations, demonstrations, training, 

26 and studies relating to the control, prevention, and 


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1 surveillance of arthritis and other rheumatic dis2 eases. 

3 ‘‘(2) TRAINING AND TECHNICAL ASSISTANCE.— 

4 With respect to the planning, development, and op5 eration of any activity carried out under paragraph 

6 (1), the Secretary may provide training, technical 

7 assistance, supplies, equipment, or services, and may 

8 assign any officer or employee of the Department of 

9 Health and Human Services to a State or local 

10 health agency, or to any public or nonprofit entity 

11 designated by a State health agency, in lieu of pro12 viding grant funds under this subsection. 

13 ‘‘(3) ARTHRITIS PREVENTION RESEARCH AT

14 THE CENTERS FOR DISEASE CONTROL AND PREVEN15 TION CENTERS.—The Secretary may provide addi16 tional grant support under this subsection to encour17 age the expansion of research related to the preven18 tion and management of arthritis at the Centers for 

19 Disease Control and Prevention. 

20 ‘‘(4) ELIGIBLE ENTITY.—For purposes of this 

21 subsection, the term ‘eligible entity’ means a na22 tional public or private nonprofit entity that dem23 onstrates to the satisfaction of the Secretary, in the 

24 application described in subsection (e), the ability of 


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1 the entity to carry out the activities described in 

2 paragraph (1). 

3 ‘‘(c) EDUCATION AND OUTREACH.— 

4 ‘‘(1) IN GENERAL.—Under the Program, the 

5 Secretary may coordinate and carry out national 

6 education and outreach activities, directly or through 

7 the provision of grants to eligible entities, to sup8 port, develop, and implement education initiatives 

9 and outreach strategies appropriate for arthritis and 

10 other rheumatic diseases. 

11 ‘‘(2) INITIATIVES AND STRATEGIES.—Initiatives 

12 and strategies implemented under paragraph (1) 

13 may include public awareness campaigns, public 

14 service announcements, and community partnership 

15 workshops, as well as programs targeted at busi16 nesses and employers, managed care organizations, 

17 and health care providers. 

18 ‘‘(3) PRIORITY.—In carrying out paragraph (1), 

19 the Secretary— 

20 ‘‘(A) may emphasize prevention, early di21 agnosis, and appropriate management of arthri22 tis, and opportunities for effective patient self23 management; and 

24 ‘‘(B) may give priority to reaching high25 risk or underserved populations. 


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1 ‘‘(4) COLLABORATION.—In carrying out this 

2 subsection, the Secretary shall consult and collabo3 rate with stake-holders from the public, private, and 

4 nonprofit sectors with expertise relating to arthritis 

5 control, prevention, and treatment. 

6 ‘‘(5) ELIGIBLE ENTITY.—For purposes of this 

7 subsection, the term ‘eligible entity’ means a na8 tional public or private nonprofit entity that dem9 onstrates to the satisfaction of the Secretary, in the 

10 application described in subsection (e), the ability of 

11 the entity to carry out the activities described in 

12 paragraph (1). 

13 ‘‘(d) COMPREHENSIVE STATE GRANTS.— 

14 ‘‘(1) IN GENERAL.—Under the Program, the 

15 Secretary may award grants to eligible entities to 

16 provide support for comprehensive arthritis control 

17 and prevention programs and to enable such entities 

18 to provide public health surveillance, prevention, and 

19 control activities related to arthritis and other rheu20 matic diseases. 

21 ‘‘(2) ELIGIBILITY.—To be eligible to receive a 

22 grant under this subsection, an entity shall be a 

23 State or Indian tribe. 

24 ‘‘(3) APPLICATION.—To be eligible to receive a 

25 grant under this subsection, an entity shall submit 


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1 to the Secretary an application at such time, in such 

2 manner, and containing such agreements, assur3 ances, and information as the Secretary may re4 quire, including a comprehensive arthritis control 

5 and prevention plan that— 

6 ‘‘(A) is developed with the advice of stake7 holders from the public, private, and nonprofit 

8 sectors that have expertise relating to arthritis 

9 control, prevention, and treatment that increase 

10 the quality of life and decrease the level of dis11 ability; 

12 ‘‘(B) is intended to reduce the morbidity of 

13 arthritis, with priority on preventing and con14 trolling arthritis in at-risk populations and re15 ducing disparities in arthritis prevention, diag16 nosis, management, and quality of care in un17 derserved populations; 

18 ‘‘(C) describes the arthritis-related services 

19 and activities to be undertaken or supported by 

20 the entity; and 

21 ‘‘(D) demonstrates the relationship the en22 tity has with the community and local entities 

23 and how the entity plans to involve such com24 munity and local entities in carrying out the ac25 tivities described in paragraph (1). 


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1 ‘‘(4) USE OF FUNDS.—An eligible entity may 

2 use amounts received under a grant awarded under 

3 this subsection to conduct, in a manner consistent 

4 with the comprehensive arthritis control and preven5 tion plan submitted by the entity in the application 

6 under paragraph (3)— 

7 ‘‘(A) public health surveillance and epide8 miological activities relating to the prevalence of 

9 arthritis and assessment of disparities in arthri10 tis prevention, diagnosis, management, and 

11 care; 

12 ‘‘(B) public information and education pro13 grams; and 

14 ‘‘(C) education, training, and clinical skills 

15 improvement activities for health professionals, 

16 including allied health personnel. 

17 ‘‘(e) GENERAL APPLICATION.—To be eligible to re18 ceive a grant under this section, except under subsection 

19 (d), an entity shall submit to the Secretary an application 

20 at such time, in such manner, and containing such agree21 ments, assurances, and information as the Secretary may 

22 require, including a description of how funds received 

23 under a grant awarded under this section will supplement 

24 or fulfill unmet needs identified in a comprehensive arthri25 tis control and prevention plan of the entity. 


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1 ‘‘(f) DEFINITIONS.—For purposes of this section: 

2 ‘‘(1) INDIAN TRIBE.—The term ‘Indian tribe’ 

3 has the meaning given such term in section 4(e) of 

4 the Indian Self-Determination and Education Assist5 ance Act (25 U.S.C. 450b(e)). 

6 ‘‘(2) STATE.—The term ‘State’ means any 

7 State of the United States, the District of Columbia, 

8 the Commonwealth of Puerto Rico, the Virgin Is9 lands, American Samoa, Guam, and the Northern 

10 Mariana Islands. 

11 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 

12 are authorized to be appropriated to carry out this sec13 tion— 

14 ‘‘(1) for fiscal year 2010, $32,000,000; 

15 ‘‘(2) for fiscal year 2011, $34,000,000; 

16 ‘‘(3) for fiscal year 2012, $36,000,000; 

17 ‘‘(4) for fiscal year 2013, $38,000,000; and 

18 ‘‘(5) for fiscal year 2014, $40,000,000.’’. 

19 SEC. 3. ACTIVITIES OF THE DEPARTMENT OF HEALTH AND 

20 HUMAN SERVICES WITH RESPECT TO JUVE21 NILE ARTHRITIS AND RELATED CONDITIONS. 

22 (a) IN GENERAL.—The Secretary of Health and 

23 Human Services, in coordination with the Director of the 

24 National Institutes of Health, may expand and intensify 

25 programs of the National Institutes of Health with respect 


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1 to research and related activities concerning various forms 

2 of juvenile arthritis and related conditions. 

3 (b) COORDINATION.—The Director of the National 

4 Institutes of Health may coordinate the programs referred 

5 to in subsection (a) and consult with additional Federal 

6 officials, voluntary health associations, medical profes7 sional societies, and private entities as appropriate. 

8 SEC. 4. PUBLIC HEALTH AND SURVEILLANCE ACTIVITIES 

9 RELATED TO JUVENILE ARTHRITIS AT THE 

10 CENTERS FOR DISEASE CONTROL AND PRE11 VENTION. 

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

13 (42 U.S.C. 243 et seq.) is amended by inserting after sec14 tion 320A the following: 

15 ‘‘SEC. 320B. SURVEILLANCE AND RESEARCH REGARDING 

16 JUVENILE ARTHRITIS. 

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

18 the Director of the Centers for Disease Control and Pre19 vention, may award grants to and enter into cooperative 

20 agreements with public or nonprofit private entities for the 

21 collection, analysis, and reporting of data on juvenile ar22 thritis. 

23 ‘‘(b) TECHNICAL ASSISTANCE.—In awarding grants 

24 and entering into agreements under subsection (a), the 


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1 Secretary may provide direct technical assistance in lieu 

2 of cash. 

3 ‘‘(c) COORDINATION WITH NIH.—The Secretary 

4 shall ensure that epidemiological and other types of infor5 mation obtained under subsection (a) is made available to 

6 the National Institutes of Health. 

7 ‘‘(d) CREATION OF A NATIONAL JUVENILE ARTHRI8 TIS POPULATION-BASED DATABASE.—The Secretary, act9 ing through the Director of the Centers for Disease Con10 trol and Prevention and in collaboration with a national 

11 voluntary health organization with experience serving the 

12 juvenile arthritis population as well as the full spectrum 

13 of arthritis-related conditions, may support the develop14 ment of a national juvenile arthritis population-based 

15 database to collect specific data for follow-up studies re16 garding the prevalence and incidence of juvenile arthritis, 

17 as well as capturing information on evidence-based health 

18 outcomes related to specific therapies and interventions. 

19 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the 

20 purpose of carrying out this section, there is authorized 

21 to be appropriated $25,000,000 for each of fiscal years 

22 2010 through 2014.’’ 

23 SEC. 5. INVESTMENT IN TOMORROW’S PEDIATRIC 

24 RHEUMATOLOGISTS. 

25 (a) ENHANCED SUPPORT.— 


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1 (1) IN GENERAL.—In order to ensure an ade2 quate future supply of pediatric rheumatologists, the 

3 Secretary of Health and Human Services, in con4 sultation with the Administrator of the Health Re5 sources and Services Administration, shall support 

6 activities that provide for— 

7 (A) an increase in the number and size of 

8 institutional training grants awarded to institu9 tions to support pediatric rheumatology train10 ing; and 

11 (B) an expansion of public-private partner12 ships to encourage academic institutions, pri13 vate sector entities, and health agencies to pro14 mote educational training and fellowship oppor15 tunities for pediatric rheumatologists. 

16 (2) AUTHORIZATION OF APPROPRIATIONS.— 

17 There are authorized to be appropriated to carry out 

18 this subsection $3,750,000 for each of the fiscal 

19 years 2010 through 2014. 

20 (b) PEDIATRIC LOAN REPAYMENT PROGRAM.— 

21 (1) IN GENERAL.—The Secretary of Health and 

22 Human Services, in consultation with the Adminis23 trator of the Health Resources and Services Admin24 istration, shall establish and, subject to the deterVerDate Nov 24 2008 01:01 Feb 28, 2009 Jkt 079200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H1210.IH H1210

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1 mination under paragraph (3), carry out a pediatric 

2 rheumatology loan repayment program. 

3 (2) PROGRAM ADMINISTRATION.—Through the 

4 program established under this subsection, the Sec5 retary shall— 

6 (A) enter into contracts with qualified 

7 health professionals who are pediatric 

8 rheumatologists under which— 

9 (i) such professionals agree to provide 

10 health care in an area with a shortage of 

11 pediatric rheumatologists and that has the 

12 capacity to support pediatric rheumatology, 

13 as determined by the Secretary of Health 

14 and Human Services; and 

15 (ii) the Federal Government agrees to 

16 repay, for each year of such service, not 

17 more than $25,000 of the principal and in18 terest of the educational loans of such pro19 fessionals; and 

20 (B) in addition to making payments under 

21 paragraph (1) on behalf of an individual, make 

22 payments to the individual for the purpose of 

23 providing reimbursement for tax liability result24 ing from the payments made under paragraph 

25 (1), in an amount equal to 39 percent of the 


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1 total amount of the payments made for the tax2 able year involved. 

3 (3) DETERMINATION OF SHORTAGE AREAS.— 

4 For purposes of this subsection, an area shall be de5 termined to be an area with a shortage of pediatric 

6 rheumatologists based on the ratio of the number of 

7 children who reside in such area who are in need of 

8 services of a pediatric rheumatologist to the number 

9 of pediatric rheumatologists who furnish services 

10 within 100 miles of the area. 

11 (4) PERIODIC ASSESSMENTS.— 

12 (A) IN GENERAL.—The Secretary of 

13 Health and Human Services shall periodically 

14 assess— 

15 (i) the extent to which the loan repay16 ment program under this section is needed; 

17 and 

18 (ii) the extent to which the program is 

19 effective in increasing the number of pedi20 atric rheumatologists nationally and the 

21 number of pediatric rheumatologists in 

22 areas with a shortage of pediatric 

23 rheumatologists. 

24 In the case that the Secretary determines, pur25 suant to an assessment under this subparaVerDate Nov 24 2008 01:01 Feb 28, 2009 Jkt 079200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\H1210.IH H1210

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1 graph, that there is no longer a need for the 

2 loan repayment program, such program shall be 

3 terminated as of a date specified by the Sec4 retary. 

5 (B) ANNUAL REPORTS.—The Secretary of 

6 Health and Human Services shall annually re7 port to Congress on the periodic assessments 

8 conducted under subparagraph (A). 

9 (5) FUNDING.— 

10 (A) IN GENERAL.—For the purpose of car11 rying out this subsection, the Secretary of 

12 Health and Human Services may reserve, from 

13 amounts appropriated for the Health Resources 

14 and Services Administration for the fiscal year 

15 involved, such amounts as the Secretary deter16 mines to be appropriate. 

17 (B) AVAILABILITY OF FUNDS.—Amounts 

18 made available to carry out this section shall re19 main available until the expiration of the second 

20 fiscal year beginning after the fiscal year for 

21 which such amounts were made available. 

Æ 


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