I 

109TH CONGRESS 

2D SESSION H. R. 5225 

To amend the Public Health Service Act to prevent and cure diabetes and 

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

reduction of health disparities within racial and ethnic minority groups, 

including the African-American, Hispanic American, Asian American and 

Pacific Islander, and American Indian and Alaskan Native communities. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 27, 2006 

Ms. DEGETTE (for herself, Mr. BECERRA, Mr. CASTLE, Mr. CUMMINGS, Mr. 

DAVIS of Alabama, Mr. DAVIS of Illinois, Mr. GUTIERREZ, Mr. 

HAYWORTH, Mr. HINOJOSA, Mr. HONDA, Mr. JACKSON of Illinois, Ms. 

JACKSON-LEE of Texas, Ms. KILPATRICK of Michigan, Mrs. 

NAPOLITANO, Mr. OWENS, Mr. REYES, Ms. LINDA T. SA ́NCHEZ of California, Ms. SOLIS, Ms. WATERS, Mr. WELDON of Pennsylvania, and Mr. 

WU) 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 

cure diabetes and to promote and improve the care of 

individuals with diabetes for the reduction of health disparities within racial and ethnic minority groups, including the African-American, Hispanic American, Asian 

American and 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 ‘‘Diabetes Prevention 

3 Access and Care Act’’. 

4 TITLE I—NATIONAL INSTITUTES 

5 OF HEALTH 

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

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

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

9 is amended by adding at the end the following section: 

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

11 ‘‘(a) IN GENERAL.—The Director of NIH shall ex12 pand, intensify, conduct, coordinate, and support research 

13 and other activities with respect to pre-diabetes and diabe14 tes, particularly type 2, in minority populations, including 

15 research to identify clinical, socioeconomic, geographical, 

16 cultural, and organizational factors that contribute to type 

17 2 diabetes in such populations. 

18 ‘‘(b) CERTAIN ACTIVITIES.—Activities under sub19 section (a) regarding type 2 diabetes in minority popu20 lations shall include the following: 

21 ‘‘(1) Research on behavior and obesity, includ22 ing research through the obesity research center that 

23 is sponsored by the National Institutes of Health. 

24 ‘‘(2) Research on environmental factors that 

25 may contribute to the increase in type 2 diabetes, 

26 which shall be conducted or supported through the 


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1 National Institute of Environmental Health Sciences 

2 and the National Human Genome Research Insti3 tute. 

4 ‘‘(3) Support for new methods to identify envi5 ronmental triggers and genetic interactions that lead 

6 to the development of type 1 and type 2 diabetes in 

7 minority newborns with a high genetic susceptibility 

8 to the disease. Such research should follow the 

9 newborns through puberty, which is a high-risk pe10 riod for developing type 1 diabetes, and—increas11 ingly—type 2 diabetes. 

12 ‘‘(4) Research to identify genes that predispose 

13 individuals to the onset of developing type 1 and 

14 type 2 diabetes and to develop complications. 

15 ‘‘(5) Research to prevent complications in indi16 viduals who have already developed diabetes, such as 

17 attempting to identify the genes that predispose in18 dividuals with diabetes to the development of com19 plications, as well as methods and alternative thera20 pies to control blood glucose. 

21 ‘‘(6) The support of ongoing research efforts 

22 examining the level of glycemia at which adverse 

23 outcomes develop during pregnancy and to address 

24 the many clinical issues associated with minority 


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1 mothers and fetuses during diabetic and gestational 

2 diabetic pregnancies. 

3 ‘‘(c) TREATMENT.— 

4 ‘‘(1) IN GENERAL.—The Director of NIH shall 

5 conduct and support programs to treat diabetes in 

6 minority populations. 

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

8 paragraph (1) regarding the treatment of diabetes in 

9 minority populations shall include recommending 

10 and disseminating, through the National Center on 

11 Minority Health and Health Disparities, the guide12 lines of the American Diabetes Association for nutri13 tion exercise and diet for diabetes treatment and 

14 prevention. 

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

16 ‘‘(1) through the National Center on Minority 

17 Health and Health Disparities— 

18 ‘‘(A) make grants to programs funded 

19 under section 485F (relating to centers of ex20 cellence) for the purpose of establishing a men21 toring program for health care professionals to 

22 be more involved in weight counseling, obesity 

23 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) DEFINITION.—For purposes of this section, the 

11 term ‘minority populations’ means racial and ethnic mi12 nority groups within the meaning of section 1707. 

13 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For the 

14 purpose of carrying out this section, there are authorized 

15 to be appropriated such sums as may be necessary for fis16 cal year 2006 and each subsequent fiscal year.’’. 

17 (b) DIABETES MELLITUS INTERAGENCY COORDI18 NATING COMMITTEE.—Section 429 of the Public Health 

19 Service Act (42 U.S.C. 285c–3) is amended by adding at 

20 the end the following subsection: 

21 ‘‘(d)(1) In addition to other duties established in this 

22 section for the Diabetes Mellitus Interagency Coordinating 

23 Committee, such Committee shall— 

24 ‘‘(A) assess the current activities of all current 

25 Federal health programs to determine their adeVerDate Aug 31 2005 18:12 Apr 30, 2006 Jkt 049200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H5225.IH H5225

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1 quacy as a systemic method of addressing the im2 pact of diabetes mellitus on minority populations; 

3 ‘‘(B) undertake strategic planning activities to 

4 develop an effective and comprehensive Federal plan 

5 to address diabetes mellitus within communities of 

6 color which will involve all appropriate Federal 

7 health programs; and 

8 ‘‘(C) conduct the implementation of such a plan 

9 throughout all Federal health programs. 

10 ‘‘(2) The Federal plan under paragraph (1)(B) 

11 shall— 

12 ‘‘(A) include steps to address issues including, 

13 but not limited to, type 1 and type 2 diabetes in 

14 children and the disproportionate impact of diabetes 

15 mellitus on minority populations; and 

16 ‘‘(B) remain consistent with the programs and 

17 activities identified in sections 399O through 399R, 

18 as well as remaining consistent with the intent of 

19 the Diabetes Prevention Access and Care Act. 

20 ‘‘(3) For purposes of this subsection, the term ‘mi21 nority populations’ means racial and ethnic minority 

22 groups within the meaning of section 1707. 

23 ‘‘(4) For the purpose of carrying out this subsection, 

24 there are authorized to be appropriated such sums as may 


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1 be necessary for fiscal year 2006 and each subsequent fis2 cal year.’’. 

3 TITLE II—CENTERS FOR DIS4 EASE CONTROL AND PREVEN5 TION 

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

7 (a) IN GENERAL.—Part B of title III of the Public 

8 Health Service Act (42 U.S.C. 243 et seq.) is amended 

9 by inserting after section 317S the following section: 

10 ‘‘SEC. 317T. DIABETES IN MINORITY POPULATIONS. 

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

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

13 through the Director of the Centers for Disease 

14 Control and Prevention, shall conduct and support 

15 research and other activities with respect to diabetes 

16 in minority populations. 

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

18 paragraph (1) regarding diabetes in minority popu19 lations shall include the following: 

20 ‘‘(A) Expanding the National Diabetes 

21 Laboratory for translational research, and the 

22 identification of genetic and immunological risk 

23 factors associated with diabetes. 

24 ‘‘(B) Enhancing the National Health and 

25 Nutrition Examination Survey on eating and diVerDate Aug 31 2005 18:12 Apr 30, 2006 Jkt 049200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H5225.IH H5225

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1 etary habits, with a focus, including cultural 

2 and socioeconomic factors, on Hispanic Amer3 ican, African-American, American Indian and 

4 Alaskan Native, and Asian American and Pa5 cific Islander communities. 

6 ‘‘(C) Further enhancing the National 

7 Health and Nutrition Examination Survey by 

8 over-sampling Asian American and Pacific Is9 landers in appropriate geographic areas to bet10 ter determine the prevalence of diabetes in 

11 these populations as well as to improve the data 

12 collection of diabetes penetration disaggregated 

13 into major ethnic groups within this population. 

14 ‘‘(D) Within the Division of Diabetes 

15 Translation, providing for prevention research 

16 to better understand how to influence health 

17 care systems changes to improve quality of care 

18 being delivered to such populations, and within 

19 the Division of Diabetes Translation, carrying 

20 out model demonstration projects to design, im21 plement, and evaluate effective diabetes preven22 tion and control intervention for these popu23 lations. 

24 ‘‘(E) Through the Division of Diabetes 

25 Translation, carrying out culturally appropriate 


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1 community-based interventions designed to ad2 dress issues and problems experienced by these 

3 populations. 

4 ‘‘(F) Conducting applied research within 

5 the Division of Diabetes Translation to reduce 

6 health disparities within these populations with 

7 diabetes. 

8 ‘‘(G) Conducting applied research on pri9 mary prevention within the Division of Diabetes 

10 Translation to specifically focus on these popu11 lations with pre-diabetes. 

12 ‘‘(b) EDUCATION.— 

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

14 through the Director of the Centers for Disease 

15 Control and Prevention, shall direct the Division of 

16 Diabetes Translation to conduct and support pro17 grams to educate the public on the causes [of] ef18 fects of diabetes in minority populations. 

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

20 paragraph (1) regarding education on diabetes in 

21 minority populations shall include the following: 

22 ‘‘(A) Making grants for diabetes-focused 

23 education classes or training programs on cul24 tural sensitivity and patient care within such 

25 populations for health care providers. 


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1 ‘‘(B) Carrying out public awareness cam2 paigns directed toward such populations to ag3 gressively emphasize the importance and impact 

4 of physical activity and diet in regard to diabe5 tes and diabetes-related complications. 

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

7 ACTIVITIES, AND ACCESS.— 

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

9 through the Director of the Centers for Disease 

10 Control and Prevention, shall carry out culturally 

11 appropriate diabetes health promotion and preven12 tion programs for minority populations. 

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

14 paragraph (1) regarding culturally appropriate dia15 betes health promotion and prevention programs for 

16 minority populations shall include the following: 

17 ‘‘(A) Expanding the Diabetes Prevention 

18 and Control Program (currently existing in all 

19 the States and territories). 

20 ‘‘(B) Providing funds for the Diabetes 

21 Today program to adapt community planning 

22 tools within such populations. 

23 ‘‘(C) Providing funds for Racial and Eth24 nic Approaches to Community Health (REACH 

25 2010) grants to develop and evaluate diabetes 


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1 prevention and control community programs fo2 cused on such populations. 

3 ‘‘(D) Providing funds to community health 

4 centers for a monthly diabetes week program of 

5 diabetes services, including screenings. 

6 ‘‘(E) Providing funds for education and 

7 community outreach on diabetes. 

8 ‘‘(F) Providing funds for the United States 

9 and Mexico Border Diabetes project to develop 

10 culturally appropriate diabetes prevention and 

11 control interventions for minority populations in 

12 the border region. 

13 ‘‘(G) Providing funds for an aggressive 

14 prevention campaign that focuses on physical 

15 inactivity and diet and its relation to type 2 di16 abetes within such populations. 

17 ‘‘(H) Providing funds for surveillance sys18 tems and strategies for strengthening existing 

19 systems to improve the quality, accuracy, and 

20 timelines of morbidity and mortality diabetes 

21 data for such populations. 

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

23 term ‘minority populations’ means racial and ethnic mi24 nority groups within the meaning of section 1707. 


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

2 purpose of carrying out this section, there are authorized 

3 to be appropriated such sums as may be necessary for fis4 cal year 2006 and each subsequent fiscal year.’’. 

5 TITLE III—ADDITIONAL 

6 PROGRAMS 

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

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

9 (42 U.S.C. 280g et seq.) is amended by inserting after 

10 section 399N the following section: 

11 ‘‘SEC. 399O. RESEARCH, EDUCATION, AND OTHER ACTIVI12 TIES REGARDING DIABETES IN MINORITY 

13 POPULATIONS. 

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

15 ‘‘(1) IN GENERAL.—In addition to activities 

16 under sections 317T and 434B, the Secretary shall 

17 conduct and support research and other activities 

18 with respect to diabetes within minority populations. 

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

20 paragraph (1) regarding diabetes in minority popu21 lations shall include the following: 

22 ‘‘(A) Expanding the National Diabetes 

23 Education Program. 

24 ‘‘(B) Through the National Center on Mi25 nority Health and Health Disparities, the Office 


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1 of Minority Health under section 1707, the 

2 Health Resources and Service Administration, 

3 the Centers for Disease Control and Prevention, 

4 and the Indian Health Service, establishing 

5 partnerships within minority populations to 

6 conduct studies on cultural, familial, and social 

7 factors that may influence health promotion, di8 abetes management, and prevention. 

9 ‘‘(C) Through the Indian Health Service, 

10 in collaboration with other appropriate Federal 

11 agencies, conducting research on ethnic and cul12 turally appropriate diabetes treatment, care, 

13 prevention, and services by health care profes14 sionals to the American Indian population. 

15 ‘‘(3) PROGRAMS RELATING TO CLINICAL RE16 SEARCH.— 

17 ‘‘(A) EDUCATION REGARDING CLINICAL

18 TRIALS.—The Secretary shall carry out edu19 cation and awareness programs designed to in20 crease participation of minority populations in 

21 clinical trials. 

22 ‘‘(B) MINORITY RESEARCHERS.—The Sec23 retary shall carry out mentorship programs for 

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1 tend to conduct research on diabetes in minor2 ity populations. 

3 ‘‘(C) SUPPLEMENTING CLINICAL RE4 SEARCH REGARDING CHILDREN.—The Sec5 retary shall make grants to supplement clinical 

6 research programs to assist such programs in 

7 obtaining the services of health professionals 

8 and other resources to provide specialized care 

9 for children with type 1 and type 2 diabetes. 

10 ‘‘(b) EDUCATION.— 

11 ‘‘(1) IN GENERAL.—The Secretary shall con12 duct and support programs to educate the public on 

13 the causes of effects of diabetes in minority popu14 lations. 

15 ‘‘(2) HEALTH RESOURCES AND SERVICES AD16 MINISTRATION.—With respect to the Health Re17 sources and Services Administration, activities under 

18 paragraph (1) regarding education on diabetes in 

19 minority populations shall include the following: 

20 ‘‘(A) Providing additional funds for the 

21 Health Careers Opportunity Program, Centers 

22 for Excellence, and the Minority Faculty Fel23 lowship Program to partner with the Office of 

24 Minority Health under section 1707 and the 

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1 grams for career opportunities within minority 

2 populations focused on diabetes treatment and 

3 care. 

4 ‘‘(B) In partnership with the Health Re5 sources and Services Administration, develop a 

6 diabetes focus within, and provide additional 

7 funds for, the National Health Service Corps 

8 Scholarship program to place individuals in 

9 areas that are disproportionately affected by di10 abetes, to provide health care services. 

11 ‘‘(C) Establishing a diabetes ambassador 

12 program for recruitment efforts to increase the 

13 number of underrepresented minorities cur14 rently serving in student, faculty, or adminis15 trative positions in institutions of higher learn16 ing, hospitals, and community health centers. 

17 ‘‘(D) Establishing a loan repayment pro18 gram that focuses on diabetes care and preven19 tion. 

20 ‘‘(3) ADDITIONAL PROGRAMS.—Activities under 

21 paragraph (1) regarding education on diabetes in 

22 minority populations shall include the following: 

23 ‘‘(A) Through collaboration between the 

24 Health Resources and Services Administration 

25 and the Indian Health Service, establishing a 


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1 joint scholarship and loan-repayment program 

2 for American Indians health profession stu3 dents. 

4 ‘‘(B) Providing funds for new and existing 

5 diabetes-focused education grants and programs 

6 for present and future students and clinicians 

7 in the medical field from minority populations, 

8 including the following: 

9 ‘‘(i) Federal and State loan repayment 

10 programs for health profession students 

11 within communities of color. 

12 ‘‘(ii) Providing funds to the Office of 

13 Minority Health under section 1707 for 

14 training health profession students to focus 

15 on diabetes within such populations. 

16 ‘‘(iii) Providing funds to State and 

17 local entities to establish diabetes aware18 ness week or day every month in schools, 

19 nursing homes, and colleges through part20 nerships with the Office of Minority Health 

21 under section 1707 and the Health Re22 sources and Services Administration. 

23 ‘‘(c) DEFINITION.—For purposes of this section, the 

24 term ‘minority populations’ means racial and ethnic mi25 nority groups within the meaning of section 1707. 


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1 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the 

2 purpose of carrying out this section, there are authorized 

3 to be appropriated such sums as may be necessary for fis4 cal year 2006 and each subsequent fiscal year.’’. 

5 TITLE IV—STUDIES 

6 SEC. 401. STUDIES. 

7 (a) INSTITUTE OF MEDICINE.—The Secretary of 

8 Health and Human Services (referred to in this section 

9 as the ‘‘Secretary’’) shall request the Institute of Medicine 

10 to conduct a study to determine the extent and impact 

11 of the shortage of adult and pediatric endocrinologists spe12 cializing in diabetes, and to submit a report describing the 

13 findings of the study to the Secretary, to the Committee 

14 on Energy and Commerce of the House of Representa15 tives, and to the Committee on Health, Education, Labor, 

16 and Pensions of the Senate. The Secretary shall ensure 

17 that the report includes recommendations on changes in 

18 Federal policies that would increase the number of adult 

19 and pediatric endocrinologists specializing in diabetes. 

20 (b) AGENCY FOR HEALTHCARE RESEARCH AND

21 QUALITY.—The Secretary, acting through the Director of 

22 the Agency for Healthcare Research and Quality, shall 

23 conduct a study to determine whether minority children 

24 with diabetes have better or worse outcomes than non25 minority children. The study shall include a determination 


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1 of the extent to which minority children have access to 

2 and participate in disease management programs, and 

3 have access to and use medical devices such as continuous 

4 glucose monitoring systems, insulin pumps, and artificial 

5 pancreas. 

Æ 


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