```

[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2515 Introduced in House (IH)]

114th CONGRESS
  1st Session
                                H. R. 2515

     To amend the Public Health Service Act with respect to eating 
                   disorders, and for other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                              May 21, 2015

Mr. Deutch (for himself and Ms. Ros-Lehtinen) introduced the following 
 bill; which was referred to the Committee on Energy and Commerce, and 
 in addition to the Committees on Education and the Workforce and Ways 
 and Means, for a period to be subsequently determined by the Speaker, 
 in each case for consideration of such provisions as fall within the 
                jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL

 
     To amend the Public Health Service Act with respect to eating 
                   disorders, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Anna Westin Act of 2015''.

SEC. 2. TABLE OF CONTENTS.

    The table of contents of this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.
Sec. 3. Findings.
Sec. 4. Definition.
Sec. 5. Training and education.
Sec. 6. Education and training for health professionals.
Sec. 7. Education and training for school and higher education 
                            professionals.
Sec. 8. Public service announcements.
Sec. 9. Clarifying application of existing parity law.
Sec. 10. Report by Federal Trade Commission.
Sec. 11. Prohibition on new appropriations.

SEC. 3. FINDINGS.

    The Congress finds the following:
            (1) Risk of death among individuals with anorexia nervosa 
        is 18 times greater than their same age peers without anorexia. 
        It is estimated that at least one person dies every 62 minutes 
        from an eating disorder; at least 23 persons each day.
            (2) Health consequences such as osteoporosis (brittle 
        bones), gastrointestinal complications, cardiac, and dental 
        problems are significant health and financial burdens 
        throughout life.
            (3) At lowest estimate, 14.5 million Americans suffer from 
        eating disorders. One percent of adolescent boys and two 
        percent of adolescent girls suffer from eating disorders; 
        eating disorders account for at least four percent of all 
        childhood hospitalizations.
            (4) Eating disorders are treatable biopsychosocial 
        illnesses. There is a high rate of co-morbidity with other 
        illnesses such as depression, substance abuse, or anxiety 
        disorders.
            (5) Anorexia nervosa is an eating disorder characterized by 
        self-starvation, weight loss, fear of gaining weight and 
        disturbances in the way in which one's body weight or shape is 
        experienced (body image disturbance).
            (6) Anorexia nervosa is associated with serious health 
        consequences including heart failure, kidney failure, 
        osteoporosis, and death. People who suffer anorexia nervosa are 
        57 times more likely to die of suicide than their peers.
            (7) Current estimates of the lifetime prevalence of bulimia 
        nervosa are between 0.9 and 1.5 percent among women and between 
        0.1 and 0.5 percent among men.
            (8) Bulimia nervosa is associated with serious health 
        consequences, including cardiac, gastrointestinal, and dental 
        problems including irregular heartbeats, gastric rupture, 
        peptic ulcer, tooth decay, and death.
            (9) Binge eating disorder is characterized by frequent 
        episodes of uncontrolled overeating. Binge eating disorder is 
        common: at lowest estimate, 3.5 percent of American women and 
        2.0 percent of American men will suffer from this disorder in 
        their lifetime.
            (10) Binge eating is often associated with obesity, high 
        blood pressure, elevated cholesterol levels, elevated 
        triglyceride levels, increased risk of bowel, breast and 
        reproductive cancers, increased risk of diabetes, and increased 
        risk of arthritic damage to the joints.
            (11) Many suffer from some, but not all, of the symptoms of 
        anorexia nervosa, bulimia nervosa, or binge eating disorder, 
        which is referred to as other specified feeding or eating 
        disorder (OSFED). Between 4 percent and 20 percent of young 
        women practice unhealthy patterns of dieting, purging, and 
        binge eating.
            (12) Eating disorders are more common in women, but they do 
        occur in men. Rates of binge eating disorder are similar in 
        females and males.
            (13) Academic evidence has demonstrated a connection 
        between the use of very thin models in advertising and consumer 
        attitudes toward a brand based on such advertising, as well as 
        a material influence of the use of such models on consumer 
        purchase intent, conduct, and reliance.
            (14) Eating disorders appear across all age groups, races, 
        ethnicities and socioeconomic groups in the United States and 
        are associated with substantial psychological problems, 
        including depression, substance abuse, and suicide. For 
        children 12 years of age and younger, hospitalizations for 
        eating disorders increased by 119 percent between 1999 and 
        2006.

SEC. 4. DEFINITION.

    In this Act, the term ``eating disorder'' includes anorexia 
nervosa, bulimia nervosa, binge eating disorder, and other specified 
feeding or eating disorder (OSFED), as defined in the fifth edition of 
``Diagnostic and Statistical Manual of Mental Disorders'' or, if 
applicable, the most recent successor edition.

SEC. 5. TRAINING AND EDUCATION.

    Subject to section 11, the Secretary of Health and Human Services, 
acting through the Director of the Office on Women's Health of the 
Department of Health and Human Services and in consultation with the 
Secretary of Education, shall--
            (1) revise and then reinstate the BodyWise Handbook and 
        related fact sheets and resource lists available on the public 
        Internet site of the National Women's Health Information Center 
        sponsored by the Office on Women's Health, to include--
                    (A) updated findings and conclusions as needed; and
                    (B) thorough information about eating disorders 
                relating to males as well as females;
            (2) incorporate, as appropriate, information from such 
        BodyWise Handbook and related facts sheets and resource lists 
        into the curriculum of the BodyWorks obesity prevention program 
        developed by the Office on Women's Health and training modules 
        used in such obesity prevention program; and
            (3) promote and make publicly available (whether through a 
        public Internet site or other method that does not impose a fee 
        on users) the BodyWise Handbook and related fact sheets and 
        resource lists, as updated under paragraph (1), and the 
        BodyWorks obesity prevention program, as updated under 
        paragraph (2), including for purposes of educating universities 
        and nonprofit entities on eating disorders.

SEC. 6. EDUCATION AND TRAINING FOR HEALTH PROFESSIONALS.

    (a) In General.--Subject to section 11, the Secretary of Health and 
Human Services, acting through the Administrator of the Substance Abuse 
and Mental Health Services Administration, shall award grants to 
eligible entities to integrate training into existing curricula for 
primary care physicians, other licensed or certified health and mental 
health professionals, and public health professionals that may 
include--
            (1) early intervention and identification of eating 
        disorders;
            (2) levels of treatment (including family-based treatment, 
        in-patient, residential, partial hospitalization programming, 
        intensive outpatient and outpatient);
            (3) how to properly refer patients to treatment;
            (4) steps to aid in the prevention of the development of 
        eating disordered behaviors; and
            (5) how to treat individuals with eating disorders.
    (b) Application.--An entity that desires a grant under this section 
shall submit to the Secretary an application at such time, in such 
manner, and containing such information as the Secretary may require, 
including a plan for the use of funds that may be awarded and an 
evaluation of the training that will be provided.
    (c) Use of Funds.--An entity that receives a grant under this 
section shall use the funds made available through such grant to--
            (1) use a training program containing evidence-based 
        findings, promising emerging best practices, or recommendations 
        that pertain to the identification, early intervention, 
        prevention of the development of eating disordered behaviors, 
        and treatment of eating disorders to conduct educational 
        training and conferences, including Internet-based courses and 
        teleconferences, on--
                    (A) how to help prevent the development of eating 
                disordered behaviors, identify, intervene early, and 
                appropriately and adequately treat eating disordered 
                patients;
                    (B) how to identify individuals with eating 
                disorders, and those who are at risk for suffering from 
                eating disorders and, therefore, at risk for related 
                severe medical and mental health conditions;
                    (C) how to conduct a comprehensive assessment of 
                individual and familial health risk factors; and
                    (D) how to conduct a comprehensive assessment of a 
                treatment plan; and
            (2) evaluate and report to the Secretary on the 
        effectiveness of the training provided by such entity in 
        increasing knowledge and changing attitudes and behaviors of 
        trainees.

SEC. 7. EDUCATION AND TRAINING FOR SCHOOL AND HIGHER EDUCATION 
              PROFESSIONALS.

    (a) Grants.--
            (1) Authorization.--Subject to section 11, the Secretary of 
        Health and Human Services, acting through the Administrator of 
        the Substance Abuse and Mental Health Services Administration, 
        shall award grants to eligible entities--
                    (A) to conduct educational seminars for school 
                personnel on eating disorders early identification, 
                intervention, and prevention of behaviors that are 
                often associated with the development of eating 
                disordered behaviors; and
                    (B) to make resources available to individuals 
                affected by eating disorders.
            (2) Educational seminars.--As a condition on the receipt of 
        a grant under this subsection, an eligible entity shall agree 
        to conduct educational seminars under paragraph (1)(A), taking 
        into consideration educational materials made available through 
        the BodyWise eating disorder initiative of the Department of 
        Health and Human Services and relevant research on eating 
        disorders.
            (3) Eligible entity.--In this subsection, the term 
        ``eligible entity'' means any State, territory, or possession 
        of the United States, the District of Columbia, any Indian 
        tribe or tribal organization (as defined in subsections (e) and 
        (l), respectively, of section 4 of the Indian Self-
        Determination and Education Assistance Act (25 U.S.C. 450b)), 
        or a public or private educational institution, including an 
        institution of higher education.

SEC. 8. PUBLIC SERVICE ANNOUNCEMENTS.

    (a) In General.--Subject to section 11, the Director of the 
National Institute of Mental Health shall conduct a program of public 
service announcements to educate the public on--
            (1) the types of eating disorders;
            (2) the seriousness of eating disorders (including 
        prevalence, comorbidities, and physical and mental health 
        consequences);
            (3) how to identify, intervene, refer for treatment, and 
        help prevent behaviors that often lead to the development of 
        eating disordered behaviors;
            (4) discrimination and bullying based on body size;
            (5) the effects of media on self esteem and body image; and
            (6) the signs and symptoms of eating disorders.
    (b) Collaboration.--The Director of the National Institute of 
Mental Health shall conduct the program under subsection (a) in 
collaboration with--
            (1) Centers of Excellence; and
            (2) community-based national nonprofit resources that 
        support individuals affected by eating disorders and work to 
        prevent eating disorders and address body image and weight 
        issues.

SEC. 9. CLARIFYING APPLICATION OF EXISTING PARITY LAW.

    (a) PHSA.--Section 2726 of the Public Health Service Act (42 U.S.C. 
300gg-26) is amended--
            (1) in subsection (a)(3), by adding at the end the 
        following new subparagraph:
                    ``(C) Treatment of permanent exclusions under 
                mental health and substance use disorder benefits.--A 
                group health plan or health insurance issuer offering 
                group or individual health insurance coverage to which 
                subparagraph (A) applies shall be considered in 
                violation of subparagraph (A)(ii) if the mental health 
                or substance use disorder benefits under such plan or 
                coverage provides for a permanent exclusion from such 
                benefits for a particular condition or disorder.''; and
            (2) by adding at the end the following new subsection:
    ``(f) Residential Treatment.--For purposes of this section, mental 
health and substance use disorder benefits include residential 
treatment.''.
    (b) ERISA.--Section 712 of the Employee Retirement Income Security 
Act of 1974 (29 U.S.C. 1185a) is amended--
            (1) in subsection (a)(3), by adding at the end the 
        following new subparagraph:
                    ``(C) Treatment of permanent exclusions under 
                mental health and substance use disorder benefits.--A 
                group health plan (or health insurance coverage offered 
                in connection with such a plan) to which subparagraph 
                (A) applies shall be considered in violation of 
                subparagraph (A)(ii) if the mental health or substance 
                use disorder benefits under such plan (or coverage) 
                provides for a permanent exclusion from such benefits 
                for a particular condition or disorder.''; and
            (2) by adding at the end the following new subsection:
    ``(h) Residential Treatment.--For purposes of this section, mental 
health and substance use disorder benefits include residential 
treatment.''.
    (c) IRC.--Section 9812 of the Internal Revenue Code of 1986 (26 
U.S.C. 9812) is amended--
            (1) in subsection (a)(3), by adding at the end the 
        following new subparagraph:
                    ``(C) Treatment of permanent exclusions under 
                mental health and substance use disorder benefits.--A 
                group health plan to which subparagraph (A) applies 
                shall be considered in violation of subparagraph 
                (A)(ii) if the mental health or substance use disorder 
                benefits under such plan provides for a permanent 
                exclusion from such benefits for a particular condition 
                or disorder.''; and
            (2) by adding at the end the following new subsection:
    ``(f) Residential Treatment.--For purposes of this section, mental 
health and substance use disorder benefits include residential 
treatment.''.
    (d) Limitation.--Nothing in this section or the amendments made by 
this section shall be construed as adding or expanding the scope of 
mental health or addiction services included under section 2726 of the 
Public Health Service Act (42 U.S.C. 300gg-26), section 712 of the 
Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185a), or 
section 9812 of the Internal Revenue Code of 1986 (26 U.S.C. 9812).

SEC. 10. REPORT BY FEDERAL TRADE COMMISSION.

    (a) In General.--Not later than 18 months after the date of the 
enactment of this Act, the Federal Trade Commission shall submit to 
Congress a report that contains--
            (1) a strategy to reduce the use, in advertising and other 
        media for the promotion of commercial products, of images that 
        have been altered to materially change the physical 
        characteristics of the faces and bodies of the individuals 
        depicted; and
            (2) recommendations for an appropriate, risk-based 
        regulatory framework with respect to such use.
    (b) Input of External Stakeholders and Experts.--In preparing the 
report required under subsection (a), the Federal Trade Commission 
shall solicit input from external stakeholders and experts on the 
strategy and recommendations required to be included in such report. 
The Commission, in consultation with the Director of the National 
Institute of Mental Health and the Administrator of the Substance Abuse 
and Mental Health Services Administration, shall ensure that input is 
obtained from an appropriate number of stakeholders and experts and, to 
the extent practicable, from stakeholders and experts that are 
geographically and culturally diverse and that include stakeholders and 
experts from the physical and mental health, business, and consumer 
advocacy communities.

SEC. 11. PROHIBITION ON NEW APPROPRIATIONS.

    No additional funds are authorized to be appropriated to carry out 
this Act or the amendments made by this Act. This Act and such 
amendments shall be carried out using amounts otherwise made available 
for such purposes.
                                 <all>
```