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Union Calendar No. 17 

111TH CONGRESS 

1ST SESSION H. R. 756 

[Report No. 111–47] 

To amend the Public Health Service Act with respect to pain care. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 28, 2009 

Mrs. CAPPS (for herself and Mr. ROGERS of Michigan) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

MARCH 23, 2009 

Additional sponsors: Mr. GORDON of Tennessee, Mr. MCCOTTER, Ms. KAPTUR, Ms. BALDWIN, Ms. SUTTON, Mr. SESTAK, Ms. ZOE LOFGREN of 

California, Mr. MCGOVERN, Mr. MARKEY of Massachusetts, Ms. 

SCHAKOWSKY, Mr. GENE GREEN of Texas, Mr. LOEBSACK, Mr. GONZALEZ, and Mr. GRIJALVA

MARCH 23, 2009 

Committed to the Committee of the Whole House on the State of the Union 

and ordered to be printed 

A BILL 

To amend the Public Health Service Act with respect to 

pain care. 

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; TABLE OF CONTENTS. 

2 (a) SHORT TITLE.—This Act may be cited as the 

3 ‘‘National Pain Care Policy Act of 2009’’. 

4 (b) TABLE OF CONTENTS.—The table of contents of 

5 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Institute of Medicine Conference on Pain. 

Sec. 3. Pain research at National Institutes of Health. 

Sec. 4. Pain care education and training. 

Sec. 5. Public awareness campaign on pain management. 

6 SEC. 2. INSTITUTE OF MEDICINE CONFERENCE ON PAIN. 

7 (a) CONVENING.—Not later than June 30, 2010, the 

8 Secretary of Health and Human Services shall seek to 

9 enter into an agreement with the Institute of Medicine of 

10 the National Academies to convene a Conference on Pain 

11 (in this section referred to as ‘‘the Conference’’). 

12 (b) PURPOSES.—The purposes of the Conference 

13 shall be to— 

14 (1) increase the recognition of pain as a signifi15 cant public health problem in the United States; 

16 (2) evaluate the adequacy of assessment, diag17 nosis, treatment, and management of acute and 

18 chronic pain in the general population, and in identi19 fied racial, ethnic, gender, age, and other demo20 graphic groups that may be disproportionately af21 fected by inadequacies in the assessment, diagnosis, 

22 treatment, and management of pain; 


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1 (3) identify barriers to appropriate pain care, 

2 including— 

3 (A) lack of understanding and education 

4 among employers, patients, health care pro5 viders, regulators, and third-party payors; 

6 (B) barriers to access to care at the pri7 mary, specialty, and tertiary care levels, includ8 ing barriers— 

9 (i) specific to those populations that 

10 are disproportionately undertreated for 

11 pain; 

12 (ii) related to physician concerns over 

13 regulatory and law enforcement policies 

14 applicable to some pain therapies; and 

15 (iii) attributable to benefit, coverage, 

16 and payment policies in both the public 

17 and private sectors; and 

18 (C) gaps in basic and clinical research on 

19 the symptoms and causes of pain, and potential 

20 assessment methods and new treatments to im21 prove pain care; and 

22 (4) establish an agenda for action in both the 

23 public and private sectors that will reduce such bar24 riers and significantly improve the state of pain care 


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1 research, education, and clinical care in the United 

2 States. 

3 (c) OTHER APPROPRIATE ENTITY.—If the Institute 

4 of Medicine declines to enter into an agreement under sub5 section (a), the Secretary of Health and Human Services 

6 may enter into such agreement with another appropriate 

7 entity. 

8 (d) REPORT.—A report summarizing the Con9 ference’s findings and recommendations shall be sub10 mitted to the Congress not later than June 30, 2011. 

11 (e) AUTHORIZATION OF APPROPRIATIONS.—For the 

12 purpose of carrying out this section, there is authorized 

13 to be appropriated $500,000 for each of fiscal years 2010 

14 and 2011. 

15 SEC. 3. PAIN RESEARCH AT NATIONAL INSTITUTES OF 

16 HEALTH. 

17 Part B of title IV of the Public Health Service Act 

18 (42 U.S.C. 284 et seq.) is amended by adding at the end 

19 the following: 

20 ‘‘SEC. 409J. PAIN RESEARCH. 

21 ‘‘(a) RESEARCH INITIATIVES.— 

22 ‘‘(1) IN GENERAL.—The Director of NIH is en23 couraged to continue and expand, through the Pain 

24 Consortium, an aggressive program of basic and 


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1 clinical research on the causes of and potential treat2 ments for pain. 

3 ‘‘(2) ANNUAL RECOMMENDATIONS.—Not less 

4 than annually, the Pain Consortium, in consultation 

5 with the Division of Program Coordination, Plan6 ning, and Strategic Initiatives, shall develop and 

7 submit to the Director of NIH recommendations on 

8 appropriate pain research initiatives that could be 

9 undertaken with funds reserved under section 

10 402A(c)(1) for the Common Fund or otherwise 

11 available for such initiatives. 

12 ‘‘(3) DEFINITION.—In this subsection, the term 

13 ‘Pain Consortium’ means the Pain Consortium of 

14 the National Institutes of Health or a similar trans15 National Institutes of Health coordinating entity 

16 designated by the Secretary for purposes of this sub17 section. 

18 ‘‘(b) INTERAGENCY PAIN RESEARCH COORDINATING

19 COMMITTEE.— 

20 ‘‘(1) ESTABLISHMENT.—The Secretary shall es21 tablish not later than 1 year after the date of the 

22 enactment of this section and as necessary maintain 

23 a committee, to be known as the Interagency Pain 

24 Research Coordinating Committee (in this section 

25 referred to as the ‘Committee’), to coordinate all efVerDate Nov 24 2008 01:37 Mar 24, 2009 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H756.RH H756

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1 forts within the Department of Health and Human 

2 Services and other Federal agencies that relate to 

3 pain research. 

4 ‘‘(2) MEMBERSHIP.— 

5 ‘‘(A) IN GENERAL.—The Committee shall 

6 be composed of the following voting members: 

7 ‘‘(i) Not more than 7 voting Federal 

8 representatives as follows: 

9 ‘‘(I) The Director of the Centers 

10 for Disease Control and Prevention. 

11 ‘‘(II) The Director of the Na12 tional Institutes of Health and the di13 rectors of such national research insti14 tutes and national centers as the Sec15 retary determines appropriate. 

16 ‘‘(III) The heads of such other 

17 agencies of the Department of Health 

18 and Human Services as the Secretary 

19 determines appropriate. 

20 ‘‘(IV) Representatives of other 

21 Federal agencies that conduct or sup22 port pain care research and treat23 ment, including the Department of 

24 Defense and the Department of Vet25 erans Affairs. 


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1 ‘‘(ii) 12 additional voting members ap2 pointed under subparagraph (B). 

3 ‘‘(B) ADDITIONAL MEMBERS.—The Com4 mittee shall include additional voting members 

5 appointed by the Secretary as follows: 

6 ‘‘(i) 6 members shall be appointed 

7 from among scientists, physicians, and 

8 other health professionals, who— 

9 ‘‘(I) are not officers or employees 

10 of the United States; 

11 ‘‘(II) represent multiple dis12 ciplines, including clinical, basic, and 

13 public health sciences; 

14 ‘‘(III) represent different geo15 graphical regions of the United 

16 States; and 

17 ‘‘(IV) are from practice settings, 

18 academia, manufacturers or other re19 search settings; and 

20 ‘‘(ii) 6 members shall be appointed 

21 from members of the general public, who 

22 are representatives of leading research, ad23 vocacy, and service organizations for indi24 viduals with pain-related conditions. 


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1 ‘‘(C) NONVOTING MEMBERS.—The Com2 mittee shall include such nonvoting members as 

3 the Secretary determines to be appropriate. 

4 ‘‘(3) CHAIRPERSON.—The voting members of 

5 the Committee shall select a chairperson from 

6 among such members. The selection of a chairperson 

7 shall be subject to the approval of the Director of 

8 NIH. 

9 ‘‘(4) MEETINGS.—The Committee shall meet at 

10 the call of the chairperson of the Committee or upon 

11 the request of the Director of NIH, but in no case 

12 less often than once each year. 

13 ‘‘(5) DUTIES.—The Committee shall— 

14 ‘‘(A) develop a summary of advances in 

15 pain care research supported or conducted by 

16 the Federal agencies relevant to the diagnosis, 

17 prevention, and treatment of pain and diseases 

18 and disorders associated with pain; 

19 ‘‘(B) identify critical gaps in basic and 

20 clinical research on the symptoms and causes of 

21 pain; 

22 ‘‘(C) make recommendations to ensure that 

23 the activities of the National Institutes of 

24 Health and other Federal agencies, including 

25 the Department of Defense and the Department 


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1 of Veteran Affairs, are free of unnecessary du2 plication of effort; 

3 ‘‘(D) make recommendations on how best 

4 to disseminate information on pain care; and 

5 ‘‘(E) make recommendations on how to ex6 pand partnerships between public entities, in7 cluding Federal agencies, and private entities to 

8 expand collaborative, cross-cutting research. 

9 ‘‘(6) REVIEW.—The Secretary shall review the 

10 necessity of the Committee at least once every 2 

11 years.’’. 

12 SEC. 4. PAIN CARE EDUCATION AND TRAINING. 

13 (a) PAIN CARE EDUCATION AND TRAINING.—Part D 

14 of title VII of the Public Health Service Act (42 U.S.C. 

15 294 et seq.) is amended— 

16 (1) by redesignating sections 754 through 758 

17 as sections 755 through 759, respectively; and 

18 (2) by inserting after section 753 the following: 

19 ‘‘SEC. 754. PROGRAM FOR EDUCATION AND TRAINING IN 

20 PAIN CARE. 

21 ‘‘(a) IN GENERAL.—The Secretary may make awards 

22 of grants, cooperative agreements, and contracts to health 

23 professions schools, hospices, and other public and private 

24 entities for the development and implementation of proVerDate Nov 24 2008 01:37 Mar 24, 2009 Jkt 059200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H756.RH H756

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1 grams to provide education and training to health care 

2 professionals in pain care. 

3 ‘‘(b) PRIORITIES.—In making awards under sub4 section (a), the Secretary shall give priority to awards for 

5 the implementation of programs under such subsection. 

6 ‘‘(c) CERTAIN TOPICS.—An award may be made 

7 under subsection (a) only if the applicant for the award 

8 agrees that the program carried out with the award will 

9 include information and education on— 

10 ‘‘(1) recognized means for assessing, diag11 nosing, treating, and managing pain and related 

12 signs and symptoms, including the medically appro13 priate use of controlled substances; 

14 ‘‘(2) applicable laws, regulations, rules, and 

15 policies on controlled substances, including the de16 gree to which misconceptions and concerns regarding 

17 such laws, regulations, rules, and policies, or the en18 forcement thereof, may create barriers to patient ac19 cess to appropriate and effective pain care; 

20 ‘‘(3) interdisciplinary approaches to the delivery 

21 of pain care, including delivery through specialized 

22 centers providing comprehensive pain care treatment 

23 expertise; 


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1 ‘‘(4) cultural, linguistic, literacy, geographic, 

2 and other barriers to care in underserved popu3 lations; and 

4 ‘‘(5) recent findings, developments, and im5 provements in the provision of pain care. 

6 ‘‘(d) PROGRAM SITES.—Education and training 

7 under subsection (a) may be provided at or through health 

8 professions schools, residency training programs, and 

9 other graduate programs in the health professions; entities 

10 that provide continuing education in medicine, pain man11 agement, dentistry, psychology, social work, nursing, and 

12 pharmacy; hospices; and such other programs or sites as 

13 the Secretary determines to be appropriate. 

14 ‘‘(e) EVALUATION OF PROGRAMS.—The Secretary 

15 shall (directly or through grants or contracts) provide for 

16 the evaluation of programs implemented under subsection 

17 (a) in order to determine the effect of such programs on 

18 knowledge and practice of pain care. 

19 ‘‘(f) PEER REVIEW GROUPS.—In carrying out section 

20 799(f) with respect to this section, the Secretary shall en21 sure that the membership of each peer review group in22 volved includes individuals with expertise and experience 

23 in pain care. 

24 ‘‘(g) DEFINITIONS.—For purposes of this section the 

25 term ‘pain care’ means the assessment, diagnosis, treatVerDate Nov 24 2008 01:37 Mar 24, 2009 Jkt 059200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H756.RH H756

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1 ment, or management of acute or chronic pain regardless 

2 of causation or body location.’’. 

3 (b) AUTHORIZATION OF APPROPRIATIONS.—Section 

4 758(b)(1) of the Public Health Service Act (as redesig5 nated by subsection (a)(1) of this section) is amended— 

6 (1) by striking ‘‘and’’ at the end of subpara7 graph (B); 

8 (2) by striking the period at the end of sub9 paragraph (C) and inserting ‘‘; and’’; and 

10 (3) by inserting after subparagraph (C) the fol11 lowing: 

12 ‘‘(D) not less than $5,000,000 for awards 

13 of grants, cooperative agreements, and con14 tracts under sections 754.’’. 

15 (c) TECHNICAL AMENDMENTS.—Title VII of the 

16 Public Health Service Act (42 U.S.C. 292 et seq.) is 

17 amended— 

18 (1) in paragraph (2) of section 757(b) (as re19 designated by subsection (a)(1)), by striking 

20 ‘‘754(3)(A), and 755(b)’’ and inserting ‘‘755(3)(A), 

21 and 756(b)’’; and 

22 (2) in subparagraph (C) of section 758(b)(1) 

23 (as redesignated by subsection (a)(1)), by striking 

24 ‘‘754, and 755’’ and inserting ‘‘755, and 756’’. 


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1 SEC. 5. PUBLIC AWARENESS CAMPAIGN ON PAIN MANAGE2 MENT. 

3 Part B of title II of the Public Health Service Act 

4 (42 U.S.C. 238 et seq.) is amended by adding at the end 

5 the following: 

6 ‘‘SEC. 249. NATIONAL EDUCATION OUTREACH AND AWARE7 NESS CAMPAIGN ON PAIN MANAGEMENT. 

8 ‘‘(a) ESTABLISHMENT.—Not later than June 30, 

9 2010, the Secretary shall establish and implement a na10 tional pain care education outreach and awareness cam11 paign described in subsection (b). 

12 ‘‘(b) REQUIREMENTS.—The Secretary shall design 

13 the public awareness campaign under this section to edu14 cate consumers, patients, their families, and other care15 givers with respect to— 

16 ‘‘(1) the incidence and importance of pain as a 

17 national public health problem; 

18 ‘‘(2) the adverse physical, psychological, emo19 tional, societal, and financial consequences that can 

20 result if pain is not appropriately assessed, diag21 nosed, treated, or managed; 

22 ‘‘(3) the availability, benefits, and risks of all 

23 pain treatment and management options; 

24 ‘‘(4) having pain promptly assessed, appro25 priately diagnosed, treated, and managed, and regu26 larly reassessed with treatment adjusted as needed; 


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1 ‘‘(5) the role of credentialed pain management 

2 specialists and subspecialists, and of comprehensive 

3 interdisciplinary centers of treatment expertise; 

4 ‘‘(6) the availability in the public, nonprofit, 

5 and private sectors of pain management-related in6 formation, services, and resources for consumers, 

7 employers, third-party payors, patients, their fami8 lies, and caregivers, including information on— 

9 ‘‘(A) appropriate assessment, diagnosis, 

10 treatment, and management options for all 

11 types of pain and pain-related symptoms; and 

12 ‘‘(B) conditions for which no treatment op13 tions are yet recognized; and 

14 ‘‘(7) other issues the Secretary deems appro15 priate. 

16 ‘‘(c) CONSULTATION.—In designing and imple17 menting the public awareness campaign required by this 

18 section, the Secretary shall consult with organizations rep19 resenting patients in pain and other consumers, employ20 ers, physicians including physicians specializing in pain 

21 care, other pain management professionals, medical device 

22 manufacturers, and pharmaceutical companies. 

23 ‘‘(d) COORDINATION.— 

24 ‘‘(1) LEAD OFFICIAL.—The Secretary shall des25 ignate one official in the Department of Health and 


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1 Human Services to oversee the campaign established 

2 under this section. 

3 ‘‘(2) AGENCY COORDINATION.—The Secretary 

4 shall ensure the involvement in the public awareness 

5 campaign under this section of the Surgeon General 

6 of the Public Health Service, the Director of the 

7 Centers for Disease Control and Prevention, and 

8 such other representatives of offices and agencies of 

9 the Department of Health and Human Services as 

10 the Secretary determines appropriate. 

11 ‘‘(e) UNDERSERVED AREAS AND POPULATIONS.—In 

12 designing the public awareness campaign under this sec13 tion, the Secretary shall— 

14 ‘‘(1) take into account the special needs of geo15 graphic areas and racial, ethnic, gender, age, and 

16 other demographic groups that are currently under17 served; and 

18 ‘‘(2) provide resources that will reduce dispari19 ties in access to appropriate diagnosis, assessment, 

20 and treatment. 

21 ‘‘(f) GRANTS AND CONTRACTS.—The Secretary may 

22 make awards of grants, cooperative agreements, and con23 tracts to public agencies and private nonprofit organiza24 tions to assist with the development and implementation 

25 of the public awareness campaign under this section. 


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1 ‘‘(g) EVALUATION AND REPORT.—Not later than the 

2 end of fiscal year 2012, the Secretary shall prepare and 

3 submit to the Congress a report evaluating the effective4 ness of the public awareness campaign under this section 

5 in educating the general public with respect to the matters 

6 described in subsection (b). 

7 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—For 

8 purposes of carrying out this section, there are authorized 

9 to be appropriated $2,000,000 for fiscal year 2010 and 

10 $4,000,000 for each of fiscal years 2011 and 2012.’’. 


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Union Calendar No. 17 

111TH CONGRESS 

1ST SESSION H. R. 756 

[Report No. 111–47] 

A BILL 

To amend the Public Health Service Act with 

respect to pain care. 

MARCH 23, 2009 

Committed to the Committee of the Whole House on the 

State of the Union and ordered to be printed 


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