```

[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 3387 Introduced in Senate (IS)]

110th CONGRESS
  2d Session
                                S. 3387

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

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                             July 31, 2008

  Mr. Hatch (for himself and Mr. Dodd) introduced the following bill; 
     which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL

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

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``National Pain Care 
Policy Act of 2008''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Sec. 3. Institute of Medicine Conference on Pain.
Sec. 4. Pain Consortium at National Institutes of Health.
Sec. 5. Pain care education and training.
Sec. 6. Public awareness campaign on pain management.

SEC. 2. FINDINGS.

    The Congress finds that--
            (1) pain is the most common reason Americans access the 
        health care system and is a leading contributor to health care 
        costs;
            (2) most painful conditions can be relieved with proper 
        treatment, and providing adequate pain management is a crucial 
        component of improving and maintaining quality of life for 
        patients, survivors, and their loved ones;
            (3) pain is a leading cause of lost productivity, temporary 
        disability, and permanent disability in the American workforce;
            (4) pain affects Americans across all ages, including 
        children. It can occur at any stage of disease, affecting 
        patients in active treatment, survivors who have completed 
        treatment, and those at the end of life;
            (5) in some cases pain is the disease itself and in others 
        it is caused by or related to other diseases and conditions;
            (6) either acute or chronic pain may accompany other health 
        conditions that are prevalent in the Medicare and Medicaid 
        populations, including cancer, arthritis, diabetes, and 
        cardiovascular disease;
            (7) pain is often improperly assessed, misdiagnosed, 
        mistreated, or undertreated;
            (8) disparities in the assessment, diagnosis, and treatment 
        of pain across racial and ethnic groups, particularly at the 
        end of life, are well documented;
            (9) pain research funding represents less than 2 percent of 
        the annual research expenditures of the National Institutes of 
        Health;
            (10) pain research needs better planning and coordination 
        across the many institutes, centers, and programs of the 
        National Institutes of Health;
            (11) many health care professionals are inadequately 
        trained in the proper assessment, diagnosis, treatment, and 
        management of pain;
            (12) patients in pain face significant barriers that can 
        prevent proper assessment, diagnosis, treatment, and management 
        of their pain; and
            (13) improving pain care research, education, access, and 
        care are national health care priorities of the United States.

SEC. 3. INSTITUTE OF MEDICINE CONFERENCE ON PAIN.

    (a) Convening.--Not later than June 30, 2009, the Secretary of 
Health and Human Services shall seek to enter an agreement with the 
Institute of Medicine of the National Academies to convene a Conference 
on Pain (in this section referred to as ``the Conference'').
    (b) Purposes.--The purposes of the Conference shall be to--
            (1) increase the recognition of pain as a significant 
        public health problem in the United States;
            (2) evaluate the adequacy of assessment, diagnosis, 
        treatment, and management of acute and chronic pain in the 
        general population, and in identified racial, ethnic, gender, 
        age, and other demographic groups that may be 
        disproportionately affected by inadequacies in the assessment, 
        diagnosis, treatment, and management of pain;
            (3) identify barriers to appropriate pain care, including--
                    (A) lack of understanding and education among 
                employers, patients, health care providers, regulators, 
                and third-party payors;
                    (B) barriers to access to care at the primary, 
                specialty, and tertiary care levels, including 
                barriers--
                            (i) specific to those populations that are 
                        disproportionately undertreated for pain;
                            (ii) related to physician concerns over 
                        regulatory and law enforcement policies 
                        applicable to some pain therapies; and
                            (iii) attributable to benefit, coverage, 
                        and payment policies in both the public and 
                        private sectors; and
                    (C) gaps in basic and clinical research on the 
                symptoms and causes of pain, and potential assessment 
                methods and new treatments to improve pain care; and
            (4) establish an agenda for action in both the public and 
        private sectors that will reduce such barriers and 
        significantly improve the state of pain care research, 
        education, and clinical care in the United States.
    (c) Other Appropriate Entity.--If the Institute of Medicine 
declines to enter into an agreement under subsection (a), the Secretary 
of Health and Human Services may enter into such agreement with another 
appropriate entity.
    (d) Report.--A report summarizing the Conference's findings and 
recommendations shall be submitted to the Congress not later than June 
30, 2010.
    (e) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary for fiscal years 2009 and 2010.

SEC. 4. PAIN CONSORTIUM AT NATIONAL INSTITUTES OF HEALTH.

    Section 401(c)(2) of the Public Health Service Act (42 U.S.C. 
281(c)(2)) is amended--
            (1) by redesignating subparagraph (B) as subparagraph (C); 
        and
            (2) by inserting after subparagraph (A) the following:
                    ``(B) Pain consortium.--
                            ``(i) Establishment.--The Director of NIH 
                        shall establish within the Division an office 
                        to be known as the Pain Consortium (referred to 
                        in this subparagraph as the `Consortium').
                            ``(ii) Purposes.--The purposes of the 
                        Consortium shall be to--
                                    ``(I) establish and maintain a 
                                national agenda for basic and clinical 
                                research on the causes and effective 
                                treatments for pain;
                                    ``(II) coordinate and promote the 
                                pain research, research training, and 
                                other pain-related activities being 
                                carried out in and across the 
                                institutes, centers, and programs of 
                                the National Institutes of Health;
                                    ``(III) convene an annual 
                                conference of prominent intramural and 
                                extramural experts in pain research, 
                                treatment, and management to assess and 
                                make recommendations with respect to 
                                the pain research activities and 
                                programs of the National Institutes of 
                                Health; and
                                    ``(IV) take such other actions as 
                                may be appropriate with respect to 
                                research on the causes and effective 
                                treatments for pain.
                            ``(iii) Representation of institutes.--The 
                        Consortium shall include the heads of the 
                        institutes, centers, and programs of the 
                        National Institutes of Health involved in pain 
                        research, as determined by the Director of NIH.
                            ``(iv) Chair.--The Consortium shall be 
                        chaired by the Director of the National 
                        Institute of Neurological Disorders and Stroke, 
                        and shall have such co-chairs as the Director 
                        of NIH shall determine.
                            ``(v) Advisory committee.--
                                    ``(I) Establishment.--The Director 
                                of NIH shall establish an advisory 
                                committee to the Consortium to be known 
                                as the National Pain Care Research 
                                Advisory Committee (in this section 
                                referred to as the `Advisory 
                                Committee').
                                    ``(II) Establishment.--The Advisory 
                                Committee shall be established and 
                                maintained in accordance with the 
                                Federal Advisory Committee Act (5 
                                U.S.C. Appendix).
                                    ``(III) Membership.--The members of 
                                the Advisory Committee shall consist of 
                                voting appointed members and nonvoting 
                                ex officio members as follows:
                                            ``(aa) The voting appointed 
                                        members of the Advisory 
                                        Committee shall be appointed by 
                                        the Director of NIH and shall 
                                        include representatives of the 
                                        broad range of medical, health, 
                                        and scientific disciplines 
                                        involved in pain research and 
                                        pain care, including 
                                        individuals with expertise and 
                                        training in pain medicine, pain 
                                        management, neuroscience, 
                                        psychology, social work, 
                                        pharmacy and pharmacology, 
                                        nursing, dentistry, and 
                                        physical and occupational 
                                        therapy, and patient 
                                        representatives.
                                            ``(bb) The nonvoting ex 
                                        officio members of the Advisory 
                                        Committee shall be the Chair of 
                                        the Consortium and such 
                                        officials as the Director of 
                                        NIH shall designate.
                                    ``(IV) Duties.--The Advisory 
                                Committee shall advise, assist, consult 
                                with, and make recommendations to the 
                                Consortium regarding the matters set 
                                forth in clause (ii).''.

SEC. 5. PAIN CARE EDUCATION AND TRAINING.

    (a) Pain Care Research and Quality.--Part A of title IX of the 
Public Health Service Act (42 U.S.C. 299 et seq.) is amended by adding 
at the end the following:

``SEC. 904. PROGRAM FOR PAIN CARE RESEARCH AND QUALITY.

    ``(a) In General.--The Director shall carry out a program--
            ``(1) to collect protocols and evidence-based practices 
        regarding pain care at all stages of life; and
            ``(2) to disseminate such information to Federal, State, 
        and local regulatory and enforcement agencies, public and 
        private health care programs, payors and providers, health 
        professions schools, hospices, and the general public.
    ``(b) Consultation.--In carrying out this section, the Secretary 
shall consult with organizations representing patients in pain and 
other consumers, employers, physicians including physicians 
specializing in pain care, other pain management professionals, medical 
device manufacturers, and pharmaceutical companies.
    ``(c) Definition.--For purposes of this section, the term `pain 
care' means the assessment, diagnosis, treatment, or management of 
acute or chronic pain regardless of causation or body location.''.
    (b) Education and Training in Pain and Palliative Care.--Part D of 
title VII of the Public Health Service Act (42 U.S.C. 294 et seq.) is 
amended--
            (1) by redesignating sections 754 through 758 as sections 
        755 through 759, respectively; and
            (2) by inserting after section 753 the following:

``SEC. 754. PROGRAM FOR EDUCATION AND TRAINING IN PAIN CARE.

    ``(a) In General.--The Secretary, in consultation with the Director 
of the Agency for Healthcare Research and Quality, may make awards of 
grants, cooperative agreements, and contracts to health professions 
schools, hospices, and other public and private entities for the 
development and implementation of programs to provide education and 
training to health care professionals in pain care.
    ``(b) Priorities.--In making awards under subsection (a), the 
Secretary shall give priority to awards for the implementation of 
programs under such subsection.
    ``(c) Certain Topics.--An award may be made under subsection (a) 
only if the applicant for the award agrees that the program carried out 
with the award will include information and education on--
            ``(1) recognized means for assessing, diagnosing, treating, 
        and managing pain and related signs and symptoms, including the 
        medically appropriate use of controlled substances;
            ``(2) applicable laws, regulations, rules, and policies on 
        controlled substances, including the degree to which 
        misconceptions and concerns regarding such laws, regulations, 
        rules, and policies, or the enforcement thereof, may create 
        barriers to patient access to appropriate and effective pain 
        care;
            ``(3) interdisciplinary approaches to the delivery of pain 
        care, including delivery through specialized centers providing 
        comprehensive pain care treatment expertise;
            ``(4) cultural, linguistic, literacy, geographic, and other 
        barriers to care in underserved populations; and
            ``(5) recent findings, developments, and improvements in 
        the provision of pain care.
    ``(d) Program Sites.--Education and training under subsection (a) 
may be provided at or through health professions schools, residency 
training programs, and other graduate programs in the health 
professions, entities that provide continuing education related to 
health professions, and such other programs or sites as the Secretary 
determines to be appropriate.
    ``(e) Evaluation of Programs.--The Secretary shall (directly or 
through grants or contracts) provide for the evaluation of programs 
implemented under subsection (a) in order to determine the effect of 
such programs on knowledge and practice of pain care.
    ``(f) Peer Review Groups.--In carrying out section 799(f) with 
respect to this section, the Secretary shall ensure that the membership 
of each peer review group involved includes individuals with expertise 
and experience in pain care.
    ``(g) Definitions.--For purposes of this section the term `pain 
care' means the assessment, diagnosis, treatment, or management of 
acute or chronic pain regardless of causation or body location.''.
    (c) Authorization of Appropriations.--Subparagraph (C) of section 
758(b)(1) of the Public Health Service Act (as redesignated by 
subsection (a)(1) of this section) is amended--
            (1) by striking ``sections 753, 754, and 755'' and 
        inserting ``section 753, 754, 755, and 756''; and
            (2) by striking ``not less than $22,631,000'' and inserting 
        ``such sums as may be necessary''.
    (d) Technical Amendment.--Paragraph (2) of section 757(b) of the 
Public Health Service Act (as redesignated by subsection (a)(1)) is 
amended by striking ``754(3)(A), and 755(b)'' and inserting 
``755(3)(A), and 756(b)''.

SEC. 6. PUBLIC AWARENESS CAMPAIGN ON PAIN MANAGEMENT.

    Part B of title II of the Public Health Service Act (42 U.S.C. 238 
et seq.) is amended by adding at the end the following:

``SEC. 249. NATIONAL EDUCATION OUTREACH AND AWARENESS CAMPAIGN ON PAIN 
              MANAGEMENT.

    ``(a) Establishment.--Not later than June 30, 2009, the Secretary 
shall establish and implement a national pain care education outreach 
and awareness campaign described in subsection (b).
    ``(b) Requirements.--The Secretary shall design the public 
awareness campaign under this section to educate consumers, patients, 
their families, and other caregivers with respect to--
            ``(1) the incidence and importance of pain as a national 
        public health problem;
            ``(2) the adverse physical, psychological, emotional, 
        societal, and financial consequences that can result if pain is 
        not appropriately assessed, diagnosed, treated, or managed;
            ``(3) the availability, benefits, and risks of all pain 
        treatment and management options;
            ``(4) having pain promptly assessed, appropriately 
        diagnosed, treated, and managed, and regularly reassessed with 
        treatment adjusted as needed;
            ``(5) the role of credentialed pain management specialists 
        and subspecialists, and of comprehensive interdisciplinary 
        centers of treatment expertise;
            ``(6) the availability in the public, nonprofit, and 
        private sectors of pain management-related information, 
        services, and resources for consumers, employers, third-party 
        payors, patients, their families, and caregivers, including 
        information on--
                    ``(A) appropriate assessment, diagnosis, treatment, 
                and management options for all types of pain and pain-
                related symptoms; and
                    ``(B) conditions for which no treatment options are 
                yet recognized; and
            ``(7) other issues the Secretary deems appropriate.
    ``(c) Consultation.--In designing and implementing the public 
awareness campaign required by this section, the Secretary shall 
consult with organizations representing patients in pain and other 
consumers, employers, physicians including physicians specializing in 
pain care, and other pain management professionals.
    ``(d) Coordination.--
            ``(1) Lead official.--The Secretary shall designate one 
        official in the Department of Health and Human Services to 
        oversee the campaign established under this section.
            ``(2) Agency coordination.--The Secretary shall ensure the 
        involvement in the public awareness campaign under this section 
        of the Surgeon General of the Public Health Service, the 
        Director of the Centers for Disease Control and Prevention, and 
        such other representatives of offices and agencies of the 
        Department of Health and Human Services as the Secretary 
        determines appropriate.
    ``(e) Underserved Areas and Populations.--In designing the public 
awareness campaign under this section, the Secretary shall--
            ``(1) take into account the special needs of geographic 
        areas and racial, ethnic, gender, age, and other demographic 
        groups that are currently underserved; and
            ``(2) provide resources that will reduce disparities in 
        access to appropriate diagnosis, assessment, and treatment.
    ``(f) Grants and Contracts.--The Secretary may make awards of 
grants, cooperative agreements, and contracts to public agencies and 
private nonprofit organizations to assist with the development and 
implementation of the public awareness campaign under this section.
    ``(g) Authorization of Appropriations.--For purposes of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary for each of fiscal years 2009, 2010, and 2011.''.
                                 <all>
```