I 

108TH CONGRESS 

2D SESSION H. R. 4610 

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

and public health, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 17, 2004 

Mr. PICKERING (for himself and Ms. ESHOO) 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, 

3 SECTION 1. SHORT TITLE. 

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

5 Control, and Cure Act of 2004’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 

8 (1) Arthritis and other rheumatic diseases are 

9 among the most common conditions in the United 

10 States. There are more than 100 different forms of 
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1 arthritis, of which the 2 most common forms are os2 teoarthritis and rheumatoid arthritis. 

3 (2) Arthritis and other rheumatic diseases 

4 cause severe and chronic pain, swollen tissue, liga5 ment and joint destruction, deformities, permanent 

6 disability, and death. Arthritis and other rheumatic 

7 diseases erode patients’ quality of life and can di8 minish their mental health, impose significant limi9 tations on their daily activities, and disrupt the lives 

10 of their family members and caregivers. 

11 (3) One out of every 3, or nearly 70,000,000, 

12 adults in the United States suffer from arthritis or 

13 chronic joint symptoms. The number of individuals 

14 in the United States with arthritis will grow as the 

15 number of older Americans continues to increase 

16 dramatically in the next few decades. 

17 (4) Arthritis and other rheumatic diseases af18 fect all types of people of the United States, not just 

19 older individuals. Arthritis and other rheumatic dis20 eases disproportionately affect women in the United 

21 States, and nearly 3 of every 5 individuals with ar22 thritis are younger than 65 years of age. Today, 

23 8,400,000 young adults ages 18 through 44 have ar24 thritis and millions of others are at risk for devel25 oping the disease. 
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1 (5) Arthritis and other rheumatic diseases are 

2 the leading cause of disability among adults in the 

3 United States. More than 8,000,000 people in the 

4 United States are disabled by arthritis and other 

5 rheumatic diseases. By 2020, arthritis will limit the 

6 daily activities of nearly 12,000,000 individuals. 

7 (6) Nearly 60 percent of people of the United 

8 States with arthritis are of working age. In general, 

9 people with arthritis have a low rate of participation 

10 in the workforce. Arthritis is exceeded only by heart 

11 disease as a cause of work disability. 

12 (7) Nearly 300,000 children in the United 

13 States, or 3 children out of every 1,000, have some 

14 form of arthritis or other rheumatic disease. It is the 

15 sense of Congress that the substantial morbidity as16 sociated with pediatric arthritis warrants a greater 

17 Federal investment in research to identify new and 

18 more effective treatments for these diseases. 

19 (8) Arthritis results in 750,000 hospitalizations, 

20 44,000,000 outpatient visits, and 4,000,000 days of 

21 hospital care every year, according to the Centers 

22 for Disease Control and Prevention. 

23 (9) The Centers for Disease Control and Pre24 vention estimate that the annual cost of medical care 

25 for arthritis is $51,000,000, and the estimated an-
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1 nual total cost of arthritis to the United States, in2 cluding lost productivity, exceeds $86,000,000. 

3 (10) In 1975, the National Arthritis Act of 

4 1974 (Public Law 93–640) was enacted to promote 

5 basic and clinical arthritis research, establish Multi6 purpose Arthritis Centers, and expand clinical 

7 knowledge in the field of arthritis. The Act was suc8 cessfully implemented, and continued funding of ar9 thritis-related research has led to important ad10 vances in arthritis control, treatment, and preven11 tion. 

12 (11) Early diagnosis, treatment, and appro13 priate management of arthritis can control symp14 toms and improve quality of life. Weight control and 

15 exercise can demonstrably lower health risks from 

16 arthritis, as can other forms of patient education, 

17 training, and self-management. The genetics of ar18 thritis are being actively investigated. New, innova19 tive, and increasingly effective drug therapies, joint 

20 replacements, and other therapeutic options are 

21 being developed. 

22 (12) While research has identified many effec23 tive interventions against arthritis, such interven24 tions are broadly underutilized. That underutiliza25 tion leads to unnecessary loss of life, health, and 
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1 quality of life, as well as avoidable or unnecessarily 

2 high health care costs. Arthritis self-management 

3 can reduce both patient pain and health care costs, 

4 with some self-management programs reducing ar5 thritis pain by 20 percent and physician visits by 40 

6 percent. Yet less than 1 percent of the 49,000,000 

7 people in the United States with arthritis participate 

8 in such programs, and self-management courses are 

9 not offered in all areas of the United States. 

10 (13) Rheumatologists are internists or pediatric 

11 sub-specialists that are uniquely qualified by an ad12 ditional 2 to 4 years of training and experience in 

13 the diagnosis and treatment of rheumatic conditions. 

14 Typically, rheumatologists act as consultants, but 

15 also often act as managers, relying on the help of 

16 many skilled professionals, including nurses, physical 

17 and occupational therapists, psychologists, and social 

18 workers. Many rheumatologists conduct research to 

19 determine the cause and effective treatment of dis20 abling and sometimes fatal rheumatic diseases. 

21 (14) Recognizing that the Nation requires a 

22 public health approach to arthritis, the Department 

23 of Health and Human Services established impor24 tant national goals related to arthritis in its Healthy 

25 People 2010 initiative. Moreover, various Federal 
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1 and non-Federal stakeholders have worked coopera2 tively to develop a comprehensive National Arthritis 

3 Action Plan: A Public Health Strategy. 

4 (15) Greater efforts and commitments are need5 ed from Congress, the States, providers, and pa6 tients to achieve the goals of Healthy People 2010, 

7 implement a national public health strategy con8 sistent with the National Arthritis Action Plan, and 

9 lessen the burden of arthritis on citizens of the 

10 United States. 

11 SEC. 3. ENHANCING THE PUBLIC HEALTH ACTIVITIES RE12 LATED TO ARTHRITIS OF THE CENTERS FOR 

13 DISEASE CONTROL AND PREVENTION 

14 THROUGH THE NATIONAL ARTHRITIS ACTION 

15 PLAN. 

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

17 (42 U.S.C. 243 et seq.) is amended by inserting after sec18 tion 314 the following: 

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

20 ACTION PLAN. 

21 ‘‘The Secretary shall develop and implement a Na22 tional Arthritis Action Plan that consists of— 

23 ‘‘(1) the Federal arthritis prevention and con24 trol activities, as described in section 315A; 
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1 ‘‘(2) the State arthritis control and prevention 

2 programs, as described in section 315B; 

3 ‘‘(3) the comprehensive arthritis action grant 

4 program, as described in section 315C; and 

5 ‘‘(4) a national arthritis education and outreach 

6 program, as described in section 315D. 

7 ‘‘SEC. 315A. FEDERAL ARTHRITIS PREVENTION AND CON8 TROL ACTIVITIES. 

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

10 the Director of the Centers for Disease Control and Pre11 vention, shall, directly, or through a grant to an eligible 

12 entity, conduct, support, and promote the coordination of 

13 research, investigations, demonstrations, training, and 

14 studies relating to the control, prevention, and surveillance 

15 of arthritis and other rheumatic diseases. 

16 ‘‘(b) DUTIES OF SECRETARY.—The activities of the 

17 Secretary under subsection (a) shall include— 

18 ‘‘(1) the collection, publication, and analysis of 

19 data on the prevalence and incidence of arthritis and 

20 other rheumatic diseases; 

21 ‘‘(2) the development of uniform data sets for 

22 public health surveillance and clinical quality im23 provement activities; 

24 ‘‘(3) the identification of evidence-based and 

25 cost-effective best practices for the prevention, diag-
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1 nosis, management, and care of arthritis and other 

2 rheumatic diseases; 

3 ‘‘(4) research, including research on behavioral 

4 interventions to prevent arthritis and on other evi5 dence-based best practices relating to arthritis pre6 vention, diagnosis, management, and care; and 

7 ‘‘(5) demonstration projects, including commu8 nity-based and patient self-management programs of 

9 arthritis control, prevention, and care, and similar 

10 collaborations with academic institutions, hospitals, 

11 health insurers, researchers, health professionals, 

12 and nonprofit organizations. 

13 ‘‘(c) TRAINING AND TECHNICAL ASSISTANCE.—With 

14 respect to the planning, development, and operation of any 

15 activity carried out under subsection (a), the Secretary 

16 may provide training, technical assistance, supplies, equip17 ment, or services, and may assign any officer or employee 

18 of the Department of Health and Human Services to a 

19 State or local health agency, or to any public or nonprofit 

20 entity designated by a State health agency, in lieu of pro21 viding grant funds under this section. 

22 ‘‘(d) ARTHRITIS PREVENTION RESEARCH AT THE

23 CENTERS FOR DISEASE CONTROL AND PREVENTION

24 CENTERS.—The Secretary shall provide additional grant 

25 support for research projects at the Centers for Prevention 
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1 Research by the Centers for Disease Control and Preven2 tion to encourage the expansion of research portfolios at 

3 the Centers for Prevention Research to include arthritis4 specific research activities related to the prevention and 

5 management of arthritis. 

6 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

7 are authorized to be appropriated to carry out this section 

8 such sums as may be necessary for each of fiscal years 

9 2005 through 2009. 

10 ‘‘SEC. 315B. STATE ARTHRITIS CONTROL AND PREVENTION 

11 PROGRAMS. 

12 ‘‘(a) IN GENERAL.—The Secretary shall award 

13 grants to eligible entities to provide support for com14 prehensive arthritis control and prevention programs and 

15 to enable such entities to provide public health surveil16 lance, prevention, and control activities related to arthritis 

17 and other rheumatic diseases. 

18 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 

19 under this section, an entity shall be a State or Indian 

20 tribe. 

21 ‘‘(c) APPLICATION.—To be eligible to receive a grant 

22 under this section, an entity shall submit to the Secretary 

23 an application at such time, in such manner, and con24 taining such agreements, assurances, and information as 
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1 the Secretary may require, including a comprehensive ar2 thritis control and prevention plan that— 

3 ‘‘(1) is developed with the advice of stake4 holders from the public, private, and nonprofit sec5 tors that have expertise relating to arthritis control, 

6 prevention, and treatment that increase the quality 

7 of life and decrease the level of disability; 

8 ‘‘(2) is intended to reduce the morbidity of ar9 thritis, with priority on preventing and controlling 

10 arthritis in at-risk populations and reducing dispari11 ties in arthritis prevention, diagnosis, management, 

12 and quality of care in underserved populations; 

13 ‘‘(3) describes the arthritis-related services and 

14 activities to be undertaken or supported by the enti15 ty; and 

16 ‘‘(4) is developed in a manner that is consistent 

17 with the National Arthritis Action Plan or a subse18 quent strategic plan designated by the Secretary. 

19 ‘‘(d) USE OF FUNDS.—An eligible entity shall use 

20 amounts received under a grant awarded under subsection 

21 (a) to conduct, in a manner consistent with the com22 prehensive arthritis control and prevention plan submitted 

23 by the entity in the application under subsection (c)— 

24 ‘‘(1) public health surveillance and epidemiolog25 ical activities relating to the prevalence of arthritis 
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1 and assessment of disparities in arthritis prevention, 

2 diagnosis, management, and care; 

3 ‘‘(2) public information and education pro4 grams; and 

5 ‘‘(3) education, training, and clinical skills im6 provement activities for health professionals, includ7 ing allied health personnel. 

8 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

9 are authorized to be appropriated to carry out this section 

10 such sums as may be necessary for each of fiscal years 

11 2005 through 2009. 

12 ‘‘SEC. 315C. COMPREHENSIVE ARTHRITIS ACTION GRANTS. 

13 ‘‘(a) IN GENERAL.—The Secretary shall award 

14 grants on a competitive basis to eligible entities to enable 

15 such eligible entities to assist in the implementation of a 

16 national strategy for arthritis control and prevention. 

17 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 

18 under this section, an entity shall be a national public or 

19 private nonprofit entity. 

20 ‘‘(c) APPLICATION.—To be eligible to receive a grant 

21 under this section, an entity shall submit to the Secretary 

22 an application at such time, in such manner, and con23 taining such agreements, assurances, and information as 

24 the Secretary may require, including a description of how 
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1 funds received under a grant awarded under this section 

2 will— 

3 ‘‘(1) supplement or fulfill unmet needs identi4 fied in the comprehensive arthritis control and pre5 vention plan of a State or Indian tribe; 

6 ‘‘(2) otherwise help achieve the goals of the Na7 tional Arthritis Action Plan or a subsequent stra8 tegic plan designated by the Secretary. 

9 ‘‘(d) PRIORITY.—In awarding grants under this sec10 tion, the Secretary shall give priority to eligible entities 

11 submitting applications proposing to carry out programs 

12 for controlling and preventing arthritis in at-risk popu13 lations or reducing disparities in underserved populations. 

14 ‘‘(e) USE OF FUNDS.—An eligible entity shall use 

15 amounts received under a grant awarded under subsection 

16 (a) for 1 or more of the following purposes: 

17 ‘‘(1) To expand the availability of physical ac18 tivity programs designed specifically for people with 

19 arthritis. 

20 ‘‘(2) To provide awareness education to pa21 tients, family members, and health care providers, to 

22 help such individuals recognize the signs and symp23 toms of arthritis, and to address the control and 

24 prevention of arthritis. 
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1 ‘‘(3) To decrease long-term consequences of ar2 thritis by making information available to individ3 uals with regard to the self-management of arthritis. 

4 ‘‘(4) To provide information on nutrition edu5 cation programs with regard to preventing or miti6 gating the impact of arthritis. 

7 ‘‘(f) EVALUATION.—An eligible entity that receives a 

8 grant under this section shall submit to the Secretary an 

9 evaluation of the operations and activities carried out 

10 under such grant that includes an analysis of increased 

11 utilization and benefit of public health programs relevant 

12 to the activities described in the appropriate provisions of 

13 subsection (e). 

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

15 are authorized to be appropriated to carry out this section 

16 such sums as may be necessary for each of fiscal years 

17 2005 through 2009. 

18 ‘‘SEC. 315D. NATIONAL ARTHRITIS EDUCATION AND OUT19 REACH. 

20 ‘‘(a) IN GENERAL.—The Secretary shall coordinate 

21 a national education and outreach program to support, de22 velop, and implement education initiatives and outreach 

23 strategies appropriate for arthritis and other rheumatic 

24 diseases. 
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1 ‘‘(b) INITIATIVES AND STRATEGIES.—Initiatives and 

2 strategies implemented under the program described in 

3 paragraph (1) may include public awareness campaigns, 

4 public service announcements, and community partnership 

5 workshops, as well as programs targeted at businesses and 

6 employers, managed care organizations, and health care 

7 providers. 

8 ‘‘(c) PRIORITY.—In carrying out subsection (a), the 

9 Secretary— 

10 ‘‘(1) may emphasize prevention, early diagnosis, 

11 and appropriate management of arthritis, and op12 portunities for effective patient self-management; 

13 and 

14 ‘‘(2) shall give priority to reaching high-risk or 

15 underserved populations. 

16 ‘‘(d) COLLABORATION.—In carrying out this section, 

17 the Secretary shall consult and collaborate with stake18 holders from the public, private, and nonprofit sectors 

19 with expertise relating to arthritis control, prevention, and 

20 treatment. 

21 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

22 are authorized to be appropriated to carry out this section 

23 such sums as may be necessary for each of fiscal years 

24 2005 through 2009.’’. 
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1 SEC. 4. EXPANSION AND COORDINATION OF ACTIVITIES OF 

2 THE NATIONAL INSTITUTES OF HEALTH WITH 

3 RESPECT TO RESEARCH ON ARTHRITIS. 

4 Title IV of the Public Health Service Act (42 U.S.C. 

5 281 et seq.) is amended by inserting after section 439 the 

6 following: 

7 ‘‘SEC. 439A. ARTHRITIS AND RHEUMATIC DISEASES INTER8 AGENCY COORDINATING COMMITTEE. 

9 ‘‘(a) IN GENERAL.— 

10 ‘‘(1) ESTABLISHMENT.—The Secretary shall es11 tablish an Arthritis and Rheumatic Diseases Inter12 agency Coordinating Committee (referred to in this 

13 section as the ‘Coordinating Committee’). 

14 ‘‘(2) DUTIES.—The coordinating committee es15 tablished under paragraph (1) shall— 

16 ‘‘(A) provide for the improved coordination 

17 of the research activities of all the national re18 search institutes relating to arthritis and rheu19 matic diseases; and 

20 ‘‘(B) provide for full and regular commu21 nication and exchange of information necessary 

22 to maintain adequate coordination across all 

23 Federal health programs and activities related 

24 to arthritis and rheumatic diseases. 

25 ‘‘(b) ARTHRITIS AND RHEUMATIC DISEASES INTER26 AGENCY COORDINATING COMMITTEE.— 
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1 ‘‘(1) COMPOSITION.—The Coordinating Com2 mittee shall consist of members, appointed by the 

3 Secretary, of which— 

‘‘(A) 2 4 ⁄3 of such members shall represent 

5 governmental agencies, including— 

6 ‘‘(i) the directors of each of the na7 tional research institutes and divisions in8 volved in research regarding arthritis and 

9 rheumatic diseases (or the directors’ re10 spective designees); and 

11 ‘‘(ii) representatives of other Federal 

12 departments and agencies (as determined 

13 appropriate by the Secretary) whose pro14 grams involve health functions or respon15 sibilities relevant to arthritis and rheu16 matic diseases, including the Centers for 

17 Disease Control and Prevention, the 

18 Health Resources and Services Administra19 tion, and the Food and Drug Administra20 tion; and 

‘‘(B) 1 21 ⁄3 of such members shall be public 

22 members, including a broad cross section of 

23 persons affected by arthritis, researchers, clini24 cians, and representatives of voluntary health 

25 agencies, who— 
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1 ‘‘(i) shall serve for a term of 3 years; 

2 and 

3 ‘‘(ii) may serve for an unlimited num4 ber of terms if reappointed. 

5 ‘‘(2) CHAIRPERSON.— 

6 ‘‘(A) APPOINTMENT.—The Chairperson of 

7 the Coordinating Committee (referred to in this 

8 subsection as the ‘Chairperson’) shall be ap9 pointed by and be directly responsible to the 

10 Secretary. 

11 ‘‘(B) DUTIES.—The Chairperson shall— 

12 ‘‘(i) serve as the principal advisor to 

13 the Secretary, the Assistant Secretary for 

14 Health, and the Director of NIH on mat15 ters relating to arthritis and rheumatic dis16 eases; and 

17 ‘‘(ii) provide advice to the Director of 

18 the Centers for Disease Control and Pre19 vention, the Commissioner of Food and 

20 Drugs, and the heads of other relevant 

21 Federal agencies, on matters relating to 

22 arthritis and rheumatic diseases. 

23 ‘‘(3) ADMINISTRATIVE SUPPORT; MEETINGS.— 

24 ‘‘(A) ADMINISTRATIVE SUPPORT.—The 

25 Secretary shall provide necessary and appro-
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1 priate administrative support to the Coordi2 nating Committee. 

3 ‘‘(B) MEETINGS.—The Coordinating Com4 mittee shall meet on a regular basis as deter5 mined by the Secretary, in consultation with the 

6 Chairperson. 

7 ‘‘(c) ARTHRITIS AND RHEUMATIC DISEASES SUM8 MIT.— 

9 ‘‘(1) IN GENERAL.—Not later than 1 year after 

10 the date of enactment of the Arthritis Prevention, 

11 Control, and Cure Act of 2004, the Coordinating 

12 Committee shall convene a summit of researchers, 

13 public health professionals, representatives of vol14 untary health agencies, representatives of academic 

15 institutions, and Federal and State policymakers, to 

16 provide a detailed overview of current research ac17 tivities at the National Institutes of Health, as well 

18 as to discuss and solicit input related to potential 

19 areas of collaboration between the National Insti20 tutes of Health and other Federal health agencies, 

21 including the Centers for Disease Control and Pre22 vention, the Agency for Healthcare Research and 

23 Quality, and the Health Resources and Services Ad24 ministration, related to research, prevention, and 

25 treatment of arthritis and rheumatic diseases. 
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1 ‘‘(2) SUMMIT DETAILS.—The summit developed 

2 under paragraph (1) shall focus on— 

3 ‘‘(A) a broad range of research activities 

4 relating to biomedical, epidemiological, psycho5 social, and rehabilitative issues, including stud6 ies of the impact of the diseases described in 

7 paragraph (1) in rural and underserved commu8 nities; 

9 ‘‘(B) clinical research for the development 

10 and evaluation of new treatments, including 

11 new biological agents; 

12 ‘‘(C) translational research on evidence13 based and cost-effective best practices in the 

14 treatment, prevention, and management of the 

15 disease; 

16 ‘‘(D) information and education programs 

17 for health care professionals and the public; 

18 ‘‘(E) priorities among the programs and 

19 activities of the various Federal agencies re20 garding such diseases; and 

21 ‘‘(F) challenges and opportunities for sci22 entists, clinicians, patients, and voluntary orga23 nizations. 

24 ‘‘(d) REPORT TO CONGRESS.—Not later than 180 

25 days after the convening of the Arthritis and Rheumatic 
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1 Diseases Summit under subsection (c)(1), the Director of 

2 NIH shall prepare and submit a report to Congress that 

3 includes proceedings from the summit and a description 

4 of arthritis research, education, and other activities that 

5 are conducted or supported through the national research 

6 institutes. 

7 ‘‘(e) PUBLIC INFORMATION.—The Coordinating 

8 Committee shall make readily available to the public infor9 mation about the research, education, and other activities 

10 relating to arthritis and other rheumatic diseases, con11 ducted or supported by the National Institutes of Health. 

12 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 

13 are authorized to be appropriated such sums as may be 

14 necessary for each of fiscal years 2005 through 2009 to 

15 carry out this section.’’. 

16 SEC. 5. EXPANSION, INTENSIFICATION, AND INNOVATION 

17 OF RESEARCH AND PUBLIC HEALTH ACTIVI18 TIES RELATED TO JUVENILE ARTHRITIS. 

19 (a) JUVENILE ARTHRITIS INITIATIVE THROUGH THE

20 DIRECTOR OF THE NATIONAL INSTITUTES OF HEALTH.— 

21 Part A of title IV of the Public Health Service Act (42 

22 U.S.C. 281 et seq.) is amended by adding at the end the 

23 following: 
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1 ‘‘SEC. 404H. JUVENILE ARTHRITIS INITIATIVE THROUGH 

2 THE DIRECTOR OF THE NATIONAL INSTI3 TUTES OF HEALTH. 

4 ‘‘(a) EXPANSION AND INTENSIFICATION OF ACTIVI5 TIES.— 

6 ‘‘(1) IN GENERAL.—The Director of NIH, in 

7 coordination with the Director of the National Insti8 tute of Arthritis and Musculoskeletal and Skin Dis9 eases, and the directors of the other national re10 search institutes, as appropriate, shall expand and 

11 intensify programs of the National Institutes of 

12 Health with respect to research and related activities 

13 concerning various forms of juvenile arthritis. 

14 ‘‘(2) COORDINATION.—The directors referred to 

15 in paragraph (1) shall jointly coordinate the pro16 grams referred to in such paragraph and consult 

17 with additional Federal officials, voluntary health as18 sociations, medical professional societies, and private 

19 entities as appropriate. 

20 ‘‘(b) PLANNING GRANTS AND CONTRACTS FOR INNO21 VATIVE RESEARCH IN JUVENILE ARTHRITIS.— 

22 ‘‘(1) IN GENERAL.—In carrying out subsection 

23 (a)(1) the Director of NIH shall award planning 

24 grants or contracts for the establishment of new re25 search programs, or enhancement of existing re26 search programs, that focus on juvenile arthritis. 
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1 ‘‘(2) RESEARCH.— 

2 ‘‘(A) TYPES OF RESEARCH.—In carrying 

3 out this subsection, the Secretary shall encour4 age research that focus on genetics, on the de5 velopment of biomarkers, and on pharma6 cological and other therapies. 

7 ‘‘(B) PRIORITY.—In awarding planning 

8 grants or contracts under paragraph (1), the 

9 Director of NIH may give priority to collabo10 rative partnerships, which may include aca11 demic health centers, private sector entities, 

12 and nonprofit organizations. 

13 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 

14 are authorized to be appropriated such sums as may be 

15 necessary for each of fiscal years 2005 through 2009 to 

16 carry out this section. Such authorization shall be in addi17 tion to any authorization of appropriations under any 

18 other provision of law to carry out juvenile arthritis activi19 ties or other arthritis-related research.’’. 

20 (b) PUBLIC HEALTH AND SURVEILLANCE ACTIVI21 TIES RELATED TO JUVENILE ARTHRITIS AT THE CEN22 TERS FOR DISEASE CONTROL AND PREVENTION.—Part 

23 B of title III of the Public Health Service Act (42 U.S.C. 

24 243 et seq.) is amended by inserting after section 320A 

25 the following: 
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1 ‘‘SEC. 320B. SURVEILLANCE AND RESEARCH REGARDING 

2 JUVENILE ARTHRITIS. 

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

4 the Director of the Centers for Disease Control and Pre5 vention, may award grants to and enter into cooperative 

6 agreements with public or nonprofit private entities for the 

7 collection, analysis, and reporting of data on juvenile ar8 thritis. 

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

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

11 Secretary may provide direct technical assistance in lieu 

12 of cash. 

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

14 shall ensure that epidemiological and other types of infor15 mation obtained under subsection (a) is made available to 

16 the National Institutes of Health. 

17 ‘‘(d) CREATION OF A NATIONAL JUVENILE ARTHRI18 TIS PATIENT REGISTRY.— The Secretary, acting through 

19 the Director of the Centers for Disease Control and Pre20 vention and in collaboration with a national voluntary 

21 health organization with experience serving the juvenile 

22 arthritis population as well as the full spectrum of arthri23 tis-related conditions, shall support the development of a 

24 National Juvenile Arthritis Patient Registry to collect spe25 cific data for follow-up studies regarding the prevalence 

26 and incidence of juvenile arthritis, as well as capturing 
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1 information on evidence-based health outcomes related to 

2 specific therapies and interventions. 

3 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

4 are authorized to be appropriated such sums as may be 

5 necessary to carry out this section.’’. 

6 SEC. 6. INVESTMENT IN TOMORROW’S PEDIATRIC 

7 RHEUMATOLOGISTS. 

8 (a) IN GENERAL.—Part Q of title III of the Public 

9 Health Service Act (42 U.S.C. 280h et seq.) is amended 

10 by adding at the end the following: 

11 ‘‘SEC. 399AA. INVESTMENT IN TOMORROW’S PEDIATRIC 

12 RHEUMATOLOGISTS. 

13 ‘‘(a) ENHANCED SUPPORT.—In order to ensure an 

14 adequate future supply of pediatric rheumatologists, the 

15 Secretary, in consultation with the Administrator of the 

16 Health Resources and Services Administration, shall sup17 port activities that provide for— 

18 ‘‘(1) an increase in the number and size of in19 stitutional training grants awarded to institutions to 

20 support pediatric rheumatology training; and 

21 ‘‘(2) an expansion of public-private partnerships 

22 to encourage academic institutions, private sector 

23 entities, and health agencies to promote educational 

24 training and fellowship opportunities for pediatric 

25 rheumatologists. 
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1 ‘‘(b) AUTHORIZATION.—There are authorized to be 

2 appropriated such sums as may be necessary for each of 

3 fiscal years 2005 through 2009 to carry out this section.’’. 

4 (b) PEDIATRIC LOAN REPAYMENT PROGRAM.—Part 

5 Q of title III of the Public Health Service Act (42 U.S.C. 

6 280h et seq.), as amended by subsection (a), is further 

7 amended by adding at the end the following: 

8 ‘‘SEC. 399BB. PEDIATRIC RHEUMATOLOGY LOAN REPAY9 MENT PROGRAM. 

10 ‘‘(a) IN GENERAL.—The Secretary, in consultation 

11 with the Administrator of the Health Resources and Serv12 ices Administration, may establish a pediatric 

13 rheumatology loan repayment program. 

14 ‘‘(b) PROGRAM ADMINISTRATION.—Through the pro15 gram established under subsection (a), the Secretary 

16 shall— 

17 ‘‘(1) enter into contracts with qualified health 

18 professionals who are pediatric rheumatologists 

19 under which— 

20 ‘‘(A) such professionals agree to provide 

21 health care in an area with a shortage of pedi22 atric rheumatologists; and 

23 ‘‘(B) the Federal Government agrees to 

24 repay, for each year of such service, not more 
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1 than $25,000 of the principal and interest of 

2 the educational loans of such professionals; and 

3 ‘‘(2) in addition to making payments under 

4 paragraph (1) on behalf of an individual, make pay5 ments to the individual for the purpose of providing 

6 reimbursement for tax liability resulting from the 

7 payments made under paragraph (1), in an amount 

8 equal to 39 percent of the total amount of the pay9 ments made for the taxable year involved. 

10 ‘‘(c) FUNDING.— 

11 ‘‘(1) IN GENERAL.—For the purpose of car12 rying out this section, the Secretary may reserve, 

13 from amounts appropriated for the Health Re14 sources and Services Administration for the fiscal 

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

17 ‘‘(2) AVAILABILITY OF FUNDS.—Amounts made 

18 available to carry out this section shall remain avail19 able until the expiration of the second fiscal year be20 ginning after the fiscal year for which such amounts 

21 were made available.’’. 

22 SEC. 7. CAREER DEVELOPMENT AWARDS IN PEDIATRIC 

23 RHEUMATOLOGY. 

24 Part G of title IV of the Public Health Service Act 

25 (42 U.S.C. 288 et seq.) is amended— 
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1 (1) by redesignating section 487F (as added by 

2 Public Law 106–505), as section 487G; 

3 (2) by inserting after section 487G (as so re4 designated) the following: 

5 ‘‘SEC. 487H. CAREER DEVELOPMENT AWARDS IN PEDI6 ATRIC RHEUMATOLOGY. 

7 ‘‘(a) IN GENERAL.—The Secretary, in consultation 

8 with the Director of NIH, may establish a program to in9 crease the number of career development awards for 

10 health professionals who intend to build careers in clinical 

11 and translational research relating to pediatric 

12 rheumatology. 

13 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 

14 are appropriated such sums as may be necessary to carry 

15 out this section.’’. 

16 SEC. 8. GENERAL ACCOUNTING OFFICE STUDY OF ARTHRI17 TIS AND THE WORKPLACE. 

18 (a) STUDY AND REPORT.—Not later than 3 years 

19 after the date of enactment of this Act, the Comptroller 

20 General of the United States shall conduct a study on the 

21 economic impact of arthritis in the workplace, and submit 

22 a report to the appropriate committees of Congress con23 taining the results of the study. 
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1 (b) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated such sums as may be 

3 necessary to carry out this section. 

Æ