tes in the United States has more than doubled in 
the past quarter-century. 
(2) The CDC reports that there are now more 
than 23,600,000 people in the United States living 
with diabetes and another 57,000,000 individuals 
with ‘‘pre-diabetes’’ in the United States, which 
means that they have higher than normal blood glu-
cose levels or are at increased risk of developing dia-
betes based on multiple risk factors. 
(3) In 2002, the landmark Diabetes Prevention 
Program (DPP) study found that lifestyle changes, 
such as diet and exercise, can prevent or delay the 
onset of type 2 diabetes, and that participants who 
made such lifestyle changes reduced their risk of 
getting type 2 diabetes by 58 percent with some re-
turning to normal blood glucose levels. 
(4) The New York Times has reported that life-
style-based interventions to control diabetes have re-
sulted in positive outcomes for patients, yet despite 
these successes, such interventions were often 
unsustainable. While insurance companies cover the 
treatments of complications of unchecked diabetes, 
they tend not to cover the cheaper interventions to 
prevent such complications. 
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(5) Emerging research and demonstrations 
projects funded by the National Institutes of Health 
and the CDC in partnership with Indiana University 
and the YMCA show that a carefully designed group 
lifestyle intervention can be delivered for less than 
$250 per person per year in community settings and 
can achieve similar weight loss results to the DPP 
for adults with pre-diabetes. 
(6) Diabetes carries staggering costs. In 2007, 
the total amount of the direct and indirect costs of 
diabetes was estimated at $174,000,000,000 accord-
ing to the American Diabetes Association. 
(7) The Urban Institute reported that if the 
Nation makes a substantial investment in a national 
program that supports group-based structured life-
style intervention programs for individuals at-risk of 
developing type 2 diabetes offered by trained non-cli-
nicians in community settings, the Nation could save 
$191,000,000,000 over 10 years and achieve a 50 
percent reduction in diabetes cases among partici-
pants. 
(8) There is a need to increase the availability 
of effective community-based lifestyle programs for 
diabetes prevention and offer incentive payments to 
health care providers who refer at-risk patients for 
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enrollment in such programs to prevent diabetes, re-
duce complications, and lower the costs associated 
with diabetes treatment in the United States, and 
the Federal Government should encourage efforts to 
replicate the results of the Diabetes Prevention Pro-
gram on a wider scale. 
SEC. 3. NATIONAL DIABETES PREVENTION PROGRAM. 
Title III of the Public Health Service Act (42 U.S.C. 
241 et seq.) is amended by inserting after section 317T 
the following: 
‘‘SEC. 317U. NATIONAL DIABETES PREVENTION PROGRAM. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, shall establish a national diabetes prevention pro-
gram targeted at persons at high risk for diabetes of all 
ages in order to eliminate the preventable burden of diabe-
tes. 
‘‘(b) PROGRAM.—The program under subsection (a) 
shall include the following: 
‘‘(1) GRANTS FOR COMMUNITY-BASED DIABE-
TES PREVENTION PROGRAM MODEL SITES FOR PER-
SONS AT HIGH RISK FOR DIABETES.—The Secretary 
may award grants to recognized eligible entities— 
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‘‘(A) to support community-based diabetes 
prevention program model sites that work with 
the health care delivery system— 
‘‘(i) to identify persons at high risk 
for diabetes; and 
‘‘(ii) to refer such persons to, or pro-
vide such persons with, cost-effective 
group-based 
lifestyle 
intervention 
pro-
grams; and 
‘‘(B) to evaluate— 
‘‘(i) 
methods 
for 
ensuring 
the 
scalability of recognized community-based 
diabetes prevention program sites nation-
ally; 
‘‘(ii) the health and economic benefits 
of a national diabetes prevention program 
for persons at high risk for diabetes in cer-
tain age groups, including the pre-Medi-
care population; 
‘‘(iii) emerging approaches to identify 
and engage persons at high risk for diabe-
tes in health care and community-based 
programs; 
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‘‘(iv) novel strategies for linking com-
munity-based program delivery with exist-
ing clinical services; and 
‘‘(v) the costs and cost effectiveness of 
clinic-community linkages. 
‘‘(2) RECOGNITION PROGRAM.—The Secretary 
shall develop and implement a program under which 
the Secretary recognizes, and re-recognizes on an 
annual basis, eligible entities that deliver commu-
nity-based diabetes prevention programs. To be rec-
ognized under this paragraph, an eligible entity 
shall— 
‘‘(A) describe its system for obtaining re-
ferral from health care professionals for persons 
at high risk for diabetes; 
‘‘(B) provide proof that the entity’s staff 
have been trained as diabetes prevention pro-
gram lifestyle interventionists and the entity 
has a system in place to ensure that staff re-
ceive timely training updates; 
‘‘(C) agree to maintain a community board 
(for purposes of advising the entity’s commu-
nity-based diabetes prevention program) whose 
membership includes— 
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‘‘(i) a person at high risk for diabetes 
who has completed a lifestyle intervention; 
‘‘(ii) a health care professional who 
refers persons at high risk for diabetes to 
lifestyle intervention programs; 
‘‘(iii) community leaders; 
‘‘(iv) representatives of the health in-
surance industry; and 
‘‘(v) representatives of employers, 
businesses, and nonprofit organizations 
that are committed to offering healthy food 
and physical activity opportunities for resi-
dents; 
‘‘(D) agree to provide data to the Sec-
retary for outcome evaluation monitoring pur-
poses and quality improvement, including data 
regarding the number of persons served, partic-
ipant attendance, completion rates, weight loss 
obtained, participant satisfaction, and referring 
clinician satisfaction; 
‘‘(E) develop a plan for communications 
between referring clinicians and community- 
based diabetes prevention program model sites; 
‘‘(F) agree to make available to the Sec-
retary copies of materials used in the entity’s 
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community-based diabetes prevention program; 
and 
‘‘(G) provide evidence to the Secretary of 
quality checks on trainers. 
‘‘(3) TRAINING AND OUTREACH.—In partner-
ship with State diabetes prevention and control pro-
grams, academic institutions, and a national net-
work of community-based nonprofit organizations fo-
cused on health and well-being, the Secretary shall 
develop and implement, directly or through grants to 
eligible entities— 
‘‘(A) a curriculum development and train-
ing program for diabetes prevention master and 
lifestyle intervention instructors to ensure con-
sistency in— 
‘‘(i) the principles of type 2 diabetes 
prevention programming throughout the 
United States; and 
‘‘(ii) the collection of outcomes data 
for quality assurance; 
‘‘(B) community outreach programs to 
identify community and provider groups to par-
ticipate in the national diabetes prevention pro-
gram and coordinate quality assurance pro-
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grams at the local level in partnership with 
community-based organizations; and 
‘‘(C) a national partner outreach program 
to identify and work with national partners— 
‘‘(i) to identify workers in the commu-
nity to complete training under subpara-
graph (A); and 
‘‘(ii) to facilitate the recognition of eli-
gible entities under paragraph (2). 
‘‘(4) EVALUATION, MONITORING, AND
TECH-
NICAL
ASSISTANCE.—The Secretary shall provide 
quality assurance for each community-based diabetes 
prevention program model site funded under para-
graph (1) and, as necessary and feasible, for other 
recognized community-based diabetes prevention 
programs through evaluation, monitoring, and tech-
nical assistance, including by— 
‘‘(A) reviewing applications for recognition 
under paragraph (2); 
‘‘(B) evaluating and monitoring program 
data including providing standardized feedback 
to sites for quality improvement; 
‘‘(C) making de-identified data available to 
the public to ensure transparency of the rec-
ognition program under paragraph (2); 
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‘‘(D) conducting site visits and periodic au-
dits; 
‘‘(E) providing technical assistance and a 
process for improving performance in sites not 
meeting standards for recognition under para-
graph (2); and 
‘‘(F) establishing a public registry of rec-
ognized eligible entities. 
‘‘(5) APPLIED
RESEARCH
PROGRAMS.—The 
Secretary shall award grants to eligible entities to 
conduct diabetes prevention research that— 
‘‘(A) advances the scalability of recognized 
community-based diabetes prevention program 
sites nationally; 
‘‘(B) examines model benefit and payment 
designs; and 
‘‘(C) tests communications strategies to 
engage providers and targeted at-risk popu-
lations. 
‘‘(6) STUDIES FOR DIABETES PREVENTION AND 
MANAGEMENT.—To build on the findings of the na-
tional diabetes prevention program under this sec-
tion, the Secretary may conduct or support studies 
to manage, reduce, and prevent type 2 diabetes in 
at-risk populations, including consideration of fac-
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tors such as nutrition, exercise education, and basic 
physical maintenance of healthy levels of cholesterol, 
body mass index, hemoglobin A1C, and blood pres-
sure rates. 
‘‘(c) REPORT TO CONGRESS.—Not later than the end 
of fiscal year 2011, and every 2 years thereafter, the Sec-
retary shall submit a report to the Congress on the imple-
mentation of this section, including the progress achieved 
in eliminating the preventable burden of diabetes. 
‘‘(d) DEFINITIONS.—In this section: 
‘‘(1) The term ‘eligible entity’ means— 
‘‘(A) a State or local health department; 
‘‘(B) a national network of community- 
based 
organizations 
described 
in 
section 
501(c)(3) of the Internal Revenue Code of 1986 
that is focused on health and well-being; 
‘‘(C) an academic institution; 
‘‘(D) an Indian tribe or tribal organization 
(as defined in section 4 of the Indian Self-De-
termination and Education Assistance Act); or 
‘‘(E) any other entity determined by the 
Secretary to be an eligible entity for purposes 
of this section. 
‘‘(2) The term ‘person at high risk for diabetes’ 
means an individual who has higher than normal 
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blood glucose levels or is at an increased risk for de-
veloping diabetes based on multiple risk factors. 
‘‘(3) The term ‘recognized’ means recognized 
under subsection (b)(2). 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$80,000,000 for fiscal year 2011, and such sums as may 
be necessary for each subsequent fiscal year.’’. 
Æ 
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