I
107TH CONGRESS
2D SESSION
H. R. 3793
To educate health professionals concerning substance abuse and addiction.
IN THE HOUSE OF REPRESENTATIVES
FEBRUARY 26, 2002
Mr. KENNEDY of Rhode Island introduced the following bill; which was
referred to the Committee on Energy and Commerce
A BILL
To educate health professionals concerning substance abuse
and addiction.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Health Professionals
Substance Abuse Education Act’’.
SEC. 2. FINDINGS AND PURPOSE.
(a) FINDINGS.—Congress makes the following find-
ings:
(1) Illegal drugs and alcohol are responsible for
thousands of deaths each year, and they fuel the
spread of a number of communicable diseases, in-
cluding AIDS and Hepatitis C, as well as some of
the worst social problems in the United States, in-
cluding child abuse, domestic violence, and sexual
assault.
(2) There are an estimated 14,800,000 current
drug users in America, more than 4,000,000 of
whom are addicts. An estimated 14,000,000 Ameri-
cans abuse alcohol or are alcoholic.
(3) There is a significant treatment gap in the
United States. Nearly 4,000,000 drug users who are
in need of immediate treatment are not receiving it.
This includes more than 1,200,000 children ages 12
to 25. These numbers do not take into account the
number of alcoholics in need of treatment.
(4) There are more than 28,000,000 children of
alcoholics in America, almost 11,000,000 of whom
are under 18 years of age. Countless other children
are affected by substance abusing parents or other
caretakers. Health professionals are uniquely posi-
tioned to help reduce or prevent alcohol and other
drug-related impairment by identifying affected fam-
ilies and youth and by providing early intervention.
(5) Drug addiction is a chronic relapsing dis-
ease. As with other chronic relapsing diseases (such
as diabetes, hypertension and asthma), there is no
cure, although a number of treatments can effec-
tively control the disease. According to an article
published in the Journal of the American Medical
Association, treatment for addiction works just as
well as treatment for other chronic relapsing dis-
eases.
(6) Drug treatment is cost effective, even when
compared with residential treatment, the most ex-
pensive type of treatment. Residential treatment for
cocaine addiction costs between $15,000 and
$20,000 a year, a substantial savings compared to
incarceration (costing nearly $40,000 a year), or un-
treated addiction (costing more than $43,000 a
year). Also, in 1998, substance abuse and addiction
accounted for approximately $10,000,000,000 in
Federal, State, and local government spending sim-
ply to maintain the child welfare system. The eco-
nomic costs associated with fetal alcohol syndrome
were estimated at $1,900,000,000 for 1992.
(7) Many doctors and other health professionals
are unprepared to recognize substance abuse in their
patients or their families and intervene in an appro-
priate manner. Only 56 percent of residency pro-
grams have a required curriculum in preventing or
treating substance abuse.
(8) Fewer than 1 in 5 doctors (only 19 percent)
feel confident about diagnosing alcoholism, and only
17 percent feel qualified to identify illegal drug use.
(9) Most doctors who are in a position to make
a diagnosis of alcoholism or drug addiction do not
believe that treatment works (less than 4 percent for
alcoholism and only 2 percent for drugs).
(10) According to a survey by the National
Center on Addiction and Substance Abuse at Colum-
bia University (referred to in this section as
‘‘CASA’’), 94 percent of primary care physicians
and 40 percent of pediatricians presented with a
classic description of an alcoholic or drug addict, re-
spectively, failed to properly recognize the problem.
(11) Another CASA report revealed that fewer
than 1 percent of doctors presented with the classic
profile of an alcoholic older woman could diagnose it
properly. Eighty-two percent misdiagnosed it as de-
pression, some treatments for which are dangerous
when taken with alcohol.
(12) Training can greatly increase the degree to
which medical and other health professionals screen
patients for substance abuse. It can also increase the
manner by which such professionals screen children
and youth who may be impacted by the addiction of
a parent or other primary caretaker. Boston Univer-
sity Medical School researchers designed and con-
ducted a seminar on detection and brief intervention
of substance abuse for doctors, nurses, physician’s
assistants, social workers and psychologists. Follow-
up studies reveal that 91 percent of those who par-
ticipated in the seminar report that they are still
using the techniques up to 5 years later.
(13) According to the National Clearinghouse
for Alcohol and Drug Information, drug and alcohol
abuse account for more than $400,000,000,000 in
health care costs each year. Arming health care pro-
fessionals with the information they need in order to
intervene and prevent further substance abuse could
lead to a significant cost savings.
(14) A study conducted by doctors at the Uni-
versity of Wisconsin found a $947 net savings pa-
tient in health care, accident, and criminal justice
costs for each individual screened and, if appro-
priate, for whom intervention was made, with re-
spect to alcohol problems.
(b) PURPOSE.—It is the purpose of this Act to—
(1) improve the ability of health care profes-
sionals to identify and assist their patients with sub-
stance abuse;
(2) improve the ability of health care profes-
sionals to identify and assist children and youth af-
fected by substance abuse in their families; and
(3) help establish an infrastructure to train
health care professionals about substance abuse
issues.
SEC. 3. HEALTH PROFESSION EDUCATION.
(a) SECRETARY
OF HEALTH
AND HUMAN SERV-
ICES.—The Secretary of Health and Human Services may
enter into interagency agreements with the Health Re-
sources Services Administration or the Substance Abuse
and Mental Health Services Administration to enable each
such Administration to carry out activities to train health
professionals (who are generalists and not already special-
ists in substance abuse) so that they are competent to—
(1) recognize substance abuse in their patients
or the family members of their patients;
(2) intervene, treat, or refer for treatment those
individuals who are affected by substance abuse;
(3) identify and assist children of substance
abusing parents; and
(4) serve as advocates and resources for com-
munity-based substance abuse prevention programs.
(b) USE OF FUNDS.—Amounts received under an
interagency agreement under this section shall be used—
(1) with respect to the Health Resources and
Services Administration, to support the Association
for Medical Education and Research in Substance
Abuse (AMERSA) Interdisciplinary Project; and
(2) with respect to the Substance Abuse and
Mental Health Services Administration, to support
the Addiction Technology Transfer Centers coun-
selor training programs to train other health profes-
sionals.
(c) COLLABORATION.—To be eligible to enter into an
interagency agreement under this section the Health Re-
sources and Services Administration or the Substance
Abuse and Mental Health Services Administration shall
demonstrate that such Administration will participate in
interdisciplinary collaboration and collaborate with other
nongovernmental organizations with respect to activities
carried out under this section.
(d) EVALUATIONS.—The Health Resources and Serv-
ices Administration and the Substance Abuse and Mental
Health Services Administration shall conduct a process
and outcome evaluation of the programs and activities car-
ried out with funds received under this section, and shall
provide semi-annual reports to the Secretary of Health
Human Services and the Director of the Office of National
Drug Control Policy.
on the date of enactment of this Act for activities of the
types described in this section.
SEC. 4. SUBSTANCE ABUSE FACULTY FELLOWSHIP.
(a) ESTABLISHMENT.—The Secretary of Health and
Human Services (referred to in this section as the ‘‘Sec-
retary’’) shall establish and administer a substance abuse
faculty fellowship program under which the Secretary
shall provide assistance to eligible institutions to enable
such institutions to employ individuals to serve as faculty
and provide substance abuse training in a multi-discipline
manner.
(b) ELIGIBILITY.—
(1) INSTITUTIONS.—To be eligible to receive as-
sistance under this section, an institution shall—
(A) be an accredited medical school or
nursing school, or be an institution of higher
education that offers one or more of the
following—
(i) an accredited physician assistant
program;
(ii) an accredited nurse practitioner
program;
(iii) a graduate program in pharmacy;
(iv) a graduate program in public
health;
(v) a graduate program in social
work; or
(vi) a graduate program in psy-
chology; and
(B) prepare and submit to the Secretary
an application at such time, in such manner,
and containing such information as the Sec-
retary may require.
(2) INDIVIDUALS.—To be eligible to receive a
fellowship from an eligible institution under this sec-
tion, an individual shall prepare and submit to the
institution an application at such time, in such man-
ner, and containing such information as the institu-
tion may require.
(c) USE OF FUNDS.—
(1) IN GENERAL.—An eligible institution shall
utilize assistance received under this section to pro-
vide one or more fellowships to eligible individuals.
Such assistance shall be used to pay not to exceed
50 percent of the annual salary of the individual
under such a fellowship for a 5-year period.
(2) FELLOWSHIPS.—Under a fellowship under
paragraph (1), an individual shall—
(A) devote a substantial number of teach-
ing hours to substance abuse issues (as part of
both required and elective courses) at the insti-
tution involved during the period of the fellow-
ship; and
(B) attempt to incorporate substance
abuse issues into the required curriculum of the
institution in a manner that is likely to be sus-
tained after the period of the fellowship ends.
Courses described in this paragraph should by
taught as part of several different health care train-
ing programs at the institution involved.
(3) EVALUATIONS.—The Secretary shall con-
duct a process and outcome evaluation of the pro-
grams and activities carried out with amounts ap-
propriated under this section and shall provide semi-
annual reports to the Director of the Office of Na-
tional Drug Control Policy and the Secretary of
Health and Human Services.
(d) AUTHORIZATION OF APPROPRIATIONS.—There is
authorized to be appropriated to carry out this section,
$3,500,000 for each of the fiscal years 2002 through
2006. Amounts made available under this subsection shall
be used to supplement and not supplant amounts being
used on the date of enactment of this Act for activities
of the types described in this section.
SEC. 5. OVERSIGHT COMMITTEE.
(a) IN GENERAL.—The Director of the Office of Na-
tional Drug Control Policy shall convene an interagency
oversight committee, composed of representatives of the
Health Resources and Services Administration, as well as
the National Institute on Drug Abuse, the National Insti-
tute on Alcohol Abuse and Alcoholism, the Substance
Abuse and Mental Health Services Administration, and
the National Institute on Mental Health, and non-govern-
mental organizations determined to be experts in the field
of substance abuse, to receive updates concerning and co-
ordinate the Federal activities funded under this Act and
the activities of various Federal agencies, toward the goal
of educating health professionals about substance abuse.
(b) MEETINGS.—The interagency oversight com-
mittee established under subsection (a) shall meet at least
twice each year at the call of the Director of the Office
of National Drug Control Policy.
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