I 
108TH CONGRESS 
1ST SESSION H. R. 3359
To increase awareness of and research on autoimmune diseases, such as 
lupus, multiple sclerosis, rheumatoid arthritis, and fibromyalgia, and 
for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 21, 2003
Mr. KENNEDY of Rhode Island (for himself and Mr. UPTON) introduced the 
following bill; which was referred to the Committee on Energy and Commerce 
A BILL 
To increase awareness of and research on autoimmune dis-
eases, such as lupus, multiple sclerosis, rheumatoid ar-
thritis, and fibromyalgia, and for other purposes.
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 ‘‘Prevention, Awareness, 
and Research Auto-Immune Disease Act’’. 
SEC. 2. FINDINGS. 
The Congress finds as follows: 
(1) The Lupus Foundation of America esti-
mates that at least 1.5 million Americans have a
form of lupus, 9 out of 10 of these Americans are 
women, and 80 percent of all newly diagnosed cases 
of lupus are among women of childbearing age. 
(2) According to a Lupus Foundation of Amer-
ica survey, more than half of the people with lupus 
suffered for 4 or more years and visited 3 or more 
doctors before obtaining a diagnosis of lupus. 
(3) Early diagnosis of and commencement of 
treatment for lupus can prevent or reduce serious 
organ damage, disability, and death. 
(4) About 1 out of 5 lupus sufferers receives 
disability payments, costing the Government several 
billion dollars each year for social security disability 
benefits, lost taxes, and medical care provided 
through Medicare and Medicaid. 
(5) The average annual cost of medical treat-
ment for an individual with lupus is $6,000 to 
$10,000; for some people, medical costs may exceed 
several thousand dollars every month. 
(6) Despite the prevalence of lupus, public 
awareness and understanding of lupus remains low. 
According to a Lupus Foundation of America sur-
vey, only 1 out of 5 Americans can provide even 
basic information about lupus.
(7) Awareness of lupus is lowest among adults 
ages 18 to 34, the age group most likely to develop 
symptoms of lupus. 
(8) Multiple sclerosis is a chronic and often dis-
abling disease of the central nervous system which 
often first appears in people who are 20 to 50 years 
of age, with lifelong physical and emotional effects. 
(9) Multiple sclerosis is twice as common in 
women as in men. 
(10) An estimated 250,000 to 400,000 individ-
uals have multiple sclerosis nationally. 
(11) The average annual cost of multiple scle-
rosis to each affected individual is approximately 
$50,000, and the total cost can exceed $3,000,000 
over an individual’s lifetime. 
(12) The annual cost of treating all people who 
suffer from multiple sclerosis in the United States is 
approximately $20,000,000,000. 
(13) Symptoms of multiple sclerosis can be mild 
(such as numbness in the limbs) or severe (such as 
paralysis or loss of vision). 
(14) The progress, severity, and specific symp-
toms of multiple sclerosis in any one individual can-
not yet be predicted.
(15) Arthritis is the number one cause of dis-
ability in the United States. 
(16) Among the 2,100,000 people with rheu-
matoid arthritis in the United States, women out-
number men 3 to 1. 
(17) The total direct costs of rheumatoid ar-
thritis, including money spent on treatments, hos-
pitalizations, medications, transportation, and spe-
cialist aids, is approximately $1,200,000,000 each 
year. 
(18) The average medical care expenditures 
over the course of a rheumatoid arthritis patient’s 
lifetime is $225,000 to $370,000. 
(19) Fibromyalgia is believed to affect approxi-
mately 3,700,000 people (approximately 2 percent of 
the United States population) and occurs more com-
monly in women than men. 
(20) The exact cause of fibromyalgia is un-
known, but may be triggered by stress, trauma, or 
possibly an infectious agent in susceptible people.
SEC. 3. GRANTS TO INCREASE AWARENESS OF AUTO-
IMMUNE DISEASES. 
(a) PURPOSE.—The purpose of this section is to in-
crease awareness of autoimmune diseases, such as lupus, 
multiple sclerosis, rheumatoid arthritis, and fibromyalgia,
in order to provide to the public a more complete under-
standing of these diseases, which affect 5 to 10 percent 
of the people in the United States. 
(b) AMENDMENTS.—Title III of the Public Health 
Service Act (42 U.S.C. 241 et seq.) is amended—
(1) by moving section 317R so that such sec-
tion follows section 317Q; and 
(2) by inserting after section 317R (as so 
moved) the following: 
‘‘SEC. 317S. (a) GRANTS TO INCREASE AWARENESS 
OF
AUTOIMMUNE
DISEASES.—The Secretary, acting 
through the Director of the Centers for Disease Control 
and Prevention, shall award grants to eligible entities to 
conduct public and professional awareness activities re-
garding autoimmune diseases, such as lupus, multiple scle-
rosis, rheumatoid arthritis, and fibromyalgia. 
‘‘(b) USE OF FUNDS.—In conducting public and pro-
fessional awareness activities with a grant under this sec-
tion, an eligible entity may do any of the following: 
‘‘(1) Promote increased awareness of early 
intervention and treatment so as to significantly im-
prove the quality of life for people with autoimmune 
diseases, such as lupus, multiple sclerosis, rheu-
matoid arthritis, and fibromyalgia.
‘‘(2) Target minority communities that may be 
underserved or disproportionately affected by auto-
immune diseases, such as lupus, multiple sclerosis, 
rheumatoid arthritis, and fibromyalgia. 
‘‘(3) Target women (who are disproportionately 
affected by autoimmune diseases, such as lupus, 
multiple 
sclerosis, 
rheumatoid 
arthritis, 
and 
fibromyalgia) so as to help reduce the amount of 
time taken for correct diagnosis of such diseases, 
which often takes more than 1 year. 
‘‘(c) ELIGIBLE ENTITY.—For purposes of this sec-
tion, the term ‘eligible entity’ means a nonprofit organiza-
tion, a consumer group, an institution of higher education 
(as defined in section 101 of the Higher Education Act 
of 1965 (20 U.S.C. 1001)), a Federal, State, or local gov-
ernmental agency, or a media organization. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$18,000,000 for each of fiscal years 2004 and 2005.’’. 
SEC. 4. GRANTS FOR EDUCATION ON RELATIONSHIP BE-
TWEEN AUTOIMMUNE DISEASES AND MEN-
TAL ILLNESSES. 
Title III of the Public Health Service Act (42 U.S.C. 
241 et seq.), as amended by section 3 of this Act, is 
amended by inserting after section 317S the following:
‘‘SEC. 317T. (a) GRANTS FOR EDUCATION ON RELA-
TIONSHIP BETWEEN AUTOIMMUNE DISEASES AND MEN-
TAL ILLNESSES.—The Secretary, acting through the Ad-
ministrator of the Health Resources and Services Admin-
istration, shall award grants to eligible entities for the 
education of health care providers on potential links be-
tween autoimmune diseases, such as lupus, multiple scle-
rosis, rheumatoid arthritis, and fibromyalgia, and cog-
nitive and mood disorders, such as depression. 
‘‘(b) ELIGIBLE ENTITY.—For purposes of this sec-
tion, the term ‘eligible entity’ means a nonprofit organiza-
tion, a consumer group, an institution of higher education 
(as defined in section 101 of the Higher Education Act 
of 1965 (20 U.S.C. 1001)), a Federal, State, or local gov-
ernmental agency, or a media organization. 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$5,000,000 for each of fiscal years 2004 and 2005.’’. 
SEC. 5. LOAN REPAYMENT PROGRAM REGARDING PHYSI-
CIAN RESEARCH ON AUTOIMMUNE DISEASES. 
Title IV of the Public Health Service Act (42 U.S.C. 
281 et seq.) is amended—
(1) by redesignating the second section 487F as 
section 487G; and
(2) by inserting after section 487G (as so re-
designated) the following: 
‘‘SEC. 487H. LOAN REPAYMENT PROGRAM REGARDING PHY-
SICIAN RESEARCH ON AUTOIMMUNE DIS-
EASES. 
‘‘(a) ESTABLISHMENT.—To the extent and in the 
amounts provided in advance in appropriations Acts, the 
Secretary, acting through the Administrator of the Health 
Resources and Services Administration, shall establish a 
program to enter into contracts with qualified physicians 
under which such qualified physicians agree to conduct re-
search for a period of at least 3 years regarding auto-
immune diseases, such as lupus, multiple sclerosis, rheu-
matoid arthritis, and fibromyalgia, in consideration of the 
Federal Government agreeing to repay, for each year of 
service conducting such research, not more than $35,000 
of the principal and interest of the educational loans of 
such qualified physicians. 
‘‘(b) APPLICATION OF PROVISIONS.—Except as in-
consistent with this section, the provisions of sections 
338B, 338C, and 338E shall apply to the program estab-
lished under this section to the same extent and in the 
same manner as such provisions apply to the National 
Health Service Corps Loan Repayment Program estab-
lished in subpart III of part D of title III.
‘‘(c) QUALIFIED PHYSICIAN.—For purposes of this 
section, the term ‘qualified physician’ means any indi-
vidual who has received, or will have received by the time 
of the research to be conducted under this section, a de-
gree of doctor of medicine or its equivalent and is licensed 
to practice medicine in the United States. 
‘‘(d) FUNDING.—
‘‘(1) AUTHORIZATION
OF
APPROPRIATIONS.—
For the purpose of carrying out this section, there 
are authorized to be appropriated such sums as may 
be necessary for each fiscal year. 
‘‘(2) AVAILABILITY.—Amounts appropriated for 
carrying out this section shall remain available until 
the expiration of the second fiscal year beginning 
after the fiscal year for which the amounts were 
made available.’’.
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