H. R. 2994
IN THE HOUSE OF REPRESENTATIVES
To amend the Public Health Service Act with respect to pain care.
Short title; table of contents
This Act may be cited as the
National Pain Care Policy Act of 2008.
Table of contents
The table of contents of this Act is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Institute of Medicine Conference on Pain.
Sec. 3. Pain research at National Institutes of Health.
Sec. 4. Pain care education and training.
Sec. 5. Public awareness campaign on pain management.
Institute of Medicine Conference on Pain
Not later than June 30, 2009, the Secretary of Health and Human Services shall seek to enter into an agreement with the Institute of Medicine of the National Academies to convene a Conference on Pain (in this section referred to as
The purposes of the Conference shall be to—
increase the recognition of pain as a significant public health problem in the United States;
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;
identify barriers to appropriate pain care, including—
lack of understanding and education among employers, patients, health care providers, regulators, and third-party payors;
barriers to access to care at the primary, specialty, and tertiary care levels, including barriers—
specific to those populations that are disproportionately undertreated for pain;
related to physician concerns over regulatory and law enforcement policies applicable to some pain therapies; and
attributable to benefit, coverage, and payment policies in both the public and private sectors; and
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
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.
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.
A report summarizing the Conference’s findings and recommendations shall be submitted to the Congress not later than June 30, 2010.
Authorization of appropriations
For the purpose of carrying out this section, there is authorized to be appropriated $500,000 for each of fiscal years 2009 and 2010.
Pain research at National Institutes of Health
Part B of title IV of the Public Health Service Act (42 U.S.C. 284 et seq.) is amended by adding at the end the following:
The Director of NIH is encouraged to continue and expand, through the Pain Consortium, an aggressive program of basic and clinical research on the causes of and potential treatments for pain.
Not less than annually, the Pain Consortium, in consultation with the Division of Program Coordination, Planning, and Strategic Initiatives, shall develop and submit to the Director of NIH recommendations on appropriate pain research initiatives that could be undertaken with funds reserved under section 402A(c)(1) for the Common Fund or otherwise available for such initiatives.
In this subsection, the term
Pain Consortium means the Pain Consortium of the National Institutes of Health or a similar trans-National Institutes of Health coordinating entity designated by the Secretary for purposes of this subsection.
Interagency pain research coordinating committee
The Secretary shall establish not later than 1 year after the date of the enactment of this section and as necessary maintain a committee, to be known as the Interagency Pain Research Coordinating Committee (in this section referred to as the
Committee), to coordinate all efforts within the Department of Health and Human Services and other Federal agencies that relate to pain research.
The Committee shall be composed of the following voting members:
Not more than 7 voting Federal representatives as follows:
The Director of the Centers for Disease Control and Prevention.
The Director of the National Institutes of Health and the directors of such national research institutes and national centers as the Secretary determines appropriate.
The heads of such other agencies of the Department of Health and Human Services as the Secretary determines appropriate.
Representatives of other Federal agencies that conduct or support pain care research and treatment, including the Department of Defense and the Department of Veterans Affairs.
12 additional voting members appointed under subparagraph (B).
The Committee shall include additional voting members appointed by the Secretary as follows:
6 members shall be appointed from among scientists, physicians, and other health professionals, who—
are not officers or employees of the United States;
represent multiple disciplines, including clinical, basic, and public health sciences;
represent different geographical regions of the United States; and
are from practice settings, academia, manufacturers or other research settings; and
6 members shall be appointed from members of the general public, who are representatives of leading research, advocacy, and service organizations for individuals with pain-related conditions
The Committee shall include such nonvoting members as the Secretary determines to be appropriate.
The voting members of the Committee shall select a chairperson from among such members. The selection of a chairperson shall be subject to the approval of the Director of NIH.
The Committee shall meet at the call of the chairperson of the Committee or upon the request of the Director of NIH, but in no case less often than once each year.
The Committee shall—
develop a summary of advances in pain care research supported or conducted by the Federal agencies relevant to the diagnosis, prevention, and treatment of pain and diseases and disorders associated with pain;
identify critical gaps in basic and clinical research on the symptoms and causes of pain;
make recommendations to ensure that the activities of the National Institutes of Health and other Federal agencies, including the Department of Defense and the Department of Veteran Affairs, are free of unnecessary duplication of effort;
make recommendations on how best to disseminate information on pain care; and
make recommendations on how to expand partnerships between public entities, including Federal agencies, and private entities to expand collaborative, cross-cutting research.
The Secretary shall review the necessity of the Committee at least once every 2 years.
Pain care education and training
Pain Care Education and Training
Part D of title VII of the Public Health Service Act (42 U.S.C. 294 et seq.) is amended—
by redesignating sections 754 through 758 as sections 755 through 759, respectively; and
by inserting after section 753 the following:
Program for education and training in pain care
The Secretary 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.
In making awards under subsection (a), the Secretary shall give priority to awards for the implementation of programs under such subsection.
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—
recognized means for assessing, diagnosing, treating, and managing pain and related signs and symptoms, including the medically appropriate use of controlled substances;
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;
interdisciplinary approaches to the delivery of pain care, including delivery through specialized centers providing comprehensive pain care treatment expertise;
cultural, linguistic, literacy, geographic, and other barriers to care in underserved populations; and
recent findings, developments, and improvements in the provision of pain care.
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 in medicine, pain management, dentistry, psychology, social work, nursing, and pharmacy; hospices; and such other programs or sites as the Secretary determines to be appropriate.
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.
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.
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.
Authorization of appropriations
Section 758(b)(1) of the Public Health Service Act (as redesignated by subsection (a)(1) of this section) is amended—
and at the end of subparagraph (B);
by striking the period at the end of subparagraph (C) and inserting
; and; and
by inserting after subparagraph (C) the following:
not less than $5,000,000 for awards of grants, cooperative agreements, and contracts under sections 754.
Title VII of the Public Health Service Act (42 U.S.C. 292 et seq.) is amended—
in paragraph (2) of section 757(b) (as redesignated by subsection (a)(1)), by striking
754(3)(A), and 755(b) and inserting
755(3)(A), and 756(b); and
in subparagraph (C) of section 758(b)(1) (as redesignated by subsection (a)(1)), by striking
754, and 755 and inserting
755, and 756.
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:
National education outreach and awareness campaign on pain management
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).
The Secretary shall design the public awareness campaign under this section to educate consumers, patients, their families, and other caregivers with respect to—
the incidence and importance of pain as a national public health problem;
the adverse physical, psychological, emotional, societal, and financial consequences that can result if pain is not appropriately assessed, diagnosed, treated, or managed;
the availability, benefits, and risks of all pain treatment and management options;
having pain promptly assessed, appropriately diagnosed, treated, and managed, and regularly reassessed with treatment adjusted as needed;
the role of credentialed pain management specialists and subspecialists, and of comprehensive interdisciplinary centers of treatment expertise;
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—
appropriate assessment, diagnosis, treatment, and management options for all types of pain and pain-related symptoms; and
conditions for which no treatment options are yet recognized; and
other issues the Secretary deems appropriate.
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, other pain management professionals, medical device manufacturers, and pharmaceutical companies.
The Secretary shall designate one official in the Department of Health and Human Services to oversee the campaign established under this section.
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.
Underserved areas and populations
In designing the public awareness campaign under this section, the Secretary shall—
take into account the special needs of geographic areas and racial, ethnic, gender, age, and other demographic groups that are currently underserved; and
provide resources that will reduce disparities in access to appropriate diagnosis, assessment, and treatment.
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.
Evaluation and Report
Not later than the end of fiscal year 2011, the Secretary shall prepare and submit to the Congress a report evaluating the effectiveness of the public awareness campaign under this section in educating the general public with respect to the matters described in subsection (b).
Authorization of appropriations
For purposes of carrying out this section, there are authorized to be appropriated $2,000,000 for fiscal year 2009 and $4,000,000 for each of fiscal years 2010 and 2011.
Passed the House of Representatives September 24, 2008.
Lorraine C. Miller,