,i #aacth ,,congress #b;d ,session ,h4 ,r4 #eejg ,,in ,,the ,,house ,,of ,,representatives ,september #ag1 #bjad ,mr4 ,pascrell introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committee on ,ways and ,means1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to provide for a study by the ,institute of ,medicine on health disparities1 to direct the ,secretary of ,health and ,human ,services to develop guidelines on reducing health disparities1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,reducing ,disparities ,using ,care ,models and ,education ,act of #bjad4 #b4 ,findings ,the ,congress finds as follows3 7#a7 ,the infant death rate among ,african-,americans is more than double that of ,whites4 7#b7 ,the death rate for all cancers is #cj percent higher for ,african-,americans than for ,whites2 for prostate cancer1 it is more than double that for ,whites4 7#c7 ,black women have a higher death rate from breast cancer despite having a mammography screening rate that is nearly the same as the rate for ,white women4 7#d7 ,diabetes incidence is highest among ,native ,americans1 at #ae4i percent1 followed by #ac4b percent for ,african-,americans1 #ab4h percent for ,hispanics1 #i4j percent for ,asians1 and #g4f percent for ,whites4 7#e7 ,new cases of hepatitis and tuberculosis are higher in ,asians and ,pacific ,islanders living in the ,united ,states than in ,whites4 7#f7 ,individuals in same-sex couples were more likely than individuals in different-sex couples to report a delay in getting necessary prescriptions4 7#g7 ,infants born to ,black women are #a4e to #c times more likely to die than those born to women of other races or ethnicities1 and ,american ,indian and ,alaska ,native infants die from sudden infant death syndrome 7,,sids7 at nearly #b4e times the rate of ,white infants4 7#h7 ,low-income children have higher rates of mortality 7even with the same condition71 have higher rates of disability1 and are more likely to have multiple conditions4 7#i7 ,white children are half as likely as ,black and ,latino children not to be in excellent or very good health4 7#aj7 ,as of #bjab1 #ch4i percent of ,united ,states adults were obese1 with the highest rate among ,african-,americans at #dg4i percent1 followed by ,hispanics at #db4e percent1 ,whites at #cb4f percent1 and ,asians at #aj4h percent4 7#aa7 ,the risk of stroke is twice as high for ,african-,americans as for ,whites1 and ,african-,americans are more likely to die of stroke4 ,other ethnic minorities also have higher risk than ,whites4 ,overall1 strokes are most prevalent in the ,southeast ,united ,states1 and less so in the ,northeast4 7#ab7 ,african-,americans accounted for #dd percent of all those infected with ,,hiv1 despite being only #ab percent of the ,united ,states population4 7#ac7 ,black men who have sex with men 7,,msm7 ages #ac to #bd had the most new infections among youth4 7#ad7 ,one study found that among heterosexuals living in the same urban community1 those below the poverty line were twice as likely to contract human immunodeficiency virus 7,,hiv74 7#ae7 ,persons with less than a high school diploma 7#f4g percent7 and high school graduates 7#d4j percent7 were more likely to report major depression than those with at least some college education 7#b4e percent74 7#af7 ,only about #aj percent of physicians practice in rural ,america despite the fact that nearly one-fourth of the population lives in these areas4 7#ag7 ,rural residents are less likely to have employer-provided health care coverage or prescription drug coverage1 and the rural poor are less likely to be covered by ,medicaid benefits than their urban counterparts4 7#ah7 ,twenty percent of nonmetropolitan counties lack mental health services versus #e percent of metropolitan counties4 7#ai7 ,fifteen percent of persons with disabilities report not seeing a doctor due to cost in comparison to #f percent of the general population4 #c4 ,institute of ,medicine study 7a7 ,in general ,not later than #fj days after the date of the enactment of this ,act1 the ,secretary shall enter into an arrangement with the ,institute of ,medicine under which the ,institute agrees to study-- 7#a7 the extent of health disparities in the type and quality of preventive interventions1 health services1 and outcomes in the ,united ,states2 7#b7 the factors that may contribute to inequities in such disparities2 7#c7 existing programs and policies intended to reduce such disparities2 7#d7 best practices and successful strategies in programs that aim to reduce such disparities2 7#e7 priorities for successful intervention programs targeting such disparities2 and 7#f7 potential opportunities for expanding or replicating such programs4 7b7 ,report ,the arrangement under subsection 7a7 shall provide for submission by the ,institute of ,medicine to the ,secretary and ,congress1 not later than #bj months after the date of enactment of this ,act1 of a report on the results of the study4 #d4 ,guidelines for development and implementation of ,health ,disparities ,reduction ,programs and ,activities 7a7 ,guidelines ,not later than #ij days after the submission of the report described in section #c7;b71 and taking such report into consideration1 the ,secretary shall develop guidelines for entities to develop and implement programs and activities to reduce health disparities4 7b7 ,use by ,,hhs ,the ,secretary shall1 where appropriate1 incorporate the use of the guidelines developed under subsection 7a7 into the programs and activities of the ,department of ,health and ,human ,services4 7c7 ,grants for disparities reduction activities 7#a7 ,in general ,the ,secretary may award grants to entities for the development and implementation of programs and activities to reduce health disparities in accordance with the guidelines described in subparagraph 7a74 7#b7 ,applications ,to seek a grant under this subsection1 an entity shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may require4 7#c7 ,minimum contents ,the ,secretary shall require that an application for a grant under this subsection contains at a minimum-- 7,a7 a description of the population and public health concern the program will target and an outreach plan to ensure that the most in need populations will benefit2 7,b7 a description of the strategies the entity will use-- 7i7 to develop and implement its programs and activities in accordance with the guidelines developed under subsection 7a72 and 7ii7 to make the interventions sustainable2 and 7,c7 an agreement by the entities to periodically provide data with respect to-- 7i7 the population served2 7ii7 improvements in reducing health disparities2 and 7iii7 effectiveness of the interventions used4 7d7 ,appropriations ,to carry out this section1 there are authorized to be appropriated #e1jjj1jjj for fiscal year #bjaf and such sums as may be necessary for each of fiscal years #bjag through #bjbj4 #e4 ,testing alternative payment and delivery models to reduce health disparities 7a7 ,in general ,the ,secretary acting through the ,centers for ,medicare and ,medicaid ,innovation under section #aaae;,a of the ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7 shall provide for the testing of a payment and service delivery model that includes incentives for reducing health disparities consistent with the cost and quality criteria otherwise applicable to the testing of models under such section4 7b7 ,documentation requirement for model testing ,in carrying out subsection 7a71 the ,secretary shall require that an application to conduct such testing of such a model include at least-- 7#a7 documentation of at least one health disparity targeted for reduction2 7#b7 a root-cause analysis of the health disparity targeted for reduction2 7#c7 identification and selection of performance targets for such reduction2 7#d7 a proposal to make payments in some way contingent on a reduction in health disparities2 and 7#e7 a reliable method for monitoring progress in achieving such a reduction4 #f4 ,definitions ,in this ,act3 7#a7 ,the term health disparity means significant disparity in the overall rate of disease incidence1 prevalence1 morbidity1 mortality1 or survival rates in a population as compared to the health status of the general population4 7#b7 ,the term intervention means an activity taken by an entity on behalf of individuals or populations to reduce health disparities4 7#c7 ,the term ,secretary means the ,secretary of ,health and ,human ,services4