,,ii #aadth ,,congress #ast ,session ,s4 #ehf ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,february #bf1 #bjae,mrs4 ,shaheen 7for herself1 ,ms4 ,collins1 ,mr4 ,brown1 ,mr4 ,markey1 ,mr4 ,kirk1 ,ms4 ,ayotte1 ,mrs4 ,boxer1 ,mr4 ,nelson1 ,mr4 ,donnelly1 ,mr4 ,carper1 ,mr4 ,booker1 ,mr4 ,grassley1 and ,mr4 ,peters7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to amend the ,public ,health ,service ,act to foster more effective implementation and coordination of clinical care for people with pre-diabetes1 diabetes1 and the chronic diseases and conditions that result from diabetes4 #a4 ,short title ,this ,act may be cited as the ,national ,diabetes ,clinical ,care ,commission ,act4 #b4 ,findings ,congress finds the following3 7#a7 ,the ,centers for ,disease ,control and ,prevention report that nearly #bi1jjj1jjj ,americans have diabetes in addition to an estimated #hf1jjj1jjj ,american adults that have pre-diabetes1 an increase of #c1jjj1jjj ,americans with diabetes and #g1jjj1jjj ,american adults with pre-diabetes since #bjaa4 7#b7 ,diabetes affects #i4c percent of ,americans of all ages and #ab4c percent of adults age #bj and older4 ,adults age #bj and older of racial and ethnic minorities continue to have higher rates of diabetes than individuals not of such minorities1 as demonstrated by the following3 #ae4i percent of all adult ,american ,indians and ,alaskan ,natives have diabetes2 #ac4b percent of all adult ,african-,americans have diabetes2 #ab4h percent of all adult ,hispanics have diabetes2 and #i4j percent of all adult ,asian-,americans have diabetes1 while #g4f percent of all non-,hispanic ,whites have diabetes4 7#c7 ,diabetes is the seventh leading cause of death in the ,united ,states4 7#d7 ,people with diabetes are more likely than people without diabetes to also have chronic diseases and conditions that are complications of diabetes1 including cardiovascular disease1 strokes1 high blood pressure1 kidney disease1 including dialysis1 blindness1 neuropathy1 and leg and feet amputations4 7#e7 ,adults with diabetes have an elevated risk of heart disease and stroke4 ,adults with diabetes have death rates from heart disease that are nearly twice as high as adults without the disease4 7#f7 ,diabetes is the leading cause of kidney failure4 ,each year1 nearly #ajj1jjj individuals in the ,united ,states are diagnosed with kidney failure1 and diabetes accounts for #dd percent of these new cases4 7#g7 ,diabetic neuropathies are a family of nerve disorders caused by diabetes and are prevalent in nearly #fj to #gj percent of individuals with diabetes4 7#h7 ,diabetes is the leading cause of new cases of blindness among adults aged #bj to #gd4 7#i7 ,about #fj percent of all non-traumatic lower limb amputations in the ,united ,states occur in individuals with diabetes4 7#aj7 ,total national costs associated with diabetes in #bjab exceeded #bde1jjj1jjj1jjj1 according to the ,centers for ,disease ,control and ,prevention4 7#aa7 ,one in three ,medicare dollars is currently spent on people with diabetes4 7#ab7 ,the ,centers for ,disease ,control and ,prevention projects that as many as #a in #c ,american adults could have diabetes by #bjej if current trends continue4 7#ac7 ,there are #ce ,federal departments1 agencies1 and offices involved in the implementation of ,federal diabetes activities4 #c4 ,establishment of the ,national ,diabetes ,clinical ,care ,commission ,part ,p of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;g et seq47 is amended by adding at the end the following new section3 #cii,v-#f4 ,national ,diabetes ,clinical ,care ,commission 7a7 ,establishment ,there is hereby established within the ,department of ,health and ,human ,services a ,national ,diabetes ,clinical ,care ,commission 7in this section referred to as the ,commission7 to evaluate and recommend solutions regarding better coordination and the leveraging of programs within the ,department of ,health and ,human ,services and other ,federal agencies that relate in any way to supporting appropriate clinical care 7such as any interactions between physicians and other health care providers and their patients7 related to the treatment and care management for people with pre-diabetes1 diabetes1 and the chronic diseases and conditions that are complications of or caused by diabetes4 7b7 ,membership 7#a7 ,in general ,the ,commission shall be composed of the following voting members3 7,a7 ,the heads 7or their designees7 of the following ,federal agencies and departments that conduct programs that could impact the clinical care of people with pre-diabetes1 diabetes1 and the chronic diseases and conditions that are complications of or caused by diabetes3 7i7 ,the ,centers for ,medicare and ,medicaid ,services4 7ii7 ,the ,agency for ,healthcare ,research and ,quality4 7iii7 ,the ,centers for ,disease ,control and ,prevention4 7iv7 ,the ,indian ,health ,service4 7v7 ,the ,department of ,veterans ,affairs4 7vi7 ,the ,national ,institutes of ,health4 7vii7 ,the ,food and ,drug ,administration4 7viii7 ,the ,health ,resources and ,services ,administration4 7ix7 ,the ,department of ,defense4 7x7 ,other governmental or nongovernmental agency heads1 at the discretion of the agency1 that impact clinical care of individuals with pre-diabetes and diabetes4 7,b7 ,twelve additional voting members appointed under paragraph 7#b74 7#b7 ,additional members ,the ,commission shall include additional voting members appointed by the ,comptroller ,general of the ,united ,states1 in consultation with national medical societies and patient advocate organizations with expertise in diabetes and the care of patients with diabetes and the diseases it causes1 including one or more from each of the following categories3 7,a7 ,clinical endocrinologists4 7,b7 ,physician specialties 7other than as described in subparagraph 7,a77 that play a role in diabetes care1 such as cardiologists1 nephrologists1 and eye care professionals4 7,c7 ,primary care physicians4 7,d7 ,non-physician health care professionals1 such as certified diabetes educators1 registered dieticians and nutrition professionals1 nurses1 nurse practitioners1 and physician assistants4 7,e7 ,patient advocates4 7,f7 ,national experts in the duties listed under subsection 7c74 7#c7 ,chairperson ,the voting members of the ,commission shall select a chairperson from the members described in paragraph 7#b77;,a74 7#d7 ,meetings ,the ,commission shall meet at least twice1 and not more than #d times1 a year4 7#e7 ,board terms ,members of the ,commission1 including the chairperson1 shall serve for a #c-year term4 ,a vacancy on the ,commission shall be filled in the same manner as the original appointments4 7c7 ,duties ,the ,commission shall-- 7#a7 evaluate programs of the ,department of ,health and ,human ,services regarding the utilization of diabetes screening benefits1 annual wellness visits1 and other preventive health benefits that may reduce the risk of diabetes and the chronic diseases and conditions that are complications of diabetes1 addressing any existing problems regarding such utilization and related data collection mechanisms2 7#b7 identify current activities and critical gaps in ,federal efforts to support clinicians in providing integrated1 high-quality care to people with pre-diabetes1 diabetes1 and the chronic diseases and conditions that are complications of diabetes2 7#c7 make recommendations regarding the coordination of clinically based activities that are being supported by the ,federal ,government2 7#d7 make recommendations regarding the development and coordination of federally funded clinical practice support tools for physicians and other health care professionals in caring for and managing the care of people with pre-diabetes1 diabetes1 and the chronic diseases and conditions that are complications of diabetes1 specifically with regard to the implementation of new treatments and technologies2 7#e7 evaluate programs in existence as of the date of the enactment of this section and determine if such programs are meeting the needs identified in paragraph 7#b7 and1 if such programs are determined to not be meeting such needs1 recommend programs that would be more appropriate2 7#f7 recommend clinical pathways for new technologies and treatments1 including future data collection activities1 and how they may be developed and then used to evaluate and develop various care models and methods and the impact of such models and methods on quality of care and diabetes management as measured by appropriate care parameters 7such as ,a#a;,c1 blood pressure1 and cholesterol levels72 7#g7 evaluate and expand education and awareness to physicians and other health care professionals regarding clinical practices for the prevention of diabetes and the chronic diseases and conditions that are complications of diabetes2 7#h7 review and recommend appropriate methods for outreach and dissemination of educational resources that regard diabetes prevention and treatments1 are funded by the ,federal ,government1 and are intended for health care professionals and the public2 and 7#i7 include other activities1 such as those relating to the areas of public health and nutrition1 that the ,commission deems appropriate4 7d7 ,operating plan 7#a7 ,initial plan ,not later than #ij days after its first meeting1 the ,commission shall submit to the ,secretary and the ,congress an operating plan for carrying out the activities of the ,commission as described in subsection 7c74 ,such operating plan may include-- 7,a7 a list of specific activities that the ,commission plans to conduct for purposes of carrying out the duties described in each of the paragraphs in subsection 7c72 7,b7 a plan for completing the activities2 7,c7 a list of members of the ,commission and other individuals who are not members of the ,commission who will need to be involved to conduct such activities2 7,d7 an explanation of ,federal agency involvement and coordination needed to conduct such activities2 7,e7 a budget for conducting such activities2 7,f7 a plan for evaluating the value and potential impact of the ,commission's work and recommendations1 including the possible continuation of the ,commission for the purposes of overseeing their implementation2 and 7,g7 other information that the ,commission deems appropriate4 7#b7 ,updates ,the ,commission shall periodically update the operating plan under paragraph 7#a7 and submit such updates to the ,secretary and the ,congress4 7e7 ,final report and sunset of the commission ,by not later than #c years after the date of the ,commission's first meeting1 the ,commission shall submit a report containing all of the findings and recommended actions of the ,commission to the ,secretary and ,congress4 ,not later than #abj days after the submission of the final report1 the ,secretary shall review the evaluation required under subsection 7d77#a77;,f7 to determine the continuation of the ,commission4 7f7 ,authorization of appropriations ,appropriations are authorized to be made available to the ,commission for each of fiscal years #bjaf1 #bjag1 and #bjah1 from amounts otherwise made available to the ,department of ,health and ,human ,services for such fiscal years1 to carry out this section4 4