,i  #aag? ,,congress  #a/ ,session  ,h4 
,r4 #chic  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,june #ae1 #bjba ,ms4 
,blunt ,ro*e/] 7= h]self & ,mr4 ,w5/rup7
 introduc$ ! foll[+ bill2 :i* 0 ref]r$  
to ! ,committee on ,en]gy & ,comm]ce  ,a
 ,,bill  ,to improve kidney disease     
rese>*1 prev5tion1 surveillance1 &      
treatm5t 9 m9ority populations & rural &
 und]s]v$ communities1 & = o!r purposes4
  #a4 ,%ort title ,?is ,act may be cit$ 
z ! ,coord9ation1 ,acc\ntability1       
,rese>*1 & ,equity = ,all ,kidneys ,act 
( #bjba or ! ,,c>e = ,all ,kidneys ,act 
( #bjba4  #b4 ,kidney disease rese>* 9  
m9ority populations & rural & und]s]v$  
communities  7a7 ,9 g5]al ,! ,director (
 ! ,national ,in/itutes ( ,heal? %all   
exp&1 int5sify1 & support ongo+ rese>* &
 o!r activities ) respect to kidney     
disease 9 m9ority populations & rural & 
und]s]v$ communities4  7b7 ,consultation
 ,! ,director ( ! ,national ,in/itutes (
 ,heal? %all c>ry out subsection 7a7 9  
consultation ) ! ,adm9i/rator ( ! ,c5t]s

 = ,m$ic>e  ,m$icaid ,s]vices1 work+ )  
p]sonnel ( ! ,c5t]s :o are responsible =
 *ronic c>e managem5t activities & h    
exp]tise 9 kidney c>e4  7c7 ,rese>*     
7#a7 ,description ,rese>* "u subsection 
7a7 %all include inve/igation into--    
7,a7 ! causes ( kidney disease1 includ+ 
socioeconomic1 geographic1 cl9ical1     
environm5tal1 g5etic1 racial1 e?nic1 &  
o!r factors t may contribute to increas$
 rates ( kidney disease 9 m9ority       
populations & rural & und]s]v$          
communities2 &  7,b7 ! causes ( increas$
 incid5ce ( kidney disease complications
 9 m9ority populations & rural &        
und]s]v$ communities1 & possible cl9ical
 & noncl9ical 7su* z food security1     
h\s+1 & access to cov]age7 int]v5tions  
to decrease su* incid5ce4  7#b7         
,inclusion ( p>ticipants ,9 conduct+ &  
support+ rese>* describ$ 9 subsection   
7a71 ! ,director ( ! ,national          
,in/itutes ( ,heal? %all seek to include
 p>ticipants f m9ority populations &    
rural & und]s]v$ communities z /udy     

subjects 9 cl9ical trials4  7d7 ,report 
7#a7 ,9 g5]al ,n lat] ?an #f mon?s aft] 
! date ( enactm5t ( ?is section1 !      
,secret>y ( ,heal? & ,human ,s]vices    
%all prep>e & submit to ! ,congress a   
report on ,f$]al rese>* & public heal?  
activities ) respect to kidney disease 9
 m9ority populations & rural & und]s]v$ 
communities4  7#b7 ,cont5ts ,! report "u
 p>agraph 7#a7 %all at m9imum address   
ea* ( ! foll[+3 7,a7 ,rese>* on kidney  
disease 9 m9ority populations & rural & 
und]s]v$ communities1 includ+ su* rese>*
 on--  7i7 socioeconomic1 geographic1   
cl9ical1 environm5tal1 g5etic1 racial1  
e?nic1 & o!r factors 7su* z food        
security1 h\s+1 & access to cov]age7 t  
may contribute to increas$ rates (      
kidney disease 9 m9ority populations &  
rural & und]s]v$ communities2 &  7ii7   
prev5tion & complications among         
individuals )9 ^! populations &         
communities :o h already develop$ kidney
 disease4  7,b7 ,surveillance & data    
collection on kidney disease 9 m9ority  

populations & rural & und]s]v$          
communities1 includ+ ) respect to-- 7i7 
ef=ts to bett] det]m9e ! preval5ce (    
kidney disease among ,black1            
,hispanic_/,lat9o1 & ,asian-,am]ican &  
,pacific ,isl&] subgr\ps2 &  7ii7 ef=ts 
to coord9ate data collection on !       
,am]ican ,indian population4  7,c7      
,community-bas$ int]v5tions to address  
kidney disease t>get+ m9ority           
populations & rural & und]s]v$          
communities1 includ+--  7i7 ! evid5ce   
base = su* int]v5tions2  7ii7 ! cultural
 appropriat5ess ( su* int]v5tions2 &    
7iii7 ef=ts to educate ! public on !    
causes ( kidney disease1 ! importance ( 
ma9ta9+ kidney heal?1 & actions         
individuals c take to avoid kidney      
disease4  7,d7 ,education & tra9+       
programs = heal? pr(essionals 7includ+  
community heal? work]s7 on ! prev5tion &
 managem5t ( kidney disease & its relat$
 complications t is support$ by ! ,heal?
 ,res\rces & ,s]vices ,adm9i/ration1    
includ+ su* programs support$ by !      

,bureau ( ,heal? ,work=ce1 ! ,bureau (  
,prim>y ,heal? ,c>e1 & ! ,heal?c>e      
,sy/ems ,bureau4  #c4 ,kidney disease   
action plan  7a7 ,9 g5]al ,! ,assi/ant  
,secret>y = ,heal? ( ! ,dep>tm5t (      
,heal? & ,human ,s]vices %all conduct1  
support1 & exp& public heal? /rategies1 
prev5tion1 diagnosis1 surveillance1 &   
public & pr(essional aw>5ess activities 
reg>d+ kidney disease4  7b7 ,national   
action plan  7#a7 ,developm5t ,n lat]   
?an #b ye>s aft] ! date ( ! enactm5t (  
?is ,act1 ! ,assi/ant ,secret>y = ,heal?
 ( ! ,dep>tm5t ( ,heal? & ,human        
,s]vices %all develop a national action 
plan to address kidney disease 9 !      
,unit$ ,/ates ) p>ticipation f pati5ts1 
c>egiv]s1 heal? pr(essionals1 pati5t    
advocacy organizations1 rese>*]s1       
provid]s1 public heal? pr(essionals1 &  
o!r /akehold]s4  7#b7 ,cont5ts ,at a    
m9imum1 su* plan %all include           
recomm5dations =-- 7,a7 public heal?    
int]v5tions = ! purpose ( implem5tation 
( ! national plan2  7,b7 biom$ical1     

heal? s]vices1 & public heal? rese>* on 
kidney disease2 &  7,c7 inclusion (     
kidney disease 9 ! heal? data           
collections ( all ,f$]al ag5cies4  7c7  
,kidney disease prev5tion programs ,at !
 conclusion ( ! developm5t ( ! national 
action plan "u subsection 7b71 !        
,director ( ! ,national ,in/itute (     
,diabetes & ,dige/ive & ,kidney ,disease
 %all conduct public education & aw>5ess
 activities ) pati5t & pr(essional      
organizations to /imulate e>li]         
diagnosis & improve pati5t outcomes f   
treatm5t ( kidney disease4 ,to ! ext5t  
kn[n & relevant1 su* public education & 
aw>5ess activities %all reflect         
diff]5ces 9 kidney disease by cause 7su*
 z hyp]t5sion1 diabetes1 & polycy/ic    
kidney disease7 & include a focus on    
outrea* to undiagnos$ &1 z appropriate1 
m9ority populations & rural & und]s]v$  
communities4  7d7 ,grants = r$uc+ burd5 
( kidney disease ,beg9n+ n lat] ?an #b  
ye>s aft] ! date ( enactm5t ( ?is ,act1 
! ,director ( ! ,c5t]s = ,disease       

,control & ,prev5tion %all supplem5t &  
exp& ^u ! activities ( ! ,national      
,in/itute ( ,diabetes & ,dige/ive &     
,kidney ,disease by mak+ grants to      
nonpr(it organizations1 ,/ate & local   
jurisdictions1 & ,indian ,tribes = !    
purpose ( r$uc+ ! burd5 ( kidney        
disease1 especially 9 disproportionately
 impact$ communities1 ?r\gh public heal?
 int]v5tions & relat$ activities4  7e7  
,developm5t ( be/ practices = diagnosis 
& managem5t ( kidney disease ,beg9n+ n  
lat] ?an #b ye>s aft] ! date ( enactm5t 
( ?is ,act1 ! ,assi/ant ,secret>y =     
,heal? ( ! ,dep>tm5t ( ,heal? & ,human  
,s]vices %all-- 7#a7 9 coord9ation ) !  
,c5t]s = ,disease ,control & ,prev5tion1
 ! ,indian ,heal? ,s]vice1 ! ,heal?     
,res\rces & ,s]vices ,adm9i/ration1 !   
,dep>tm5t ( ,vet]ans ,affairs1 dialysis 
provid]s1 nephrologi/s1 m$ical          
societies1 & nurs+ gr\ps1 develop pilot 
programs to demon/rate be/ practices = !
 diagnosis & managem5t ( kidney disease2
 &  7#b7 design su* pilot programs & be/

 practices = use by-- 7,a7 g5]al        
practition]s1 family physicians1 int]nal
 m$ic9e practition]s1 nurse             
practition]s1 & physician assi/ants 9   
private practice2 &  7,b7 ,f$]ally      
qualifi$ heal? c5t]s1 ,indian           
res]vations1 prisons1 community heal?   
c5t]s1 & o!r prim>y c>e sett+s4  7f7    
,data collection ,n lat] ?an #ahj days  
aft] ! date ( enactm5t ( ?is ,act1 !    
,director ( ! ,national ,in/itute (     
,diabetes & ,dige/ive & ,kidney ,disease
 & ! ,director ( ! ,c5t]s = ,disease    
,control & ,prev5tion1 act+ jo9tly1 %all
 assess ! dep? & quality ( in=mation on 
kidney disease t is collect$ 9 surveys &
 population /udies conduct$ by ! ,c5t]s 
= ,disease ,control & ,prev5tion1       
includ+ :e!r !re are additional         
opportunities = in=mation to be collect$
 9 ! ,national ,heal? & ,nutrition      
,exam9ation ,survey1 ! ,national ,heal? 
,int]view ,survey1 & ! ,behavioral ,risk
 ,factors ,surveillance ,sy/em surveys4 
,! ,director ( ! ,national ,in/itute (  

,diabetes & ,dige/ive & ,kidney ,disease
 %all include ! results ( su* assessm5t 
9 ! national action plan "u subsection  
7b74  7g7 ,au?orization ( appropriations
 ,!re are au?oriz$ to be appropriat$ to 
c>ry out ?is section-- 7#a7 #a1jjj1jjj =
 fiscal ye> #bjbb2  7#b7 #a1jjj1jjj =   
fiscal ye> #bjbc2  7#c7 #a1jjj1jjj =    
fiscal ye> #bjbd2  7#d7 #a1jjj1jjj =    
fiscal ye> #bjbe2 &  7#e7 #a1jjj1jjj =  
fiscal ye> #bjbf4  #d4 ,report on       
end-/age r5al disease 7,,esrd7 treatm5t 
*oices 7,,etc7 model ,! ,assi/ant       
,secret>y = ,heal? ( ! ,dep>tm5t (      
,heal? & ,human ,s]vices %all-- 7#a7    
annually provide to ! ,congress a report
 on h[ ! end-/age r5al disease treatm5t 
*oices model has affect$ m9ority        
populations & rural & und]s]v$          
communities2 &  7#b7 9 ea* su* report1  
include ! numb] & p]c5tage ( p 9 home   
dialysis categoriz$ by race1 e?nicity1  
g5d]1 geographic location1 & age4  #e4  
,increas+ kidney transplants 9 m9ority1 
rural1 & und]s]v$ communities  7a7 ,9   

g5]al ,! ,director ( ! ,national        
,in/itutes ( ,heal? %all exp&1 int5sify1
 & support ongo+ rese>* & o!r activities
 ) respect to kidney transplants 9      
m9ority populations & rural & und]s]v$  
communities4  7b7 ,consultation ,!      
,director ( ! ,national ,in/itutes (    
,heal? %all c>ry out ?is section 9      
consultation ) ! ,adm9i/rator ( ! ,c5t]s
 = ,m$ic>e  ,m$icaid ,s]vices1 work+ )  
p]sonnel ( ! ,c5t]s :o are responsible =
 *ronic c>e managem5t activities & h    
exp]tise 9 kidney c>e4  7c7 ,rese>*     
,rese>* "u subsection 7a7 %all include  
inve/igation into--  7#a7 ! causes ( l[]
 rates ( kidney transplants 9 m9ority1  
rural1 & und]s]v$ communities1 includ+  
socioeconomic1 geographic1 cl9ical1     
environm5tal1 g5etic1 racial1 e?nic1 &  
o!r factors t may contribute to l[]     
rates ( kidney transplants 9 m9ority    
populations & rural & und]s]v$          
communities2 &  7#b7 possible           
int]v5tions to increase kidney          
transplants4  7d7 ,report2 compreh5sive 

plan  7#a7 ,9 g5]al ,! ,secret>y (      
,heal? & ,human ,s]vices %all-- 7,a7    
prep>e & submit to ! ,congress1 n lat]  
?an #f mon?s aft] ! date ( enactm5t (   
?is section1 a report on ,f$]al rese>* &
 public heal? activities ) respect to   
kidney transplants z a treatm5t =       
end-/age r5al disease 9 m9ority         
populations & rural & und]s]v$          
communities2 &  7,b7 develop & submit to
 ! ,congress1 n lat] ?an #a ye> aft] !  
date ( enactm5t ( ?is section1 an       
effective & compreh5sive ,f$]al plan    
7includ+ all appropriate ,f$]al heal?   
programs7 to increase ! numb] ( kidney  
transplants 9 m9ority populations &     
rural & und]s]v$ communities4  7#b7     
,cont5ts ,! report "u p>agraph 7#a77;,a7
 %all at m9imum address ea* ( ! foll[+3 
7,a7 ,rese>* on kidney transplants 9    
m9ority populations & rural & und]s]v$  
communities1 includ+ su* rese>* on      
f9ancial1 insurance cov]age1 g5etic1    
behavioral1 & environm5tal factors4     
7,b7 ,surveillance & data collection on 

kidney transplants 9 m9ority populations
 & rural & und]s]v$ communities1 includ+
 ) respect to--  7i7 ef=ts to increase  
kidney transplants among ,black1        
,hispanic_/,lat9o1 ,asian-,am]ican1 &   
,pacific ,isl&] subgr\ps ) end-/age r5al
 disease2 &  7ii7 ef=ts to increase     
kidney transplants 9 ! ,am]ican ,indian 
population4  7,c7 ,community-bas$ ef=ts 
to increase kidney transplants t>get+   
m9ority populations & rural & und]s]v$  
communities1 includ+-- 7i7 ! evid5ce    
base = su* increases2  7ii7 ! cultural  
appropriat5ess ( su* increases2 &  7iii7
 ef=ts to educate ! public on ! kidney  
transplants4  7,d7 ,education & tra9+   
programs = heal? pr(essionals 7includ+  
community heal? work]s7 on kidney       
transplants t are support$ by ! ,heal?  
,res\rces & ,s]vices ,adm9i/ration1     
includ+ su* programs support$ by !      
,bureau ( ,heal? ,work=ce1 ! ,bureau (  
,prim>y ,heal? ,c>e1 & ! ,heal?c>e      
,sy/ems ,bureau4  #f4 ,environm5tal &   
occupational heal? programs ,! ,director

 ( ! ,c5t]s = ,disease ,control &       
,prev5tion %all--  7#a7 support rese>*  
into ! environm5tal & occupational      
causes & biological me*anisms t         
contribute to kidney disease2 &  7#b7   
develop & dissem9ate public heal?       
int]v5tions t w less5 ! impact (        
environm5tal & occupational causes (    
kidney disease4  #g4 ,und]/&+ ! treatm5t
 patt]ns associat$ ) provid+ c>e &      
treatm5t ( kidney failure 9 m9ority     
populations & rural & und]s]v$          
communities  7a7 ,/udy ,! ,secret>y (   
,heal? & ,human ,s]vices 79 ?is section 
ref]r$ to z ! ,secret>y7 %all conduct a 
/udy on treatm5t patt]ns associat$ )    
provid+ c>e1 "u ! ,m$ic>e program "u    
title ,,xviii ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acie et seq471 !       
,m$icaid program "u title ,,xix ( su*   
,act 7#db ,u4,s4,c4 #acif et seq471 &   
?r\gh private heal? insurance1 to       
m9ority populations1 & rural & und]s]v$ 
communities1 t are disproportionately   
affect$ by kidney failure4  7b7 ,report 

,n lat] ?an #a ye> aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y %all   
submit to ! ,congress a report on ! /udy
 conduct$ "u subsection 7a71 toge!r )   
su* recomm5dations z ! ,secret>y        
det]m9es to be appropriate4  #h4        
,improv+ access 9 und]s]v$ areas  7a7   
,def9ition ( prim>y c>e s]vices ,section
 #cca7;a77#c77;,d7 ( ! ,public ,heal?   
,s]vice ,act 7#db ,u4,s4,c4             
#bed;d7a77#c77;,d77 is am5d$ by ins]t+  
r5al dialysis1 aft] d5ti/ry14  7b7      
,national ,heal? ,s]vice ,corps s*ol>%ip
 program ,section #cch;,a7a77#b7 ( !    
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bedl7a77#b77 is am5d$ by     
ins]t+ 1 :i* may include nephrology     
heal? pr(essionals be=e ! p]iod at !    
end4  7c7 ,national ,heal? ,s]vice      
,corps loan repaym5t program ,section   
#cch;,b7a77#b7 ( ! ,public ,heal?       
,s]vice ,act 7#db ,u4,s4,c4             
#bedl-#a7;a77#b77 is am5d$ by ins]t+ 1  
:i* may include nephrology heal?        
pr(essionals be=e ! p]iod at ! end4