[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1888 Introduced in House (IH)]
<DOC>
116th CONGRESS
1st Session
H. R. 1888
To provide for a grants program to develop and enhance integrated
nutrition and physical activity curricula in medical schools.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 26, 2019
Mr. Ryan (for himself and Mr. Grijalva) introduced the following bill;
which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To provide for a grants program to develop and enhance integrated
nutrition and physical activity curricula in medical schools.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Expanding Nutrition's Role in
Curricula and Healthcare Act'' or the ``ENRICH Act''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) In 2012, United States health care spending was about
$8,915 per resident and accounted for 17.2 percent of the
Nation's gross domestic product, which is among the highest of
all industrialized countries.
(2) Expenditures in the United States on health care
surpassed $2.3 trillion in 2008, more than three times the $714
billion spent in 1990, and over eight times the $253 billion
spent in 1980. Cardiovascular disease cost American's $555
billion in 2016 alone.
(3) It is estimated that health care costs for chronic
disease treatment account for over 75 percent of national
health expenditures.
(4) In March 2003, a report from the World Health
Organization concluded diet was a major factor in the cause of
chronic diseases.
(5) Seven out of 10 deaths among Americans each year are
from chronic diseases. Heart disease, cancer, and stroke--each
of which has been strongly linked to dietary and lifestyle
choices--account for more than 50 percent of all deaths each
year.
(6) In 2015, 102.7 million people in the United States had
at least one form of cardiovascular disease. Approximately
2,300 Americans die every day from cardiovascular disease. In
2010, cardiovascular disease cost American taxpayers $189.4
billion. The American Heart Association estimates that, by
2035, costs related to cardiovascular disease will triple to
around $1.1 trillion. Research has shown that following a
healthful diet can not only reduce symptoms related to heart
disease but also reverse the damage done to the arteries.
(7) Two-thirds of the American population is currently
overweight, half of whom are obese. One in three children is
now overweight, and one-fifth of children are obese. In 2008,
the United States spent $190 billion on obesity-related health
care costs.
(8) An estimated 29 million Americans have diabetes.
Another 86 million adults have prediabetes. The Centers for
Disease Control and Prevention predict that one in three
children born in 2000 will develop diabetes at some point in
their lives. Diabetes cost the government $116 billion in 2007.
Research has shown that nutrition therapy is a key component of
diabetes management and can improve clinical outcomes.
(9) Cancer kills approximately 570,000 Americans each year,
accounting for one in every four deaths. More than 1.5 million
new cancer cases are diagnosed annually. In 2010, the direct
costs of cancer were $102.8 billion and that number is expected
to rise to $172 billion by 2020. More than 33 percent of
cancers are diet related and could be prevented with a
healthful diet.
(10) Eating is a complex social phenomenon influenced by
family, social networks, culture, socioeconomic and educational
status. An interprofessional approach to nutrition education
for clinicians may not necessarily overcome these forces but
may help the health professions team, including physicians and
non-physicians, identify effective strategies for nutrition
counseling and management.
(11) Physicians are an important source of information and
motivation for patients' health behavior. Multiple studies have
shown that physician counseling on weight loss increases the
likelihood that patients will attempt weight loss, increase
physical activity, improve diet, and lose weight.
(12) Leading medical bodies recommend that physicians
address diet with overweight patients. Guidelines from leading
medical bodies such as the National Institutes of Health, the
American Heart Association, the American College of Cardiology,
and the Obesity Society recommend that physicians counsel
overweight and obese patients on the benefits of lifestyle
changes through lifestyle changes such as diet and physical
activity.
SEC. 3. GRANTS PROGRAM TO DEVELOP OR ENHANCE INTEGRATED NUTRITION
CURRICULA IN MEDICAL SCHOOLS.
(a) In General.--The Secretary of Health and Human Services, acting
through the Administrator of the Health Resources and Services
Administration and in conjunction with the National Institutes of
Health National Heart, Lung, and Blood Institute, shall establish a
competitive grants program under which the Secretary may award grants
to medical schools in the United States for the purpose described in
subsection (b)(1).
(b) Use of Grant Funds.--
(1) In general.--A medical school receiving a grant under
this section shall use the grant to create new or expand
existing integrated nutrition and physical activity curriculum
described in paragraph (2) for the medical school.
(2) Integrated nutrition curriculum.--For purposes of
paragraph (1), an integrated nutrition and physical activity
curriculum--
(A) shall be designed based on the best possible
evidence to improve communication and provider
preparedness in the prevention, management, and, as
possible, reversal of obesity, cardiovascular disease,
diabetes, and cancer; and
(B) shall, to the greatest extent practicable,
address such additional topics, including nutrition
across the life cycle of individuals who are members of
at-risk populations, physical activity training and
programs for such individuals, food insecurity among
such individuals, and malnutrition among such
individuals.
(c) Eligibility.--To be eligible to receive a grant under this
section, an eligible entity shall--
(1) be a medical school in the United States that is
accredited by the Liaison Committee on Medical Education and
Residency Program Accreditation Council for Graduate Education
or by the American Osteopathic Association Commission on
Osteopathic College Accreditation; and
(2) submit an application to the Secretary, in accordance
with such time, form, and manner and containing such
information as specified by the Secretary, including--
(A) a description of how the medical school intends
to implement the integrated nutrition and physical
activity curriculum described in subsection (b)(2); and
(B) a description of benchmarks to measure the
success of the implementation of such curriculum.
(d) Administrative Provisions.--
(1) Duration of program.--A grant awarded to a medical
school under this section shall be for a three-year period,
beginning on the date of the establishment of the grants
program under subsection (a).
(2) Limitations.--
(A) Grant amounts.--A grant awarded to a medical
school under this section may not exceed $500,000.
(B) One grant per school.--A medical school shall
not be eligible for more than one grant under this
section and may not renew such a grant.
(3) Priority.--In awarding grants, the Secretary shall give
priority to medical schools--
(A) that submit applications under subsection
(c)(1) that describe an integrated nutrition and
physical activity curriculum that will be implemented
through the use of such a grant--
(i) that is coordinated with a residency
program; or
(ii) provides that students of such school
should receive at least 25 hours of nutrition
education; or
(B) that, for purposes of carrying out such
curriculum through the use of such a grant, partner
with education programs for both physicians and non-
physician health professionals.
(e) Reports.--
(1) Periodic reports during grants program.--
(A) In general.--For each school year ending during
the duration of the grants program under this section,
the Secretary shall submit to Congress a report on the
grants program.
(B) Report elements.--Each such report shall
include--
(i) the findings and conclusions of the
Secretary with respect to the integration of
nutrition and physical activity curriculum into
the curriculum of the medical schools receiving
a grant under the grants program;
(ii) an assessment of the benefits of the
grants program for--
(I) establishing best practices for
providers to advise patients in the
clinical setting;
(II) providing greater nutrition
and physical activity awareness to
physicians and other health
professionals and patients of such
physicians and professionals; and
(III) improving healthfulness of
patients' diets and improving patient
health outcomes; and
(iii) suggestions on how to promote the
integration of nutrition curriculum in medical
schools around the United States.
(2) Final report.--Not later than 180 days after the last
day of the grants program under this section, the Secretary
shall submit to Congress a report detailing the recommendations
of the Secretary as to any benefits or barriers of integrating
nutrition and physical activity curriculum at both the medical
school and residency levels.
(f) Funding.--No additional funds are authorized to carry out the
requirements of this section. The Secretary shall carry out such
requirements by using, from amounts otherwise authorized or
appropriated, up to $5,000,000 for each of fiscal years 2019 through
2021.
<all>