[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8964 Introduced in House (IH)]
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117th CONGRESS
2d Session
H. R. 8964
To require the Secretary of Health and Human Services to issue to
Federal agencies guidelines for developing procedures and requirements
relating to certain primary care Federal health professionals
completing continuing medical education on nutrition and to require
Federal agencies to submit annual reports relating to such guidelines,
and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 22, 2022
Mr. Grijalva (for himself and Mr. McGovern) introduced the following
bill; which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To require the Secretary of Health and Human Services to issue to
Federal agencies guidelines for developing procedures and requirements
relating to certain primary care Federal health professionals
completing continuing medical education on nutrition and to require
Federal agencies to submit annual reports relating to such guidelines,
and for other purposes.
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 ``Education And Training for Health
Act of 2022'' or the ``EAT for Health Act of 2022''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) According to 2019 National Health Expenditure Account
data, the growth in total national healthcare expenditures in
2019 reached $3.8 trillion, or $11,582 per person.
(2) According to the Center for Disease Control and
Prevention (CDC) around 90 percent of annual health
expenditures are for people with chronic and mental health
conditions.
(3) According to the CDC most people in the United States
don't eat a healthy diet and consume too much sodium, saturated
fat, and sugar, increasing their risk of chronic diseases.
Fewer than 1 in 10 adolescents and adults eat enough fruits or
vegetables.
(4) According to National Center for Chronic Disease
Prevention and Health Promotion (NCCDPHP) six in ten Americans
live with at least one chronic disease, like heart disease and
stroke, cancer, or diabetes.
(5) Seven out of 10 deaths among people in the United
States each year are from chronic diseases such as
cardiovascular disease, obesity, diabetes, and cancer.
(6) According to NCCDPHP eating healthy helps prevent,
delay, and manage heart disease, type 2 diabetes, and other
chronic diseases. (5) According to the CDC, heart disease is
the leading cause of death for American adults. Approximately
659,000 American adults die each year from cardiovascular
disease. Coronary heart disease alone costs American taxpayers
$363 billion each year.
(7) Research has shown that following a healthful diet,
including a plant-based diet, can not only reduce symptoms
related to cardiovascular disease but can also actually reverse
damage done to the arteries.
(8) According to the Journal of the American Medical
Association, two-thirds of adults in the United States are
currently overweight, and half of those overweight individuals
are obese. One in three children are overweight, and one-fifth
of children are obese. The United States spends about $147 to
$210 billion a year on obesity related diseases, including type
2 diabetes, hypertension, heart disease, and arthritis.
(9) An estimated 34.2 million people in the United States
have diabetes. Another 88 million American adults have
prediabetes. The Centers for Disease Control and Prevention
predicts that one in three children born in 2000 will develop
diabetes at some point in their lives. Total direct estimated
costs of diagnosed diabetes increased from $188 billion in 2012
to $237 billion in 2017.
(10) A consensus statement endorsed by American Association
of Clinical Endocrinology, supported by the Academy of
Nutrition and Dietetics, and co-sponsored by the Endocrine
Society reports that plant-based diets and other nutrition
interventions aid type 2 diabetes remission.
(11) According to the American Cancer Society, there will
be an estimated 1,918,030 new cancer cases diagnosed and
609,360 cancer deaths in the United States in 2022. That is
equivalent to about 1,670 deaths per day and accounts for
nearly 1 of every 4 deaths. The National Cancer Institute
estimates that cancer-related direct medical costs in the U.S.
were $183 billion in 2015 and are projected to increase to $246
billion by 2030, a 34% increase based only on population growth
and aging.
(12) According to a 2008 survey published in Journal of the
American College of Nutrition, physicians felt inadequately
trained to provide proper nutrition advice. Ninety-four percent
felt nutrition counseling should be included during primary
care visits, but only 14 percent felt adequately trained to
provide such counseling.
(13) A 1985 National Academy of Sciences report recommended
that all medical schools require at least 25 contact hours of
nutrition education. According to a 2009 national survey of
medical colleges published in Academic Medicine, only 38
percent of medical schools met these minimum standards by
requiring 25 hours of nutrition education as part of their
general curricula in 2004. By 2010, that number had shrunk to
27 percent.
(14) According to the Journal of Nutrition in Clinical
Practice in 2010, more than half of graduating medical students
felt their nutrition education was insufficient.
(15) Recognizing the importance of nutrition, Healthy
People 2030--the Federal Government's framework for a healthier
Nation--includes a goal (NWS-05) to increase the proportion of
health care visits by adults with obesity that include
counseling or education related to nutrition, weight loss, or
physical activity. According to Healthy People 2030, only 24.8
percent of physician office visits included counseling about
nutrition or diet in 2016.
(16) According to Mission: Readiness, obesity disqualifies
31 percent of youth from serving if they so choose.
(17) According to the Journal of American Health Promotion,
the military spends well over $1 billion a year to treat
weight-related health problems such as heart disease and
diabetes through its TRICARE health insurance for active duty
personnel, reservists, retirees and their families.
(18) According to the Department of Health and Human
Services, racial and ethnic minority groups experience higher
rates of chronic health conditions, including diabetes,
hypertension, obesity, heart disease, and cancer when compared
to their White counterparts due to Social Determinants of
Health, including lack of access to nutritious food.
SEC. 3. DEPARTMENT OF HEALTH AND HUMAN SERVICES GUIDELINES, AND FEDERAL
AGENCIES ANNUAL REPORTS, RELATING TO CERTAIN PRIMARY CARE
FEDERAL HEALTH PROFESSIONALS COMPLETING CONTINUING
MEDICAL EDUCATION ON NUTRITION.
(a) Guidelines.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Health and Human Services shall
issue guidelines to Federal agencies for developing procedures and
requirements to ensure that every primary care health professional
employed full-time for such agencies have continuing education courses
relating to nutrition (as described in subsection (c)).
(b) Biannual Reports.--Not later than 18 months after the date of
the enactment of this Act and each subsequent year, the head of each
Federal agency that employs full-time primary care health professionals
shall submit to Congress a report attesting, in a form and manner
specified by the Secretary of Health and Human Services, to the extent
to which the agency has adopted and encouraged the guidelines issued
under subsection (a) with respect to such professionals employed by
such agency during any portion of the previous year. If the agency,
with respect to such previous year, did not fully adopt and encourage
such guidelines with respect to such professionals, the head of the
agency shall include in the report for the year the percentage of such
professionals employed by such agency to furnish primary care services
who completed continuing education courses relating to nutrition (as
described in subsection (c)).
(c) Continuing Education Relating to Nutrition.--For purposes of
subsections (a) and (b), continuing education courses relating to
nutrition shall include at least content on the role of nutrition, in
the prevention, management, and, as possible, reversal of obesity,
cardiovascular disease, diabetes, or cancer.
(d) Definitions.--For purposes of this Act:
(1) Continuing education.--The term ``continuing
education'' is defined as courses that meet requirements for
Continuing Medical Education (CME) or Continuing Education (CE)
by medical or nurse practitioner professional organizations or
certified accrediting bodies.
(2) Nurse practitioner.--The term ``nurse practitioner''
has the meaning given such term in section 1861(aa)(5) of the
Social Security Act (42 U.S.C. 1395x(aa)(5)).
(3) Physician.--The term ``physician'' has the meaning
given such term in section 1861(r)(1) of the Social Security
Act (42 U.S.C. 1395x(r)(1)).
(4) Primary care health professional.--The term ``primary
care health professional'' means a physician or nurse
practitioner who furnishes primary care services.
(5) Primary care services.--The term ``primary care
services'' has the meaning given such term in section
1842(i)(4) of the Social Security Act (42 U.S.C. 1395u(i)(4)),
but shall include such services furnished by a nurse
practitioner as would otherwise be included if furnished by a
physician.
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