[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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