Modernizing Disease Prevention & Public Health Systems
- National Prevention, Health Promotion and Public Health Council
- New Council. Requires the President to establish within HHS a National Prevention, Health Promotion and Public Health Council, to be composed of representatives from designated federal agencies, to:
- Provide coordination and leadership with respect to prevention, wellness, health promotion practices and the public health system.
- Develop a strategy to improve health status and reduce preventable illness.
- Make recommendations to the President and Congress concerning the country’s most pressing health challenges.
- Consider and propose evidence-based and innovative approaches to promote new models of prevention, integrative health and public health on individual and community levels.
- The President shall establish an Advisory Group to the Council, composed of 25 non-federal members (including a diverse group of licensed healthprofessionals).
- National strategy. Within one year of enactment, requires the council to recommend a national prevention, health promotion and public health strategy that sets specific goals for improving health in the United States, establishes specific and measureable actions and timelines to carry out the strategy and makes recommendations to improve federal efforts.
- Reports. Requires the Council, by 7/1/10 (and annually thereafter through 1/1/15), to report on the Council’s prevention and health promotion efforts and national progress in meeting specific goals, with lists of national priorities, and including specific plans for meeting goals. No less than every 5 years, requires joint reviews and evaluations by HHS and GAO of every Federal disease prevention and health promotion initiative, program and agency. (PPACA § 4001)
- Prevention and Public Health Fund. Establishes a new Prevention and Public Health Investment Fund for prevention and public health programs. Appropriates $500 million for FY 2010; $750 million for FY 2011; $1 billion for FY 2012; $1.25 billion for FY 2013; $1.5 billion for FY 2014 and $2 billion for each of FYs 2015 and beyond. (PPACA § 4002)
- Clinical and Community Preventive Services. Requires AHRQ and CDC to convene an independent Prevention Services Task Force (to review and make recommendations on clinical preventive services) and a Community Preventive Services Task Force (to review and make recommendations on population-based preventive services). Duties of the Task Forces to include:
- Develop additional topic areas for recommendation.
- Review interventions and update recommendations (at least once every 5 years).
- Improve integration with federal health objectives and related target setting for health improvement.
- Enhance dissemination of recommendations.
- Report annually to identify gaps in research and recommend areas deserving further examination.
- Directs the task forces to coordinate their work. (PPACA § 4003)
- Education and Outreach
- Public-Private Partnership. Requires HHS to implement a national public-private partnership for a prevention and health promotion outreach and education campaign to raise public awareness of health improvement across the life-span.
- Media Campaign. By one year after enactment, requires the CDC to implement a national science-based media campaign on health promotion and disease prevention to address nutrition, exercise, smoking cessation, obesity reduction, the 5 leading disease killers in the country and disease screening. Requires HHS to evaluate the campaign every 2 years. Requires creation of an Internet website with science-based information on these topics.
- Provider Focus. Requires dissemination of information to providers who participate in federal programs.
- Personalized Prevention Plans. Requires development and operation of a federal Internet website that provides a personalized prevention plan tool that will allow individuals to determine their risk of disease and obtain personalized suggestions for preventing such diseases.
- Internet Portal. Requires establishment of an Internet portal for accessing risk assessment tools developed and maintained by private and academic entities.
- State Guidance. Requires HHS to provide information to states and providers regarding preventive and obesity-related services available to Medicaid enrollees and requires states to design public awareness campaigns regarding the availability and coverage of such services. Requires HHS to report to Congress on these efforts by 1/1/11 and every 3 years thereafter though 1/1/17. (PPACA § 4004)
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Improved Access to Preventive Services
- School-Based Health Centers. Appropriates $50 million for each of FYs 2010-2013 to provide grants to states to support the operation of school-based clinics. (PPACA §§ 4101, 10402)
- Health Care Prevention. Provides for a national 5-year public education campaign focusing on oral health care prevention and education. Also provides for demonstration grants on the effectiveness of dental caries disease management activities. (PPACA § 4102)
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HHS Prevention and Wellness Initiatives
- Community Transformation Grants. Provides for grants to state and local government agencies and community-based organizations for evidence-based community preventive health activities to reduce chronic disease rates, address health disparities and develop a stronger evidence-base of effective prevention programming. Examples of activities to be funded include programs to create healthier school environments; highlight healthy food options;assess and implement worksite wellness programs; and promote programs to improve nutrition, physical activities and smoking cessation. (PPACA §§ 4201, 10403)
- Community-Based Prevention and Wellness Programs for Medicare Beneficiaries
- Grants. Provides for grants to state or local health departments and Indian tribes to carry out 5-year pilot programs to provide public health community interventions, screenings and clinical referrals for individuals between 55 and 64 years of age. Examples of activities to be funded include public health intervention activities (e.g., improving nutrition); health screenings; and measuring changes in the prevalence of risk factors among participants.
- Evaluation and Plan for Medicare. Allocates $50 million from the Medicare Trust Fund for HHS to evaluate community-based prevention and wellness programs and develop a plan for promoting healthy lifestyles and chronic disease self-management for Medicare beneficiaries. (PPACA § 4202)
- Improved Access for Disabled Individuals. Within 24 months of enactment, requires federal standards for medical diagnostic equipment (e.g., exam tables and chairs, scales, mammography equipment and radiologic equipment) used in physicians’ offices, hospitals and other settings to ensure its usability for disabled individuals. (PPACA § 4203)
- Immunizations. Allows HHS to negotiate with vaccine manufacturers to purchase certain vaccines for adults, and allows states to obtain additional quantities of such vaccines at a price negotiated by HHS. Establishes a demonstration program to improve immunization rates of high-risk populations. Requires GAO report to Congress on the impact of coverage of adult immunizations under Part D on access to those immunizations by Medicare beneficiaries. (PPACA § 4204)
- Nutrition Labeling at Chain Restaurants. Requires restaurants that are part of a chain with 20 or more locations to disclose nutritional content and calorie information on its standard menu items, as well as information on suggested daily caloric intake as specified by the FDA. Includes exceptions to such requirements. Establishes similar requirements for packaging on vending machine items. (PPACA § 4205)
- Individualized Wellness Plan Demonstration. Requires HHS to establish a pilot program to test the impact of providing at-risk populations who use community health centers an individualized wellness plan designed to reduce their risk factors for preventable conditions. (PPACA § 4206)
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HHS Prevention and Wellness Research
- Research on Optimizing Delivery of Public Health Services. Requires HHS to fund research in the following areas:
- Examining evidence-based practices relating to prevention, and comparing community-based public health interventions in terms of effectiveness and cost.
- Analyzing the translation of interventions from academic settings to real world settings.
- Identifying effective strategies for organizing, financing or delivering public health services. (PPACA § 4301)
- Health Disparities Research
- Data Collection, Analysis, Reporting and Dissemination. Within 2 years after enactment, requires HHS to ensure that federally supported health care or public programs collect data on race, ethnicity, gender, geographic location, socioeconomic status, primary language, disability status and any other demographic data deemed appropriate. Requires HHS to develop national standards for various measures and for the management of data collected and develop interoperability and security systems for data management. Requires HHS to disseminate its analyses to various federal agencies, publish the analysis on the HHS website and make data available for research. Requires HIPAA privacy protections be used with respect to such data.
- Standardized Data Collection in Medicaid and CHIP. Requires that any data collected under Medicaid and CHIP programs meet the requirements above. Requires HHS to evaluate approaches for collecting health disparities data under these programs, and to implement such approaches within 24 months of enactment. (PPACA § 4302)
- Epidemiology Lab Capacity Grants. Provides grants to assist public health agencies in improving surveillance for, and response to infectious disease and other conditions of public health importance. (PPACA § 4304)
- Research and Treatment for Pain Care Management. Takes multiple steps to address pain care, including:
- Convening an Institute of Medicine conference on pain.
- Encouraging the NIH to continue and expand an aggressive program of basic and clinical research on the causes and potential treatments for pain.
- Establishing an Interagency Pain Research Coordinating Committee to coordinate all efforts among federal agencies relating to pain research.
- Supporting programs to educate and train providers in pain care. (PPACA § 4305)
- Funding for Childhood Obesity Demonstration. Appropriates $25 million for these demonstrations for FYs 2010-2014. (PPACA § 4306)
- Evaluation of Federal Health and Wellness Initiatives. Requires HHS to evaluate whether existing federal health and wellness initiatives are achieving their stated goals. (PPACA § 4402)
- Cures Acceleration Network. Requires the NIH to establish a Cures Acceleration Network to award grants and contracts to develop cures and treatments of diseases. Grants will be awarded to accelerate the development of “high need cures” through the development of medical products and behavioral therapies. Defines “high need cures” as a drug or device that is a priority to diagnose, mitigate, prevent or treat harm from a disease or condition, for which private market incentives are unlikely to result in its adequate or timely development. (PPACA § 10409)
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Diabetes Care
- Better Diabetes Care. Directs HHS to develop a national report card on diabetes to be updated every 2 years and to work with health professionals and states to improve data collection related to diabetes and other chronic diseases. Provides for an Institute of Medicine study on the impact of diabetes on medical care. (PPACA § 10407)
- National Diabetes Prevention Program. Establishes a national diabetes prevention program at the CDC. State, local and tribal public health departments and non-profit entities can use funds for community-based prevention activities, training and outreach and evaluation. (PPACA § 10501(g))
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