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Patient Protection and Affordable Care Act
Public Health Initiatives: Provisions Relating to Title IV, Prevention of Chronic Diseases and Improving Public Health

Fri, 2012-04-27 17:07 — healthinfolaw_admin


 

Sec. 10407 Better Diabetes Care

 

  • Reports Cards. The Secretary of Health and Human Services, along with the CDC, must prepare a national diabetes report card on a biannual basis. If feasible, the Secretary must also prepare state diabetes report cards. 288 The report cards will contain “aggregate health outcomes related to individuals diagnosed with diabetes and pre-diabetes” and all subsequent report cards must contain trend analysis.289 The Secretary must release the report cards to the public through the internet. 290
  • Data Collection. The Secretary and CDC must work with federal and state agencies to improve the collection of vital statistics. This includes “training physicians on the importance of birth and death certificate data” and how to properly complete the documents, promoting the adoption by states “of the latest standard revisions of birth and death certificates,” and helping states to “re-engineer their vital statistics systems in order to provide cost-effective, timely, and accurate vital systems data.”291 The Secretary has discretion to also “promote improvements to the collection of diabetes mortality data.”292
  • Study. The Secretary, along with the Institute of Medicine and other “appropriate associations,” must study “the impact of diabetes on the practice of medicine...and the appropriateness of the level of diabetes medical education that should be required prior to licensure” and certification.293 The Secretary must report the results of this study to Congress within 2 years of enactment.294

 

 

Sec. 10410 Centers of Excellence for Depression

 

  • Grants. The Secretary of Health and Human Services must provide grants for the purpose of establishing National Centers of Excellence for Depression.295 Public or private nonprofit research institutions and academic institutions may apply for such grants by submitting an application to the Secretary that contains evidence of the institution’s ability to provide mental health service, coordinate with additional mental health providers, and provide professionals with training on mental health.296 Entities that receive grants must match every five dollars of federal funding with 1 dollar of non-federal funding. 297
  • Priority. The Secretary will give priority to applicants that: (1) have the “capacity and expertise to serve the targeted population;” (2) have an infrastructure to provide “evidence-based and culturally, and linguistically competent services;” (3) are located in an area with “disproportionate numbers of underserved and at-risk populations in medically underserved areas and health professional shortage areas;” (4) have “innovative approaches” to increasing services; (5) use the latest practices and interventions; (6) have the capacity to work with community entities (e.g. health centers) “to provide mental health, social, and human services to individuals with depressive disorders.”298
  • National Coordinating Center. The Secretary will select one grantee to function as the National Coordinating Center.299 The Coordinating Center’s duties will include coordinating a network of Centers, coordinating a national database, disseminating information, and acting a liaison to other government agencies or initiatives.”300
  • Center Functions. Centers will conduct research in order to develop evidence-based interventions, develop a research agenda after consulting with “a broad cross-section of stakeholders,” train mental health professionals, and educate the public, policy makers, community leaders, and employers about depressive disorders in an effort to reduce the stigma associated with treatment.301 Centers must collaborate with other Centers to create treatment guidelines and protocols, facilitate communication with providers regarding “co-occurring physical health conditions” (e.g. cancer, diabetes), develop “self-management” plans,” and “use electronic health records and telehealth technology to better coordinate and manage, and improve access to, care, as determined by the coordinating center.”302  Finally, Centers must collaborate with community-based organizations to (1) “demonstrate the effective use of public-private partnership to foster collaborations among networks and community-based organizations;” (2) increase “interdisciplinary, translational, and patient-oriented research and treatment;” and (3) work with academic programs to provide continual education for mental health providers.303
  • National Database. The Coordinating Center must create, and make public, a national database that will house data collected by each Center.304 Such data includes: (1) “prevalence and incidence of depressive disorders;” (2) “health and social outcomes of individuals with depressive disorders;” (3) intervention effectiveness; and (4) any other information as specified by the Secretary. Centers must submit data to the Coordinating Center prior to publishing their findings. 305
  • Evaluation. The Secretary must create a report card for each Center that evaluates their performance. This report card must be issued within 3 years of the Secretary awarding the Center a grant. The Secretary must also submit a report card to Congress within three years of awarding the first Center grant that rates the network’s performance.306 The Secretary will use these report cards to provide Centers with recommended improvements and Congress with recommendations on how to expand the program to serve other mental disorders.307 Finally, the Secretary must contract, within three years of awarding a grant, for review of the Centers by an independent third party.308

             

Sec. 10411 Programs Relating to Congenital Heart Disease

 

  • Surveillance. The Secretary of Health and Human Services must establish a National Congenital Heart Disease Surveillance System through the Centers for Disease Control and Prevention (“CDC”) or a contract with a “public or private nonprofit entity with specialized experience in congenital heart disease.”309
  • Data Collection. The System may collect and organize data on (1) the incidence of congenital heart disease in the United States; (2) the demographics, risk factors, and causes associated with congenital heart disease; (3) treatments for congenital heart disease and outcome measures that will allow for development of “evidence-based best practices and guidelines;” and (4) the “longitudinal data related to individuals of all ages with congenital heart disease…”310 The Secretary must provide the public, and heart disease researches in particular, with appropriate access to the System’s data.311 However, the Secretary must protect patient privacy by maintaining the System in compliance with HIPPA regulations.312

Research. The Director may expand congenital heart disease research. Permissible areas of research include studies on the cause, long term outcomes, diagnosis, treatment, and prevention of congenital heart disease, “studies using longitudinal data and retrospective analysis to identify effective treatments and outcomes,” and studies on the barriers to “life-long care” for persons with congenital heart disease.313 The Director has authority to coordinate congenital heart disease research, conducted pursuant to this section, among institutions and to establish research networks.314 The Director must conduct congenital heart disease research after consideration of the application of such research to “minority and medically underserved communities.”315

 

Footnotes

  • 288. Affordable Care Act §10407(b)(1); 42 U.S.C. 247b-9a(b)(1).
  • 289. Affordable Care Act §10407(b)(2); 42 U.S.C. 247b-9a(b)(2).
  • 290. Affordable Care Act §10407(b)(3); 42 U.S.C. 247b-9a(b)(3).
  • 291. Affordable Care Act §10407(c)(1); 42 U.S.C. 247b-9a(c)(1).
  • 292. Affordable Care Act §10407(c)(2); 42 U.S.C. 247b-9a(c)(2).
  • 293. Affordable Care Act §10407(d)(1); 42 U.S.C. 247b-9a(d)(1).
  • 294. Affordable Care Act §10407(d)(2); 42 U.S.C. 247b-9a(d)(2).
  • 295. Affordable Care Act §10410(b); 42 U.S.C. 290bb-33(b).
  • 296. Affordable Care Act §10410(b); 42 U.S.C. 290bb-33(b)(5).
  • 297. Affordable Care Act §10410(b); 42 U.S.C. 290bb-33(b)(7).
  • 298. Affordable Care Act §10410(b); 42 U.S.C. 290bb-33(b)(5)(C).
  • 299. Affordable Care Act §10410(b); 42 U.S.C. 290bb-33(b)(6).
  • 300. Affordable Care Act §10410(b); 42 U.S.C. 290bb-33(b)(6)(C).
  • 301. Affordable Care Act §10410(b); 42 U.S.C. 290bb-33(c)(1).
  • 302. Affordable Care Act §10410(b); 42 U.S.C. 290bb-33(c)(2).
  • 303. Affordable Care Act §10410(b); 42 U.S.C. 290bb-33(c)(3).
  • 304. Affordable Care Act §10410(b); 42 U.S.C. 290bb-33(d)(1).
  • 305. Affordable Care Act §10410(b); 42 U.S.C. 290bb-33(d)(2).
  • 306. Affordable Care Act §10410(b); 42 U.S.C. 290bb-33(e)(2).
  • 307. Affordable Care Act §10410(b); 42 U.S.C. 290bb-33(e)(3).
  • 308. Affordable Care Act §10410(b); 42 U.S.C. 290bb-33(e)(4).
  • 309. Affordable Care Act §10411(b)(1); 42 U.S.C. 280g-13(a).
  • 310. Affordable Care Act §10411(b)(1); 42 U.S.C. 280g-13(c).
  • 311. Affordable Care Act §10411(b)(1); 42 U.S.C. 280g-13(d).
  • 312. Affordable Care Act §10411(b)(1); 42 U.S.C. 280g-13(e).
  • 313. Affordable Care Act §10411(b)(2); 42 U.S.C. 285b-8(a).
  • 314. Affordable Care Act §10411(b)(2); 42 U.S.C. 285b-8(b).
  • 315. Affordable Care Act §10411(b)(2); 42 U.S.C. 285b-8(c).

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