IN THE SENATE OF THE UNITED STATES , 2003. M. introduced the following bill; which was referred to the Committee on A BILL



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DRAFT //0 0TH CONGRESS ST SESS. S. To direct the Secretary of Health and Human Services to establish, promote, and support a comprehensive program for education, prevention, and treatment of Hepatitis C virus infection. IN THE SENATE OF THE UNITED STATES, 00 M. introduced the following bill; which was referred to the Committee on A BILL To direct the Secretary of Health and Human Services to establish a comprehensive program for the education, prevention, and treatment of Hepatitis C virus infection. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 0. SHORT TITLE. This Act may be cited as the Hepatitis C Epidemic Control and Prevention Act. SECTION 0. FINDINGS. (a) The Congress finds as follows:

DRAFT //0 0 0 () Hepatitis C virus infects approximately million people in the United States, making it the nation s most common, bloodborne viral infection. () Nearly two percent of the population of the United States have been infected with the Hepatitis C virus. () Approximately,000 new Hepatitis C virus infections are conservatively estimated to occur in the United States each year. () Hepatitis C virus infection can cause life-threatening liver disease. () Hepatitis C virus infected persons serve as a source of transmission to others and, since very few are aware that they are infected, they are unlikely to take precautions to prevent the spread or exacerbation of their infection. () There is no vaccine available for Hepatitis C virus. () Treatments are available to slow the progression of chronic Hepatitis C virus infection. () An estimated. to. million people who are chronically infected with Hepatitis C virus are receiving no treatment. () Conservative estimates now place the costs of lost productivity and medical care arising from Hepatitis C virus infection in the United States to be in excess of $00 million annually; and such costs will undoubtedly increase in the absence of expanded education and prevention efforts. (0) To combat our nation s Hepatitis C virus epidemic, the National Hepatitis C Prevention Strategy of the Centers for

DRAFT //0 0 Disease Control and Prevention and the expert panel of the 00 National Institutes of Health Consensus Development Conference on the Management of Hepatitis C urge support for Hepatitis C prevention programs that include strategies for education and training, surveillance and early detection, disease control, and research. () Federal support is necessary to increase knowledge and awareness of Hepatitis C and to assist state and local prevention efforts. SECTION 0. FEDERAL PLAN FOR PREVENTION AND TREATMENT OF HEPATITIS C. (a) IN GENERAL- The Secretary of Health and Human Services (hereinafter referred to as Secretary ), shall implement a federal plan for prevention of Hepatitis C. The plan shall include strategies for education and training, surveillance and early detection, disease control, and research. (b) INPUT IN DEVELOPING PLAN- In designing the federal 0 prevention plan referred to in subsection (a), the Secretary shall be guided by the recommendations embodied in the National Hepatitis C Prevention Strategy and shall develop the plan in consultation with any or all of the following: () the Centers for Disease Control and Prevention, the National Institutes of Health, or other federal agencies or offices providing services to persons with Hepatitis C virus infections or the functions of which otherwise involve Hepatitis C;

DRAFT //0 () the public, including members of the public infected with Hepatitis C virus, as well as public advocates concerned with issues related to Hepatitis C; and () medical advisory bodies that address issues related to Hepatitis C. (c) BIANNUAL UPDATE OF PLAN The Secretary shall 0 conduct a biannual assessment of the federal prevention plan and shall update the plan to incorporate new knowledge and/or observations, such as that which may be derived from clinical and scientific research, epidemiological studies, and disease detection and surveillance outcomes and methodologies. () Biennially, beginning on the first even-numbered year after the year of enactment of this Act, and not later than October of each even-numbered year thereafter, the Secretary shall publish a notice in the Federal Register of the product of the biannual assessment referred to in subsection (c). The notice shall also describe: (A) (B) revisions to the federal prevention plan; an explanation of the basis for any revisions 0 to the plan, including the ways in which such revisions can be reasonably expected to further promote the original goals and objectives of the plan; and (C) where the Secretary determines that updates to the plan are not indicated, the Secretary shall explain the basis for that determination. SECTION 0. ELEMENTS OF THE FEDERAL HEPATITIS C PREVENTION PLAN

DRAFT //0 (a) EDUCATION AND TRAINING- The Secretary, acting 0 0 through the Centers for Disease Control and Prevention, shall implement programs to heighten awareness and enhance knowledge and understanding of Hepatitis C. This program shall include: () health education, public awareness campaigns, and community outreach activities to promote public awareness and knowledge about risk factors, methods of disease transmission, the value of early detection, available screening services, and options available for the treatment of Hepatitis C virus infection; () training of health care personnel regarding the treatment, detection, and methods of transmission of Hepatitis C virus infection, as well as the benefits of disease awareness and prevention; and () distribution of training curricula for persons providing Hepatitis C counseling, as well as support for its implementation by state and local public health agencies. The training course shall include information relating to the special needs of persons with positive Hepatitis C virus test results, including the importance of early intervention and treatment and recognition of psychosocial needs. (b) EARLY DETECTION AND SURVEILLANCE- The Secretary shall, acting through the Centers for Disease Control and Prevention, the National Institutes of Health, and/or other federal agencies or offices establish and support the following activities to promote early detection of Hepatitis C virus infections,

DRAFT //0 identification of risk factors for infection, and surveillance of Hepatitis C virus infection trends: () VOLUNTARY TESTING PROGRAMS- The Secretary shall establish a mechanism by which to support and promote the development of state and local voluntary Hepatitis C testing programs to aid in the early identification of infected individuals. (A) The Secretary shall promote and support 0 provision of appropriate referrals for counseling and other follow-up services for Hepatitis C virus-infected individuals identified pursuant to paragraph () of this subsection. (B) The results of a Hepatitis C test conducted by 0 a testing program developed or supported under this subsection are to be considered confidential medical information and may not be used for insurance purposes, to screen or determine suitability for employment, or to discharge a person from employment. () SURVEILLANCE PROGRAMS- The Secretary shall promote and support the establishment of new state Hepatitis C virus surveillance databases and the expansion and maintenance of existing state Hepatitis C virus surveillance databases. (A) The Secretary shall promote and support the analysis of data collected pursuant to paragraph () of this subsection for the following purposes: (i) identification of risk factors for Hepatitis C virus infection;

DRAFT //0 (ii) identification of trends in the incidence of acute and chronic Hepatitis C virus infection; (iii) identification of trends in the 0 prevalence of Hepatitis C virus infection among specific demographic groups that may be disproportionately affected by Hepatitis C, including persons infected with Human Immunodeficiency Virus (HIV), military veterans, emergency firstresponders, racial or ethnic minorities that have a higher prevalence of Hepatitis C virus infection, and persons who engage in high risk behavior, such as intravenous drug use; and (iv) assessment and improvement of Hepatitis C virus infection prevention programs. (B) SEROPREVALENCE STUDY- The 0 (c) Secretary shall ensure that a population-based seroprevalence study is conducted to estimate the current and future impact of Hepatitis C. The study shall consider the economic and clinical impacts of Hepatitis C, as well as the impact of Hepatitis C on quality of life. CLINICAL RESEARCH NETWORK- The Secretary shall, acting through the Centers for Disease Control and Prevention, the National Institutes of Health, and/or other federal agencies or offices, establish and support a Hepatitis C Clinical Research Network for the purpose of conducting research related to the natural history, epidemiology, testing, prevention, and treatment of Hepatitis C.

DRAFT //0 (d) HEPATITIS C DISEASE CONTROL- The Secretary shall, 0 0 acting through the Centers for Disease Control and Prevention, the National Institutes of Health, and/or other federal agencies or offices, promote and support state and local Hepatitis C counseling, pharmaceutical treatment, testing, and prevention programs. () VACCINATIONS- The Secretary shall promote and support both the establishment and maintenance of state and local programs to vaccinate Hepatitis C virus infected persons, as well as persons at elevated risk of contracting Hepatitis C virus infections, against contraction of other infectious diseases of which Hepatitis C virus infected individuals may be at elevated risk, such as Hepatitis A and Hepatitis B. () HEPATITIS C COORDINATORS- The Secretary shall, acting through the Centers for Disease Control and Prevention, increase current levels of support for the provision of Hepatitis C Coordinators to each state and large metropolitan health department to provide the additional management, networking, and technical expertise needed to ensure successful integration of Hepatitis C prevention and control activities into existing public health programs. () UNDERSERVED AND DISPROPORTIONATELY AFFECTED POPULATIONS- The Secretary shall promote expanded support for persons with limited access to health education, testing, and health care services and groups that may be disproportionately affected by Hepatitis C. SECTION 0. EFFECTIVE DATE.

DRAFT //0 This Act take effects immediately upon enactment. SECTION 0. AUTHORIZATION OF APPROPRIATIONS. For the purpose of carrying out this Act, there are authorized to be appropriated to the Department of Health and Human Services such sums as may be necessary for each of the fiscal years 00 through 00. Reauthorization of appropriations may be sought for years thereafter.