RECOGNIZING THE NEED TO IMPROVE THE DIAGNOSIS AND TREATMENT OF DIABETES

WHEREAS, the National Black Caucus of State Legislators (NBCSL) has passed extensive policy regarding diabetes treatment and expanded its policy base regarding this issue perennially over the past decade (including Resolutions HHS-10-11, HHS-10-20, HHS-07-27, and HHS-06-50), as further research and greater technological advances in the screening and treatment of diabetes have prompted updates to the Caucus’s policy coverage of this important concern;

WHEREAS, diabetes is a serious, costly, and an increasingly common chronic disease that affects almost 26 million Americans, or eight percent of the total population, with millions more at risk for the disease;

WHEREAS, diabetes contributes to more than 231,000 deaths per year and is the seventh leading cause of death by disease in the United States;

WHEREAS, the direct and indirect costs of diabetes are over $174 billion per year, and minority populations suffer from diabetes at rates much higher than the general population and have the highest rates of complications of the disease;

WHEREAS, 4.9 million African Americans or 18.7 percent of all African Americans over the age of 20 live with diabetes;

WHEREAS, African Americans are twice as likely to be diagnosed with diabetes than Caucasians;

WHEREAS, African Americans experience higher rates of some of the most serious complications of diabetes--being 2.3 times more likely to suffer from lower limb amputations, 2.2 times more likely to suffer from kidney disease, and 2.3 times as likely to die from diabetes;

WHEREAS, diabetes is frequently undiagnosed until complications appear, and approximately one-third of all people with diabetes may go undiagnosed;

WHEREAS, unlike detection when an individual exhibits symptoms or signs of the disease, screening is conducted to identify asymptomatic individuals who are likely to have diabetes, and the NBCSL supports the expert opinion that screening should be considered by health care providers at one-year intervals beginning at age 35, or more frequently in cases where individuals are overweight and/or have two or more other risk factors, such as family history of diabetes or hypertension;

WHEREAS, the Patient Protection and Affordable Care Act (ACA) provides short-term access to health insurance coverage for individuals with pre-existing conditions, including diabetes, and restricts the ability of insurers to limit coverage based on such pre-existing conditions beginning in 2014;

WHEREAS, the ACA also eliminates the use of annual or lifetime dollar limits on coverage, which provides relief from some of the cost burden for people with diabetes whose medical expenses are, on average, twice as high as people without diabetes; and

WHEREAS, the ACA improves diabetes prevention efforts by requiring coverage of diabetes screening recommended by the United States Preventive Services Task Force and funding grants to support primary prevention activities under Medicaid, including efforts to avoid the onset of diabetes and to provide disease management for individuals with diabetes and wellness initiatives by states and communities to reduce the effects of chronic diseases, such as diabetes. THEREFORE BE IT RESOLVED, that the National Black Caucus of State Legislators (NBSCL) supports innovative approaches that allow states to implement efforts to prevent, diagnose, and treat diabetes while reducing the burdens associated with the disease for African Americans living with or at-risk for diabetes;

BE IT FURTHER RESOLVED, that the NBCSL urges the United States Congress to appropriate dollars for diabetes-related projects authorized but not funded under the ACA, including the National Diabetes Prevention Program to support lifestyle intervention programs to prevent type 2 diabetes as well as Healthy Aging and Living Well Grants for public health interventions including identifying risk factors for diabetes in adults age 55 to 64;

BE IT FURTHER RESOLVED, that the NBCSL further urges the Secretary of the United States Department of Health and Human Services to prepare, in a timely and comprehensive manner, the National Diabetes Report Card and State Diabetes Report Card required by the ACA;

BE IT FURTHER RESOLVED, that the NBCSL urges state officials to develop programs in response to opportunities provided under the ACA to improve prevention and education efforts related to diabetes, and to ensure those efforts reach high-risk African Americans groups;

BE IT FURTHER RESOLVED, that the NBCSL calls upon medical and health officials in the public and private sector to increase efforts to identify individuals with undiagnosed diabetes or pre-diabetes, drawing on lessons learned from cancer screening initiatives such as programs intended to encourage women to receive mammograms;

BE IT FURTHER RESOLVED, that the NBCSL urges the United States Preventive Services Task Force to continually evaluate the evidence about the benefits, harms, and costs of screening and its role to reduce the burden of persons suffering with diabetes, and to respond, in a timely manner, to the introduction of any new evidence that supports expanding screening;

BE IT FURTHER RESOLVED, that the NBCSL encourages researchers and clinicians to conduct studies to clarify the benefits of screening efforts and those persons who should be screened to reduce the prevalence of diabetes and complications from the disease;

BE IT FURTHER RESOLVED, that the NBCSL also calls upon the United States Centers for Disease Control and Prevention to work with state officials to improve collection of vital statistics including information on diabetes; training for physicians on completing death certificates, as required by the ACA; and improve the funding needed to effectively carry out these endeavors;

BE IT FURTHER RESOLVED, that the NBSCL urges the Secretary of the United States Department of Health and Human Services, the Institute of Medicine, and other relevant groups to carefully evaluate the extensive impact of diabetes on the delivery of healthcare and the appropriateness of diabetes medical education in developing the Report Card to the United States Congress mandated by the ACA;

BE IT FURTHER RESOLVED, that the NBCSL supports improvements, including more funding, under the ACA of data collection efforts to better identify and evaluate health care disparities, including those related to race; and

BE IT FINALLY RESOLVED, that copies of this resolution be transmitted to the President of the United States, the Vice President of the United States, members of the United States House of Representatives and the United States Senate, the United States Secretary of Health and Human Services, the Director of the United States Centers for Disease Control, and other elected officials as appropriate.

SPONSOR: Representative Charmaine L. Marchand (LA)
Committee of Jurisdiction: Health and Human Services Policy Committee
Certified by Committee Chair: Representative Beverly Earle (NC)
Ratified in Plenary Session: Ratification Date is December 9, 2011
Ratification is certified by: Representative Barbara W. Ballard (KS), President