107th Congress

Stroke Treatment and Ongoing Prevention Act of 2000

H.R. 3431 and S. 1274

Background

A stroke occurs when the blood supply to part of the brain is suddenly interrupted (ischemic) or when a blood vessel in the brain bursts, spilling blood into the spaces surrounding the brain cells (hemorrhagic). The symptoms of stroke are easy to spot: sudden numbness or weakness, especially on one side of the body; sudden confusion, trouble speaking, or trouble understanding speech; sudden trouble seeing in one or both eyes; and sudden trouble walking, dizziness, or loss of balance or coordination. Brain cells die when they no longer receive oxygen and nutrients from the blood or when they are damaged by sudden bleeding into or around the brain. These damaged cells can linger in a compromised state for several hours; with timely treatment, they can be saved. Stroke is diagnosed through several techniques: a short neurological examination, blood tests, CT scans, MRI scans, Doppler ultrasound, and arteriography. Stroke seems to run in some families. Family members may have a genetic tendency for stroke or share a lifestyle that contributes to stroke. The most important risk factors for stroke are hypertension, heart disease, diabetes, and cigarette smoking. Other risks include heavy alcohol consumption, high blood cholesterol levels, illicit drug use, and genetic or congenital conditions. Some risk factors, such as pregnancy, childbirth, and menopause, apply only to women.

Provisions of the Legislation/Impact on NIH

S. 1274 and H.R. 3431 were identical bills that would have amended the Public Health Service Act to create a new title covering stroke prevention, treatment, and rehabilitation. It was the goal of this legislation to improve the provision of stroke care in every State and territory and in the District of Columbia, and to increase public awareness about the prevention, detection, and treatment of stroke. Bill language would have directed the Secretary of Health and Human Services (HHS) to:

• Carry out a national education and information campaign to promote stroke prevention and increase the number of stroke patients who seek immediate treatment, but avoid duplicating existing stroke education efforts by other Federal Government agencies.
• Ensure the availability of published stroke research.
• Conduct research concerning best practices of and access barriers to stroke prevention, diagnosis, treatment, and rehabilitation services; the effectiveness of existing public awareness campaigns regarding stroke; and disparities in stroke prevention, diagnosis, treatment, and rehabilitation among different populations.
• Conduct any other studies that the Secretary of HHS determines are necessary or useful to conduct a thorough and effective research program regarding stroke prevention, treatment, and rehabilitation.
• Establish and evaluate a grant program to enable States to develop statewide stroke prevention, treatment, and rehabilitation systems; develop standards of care for stroke patients in all phases of stroke recovery and foster the development of modern systems of stroke care; and provide technical assistance to State and local agencies. (The Health Resources and Services Administration would likely have implementation responsibility.)
• Maintain the Paul Coverdell National Acute Stroke Registry and Clearinghouse to develop specific data on delivery of care to patients (which the Centers for Disease Control and Prevention would manage).
• Make grants to public and nonprofit private entities for the development and implementation of education programs for appropriate medical personnel in the use of newly developed diagnostic approaches, technologies, and therapies for the prevention and treatment of stroke.
• Consult with medical, surgical, rehabilitation, and nursing specialty groups, hospital associations, voluntary health organizations, emergency medical services, State directors, associations, experts in the use of telecommunication technology to provide stroke care, national disability and consumer organizations representing individuals with disabilities and chronic illnesses, concerned advocates, and other interested parties in implementing provisions of the Act.

The National Institutes of Health (NIH has existing authority to, and does, support and conduct research on stroke prevention, treatment, and rehabilitation. The stroke education activities identified in the current legislation are being carried out through the communication and public liaison components of NIH. These bills would have likely resulted in an expansion of efforts in these areas.

Status and Outlook

H.R. 3431 was introduced on December 6, 2001, by Representative Lois Capps (D-CA) and was referred to the House Energy and Commerce Subcommittee on Health. On June 6, 2002, the Subcommittee held a hearing entitled "The NIH: Investing in Research to Prevent Disease." The Director of the National Heart, Lung, and Blood Institute and the Acting Director of the National Institute of Neurological Disorders and Stroke testified at this hearing, at which H.R. 3431 and S. 1274 were discussed.

S. 1274 was introduced on July 31, 2001, by Senator Edward M. Kennedy (D-MA). On February 6, 2002, S. 1274 passed the Senate and was referred to the House Energy and Commerce Committee. On March 5, S. 1274 was referred to the House Energy and Commerce Subcommittee on Health. .

Although there was no further action on this legislation during the 107th Congress, it is anticipated that similar legislation will be introduced in the 108th Congress.