1 *


               a


                 regional
                 medical                                                                               SPECIAL ISSUE
                                                                                                    FOR LIMITED DISTRIBUTION
             programs
                       service
                                                     ii evv s
                                                      0
                                                     ififorinatioll
                                                     data
             A et)iiiniuiiicatioii  tl(.,vice
                      ilesigiie(i  to  BPCC(L        LEGISLATION EXTENDED IND               AMENDED FOR Regional Medical
                 tli(-  exchaiitre  of  news,        Progr@           Public Law'91-SlS
             inforiiiatioti  in(I  (lata   on
          iiegioiial Nle(fical  Pro.-,rai-n-s
                  an(]  related   activities.

                                                                                                                       Vol.  4, No.  51S
                                                                                       November 20,  1970

                 N October 30,  1970,  the President signed Public Law 91-SIS which                                    extends
                                                                                                    -is well as that of
                 and amends the Regional Medical Program  legislation,
                                                                     Services,  the National Center for Health
                 comprehensive Health Planning and
                 Services Research and Development                   and the National Center for Ifealth
                 Statistics..
                 To reflect     the details of          this    action,  a copy of Title  i of the new law
                                S)  referring to Regional Medical Program specifically,  and
                 (P.L.  91-Sl                                                     Regional Medical Programs,  are
                 Parts of certain other titles relevant to
                 ep oduced in the first part of this  issue.
                 r   r
                 To indicate how the  toial,Regional Medical Programs law now -reads@as part
                 of the Public Health Service Act,  all changes have been                               interpolated into
                 the original law  (Public Law 89-239,  as am(,%nded by Public Law 90-574)  on
                 the page@that follow.   Deletions in the previous law are shown in
                 Lbracketj          while the new legislative language is underscored.

                 Distribution:              Coordinators of Regional Medical Progrwns
                                            Members of National Advisory Council and
                                            Review Comittee on Regional Medi.cal Programs
                                            Staff of R6gional Medical Programs Service
                                            Regional Health Di-rectors and Regional Wdital
                                            Programs Service Representatives of Health
                                            Education,  and Welfare Regional Offices

                                  IJ.S. I)EPAII'I'MEN'I' OF                      El)tl(:A'I'ION, ANI) -WEI,FARI@
                                                                                                                             NIkl-%-Iltii(i 201152


                                                                   Public Law 91-515
                                                           gist Congress,  H.  R.  17570
                                                                     October 30,  1970
                                                                              !aii 2tct
                                     Ti) aiiieiid titles III aiid ix of tile  Publi@  iiL.iti,  SLr,i(.(!  Act  so  ,I.,;  ii)  r(.vise,
                                              ,xteii(l,  told  inil)rove  the  I)rograiiis  of  reseiir(-Ii,
                                              training, aiid demonstrations authorized tliereiiii(l(-r,  laid  for  other  1)urlx),s(@s.
                                              Be  ;f,  enacted  bil  the  ?(,,n47te   a-itd   House   of   Rep?-est?tt,it;VG8   of   the
                                     filri;ted,@tate.@   of   A7,ttei-ica;n   Congt-ey8   (tssetitble(l,                               Pul)li,, fir-alth
                                                                                                                                       Service Act,
                                                                                                                                  13LI(, ainencbnents.
                                     TITLE I-AMENI)'@NIENTS TO TITLE IX OF TIIE I'li
                                                                 IIEALTII Sl@,ItN"I(,E AC'F
                                              SFc.  101.  Tiiis  title  may  be   cited   is   the   "lle;trt   Dis(,,,ise,   ('aiie(@r, Citation of
                                     Stroke, iiid Kidnev Disease Amendments of 1970!1.                                                 title.
                                              SiEc.  102.  Iiecti(@ii  900  of  the  public  Ileiltli  @SLr%-ice   Act   is   tiiieiided 79   Stat.   926.
                                     to read as follows:                                                                               42 USC 299.
                                                                              I(PURPOSFS
                                              "SEc. 900. The purposes of this title fire
                                                       titroli@,,Ii  grints  itlid  contracts,   to   ciicoiti-itge   tiid   assist   in
                                              tile   establishment   of   regional   cool)ei-,ttive    arj-:tiigeiii(,-iits    ,tiyioiig
                                              medical selioois,                institutions,   :tied    liosl)ittls    for    resoai-eli
                                              and    tritiiiin@r    (including    continuing    education),    for    i)iedical     data
                                              exe.illtlige, Iiid for (leiiioiistriiiioils'-Of 1);ttieiit @,ii-e  iii@:  tile  fields  of
                                              lietrt   -diseist@.   ctncer,    stroke,    and    kidney    disefise,    -.laid    otlier
                                              related disetises;                                                                       84  @"PAT.   1297
                                                 (1)) to iiroi.(]
                                                                                                                                       84 S'PAT. I-el-4ti
                                              til tiolis   of   tii(@   Nition,    tlir
                                              tli(,- o))I)ortuiiit-v     of      making                icii-            tile     ltt(.St
                                                          ill   tile   i)reveiitioll                   I  treatment  :111(l  I.(tlllL-
                                              bilitttioii  of   t)et-.,@)iissufftrii                   s@LSL@- ;
                                                l(c)   to    1)@oinote    tiid    f(                              @irliolig   ]IC-,Lltli
                                              eal..c institutions -,tnd I)rovi   i  s         s  to   sl         it     tiid     improve
                                              l@i-itilary  care   tiid   tlie-i-el,,ttionsliij)   betwe(         tlize(I    and    I)ri-
                                              late y, i -,tre; ttn(i
                                                                     me,            improve     generally      the      quality      and
                                                  @(l;  I)v tlie.@        tiis,.  to
                                              citiltilce    the    capacity    of    the     liealth     manpower     and     facilities
                                                :til-                    a
                                                    tbIC@   to   the   N    tioli    and    to    init)rove    health    services    for
                                              I)cr.s()iis   rLsi(Iiiig   in   aretts   with   limit-efl   health   services,   and    to
                                              @'tceoilll)lisli    these    ends    without    interfering     with     the     patterns;
                                              oi-  the   method,,   of   fiiiiiii(,ing.   o.-f   patient        oi-   1)rof(t.,;Siorlitl
                                              I)I-Itclie,e, or with tlit- t(i,niiliisti-:ttit)tl of hospitals, &Lll(l  ill  (!ool)(-,I--
                                              .Itioll wi(.Il                I)IIysiciltlls, ilit@tli(',Itl Zolit(@,r olli(,ials, lio,,I)i-
                                              t.tt   Ldiiiiiiistrttot-s,     tii(I   "    rel)resent@ttiv@    1'rOnl    ILI)prol)ri-,tte
                                              voluntary   11(@,ititil   ageitei(-.S.
                                              ,9EV.. 10,'I. (11)(1) rlle, fit-St scnterim- i)f ,(-(:tiori  901  (it)  of  Sli4,li      Apl)r,opy-itt@,iorts.
                                              A(-t, is         I)y stri@til(,r (Wait           iiiiiii(@(litLt,(@ly  after  "Jun(,-  30, 8 2 ' ;(,;.Lt. 1005.
                                              I!)(;9,",  @tii(i  I)y  iii,,t-rttiig  irxitrie(ii:ttely  1)(-,foi-e  ",  for   irriiiitS" 42 IJSC  2c)ga.
                                              .,(@ foll(k%villg:'@, $12.:'),01)0,000 for the                                   197    1,
                                              I                                            fiscal year ending June
                                                   t                    tl   yetr   ending   June    .30        all
                                              $150,01)0 000 for the lise,                               1972)      (I       $250,000,000
                                               l(t                                 '10, lf
                                              fol- t] liA.,:Il Year ciidiiig.f title    )7i@".
                                              (2)  qii4-lifirst,;(,,iit(@ilc(.isful-tli@riiiieii(le(II)y,,trikiii,routtlieperio(I
                                              tifter"'titic"  tiid  iii,,(-rting  in  licti  thereof  "itnd  for  constricts  to   carry
                                              out the          of    this    title."
                                              (3)        section   901   (.1)   is    tmeikded    by    striking    out    the    second Funds,    lirril-
                                              44-111@itce :t)141 iiikt-ting in Iran thereof the following: t,of the, sums tation.
                                              ltl)l)rol)rittie(I  under  this  section  for  the  fiscal  year  ending   June   30,1971,
                                              not more th,,tii  $I.,-),000,000  slitll  be  tvailable  for  activities  in  tli'c  field

                                              f,2-f)F.7


                                                                                                                                          October         30,         11970
                                                         pub.      L  Iaw gi-515
                                                                                                                                                                fol
                                                                                                                                                                    -        itity
                                                         (of kititi(@y                     tll(@     sull's                               lol't,   $,r),(H)O,Ooo              iii;ty
                                                                               (-ii(liligtftel'.1111,      :11),       IS)70,        not  (.,II,  fOl,        fol.             lltw
                                                                      .Id      'I                          -11(-Il
                                                                                                                     fis(,Ill         Y
                                                         i-otistrtic,tioll.!                                                                    I,y   -.141(lilig   -,It    tile,
                                                              (Ill     SC(!tioll     S)OI     of      siicll
                           79 StELt-  925;                                                                           kction:
                           82 St&t-  1006.               end     @iter('Of     t,lie     following      lelv                                tinder      this       title,       tl'B
                                                              cc(e)  At tilt! reqikl,"t- of                                                  air     jii-.trket,      vLIUL'      Of
                           42 TJSC  21)9&.               I),tylllellt..,      to                                                                                              II(.II
                                                                               sit(.,II       r(!t'il)it'llt                               II(,- Se(-.r(-t-.try t,(' s  -
                                                                               it,  slil)pl   les,   or                                   owtll(!e, t rit-VOI ilig ex)),-,nqLs,
                                                                                    tile         amount                                   detail'of an offi(,,t@r  or  en]-
                                                                                          in            COn!                              when steel, f@rniSh      .nL,           or
                                                                                                 roverliment
                                                                                  tile                  nit, ix.     for               tile convellellce Of      out       tb(,,
                                                                                                           id.      for      the,       Pi]                    s            iiiade."
                                                                                                                     ch      t)ie       gra
                                                                                                                     uch       Act        i                 riking               out
                            42 USC  299b.                             104.                                           eiit         relftt-ii                ase,              cancer,
                                                         "tritining,           d                                                                            disease               or
                                                         or              stroke,                                                                                             gnosis,
                                                         disei@'              an                                                                                             stroke,
                                                                      ,]It,    v                                                            sease, CT,                       related
                                                         treittnl(,                                                                       lie al)t)licallt, c
                                                         Or kidney @ @-tse an(                            att
                                                                                                                                                     .1        (.Iiides"         and
                                                                                                                                          i-ikifig  out  '-Ill
                                                              (b)        Se(!tioll         902(f)         is Imelld  ,t@(I  ')y           'trll('.ti'n of         facilities         for
                                                                                                           '@nl(,iiii.;     new      et))",
                                                                               ill      lien       ili(treof                                             to    Carry     Olit.
                                                         demonstrations,                            @ar(,.b, ti id       training       wll(',". II(.,cesstry
                                                         I-(.gioititi        Die                                                          is anieiided-
                                                                                                                          I            A(@t
                                                              SF,(!.        105.                                                              .     find"   ,,id    in--A-i't-
                              42 IJSC                                                                                      earn) a    holes,

                                                                      itig    in
                                                                      plitnnir                                                            ertliel)rogi-atn
                                                                      (2)                                                                                          x         otn(-io
                                                                      it   first                                                                                      ills       ot,
                                                                      nietiilm                                                            inini                                indi-
                                                                                                              t                                                                 have
                                                                      other    I                              istrator                   of rans'                           iititive
                                                                      vidual   -,tted tf)      serve      oil -;u(-]'i advisory gT,lp R, the rep@e                           Admill-
                                                                      de-,i                                                               e  facilities of Si'(',)
                                                                      of       t                           other        health        (!ttr
                                                                                                           located in such region)"-,  .tlid
                                                                      i@tri                                ut    Igneed    for    the     services     Provided     tinder     tile,
                                                                                                           g    in    ]fell    thereof    "i@@d    for    and    fin-,it)eilig    of
                                                                                                                                                           ivii            tidviw)ry
                                                                                                                            prograin,  ti@d  wh
                                                                      pro,
                                                                      the                                                                 to   iii-,ure   ft(ieqitate   (-oinmxinitv
                                                                      gr@                                                                 .9erretitry)
                                                                      orici                                e. secon   sell                 se.(-tion     904(b)      of      sl!(-It
                                                                      SF.C,. 1 (                           (1)          is          ,Imeii(  striking        olit         '4.-wtiOll                  .    .             .
                                  42 USC 299d.                Act      prP,('e(i                                     ]real              til lie,         following:          reaction                      .    I.          .I  .
                                                              (      .1                                                                      Y)rior to                      recoll)-
                                                              .)o, (1)) (4)                                lip,
                                                                                                                     , 1)(wit  I)rovi(l(,(I,
                                                              !)o,i (1) (4),                                         tll(@
                                                                                                                        ft@l)ii(..Itioll I;.v eii(,b
                                                                                                                                          )ii(til )ills (](@velol)(@(i
                                                                                     tgmii(ty     or      OT         iz-,Ition            w
                                                                                                           )I        itrpit,  or   t)tii(tr
                                                              )ittiisiv(t      rtLiolknl.        ins-,trf)l)(                             .11  Wlli(!Il  tiit@  regional  iiiedi(-itl
                                                              to   ill            314(1,)       !,),,eritiLr       any        area        1             3 e(l, ;tied  if  ill(k
                                                              iii,oi-rrani for which tbt' Rpplicftioii is in,,td(,, Will 1)(t loc it
                                                              tl)     -                                              of                   A(-t  is Illlelliii@41
                                  NaLtione,l           Ad-                     107.  (-.t)                                                                              to      tile
                                   i,,ry     counci      I    follow
                                  on RegioneLl                                                                       rally itl)Poiiit, '%%it"
                                                                                                           iotial A(Ivisor,v'Coiint!il 0),
                                  Medloal Pro                 t-ivil          .9                                        -                 f   the   As-;ist,tlif   stq.retltry    of
                                  gramgo                      Ilroirr                                                coil.;i%t            0i(l)               Afritir-,,      -,vllo
                                  42       USC       299a.    iteFLItl                                               r(-      for      He@l


                                              Octbber 30,  1970                                                             Pub.         Law         91-515
                                                                                                                                                                     4             13UU

                                                                                                                        )i      ol' Of' I I )it   \'('I
                                              Atljiiiiii,,Ii-;tti(iii           sli@ill             (@x oili(@io                    @ill(I                III(-III

                                              't;ttt-ls, %Vill)         I(.:I
                                                                            (it-I'S ill til(! fit',](IS Of tilt@
                                                                         lie;tltli                                      ()I- I)III)Iii!
                                              two of fliL-,tl)l)oijite(i itieiril)ei@, sli;ill Ile I)i-iteti(-iiig                                        -'Jlllll
                                              I)(., otitst;tiidiii,, iii tli(@ stti(ly oi- liealtl) t.,,tre of I)ei-soijs siiii(,j-iii@r el-oirl
                                                         (li@t-;Ise,  011(@  Sli:lll  be   olltst.,tlldiiig   it,   the   stii(ly   oi-   lk(@@iltli   (,;ii-e   of
                                              1)(Itl,4)i)S stiffei-ilia fi@Olli                   oiie sliill'i)(, otitst:t@i(iiitg iii tli(, siii(]3r
                                              oi- lietitli          of I)ei-sojis stiffei-iiiA., froiii ,tilt)ke, ()lie sliifl lie oiitst;tii(l-
                                              Ill,f iii the @tii(lv or liealtli i-:xi-e                of         -,oiis ,itill'eriiig  fi-oiii  ki(Iiiev
                                              (li,(,:ise. two sliill I)L@ oiitstaiidiii,,              iii ti@,@  field  of  I)re%-ent,ioll  of  lieq@t
                                                                       stro@-e. oi, L-i(
                                              (I i.,                                                                :111(i foill- still] 1)('
                                              of     the
                                                  (b)  ()f the                       first  :tl)l)oliit(@d                  s(@(-tioii  905(@t)  Of   tli(@         Tenn of
                                              l'itillil. It(..Iitil                @ket to serve :is tll(@ foill. ;I(I(Iitioll:ll                               or
                                              ttio iNT-,itioiitl Advisot-v                       oil      Regionti
                                              iz(-(l i)y tli(, :iiiieii(Iiii(@lit iii:ttle by subsection (:I) of this S(-(@tioll
                                                         (1)  oil(! sliiii                 for t  tei-iii  of  oii(@
                                                         (2)  oite sliill sei-%-e  f4)i- :I  tei-iii of two y(!@ii-S.
                                                         (:',)  oll(k sli-ill              foi- ;I tei-iii (If
                                                         (4)  oiie sli:ill                 fill- @t  tariff  of  foill'
                                              :is iii,sigli;tt('(l I)Y t,l)(@ St-i-l-t-,t:ii-y of                                       :kill]                  ;II

                                                                                                                                         oil Ill(. (I:Itf@ tkr
                                              Ill 9      ills  (otil(@t- I lt;ili t Ile                                    ill
                                              II :1 I .1 I ii(@i it, ( or llii,, A(-l  -Ji:tll i-olitiiiiit,, ill ollit.(. ill                      will)     tll(@
                                              t(@i-iii  of          fol. %viiif.ll til(@y %vi@l-t! ]list                        to ili(t
                                                  SFI..  10@. Se(.tioli  !)07 of sit(-Ii  k(-t.  is                              I)y  s(I-ilzilit',   4,llt  "Oi'   71)            030.
                                              ,I  i,(ike,"                             li(!ii i.liet@t@of "St t-()kt@, oi- l(i:fli(@y                               4? U2C  299g.
                                                  SF,(..  10!). @(@(.tioll  !)O!)                     -II   A(-(   is             @(i  I)Y                     "oi, 42 USC  299i
                                                                                     (it)  of siii
                                                  Sr(-. 110. (,I) Se(.tioll         !)IO   of   St[(.Ii   A(-t   is                to   i-e;i(I   :is    follo%v,,: 82 Stat.  1006.
                                                                                                                                                                    42 USC  299J.

                                                          !110.  (;I) TI) f.,I(-ilit-,tte iiit(Tregioil;tl (-ool)(!I-@itioll, @111(i
                                              ilill.ii-ove(I   ti@itioit-,tl   (-,tl),tl)ility   foi-    cleli%f(','y    of        sei-vi(!es,
                                              t;tt-v is tiitlioi-iz(@d to iitilize filli(is                                 iiii(lei-tliis   title   to    iiitk(@,
                                              ,rl,;Illts to I)III)li(t of- llolli)lofit J)I.ivitte                          oi-   iiistitiitiotis    oi-    (-Olll-
                                                                          air(] to                   for-
                                                                 I)].ogi-itills,   S(Ill%'i(,(,Sl    :11)d    I(.tivitit@s    Of    siil)sf;tlltiill    Its("    to
                                                     (wo oil itiol-t@ I.(@Lyi4)   fall                    I)I-ogi.-tills;
                                                                              111(@lit,   trial,   oil   (lettiolisli.;Illf)ii    of    iiielliotis    foi-
                                                                          (lis(@:lse,              St I    -(@,  l@i(lli(                  - ol I)(![.  I.(
                                                                                                                           (I            ol               !I@tf(,

                                                                                          .11141 silitly or
                                                     :Ill   of (Ike                                     ill
                                                                                                                                       ;it(-(I   lo   lilt-
                                                                                         I)f  11-:iiililig
                                                                                                             oil  -.til   (if (I)(. (lis(@ilsf!s
                                                                                                                        y
                                                     to ill  I):tl.ltgl.ltl)li  (2), Ill. to tll(-,                              or
                                                                             I(-II  li.@!,ts(ks;  til(I  foil  (;olll   ifillilig   I)li(igl.;tflis   of   sli(..Il
                                                     fi-olli :illy of St
                                                                     wliei,t-,   sliol.iig(@   of    tl-,till(-tl    1)(@i-solit)(@l    %%.olil(l    oill(tl.%Vis(t
                                                     limit   ti)l)lieitioii   of   ktiowlt@(ige   -,Ili(l   SI(IIIS   iltll)Ol'tLllt,   to   i   II('    (!()Iltlol
                                                         -,tiiy   -r sii(-,Ii diseit-x-.,;; tli4l
                                                         11(f))  tile coll(itl(.,t, of (tool)(@,i-;ttive
                                                                   s(.,(.m@tii-y is it,itiioi.ize(i to                     iii  lll(-(@tiiig tile (.osts
                                              special    1)i-oi(@(-ts    for    ltiil)i-ovitig    ?r    developing    ii(!w    nicins    foil     tile.     (leliv-
                                              4.!.y    of                         ('OlkCel'll(!(l   Witli   tile   (lis(@,tses    witli    wili(li    this    title

                                                                                                                    3


                                                              Pub.  Law 91-515                                                                     October        30,         1970
                               f14 f,'I'AT. 1301
                                                                            Tile Se(.       I.et,.,,.y      is  tillilol.iz(-@(i  to  siil)l)ort   r@-ar(!]I,   Stud,,,,
                                                              in  ti  iLtioll",  training,  itil(i   (leilloitstrittioits   (tesi   led   -to   iiiitxiiiiize
                                                                 V@'4
                                                              tile litifizittioll  of  ill-.Illl)ow(.I.           in  the   deliv(@ry   of   lieatltli
                                                                 si,(!. it i. (:t) riie                             totiti(@ ix of                      Act,  is  itni(@iide(I   by
                                                              sti ikiiig out                                A,14'1)                          I)IS14,ASFS"     and     iit,-*rt.-
                                                              iiig ill lieti tlit-i-tof "STICOI@l,,,                                                             ANI)     O'I'IIEI,'.
                                                                                              I)ISFASI,',S".
                               42  1,T::(,'  299b-                                                          00:@(aL),               903(b),
                                                                                                                  of sii(-Ii Act (its
                               299g,  299i.
                                                              I)I,OvlslOlls  of  ttiis  Act)  atr(@  eit(-Ii   ftirtli(@r
                                                                                                  citcli              it ttl)l)eai-s tit

                                   Other  New  Provisions  Relevant                                               to Regional Medical  Programs
                                                                                            @In   P.L.            91-sis
                                                                                 11-ANIE-NI)ME'@,\T@-3 TO TITLE III OF THE llUBLIC
                                                                                                    la,'Al,'rll SERVICE ACT

                                            H-AD-'%IIWISTI@ITIO-@   OF   GIL%NTS   IN   ("ERTAl,
                                                                                      PitOJE(,-rs
                                                               A of title Ill of the Public I-lealtli Service Act is 58 Stat.                                                 691;
                                    @SF.il. 270. I'll
                                @iiii(,jiiled lay td4LIiilg it the end thereof the  following new @etion:                                                        76 Stat.     59?.
                                                                                                                                                                 42 USC  241-
                                                                                                                                                                 242h.
                                            "A(Iiiiiiiistratiott   of   Cxmjits   in   Certtin   Miiltigi-,tnt   Proje(@ts
                                                                                                 f,         a  iliL,   thetdiiiit)is
                                    "SFt,.     :110A. For tli(-, ptir[)OSL@                       t(,.ilit                                tr:ttion             of,
                                                                      ettri-yiiig  Olit of  Lli(@   )urloos(@,
                                                                                                                           i      of,      the       I)ri)(,,ranii
                                                                                                                  314(it),           '@14(i)),           .314(i-),
                                                                       IX      :111(l      se(ttions      :10
                                                                            i                                                                       IIL,,Ilt   n@e,      pp.         12!)7,
                                                                                                                                                                 304.
                                                                    or    itiol-C     of     sll(!Ii     programs     witli     re--;I)ect     to     I     singleI
                                 1'roj(-.(-I,    the    Si-ci    el    ary    is    itutlioi-izt,,d     to     1)i-oiyiul     ttc     regulat.iolls-
                                                                                 the   -,t(lininistrLtiV(@   functions    iiii(](@r                        sii(-Ii
                                            lit'091,;Inls will,                     i@f)            I)roj(@,ct.    will    1)@-,     IA-rfi,i-iiie(I by          a
                                            siiil,,Ie.   t(Iiiiiiiistrittiv@   killit  Wil@(.,Ik   is   file                                                  unit
                                                      I    wit,li    iii(-    tdiriiiiisti-:ttif)ii    of    iiiiv    of     4tic)i     I)r4)grani,;     or     is
                                            tile                                     (,Iitt-gt,-d      with       t,It(-,      stil)ervisioti.()f       two       or
                                            iiiot-cof,iii(,Ii prt),,rains;
                                                        (I    s 'II(.            -edu(%@       the       number        of        al)l)lictttioiis,        reports,
                                            -.1ii(I  otile:'                     required        under        such        programs        to        be        sub-
                                            init,,ted      -,with      respect      to      each      project,       itnd       otherwise       to       simplify,
                                            con-,oli(late;      and      make      uniform       (to       the       extent       feasible),       the       (late
                                                                                                            tained         in         such         rtpl)lications,
                                            ;Ill(l     iiifoi-ii)atioii     required      to      be      con
                                            i-e,p  its, aii(I other materials;  and
                                                0
                                              49       (3)       iiiidei-       which       inconsistent       or       duplicative        requirements        im-
                                            I)osed      I)v      such      programs      will       be       revised       and       made       uniform       with
                                            r@,I)ect                             t;
                                                       io       such       1)rbjec
                                  e,x(.-t-,i)t     tbsit-iiotitin@     ill-tz@is     section      sli,,til      be      const-;ucd      to      authorize      the
                                     eel.p.tat-Y     to     waive     or     spsr)eDd,     jxith     respect      to      any      such      pro      rt,      any
                                                         wif)i                   to     itti@     of     sit(-.h     programs      if,,ijeb      r,("(Itiirernf,nt
                                   is itti )ost,-ii toy law or by triy rt,.gulittif)ll  re(iiiii-e(i lpy law."

                                                                                                            4


                                                                                                                                                 1970
                                                                                                                            -ober 30
                                                          Pub.  Law 91-515                                            0 ct
                                  84 STAT  I  1307             PART     I-ANNUAL     IRFroRT,     @,iTIONAL     ADI-ISORY      CO.UNCII,, I",'rC.
                                                            Si.-,c.  280.   Part   A   of   title   III   of   the   Public   Health   Service   Act   is
                                                          further    amended    by    adding    ifter    section    310A    thereof    (as    Idded    bv
                                                          section 2iO of this Act) the following new section:

                                                            "31013.  On  or   before   Taiiuarv   1   of   eitcli   i-e,.ir,   the   Secretary   sh.-ill
                                                          tr,iiisn-iit  to   the   Congress   a   re,@ort   of   the   activities   carric(l   on   under
                                    An@te  pp. 1297,      the provisions of title IX of this Act and sections 304, 305,
                                    1304.                 314(b),314(c),314(d),aiid    314(c)    of    this    title    to(retlici-    with    (1)    iii
                                                          evtlii-,itioji of the                  of  such   tfti%-ities   )li   improving   the   efli-
                                                          cieticy -tiid effectiveness of the t-(,s(@arcl), 1)laiiiiiiiL,, iijid                 of
                                                          Health  services  in  carrying  oitt  the   1)iii-r)oses   foi-   wall   stl(.Il   I)rovisioiis
                                                          IN-ei-c oii:tc-t(-(I, (2)  it            of the 1.4!llltiolisIlil)
                                                          Iiii@iii(,infr ttiil fiiiiiii,!iiig from oi,li(,r         of tli(@, IL(,tivitif,,s
                                                          taken I)iir,,ttmnt to sii(-,Ii I)rt)vi,,iot , (ill(!Ill(lilllr t,li(,@ possibilities  for  more
                                                          efficie@t support of  sti(-Ii  :iflivi  ie.,;  tlirotigfi'  ii.%  of  ,tlternitt(@  soiii-(-A@s
                                                          of   financing   itfter   in   initial   1   criod   of   siil)l)ort   under    such    I)rovi-
                                                          sioiis),  ind  -(3)   such   reconinieii(   nations   wi(@li   respect   to   such   provisions
                                                                         -tl)propriatc."
                                                          as he deems,

                                                          TITLE VI-MISCEI,LINEOUS

                                                               NATIONAI, ADVISORY COUNCIL

                                        (b)   (1)   Subsection   (c)   of   section   208   of    the    Public    Health    Service Compensation.
                                     Act is amended to retd                                                                     64   Stat.   447.
                                          (e)    Members    of    the    National    Advisory     Health     Council     and     MeM- 42 USC 210.
                                     bers   of   other   national   advisory   or   review    councils    or    committees    estab-
                                     I   allied   under   this   Act,,   incliidi-na   member-,   of   the   Technical    Electronic
                                     Product   IZa(li-,vtioti   Sifeky    Stindards    Comniittee    aLzid    the    lioard    of
                                     IZ4aLreiit.,; of                Library   of   Medicine,   but    excluding    ex    officio
                                     members,   while   atteiidiiiir    coiiferenms    or    me@tinLrs    of    tbei@resl)ective,
                                     cotinei'l,i   or   committees   Or   while   otherwise   servi@g   at   the    request    of
                                     the,               sliitll  be  entitled  to  receive  corril)cnsittion  tut  rates  to   be
                                     fixed by the @Secrettry, but tt riti%- not ex(!e(@dii                                ivalent
                                     of tli6 late specified at the time of such service                                of     the
                                     ('Yeii6ial Sclied le, including traveltime; and                                        their 35. F. R. 6247.
                                     homes or regular-l)laces of-business they may                                    vel     ex- 5 tisc 5332
                                                                                                                                note.
                                                                                                                                84    STAT.  1311
                                    I)ensL@s, including i)cr dieni in  I  ieu  of  ,;ubsistence,  as  ftittliot-ized  by  see-  -
                                    tion  5703(b)  of  title  5  of   the   United   States   Code   for   persoiis   in   the  80    Stai.   499;
                                    Government service employed intermittently."                                                83    Stat.  190.
                                       (2)  Tite.@Tond  sentence  of  subsection   (d)   of   section   30C),   the   @ecoii(I
                                                                                                                                42   USC   242d.
                                    Sentence  of  subsection  (d)   of   section   301,   the   first   sentence   of   1)@ra-  42   Use   242e.
                                    gnll)li  (2)  of  subsection   (f)   of   section   358,   subsection   (d)   of   section  42   UsC   263f,
                                    373, subsection (e) of section 641, subsection                   of  section   703,   sub-  Ante,      pp.66,344.
                                                           'ioii 72r
                                    .section ((I) ofsect             subs6ctioii (d I of s@ti      n   774,   subsection   (e)  2@YJSC     292b.
                                    of sect ion 841       and  subsection   (e)   oi   section   0905   of   such   Act   tire  42   Use   293e,
                                    deleted.                                                                                    295V-4,     298,


                                                                          of                     of
                                                               -liciligotit
                                      1.70.                                                               tli(3 s(@oll(I
                                                                                                            Of tll(- (',oltll(littt-,43
                                             ill(tl.(!I)f3iii(i I;y illatil,iligiii liell
                                                                              I)IOV(-,(-,'i of tll(,, I lili(t@(I @Stat("i I)III@-tiitit tx),
                                             wilf)      ]lot oflicei-, or elit.
                                             sill).@t(!tion (c,) of station 208 ot tiiis Act"
                         7')  StELt.  920.      (4) 4til) ' '-tioll ((I) of sm-tioii uo.,) of sticii Act is red(Nsigiii@d tt-s
                                             sill)SCctioii  (c).

                       LEGISLATRVE tUSTORYt
                       MUSE   RFPORTST    No.    91-1297    (C@,,. on Interstate and Foreigi
                                         Commerce) and No. 91-1590 (Cme. of Conference).
                       SEtiAl-E  RL?ORT  No. 91-1090 acoompar(Ying S. 3355 (Cmm. on labor
                                         and Pub]-to We'lfeLre).
                       CON(;RESSIOIIAL   RECORD, Vol. 116 (1970)t
                             Aug.   12,  considered and passed flouos.
                             Sept.   91  considered and passed Senate, amended, In lieu of
                                         S. 3355.
                             Oct.   13,  House agreed to conference report.
                             Oct.   14,  Senate agreed to conference report.


                                                         A(,T

                           IX-EDUCA,rION, RI,@l@;AI'Cil, 'J'@AIINING,  AND
                   TIl
                        .N[ONS'PRA'rIONS IN rp[Ili, FIELDS O,[,' HEART  DIS-
                     DE
                                   -1@, STROI-E. CAND3
                           'CANCE                        KIDIVE(Y DISE,,ISrf,.
                          OTIIE[? ItEl.,ATED DISEASES

                                           PLIKPOSES

             Sec. 900.  The purposes of this title are
                  (a) through grants and contracts, to  encourage  and  assist  in
                                  of       ,   cooperative arrangements among
                the establishment    region
                medical schools, research institutions, ind hospitals for research
                and training (including continuing education),  for  medical  data
                exchange;' and for [related] demonstrations of patient care in @c
                -iel s of heart disease, cancer, stroke  and kidney disease, and
                other related diseases;
                       to afford to the medical profession  and  the  medical  in-
                stitutions of the Nation, through such cooperative arrangements,
                the opportunity of making available to their patients the latest
                advances in-the Idiagnosis.and treatment of these diseases]
                Drevention,  dia            treatment and rehabilitation of nersons
                suffer                     ses;
                                           ter regional linkages among health care
                ins                                              and improve'-prima
                car
                       (d)  by these means, to improv
                   [c                                  o generally the quality and
                enhance the capacity of the health manpower and  ai @ties 'aval able
                                           improve health services for persons residing
                to the Nat:
                in areas W                                   to accomp.
                ends without- nt@e-rfei                       or the methods of
                .financing, of patient                       practice, or witlithe
                administration of hospitals, and i  cooperation with practicing
                physician@, medical  center  officials,  hospital  administrators'
                -and representatives from appropriate voluntary health agencies.
                               AUTHORIZATIONS OF APPROPRIATIONS
                Sec'. 901. (a) 'There  are authorized to be appropriated $SO,000,000
              for the fiscal  year  ending June 30, 1966, $90,000,000 for the fiscal
              year ending June  30,  1967, '$200,000,000 for the@fiscal year ending
                               65,000,000  for the fiscalyear ending June 30, 1969
              June 30,@ 1968,  $
              [anj] $120,000,000  for  the next fiscal yea@, $125,000,000 for   the fiscal
              year  ending  June 30.  1971,           0 for  he fiscal.year eT
              3 .  1972,  and  2                                             3
              Trants fo-  assist                                            me(
              schools,.researc.                                   or nonprofit  private

                                               7


                                 es in planning, in conducting feasibility studies,
           institutions and agenci                              tp  of  -regional
                                  rojects for the establishmen
           and in operatingPilOt P  .       . ing, and demonstration activities
           medical programs of research, train                      tracts    to
           for carrying out tjlc purposes of this title and for c               iis
            ry out the T)urposes_ if this title.  [Sums approprl
           Ca                                rei in  available  for  making  such
           @c                               I  vear  following  the  fiscal  year
           grants until                                               rooriated
                           -rop-riation is inadc.1 of the  sums
           for which the app                                                  t
           under this s ction for the fisca             r ac ivi                eld

                                                        not more
                                                                             new

                                                   uant to this  sE             ie
                                  ropriations Pul             centum thereof  ,
                                    but not exceeding 1-oer
                                   e Secreta-rv for evaluation  (directly    or
                                 th
           by grants oi con rac ) of  the  program  authorized  by  this  title
             (b) A grant under this title  shall  be  for  part  or  all  of  the
                                             ivities  with  respect  to   which
           cost of the planning or  other  act
           the application is made, except  that  any  such  grant  with  respect
           to construction,of' or provision  of  built-in  (as  determined  in,
            cordance with regulations) equipment for, any facility may
           ac
           not exceed 90 per centm of the   cost of such construction   Ior equip-
           ment.
             (c)@ Funds appropriated  pursuant  to  this  title  shall  not  be
           available to pay the cost of hospi,,-al, medical,  or  other  care  of
                                   -extent it is,  as  determined  in  accordance
           patients except to the
           with regulations, incident to those  research,  training,  or  demon.-
           stration activities which  are  encompassed  by  the.purposes  of  this
           title. No patient shall  be  furnished  hospital,  medical,  or  other
                       facility incident to research     training,  or   demon-
           care at any
                                         out  with  funds appropriated    pursuant
           striation activities-carried                   --                                   X
           to this title, unless  he  has  been  referred to  such  facility  by
           a.practicing physician or, where appropriate,    a practicing dentist.
                   Grants under, this title to any agency   or  institution,  or@
              (d)
                                 for a  regional  medical  program  may  be  used
           combination thereof
           by it to assist in meeting the cost of participation in such
           program by  any  Federal  hospital.
              (e) At the reque t of  any  -r  idient  of  a  Qrant  under  this
                                                                              ir

                                  e)cr)ense                                     n

                                                                    0

                                           8


                                          DEFINITIONS

             Sec. 902.  For the purposes of this title
                   (a) the term "regional medical  pro-raiii"  means  a  cooperative
                 arrangement among a group of public  or  nonprofit  private  insti-
               .tutions or agencies engaged in research, [trdining, diagnosis, and
                 treatment relating to heart disease,  cancer,  or  stroke,  and  at
               ,the option of the applicant, related disease or.diseases)
                 prevention.  di            atmont, and rehabilitation relating to
                 heart   iscase,
                 o-f the applica                                             I group
                                                             ic  area,  composed  of
                         part  or parts of any one or more States (wlii
                      any                                                ch for purposes
                      of this title includes the Distri'ct of Columbia, the Conunon-
                      wealth of Puerto  Rico  the  Virgin  Islands,  Guam,  American
                      Samoa, and the Trust Territory of the Pacific Islands), which
                      the [Surgeon General]             determines,  in   accordance
                      with regulations  to  be  appropriate  for  carrying  out  the
                      purposes of this title;
                         (2)  consists of one or more medical centers, one or more
                      clinical research centers, and  one  or  more  hospitals;  and
                         (3)  has in effect cooperative arrangements among its com-
                       onent units  which  the  [Surgeon  General)  Secretary  finds
                      p
                      will be adequate for effectively carrying out      e purposes of
                      this title.
                    (b)  the term  medical cente:C' means a medical school or other
                 medical institution  involved  in  post-graduate  medical  training
                 Iand one or more hospitals affiliated therewith for teaching,
                 research  and demonstration purposes..
                    (c)  the term "clinical research center" means an institution'
                 (or part of an institution) the primary function of which is
                 research, Itraining of specialists, and demonstrations and which,
                 in connection  therewith,  provides  specialized,  higli-quality  ,  7..   . m
                 diagnostic and treatment services for inpatients and-outpatients.
                    (d)  the-term "hospital" means a hospital as defined in section
                 625(c) or other health  facility  in  which  local  capability  for
                 diagnosis and treatment in supported and augmented by the program
                 established under this title.
                    (e) the term "nonprofit"  as  applied  to  any  institution  or.
                 agency means an institution or agency which is owned and operated
                 by one or more non-profit  corporations  or  associations  no  part
                 of the net earnings of which inures,  or  may  lawfully  inure,  to
                 the benefit of Iny private shareholder or individual.
                    (f)  the term "construction" [includes] means new construction
                 of facilities for demonstrations, research, an,
                 necessary  o carry out r(            ical  programs,  altcra  i-on,
                                       ext(           c                     remodeling
                                       sting building (inclu  ng initial equipment
                 thereof), and  replacementlof  obsolete,  built-in  (as  determined
                 in accordance with regulations) equipment of existing buildings.

                                              9


                                                  R PLN"L ING
                                       GRA,NTS   FO
                                                                          n the recm
                                     Surgeon Generall Secretary, uPO
               Sec. 903 (a)  I'he    onal Advisory (fo  cil on Regional Medical
            mendation  of   the   Nati            905  (hereafter  in   this   title   refer-
            Programs   established   by    section
            red to as the "Council"), is authorized to make grants to public               or
                                                  medical schools, research institutions,-
            nonprofit    private     universities,
            ,tnd  other  public  or  nonP  ofit   private   agencies   and   institutions,   and
                                         r
            combinations thereof, to assi-,;t them in planning the development
            of -regional medical programs.
               (b)  Grants  under  this  section  mav   be   made   only   upon   application
            therefor  approved  by  the  ESprgeon   General]   Secretary.   Any   such   ap-7
            plicatioii  may  be  approved  only  if  it  contains  or  is.supported   by   --
                     (1)  reasonable  assurances   that   Federal   funds   paid   pursuant   to
                    any  such  grant  will  be  used  only  for  the  purposes  for  which  paid
                    and  in  accordance  with  the  applicable   provisions   of   this   title-
                    and the regulations,thereunder;
                                                 es  that  the  applicant   will   provide   for
                      (2)   reasonable    assuranc
                                      rol and fund accounting procedures as are
                    such fiscal cont
                    -required  by  the  [Silrgeon  Generall  Secretary   to   assure   proper
                    disbursement of and accounting fo@                 ral  funds;,..
                      (3)  reasonable  assurances  that  the   applicant   will   make   such
                    reports,  in  such  form  and  containing   such   information   as   the
                    [Surgeon Genera-11 Secretary nay from time to time reasonab
                                                                                           ly
                    @uire, and will  eep such records and afford such access thereto
                    as  the  [Surgeo'  General3,Secretary   may   find   necessary   to   assure
                                    n
                    the    correctness and   veri@            such reports; and
                (4)   a   satisfactory showing that the       licant   has   designated    an
               ad-.,isory-group, to advise the applican       and   the   institutions    and
               agencies  participating   in   the   resulting   regional   medical   program) in
               formulating  and  carrying  out  the  plan   for   the   establishmentI-and opera-
               tion  of  such  regional  medical  program,   which   advisory   group   includes
               practicing physicians, medical center officials, hospital administrators,
               representatives from appropriate medical societies, rvolunta              health
                    -.Les, and                   tticial health agencies
               age-nc           voluntary   or   o
                                                                                            0
               and agencies co                  activities  of   th   kind   to   e   carried on
               under  the  program  (including  as  an  ex  officio  member,  if   there   is
               located in such    rel                                                          ities
               o    e      Vcteran@A(                                                       trator
                                                                                         care

               provided under the progran3 need for and fi                     the      services
                         under    the                            sory gr
                                                                         OUP

                                                                                                        I
                                                 - 10 -                                     I  .


                             GRANTS FOR E-S-FABLISIMN'r AND OPIl-RAI'101\' OF
                                      REGIONAL ML-'DICAL PROGRAMS
                  Sec. 904.  (a) the LSurgeon General] Secretary, upon       the rbcom-
                         on of the Council is authorize  to make grants      to public or
                mendati                             medical schools, research institutions
                                    universities
                nonprofit private     1   "-      ?
                and other public or non-profit private agencies and institutions.
                and combinations thereof, to assist in establishment and operation
                of -regional medical program, including construction and equipment
                of facilities in connection therewith.
                  (b)  Grants under this section may be made only upon application
                therefor  approved by the [Surgeon General] Secretary.  Any such
                application may be approved only if it i* refommended by the advisory
                group described in [section 903(b) (4) and I section 903 (b) (4),
                                        en provided,prior tb su                           r
                                                                                           ate
                                                                           ell!            al,

                           e 1                                  onal
                conta                                    le as             at
                         (1)Feder,                       t to any such grant (A) will be
                                                           ich paid and in accordance with
                         the applic                      is title and the regulations there
                         under, an     wi                t funds.that are otherwise avail-
                         able 'for establishment -i     ation of the regional medical
                         rogram with,respect  to  u     the grant is made;
                         p
                         (2)the applica'ntwill provide for such fiscal-control and        fund
                         ccoluiting procedures as are required by the [Surgeon General]
                         a
                         Secretary to assure proper disbursement of and accounting for
                         su Federal funds;
                         (3)the applicant will make such r  orts, in such form an
                         containing such  information  as  the  ipsurgeon  General]  Secretary
                         may from time to time reasonably require, and will ki
                         records and afford such access thereto as the (Surgei
                         Secretary may find necessary to assure the correctness and
                         veri :Lcation of such reports; and
                         (4)any laborer or mechanic employed 1.)y any contractor or
                         subcontractor in the performance of work on any construction
                         aided by payments pursuant to any grant under this section will
                         be paid wages at rates not less than those prevailing oil similar
                         construction in the  locality  as  determined  by  the  Secretary  of
                                   cordance with the Davis-Bacon Act, as amended
                         Labor in at
                         (40 U.S.C. 276a -- 276a -  5);  and  the  Secretary  of  Labor  shall
                         have, with respect to the labor standards specified in this  .
                         aragraph, the authority and functions set forth in Reorganization
                         p
                         Plan Numbered 14 of 19SO (15 F. R. 3176; 5, U.S. C. 133z - 15)
                         and section 2 of the Act of June   13, 1934, as amended (40 U.S.C.
                         276c).


                   K,KTIONNL ADVISORY COUNCIL ON RECIONAL MEDICAL PROGRAMS
                Sec. 90S. (a)  The ESurgeon General, with the       approval  of   the
               Secretary,]  Secretary  may  appoint,  without  regard  to  the   civil
               service law  ,  a  National  Advisory  Council  on  Regional  Medical
               Programs.  I'he  Council  shall  consist  of.the  [Surgeon   General]
               /@sistant Secretary of Ilealth, Education   . and  Welfare  for   Health
               and Scientific Afrairs, w 0 f
                                         Veterans' Administration v               e  an
                                                               ers,   not    otherwise
                                      imc employ o             d  States,  who   are
               leaders in the fiel  s  of  the  fun(Imneiital  sciences,  the  medical
               sciences, health  care  adviinistrat.Loii,  or  public  affairs.  At least.
               two of th  appoint                        practicing     physicians, one
               shall  be  outstanding  in  the  study  r,  diagnosis  or  treatment]
               or health care of -persons  suffering  from  [of)  heart  disease,  one.
               hall be outstandi                             nosis,  or   treatment)
               or health care of r)eisons su  erinR fr(      [oil  cancer,  Land]  one
               shall be outstandi@                        agnosis   or    treatment]
               or health care of 1)erso     suffering        [of] stroke.  one  shall.
               be outsl                                      e of  -persons  suffering
               rom ki(                           be   outstani
                                               cancer,   stro.
                                       ers of
                                                             il shall hold office for
               a term of four yea s, except  that  any  i-nember  appointed  to  fill,
               a vacancy prior to the  @,piration  of  the  term  for  which  his  pre-
               decessor  was  appointed  shall  be  appointed  for  the  remainder  of
               such term, and except  th4t-the  term-,  of  office  of  the  members
               first taking  office  shall  expire,  as  designated  by  the  Lsurgeon
               General]       ta    at the time  of  appointment,  four  at  the  end,
               of the f irst year, four at  the  end  of  the  second  year,  four  at
               the end of the third year, and fou-c  at-,  the  end  of  the  fourth
               year  after  the  date  of  appointment.  ,@  appointed  member   shall
               not be  eligible  to  serve  continuously  for  more  than  two  terms.
                f(c)  Appointed members of the Council, while attending meetings
               or conferences thereof  or  otherwise  serving  on  business  of  the  ..
               Council, shall be entitled to receive compensation at rates fixed
               by the Secretary, but not exceeding $100 per day, including-travel-
               time, and while so serving away from their homes or regular places
               of  business  they  may  be  allowed  travel  expenses,  including  per
               them in lieu  of  subsistence,  as  authorized  by  section  5  of  the
               Administrative  Fxpenses  Act  of  1946  (5  U.S.C.  73b-2)  for  persons
               in the Government service employed intermittentlyl
                  f(d)] (c) The  Council  shall  ach-ise  and  assist  i]Te  rurgeon
               (icnerall .Se reta    in the  preparation  of  regulations  for,  and  as
               to  policy  matters  arising  with  respect  to  the  administration  of.
               this title.  I'he Council shall consider all application for grants
               tinder this  title  and  shall  make  recomendations  to  the  f,)urgeon
               C,cnQrall  Secretary  with  respect  to  approval  of   applications for
               and the amounts oZ grants under this title.
                                                                                                   I

               *  See explanatory addenda page 10.

                                               - 12 -


                                                REGULATIONS
                   Sec. 906.  The   Purgeon General) Secretary, after consultation
                 with the Council.  shall prescribe g neral rei6lations covering
                 the terms and conditions for approving applications for grants
                 under,this title and the coordination of programs assisted under
                 this title with programs for training, research, and demonstrations
                 relating to the same diseases assisted or authorized under titles
                 of this Act or  other  Acts  of  Congress.
                      INFORMATION ON SPECIAL -TRE-AIMENT AND 'I'RAINING CENITRS
                   Sec..907.  The [Surgeon General] Secretary,, shall establish, and
                 maintain.on a current basis, a list or lists of facilities in the
                 United States,equipped.and staffed to provide the most advanced methods
                 and techniques in.the diagnosis and treatment of heart disease,
                 .Cancer, [or strokel stroke, or kidne-Y disease, together with such
                 related information, inclu ing tle availability of advanced specialty
                 training in such facilities, as he deems useful, and shall make
                 @s-uch@list or lists ancl related information readily available to
                 licensed practitioners and other persons requiring such information.
                 To the'end of making such list or-lists and other information
                 most useful,@the @geon Generall Secretary shall from time to
                 time consult 'withlinterested national-professi6@l organizations.

                                                  REPORT
                   Sec. 908.   On or before  June  30, 1967,  the Surgeon  GeneraL after
                 consultation    with  the Council, shall submit to the Secretary.for
                 transmission  to the President and then to the Congress, a     report
                 of  the activities under this   title toQether w4th (1)   a statement of
                 the relationship between Federal financing and financing from
                 other sources  of  the activities undertaken pursuant    to this-title,.
                 (2)  an appraisal  of the activities  assisted under this title in
                 the-light   of their.effectiv6ness in carrying@'out the   purposes  of
                                  -(3)   recommendations with.'.Tespect to extension or.
                 this;title,.ahd
                 .modification of this  title in the light thereof.

                                           @ORI)S AND AUDIT
                   Sec. 909.  (a)   Each recipient  of  a grant or   contract under this
                 title shall  keep  such records  as  the [Surgeon.Generall  Secretary
                 may Drescribe..  including records which  fully  disclo-se  te am6u@t
                 and disposition  by  such  recipient  of the proceeds of such Rrant or
                 contract, the total  cost  of  the  project  or  undertaking in conn'ec7t'lon
                 wit w i@h such grant  or  contract  is  made  or  used,  and the amount
                          po- t
                 .of that   r ion of the cost o 't   e                          supplied
                                                       project or undertaking         1
                 by other  sources, and  uch 'records as will facilitate'an effective
                                         s
                 audit

                                                  13


                                                      on,  and   We
                 (b)  The Secretary of flealth, Educati           ifare and the
              Comptroller General of the.United States, or any    of their duly author-
              i.zed representatives, shall have access for the purpose of audit
              and exami           any books, documents, papers  and records of the
                       -nation to                              y
              recipient of- any grant under this title which are pertinent to any
              such grant.
                          LPIZOJE-CT GRANTS FOR @RJLTIPROGRAM SERVICES
                 Occ. 910.  Funds appropriated under this title shall also be
              available for grants to any public or nonprofit private agency or
              institution for services needed by, or which will be of substantial
              use to any two or more regional n,.edicdl  programs.)
                                     MULTIPROGRANI SERVICES
                 Sec. 910. (a)  To facilitate interregional cooperation     nd develop
              iwrov
                                                                  ated u-nde'
                                                                  te agencies or

                                      ices                        stantial use to

                      r mo
                                                        ation of methods  for control
                                                                     or
                            collection and study of el)idemiolo ic data related to
                            loya                                    ed to. the -pre-
                                                                  diseases reterrecL
                 e@rii                                                           of
                 such
                 TILM@                                            tant to 1
                            c)nduc              ive clinical field trl ls.
                            reta                                  etinR t e costs of
                            cts                                   m@ TC                ry
                             ices concerned                                  is title
                                                          rt research, studies,.
                                                                          maximize
                                                                        ervices.

                                               14


                O'n[E-R   PROVISIONS RELF-,VANR TO REGIONAI, MEDICAL lIROGfMS
                                        IN P.L. 91-515

                TITLE II - PART H
                    ADMINISTRATION OF GRANTS IN CERTAIN MULTIGRANT PROFECTS
                 Sec. 310A. For the purpose of facilitating the administration of,,
                and expediting the carrying out of the purposes of, the programs
                established by title IX, and sections 304)314(a), 314(b), 314(c),
                314(d), and 314(e) of this Act in situations in which grants are
                sought or made under two or more of@such programs with respect to
                a single project, the Secretay  is authorized to promulgate regu-
                lations
                      (1) under which the administrative functions under such
                    programs with respect to such project will be performed by a
                    single administrative unit which is the administrative unit
                    charged with the administration.of any of such programs or is
                    the administrative unit charged with the supervision of two or
                    more of such programs;
                      (2) designed to reduce the number of applications, reports,
                    and other materials required under such programs to be sub-
                    mitted with respect to such project, 'and otherwise to simplify,
                    consolidate, and make uniform (to the extent feasible), the
                    data and information required to be contained in such appli-
                    cations, reports, and other materials; and
                                                    or duplicative requirements im-
                      (3) under which inconsistent
                    posed b  such programs will be revised and made uniform with
                           y
                    respect to such project;
                except that nothing in this section shall be construed to authorize
                the Secretary-to@waive or sets end, with respect to any such project,
                                            p
                any, requirement with respect to any of such programs if such require
                ment is imposed by law or b  any regulation required by law.
                                           y

                TITLE II - PART I
                    ANNUAL REPORT
                 310B. On or before  January 1 of each year, the Secretary shall
                transmit to the Congress a report of the activities carried on under
                the provisionslof title IX of this Act a@d sections 304, 305, 314(a),-
                514(b), 314(c), 314(d), and 314(e) of this title together with (1) an
                evaluation of the effectiveness of such activities in improving the
                efficiency and effectiveness of the research, planning, and delivery
                of,health services in carrying out the purposes for which such pro-
                visions were enacted, (2) a statement of the relationship between
                Federal financing and financing from other-sources of the activities
                undertaken.pursuant to such.provisions (including the possibilities
                for more efficient support of such activities through use of alternate
                sources of financing after an-initial period of support under such
                provisions), and (3) such recommendations with respect to such pro-
                visions as he deems appropriate.


             TITLY: VI
                                 NATIONAL ADVISORY COUNCILS
                CCMPEN,SATION FOR
             Amends section 208 of the Public Health Services Act to rea4:
             tt(c)  Members of the National Advisory Health Council and mem-
             bers of other national advisory or review councils.or committees estab-
             lished under this Act, including members of the Technical Electronic
             Product Radiation Safety.Standards Committee and the Board
                                                                       of
             Regents of the National Library of Medicine, but excluding ex officio
             members, while attending conferences or meetings of their respective
             councils or committees or while otherwise serving at the request of
             the Secretary, shall be entitled to receive compensation at rates to
             be fixed by the Secretary, but at rates not exceeding the daily
             equivalent of the rate specified at the time of such service for grade
             GS-18 of the General Schedule, including traveltime; and while away
             from their homes or regular places of business they may be allowed
             travel expenses, including per them in lieu of subsistence, as
             authorized by section S703(b) of title 5 ok the United'States Code
             for persons in the Goverment service employed intemittently.It

             @anatory Addenda to Section 90S     National Advisory Council
             ."Of the persons first appointed under section 9OS(a) of the
               Public Health Service Act to serve as the four additional members
               of'the National Advisory Council on Regional Medical Programs
               authorized by the amendment made by subsection (a) of this
               section
                    (1) one shall serve for a term of one year,
                    (2) one shall serve for a term of two years,
                    (3) one shall serve for a term of three years, and
                    (4) one shall serve for a term of four years,
               as designated by the Secretary of Health, 'Education, and Welfare
               at the time of appointment
             ."Members of the NF-tiona@ Advisory Council on Regional Medical
               Program (other than tne Surgeon General) in office on  the  date
               of enactment of this Act shall continue in office in  accordance
               with the term of office for which they were last appointed, to
               the Council."

                                            16