```

[106th Congress Public Law 525]
[From the U.S. Government Printing Office]

<DOC>
[DOCID: f:publ525.106]

[[Page 114 STAT. 2495]]

Public Law 106-525
106th Congress

                                 An Act

 
To amend the Public Health Service Act to improve the health of minority 
           individuals. <<NOTE: Nov. 22, 2000 -  [S. 1880]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in <<NOTE: Minority Health and Health 
Disparities Research and Education Act of 2000.>> Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF <<NOTE: 42 USC 202 note.>> CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Minority Health and 
Health Disparities Research and Education Act of 2000''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.

   TITLE I--IMPROVING MINORITY HEALTH AND REDUCING HEALTH DISPARITIES 
 THROUGH NATIONAL INSTITUTES OF HEALTH; ESTABLISHMENT OF NATIONAL CENTER

Sec. 101. Establishment of National Center on Minority Health and Health 
           Disparities.
Sec. 102. Centers of excellence for research education and training.
Sec. 103. Extramural loan repayment program for minority health 
           disparities research.
Sec. 104. General provisions regarding the Center.
Sec. 105. Report regarding resources of National Institutes of Health 
           dedicated to minority and other health disparities research.

TITLE II--HEALTH DISPARITIES RESEARCH BY AGENCY FOR HEALTHCARE RESEARCH 
                               AND QUALITY

Sec. 201. Health disparities research by Agency for Healthcare Research 
           and Quality.

        TITLE III--DATA COLLECTION RELATING TO RACE OR ETHNICITY

Sec. 301. Study and report by National Academy of Sciences.

                 TITLE IV--HEALTH PROFESSIONS EDUCATION

Sec. 401. Health professions education in health disparities.
Sec. 402. National conference on health professions education and health 
           disparities.
Sec. 403. Advisory responsibilities in health professions education in 
           health disparities and cultural competency.

  TITLE V--PUBLIC AWARENESS AND DISSEMINATION OF INFORMATION ON HEALTH 
                               DISPARITIES

Sec. 501. Public awareness and information dissemination.

                   TITLE VI--MISCELLANEOUS PROVISIONS

Sec. 601. Departmental definition regarding minority individuals.
Sec. 602. Conforming provision regarding definitions.
Sec. 603. Effective date.

SEC. 2. <<NOTE: 42 USC 287c-31 note.>>  FINDINGS.

    The Congress finds as follows:

[[Page 114 STAT. 2496]]

            (1) Despite notable progress in the overall health of the 
        Nation, there are continuing disparities in the burden of 
        illness and death experienced by African Americans, Hispanics, 
        Native Americans, Alaska Natives, and Asian Pacific Islanders, 
        compared to the United States population as a whole.
            (2) The largest numbers of the medically underserved are 
        white individuals, and many of them have the same health care 
        access problems as do members of minority groups. Nearly 
        20,000,000 white individuals live below the poverty line with 
        many living in nonmetropolitan, rural areas such as Appalachia, 
        where the high percentage of counties designated as health 
        professional shortage areas (47 percent) and the high rate of 
        poverty contribute to disparity outcomes. However, there is a 
        higher proportion of racial and ethnic minorities in the United 
        States represented among the medically underserved.
            (3) There is a national need for minority scientists in the 
        fields of biomedical, clinical, behavioral, and health services 
        research. Ninety percent of minority physicians educated at 
        Historically Black Medical Colleges live and serve in minority 
        communities.
            (4) Demographic trends inspire concern about the Nation's 
        ability to meet its future scientific, technological, and 
        engineering workforce needs. Historically, non-Hispanic white 
        males have made up the majority of the United States scientific, 
        technological, and engineering workers.
            (5) The Hispanic and Black population will increase 
        significantly in the next 50 years. The scientific, 
        technological, and engineering workforce may decrease if 
        participation by underrepresented minorities remains the same.
            (6) Increasing rates of Black and Hispanic workers can help 
        ensure a strong scientific, technological, and engineering 
        workforce.
            (7) Individuals such as underrepresented minorities and 
        women in the scientific, technological, and engineering 
        workforce enable society to address its diverse needs.
            (8) If there had not been a substantial increase in the 
        number of science and engineering degrees awarded to women and 
        underrepresented minorities over the past few decades, the 
        United States would be facing even greater shortages in 
        scientific, technological, and engineering workers.
            (9) In order to effectively promote a diverse and strong 
        21st century scientific, technological, and engineering 
        workforce, Federal agencies should expand or add programs that 
        effectively overcome barriers such as educational transition 
        from one level to the next and student requirements for 
        financial resources.
            (10) Federal agencies should work in concert with the 
        private nonprofit sector to emphasize the recruitment and 
        retention of qualified individuals from ethnic and gender groups 
        that are currently underrepresented in the scientific, 
        technological, and engineering workforce.
            (11) Behavioral and social sciences research has increased 
        awareness and understanding of factors associated with health 
        care utilization and access, patient attitudes toward health 
        services, and risk and protective behaviors that affect health 
        and illness. These factors have the potential to then be 
        modified

[[Page 114 STAT. 2497]]

        to help close the health disparities gap among ethnic minority 
        populations. In addition, there is a shortage of minority 
        behavioral science researchers and behavioral health care 
        professionals. According to the National Science Foundation, 
        only 15.5 percent of behavioral research-oriented psychology 
        doctorate degrees were awarded to minority students in 1997. In 
        addition, only 17.9 percent of practice-oriented psychology 
        doctorate degrees were awarded to ethnic minorities.

   TITLE I--IMPROVING MINORITY HEALTH AND REDUCING HEALTH DISPARITIES 
 THROUGH NATIONAL INSTITUTES OF HEALTH; ESTABLISHMENT OF NATIONAL CENTER

SEC. 101. ESTABLISHMENT OF NATIONAL CENTER ON MINORITY HEALTH AND 
                        HEALTH DISPARITIES.

    (a) In General.--Part E of title IV of the Public Health Service Act 
(42 U.S.C. 287 et seq.) is amended by adding at the end the following 
subpart:

 ``Subpart 6--National Center on Minority Health and Health Disparities

``SEC. 485E. <<NOTE: 42 USC 287c-31.>>  PURPOSE OF CENTER.

    ``(a) In General.--The general purpose of the National Center on 
Minority Health and Health Disparities (in this subpart referred to as 
the `Center') is the conduct and support of research, training, 
dissemination of information, and other programs with respect to 
minority health conditions and other populations with health 
disparities.
    ``(b) Priorities.--The Director of the Center shall in expending 
amounts appropriated under this subpart give priority to conducting and 
supporting minority health disparities research.
    ``(c) Minority Health Disparities Research.--For purposes of this 
subpart:
            ``(1) The term `minority health disparities research' means 
        basic, clinical, and behavioral research on minority health 
        conditions (as defined in paragraph (2)), including research to 
        prevent, diagnose, and treat such conditions.
            ``(2) The term `minority health conditions', with respect to 
        individuals who are members of minority groups, means all 
        diseases, disorders, and conditions (including with respect to 
        mental health and substance abuse)--
                    ``(A) unique to, more serious, or more prevalent in 
                such individuals;
                    ``(B) for which the factors of medical risk or types 
                of medical intervention may be different for such 
                individuals, or for which it is unknown whether such 
                factors or types are different for such individuals; or
                    ``(C) with respect to which there has been 
                insufficient research involving such individuals as 
                subjects or insufficient data on such individuals.

[[Page 114 STAT. 2498]]

            ``(3) The term `minority group' has the meaning given the 
        term `racial and ethnic minority group' in section 1707.
            ``(4) The terms `minority' and `minorities' refer to 
        individuals from a minority group.

    ``(d) Health Disparity Populations.--For purposes of this subpart:
            ``(1) A population is a health disparity population if, as 
        determined by the Director of the Center after consultation with 
        the Director of the Agency for Healthcare Research and Quality, 
        there is a significant disparity in the overall rate of disease 
        incidence, prevalence, morbidity, mortality, or survival rates 
        in the population as compared to the health status of the 
        general population.
            ``(2) The Director shall give priority consideration to 
        determining whether minority groups qualify as health disparity 
        populations under paragraph (1).
            ``(3) The term `health disparities research' means basic, 
        clinical, and behavioral research on health disparity 
        populations (including individual members and communities of 
        such populations) that relates to health disparities as defined 
        under paragraph (1), including the causes of such disparities 
        and methods to prevent, diagnose, and treat such disparities.

    ``(e) Coordination of Activities.--The Director of the Center shall 
act as the primary Federal official with responsibility for coordinating 
all minority health disparities research and other health disparities 
research conducted or supported by the National Institutes of Health, 
and--
            ``(1) shall represent the health disparities research 
        program of the National Institutes of Health, including the 
        minority health disparities research program, at all relevant 
        Executive branch task forces, committees and planning 
        activities; and
            ``(2) shall maintain communications with all relevant Public 
        Health Service agencies, including the Indian Health Service, 
        and various other departments of the Federal Government to 
        ensure the timely transmission of information concerning 
        advances in minority health disparities research and other 
        health disparities research between these various agencies for 
        dissemination to affected communities and health care providers.

    ``(f) Collaborative Comprehensive Plan and Budget.--
            ``(1) In general.--Subject to the provisions of this section 
        and other applicable law, the Director of NIH, the Director of 
        the Center, and the directors of the other agencies of the 
        National Institutes of Health in collaboration (and in 
        consultation with the advisory council for the Center) shall--
                    ``(A) <<NOTE: Deadline.>>  establish a comprehensive 
                plan and budget for the conduct and support of all 
                minority health disparities research and other health 
                disparities research activities of the agencies of the 
                National Institutes of Health (which plan and budget 
                shall be first established under this subsection not 
                later than 12 months after the date of the enactment of 
                this subpart);
                    ``(B) ensure that the plan and budget establish 
                priorities among the health disparities research 
                activities that such agencies are authorized to carry 
                out;
                    ``(C) ensure that the plan and budget establish 
                objectives regarding such activities, describes the 
                means for

[[Page 114 STAT. 2499]]

                achieving the objectives, and designates the date by 
                which the objectives are expected to be achieved;
                    ``(D) ensure that, with respect to amounts 
                appropriated for activities of the Center, the plan and 
                budget give priority in the expenditure of funds to 
                conducting and supporting minority health disparities 
                research;
                    ``(E) ensure that all amounts appropriated for such 
                activities are expended in accordance with the plan and 
                budget;
                    ``(F) review the plan and budget not less than 
                annually, and revise the plan and budget as appropriate;
                    ``(G) ensure that the plan and budget serve as a 
                broad, binding statement of policies regarding minority 
                health disparities research and other health disparities 
                research activities of the agencies, but do not remove 
                the responsibility of the heads of the agencies for the 
                approval of specific programs or projects, or for other 
                details of the daily administration of such activities, 
                in accordance with the plan and budget; and
                    ``(H) promote coordination and collaboration among 
                the agencies conducting or supporting minority health or 
                other health disparities research.
            ``(2) Certain components of plan and budget.--With respect 
        to health disparities research activities of the agencies of the 
        National Institutes of Health, the Director of the Center shall 
        ensure that the plan and budget under paragraph (1) provide 
        for--
                    ``(A) basic research and applied research, including 
                research and development with respect to products;
                    ``(B) research that is conducted by the agencies;
                    ``(C) research that is supported by the agencies;
                    ``(D) proposals developed pursuant to solicitations 
                by the agencies and for proposals developed 
                independently of such solicitations; and
                    ``(E) behavioral research and social sciences 
                research, which may include cultural and linguistic 
                research in each of the agencies.
            ``(3) Minority health disparities research.--The plan and 
        budget under paragraph (1) shall include a separate statement of 
        the plan and budget for minority health disparities research.

    ``(g) Participation in Clinical Research.--The Director of the 
Center shall work with the Director of NIH and the directors of the 
agencies of the National Institutes of Health to carry out the 
provisions of section 492B that relate to minority groups.
    ``(h) Research Endowments.--
            ``(1) In general.--The Director of the Center may carry out 
        a program to facilitate minority health disparities research and 
        other health disparities research by providing for research 
        endowments at centers of excellence under section 736.
            ``(2) Eligibility.--The Director of the Center may provide 
        for a research endowment under paragraph (1) only if the 
        institution involved meets the following conditions:
                    ``(A) The institution does not have an endowment 
                that is worth in excess of an amount equal to 50 percent 
                of the national average of endowment funds at 
                institutions

[[Page 114 STAT. 2500]]

                that conduct similar biomedical research or training of 
                health professionals.
                    ``(B) The application of the institution under 
                paragraph (1) regarding a research endowment has been 
                recommended pursuant to technical and scientific peer 
                review and has been approved by the advisory council 
                under subsection (j).

    ``(i) Certain Activities.--In carrying out subsection (a), the 
Director of the Center--
            ``(1) shall assist the Director of the National Center for 
        Research Resources in carrying out section 481(c)(3) and in 
        committing resources for construction at Institutions of 
        Emerging Excellence;
            ``(2) shall establish projects to promote cooperation among 
        Federal agencies, State, local, tribal, and regional public 
        health agencies, and private entities in health disparities 
        research; and
            ``(3) may utilize information from previous health 
        initiatives concerning minorities and other health disparity 
        populations.

    ``(j) Advisory Council.--
            ``(1) In general.--The Secretary shall, in accordance with 
        section 406, establish an advisory council to advise, assist, 
        consult with, and make recommendations to the Director of the 
        Center on matters relating to the activities described in 
        subsection (a), and with respect to such activities to carry out 
        any other functions described in section 406 for advisory 
        councils under such section. Functions under the preceding 
        sentence shall include making recommendations on budgetary 
        allocations made in the plan under subsection (f), and shall 
        include reviewing reports under subsection (k) before the 
        reports are submitted under such subsection.
            ``(2) Membership.--With respect to the membership of the 
        advisory council under paragraph (1), a majority of the members 
        shall be individuals with demonstrated expertise regarding 
        minority health disparity and other health disparity issues; 
        representatives of communities impacted by minority and other 
        health disparities shall be included; and a diversity of health 
        professionals shall be represented. The membership shall in 
        addition include a representative of the Office of Behavioral 
        and Social Sciences Research under section 404A.

    ``(k) Annual Report.--The Director of the Center shall prepare an 
annual report on the activities carried out or to be carried out by the 
Center, and shall submit each such report to the Committee on Health, 
Education, Labor, and Pensions of the Senate, the Committee on Commerce 
of the House of Representatives, the Secretary, and the Director of NIH. 
With respect to the fiscal year involved, the report shall--
            ``(1) describe and evaluate the progress made in health 
        disparities research conducted or supported by the national 
        research institutes;
            ``(2) summarize and analyze expenditures made for activities 
        with respect to health disparities research conducted or 
        supported by the National Institutes of Health;
            ``(3) include a separate statement applying the requirements 
        of paragraphs (1) and (2) specifically to minority health 
        disparities research; and

[[Page 114 STAT. 2501]]

            ``(4) contain such recommendations as the Director considers 
        appropriate.

    ``(l) Authorization of Appropriations.--For the purpose of carrying 
out this subpart, there are authorized to be appropriated $100,000,000 
for fiscal year 2001, and such sums as may be necessary for each of the 
fiscal years 2002 through 2005. Such authorization of appropriations is 
in addition to other authorizations of appropriations that are available 
for the conduct and support of minority health disparities research or 
other health disparities research by the agencies of the National 
Institutes of Health.''.
    (b) Conforming Amendment.--Part A of title IV of the Public Health 
Service Act (42 U.S.C. 281 et seq.) is amended--
            (1) in section <<NOTE: 42 USC 281.>> 401(b)(2)--
                    (A) in subparagraph (F), by moving the subparagraph 
                two ems to the left; and
                    (B) by adding at the end the following subparagraph:
            ``(G) The National Center on Minority Health and Health 
        Disparities.''; and
            (2) by striking section 404.
SEC. 102.  <<NOTE: 42 USC 283b.>> CENTERS OF EXCELLENCE FOR 
                        RESEARCH EDUCATION AND TRAINING.

    Subpart 6 of part E of title IV of the Public Health Service Act, as 
added by section 101(a) of this Act, is amended by adding at the end the 
following section:
``SEC. 485F.  <<NOTE: 42 USC 287c-32.>> CENTERS OF EXCELLENCE FOR 
                            RESEARCH EDUCATION AND TRAINING.

    ``(a) In General.-- <<NOTE: Grants. Contracts.>> The Director of the 
Center shall make awards of grants or contracts to designated biomedical 
and behavioral research institutions under paragraph (1) of subsection 
(c), or to consortia under paragraph (2) of such subsection, for the 
purpose of assisting the institutions in supporting programs of 
excellence in biomedical and behavioral research training for 
individuals who are members of minority health disparity populations or 
other health disparity populations.

    ``(b) Required Use of Funds.--An award may be made under subsection 
(a) only if the applicant involved agrees that the grant will be 
expended--
            ``(1) to train members of minority health disparity 
        populations or other health disparity populations as 
        professionals in the area of biomedical or behavioral research 
        or both; or
            ``(2) to expand, remodel, renovate, or alter existing 
        research facilities or construct new research facilities for the 
        purpose of conducting minority health disparities research and 
        other health disparities research.

    ``(c) Centers of Excellence.--
            ``(1) In general.--For purposes of this section, a 
        designated biomedical and behavioral research institution is a 
        biomedical and behavioral research institution that--
                    ``(A) has a significant number of members of 
                minority health disparity populations or other health 
                disparity populations enrolled as students in the 
                institution (including individuals accepted for 
                enrollment in the institution);
                    ``(B) has been effective in assisting such students 
                of the institution to complete the program of education 
                or training and receive the degree involved;

[[Page 114 STAT. 2502]]

                    ``(C) has made significant efforts to recruit 
                minority students to enroll in and graduate from the 
                institution, which may include providing means-tested 
                scholarships and other financial assistance as 
                appropriate; and
                    ``(D) has made significant recruitment efforts to 
                increase the number of minority or other members of 
                health disparity populations serving in faculty or 
                administrative positions at the institution.
            ``(2) Consortium.--Any designated biomedical and behavioral 
        research institution involved may, with other biomedical and 
        behavioral institutions (designated or otherwise), including 
        tribal health programs, form a consortium to receive an award 
        under subsection (a).
            ``(3) Application of criteria to other programs.--In the 
        case of any criteria established by the Director of the Center 
        for purposes of determining whether institutions meet the 
        conditions described in paragraph (1), this section may not, 
        with respect to minority health disparity populations or other 
        health disparity populations, be construed to authorize, 
        require, or prohibit the use of such criteria in any program 
        other than the program established in this section.

    ``(d) Duration of Grant.--The period during which payments are made 
under a grant under subsection (a) may not exceed 5 years. Such payments 
shall be subject to annual approval by the Director of the Center and to 
the availability of appropriations for the fiscal year involved to make 
the payments.
    ``(e) Maintenance of Effort.--
            ``(1) In general.--With respect to activities for which an 
        award under subsection (a) is authorized to be expended, the 
        Director of the Center may not make such an award to a 
        designated research institution or consortium for any fiscal 
        year unless the institution, or institutions in the consortium, 
        as the case may be, agree to maintain expenditures of non-
        Federal amounts for such activities at a level that is not less 
        than the level of such expenditures maintained by the 
        institutions involved for the fiscal year preceding the fiscal 
        year for which such institutions receive such an award.
            ``(2) Use of federal funds.--With respect to any Federal 
        amounts received by a designated research institution or 
        consortium and available for carrying out activities for which 
        an award under subsection (a) is authorized to be expended, the 
        Director of the Center may make such an award only if the 
        institutions involved agree that the institutions will, before 
        expending the award, expend the Federal amounts obtained from 
        sources other than the award.

    ``(f) Certain Expenditures.--The Director of the Center may 
authorize a designated biomedical and behavioral research institution to 
expend a portion of an award under subsection (a) for research 
endowments.
    ``(g) Definitions.--For purposes of this section:
            ``(1) The term `designated biomedical and behavioral 
        research institution' has the meaning indicated for such term in 
        subsection (c)(1). Such term includes any health professions 
        school receiving an award of a grant or contract under section 
        736.
            ``(2) The term `program of excellence' means any program 
        carried out by a designated biomedical and behavioral research

[[Page 114 STAT. 2503]]

        institution with an award under subsection (a), if the program 
        is for purposes for which the institution involved is authorized 
        in subsection (b) to expend the grant.

    ``(h) Authorization of Appropriations.--For the purpose of making 
grants under subsection (a), there are authorized to be appropriated 
such sums as may be necessary for each of the fiscal years 2001 through 
2005.''.
SEC. 103. EXTRAMURAL LOAN REPAYMENT PROGRAM FOR MINORITY HEALTH 
                        DISPARITIES RESEARCH.

    Subpart 6 of part E of title IV of the Public Health Service Act, as 
amended by section 102 of this Act, is amended by adding at the end the 
following section:
``SEC. 485G.  <<NOTE: 42 USC 287c-33.>> LOAN REPAYMENT PROGRAM FOR 
                            MINORITY HEALTH DISPARITIES RESEARCH.

    ``(a) In General.-- <<NOTE: Contracts.>> The Director of the Center 
shall establish a program of entering into contracts with qualified 
health professionals under which such health professionals agree to 
engage in minority health disparities research or other health 
disparities research in consideration of the Federal Government agreeing 
to repay, for each year of engaging in such research, not more than 
$35,000 of the principal and interest of the educational loans of such 
health professionals.

    ``(b) Service Provisions.--The provisions of sections 338B, 338C, 
and 338E shall, except as inconsistent with subsection (a), apply to the 
program established in such subsection to the same extent and in the 
same manner as such provisions apply to the National Health Service 
Corps Loan Repayment Program established in subpart III of part D of 
title III.
    ``(c) Requirement Regarding Health Disparity Populations.--The 
Director of the Center shall ensure that not fewer than 50 percent of 
the contracts entered into under subsection (a) are for appropriately 
qualified health professionals who are members of a health disparity 
population.
    ``(d) Priority.--With respect to minority health disparities 
research and other health disparities research under subsection (a), the 
Secretary shall ensure that priority is given to conducting projects of 
biomedical research.
    ``(e) Funding.--
            ``(1) Authorization of appropriations.--For the purpose of 
        carrying out this section, there are authorized to be 
        appropriated such sums as may be necessary for each of the 
        fiscal years 2001 through 2005.
            ``(2) Availability of appropriations.--Amounts available for 
        carrying out this section shall remain available until the 
        expiration of the second fiscal year beginning after the fiscal 
        year for which the amounts were made available.''.

SEC. 104. GENERAL PROVISIONS REGARDING THE CENTER.

    Subpart 6 of part E of title IV of the Public Health Service Act, as 
amended by section 103 of this Act, is amended by adding at the end the 
following section:

``SEC. 485H. <<NOTE: 42 USC 287c-34.>> GENERAL PROVISIONS REGARDING THE 
            CENTER.

    ``(a) Administrative Support for Center.--The Secretary, acting 
through the Director of the National Institutes of Health, shall provide 
administrative support and support services to the

[[Page 114 STAT. 2504]]

Director of the Center and shall ensure that such support takes maximum 
advantage of existing administrative structures at the agencies of the 
National Institutes of Health.
    ``(b) Evaluation and Report.--
            ``(1)  <<NOTE: Deadline.>> Evaluation.--Not later than 5 
        years after the date of the enactment of this subpart, the 
        Secretary shall conduct an evaluation to--
                    ``(A) determine the effect of this subpart on the 
                planning and coordination of health disparities research 
                programs at the agencies of the National Institutes of 
                Health;
                    ``(B) evaluate the extent to which this subpart has 
                eliminated the duplication of administrative resources 
                among such Institutes, centers and divisions; and
                    ``(C) provide, to the extent determined by the 
                Secretary to be appropriate, recommendations concerning 
                future legislative modifications with respect to this 
                subpart, for both minority health disparities research 
                and other health disparities research.
            ``(2) Minority health disparities research.--The evaluation 
        under paragraph (1) shall include a separate statement that 
        applies subparagraphs (A) and (B) of such paragraph to minority 
        health disparities research.
            ``(3)  <<NOTE: Deadline.>> Report.--Not later than 1 year 
        after the date on which the evaluation is commenced under 
        paragraph (1), the Secretary shall prepare and submit to the 
        Committee on Health, Education, Labor, and Pensions of the 
        Senate, and the Committee on Commerce of the House of 
        Representatives, a report concerning the results of such 
        evaluation.''.
SEC. 105.  <<NOTE: 42 USC 287c-31 note.>> REPORT REGARDING 
                        RESOURCES OF NATIONAL INSTITUTES OF HEALTH 
                        DEDICATED TO MINORITY AND OTHER HEALTH 
                        DISPARITIES RESEARCH.

     <<NOTE: Deadline.>> Not later than December 1, 2003, the Director 
of the National Center on Minority Health and Health Disparities 
(established by the amendment made by section 101(a)), after 
consultation with the advisory council for such Center, shall submit to 
the Congress, the Secretary of Health and Human Services, and the 
Director of the National Institutes of Health a report that provides the 
following:
            (1) Recommendations for the methodology that should be used 
        to determine the extent of the resources of the National 
        Institutes of Health that are dedicated to minority health 
        disparities research and other health disparities research, 
        including determining the amount of funds that are used to 
        conduct and support such research. With respect to such 
        methodology, the report shall address any discrepancies between 
        the methodology used by such Institutes as of the date of the 
        enactment of this Act and the methodology used by the Institute 
        of Medicine as of such date.
            (2) A determination of whether and to what extent, relative 
        to fiscal year 1999, there has been an increase in the level of 
        resources of the National Institutes of Health that are 
        dedicated to minority health disparities research, including the 
        amount of funds used to conduct and support such research. The 
        report shall include provisions describing whether and to what 
        extent there have been increases in the number and amount of 
        awards to minority serving institutions.

[[Page 114 STAT. 2505]]

TITLE II--HEALTH DISPARITIES RESEARCH BY AGENCY FOR HEALTHCARE RESEARCH 
                               AND QUALITY

SEC. 201. HEALTH DISPARITIES RESEARCH BY AGENCY FOR HEALTHCARE 
                        RESEARCH AND QUALITY.

    (a)  In General.--Part A of title IX of the Public Health Service 
Act (42 U.S.C. 299 et seq.) is amended--
            (1) <<NOTE: 42 USC 299a.>> in section 902, by striking 
        subsection (g); and
            (2) by adding at the end the following:

<<NOTE: 42 USC 299a-1.>> ``SEC. 903. RESEARCH ON HEALTH DISPARITIES.

    ``(a) In General.--The Director shall--
            ``(1) conduct and support research to identify populations 
        for which there is a significant disparity in the quality, 
        outcomes, cost, or use of health care services or access to and 
        satisfaction with such services, as compared to the general 
        population;
            ``(2) conduct and support research on the causes of and 
        barriers to reducing the health disparities identified in 
        paragraph (1), taking into account such factors as socioeconomic 
        status, attitudes toward health, the language spoken, the extent 
        of formal education, the area or community in which the 
        population resides, and other factors the Director determines to 
        be appropriate;
            ``(3) conduct and support research and support demonstration 
        projects to identify, test, and evaluate strategies for reducing 
        or eliminating health disparities, including development or 
        identification of effective service delivery models, and 
        disseminate effective strategies and models;
            ``(4) develop measures and tools for the assessment and 
        improvement of the outcomes, quality, and appropriateness of 
        health care services provided to health disparity populations;
            ``(5) in carrying out section 902(c), provide support to 
        increase the number of researchers who are members of health 
        disparity populations, and the health services research capacity 
        of institutions that train such researchers; and
            ``(6) <<NOTE: Reports.>>  beginning with fiscal year 2003, 
        annually submit to the Congress a report regarding prevailing 
        disparities in health care delivery as it relates to racial 
        factors and socioeconomic factors in priority populations.

    ``(b) Research and Demonstration Projects.--
            ``(1) In general.--In carrying out subsection (a), the 
        Director shall conduct and support research and support 
        demonstrations to--
                    ``(A) identify the clinical, cultural, 
                socioeconomic, geographic, and organizational factors 
                that contribute to health disparities, including 
                minority health disparity populations, which research 
                shall include behavioral research, such as examination 
                of patterns of clinical decisionmaking, and research on 
                access, outreach, and the availability of related 
                support services (such as cultural and linguistic 
                services);
                    ``(B) identify and evaluate clinical and 
                organizational strategies to improve the quality, 
                outcomes, and access

[[Page 114 STAT. 2506]]

                to care for health disparity populations, including 
                minority health disparity populations;
                    ``(C) test such strategies and widely disseminate 
                those strategies for which there is scientific evidence 
                of effectiveness; and
                    ``(D) determine the most effective approaches for 
                disseminating research findings to health disparity 
                populations, including minority populations.
            ``(2) Use of certain strategies.--In carrying out this 
        section, the Director shall implement research strategies and 
        mechanisms that will enhance the involvement of individuals who 
        are members of minority health disparity populations or other 
        health disparity populations, health services researchers who 
        are such individuals, institutions that train such individuals 
        as researchers, members of minority health disparity populations 
        or other health disparity populations for whom the Agency is 
        attempting to improve the quality and outcomes of care, and 
        representatives of appropriate tribal or other community-based 
        organizations with respect to health disparity populations. Such 
        research strategies and mechanisms may include the use of--
                    ``(A) centers of excellence that can demonstrate, 
                either individually or through consortia, a combination 
                of multi-disciplinary expertise in outcomes or quality 
                improvement research, linkages to relevant sites of 
                care, and a demonstrated capacity to involve members and 
                communities of health disparity populations, including 
                minority health disparity populations, in the planning, 
                conduct, dissemination, and translation of research;
                    ``(B) provider-based research networks, including 
                health plans, facilities, or delivery system sites of 
                care (especially primary care), that make extensive use 
                of health care providers who are members of health 
                disparity populations or who serve patients in such 
                populations and have the capacity to evaluate and 
                promote quality improvement;
                    ``(C) service delivery models (such as health 
                centers under section 330 and the Indian Health Service) 
                to reduce health disparities; and
                    ``(D) innovative mechanisms or strategies that will 
                facilitate the translation of past research investments 
                into clinical practices that can reasonably be expected 
                to benefit these populations.

    ``(c) Quality Measurement Development.--
            ``(1) In general.--To ensure that health disparity 
        populations, including minority health disparity populations, 
        benefit from the progress made in the ability of individuals to 
        measure the quality of health care delivery, the Director shall 
        support the development of quality of health care measures that 
        assess the experience of such populations with health care 
        systems, such as measures that assess the access of such 
        populations to health care, the cultural competence of the care 
        provided, the quality of the care provided, the outcomes of 
        care, or other aspects of health care practice that the Director 
        determines to be important.
            ``(2) Examination of certain practices.--The Director shall 
        examine the practices of providers that have a record of 
        reducing health disparities or have experience in providing

[[Page 114 STAT. 2507]]

        culturally competent health services to minority health 
        disparity populations or other health disparity populations. In 
        examining such practices of providers funded under the 
        authorities of this Act, the Director shall consult with the 
        heads of the relevant agencies of the Public Health Service.
            ``(3)  <<NOTE: Deadline.>> Report.--Not later than 36 months 
        after the date of the enactment of this section, the Secretary, 
        acting through the Director, shall prepare and submit to the 
        appropriate committees of Congress a report describing the 
        state-of-the-art of quality measurement for minority and other 
        health disparity populations that will identify critical unmet 
        needs, the current activities of the Department to address those 
        needs, and a description of related activities in the private 
        sector.

    ``(d) Definition.--For purposes of this section:
            ``(1) The term `health disparity population' has the meaning 
        given such term in section 485E, except that in addition to the 
        meaning so given, the Director may determine that such term 
        includes populations for which there is a significant disparity 
        in the quality, outcomes, cost, or use of health care services 
        or access to or satisfaction with such services as compared to 
        the general population.
            ``(2) The term `minority', with respect to populations, 
        refers to racial and ethnic minority groups as defined in 
        section 1707.''.

    (b) Funding.--Section 927 of the Public Health Service Act (42 
U.S.C. 299c-6) is amended by adding at the end the following:
    ``(d) Health Disparities Research.--For the purpose of carrying out 
the activities under section 903, there are authorized to be 
appropriated $50,000,000 for fiscal year 2001, and such sums as may be 
necessary for each of the fiscal years 2002 through 2005.''.

        TITLE III--DATA COLLECTION RELATING TO RACE OR ETHNICITY

SEC. 301. <<NOTE: 42 USC 3501 note.>> STUDY AND REPORT BY NATIONAL 
            ACADEMY OF SCIENCES.

    (a) Study.--The National Academy of Sciences shall conduct a 
comprehensive study of the Department of Health and Human Services' data 
collection systems and practices, and any data collection or reporting 
systems required under any of the programs or activities of the 
Department, relating to the collection of data on race or ethnicity, 
including other Federal data collection systems (such as the Social 
Security Administration) with which the Department interacts to collect 
relevant data on race and ethnicity.
    (b)  <<NOTE: Deadline.>> Report.--Not later than 1 year after the 
date of enactment of this Act, the National Academy of Sciences shall 
prepare and submit to the Committee on Health, Education, Labor, and 
Pensions of the Senate and the Committee on Commerce of the House of 
Representatives, a report that--
            (1) identifies the data needed to support efforts to 
        evaluate the effects of socioeconomic status, race and ethnicity 
        on access to health care and other services and on disparity in 
        health and other social outcomes and the data needed to enforce 
        existing protections for equal access to health care;
            (2) examines the effectiveness of the systems and practices 
        of the Department of Health and Human Services described in 
        subsection (a), including pilot and demonstration projects

[[Page 114 STAT. 2508]]

        of the Department, and the effectiveness of selected systems and 
        practices of other Federal, State, and tribal agencies and the 
        private sector, in collecting and analyzing such data;
            (3) contains recommendations for ensuring that the 
        Department of Health and Human Services, in administering its 
        entire array of programs and activities, collects, or causes to 
        be collected, reliable and complete information relating to race 
        and ethnicity; and
            (4) includes projections about the costs associated with the 
        implementation of the recommendations described in paragraph 
        (3), and the possible effects of the costs on program 
        operations.

    (c) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary for fiscal year 2001.

                 TITLE IV--HEALTH PROFESSIONS EDUCATION

SEC. 401. HEALTH PROFESSIONS EDUCATION IN HEALTH DISPARITIES.

    (a) In General.--Part B of title VII of the Public Health Service 
Act (42 U.S.C. 293 et seq.) is amended by inserting after section 740 
the following:

``SEC. 741. <<NOTE: 42 USC 293e.>> GRANTS FOR HEALTH PROFESSIONS 
            EDUCATION.

    ``(a) Grants for Health Professions Education in Health Disparities 
and Cultural Competency.--
            ``(1) In general.--The Secretary, acting through the 
        Administrator of the Health Resources and Services 
        Administration, may make awards of grants, contracts, or 
        cooperative agreements to public and nonprofit private entities 
        (including tribal entities) for the purpose of carrying out 
        research and demonstration projects (including research and 
        demonstration projects for continuing health professions 
        education) for training and education of health professionals 
        for the reduction of disparities in health care outcomes and the 
        provision of culturally competent health care.
            ``(2) Eligible entities.--Unless specifically required 
        otherwise in this title, the Secretary shall accept applications 
        for grants or contracts under this section from health 
        professions schools, academic health centers, State or local 
        governments, or other appropriate public or private nonprofit 
        entities (or consortia of entities, including entities promoting 
        multidisciplinary approaches) for funding and participation in 
        health professions training activities. The Secretary may accept 
        applications from for-profit private entities as determined 
        appropriate by the Secretary.

    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out subsection (a), $3,500,000 for fiscal year 
2001, $7,000,000 for fiscal year 2002, $7,000,000 for fiscal year 2003, 
and $3,500,000 for fiscal year 2004.''.
    (b) Nursing Education.--Part A of title VIII of the Public Health 
Service Act (42 U.S.C. 296 et seq.) is amended--
            (1) by redes <<NOTE: 42 USC 296f.>> ignating section 807 as 
        section 808; and
            (2) by inser <<NOTE: 42 USC 296e-1.>> ting after section 806 
        the following:

[[Page 114 STAT. 2509]]

``SEC. 807. GRANTS FOR HEALTH PROFESSIONS EDUCATION.

    ``(a) Grants for Health Professions Education in Health Disparities 
and Cultural Competency.--The Secretary, acting through the 
Administrator of the Health Resources and Services Administration, may 
make awards of grants, contracts, or cooperative agreements to eligible 
entities for the purpose of carrying out research and demonstration 
projects (including research and demonstration projects for continuing 
health professions education) for training and education for the 
reduction of disparities in health care outcomes and the provision of 
culturally competent health care. Grants under this section shall be the 
same as provided in section 741.''.
    ``(b) Authorization of Appropriations.--There are to be appropriated 
to carry out subsection (a) such sums as may be necessary for each of 
the fiscal years 2001 through 2004.''.
SEC. 402. NATIONAL CONFERE <<NOTE: 42 USC 293e note.>> NCE ON 
                        HEALTH PROFESSIONS EDUCATION AND HEALTH 
                        DISPARITIES.

    (a)  <<NOTE: Deadline.>> In General.--Not later than 1 year after 
the date of enactment of this Act, the Secretary of Health and Human 
Services (in this section referred to as the ``Secretary''), acting 
through the Administrator of the Health Resources and Services 
Administration, shall convene a national conference on health 
professions education as a method for reducing disparities in health 
outcomes.

    (b) Participants.--The Secretary shall include in the national 
conference convened under subsection (a) advocacy groups and educational 
entities as described in section 741 of the Public Health Service Act 
(as added by section 401), tribal health programs, health centers under 
section 330 of such Act, and other interested parties.
    (c) Issues.--The national conference convened under subsection (a) 
shall include, but is not limited to, issues that address the role and 
impact of health professions education on the reduction of disparities 
in health outcomes, including the role of education on cultural 
competency. The conference shall focus on methods to achieve reductions 
in disparities in health outcomes through health professions education 
(including continuing education programs) and strategies for outcomes 
measurement to assess the effectiveness of education in reducing 
disparities.
    (d)  <<NOTE: Deadline. Federal Register, publication.>> Publication 
of Findings.--Not later than 6 months after the national conference 
under subsection (a) has convened, the Secretary shall publish in the 
Federal Register a summary of the proceedings and findings of the 
conference.

    (e) Authorization of Appropriations.--There is authorized to be 
appropriated such sums as may be necessary to carry out this section.
SEC. 403. ADVISORY RESPONSIBILITIES IN HEALTH PROFESSIONS 
                        EDUCATION IN HEALTH DISPARITIES AND 
                        CULTURAL COMPETENCY.

    Section 1707 of the Public Health Service Act (42 U.S.C. 300u-6) is 
amended--
            (1) in subsection (b), by adding at the end the following 
        paragraph:
            ``(10) Advise in matters related to the development, 
        implementation, and evaluation of health professions education 
        in decreasing disparities in health care outcomes, including

[[Page 114 STAT. 2510]]

        cultural competency as a method of eliminating health 
        disparities.'';
            (2) in subsection (c)(2), by striking ``paragraphs (1) 
        through (9)'' and inserting ``paragraphs (1) through (10)''; and
            (3) in subsection (d), by amending paragraph (1) to read as 
        follows:
            ``(1) Recommendations regarding language.--
                    ``(A) Proficiency in speaking english.--The Deputy 
                Assistant Secretary shall consult with the Director of 
                the Office of International and Refugee Health, the 
                Director of the Office of Civil Rights, and the 
                Directors of other appropriate departmental entities 
                regarding recommendations for carrying out activities 
                under subsection (b)(9).
                    ``(B) Health professions education regarding health 
                disparities.--The Deputy Assistant Secretary shall carry 
                out the duties under subsection (b)(10) in collaboration 
                with appropriate personnel of the Department of Health 
                and Human Services, other Federal agencies, and other 
                offices, centers, and institutions, as appropriate, that 
                have responsibilities under the Minority Health and 
                Health Disparities Research and Education Act of 
                2000.''.

  TITLE V--PUBLIC AWARENESS AND DISSEMINATION OF INFORMATION ON HEALTH 
                               DISPARITIES

SEC. 501. <<NOTE: 42 USC 287c-31 note.>> PUBLIC AWARENESS AND 
            INFORMATION DISSEMINATION.

    (a) Public Awareness on Health Disparities.--The Secretary of Health 
and Human Services (in this section referred to as the ``Secretary'') 
shall conduct a national campaign to inform the public and health care 
professionals about health disparities in minority and other underserved 
populations by disseminating information and materials available on 
specific diseases affecting these populations and programs and 
activities to address these disparities. The campaign shall--
            (1) have a specific focus on minority and other underserved 
        communities with health disparities; and
            (2) include an evaluation component to assess the impact of 
        the national campaign in raising awareness of health disparities 
        and information on available resources.

    (b) Dissemination of Information on Health Disparities.--The 
Secretary shall develop and implement a plan for the dissemination of 
information and findings with respect to health disparities under titles 
I, II, III, and IV of this Act. The plan shall--
            (1) include the participation of all agencies of the 
        Department of Health and Human Services that are responsible for 
        serving populations included in the health disparities research; 
        and
            (2) have agency-specific strategies for disseminating 
        relevant findings and information on health disparities and 
        improving health care services to affected communities.

[[Page 114 STAT. 2511]]

                   TITLE VI--MISCELLANEOUS PROVISIONS

SEC. 601. DEPARTMENTAL DEFINITION REGARDING MINORITY INDIVIDUALS.

    Section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 300u-
6) is amended--
            (1) by striking ``Asian Americans and'' and inserting 
        ``Asian Americans;''; and
            (2) by inserting ``Native Hawaiians and other'' before 
        ``Pacific Islanders;''.

SEC. 602. CONFORMING PROVISION REGARDING DEFINITIONS.

    For purposes of this Act, the term ``racial and ethnic minority 
group'' has the meaning given such term in section 1707 of the Public 
Health Service Act.

SEC. 603. <<NOTE: 42 USC 281 note.>> EFFECTIVE DATE.

    This Act and the amendments made by this Act take effect October 1, 
2000, or upon the date of the enactment of this Act, whichever occurs 
later.

    Approved November 22, 2000.

LEGISLATIVE HISTORY--S. 1880 (H.R. 3250):
---------------------------------------------------------------------------

HOUSE REPORTS: No. 106-986 accompanying H.R. 3250 (Comm. on Commerce).
CONGRESSIONAL RECORD, Vol. 146 (2000):
            Oct. 26, considered and passed Senate.
            Oct. 31, considered and passed House.
WEEKLY COMPILATION OF PRESIDENTIAL DOCUMENTS, Vol. 36 (2000):
            Nov. 22, Presidential statement.

                                  <all>
```