```

[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[S. 555 Reported in Senate (RS)]

                                                       Calendar No. 121

104th CONGRESS

  1st Session

                                 S. 555

                          [Report No. 104-93]

_______________________________________________________________________

                                 A BILL

 To amend the Public Health Service Act to consolidate and reauthorize 
  health professions and minority and disadvantaged health education 
                   programs, and for other purposes.

_______________________________________________________________________

                 June 6 (legislative day, June 5), 1995

                       Reported with an amendment
                                                       Calendar No. 121
104th CONGRESS
  1st Session
                                 S. 555

                          [Report No. 104-93]

 To amend the Public Health Service Act to consolidate and reauthorize 
  health professions and minority and disadvantaged health education 
                   programs, and for other purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

               March 14 (legislative day, March 6), 1995

Mrs. Kassebaum (for herself, Mr. Kennedy, and Mr. Frist) introduced the 
 following bill; which was read twice and referred to the Committee on 
                       Labor and Human Resources

                 June 6 (legislative day, June 5), 1995

             Reported by Mrs. Kassebaum, with an amendment

_______________________________________________________________________

 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

                                 A BILL

 
 To amend the Public Health Service Act to consolidate and reauthorize 
  health professions and minority and disadvantaged health education 
                   programs, and for other purposes.
    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,
<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    (a) Short Title.--This Act may be cited as the ``Health 
Professions Education Consolidation and Reauthorization Act of 
1995''.</DELETED>
<DELETED>    (b) Table of Contents.--The table of contents for this Act 
is as follows:</DELETED>

<DELETED>Sec. 1. Short title.
<DELETED>TITLE I--HEALTH PROFESSIONS EDUCATION AND FINANCIAL ASSISTANCE 
                                PROGRAMS

       <DELETED>Subtitle A--Health Professions Education Programs

<DELETED>Sec. 101. Minority health professions grant program.
<DELETED>Sec. 102. Training in primary health care and preventive 
                            medicine.
<DELETED>Sec. 103. Enhanced health education and training.
<DELETED>Sec. 104. Health profession workforce development.
<DELETED>Sec. 105. General provisions.
<DELETED>Sec. 106. Preference and required information in certain 
                            programs.
<DELETED>Sec. 107. Definitions.
<DELETED>Sec. 108. Savings provision.
                 <DELETED>Subtitle B--Nursing Education

<DELETED>Sec. 121. Short title.
<DELETED>Sec. 122. Purpose.
<DELETED>Sec. 123. Amendments to Public Health Service Act.
<DELETED>Sec. 124. Savings provision.
<DELETED>Sec. 125. Preference and required information in certain 
                            programs.
               <DELETED>Subtitle C--Financial Assistance

  <DELETED>Part 1--National Health Service Corps Financial Assistance 
                                Programs

<DELETED>Sec. 131. General amendments with respect to federally 
                            supported loans.
<DELETED>Sec. 132. Restructuring and technical amendments.
<DELETED>Sec. 133. Definition of underserved areas.
<DELETED>Sec. 134. Conforming amendments.
           <DELETED>Part 2--School-Based Revolving Loan Funds

<DELETED>Sec. 135. Primary care loan program.
<DELETED>Sec. 136. Loans for disadvantaged students.
<DELETED>Sec. 137. Student loans regarding schools of nursing.
<DELETED>Part 3--Insured Health Education Assistance Loans to Graduate 
                                Students

<DELETED>Sec. 141. Health education assistance loan program.
        <DELETED>Part 4--Scholarships for Disadvantaged Students

<DELETED>Sec. 151. Scholarships for disadvantaged students.
              <DELETED>TITLE II--OFFICE OF MINORITY HEALTH

<DELETED>Sec. 201. Revision and extension of programs of Office of 
                            Minority Health.
                <DELETED>TITLE III--SELECTED INITIATIVES

<DELETED>Sec. 301. Programs regarding birth defects.
<DELETED>Sec. 302. Traumatic brain injury.
<DELETED>Sec. 303. State offices of rural health.
<DELETED>Sec. 304. Health services for Pacific Islanders.
<DELETED>Sec. 305. Demonstration projects regarding Alzheimer's 
                            Disease.
              <DELETED>TITLE IV--MISCELLANEOUS PROVISIONS

<DELETED>Sec. 401. Technical corrections regarding Public Law 103-183.
<DELETED>Sec. 402. Certain authorities of Centers for Disease Control 
                            and Prevention.
<DELETED>Sec. 403. Administration of certain requirements.
<DELETED>Sec. 404. Technical corrections relating to health professions 
                            programs.
<DELETED>Sec. 405. Clinical traineeships.
<DELETED>Sec. 406. Construction of regional centers for research on 
                            primates.
<DELETED>TITLE I--HEALTH PROFESSIONS EDUCATION AND FINANCIAL ASSISTANCE 
                           PROGRAMS</DELETED>

  <DELETED>Subtitle A--Health Professions Education Programs</DELETED>

<DELETED>SEC. 101. MINORITY HEALTH PROFESSIONS GRANT PROGRAM.</DELETED>

<DELETED>    (a) In General.--Part B of title VII of the Public Health 
Service Act (42 U.S.C. 293 et seq.) is amended to read as 
follows:</DELETED>

 <DELETED>``Part B--Disadvantaged Health Professions Training</DELETED>

<DELETED>``Sec. 736. Statement of purpose</DELETED>
<DELETED>    ``(a) In General.--The Secretary shall make grants to or 
enter into contracts with eligible entities for the purpose of 
establishing, enhancing, and expanding programs to increase the number 
and the quality of disadvantaged health professionals, particularly 
those who provide health services to disadvantaged populations or in 
medically underserved areas or rural areas.</DELETED>
<DELETED>    ``(b) Use of Funds.--Amounts provided under a grant or 
contract awarded under this part may be used for costs of planning, 
developing, or operating centers of excellence in minority health 
professions education, programs for assisting individuals from 
disadvantaged backgrounds to enter a health profession, minority 
faculty development, minority faculty loan repayment or fellowships, 
trainee support, technical assistance, workforce analysis, and 
dissemination of information.</DELETED>
<DELETED>    ``(c) Consortium.--Schools within a consortium that 
applies for a grant or contract under this part shall enter into an 
agreement to allocate the funds received under the grant or contract 
among such schools and expend such funds in accordance with the 
application for such grant or contract.</DELETED>
<DELETED>``Sec. 737. Preferences</DELETED>
<DELETED>    ``In awarding grants or contracts to eligible entities 
under this part, the Secretary shall give preference to--</DELETED>
        <DELETED>    ``(1) projects that involve more than one health 
        professions discipline or training institution and have an 
        above average record of retention and graduation of individuals 
        from disadvantaged backgrounds; and</DELETED>
        <DELETED>    ``(2) centers of excellence at Historically Black 
        Colleges and Universities (as defined in section 739) beginning 
        in fiscal year 1999 and for each fiscal year 
        thereafter.</DELETED>
<DELETED>``Sec. 738. Authorization of appropriation</DELETED>
<DELETED>    ``(a) In General.--There are authorized to be appropriated 
to carry out this part, $51,000,000 for fiscal year 1996, and such sums 
as may be necessary for each of the fiscal years 1997 through 
1999.</DELETED>
<DELETED>    ``(b) Set-Aside.--With respect to each of the fiscal years 
1996, 1997, and 1998, the Secretary shall set-aside 23.5 percent of the 
amount appropriated under subsection (a) in each such fiscal year for 
the purpose of making grants under section 736 to centers of excellence 
at certain Historically Black Colleges and Universities.</DELETED>
<DELETED>``Sec. 739. Definitions</DELETED>
<DELETED>    ``As used in this part:</DELETED>
        <DELETED>    ``(1) Centers of excellence.--The term `centers of 
        excellence' means a health professions school that--</DELETED>
                <DELETED>    ``(A)(i) has a significant number of 
                minority individuals enrolled in the school, including 
                individuals accepted for enrollment in the 
                school;</DELETED>
                <DELETED>    ``(ii) has been effective in assisting 
                minority students of the school to complete the program 
                of education and receive the degree involved;</DELETED>
                <DELETED>    ``(iii) has been effective in recruiting 
                minority individuals to attend the school and 
                encouraging minority students of secondary educational 
                institutions to attend the health professions school; 
                and</DELETED>
                <DELETED>    ``(iv) has made significant recruitment 
                efforts to increase the number of minority individuals 
                serving in faculty or administrative positions at the 
                school; or</DELETED>
                <DELETED>    ``(B) is a center of excellence at certain 
                Historically Black Colleges and Universities.</DELETED>
        <DELETED>    ``(2) Consortium.--The term `consortium' means the 
        designated eligible entity seeking a grant under this part and 
        one or more schools of medicine, osteopathic medicine, 
        dentistry, pharmacy, nursing, allied health, public health, or 
        graduate programs in mental health practice.</DELETED>
        <DELETED>    ``(3) Eligible entities.--The term `eligible 
        entities' means schools of medicine, osteopathic medicine, 
        dentistry, pharmacy, podiatric medicine, optometry, veterinary 
        medicine, public health, or allied health or schools offering 
        graduate programs in mental health practice, State or local 
        governments, and other public or nonprofit private entities 
        determined appropriate by the Secretary that submit to the 
        Secretary an application.</DELETED>
        <DELETED>    ``(4) Historically black colleges and 
        universities.--The term `Historically Black Colleges and 
        Universities' means a school described in section 799(1) that 
        has received a contract under section 788B for fiscal year 
        1987, as such section was in effect for such fiscal 
        year.''.</DELETED>
<DELETED>    (b) Repeal.--</DELETED>
        <DELETED>    (1) In general.--Section 795 of the Public Health 
        Service Act (42 U.S.C. 295n) is repealed.</DELETED>
        <DELETED>    (2) Nontermination of authority.--The amendments 
        made by this section shall not be construed to terminate 
        agreements that, on the day before the date of enactment of 
        this Act, are in effect pursuant to section 795 of the Public 
        Health Service Act (42 U.S.C. 795) as such section existed on 
        such date. Such agreements shall continue in effect in 
        accordance with the terms of the agreements. With respect to 
        compliance with such agreements, any period of practice as a 
        provider of primary health services shall be counted towards 
        the satisfaction of the requirement of practice pursuant to 
        such section 795.</DELETED>
<DELETED>    (c) Conforming Amendments.--Section 481A(c)(3)(D)(i) of 
the Public Health Service Act (42 U.S.C. 287a-2(c)(3)(D)(i)) is amended 
by striking ``section 739'' and inserting ``part B of title 
VII''.</DELETED>

<DELETED>SEC. 102. TRAINING IN PRIMARY HEALTH CARE AND PREVENTIVE 
              MEDICINE.</DELETED>

<DELETED>    Part C of title VII of the Public Health Service Act is 
amended--</DELETED>
        <DELETED>    (1) in the part heading by striking ``Care'' and 
        inserting ``Care and Preventive Medicine'';</DELETED>
        <DELETED>    (2) by repealing section 746 and sections 748 
        through 752 (42 U.S.C. 293j and 293l through 293p); 
        and</DELETED>
        <DELETED>    (3) in section 747 (42 U.S.C. 293k)--</DELETED>
                <DELETED>    (A) by striking the section heading and 
                inserting the following:</DELETED>
<DELETED>``Sec. 747. Family medicine, general internal medicine, 
              general pediatrics, preventive medicine, and physician 
              assistants'';</DELETED>
                <DELETED>    (B) in subsection (a)--</DELETED>
                        <DELETED>    (i) in paragraph (1)--</DELETED>
                                <DELETED>    (I) by inserting ``, 
                                internal medicine, or pediatrics'' 
                                after ``family medicine''; 
                                and</DELETED>
                                <DELETED>    (II) by inserting before 
                                the semicolon the following: ``that 
                                emphasizes training for the practice of 
family medicine, general internal medicine, or general pediatrics (as 
defined in regulations promulgated by the Secretary)'';</DELETED>
                        <DELETED>    (ii) in paragraph (2), by 
                        inserting ``, general internal medicine, or 
                        pediatrics'' before the semicolon;</DELETED>
                        <DELETED>    (iii) in paragraphs (3) and (4), 
                        by inserting ``, general internal medicine 
                        (including geriatrics), or general pediatrics'' 
                        after ``family medicine'';</DELETED>
                        <DELETED>    (iv) in paragraphs (3) and (4), by 
                        inserting ``(including geriatrics) after 
                        ``family medicine'';</DELETED>
                        <DELETED>    (v) in paragraph (3), by striking 
                        ``and'' at the end thereof;</DELETED>
                        <DELETED>    (vi) in paragraph (4), by striking 
                        the period and inserting a semicolon; 
                        and</DELETED>
                        <DELETED>    (vii) by adding at the end thereof 
                        the following new paragraphs:</DELETED>
        <DELETED>    ``(5) to meet the costs of projects to plan, 
        develop, and operate or maintain programs for the training of 
        physician assistants (as defined in section 799), and for the 
        training of individuals who will teach programs to provide such 
        training; and</DELETED>
        <DELETED>    ``(6) to meet the costs of projects--</DELETED>
                <DELETED>    ``(A) to plan and develop new residency 
                training programs and to maintain or improve existing 
                residency training programs in preventive medicine, 
                that have available full-time faculty members with 
                training and experience in the fields of preventive 
                medicine; and</DELETED>
                <DELETED>    ``(B) to provide financial assistance to 
                residency trainees enrolled in such 
                programs.'';</DELETED>
                <DELETED>    (C) in paragraphs (1) and (2)(A) of 
                subsection (b), by inserting ``, general internal 
                medicine, or general pediatrics'' after ``family 
                medicine'';</DELETED>
                <DELETED>    (D) by redesignating subsections (c) and 
                (d) as subsections (d) and (e), respectively;</DELETED>
                <DELETED>    (E) by inserting after subsection (b), the 
                following new subsection:</DELETED>
<DELETED>    ``(c) Priority and Limitation.--</DELETED>
        <DELETED>    ``(1) Priority.--With respect to programs for the 
        training of interns or residents, the Secretary shall give 
        priority in awarding grants under this section to qualified 
        applicants that have a record of training the greatest 
        percentage of providers, or that have demonstrated significant 
        improvements in the percentage of providers, which enter and 
        remain in primary care practice upon completion of their first 
        period of training required to obtain initial board 
        certification. Each program shall designate the primary care 
        training positions that such program shall provide with grant 
        funding to support and for which such program shall be held 
        accountable regarding the primary care requirement set forth in 
        this section.</DELETED>
        <DELETED>    ``(2) Limitation.--With respect to programs for 
        the training and education of medical students, the Secretary 
        may only provide grants or contracts under this section to 
        administrative units in general pediatrics or general internal 
        medicine if a qualified administrative unit applicant 
        demonstrates that its medical school has--</DELETED>
                <DELETED>    ``(A) a mission statement that has a 
                primary care medical education objective;</DELETED>
                <DELETED>    ``(B) faculty role models and 
                administrative units in primary care; and</DELETED>
                <DELETED>    ``(C) required undergraduate ambulatory 
                medical student clerkships in family medicine, internal 
                medicine, and pediatrics.</DELETED>
        <DELETED>Where a medical school does not have an administrative 
        unit in family medicine clerkships in family medicine shall not 
        be required.''; and</DELETED>
                <DELETED>    (F) in subsection (e) (as so 
                redesignated)--</DELETED>
                        <DELETED>    (i) in paragraph (1), by striking 
                        ``$54,000,000'' and all that follows and 
                        inserting ``$76,000,000 for fiscal year 1996, 
                        and such sums as may be necessary for each of 
                        the fiscal years 1997 and 1999.''; 
                        and</DELETED>
                        <DELETED>    (ii) in paragraph (2)--</DELETED>
                                <DELETED>    (I) by striking ``20'' and 
                                inserting ``12''; and</DELETED>
                                <DELETED>    (II) by inserting ``for 
                                family medicine academic administrative 
                                units'' after ``under subsection 
                                (b)''.</DELETED>

<DELETED>SEC. 103. ENHANCED HEALTH EDUCATION AND TRAINING.</DELETED>

<DELETED>    Part D of title VII of the Public Health Service Act (42 
U.S.C. 294 et seq.) is amended to read as follows:</DELETED>

       <DELETED>``Part D--Area Health Education Centers</DELETED>

<DELETED>``Sec. 750. Area health education centers</DELETED>
<DELETED>    ``(a) In General.--The Secretary may award grants to and 
enter into contracts with eligible entities for projects which--
</DELETED>
        <DELETED>    ``(1) improve the recruitment, distribution, 
        supply, quality, utilization, and efficiency of personnel 
        providing health services in urban and rural areas and 
        populations that have demonstrated serious unmet health care 
        need;</DELETED>
        <DELETED>    ``(2) encourage the regionalization of educational 
        responsibilities of the health professions schools;</DELETED>
        <DELETED>    ``(3) are designed to prepare, through field 
        placements, preceptorships, the conduct or affiliation with 
        community-based primary care residency programs, agreements 
        with community-based organizations for the delivery of 
        education and training in the health professions, and other 
        programs, individuals to effectively provide health services in 
        health professional shortage areas;</DELETED>
        <DELETED>    ``(4) conduct health professions education and 
        training activities consistent with national and State 
        priorities, including geriatrics;</DELETED>
        <DELETED>    ``(5) encourage health promotion and disease 
        prevention activities;</DELETED>
        <DELETED>    ``(6) conduct interdisciplinary training and 
        practice involving other health professionals;</DELETED>
        <DELETED>    ``(7) conduct continuing education programs for 
        health professionals or coordinates with such programs; 
        and</DELETED>
        <DELETED>    ``(8) address other areas as determined 
        appropriate by the Secretary.</DELETED>
<DELETED>    ``(b) Preferences.--In awarding grants or contracts to 
eligible entities under this part, the Secretary shall give preference 
to projects that--</DELETED>
        <DELETED>    ``(1) involve more than one health professions 
        discipline or training institution;</DELETED>
        <DELETED>    ``(2) have a good record of retention and 
        graduation of individuals that enter practice in medically 
        underserved communities; and</DELETED>
        <DELETED>    ``(3) have a higher percentage of medical students 
        or residents that enter primary care practice.</DELETED>
<DELETED>    ``(c) Other Eligible Programs.--The Secretary may award 
grants or contracts under this section for the establishment of 
geriatric education centers. In making a determination to fund such 
centers the Secretary shall consider the impact the programs under 
section 747, this part, and title VIII have made in the production of 
personnel to care for geriatric populations.</DELETED>
<DELETED>    ``(d) Eligible Entities.--As used in this part, the term 
`eligible entities' means schools of medicine, osteopathic medicine, 
dentistry, pharmacy, podiatric medicine, optometry, veterinary 
medicine, public health, or allied health or schools offering graduate 
programs in mental health practice, State or local governments, and 
other public or nonprofit private entities determined appropriate by 
the Secretary that submit to the Secretary an application.</DELETED>
<DELETED>    ``(e) Geriatric Education Centers.--A geriatric education 
center shall be an accredited health professions school or program 
that--</DELETED>
        <DELETED>    ``(1) improves the training of health 
        professionals in geriatrics, including geriatric residencies, 
        traineeships, or fellowships;</DELETED>
        <DELETED>    ``(2) develops and disseminates curricula relating 
        to the treatment of the health problems of elderly 
        individuals;</DELETED>
        <DELETED>    ``(3) supports the training and retraining of 
        faculty to provide instruction in geriatrics;</DELETED>
        <DELETED>    ``(4) supports continuing education of health 
        professionals who provide geriatric care; and</DELETED>
        <DELETED>    ``(5) provides students with clinical training in 
        geriatrics in nursing homes, chronic and acute disease 
        hospitals, ambulatory care centers, and senior 
        centers.</DELETED>
<DELETED>``Sec. 751. Authorization of appropriations</DELETED>
<DELETED>    ``There are authorized to be appropriated to carry out 
this part, $39,000,000 for fiscal year 1996, such sums as may be 
necessary for each of the fiscal years 1997 and 1998, and $25,000,000 
for fiscal year 1999.''.</DELETED>

<DELETED>SEC. 104. HEALTH PROFESSION WORKFORCE DEVELOPMENT.</DELETED>

<DELETED>    (a) In General.--Part E of title VII of the Public Health 
Service Act (42 U.S.C. 294n et seq.) is amended--</DELETED>
        <DELETED>    (1) in the part heading to read as 
        follows:</DELETED>

<DELETED>``Part E--Health Profession Workforce Development'';</DELETED>

        <DELETED>    (2) by redesignating section 776 (42 U.S.C. 294n) 
        as section 761; and</DELETED>
        <DELETED>    (3) by striking sections 777 and 778 (42 U.S.C. 
        294o and 294p) and inserting the following new 
        section:</DELETED>
<DELETED>``Sec. 762. Health profession workforce development</DELETED>
<DELETED>    ``(a) In General.--The Secretary may award grants to and 
enter into contracts with eligible entities for projects to strengthen 
capacity for health professions education and practice.</DELETED>
<DELETED>    ``(b) Eligible Applicants.--Applicants eligible to obtain 
funds under subsection (a) shall include schools of medicine, 
osteopathic medicine, dentistry, veterinary medicine, pharmacy, 
podiatric medicine, chiropractic medicine, optometry, public health, or 
allied health, graduate programs in mental health practice, physician 
assistant training programs, and other public and nonprofit private 
entities.</DELETED>
<DELETED>    ``(c) Priority Areas.--In awarding grants or contracts 
under subsection (a), the Secretary shall give priority to entities 
that will use amounts provided under such grants or contracts to 
enhance the education of health professionals for purposes of--
</DELETED>
        <DELETED>    ``(1) providing care for underserved populations 
        and other high-risk groups;</DELETED>
        <DELETED>    ``(2) increasing the number of individuals who are 
        pursuing a course of study in a health professions field in 
        which there is a severe shortage of health 
        professionals;</DELETED>
        <DELETED>    ``(3) conducting health professions research and 
        data collection; and</DELETED>
        <DELETED>    ``(4) carrying out other activities in areas 
        determined appropriate by the Secretary.</DELETED>
<DELETED>    ``(d) Authorization of Appropriations.--</DELETED>
        <DELETED>    ``(1) In general.--There are authorized to be 
        appropriated to carry out this section, $20,000,000 for fiscal 
        year 1996, such sums as may be necessary for each of the fiscal 
        years 1997 and 1998, and $5,000,000 for fiscal year 
        1999.</DELETED>
        <DELETED>    ``(2) Reservation.--Of the amounts appropriated 
        under subsection (a) for a fiscal year, the Secretary may 
        reserve not more than $2,000,000 for conducting health 
        professions research and data collection in accordance with 
        section 792.''.</DELETED>
<DELETED>    (b) Health Professions Data.--The second sentence of 
section 792(a) of the Public Health Service Act (42 U.S.C. 295k(a)) is 
amended by striking ``is authorized to'' and inserting 
``shall''.</DELETED>
<DELETED>    (c) Council on Graduate Medical Education.--Section 301 of 
the Health Professions Education Extension Amendments of 1992 (Public 
Law 102-408) is amended--</DELETED>
        <DELETED>    (1) in subsection (j), by striking ``1995'' and 
        inserting ``1999'';</DELETED>
        <DELETED>    (2) in subsection (k), by striking ``1995'' and 
        inserting ``1999'';</DELETED>
        <DELETED>    (3) by adding at the end thereof the following new 
        subsection:</DELETED>
<DELETED>    ``(l) Funding.--Amounts otherwise appropriated under this 
title may be utilized by the Secretary to support the medical education 
activities of the Council.'';</DELETED>
        <DELETED>    (4) by transferring such section to part E of 
        title VII of the Public Health Service Act (as amended by 
        subsection (a));</DELETED>
        <DELETED>    (5) by redesignating such section as section 763; 
        and</DELETED>
        <DELETED>    (6) by inserting such section after section 
        762.</DELETED>

<DELETED>SEC. 105. GENERAL PROVISIONS.</DELETED>

<DELETED>    (a) In General.--</DELETED>
        <DELETED>    (1) Part F of title VII of the Public Health 
        Service Act (42 U.S.C. 295 et seq.) is repealed.</DELETED>
        <DELETED>    (2) Part G of title VII of the Public Health 
        Service Act (42 U.S.C. 295j et seq.) is amended--</DELETED>
                <DELETED>    (A) by redesignating such part as part 
                F;</DELETED>
                <DELETED>    (B) in section 791 (42 U.S.C. 295j) by 
                striking subsection (b);</DELETED>
                <DELETED>    (C) by repealing section 793 (42 U.S.C. 
                295l);</DELETED>
                <DELETED>    (D) by repealing section 798;</DELETED>
                <DELETED>    (E) by redesignating section 799 as 
                section 799B; and</DELETED>
                <DELETED>    (F) by inserting after section 794, the 
                following new sections:</DELETED>
<DELETED>``Sec. 796. Application</DELETED>
<DELETED>    ``(a) In General.--To be eligible to receive a grant or 
contract under this title, an eligible entity shall prepare and submit 
to the Secretary an application that meets the requirements of this 
section, at such time, in such manner, and containing such information 
as the Secretary may require.</DELETED>
<DELETED>    ``(b) Plan.--An application submitted under this section 
shall contain the plan of the applicant for carrying out a project with 
amounts received under this title. Such plan shall be consistent with 
relevant Federal, State, or regional program plans.</DELETED>
<DELETED>    ``(c) Performance Outcome Standards.--An application 
submitted under this section shall contain a specification by the 
applicant entity of performance outcome standards that the project to 
be funded under the grant or contract will be measured against. Such 
standards shall address relevant health workforce needs that the 
project will meet. The recipient of a grant or contract under this 
section shall meet the standards set forth in the grant or contract 
application.</DELETED>
<DELETED>    ``(d) Linkages.--An application submitted under this 
section shall contain a description of the linkages with relevant 
educational and health care entities, including training programs for 
other health professionals as appropriate, that the project to be 
funded under the grant or contract will establish.</DELETED>
<DELETED>``Sec. 797. Use of funds</DELETED>
<DELETED>    ``(a) In General.--Amounts provided under a grant or 
contract awarded under this title may be used for training program 
development and support, faculty development, model demonstrations, 
trainee support including tuition, books, program fees and reasonable 
living expenses during the period of training, technical assistance, 
workforce analysis, and dissemination of information, as appropriate to 
meet recognized health workforce objectives, in accordance with this 
title.</DELETED>
<DELETED>    ``(b) Maintenance of Effort.--With respect to activities 
for which a grant awarded under this title is to be expended, the 
entity shall 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 entity for the fiscal year preceding the 
fiscal year for which the entity receives such a grant.</DELETED>
<DELETED>``Sec. 798. Matching requirement</DELETED>
<DELETED>    ``The Secretary may require that an entity that applies 
for a grant or contract under this title provide non-Federal matching 
funds, as appropriate, to ensure the institutional commitment of the 
entity to the projects funded under the grant. As determined by the 
Secretary, such non-Federal matching funds may be provided directly or 
through donations from public or private entities and may be in cash or 
in-kind, fairly evaluated, including plant, equipment, or 
services.</DELETED>
<DELETED>``Sec. 799. Generally applicable provisions</DELETED>
<DELETED>    ``(a) Awarding of Grants and Contracts.--The Secretary 
shall ensure that grants and contracts under this title are awarded on 
a competitive basis, as appropriate, to carry out innovative 
demonstration projects or provide for strategic workforce 
supplementation activities as needed to meet health workforce goals and 
in accordance with this title.</DELETED>
<DELETED>    ``(b) Information Requirements.--Recipients of grants and 
contracts under this title shall meet information requirements as 
specified by the Secretary.</DELETED>
<DELETED>    ``(c) Training Programs.--Training programs conducted with 
amounts received under this title shall meet applicable accreditation 
and quality standards.</DELETED>
<DELETED>    ``(d) Duration of Assistance.--</DELETED>
        <DELETED>    ``(1) In general.--Subject to paragraph (2), in 
        the case of an award to an entity of a grant, cooperative 
        agreement, or contract under this title, the period during 
        which payments are made to the entity under the award may not 
        exceed 5 years. The provision of payments under the award shall 
        be subject to annual approval by the Secretary of the payments 
        and subject to the availability of appropriations for the 
        fiscal year involved to make the payments. This paragraph may 
        not be construed as limiting the number of awards under the 
        program involved that may be made to the entity.</DELETED>
        <DELETED>    ``(2) Limitation.--In the case of an award to an 
        entity of a grant, cooperative agreement, or contract under 
        this title, paragraph (1) shall apply only to the extent not 
        inconsistent with any other provision of this title that 
        relates to the period during which payments may be made under 
        the award.</DELETED>
<DELETED>    ``(e) Peer Review Regarding Certain Programs.--Each 
application for a grant under this title, except any scholarship or 
loan program, including those under sections 701, 721, or 723, shall be 
submitted to a peer review group for an evaluation of the merits of the 
proposals made in the application. The Secretary may not approve such 
an application unless a peer review group has recommended the 
application for approval. Each peer review group under this subsection 
shall be composed principally of individuals who are not officers or 
employees of the Federal Government. This subsection shall be carried 
out by the Secretary acting through the Administrator of the Health 
Resources and Services Administration.</DELETED>
<DELETED>    ``(f) Preference Considerations.--In considering a 
preference for funding which is based on outcome measures for an 
eligible entity under this title, the Secretary shall also consider the 
future ability of the eligible entity to meet the outcome preference 
through improvements in the eligible entity's program design.</DELETED>
<DELETED>``Sec. 799A. Technical assistance</DELETED>
<DELETED>    ``Funds appropriated under this title may be used by the 
Secretary to provide technical assistance in relation to any of the 
authorities under this title.''.</DELETED>
<DELETED>    (b) Conforming Amendments.--Section 791(a)(2) of the 
Public Health Service Act (42 U.S.C. 295j(a)) is amended by inserting 
``as such section existed one day prior to the date of enactment of the 
Health Professions Education Consolidation and Reauthorization Act of 
1995'' before the period.</DELETED>

<DELETED>SEC. 106. PREFERENCE AND REQUIRED INFORMATION IN CERTAIN 
              PROGRAMS.</DELETED>

<DELETED>    (a) In General.--Section 791 of the Public Health Service 
Act (42 U.S.C. 295j) is amended by adding at the end thereof the 
following subsection:</DELETED>
<DELETED>    ``(d) Exceptions.--</DELETED>
        <DELETED>    ``(1) In general.--To permit new programs to 
        compete equitably for funding under this section, those new 
        programs that meet the criteria described in paragraph (3) 
        shall qualify for a funding preference under this 
        section.</DELETED>
        <DELETED>    ``(2) Definition.--As used in this subsection, the 
        term `new program' means any program that has graduated less 
        than three classes. Upon graduating at least three classes, a 
        program shall have the capability to provide the information 
        necessary to qualify the program for the general funding 
        preferences described in subsection (a).</DELETED>
        <DELETED>    ``(3) Criteria.--The criteria referred to in 
        paragraph (1) are the following:</DELETED>
                <DELETED>    ``(A) The mission statement of the program 
                identifies a specific purpose of the program as being 
                the preparation of health professionals to serve 
                underserved populations.</DELETED>
                <DELETED>    ``(B) The curriculum of the program 
                includes content which will help to prepare 
                practitioners to serve underserved 
                populations.</DELETED>
                <DELETED>    ``(C) Substantial clinical training 
                experience is required under the program in medically 
                underserved communities.</DELETED>
                <DELETED>    ``(D) A minimum of 20 percent of the 
                clinical faculty of the program spend at least 50 
                percent of their time providing or supervising care in 
                medically underserved communities.</DELETED>
                <DELETED>    ``(E) The entire program or a substantial 
                portion of the program is physically located in a 
                medically underserved community.</DELETED>
                <DELETED>    ``(F) Student assistance, which is linked 
                to service in medically underserved communities 
                following graduation, is available to the students in 
                the program.</DELETED>
                <DELETED>    ``(G) The program provides a placement 
                mechanism for deploying graduates to medically 
                underserved communities.''.</DELETED>
<DELETED>    (b) Conforming Amendments.--Section 791(a) of the Public 
Health Service Act (42 U.S.C. 295j(a)) is amended--</DELETED>
        <DELETED>    (1) in paragraph (1), by striking ``sections 747'' 
        and all that follows through ``767'' and inserting ``section 
        747''; and</DELETED>
        <DELETED>    (2) in paragraph (2), by striking ``under section 
        798(a)''.</DELETED>

<DELETED>SEC. 107. DEFINITIONS.</DELETED>

<DELETED>    Section 799B(6) of the Public Health Service Act (42 
U.S.C. 295p(6)) (as so redesignated by section 105(a)(2)(E)) is 
amended--</DELETED>
        <DELETED>    (1) in subparagraph (B), by striking ``or'' at the 
        end thereof;</DELETED>
        <DELETED>    (2) in subparagraph (C), by striking the period 
        and inserting ``; or''; and</DELETED>
        <DELETED>    (3) by adding at the end the following new 
        subparagraph:</DELETED>
                <DELETED>    ``(D) is a State or local health 
                department that has a severe shortage of public health 
                personnel as determined under criteria established by 
                the Secretary.''.</DELETED>

<DELETED>SEC. 108. SAVINGS PROVISION.</DELETED>

<DELETED>    In the case of any authority for making awards of grants 
or contracts that is terminated by the amendments made by this 
subtitle, the Secretary of Health and Human Services may, 
notwithstanding the termination of the authority, continue in effect 
any grant or contract made under the authority that is in effect on the 
day before the date of the enactment of this Act, subject to the 
duration of any such grant or contract not exceeding the period 
determined by the Secretary in first approving such financial 
assistance, or in approving the most recent request made (before the 
date of such enactment) for continuation of such assistance, as the 
case may be.</DELETED>

            <DELETED>Subtitle B--Nursing Education</DELETED>

<DELETED>SEC. 121. SHORT TITLE.</DELETED>

<DELETED>    This title may be cited as the ``Nursing Education 
Consolidation and Reauthorization Act of 1995''.</DELETED>

<DELETED>SEC. 122. PURPOSE.</DELETED>

<DELETED>    It is the purpose of this title to restructure the nurse 
education authorities of title VIII of the Public Health Service Act to 
permit a comprehensive, flexible, and effective approach to Federal 
support for nursing workforce development.</DELETED>

<DELETED>SEC. 123. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.</DELETED>

<DELETED>    Title VIII of the Public Health Service Act (42 U.S.C. 
296k et seq.) is amended--</DELETED>
        <DELETED>    (1) by striking the title heading and all that 
        follows except for subparts II and III of part B and sections 
        855 and 860; and inserting the following:</DELETED>

   <DELETED>``TITLE VIII--NURSING WORKFORCE DEVELOPMENT'';</DELETED>

        <DELETED>    (2) in subpart II of part B, by striking the 
        subpart heading and inserting the following:</DELETED>

               <DELETED>``Part E--Student Loans</DELETED>

           <DELETED>``subpart i--general program'';</DELETED>

        <DELETED>    (3) by redesignating subpart III as subpart 
        II;</DELETED>
        <DELETED>    (4) by striking section 837;</DELETED>
        <DELETED>    (5) by inserting after the title heading the 
        following new parts:</DELETED>

            <DELETED>``Part A--General Provisions</DELETED>

<DELETED>``Sec. 801. Definitions</DELETED>
<DELETED>    ``As used in this title:</DELETED>
        <DELETED>    ``(1) Eligible entities.--The term `eligible 
        entities' means schools of nursing, nursing centers, State or 
        local governments, and other public or nonprofit private 
        entities determined appropriate by the Secretary that submit to 
        the Secretary an application in accordance with section 
        802.</DELETED>
        <DELETED>    ``(2) School of nursing.--The term `school of 
        nursing' means a collegiate, associate degree, or diploma 
        school of nursing in a State.</DELETED>
        <DELETED>    ``(3) Collegiate school of nursing.--The term 
        `collegiate school of nursing' means a department, division, or 
        other administrative unit in a college or university which 
        provides primarily or exclusively a program of education in 
        professional nursing and related subjects leading to the degree 
        of bachelor of arts, bachelor of science, bachelor of nursing, 
        or to an equivalent degree, or to a graduate degree in nursing, 
        and including advanced training related to such program of 
        education provided by such school, but only if such program, or 
        such unit, college or university is accredited.</DELETED>
        <DELETED>    ``(4) Associate degree school of nursing.--The 
        term `associate degree school of nursing' means a department, 
        division, or other administrative unit in a junior college, 
        community college, college, or university which provides 
        primarily or exclusively a two-year program of education in 
        professional nursing and allied subjects leading to an 
        associate degree in nursing or to an equivalent degree, but 
only if such program, or such unit, college, or university is 
accredited.</DELETED>
        <DELETED>    ``(5) Diploma school of nursing.--The term 
        `diploma school of nursing' means a school affiliated with a 
        hospital or university, or an independent school, which 
        provides primarily or exclusively a program of education in 
        professional nursing and allied subjects leading to a diploma 
        or to equivalent indicia that such program has been 
        satisfactorily completed, but only if such program, or such 
        affiliated school or such hospital or university or such 
        independent school is accredited.</DELETED>
        <DELETED>    ``(6) Accredited.--</DELETED>
                <DELETED>    ``(A) In general.--Except as provided in 
                subparagraph (B), the term `accredited' when applied to 
                any program of nurse education means a program 
                accredited by a recognized body or bodies, or by a 
                State agency, approved for such purpose by the 
                Secretary of Education and when applied to a hospital, 
                school, college, or university (or a unit thereof) 
                means a hospital, school, college, or university (or a 
                unit thereof) which is accredited by a recognized body 
                or bodies, or by a State agency, approved for such 
                purpose by the Secretary of Education. For the purpose 
                of this paragraph, the Secretary of Education shall 
                publish a list of recognized accrediting bodies, and of 
                State agencies, which the Secretary of Education 
                determines to be reliable authority as to the quality 
                of education offered.</DELETED>
                <DELETED>    ``(B) New programs.--A new school of 
                nursing that, by reason of an insufficient period of 
                operation, is not, at the time of the submission of an 
                application for a grant or contract under this title, 
                eligible for accreditation by such a recognized body or 
                bodies or State agency, shall be deemed accredited for 
                purposes of this title if the Secretary of Education 
                finds, after consultation with the appropriate 
                accreditation body or bodies, that there is reasonable 
                assurance that the school will meet the accreditation 
                standards of such body or bodies prior to the beginning 
                of the academic year following the normal graduation 
                date of students of the first entering class in such 
                school.</DELETED>
        <DELETED>    ``(7) Nonprofit.--The term `nonprofit' as applied 
        to any school, agency, organization, or institution means one 
        which is a corporation or association, or is owned and operated 
        by one or more corporations or associations, no part of the net 
        earnings of which inures, or may lawfully inure, to the benefit 
        of any private shareholder or individual.</DELETED>
        <DELETED>    ``(8) State.--The term `State' means a State, the 
        Commonwealth of Puerto Rico, the District of Columbia, the 
        Commonwealth of the Northern Mariana Islands, Guam, American 
        Samoa, the Virgin Islands, or the Trust Territory of the 
        Pacific Islands.</DELETED>
<DELETED>``Sec. 802. Application</DELETED>
<DELETED>    ``(a) In General.--To be eligible to receive a grant or 
contract under this title, an eligible entity shall prepare and submit 
to the Secretary an application that meets the requirements of this 
section, at such time, in such manner, and containing such information 
as the Secretary may require.</DELETED>
<DELETED>    ``(b) Plan.--An application submitted under this section 
shall contain the plan of the applicant for carrying out a project with 
amounts received under this title. Such plan shall be consistent with 
relevant Federal, State, or regional program plans.</DELETED>
<DELETED>    ``(c) Performance Outcome Standards.--An application 
submitted under this section shall contain a specification by the 
applicant entity of performance outcome standards that the project to 
be funded under the grant or contract will be measured against. Such 
standards shall address relevant national nursing needs that the 
project will meet. The recipient of a grant or contract under this 
section shall meet the standards set forth in the grant or contract 
application.</DELETED>
<DELETED>    ``(d) Linkages.--An application submitted under this 
section shall contain a description of the linkages with relevant 
educational and health care entities, including training programs for 
other health professionals as appropriate, that the project to be 
funded under the grant or contract will establish.</DELETED>
<DELETED>``Sec. 803. Use of funds</DELETED>
<DELETED>    ``(a) In General.--Amounts provided under a grant or 
contract awarded under this title may be used for training program 
development and support, faculty development, model demonstrations, 
trainee support including tuition, books, program fees and reasonable 
living expenses during the period of training, technical assistance, 
workforce analysis, and dissemination of information, as appropriate to 
meet recognized nursing objectives, in accordance with this 
title.</DELETED>
<DELETED>    ``(b) Maintenance of Effort.--With respect to activities 
for which a grant awarded under this title is to be expended, the 
entity shall 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 entity for the fiscal year preceding the 
fiscal year for which the entity receives such a grant.</DELETED>
<DELETED>``Sec. 804. Matching requirement</DELETED>
<DELETED>    ``The Secretary may require that an entity that applies 
for a grant or contract under this title provide non-Federal matching 
funds, as appropriate, to ensure the institutional commitment of the 
entity to the projects funded under the grant. Such non-Federal 
matching funds may be provided directly or through donations from 
public or private entities and may be in cash or in-kind, fairly 
evaluated, including plant, equipment, or services.</DELETED>
<DELETED>``Sec. 805. Preference</DELETED>
<DELETED>    ``In awarding grants or contracts under this title, the 
Secretary shall give preference to applicants with projects that will 
substantially benefit rural or underserved populations, or public 
health personnel shortage professions in State or local health 
departments.</DELETED>
<DELETED>``Sec. 806. Generally applicable provisions</DELETED>
<DELETED>    ``(a) Awarding of Grants and Contracts.--The Secretary 
shall ensure that grants and contracts under this title are awarded on 
a competitive basis to carry out innovative demonstration projects or 
provide for strategic workforce supplementation activities as needed to 
meet national nursing service goals and in accordance with this 
title.</DELETED>
<DELETED>    ``(b) Information Requirements.--Recipients of grants and 
contracts under this title shall meet information requirements as 
specified by the Secretary.</DELETED>
<DELETED>    ``(c) Training Programs.--Training programs conducted with 
amounts received under this title shall meet applicable accreditation 
and quality standards.</DELETED>
<DELETED>    ``(d) Duration of Assistance.--</DELETED>
        <DELETED>    ``(1) In general.--Subject to paragraph (2), in 
        the case of an award to an entity of a grant, cooperative 
        agreement, or contract under this title, the period during 
        which payments are made to the entity under the award may not 
        exceed 5 years. The provision of payments under the award shall 
        be subject to annual approval by the Secretary of the payments 
        and subject to the availability of appropriations for the 
        fiscal year involved to make the payments. This paragraph may 
        not be construed as limiting the number of awards under the 
        program involved that may be made to the entity.</DELETED>
        <DELETED>    ``(2) Limitation.--In the case of an award to an 
        entity of a grant, cooperative agreement, or contract under 
        this title, paragraph (1) shall apply only to the extent not 
        inconsistent with any other provision of this title that 
        relates to the period during which payments may be made under 
        the award.</DELETED>
<DELETED>    ``(e) Peer Review Regarding Certain Programs.--Each 
application for a grant under this title, except advanced nurse 
traineeship grants under section 811(a)(2), shall be submitted to a 
peer review group for an evaluation of the merits of the proposals made 
in the application. The Secretary may not approve such an application 
unless a peer review group has recommended the application for 
approval. Each peer review group under this subsection shall be 
composed principally of individuals who are not officers or employees 
of the Federal Government. This subsection shall be carried out by the 
Secretary acting through the Administrator of the Health Resources and 
Services Administration.</DELETED>
<DELETED>``Sec. 807. National advisory council on nurse education and 
              practice</DELETED>
<DELETED>    ``(a) Establishment.--There is hereby established a 
National Advisory Council on Nurse Education and Practice (in this 
section referred to as the `Council'), consisting of the Secretary or 
the delegate of the Secretary (who shall be an ex officio member and 
shall serve as the Chairperson), and 15 members appointed by the 
Secretary without regard to the Federal civil service laws, of which--
</DELETED>
        <DELETED>    ``(1) 2 shall be selected from full-time students 
        enrolled in schools of nursing;</DELETED>
        <DELETED>    ``(2) 3 shall be selected from the general 
        public;</DELETED>
        <DELETED>    ``(3) 2 shall be selected from practicing 
        professional nurses; and</DELETED>
        <DELETED>    ``(4) 8 shall be selected from among the leading 
        authorities in the various fields of nursing, higher, and 
        secondary education, and from representatives of hospitals and 
        other institutions and organizations which provide nursing 
        services.</DELETED>
<DELETED>A majority of the members shall be nurses. The student-members 
of the Council shall be appointed for terms of one year and shall be 
eligible for reappointment to the Council.</DELETED>
<DELETED>    ``(b) Duties.--The Council shall advise the Secretary in 
the preparation of general regulations and with respect to policy 
matters arising in the administration of this title, including the 
range of issues relating to nurse supply, education and practice 
improvement.</DELETED>
<DELETED>    ``(c) Funding.--Amounts appropriated under this title may 
be utilized by the Secretary to support the nurse education and 
practice activities of the Council.</DELETED>
<DELETED>``Sec. 808. Technical assistance</DELETED>
<DELETED>    ``Funds appropriated under this title may be used by the 
Secretary to provide technical assistance in relation to any of the 
authorities under this title.</DELETED>
<DELETED>``Sec. 809. Recovery for construction assistance</DELETED>
<DELETED>    ``(a) In General.--If at any time within 20 years (or 
within such shorter period as the Secretary may prescribe by regulation 
for an interim facility) after the completion of construction of a 
facility with respect to which funds have been paid under subpart I of 
part A (as such subpart was in effect on September 30, 1985)--
</DELETED>
        <DELETED>    ``(1) the owner of the facility ceases to be a 
        public or nonprofit school,</DELETED>
        <DELETED>    ``(2) the facility ceases to be used for the 
        training purposes for which it was constructed, or</DELETED>
        <DELETED>    ``(3) the facility is used for sectarian 
        instruction or as a place for religious worship,</DELETED>
<DELETED>the United States shall be entitled to recover from the owner 
of the facility the base amount prescribed by subsection (c)(1) plus 
the interest (if any) prescribed by subsection (c)(2).</DELETED>
<DELETED>    ``(b) Notice of Change in Status.--The owner of a facility 
which ceases to be a public or nonprofit school as described in 
paragraph (1) of subsection (a), or the owner of a facility the use of 
which changes as described in paragraph (2) or (3) of such subsection 
shall provide the Secretary written notice of such cessation or change 
of use within 10 days after the date on which such cessation or change 
of use occurs or within 30 days after the date of enactment of the 
Health Professions Training Assistance Act of 1985, whichever is 
later.</DELETED>
<DELETED>    ``(c) Amount of Recovery.--</DELETED>
        <DELETED>    ``(1) Base amount.--The base amount that the 
        United States is entitled to recover under subsection (a) is 
        the amount bearing the same ratio to the then value (as 
        determined by the agreement of the parties or in an action 
        brought in the district court of the United States for the 
        district in which the facility is situated) of the facility as 
        the amount of the Federal participation bore to the cost of the 
        construction.</DELETED>
        <DELETED>    ``(2) Interest.--</DELETED>
                <DELETED>    ``(A) In general.--The interest that the 
                United States is entitled to recover under subsection 
                (a) is the interest for the period (if any) described 
                in subparagraph (B) at a rate (determined by the 
                Secretary) based on the average of the bond equivalent 
                rates of 91-day Treasury bills auctioned during such 
                period.</DELETED>
                <DELETED>    ``(B) Time period.--The period referred to 
                in subparagraph (A) is the period beginning--</DELETED>
                        <DELETED>    ``(i) if notice is provided as 
                        prescribed by subsection (b), 191 days after 
                        the date on which the owner of the facility 
                        ceases to be a public or nonprofit school as 
                        described in paragraph (1) of subsection (a), 
                        or 191 days after the date on which the use of 
                        the facility changes as described in paragraph 
                        (2) or (3) of such subsection, or</DELETED>
                        <DELETED>    ``(ii) if notice is not provided 
                        as prescribed by subsection (b), 11 days after 
                        the date on which such cessation or change of 
                        use occurs,</DELETED>
                <DELETED>and ending on the date the amount the United 
                States is entitled to recover if collected.</DELETED>
<DELETED>    ``(d) Waiver of Rights.--The Secretary may waive the 
recovery rights of the United States under subsection (a)(2) with 
respect to a facility (under such conditions as the Secretary may 
establish by regulation) if the Secretary determines that there is good 
cause for waiving such rights.</DELETED>
<DELETED>    ``(e) Limitation on Liens.--The right of recovery of the 
United States under subsection (a) shall not, prior to judgment, 
constitute a lien on any facility.</DELETED>

   <DELETED>``Part B--Nurse Practitioners, Nurse Midwives, and Other 
                   Advanced Practice Nurses</DELETED>

<DELETED>``Sec. 811. Advanced practice nursing grants</DELETED>
<DELETED>    ``(a) In General.--The Secretary may award grants to and 
enter into contracts with eligible entities to meet the costs of--
</DELETED>
        <DELETED>    ``(1) projects that support the enhancement of 
        advanced practice nursing education and practice; and</DELETED>
        <DELETED>    ``(2) traineeships for individuals in advanced 
        practice nursing programs.</DELETED>
<DELETED>    ``(b) Definition of Advanced Practice Nurses.--For 
purposes of this section, the term `advanced practice nurses' means 
nurses trained in advanced degree programs including individuals in 
combined R.N./Master's degree programs, post-nursing master's 
certificate programs, or, in the case of nurse midwives or nurse 
anesthetists, in certificate programs that received funding under this 
title on the date that is one day prior to the date of enactment of 
this section, to serve as nurse practitioners, nurse midwives, nurse 
anesthetists, nurse educators, or public health nurses, or in other 
nurse specialties determined by the secretary to require advanced 
education.</DELETED>
<DELETED>    ``(c) Authorized Nurse Practitioner and Nurse-Midwifery 
Programs.--</DELETED>
        <DELETED>    ``(1) In general.--Nurse practitioner and nurse 
        midwifery programs eligible for support under this section are 
        educational programs for registered nurses (irrespective of the 
        type of school of nursing in which the nurses received their 
        training) that--</DELETED>
                <DELETED>    ``(A) meet guidelines prescribed by the 
                Secretary in accordance with paragraph (2); 
                and</DELETED>
                <DELETED>    ``(B) have as their objective the 
                education of nurses who will upon completion of their 
                studies in such programs, be qualified to effectively 
                provide primary health care, including primary health 
                care in homes and in ambulatory care facilities, long-
                term care facilities and other health care 
                institutions.</DELETED>
        <DELETED>    ``(2) Guidelines.--After consultation with 
        appropriate educational organizations and professional nursing 
        and medical organizations, the Secretary shall prescribe 
        guidelines for programs described in paragraph (1). Such 
        guidelines shall, as a minimum, require that such a program--
        </DELETED>
                <DELETED>    ``(A) extend for at least one academic 
                year and consist of--</DELETED>
                        <DELETED>    ``(i) supervised clinical practice 
                        directed toward preparing nurses to deliver 
                        primary health care; and</DELETED>
                        <DELETED>    ``(ii) at least four months (in 
                        the aggregate) of classroom instruction that is 
                        so directed; and</DELETED>
                <DELETED>    ``(B) have an enrollment of not less than 
                six full-time equivalent students.</DELETED>
<DELETED>    ``(d) Other Authorized Educational Programs.--The 
Secretary shall prescribe guidelines as appropriate for other advanced 
practice nurse education programs eligible for support under this 
section.</DELETED>
<DELETED>    ``(e) Traineeships.--</DELETED>
        <DELETED>    ``(1) In general.--The Secretary may not award a 
        grant to an applicant under subsection (a) unless the applicant 
        involved agrees that traineeships provided with the grant will 
        only pay all or part of the costs of--</DELETED>
                <DELETED>    ``(A) the tuition, books, and fees of the 
                program of advanced nursing practice with respect to 
                which the traineeship is provided; and</DELETED>
                <DELETED>    ``(B) the reasonable living expenses of 
                the individual during the period for which the 
                traineeship is provided.</DELETED>
        <DELETED>    ``(2) Doctoral programs.--The Secretary may not 
        obligate more than 10 percent of the traineeships under 
        subsection (a) for individuals in doctorate degree 
        programs.</DELETED>
        <DELETED>    ``(3) Special consideration.--In making awards of 
        grants and contracts under subsection (a)(2), the Secretary 
        shall give special consideration to an eligible entity that 
        agrees to expend the award to train advanced practice nurses 
        who will practice in health professional shortage areas 
        designated under section 332.</DELETED>

  <DELETED>``Part C--Increasing Nursing Workforce Diversity</DELETED>

<DELETED>``Sec. 821. Workforce diversity grants</DELETED>
<DELETED>    ``(a) In General.--The Secretary may award grants to and 
enter into contracts with eligible entities to meet the costs of 
special projects to increase nursing education opportunities for 
individuals who are from disadvantaged racial and ethnic backgrounds 
underrepresented among registered nurses by providing student 
scholarships or stipends, pre-entry preparation, and retention 
activities.</DELETED>
<DELETED>    ``(b) Guidance.--In carrying out subsection (a), the 
Secretary shall take into consideration the recommendations of the 
First and Second Invitational Congresses for Minority Nurse Leaders on 
`Caring for the Emerging Majority,' in 1992 and 1993, and consult with 
nursing associations including the American Nurses Association, the 
National League for Nursing, the American Association of Colleges of 
Nursing, the Black Nurses Association, the Association of Hispanic 
Nurses, the Association of Asian American and Pacific Islander Nurses, 
the National Nurses Association, the Native American Indian and Alaskan 
Nurses Association.</DELETED>
<DELETED>    ``(c) Required Information and Conditions for Award 
Recipients.--</DELETED>
        <DELETED>    ``(1) In general.--Recipients of awards under this 
        section may be required, where requested, to report to the 
        Secretary concerning the annual admission, retention, and 
        graduation rates for ethnic and racial minorities in the school 
        or schools involved in the projects.</DELETED>
        <DELETED>    ``(2) Falling rates.--If any of the rates reported 
        under paragraph (1) fall below the average of the two previous 
        years, the grant or contract recipient shall provide the 
        Secretary with plans for immediately improving such 
        rates.</DELETED>
        <DELETED>    ``(3) Ineligibility.--A recipient described in 
        paragraph (2) shall be ineligible for continued funding under 
        this section if the plan of the recipient fails to improve the 
        rates within the 1-year period beginning on the date such plan 
        is implemented.</DELETED>

<DELETED>``Part D--Strengthening Capacity for Basic Nurse Education and 
                           Practice</DELETED>

<DELETED>``Sec. 831. Basic nurse education and practice 
              grants</DELETED>

<DELETED>    ``(a) In General.--The Secretary may award grants to and 
enter into contracts with eligible entities for projects to strengthen 
capacity for basic nurse education and practice.</DELETED>
<DELETED>    ``(b) Priority Areas.--In awarding grants or contracts 
under this section the Secretary shall give priority to entities that 
will use amounts provided under such a grant or contract to enhance the 
education mix and utilization of the basic nursing workforce by 
strengthening programs that provide basic nurse education for purposes 
of--</DELETED>
        <DELETED>    ``(1) improving nursing services in schools and 
        other community settings;</DELETED>
        <DELETED>    ``(2) providing care for underserved populations 
        and other high-risk groups such as the elderly, individuals 
        with HIV-AIDS, substance abusers, homeless, and battered 
        women;</DELETED>
        <DELETED>    ``(3) providing case management, quality 
        improvement, delegation and supervision, other skills needed 
        under new health care systems;</DELETED>
        <DELETED>    ``(4) developing cultural competencies among 
        nurses;</DELETED>
        <DELETED>    ``(5) providing emergency health 
        services;</DELETED>
        <DELETED>    ``(6) promoting career mobility for nursing 
        personnel in a variety of training settings and cross training 
        or specialty training among diverse population groups; 
        or</DELETED>
        <DELETED>    ``(7) other priority areas as determined by the 
        Secretary.</DELETED>

      <DELETED>``Part E--Authorization of Appropriations</DELETED>

<DELETED>``Sec. 841. Authorization of appropriations</DELETED>
<DELETED>    ``There are authorized to be appropriated to carry out 
section 811, 821, and 831, $62,000,000 for fiscal year 1996, such sums 
as may be necessary in each of the fiscal years 1997 and 1998, and 
$59,000,000 for fiscal year 1999.''; and</DELETED>
        <DELETED>    (6) by redesignating sections 855 and 860 as 
        sections 810 and 810A, and transferring such sections so as to 
        appear after section 809 (as added by the amendment made by 
        paragraph (5)).</DELETED>

<DELETED>SEC. 124. SAVINGS PROVISION.</DELETED>

<DELETED>    In the case of any authority for making awards of grants 
or contracts that is terminated by the amendment made by section 123, 
the Secretary of Health and Human Services may, notwithstanding the 
termination of the authority, continue in effect any grant or contract 
made under the authority that is in effect on the day before the date 
of the enactment of this Act, subject to the duration of any such grant 
or contract not exceeding the period determined by the Secretary in 
first approving such financial assistance, or in approving the most 
recent request made (before the date of such enactment) for 
continuation of such assistance, as the case may be.</DELETED>

<DELETED>SEC. 125. PREFERENCE AND REQUIRED INFORMATION IN CERTAIN 
              PROGRAMS.</DELETED>

<DELETED>    Section 810A of the Public Health Service Act (42 U.S.C. 
298b-7) (as so redesignated by section 123(6)) is amended by adding at 
the end thereof the following subsection:</DELETED>
<DELETED>    ``(f) Exceptions.--</DELETED>
        <DELETED>    ``(1) In general.--To permit new programs to 
        compete equitably for funding under this section, those new 
        programs that meet the criteria described in paragraph (3) 
        shall qualify for a funding preference under this 
        section.</DELETED>
        <DELETED>    ``(2) Definition.--As used in this subsection, the 
        term `new program' means any program that has graduated less 
        than three classes. Upon graduating at least three classes, a 
        program shall have the capability to provide the information 
        necessary to qualify the program for the general funding 
        preferences described in subsection (a).</DELETED>
        <DELETED>    ``(3) Criteria.--The criteria referred to in 
        paragraph (1) are the following:</DELETED>
                <DELETED>    ``(A) The mission statement of the program 
                identifies a specific purpose of the program as being 
                the preparation of nurses to serve underserved 
                populations.</DELETED>
                <DELETED>    ``(B) The curriculum of the program 
                includes content which will help to prepare 
                practitioners to serve underserved 
                populations.</DELETED>
                <DELETED>    ``(C) Substantial clinical training 
                experience is required under the program in medically 
                underserved communities.</DELETED>
                <DELETED>    ``(D) A minimum of 20 percent of the 
                faculty of the program spend at least 50 percent of 
                their time providing or supervising care in medically 
                underserved communities.</DELETED>
                <DELETED>    ``(E) The entire program or a substantial 
                portion of the program is physically located in a 
                medically underserved community.</DELETED>
                <DELETED>    ``(F) Student assistance, which is linked 
                to service in medically underserved communities 
                following graduation, is available to the students in 
                the program.</DELETED>
                <DELETED>    ``(G) The program provides a placement 
                mechanism for deploying graduates to medically 
                underserved communities.''.</DELETED>

<DELETED>SEC. 126. EFFECTIVE DATE.</DELETED>

<DELETED>    This title shall take effect on October 1, 1995, or the 
date of enactment of this Act, whichever is later.</DELETED>

          <DELETED>Subtitle C--Financial Assistance</DELETED>

  <DELETED>PART 1--NATIONAL HEALTH SERVICE CORPS FINANCIAL ASSISTANCE 
                           PROGRAMS</DELETED>

<DELETED>SEC. 131. GENERAL AMENDMENTS WITH RESPECT TO FEDERALLY 
              SUPPORTED LOANS.</DELETED>

<DELETED>    (a) Loan Repayment Program.--Section 338B of the Public 
Health Service Act (42 U.S.C. 254l-1) is amended--</DELETED>
        <DELETED>    (1) in subsection (a)--</DELETED>
                <DELETED>    (A) in the matter preceding paragraph (1), 
                by inserting ``and public health disease prevention and 
                health promotion activities'' before the dash; 
                and</DELETED>
                <DELETED>    (B) in paragraph (1), by striking ``and 
                physician assistants'' and inserting ``physician 
                assistants, and public health 
                professionals'';</DELETED>
        <DELETED>    (2) in subsection (b)(1)--</DELETED>
                <DELETED>    (A) in subparagraph (A), by inserting 
                ``public health,'' after ``dentistry,'';</DELETED>
                <DELETED>    (B) in subparagraph (B), by inserting 
                ``public health,'' after ``dentistry,''; and</DELETED>
                <DELETED>    (C) in subparagraph (C), by inserting 
                ``public health,'' after ``dentistry,'';</DELETED>
        <DELETED>    (3) in subsection (c)(4)--</DELETED>
                <DELETED>    (A) in subparagraph (A), by inserting 
                ``and schools of public health'' after ``professions 
                schools'';</DELETED>
                <DELETED>    (B) in subparagraph (B)(i)--</DELETED>
                        <DELETED>    (i) by inserting ``or public 
                        health professional'' after ``and health 
                        professional''; and</DELETED>
                        <DELETED>    (ii) by inserting ``or public 
                        health disease prevention and health promotion 
                        activities'' before the period;</DELETED>
                <DELETED>    (C) in subparagraph (C)--</DELETED>
                        <DELETED>    (i) by inserting ``or public 
                        health disease prevention and health promotion 
                        activities,'' after primary health 
                        services,'';</DELETED>
                        <DELETED>    (ii) by inserting ``or public 
                        health professions'' after ``health 
                        professions''; and</DELETED>
                        <DELETED>    (iii) by inserting ``or public 
                        health professionals'' after ``health 
                        professionals'' each place that such 
                        occurs;</DELETED>
        <DELETED>    (4) in subsection (f)(1)(B)(iv), by inserting ``or 
        public health disease prevention and health promotion 
        activities'' after ``primary health services'';</DELETED>
        <DELETED>    (5) in subsection (g)(2)(A)(iii)--</DELETED>
                <DELETED>    (A) by inserting ``or public health 
                professional'' after ``the health professional''; 
                and</DELETED>
                <DELETED>    (B) by inserting ``or public health 
                disease prevention and health promotion activities'' 
                after ``primary health services''; and</DELETED>
        <DELETED>    (6) in subsection (i)(8), --</DELETED>
                <DELETED>    (A) by inserting ``or public health 
                professionals'' after ``health professionals''; 
                and</DELETED>
                <DELETED>    (B) by inserting ``or public health 
                disease prevention and health promotion activities'' 
                after ``primary health services''.</DELETED>
<DELETED>    (b) Obligated Service.--Section 338C(b)(5) of the Public 
Health Service Act (42 U.S.C. 254m(b)(5)) is amended--</DELETED>
        <DELETED>    (1) in subparagraph (A), by inserting ``public 
        health,'' after ``dentistry,''; and</DELETED>
        <DELETED>    (2) in subparagraph (E)--</DELETED>
                <DELETED>    (A) in clause (ii), by inserting ``public 
                health,'' after ``dentistry,''; and</DELETED>
                <DELETED>    (B) in clause (iii), by inserting ``public 
                health,'' after ``dentistry,''.</DELETED>
<DELETED>    (c) Authorization of Appropriations.--Section 338H of the 
Public Health Service Act (42 U.S.C. 254q) is amended to read as 
follows:</DELETED>
<DELETED>``Sec. 338h. Authorization of appropriations</DELETED>
<DELETED>    ``(a) Authorization of Appropriations.--For the purpose of 
carrying out this subpart, there are authorized to be appropriated 
$90,000,000 for fiscal year 1996 and such sums as may be necessary for 
each of the fiscal years 1997 through 2000.</DELETED>
<DELETED>    ``(b) Distribution of Amounts.--The Secretary shall 
determine the most appropriate manner in which to allocate amounts 
appropriated under subsection (a) between the programs authorized in 
chapter 1, chapter 2, and chapter 3. In determining the manner in which 
to allocate such amounts, the Secretary shall give priority to funding 
State-based programs as appropriate under chapter 3. The Secretary 
shall distribute such amounts among the various programs in such 
chapters in a manner which furthers both Federal and State needs for 
health professionals in underserved areas.''.</DELETED>
<DELETED>    (d) Grants for Loan Repayment Program.--Section 338I of 
the Public Health Service Act (42 U.S.C. 254q-1) is amended--</DELETED>
        <DELETED>    (1) in subsection (a)--</DELETED>
                <DELETED>    (A) in paragraph (1), by striking ``in 
                health professional shortage areas'' and inserting ``or 
                public health disease prevention and health promotion 
                activities in Federal health professional shortage 
                areas or approved State designated health professional 
                shortage areas''; and</DELETED>
                <DELETED>    (B) in paragraph (2)--</DELETED>
                        <DELETED>    (i) by inserting ``or public 
                        health professionals'' after ``health 
                        professionals''; and</DELETED>
                        <DELETED>    (ii) by striking ``in health 
                        professional shortage areas'' and inserting 
                        ``or public health disease prevention and 
                        health promotion activities in Federal health 
                        professional shortage areas or approved State 
                        designated health professional shortage 
                        areas'';</DELETED>
        <DELETED>    (2) in subsection (c)--</DELETED>
                <DELETED>    (A) in paragraph (1)--</DELETED>
                        <DELETED>    (i) in the paragraph heading, by 
                        striking ``federal'' and inserting ``federal or 
                        approved state''; and</DELETED>
                        <DELETED>    (ii) by inserting before the 
                        period the following: ``or approved State 
                        designated health professional shortage 
                        areas'';</DELETED>
                <DELETED>    (B) in paragraph (2), by inserting ``or 
                public health professionals'' after ``health 
                professionals'';</DELETED>
                <DELETED>    (C) in paragraph (3)--</DELETED>
                        <DELETED>    (i) in subparagraph (A)--
                        </DELETED>
                                <DELETED>    (I) in the matter 
                                preceding clause (i), by inserting ``or 
                                public health professionals'' after 
                                ``health professionals''; and</DELETED>
                                <DELETED>    (II) in clause (ii), by 
                                striking health'';</DELETED>
                        <DELETED>    (ii) in subparagraph (B)--
                        </DELETED>
                                <DELETED>    (I) in the matter 
                                preceding clause (i), by inserting ``or 
                                public health professional'' after 
                                ``health professional''; and</DELETED>
                                <DELETED>    (II) in clause (ii)--
                                </DELETED>
                                        <DELETED>    (aa) by inserting 
                                        ``or public health 
                                        professional'' after ``the 
                                        health professional''; 
                                        and</DELETED>
                                        <DELETED>    (bb) by striking 
                                        ``services in a'' and inserting 
                                        ``services or public health 
                                        disease prevention and health 
                                        promotion activities in a 
                                        Federal''; and</DELETED>
                <DELETED>    (D) by adding at the end thereof the 
                following new paragraph:</DELETED>
        <DELETED>    ``(4) Private practice.--</DELETED>
                <DELETED>    ``(A) In carrying out the program operated 
                with a grant under subsection (a), a State may waive 
                the requirement of paragraph (1) regarding the 
                assignment of a health professional if, subject to 
                subparagraph (B), the health professional enters into 
                an agreement with the State to provide primary health 
                services in a full-time private clinical practice in a 
                health professional shortage area.</DELETED>
                <DELETED>    ``(B) The Secretary may not make a grant 
                under subsection (a) unless the State involved agrees 
that, if the State provides a waiver under subparagraph (A) for a 
health professional, section 338D(b)(1) will apply to the agreement 
under such subparagraph between the State and the health professional 
to the same extent and in the same manner as such section applies to an 
agreement between the Secretary and a health professional regarding a 
full-time private clinical practice.''; and</DELETED>
        <DELETED>    (3) in subsection (h), to read as 
        follows:</DELETED>
<DELETED>    ``(h) Definitions.--Unless specifically provided 
otherwise, as used in this subpart and section 338F:</DELETED>
        <DELETED>    ``(1) Approved state designated health 
        professional shortage area.--The term `approved State 
        designated health professional shortage area' means an area 
        designated by the State as underserved using specific 
        methodology and criteria to identify such areas. Such criteria 
        and methodology shall be approved by the Secretary.</DELETED>
        <DELETED>    ``(2) Community organization.--The term `community 
        organization' means a public or nonprofit private 
        entity.</DELETED>
        <DELETED>    ``(3) Primary health care.--The term `primary 
        health care' means health services regarding family medicine, 
        general internal medicine, general pediatrics, or may include 
        obstetrics and gynecology, that are provided by physicians, 
        certified nurse practitioners, certified nurse midwives, or 
        physician assistants.</DELETED>
        <DELETED>    ``(4) State.--The term `State' means each of the 
        several States and the District of Columbia.''.</DELETED>
<DELETED>    (e) Community Scholarship Programs.--Section 338L of the 
Public Health Service Act (42 U.S.C. 254t) is amended--</DELETED>
        <DELETED>    (1) in the section heading, by striking 
        ``demonstration grants to states for''</DELETED>
        <DELETED>    (2) in subsection (a), by striking ``manpower 
        shortage areas'' and inserting ``Federal health professional 
        shortage areas and in approved State designated health 
        professional shortage areas'';</DELETED>
        <DELETED>    (3) in subsection (c)--</DELETED>
                <DELETED>    (A) in the matter preceding paragraph (1), 
                by striking ``manpower shortage areas'' and inserting 
                ``Federal health professional shortage areas and in 
                approved State designated health professional shortage 
                areas''; and</DELETED>
                <DELETED>    (B) in paragraph (2), by striking 
                ``manpower shortage areas'' and inserting ``Federal 
                health professional shortage areas and in approved 
                State designated health professional shortage 
                areas'';</DELETED>
        <DELETED>    (4) in subsection (e)(1), by striking ``manpower 
        shortage areas'' and inserting ``Federal health professional 
        shortage areas and in approved State designated health 
        professional shortage areas'';</DELETED>
        <DELETED>    (5) in subsection (f)(1)(A), by striking 
        ``manpower shortage areas'' and inserting ``Federal health 
        professional shortage areas and in approved State designated 
        health professional shortage areas'';</DELETED>
        <DELETED>    (6) in subsection (g), by striking ``manpower 
        shortage areas'' each place that such appears and inserting 
        ``Federal health professional shortage areas and in approved 
        State designated health professional shortage areas''; 
        and</DELETED>
        <DELETED>    (7) by striking subsections (j) through 
        (l).</DELETED>

<DELETED>SEC. 132. RESTRUCTURING AND TECHNICAL AMENDMENTS.</DELETED>

<DELETED>    (a) Redesignations.--Subpart III of part D of title III of 
the Public Health Service Act (42 U.S.C. 254l et seq.) is amended--
</DELETED>
        <DELETED>    (1) by redesignating sections 338J and 338K (42 
        U.S.C. 254s and 254t) as sections 338M and 338N, 
        respectively;</DELETED>
        <DELETED>    (2) by redesignating sections 338C through 338H 
        (42 U.S.C. 254m through 254q) as sections 338G through 338L, 
        respectively;</DELETED>
        <DELETED>    (3) by redesignating section 338I (as such section 
        exists one day prior to the date of enactment of this Act) (42 
        U.S.C. 254r) as section 338E;</DELETED>
        <DELETED>    (4) by redesignating section 338L (as such section 
        exists one day prior to the date of enactment of this Act) (42 
        U.S.C. 254u) as section 338F;</DELETED>
<DELETED>    (b) Consolidation of Certain Programs.--Subpart III of 
part D of title III of the Public Health Service Act (42 U.S.C. 254l et 
seq.) (as amended by subsection (a)) is further amended--</DELETED>
        <DELETED>    (1) by striking the subpart heading and inserting 
        the following:</DELETED>

     <DELETED>``subpart iii--federally supported scholarships and 
                            loans</DELETED>

   <DELETED>``CHAPTER 1--NATIONAL HEALTH SERVICE CORPS SCHOLARSHIPS 
                           PROGRAMS</DELETED>

        <DELETED>    (2) by redesignating section 338b as section 
        338c;</DELETED>
        <DELETED>    (3) by inserting before section 338c (as so 
        redesignated) the following:</DELETED>

  <DELETED>``CHAPTER 2--NATIONAL HEALTH SERVICE CORPS LOAN REPAYMENT 
                           PROGRAMS</DELETED>

      <DELETED>``Subchapter A--Loan Repayment Program'';</DELETED>

        <DELETED>and</DELETED>
        <DELETED>    (4) by inserting after section 338C (as so 
        redesignated) the following:</DELETED>

  <DELETED>``Subchapter B--Nursing Loan Repayment Program''.</DELETED>

<DELETED>    (c) Transfers and Redesignations of Nursing Loan Repayment 
Program.--Subpart III of part B of title VIII (42 U.S.C. 297n et seq.) 
is amended--</DELETED>
        <DELETED>    (1) by striking the subpart heading;</DELETED>
        <DELETED>    (2) by transferring section 846 (42 U.S.C. 297n) 
        to subchapter B of chapter 2 of subpart III of part D of title 
        III (as added by subsection (b)(4)); and</DELETED>
        <DELETED>    (3) in section 846--</DELETED>
                <DELETED>    (A) by striking the section heading and 
                inserting the following:</DELETED>
<DELETED>``Sec. 338d. Nursing loan repayment program'';</DELETED>
                <DELETED>    (B) by striking subsection (d); 
                and</DELETED>
                <DELETED>    (C) by striking subsection (g).</DELETED>
<DELETED>    (d) Transfers and Redesignations of State Loan Repayment 
and Community Scholarship Programs.--Subpart III of part D of title III 
of the Public Health Service Act (42 U.S.C. 254l et seq.) (as amended 
by subsections (a) through (c)) is further amended--</DELETED>
        <DELETED>    (1) by inserting after section 338D (as so 
        transferred and redesignated by subsection (c)(3)) the 
        following:</DELETED>

 <DELETED>``CHAPTER 3--STATE LOAN REPAYMENT AND COMMUNITY SCHOLARSHIP 
                           PROGRAMS</DELETED>

  <DELETED>``Subchapter A--State Loan Repayment Programs'';</DELETED>

        <DELETED>    (2) by transferring section 338E (as so 
        redesignated by subsection (a)(3)) to subchapter A of chapter 3 
        of such subpart (as added by paragraph (1));</DELETED>
        <DELETED>    (3) by inserting after section 338E (as 
        transferred by paragraph (2)) the following:</DELETED>

  <DELETED>``Subchapter B--Community Scholarship Programs'';</DELETED>

        <DELETED>    (4) by transferring section 338F (as so 
        redesignated by subsection (a)(4)) to subchapter B of chapter 3 
        of such subpart (as added by paragraph (3)); and</DELETED>
        <DELETED>    (5) by inserting after section 338F (as 
        transferred by paragraph (4)) the following:</DELETED>

          <DELETED>``CHAPTER 4--GENERAL PROVISIONS''</DELETED>

<DELETED>    (e) Clinical Researchers.--Paragraph (3) of section 
487E(a) of the Public Health Service Act (42 U.S.C. 288-5(a)(3)) is 
amended to read as follows:</DELETED>
        <DELETED>    ``(3) Applicability of certain provisions 
        regarding obligated service.--With respect to the National 
        Health Service Corps loan repayment program established in 
        subpart III of part D of title III, the provisions of such 
        subpart shall, except as inconsistent with this section, apply 
        to the program established in subsection (a) in the same manner 
        and to the same extent as such provisions apply to the National 
        Health Service Corps loan repayment programs.''.</DELETED>

<DELETED>SEC. 133. DEFINITION OF UNDERSERVED AREAS.</DELETED>

<DELETED>    Section 332(a)(1) of the Public Health Service Act (42 
U.S.C. 254e(a)(1)) is amended in the first sentence--</DELETED>
        <DELETED>    (1) by striking ``, or (C)'' and inserting ``, 
        (C)''; and</DELETED>
        <DELETED>    (2) by inserting before the period the following: 
        ``, or (D) a State or local health department that has a severe 
        shortage of public health personnel as determined under 
        criteria established by the Secretary''.</DELETED>

<DELETED>SEC. 134. CONFORMING AMENDMENTS.</DELETED>

<DELETED>    Title III of the Public Health Service Act (42 U.S.C. 241 
et seq.) is amended--</DELETED>
        <DELETED>    (1) in subparagraphs (A) and (B) of section 
        303(d)(4) (42 U.S.C. 242a(d)(4)(A) and (B)), by striking ``338C 
        or 338D'' each place that such occurs and inserting ``338G or 
        338H'';</DELETED>
        <DELETED>    (2) in section 331(c) (42 U.S.C. 254d(c)), by 
        striking ``338D'' and inserting ``338H'';</DELETED>
        <DELETED>    (3) in section 337(a) (42 U.S.C. 254j(a)), by 
        striking ``338G'' and inserting ``338K'';</DELETED>
        <DELETED>    (4) in 338A (42 U.S.C. 254l)--</DELETED>
                <DELETED>    (A) in subsection (c)(1)--</DELETED>
                        <DELETED>    (i) in subparagraph (A), by 
                        striking ``338D'' and inserting ``338I''; 
                        and</DELETED>
                        <DELETED>    (ii) in subparagraph (B), by 
                        striking ``338C'' and inserting 
                        ``338H'';</DELETED>
                <DELETED>    (B) in subsection (f)(3), by striking 
                ``338D'' and inserting ``338I''; and</DELETED>
                <DELETED>    (C) in subsection (i)(5)--</DELETED>
                        <DELETED>    (i) in subparagraph (A), by 
                        striking ``338E'' and inserting ``338I''; 
                        and</DELETED>
                        <DELETED>    (ii) in subparagraph (B)(ii), by 
                        striking ``338E'' and inserting 
                        ``338I'';</DELETED>
        <DELETED>    (5) in section 338B (42 U.S.C. 254l-1)--</DELETED>
                <DELETED>    (A) in subsection (c)(1)--</DELETED>
                        <DELETED>    (i) in subparagraph (A), by 
                        striking ``338E'' and inserting ``338I''; 
                        and</DELETED>
                        <DELETED>    (ii) in subparagraph (B), by 
                        striking ``338D'' and inserting 
                        ``338H'';</DELETED>
                <DELETED>    (B) in subsection (f)(1)(B)(iv), by 
                striking ``338D'' and inserting ``338H'';</DELETED>
                <DELETED>    (C) in subsection (f)(4), by striking 
                ``338E'' and inserting ``338I''; and</DELETED>
                <DELETED>    (D) in subsection (i)(7)--</DELETED>
                        <DELETED>    (i) in subparagraph (A), by 
                        striking ``338E'' and inserting ``338I''; 
                        and</DELETED>
                        <DELETED>    (ii) in subparagraph (B)(ii), by 
                        striking ``338E'' and inserting 
                        ``338I'';</DELETED>
        <DELETED>    (6) in section 338E(d)(1)(C) (as so redesignated 
        by section 102), by striking ``338J'' and inserting 
        ``338M'';</DELETED>
        <DELETED>    (7) in section 338G (as so redesignated by section 
        102)--</DELETED>
                <DELETED>    (A) in subsection (a), by striking 
                ``338D'' and inserting ``338H''; and</DELETED>
                <DELETED>    (B) in subsection (c)(2), by striking 
                ``338D'' and inserting ``338H'';</DELETED>
        <DELETED>    (8) in section 338H(a) (as so redesignated by 
        section 102), by striking ``338C'' and inserting 
        ``338G'';</DELETED>
        <DELETED>    (9) in section 338I (as so redesignated by section 
        102)--</DELETED>
                <DELETED>    (A) in subsection (b)(1)(A)--</DELETED>
                        <DELETED>    (i) by striking ``338F'' and 
                        inserting ``338K'';</DELETED>
                        <DELETED>    (ii) by striking ``338C or 338D'' 
                        and inserting ``338G or 338H'';</DELETED>
                        <DELETED>    (iii) by striking ``338C'' and 
                        inserting ``338G''; and</DELETED>
                        <DELETED>    (iv) by striking ``338D'' and 
                        inserting ``338H''; and</DELETED>
                <DELETED>    (B) in subsection (c)(1)--</DELETED>
                        <DELETED>    (i) by striking ``338F'' and 
                        inserting ``338K''; and</DELETED>
                        <DELETED>    (ii) by striking ``338C or 338D'' 
                        and inserting ``338G or 338H'';</DELETED>
        <DELETED>    (10) in section 338J(b) (as so redesignated by 
        section 102)--</DELETED>
                <DELETED>    (A) in paragraph (1), by striking ``338E'' 
                and inserting ``338I''; and</DELETED>
                <DELETED>    (B) in paragraph (2), by striking ``338I'' 
                and inserting ``338E'';</DELETED>
        <DELETED>    (11) in section 338K (as so redesignated by 
        section 102)--</DELETED>
                <DELETED>    (A) in subsection (a)(2), by striking 
                ``338D'' and inserting ``338H''; and</DELETED>
                <DELETED>    (B) in subsection (d)(1), by striking 
                ``338E'' and inserting ``338I''; and</DELETED>
        <DELETED>    (12) in section 338M(e)(1)(B)(ii)(III) (as so 
        redesignated by section 102), by striking ``338I'' and 
        inserting ``338E''.</DELETED>

      <DELETED>PART 2--SCHOOL-BASED REVOLVING LOAN FUNDS</DELETED>

<DELETED>SEC. 135. PRIMARY CARE LOAN PROGRAM.</DELETED>

<DELETED>    (a) Requirement for Schools.--Section 723(b)(1) of the 
Public Health Service Act (42 U.S.C. 292s(b)(1)), as amended by section 
2014(c)(2)(A)(ii) of Public Law 103-43 (107 Stat. 216), is amended by 
striking ``3 years before'' and inserting ``4 years before''.</DELETED>
<DELETED>    (b) Service Requirement for Primary Care Loan Borrowers.--
Section 723(a) of the Public Health Service Act (42 U.S.C. 292s(a)) is 
amended in subparagraph (B) of paragraph (1), by striking ``through the 
date on which the loan is repaid in full'' and inserting ``for 5 years 
after completing the residency program''.</DELETED>

<DELETED>SEC. 136. LOANS FOR DISADVANTAGED STUDENTS.</DELETED>

<DELETED>    (a) Authorization of Appropriations.--Section 724(f)(1) of 
the Public Health Service Act (42 U.S.C. 292t(f)(1)) is amended by 
striking ``$15,000,000 for fiscal year 1993'' and inserting 
``$8,000,000 for each of the fiscal years 1996 through 
1998''.</DELETED>
<DELETED>    (b) Repeal.--Effective October 1, 1998, paragraph (1) of 
section 724(f) of the Public Health Service Act (42 U.S.C. 292t(f)(1)) 
is repealed.</DELETED>

<DELETED>SEC. 137. STUDENT LOANS REGARDING SCHOOLS OF 
              NURSING.</DELETED>

<DELETED>    (a) In General.--Section 836(b) of the Public Health 
Service Act (42 U.S.C. 297b(b)) is amended--</DELETED>
        <DELETED>    (1) in paragraph (1), by striking the period at 
        the end and inserting a semicolon;</DELETED>
        <DELETED>    (2) in paragraph (2)--</DELETED>
                <DELETED>    (A) in subparagraph (A), by striking 
                ``and'' at the end; and</DELETED>
                <DELETED>    (B) by inserting before the semicolon at 
                the end the following: ``, and (C) such additional 
                periods under the terms of paragraph (8) of this 
                subsection'';</DELETED>
        <DELETED>    (3) in paragraph (7), by striking the period at 
        the end and inserting ``; and''; and</DELETED>
        <DELETED>    (4) by adding at the end the following 
        paragraph:</DELETED>
        <DELETED>    ``(8) pursuant to uniform criteria established by 
        the Secretary, the repayment period established under paragraph 
        (2) for any student borrower who during the repayment period 
        failed to make consecutive payments and who, during the last 12 
        months of the repayment period, has made at least 12 
        consecutive payments may be extended for a period not to exceed 
        10 years.''.</DELETED>
<DELETED>    (b) Breach of Agreements.--Subpart II of part B of title 
VIII of the Public Health Service Act (42 U.S.C. 297a et seq.) is 
amended by adding at the end thereof the following new 
section:</DELETED>
<DELETED>``Sec. 843. Breach of agreement</DELETED>
<DELETED>    ``(a) In General.--In the case of any program under this 
subpart under which an individual makes an agreement to provide health 
services for a period of time in accordance with such program in 
consideration of receiving an award of Federal funds regarding 
education as a nurse (including an award for the repayment of loans), 
the following applies if the agreement provides that this section is 
applicable:</DELETED>
        <DELETED>    ``(1) In the case of a program under this subpart 
        that makes an award of Federal funds for attending an 
        accredited program of nursing (in this section referred to as a 
        `nursing program'), the individual is liable to the Federal 
        Government for the amount of such award (including amounts 
        provided for expenses related to such attendance), and for 
        interest on such amount at the maximum legal prevailing rate, 
        if the individual--</DELETED>
                <DELETED>    ``(A) fails to maintain an acceptable 
                level of academic standing in the nursing program (as 
                indicated by the program in accordance with 
                requirements established by the Secretary);</DELETED>
                <DELETED>    ``(B) is dismissed from the nursing 
                program for disciplinary reasons; or</DELETED>
                <DELETED>    ``(C) voluntarily terminates the nursing 
                program.</DELETED>
        <DELETED>    ``(2) The individual is liable to the Federal 
        Government for the amount of such award (including amounts 
        provided for expenses related to such attendance), and for 
        interest on such amount at the maximum legal prevailing rate, 
        if the individual fails to provide health services in 
        accordance with the program under this subpart for the period 
        of time applicable under the program.</DELETED>
<DELETED>    ``(b) Waiver or Suspension of Liability.--In the case of 
an individual or health facility making an agreement for purposes of 
subsection (a), the Secretary shall provide for the waiver or 
suspension of liability under such subsection if compliance by the 
individual or the health facility, as the case may be, with the 
agreements involved is impossible, or would involve extreme hardship to 
the individual or facility, and if enforcement of the agreements with 
respect to the individual or facility would be 
unconscionable.</DELETED>
<DELETED>    ``(c) Date Certain for Recovery.--Subject to subsection 
(b), any amount that the Federal Government is entitled to recover 
under subsection (a) shall be paid to the United States not later than 
the expiration of the 3-year period beginning on the date the United 
States becomes so entitled.</DELETED>
<DELETED>    ``(d) Availability.--Amounts recovered under subsection 
(a) with respect to a program under this subpart shall be available for 
the purposes of such program, and shall remain available for such 
purposes until expended.''.</DELETED>
<DELETED>    (c) Technical Amendments.--Section 839 of the Public 
Health Service Act (42 U.S.C. 297e) is amended--</DELETED>
        <DELETED>    (1) in subsection (a)--</DELETED>
                <DELETED>    (A) by striking the matter preceding 
                paragraph (1) and inserting the following:</DELETED>
<DELETED>    ``(a) If a school terminates a loan fund established under 
an agreement pursuant to section 835(b), or if the Secretary for good 
cause terminates the agreement with the school, there shall be a 
capital distribution as follows:''; and</DELETED>
                <DELETED>    (B) in paragraph (1), by striking ``at the 
                close of September 30, 1999,'' and inserting ``on the 
                date of termination of the fund''; and</DELETED>
        <DELETED>    (2) in subsection (b), to read as 
        follows:</DELETED>
<DELETED>    ``(b) If a capital distribution is made under subsection 
(a), the school involved shall, after such capital distribution, pay to 
the Secretary, not less often than quarterly, the same proportionate 
share of amounts received by the school in payment of principal or 
interest on loans made from the loan fund established under section 
835(b) as determined by the Secretary under subsection 
(a).''.</DELETED>

<DELETED>PART 3--INSURED HEALTH EDUCATION ASSISTANCE LOANS TO GRADUATE 
                           STUDENTS</DELETED>

<DELETED>SEC. 141. HEALTH EDUCATION ASSISTANCE LOAN PROGRAM.</DELETED>

<DELETED>    (a) Health Education Assistance Loan Deferment for 
Borrowers Providing Health Services to Indians.--</DELETED>
        <DELETED>    (1) In general.--Section 705(a)(2)(C) of the 
        Public Health Service Act is amended by striking ``and (x)'' 
        and inserting ``(x) not in excess of three years, during which 
        the borrower is providing health care services to Indians 
        through an Indian health program (as defined in section 
        108(a)(2)(A) of the Indian Health Care Improvement Act (25 
        U.S.C. 1616a(a)(2)(A)); and (xi)''.</DELETED>
        <DELETED>    (2) Conforming amendments.--Section 705(a)(2)(C) 
        of the Public Health Service Act is further amended--</DELETED>
                <DELETED>    (A) in clause (xi) (as so redesignated) by 
                striking ``(ix)'' and inserting ``(x)''; and</DELETED>
                <DELETED>    (B) in the matter following such clause 
                (xi), by striking ``(x)'' and inserting 
                ``(xi)''.</DELETED>
        <DELETED>    (3) Effective date.--The amendments made by this 
        subsection shall apply with respect to services provided on or 
        after the first day of the third month that begins after the 
        date of the enactment of this Act.</DELETED>
<DELETED>    (b) Maximum Student Loan Provision.--</DELETED>
        <DELETED>    (1) In general.--Section 722(a)(1) of the Public 
        Health Service Act (42 U.S.C. 292r(a)(1)), as amended by 
        section 2014(b)(1) of Public Law 103-43, is amended by striking 
        ``the sum of'' and all that follows through the end thereof and 
        inserting ``the cost of attendance (including tuition, other 
        reasonable educational expenses, and reasonable living costs) 
        for that year at the educational institution attended by the 
        student (as determined by such educational 
        institution).''.</DELETED>
        <DELETED>    (2) Third and fourth years.--Section 722(a)(2) of 
        the Public Health Service Act (42 U.S.C. 292r(a)(2)), as 
        amended by section 2014(b)(1) of Public Law 103-43, is amended 
        by striking ``the amount $2,500'' and all that follows through 
        ``including such $2,500'' and inserting ``the amount of the 
        loan may, in the case of the third or fourth year of a student 
        at school of medicine or osteopathic medicine, be increased to 
        the extent necessary''.</DELETED>

   <DELETED>PART 4--SCHOLARSHIPS FOR DISADVANTAGED STUDENTS</DELETED>

<DELETED>SEC. 151. SCHOLARSHIPS FOR DISADVANTAGED STUDENTS.</DELETED>

<DELETED>    Part B of title VII of the Public Health Service Act (as 
amended by section 101(a)) is further amended by adding at the end 
thereof the following new section:</DELETED>
<DELETED>``Sec. 740. Scholarships for disadvantaged students</DELETED>
<DELETED>    ``(a) In General.--The Secretary may make a grant or enter 
into a contract with an eligible entity (as defined in subsection 
(f)(1)) under this section for the awarding of scholarships by schools 
to any full-time student who is an eligible individual as defined in 
subsection (f). Such scholarships may be expended only for tuition 
expenses, other reasonable educational expenses, and reasonable living 
expenses incurred in the attendance of such school, and may not, for 
any year of such attendance for which the scholarship is provided, 
provide an amount exceeding the total amount required for the 
year.</DELETED>
<DELETED>    ``(b) Preference in Providing Scholarships.--The Secretary 
may not make a grant to or enter into a contract with an entity under 
subsection (a) unless the health professions school involved agrees 
that, in providing scholarships pursuant to the grant or contract, the 
school will give preference to students for whom the costs of attending 
the school would constitute a severe financial hardship.</DELETED>
<DELETED>    ``(c) Amount of Award.--In awarding grants and contracts 
to eligible entities that are health professions schools, the Secretary 
shall give priority to eligible entities based on the proportion of 
graduating students going into primary care, the proportion of minority 
students, and the proportion of graduates working in medically 
underserved areas.</DELETED>
<DELETED>    ``(d) Maximum Scholarship Award.--The maximum scholarship 
that an individual may receive in any year from an eligible entity that 
is a health professions school shall be $3000.</DELETED>
<DELETED>    ``(e) Authorization of Appropriations.--There are 
authorized to be appropriated to carry out this section, $32,000,000 
for each of the fiscal years 1996 through 1999.</DELETED>
<DELETED>    ``(f) Definitions.--As used in this section:</DELETED>
        <DELETED>    ``(1) Eligible entities.--The term `eligible 
        entities' means an entity that--</DELETED>
                <DELETED>    ``(A) is a school of medicine, osteopathic 
                medicine, dentistry, nursing, pharmacy, podiatric 
                medicine, optometry, veterinary medicine, public 
                health, or allied health, a school offering graduate 
                programs in mental health practices, or an entity 
                providing programs offering physician assistant 
                training; and</DELETED>
                <DELETED>    ``(B) is carrying out a program for 
                recruiting and retaining students from disadvantaged 
                backgrounds, including students who are members of 
                racial and ethnic minority groups.</DELETED>
        <DELETED>    ``(2) Eligible individual.--The term `eligible 
        individual' means an individual who--</DELETED>
                <DELETED>    ``(A) is from a disadvantaged 
                background;</DELETED>
                <DELETED>    ``(B) has a financial need for a 
                scholarship; and</DELETED>
                <DELETED>    ``(C) is enrolled (or accepted for 
                enrollment) at an eligible health profession school as 
                a full-time student in a program leading to a degree in 
                a health profession.''.</DELETED>

         <DELETED>TITLE II--OFFICE OF MINORITY HEALTH</DELETED>

<DELETED>SEC. 201. REVISION AND EXTENSION OF PROGRAMS OF OFFICE OF 
              MINORITY HEALTH.</DELETED>

<DELETED>    (a) In General.--Section 1707 of the Public Health Service 
Act (42 U.S.C. 300u-6) is amended by striking subsection (b) and all 
that follows and inserting the following:</DELETED>
<DELETED>    ``(b) Duties.--With respect to improving the health of 
racial and ethnic minority groups, the Secretary, acting through the 
Deputy Assistant Secretary for Minority Health (in this section 
referred to as the `Deputy Assistant Secretary'), shall carry out the 
following:</DELETED>
        <DELETED>    ``(1) Establish short-range and long-range goals 
        and objectives and coordinate all other activities within the 
        Public Health Service that relate to disease prevention, health 
        promotion, service delivery, and research concerning such 
        individuals. The heads of each of the agencies of the Service 
        shall consult with the Deputy Assistant Secretary to ensure the 
        coordination of such activities.</DELETED>
        <DELETED>    ``(2) Carry out the following types of activities 
        by entering into interagency agreements with other agencies of 
        the Public Health Service:</DELETED>
                <DELETED>    ``(A) Support research, demonstrations and 
                evaluations to test new and innovative 
                models.</DELETED>
                <DELETED>    ``(B) Increase knowledge and understanding 
                of health risk factors.</DELETED>
                <DELETED>    ``(C) Develop mechanisms that support 
                better information dissemination, education, 
                prevention, and service delivery to individuals from 
                disadvantaged backgrounds, including individuals who 
                are members of racial or ethnic minority 
                groups.</DELETED>
                <DELETED>    ``(D) Ensure that the National Center for 
                Health Statistics collects data on the health status of 
                each minority group.</DELETED>
                <DELETED>    ``(E) With respect to individuals who lack 
                proficiency in speaking the English language, enter 
                into contracts with public and nonprofit private 
                providers of primary health services for the purpose of 
                increasing the access of the individuals to such 
                services by developing and carrying out programs to 
                provide bilingual or interpretive services.</DELETED>
        <DELETED>    ``(3) Support a national minority health resource 
        center to carry out the following:</DELETED>
                <DELETED>    ``(A) Facilitate the exchange of 
                information regarding matters relating to health 
                information and health promotion, preventive health 
                services, and education in the appropriate use of 
                health care.</DELETED>
                <DELETED>    ``(B) Facilitate access to such 
                information.</DELETED>
                <DELETED>    ``(C) Assist in the analysis of issues and 
                problems relating to such matters.</DELETED>
                <DELETED>    ``(D) Provide technical assistance with 
                respect to the exchange of such information (including 
                facilitating the development of materials for such 
                technical assistance).</DELETED>
        <DELETED>    ``(4) Carry out programs to improve access to 
        health care services for individuals with limited proficiency 
        in speaking the English language by facilitating the removal of 
        impediments to the receipt of health care that result from such 
        limitation. Activities under the preceding sentence shall 
        include conducting research and developing and evaluating model 
        projects.</DELETED>
        <DELETED>    ``(5) Not later than June 8 of each year, the 
        heads of the Public Health Service agencies shall submit to the 
        Deputy Assistant Secretary a report summarizing the minority 
        health activities of each of the respective agencies.</DELETED>
<DELETED>    ``(c) Advisory Committee.--</DELETED>
        <DELETED>    ``(1) In general.--The Secretary shall establish 
        an advisory committee to be known as the Advisory Committee on 
        Minority Health (in this subsection referred to as the 
        `Committee'). The Deputy Assistant Secretary shall consult with 
        the Committee in carrying out this section.</DELETED>
        <DELETED>    ``(2) Duties.--The Committee shall provide advice 
        to the Deputy Assistant Secretary carrying out this section, 
        including advice on the development of goals and specific 
        program activities under paragraphs (1) and (2) of subsection 
        (b) for each racial and ethnic minority group.</DELETED>
        <DELETED>    ``(3) Chair.--The Deputy Assistant Secretary shall 
        serve as the chair of the Committee.</DELETED>
        <DELETED>    ``(4) Composition.--</DELETED>
                <DELETED>    ``(A) The Committee shall be composed of 
                12 voting members appointed in accordance with 
                subparagraph (B), and nonvoting, ex officio members 
                designated in subparagraph (C).</DELETED>
                <DELETED>    ``(B) The voting members of the Committee 
                shall be appointed by the Secretary from among 
                individuals who are not officers or employees of the 
                Federal Government and who have expertise regarding 
                issues of minority health. The racial and ethnic 
                minority groups shall be equally represented among such 
                members.</DELETED>
                <DELETED>    ``(C) The nonvoting, ex officio members of 
                the Committee shall be the directors of each of the 
                minority health offices, and such additional officials 
                of the Department of Health and Human Services as the 
                Secretary determines to be appropriate.</DELETED>
        <DELETED>    ``(5) Terms.--Each member of the Committee shall 
        serve for a term of 4 years, except that the Secretary shall 
        initially appoint a portion of the members to terms of 1 year, 
        2 years, and 3 years.</DELETED>
        <DELETED>    ``(6) Vacancies.--If a vacancy occurs on the 
        Committee, a new member shall be appointed by the Secretary 
        within 90 days from the date that the vacancy occurs, and serve 
        for the remainder of the term for which the predecessor of such 
        member was appointed. The vacancy shall not affect the power of 
        the remaining members to execute the duties of the 
        Committee.</DELETED>
        <DELETED>    ``(7) Compensation.--Members of the Committee who 
        are officers or employees of the United States shall serve 
        without compensation. Members of the Committee who are not 
        officers or employees of the United States shall receive 
        compensation, for each day (including travel time) they are 
        engaged in the performance of the functions of the Committee. 
        Such compensation may not be in an amount in excess of the 
        daily equivalent of the annual maximum rate of basic pay 
        payable under the General Schedule (under title 5, United 
        States Code) for positions above GS-15.</DELETED>
<DELETED>    ``(d) Certain Requirements Regarding Duties.--</DELETED>
        <DELETED>    ``(1) Recommendations regarding language as 
        impediment to health care.--The Deputy Assistant Secretary for 
        Minority Health shall consult with the Director of the Office 
        of Refugee Health, the Director of the Office of Civil Rights, 
        and the Director of the Office of Minority Health of the Health 
        Resources and Services Administration, and other appropriate 
        offices, regarding recommendations for carrying out activities 
        under subsection (b)(4).</DELETED>
        <DELETED>    ``(2) Equitable allocation regarding activities.--
        </DELETED>
                <DELETED>    ``(A) In making awards of grants, 
                cooperative agreements, or contracts under this section 
                or section 338A, 338B, 340A, 404, or 724, or part B of 
                title VII, the Secretary, acting as appropriate through 
                the Deputy Assistant Secretary or the Administrator of 
                the Health Resources and Services Administration, shall 
                ensure that such awards are equitably allocated with 
                respect to the various racial and minority 
                populations.</DELETED>
                <DELETED>    ``(B) With respect to grants, cooperative 
                agreements, and contracts that are available under the 
                sections specified in subparagraph (A), the Secretary 
                shall--</DELETED>
                        <DELETED>    ``(i) carry out activities to 
                        inform entities, as appropriate, that the 
                        entities may be eligible for awards of such 
                        assistance;</DELETED>
                        <DELETED>    ``(ii) provide technical 
                        assistance to such entities in the process of 
                        preparing and submitting applications for the 
                        awards in accordance with the policies of the 
                        Secretary regarding such application; 
                        and</DELETED>
                        <DELETED>    ``(iii) inform populations, as 
                        appropriate, that members of the populations 
                        may be eligible to receive services or 
                        otherwise participate in the activities carried 
                        out with such awards.</DELETED>
        <DELETED>    ``(3) Cultural competency of services.--The 
        Secretary shall ensure that information and services provided 
        pursuant to subsection (b) are provided in the language, 
        educational, and cultural context that is most appropriate for 
        the individuals for whom the information and services are 
        intended.</DELETED>
<DELETED>    ``(e) Grants and Contracts Regarding Duties.--</DELETED>
        <DELETED>    ``(1) In general.--In carrying out subsection (b), 
        the Deputy Assistant Secretary may make awards of grants, 
        cooperative agreements, and contracts to public and nonprofit 
        private entities.</DELETED>
        <DELETED>    ``(2) Process for making awards.--The Deputy 
        Assistant Secretary shall ensure that awards under paragraph 
        (1) are made only on a competitive basis, and that a grant is 
        awarded for a proposal only if the proposal has been 
        recommended for such an award through a process of peer review 
        and has been so recommended by the advisory committee 
        established under subsection (c).</DELETED>
        <DELETED>    ``(3) Evaluation and dissemination.--The Deputy 
        Assistant Secretary, directly or through contracts with public 
        and private entities, shall provide for evaluations of projects 
        carried out with awards made under paragraph (1) during the 
        preceding 2 fiscal years. The report shall be included in the 
        report required under subsection (f) for the fiscal year 
        involved.</DELETED>
<DELETED>    ``(f) Biennial Reports.--Not later than February 1 of 
fiscal year 1996 and of each second year thereafter, the Deputy 
Assistant Secretary shall submit to the Committee on Energy and 
Commerce of the House of Representatives, and to the Committee on Labor 
and Human Resources of the Senate, a report describing the activities 
carried out under this section during the preceding 2 fiscal years and 
evaluating the extent to which such activities have been effective in 
improving the health of racial and ethnic minority groups. Each such 
report shall include the biennial reports submitted to the Deputy 
Assistant Secretary under section 201(b)(5) for such years by the heads 
of the Public Health Service agencies.</DELETED>
<DELETED>    ``(g) Definition.--For purposes of this section:</DELETED>
        <DELETED>    ``(1) The term `racial and ethnic minority group' 
        means American Indians (including Alaska Natives, Eskimos, and 
        Aleuts); Asian Americans and Pacific Islanders; Blacks; and 
        Hispanics.</DELETED>
        <DELETED>    ``(2) The term `Hispanic' means individuals whose 
        origin is Mexican, Puerto Rican, Cuban, Central or South 
        American, or any other Spanish-speaking country.</DELETED>
<DELETED>    ``(h) Funding.--For the purpose of carrying out this 
section, there are authorized to be appropriated $21,000,000 for fiscal 
year 1996, such sums as may be necessary for each of the fiscal years 
1997 and 1998, and $19,000,000 for fiscal year 1999.''.</DELETED>
<DELETED>    (b) Miscellaneous Amendment.--Section 1707 of the Public 
Health Service Act (42 U.S.C. 300u-6) is amended in the heading for the 
section by striking ``establishment of''.</DELETED>

           <DELETED>TITLE III--SELECTED INITIATIVES</DELETED>

<DELETED>SEC. 301. PROGRAMS REGARDING BIRTH DEFECTS.</DELETED>

<DELETED>    Section 317C of the Public Health Service Act (42 U.S.C. 
247b-4) is amended to read as follows:</DELETED>

         <DELETED>``programs regarding birth defects</DELETED>

<DELETED>    ``Sec. 317C. (a) The Secretary, acting through the 
Director of the Centers for Disease Control and Prevention, shall carry 
out programs--</DELETED>
        <DELETED>    ``(1) to collect, analyze, and make available data 
        on birth defects (in a manner that facilitates compliance with 
        subsection (d)(2)), including data on the causes of such 
        defects and on the incidence and prevalence of such defects; 
        and</DELETED>
        <DELETED>    ``(2) to operate regional centers for the conduct 
        of applied epidemiological research on the prevention of such 
        defects.</DELETED>
<DELETED>    ``(b) Additional Provisions Regarding Collection of 
Data.--</DELETED>
        <DELETED>    ``(1) In general.--In carrying out subsection 
        (a)(1), the Secretary--</DELETED>
                <DELETED>    ``(A) shall collect and analyze data by 
                gender and by racial and ethnic group, including 
                Hispanics, non-Hispanic whites, Blacks, Native 
                Americans, Asian Americans, and Pacific 
                Islanders;</DELETED>
                <DELETED>    ``(B) shall collect data under 
                subparagraph (A) from birth certificates, death 
                certificates, hospital records, and such other sources 
                as the Secretary determines to be appropriate; 
                and</DELETED>
                <DELETED>    ``(C) shall encourage States to establish 
                or improve programs for the collection and analysis of 
                epidemiological data on birth defects, and to make the 
                data available.</DELETED>
        <DELETED>    ``(2) National clearinghouse.--In carrying out 
        subsection (a)(1), the Secretary shall establish and maintain a 
        National Information Clearinghouse on Birth Defects to collect 
        and disseminate to health professionals and the general public 
        information on birth defects, including the prevention of such 
        defects.</DELETED>
<DELETED>    ``(c) Grants and Contracts.--</DELETED>
        <DELETED>    ``(1) In general.--In carrying out subsection (a), 
        the Secretary may make grants to and enter into contracts with 
        public and nonprofit private entities.</DELETED>
        <DELETED>    ``(2) Supplies and services in lieu of award 
        funds.--</DELETED>
                <DELETED>    ``(A) Upon the request of a recipient of 
                an award of a grant or contract under paragraph (1), 
                the Secretary may, subject to subparagraph (B), provide 
                supplies, equipment, and services for the purpose of 
                aiding the recipient in carrying out the purposes for 
                which the award is made and, for such purposes, may 
                detail to the recipient any officer or employee of the 
                Department of Health and Human Services.</DELETED>
                <DELETED>    ``(B) With respect to a request described 
                in subparagraph (A), the Secretary shall reduce the 
                amount of payments under the award involved by an 
                amount equal to the costs of detailing personnel and 
                the fair market value of any supplies, equipment, or 
                services provided by the Secretary. The Secretary 
                shall, for the payment of expenses incurred in 
                complying with such request, expend the amounts 
                withheld.</DELETED>
        <DELETED>    ``(3) Application for award.--The Secretary may 
        make an award of a grant or contract under paragraph (1) only 
        if an application for the award is submitted to the Secretary 
        and the application is in such form, is made in such manner, 
        and contains such agreements, assurances, and information as 
        the Secretary determines to be necessary to carry out the 
        purposes for which the award is to be made.</DELETED>
<DELETED>    ``(d) Biennial Report.--Not later than February 1 of 
fiscal year 1997 and of every second such year thereafter, the 
Secretary shall submit to the Committee on Energy and Commerce of the 
House of Representatives, and the Committee on Labor and Human 
Resources of the Senate, a report that, with respect to the preceding 2 
fiscal years--</DELETED>
        <DELETED>    ``(1) contains information regarding the incidence 
        and prevalence of birth defects and the extent to which birth 
        defects have contributed to the incidence and prevalence of 
        infant mortality;</DELETED>
        <DELETED>    ``(2) contains information under paragraph (1) 
        that is specific to various racial and ethnic groups (including 
        Hispanics, non-Hispanic whites, Blacks, Native Americans, and 
        Asian Americans);</DELETED>
        <DELETED>    ``(3) contains an assessment of the extent to 
        which various approaches of preventing birth defects have been 
        effective;</DELETED>
        <DELETED>    ``(4) describes the activities carried out under 
        this section; and</DELETED>
        <DELETED>    ``(5) contains any recommendations of the 
        Secretary regarding this section.''.</DELETED>

<DELETED>SEC. 302. TRAUMATIC BRAIN INJURY.</DELETED>

<DELETED>    (a) Programs of National Institutes of Health.--Section 
1261 of the Public Health Service Act (42 U.S.C. 300d-61) is amended--
</DELETED>
        <DELETED>    (1) in subsection (d)--</DELETED>
                <DELETED>    (A) in paragraph (2), by striking ``and'' 
                after the semicolon at the end;</DELETED>
                <DELETED>    (B) in paragraph (3), by striking the 
                period and inserting ``; and''; and</DELETED>
                <DELETED>    (C) by adding at the end the following 
                paragraph:</DELETED>
        <DELETED>    ``(4) the authority to make awards of grants or 
        contracts to public or nonprofit private entities for the 
        conduct of basic and applied research regarding traumatic brain 
        injury, which research may include--</DELETED>
                <DELETED>    ``(A) the development of new methods and 
                modalities for the more effective diagnosis, 
                measurement of degree of injury, post-injury monitoring 
                and prognostic assessment of head injury for acute, 
                subacute and later phases of care;</DELETED>
                <DELETED>    ``(B) the development, modification and 
                evaluation of therapies that retard, prevent or reverse 
                brain damage after acute head injury, that arrest 
                further deterioration following injury and that provide 
                the restitution of function for individuals with long-
                term injuries;</DELETED>
                <DELETED>    ``(C) the development of research on a 
                continuum of care from acute care through 
                rehabilitation, designed, to the extent practicable, to 
                integrate rehabilitation and long-term outcome 
                evaluation with acute care research; and</DELETED>
                <DELETED>    ``(D) the development of programs that 
                increase the participation of academic centers of 
                excellence in head injury treatment and rehabilitation 
                research and training.''; and</DELETED>
        <DELETED>    (2) in subsection (h), by adding at the end the 
        following paragraph:</DELETED>
        <DELETED>    ``(4) The term `traumatic brain injury' means an 
        acquired injury to the brain. Such term does not include brain 
        dysfunction caused by congenital or degenerative disorders, nor 
        birth trauma, but may include brain injuries caused by anoxia 
due to near drowning.''.</DELETED>
<DELETED>    (b) Programs of Health Resources and Services 
Administration.--Part E of title XII of the Public Health Service Act 
(42 U.S.C. 300d-51 et seq.) is amended by adding at the end the 
following new section:</DELETED>
<DELETED>``Sec. 1252. State grants for demonstration projects regarding 
              traumatic brain injury</DELETED>
<DELETED>    ``(a) In General.--The Secretary, acting through the 
Administrator of the Health Resources and Services Administration, may 
make grants to States for the purpose of carrying out demonstration 
projects to improve the availability of health services regarding 
traumatic brain injury.</DELETED>
<DELETED>    ``(b) State Advisory Board.--</DELETED>
        <DELETED>    ``(1) In general.--The Secretary may make a grant 
        under subsection (a) only if the State involved agrees to 
        establish an advisory board within the appropriate health 
        department of the State or within another department as 
        designated by the chief executive officer of the 
        State.</DELETED>
        <DELETED>    ``(2) Functions.--An advisory board established 
        under paragraph (1) shall be cognizant of findings and concerns 
        of Federal, State and local agencies, citizens groups, and 
        private industry (such as insurance, health care, automobile, 
        and other industry entities). Such advisory boards shall 
        encourage citizen participation through the establishment of 
        public hearings and other types of community outreach 
        programs.</DELETED>
        <DELETED>    ``(3) Composition.--An advisory board established 
        under paragraph (1) shall be composed of--</DELETED>
                <DELETED>    ``(A) representatives of--</DELETED>
                        <DELETED>    ``(i) the corresponding State 
                        agencies involved;</DELETED>
                        <DELETED>    ``(ii) public and nonprofit 
                        private health related organizations;</DELETED>
                        <DELETED>    ``(iii) other disability advisory 
                        or planning groups within the State;</DELETED>
                        <DELETED>    ``(iv) members of an organization 
                        or foundation representing traumatic brain 
                        injury survivors in that State; and</DELETED>
                        <DELETED>    ``(v) injury control programs at 
                        the State or local level if such programs 
                        exist; and</DELETED>
                <DELETED>    ``(B) a substantial number of individuals 
                who are survivors of traumatic brain injury, or the 
                family members of such individuals.</DELETED>
<DELETED>    ``(c) Matching Funds.--</DELETED>
        <DELETED>    ``(1) In general.--With respect to the costs to be 
        incurred by a State in carrying out the purpose described in 
        subsection (a), the Secretary may make a grant under such 
        subsection only if the State agrees to make available, in cash, 
        non-Federal contributions toward such costs in an amount that 
        is not less than $1 for each $2 of Federal funds provided under 
        the grant.</DELETED>
        <DELETED>    ``(2) Determination of amount contributed.--In 
        determining the amount of non-Federal contributions in cash 
        that a State has provided pursuant to paragraph (1), the 
        Secretary may not include any amounts provided to the State by 
        the Federal Government.</DELETED>
<DELETED>    ``(d) Application for Grant.--The Secretary may make a 
grant under subsection (a) only if an application for the grant is 
submitted to the Secretary and the application is in such form, is made 
in such manner, and contains such agreements, assurances, and 
information as the Secretary determines to be necessary to carry out 
this section.</DELETED>
<DELETED>    ``(e) Coordination of Activities.--The Secretary shall 
ensure that activities under this section are coordinated as 
appropriate with other agencies of the Public Health Service that carry 
out activities regarding traumatic brain injury.</DELETED>
<DELETED>    ``(f) Report.--Not later than 2 years after the date of 
enactment of this section, the Secretary shall submit to the Committee 
on Energy and Commerce of the House of Representatives, and to the 
Committee on Labor and Human Resources of the Senate, a report 
describing the findings and results of the programs established under 
this section, including measures of outcomes and consumer and surrogate 
satisfaction.</DELETED>
<DELETED>    ``(g) Definition.--For purposes of this section, the term 
`traumatic brain injury' means an acquired injury to the brain. Such 
term does not include brain dysfunction caused by congenital or 
degenerative disorders, nor birth trauma, but may include brain 
injuries caused by anoxia due to near drowning.</DELETED>
<DELETED>    ``(h) Authorization of Appropriations.--There are 
authorized to be appropriated to carry out this section, $5,000,000 for 
fiscal year 1996, and such sums as may be necessary for each of the 
fiscal years 1997 and 1998.''.</DELETED>
<DELETED>    (c) Study; Consensus Conference.--</DELETED>
        <DELETED>    (1) Study.--</DELETED>
                <DELETED>    (A) In general.--The Secretary of Health 
                and Human Services (in this subsection referred to as 
                the ``Secretary''), acting through the appropriate 
agencies of the Public Health Service, shall conduct a study for the 
purpose of carrying out the following with respect to traumatic brain 
injury:</DELETED>
                        <DELETED>    (i) In collaboration with 
                        appropriate State and local health-related 
                        agencies--</DELETED>
                                <DELETED>    (I) determine the 
                                incidence and prevalence of traumatic 
                                brain injury; and</DELETED>
                                <DELETED>    (II) develop a uniform 
                                reporting system under which States 
                                report incidence of traumatic brain 
                                injury, if the Secretary determines 
                                that such a system is 
                                appropriate.</DELETED>
                        <DELETED>    (ii) Identify common therapeutic 
                        interventions which are used for the 
                        rehabilitation of individuals with such 
                        injuries, and shall, subject to the 
                        availability of information, include an 
                        analysis of--</DELETED>
                                <DELETED>    (I) the effectiveness of 
                                each such intervention in improving the 
                                functioning of individuals with brain 
                                injuries;</DELETED>
                                <DELETED>    (II) the comparative 
                                effectiveness of interventions employed 
                                in the course of rehabilitation of 
                                individuals with brain injuries to 
                                achieve the same or similar clinical 
                                outcome; and</DELETED>
                                <DELETED>    (III) the adequacy of 
                                existing measures of outcomes and 
                                knowledge of factors influencing 
                                differential outcomes.</DELETED>
                        <DELETED>    (iii) Develop practice guidelines 
                        for the rehabilitation of traumatic brain 
                        injury at such time as appropriate scientific 
                        research becomes available.</DELETED>
                <DELETED>    (B) Dates certain for reports.--</DELETED>
                        <DELETED>    (i) Not later than 18 months after 
                        the date of enactment of this Act, the 
                        Secretary shall submit to the Committee on 
                        Commerce of the House of Representatives, and 
                        to the Committee on Labor and Human Resources 
                        of the Senate, a report describing the findings 
                        made as a result of carrying out subparagraph 
                        (A)(i).</DELETED>
                        <DELETED>    (ii) Not later than 3 years after 
                        the date of enactment of this Act, the 
                        Secretary shall submit to the Committees 
                        specified in clause (i) a report describing the 
                        findings made as a result of carrying out 
                        clauses (ii) and (iii) of subparagraph 
                        (A).</DELETED>
        <DELETED>    (2) Consensus conference.--The Secretary, acting 
        through the Director of the National Center for Medical 
        Rehabilitation Research within the National Institute for Child 
        Health and Human Development, shall conduct a national 
        consensus conference on managing traumatic brain injury and 
        related rehabilitation concerns.</DELETED>
        <DELETED>    (3) Definition.--For purposes of this subsection, 
        the term ``traumatic brain injury'' means an acquired injury to 
        the brain. Such term does not include brain dysfunction caused 
        by congenital or degenerative disorders, nor birth trauma, but 
        may include brain injuries caused by anoxia due to near 
        drowning.</DELETED>

<DELETED>SEC. 303. STATE OFFICES OF RURAL HEALTH.</DELETED>

<DELETED>    (a) In General.--Section 338M of the Public Health Service 
Act (as so redesignated by section 132) is amended--</DELETED>
        <DELETED>    (1) in subsection (b)(1), in the matter preceding 
        subparagraph (A), by striking ``in cash''; and</DELETED>
        <DELETED>    (2) in subsection (j)(1)--</DELETED>
                <DELETED>    (A) by striking ``and'' after ``1992,''; 
                and</DELETED>
                <DELETED>    (B) by inserting before the period the 
                following: ``, and such sums as may be necessary for 
                each of the fiscal years 1996 through 1997''; 
                and</DELETED>
        <DELETED>    (3) in subsection (k), by striking ``$10,000,000'' 
        and inserting ``$20,000,000''.</DELETED>
<DELETED>    (b) Repeal.--Effective on October 1, 1997, section 338M of 
the Public Health Service Act (as so redesignated by section 132) is 
repealed.</DELETED>

<DELETED>SEC. 304. HEALTH SERVICES FOR PACIFIC ISLANDERS.</DELETED>

<DELETED>    Section 10 of the Disadvantaged Minority Health 
Improvement Act of 1990 (42 U.S.C. 254c-1) is amended--</DELETED>
        <DELETED>    (1) in subsection (b)--</DELETED>
                <DELETED>    (A) in paragraph (2)--</DELETED>
                        <DELETED>    (i) by inserting ``, substance 
                        abuse'' after ``availability of health''; 
                        and</DELETED>
                        <DELETED>    (ii) by striking ``, including 
                        improved health data systems'';</DELETED>
                <DELETED>    (B) in paragraph (3)--</DELETED>
                        <DELETED>    (i) by striking ``manpower'' and 
                        inserting ``care providers''; and</DELETED>
                        <DELETED>    (ii) by striking ``by--'' and all 
                        that follows through the end thereof and 
                        inserting a semicolon;</DELETED>
                <DELETED>    (C) by striking paragraphs (5) and 
                (6);</DELETED>
                <DELETED>    (D) by redesignating paragraphs (7), and 
                (8) as paragraphs (5) and (6), respectively;</DELETED>
                <DELETED>    (E) in paragraph (5) (as so redesignated), 
                by striking ``and'' at the end thereof;</DELETED>
                <DELETED>    (F) in paragraph (6) (as so redesignated), 
                by striking the period and inserting a semicolon; 
                and</DELETED>
                <DELETED>    (G) by inserting after paragraph (6) (as 
                so redesignated), the following new 
                paragraphs:</DELETED>
        <DELETED>    ``(7) to provide primary health care, preventive 
        health care, and related training to American Samoan health 
        care professionals; and</DELETED>
        <DELETED>    ``(8) to improve access to health promotion and 
        disease prevention services for rural American 
        Samoa.'';</DELETED>
        <DELETED>    (2) in subsection (f)--</DELETED>
                <DELETED>    (A) by striking ``there is'' and inserting 
                ``there are''; and</DELETED>
                <DELETED>    (B) by striking ``$10,000,000'' and all 
                that follows through ``1993'' and inserting 
                ``$3,000,000 for fiscal year 1995, $4,000,000 for 
                fiscal year 1996, and $5,000,000 for fiscal year 
                1997''; and</DELETED>
        <DELETED>    (3) by adding at the end thereof the following new 
        subsection:</DELETED>
<DELETED>    ``(g) Study and Report.--</DELETED>
        <DELETED>    ``(1) Study.--Not later than 180 days after the 
        date of enactment of this subsection, the Secretary, acting 
        through the Administrator of the Health Resources and Services 
        Administration, shall enter into a contract with a public or 
        nonprofit private entity for the conduct of a study to 
        determine the effectiveness of projects funded under this 
        section.</DELETED>
        <DELETED>    ``(2) Report.--Not later than July 1, 1996, the 
        Secretary shall prepare and submit to the Committee on Labor 
        and Human Resources of the Senate and the Committee on Energy 
        and Commerce of the House of Representatives a report 
        describing the findings made with respect to the study 
        conducted under paragraph (1).''.</DELETED>

<DELETED>SEC. 305. DEMONSTRATION PROJECTS REGARDING ALZHEIMER'S 
              DISEASE.</DELETED>

<DELETED>    (a) In General.--Section 398(a) of the Public Health 
Service Act (42 U.S.C. 280c-3(a)) is amended--</DELETED>
        <DELETED>    (1) in the matter preceding paragraph (1), by 
        striking ``not less than 5, and not more than 15,'';</DELETED>
        <DELETED>    (2) in paragraph (2)--</DELETED>
                <DELETED>    (A) by inserting after ``disorders'' the 
                following: ``who are living in single family homes or 
                in congregate settings''; and</DELETED>
                <DELETED>    (B) by striking ``and'' at the 
                end;</DELETED>
        <DELETED>    (3) by redesignating paragraph (3) as paragraph 
        (4); and</DELETED>
        <DELETED>    (4) by inserting after paragraph (2) the 
        following:</DELETED>
        <DELETED>    ``(3) to improve the access of such individuals to 
        home-based or community-based long-term care services (subject 
        to the services being provided by entities that were providing 
        such services in the State involved as of October 1, 1995), 
        particularly such individuals who are members of racial or 
        ethnic minority groups, who have limited proficiency in 
        speaking the English language, or who live in rural areas; 
        and''.</DELETED>
<DELETED>    (b) Duration.--Section 398A of the Public Health Service 
Act (42 U.S.C. 280c-4) is amended--</DELETED>
        <DELETED>    (1) in the heading for the section, by striking 
        ``limitation'' and all that follows and inserting ``requirement 
        of matching funds'';</DELETED>
        <DELETED>    (2) by striking subsection (a);</DELETED>
        <DELETED>    (3) by redesignating subsections (b) and (c) as 
        subsections (a) and (b), respectively;</DELETED>
        <DELETED>    (4) in subsection (a) (as so redesignated), in 
        each of paragraphs (1)(C) and (2)(C), by striking ``third 
        year'' and inserting ``third or subsequent year''.</DELETED>
<DELETED>    (c) Authorization of Appropriations.--Section 398B(e) of 
the Public Health Service Act (42 U.S.C. 280c-5(e)) is amended by 
striking ``and 1993'' and inserting ``through 1998''.</DELETED>

         <DELETED>TITLE IV--MISCELLANEOUS PROVISIONS</DELETED>

<DELETED>SEC. 401. TECHNICAL CORRECTIONS REGARDING PUBLIC LAW 103-
              183.</DELETED>

<DELETED>    (a) Amendatory Instructions.--Public Law 103-183 is 
amended--</DELETED>
        <DELETED>    (1) in section 601--</DELETED>
                <DELETED>    (A) in subsection (b), in the matter 
                preceding paragraph (1), by striking ``Section 1201 of 
                the Public Health Service Act (42 U.S.C. 300d)'' and 
                inserting ``Title XII of the Public Health Service Act 
                (42 U.S.C. 300d et seq.)''; and</DELETED>
                <DELETED>    (B) in subsection (f)(1), by striking ``in 
                section 1204(c)'' and inserting ``in section 1203(c) 
                (as redesignated by subsection (b)(2) of this 
                section)'';</DELETED>
        <DELETED>    (2) in section 602, by striking ``for the 
        purpose'' and inserting ``For the purpose''; and</DELETED>
        <DELETED>    (3) in section 705(b), by striking ``317D((l)(1)'' 
        and inserting ``317D(l)(1)''.</DELETED>
<DELETED>    (b) Public Health Service Act.--The Public Health Service 
Act, as amended by Public Law 103-183 and by subsection (a) of this 
section, is amended--</DELETED>
        <DELETED>    (1) in section 317E(g)(2), by striking ``making 
        grants under subsection (b)'' and inserting ``carrying out 
        subsection (b)'';</DELETED>
        <DELETED>    (2) in section 318, in subsection (e) as in effect 
        on the day before the date of the enactment of Public Law 103-
        183, by redesignating the subsection as subsection 
        (f);</DELETED>
        <DELETED>    (3) in subpart 6 of part C of title IV--</DELETED>
                <DELETED>    (A) by transferring the first section 447 
                (added by section 302 of Public Law 103-183) from the 
                current placement of the section;</DELETED>
                <DELETED>    (B) by redesignating the section as 
                section 447A; and</DELETED>
                <DELETED>    (C) by inserting the section after section 
                447;</DELETED>
        <DELETED>    (4) in section 1213(a)(8), by striking ``provides 
        for for'' and inserting ``provides for'';</DELETED>
        <DELETED>    (5) in section 1501, by redesignating the second 
        subsection (c) (added by section 101(f) of Public Law 103-183) 
        as subsection (d); and</DELETED>
        <DELETED>    (6) in section 1505(3), by striking 
        ``nonprofit''.</DELETED>
<DELETED>    (c) Miscellaneous Correction.--Section 401(c)(3) of Public 
Law 103-183 is amended in the matter preceding subparagraph (A) by 
striking ``(d)(5)'' and inserting ``(e)(5)''.</DELETED>
<DELETED>    (d) Effective Date.--This section is deemed to have taken 
effect immediately after the enactment of Public Law 103-183.</DELETED>

<DELETED>SEC. 402. CERTAIN AUTHORITIES OF CENTERS FOR DISEASE CONTROL 
              AND PREVENTION.</DELETED>

<DELETED>    (a) In General.--Part B of title III of the Public Health 
Service Act is amended by inserting after section 317H the following 
section:</DELETED>

  <DELETED>``miscellaneous authorities regarding centers for disease 
                    control and prevention</DELETED>

<DELETED>    ``Sec. 317I. (a) Technical and Scientific Peer Review 
Groups.--The Secretary, acting through the Director of the Centers for 
Disease Control and Prevention, may, without regard to the provisions 
of title 5, United States Code, governing appointments in the 
competitive service, and without regard to the provisions of chapter 51 
and subchapter III of chapter 53 of such title relating to 
classification and General Schedule pay rates, establish such technical 
and scientific peer review groups and scientific program advisory 
committees as are needed to carry out the functions of such Centers and 
appoint and pay the members of such groups, except that officers and 
employees of the United States shall not receive additional 
compensation for service as members of such groups. The Federal 
Advisory Committee Act shall not apply to the duration of such peer 
review groups. Not more than one-fourth of the members of any such 
group shall be officers or employees of the United States.</DELETED>
<DELETED>    ``(b) Fellowship and Training Programs.--The Secretary, 
acting through the Director of the Centers for Disease Control and 
Prevention, shall establish fellowship and training programs to be 
conducted by such Centers to train individuals to develop skills in 
epidemiology, surveillance, laboratory analysis, and other disease 
detection and prevention methods. Such programs shall be designed to 
enable health professionals and health personnel trained under such 
programs to work, after receiving such training, in local, State, 
national, and international efforts toward the prevention and control 
of diseases, injuries, and disabilities. Such fellowships and training 
may be administered through the use of either appointment or 
nonappointment procedures.''.</DELETED>
<DELETED>    (b) Effective Date.--This section is deemed to have taken 
effect July 1, 1995.</DELETED>

<DELETED>SEC. 403. ADMINISTRATION OF CERTAIN REQUIREMENTS.</DELETED>

<DELETED>    (a) In General.--Section 2004 of Public Law 103-43 (107 
Stat. 209) is amended by striking subsection (a).</DELETED>
<DELETED>    (b) Conforming Amendments.--Section 2004 of Public Law 
103-43, as amended by subsection (a) of this section, is amended--
</DELETED>
        <DELETED>    (1) by striking ``(b) Sense'' and all that follows 
        through ``In the case'' and inserting the following:</DELETED>
<DELETED>    ``(a) Sense of Congress Regarding Purchase of American-
Made Equipment and Products.--In the case'';</DELETED>
        <DELETED>    (2) by striking ``(2) Notice to recipients of 
        assistance'' and inserting the following:</DELETED>
<DELETED>    ``(b) Notice to Recipients of Assistance''; and</DELETED>
        <DELETED>    (3) in subsection (b), as redesignated by 
        paragraph (2) of this subsection, by striking ``paragraph (1)'' 
        and inserting ``subsection (a)''.</DELETED>
<DELETED>    (c) Effective Date.--This section is deemed to have taken 
effect immediately after the enactment of Public Law 103-43.</DELETED>

<DELETED>SEC. 404. TECHNICAL CORRECTIONS RELATING TO HEALTH PROFESSIONS 
              PROGRAMS.</DELETED>

<DELETED>    (a) Definitions.--Section 799B(6) of the Public Health 
Service Act (as so redesignated by section 105(a)(2)(C)) is amended--
</DELETED>
        <DELETED>    (1) in subparagraph (B) by striking ``; or'' at 
        the end thereof;</DELETED>
        <DELETED>    (2) in subparagraph (C) by striking the period and 
        inserting a semicolon; and</DELETED>
        <DELETED>    (3) by adding at the end thereof the 
        following:</DELETED>
                <DELETED>    ``(D) ambulatory practice sites designated 
                by State Governors as shortage areas or medically 
                underserved communities for purposes of State 
                scholarships or loan repayment or related programs; 
                or</DELETED>
                <DELETED>    ``(E) practices or facilities in which not 
                less than 50 percent of the patients are recipients of 
                aid under title XIX of the Social Security Act or 
                eligible and uninsured.''.</DELETED>
<DELETED>    (b) Recovery.--Part G of title VII of the Public Health 
Service Act (42 U.S.C. 295j et seq.) is amended by inserting after 
section 794 the following section:</DELETED>
<DELETED>``Sec. 794a. Recovery</DELETED>
<DELETED>    ``(a) In General.--If at any time within 20 years (or 
within such shorter period as the Secretary may prescribe by regulation 
for an interim facility) after the completion of construction of a 
facility with respect to which funds have been paid under section 
720(a) (as such section existed one day prior to the date of enactment 
of the Health Professions Education Extension Amendments of 1992 
(Public Law 102-408)--</DELETED>
        <DELETED>    ``(1)(A) in case of a facility which was an 
        affiliated hospital or outpatient facility with respect to 
        which funds have been paid under such section 720(a)(1), the 
        owner of the facility ceases to be a public or other nonprofit 
        agency that would have been qualified to file an application 
        under section 605;</DELETED>
        <DELETED>    ``(B) in case of a facility which was not an 
        affiliated hospital or outpatient facility but was a facility 
        with respect to which funds have been paid under paragraph (1) 
        or (3) of such section 720(a), the owner of the facility ceases 
        to be a public or nonprofit school, or</DELETED>
        <DELETED>    ``(C) in case of a facility which was a facility 
        with respect to which funds have been paid under such section 
        720(a)(2), the owner of the facility ceases to be a public or 
        nonprofit entity,</DELETED>
        <DELETED>    ``(2) the facility ceases to be used for the 
        teaching or training purposes (or other purposes permitted 
        under section 722 (as such section existed one day prior to the 
        date of enactment of the Health Professions Education Extension 
        Amendments of 1992 (Public Law 102-408)) for which it was 
        constructed, or</DELETED>
        <DELETED>    ``(3) the facility is used for sectarian 
        instruction or as a place for religious worship,</DELETED>
<DELETED>the United States shall be entitled to recover from the owner 
of the facility the base amount prescribed by subsection (c)(1) plus 
the interest (if any) prescribed by subsection (c)(2).</DELETED>
<DELETED>    ``(b) Notice.--The owner of a facility which ceases to be 
a public or nonprofit agency, school, or entity as described in 
subparagraph (A), (B), or (C) of subsection (a)(1), as the case may be, 
or the owner of a facility the use of which changes as described in 
paragraph (2) or (3) of subsection (a), shall provide the Secretary 
written notice of such cessation or change of use within 10 days after 
the date on which such cessation or change of use occurs or within 30 
days after the date of enactment of this subsection, whichever is 
later.</DELETED>
<DELETED>    ``(c) Amount.--</DELETED>
        <DELETED>    ``(1) Base amount.--The base amount that the 
        United States is entitled to recover under subsection (a) is 
        the amount bearing the same ratio to the then value (as 
        determined by the agreement of the parties or in an action 
        brought in the district court of the United States for the 
        district in which the facility is situated) of the facility as 
        the amount of the Federal participation bore to the cost of 
        construction.</DELETED>
        <DELETED>    ``(2) Interest.--</DELETED>
                <DELETED>    ``(A) In general.--The interest that the 
                United States is entitled to recover under subsection 
                (a) is the interest for the period (if any) described 
                in subparagraph (B) at a rate (determined by the 
                Secretary) based on the average of the bond equivalent 
                rates of ninety-one-day Treasury bills auctioned during 
                that period.</DELETED>
                <DELETED>    ``(B) Period.--The period referred to in 
                subparagraph (A) is the period beginning--</DELETED>
                        <DELETED>    ``(i) if notice is provided as 
                        prescribed by subsection (b), 191 days after 
                        the date on which the owner of the facility 
                        ceases to be a public or nonprofit agency, 
                        school, or entity as described in subparagraph 
                        (A), (B), or (C) of subsection (a)(1), as the 
                        case may be, or 191 days after the date on 
                        which the use of the facility changes as 
                        described in paragraph (2) or (3) of subsection 
                        (a), or</DELETED>
                        <DELETED>    ``(ii) if notice is not provided 
                        as prescribed by subsection (b), 11 days after 
                        the date on which such cessation or change of 
                        use occurs,</DELETED>
                <DELETED>and ending on the date the amount the United 
                States is entitled to recover is collected.</DELETED>
<DELETED>    ``(d) Waiver.--The Secretary may waive the recovery rights 
of the United States under subsection (a)(2) with respect to a facility 
(under such conditions as the Secretary may establish by regulation) if 
the Secretary determines that there is good cause for waiving such 
rights.</DELETED>
<DELETED>    ``(e) Lien.--The right of recovery of the United States 
under subsection (a) shall not, prior to judgment, constitute a lien on 
any facility.''.</DELETED>

<DELETED>SEC. 405. CLINICAL TRAINEESHIPS.</DELETED>

<DELETED>    Section 303(d)(1) of the Public Health Service Act (42 
U.S.C. 242a(d)(1)) is amended by inserting ``counseling'' after 
``family therapy,''.</DELETED>

<DELETED>SEC. 406. CONSTRUCTION OF REGIONAL CENTERS FOR RESEARCH ON 
              PRIMATES.</DELETED>

<DELETED>    Section 481B(a) of the Public Health Service Act (42 
U.S.C. 287a-3(a)) is amended by striking ``$5,000,000'' and inserting 
``$2,500,000''.</DELETED>
SECTION 1. SHORT TITLE.

    (a) Short Title.--This Act may be cited as the ``Health Professions 
Education Consolidation and Reauthorization Act of 1995''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title.

TITLE I--HEALTH PROFESSIONS EDUCATION AND FINANCIAL ASSISTANCE PROGRAMS

           Subtitle A--Health Professions Education Programs

Sec. 101. Minority and disadvantaged health professions grant program.
Sec. 102. Training in family medicine, general internal medicine, 
                            general pediatrics, preventive medicine, 
                            physician assistants, and general 
                            dentistry.
Sec. 103. Enhanced health education and training.
Sec. 104. Health professions workforce development.
Sec. 105. General provisions.
Sec. 106. Preference in certain programs.
Sec. 107. Definitions.
Sec. 108. Savings provision.

                     Subtitle B--Nursing Education

Sec. 121. Short title.
Sec. 122. Purpose.
Sec. 123. Amendments to Public Health Service Act.
Sec. 124. Savings provision.

                    Subtitle C--Financial Assistance

  Part 1--National Health Service Corps Financial Assistance Programs

Sec. 131. General amendments with respect to federally supported loans.
Sec. 132. Restructuring and technical amendments.
Sec. 133. Definition of underserved areas.
Sec. 134. Conforming amendments.

               Part 2--School-based Revolving Loan Funds

Sec. 135. Primary care loan program.
Sec. 136. Loans for disadvantaged students.
Sec. 137. Student loans regarding schools of nursing.
Sec. 138. General provisions.

 Part 3--Insured Health Education Assistance Loans to Graduate Students

Sec. 141. Health education assistance loan program.
Sec. 142. HEAL lender and holder performance standards.
Sec. 143. Reauthorization.

            Part 4--Scholarships for Disadvantaged Students

Sec. 151. Scholarships for disadvantaged students.

                  TITLE II--OFFICE OF MINORITY HEALTH

Sec. 201. Revision and extension of programs of Office of Minority 
                            Health.

                    TITLE III--SELECTED INITIATIVES

Sec. 301. Programs regarding birth defects.
Sec. 302. Traumatic brain injury.
Sec. 303. State offices of rural health.
Sec. 304. Health services for Pacific Islanders.
Sec. 305. Demonstration projects regarding Alzheimer's Disease.

                   TITLE IV--MISCELLANEOUS PROVISIONS

Sec. 401. Technical corrections regarding Public Law 103-183.
Sec. 402. Certain authorities of Centers for Disease Control and 
                            Prevention.
Sec. 403. Administration of certain requirements.
Sec. 404. Technical corrections relating to health professions 
                            programs.
Sec. 405. Clinical traineeships.
Sec. 406. Construction of regional centers for research on primates.
Sec. 407. Required consultation by Secretary.
TITLE I--HEALTH PROFESSIONS EDUCATION AND FINANCIAL ASSISTANCE PROGRAMS

           Subtitle A--Health Professions Education Programs

SEC. 101. MINORITY AND DISADVANTAGED HEALTH PROFESSIONS GRANT PROGRAM.

    (a) In General.--Part B of title VII of the Public Health Service 
Act (42 U.S.C. 293 et seq.) is amended to read as follows:

          ``PART B--DISADVANTAGED HEALTH PROFESSIONS TRAINING

``SEC. 736. STATEMENT OF PURPOSE.

    ``(a) In General.--The Secretary shall make grants to or enter into 
contracts with eligible entities for the purpose of establishing, 
enhancing, and expanding programs to increase the number and the 
quality of disadvantaged health professionals, particularly those who 
provide health services to disadvantaged populations or in medically 
underserved areas or rural areas.
    ``(b) Use of Funds.--Amounts provided under a grant or contract 
awarded under this part may be used for costs of planning, developing, 
or operating centers of excellence in minority health professions 
education, programs for assisting individuals from disadvantaged 
backgrounds to enter a health profession, minority faculty development, 
minority faculty loan repayment or fellowships, trainee support, 
technical assistance, workforce analysis, and dissemination of 
information.
    ``(c) Consortium.--Schools within a consortium that applies for a 
grant or contract under this part shall enter into an agreement to 
allocate the funds received under the grant or contract among such 
schools and expend such funds in accordance with the application for 
such grant or contract.

``SEC. 737. PREFERENCES.

    ``In awarding grants or contracts to eligible entities under this 
part, the Secretary shall give preference to--
            ``(1) projects that involve more than one health 
        professions discipline or training institution and have an 
        above average record of retention and graduation of individuals 
        from disadvantaged backgrounds; and
            ``(2) centers of excellence at Historically Black Colleges 
        and Universities (as defined in section 739) beginning in 
        fiscal year 1999 and for each fiscal year thereafter.

``SEC. 738. AUTHORIZATION OF APPROPRIATION.

    ``(a) In General.--There are authorized to be appropriated to carry 
out this part, $51,000,000 for fiscal year 1996, and such sums as may 
be necessary for each of the fiscal years 1997 through 1999.
    ``(b) Set-Aside.--With respect to each of the fiscal years 1996, 
1997 and 1998, the Secretary shall set-aside $12,000,000 of the amount 
appropriated under subsection (a) in each such fiscal year for the 
purpose of making grants under section 736 to centers of excellence at 
certain Historically Black Colleges and Universities.
    ``(c) No Limitation.--Nothing in this section shall be construed as 
limiting the centers of excellence referred to in subsection (b) to the 
set-aside amount, or to preclude such entities from competing for other 
grants under section 736.

``SEC. 739. DEFINITIONS.

    ``As used in this part:
            ``(1) Centers of excellence.--The term `centers of 
        excellence' means a health professions school that--
                    ``(A)(i) has a significant number of minority 
                individuals enrolled in the school, including 
                individuals accepted for enrollment in the school;
                    ``(ii) has been effective in assisting minority 
                students of the school to complete the program of 
                education and receive the degree involved;
                    ``(iii) has been effective in recruiting minority 
                individuals to attend the school and encouraging 
                minority students of secondary educational institutions 
                to attend the health professions school; and
                    ``(iv) has made significant recruitment efforts to 
                increase the number of minority individuals serving in 
                faculty or administrative positions at the school; or
                    ``(B) is a center of excellence at certain 
                Historically Black Colleges and Universities.
            ``(2) Consortium.--The term `consortium' means the 
        designated eligible entity seeking a grant under this part and 
        one or more schools of medicine, osteopathic medicine, 
        dentistry, pharmacy, nursing, allied health, public health, or 
        graduate programs in mental health practice.
            ``(3) Eligible entities.--The term `eligible entities' 
        means schools of medicine, osteopathic medicine, dentistry, 
        pharmacy, podiatric medicine, optometry, veterinary medicine, 
        public health, or allied health or schools offering graduate 
        programs in mental health practice, State or local governments, 
        and other public or nonprofit private entities determined 
        appropriate by the Secretary that submit to the Secretary an 
        application.
            ``(4) Historically black colleges and universities.--The 
        term `Historically Black Colleges and Universities' means a 
        school described in section 799B(1) that has received a 
        contract under section 788B for fiscal year 1987, as such 
        section was in effect for such fiscal year.''.
    (b) Repeal.--
            (1) In general.--Section 795 of the Public Health Service 
        Act (42 U.S.C. 295n) is repealed.
            (2) Nontermination of authority.--The amendments made by 
        this section shall not be construed to terminate agreements 
        that, on the day before the date of enactment of this Act, are 
        in effect pursuant to section 795 of the Public Health Service 
        Act (42 U.S.C. 795) as such section existed on such date. Such 
        agreements shall continue in effect in accordance with the 
        terms of the agreements. With respect to compliance with such 
        agreements, any period of practice as a provider of primary 
        health services shall be counted towards the satisfaction of 
        the requirement of practice pursuant to such section 795.
    (c) Conforming Amendments.--Section 481A(c)(3)(D)(i) of the Public 
Health Service Act (42 U.S.C. 287a-2(c)(3)(D)(i)) is amended by 
striking ``section 739'' and inserting ``part B of title VII''.

SEC. 102. TRAINING IN FAMILY MEDICINE, GENERAL INTERNAL MEDICINE, 
              GENERAL PEDIATRICS, PREVENTIVE MEDICINE, PHYSICIAN 
              ASSISTANTS, AND GENERAL DENTISTRY.

    Part C of title VII of the Public Health Service Act (42 U.S.C. 293 
et seq.) is amended--
            (1) in the part heading by striking ``PRIMARY HEALTH CARE'' 
        and inserting ``FAMILY MEDICINE, GENERAL INTERNAL MEDICINE, 
        GENERAL PEDIATRICS, PREVENTIVE MEDICINE, PHYSICIAN ASSISTANTS, 
        AND GENERAL DENTISTRY'';
            (2) by repealing section 746 and sections 748 through 752 
        (42 U.S.C. 293j and 293l through 293p); and
            (3) in section 747 (42 U.S.C. 293k)--
                    (A) by striking the section heading and inserting 
                the following:

``SEC. 747. FAMILY MEDICINE, GENERAL INTERNAL MEDICINE, GENERAL 
              PEDIATRICS, PREVENTIVE MEDICINE, GENERAL DENTISTRY, AND 
              PHYSICIAN ASSISTANTS.'';

                    (B) in subsection (a)--
                            (i) in paragraph (1)--
                                    (I) by inserting ``, internal 
                                medicine, or pediatrics'' after 
                                ``family medicine''; and
                                    (II) by inserting before the 
                                semicolon the following: ``that 
                                emphasizes training for the practice of 
                                family medicine, general internal 
                                medicine, or general pediatrics (as 
                                defined by the Secretary)'';
                            (ii) in paragraph (2), by inserting ``, 
                        general internal medicine, or general 
                        pediatrics'' before the semicolon;
                            (iii) in paragraphs (3) and (4), by 
                        inserting ``, general internal medicine 
                        (including geriatrics), or general pediatrics'' 
                        after ``family medicine'';
                            (iv) in paragraphs (3) and (4), by 
                        inserting ``(including geriatrics) after 
                        ``family medicine'';
                            (v) in paragraph (3), by striking ``and'' 
                        at the end thereof;
                            (vi) in paragraph (4), by striking the 
                        period and inserting a semicolon; and
                            (vii) by adding at the end thereof the 
                        following new paragraphs:
            ``(5) to meet the costs of projects to plan, develop, and 
        operate or maintain programs for the training of physician 
        assistants (as defined in section 799B), and for the training 
        of individuals who will teach in programs to provide such 
        training;
            ``(6) to meet the costs of projects--
                    ``(A) to plan and develop new residency training 
                programs and to maintain or improve existing residency 
                training programs in preventive medicine, that have 
                available full-time faculty members with training and 
                experience in the fields of preventive medicine; and
                    ``(B) to provide financial assistance to residency 
                trainees enrolled in such programs; and
            ``(7) to meet the costs of planning, developing, or 
        operating programs, and to provide financial assistance to 
        residents in such programs, that would lead to a significantly 
        greater ratio of participating individuals in such programs 
        eventually entering practice in general dentistry in rural and 
        medically underserved communities compared to the current ratio 
        of all dentists nationally practicing general dentistry in 
        rural and medically underserved communities.
For purposes of paragraph (7), entities eligible for such grants or 
contracts shall include entities that have programs in dental schools, 
approved residency programs in the general practice of dentistry, or 
approved advanced education programs in the general practice of 
dentistry. The Secretary may only fund programs under such paragraph if 
such programs provide a significant amount of care for underserved 
populations and other high-risk groups, and if the Secretary determines 
that there is a national shortage of general dentists.'';
                    (C) in paragraphs (1) and (2)(A) of subsection (b), 
                by inserting ``, general internal medicine, or general 
                pediatrics'' after ``family medicine'';
                    (D) by redesignating subsections (c) and (d) as 
                subsections (d) and (e), respectively;
                    (E) by inserting after subsection (b), the 
                following new subsection:
    ``(c) Priority and Limitation.--
            ``(1) Priority.--With respect to programs for the training 
        of interns or residents, the Secretary shall give priority in 
        awarding grants under this section to qualified applicants that 
        have a record of training the greatest percentage of providers, 
        or that have demonstrated significant improvements in the 
        percentage of providers, which enter and remain in primary care 
        practice or general dentistry upon completion of their first 
        period of training required to obtain initial board 
        certification. Each program shall designate the primary care 
        training or general dentistry positions that such program shall 
        provide with grant funding to support and for which such 
        program shall be held accountable regarding the primary care or 
        general dentistry requirement set forth in this section.
            ``(2) Limitation.--With respect to programs for the 
        training and education of medical students, the Secretary may 
        only provide grants or contracts under this section to 
        administrative units in general pediatrics or general internal 
        medicine if a qualified administrative unit applicant 
        demonstrates that its medical school has--
                    ``(A) a mission statement that has a primary care 
                medical education objective;
                    ``(B) faculty role models and administrative units 
                in primary care; and
                    ``(C) required undergraduate ambulatory medical 
                student clerkships in family medicine, internal 
                medicine, and pediatrics.
        Where a medical school does not have an administrative unit in 
        family medicine, clerkships in family medicine shall not be 
        required.''; and
                    (F) in subsection (e) (as so redesignated by 
                subparagraph (D))--
                            (i) in paragraph (1), by striking 
                        ``$54,000,000'' and all that follows and 
                        inserting ``$76,000,000 for fiscal year 1996, 
                        and such sums as may be necessary for each of 
                        the fiscal years 1997 through 1999.''; and
                            (ii) in paragraph (2)--
                                    (I) by striking ``20'' and 
                                inserting ``12''; and
                                    (II) by inserting ``for family 
                                medicine academic administrative 
                                units'' after ``under subsection (b)''.

SEC. 103. ENHANCED HEALTH EDUCATION AND TRAINING.

    Part D of title VII of the Public Health Service Act (42 U.S.C. 294 
et seq.) is amended to read as follows:

                ``PART D--AREA HEALTH EDUCATION CENTERS

``SEC. 750. AREA HEALTH EDUCATION CENTERS.

    ``(a) In General.--The Secretary may award grants to and enter into 
contracts with eligible entities for projects which --
            ``(1) improve the recruitment, distribution, supply, 
        quality, utilization, and efficiency of personnel providing 
        health services in urban and rural areas and to populations 
        that have demonstrated serious unmet health care need;
            ``(2) encourage the regionalization of educational 
        responsibilities of the health professions schools;
            ``(3) are designed to prepare, through field placements, 
        preceptorships, the conduct of or affiliation with community-
        based primary care residency programs, agreements with 
        community-based organizations for the delivery of education and 
        training in the health professions, and other programs, 
        individuals to effectively provide health services in health 
        professional shortage areas;
            ``(4) conduct health professions education and training 
        activities consistent with national and State priorities, 
        including geriatrics;
            ``(5) encourage health promotion and disease prevention 
        activities;
            ``(6) conduct interdisciplinary training and practice 
        involving other health professionals;
            ``(7) conduct continuing education programs for health 
        professionals or coordinate with such programs; and
            ``(8) address other areas as determined appropriate by the 
        Secretary.
    ``(b) Preferences.--In awarding grants or contracts to eligible 
entities under this part, the Secretary shall give preference to 
projects that--
            ``(1) involve more than one health professions discipline 
        or training institution; and
            ``(2) have a good record of retention and graduation of 
        individuals that enter practice in medically underserved 
        communities.
    ``(c) Other Eligible Programs.--
            ``(1) Geriatric education centers.--The Secretary shall 
        award grants or contracts under this section for the 
        establishment or operation of geriatric education centers.
            ``(2) Public health training centers.--
                    ``(A) In general.--The Secretary shall award grants 
                or contracts under this section for the operation of 
                public health training centers.
                    ``(B) Eligible entities.--A public health training 
                center shall be an accredited school of public health, 
                or another public or nonprofit private institution 
                accredited for the provision of graduate or specialized 
                training in public health, that plans, develops, 
                operates, and evaluates projects that are in 
                furtherance of the goals established by the Secretary 
                for the year 2000 in the areas of preventive medicine, 
                health promotion and disease prevention, or improving 
                access to and quality of health services in medically 
                underserved communities.
                    ``(C) Certain requirements.--With respect to a 
                public health training center, an award may not be made 
                under subparagraph (A) unless the program agrees that 
                it--
                            ``(i) will establish or strengthen field 
                        placements for students in public or nonprofit 
                        private health agencies or organizations; and
                            ``(ii) will involve faculty members and 
                        students in collaborative projects to enhance 
                        public health services to medically underserved 
                        communities.
    ``(d) Eligible Entities.--As used in this part, the term `eligible 
entities' means schools of medicine, osteopathic medicine, dentistry, 
pharmacy, podiatric medicine, optometry, veterinary medicine, public 
health, or allied health or schools offering graduate programs in 
mental health practice or physician assistant training programs, State 
or local governments, and other public or nonprofit private entities 
determined appropriate by the Secretary that submit to the Secretary an 
application.
    ``(e) Geriatric Education Centers.--A geriatric education center 
shall be an accredited health professions school or program that--
            ``(1) improves the training of health professionals in 
        geriatrics, including geriatric residencies, traineeships, or 
        fellowships;
            ``(2) develops and disseminates curricula relating to the 
        treatment of the health problems of elderly individuals;
            ``(3) supports the training and retraining of faculty to 
        provide instruction in geriatrics;
            ``(4) supports continuing education of health professionals 
        who provide geriatric care; and
            ``(5) provides students with clinical training in 
        geriatrics in nursing homes, chronic and acute disease 
        hospitals, ambulatory care centers, and senior centers.

``SEC. 751. AUTHORIZATION OF APPROPRIATIONS.

    ``There are authorized to be appropriated to carry out this part, 
$43,000,000 for fiscal year 1996, such sums as may be necessary for 
each of the fiscal years 1997 and 1998, and $29,000,000 for fiscal year 
1999.''.

SEC. 104. HEALTH PROFESSIONS WORKFORCE DEVELOPMENT.

    (a) In General.--Part E of title VII of the Public Health Service 
Act (42 U.S.C. 294n et seq.) is amended--
            (1) in the part heading to read as follows:

         ``PART E--HEALTH PROFESSIONS WORKFORCE DEVELOPMENT'';

            (2) by redesignating section 776 (42 U.S.C. 294n) as 
        section 761; and
            (3) by striking sections 777 and 778 (42 U.S.C. 294o and 
        294p) and inserting the following new section:

``SEC. 762. HEALTH PROFESSIONS WORKFORCE DEVELOPMENT.

    ``(a) In General.--The Secretary may award grants to and enter into 
contracts with eligible entities for projects to strengthen capacity 
for health professions education and practice.
    ``(b) Eligible Applicants.--Applicants eligible to obtain funds 
under subsection (a) shall include schools of medicine, osteopathic 
medicine, dentistry, veterinary medicine, pharmacy, podiatric medicine, 
chiropractic medicine, optometry, public health, or allied health, 
graduate programs in mental health practice, physician assistant 
training programs, and other public and nonprofit private entities.
    ``(c) Priority Areas.--In awarding grants or contracts under 
subsection (a), the Secretary shall give priority to entities that will 
use amounts provided under such grants or contracts to enhance the 
education of health professionals for purposes of--
            ``(1) providing care for underserved populations and other 
        high-risk groups;
            ``(2) increasing the number of individuals who are pursuing 
        a course of study in a health professions field in which there 
        is a severe shortage of health professionals;
            ``(3) conducting health professions research and data 
        collection; and
            ``(4) carrying out other activities in areas determined 
        appropriate by the Secretary.
    ``(d) Authorization of Appropriations.--
            ``(1) In general.--There are authorized to be appropriated 
        to carry out this section, $16,000,000 for fiscal year 1996, 
        and such sums as may be necessary for each of the fiscal years 
        1997 through 1999.
            ``(2) Reservation.--Of the amounts appropriated under 
        subsection (a) for a fiscal year, the Secretary shall reserve 
        not less than $2,000,000 for conducting health professions 
        research and for carrying out data collection and analysis in 
        accordance with section 792.''.
    (b) Health Professions Data.--The second sentence of section 792(a) 
of the Public Health Service Act (42 U.S.C. 295k(a)) is amended--
            (1) by striking ``is authorized to'' and inserting 
        ``shall''; and
            (2) by inserting ``clinical social workers,'' after 
        ``clinical psychologists,''.
    (c) Council on Graduate Medical Education.--Section 301 of the 
Health Professions Education Extension Amendments of 1992 (Public Law 
102-408) is amended--
            (1) in subsection (j), by striking ``1995'' and inserting 
        ``1999'';
            (2) in subsection (k), by striking ``1995'' and inserting 
        ``1999'';
            (3) by adding at the end thereof the following new 
        subsection:
    ``(l) Funding.--Amounts otherwise appropriated under this title may 
be utilized by the Secretary to support the activities of the 
Council.'';
            (4) by transferring such section to part E of title VII of 
        the Public Health Service Act (as amended by subsection (a));
            (5) by redesignating such section as section 763; and
            (6) by inserting such section after section 762.

SEC. 105. GENERAL PROVISIONS.

    (a) In General.--
            (1) Part F of title VII of the Public Health Service Act 
        (42 U.S.C. 295 et seq.) is repealed.
            (2) Part G of title VII of the Public Health Service Act 
        (42 U.S.C. 295j et seq.) is amended--
                    (A) by redesignating such part as part F;
                    (B) in section 791 (42 U.S.C. 295j)--
                            (i) by striking subsection (b); and
                            (ii) redesignating subsection (c) as 
                        subsection (b);
                    (C) by repealing section 793 (42 U.S.C. 295l);
                    (D) by repealing section 798;
                    (E) by redesignating section 799 as section 799B; 
                and
                    (F) by inserting after section 794, the following 
                new sections:

``SEC. 796. APPLICATION.

    ``(a) In General.--To be eligible to receive a grant or contract 
under this title, an eligible entity shall prepare and submit to the 
Secretary an application that meets the requirements of this section, 
at such time, in such manner, and containing such information as the 
Secretary may require.
    ``(b) Plan.--An application submitted under this section shall 
contain the plan of the applicant for carrying out a project with 
amounts received under this title. Such plan shall be consistent with 
relevant Federal, State, or regional program plans.
    ``(c) Performance Outcome Standards.--An application submitted 
under this section shall contain a specification by the applicant 
entity of performance outcome standards that the project to be funded 
under the grant or contract will be measured against. Such standards 
shall address relevant health workforce needs that the project will 
meet. The recipient of a grant or contract under this section shall 
meet the standards set forth in the grant or contract application.
    ``(d) Linkages.--An application submitted under this section shall 
contain a description of the linkages with relevant educational and 
health care entities, including training programs for other health 
professionals as appropriate, that the project to be funded under the 
grant or contract will establish.

``SEC. 797. USE OF FUNDS.

    ``(a) In General.--Amounts provided under a grant or contract 
awarded under this title may be used for training program development 
and support, faculty development, model demonstrations, trainee support 
including tuition, books, program fees and reasonable living expenses 
during the period of training, technical assistance, workforce 
analysis, and dissemination of information, as appropriate to meet 
recognized health workforce objectives, in accordance with this title.
    ``(b) Maintenance of Effort.--With respect to activities for which 
a grant awarded under this title is to be expended, the entity shall 
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 entity for the fiscal year preceding the 
fiscal year for which the entity receives such a grant.

``SEC. 798. MATCHING REQUIREMENT.

    ``The Secretary may require that an entity that applies for a grant 
or contract under this title provide non-Federal matching funds, as 
appropriate, to ensure the institutional commitment of the entity to 
the projects funded under the grant. As determined by the Secretary, 
such non-Federal matching funds may be provided directly or through 
donations from public or private entities and may be in cash or in-
kind, fairly evaluated, including plant, equipment, or services.

``SEC. 799. GENERALLY APPLICABLE PROVISIONS.

    ``(a) Awarding of Grants and Contracts.--The Secretary shall ensure 
that grants and contracts under this title are awarded on a competitive 
basis, as appropriate, to carry out innovative demonstration projects 
or provide for strategic workforce supplementation activities as needed 
to meet health workforce goals and in accordance with this title. 
Contracts may be entered into under this title with public or private 
entities as may be necessary.
    ``(b) Information Requirements.--Recipients of grants and contracts 
under this title shall meet information requirements as specified by 
the Secretary.
    ``(c) Training Programs.--Training programs conducted with amounts 
received under this title shall meet applicable accreditation and 
quality standards.
    ``(d) Duration of Assistance.--
            ``(1) In general.--Subject to paragraph (2), in the case of 
        an award to an entity of a grant, cooperative agreement, or 
        contract under this title, the period during which payments are 
        made to the entity under the award may not exceed 5 years. The 
        provision of payments under the award shall be subject to 
        annual approval by the Secretary of the payments and subject to 
        the availability of appropriations for the fiscal year involved 
        to make the payments. This paragraph may not be construed as 
        limiting the number of awards under the program involved that 
        may be made to the entity.
            ``(2) Limitation.--In the case of an award to an entity of 
        a grant, cooperative agreement, or contract under this title, 
        paragraph (1) shall apply only to the extent not inconsistent 
        with any other provision of this title that relates to the 
        period during which payments may be made under the award.
    ``(e) Peer Review Regarding Certain Programs.--Each application for 
a grant under this title, except any scholarship or loan program, 
including those under sections 701, 721, or 723, shall be submitted to 
a peer review group for an evaluation of the merits of the proposals 
made in the application. The Secretary may not approve such an 
application unless a peer review group has recommended the application 
for approval. Each peer review group under this subsection shall be 
composed principally of individuals who are not officers or employees 
of the Federal Government. This subsection shall be carried out by the 
Secretary acting through the Administrator of the Health Resources and 
Services Administration.
    ``(f) Preference or priority Considerations.--In considering a 
preference or priority for funding which is based on outcome measures 
for an eligible entity under this title, the Secretary may also 
consider the future ability of the eligible entity to meet the outcome 
preference or priority through improvements in the eligible entity's 
program design.
``SEC. 799A. TECHNICAL ASSISTANCE.

    ``Funds appropriated under this title may be used by the Secretary 
to provide technical assistance in relation to any of the authorities 
under this title.''.

SEC. 106. PREFERENCE IN CERTAIN PROGRAMS.

    (a) In General.--Section 791 of the Public Health Service Act (42 
U.S.C. 295j), as amended by section 105(a)(2)(B), is further amended by 
adding at the end thereof the following subsection:
    ``(c) Exceptions for New Programs.--
            ``(1) In general.--To permit new programs to compete 
        equitably for funding under this section, those new programs 
        that meet the criteria described in paragraph (3) shall qualify 
        for a funding preference under this section.
            ``(2) Definition.--As used in this subsection, the term 
        `new program' means any program that has graduated less than 
        three classes. Upon graduating at least three classes, a 
        program shall have the capability to provide the information 
        necessary to qualify the program for the general funding 
        preferences described in subsection (a).
            ``(3) Criteria.--The criteria referred to in paragraph (1) 
        are the following:
                    ``(A) The mission statement of the program 
                identifies a specific purpose of the program as being 
                the preparation of health professionals to serve 
                underserved populations.
                    ``(B) The curriculum of the program includes 
                content which will help to prepare practitioners to 
                serve underserved populations.
                    ``(C) Substantial clinical training experience is 
                required under the program in medically underserved 
                communities.
                    ``(D) A minimum of 20 percent of the clinical 
                faculty of the program spend at least 50 percent of 
                their time providing or supervising care in medically 
                underserved communities.
                    ``(E) The entire program or a substantial portion 
                of the program is physically located in a medically 
                underserved community.
                    ``(F) Student assistance, which is linked to 
                service in medically underserved communities following 
                graduation, is available to the students in the 
                program.
                    ``(G) The program provides a placement mechanism 
                for deploying graduates to medically underserved 
                communities.''.
    (b) Conforming Amendments.--Section 791(a) of the Public Health 
Service Act (42 U.S.C. 295j(a)) is amended--
            (1) in paragraph (1), by striking ``sections 747'' and all 
        that follows through ``767'' and inserting ``section 747''; and
            (2) in paragraph (2), by striking ``under section 798(a)''.

SEC. 107. DEFINITIONS.

    (a) Professional Psychology.--Section 799B(1)(B) of the Public 
Health Service Act (42 U.S.C. 295p(1)(B)) (as so redesignated by 
section 105(a)(2)(E)) is amended by striking ``program in clinical 
psychology'' and inserting ``graduate programs in professional 
psychology''.
    (b) Medically Underserved Community.--Section 799B(6) of the Public 
Health Service Act (42 U.S.C. 295p(6)) (as so redesignated by section 
105(a)(2)(E)) is amended--
            (1) in subparagraph (B), by striking ``or'' at the end 
        thereof;
            (2) in subparagraph (C), by striking the period and 
        inserting a semicolon; and
            (3) by adding at the end the following new subparagraphs:
                    ``(D) is a State or local health department that 
                has a severe shortage of public health personnel as 
                determined under criteria established by the Secretary;
                    ``(E) has ambulatory practice sites designated by 
                State Governors as shortage areas or medically 
                underserved communities for purposes of State 
                scholarships or loan repayment or related programs; or
                    ``(F) has practices or facilities in which not less 
                than 50 percent of the patients are recipients of aid 
                under title XIX of the Social Security Act or eligible 
                and uninsured.''.
    (c) Programs for the Training of Physician Assistants.--Paragraph 
(3) of section 799B of the Public Health Service Act (42 U.S.C. 295p) 
(as so redesignated by section 105(a)(2)(E)) is amended to read as 
follows:
            ``(3) The term `program for the training of physician 
        assistants' means an educational program that--
                    ``(A) has as its objective the education of 
                individuals who will, upon completion of their studies 
                in the program, be qualified to provide primary care 
                under the supervision of a physician;
                    ``(B) extends for at least one academic year and 
                consists of--
                            ``(i) supervised clinical practice; and
                            ``(ii) at least four months (in the 
                        aggregate) of classroom instruction, directed 
                        toward preparing students to deliver health 
                        care;
                    ``(C) has an enrollment of not less than eight 
                students; and
                    ``(D) trains students in primary care, disease 
                prevention, health promotion, geriatric medicine, and 
                home health care.''.

SEC. 108. SAVINGS PROVISION.

    In the case of any authority for making awards of grants or 
contracts that is terminated by the amendments made by this subtitle, 
the Secretary of Health and Human Services may, notwithstanding the 
termination of the authority, continue in effect any grant or contract 
made under the authority that is in effect on the day before the date 
of the enactment of this Act, subject to the duration of any such grant 
or contract not exceeding the period determined by the Secretary in 
first approving such financial assistance, or in approving the most 
recent request made (before the date of such enactment) for 
continuation of such assistance, as the case may be.
                     Subtitle B--Nursing Education

SEC. 121. SHORT TITLE.

    This title may be cited as the ``Nursing Education Consolidation 
and Reauthorization Act of 1995''.

SEC. 122. PURPOSE.

    It is the purpose of this title to restructure the nurse education 
authorities of title VIII of the Public Health Service Act to permit a 
comprehensive, flexible, and effective approach to Federal support for 
nursing workforce development.

SEC. 123. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.

    Title VIII of the Public Health Service Act (42 U.S.C. 296k et 
seq.) is amended--
            (1) by striking the title heading and all that follows 
        except for subparts II and III of part B and section 855; and 
        inserting the following:

             ``TITLE VIII--NURSING WORKFORCE DEVELOPMENT'';

            (2) by redesignating subpart III of part B as subpart II;
            (3) in subpart II of part B, by striking the subpart 
        heading and inserting the following:

                        ``PART E--STUDENT LOANS

                    ``Subpart I--General Program'';

            (4) by striking section 837;
            (5) by inserting after the title heading the following new 
        parts:

                      ``PART A--GENERAL PROVISIONS

``SEC. 801. DEFINITIONS.

    ``As used in this title:
            ``(1) Eligible entities.--The term `eligible entities' 
        means schools of nursing, nursing centers, State or local 
        governments, and other public or nonprofit private entities 
        determined appropriate by the Secretary that submit to the 
        Secretary an application in accordance with section 802.
            ``(2) School of nursing.--The term `school of nursing' 
        means a collegiate, associate degree, or diploma school of 
        nursing in a State.
            ``(3) Collegiate school of nursing.--The term `collegiate 
        school of nursing' means a department, division, or other 
        administrative unit in a college or university which provides 
        primarily or exclusively a program of education in professional 
        nursing and related subjects leading to the degree of bachelor 
        of arts, bachelor of science, bachelor of nursing, or to an 
        equivalent degree, or to a graduate degree in nursing, and 
        including advanced training related to such program of 
        education provided by such school, but only if such program, or 
        such unit, college or university is accredited.
            ``(4) Associate degree school of nursing.--The term 
        `associate degree school of nursing' means a department, 
        division, or other administrative unit in a junior college, 
        community college, college, or university which provides 
        primarily or exclusively a two-year program of education in 
        professional nursing and allied subjects leading to an 
        associate degree in nursing or to an equivalent degree, but 
        only if such program, or such unit, college, or university is 
        accredited.
            ``(5) Diploma school of nursing.--The term `diploma school 
        of nursing' means a school affiliated with a hospital or 
        university, or an independent school, which provides primarily 
        or exclusively a program of education in professional nursing 
        and allied subjects leading to a diploma or to equivalent 
        indicia that such program has been satisfactorily completed, 
        but only if such program, or such affiliated school or such 
        hospital or university or such independent school is 
        accredited.
            ``(6) Accredited.--
                    ``(A) In general.--Except as provided in 
                subparagraph (B), the term `accredited' when applied to 
                any program of nurse education means a program 
                accredited by a recognized body or bodies, or by a 
                State agency, approved for such purpose by the 
                Secretary of Education and when applied to a hospital, 
                school, college, or university (or a unit thereof) 
                means a hospital, school, college, or university (or a 
                unit thereof) which is accredited by a recognized body 
                or bodies, or by a State agency, approved for such 
                purpose by the Secretary of Education. For the purpose 
                of this paragraph, the Secretary of Education shall 
                publish a list of recognized accrediting bodies, and of 
                State agencies, which the Secretary of Education 
                determines to be reliable authority as to the quality 
                of education offered.
                    ``(B) New programs.--A new school of nursing that, 
                by reason of an insufficient period of operation, is 
                not, at the time of the submission of an application 
                for a grant or contract under this title, eligible for 
                accreditation by such a recognized body or bodies or 
                State agency, shall be deemed accredited for purposes 
                of this title if the Secretary of Education finds, 
                after consultation with the appropriate accreditation 
                body or bodies, that there is reasonable assurance that 
                the school will meet the accreditation standards of 
                such body or bodies prior to the beginning of the 
                academic year following the normal graduation date of 
                students of the first entering class in such school.
            ``(7) Nonprofit.--The term `nonprofit' as applied to any 
        school, agency, organization, or institution means one which is 
        a corporation or association, or is owned and operated by one 
        or more corporations or associations, no part of the net 
        earnings of which inures, or may lawfully inure, to the benefit 
        of any private shareholder or individual.
            ``(8) State.--The term `State' means a State, the 
        Commonwealth of Puerto Rico, the District of Columbia, the 
        Commonwealth of the Northern Mariana Islands, Guam, American 
        Samoa, the Virgin Islands, or the Trust Territory of the 
        Pacific Islands.

``SEC. 802. APPLICATION.

    ``(a) In General.--To be eligible to receive a grant or contract 
under this title, an eligible entity shall prepare and submit to the 
Secretary an application that meets the requirements of this section, 
at such time, in such manner, and containing such information as the 
Secretary may require.
    ``(b) Plan.--An application submitted under this section shall 
contain the plan of the applicant for carrying out a project with 
amounts received under this title. Such plan shall be consistent with 
relevant Federal, State, or regional program plans.
    ``(c) Performance Outcome Standards.--An application submitted 
under this section shall contain a specification by the applicant 
entity of performance outcome standards that the project to be funded 
under the grant or contract will be measured against. Such standards 
shall address relevant national nursing needs that the project will 
meet. The recipient of a grant or contract under this section shall 
meet the standards set forth in the grant or contract application.
    ``(d) Linkages.--An application submitted under this section shall 
contain a description of the linkages with relevant educational and 
health care entities, including training programs for other health 
professionals as appropriate, that the project to be funded under the 
grant or contract will establish.

``SEC. 803. USE OF FUNDS.

    ``(a) In General.--Amounts provided under a grant or contract 
awarded under this title may be used for training program development 
and support, faculty development, model demonstrations, trainee support 
including tuition, books, program fees and reasonable living expenses 
during the period of training, technical assistance, workforce 
analysis, and dissemination of information, as appropriate to meet 
recognized nursing objectives, in accordance with this title.
    ``(b) Maintenance of Effort.--With respect to activities for which 
a grant awarded under this title is to be expended, the entity shall 
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 entity for the fiscal year preceding the 
fiscal year for which the entity receives such a grant.

``SEC. 804. MATCHING REQUIREMENT.

    ``The Secretary may require that an entity that applies for a grant 
or contract under this title provide non-Federal matching funds, as 
appropriate, to ensure the institutional commitment of the entity to 
the projects funded under the grant. Such non-Federal matching funds 
may be provided directly or through donations from public or private 
entities and may be in cash or in-kind, fairly evaluated, including 
plant, equipment, or services.

``SEC. 805. PREFERENCE.

    ``In awarding grants or contracts under this title, the Secretary 
shall give preference to applicants with projects that will 
substantially benefit rural or underserved populations, or help meet 
public health nursing needs in State or local health departments.

``SEC. 806. GENERALLY APPLICABLE PROVISIONS.

    ``(a) Awarding of Grants and Contracts.--The Secretary shall ensure 
that grants and contracts under this title are awarded on a competitive 
basis, as appropriate, to carry out innovative demonstration projects 
or provide for strategic workforce supplementation activities as needed 
to meet national nursing service goals and in accordance with this 
title. Contracts may be entered into under this title with public or 
private entities as determined necessary by the Secretary.
    ``(b) Information Requirements.--Recipients of grants and contracts 
under this title shall meet information requirements as specified by 
the Secretary.
    ``(c) Training Programs.--Training programs conducted with amounts 
received under this title shall meet applicable accreditation and 
quality standards.
    ``(d) Duration of Assistance.--
            ``(1) In general.--Subject to paragraph (2), in the case of 
        an award to an entity of a grant, cooperative agreement, or 
        contract under this title, the period during which payments are 
        made to the entity under the award may not exceed 5 years. The 
        provision of payments under the award shall be subject to 
        annual approval by the Secretary of the payments and subject to 
        the availability of appropriations for the fiscal year involved 
        to make the payments. This paragraph may not be construed as 
        limiting the number of awards under the program involved that 
        may be made to the entity.
            ``(2) Limitation.--In the case of an award to an entity of 
        a grant, cooperative agreement, or contract under this title, 
        paragraph (1) shall apply only to the extent not inconsistent 
        with any other provision of this title that relates to the 
        period during which payments may be made under the award.
    ``(e) Peer Review Regarding Certain Programs.--Each application for 
a grant under this title, except advanced nurse traineeship grants 
under section 811(a)(2), shall be submitted to a peer review group for 
an evaluation of the merits of the proposals made in the application. 
The Secretary may not approve such an application unless a peer review 
group has recommended the application for approval. Each peer review 
group under this subsection shall be composed principally of 
individuals who are not officers or employees of the Federal 
Government. This subsection shall be carried out by the Secretary 
acting through the Administrator of the Health Resources and Services 
Administration.
``SEC. 807. NATIONAL ADVISORY COUNCIL ON NURSE EDUCATION AND PRACTICE.

    ``(a) Establishment.--There is hereby established a National 
Advisory Council on Nurse Education and Practice (in this section 
referred to as the `Council'), consisting of the Secretary or the 
delegate of the Secretary (who shall be an ex officio member and shall 
serve as the Chairperson), and 15 members appointed by the Secretary 
without regard to the Federal civil service laws, of which--
            ``(1) 2 shall be selected from full-time students enrolled 
        in schools of nursing;
            ``(2) 3 shall be selected from the general public;
            ``(3) 2 shall be selected from practicing professional 
        nurses; and
            ``(4) 8 shall be selected from among the leading 
        authorities in the various fields of nursing, higher, and 
        secondary education, and from representatives of hospitals and 
        other institutions and organizations which provide nursing 
        services.
A majority of the members shall be nurses. The student-members of the 
Council shall be appointed for terms of one year and shall be eligible 
for reappointment to the Council.
    ``(b) Duties.--The Council shall advise the Secretary in the 
preparation of general regulations and with respect to policy matters 
arising in the administration of this title, including the range of 
issues relating to nurse supply, education and practice improvement.
    ``(c) Funding.--Amounts appropriated under this title may be 
utilized by the Secretary to support the nurse education and practice 
activities of the Council.

``SEC. 808. TECHNICAL ASSISTANCE.

    ``Funds appropriated under this title may be used by the Secretary 
to provide technical assistance in relation to any of the authorities 
under this title.

``SEC. 809. RECOVERY FOR CONSTRUCTION ASSISTANCE.

    ``(a) In General.--If at any time within 20 years (or within such 
shorter period as the Secretary may prescribe by regulation for an 
interim facility) after the completion of construction of a facility 
with respect to which funds have been paid under subpart I of part A 
(as such subpart was in effect on September 30, 1985)--
            ``(1) the owner of the facility ceases to be a public or 
        nonprofit school;
            ``(2) the facility ceases to be used for the training 
        purposes for which it was constructed; or
            ``(3) the facility is used for sectarian instruction or as 
        a place for religious worship,
the United States shall be entitled to recover from the owner of the 
facility the base amount prescribed by subsection (c)(1) plus the 
interest (if any) prescribed by subsection (c)(2).
    ``(b) Notice of Change in Status.--The owner of a facility which 
ceases to be a public or nonprofit school as described in paragraph (1) 
of subsection (a), or the owner of a facility the use of which changes 
as described in paragraph (2) or (3) of such subsection shall provide 
the Secretary written notice of such cessation or change of use within 
10 days after the date on which such cessation or change of use occurs 
or within 30 days after the date of enactment of the Health Professions 
Training Assistance Act of 1985, whichever is later.
    ``(c) Amount of Recovery.--
            ``(1) Base amount.--The base amount that the United States 
        is entitled to recover under subsection (a) is the amount 
        bearing the same ratio to the then value (as determined by the 
        agreement of the parties or in an action brought in the 
        district court of the United States for the district in which 
        the facility is situated) of the facility as the amount of the 
        Federal participation bore to the cost of the construction.
            ``(2) Interest.--
                    ``(A) In general.--The interest that the United 
                States is entitled to recover under subsection (a) is 
                the interest for the period (if any) described in 
                subparagraph (B) at a rate (determined by the 
                Secretary) based on the average of the bond equivalent 
                rates of 91-day Treasury bills auctioned during such 
                period.
                    ``(B) Time period.--The period referred to in 
                subparagraph (A) is the period beginning--
                            ``(i) if notice is provided as prescribed 
                        by subsection (b), 191 days after the date on 
                        which the owner of the facility ceases to be a 
                        public or nonprofit school as described in 
                        paragraph (1) of subsection (a), or 191 days 
                        after the date on which the use of the facility 
                        changes as described in paragraph (2) or (3) of 
                        such subsection; or
                            ``(ii) if notice is not provided as 
                        prescribed by subsection (b), 11 days after the 
                        date on which such cessation or change of use 
                        occurs,
                and ending on the date the amount the United States is 
                entitled to recover is collected.
    ``(d) Waiver of Rights.--The Secretary may waive the recovery 
rights of the United States under subsection (a)(2) with respect to a 
facility (under such conditions as the Secretary may establish by 
regulation) if the Secretary determines that there is good cause for 
waiving such rights.
    ``(e) Limitation on Liens.--The right of recovery of the United 
States under subsection (a) shall not, prior to judgment, constitute a 
lien on any facility.

   ``PART B--NURSE PRACTITIONERS, NURSE MIDWIVES, AND OTHER ADVANCED 
                            PRACTICE NURSES

``SEC. 811. ADVANCED PRACTICE NURSING GRANTS.

    ``(a) In General.--The Secretary may award grants to and enter into 
contracts with eligible entities to meet the costs of--
            ``(1) projects that support the enhancement of advanced 
        practice nursing education and practice; and
            ``(2) traineeships for individuals in advanced practice 
        nursing programs.
    ``(b) Definition of Advanced Practice Nurses.--For purposes of this 
section, the term `advanced practice nurses' means nurses trained in 
advanced degree programs including individuals in combined R.N./
Master's degree programs, post-nursing master's certificate programs, 
or, in the case of nurse midwives or nurse anesthetists, in certificate 
programs in existence on the date that is one day prior to the date of 
enactment of this section, to serve as nurse practitioners, nurse 
midwives, nurse anesthetists, nurse educators, or public health nurses, 
or in other nurse specialties determined by the Secretary to require 
advanced education.
    ``(c) Authorized Nurse Practitioner and Nurse-Midwifery Programs.--
Nurse practitioner and nurse midwifery programs eligible for support 
under this section are educational programs for registered nurses 
(irrespective of the type of school of nursing in which the nurses 
received their training) that--
            ``(1) meet guidelines prescribed by the Secretary; and
            ``(2) have as their objective the education of nurses who 
        will upon completion of their studies in such programs, be 
        qualified to effectively provide primary health care, including 
        primary health care in homes and in ambulatory care facilities, 
        long-term care facilities and other health care institutions.
    ``(d) Other Authorized Educational Programs.--The Secretary shall 
prescribe guidelines as appropriate for other advanced practice nurse 
education programs eligible for support under this section.
    ``(e) Traineeships.--
            ``(1) In general.--The Secretary may not award a grant to 
        an applicant under subsection (a) unless the applicant involved 
        agrees that traineeships provided with the grant will only pay 
        all or part of the costs of--
                    ``(A) the tuition, books, and fees of the program 
                of advanced nursing practice with respect to which the 
                traineeship is provided; and
                    ``(B) the reasonable living expenses of the 
                individual during the period for which the traineeship 
                is provided.
            ``(2) Doctoral programs.--The Secretary may not obligate 
        more than 10 percent of the traineeships under subsection (a) 
        for individuals in doctorate degree programs.
            ``(3) Special consideration.--In making awards of grants 
        and contracts under subsection (a)(2), the Secretary shall give 
        special consideration to an eligible entity that agrees to 
        expend the award to train advanced practice nurses who will 
        practice in health professional shortage areas designated under 
        section 332.

            ``PART C--INCREASING NURSING WORKFORCE DIVERSITY

``SEC. 821. WORKFORCE DIVERSITY GRANTS.

    ``(a) In General.--The Secretary may award grants to and enter into 
contracts with eligible entities to meet the costs of special projects 
to increase nursing education opportunities for individuals who are 
from disadvantaged backgrounds (including racial and ethnic minorities 
underrepresented among registered nurses) by providing student 
scholarships or stipends, pre-entry preparation, and retention 
activities.
    ``(b) Guidance.--In carrying out subsection (a), the Secretary 
shall take into consideration the recommendations of the First and 
Second Invitational Congresses for Minority Nurse Leaders on `Caring 
for the Emerging Majority,' in 1992 and 1993, and consult with nursing 
associations including the American Nurses Association, the National 
League for Nursing, the American Association of Colleges of Nursing, 
the Black Nurses Association, the Association of Hispanic Nurses, the 
Association of Asian American and Pacific Islander Nurses, the National 
Nurses Association, and the Native American Indian and Alaskan Nurses 
Association.
    ``(c) Required Information and Conditions for Award Recipients.--
            ``(1) In general.--Recipients of awards under this section 
        may be required, where requested, to report to the Secretary 
        concerning the annual admission, retention, and graduation 
        rates for ethnic and racial minorities in the school or schools 
        involved in the projects.
            ``(2) Falling rates.--If any of the rates reported under 
        paragraph (1) fall below the average of the two previous years, 
        the grant or contract recipient shall provide the Secretary 
        with plans for immediately improving such rates.
            ``(3) Ineligibility.--A recipient described in paragraph 
        (2) shall be ineligible for continued funding under this 
        section if the plan of the recipient fails to improve the rates 
        within the 1-year period beginning on the date such plan is 
        implemented.

``PART D--STRENGTHENING CAPACITY FOR BASIC NURSE EDUCATION AND PRACTICE

``SEC. 831. BASIC NURSE EDUCATION AND PRACTICE GRANTS.

    ``(a) In General.--The Secretary may award grants to and enter into 
contracts with eligible entities for projects to strengthen capacity 
for basic nurse education and practice.
    ``(b) Priority Areas.--In awarding grants or contracts under this 
section the Secretary shall give priority to entities that will use 
amounts provided under such a grant or contract to enhance the 
education mix and utilization of the basic nursing workforce by 
strengthening programs that provide basic nurse education for purposes 
of--
            ``(1) improving nursing services in schools and other 
        community settings;
            ``(2) providing care for underserved populations and other 
        high-risk groups such as the elderly, individuals with HIV-
        AIDS, substance abusers, homeless, and battered women;
            ``(3) providing managed care, quality improvement, and 
        other skills needed under new systems of organized health care 
        systems;
            ``(4) developing cultural competencies among nurses;
            ``(5) providing emergency health services;
            ``(6) promoting career mobility for nursing personnel in a 
        variety of training settings and cross training or specialty 
        training among diverse population groups; or
            ``(7) other priority areas as determined by the Secretary.

               ``PART F--AUTHORIZATION OF APPROPRIATIONS

``SEC. 841. AUTHORIZATION OF APPROPRIATIONS.

    ``There are authorized to be appropriated to carry out sections 
811, 821, and 831, $62,000,000 for fiscal year 1996, such sums as may 
be necessary in each of the fiscal years 1997 and 1998, and $59,000,000 
for fiscal year 1999.''; and
            (6) by redesignating section 855 as section 810, and 
        transferring such section so as to appear after section 809 (as 
        added by the amendment made by paragraph (5)).

SEC. 124. SAVINGS PROVISION.

    In the case of any authority for making awards of grants or 
contracts that is terminated by the amendment made by section 123, the 
Secretary of Health and Human Services may, notwithstanding the 
termination of the authority, continue in effect any grant or contract 
made under the authority that is in effect on the day before the date 
of the enactment of this Act, subject to the duration of any such grant 
or contract not exceeding the period determined by the Secretary in 
first approving such financial assistance, or in approving the most 
recent request made (before the date of such enactment) for 
continuation of such assistance, as the case may be.

                    Subtitle C--Financial Assistance

  PART 1--NATIONAL HEALTH SERVICE CORPS FINANCIAL ASSISTANCE PROGRAMS

SEC. 131. GENERAL AMENDMENTS WITH RESPECT TO FEDERALLY SUPPORTED LOANS.

    (a) Loan Repayment Program.--Section 338B of the Public Health 
Service Act (42 U.S.C. 254l-1) is amended--
            (1) in subsection (a)--
                    (A) in the matter preceding paragraph (1), by 
                inserting ``and public health disease prevention and 
                health promotion activities'' before the dash; and
                    (B) in paragraph (1), by striking ``and physician 
                assistants'' and inserting ``physician assistants, and 
                public health professionals'';
            (2) in subsection (b)(1)--
                    (A) in subparagraph (A), by inserting ``public 
                health,'' after ``dentistry,'';
                    (B) in subparagraph (B), by inserting ``public 
                health,'' after ``dentistry,''; and
                    (C) in subparagraph (C), by inserting ``public 
                health,'' after ``dentistry,'';
            (3) in subsection (c)(4)--
                    (A) in subparagraph (A), by inserting ``and schools 
                of public health'' after ``professions schools'';
                    (B) in subparagraph (B)(i)--
                            (i) by inserting ``or public health 
                        professional'' after ``any health 
                        professional''; and
                            (ii) by inserting ``or public health 
                        disease prevention and health promotion 
                        activities'' before the period;
                    (C) in subparagraph (C)--
                            (i) by inserting ``or public health disease 
                        prevention and health promotion activities,'' 
                        after ``primary health services,'';
                            (ii) by inserting ``or public health 
                        professions'' after ``health professions''; and
                            (iii) by inserting ``or public health 
                        professionals'' after ``health professionals'' 
                        each place that such occurs;
            (4) in subsection (f)(1)(B)(iv), by inserting ``or public 
        health disease prevention and health promotion activities'' 
        after ``primary health services'';
            (5) in subsection (g)(2)(A)(iii)--
                    (A) by inserting ``or public health professional'' 
                after ``the health professional''; and
                    (B) by inserting ``or public health disease 
                prevention and health promotion activities'' after 
                ``primary health services''; and
            (6) in subsection (i)(8), --
                    (A) by inserting ``or public health professionals'' 
                after ``health professionals''; and
                    (B) by inserting ``or public health disease 
                prevention and health promotion activities'' after 
                ``primary health services''.
    (b) Obligated Service.--Section 338C(b)(5) of the Public Health 
Service Act (42 U.S.C. 254m(b)(5)) is amended--
            (1) in subparagraph (A), by inserting ``public health,'' 
        after ``dentistry,''; and
            (2) in subparagraph (E)--
                    (A) in clause (ii), by inserting ``public health,'' 
                after ``dentistry,''; and
                    (B) in clause (iii), by inserting ``public 
                health,'' after ``dentistry,''.
    (c) Authorization of Appropriations.--Section 338H of the Public 
Health Service Act (42 U.S.C. 254q) is amended to read as follows:

``SEC. 338H. AUTHORIZATION OF APPROPRIATIONS.

    ``(a) Authorization of Appropriations.--For the purpose of carrying 
out this subpart, there are authorized to be appropriated $90,000,000 
for fiscal year 1996 and such sums as may be necessary for each of the 
fiscal years 1997 through 2000.
    ``(b) Distribution of Amounts.--The Secretary shall determine the 
most appropriate manner in which to allocate amounts appropriated under 
subsection (a) between the programs authorized in chapter 1, chapter 2, 
and chapter 3. In determining the manner in which to allocate such 
amounts, the Secretary shall give priority to funding State-based 
programs as appropriate under chapter 3. The Secretary shall distribute 
such amounts among the various programs in such chapters in a manner 
which furthers both Federal and State needs for health professionals in 
underserved areas.''.
    (d) Grants for Loan Repayment Program.--Section 338I of the Public 
Health Service Act (42 U.S.C. 254q-1) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (1), by striking ``in health 
                professional shortage areas'' and inserting ``or public 
                health disease prevention and health promotion 
                activities in Federal health professional shortage 
                areas or approved State designated health professional 
                shortage areas''; and
                    (B) in paragraph (2)--
                            (i) by inserting ``or public health 
                        professionals'' after ``health professionals''; 
                        and
                            (ii) by striking ``in health professional 
                        shortage areas'' and inserting ``or public 
                        health disease prevention and health promotion 
                        activities in Federal health professional 
                        shortage areas or approved State designated 
                        health professional shortage areas'';
            (2) in subsection (c)--
                    (A) in paragraph (1)--
                            (i) in the paragraph heading, by striking 
                        ``federal'' and inserting ``federal or approved 
                        state''; and
                            (ii) by inserting before the period the 
                        following: ``or approved State designated 
                        health professional shortage areas'';
                    (B) in paragraph (2), by inserting ``or public 
                health professionals'' after ``health professionals'';
                    (C) in paragraph (3)--
                            (i) in subparagraph (A)--
                                    (I) in the matter preceding clause 
                                (i), by inserting ``or public health 
                                professionals'' after ``health 
                                professionals''; and
                                    (II) in clause (ii), by striking 
                                health'';
                            (ii) in subparagraph (B)--
                                    (I) in the matter preceding clause 
                                (i), by inserting ``or public health 
                                professional'' after ``health 
                                professional''; and
                                    (II) in clause (ii)--
                                            (aa) by inserting ``or 
                                        public health professional'' 
                                        after ``the health 
                                        professional''; and
                                            (bb) by striking ``services 
                                        in a'' and inserting ``services 
                                        or public health disease 
                                        prevention and health promotion 
                                        activities in a Federal''; and
                    (D) by adding at the end thereof the following new 
                paragraph:
            ``(4) Private practice.--
                    ``(A) In carrying out the program operated with a 
                grant under subsection (a), a State may waive the 
                requirement of paragraph (1) regarding the assignment 
                of a health professional if, subject to subparagraph 
                (B), the health professional enters into an agreement 
                with the State to provide primary health services in a 
                full-time private clinical practice in a health 
                professional shortage area.
                    ``(B) The Secretary may not make a grant under 
                subsection (a) unless the State involved agrees that, 
                if the State provides a waiver under subparagraph (A) 
                for a health professional, section 338D(b)(1) will 
                apply to the agreement under such subparagraph between 
                the State and the health professional to the same 
                extent and in the same manner as such section applies 
                to an agreement between the Secretary and a health 
                professional regarding a full-time private clinical 
                practice.''; and
            (3) in subsection (h), to read as follows:
    ``(h) Definitions.--Unless specifically provided otherwise, as used 
in this subpart and section 338F:
            ``(1) Approved state designated health professional 
        shortage area.--The term `approved State designated health 
        professional shortage area' means an area designated by the 
        State as underserved using specific methodology and criteria to 
        identify such areas. Such criteria and methodology shall be 
        approved by the Secretary.
            ``(2) Community organization.--The term `community 
        organization' means a public or nonprofit private entity.
            ``(3) Primary health care.--The term `primary health care' 
        means health services regarding family medicine, general 
        internal medicine, general
         pediatrics, or may include obstetrics and gynecology, that are 
provided by physicians, certified nurse practitioners, certified nurse 
midwives, or physician assistants.
            ``(4) State.--The term `State' means each of the several 
        States and the District of Columbia.''.
    (e) Community Scholarship Programs.--Section 338L of the Public 
Health Service Act (42 U.S.C. 254t) is amended--
            (1) in the section heading, by striking ``demonstration 
        grants to states for'';
            (2) in subsection (a), by striking ``health manpower 
        shortage areas'' and inserting ``Federal health professional 
        shortage areas and in approved State designated health 
        professional shortage areas'';
            (3) in subsection (c)--
                    (A) in the matter preceding paragraph (1), by 
                striking ``health manpower shortage areas'' and 
                inserting ``Federal health professional shortage areas 
                and in approved State designated health professional 
                shortage areas''; and
                    (B) in paragraph (2), by striking ``health manpower 
                shortage areas'' and inserting ``Federal health 
                professional shortage areas and in approved State 
                designated health professional shortage areas'';
            (4) in subsection (e)(1), by striking ``health manpower 
        shortage areas'' and inserting ``Federal health professional 
        shortage areas and in approved State designated health 
        professional shortage areas'';
            (5) in subsection (f)(1)(A), by striking ``health manpower 
        shortage areas'' and inserting ``Federal health professional 
        shortage areas and in approved State designated health 
        professional shortage areas'';
            (6) in subsection (g), by striking ``health manpower 
        shortage areas'' each place that such appears and inserting 
        ``Federal health professional shortage areas and in approved 
        State designated health professional shortage areas''; and
            (7) by striking subsections (j) through (l).

SEC. 132. RESTRUCTURING AND TECHNICAL AMENDMENTS.

    (a) Redesignations.--Subpart III of part D of title III of the 
Public Health Service Act (42 U.S.C. 254l et seq.) is amended--
            (1) by redesignating sections 338J and 338K (42 U.S.C. 254s 
        and 254t) as sections 338M and 338N, respectively;
            (2) by redesignating sections 338C through 338H (42 U.S.C. 
        254m through 254q) as sections 338G through 338L, respectively;
            (3) by redesignating section 338I (as such section exists 
        one day prior to the date of enactment of this Act) (42 U.S.C. 
        254r) as section 338E;
            (4) by redesignating section 338L (as such section exists 
        one day prior to the date of enactment of this Act) (42 U.S.C. 
        254u) as section 338F;
    (b) Consolidation of Certain Programs.--Subpart III of part D of 
title III of the Public Health Service Act (42 U.S.C. 254l et seq.) (as 
amended by subsection (a)) is further amended--
            (1) by striking the subpart heading and inserting the 
        following:

       ``Subpart III--Federally Supported Scholarships and Loans

    ``CHAPTER 1--NATIONAL HEALTH SERVICE CORPS SCHOLARSHIPS PROGRAMS

            (2) by redesignating section 338B as section 338C;
            (3) by inserting before section 338C (as so redesignated) 
        the following:

   ``CHAPTER 2--NATIONAL HEALTH SERVICE CORPS LOAN REPAYMENT PROGRAMS

               ``Subchapter A--Loan Repayment Program'';

            and
            (4) by inserting after section 338C (as so redesignated) 
        the following:

           ``Subchapter B--Nursing Loan Repayment Program''.

    (c) Transfers and Redesignations of Nursing Loan Repayment 
Program.--Subpart II of part E of title VIII (42 U.S.C. 297n et seq.) 
(as so redesignated by section 123(3)) is amended--
            (1) by striking the subpart heading;
            (2) by transferring section 846 (42 U.S.C. 297n) to 
        subchapter B of chapter 2 of subpart III of part D of title III 
        (as added by subsection (b)(4)); and
            (3) in section 846--
                    (A) by striking the section heading and inserting 
                the following:

``SEC. 338D. NURSING LOAN REPAYMENT PROGRAM.'';

                    (B) by striking subsection (d); and
                    (C) by striking subsection (g).
    (d) Transfers and Redesignations of State Loan Repayment and 
Community Scholarship Programs.--Subpart III of part D of title III of 
the Public Health Service Act (42 U.S.C. 254l et seq.) (as amended by 
subsections (a) through (c)) is further amended--
            (1) by inserting after section 338D (as so transferred and 
        redesignated by subsection (c)(3)) the following:

  ``CHAPTER 3--STATE LOAN REPAYMENT AND COMMUNITY SCHOLARSHIP PROGRAMS

            ``Subchapter A--State Loan Repayment Programs'';

            (2) by transferring section 338E (as so redesignated by 
        subsection (a)(3)) to subchapter A of chapter 3 of such subpart 
        (as added by paragraph (1));
            (3) by inserting after section 338E (as transferred by 
        paragraph (2)) the following:

           ``Subchapter B--Community Scholarship Programs'';

            (4) by transferring section 338F (as so redesignated by 
        subsection (a)(4)) to subchapter B of chapter 3 of such subpart 
        (as added by paragraph (3)); and
            (5) by inserting after section 338F (as transferred by 
        paragraph (4)) the following:

                   ``CHAPTER 4--GENERAL PROVISIONS''.

    (e) Clinical Researchers.--Paragraph (3) of section 487E(a) of the 
Public Health Service Act (42 U.S.C. 288-5(a)(3)) is amended to read as 
follows:
            ``(3) Applicability of certain provisions regarding 
        obligated service.--With respect to the National Health Service 
        Corps loan repayment program established in subpart III of part 
        D of title III, the provisions of such subpart shall, except as 
        inconsistent with this section, apply to the program 
        established in subsection (a) in the same manner and to the 
        same extent as such provisions apply to the National Health 
        Service Corps loan repayment programs.''.

SEC. 133. DEFINITION OF UNDERSERVED AREAS.

    Section 332(a)(1) of the Public Health Service Act (42 U.S.C. 
254e(a)(1)) is amended in the first sentence--
            (1) by striking ``, or (C)'' and inserting ``, (C)''; and
            (2) by inserting before the period the following: ``, or 
        (D) a State or local health department that has a severe 
        shortage of public health personnel as determined under 
        criteria established by the Secretary''.

SEC. 134. CONFORMING AMENDMENTS.

    Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) 
is amended--
            (1) in subparagraphs (A) and (B) of section 303(d)(4) (42 
        U.S.C. 242a(d)(4)(A) and (B)), by striking ``338C or 338D'' 
        each place that such occurs and inserting ``338G or 338H'';
            (2) in section 331(c) (42 U.S.C. 254d(c)), by striking 
        ``338D'' and inserting ``338H'';
            (3) in section 337(a) (42 U.S.C. 254j(a)), by striking 
        ``338G'' and inserting ``338K'';
            (4) in 338A (42 U.S.C. 254l)--
                    (A) in subsection (c)(1)--
                            (i) in subparagraph (A), by striking 
                        ``338D'' and inserting ``338I''; and
                            (ii) in subparagraph (B), by striking 
                        ``338C'' and inserting ``338H'';
                    (B) in subsection (f)(3), by striking ``338D'' and 
                inserting ``338I''; and
                    (C) in subsection (i)(5)--
                            (i) in subparagraph (A), by striking 
                        ``338E'' and inserting ``338I''; and
                            (ii) in subparagraph (B)(ii), by striking 
                        ``338E'' and inserting ``338I'';
            (5) in section 338C (as so redesignated) (42 U.S.C. 254l-
        1)--
                    (A) in subsection (c)(1)--
                            (i) in subparagraph (A), by striking 
                        ``338E'' and inserting ``338I''; and
                            (ii) in subparagraph (B), by striking 
                        ``338D'' and inserting ``338H'';
                    (B) in subsection (f)(1)(B)(iv), by striking 
                ``338D'' and inserting ``338H'';
                    (C) in subsection (f)(4), by striking ``338E'' and 
                inserting ``338I''; and
                    (D) in subsection (i)(7)--
                            (i) in subparagraph (A), by striking 
                        ``338E'' and inserting ``338I''; and
                            (ii) in subparagraph (B)(ii), by striking 
                        ``338E'' and inserting ``338I'';
            (6) in section 338E(d)(1)(C) (as so redesignated by section 
        132), by striking ``338J'' and inserting ``338M'';
            (7) in section 338G (as so redesignated by section 132)--
                    (A) in subsection (a)--
                            (i) by striking ``338D'' and inserting 
                        ``338H''; and
                            (ii) by striking ``338B'' and inserting 
                        ``338C''; and
                    (B) in subsection (c)(2), by striking ``338D'' and 
                inserting ``338H'';
            (8) in section 338H (as so redesignated by section 132)--
                    (A) in subsection (a), by striking ``338C'' and 
                inserting ``338G''; and
                    (B) in subsection (c), by striking ``338B'' and 
                inserting ``338C'';
            (9) in section 338I (as so redesignated by section 132)--
                    (A) in subsection (b)(1)(A)--
                            (i) by striking ``338F'' and inserting 
                        ``338J'';
                            (ii) by striking ``338C or 338D'' and 
                        inserting ``338G or 338H'';
                            (iii) by striking ``338C'' and inserting 
                        ``338G''; and
                            (iv) by striking ``338D'' and inserting 
                        ``338H''; and
                    (B) in subsection (c)(1)--
                            (i) by striking ``338F'' and inserting 
                        ``338K'';
                            (ii) by striking ``338B'' and inserting 
                        ``338C''; and
                            (iii) by striking ``338C or 338D'' and 
                        inserting ``338G or 338H'';
            (10) in section 338J(b) (as so redesignated by section 
        132)--
                    (A) in paragraph (1)--
                            (i) by striking ``338E'' and inserting 
                        ``338I''; and
                            (ii) by striking ``338B'' and inserting 
                        ``338C''; and
                    (B) in paragraph (2), by striking ``338I'' and 
                inserting ``338E'';
            (11) in section 338K (as so redesignated by section 132)--
                    (A) in subsection (a)(2), by striking ``338D'' and 
                inserting ``338H''; and
                    (B) in subsection (d)(1), by striking ``338E'' and 
                inserting ``338I''; and
            (12) in section 338M(e)(1)(B)(ii)(III) (as so redesignated 
        by section 132), by striking ``338I'' and inserting ``338E''.

               PART 2--SCHOOL-BASED REVOLVING LOAN FUNDS

SEC. 135. PRIMARY CARE LOAN PROGRAM.

    (a) Requirement for Schools.--Section 723(b)(1) of the Public 
Health Service Act (42 U.S.C. 292s(b)(1)), as amended by section 
2014(c)(2)(A)(ii) of Public Law 103-43 (107 Stat. 216), is amended by 
striking ``3 years before'' and inserting ``4 years before''.
    (b) Service Requirement for Primary Care Loan Borrowers.--Section 
723(a) of the Public Health Service Act (42 U.S.C. 292s(a)) is amended 
in subparagraph (B) of paragraph (1), by striking ``through the date on 
which the loan is repaid in full'' and inserting ``for 5 years after 
completing the residency program''.
    (c) Report Requirement.--Section 723 of the Public Health Service 
Act (42 U.S.C. 292s) is amended--
            (1) by striking subsection (c); and
            (2) by redesignating subsection (d) as subsection (c).

SEC. 136. LOANS FOR DISADVANTAGED STUDENTS.

    (a) Authorization of Appropriations.--Section 724(f)(1) of the 
Public Health Service Act (42 U.S.C. 292t(f)(1)) is amended by striking 
``$15,000,000 for fiscal year 1993'' and inserting ``$8,000,000 for 
each of the fiscal years 1996 through 1998''.
    (b) Repeal.--Effective October 1, 1998, paragraph (1) of section 
724(f) of the Public Health Service Act (42 U.S.C. 292t(f)(1)) is 
repealed.

SEC. 137. STUDENT LOANS REGARDING SCHOOLS OF NURSING.

    (a) In General.--Section 836(b) of the Public Health Service Act 
(42 U.S.C. 297b(b)) is amended--
            (1) in paragraph (1), by striking the period at the end and 
        inserting a semicolon;
            (2) in paragraph (2)--
                    (A) in subparagraph (A), by striking ``and'' at the 
                end; and
                    (B) by inserting before the semicolon at the end 
                the following: ``, and (C) such additional periods 
                under the terms of paragraph (8) of this subsection'';
            (3) in paragraph (7), by striking the period at the end and 
        inserting ``; and''; and
            (4) by adding at the end the following paragraph:
            ``(8) pursuant to uniform criteria established by the 
        Secretary, the repayment period established under paragraph (2) 
        for any student borrower who during the repayment period failed 
        to make consecutive payments and who, during the last 12 months 
        of the repayment period, has made at least 12 consecutive 
        payments may be extended for a period not to exceed 10 
        years.''.
    (b) Minimum Monthly Payments.--Section 836(g) of the Public Health 
Service Act (42 U.S.C. 297b(g)) is amended by striking ``$15'' and 
inserting ``$40''.
    (c) Elimination of Statute of Limitation for Loan Collections.--
            (1) In general.--Section 836 of the Public Health Service 
        Act (42 U.S.C. 297b) is amended by adding at the end the 
        following new subsection:
    ``(l) Elimination of Statute of Limitation for Loan Collections.--
            ``(1) Purpose.--It is the purpose of this subsection to 
        ensure that obligations to repay loans under this section are 
        enforced without regard to any Federal or State statutory, 
        regulatory, or administrative limitation on the period within 
        which debts may be enforced.
            ``(2) Prohibition.--Notwithstanding any other provision of 
        Federal or State law, no limitation shall terminate the period 
        within which suit may be filed, a judgment may be enforced, or 
        an offset, garnishment, or other action may be initiated or 
        taken by a school of nursing that has an agreement with the 
        Secretary pursuant to section 835 that is seeking the repayment 
        of the amount due from a borrower on a loan made under this 
        subpart after the default of the borrower on such loan.''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall be effective with respect to actions pending on or after 
        the date of enactment of this Act.
    (d) Breach of Agreements.--Section 338D of the Public Health 
Service Act (as so redesignated and amended under section 132(c)) is 
amended by adding at the end thereof the following new subsection:
    ``(g) Breach of Agreement.--
            ``(1) In general.--In the case of any program under this 
        section under which an individual makes an agreement to provide 
        health services for a period of time in accordance with such 
        program in consideration of receiving an award of Federal funds 
        regarding education as a nurse (including an award for the 
        repayment of loans), the following applies if the agreement 
        provides that this subsection is applicable:
                    ``(A) In the case of a program under this section 
                that makes an award of Federal funds for attending an 
                accredited program of nursing (in this section referred 
                to as a `nursing program'), the individual is liable to 
                the Federal Government for the amount of such award 
                (including amounts provided for expenses related to 
                such attendance), and for interest on such amount at 
                the maximum legal prevailing rate, if the individual--
                            ``(i) fails to maintain an acceptable level 
                        of academic standing in the nursing program (as 
                        indicated by the program in accordance with 
                        requirements established by the Secretary);
                            ``(ii) is dismissed from the nursing 
                        program for disciplinary reasons; or
                            ``(iii) voluntarily terminates the nursing 
                        program.
                    ``(B) The individual is liable to the Federal 
                Government for the amount of such award (including 
                amounts provided for expenses related to such 
                attendance), and for interest on such amount at the 
                maximum legal prevailing rate, if the individual fails 
                to provide health services in accordance with the 
                program under this section for the period of time 
                applicable under the program.
            ``(2) Waiver or suspension of liability.--In the case of an 
        individual or health facility making an agreement for purposes 
        of paragraph (1), the Secretary shall provide for the waiver or 
        suspension of liability under such subsection if compliance by 
        the individual or the health facility, as the case may be, with 
        the agreements involved is impossible, or would involve extreme 
        hardship to the individual or facility, and if enforcement of 
        the agreements with respect to the individual or facility would 
        be unconscionable.
            ``(3) Date certain for recovery.--Subject to paragraph (2), 
        any amount that the Federal Government is entitled to recover 
        under paragraph (1) shall be paid to the United States not 
        later than the expiration of the 3-year period beginning on the 
        date the United States becomes so entitled.
            ``(4) Availability.--Amounts recovered under paragraph (1) 
        with respect to a program under this section shall be available 
        for the purposes of such program, and shall remain available 
        for such purposes until expended.''.
    (e) Technical Amendments.--Section 839 of the Public Health Service 
Act (42 U.S.C. 297e) is amended--
            (1) in subsection (a)--
                    (A) by striking the matter preceding paragraph (1) 
                and inserting the following:
    ``(a) If a school terminates a loan fund established under an 
agreement pursuant to section 835(b), or if the Secretary for good 
cause terminates the agreement with the school, there shall be a 
capital distribution as follows:''; and
                    (B) in paragraph (1), by striking ``at the close of 
                September 30, 1999,'' and inserting ``on the date of 
                termination of the fund''; and
            (2) in subsection (b), to read as follows:
    ``(b) If a capital distribution is made under subsection (a), the 
school involved shall, after such capital distribution, pay to the 
Secretary, not less often than quarterly, the same proportionate share 
of amounts received by the school in payment of principal or interest 
on loans made from the loan fund established under section 835(b) as 
determined by the Secretary under subsection (a).''.

SEC. 138. GENERAL PROVISIONS.

    (a) Maximum Student Loan Provisions and Minimum Payments.--
            (1) In general.--Section 722(a)(1) of the Public Health 
        Service Act (42 U.S.C. 292r(a)(1)), as amended by section 
        2014(b)(1) of Public Law 103-43, is amended by striking ``the 
        sum of'' and all that follows through the end thereof and 
        inserting ``the cost of attendance (including tuition, other 
        reasonable educational expenses, and reasonable living costs) 
        for that year at the educational institution attended by the 
        student (as determined by such educational institution).''.
            (2) Third and fourth years.--Section 722(a)(2) of the 
        Public Health Service Act (42 U.S.C. 292r(a)(2)), as amended by 
        section 2014(b)(1) of Public Law 103-43, is amended by striking 
        ``the amount $2,500'' and all that follows through ``including 
        such $2,500'' and inserting ``the amount of the loan may, in 
        the case of the third or fourth year of a student at a school 
        of medicine or osteopathic medicine, be increased to the extent 
        necessary''.
            (3) Repayment period.--Section 722(c) of the Public Health 
        Service Act (42 U.S.C. 292r(c)), as amended by section 
        2014(b)(1) of Public Law 103-43, is amended--
                    (A) in the subsection heading by striking ``Ten-
                Year'' and inserting ``Repayment'';
                    (B) by striking ``ten-year period which begins'' 
                and inserting ``period of not less than 10 years nor 
                more than 25 years which begins''; and
                    (C) by striking ``such ten-year period'' and 
                inserting ``such period''.
            (4) Minimum payments.--Section 722(j) of the Public Health 
        Service Act (42 U.S.C. 292r(j)), as amended by section 
        2014(b)(1) of Public Law 103-43, is amended by striking ``$15'' 
        and inserting $40''.
    (b) Elimination of Statute of Limitation for Loan Collections.--
            (1) In general.--Section 722 of the Public Health Service 
        Act (42 U.S.C. 292r), as amended by section 2014(b)(1) of 
        Public Law 103-43, is amended by adding at the end the 
        following new subsection:
    ``(m) Elimination of Statute of Limitation for Loan Collections.--
            ``(1) Purpose.--It is the purpose of this subsection to 
        ensure that obligations to repay loans under this section are 
        enforced without regard to any Federal or State statutory, 
        regulatory, or administrative limitation on the period within 
        which debts may be enforced.
            ``(2) Prohibition.--Notwithstanding any other provision of 
        Federal or State law, no limitation shall terminate the period 
        within which suit may be filed, a judgment may be enforced, or 
        an offset, garnishment, or other action may be initiated or 
        taken by a school that has an agreement with the Secretary 
        pursuant to section 721 that is seeking the repayment of the 
        amount due from a borrower on a loan made under this subpart 
        after the default of the borrower on such loan.''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall be effective with respect to actions pending on or after 
        the date of enactment of this Act.
    (c) Date Certain for Contributions.--Paragraph (2) of section 
735(e) of the Public Health Service Act (42 U.S.C. 292y(e)(2)) is 
amended to read as follows:
            ``(2) Date certain for contributions.--Amounts described in 
        paragraph (1) that are returned to the Secretary shall be 
        obligated before the end of the succeeding fiscal year.''.

 PART 3--INSURED HEALTH EDUCATION ASSISTANCE LOANS TO GRADUATE STUDENTS

SEC. 141. HEALTH EDUCATION ASSISTANCE LOAN PROGRAM.

    (a) Health Education Assistance Loan Deferment for Borrowers 
Providing Health Services to Indians.--
            (1) In general.--Section 705(a)(2)(C) of the Public Health 
        Service Act (42 U.S.C. 292d(a)(2)(C)) is amended by striking 
        ``and (x)'' and inserting ``(x) not in excess of three years, 
        during which the borrower is providing health care services to 
        Indians through an Indian health program (as defined in section 
        108(a)(2)(A) of the Indian Health Care Improvement Act (25 
        U.S.C. 1616a(a)(2)(A)); and (xi)''.
            (2) Conforming amendments.--Section 705(a)(2)(C) of the 
        Public Health Service Act (42 U.S.C. 292d(a)(2)(C)) is further 
        amended--
                    (A) in clause (xi) (as so redesignated) by striking 
                ``(ix)'' and inserting ``(x)''; and
                    (B) in the matter following such clause (xi), by 
                striking ``(x)'' and inserting ``(xi)''.
            (3) Effective date.--The amendments made by this subsection 
        shall apply with respect to services provided on or after the 
        first day of the third month that begins after the date of the 
        enactment of this Act.
    (b) Report Requirement.--Section 709(b) of the Public Health 
Service Act (42 U.S.C. 292h(b)) is amended--
            (1) in paragraph (4)(B), by adding ``and'' after the 
        semicolon;
            (2) in paragraph (5), by striking ``; and'' and inserting a 
        period; and
            (3) by striking paragraph (6).
    (c) Collection from Estates.--Section 714 of the Public Health 
Service Act (42 U.S.C. 292m) is amended by adding at the end the 
following new sentence: ``Notwithstanding the first sentence, the 
Secretary may, in the case of a borrower who dies, collect any 
remaining unpaid balance owed to the lender, the holder of the loan, or 
the Federal Government from the borrower's estate.''.

SEC. 142. HEAL LENDER AND HOLDER PERFORMANCE STANDARDS.

    (a) General Amendments.--Section 707(a) of the Public Health 
Service Act (42 U.S.C. 292f) is amended--
            (1) by striking the last sentence;
            (2) by striking ``determined.'' and inserting ``determined, 
        except that, if the insurance beneficiary including any 
        servicer of the loan is not designated for `exceptional 
        performance', as set forth in paragraph (2), the Secretary 
        shall pay to the beneficiary a sum equal to 98 percent of the 
        amount of the loss sustained by the insured upon that loan.'';
            (3) by striking ``Upon'' and inserting:
            ``(1) In general.--Upon''; and
            (4) by adding at the end the following new paragraph:
            ``(2) Exceptional performance.--
                    ``(A) Authority.--Where the Secretary determines 
                that an eligible lender, holder, or servicer has a 
                compliance performance rating that equals or exceeds 97 
                percent, the Secretary shall designate that eligible 
                lender, holder, or servicer, as the case may be, for 
                exceptional performance.
                    ``(B) Compliance performance rating.--For purposes 
                of subparagraph (A), a compliance performance rating is 
                determined with respect to compliance with due 
                diligence in the disbursement, servicing, and 
                collection of loans under this subpart for each year 
                for which the determination is made. Such rating shall 
                be equal to the percentage of all due diligence 
                requirements applicable to each loan, on average, as 
                established by the Secretary, with respect to loans 
                serviced during the period by the eligible lender, 
                holder, or servicer.
                    ``(C) Annual audits for lenders, holders, and 
                servicers.--Each eligible lender, holder, or servicer 
                desiring a designation under subparagraph (A) shall 
                have an annual financial and compliance audit conducted 
                with respect to the loan portfolio of such eligible 
                lender, holder, or servicer, by a qualified independent 
                organization from a list of qualified organizations 
                identified by the Secretary and in accordance with 
                standards established by the Secretary. The standards 
                shall measure the lender's, holder's, or servicer's 
                compliance with due diligence standards and shall 
                include a defined statistical sampling technique 
                designed to measure the performance rating of the 
                eligible lender, holder, or servicer for the purpose of 
                this section. Each eligible lender, holder, or servicer 
                shall submit the audit required by this section to the 
                Secretary.
                    ``(D) Secretary's determinations.--The Secretary 
                shall make the determination under subparagraph (A) 
                based upon the audits submitted under this paragraph 
                and any information in the possession of the Secretary 
                or submitted by any other agency or office of the 
                Federal Government.
                    ``(E) Quarterly compliance audit.--To maintain its 
                status as an exceptional performer, the lender, holder, 
                or servicer shall undergo a quarterly compliance audit 
                at the end of each quarter (other than the quarter in 
                which status as an exceptional performer is established 
                through a financial and compliance audit, as described 
                in subparagraph (C)), and submit the results of such 
                audit to the Secretary. The compliance audit shall 
                review compliance with due diligence requirements for 
                the period beginning on the day after the ending date 
                of the previous audit, in accordance with standards 
                determined by the Secretary.
                    ``(F) Revocation authority.--The Secretary shall 
                revoke the designation of a lender, holder, or servicer 
                under subparagraph (A) if any quarterly audit required 
                under subparagraph (E) is not received by the Secretary 
                by the date established by the Secretary or if the 
                audit indicates the lender, holder, or servicer has 
                failed to meet the standards for designation as an 
                exceptional performer under subparagraph (A). A lender, 
                holder, or servicer receiving a compliance audit not 
                meeting the standard for designation as an exceptional 
                performer may reapply for designation under 
                subparagraph (A) at any time.
                    ``(G) Documentation.--Nothing in this section shall 
                restrict or limit the authority of the Secretary to 
                require the submission of claims documentation 
                evidencing servicing performed on loans, except that 
                the Secretary may not require exceptional performers to 
                submit greater documentation than that required for 
                lenders, holders, and servicers not designated under 
                subparagraph (A).
                    ``(H) Cost of audits.--Each eligible lender, 
                holder, or servicer shall pay for all the costs 
                associated with the audits required under this section.
                    ``(I) Additional revocation authority.--
                Notwithstanding any other provision of this section, a 
                designation under subparagraph (A) may be revoked at 
                any time by the Secretary if the Secretary determines 
                that the eligible lender, holder, or servicer has 
                failed to maintain an overall level of compliance 
                consistent with the audit submitted by the eligible 
                lender, holder, or servicer under this paragraph or if 
                the Secretary asserts that the lender, holder, or 
                servicer may have engaged in fraud in securing 
                designation under subparagraph (A) or is failing to 
                service loans in accordance with program requirements.
                    ``(J) Noncompliance.--A lender, holder, or servicer 
                designated under subparagraph (A) that fails to service 
                loans or otherwise comply with applicable program 
                regulations shall be considered in violation of the 
                Federal False Claims Act.''.
    (b) Definition.--Section 707(e) of the Public Health Service Act 
(42 U.S.C. 292f(e)) is amended by adding at the end the following new 
paragraph:
            ``(4) The term `servicer' means any agency acting on behalf 
        of the insurance beneficiary.''.
    (c) Effective Date.--The amendments made by subsections (a) and (b) 
shall apply with respect to loans submitted to the Secretary for 
payment on or after the first day of the sixth month that begins after 
the date of enactment of this Act.

SEC. 143. REAUTHORIZATION.

    (a) Loan Program.--Section 702(a) of the Public Health Service Act 
(42 U.S.C. 292a(a)) is amended--
            (1) by striking ``1993'' and inserting ``1996'';
            (2) by striking ``1994'' and inserting ``1997'';
            (3) by striking ``fiscal year 1995'' and inserting ``each 
        of the fiscal years 1998 and 1999''; and
            (4) by striking ``September 30, 1998'' and inserting 
        ``September 20, 2002''.
    (b) Insurance Program.--Section 710(a)(2)(B) of the Public Health 
Service Act (42 U.S.C. 292i(a)(2)(B)) is amended by striking ``any of 
the fiscal years 1993 through 1996'' and inserting ``fiscal year 1993 
and subsequent fiscal years''.

            PART 4--SCHOLARSHIPS FOR DISADVANTAGED STUDENTS

SEC. 151. SCHOLARSHIPS FOR DISADVANTAGED STUDENTS.

    Part B of title VII of the Public Health Service Act (as amended by 
section 101(a)) is further amended by adding at the end thereof the 
following new section:
``SEC. 740. SCHOLARSHIPS FOR DISADVANTAGED STUDENTS.

    ``(a) In General.--The Secretary may make a grant to an eligible 
entity (as defined in subsection (f)(1)) under this section for the 
awarding of scholarships by schools to any full-time student who is an 
eligible individual as defined in subsection (f). Such scholarships may 
be expended only for tuition expenses, other reasonable educational 
expenses, and reasonable living expenses incurred in the attendance of 
such school, and may not, for any year of such attendance for which the 
scholarship is provided, provide an amount exceeding the total amount 
required for the year.
    ``(b) Preference in Providing Scholarships.--The Secretary may not 
make a grant to an entity under subsection (a) unless the health 
professions and nursing schools involved agrees that, in providing 
scholarships pursuant to the grant, the school will give preference to 
students for whom the costs of attending the school would constitute a 
severe financial hardship and, notwithstanding other provisions of this 
section, to former recipients of scholarships under sections 736 and 
740(d)(2)(B) (as such sections existed on the day before the date of 
enactment of this section).
    ``(c) Amount of Award.--In awarding grants to eligible entities 
that are health professions and nursing schools, the Secretary shall 
give priority to eligible entities based on the proportion of 
graduating students going into primary care, the proportion of minority 
students, and the proportion of graduates working in medically 
underserved areas.
    ``(d) Maximum Scholarship Award.--The maximum scholarship that an 
individual may receive in any year from an eligible entity that is a 
health professions and nursing schools shall be $3000.
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, $32,000,000 for each of the 
fiscal years 1996 through 1999. Of the amount appropriated in any 
fiscal year, the Secretary shall ensure that not less than 16 percent 
shall be distributed to schools of nursing.
    ``(f) Definitions.--As used in this section:
            ``(1) Eligible entities.--The term `eligible entities' 
        means an entity that--
                    ``(A) is a school of medicine, osteopathic 
                medicine, dentistry, nursing (as defined in section 
                801), pharmacy, podiatric medicine, optometry, 
                veterinary medicine, public health, or allied health, a 
                school offering a graduate program in mental health 
                practice, or an entity providing programs for the 
                training of physician assistant; and
                    ``(B) is carrying out a program for recruiting and 
                retaining students from disadvantaged backgrounds, 
                including students who are members of racial and ethnic 
                minority groups.
            ``(2) Eligible individual.--The term `eligible individual' 
        means an individual who--
                    ``(A) is from a disadvantaged background;
                    ``(B) has a financial need for a scholarship; and
                    ``(C) is enrolled (or accepted for enrollment) at 
                an eligible health profession or nursing school as a 
                full-time student in a program leading to a degree in a 
                health profession or nursing.''.

                  TITLE II--OFFICE OF MINORITY HEALTH

SEC. 201. REVISION AND EXTENSION OF PROGRAMS OF OFFICE OF MINORITY 
              HEALTH.

    (a) In General.--Section 1707 of the Public Health Service Act (42 
U.S.C. 300u-6) is amended by striking subsection (b) and all that 
follows and inserting the following:
    ``(b) Duties.--With respect to improving the health of racial and 
ethnic minority groups, the Secretary, acting through the Deputy 
Assistant Secretary for Minority Health (in this section referred to as 
the `Deputy Assistant Secretary'), shall carry out the following:
            ``(1) Establish short-range and long-range goals and 
        objectives and coordinate all other activities within the 
        Public Health Service that relate to disease prevention, health 
        promotion, service delivery, and research concerning such 
        individuals. The heads of each of the agencies of the Service 
        shall consult with the Deputy Assistant Secretary to ensure the 
        coordination of such activities.
            ``(2) Carry out the following types of activities by 
        entering into interagency agreements with other agencies of the 
        Public Health Service:
                    ``(A) Support research, demonstrations and 
                evaluations to test new and innovative models.
                    ``(B) Increase knowledge and understanding of 
                health risk factors.
                    ``(C) Develop mechanisms that support better 
                information dissemination, education, prevention, and 
                service delivery to individuals from disadvantaged 
                backgrounds, including individuals who are members of 
                racial or ethnic minority groups.
                    ``(D) Ensure that the National Center for Health 
                Statistics collects data on the health status of each 
                minority group.
                    ``(E) With respect to individuals who lack 
                proficiency in speaking the English language, enter 
                into contracts with public and nonprofit private 
                providers of primary health services for the purpose of 
                increasing the access of the individuals to such 
                services by developing and carrying out programs to 
                provide bilingual or interpretive services.
            ``(3) Support a national minority health resource center to 
        carry out the following:
                    ``(A) Facilitate the exchange of information 
                regarding matters relating to health information and 
                health promotion, preventive health services, and 
                education in the appropriate use of health care.
                    ``(B) Facilitate access to such information.
                    ``(C) Assist in the analysis of issues and problems 
                relating to such matters.
                    ``(D) Provide technical assistance with respect to 
                the exchange of such information (including 
                facilitating the development of materials for such 
                technical assistance).
            ``(4) Carry out programs to improve access to health care 
        services for individuals with limited proficiency in speaking 
        the English language by facilitating the removal of impediments 
        to the receipt of health care that result from such limitation. 
        Activities under the preceding sentence shall include 
        conducting research and developing and evaluating model 
        projects.
            ``(5) Not later than June 8 of each year, the heads of the 
        Public Health Service agencies shall submit to the Deputy 
        Assistant Secretary a report summarizing the minority health 
        activities of each of the respective agencies.
    ``(c) Advisory Committee.--
            ``(1) In general.--The Secretary shall establish an 
        advisory committee to be known as the Advisory Committee on 
        Minority Health (in this subsection referred to as the 
        `Committee'). The Deputy Assistant Secretary shall consult with 
        the Committee in carrying out this section.
            ``(2) Duties.--The Committee shall provide advice to the 
        Deputy Assistant Secretary carrying out this section, including 
        advice on the development of goals and specific program 
        activities under paragraphs (1) and (2) of subsection (b) for 
        each racial and ethnic minority group.
            ``(3) Chair.--The Deputy Assistant Secretary shall serve as 
        the chair of the Committee.
            ``(4) Composition.--
                    ``(A) The Committee shall be composed of 12 voting 
                members appointed in accordance with subparagraph (B), 
                and nonvoting, ex officio members designated in 
                subparagraph (C).
                    ``(B) The voting members of the Committee shall be 
                appointed by the Secretary from among individuals who 
                are not officers or employees of the Federal Government 
                and who have expertise regarding issues of minority 
                health. The racial and ethnic minority groups shall be 
                equally represented among such members.
                    ``(C) The nonvoting, ex officio members of the 
                Committee shall be the directors of each of the 
                minority health offices, and such additional officials 
                of the Department of Health and Human Services as the 
                Secretary determines to be appropriate.
            ``(5) Terms.--Each member of the Committee shall serve for 
        a term of 4 years, except that the Secretary shall initially 
        appoint a portion of the members to terms of 1 year, 2 years, 
        and 3 years.
            ``(6) Vacancies.--If a vacancy occurs on the Committee, a 
        new member shall be appointed by the Secretary within 90 days 
        from the date that the vacancy occurs, and serve for the 
        remainder of the term for which the predecessor of such member 
        was appointed. The vacancy shall not affect the power of the 
        remaining members to execute the duties of the Committee.
            ``(7) Compensation.--Members of the Committee who are 
        officers or employees of the United States shall serve without 
        compensation. Members of the Committee who are not officers or 
        employees of the United States shall receive compensation, for 
        each day (including travel time) they are engaged in the 
        performance of the functions of the Committee. Such 
        compensation may not be in an amount in excess of the daily 
        equivalent of the annual maximum rate of basic pay payable 
        under the General Schedule (under title 5, United States Code) 
        for positions above GS-15.
    ``(d) Certain Requirements Regarding Duties.--
            ``(1) Recommendations regarding language as impediment to 
        health care.--The Deputy Assistant Secretary for Minority 
        Health shall consult with the Director of the Office of Refugee 
        Health, the Director of the Office of Civil Rights, and the 
        Director of the Office of Minority Health of the Health 
        Resources and Services Administration, and other appropriate 
        offices, regarding recommendations for carrying out activities 
        under subsection (b)(4).
            ``(2) Equitable allocation regarding activities.--
                    ``(A) In making awards of grants, cooperative 
                agreements, or contracts under this section or section 
                338A, 338B, 340A, 404, or 724, or part B of title VII, 
                the Secretary, acting as appropriate through the Deputy 
                Assistant Secretary or the Administrator of the Health 
                Resources and Services Administration, shall ensure 
                that such awards are equitably allocated with respect 
                to the various racial and minority populations.
                    ``(B) With respect to grants, cooperative 
                agreements, and contracts that are available under the 
                sections specified in subparagraph (A), the Secretary 
                shall--
                            ``(i) carry out activities to inform 
                        entities, as appropriate, that the entities may 
                        be eligible for awards of such assistance;
                            ``(ii) provide technical assistance to such 
                        entities in the process of preparing and 
                        submitting applications for the awards in 
                        accordance with the policies of the Secretary 
                        regarding such application; and
                            ``(iii) inform populations, as appropriate, 
                        that members of the populations may be eligible 
                        to receive services or otherwise participate in 
                        the activities carried out with such awards.
            ``(3) Cultural competency of services.--The Secretary shall 
        ensure that information and services provided pursuant to 
        subsection (b) are provided in the language, educational, and 
        cultural context that is most appropriate for the individuals 
        for whom the information and services are intended.
    ``(e) Grants and Contracts Regarding Duties.--
            ``(1) In general.--In carrying out subsection (b), the 
        Deputy Assistant Secretary may make awards of grants, 
        cooperative agreements, and contracts to public and nonprofit 
        private entities.
            ``(2) Process for making awards.--The Deputy Assistant 
        Secretary shall ensure that awards under paragraph (1) are made 
        only on a competitive basis, and that a grant is awarded for a 
        proposal only if the proposal has been recommended for such an 
        award through a process of peer review and has been so 
        recommended by the advisory committee established under 
        subsection (c).
            ``(3) Evaluation and dissemination.--The Deputy Assistant 
        Secretary, directly or through contracts with public and 
        private entities, shall provide for evaluations of projects 
        carried out with awards made under paragraph (1) during the 
        preceding 2 fiscal years. The report shall be included in the 
        report required under subsection (f) for the fiscal year 
        involved.
    ``(f) Biennial Reports.--Not later than February 1 of fiscal year 
1996 and of each second year thereafter, the Deputy Assistant Secretary 
shall submit to the Committee on Energy and Commerce of the House of 
Representatives, and to the Committee on Labor and Human Resources of 
the Senate, a report describing the activities carried out under this 
section during the preceding 2 fiscal years and evaluating the extent 
to which such activities have been effective in improving the health of 
racial and ethnic minority groups. Each such report shall include the 
biennial reports submitted to the Deputy Assistant Secretary under 
section 201(b)(5) for such years by the heads of the Public Health 
Service agencies.
    ``(g) Definition.--For purposes of this section:
            ``(1) The term `racial and ethnic minority group' means 
        American Indians (including Alaska Natives, Eskimos, and 
        Aleuts); Asian Americans and Pacific Islanders; Blacks; and 
        Hispanics.
            ``(2) The term `Hispanic' means individuals whose origin is 
        Mexican, Puerto Rican, Cuban, Central or South American, or any 
        other Spanish-speaking country.
    ``(h) Funding.--For the purpose of carrying out this section, there 
are authorized to be appropriated $21,000,000 for fiscal year 1996, 
such sums as may be necessary for each of the fiscal years 1997 and 
1998, and $19,000,000 for fiscal year 1999.''.
    (b) Miscellaneous Amendment.--Section 1707 of the Public Health 
Service Act (42 U.S.C. 300u-6) is amended in the heading for the 
section by striking ``establishment of''.

                    TITLE III--SELECTED INITIATIVES

SEC. 301. PROGRAMS REGARDING BIRTH DEFECTS.

    Section 317C of the Public Health Service Act (42 U.S.C. 247b-4) is 
amended to read as follows:

                   ``programs regarding birth defects

    ``Sec. 317C. (a) The Secretary, acting through the Director of the 
Centers for Disease Control and Prevention, shall carry out programs--
            ``(1) to collect, analyze, and make available data on birth 
        defects (in a manner that facilitates compliance with 
        subsection (d)(2)), including data on the causes of such 
        defects and on the incidence and prevalence of such defects; 
        and
            ``(2) to operate regional centers for the conduct of 
        applied epidemiological research on the prevention of such 
        defects.
    ``(b) Additional Provisions Regarding Collection of Data.--
            ``(1) In general.--In carrying out subsection (a)(1), the 
        Secretary--
                    ``(A) shall collect and analyze data by gender and 
                by racial and ethnic group, including Hispanics, non-
                Hispanic whites, Blacks, Native Americans, Asian 
                Americans, and Pacific Islanders;
                    ``(B) shall collect data under subparagraph (A) 
                from birth certificates, death certificates, hospital 
                records, and such other sources as the Secretary 
                determines to be appropriate; and
                    ``(C) shall encourage States to establish or 
                improve programs for the collection and analysis of 
                epidemiological data on birth defects, and to make the 
                data available.
            ``(2) National clearinghouse.--In carrying out subsection 
        (a)(1), the Secretary shall establish and maintain a National 
        Information Clearinghouse on Birth Defects to collect and 
        disseminate to health professionals and the general public 
        information on birth defects, including the prevention of such 
        defects.
    ``(c) Grants and Contracts.--
            ``(1) In general.--In carrying out subsection (a), the 
        Secretary may make grants to and enter into contracts with 
        public and nonprofit private entities.
            ``(2) Supplies and services in lieu of award funds.--
                    ``(A) Upon the request of a recipient of an award 
                of a grant or contract under paragraph (1), the 
                Secretary may, subject to subparagraph (B), provide 
                supplies, equipment, and services for the purpose of 
                aiding the recipient in carrying out the purposes for 
                which the award is made and, for such purposes, may 
                detail to the recipient any officer or employee of the 
                Department of Health and Human Services.
                    ``(B) With respect to a request described in 
                subparagraph (A), the Secretary shall reduce the amount 
                of payments under the award involved by an amount equal 
                to the costs of detailing personnel and the fair market 
                value of any supplies, equipment, or services provided 
                by the Secretary. The Secretary shall, for the payment 
                of expenses incurred in complying with such request, 
                expend the amounts withheld.
            ``(3) Application for award.--The Secretary may make an 
        award of a grant or contract under paragraph (1) only if an 
        application for the award is submitted to the Secretary and the 
        application is in such form, is made in such manner, and 
        contains such agreements, assurances, and information as the 
        Secretary determines to be necessary to carry out the purposes 
        for which the award is to be made.
    ``(d) Biennial Report.--Not later than February 1 of fiscal year 
1997 and of every second such year thereafter, the Secretary shall 
submit to the Committee on Energy and Commerce of the House of 
Representatives, and the Committee on Labor and Human Resources of the 
Senate, a report that, with respect to the preceding 2 fiscal years--
            ``(1) contains information regarding the incidence and 
        prevalence of birth defects and the extent to which birth 
        defects have contributed to the incidence and prevalence of 
        infant mortality;
            ``(2) contains information under paragraph (1) that is 
        specific to various racial and ethnic groups (including 
        Hispanics, non-Hispanic whites, Blacks, Native Americans, and 
        Asian Americans);
            ``(3) contains an assessment of the extent to which various 
        approaches of preventing birth defects have been effective;
            ``(4) describes the activities carried out under this 
        section; and
            ``(5) contains any recommendations of the Secretary 
        regarding this section.''.

SEC. 302. TRAUMATIC BRAIN INJURY.

    (a) Programs of National Institutes of Health.--Section 1261 of the 
Public Health Service Act (42 U.S.C. 300d-61) is amended--
            (1) in subsection (d)--
                    (A) in paragraph (2), by striking ``and'' after the 
                semicolon at the end;
                    (B) in paragraph (3), by striking the period and 
                inserting ``; and''; and
                    (C) by adding at the end the following paragraph:
            ``(4) the authority to make awards of grants or contracts 
        to public or nonprofit private entities for the conduct of 
        basic and applied research regarding traumatic brain injury, 
        which research may include--
                    ``(A) the development of new methods and modalities 
                for the more effective diagnosis, measurement of degree 
                of injury, post-injury monitoring and prognostic 
                assessment of head injury for acute, subacute and later 
                phases of care;
                    ``(B) the development, modification and evaluation 
                of therapies that retard, prevent or reverse brain 
                damage after acute head injury, that arrest further 
                deterioration following injury and that provide the 
                restitution of function for individuals with long-term 
                injuries;
                    ``(C) the development of research on a continuum of 
                care from acute care through rehabilitation, designed, 
                to the extent practicable, to integrate rehabilitation 
                and long-term outcome evaluation with acute care 
                research; and
                    ``(D) the development of programs that increase the 
                participation of academic centers of excellence in head 
                injury treatment and rehabilitation research and 
                training.''; and
            (2) in subsection (h), by adding at the end the following 
        paragraph:
            ``(4) The term `traumatic brain injury' means an acquired 
        injury to the brain. Such term does not include brain 
        dysfunction caused by congenital or degenerative disorders, nor 
        birth trauma, but may include brain injuries caused by anoxia 
        due to near drowning.''.
    (b) Programs of Health Resources and Services Administration.--Part 
E of title XII of the Public Health Service Act (42 U.S.C. 300d-51 et 
seq.) is amended by adding at the end the following new section:

``SEC. 1252. STATE GRANTS FOR DEMONSTRATION PROJECTS REGARDING 
              TRAUMATIC BRAIN INJURY.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Health Resources and Services Administration, may make grants to 
States for the purpose of carrying out demonstration projects to 
improve the availability of health services regarding traumatic brain 
injury.
    ``(b) State Advisory Board.--
            ``(1) In general.--The Secretary may make a grant under 
        subsection (a) only if the State involved agrees to establish 
        an advisory board within the appropriate health department of 
        the State or within another department as designated by the 
        chief executive officer of the State.
            ``(2) Functions.--An advisory board established under 
        paragraph (1) shall be cognizant of findings and concerns of 
        Federal, State and local agencies, citizens groups, and private 
        industry (such as insurance, health care, automobile, and other 
        industry entities). Such advisory boards shall encourage 
        citizen participation through the establishment of public 
        hearings and other types of community outreach programs.
            ``(3) Composition.--An advisory board established under 
        paragraph (1) shall be composed of--
                    ``(A) representatives of--
                            ``(i) the corresponding State agencies 
                        involved;
                            ``(ii) public and nonprofit private health 
                        related organizations;
                            ``(iii) other disability advisory or 
                        planning groups within the State;
                            ``(iv) members of an organization or 
                        foundation representing traumatic brain injury 
                        survivors in that State; and
                            ``(v) injury control programs at the State 
                        or local level if such programs exist; and
                    ``(B) a substantial number of individuals who are 
                survivors of traumatic brain injury, or the family 
                members of such individuals.
    ``(c) Matching Funds.--
            ``(1) In general.--With respect to the costs to be incurred 
        by a State in carrying out the purpose described in subsection 
        (a), the Secretary may make a grant under such subsection only 
        if the State agrees to make available, in cash, non-Federal 
        contributions toward such costs in an amount that is not less 
        than $1 for each $2 of Federal funds provided under the grant.
            ``(2) Determination of amount contributed.--In determining 
        the amount of non-Federal contributions in cash that a State 
        has provided pursuant to paragraph (1), the Secretary may not 
        include any amounts provided to the State by the Federal 
        Government.
    ``(d) Application for Grant.--The Secretary may make a grant under 
subsection (a) only if an application for the grant is submitted to the 
Secretary and the application is in such form, is made in such manner, 
and contains such agreements, assurances, and information as the 
Secretary determines to be necessary to carry out this section.
    ``(e) Coordination of Activities.--The Secretary shall ensure that 
activities under this section are coordinated as appropriate with other 
agencies of the Public Health Service that carry out activities 
regarding traumatic brain injury.
    ``(f) Report.--Not later than 2 years after the date of enactment 
of this section, the Secretary shall submit to the Committee on Energy 
and Commerce of the House of Representatives, and to the Committee on 
Labor and Human Resources of the Senate, a report describing the 
findings and results of the programs established under this section, 
including measures of outcomes and consumer and surrogate satisfaction.
    ``(g) Definition.--For purposes of this section, the term 
`traumatic brain injury' means an acquired injury to the brain. Such 
term does not include brain dysfunction caused by congenital or 
degenerative disorders, nor birth trauma, but may include brain 
injuries caused by anoxia due to near drowning.
    ``(h) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, $5,000,000 for fiscal year 
1995, and such sums as may be necessary for each of the fiscal years 
1996 and 1997.''.
    (c) Study; Consensus Conference.--
            (1) Study.--
                    (A) In general.--The Secretary of Health and Human 
                Services (in this subsection referred to as the 
                ``Secretary''), acting through the appropriate agencies 
                of the Public Health Service, shall conduct a study for 
                the purpose of carrying out the following with respect 
                to traumatic brain injury:
                            (i) In collaboration with appropriate State 
                        and local health-related agencies--
                                    (I) determine the incidence and 
                                prevalence of traumatic brain injury; 
                                and
                                    (II) develop a uniform reporting 
                                system under which States report 
                                incidence of traumatic brain injury, if 
                                the Secretary determines that such a 
                                system is appropriate.
                            (ii) Identify common therapeutic 
                        interventions which are used for the 
                        rehabilitation of individuals with such 
                        injuries, and shall, subject to the 
                        availability of information, include an 
                        analysis of--
                                    (I) the effectiveness of each such 
                                intervention in improving the 
                                functioning of individuals with brain 
                                injuries;
                                    (II) the comparative effectiveness 
                                of interventions employed in the course 
                                of rehabilitation of individuals with 
                                brain injuries to achieve the same or 
                                similar clinical outcome; and
                                    (III) the adequacy of existing 
                                measures of outcomes and knowledge of 
                                factors influencing differential 
                                outcomes.
                            (iii) Develop practice guidelines for the 
                        rehabilitation of traumatic brain injury at 
                        such time as appropriate scientific research 
                        becomes available.
                    (B) Dates certain for reports.--
                            (i) Not later than 18 months after the date 
                        of enactment of this Act, the Secretary shall 
                        submit to the Committee on Commerce of the 
                        House of Representatives, and to the Committee 
                        on Labor and Human Resources of the Senate, a 
                        report describing the findings made as a result 
                        of carrying out subparagraph (A)(i).
                            (ii) Not later than 3 years after the date 
                        of enactment of this Act, the Secretary shall 
                        submit to the Committees specified in clause 
                        (i) a report describing the findings made as a 
                        result of carrying out clauses (ii) and (iii) 
                        of subparagraph (A).
            (2) Consensus conference.--The Secretary, acting through 
        the Director of the National Center for Medical Rehabilitation 
        Research within the National Institute for Child Health and 
        Human Development, shall conduct a national consensus 
        conference on managing traumatic brain injury and related 
        rehabilitation concerns.
            (3) Definition.--For purposes of this subsection, the term 
        ``traumatic brain injury'' means an acquired injury to the 
        brain. Such term does not include brain dysfunction caused by 
        congenital or degenerative disorders, nor birth trauma, but may 
        include brain injuries caused by anoxia due to near drowning.

SEC. 303. STATE OFFICES OF RURAL HEALTH.

    (a) In General.--Section 338M of the Public Health Service Act (as 
so redesignated by section 132) is amended--
            (1) in subsection (b)(1), in the matter preceding 
        subparagraph (A), by striking ``in cash''; and
            (2) in subsection (j)(1)--
                    (A) by striking ``and'' after ``1992,''; and
                    (B) by inserting before the period the following: 
                ``, and such sums as may be necessary for each of the 
                fiscal years 1996 through 1997''; and
            (3) in subsection (k), by striking ``$10,000,000'' and 
        inserting ``$20,000,000''.
    (b) Repeal.--Effective on October 1, 1997, section 338M of the 
Public Health Service Act (as so redesignated by section 132) is 
repealed.

SEC. 304. HEALTH SERVICES FOR PACIFIC ISLANDERS.

    Section 10 of the Disadvantaged Minority Health Improvement Act of 
1990 (42 U.S.C. 254c-1) is amended--
            (1) in subsection (b)--
                    (A) in paragraph (2)--
                            (i) by inserting ``, substance abuse'' 
                        after ``availability of health''; and
                            (ii) by striking ``, including improved 
                        health data systems'';
                    (B) in paragraph (3)--
                            (i) by striking ``manpower'' and inserting 
                        ``care providers''; and
                            (ii) by striking ``by--'' and all that 
                        follows through the end thereof and inserting a 
                        semicolon;
                    (C) by striking paragraphs (5) and (6);
                    (D) by redesignating paragraphs (7), and (8) as 
                paragraphs (5) and (6), respectively;
                    (E) in paragraph (5) (as so redesignated), by 
                striking ``and'' at the end thereof;
                    (F) in paragraph (6) (as so redesignated), by 
                striking the period and inserting a semicolon; and
                    (G) by inserting after paragraph (6) (as so 
                redesignated), the following new paragraphs:
            ``(7) to provide primary health care, preventive health 
        care, and related training to American Samoan health care 
        professionals; and
            ``(8) to improve access to health promotion and disease 
        prevention services for rural American Samoa.'';
            (2) in subsection (f)--
                    (A) by striking ``there is'' and inserting ``there 
                are''; and
                    (B) by striking ``$10,000,000'' and all that 
                follows through ``1993'' and inserting ``$3,000,000 for 
                fiscal year 1995, $4,000,000 for fiscal year 1996, and 
                $5,000,000 for fiscal year 1997''; and
            (3) by adding at the end thereof the following new 
        subsection:
    ``(g) Study and Report.--
            ``(1) Study.--Not later than 180 days after the date of 
        enactment of this subsection, the Secretary, acting through the 
        Administrator of the Health Resources and Services 
        Administration, shall enter into a contract with a public or 
        nonprofit private entity for the conduct of a study to 
        determine the effectiveness of projects funded under this 
        section.
            ``(2) Report.--Not later than July 1, 1996, the Secretary 
        shall prepare and submit to the Committee on Labor and Human 
        Resources of the Senate and the Committee on Energy and 
        Commerce of the House of Representatives a report describing 
        the findings made with respect to the study conducted under 
        paragraph (1).''.

SEC. 305. DEMONSTRATION PROJECTS REGARDING ALZHEIMER'S DISEASE.

    (a) In General.--Section 398(a) of the Public Health Service Act 
(42 U.S.C. 280c-3(a)) is amended--
            (1) in the matter preceding paragraph (1), by striking 
        ``not less than 5, and not more than 15,'';
            (2) in paragraph (2)--
                    (A) by inserting after ``disorders'' the following: 
                ``who are living in single family homes or in 
                congregate settings''; and
                    (B) by striking ``and'' at the end;
            (3) by redesignating paragraph (3) as paragraph (4); and
            (4) by inserting after paragraph (2) the following:
            ``(3) to improve the access of such individuals to home-
        based or community-based long-term care services (subject to 
        the services being provided by entities that were providing 
        such services in the State involved as of October 1, 1995), 
        particularly such individuals who are members of racial or 
        ethnic minority groups, who have limited proficiency in 
        speaking the English language, or who live in rural areas; 
        and''.
    (b) Duration.--Section 398A of the Public Health Service Act (42 
U.S.C. 280c-4) is amended--
            (1) in the heading for the section, by striking 
        ``LIMITATION'' and all that follows and inserting ``REQUIREMENT 
        OF MATCHING FUNDS'';
            (2) by striking subsection (a);
            (3) by redesignating subsections (b) and (c) as subsections 
        (a) and (b), respectively;
            (4) in subsection (a) (as so redesignated), in each of 
        paragraphs (1)(C) and (2)(C), by striking ``third year'' and 
        inserting ``third or subsequent year''.
    (c) Authorization of Appropriations.--Section 398B(e) of the Public 
Health Service Act (42 U.S.C. 280c-5(e)) is amended by striking ``and 
1993'' and inserting ``through 1998''.

                   TITLE IV--MISCELLANEOUS PROVISIONS

SEC. 401. TECHNICAL CORRECTIONS REGARDING PUBLIC LAW 103-183.

    (a) Amendatory Instructions.--Public Law 103-183 is amended--
            (1) in section 601--
                    (A) in subsection (b), in the matter preceding 
                paragraph (1), by striking ``Section 1201 of the Public 
                Health Service Act (42 U.S.C. 300d)'' and inserting 
                ``Title XII of the Public Health Service Act (42 U.S.C. 
                300d et seq.)''; and
                    (B) in subsection (f)(1), by striking ``in section 
                1204(c)'' and inserting ``in section 1203(c) (as 
                redesignated by subsection (b)(2) of this section)'';
            (2) in section 602, by striking ``for the purpose'' and 
        inserting ``For the purpose''; and
            (3) in section 705(b), by striking ``317D((l)(1)'' and 
        inserting ``317D(l)(1)''.
    (b) Public Health Service Act.--The Public Health Service Act, as 
amended by Public Law 103-183 and by subsection (a) of this section, is 
amended--
            (1) in section 317E(g)(2), by striking ``making grants 
        under subsection (b)'' and inserting ``carrying out subsection 
        (b)'';
            (2) in section 318, in subsection (e) as in effect on the 
        day before the date of the enactment of Public Law 103-183, by 
        redesignating the subsection as subsection (f);
            (3) in subpart 6 of part C of title IV--
                    (A) by transferring the first section 447 (added by 
                section 302 of Public Law 103-183) from the current 
                placement of the section;
                    (B) by redesignating the section as section 447A; 
                and
                    (C) by inserting the section after section 447;
            (4) in section 1213(a)(8), by striking ``provides for for'' 
        and inserting ``provides for'';
            (5) in section 1501, by redesignating the second subsection 
        (c) (added by section 101(f) of Public Law 103-183) as 
        subsection (d); and
            (6) in section 1505(3), by striking ``nonprivate'' and 
        inserting ``private''.
    (c) Miscellaneous Correction.--Section 401(c)(3) of Public Law 103-
183 is amended in the matter preceding subparagraph (A) by striking 
``(d)(5)'' and inserting ``(e)(5)''.
    (d) Effective Date.--This section is deemed to have taken effect 
immediately after the enactment of Public Law 103-183.

SEC. 402. CERTAIN AUTHORITIES OF CENTERS FOR DISEASE CONTROL AND 
              PREVENTION.

    (a) In General.--Part B of title III of the Public Health Service 
Act is amended by inserting after section 317H the following section:

 ``miscellaneous authorities regarding centers for disease control and 
                               prevention

    ``Sec. 317I. (a) Technical and Scientific Peer Review Groups.--The 
Secretary, acting through the Director of the Centers for Disease 
Control and Prevention, may, without regard to the provisions of title 
5, United States Code, governing appointments in the competitive 
service, and without regard to the provisions of chapter 51 and 
subchapter III of chapter 53 of such title relating to classification 
and General Schedule pay rates, establish such technical and scientific 
peer review groups and scientific program advisory committees as are 
needed to carry out the functions of such Centers and appoint and pay 
the members of such groups, except that officers and employees of the 
United States shall not receive additional compensation for service as 
members of such groups. The Federal Advisory Committee Act shall not 
apply to the duration of such peer review groups. Not more than one-
fourth of the members of any such group shall be officers or employees 
of the United States.
    ``(b) Fellowship and Training Programs.--The Secretary, acting 
through the Director of the Centers for Disease Control and Prevention, 
shall establish fellowship and training programs to be conducted by 
such Centers to train individuals to develop skills in epidemiology, 
surveillance, laboratory analysis, and other disease detection and 
prevention methods. Such programs shall be designed to enable health 
professionals and health personnel trained under such programs to work, 
after receiving such training, in local, State, national, and 
international efforts toward the prevention and control of diseases, 
injuries, and disabilities. Such fellowships and training may be 
administered through the use of either appointment or nonappointment 
procedures.''.
    (b) Effective Date.--This section is deemed to have taken effect 
July 1, 1995.

SEC. 403. ADMINISTRATION OF CERTAIN REQUIREMENTS.

    (a) In General.--Section 2004 of Public Law 103-43 (107 Stat. 209) 
is amended by striking subsection (a).
    (b) Conforming Amendments.--Section 2004 of Public Law 103-43, as 
amended by subsection (a) of this section, is amended--
            (1) by striking ``(b) Sense'' and all that follows through 
        ``In the case'' and inserting the following:
    ``(a) Sense of Congress Regarding Purchase of American-Made 
Equipment and Products.--In the case'';
            (2) by striking ``(2) Notice to recipients of assistance'' 
        and inserting the following:
    ``(b) Notice to Recipients of Assistance''; and
            (3) in subsection (b), as redesignated by paragraph (2) of 
        this subsection, by striking ``paragraph (1)'' and inserting 
        ``subsection (a)''.
    (c) Effective Date.--This section is deemed to have taken effect 
immediately after the enactment of Public Law 103-43.

SEC. 404. TECHNICAL CORRECTIONS RELATING TO HEALTH PROFESSIONS 
              PROGRAMS.

    Part G of title VII of the Public Health Service Act (42 U.S.C. 
295j et seq.) is amended by inserting after section 794 the following 
section:

``SEC. 794A. RECOVERY.

    ``(a) In General.--If at any time within 20 years (or within such 
shorter period as the Secretary may prescribe by regulation for an 
interim facility) after the completion of construction of a facility 
with respect to which funds have been paid under section 720(a) (as 
such section existed one day prior to the date of enactment of the 
Health Professions Education Extension Amendments of 1992 (Public Law 
102-408))--
            ``(1)(A) in the case of a facility which was an affiliated 
        hospital or outpatient facility with respect to which funds 
        have been paid under such section 720(a)(1), the owner of the 
        facility ceases to be a public or other nonprofit agency that 
        would have been qualified to file an application under section 
        605;
            ``(B) in the case of a facility which was not an affiliated 
        hospital or outpatient facility but was a facility with respect 
        to which funds have been paid under paragraph (1) or (3) of 
        such section 720(a), the owner of the facility ceases to be a 
        public or nonprofit school; or
            ``(C) in the case of a facility which was a facility with 
        respect to which funds have been paid under such section 
        720(a)(2), the owner of the facility ceases to be a public or 
        nonprofit entity;
            ``(2) the facility ceases to be used for the teaching or 
        training purposes (or other purposes permitted under section 
        722 (as such section existed one day prior to the date of 
        enactment of the Health Professions Education Extension 
        Amendments of 1992 (Public Law 102-408)) for which it was 
        constructed, or
            ``(3) the facility is used for sectarian instruction or as 
        a place for religious worship,
the United States shall be entitled to recover from the owner of the 
facility the base amount prescribed by subsection (c)(1) plus the 
interest (if any) prescribed by subsection (c)(2).
    ``(b) Notice.--The owner of a facility which ceases to be a public 
or nonprofit agency, school, or entity as described in subparagraph 
(A), (B), or (C) of subsection (a)(1), as the case may be, or the owner 
of a facility the use of which changes as described in paragraph (2) or 
(3) of subsection (a), shall provide the Secretary written notice of 
such cessation or change of use within 10 days after the date on which 
such cessation or change of use occurs or within 30 days after the date 
of enactment of this subsection, whichever is later.
    ``(c) Amount.--
            ``(1) Base amount.--The base amount that the United States 
        is entitled to recover under subsection (a) is the amount 
        bearing the same ratio to the then value (as determined by the 
        agreement of the parties or in an action brought in the 
        district court of the United States for the district in which 
        the facility is situated) of the facility as the amount of the 
        Federal participation bore to the cost of construction.
            ``(2) Interest.--
                    ``(A) In general.--The interest that the United 
                States is entitled to recover under subsection (a) is 
                the interest for the period (if any) described in 
                subparagraph (B) at a rate (determined by the 
                Secretary) based on the average of the bond equivalent 
                rates of ninety-one-day Treasury bills auctioned during 
                that period.
                    ``(B) Period.--The period referred to in 
                subparagraph (A) is the period beginning--
                            ``(i) if notice is provided as prescribed 
                        by subsection (b), 191 days after the date on 
                        which the owner of the facility ceases to be a 
                        public or nonprofit agency, school, or entity 
                        as described in subparagraph (A), (B), or (C) 
                        of subsection (a)(1), as the case may be, or 
                        191 days after the date on which the use of the 
                        facility changes as described in paragraph (2) 
                        or (3) of subsection (a); or
                            ``(ii) if notice is not provided as 
                        prescribed by subsection (b), 11 days after the 
                        date on which such cessation or change of use 
                        occurs,
                and ending on the date the amount the United States is 
                entitled to recover is collected.
    ``(d) Waiver.--The Secretary may waive the recovery rights of the 
United States under subsection (a)(2) with respect to a facility (under 
such conditions as the Secretary may establish by regulation) if the 
Secretary determines that there is good cause for waiving such rights.
    ``(e) Lien.--The right of recovery of the United States under 
subsection (a) shall not, prior to judgment, constitute a lien on any 
facility.''.

SEC. 405. CLINICAL TRAINEESHIPS.

    Section 303(d)(1) of the Public Health Service Act (42 U.S.C. 
242a(d)(1)) is amended by inserting ``counseling,'' after ``family 
therapy,''.

SEC. 406. CONSTRUCTION OF REGIONAL CENTERS FOR RESEARCH ON PRIMATES.

    Section 481B(a) of the Public Health Service Act (42 U.S.C. 287a-
3(a)) is amended by striking ``$5,000,000'' and inserting 
``$2,500,000''.

SEC. 407. REQUIRED CONSULTATION BY SECRETARY.

    The Secretary of Health and Human Services, regarding the programs 
under parts B, C, D, and E of title VII, and parts B, C, and D of title 
VIII, of the Public Health Service Act, as amended by this Act, shall--
            (1) publish in the Federal Register a general program 
        description for the funding of awards under such parts;
            (2) solicit and receive written and oral comments 
        concerning such description, including the holding of a public 
        forum at which interested individuals and groups may provide 
        comment; and
            (3) take into consideration information received under 
        paragraph (2).
S 555 RS----2
S 555 RS----3
S 555 RS----4
S 555 RS----5
S 555 RS----6
S 555 RS----7
S 555 RS----8
S 555 RS----9
S 555 RS----10
S 555 RS----11
S 555 RS----12
S 555 RS----13
S 555 RS----14
S 555 RS----15
S 555 RS----16
```