105TH CONGRESS

2D SESSION S. 1754

AN ACT

To amend the Public Health Service Act to consolidate and

reauthorize health professions and minority and disadvantaged health education programs, and for other

purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

4 (a) SHORT TITLE.—This Act may be cited as the

5 ‘‘Health Professions Education Partnerships Act of

6 1998’’.
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1 (b) TABLE OF CONTENTS.—The table of contents of

2 this Act is as follows:

Sec. 1. Short title; table of contents.

TITLE I—HEALTH PROFESSIONS EDUCATION AND FINANCIAL

ASSISTANCE PROGRAMS

Subtitle A—Health Professions Education Programs

Sec. 101. Under-represented minority health professions grant program.

Sec. 102. Training in primary care medicine and dentistry.

Sec. 103. Interdisciplinary, community-based linkages.

Sec. 104. Health professions workforce information and analysis.

Sec. 105. Public health workforce development.

Sec. 106. General provisions.

Sec. 107. Preference in certain programs.

Sec. 108. Definitions.

Sec. 109. Technical amendment on National Health Service Corps.

Sec. 110. Savings provision.

Subtitle B—Nursing Workforce Development

Sec. 121. Short title.

Sec. 122. Purpose.

Sec. 123. Amendments to Public Health Service Act.

Sec. 124. Savings provision.

Subtitle C—Financial Assistance

CHAPTER 1—SCHOOL-BASED REVOLVING LOAN FUNDS

Sec. 131. Primary care loan program.

Sec. 132. Loans for disadvantaged students.

Sec. 133. Student loans regarding schools of nursing.

Sec. 134. General provisions.

CHAPTER 2—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. Insurance Program.

Sec. 144. HEAL bankruptcy.

Sec. 145. HEAL refinancing.

TITLE II—OFFICE OF MINORITY HEALTH

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

TITLE III—SELECTED INITIATIVES

Sec. 301. State offices of rural health.

Sec. 302. Demonstration projects regarding Alzheimer’s Disease.

Sec. 303. Project grants for immunization services.

TITLE IV—MISCELLANEOUS PROVISIONS
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Sec. 401. Technical corrections regarding Public Law 103–183.

Sec. 402. Miscellaneous amendments regarding PHS commissioned officers.

Sec. 403. Clinical traineeships.

Sec. 404. Project grants for screenings, referrals, and education regarding lead

poisoning.

Sec. 405. Project grants for preventive health services regarding tuberculosis.

Sec. 406. CDC loan repayment program.

Sec. 407. Community programs on domestic violence.

Sec. 408. State loan repayment program.

Sec. 409. Authority of the director of NIH.

Sec. 410. Raise in maximum level of loan repayments.

Sec. 411. Construction of regional centers for research on primates.

Sec. 412. Peer review.

Sec. 413. Funding for trauma care.

Sec. 414. Health information and health promotion.

Sec. 415. Emergency medical services for children.

Sec. 416. Administration of certain requirements.

Sec. 417. Aids drug assistance program.

Sec. 418. National Foundation for Biomedical Research.

Sec. 419. Fetal Alcohol Syndrome prevention and services.

1 TITLE I—HEALTH PROFESSIONS

2 EDUCATION AND FINANCIAL

3 ASSISTANCE PROGRAMS

4 Subtitle A—Health Professions

5 Education Programs

6 SEC. 101. UNDER-REPRESENTED MINORITY HEALTH PRO7 FESSIONS GRANT PROGRAM.

8 (a) IN GENERAL.—Part B of title VII of the Public

9 Health Service Act (42 U.S.C. 293 et seq.) is amended

10 to read as follows:

11 ‘‘PART B—HEALTH PROFESSIONS TRAINING FOR

12 DIVERSITY

13 ‘‘SEC. 736. CENTERS OF EXCELLENCE.

14 ‘‘(a) IN GENERAL.—The Secretary shall make grants

15 to, and enter into contracts with, designated health profes16 sions schools described in subsection (c), and other public
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1 and nonprofit health or educational entities, for the pur2 pose of assisting the schools in supporting programs of

3 excellence in health professions education for under-rep4 resented minority individuals.

5 ‘‘(b) REQUIRED USE OF FUNDS.—The Secretary

6 may not make a grant under subsection (a) unless the des7 ignated health professions school involved agrees, subject

8 to subsection (c)(1)(C), to expend the grant—

9 ‘‘(1) to develop a large competitive applicant

10 pool through linkages with institutions of higher

11 education, local school districts, and other commu12 nity-based entities and establish an education pipe13 line for health professions careers;

14 ‘‘(2) to establish, strengthen, or expand pro15 grams to enhance the academic performance of

16 under-represented minority students attending the

17 school;

18 ‘‘(3) to improve the capacity of such school to

19 train, recruit, and retain under-represented minority

20 faculty including the payment of such stipends and

21 fellowships as the Secretary may determine appro22 priate;

23 ‘‘(4) to carry out activities to improve the infor24 mation resources, clinical education, curricula and
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1 cultural competence of the graduates of the school,

2 as it relates to minority health issues;

3 ‘‘(5) to facilitate faculty and student research

4 on health issues particularly affecting under-rep5 resented minority groups, including research on

6 issues relating to the delivery of health care;

7 ‘‘(6) to carry out a program to train students

8 of the school in providing health services to a signifi9 cant number of under-represented minority individ10 uals through training provided to such students at

11 community-based health facilities that—

12 ‘‘(A) provide such health services; and

13 ‘‘(B) are located at a site remote from the

14 main site of the teaching facilities of the school;

15 and

16 ‘‘(7) to provide stipends as the Secretary deter17 mines appropriate, in amounts as the Secretary de18 termines appropriate.

19 ‘‘(c) CENTERS OF EXCELLENCE.—

20 ‘‘(1) DESIGNATED SCHOOLS.—

21 ‘‘(A) IN GENERAL.—The designated health

22 professions schools referred to in subsection (a)

23 are such schools that meet each of the condi24 tions specified in subparagraphs (B) and (C),

25 and that—
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1 ‘‘(i) meet each of the conditions speci2 fied in paragraph (2)(A);

3 ‘‘(ii) meet each of the conditions spec4 ified in paragraph (3);

5 ‘‘(iii) meet each of the conditions

6 specified in paragraph (4); or

7 ‘‘(iv) meet each of the conditions spec8 ified in paragraph (5).

9 ‘‘(B) GENERAL CONDITIONS.—The condi10 tions specified in this subparagraph are that a

11 designated health professions school—

12 ‘‘(i) has a significant number of

13 under-represented minority individuals en14 rolled in the school, including individuals

15 accepted for enrollment in the school;

16 ‘‘(ii) has been effective in assisting

17 under-represented minority students of the

18 school to complete the program of edu19 cation and receive the degree involved;

20 ‘‘(iii) has been effective in recruiting

21 under-represented minority individuals to

22 enroll in and graduate from the school, in23 cluding providing scholarships and other fi24 nancial assistance to such individuals and

25 encouraging under-represented minority
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1 students from all levels of the educational

2 pipeline to pursue health professions ca3 reers; and

4 ‘‘(iv) has made significant recruitment

5 efforts to increase the number of under6 represented minority individuals serving in

7 faculty or administrative positions at the

8 school.

9 ‘‘(C) CONSORTIUM.—The condition speci10 fied in this subparagraph is that, in accordance

11 with subsection (e)(1), the designated health

12 profession school involved has with other health

13 profession schools (designated or otherwise)

14 formed a consortium to carry out the purposes

15 described in subsection (b) at the schools of the

16 consortium.

17 ‘‘(D) APPLICATION OF CRITERIA TO

18 OTHER PROGRAMS.—In the case of any criteria

19 established by the Secretary for purposes of de20 termining whether schools meet the conditions

21 described in subparagraph (B), this section may

22 not, with respect to racial and ethnic minorities,

23 be construed to authorize, require, or prohibit

24 the use of such criteria in any program other

25 than the program established in this section.
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1 ‘‘(2) CENTERS OF EXCELLENCE AT CERTAIN

2 HISTORICALLY BLACK COLLEGES AND UNIVER3 SITIES.—

4 ‘‘(A) CONDITIONS.—The conditions speci5 fied in this subparagraph are that a designated

6 health professions school—

7 ‘‘(i) is a school described in section

8 799B(1); and

9 ‘‘(ii) received a contract under section

10 788B for fiscal year 1987, as such section

11 was in effect for such fiscal year.

12 ‘‘(B) USE OF GRANT.—In addition to the

13 purposes described in subsection (b), a grant

14 under subsection (a) to a designated health pro15 fessions school meeting the conditions described

16 in subparagraph (A) may be expended—

17 ‘‘(i) to develop a plan to achieve insti18 tutional improvements, including financial

19 independence, to enable the school to sup20 port programs of excellence in health pro21 fessions education for under-represented

22 minority individuals; and

23 ‘‘(ii) to provide improved access to the

24 library and informational resources of the

25 school.
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1 ‘‘(C) EXCEPTION.—The requirements of

2 paragraph (1)(C) shall not apply to a histori3 cally black college or university that receives

4 funding under paragraphs (2) or (5).

5 ‘‘(3) HISPANIC CENTERS OF EXCELLENCE.—

6 The conditions specified in this paragraph are

7 that—

8 ‘‘(A) with respect to Hispanic individuals,

9 each of clauses (i) through (iv) of paragraph

10 (1)(B) applies to the designated health profes11 sions school involved;

12 ‘‘(B) the school agrees, as a condition of

13 receiving a grant under subsection (a), that the

14 school will, in carrying out the duties described

15 in subsection (b), give priority to carrying out

16 the duties with respect to Hispanic individuals;

17 and

18 ‘‘(C) the school agrees, as a condition of

19 receiving a grant under subsection (a), that—

20 ‘‘(i) the school will establish an ar21 rangement with 1 or more public or non22 profit community based Hispanic serving

23 organizations, or public or nonprofit pri24 vate institutions of higher education, in25 cluding schools of nursing, whose enroll-
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1 ment of students has traditionally included

2 a significant number of Hispanic individ3 uals, the purposes of which will be to carry

4 out a program—

5 ‘‘(I) to identify Hispanic students

6 who are interested in a career in the

7 health profession involved; and

8 ‘‘(II) to facilitate the educational

9 preparation of such students to enter

10 the health professions school; and

11 ‘‘(ii) the school will make efforts to

12 recruit Hispanic students, including stu13 dents who have participated in the under14 graduate or other matriculation program

15 carried out under arrangements established

16 by the school pursuant to clause (i)(II) and

17 will assist Hispanic students regarding the

18 completion of the educational requirements

19 for a degree from the school.

20 ‘‘(4) NATIVE AMERICAN CENTERS OF EXCEL21 LENCE.—Subject to subsection (e), the conditions

22 specified in this paragraph are that—

23 ‘‘(A) with respect to Native Americans,

24 each of clauses (i) through (iv) of paragraph
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1 (1)(B) applies to the designated health profes2 sions school involved;

3 ‘‘(B) the school agrees, as a condition of

4 receiving a grant under subsection (a), that the

5 school will, in carrying out the duties described

6 in subsection (b), give priority to carrying out

7 the duties with respect to Native Americans;

8 and

9 ‘‘(C) the school agrees, as a condition of

10 receiving a grant under subsection (a), that—

11 ‘‘(i) the school will establish an ar12 rangement with 1 or more public or non13 profit private institutions of higher edu14 cation, including schools of nursing, whose

15 enrollment of students has traditionally in16 cluded a significant number of Native

17 Americans, the purpose of which arrange18 ment will be to carry out a program—

19 ‘‘(I) to identify Native American

20 students, from the institutions of

21 higher education referred to in clause

22 (i), who are interested in health pro23 fessions careers; and

24 ‘‘(II) to facilitate the educational

25 preparation of such students to enter
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1 the designated health professions

2 school; and

3 ‘‘(ii) the designated health professions

4 school will make efforts to recruit Native

5 American students, including students who

6 have participated in the undergraduate

7 program carried out under arrangements

8 established by the school pursuant to

9 clause (i) and will assist Native American

10 students regarding the completion of the

11 educational requirements for a degree from

12 the designated health professions school.

13 ‘‘(5) OTHER CENTERS OF EXCELLENCE.—The

14 conditions specified in this paragraph are—

15 ‘‘(A) with respect to other centers of excel16 lence, the conditions described in clauses (i)

17 through (iv) of paragraph (1)(B); and

18 ‘‘(B) that the health professions school in19 volved has an enrollment of under-represented

20 minorities above the national average for such

21 enrollments of health professions schools.

22 ‘‘(d) DESIGNATION AS CENTER OF EXCELLENCE.—

23 ‘‘(1) IN GENERAL.—Any designated health pro24 fessions school receiving a grant under subsection

25 (a) and meeting the conditions described in para-
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1 graph (2) or (5) of subsection (c) shall, for purposes

2 of this section, be designated by the Secretary as a

3 Center of Excellence in Under-Represented Minority

4 Health Professions Education.

5 ‘‘(2) HISPANIC CENTERS OF EXCELLENCE.—

6 Any designated health professions school receiving a

7 grant under subsection (a) and meeting the condi8 tions described in subsection (c)(3) shall, for pur9 poses of this section, be designated by the Secretary

10 as a Hispanic Center of Excellence in Health Profes11 sions Education.

12 ‘‘(3) NATIVE AMERICAN CENTERS OF EXCEL13 LENCE.—Any designated health professions school

14 receiving a grant under subsection (a) and meeting

15 the conditions described in subsection (c)(4) shall,

16 for purposes of this section, be designated by the

17 Secretary as a Native American Center of Excellence

18 in Health Professions Education. Any consortium

19 receiving such a grant pursuant to subsection (e)

20 shall, for purposes of this section, be so designated.

21 ‘‘(e) AUTHORITY REGARDING NATIVE AMERICAN

22 CENTERS OF EXCELLENCE.—With respect to meeting the

23 conditions specified in subsection (c)(4), the Secretary

24 may make a grant under subsection (a) to a designated
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1 health professions school that does not meet such condi2 tions if—

3 ‘‘(1) the school has formed a consortium in ac4 cordance with subsection (d)(1); and

5 ‘‘(2) the schools of the consortium collectively

6 meet such conditions, without regard to whether the

7 schools individually meet such conditions.

8 ‘‘(f) DURATION OF GRANT.—The period during

9 which payments are made under a grant under subsection

10 (a) may not exceed 5 years. Such payments shall be sub11 ject to annual approval by the Secretary and to the avail12 ability of appropriations for the fiscal year involved to

13 make the payments.

14 ‘‘(g) DEFINITIONS.—In this section:

15 ‘‘(1) DESIGNATED HEALTH PROFESSIONS

16 SCHOOL.—

17 ‘‘(A) IN GENERAL.—The term ‘health pro18 fessions school’ means, except as provided in

19 subparagraph (B), a school of medicine, a

20 school of osteopathic medicine, a school of den21 tistry, a school of pharmacy, or a graduate pro22 gram in behavioral or mental health.

23 ‘‘(B) EXCEPTION.—The definition estab24 lished in subparagraph (A) shall not apply to
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1 the use of the term ‘designated health profes2 sions school’ for purposes of subsection (c)(2).

3 ‘‘(2) PROGRAM OF EXCELLENCE.—The term

4 ‘program of excellence’ means any program carried

5 out by a designated health professions school with a

6 grant made under subsection (a), if the program is

7 for purposes for which the school involved is author8 ized in subsection (b) or (c) to expend the grant.

9 ‘‘(3) NATIVE AMERICANS.—The term ‘Native

10 Americans’ means American Indians, Alaskan Na11 tives, Aleuts, and Native Hawaiians.

12 ‘‘(h) FUNDING.—

13 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—

14 For the purpose of making grants under subsection

15 (a), there authorized to be appropriated $26,000,000

16 for fiscal year 1998, and such sums as may be nec17 essary for each of the fiscal years 1999 through

18 2002.

19 ‘‘(2) ALLOCATIONS.—Based on the amount ap20 propriated under paragraph (1) for a fiscal year, one

21 of the following subparagraphs shall apply:

22 ‘‘(A) IN GENERAL.—If the amounts appro23 priated under paragraph (1) for a fiscal year

24 are $24,000,000 or less—
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1 ‘‘(i) the Secretary shall make available

2 $12,000,000 for grants under subsection

3 (a) to health professions schools that meet

4 the conditions described in subsection

5 (c)(2)(A); and

6 ‘‘(ii) and available after grants are

7 made with funds under clause (i), the Sec8 retary shall make available—

9 ‘‘(I) 60 percent of such amount

10 for grants under subsection (a) to

11 health professions schools that meet

12 the conditions described in paragraph

13 (3) or (4) of subsection (c) (including

14 meeting the conditions under sub15 section (e)); and

16 ‘‘(II) 40 percent of such amount

17 for grants under subsection (a) to

18 health professions schools that meet

19 the conditions described in subsection

20 (c)(5).

21 ‘‘(B) FUNDING IN EXCESS OF

22 $24,000,000.—If amounts appropriated under

23 paragraph (1) for a fiscal year exceed

24 $24,000,000 but are less than $30,000,000—
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1 ‘‘(i) 80 percent of such excess

2 amounts shall be made available for grants

3 under subsection (a) to health professions

4 schools that meet the requirements de5 scribed in paragraph (3) or (4) of sub6 section (c) (including meeting conditions

7 pursuant to subsection (e)); and

8 ‘‘(ii) 20 percent of such excess

9 amount shall be made available for grants

10 under subsection (a) to health professions

11 schools that meet the conditions described

12 in subsection (c)(5).

13 ‘‘(C) FUNDING IN EXCESS OF

14 $30,000,000.—If amounts appropriated under

15 paragraph (1) for a fiscal year are $30,000,000

16 or more, the Secretary shall make available—

17 ‘‘(i) not less than $12,000,000 for

18 grants under subsection (a) to health pro19 fessions schools that meet the conditions

20 described in subsection (c)(2)(A);

21 ‘‘(ii) not less than $12,000,000 for

22 grants under subsection (a) to health pro23 fessions schools that meet the conditions

24 described in paragraph (3) or (4) of sub-
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1 section (c) (including meeting conditions

2 pursuant to subsection (e));

3 ‘‘(iii) not less than $6,000,000 for

4 grants under subsection (a) to health pro5 fessions schools that meet the conditions

6 described in subsection (c)(5); and

7 ‘‘(iv) after grants are made with

8 funds under clauses (i) through (iii), any

9 remaining funds for grants under sub10 section (a) to health professions schools

11 that meet the conditions described in para12 graph (2)(A), (3), (4), or (5) of subsection

13 (c).

14 ‘‘(3) NO LIMITATION.—Nothing in this sub15 section shall be construed as limiting the centers of

16 excellence referred to in this section to the des17 ignated amount, or to preclude such entities from

18 competing for other grants under this section.

19 ‘‘(4) MAINTENANCE OF EFFORT.—

20 ‘‘(A) IN GENERAL.—With respect to activi21 ties for which a grant made under this part are

22 authorized to be expended, the Secretary may

23 not make such a grant to a center of excellence

24 for any fiscal year unless the center agrees to

25 maintain expenditures of non-Federal amounts
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1 for such activities at a level that is not less

2 than the level of such expenditures maintained

3 by the center for the fiscal year preceding the

4 fiscal year for which the school receives such a

5 grant.

6 ‘‘(B) USE OF FEDERAL FUNDS.—With re7 spect to any Federal amounts received by a cen8 ter of excellence and available for carrying out

9 activities for which a grant under this part is

10 authorized to be expended, the Secretary may

11 not make such a grant to the center for any fis12 cal year unless the center agrees that the center

13 will, before expending the grant, expend the

14 Federal amounts obtained from sources other

15 than the grant.

16 ‘‘SEC. 737. SCHOLARSHIPS FOR DISADVANTAGED STU17 DENTS.

18 ‘‘(a) IN GENERAL.—The Secretary may make a grant

19 to an eligible entity (as defined in subsection (d)(1)) under

20 this section for the awarding of scholarships by schools

21 to any full-time student who is an eligible individual as

22 defined in subsection (d). Such scholarships may be ex23 pended only for tuition expenses, other reasonable edu24 cational expenses, and reasonable living expenses incurred

25 in the attendance of such school.
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1 ‘‘(b) PREFERENCE IN PROVIDING SCHOLARSHIPS.—

2 The Secretary may not make a grant to an entity under

3 subsection (a) unless the health professions and nursing

4 schools involved agree that, in providing scholarships pur5 suant to the grant, the schools will give preference to stu6 dents for whom the costs of attending the schools would

7 constitute a severe financial hardship and, notwithstand8 ing other provisions of this section, to former recipients

9 of scholarships under sections 736 and 740(d)(2)(B) (as

10 such sections existed on the day before the date of enact11 ment of this section).

12 ‘‘(c) AMOUNT OF AWARD.—In awarding grants to eli13 gible entities that are health professions and nursing

14 schools, the Secretary shall give priority to eligible entities

15 based on the proportion of graduating students going into

16 primary care, the proportion of underrepresented minority

17 students, and the proportion of graduates working in

18 medically underserved communities.

19 ‘‘(d) DEFINITIONS.—In this section:

20 ‘‘(1) ELIGIBLE ENTITIES.—The term ‘eligible

21 entities’ means an entity that—

22 ‘‘(A) is a school of medicine, osteopathic

23 medicine, dentistry, nursing (as defined in sec24 tion 801), pharmacy, podiatric medicine, optom25 etry, veterinary medicine, public health, chiro-
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1 practic, or allied health, a school offering a

2 graduate program in behavioral and mental

3 health practice, or an entity providing programs

4 for the training of physician assistants; and

5 ‘‘(B) is carrying out a program for recruit6 ing and retaining students from disadvantaged

7 backgrounds, including students who are mem8 bers of racial and ethnic minority groups.

9 ‘‘(2) ELIGIBLE INDIVIDUAL.—The term ‘eligible

10 individual’ means an individual who—

11 ‘‘(A) is from a disadvantaged background;

12 ‘‘(B) has a financial need for a scholar13 ship; and

14 ‘‘(C) is enrolled (or accepted for enroll15 ment) at an eligible health professions or nurs16 ing school as a full-time student in a program

17 leading to a degree in a health profession or

18 nursing.

19 ‘‘SEC. 738. LOAN REPAYMENTS AND FELLOWSHIPS REGARD20 ING FACULTY POSITIONS.

21 ‘‘(a) LOAN REPAYMENTS.—

22 ‘‘(1) ESTABLISHMENT OF PROGRAM.—The Sec23 retary shall establish a program of entering into con24 tracts with individuals described in paragraph (2)

25 under which the individuals agree to serve as mem-
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1 bers of the faculties of schools described in para2 graph (3) in consideration of the Federal Govern3 ment agreeing to pay, for each year of such service,

4 not more than $20,000 of the principal and interest

5 of the educational loans of such individuals.

6 ‘‘(2) ELIGIBLE INDIVIDUALS.—The individuals

7 referred to in paragraph (1) are individuals from

8 disadvantaged backgrounds who—

9 ‘‘(A) have a degree in medicine, osteo10 pathic medicine, dentistry, nursing, or another

11 health profession;

12 ‘‘(B) are enrolled in an approved graduate

13 training program in medicine, osteopathic medi14 cine, dentistry, nursing, or other health profes15 sion; or

16 ‘‘(C) are enrolled as full-time students—

17 ‘‘(i) in an accredited (as determined

18 by the Secretary) school described in para19 graph (3); and

20 ‘‘(ii) in the final year of a course of

21 a study or program, offered by such insti22 tution and approved by the Secretary, lead23 ing to a degree from such a school.

24 ‘‘(3) ELIGIBLE HEALTH PROFESSIONS

25 SCHOOLS.—The schools described in this paragraph
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1 are schools of medicine, nursing (as schools of nurs2 ing are defined in section 801), osteopathic medi3 cine, dentistry, pharmacy, allied health, podiatric

4 medicine, optometry, veterinary medicine, or public

5 health, or schools offering graduate programs in be6 havioral and mental health.

7 ‘‘(4) REQUIREMENTS REGARDING FACULTY PO8 SITIONS.—The Secretary may not enter into a con9 tract under paragraph (1) unless—

10 ‘‘(A) the individual involved has entered

11 into a contract with a school described in para12 graph (3) to serve as a member of the faculty

13 of the school for not less than 2 years; and

14 ‘‘(B) the contract referred to in subpara15 graph (A) provides that—

16 ‘‘(i) the school will, for each year for

17 which the individual will serve as a mem18 ber of the faculty under the contract with

19 the school, make payments of the principal

20 and interest due on the educational loans

21 of the individual for such year in an

22 amount equal to the amount of such pay23 ments made by the Secretary for the year;

24 ‘‘(ii) the payments made by the school

25 pursuant to clause (i) on behalf of the indi-
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1 vidual will be in addition to the pay that

2 the individual would otherwise receive for

3 serving as a member of such faculty; and

4 ‘‘(iii) the school, in making a deter5 mination of the amount of compensation to

6 be provided by the school to the individual

7 for serving as a member of the faculty, will

8 make the determination without regard to

9 the amount of payments made (or to be

10 made) to the individual by the Federal

11 Government under paragraph (1).

12 ‘‘(5) APPLICABILITY OF CERTAIN PROVI13 SIONS.—The provisions of sections 338C, 338G, and

14 338I shall apply to the program established in para15 graph (1) to the same extent and in the same man16 ner as such provisions apply to the National Health

17 Service Corps Loan Repayment Program established

18 in subpart III of part D of title III, including the

19 applicability of provisions regarding reimbursements

20 for increased tax liability and regarding bankruptcy.

21 ‘‘(6) WAIVER REGARDING SCHOOL CONTRIBU22 TIONS.—The Secretary may waive the requirement

23 established in paragraph (4)(B) if the Secretary de24 termines that the requirement will impose an undue

25 financial hardship on the school involved.
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1 ‘‘(b) FELLOWSHIPS.—

2 ‘‘(1) IN GENERAL.—The Secretary may make

3 grants to and enter into contracts with eligible enti4 ties to assist such entities in increasing the number

5 of underrepresented minority individuals who are

6 members of the faculty of such schools.

7 ‘‘(2) APPLICATIONS.—To be eligible to receive a

8 grant or contract under this subsection, an entity

9 shall provide an assurance, in the application sub10 mitted by the entity, that—

11 ‘‘(A) amounts received under such a grant

12 or contract will be used to award a fellowship

13 to an individual only if the individual meets the

14 requirements of paragraphs (3) and (4); and

15 ‘‘(B) each fellowship awarded pursuant to

16 the grant or contract will include—

17 ‘‘(i) a stipend in an amount not ex18 ceeding 50 percent of the regular salary of

19 a similar faculty member for not to exceed

20 3 years of training; and

21 ‘‘(ii) an allowance for other expenses,

22 such as travel to professional meetings and

23 costs related to specialized training.

24 ‘‘(3) ELIGIBILITY.—To be eligible to receive a

25 grant or contract under paragraph (1), an applicant
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1 shall demonstrate to the Secretary that such appli2 cant has or will have the ability to—

3 ‘‘(A) identify, recruit and select underrep4 resented minority individuals who have the po5 tential for teaching, administration, or conduct6 ing research at a health professions institution;

7 ‘‘(B) provide such individuals with the

8 skills necessary to enable them to secure a

9 tenured faculty position at such institution,

10 which may include training with respect to ped11 agogical skills, program administration, the de12 sign and conduct of research, grants writing,

13 and the preparation of articles suitable for pub14 lication in peer reviewed journals;

15 ‘‘(C) provide services designed to assist

16 such individuals in their preparation for an aca17 demic career, including the provision of coun18 selors; and

19 ‘‘(D) provide health services to rural or

20 medically underserved populations.

21 ‘‘(4) REQUIREMENTS.—To be eligible to receive

22 a grant or contract under paragraph (1) an appli23 cant shall—

24 ‘‘(A) provide an assurance that such appli25 cant will make available (directly through cash
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1 donations) $1 for every $1 of Federal funds re2 ceived under this section for the fellowship;

3 ‘‘(B) provide an assurance that institu4 tional support will be provided for the individ5 ual for the second and third years at a level

6 that is equal to the total amount of institutional

7 funds provided in the year in which the grant

8 or contract was awarded;

9 ‘‘(C) provide an assurance that the individ10 ual that will receive the fellowship will be a

11 member of the faculty of the applicant school;

12 and

13 ‘‘(D) provide an assurance that the individ14 ual that will receive the fellowship will have, at

15 a minimum, appropriate advanced preparation

16 (such as a master’s or doctoral degree) and spe17 cial skills necessary to enable such individual to

18 teach and practice.

19 ‘‘(5) DEFINITION.—For purposes of this sub20 section, the term ‘underrepresented minority individ21 uals’ means individuals who are members of racial

22 or ethnic minority groups that are underrepresented

23 in the health professions including nursing.
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1 ‘‘SEC. 739. EDUCATIONAL ASSISTANCE IN THE HEALTH

2 PROFESSIONS REGARDING INDIVIDUALS

3 FROM DISADVANTAGED BACKGROUNDS.

4 ‘‘(a) IN GENERAL.—

5 ‘‘(1) AUTHORITY FOR GRANTS.—For the pur6 pose of assisting individuals from disadvantaged

7 backgrounds, as determined in accordance with cri8 teria prescribed by the Secretary, to undertake edu9 cation to enter a health profession, the Secretary

10 may make grants to and enter into contracts with

11 schools of medicine, osteopathic medicine, public

12 health, dentistry, veterinary medicine, optometry,

13 pharmacy, allied health, chiropractic, and podiatric

14 medicine, public and nonprofit private schools that

15 offer graduate programs in behavioral and mental

16 health, programs for the training of physician assist17 ants, and other public or private nonprofit health or

18 educational entities to assist in meeting the costs de19 scribed in paragraph (2).

20 ‘‘(2) AUTHORIZED EXPENDITURES.—A grant or

21 contract under paragraph (1) may be used by the

22 entity to meet the cost of—

23 ‘‘(A) identifying, recruiting, and selecting

24 individuals from disadvantaged backgrounds, as

25 so determined, for education and training in a

26 health profession;
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1 ‘‘(B) facilitating the entry of such individ2 uals into such a school;

3 ‘‘(C) providing counseling, mentoring, or

4 other services designed to assist such individ5 uals to complete successfully their education at

6 such a school;

7 ‘‘(D) providing, for a period prior to the

8 entry of such individuals into the regular course

9 of education of such a school, preliminary edu10 cation and health research training designed to

11 assist them to complete successfully such regu12 lar course of education at such a school, or re13 ferring such individuals to institutions providing

14 such preliminary education;

15 ‘‘(E) publicizing existing sources of finan16 cial aid available to students in the education

17 program of such a school or who are undertak18 ing training necessary to qualify them to enroll

19 in such a program;

20 ‘‘(F) paying such scholarships as the Sec21 retary may determine for such individuals for

22 any period of health professions education at a

23 health professions school;

24 ‘‘(G) paying such stipends as the Secretary

25 may approve for such individuals for any period
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1 of education in student-enhancement programs

2 (other than regular courses), except that such a

3 stipend may not be provided to an individual

4 for more than 12 months, and such a stipend

5 shall be in an amount determined appropriate

6 by the Secretary (notwithstanding any other

7 provision of law regarding the amount of sti8 pends);

9 ‘‘(H) carrying out programs under which

10 such individuals gain experience regarding a ca11 reer in a field of primary health care through

12 working at facilities of public or private non13 profit community-based providers of primary

14 health services; and

15 ‘‘(I) conducting activities to develop a larg16 er and more competitive applicant pool through

17 partnerships with institutions of higher edu18 cation, school districts, and other community19 based entities.

20 ‘‘(3) DEFINITION.—In this section, the term

21 ‘regular course of education of such a school’ as

22 used in subparagraph (D) includes a graduate pro23 gram in behavioral or mental health.

24 ‘‘(b) REQUIREMENTS FOR AWARDS.—In making

25 awards to eligible entities under subsection (a)(1), the
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1 Secretary shall give preference to approved applications

2 for programs that involve a comprehensive approach by

3 several public or nonprofit private health or educational

4 entities to establish, enhance and expand educational pro5 grams that will result in the development of a competitive

6 applicant pool of individuals from disadvantaged back7 grounds who desire to pursue health professions careers.

8 In considering awards for such a comprehensive partner9 ship approach, the following shall apply with respect to

10 the entity involved:

11 ‘‘(1) The entity shall have a demonstrated com12 mitment to such approach through formal agree13 ments that have common objectives with institutions

14 of higher education, school districts, and other com15 munity-based entities.

16 ‘‘(2) Such formal agreements shall reflect the

17 coordination of educational activities and support

18 services, increased linkages, and the consolidation of

19 resources within a specific geographic area.

20 ‘‘(3) The design of the educational activities in21 volved shall provide for the establishment of a com22 petitive health professions applicant pool of individ23 uals from disadvantaged backgrounds by enhancing

24 the total preparation (academic and social) of such

25 individuals to pursue a health professions career.
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1 ‘‘(4) The programs or activities under the

2 award shall focus on developing a culturally com3 petent health care workforce that will serve the

4 unserved and underserved populations within the ge5 ographic area.

6 ‘‘(c) EQUITABLE ALLOCATION OF FINANCIAL AS7 SISTANCE.—The Secretary, to the extent practicable, shall

8 ensure that services and activities under subsection (a) are

9 adequately allocated among the various racial and ethnic

10 populations who are from disadvantaged backgrounds.

11 ‘‘(d) MATCHING REQUIREMENTS.—The Secretary

12 may require that an entity that applies for a grant or con13 tract under subsection (a), provide non-Federal matching

14 funds, as appropriate, to ensure the institutional commit15 ment of the entity to the projects funded under the grant

16 or contract. As determined by the Secretary, such non17 Federal matching funds may be provided directly or

18 through donations from public or private entities and may

19 be in cash or in-kind, fairly evaluated, including plant,

20 equipment, or services.

21 ‘‘SEC. 740. AUTHORIZATION OF APPROPRIATION.

22 ‘‘(a) SCHOLARSHIPS.—There are authorized to be ap23 propriated to carry out section 737, $37,000,000 for fiscal

24 year 1998, and such sums as may be necessary for each

25 of the fiscal years 1999 through 2002. Of the amount ap-
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1 propriated in any fiscal year, the Secretary shall ensure

2 that not less than 16 percent shall be distributed to

3 schools of nursing.

4 ‘‘(b) LOAN REPAYMENTS AND FELLOWSHIPS.—For

5 the purpose of carrying out section 738, there is author6 ized to be appropriated $1,100,000 for fiscal year 1998,

7 and such sums as may be necessary for each of the fiscal

8 years 1999 through 2002.

9 ‘‘(c) EDUCATIONAL ASSISTANCE IN HEALTH PRO10 FESSIONS REGARDING INDIVIDUALS FOR DISADVAN11 TAGED BACKGROUNDS.—For the purpose of grants and

12 contracts under section 739(a)(1), there is authorized to

13 be appropriated $29,400,000 for fiscal year 1998, and

14 such sums as may be necessary for each of the fiscal years

15 1999 through 2002. The Secretary may use not to exceed

16 20 percent of the amount appropriated for a fiscal year

17 under this subsection to provide scholarships under section

18 739(a)(2)(F).

19 ‘‘(d) REPORT.—Not later than 6 months after the

20 date of enactment of this part, the Secretary shall prepare

21 and submit to the appropriate committees of Congress a

22 report concerning the efforts of the Secretary to address

23 the need for a representative mix of individuals from his24 torically minority health professions schools, or from insti25 tutions or other entities that historically or by geographic
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1 location have a demonstrated record of training or educat2 ing underrepresented minorities, within various health

3 professions disciplines, on peer review councils.’’.

4 (b) REPEAL.—

5 (1) IN GENERAL.—Section 795 of the Public

6 Health Service Act (42 U.S.C. 295n) is repealed.

7 (2) NONTERMINATION OF AUTHORITY.—The

8 amendments made by this section shall not be con9 strued to terminate agreements that, on the day be10 fore the date of enactment of this Act, are in effect

11 pursuant to section 795 of the Public Health Service

12 Act (42 U.S.C. 795) as such section existed on such

13 date. Such agreements shall continue in effect in ac14 cordance with the terms of the agreements. With re15 spect to compliance with such agreements, any pe16 riod of practice as a provider of primary health serv17 ices shall be counted towards the satisfaction of the

18 requirement of practice pursuant to such section

19 795.

20 (c) CONFORMING AMENDMENTS.—Section

21 481A(c)(3)(D)(i) of the Public Health Service Act (42

22 U.S.C. 287a–2(c)(3)(D)(i)) is amended by striking ‘‘sec23 tion 739’’ and inserting ‘‘part B of title VII’’.
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1 SEC. 102. TRAINING IN PRIMARY CARE MEDICINE AND DEN2 TISTRY.

3 Part C of title VII of the Public Health Service Act

4 (42 U.S.C. 293 et seq.) is amended—

5 (1) in the part heading by striking ‘‘PRI6 MARY HEALTH CARE’’ and inserting ‘‘FAM7 ILY MEDICINE, GENERAL INTERNAL

8 MEDICINE, GENERAL PEDIATRICS,

9 PHYSICIAN ASSISTANTS, GENERAL

10 DENTISTRY, AND PEDIATRIC DEN11 TISTRY’’;

12 (2) by repealing section 746 (42 U.S.C. 293j);

13 (3) in section 747 (42 U.S.C. 293k)—

14 (A) by striking the section heading and in15 serting the following:

16 ‘‘SEC. 747. FAMILY MEDICINE, GENERAL INTERNAL MEDI17 CINE, GENERAL PEDIATRICS, GENERAL DEN18 TISTRY, PEDIATRIC DENTISTRY, AND PHYSI19 CIAN ASSISTANTS.’’;

20 (B) in subsection (a)—

21 (i) in paragraph (1)—

22 (I) by inserting ‘‘, internal medi23 cine, or pediatrics’’ after ‘‘family med24 icine’’; and

25 (II) by inserting before the semi26 colon the following: ‘‘that emphasizes
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1 training for the practice of family

2 medicine, general internal medicine,

3 or general pediatrics (as defined by

4 the Secretary)’’;

5 (ii) in paragraph (2), by inserting ‘‘,

6 general internal medicine, or general pedi7 atrics’’ before the semicolon;

8 (iii) in paragraphs (3) and (4), by in9 serting ‘‘(including geriatrics), general in10 ternal medicine or general pediatrics’’ after

11 ‘‘family medicine’’;

12 (iv) in paragraph (3), by striking

13 ‘‘and’’ at the end thereof;

14 (v) in paragraph (4), by striking the

15 period and inserting a semicolon; and

16 (vii) by adding at the end thereof the

17 following new paragraphs:

18 ‘‘(5) to meet the costs of projects to plan, de19 velop, and operate or maintain programs for the

20 training of physician assistants (as defined in sec21 tion 799B), and for the training of individuals who

22 will teach in programs to provide such training; and

23 ‘‘(6) to meet the costs of planning, developing,

24 or operating programs, and to provide financial as-
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1 sistance to residents in such programs, of general

2 dentistry or pediatric dentistry.

3 For purposes of paragraph (6), entities eligible for such

4 grants or contracts shall include entities that have pro5 grams in dental schools, approved residency programs in

6 the general or pediatric practice of dentistry, approved ad7 vanced education programs in the general or pediatric

8 practice of dentistry, or approved residency programs in

9 pediatric dentistry.’’;

10 (C) in subsection (b)—

11 (i) in paragraphs (1) and (2)(A), by

12 inserting ‘‘, general internal medicine, or

13 general pediatrics’’ after ‘‘family medi14 cine’’;

15 (ii) in paragraph (2)—

16 (I) in subparagraph (A), by strik17 ing ‘‘or’’ at the end; and

18 (II) in subparagraph (B), by

19 striking the period and inserting ‘‘;

20 or’’; and

21 (iii) by adding at the end the follow22 ing:

23 ‘‘(3) PRIORITY IN MAKING AWARDS.—In mak24 ing awards of grants and contracts under paragraph

25 (1), the Secretary shall give priority to any qualified
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1 applicant for such an award that proposes a collabo2 rative project between departments of primary

3 care.’’;

4 (D) by redesignating subsections (c) and

5 (d) as subsections (d) and (e), respectively;

6 (E) by inserting after subsection (b), the

7 following new subsection:

8 ‘‘(c) PRIORITY.—

9 ‘‘(1) IN GENERAL.—With respect to programs

10 for the training of interns or residents, the Secretary

11 shall give priority in awarding grants under this sec12 tion to qualified applicants that have a record of

13 training the greatest percentage of providers, or that

14 have demonstrated significant improvements in the

15 percentage of providers, which enter and remain in

16 primary care practice or general or pediatric den17 tistry.

18 ‘‘(2) DISADVANTAGED INDIVIDUALS.—With re19 spect to programs for the training of interns, resi20 dents, or physician assistants, the Secretary shall

21 give priority in awarding grants under this section

22 to qualified applicants that have a record of training

23 individuals who are from disadvantaged backgrounds

24 (including racial and ethnic minorities underrep-
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1 resented among primary care practice or general or

2 pediatric dentistry).

3 ‘‘(3) SPECIAL CONSIDERATION.—In awarding

4 grants under this section the Secretary shall give

5 special consideration to projects which prepare prac6 titioners to care for underserved populations and

7 other high risk groups such as the elderly, individ8 uals with HIV-AIDS, substance abusers, homeless,

9 and victims of domestic violence.’’; and

10 (F) in subsection (e) (as so redesignated

11 by subparagraph (D))—

12 (i) in paragraph (1), by striking

13 ‘‘$54,000,000’’ and all that follows and in14 serting ‘‘$78,300,000 for fiscal year 1998,

15 and such sums as may be necessary for

16 each of the fiscal years 1999 through

17 2002.’’; and

18 (ii) by striking paragraph (2) and in19 serting the following:

20 ‘‘(2) ALLOCATION.—

21 ‘‘(A) IN GENERAL.—Of the amounts ap22 propriated under paragraph (1) for a fiscal

23 year, the Secretary shall make available—

24 ‘‘(i) not less than $49,300,000 for

25 awards of grants and contracts under sub-
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1 section (a) to programs of family medicine,

2 of which not less than $8,600,000 shall be

3 made available for awards of grants and

4 contracts under subsection (b) for family

5 medicine academic administrative units;

6 ‘‘(ii) not less than $17,700,000 for

7 awards of grants and contracts under sub8 section (a) to programs of general internal

9 medicine and general pediatrics;

10 ‘‘(iii) not less than $6,800,000 for

11 awards of grants and contracts under sub12 section (a) to programs relating to physi13 cian assistants; and

14 ‘‘(iv) not less than $4,500,000 for

15 awards of grants and contracts under sub16 section (a) to programs of general or pedi17 atric dentistry.

18 ‘‘(B) RATABLE REDUCTION.—If amounts

19 appropriated under paragraph (1) for any fiscal

20 year are less than the amount required to com21 ply with subparagraph (A), the Secretary shall

22 ratably reduce the amount to be made available

23 under each of clauses (i) through (iv) of such

24 subparagraph accordingly.’’; and
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1 (4) by repealing sections 748 through 752 (42

2 U.S.C. 293l through 293p) and inserting the follow3 ing:

4 ‘‘SEC. 748. ADVISORY COMMITTEE ON TRAINING IN PRI5 MARY CARE MEDICINE AND DENTISTRY.

6 ‘‘(a) ESTABLISHMENT.—The Secretary shall estab7 lish an advisory committee to be known as the Advisory

8 Committee on Training in Primary Care Medicine and

9 Dentistry (in this section referred to as the ‘Advisory

10 Committee’).

11 ‘‘(b) COMPOSITION.—

12 ‘‘(1) IN GENERAL.—The Secretary shall deter13 mine the appropriate number of individuals to serve

14 on the Advisory Committee. Such individuals shall

15 not be officers or employees of the Federal Govern16 ment.

17 ‘‘(2) APPOINTMENT.—Not later than 90 days

18 after the date of enactment of this Act, the Sec19 retary shall appoint the members of the Advisory

20 Committee from among individuals who are health

21 professionals. In making such appointments, the

22 Secretary shall ensure a fair balance between the

23 health professions, that at least 75 percent of the

24 members of the Advisory Committee are health pro25 fessionals, a broad geographic representation of
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1 members and a balance between urban and rural

2 members. Members shall be appointed based on their

3 competence, interest, and knowledge of the mission

4 of the profession involved.

5 ‘‘(3) MINORITY REPRESENTATION.—In appoint6 ing the members of the Advisory Committee under

7 paragraph (2), the Secretary shall ensure the ade8 quate representation of women and minorities.

9 ‘‘(c) TERMS.—

10 ‘‘(1) IN GENERAL.—A member of the Advisory

11 Committee shall be appointed for a term of 3 years,

12 except that of the members first appointed—

‘‘(A) 1 13 ⁄3 of such members shall serve for a

14 term of 1 year;

‘‘(B) 1 15 ⁄3 of such members shall serve for a

16 term of 2 years; and

‘‘(C) 1 17 ⁄3 of such members shall serve for a

18 term of 3 years.

19 ‘‘(2) VACANCIES.—

20 ‘‘(A) IN GENERAL.—A vacancy on the Ad21 visory Committee shall be filled in the manner

22 in which the original appointment was made

23 and shall be subject to any conditions which ap24 plied with respect to the original appointment.
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1 ‘‘(B) FILLING UNEXPIRED TERM.—An in2 dividual chosen to fill a vacancy shall be ap3 pointed for the unexpired term of the member

4 replaced.

5 ‘‘(d) DUTIES.—The Advisory Committee shall—

6 ‘‘(1) provide advice and recommendations to the

7 Secretary concerning policy and program develop8 ment and other matters of significance concerning

9 the activities under section 747; and

10 ‘‘(2) not later than 3 years after the date of en11 actment of this section, and annually thereafter, pre12 pare and submit to the Secretary, and the Commit13 tee on Labor and Human Resources of the Senate,

14 and the Committee on Commerce of the House of

15 Representatives, a report describing the activities of

16 the Committee, including findings and recommenda17 tions made by the Committee concerning the activi18 ties under section 747.

19 ‘‘(e) MEETINGS AND DOCUMENTS.—

20 ‘‘(1) MEETINGS.—The Advisory Committee

21 shall meet not less than 2 times each year. Such

22 meetings shall be held jointly with other related enti23 ties established under this title where appropriate.

24 ‘‘(2) DOCUMENTS.—Not later than 14 days

25 prior to the convening of a meeting under paragraph
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1 (1), the Advisory Committee shall prepare and make

2 available an agenda of the matters to be considered

3 by the Advisory Committee at such meeting. At any

4 such meeting, the Advisory Council shall distribute

5 materials with respect to the issues to be addressed

6 at the meeting. Not later than 30 days after the ad7 journing of such a meeting, the Advisory Committee

8 shall prepare and make available a summary of the

9 meeting and any actions taken by the Committee

10 based upon the meeting.

11 ‘‘(f) COMPENSATION AND EXPENSES.—

12 ‘‘(1) COMPENSATION.—Each member of the

13 Advisory Committee shall be compensated at a rate

14 equal to the daily equivalent of the annual rate of

15 basic pay prescribed for level IV of the Executive

16 Schedule under section 5315 of title 5, United

17 States Code, for each day (including travel time)

18 during which such member is engaged in the per19 formance of the duties of the Committee.

20 ‘‘(2) EXPENSES.—The members of the Advisory

21 Committee shall be allowed travel expenses, includ22 ing per diem in lieu of subsistence, at rates author23 ized for employees of agencies under subchapter I of

24 chapter 57 of title 5, United States Code, while
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1 away from their homes or regular places of business

2 in the performance of services for the Committee.

3 ‘‘(g) FACA.—The Federal Advisory Committee Act

4 shall apply to the Advisory Committee under this section

5 only to the extent that the provisions of such Act do not

6 conflict with the requirements of this section.’’.

7 SEC. 103. INTERDISCIPLINARY, COMMUNITY-BASED LINK8 AGES.

9 Part D of title VII of the Public Health Service Act

10 (42 U.S.C. 294 et seq.) is amended to read as follows:

11 ‘‘PART D—INTERDISCIPLINARY, COMMUNITY12 BASED LINKAGES

13 ‘‘SEC. 750. GENERAL PROVISIONS.

14 ‘‘(a) COLLABORATION.—To be eligible to receive as15 sistance under this part, an academic institution shall use

16 such assistance in collaboration with 2 or more disciplines.

17 ‘‘(b) ACTIVITIES.—An entity shall use assistance

18 under this part to carry out innovative demonstration

19 projects for strategic workforce supplementation activities

20 as needed to meet national goals for interdisciplinary,

21 community-based linkages. Such assistance may be used

22 consistent with this part—

23 ‘‘(1) to develop and support training programs;

24 ‘‘(2) for faculty development;

25 ‘‘(3) for model demonstration programs;
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1 ‘‘(4) for the provision of stipends for fellowship

2 trainees;

3 ‘‘(5) to provide technical assistance; and

4 ‘‘(6) for other activities that will produce out5 comes consistent with the purposes of this part.

6 ‘‘SEC. 751. AREA HEALTH EDUCATION CENTERS.

7 ‘‘(a) AUTHORITY FOR PROVISION OF FINANCIAL AS8 SISTANCE.—

9 ‘‘(1) ASSISTANCE FOR PLANNING, DEVELOP10 MENT, AND OPERATION OF PROGRAMS.—

11 ‘‘(A) IN GENERAL.—The Secretary shall

12 award grants to and enter into contracts with

13 schools of medicine and osteopathic medicine,

14 and incorporated consortia made up of such

15 schools, or the parent institutions of such

16 schools, for projects for the planning, develop17 ment and operation of area health education

18 center programs that—

19 ‘‘(i) improve the recruitment, distribu20 tion, supply, quality and efficiency of per21 sonnel providing health services in under22 served rural and urban areas and person23 nel providing health services to populations

24 having demonstrated serious unmet health

25 care needs;
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1 ‘‘(ii) increase the number of primary

2 care physicians and other primary care

3 providers who provide services in under4 served areas through the offering of an

5 educational continuum of health career re6 cruitment through clinical education con7 cerning underserved areas in a comprehen8 sive health workforce strategy;

9 ‘‘(iii) carry out recruitment and health

10 career awareness programs to recruit indi11 viduals from underserved areas and under12 represented populations, including minority

13 and other elementary or secondary stu14 dents, into the health professions;

15 ‘‘(iv) prepare individuals to more ef16 fectively provide health services to under17 served areas or underserved populations

18 through field placements, preceptorships,

19 the conduct of or support of community20 based primary care residency programs,

21 and agreements with community-based or22 ganizations such as community health cen23 ters, migrant health centers, Indian health

24 centers, public health departments and

25 others;
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1 ‘‘(v) conduct health professions edu2 cation and training activities for students

3 of health professions schools and medical

4 residents;

5 ‘‘(vi) conduct at least 10 percent of

6 medical student required clinical education

7 at sites remote to the primary teaching fa8 cility of the contracting institution; and

9 ‘‘(vii) provide information dissemina10 tion and educational support to reduce pro11 fessional isolation, increase retention,

12 enhance the practice environment, and im13 prove health care through the timely dis14 semination of research findings using rel15 evant resources.

16 ‘‘(B) OTHER ELIGIBLE ENTITIES.—With

17 respect to a State in which no area health edu18 cation center program is in operation, the Sec19 retary may award a grant or contract under

20 subparagraph (A) to a school of nursing.

21 ‘‘(C) PROJECT TERMS.—

22 ‘‘(i) IN GENERAL.—Except as pro23 vided in clause (ii), the period during

24 which payments may be made under an
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1 award under subparagraph (A) may not

2 exceed—

3 ‘‘(I) in the case of a project, 12

4 years or

5 ‘‘(II) in the case of a center with6 in a project, 6 years.

7 ‘‘(ii) EXCEPTION.—The periods de8 scribed in clause (i) shall not apply to

9 projects that have completed the initial pe10 riod of Federal funding under this section

11 and that desire to compete for model

12 awards under paragraph (2)(A).

13 ‘‘(2) ASSISTANCE FOR OPERATION OF MODEL

14 PROGRAMS.—

15 ‘‘(A) IN GENERAL.—In the case of any en16 tity described in paragraph (1)(A) that—

17 ‘‘(i) has previously received funds

18 under this section;

19 ‘‘(ii) is operating an area health edu20 cation center program; and

21 ‘‘(iii) is no longer receiving financial

22 assistance under paragraph (1);

23 the Secretary may provide financial assistance

24 to such entity to pay the costs of operating and
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1 carrying out the requirements of the program

2 as described in paragraph (1).

3 ‘‘(B) MATCHING REQUIREMENT.—With re4 spect to the costs of operating a model program

5 under subparagraph (A), an entity, to be eligi6 ble for financial assistance under subparagraph

7 (A), shall make available (directly or through

8 contributions from State, county or municipal

9 governments, or the private sector) recurring

10 non-Federal contributions in cash toward such

11 costs in an amount that is equal to not less

12 than 50 percent of such costs.

13 ‘‘(C) LIMITATION.—The aggregate amount

14 of awards provided under subparagraph (A) to

15 entities in a State for a fiscal year may not ex16 ceed the lesser of—

17 ‘‘(i) $2,000,000; or

18 ‘‘(ii) an amount equal to the product

19 of $250,000 and the aggregate number of

20 area health education centers operated in

21 the State by such entities.

22 ‘‘(b) REQUIREMENTS FOR CENTERS.—

23 ‘‘(1) GENERAL REQUIREMENT.—Each area

24 health education center that receives funds under

25 this section shall encourage the regionalization of
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1 health professions schools through the establishment

2 of partnerships with community-based organizations.

3 ‘‘(2) SERVICE AREA.—Each area health edu4 cation center that receives funds under this section

5 shall specifically designate a geographic area or

6 medically underserved population to be served by the

7 center. Such area or population shall be in a location

8 removed from the main location of the teaching fa9 cilities of the schools participating in the program

10 with such center.

11 ‘‘(3) OTHER REQUIREMENTS.—Each area

12 health education center that receives funds under

13 this section shall—

14 ‘‘(A) assess the health personnel needs of

15 the area to be served by the center and assist

16 in the planning and development of training

17 programs to meet such needs;

18 ‘‘(B) arrange and support rotations for

19 students and residents in family medicine, gen20 eral internal medicine or general pediatrics,

21 with at least one center in each program being

22 affiliated with or conducting a rotating osteo23 pathic internship or medical residency training

24 program in family medicine (including geri25 atrics), general internal medicine (including
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1 geriatrics), or general pediatrics in which no

2 fewer than 4 individuals are enrolled in first3 year positions;

4 ‘‘(C) conduct and participate in inter5 disciplinary training that involves physicians

6 and other health personnel including, where

7 practicable, public health professionals, physi8 cian assistants, nurse practitioners, nurse mid9 wives, and behavioral and mental health provid10 ers; and

11 ‘‘(D) have an advisory board, at least 75

12 percent of the members of which shall be indi13 viduals, including both health service providers

14 and consumers, from the area served by the

15 center.

16 ‘‘(c) CERTAIN PROVISIONS REGARDING FUNDING.—

17 ‘‘(1) ALLOCATION TO CENTER.—Not less than

18 75 percent of the total amount of Federal funds pro19 vided to an entity under this section shall be allo20 cated by an area health education center program to

21 the area health education center. Such entity shall

22 enter into an agreement with each center for pur23 poses of specifying the allocation of such 75 percent

24 of funds.
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1 ‘‘(2) OPERATING COSTS.—With respect to the

2 operating costs of the area health education center

3 program of an entity receiving funds under this sec4 tion, the entity shall make available (directly or

5 through contributions from State, county or munici6 pal governments, or the private sector) non-Federal

7 contributions in cash toward such costs in an

8 amount that is equal to not less than 50 percent of

9 such costs, except that the Secretary may grant a

10 waiver for up to 75 percent of the amount of the re11 quired non-Federal match in the first 3 years in

12 which an entity receives funds under this section.

13 ‘‘SEC. 752. HEALTH EDUCATION AND TRAINING CENTERS.

14 ‘‘(a) IN GENERAL.—To be eligible for funds under

15 this section, a health education training center shall be

16 an entity otherwise eligible for funds under section 751

17 that—

18 ‘‘(1) addresses the persistent and severe unmet

19 health care needs in States along the border between

20 the United States and Mexico and in the State of

21 Florida, and in other urban and rural areas with

22 populations with serious unmet health care needs;

23 ‘‘(2) establishes an advisory board comprised of

24 health service providers, educators and consumers

25 from the service area;
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1 ‘‘(3) conducts training and education programs

2 for health professions students in these areas;

3 ‘‘(4) conducts training in health education serv4 ices, including training to prepare community health

5 workers; and

6 ‘‘(5) supports health professionals (including

7 nursing) practicing in the area through educational

8 and other services.

9 ‘‘(b) ALLOCATION OF FUNDS.—The Secretary shall

10 make available 50 percent of the amounts appropriated

11 for each fiscal year under section 752 for the establish12 ment or operation of health education training centers

13 through projects in States along the border between the

14 United States and Mexico and in the State of Florida.

15 ‘‘SEC. 753. EDUCATION AND TRAINING RELATING TO GERI16 ATRICS.

17 ‘‘(a) GERIATRIC EDUCATION CENTERS.—

18 ‘‘(1) IN GENERAL.—The Secretary shall award

19 grants or contracts under this section to entities de20 scribed in paragraphs (1), (3), or (4) of section

21 799B, and section 853(2), for the establishment or

22 operation of geriatric education centers.

23 ‘‘(2) REQUIREMENTS.—A geriatric education

24 center is a program that—
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1 ‘‘(A) improves the training of health pro2 fessionals in geriatrics, including geriatric

3 residencies, traineeships, or fellowships;

4 ‘‘(B) develops and disseminates curricula

5 relating to the treatment of the health problems

6 of elderly individuals;

7 ‘‘(C) supports the training and retraining

8 of faculty to provide instruction in geriatrics;

9 ‘‘(D) supports continuing education of

10 health professionals who provide geriatric care;

11 and

12 ‘‘(E) provides students with clinical train13 ing in geriatrics in nursing homes, chronic and

14 acute disease hospitals, ambulatory care cen15 ters, and senior centers.

16 ‘‘(b) GERIATRIC TRAINING REGARDING PHYSICIANS

17 AND DENTISTS.—

18 ‘‘(1) IN GENERAL.—The Secretary may make

19 grants to, and enter into contracts with, schools of

20 medicine, schools of osteopathic medicine, teaching

21 hospitals, and graduate medical education programs,

22 for the purpose of providing support (including

23 residencies, traineeships, and fellowships) for geri24 atric training projects to train physicians, dentists

25 and behavioral and mental health professionals who
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1 plan to teach geriatric medicine, geriatric behavioral

2 or mental health, or geriatric dentistry.

3 ‘‘(2) REQUIREMENTS.—Each project for which

4 a grant or contract is made under this subsection

5 shall—

6 ‘‘(A) be staffed by full-time teaching physi7 cians who have experience or training in geri8 atric medicine or geriatric behavioral or mental

9 health;

10 ‘‘(B) be staffed, or enter into an agree11 ment with an institution staffed by full-time or

12 part-time teaching dentists who have experience

13 or training in geriatric dentistry;

14 ‘‘(C) be staffed, or enter into an agreement

15 with an institution staffed by full-time or part16 time teaching behavioral mental health profes17 sionals who have experience or training in geri18 atric behavioral or mental health;

19 ‘‘(D) be based in a graduate medical edu20 cation program in internal medicine or family

21 medicine or in a department of geriatrics or be22 havioral or mental health;

23 ‘‘(E) provide training in geriatrics and ex24 posure to the physical and mental disabilities of

25 elderly individuals through a variety of service
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1 rotations, such as geriatric consultation serv2 ices, acute care services, dental services, geri3 atric behavioral or mental health units, day and

4 home care programs, rehabilitation services, ex5 tended care facilities, geriatric ambulatory care

6 and comprehensive evaluation units, and com7 munity care programs for elderly mentally re8 tarded individuals; and

9 ‘‘(F) provide training in geriatrics through

10 one or both of the training options described in

11 subparagraphs (A) and (B) of paragraph (3).

12 ‘‘(3) TRAINING OPTIONS.—The training options

13 referred to in subparagraph (F) of paragraph (2)

14 shall be as follows:

15 ‘‘(A) A 1-year retraining program in geri16 atrics for—

17 ‘‘(i) physicians who are faculty mem18 bers in departments of internal medicine,

19 family medicine, gynecology, geriatrics, and

20 behavioral or mental health at schools of

21 medicine and osteopathic medicine;

22 ‘‘(ii) dentists who are faculty members

23 at schools of dentistry or at hospital de24 partments of dentistry; and
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1 ‘‘(iii) behavioral or mental health pro2 fessionals who are faculty members in de3 partments of behavioral or mental health;

4 and

5 ‘‘(B) A 2-year internal medicine or family

6 medicine fellowship program providing emphasis

7 in geriatrics, which shall be designed to provide

8 training in clinical geriatrics and geriatrics re9 search for—

10 ‘‘(i) physicians who have completed

11 graduate medical education programs in

12 internal medicine, family medicine, behav13 ioral or mental health, neurology, gyne14 cology, or rehabilitation medicine;

15 ‘‘(ii) dentists who have demonstrated

16 a commitment to an academic career and

17 who have completed postdoctoral dental

18 training, including postdoctoral dental edu19 cation programs or who have relevant ad20 vanced training or experience; and

21 ‘‘(iii) behavioral or mental health pro22 fessionals who have completed graduate

23 medical education programs in behavioral

24 or mental health.
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1 ‘‘(4) DEFINITIONS.—For purposes of this sub2 section:

3 ‘‘(A) The term ‘graduate medical education

4 program’ means a program sponsored by a

5 school of medicine, a school of osteopathic med6 icine, a hospital, or a public or private institu7 tion that—

8 ‘‘(i) offers postgraduate medical train9 ing in the specialties and subspecialties of

10 medicine; and

11 ‘‘(ii) has been accredited by the Ac12 creditation Council for Graduate Medical

13 Education or the American Osteopathic

14 Association through its Committee on

15 Postdoctoral Training.

16 ‘‘(B) The term ‘post-doctoral dental edu17 cation program’ means a program sponsored by

18 a school of dentistry, a hospital, or a public or

19 private institution that—

20 ‘‘(i) offers post-doctoral training in

21 the specialties of dentistry, advanced edu22 cation in general dentistry, or a dental

23 general practice residency; and

24 ‘‘(ii) has been accredited by the Com25 mission on Dental Accreditation.
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1 ‘‘(c) GERIATRIC FACULTY FELLOWSHIPS.—

2 ‘‘(1) ESTABLISHMENT OF PROGRAM.—The Sec3 retary shall establish a program to provide Geriatric

4 Academic Career Awards to eligible individuals to

5 promote the career development of such individuals

6 as academic geriatricians.

7 ‘‘(2) ELIGIBLE INDIVIDUALS.—To be eligible to

8 receive an Award under paragraph (1), an individual

9 shall—

10 ‘‘(A) be board certified or board eligible in

11 internal medicine, family practice, or psychia12 try;

13 ‘‘(B) have completed an approved fellow14 ship program in geriatrics; and

15 ‘‘(C) have a junior faculty appointment at

16 an accredited (as determined by the Secretary)

17 school of medicine or osteopathic medicine.

18 ‘‘(3) LIMITATIONS.—No Award under para19 graph (1) may be made to an eligible individual un20 less the individual—

21 ‘‘(A) has submitted to the Secretary an ap22 plication, at such time, in such manner, and

23 containing such information as the Secretary

24 may require, and the Secretary has approved

25 such application; and
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1 ‘‘(B) provides, in such form and manner as

2 the Secretary may require, assurances that the

3 individual will meet the service requirement de4 scribed in subsection (e).

5 ‘‘(4) AMOUNT AND TERM.—

6 ‘‘(A) AMOUNT.—The amount of an Award

7 under this section shall equal $50,000 for fiscal

8 year 1998, adjusted for subsequent fiscal years

9 to reflect the increase in the Consumer Price

10 Index.

11 ‘‘(B) TERM.—The term of any Award

12 made under this subsection shall not exceed 5

13 years.

14 ‘‘(5) SERVICE REQUIREMENT.—An individual

15 who receives an Award under this subsection shall

16 provide training in clinical geriatrics, including the

17 training of interdisciplinary teams of health care

18 professionals. The provision of such training shall

19 constitute at least 75 percent of the obligations of

20 such individual under the Award.

21 ‘‘SEC. 754. RURAL INTERDISCIPLINARY TRAINING GRANTS.

22 ‘‘(a) GRANTS.—The Secretary may make grants or

23 contracts under this section to help entities fund author24 ized activities under an application approved under sub25 section (c).
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1 ‘‘(b) USE OF AMOUNTS.—

2 ‘‘(1) IN GENERAL.—Amounts provided under

3 subsection (a) shall be used by the recipients to fund

4 interdisciplinary training projects designed to—

5 ‘‘(A) use new and innovative methods to

6 train health care practitioners to provide serv7 ices in rural areas;

8 ‘‘(B) demonstrate and evaluate innovative

9 interdisciplinary methods and models designed

10 to provide access to cost-effective comprehensive

11 health care;

12 ‘‘(C) deliver health care services to individ13 uals residing in rural areas;

14 ‘‘(D) enhance the amount of relevant re15 search conducted concerning health care issues

16 in rural areas; and

17 ‘‘(E) increase the recruitment and reten18 tion of health care practitioners from rural

19 areas and make rural practice a more attractive

20 career choice for health care practitioners.

21 ‘‘(2) METHODS.—A recipient of funds under

22 subsection (a) may use various methods in carrying

23 out the projects described in paragraph (1), includ24 ing—
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1 ‘‘(A) the distribution of stipends to stu2 dents of eligible applicants;

3 ‘‘(B) the establishment of a post-doctoral

4 fellowship program;

5 ‘‘(C) the training of faculty in the eco6 nomic and logistical problems confronting rural

7 health care delivery systems; or

8 ‘‘(D) the purchase or rental of transpor9 tation and telecommunication equipment where

10 the need for such equipment due to unique

11 characteristics of the rural area is demonstrated

12 by the recipient.

13 ‘‘(3) ADMINISTRATION.—

14 ‘‘(A) IN GENERAL.—An applicant shall not

15 use more than 10 percent of the funds made

16 available to such applicant under subsection (a)

17 for administrative expenses.

18 ‘‘(B) TRAINING.—Not more than 10 per19 cent of the individuals receiving training with

20 funds made available to an applicant under sub21 section (a) shall be trained as doctors of medi22 cine or doctors of osteopathy.

23 ‘‘(C) LIMITATION.—An institution that re24 ceives a grant under this section shall use

25 amounts received under such grant to supple-
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1 ment, not supplant, amounts made available by

2 such institution for activities of the type de3 scribed in subsection (b)(1) in the fiscal year

4 preceding the year for which the grant is re5 ceived.

6 ‘‘(c) APPLICATIONS.—Applications submitted for as7 sistance under this section shall—

8 ‘‘(1) be jointly submitted by at least two eligible

9 applicants with the express purpose of assisting indi10 viduals in academic institutions in establishing long11 term collaborative relationships with health care pro12 viders in rural areas; and

13 ‘‘(2) designate a rural health care agency or

14 agencies for clinical treatment or training, including

15 hospitals, community health centers, migrant health

16 centers, rural health clinics, community behavioral

17 and mental health centers, long-term care facilities,

18 Native Hawaiian health centers, or facilities oper19 ated by the Indian Health Service or an Indian tribe

20 or tribal organization or Indian organization under

21 a contract with the Indian Health Service under the

22 Indian Self-Determination Act.

23 ‘‘(d) DEFINITIONS.—For the purposes of this section,

24 the term ‘rural’ means geographic areas that are located

25 outside of standard metropolitan statistical areas.
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1 ‘‘SEC. 755. ALLIED HEALTH AND OTHER DISCIPLINES.

2 ‘‘(a) IN GENERAL.—The Secretary may make grants

3 or contracts under this section to help entities fund activi4 ties of the type described in subsection (b).

5 ‘‘(b) ACTIVITIES.—Activities of the type described in

6 this subsection include the following:

7 ‘‘(1) Assisting entities in meeting the costs as8 sociated with expanding or establishing programs

9 that will increase the number of individuals trained

10 in allied health professions. Programs and activities

11 funded under this paragraph may include—

12 ‘‘(A) those that expand enrollments in al13 lied health professions with the greatest short14 ages or whose services are most needed by the

15 elderly;

16 ‘‘(B) those that provide rapid transition

17 training programs in allied health fields to indi18 viduals who have baccalaureate degrees in

19 health-related sciences;

20 ‘‘(C) those that establish community-based

21 allied health training programs that link aca22 demic centers to rural clinical settings;

23 ‘‘(D) those that provide career advance24 ment training for practicing allied health pro25 fessionals;
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1 ‘‘(E) those that expand or establish clinical

2 training sites for allied health professionals in

3 medically underserved or rural communities in

4 order to increase the number of individuals

5 trained;

6 ‘‘(F) those that develop curriculum that

7 will emphasize knowledge and practice in the

8 areas of prevention and health promotion, geri9 atrics, long-term care, home health and hospice

10 care, and ethics;

11 ‘‘(G) those that expand or establish inter12 disciplinary training programs that promote the

13 effectiveness of allied health practitioners in

14 geriatric assessment and the rehabilitation of

15 the elderly;

16 ‘‘(H) those that expand or establish dem17 onstration centers to emphasize innovative mod18 els to link allied health clinical practice, edu19 cation, and research;

20 ‘‘(I) those that provide financial assistance

21 (in the form of traineeships) to students who

22 are participants in any such program; and

23 ‘‘(i) who plan to pursue a career in an

24 allied health field that has a demonstrated

25 personnel shortage; and
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1 ‘‘(ii) who agree upon completion of

2 the training program to practice in a medi3 cally underserved community;

4 that shall be utilized to assist in the payment

5 of all or part of the costs associated with tui6 tion, fees and such other stipends as the Sec7 retary may consider necessary; and

8 ‘‘(J) those to meet the costs of projects to

9 plan, develop, and operate or maintain graduate

10 programs in behavioral and mental health prac11 tice.

12 ‘‘(2) Planning and implementing projects in

13 preventive and primary care training for podiatric

14 physicians in approved or provisionally approved

15 residency programs that shall provide financial as16 sistance in the form of traineeships to residents who

17 participate in such projects and who plan to special18 ize in primary care.

19 ‘‘(3) Carrying out demonstration projects in

20 which chiropractors and physicians collaborate to

21 identify and provide effective treatment for spinal

22 and lower-back conditions.
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1 ‘‘SEC. 756. ADVISORY COMMITTEE ON INTERDISCIPLINARY,

2 COMMUNITY-BASED LINKAGES.

3 ‘‘(a) ESTABLISHMENT.—The Secretary shall estab4 lish an advisory committee to be known as the Advisory

5 Committee on Interdisciplinary, Community-Based Link6 ages (in this section referred to as the ‘Advisory Commit7 tee’).

8 ‘‘(b) COMPOSITION.—

9 ‘‘(1) IN GENERAL.—The Secretary shall deter10 mine the appropriate number of individuals to serve

11 on the Advisory Committee. Such individuals shall

12 not be officers or employees of the Federal Govern13 ment.

14 ‘‘(2) APPOINTMENT.—Not later than 90 days

15 after the date of enactment of this Act, the Sec16 retary shall appoint the members of the Advisory

17 Committee from among individuals who are health

18 professionals from schools of the types described in

19 sections 751(a)(1)(A), 751(a)(1)(B), 753(b),

20 754(3)(A), and 755(b). In making such appoint21 ments, the Secretary shall ensure a fair balance be22 tween the health professions, that at least 75 per23 cent of the members of the Advisory Committee are

24 health professionals, a broad geographic representa25 tion of members and a balance between urban and

26 rural members. Members shall be appointed based
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1 on their competence, interest, and knowledge of the

2 mission of the profession involved.

3 ‘‘(3) MINORITY REPRESENTATION.—In appoint4 ing the members of the Advisory Committee under

5 paragraph (2), the Secretary shall ensure the ade6 quate representation of women and minorities.

7 ‘‘(c) TERMS.—

8 ‘‘(1) IN GENERAL.—A member of the Advisory

9 Committee shall be appointed for a term of 3 years,

10 except that of the members first appointed—

‘‘(A) 1 11 ⁄3 of the members shall serve for a

12 term of 1 year;

‘‘(B) 1 13 ⁄3 of the members shall serve for a

14 term of 2 years; and

‘‘(C) 1 15 ⁄3 of the members shall serve for a

16 term of 3 years.

17 ‘‘(2) VACANCIES.—

18 ‘‘(A) IN GENERAL.—A vacancy on the Ad19 visory Committee shall be filled in the manner

20 in which the original appointment was made

21 and shall be subject to any conditions which ap22 plied with respect to the original appointment.

23 ‘‘(B) FILLING UNEXPIRED TERM.—An in24 dividual chosen to fill a vacancy shall be ap-
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1 pointed for the unexpired term of the member

2 replaced.

3 ‘‘(d) DUTIES.—The Advisory Committee shall—

4 ‘‘(1) provide advice and recommendations to the

5 Secretary concerning policy and program develop6 ment and other matters of significance concerning

7 the activities under this part; and

8 ‘‘(2) not later than 3 years after the date of en9 actment of this section, and annually thereafter, pre10 pare and submit to the Secretary, and the Commit11 tee on Labor and Human Resources of the Senate,

12 and the Committee on Commerce of the House of

13 Representatives, a report describing the activities of

14 the Committee, including findings and recommenda15 tions made by the Committee concerning the activi16 ties under this part.

17 ‘‘(e) MEETINGS AND DOCUMENTS.—

18 ‘‘(1) MEETINGS.—The Advisory Committee

19 shall meet not less than 3 times each year. Such

20 meetings shall be held jointly with other related enti21 ties established under this title where appropriate.

22 ‘‘(2) DOCUMENTS.—Not later than 14 days

23 prior to the convening of a meeting under paragraph

24 (1), the Advisory Committee shall prepare and make

25 available an agenda of the matters to be considered
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1 by the Advisory Committee at such meeting. At any

2 such meeting, the Advisory Council shall distribute

3 materials with respect to the issues to be addressed

4 at the meeting. Not later than 30 days after the ad5 journing of such a meeting, the Advisory Committee

6 shall prepare and make available a summary of the

7 meeting and any actions taken by the Committee

8 based upon the meeting.

9 ‘‘(f) COMPENSATION AND EXPENSES.—

10 ‘‘(1) COMPENSATION.—Each member of the

11 Advisory Committee shall be compensated at a rate

12 equal to the daily equivalent of the annual rate of

13 basic pay prescribed for level IV of the Executive

14 Schedule under section 5315 of title 5, United

15 States Code, for each day (including travel time)

16 during which such member is engaged in the per17 formance of the duties of the Committee.

18 ‘‘(2) EXPENSES.—The members of the Advisory

19 Committee shall be allowed travel expenses, includ20 ing per diem in lieu of subsistence, at rates author21 ized for employees of agencies under subchapter I of

22 chapter 57 of title 5, United States Code, while

23 away from their homes or regular places of business

24 in the performance of services for the Committee.
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1 ‘‘(g) FACA.—The Federal Advisory Committee Act

2 shall apply to the Advisory Committee under this section

3 only to the extent that the provisions of such Act do not

4 conflict with the requirements of this section.

5 ‘‘SEC. 757. AUTHORIZATION OF APPROPRIATIONS.

6 ‘‘(a) IN GENERAL.—There are authorized to be ap7 propriated to carry out this part, $55,600,000 for fiscal

8 year 1998, and such sums as may be necessary for each

9 of the fiscal years 1999 through 2002.

10 ‘‘(b) ALLOCATION.—

11 ‘‘(1) IN GENERAL.—Of the amounts appro12 priated under subsection (a) for a fiscal year, the

13 Secretary shall make available—

14 ‘‘(A) not less than $28,587,000 for awards

15 of grants and contracts under section 751;

16 ‘‘(B) not less than $3,765,000 for awards

17 of grants and contracts under section 752, of

18 which not less than 50 percent of such amount

19 shall be made available for centers described in

20 subsection (a)(1) of such section; and

21 ‘‘(C) not less than $22,631,000 for awards

22 of grants and contracts under sections 753,

23 754, and 755.

24 ‘‘(2) RATABLE REDUCTION.—If amounts appro25 priated under subsection (a) for any fiscal year are
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1 less than the amount required to comply with para2 graph (1), the Secretary shall ratably reduce the

3 amount to be made available under each of subpara4 graphs (A) through (C) of such paragraph accord5 ingly.

6 ‘‘(3) INCREASE IN AMOUNTS.—If amounts ap7 propriated for a fiscal year under subsection (a) ex8 ceed the amount authorized under such subsection

9 for such fiscal year, the Secretary may increase the

10 amount to be made available for programs and ac11 tivities under this part without regard to the

12 amounts specified in each of subparagraphs (A)

13 through (C) of paragraph (2).

14 ‘‘(c) OBLIGATION OF CERTAIN AMOUNTS.—

15 ‘‘(1) AREA HEALTH EDUCATION CENTER PRO16 GRAMS.—Of the amounts made available under sub17 section (b)(1)(A) for each fiscal year, the Secretary

18 may obligate for awards under section 751(a)(2)—

19 ‘‘(A) not less than 23 percent of such

20 amounts in fiscal year 1998;

21 ‘‘(B) not less than 30 percent of such

22 amounts in fiscal year 1999;

23 ‘‘(C) not less than 35 percent of such

24 amounts in fiscal year 2000;
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1 ‘‘(D) not less than 40 percent of such

2 amounts in fiscal year 2001; and

3 ‘‘(E) not less than 45 percent of such

4 amounts in fiscal year 2002.

5 ‘‘(2) SENSE OF CONGRESS.—It is the sense of

6 the Congress that—

7 ‘‘(A) every State have an area health edu8 cation center program in effect under this sec9 tion; and

10 ‘‘(B) the ratio of Federal funding for the

11 model program under section 751(a)(2) should

12 increase over time and that Federal funding for

13 other awards under this section shall decrease

14 so that the national program will become en15 tirely comprised of programs that are funded at

16 least 50 percent by State and local partners.’’.

17 SEC. 104. HEALTH PROFESSIONS WORKFORCE INFORMA18 TION AND ANALYSIS.

19 (a) IN GENERAL.—Part E of title VII of the Public

20 Health Service Act (42 U.S.C. 294n et seq.) is amended

21 to read as follows:
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1 ‘‘PART E—HEALTH PROFESSIONS AND PUBLIC

2 HEALTH WORKFORCE

3 ‘‘Subpart 1—Health Professions Workforce

4 Information and Analysis

5 ‘‘SEC. 761. HEALTH PROFESSIONS WORKFORCE INFORMA6 TION AND ANALYSIS.

7 ‘‘(a) PURPOSE.—It is the purpose of this section to—

8 ‘‘(1) provide for the development of information

9 describing the health professions workforce and the

10 analysis of workforce related issues; and

11 ‘‘(2) provide necessary information for decision12 making regarding future directions in health profes13 sions and nursing programs in response to societal

14 and professional needs.

15 ‘‘(b) GRANTS OR CONTRACTS.—The Secretary may

16 award grants or contracts to State or local governments,

17 health professions schools, schools of nursing, academic

18 health centers, community-based health facilities, and

19 other appropriate public or private nonprofit entities to

20 provide for—

21 ‘‘(1) targeted information collection and analy22 sis activities related to the purposes described in

23 subsection (a);

24 ‘‘(2) research on high priority workforce ques25 tions;
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1 ‘‘(3) the development of a non-Federal analytic

2 and research infrastructure related to the purposes

3 described in subsection (a); and

4 ‘‘(4) the conduct of program evaluation and as5 sessment.

6 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—

7 ‘‘(1) IN GENERAL.—There are authorized to be

8 appropriated to carry out this section, $750,000 for

9 fiscal year 1998, and such sums as may be nec10 essary for each of the fiscal years 1999 through

11 2002.

12 ‘‘(2) RESERVATION.—Of the amounts appro13 priated under subsection (a) for a fiscal year, the

14 Secretary shall reserve not less than $600,000 for

15 conducting health professions research and for car16 rying out data collection and analysis in accordance

17 with section 792.

18 ‘‘(3) AVAILABILITY OF ADDITIONAL FUNDS.—

19 Amounts otherwise appropriated for programs or ac20 tivities under this title may be used for activities

21 under subsection (b) with respect to the programs or

22 activities from which such amounts were made avail23 able.’’.

24 (b) COUNCIL ON GRADUATE MEDICAL EDU25 CATION.—Section 301 of the Health Professions Edu-
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1 cation Extension Amendments of 1992 (Public Law 102–

2 408) is amended—

3 (1) in subsection (j), by striking ‘‘1995’’ and

4 inserting ‘‘2002’’;

5 (2) in subsection (k), by striking ‘‘1995’’ and

6 inserting ‘‘2002’’;

7 (3) by adding at the end thereof the following

8 new subsection:

9 ‘‘(l) FUNDING.—Amounts otherwise appropriated

10 under this title may be utilized by the Secretary to support

11 the activities of the Council.’’;

12 (4) by transferring such section to part E of

13 title VII of the Public Health Service Act (as

14 amended by subsection (a));

15 (5) by redesignating such section as section

16 762; and

17 (6) by inserting such section after section 761.

18 SEC. 105. PUBLIC HEALTH WORKFORCE DEVELOPMENT.

19 Part E of title VII of the Public Health Service Act

20 (as amended by section 104) is further amended by adding

21 at the end the following:

22 ‘‘Subpart 2—Public Health Workforce

23 ‘‘SEC. 765. GENERAL PROVISIONS.

24 ‘‘(a) IN GENERAL.—The Secretary may award grants

25 or contracts to eligible entities to increase the number of
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1 individuals in the public health workforce, to enhance the

2 quality of such workforce, and to enhance the ability of

3 the workforce to meet national, State, and local health

4 care needs.

5 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant

6 or contract under subsection (a) an entity shall—

7 ‘‘(1) be—

8 ‘‘(A) a health professions school, including

9 an accredited school or program of public

10 health, health administration, preventive medi11 cine, or dental public health or a school provid12 ing health management programs;

13 ‘‘(B) an academic health center;

14 ‘‘(C) a State or local government; or

15 ‘‘(D) any other appropriate public or pri16 vate nonprofit entity; and

17 ‘‘(2) prepare and submit to the Secretary an

18 application at such time, in such manner, and con19 taining such information as the Secretary may re20 quire.

21 ‘‘(c) PREFERENCE.—In awarding grants or contracts

22 under this section the Secretary may grant a preference

23 to entities—
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1 ‘‘(1) serving individuals who are from disadvan2 taged backgrounds (including underrepresented ra3 cial and ethnic minorities); and

4 ‘‘(2) graduating large proportions of individuals

5 who serve in underserved communities.

6 ‘‘(d) ACTIVITIES.—Amounts provided under a grant

7 or contract awarded under this section may be used for—

8 ‘‘(1) the costs of planning, developing, or oper9 ating demonstration training programs;

10 ‘‘(2) faculty development;

11 ‘‘(3) trainee support;

12 ‘‘(4) technical assistance;

13 ‘‘(5) to meet the costs of projects—

14 ‘‘(A) to plan and develop new residency

15 training programs and to maintain or improve

16 existing residency training programs in preven17 tive medicine and dental public health, that

18 have available full-time faculty members with

19 training and experience in the fields of preven20 tive medicine and dental public health; and

21 ‘‘(B) to provide financial assistance to resi22 dency trainees enrolled in such programs;

23 ‘‘(6) the retraining of existing public health

24 workers as well as for increasing the supply of new

25 practitioners to address priority public health, pre-
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1 ventive medicine, public health dentistry, and health

2 administration needs;

3 ‘‘(7) preparing public health professionals for

4 employment at the State and community levels; or

5 ‘‘(8) other activities that may produce outcomes

6 that are consistent with the purposes of this section

7 ‘‘(e) TRAINEESHIPS.—

8 ‘‘(1) IN GENERAL.—With respect to amounts

9 used under this section for the training of health

10 professionals, such training programs shall be de11 signed to—

12 ‘‘(A) make public health education more

13 accessible to the public and private health work14 force;

15 ‘‘(B) increase the relevance of public

16 health academic preparation to public health

17 practice in the future;

18 ‘‘(C) provide education or training for stu19 dents from traditional on-campus programs in

20 practice-based sites; or

21 ‘‘(D) develop educational methods and dis22 tance-based approaches or technology that ad23 dress adult learning requirements and increase

24 knowledge and skills related to community-
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1 based cultural diversity in public health edu2 cation.

3 ‘‘(2) SEVERE SHORTAGE DISCIPLINES.—

4 Amounts provided under grants or contracts under

5 this section may be used for the operation of pro6 grams designed to award traineeships to students in

7 accredited schools of public health who enter edu8 cational programs in fields where there is a severe

9 shortage of public health professionals, including ep10 idemiology, biostatistics, environmental health, toxi11 cology, public health nursing, nutrition, preventive

12 medicine, maternal and child health, and behavioral

13 and mental health professions.

14 ‘‘SEC. 766. PUBLIC HEALTH TRAINING CENTERS.

15 ‘‘(a) IN GENERAL.—The Secretary may make grants

16 or contracts for the operation of public health training

17 centers.

18 ‘‘(b) ELIGIBLE ENTITIES.—

19 ‘‘(1) IN GENERAL.—A public health training

20 center shall be an accredited school of public health,

21 or another public or nonprofit private institution ac22 credited for the provision of graduate or specialized

23 training in public health, that plans, develops, oper24 ates, and evaluates projects that are in furtherance

25 of the goals established by the Secretary for the year
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1 2000 in the areas of preventive medicine, health pro2 motion and disease prevention, or improving access

3 to and quality of health services in medically under4 served communities.

5 ‘‘(2) PREFERENCE.—In awarding grants or

6 contracts under this section the Secretary shall give

7 preference to accredited schools of public health.

8 ‘‘(c) CERTAIN REQUIREMENTS.—With respect to a

9 public health training center, an award may not be made

10 under subsection (a) unless the program agrees that it—

11 ‘‘(1) will establish or strengthen field place12 ments for students in public or nonprofit private

13 health agencies or organizations;

14 ‘‘(2) will involve faculty members and students

15 in collaborative projects to enhance public health

16 services to medically underserved communities;

17 ‘‘(3) will specifically designate a geographic

18 area or medically underserved population to be

19 served by the center that shall be in a location re20 moved from the main location of the teaching facility

21 of the school that is participating in the program

22 with such center; and

23 ‘‘(4) will assess the health personnel needs of

24 the area to be served by the center and assist in the
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1 planning and development of training programs to

2 meet such needs.

3 ‘‘SEC. 767. PUBLIC HEALTH TRAINEESHIPS.

4 ‘‘(a) IN GENERAL.—The Secretary may make grants

5 to accredited schools of public health, and to other public

6 or nonprofit private institutions accredited for the provi7 sion of graduate or specialized training in public health,

8 for the purpose of assisting such schools and institutions

9 in providing traineeships to individuals described in sub10 section (b)(3).

11 ‘‘(b) CERTAIN REQUIREMENTS.—

12 ‘‘(1) AMOUNT.—The amount of any grant

13 under this section shall be determined by the Sec14 retary.

15 ‘‘(2) USE OF GRANT.—Traineeships awarded

16 under grants made under subsection (a) shall pro17 vide for tuition and fees and such stipends and al18 lowances (including travel and subsistence expenses

19 and dependency allowances) for the trainees as the

20 Secretary may deem necessary.

21 ‘‘(3) ELIGIBLE INDIVIDUALS.—The individuals

22 referred to in subsection (a) are individuals who are

23 pursuing a course of study in a health professions

24 field in which there is a severe shortage of health

25 professionals (which fields include the fields of epide-
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1 miology, environmental health, biostatistics, toxi2 cology, nutrition, and maternal and child health).

3 ‘‘SEC. 768. PREVENTIVE MEDICINE; DENTAL PUBLIC

4 HEALTH.

5 ‘‘(a) IN GENERAL.—The Secretary may make grants

6 to and enter into contracts with schools of medicine, osteo7 pathic medicine, public health, and dentistry to meet the

8 costs of projects—

9 ‘‘(1) to plan and develop new residency training

10 programs and to maintain or improve existing resi11 dency training programs in preventive medicine and

12 dental public health; and

13 ‘‘(2) to provide financial assistance to residency

14 trainees enrolled in such programs.

15 ‘‘(b) ADMINISTRATION.—

16 ‘‘(1) AMOUNT.—The amount of any grant

17 under subsection (a) shall be determined by the Sec18 retary.

19 ‘‘(2) ELIGIBILITY.—To be eligible for a grant

20 under subsection (a), the applicant must dem21 onstrate to the Secretary that it has or will have

22 available full-time faculty members with training and

23 experience in the fields of preventive medicine or

24 dental public health and support from other faculty
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1 members trained in public health and other relevant

2 specialties and disciplines.

3 ‘‘(3) OTHER FUNDS.—Schools of medicine, os4 teopathic medicine, dentistry, and public health may

5 use funds committed by State, local, or county pub6 lic health officers as matching amounts for Federal

7 grant funds for residency training programs in pre8 ventive medicine.

9 ‘‘SEC. 769. HEALTH ADMINISTRATION TRAINEESHIPS AND

10 SPECIAL PROJECTS.

11 ‘‘(a) IN GENERAL.—The Secretary may make grants

12 to State or local governments (that have in effect preven13 tive medical and dental public health residency programs)

14 or public or nonprofit private educational entities (includ15 ing graduate schools of social work and business schools

16 that have health management programs) that offer a pro17 gram described in subsection (b)—

18 ‘‘(1) to provide traineeships for students en19 rolled in such a program; and

20 ‘‘(2) to assist accredited programs health ad21 ministration in the development or improvement of

22 programs to prepare students for employment with

23 public or nonprofit private entities.

24 ‘‘(b) RELEVANT PROGRAMS.—The program referred

25 to in subsection (a) is an accredited program in health
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1 administration, hospital administration, or health policy

2 analysis and planning, which program is accredited by a

3 body or bodies approved for such purpose by the Secretary

4 of Education and which meets such other quality stand5 ards as the Secretary of Health and Human Services by

6 regulation may prescribe.

7 ‘‘(c) PREFERENCE IN MAKING GRANTS.—In making

8 grants under subsection (a), the Secretary shall give pref9 erence to qualified applicants that meet the following con10 ditions:

11 ‘‘(1) Not less than 25 percent of the graduates

12 of the applicant are engaged in full-time practice

13 settings in medically underserved communities.

14 ‘‘(2) The applicant recruits and admits students

15 from medically underserved communities.

16 ‘‘(3) For the purpose of training students, the

17 applicant has established relationships with public

18 and nonprofit providers of health care in the com19 munity involved.

20 ‘‘(4) In training students, the applicant empha21 sizes employment with public or nonprofit private

22 entities.

23 ‘‘(d) CERTAIN PROVISIONS REGARDING

24 TRAINEESHIPS.—
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1 ‘‘(1) USE OF GRANT.—Traineeships awarded

2 under grants made under subsection (a) shall pro3 vide for tuition and fees and such stipends and al4 lowances (including travel and subsistence expenses

5 and dependency allowances) for the trainees as the

6 Secretary may deem necessary.

7 ‘‘(2) PREFERENCE FOR CERTAIN STUDENTS.—

8 Each entity applying for a grant under subsection

9 (a) for traineeships shall assure to the satisfaction

10 of the Secretary that the entity will give priority to

11 awarding the traineeships to students who dem12 onstrate a commitment to employment with public

13 or nonprofit private entities in the fields with respect

14 to which the traineeships are awarded.

15 ‘‘SEC. 770. AUTHORIZATION OF APPROPRIATIONS.

16 ‘‘(a) IN GENERAL.—For the purpose of carrying out

17 this subpart, there is authorized to be appropriated

18 $9,100,000 for fiscal year 1998, and such sums as may

19 be necessary for each of the fiscal years 1999 through

20 2002.

21 ‘‘(b) LIMITATION REGARDING CERTAIN PROGRAM.—

22 In obligating amounts appropriated under subsection (a),

23 the Secretary may not obligate more than 30 percent for

24 carrying out section 767.’’.
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1 SEC. 106. GENERAL PROVISIONS.

2 (a) IN GENERAL.—

3 (1) Part F of title VII of the Public Health

4 Service Act (42 U.S.C. 295 et seq.) is repealed.

5 (2) Part G of title VII of the Public Health

6 Service Act (42 U.S.C. 295j et seq.) is amended—

7 (A) by redesignating such part as part F;

8 (B) in section 791 (42 U.S.C. 295j)—

9 (i) by striking subsection (b); and

10 (ii) redesignating subsection (c) as

11 subsection (b);

12 (C) by repealing section 793 (42 U.S.C.

13 295l);

14 (D) by repealing section 798;

15 (E) by redesignating section 799 as section

16 799B; and

17 (F) by inserting after section 794, the fol18 lowing new sections:

19 ‘‘SEC. 796. APPLICATION.

20 ‘‘(a) IN GENERAL.—To be eligible to receive a grant

21 or contract under this title, an eligible entity shall prepare

22 and submit to the Secretary an application that meets the

23 requirements of this section, at such time, in such manner,

24 and containing such information as the Secretary may re25 quire.
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1 ‘‘(b) PLAN.—An application submitted under this

2 section shall contain the plan of the applicant for carrying

3 out a project with amounts received under this title. Such

4 plan shall be consistent with relevant Federal, State, or

5 regional health professions program plans.

6 ‘‘(c) PERFORMANCE OUTCOME STANDARDS.—An ap7 plication submitted under this section shall contain a spec8 ification by the applicant entity of performance outcome

9 standards that the project to be funded under the grant

10 or contract will be measured against. Such standards shall

11 address relevant health workforce needs that the project

12 will meet. The recipient of a grant or contract under this

13 section shall meet the standards set forth in the grant or

14 contract application.

15 ‘‘(d) LINKAGES.—An application submitted under

16 this section shall contain a description of the linkages with

17 relevant educational and health care entities, including

18 training programs for other health professionals as appro19 priate, that the project to be funded under the grant or

20 contract will establish. To the extent practicable, grantees

21 under this section shall establish linkages with health care

22 providers who provide care for underserved communities

23 and populations.
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1 ‘‘SEC. 797. USE OF FUNDS.

2 ‘‘(a) IN GENERAL.—Amounts provided under a grant

3 or contract awarded under this title may be used for train4 ing program development and support, faculty develop5 ment, model demonstrations, trainee support including

6 tuition, books, program fees and reasonable living ex7 penses during the period of training, technical assistance,

8 workforce analysis, dissemination of information, and ex9 ploring new policy directions, as appropriate to meet rec10 ognized health workforce objectives, in accordance with

11 this title.

12 ‘‘(b) MAINTENANCE OF EFFORT.—With respect to

13 activities for which a grant awarded under this title is to

14 be expended, the entity shall agree to maintain expendi15 tures of non-Federal amounts for such activities at a level

16 that is not less than the level of such expenditures main17 tained by the entity for the fiscal year preceding the fiscal

18 year for which the entity receives such a grant.

19 ‘‘SEC. 798. MATCHING REQUIREMENT.

20 ‘‘The Secretary may require that an entity that ap21 plies for a grant or contract under this title provide non22 Federal matching funds, as appropriate, to ensure the in23 stitutional commitment of the entity to the projects funded

24 under the grant. As determined by the Secretary, such

25 non-Federal matching funds may be provided directly or

26 through donations from public or private entities and may
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1 be in cash or in-kind, fairly evaluated, including plant,

2 equipment, or services.

3 ‘‘SEC. 799. GENERALLY APPLICABLE PROVISIONS.

4 ‘‘(a) AWARDING OF GRANTS AND CONTRACTS.—The

5 Secretary shall ensure that grants and contracts under

6 this title are awarded on a competitive basis, as appro7 priate, to carry out innovative demonstration projects or

8 provide for strategic workforce supplementation activities

9 as needed to meet health workforce goals and in accord10 ance with this title. Contracts may be entered into under

11 this title with public or private entities as may be nec12 essary.

13 ‘‘(b) ELIGIBLE ENTITIES.—Unless specifically re14 quired otherwise in this title, the Secretary shall accept

15 applications for grants or contracts under this title from

16 health professions schools, academic health centers, State

17 or local governments, or other appropriate public or pri18 vate nonprofit entities for funding and participation in

19 health professions and nursing training activities. The

20 Secretary may accept applications from for-profit private

21 entities if determined appropriate by the Secretary.

22 ‘‘(c) INFORMATION REQUIREMENTS.—

23 ‘‘(1) IN GENERAL.—Recipients of grants and

24 contracts under this title shall meet information re25 quirements as specified by the Secretary.
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1 ‘‘(2) DATA COLLECTION.—The Secretary shall

2 establish procedures to ensure that, with respect to

3 any data collection required under this title, such

4 data is collected in a manner that takes into account

5 age, sex, race, and ethnicity.

6 ‘‘(3) USE OF FUNDS.—The Secretary shall es7 tablish procedures to permit the use of amounts ap8 propriated under this title to be used for data collec9 tion purposes.

10 ‘‘(4) EVALUATIONS.—The Secretary shall es11 tablish procedures to ensure the annual evaluation of

12 programs and projects operated by recipients of

13 grants or contracts under this title. Such procedures

14 shall ensure that continued funding for such pro15 grams and projects will be conditioned upon a dem16 onstration that satisfactory progress has been made

17 by the program or project in meeting the objectives

18 of the program or project.

19 ‘‘(d) TRAINING PROGRAMS.—Training programs con20 ducted with amounts received under this title shall meet

21 applicable accreditation and quality standards.

22 ‘‘(e) DURATION OF ASSISTANCE.—

23 ‘‘(1) IN GENERAL.—Subject to paragraph (2),

24 in the case of an award to an entity of a grant, co25 operative agreement, or contract under this title, the
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1 period during which payments are made to the en2 tity under the award may not exceed 5 years. The

3 provision of payments under the award shall be sub4 ject to annual approval by the Secretary of the pay5 ments and subject to the availability of appropria6 tions for the fiscal year involved to make the pay7 ments. This paragraph may not be construed as lim8 iting the number of awards under the program in9 volved that may be made to the entity.

10 ‘‘(2) LIMITATION.—In the case of an award to

11 an entity of a grant, cooperative agreement, or con12 tract under this title, paragraph (1) shall apply only

13 to the extent not inconsistent with any other provi14 sion of this title that relates to the period during

15 which payments may be made under the award.

16 ‘‘(f) PEER REVIEW REGARDING CERTAIN PRO17 GRAMS.—

18 ‘‘(1) IN GENERAL.—Each application for a

19 grant under this title, except any scholarship or loan

20 program, including those under sections 701, 721, or

21 723, shall be submitted to a peer review group for

22 an evaluation of the merits of the proposals made in

23 the application. The Secretary may not approve such

24 an application unless a peer review group has rec25 ommended the application for approval.
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1 ‘‘(2) COMPOSITION.—Each peer review group

2 under this subsection shall be composed principally

3 of individuals who are not officers or employees of

4 the Federal Government. In providing for the estab5 lishment of peer review groups and procedures, the

6 Secretary shall ensure sex, racial, ethnic, and geo7 graphic balance among the membership of such

8 groups.

9 ‘‘(3) ADMINISTRATION.—This subsection shall

10 be carried out by the Secretary acting through the

11 Administrator of the Health Resources and Services

12 Administration.

13 ‘‘(g) PREFERENCE OR PRIORITY CONSIDER14 ATIONS.—In considering a preference or priority for fund15 ing which is based on outcome measures for an eligible

16 entity under this title, the Secretary may also consider the

17 future ability of the eligible entity to meet the outcome

18 preference or priority through improvements in the eligible

19 entity’s program design.

20 ‘‘(h) ANALYTIC ACTIVITIES.—The Secretary shall en21 sure that—

22 ‘‘(1) cross-cutting workforce analytical activities

23 are carried out as part of the workforce information

24 and analysis activities under section 761; and
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1 ‘‘(2) discipline-specific workforce information

2 and analytical activities are carried out as part of—

3 ‘‘(A) the community-based linkage pro4 gram under part D; and

5 ‘‘(B) the health workforce development

6 program under subpart 2 of part E.

7 ‘‘(i) OSTEOPATHIC SCHOOLS.—For purposes of this

8 title, any reference to—

9 ‘‘(1) medical schools shall include osteopathic

10 medical schools; and

11 ‘‘(2) medical students shall include osteopathic

12 medical students.

13 ‘‘SEC. 799A. TECHNICAL ASSISTANCE.

14 ‘‘Funds appropriated under this title may be used by

15 the Secretary to provide technical assistance in relation

16 to any of the authorities under this title.’’.

17 (b) PROFESSIONAL COUNSELORS AS MENTAL

18 HEALTH PROFESSIONALS.—Section 792(a) of the Public

19 Health Service Act (42 U.S.C. 295k(a)) is amended by

20 inserting ‘‘professional counselors,’’ after ‘‘clinical psy21 chologists,’’.

22 SEC. 107. PREFERENCE IN CERTAIN PROGRAMS.

23 (a) IN GENERAL.—Section 791 of the Public Health

24 Service Act (42 U.S.C. 295j), as amended by section
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1 105(a)(2)(B), is further amended by adding at the end

2 thereof the following subsection:

3 ‘‘(c) EXCEPTIONS FOR NEW PROGRAMS.—

4 ‘‘(1) IN GENERAL.—To permit new programs to

5 compete equitably for funding under this section,

6 those new programs that meet at least 4 of the cri7 teria described in paragraph (3) shall qualify for a

8 funding preference under this section.

9 ‘‘(2) DEFINITION.—As used in this subsection,

10 the term ‘new program’ means any program that

11 has graduated less than three classes. Upon grad12 uating at least three classes, a program shall have

13 the capability to provide the information necessary

14 to qualify the program for the general funding pref15 erences described in subsection (a).

16 ‘‘(3) CRITERIA.—The criteria referred to in

17 paragraph (1) are the following:

18 ‘‘(A) The mission statement of the pro19 gram identifies a specific purpose of the pro20 gram as being the preparation of health profes21 sionals to serve underserved populations.

22 ‘‘(B) The curriculum of the program in23 cludes content which will help to prepare practi24 tioners to serve underserved populations.
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1 ‘‘(C) Substantial clinical training experi2 ence is required under the program in medically

3 underserved communities.

4 ‘‘(D) A minimum of 20 percent of the clin5 ical faculty of the program spend at least 50

6 percent of their time providing or supervising

7 care in medically underserved communities.

8 ‘‘(E) The entire program or a substantial

9 portion of the program is physically located in

10 a medically underserved community.

11 ‘‘(F) Student assistance, which is linked to

12 service in medically underserved communities

13 following graduation, is available to the stu14 dents in the program.

15 ‘‘(G) The program provides a placement

16 mechanism for deploying graduates to medically

17 underserved communities.’’.

18 (b) CONFORMING AMENDMENTS.—Section 791(a) of

19 the Public Health Service Act (42 U.S.C. 295j(a)) is

20 amended—

21 (1) in paragraph (1), by striking ‘‘sections 747’’

22 and all that follows through ‘‘767’’ and inserting

23 ‘‘sections 747 and 750’’; and

24 (2) in paragraph (2), by striking ‘‘under section

25 798(a)’’.
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1 SEC. 108. DEFINITIONS.

2 (a) GRADUATE PROGRAM IN BEHAVIORAL AND MEN3 TAL HEALTH PRACTICE.—Section 799B(1)(D) of the

4 Public Health Service Act (42 U.S.C. 295p(1)(D)) (as so

5 redesignated by section 106(a)(2)(E)) is amended—

6 (1) by inserting ‘‘behavioral health and’’ before

7 ‘‘mental’’; and

8 (2) by inserting ‘‘behavioral health and mental

9 health practice,’’ before ‘‘clinical’’.

10 (b) PROFESSIONAL COUNSELING AS A BEHAVIORAL

11 AND MENTAL HEALTH PRACTICE.—Section 799B of the

12 Public Health Service Act (42 U.S.C. 295p) (as so redes13 ignated by section 106(a)(2)(E)) is amended—

14 (1) in paragraph (1)—

15 (A) in subparagraph (C)—

16 (i) by inserting ‘‘and ‘graduate pro17 gram in professional counseling’ ’’ after

18 ‘‘graduate program in marriage and family

19 therapy’ ’’; and

20 (ii) by inserting before the period the

21 following: ‘‘and a concentration leading to

22 a graduate degree in counseling’’;

23 (B) in subparagraph (D), by inserting

24 ‘‘professional counseling,’’ after ‘‘social work,’’;

25 and
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1 (C) in subparagraph (E), by inserting

2 ‘‘professional counseling,’’ after ‘‘social work,’’;

3 and

4 (2) in paragraph (5)(C), by inserting before the

5 period the following: ‘‘or a degree in counseling or

6 an equivalent degree’’.

7 (c) MEDICALLY UNDERSERVED COMMUNITY.—Sec8 tion 799B(6) of the Public Health Service Act (42 U.S.C.

9 295p(6)) (as so redesignated by section 105(a)(2)(E)) is

10 amended—

11 (1) in subparagraph (B), by striking ‘‘or’’ at

12 the end thereof;

13 (2) in subparagraph (C), by striking the period

14 and inserting ‘‘; or’’; and

15 (3) by adding at the end the following:

16 ‘‘(D) is designated by a State Governor (in

17 consultation with the medical community) as a

18 shortage area or medically underserved commu19 nity.’’.

20 (d) PROGRAMS FOR THE TRAINING OF PHYSICIAN

21 ASSISTANTS.—Paragraph (3) of section 799B of the Pub22 lic Health Service Act (42 U.S.C. 295p) (as so redesig23 nated by section 105(a)(2)(E)) is amended to read as fol24 lows:
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1 ‘‘(3) The term ‘program for the training of phy2 sician assistants’ means an educational program

3 that—

4 ‘‘(A) has as its objective the education of

5 individuals who will, upon completion of their

6 studies in the program, be qualified to provide

7 primary care under the supervision of a physi8 cian;

9 ‘‘(B) extends for at least one academic

10 year and consists of—

11 ‘‘(i) supervised clinical practice; and

12 ‘‘(ii) at least four months (in the ag13 gregate) of classroom instruction, directed

14 toward preparing students to deliver health

15 care;

16 ‘‘(C) has an enrollment of not less than

17 eight students; and

18 ‘‘(D) trains students in primary care, dis19 ease prevention, health promotion, geriatric

20 medicine, and home health care.’’.

21 (e) PSYCHOLOGIST.—Section 799B of the Public

22 Health Service Act (42 U.S.C. 295p) (as so redesignated

23 by section 105(a)(2)(E)) is amended by adding at the end

24 the following:
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1 ‘‘(11) The term ‘psychologist’ means an individ2 ual who—

3 ‘‘(A) holds a doctoral degree in psychology;

4 and

5 ‘‘(B) is licensed or certified on the basis of

6 the doctoral degree in psychology, by the State

7 in which the individual practices, at the inde8 pendent practice level of psychology to furnish

9 diagnostic, assessment, preventive, and thera10 peutic services directly to individuals.’’.

11 SEC. 109. TECHNICAL AMENDMENT ON NATIONAL HEALTH

12 SERVICE CORPS.

13 Section 338B(b)(1)(B) of the Public Health Service

14 Act (42 U.S.C. 254l–1(b)(1)(B)) is amended by striking

15 ‘‘or other health profession’’ and inserting ‘‘behavioral and

16 mental health, or other health profession’’.

17 SEC. 110. SAVINGS PROVISION.

18 In the case of any authority for making awards of

19 grants or contracts that is terminated by the amendments

20 made by this subtitle, the Secretary of Health and Human

21 Services may, notwithstanding the termination of the au22 thority, continue in effect any grant or contract made

23 under the authority that is in effect on the day before the

24 date of the enactment of this Act, subject to the duration

25 of any such grant or contract not exceeding the period
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1 determined by the Secretary in first approving such finan2 cial assistance, or in approving the most recent request

3 made (before the date of such enactment) for continuation

4 of such assistance, as the case may be.

5 Subtitle B—Nursing Workforce

6 Development

7 SEC. 121. SHORT TITLE.

8 This title may be cited as the ‘‘Nursing Education

9 and Practice Improvement Act of 1998’’.

10 SEC. 122. PURPOSE.

11 It is the purpose of this title to restructure the nurse

12 education authorities of title VIII of the Public Health

13 Service Act to permit a comprehensive, flexible, and effec14 tive approach to Federal support for nursing workforce

15 development.

16 SEC. 123. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.

17 Title VIII of the Public Health Service Act (42

18 U.S.C. 296k et seq.) is amended—

19 (1) by striking the title heading and all that fol20 lows except for subpart II of part B and sections

21 846 and 855; and inserting the following:

22 ‘‘TITLE VIII—NURSING

23 WORKFORCE DEVELOPMENT’’;

24 (2) in subpart II of part B, by striking the sub25 part heading and inserting the following:
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1 ‘‘PART E—STUDENT LOANS’’;

2 (3) by striking section 837;

3 (4) by inserting after the title heading the fol4 lowing new parts:

5 ‘‘PART A—GENERAL PROVISIONS

6 ‘‘SEC. 801. DEFINITIONS.

7 ‘‘As used in this title:

8 ‘‘(1) ELIGIBLE ENTITIES.—The term ‘eligible

9 entities’ means schools of nursing, nursing centers,

10 academic health centers, State or local governments,

11 and other public or private nonprofit entities deter12 mined appropriate by the Secretary that submit to

13 the Secretary an application in accordance with sec14 tion 802.

15 ‘‘(2) SCHOOL OF NURSING.—The term ‘school

16 of nursing’ means a collegiate, associate degree, or

17 diploma school of nursing in a State.

18 ‘‘(3) COLLEGIATE SCHOOL OF NURSING.—The

19 term ‘collegiate school of nursing’ means a depart20 ment, division, or other administrative unit in a col21 lege or university which provides primarily or exclu22 sively a program of education in professional nursing

23 and related subjects leading to the degree of bach24 elor of arts, bachelor of science, bachelor of nursing,

25 or to an equivalent degree, or to a graduate degree

26 in nursing, or to an equivalent degree, and including
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1 advanced training related to such program of edu2 cation provided by such school, but only if such pro3 gram, or such unit, college or university is accred4 ited.

5 ‘‘(4) ASSOCIATE DEGREE SCHOOL OF NURS6 ING.—The term ‘associate degree school of nursing’

7 means a department, division, or other administra8 tive unit in a junior college, community college, col9 lege, or university which provides primarily or exclu10 sively a two-year program of education in profes11 sional nursing and allied subjects leading to an asso12 ciate degree in nursing or to an equivalent degree,

13 but only if such program, or such unit, college, or

14 university is accredited.

15 ‘‘(5) DIPLOMA SCHOOL OF NURSING.—The

16 term ‘diploma school of nursing’ means a school af17 filiated with a hospital or university, or an independ18 ent school, which provides primarily or exclusively a

19 program of education in professional nursing and al20 lied subjects leading to a diploma or to equivalent

21 indicia that such program has been satisfactorily

22 completed, but only if such program, or such affili23 ated school or such hospital or university or such

24 independent school is accredited.

25 ‘‘(6) ACCREDITED.—
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1 ‘‘(A) IN GENERAL.—Except as provided in

2 subparagraph (B), the term ‘accredited’ when

3 applied to any program of nurse education

4 means a program accredited by a recognized

5 body or bodies, or by a State agency, approved

6 for such purpose by the Secretary of Education

7 and when applied to a hospital, school, college,

8 or university (or a unit thereof) means a hos9 pital, school, college, or university (or a unit

10 thereof) which is accredited by a recognized

11 body or bodies, or by a State agency, approved

12 for such purpose by the Secretary of Education.

13 For the purpose of this paragraph, the Sec14 retary of Education shall publish a list of recog15 nized accrediting bodies, and of State agencies,

16 which the Secretary of Education determines to

17 be reliable authority as to the quality of edu18 cation offered.

19 ‘‘(B) NEW PROGRAMS.—A new program of

20 nursing that, by reason of an insufficient period

21 of operation, is not, at the time of the submis22 sion of an application for a grant or contract

23 under this title, eligible for accreditation by

24 such a recognized body or bodies or State agen25 cy, shall be deemed accredited for purposes of
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1 this title if the Secretary of Education finds,

2 after consultation with the appropriate accredi3 tation body or bodies, that there is reasonable

4 assurance that the program will meet the ac5 creditation standards of such body or bodies

6 prior to the beginning of the academic year fol7 lowing the normal graduation date of students

8 of the first entering class in such a program.

9 ‘‘(7) NONPROFIT.—The term ‘nonprofit’ as ap10 plied to any school, agency, organization, or institu11 tion means one which is a corporation or association,

12 or is owned and operated by one or more corpora13 tions or associations, no part of the net earnings of

14 which inures, or may lawfully inure, to the benefit

15 of any private shareholder or individual.

16 ‘‘(8) STATE.—The term ‘State’ means a State,

17 the Commonwealth of Puerto Rico, the District of

18 Columbia, the Commonwealth of the Northern Mari19 ana Islands, Guam, American Samoa, the Virgin Is20 lands, or the Trust Territory of the Pacific Islands.

21 ‘‘SEC. 802. APPLICATION.

22 ‘‘(a) IN GENERAL.—To be eligible to receive a grant

23 or contract under this title, an eligible entity shall prepare

24 and submit to the Secretary an application that meets the

25 requirements of this section, at such time, in such manner,
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1 and containing such information as the Secretary may re2 quire.

3 ‘‘(b) PLAN.—An application submitted under this

4 section shall contain the plan of the applicant for carrying

5 out a project with amounts received under this title. Such

6 plan shall be consistent with relevant Federal, State, or

7 regional program plans.

8 ‘‘(c) PERFORMANCE OUTCOME STANDARDS.—An ap9 plication submitted under this section shall contain a spec10 ification by the applicant entity of performance outcome

11 standards that the project to be funded under the grant

12 or contract will be measured against. Such standards shall

13 address relevant national nursing needs that the project

14 will meet. The recipient of a grant or contract under this

15 section shall meet the standards set forth in the grant or

16 contract application.

17 ‘‘(d) LINKAGES.—An application submitted under

18 this section shall contain a description of the linkages with

19 relevant educational and health care entities, including

20 training programs for other health professionals as appro21 priate, that the project to be funded under the grant or

22 contract will establish.

23 ‘‘SEC. 803. USE OF FUNDS.

24 ‘‘(a) IN GENERAL.—Amounts provided under a grant

25 or contract awarded under this title may be used for train-
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1 ing program development and support, faculty develop2 ment, model demonstrations, trainee support including

3 tuition, books, program fees and reasonable living ex4 penses during the period of training, technical assistance,

5 workforce analysis, and dissemination of information, as

6 appropriate to meet recognized nursing objectives, in ac7 cordance with this title.

8 ‘‘(b) MAINTENANCE OF EFFORT.—With respect to

9 activities for which a grant awarded under this title is to

10 be expended, the entity shall agree to maintain expendi11 tures of non-Federal amounts for such activities at a level

12 that is not less than the level of such expenditures main13 tained by the entity for the fiscal year preceding the fiscal

14 year for which the entity receives such a grant.

15 ‘‘SEC. 804. MATCHING REQUIREMENT.

16 ‘‘The Secretary may require that an entity that ap17 plies for a grant or contract under this title provide non18 Federal matching funds, as appropriate, to ensure the in19 stitutional commitment of the entity to the projects funded

20 under the grant. Such non-Federal matching funds may

21 be provided directly or through donations from public or

22 private entities and may be in cash or in-kind, fairly evalu23 ated, including plant, equipment, or services.
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1 ‘‘SEC. 805. PREFERENCE.

2 ‘‘In awarding grants or contracts under this title, the

3 Secretary shall give preference to applicants with projects

4 that will substantially benefit rural or underserved popu5 lations, or help meet public health nursing needs in State

6 or local health departments.

7 ‘‘SEC. 806. GENERALLY APPLICABLE PROVISIONS.

8 ‘‘(a) AWARDING OF GRANTS AND CONTRACTS.—The

9 Secretary shall ensure that grants and contracts under

10 this title are awarded on a competitive basis, as appro11 priate, to carry out innovative demonstration projects or

12 provide for strategic workforce supplementation activities

13 as needed to meet national nursing service goals and in

14 accordance with this title. Contracts may be entered into

15 under this title with public or private entities as deter16 mined necessary by the Secretary.

17 ‘‘(b) INFORMATION REQUIREMENTS.—

18 ‘‘(1) IN GENERAL.—Recipients of grants and

19 contracts under this title shall meet information re20 quirements as specified by the Secretary.

21 ‘‘(2) EVALUATIONS.—The Secretary shall es22 tablish procedures to ensure the annual evaluation of

23 programs and projects operated by recipients of

24 grants under this title. Such procedures shall ensure

25 that continued funding for such programs and

26 projects will be conditioned upon a demonstration
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1 that satisfactory progress has been made by the pro2 gram or project in meeting the objectives of the pro3 gram or project.

4 ‘‘(c) TRAINING PROGRAMS.—Training programs con5 ducted with amounts received under this title shall meet

6 applicable accreditation and quality standards.

7 ‘‘(d) DURATION OF ASSISTANCE.—

8 ‘‘(1) IN GENERAL.—Subject to paragraph (2),

9 in the case of an award to an entity of a grant, co10 operative agreement, or contract under this title, the

11 period during which payments are made to the en12 tity under the award may not exceed 5 years. The

13 provision of payments under the award shall be sub14 ject to annual approval by the Secretary of the pay15 ments and subject to the availability of appropria16 tions for the fiscal year involved to make the pay17 ments. This paragraph may not be construed as lim18 iting the number of awards under the program in19 volved that may be made to the entity.

20 ‘‘(2) LIMITATION.—In the case of an award to

21 an entity of a grant, cooperative agreement, or con22 tract under this title, paragraph (1) shall apply only

23 to the extent not inconsistent with any other provi24 sion of this title that relates to the period during

25 which payments may be made under the award.
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1 ‘‘(e) PEER REVIEW REGARDING CERTAIN PRO2 GRAMS.—

3 ‘‘(1) IN GENERAL.—Each application for a

4 grant under this title, except advanced nurse

5 traineeship grants under section 811(a)(2), shall be

6 submitted to a peer review group for an evaluation

7 of the merits of the proposals made in the applica8 tion. The Secretary may not approve such an appli9 cation unless a peer review group has recommended

10 the application for approval.

11 ‘‘(2) COMPOSITION.—Each peer review group

12 under this subsection shall be composed principally

13 of individuals who are not officers or employees of

14 the Federal Government. In providing for the estab15 lishment of peer review groups and procedures, the

16 Secretary shall, except as otherwise provided, ensure

17 sex, racial, ethnic, and geographic representation

18 among the membership of such groups.

19 ‘‘(3) ADMINISTRATION.—This subsection shall

20 be carried out by the Secretary acting through the

21 Administrator of the Health Resources and Services

22 Administration.

23 ‘‘(f) ANALYTIC ACTIVITIES.—The Secretary shall en24 sure that—
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1 ‘‘(1) cross-cutting workforce analytical activities

2 are carried out as part of the workforce information

3 and analysis activities under this title; and

4 ‘‘(2) discipline-specific workforce information is

5 developed and analytical activities are carried out as

6 part of—

7 ‘‘(A) the advanced practice nursing activi8 ties under part B;

9 ‘‘(B) the workforce diversity activities

10 under part C; and

11 ‘‘(C) basic nursing education and practice

12 activities under part D.

13 ‘‘(g) STATE AND REGIONAL PRIORITIES.—Activities

14 under grants or contracts under this title shall, to the ex15 tent practicable, be consistent with related Federal, State,

16 or regional nursing professions program plans and prior17 ities.

18 ‘‘(h) FILING OF APPLICATIONS.—

19 ‘‘(1) IN GENERAL.—Applications for grants or

20 contracts under this title may be submitted by

21 health professions schools, schools of nursing, aca22 demic health centers, State or local governments, or

23 other appropriate public or private nonprofit entities

24 as determined appropriate by the Secretary in ac25 cordance with this title.
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1 ‘‘(2) FOR PROFIT ENTITIES.—Notwithstanding

2 paragraph (1), a for-profit entity may be eligible for

3 a grant or contract under this title as determined

4 appropriated by the Secretary.

5 ‘‘SEC. 807. TECHNICAL ASSISTANCE.

6 ‘‘Funds appropriated under this title may be used by

7 the Secretary to provide technical assistance in relation

8 to any of the authorities under this title.

9 ‘‘PART B—NURSE PRACTITIONERS, NURSE MID10 WIVES, NURSE ANESTHETISTS, AND OTHER

11 ADVANCED PRACTICE NURSES

12 ‘‘SEC. 811. ADVANCED PRACTICE NURSING GRANTS.

13 ‘‘(a) IN GENERAL.—The Secretary may award grants

14 to and enter into contracts with eligible entities to meet

15 the costs of—

16 ‘‘(1) projects that support the enhancement of

17 advanced practice nursing education and practice;

18 and

19 ‘‘(2) traineeships for individuals in advanced

20 practice nursing programs.

21 ‘‘(b) DEFINITION OF ADVANCED PRACTICE

22 NURSES.—For purposes of this section, the term ‘ad23 vanced practice nurses’ means individuals trained in ad24 vanced degree programs including individuals in combined

25 R.N./Master’s degree programs, post-nursing master’s
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1 certificate programs, or, in the case of nurse midwives,

2 in certificate programs in existence on the date that is one

3 day prior to the date of enactment of this section, to serve

4 as nurse practitioners, clinical nurse specialists, nurse

5 midwives, nurse anesthetists, nurse educators, nurse ad6 ministrators, or public health nurses, or in other nurse

7 specialties determined by the Secretary to require ad8 vanced education.

9 ‘‘(c) AUTHORIZED NURSE PRACTITIONER AND

10 NURSE-MIDWIFERY PROGRAMS.—Nurse practitioner and

11 nurse midwifery programs eligible for support under this

12 section are educational programs for registered nurses (ir13 respective of the type of school of nursing in which the

14 nurses received their training) that—

15 ‘‘(1) meet guidelines prescribed by the Sec16 retary; and

17 ‘‘(2) have as their objective the education of

18 nurses who will upon completion of their studies in

19 such programs, be qualified to effectively provide

20 primary health care, including primary health care

21 in homes and in ambulatory care facilities, long-term

22 care facilities, acute care, and other health care set23 tings.
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1 ‘‘(d) AUTHORIZED NURSE ANESTHESIA PRO2 GRAMS.—Nurse anesthesia programs eligible for support

3 under this section are education programs that—

4 ‘‘(1) provide registered nurses with full-time an5 esthetist education; and

6 ‘‘(2) are accredited by the Council on Accredita7 tion of Nurse Anesthesia Educational Programs.

8 ‘‘(e) OTHER AUTHORIZED EDUCATIONAL PRO9 GRAMS.—The Secretary shall prescribe guidelines as ap10 propriate for other advanced practice nurse education pro11 grams eligible for support under this section.

12 ‘‘(f) TRAINEESHIPS.—

13 ‘‘(1) IN GENERAL.—The Secretary may not

14 award a grant to an applicant under subsection (a)

15 unless the applicant involved agrees that

16 traineeships provided with the grant will only pay all

17 or part of the costs of—

18 ‘‘(A) the tuition, books, and fees of the

19 program of advanced nursing practice with re20 spect to which the traineeship is provided; and

21 ‘‘(B) the reasonable living expenses of the

22 individual during the period for which the

23 traineeship is provided.

24 ‘‘(2) DOCTORAL PROGRAMS.—The Secretary

25 may not obligate more than 10 percent of the
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1 traineeships under subsection (a) for individuals in

2 doctorate degree programs.

3 ‘‘(3) SPECIAL CONSIDERATION.—In making

4 awards of grants and contracts under subsection

5 (a)(2), the Secretary shall give special consideration

6 to an eligible entity that agrees to expend the award

7 to train advanced practice nurses who will practice

8 in health professional shortage areas designated

9 under section 332.

10 ‘‘PART C—INCREASING NURSING WORKFORCE

11 DIVERSITY

12 ‘‘SEC. 821. WORKFORCE DIVERSITY GRANTS.

13 ‘‘(a) IN GENERAL.—The Secretary may award grants

14 to and enter into contracts with eligible entities to meet

15 the costs of special projects to increase nursing education

16 opportunities for individuals who are from disadvantaged

17 backgrounds (including racial and ethnic minorities under18 represented among registered nurses) by providing stu19 dent scholarships or stipends, pre-entry preparation, and

20 retention activities.

21 ‘‘(b) GUIDANCE.—In carrying out subsection (a), the

22 Secretary shall take into consideration the recommenda23 tions of the First, Second and Third Invitational Con24 gresses for Minority Nurse Leaders on ‘Caring for the

25 Emerging Majority,’ in 1992, 1993 and 1997, and consult
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1 with nursing associations including the American Nurses

2 Association, the National League for Nursing, the Amer3 ican Association of Colleges of Nursing, the National

4 Black Nurses Association, the National Association of

5 Hispanic Nurses, the Association of Asian American and

6 Pacific Islander Nurses, the Native American Indian and

7 Alaskan Nurses Association, and the National Council of

8 State Boards of Nursing.

9 ‘‘(c) REQUIRED INFORMATION AND CONDITIONS FOR

10 AWARD RECIPIENTS.—

11 ‘‘(1) IN GENERAL.—Recipients of awards under

12 this section may be required, where requested, to re13 port to the Secretary concerning the annual admis14 sion, retention, and graduation rates for individuals

15 from disadvantaged backgrounds and ethnic and ra16 cial minorities in the school or schools involved in

17 the projects.

18 ‘‘(2) FALLING RATES.—If any of the rates re19 ported under paragraph (1) fall below the average of

20 the two previous years, the grant or contract recipi21 ent shall provide the Secretary with plans for imme22 diately improving such rates.

23 ‘‘(3) INELIGIBILITY.—A recipient described in

24 paragraph (2) shall be ineligible for continued fund25 ing under this section if the plan of the recipient
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1 fails to improve the rates within the 1-year period

2 beginning on the date such plan is implemented.

3 ‘‘PART D—STRENGTHENING CAPACITY FOR

4 BASIC NURSE EDUCATION AND PRACTICE

5 ‘‘SEC. 831. BASIC NURSE EDUCATION AND PRACTICE

6 GRANTS.

7 ‘‘(a) IN GENERAL.—The Secretary may award grants

8 to and enter into contracts with eligible entities for

9 projects to strengthen capacity for basic nurse education

10 and practice.

11 ‘‘(b) PRIORITY AREAS.—In awarding grants or con12 tracts under this section the Secretary shall give priority

13 to entities that will use amounts provided under such a

14 grant or contract to enhance the educational mix and utili15 zation of the basic nursing workforce by strengthening

16 programs that provide basic nurse education, such as

17 through—

18 ‘‘(1) establishing or expanding nursing practice

19 arrangements in noninstitutional settings to dem20 onstrate methods to improve access to primary

21 health care in medically underserved communities;

22 ‘‘(2) providing care for underserved populations

23 and other high-risk groups such as the elderly, indi24 viduals with HIV-AIDS, substance abusers, the

25 homeless, and victims of domestic violence;
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1 ‘‘(3) providing managed care, quality improve2 ment, and other skills needed to practice in existing

3 and emerging organized health care systems;

4 ‘‘(4) developing cultural competencies among

5 nurses;

6 ‘‘(5) expanding the enrollment in baccalaureate

7 nursing programs;

8 ‘‘(6) promoting career mobility for nursing per9 sonnel in a variety of training settings and cross

10 training or specialty training among diverse popu11 lation groups;

12 ‘‘(7) providing education in informatics, includ13 ing distance learning methodologies; or

14 ‘‘(8) other priority areas as determined by the

15 Secretary.’’;

16 (5) by adding at the end the following:

17 ‘‘PART F—AUTHORIZATION OF APPROPRIATIONS

18 ‘‘SEC. 841. AUTHORIZATION OF APPROPRIATIONS.

19 ‘‘There are authorized to be appropriated to carry out

20 sections 811, 821, and 831, $65,000,000 for fiscal year

21 1998, and such sums as may be necessary in each of the

22 fiscal years 1999 through 2002.
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1 ‘‘PART G—NATIONAL ADVISORY COUNCIL ON

2 NURSE EDUCATION AND PRACTICE

3 ‘‘SEC. 845. NATIONAL ADVISORY COUNCIL ON NURSE EDU4 CATION AND PRACTICE.

5 ‘‘(a) ESTABLISHMENT.—The Secretary shall estab6 lish an advisory council to be known as the National Advi7 sory Council on Nurse Education and Practice (in this sec8 tion referred to as the ‘Advisory Council’).

9 ‘‘(b) COMPOSITION.—

10 ‘‘(1) IN GENERAL.—The Advisory Council shall

11 be composed of

12 ‘‘(A) not less than 21, nor more than 23

13 individuals, who are not officers or employees of

14 the Federal Government, appointed by the Sec15 retary without regard to the Federal civil serv16 ice laws, of which—

17 ‘‘(i) 2 shall be selected from full-time

18 students enrolled in schools of nursing;

19 ‘‘(ii) 2 shall be selected from the gen20 eral public;

21 ‘‘(iii) 2 shall be selected from practic22 ing professional nurses; and

23 ‘‘(iv) 9 shall be selected from among

24 the leading authorities in the various fields

25 of nursing, higher, secondary education,

26 and associate degree schools of nursing,
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1 and from representatives of advanced prac2 tice nursing groups (such as nurse practi3 tioners, nurse midwives, and nurse anes4 thetists), hospitals, and other institutions

5 and organizations which provide nursing

6 services; and

7 ‘‘(B) the Secretary (or the delegate of the

8 Secretary (who shall be an ex officio member

9 and shall serve as the Chairperson)).

10 ‘‘(2) APPOINTMENT.—Not later than 90 days

11 after the date of enactment of this Act, the Sec12 retary shall appoint the members of the Advisory

13 Council and each such member shall serve a 4 year

14 term. In making such appointments, the Secretary

15 shall ensure a fair balance between the nursing pro16 fessions, a broad geographic representation of mem17 bers and a balance between urban and rural mem18 bers. Members shall be appointed based on their

19 competence, interest, and knowledge of the mission

20 of the profession involved. A majority of the mem21 bers shall be nurses.

22 ‘‘(3) MINORITY REPRESENTATION.—In appoint23 ing the members of the Advisory Council under

24 paragraph (1), the Secretary shall ensure the ade25 quate representation of minorities.
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1 ‘‘(c) VACANCIES.—

2 ‘‘(1) IN GENERAL.—A vacancy on the Advisory

3 Council shall be filled in the manner in which the

4 original appointment was made and shall be subject

5 to any conditions which applied with respect to the

6 original appointment.

7 ‘‘(2) FILLING UNEXPIRED TERM.—An individ8 ual chosen to fill a vacancy shall be appointed for

9 the unexpired term of the member replaced.

10 ‘‘(d) DUTIES.—The Advisory Council shall—

11 ‘‘(1) provide advice and recommendations to the

12 Secretary and Congress concerning policy matters

13 arising in the administration of this title, including

14 the range of issues relating to the nurse workforce,

15 education, and practice improvement;

16 ‘‘(2) provide advice to the Secretary and Con17 gress in the preparation of general regulations and

18 with respect to policy matters arising in the adminis19 tration of this title, including the range of issues re20 lating to nurse supply, education and practice im21 provement; and

22 ‘‘(3) not later than 3 years after the date of en23 actment of this section, and annually thereafter, pre24 pare and submit to the Secretary, the Committee on

25 Labor and Human Resources of the Senate, and the
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1 Committee on Commerce of the House of Represent2 atives, a report describing the activities of the Coun3 cil, including findings and recommendations made by

4 the Council concerning the activities under this title.

5 ‘‘(e) MEETINGS AND DOCUMENTS.—

6 ‘‘(1) MEETINGS.—The Advisory Council shall

7 meet not less than 2 times each year. Such meetings

8 shall be held jointly with other related entities estab9 lished under this title where appropriate.

10 ‘‘(2) DOCUMENTS.—Not later than 14 days

11 prior to the convening of a meeting under paragraph

12 (1), the Advisory Council shall prepare and make

13 available an agenda of the matters to be considered

14 by the Advisory Council at such meeting. At any

15 such meeting, the Advisory Council shall distribute

16 materials with respect to the issues to be addressed

17 at the meeting. Not later than 30 days after the ad18 journing of such a meeting, the Advisory Council

19 shall prepare and make available a summary of the

20 meeting and any actions taken by the Council based

21 upon the meeting.

22 ‘‘(f) COMPENSATION AND EXPENSES.—

23 ‘‘(1) COMPENSATION.—Each member of the

24 Advisory Council shall be compensated at a rate

25 equal to the daily equivalent of the annual rate of
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1 basic pay prescribed for level IV of the Executive

2 Schedule under section 5315 of title 5, United

3 States Code, for each day (including travel time)

4 during which such member is engaged in the per5 formance of the duties of the Council. All members

6 of the Council who are officers or employees of the

7 United States shall serve without compensation in

8 addition to that received for their services as officers

9 or employees of the United States.

10 ‘‘(2) EXPENSES.—The members of the Advisory

11 Council shall be allowed travel expenses, including

12 per diem in lieu of subsistence, at rates authorized

13 for employees of agencies under subchapter I of

14 chapter 57 of title 5, United States Code, while

15 away from their homes or regular places of business

16 in the performance of services for the Council.

17 ‘‘(g) FUNDING.—Amounts appropriated under this

18 title may be utilized by the Secretary to support the nurse

19 education and practice activities of the Council.

20 ‘‘(h) FACA.—The Federal Advisory Committee Act

21 shall apply to the Advisory Committee under this section

22 only to the extent that the provisions of such Act do not

23 conflict with the requirements of this section.’’; and

24 (6) by redesignating section 855 as section 810,

25 and transferring such section so as to appear after
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1 section 809 (as added by the amendment made by

2 paragraph (5)).

3 SEC. 124. SAVINGS PROVISION.

4 In the case of any authority for making awards of

5 grants or contracts that is terminated by the amendment

6 made by section 123, the Secretary of Health and Human

7 Services may, notwithstanding the termination of the au8 thority, continue in effect any grant or contract made

9 under the authority that is in effect on the day before the

10 date of the enactment of this Act, subject to the duration

11 of any such grant or contract not exceeding the period

12 determined by the Secretary in first approving such finan13 cial assistance, or in approving the most recent request

14 made (before the date of such enactment) for continuation

15 of such assistance, as the case may be.

16 Subtitle C—Financial Assistance

17 CHAPTER 1—SCHOOL-BASED REVOLVING LOAN

18 FUNDS

19 SEC. 131. PRIMARY CARE LOAN PROGRAM.

20 (a) REQUIREMENT FOR SCHOOLS.—Section

21 723(b)(1) of the Public Health Service Act (42 U.S.C.

22 292s(b)(1)), as amended by section 2014(c)(2)(A)(ii) of

23 Public Law 103–43 (107 Stat. 216), is amended by strik24 ing ‘‘3 years before’’ and inserting ‘‘4 years before’’.
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1 (b) NONCOMPLIANCE.—Section 723(a)(3) of the

2 Public Health Service Act (42 U.S.C. 292s(a)(3)) is

3 amended to read as follows:

4 ‘‘(3) NONCOMPLIANCE BY STUDENT.—Each

5 agreement entered into with a student pursuant to

6 paragraph (1) shall provide that, if the student fails

7 to comply with such agreement, the loan involved

8 will begin to accrue interest at a rate of 18 percent

9 per year beginning on the date of such noncompli10 ance.’’.

11 (c) REPORT REQUIREMENT.—Section 723 of the

12 Public Health Service Act (42 U.S.C. 292s) is amended—

13 (1) by striking subsection (c); and

14 (2) by redesignating subsection (d) as sub15 section (c).

16 SEC. 132. LOANS FOR DISADVANTAGED STUDENTS.

17 (a) AUTHORIZATION OF APPROPRIATIONS.—Section

18 724(f)(1) of the Public Health Service Act (42 U.S.C.

19 292t(f)(1)) is amended by striking ‘‘$15,000,000 for fiscal

20 year 1993’’ and inserting ‘‘$8,000,000 for each of the fis21 cal years 1998 through 2002’’.

22 (b) REPEAL.—Effective October 1, 2002, paragraph

23 (1) of section 724(f) of the Public Health Service Act (42

24 U.S.C. 292t(f)(1)) is repealed.
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1 SEC. 133. STUDENT LOANS REGARDING SCHOOLS OF

2 NURSING.

3 (a) IN GENERAL.—Section 836(b) of the Public

4 Health Service Act (42 U.S.C. 297b(b)) is amended—

5 (1) in paragraph (1), by striking the period at

6 the end and inserting a semicolon;

7 (2) in paragraph (2)—

8 (A) in subparagraph (A), by striking

9 ‘‘and’’ at the end; and

10 (B) by inserting before the semicolon at

11 the end the following: ‘‘, and (C) such addi12 tional periods under the terms of paragraph (8)

13 of this subsection’’;

14 (3) in paragraph (7), by striking the period at

15 the end and inserting ‘‘; and’’; and

16 (4) by adding at the end the following para17 graph:

18 ‘‘(8) pursuant to uniform criteria established by

19 the Secretary, the repayment period established

20 under paragraph (2) for any student borrower who

21 during the repayment period failed to make consecu22 tive payments and who, during the last 12 months

23 of the repayment period, has made at least 12 con24 secutive payments may be extended for a period not

25 to exceed 10 years.’’.
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1 (b) MINIMUM MONTHLY PAYMENTS.—Section 836(g)

2 of the Public Health Service Act (42 U.S.C. 297b(g)) is

3 amended by striking ‘‘$15’’ and inserting ‘‘$40’’.

4 (c) ELIMINATION OF STATUTE OF LIMITATION FOR

5 LOAN COLLECTIONS.—

6 (1) IN GENERAL.—Section 836 of the Public

7 Health Service Act (42 U.S.C. 297b) is amended by

8 adding at the end the following new subsection:

9 ‘‘(l) ELIMINATION OF STATUTE OF LIMITATION FOR

10 LOAN COLLECTIONS.—

11 ‘‘(1) PURPOSE.—It is the purpose of this sub12 section to ensure that obligations to repay loans

13 under this section are enforced without regard to

14 any Federal or State statutory, regulatory, or ad15 ministrative limitation on the period within which

16 debts may be enforced.

17 ‘‘(2) PROHIBITION.—Notwithstanding any other

18 provision of Federal or State law, no limitation shall

19 terminate the period within which suit may be filed,

20 a judgment may be enforced, or an offset, garnish21 ment, or other action may be initiated or taken by

22 a school of nursing that has an agreement with the

23 Secretary pursuant to section 835 that is seeking

24 the repayment of the amount due from a borrower
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1 on a loan made under this subpart after the default

2 of the borrower on such loan.’’.

3 (2) EFFECTIVE DATE.—The amendment made

4 by paragraph (1) shall be effective with respect to

5 actions pending on or after the date of enactment of

6 this Act.

7 (d) BREACH OF AGREEMENTS.—Section 846 of the

8 Public Health Service Act (42 U.S.C. 297n) is amended

9 by adding at the end thereof the following new subsection:

10 ‘‘(h) BREACH OF AGREEMENT.—

11 ‘‘(1) IN GENERAL.—In the case of any program

12 under this section under which an individual makes

13 an agreement to provide health services for a period

14 of time in accordance with such program in consid15 eration of receiving an award of Federal funds re16 garding education as a nurse (including an award

17 for the repayment of loans), the following applies if

18 the agreement provides that this subsection is appli19 cable:

20 ‘‘(A) In the case of a program under this

21 section that makes an award of Federal funds

22 for attending an accredited program of nursing

23 (in this section referred to as a ‘nursing pro24 gram’), the individual is liable to the Federal

25 Government for the amount of such award (in-
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1 cluding amounts provided for expenses related

2 to such attendance), and for interest on such

3 amount at the maximum legal prevailing rate,

4 if the individual—

5 ‘‘(i) fails to maintain an acceptable

6 level of academic standing in the nursing

7 program (as indicated by the program in

8 accordance with requirements established

9 by the Secretary);

10 ‘‘(ii) is dismissed from the nursing

11 program for disciplinary reasons; or

12 ‘‘(iii) voluntarily terminates the nurs13 ing program.

14 ‘‘(B) The individual is liable to the Federal

15 Government for the amount of such award (in16 cluding amounts provided for expenses related

17 to such attendance), and for interest on such

18 amount at the maximum legal prevailing rate,

19 if the individual fails to provide health services

20 in accordance with the program under this sec21 tion for the period of time applicable under the

22 program.

23 ‘‘(2) WAIVER OR SUSPENSION OF LIABILITY.—

24 In the case of an individual or health facility making

25 an agreement for purposes of paragraph (1), the
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1 Secretary shall provide for the waiver or suspension

2 of liability under such subsection if compliance by

3 the individual or the health facility, as the case may

4 be, with the agreements involved is impossible, or

5 would involve extreme hardship to the individual or

6 facility, and if enforcement of the agreements with

7 respect to the individual or facility would be uncon8 scionable.

9 ‘‘(3) DATE CERTAIN FOR RECOVERY.—Subject

10 to paragraph (2), any amount that the Federal Gov11 ernment is entitled to recover under paragraph (1)

12 shall be paid to the United States not later than the

13 expiration of the 3-year period beginning on the date

14 the United States becomes so entitled.

15 ‘‘(4) AVAILABILITY.—Amounts recovered under

16 paragraph (1) with respect to a program under this

17 section shall be available for the purposes of such

18 program, and shall remain available for such pur19 poses until expended.’’.

20 (e) TECHNICAL AMENDMENTS.—Section 839 of the

21 Public Health Service Act (42 U.S.C. 297e) is amended—

22 (1) in subsection (a)—

23 (A) by striking the matter preceding para24 graph (1) and inserting the following:
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1 ‘‘(a) If a school terminates a loan fund established

2 under an agreement pursuant to section 835(b), or if the

3 Secretary for good cause terminates the agreement with

4 the school, there shall be a capital distribution as fol5 lows:’’; and

6 (B) in paragraph (1), by striking ‘‘at the

7 close of September 30, 1999,’’ and inserting

8 ‘‘on the date of termination of the fund’’; and

9 (2) in subsection (b), to read as follows:

10 ‘‘(b) If a capital distribution is made under sub11 section (a), the school involved shall, after such capital dis12 tribution, pay to the Secretary, not less often than quar13 terly, the same proportionate share of amounts received

14 by the school in payment of principal or interest on loans

15 made from the loan fund established under section 835(b)

16 as determined by the Secretary under subsection (a).’’.

17 SEC. 134. GENERAL PROVISIONS.

18 (a) MAXIMUM STUDENT LOAN PROVISIONS AND

19 MINIMUM PAYMENTS.—

20 (1) IN GENERAL.—Section 722(a)(1) of the

21 Public Health Service Act (42 U.S.C. 292r(a)(1)),

22 as amended by section 2014(b)(1) of Public Law

23 103–43, is amended by striking ‘‘the sum of’’ and

24 all that follows through the end thereof and insert25 ing ‘‘the cost of attendance (including tuition, other
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1 reasonable educational expenses, and reasonable liv2 ing costs) for that year at the educational institution

3 attended by the student (as determined by such edu4 cational institution).’’.

5 (2) THIRD AND FOURTH YEARS.—Section

6 722(a)(2) of the Public Health Service Act (42

7 U.S.C. 292r(a)(2)), as amended by section

8 2014(b)(1) of Public Law 103–43, is amended by

9 striking ‘‘the amount $2,500’’ and all that follows

10 through ‘‘including such $2,500)’’ and inserting ‘‘the

11 amount of the loan may, in the case of the third or

12 fourth year of a student at a school of medicine or

13 osteopathic medicine, be increased to the extent nec14 essary’’.

15 (3) REPAYMENT PERIOD.—Section 722(c) of

16 the Public Health Service Act (42 U.S.C. 292r(c)),

17 as amended by section 2014(b)(1) of Public Law

18 103–43, is amended—

19 (A) in the subsection heading by striking

20 ‘‘TEN-YEAR’’ and inserting ‘‘REPAYMENT’’;

21 (B) by striking ‘‘ten-year period which be22 gins’’ and inserting ‘‘period of not less than 10

23 years nor more than 25 years, at the discretion

24 of the institution, which begins’’; and
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1 (C) by striking ‘‘such ten-year period’’ and

2 inserting ‘‘such period’’.

3 (4) MINIMUM PAYMENTS.—Section 722(j) of

4 the Public Health Service Act (42 U.S.C. 292r(j)),

5 as amended by section 2014(b)(1) of Public Law

6 103–43, is amended by striking ‘‘$15’’ and inserting

7 $40’’.

8 (b) ELIMINATION OF STATUTE OF LIMITATION FOR

9 LOAN COLLECTIONS.—

10 (1) IN GENERAL.—Section 722 of the Public

11 Health Service Act (42 U.S.C. 292r), as amended by

12 section 2014(b)(1) of Public Law 103–43, is amend13 ed by adding at the end the following new sub14 section:

15 ‘‘(m) ELIMINATION OF STATUTE OF LIMITATION FOR

16 LOAN COLLECTIONS.—

17 ‘‘(1) PURPOSE.—It is the purpose of this sub18 section to ensure that obligations to repay loans

19 under this section are enforced without regard to

20 any Federal or State statutory, regulatory, or ad21 ministrative limitation on the period within which

22 debts may be enforced.

23 ‘‘(2) PROHIBITION.—Notwithstanding any other

24 provision of Federal or State law, no limitation shall

25 terminate the period within which suit may be filed,
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1 a judgment may be enforced, or an offset, garnish2 ment, or other action may be initiated or taken by

3 a school that has an agreement with the Secretary

4 pursuant to section 721 that is seeking the repay5 ment of the amount due from a borrower on a loan

6 made under this subpart after the default of the bor7 rower on such loan.’’.

8 (2) EFFECTIVE DATE.—The amendment made

9 by paragraph (1) shall be effective with respect to

10 actions pending on or after the date of enactment of

11 this Act.

12 (c) DATE CERTAIN FOR CONTRIBUTIONS.—Para13 graph (2) of section 735(e) of the Public Health Service

14 Act (42 U.S.C. 292y(e)(2)) is amended to read as follows:

15 ‘‘(2) DATE CERTAIN FOR CONTRIBUTIONS.—

16 Amounts described in paragraph (1) that are re17 turned to the Secretary shall be obligated before the

18 end of the succeeding fiscal year.’’.

19 CHAPTER 2—INSURED HEALTH EDUCATION

20 ASSISTANCE LOANS TO GRADUATE STUDENTS

21 SEC. 141. HEALTH EDUCATION ASSISTANCE LOAN PRO22 GRAM.

23 (a) HEALTH EDUCATION ASSISTANCE LOAN

24 DEFERMENT FOR BORROWERS PROVIDING HEALTH

25 SERVICES TO INDIANS.—
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1 (1) IN GENERAL.—Section 705(a)(2)(C) of the

2 Public Health Service Act (42 U.S.C.

3 292d(a)(2)(C)) is amended by striking ‘‘and (x)’’

4 and inserting ‘‘(x) not in excess of three years, dur5 ing which the borrower is providing health care serv6 ices to Indians through an Indian health program

7 (as defined in section 108(a)(2)(A) of the Indian

8 Health Care Improvement Act (25 U.S.C.

9 1616a(a)(2)(A)); and (xi)’’.

10 (2) CONFORMING AMENDMENTS.—Section

11 705(a)(2)(C) of the Public Health Service Act (42

12 U.S.C. 292d(a)(2)(C)) is further amended—

13 (A) in clause (xi) (as so redesignated) by

14 striking ‘‘(ix)’’ and inserting ‘‘(x)’’; and

15 (B) in the matter following such clause

16 (xi), by striking ‘‘(x)’’ and inserting ‘‘(xi)’’.

17 (3) EFFECTIVE DATE.—The amendments made

18 by this subsection shall apply with respect to serv19 ices provided on or after the first day of the third

20 month that begins after the date of the enactment

21 of this Act.

22 (b) REPORT REQUIREMENT.—Section 709(b) of the

23 Public Health Service Act (42 U.S.C. 292h(b)) is

24 amended—
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1 (1) in paragraph (4)(B), by adding ‘‘and’’ after

2 the semicolon;

3 (2) in paragraph (5), by striking ‘‘; and’’ and

4 inserting a period; and

5 (3) by striking paragraph (6).

6 (c) PROGRAM ELIGIBILITY.—

7 (1) LIMITATIONS ON LOANS.—Section 703(a) of

8 the Public Health Service Act (42 U.S.C. 292b(a))

9 is amended by striking ‘‘or clinical psychology’’ and

10 inserting ‘‘or behavioral and mental health practice,

11 including clinical psychology’’.

12 (2) DEFINITION OF ELIGIBLE INSTITUTION.—

13 Section 719(1) of the Public Health Service Act (42

14 U.S.C. 292o(1)) is amended by striking ‘‘or clinical

15 psychology’’ and inserting ‘‘or behavioral and mental

16 health practice, including clinical psychology’’.

17 SEC. 142. HEAL LENDER AND HOLDER PERFORMANCE

18 STANDARDS.

19 (a) GENERAL AMENDMENTS.—Section 707(a) of the

20 Public Health Service Act (42 U.S.C. 292f) is amended—

21 (1) by striking the last sentence;

22 (2) by striking ‘‘determined.’’ and inserting

23 ‘‘determined, except that, if the insurance bene24 ficiary including any servicer of the loan is not des25 ignated for ‘exceptional performance’, as set forth in
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1 paragraph (2), the Secretary shall pay to the bene2 ficiary a sum equal to 98 percent of the amount of

3 the loss sustained by the insured upon that loan.’’;

4 (3) by striking ‘‘Upon’’ and inserting:

5 ‘‘(1) IN GENERAL.—Upon’’; and

6 (4) by adding at the end the following new

7 paragraph:

8 ‘‘(2) EXCEPTIONAL PERFORMANCE.—

9 ‘‘(A) AUTHORITY.—Where the Secretary

10 determines that an eligible lender, holder, or

11 servicer has a compliance performance rating

12 that equals or exceeds 97 percent, the Secretary

13 shall designate that eligible lender, holder, or

14 servicer, as the case may be, for exceptional

15 performance.

16 ‘‘(B) COMPLIANCE PERFORMANCE RAT17 ING.—For purposes of subparagraph (A), a

18 compliance performance rating is determined

19 with respect to compliance with due diligence in

20 the disbursement, servicing, and collection of

21 loans under this subpart for each year for

22 which the determination is made. Such rating

23 shall be equal to the percentage of all due dili24 gence requirements applicable to each loan, on

25 average, as established by the Secretary, with
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1 respect to loans serviced during the period by

2 the eligible lender, holder, or servicer.

3 ‘‘(C) ANNUAL AUDITS FOR LENDERS,

4 HOLDERS, AND SERVICERS.—Each eligible lend5 er, holder, or servicer desiring a designation

6 under subparagraph (A) shall have an annual

7 financial and compliance audit conducted with

8 respect to the loan portfolio of such eligible

9 lender, holder, or servicer, by a qualified inde10 pendent organization from a list of qualified or11 ganizations identified by the Secretary and in

12 accordance with standards established by the

13 Secretary. The standards shall measure the

14 lender’s, holder’s, or servicer’s compliance with

15 due diligence standards and shall include a de16 fined statistical sampling technique designed to

17 measure the performance rating of the eligible

18 lender, holder, or servicer for the purpose of

19 this section. Each eligible lender, holder, or

20 servicer shall submit the audit required by this

21 section to the Secretary.

22 ‘‘(D) SECRETARY’S DETERMINATIONS.—

23 The Secretary shall make the determination

24 under subparagraph (A) based upon the audits

25 submitted under this paragraph and any infor-
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1 mation in the possession of the Secretary or

2 submitted by any other agency or office of the

3 Federal Government.

4 ‘‘(E) QUARTERLY COMPLIANCE AUDIT.—

5 To maintain its status as an exceptional per6 former, the lender, holder, or servicer shall un7 dergo a quarterly compliance audit at the end

8 of each quarter (other than the quarter in

9 which status as an exceptional performer is es10 tablished through a financial and compliance

11 audit, as described in subparagraph (C)), and

12 submit the results of such audit to the Sec13 retary. The compliance audit shall review com14 pliance with due diligence requirements for the

15 period beginning on the day after the ending

16 date of the previous audit, in accordance with

17 standards determined by the Secretary.

18 ‘‘(F) REVOCATION AUTHORITY.—The Sec19 retary shall revoke the designation of a lender,

20 holder, or servicer under subparagraph (A) if

21 any quarterly audit required under subpara22 graph (E) is not received by the Secretary by

23 the date established by the Secretary or if the

24 audit indicates the lender, holder, or servicer

25 has failed to meet the standards for designation
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1 as an exceptional performer under subpara2 graph (A). A lender, holder, or servicer receiv3 ing a compliance audit not meeting the stand4 ard for designation as an exceptional performer

5 may reapply for designation under subpara6 graph (A) at any time.

7 ‘‘(G) DOCUMENTATION.—Nothing in this

8 section shall restrict or limit the authority of

9 the Secretary to require the submission of

10 claims documentation evidencing servicing per11 formed on loans, except that the Secretary may

12 not require exceptional performers to submit

13 greater documentation than that required for

14 lenders, holders, and servicers not designated

15 under subparagraph (A).

16 ‘‘(H) COST OF AUDITS.—Each eligible

17 lender, holder, or servicer shall pay for all the

18 costs associated with the audits required under

19 this section.

20 ‘‘(I) ADDITIONAL REVOCATION AUTHOR21 ITY.—Notwithstanding any other provision of

22 this section, a designation under subparagraph

23 (A) may be revoked at any time by the Sec24 retary if the Secretary determines that the eligi25 ble lender, holder, or servicer has failed to
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1 maintain an overall level of compliance consist2 ent with the audit submitted by the eligible

3 lender, holder, or servicer under this paragraph

4 or if the Secretary asserts that the lender, hold5 er, or servicer may have engaged in fraud in se6 curing designation under subparagraph (A) or

7 is failing to service loans in accordance with

8 program requirements.

9 ‘‘(J) NONCOMPLIANCE.—A lender, holder,

10 or servicer designated under subparagraph (A)

11 that fails to service loans or otherwise comply

12 with applicable program regulations shall be

13 considered in violation of the Federal False

14 Claims Act.’’.

15 (b) DEFINITION.—Section 707(e) of the Public

16 Health Service Act (42 U.S.C. 292f(e)) is amended by

17 adding at the end the following new paragraph:

18 ‘‘(4) The term ‘servicer’ means any agency act19 ing on behalf of the insurance beneficiary.’’.

20 (c) EFFECTIVE DATE.—The amendments made by

21 subsections (a) and (b) shall apply with respect to loans

22 submitted to the Secretary for payment on or after the

23 first day of the sixth month that begins after the date

24 of enactment of this Act.
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1 SEC. 143. INSURANCE PROGRAM.

2 Section 710(a)(2)(B) of the Public Health Service

3 Act (42 U.S.C. 292i(a)(2)(B)) is amended by striking

4 ‘‘any of the fiscal years 1993 through 1996’’ and inserting

5 ‘‘fiscal year 1993 and subsequent fiscal years’’.

6 SEC. 144. HEAL BANKRUPTCY.

7 (a) IN GENERAL.—Section 707(g) of the Public

8 Health Service Act (42 U.S.C. 292f(g)) is amended in the

9 first sentence by striking ‘‘A debt which is a loan insured’’

10 and inserting ‘‘Notwithstanding any other provision of

11 Federal or State law, a debt that is a loan insured’’.

12 (b) APPLICATION.—The amendment made by sub13 section (a) shall apply to any loan insured under the au14 thority of subpart I of part A of title VII of the Public

15 Health Service Act (42 U.S.C. 292 et seq.) that is listed

16 or scheduled by the debtor in a case under title XI, United

17 States Code, filed—

18 (1) on or after the date of enactment of this

19 Act; or

20 (2) prior to such date of enactment in which a

21 discharge has not been granted.

22 SEC. 145. HEAL REFINANCING.

23 Section 706 of the Public Health Service Act (42

24 U.S.C. 292e) is amended—

25 (1) in subsection (d)—
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1 (A) in the subsection heading, by striking

2 ‘‘CONSOLIDATION’’ and inserting ‘‘REFINANC3 ING OR CONSOLIDATION’’; and

4 (B) in the first sentence, by striking ‘‘in5 debtedness’’ and inserting ‘‘indebtedness or the

6 refinancing of a single loan’’; and

7 (2) in subsection (e)—

8 (A) in the subsection heading, by striking

9 ‘‘DEBTS’’ and inserting ‘‘DEBTS AND REFI10 NANCING’’;

11 (B) in the first sentence, by striking ‘‘all

12 of the borrower’s debts into a single instru13 ment’’ and inserting ‘‘all of the borrower’s loans

14 insured under this subpart into a single instru15 ment (or, if the borrower obtained only 1 loan

16 insured under this subpart, refinancing the loan

17 1 time)’’; and

18 (C) in the second sentence, by striking

19 ‘‘consolidation’’ and inserting ‘‘consolidation or

20 refinancing’’.
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1 TITLE II—OFFICE OF MINORITY

2 HEALTH

3 SEC. 201. REVISION AND EXTENSION OF PROGRAMS OF OF4 FICE OF MINORITY HEALTH.

5 (a) DUTIES AND REQUIREMENTS.—Section 1707 of

6 the Public Health Service Act (42 U.S.C. 300u–6) is

7 amended by striking subsection (b) and all that follows

8 and inserting the following:

9 ‘‘(b) DUTIES.—With respect to improving the health

10 of racial and ethnic minority groups, the Secretary, acting

11 through the Deputy Assistant Secretary for Minority

12 Health (in this section referred to as the ‘Deputy Assist13 ant Secretary’), shall carry out the following:

14 ‘‘(1) Establish short-range and long-range goals

15 and objectives and coordinate all other activities

16 within the Public Health Service that relate to dis17 ease prevention, health promotion, service delivery,

18 and research concerning such individuals. The heads

19 of each of the agencies of the Service shall consult

20 with the Deputy Assistant Secretary to ensure the

21 coordination of such activities.

22 ‘‘(2) Enter into interagency agreements with

23 other agencies of the Public Health Service.

24 ‘‘(3) Support research, demonstrations and

25 evaluations to test new and innovative models.
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1 ‘‘(4) Increase knowledge and understanding of

2 health risk factors.

3 ‘‘(5) Develop mechanisms that support better

4 information dissemination, education, prevention,

5 and service delivery to individuals from disadvan6 taged backgrounds, including individuals who are

7 members of racial or ethnic minority groups.

8 ‘‘(6) Ensure that the National Center for

9 Health Statistics collects data on the health status

10 of each minority group.

11 ‘‘(7) With respect to individuals who lack pro12 ficiency in speaking the English language, enter into

13 contracts with public and nonprofit private providers

14 of primary health services for the purpose of increas15 ing the access of the individuals to such services by

16 developing and carrying out programs to provide bi17 lingual or interpretive services.

18 ‘‘(8) Support a national minority health re19 source center to carry out the following:

20 ‘‘(A) Facilitate the exchange of informa21 tion regarding matters relating to health infor22 mation and health promotion, preventive health

23 services, and education in the appropriate use

24 of health care.

25 ‘‘(B) Facilitate access to such information.
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1 ‘‘(C) Assist in the analysis of issues and

2 problems relating to such matters.

3 ‘‘(D) Provide technical assistance with re4 spect to the exchange of such information (in5 cluding facilitating the development of materials

6 for such technical assistance).

7 ‘‘(9) Carry out programs to improve access to

8 health care services for individuals with limited pro9 ficiency in speaking the English language. Activities

10 under the preceding sentence shall include develop11 ing and evaluating model projects.

12 ‘‘(c) ADVISORY COMMITTEE.—

13 ‘‘(1) IN GENERAL.—The Secretary shall estab14 lish an advisory committee to be known as the Advi15 sory Committee on Minority Health (in this sub16 section referred to as the ‘Committee’).

17 ‘‘(2) DUTIES.—The Committee shall provide

18 advice to the Deputy Assistant Secretary carrying

19 out this section, including advice on the development

20 of goals and specific program activities under para21 graphs (1) through (9) of subsection (b) for each ra22 cial and ethnic minority group.

23 ‘‘(3) CHAIR.—The chairperson of the Commit24 tee shall be selected by the Secretary from among

25 the members of the voting members of the Commit-
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1 tee. The term of office of the chairperson shall be

2 2 years.

3 ‘‘(4) COMPOSITION.—

4 ‘‘(A) The Committee shall be composed of

5 12 voting members appointed in accordance

6 with subparagraph (B), and nonvoting, ex offi7 cio members designated in subparagraph (C).

8 ‘‘(B) The voting members of the Commit9 tee shall be appointed by the Secretary from

10 among individuals who are not officers or em11 ployees of the Federal Government and who

12 have expertise regarding issues of minority

13 health. The racial and ethnic minority groups

14 shall be equally represented among such mem15 bers.

16 ‘‘(C) The nonvoting, ex officio members of

17 the Committee shall be such officials of the De18 partment of Health and Human Services as the

19 Secretary determines to be appropriate.

20 ‘‘(5) TERMS.—Each member of the Committee

21 shall serve for a term of 4 years, except that the

22 Secretary shall initially appoint a portion of the

23 members to terms of 1 year, 2 years, and 3 years.

24 ‘‘(6) VACANCIES.—If a vacancy occurs on the

25 Committee, a new member shall be appointed by the
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1 Secretary within 90 days from the date that the va2 cancy occurs, and serve for the remainder of the

3 term for which the predecessor of such member was

4 appointed. The vacancy shall not affect the power of

5 the remaining members to execute the duties of the

6 Committee.

7 ‘‘(7) COMPENSATION.—Members of the Com8 mittee who are officers or employees of the United

9 States shall serve without compensation. Members of

10 the Committee who are not officers or employees of

11 the United States shall receive compensation, for

12 each day (including travel time) they are engaged in

13 the performance of the functions of the Committee.

14 Such compensation may not be in an amount in ex15 cess of the daily equivalent of the annual maximum

16 rate of basic pay payable under the General Sched17 ule (under title 5, United States Code) for positions

18 above GS–15.

19 ‘‘(d) CERTAIN REQUIREMENTS REGARDING DU20 TIES.—

21 ‘‘(1) RECOMMENDATIONS REGARDING LAN22 GUAGE AS IMPEDIMENT TO HEALTH CARE.—The

23 Deputy Assistant Secretary for Minority Health

24 shall consult with the Director of the Office of Inter25 national and Refugee Health, the Director of the Of-
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1 fice of Civil Rights, and the Directors of other ap2 propriate Departmental entities regarding rec3 ommendations for carrying out activities under sub4 section (b)(9).

5 ‘‘(2) EQUITABLE ALLOCATION REGARDING AC6 TIVITIES.—In carrying out subsection (b), the Sec7 retary shall ensure that services provided under such

8 subsection are equitably allocated among all groups

9 served under this section by the Secretary.

10 ‘‘(3) CULTURAL COMPETENCY OF SERVICES.—

11 The Secretary shall ensure that information and

12 services provided pursuant to subsection (b) are pro13 vided in the language, educational, and cultural con14 text that is most appropriate for the individuals for

15 whom the information and services are intended.

16 ‘‘(e) GRANTS AND CONTRACTS REGARDING DU17 TIES.—

18 ‘‘(1) IN GENERAL.—In carrying out subsection

19 (b), the Secretary acting through the Deputy Assist20 ant Secretary may make awards of grants, coopera21 tive agreements, and contracts to public and non22 profit private entities.

23 ‘‘(2) PROCESS FOR MAKING AWARDS.—The

24 Deputy Assistant Secretary shall ensure that awards

25 under paragraph (1) are made, to the extent prac-
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1 tical, only on a competitive basis, and that a grant

2 is awarded for a proposal only if the proposal has

3 been recommended for such an award through a

4 process of peer review.

5 ‘‘(3) EVALUATION AND DISSEMINATION.—The

6 Deputy Assistant Secretary, directly or through con7 tracts with public and private entities, shall provide

8 for evaluations of projects carried out with awards

9 made under paragraph (1) during the preceding 2

10 fiscal years. The report shall be included in the re11 port required under subsection (f) for the fiscal year

12 involved.

13 ‘‘(f) REPORTS.—

14 ‘‘(1) IN GENERAL.—Not later than February 1

15 of fiscal year 1999 and of each second year there16 after, the Secretary shall submit to the Committee

17 on Energy and Commerce of the House of Rep18 resentatives, and to the Committee on Labor and

19 Human Resources of the Senate, a report describing

20 the activities carried out under this section during

21 the preceding 2 fiscal years and evaluating the ex22 tent to which such activities have been effective in

23 improving the health of racial and ethnic minority

24 groups. Each such report shall include the biennial

25 reports submitted under sections 201(e)(3) and
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1 201(f)(2) for such years by the heads of the Public

2 Health Service agencies.

3 ‘‘(2) AGENCY REPORTS.—Not later than Feb4 ruary 1, 1999, and biennially thereafter, the heads

5 of the Public Health Service agencies shall submit to

6 the Deputy Assistant Secretary a report summariz7 ing the minority health activities of each of the re8 spective agencies.

9 ‘‘(g) DEFINITION.—For purposes of this section:

10 ‘‘(1) The term ‘racial and ethnic minority

11 group’ means American Indians (including Alaska

12 Natives, Eskimos, and Aleuts); Asian Americans and

13 Pacific Islanders; Blacks; and Hispanics.

14 ‘‘(2) The term ‘Hispanic’ means individuals

15 whose origin is Mexican, Puerto Rican, Cuban, Cen16 tral or South American, or any other Spanish-speak17 ing country.

18 ‘‘(h) FUNDING.—

19 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—

20 For the purpose of carrying out this section, there

21 are authorized to be appropriated $30,000,000 for

22 fiscal year 1998, such sums as may be necessary for

23 each of the fiscal years 1999 through 2002.’’.
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1 (b) AUTHORIZATION FOR NATIONAL CENTER FOR

2 HEALTH STATISTICS.—Section 306 of the Public Health

3 Service Act (42 U.S.C. 242k) is amended—

4 (1) in subsection (m), by adding at the end the

5 following:

6 ‘‘(4)(A) Subject to subparagraph (B), the Secretary,

7 acting through the Center, shall collect data on Hispanics

8 and major Hispanic subpopulation groups and American

9 Indians, and for developing special area population studies

10 on major Asian American and Pacific Islander popu11 lations.

12 ‘‘(B) The provisions of subparagraph (A) shall be ef13 fective with respect to a fiscal year only to the extent that

14 funds are appropriated pursuant to paragraph (3) of sub15 section (n), and only if the amounts appropriated for such

16 fiscal year pursuant to each of paragraphs (1) and (2)

17 of subsection (n) equal or exceed the amounts so appro18 priated for fiscal year 1997.’’;

19 (2) in subsection (n)(1), by striking ‘‘through

20 1998’’ and inserting ‘‘through 2003’’; and

21 (3) in subsection (n)

22 (A) in the first sentence of paragraph

23 (2)—

24 (i) by striking ‘‘authorized in sub25 section (m)’’ and inserting ‘‘authorized in
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1 paragraphs (1) through (3) of subsection

2 (m)’’; and

3 (ii) by striking ‘‘$5,000,000’’ and all

4 that follows through the period and insert5 ing ‘‘such sums as may be necessary for

6 each of the fiscal years 1999 through

7 2003.’’; and

8 (B) by adding at the end the following:

9 ‘‘(3) For activities authorized in subsection (m)(4),

10 there are authorized to be appropriated $1,000,000 for fis11 cal year 1998, and such sums as may be necessary for

12 each of the fiscal years 1999 through 2002.’’.

13 (c) MISCELLANEOUS AMENDMENTS.—Section 1707

14 of the Public Health Service Act (42 U.S.C. 300u–6) is

15 amended—

16 (1) in the heading for the section by striking

17 ‘‘ESTABLISHMENT OF’’; and

18 (2) in subsection (a), by striking ‘‘Office of the

19 Assistant Secretary for Health’’ and inserting ‘‘Of20 fice of Public Health and Science’’.

21 TITLE III—SELECTED

22 INITIATIVES

23 SEC. 301. STATE OFFICES OF RURAL HEALTH.

24 Section 338J of the Public Health Service Act (42

25 U.S.C. 254r) is amended—
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1 (1) in subsection (b)(1), in the matter preced2 ing subparagraph (A), by striking ‘‘in cash’’; and

3 (2) in subsection (j)(1)—

4 (A) by striking ‘‘and’’ after ‘‘1992,’’; and

5 (B) by inserting before the period the fol6 lowing: ‘‘, and such sums as may be necessary

7 for each of the fiscal years 1998 through

8 2002’’; and

9 (3) in subsection (k), by striking

10 ‘‘$10,000,000’’ and inserting ‘‘$36,000,000’’.

11 SEC. 302. DEMONSTRATION PROJECTS REGARDING ALZ12 HEIMER’S DISEASE.

13 (a) IN GENERAL.—Section 398(a) of the Public

14 Health Service Act (42 U.S.C. 280c–3(a)) is amended—

15 (1) in the matter preceding paragraph (1), by

16 striking ‘‘not less than 5, and not more than 15,’’;

17 (2) in paragraph (2)—

18 (A) by inserting after ‘‘disorders’’ the fol19 lowing: ‘‘who are living in single family homes

20 or in congregate settings’’; and

21 (B) by striking ‘‘and’’ at the end;

22 (3) by redesignating paragraph (3) as para23 graph (4); and

24 (4) by inserting after paragraph (2) the follow25 ing:
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1 ‘‘(3) to improve the access of such individuals

2 to home-based or community-based long-term care

3 services (subject to the services being provided by

4 entities that were providing such services in the

5 State involved as of October 1, 1995), particularly

6 such individuals who are members of racial or ethnic

7 minority groups, who have limited proficiency in

8 speaking the English language, or who live in rural

9 areas; and’’.

10 (b) DURATION.—Section 398A of the Public Health

11 Service Act (42 U.S.C. 280c–4) is amended—

12 (1) in the heading for the section, by striking

13 ‘‘LIMITATION’’ and all that follows and inserting

14 ‘‘REQUIREMENT OF MATCHING

15 FUNDS’’;

16 (2) by striking subsection (a);

17 (3) by redesignating subsections (b) and (c) as

18 subsections (a) and (b), respectively; and

19 (4) in subsection (a) (as so redesignated), in

20 each of paragraphs (1)(C) and (2)(C), by striking

21 ‘‘third year’’ and inserting ‘‘third or subsequent

22 year’’.

23 (c) AUTHORIZATION OF APPROPRIATIONS.—Section

24 398B(e) of the Public Health Service Act (42 U.S.C.

25 280c–5(e)) is amended—
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1 (1) by striking ‘‘and such sums’’ and inserting

2 ‘‘such sums’’; and

3 (2) by inserting before the period the following:

4 ‘‘, $8,000,000 for fiscal year 1998, and such sums

5 as may be necessary for each of the fiscal years

6 1999 through 2002’’.

7 SEC. 303. PROJECT GRANTS FOR IMMUNIZATION SERVICES.

8 Section 317(j) of the Public Health Service Act (42

9 U.S.C. 247b(j)) is amended—

10 (1) in paragraph (1), by striking ‘‘individuals

11 against vaccine-preventable diseases’’ and all that

12 follows through the first period and inserting the fol13 lowing: ‘‘children, adolescents, and adults against

14 vaccine-preventable diseases, there are authorized to

15 be appropriated such sums as may be necessary for

16 each of the fiscal years 1998 through 2002.’’; and

17 (2) in paragraph (2), by striking ‘‘1990’’ and

18 inserting ‘‘1997’’.

19 TITLE IV—MISCELLANEOUS

20 PROVISIONS

21 SEC. 401. TECHNICAL CORRECTIONS REGARDING PUBLIC

22 LAW 103–183.

23 (a) AMENDATORY INSTRUCTIONS.—Public Law 103–

24 183 is amended—

25 (1) in section 601—
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1 (A) in subsection (b), in the matter preced2 ing paragraph (1), by striking ‘‘Section 1201 of

3 the Public Health Service Act (42 U.S.C.

4 300d)’’ and inserting ‘‘Title XII of the Public

5 Health Service Act (42 U.S.C. 300d et seq.)’’;

6 and

7 (B) in subsection (f)(1), by striking ‘‘in

8 section 1204(c)’’ and inserting ‘‘in section

9 1203(c) (as redesignated by subsection (b)(2) of

10 this section)’’;

11 (2) in section 602, by striking ‘‘for the pur12 pose’’ and inserting ‘‘For the purpose’’; and

13 (3) in section 705(b), by striking ‘‘317D((l)(1)’’

14 and inserting ‘‘317D(l)(1)’’.

15 (b) PUBLIC HEALTH SERVICE ACT.—The Public

16 Health Service Act, as amended by Public Law 103–183

17 and by subsection (a) of this section, is amended—

18 (1) in section 317E(g)(2), by striking ‘‘making

19 grants under subsection (b)’’ and inserting ‘‘carrying

20 out subsection (b)’’;

21 (2) in section 318, in subsection (e) as in effect

22 on the day before the date of the enactment of Pub23 lic Law 103–183, by redesignating the subsection as

24 subsection (f);

25 (3) in subpart 6 of part C of title IV—
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1 (A) by transferring the first section 447

2 (added by section 302 of Public Law 103–183)

3 from the current placement of the section;

4 (B) by redesignating the section as section

5 447A; and

6 (C) by inserting the section after section

7 447;

8 (4) in section 1213(a)(8), by striking ‘‘provides

9 for for’’ and inserting ‘‘provides for’’;

10 (5) in section 1501, by redesignating the second

11 subsection (c) (added by section 101(f) of Public

12 Law 103–183) as subsection (d); and

13 (6) in section 1505(3), by striking ‘‘nonprofit’’.

14 (c) MISCELLANEOUS CORRECTION.—Section

15 401(c)(3) of Public Law 103–183 is amended in the mat16 ter preceding subparagraph (A) by striking ‘‘(d)(5)’’ and

17 inserting ‘‘(e)(5)’’.

18 (d) CONFORMING AMENDMENT.—Section 308(b) of

19 the Public Health Service Act (42 U.S.C. 242m(b)) is

20 amended—

21 (1) in paragraph (2)(A), by striking ‘‘306(n)’’

22 and inserting ‘‘306(m)’’; and

23 (2) in paragraph (2)(C), by striking ‘‘306(n)’’

24 and inserting ‘‘306(m)’’.
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1 (e) EFFECTIVE DATE.—This section is deemed to

2 have taken effect immediately after the enactment of Pub3 lic Law 103–183.

4 SEC. 402. MISCELLANEOUS AMENDMENTS REGARDING PHS

5 COMMISSIONED OFFICERS.

6 (a) ANTI-DISCRIMINATION LAWS.—Amend section

7 212 of the Public Health Service Act (42 U.S.C. 213) by

8 adding the following new subsection at the end thereof:

9 ‘‘(f) Active service of commissioned officers of the

10 Service shall be deemed to be active military service in

11 the Armed Forces of the United States for purposes of

12 all laws related to discrimination on the basis of race,

13 color, sex, ethnicity, age, religion, and disability.’’

14 (b) TRAINING IN LEAVE WITHOUT PAY STATUS.—

15 Section 218 of the Public Health Service Act (42 U.S.C.

16 218a) is amended by adding at the end the following:

17 ‘‘(c) A commissioned officer may be placed in leave

18 without pay status while attending an educational institu19 tion or training program whenever the Secretary deter20 mines that such status is in the best interest of the Serv21 ice. For purposes of computation of basic pay, promotion,

22 retirement, compensation for injury or death, and the ben23 efits provided by sections 212 and 224, an officer in such

24 status pursuant to the preceding sentence shall be consid25 ered as performing service in the Service and shall have
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1 an active service obligation as set forth in subsection (b)

2 of this section.’’.

3 (c) UTILIZATION OF ALCOHOL AND DRUG ABUSE

4 RECORDS THAT APPLY TO THE ARMED FORCES.—Sec5 tion 543(e) of the Public Health Service Act (42 U.S.C.

6 290dd–2(e)) is amended by striking ‘‘Armed Forces’’ each

7 place that such term appears and inserting ‘‘Uniformed

8 Services’’.

9 SEC. 403. CLINICAL TRAINEESHIPS.

10 Section 303(d)(1) of the Public Health Service Act

11 (42 U.S.C. 242a(d)(1)) is amended by inserting ‘‘counsel12 ing,’’ after ‘‘family therapy,’’.

13 SEC. 404. PROJECT GRANTS FOR SCREENINGS, REFERRALS,

14 AND EDUCATION REGARDING LEAD POISON15 ING.

16 Section 317A(l)(1) of the Public Health Service Act

17 (42 U.S.C. 247b–1(l)(1)) is amended by striking ‘‘1998’’

18 and inserting ‘‘2002’’.

19 SEC. 405. PROJECT GRANTS FOR PREVENTIVE HEALTH

20 SERVICES REGARDING TUBERCULOSIS.

21 Section 317E(g) of the Public Health Service Act (42

22 U.S.C. 247b–6(g)(1)) is amended—

23 (1) in paragraph (1)—

24 (A) in subparagraph (A), by striking

25 ‘‘1998’’ and inserting ‘‘2002’’; and
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1 (B) in subparagraph (B), by striking

2 ‘‘$50,000,000’’ and inserting ‘‘25 percent’’; and

3 (2) in paragraph (2), by striking ‘‘1998’’ and

4 inserting ‘‘2002’’.

5 SEC. 406. CDC LOAN REPAYMENT PROGRAM.

6 Section 317F of the Public Health Service Act (42

7 U.S.C. 247b-7) is amended—

8 (1) in subsection (a)(1), by striking ‘‘$20,000’’

9 and inserting ‘‘$35,000’’;

10 (2) in subsection (c), by striking ‘‘1998’’ and

11 inserting ‘‘2002’’; and

12 (3) by adding at the end the following:

13 ‘‘(d) AVAILABILITY OF APPROPRIATIONS.—Amounts

14 appropriated for a fiscal year for contracts under sub15 section (a) shall remain available until the expiration of

16 the second fiscal year beginning after the fiscal year for

17 which the amounts were appropriated.’’.

18 SEC. 407. COMMUNITY PROGRAMS ON DOMESTIC VIO19 LENCE.

20 (a) IN GENERAL.—Section 318(h)(2) of the Family

21 Violence Prevention and Services Act (42 U.S.C.

22 10418(h)(2)) is amended by striking ‘‘fiscal year 1997’’

23 and inserting ‘‘for each of the fiscal years 1997 through

24 2002’’.
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1 (b) STUDY.—The Secretary of Health and Human

2 Services shall request that the Institute of Medicine con3 duct a study concerning the training needs of health pro4 fessionals with respect to the detection and referral of vic5 tims of family or acquaintance violence. Not later than 2

6 years after the date of enactment of this Act, the Institute

7 of Medicine shall prepare and submit to Congress a report

8 concerning the study conducted under this subsection.

9 SEC. 408. STATE LOAN REPAYMENT PROGRAM.

10 Section 338I(i)(1) of the Public Health Service Act

11 (42 U.S.C. 254q–1(i)(1)) is amended by inserting before

12 the period ‘‘, and such sums as may be necessary for each

13 of the fiscal years 1998 through 2002’’.

14 SEC. 409. AUTHORITY OF THE DIRECTOR OF NIH.

15 Section 402(b) of the Public Health Service Act (42

16 U.S.C. 282(b)) is amended—

17 (1) in paragraph (11), by striking ‘‘and’’ at the

18 end thereof;

19 (2) in paragraph (12), by striking the period

20 and inserting a semicolon; and

21 (3) by adding after paragraph (12), the follow22 ing new paragraphs:

23 ‘‘(13) may conduct and support research train24 ing—
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1 ‘‘(A) for which fellowship support is not

2 provided under section 487; and

3 ‘‘(B) which does not consist of residency

4 training of physicians or other health profes5 sionals; and

6 ‘‘(14) may appoint physicians, dentists, and

7 other health care professionals, subject to the provi8 sions of title 5, United States Code, relating to ap9 pointments and classifications in the competitive

10 service, and may compensate such professionals sub11 ject to the provisions of chapter 74 of title 38,

12 United States Code.’’.

13 SEC. 410. RAISE IN MAXIMUM LEVEL OF LOAN REPAY14 MENTS.

15 (a) REPAYMENT PROGRAMS WITH RESPECT TO

16 AIDS.—Section 487A of the Public Health Service Act

17 (42 U.S.C. 288–1) is amended—

18 (1) in subsection (a), by striking ‘‘$20,000’’

19 and inserting ‘‘$35,000’’; and

20 (2) in subsection (c), by striking ‘‘1996’’ and

21 inserting ‘‘2001’’.

22 (b) REPAYMENT PROGRAMS WITH RESPECT TO CON23 TRACEPTION AND INFERTILITY.—Section 487B(a) of the

24 Public Health Service Act (42 U.S.C. 288–2(a)) is amend25 ed by striking ‘‘$20,000’’ and inserting ‘‘$35,000’’.
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1 (c) REPAYMENT PROGRAMS WITH RESPECT TO RE2 SEARCH GENERALLY.—Section 487C(a)(1) of the Public

3 Health Service Act (42 U.S.C. 288–3(a)(1)) is amended

4 by striking ‘‘$20,000’’ and inserting ‘‘$35,000’’.

5 (d) REPAYMENT PROGRAMS WITH RESPECT TO

6 CLINICAL RESEARCHERS FROM DISADVANTAGED BACK7 GROUNDS.—Section 487E(a) of the Public Health Service

8 Act (42 U.S.C. 288–5(a)) is amended—

9 (1) in paragraph (1), by striking ‘‘$20,000’’

10 and inserting ‘‘$35,000’’; and

11 (2) in paragraph (3), by striking ‘‘338C’’ and

12 inserting ‘‘338B, 338C’’.

13 SEC. 411. CONSTRUCTION OF REGIONAL CENTERS FOR RE14 SEARCH ON PRIMATES.

15 Section 481B(a) of the Public Health Service Act (42

16 U.S.C. 287a–3(a)) is amended—

17 (1) by striking ‘‘shall’’ and inserting ‘‘may’’;

18 and

19 (2) by striking ‘‘$5,000,000’’ and inserting ‘‘up

20 to $2,500,000’’.

21 SEC. 412. PEER REVIEW.

22 Section 504(d)(2) of the Public Health Service Act

23 (42 U.S.C. 290aa–3(d)(2)) is amended by striking ‘‘coop24 erative agreement, or contract’’ each place that such ap25 pears and inserting ‘‘or cooperative agreement’’.
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1 SEC. 413. FUNDING FOR TRAUMA CARE.

2 Section 1232(a) of the Public Health Service Act (42

3 U.S.C. 300d–32) is amended by striking ‘‘and 1996’’ and

4 inserting ‘‘through 2002’’.

5 SEC. 414. HEALTH INFORMATION AND HEALTH PRO6 MOTION.

7 Section 1701(b) of the Public Health Service Act (42

8 U.S.C. 300u(b)) is amended by striking ‘‘through 1996’’

9 and inserting ‘‘through 2002’’.

10 SEC. 415. EMERGENCY MEDICAL SERVICES FOR CHILDREN.

11 Section 1910 of the Public Health Service Act (42

12 U.S.C. 300w–9) is amended—

13 (1) in subsection (a)—

14 (A) by striking ‘‘two-year period’’ and in15 serting ‘‘3-year period (with an optional 4th

16 year based on performance)’’; and

17 (B) by striking ‘‘one grant’’ and inserting

18 ‘‘3 grants’’; and

19 (2) in subsection (d), by striking ‘‘1997’’ and

20 inserting ‘‘2005’’.

21 SEC. 416. ADMINISTRATION OF CERTAIN REQUIREMENTS.

22 (a) IN GENERAL.—Section 2004 of Public Law 103–

23 43 (107 Stat. 209) is amended by striking subsection (a).

24 (b) CONFORMING AMENDMENTS.—Section 2004 of

25 Public Law 103–43, as amended by subsection (a) of this

26 section, is amended—
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1 (1) by striking ‘‘(b) SENSE’’ and all that follows

2 through ‘‘In the case’’ and inserting the following:

3 ‘‘(a) SENSE OF CONGRESS REGARDING PURCHASE

4 OF AMERICAN-MADE EQUIPMENT AND PRODUCTS.—In

5 the case’’;

6 (2) by striking ‘‘(2) NOTICE TO RECIPIENTS OF

7 ASSISTANCE’’ and inserting the following:

8 ‘‘(b) NOTICE TO RECIPIENTS OF ASSISTANCE’’; and

9 (3) in subsection (b), as redesignated by para10 graph (2) of this subsection, by striking ‘‘paragraph

11 (1)’’ and inserting ‘‘subsection (a)’’.

12 (c) EFFECTIVE DATE.—This section is deemed to

13 have taken effect immediately after the enactment of Pub14 lic Law 103–43.

15 SEC. 417. AIDS DRUG ASSISTANCE PROGRAM.

16 Section 2618(b)(3) of the Public Health Service Act

17 (42 U.S.C. 300ff–28(b)(3)) is amended—

18 (1) in subparagraph (A), by striking ‘‘and the

19 Commonwealth of Puerto Rico’’ and inserting ‘‘, the

20 Commonwealth of Puerto Rico, the Virgin Islands,

21 and Guam’’; and

22 (2) in subparagraph (B), by striking ‘‘the Vir23 gin Islands, Guam’’.
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1 SEC. 418. NATIONAL FOUNDATION FOR BIOMEDICAL RE2 SEARCH.

3 Part I of title IV of the Public Health Service Act

4 (42 U.S.C. 290b et seq.) is amended—

5 (1) by striking the part heading and inserting

6 the following:

7 ‘‘PART I—FOUNDATION FOR THE NATIONAL

8 INSTITUTES OF HEALTH’’;

9 and

10 (2) in section 499—

11 (A) in subsection (a), by striking ‘‘Na12 tional Foundation for Biomedical Research’’

13 and inserting ‘‘Foundation for the National In14 stitutes of Health’’;

15 (B) in subsection (k)(10)—

16 (i) by striking ‘‘not’’; and

17 (ii) by adding at the end the follow18 ing: ‘‘Any funds transferred under this

19 paragraph shall be subject to all Federal

20 limitations relating to Federally-funded re21 search.’’; and

22 (C) in subsection (m)(1), by striking

23 ‘‘$200,000’’ and all that follows through

24 ‘‘1995’’ and inserting ‘‘$500,000 for each fiscal

25 year’’.
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1 SEC. 419. FETAL ALCOHOL SYNDROME PREVENTION AND

2 SERVICES.

3 (a) SHORT TITLE.—This section may be cited as the

4 ‘‘Fetal Alcohol Syndrome and Fetal Alcohol Effect Pre5 vention and Services Act’’.

6 (b) FINDINGS.—Congress finds that—

7 (1) Fetal Alcohol Syndrome is the leading pre8 ventable cause of mental retardation, and it is 100

9 percent preventable;

10 (2) estimates on the number of children each

11 year vary, but according to some researchers, up to

12 12,000 infants are born in the United States with

13 Fetal Alcohol Syndrome, suffering irreversible phys14 ical and mental damage;

15 (3) thousands more infants are born each year

16 with Fetal Alcohol Effect, also known as Alcohol Re17 lated Neurobehavioral Disorder (ARND), a related

18 and equally tragic syndrome;

19 (4) children of women who use alcohol while

20 pregnant have a significantly higher infant mortality

21 rate (13.3 per 1000) than children of those women

22 who do not use alcohol (8.6 per 1000);

23 (5) Fetal Alcohol Syndrome and Fetal Alcohol

24 Effect are national problems which can impact any

25 child, family, or community, but their threat to
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1 American Indians and Alaska Natives is especially

2 alarming;

3 (6) in some American Indian communities,

4 where alcohol dependency rates reach 50 percent

5 and above, the chances of a newborn suffering Fetal

6 Alcohol Syndrome or Fetal Alcohol Effect are up to

7 30 times greater than national averages;

8 (7) in addition to the immeasurable toll on chil9 dren and their families, Fetal Alcohol Syndrome and

10 Fetal Alcohol Effect pose extraordinary financial

11 costs to the Nation, including the costs of health

12 care, education, foster care, job training, and gen13 eral support services for affected individuals;

14 (8) the total cost to the economy of Fetal Alco15 hol Syndrome was approximately $2,500,000,000 in

16 1995, and over a lifetime, health care costs for one

17 Fetal Alcohol Syndrome child are estimated to be at

18 least $1,400,000;

19 (9) researchers have determined that the possi20 bility of giving birth to a baby with Fetal Alcohol

21 Syndrome or Fetal Alcohol Effect increases in pro22 portion to the amount and frequency of alcohol con23 sumed by a pregnant woman, and that stopping al24 cohol consumption at any point in the pregnancy re-
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1 duces the emotional, physical, and mental con2 sequences of alcohol exposure to the baby; and

3 (10) though approximately 1 out of every 5

4 pregnant women drink alcohol during their preg5 nancy, we know of no safe dose of alcohol during

6 pregnancy, or of any safe time to drink during preg7 nancy, thus, it is in the best interest of the Nation

8 for the Federal Government to take an active role in

9 encouraging all women to abstain from alcohol con10 sumption during pregnancy.

11 (c) PURPOSE.—It is the purpose of this section to

12 establish, within the Department of Health and Human

13 Services, a comprehensive program to help prevent Fetal

14 Alcohol Syndrome and Fetal Alcohol Effect nationwide

15 and to provide effective intervention programs and services

16 for children, adolescents and adults already affected by

17 these conditions. Such program shall—

18 (1) coordinate, support, and conduct national,

19 State, and community-based public awareness, pre20 vention, and education programs on Fetal Alcohol

21 Syndrome and Fetal Alcohol Effect;

22 (2) coordinate, support, and conduct prevention

23 and intervention studies as well as epidemiologic re24 search concerning Fetal Alcohol Syndrome and Fetal

25 Alcohol Effect;
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1 (3) coordinate, support and conduct research

2 and demonstration projects to develop effective de3 velopmental and behavioral interventions and pro4 grams that foster effective advocacy, educational and

5 vocational training, appropriate therapies, counsel6 ing, medical and mental health, and other supportive

7 services, as well as models that integrate or coordi8 nate such services, aimed at the unique challenges

9 facing individuals with Fetal Alcohol Syndrome or

10 Fetal Alcohol Effect and their families; and

11 (4) foster coordination among all Federal, State

12 and local agencies, and promote partnerships be13 tween research institutions and communities that

14 conduct or support Fetal Alcohol Syndrome and

15 Fetal Alcohol Effect research, programs, surveil16 lance, prevention, and interventions and otherwise

17 meet the general needs of populations already af18 fected or at risk of being impacted by Fetal Alcohol

19 Syndrome and Fetal Alcohol Effect.

20 (d) ESTABLISHMENT OF PROGRAM.—Title III of the

21 Public Health Service Act (42 U.S.C. 241 et seq.) is

22 amended by adding at the end the following:
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1 ‘‘PART O—FETAL ALCOHOL SYNDROME

2 PREVENTION AND SERVICES PROGRAM

3 ‘‘SEC. 399G. ESTABLISHMENT OF FETAL ALCOHOL SYN4 DROME PREVENTION AND SERVICES PRO5 GRAM.

6 ‘‘(a) FETAL ALCOHOL SYNDROME PREVENTION,

7 INTERVENTION AND SERVICES DELIVERY PROGRAM.—

8 The Secretary shall establish a comprehensive Fetal Alco9 hol Syndrome and Fetal Alcohol Effect prevention, inter10 vention and services delivery program that shall include—

11 ‘‘(1) an education and public awareness pro12 gram to support, conduct, and evaluate the effective13 ness of—

14 ‘‘(A) educational programs targeting medi15 cal schools, social and other supportive services,

16 educators and counselors and other service pro17 viders in all phases of childhood development,

18 and other relevant service providers, concerning

19 the prevention, identification, and provision of

20 services for children, adolescents and adults

21 with Fetal Alcohol Syndrome and Fetal Alcohol

22 Effect;

23 ‘‘(B) strategies to educate school-age chil24 dren, including pregnant and high risk youth,

25 concerning Fetal Alcohol Syndrome and Fetal

26 Alcohol Effect;
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1 ‘‘(C) public and community awareness pro2 grams concerning Fetal Alcohol Syndrome and

3 Fetal Alcohol Effect; and

4 ‘‘(D) strategies to coordinate information

5 and services across affected community agen6 cies, including agencies providing social services

7 such as foster care, adoption, and social work,

8 medical and mental health services, and agen9 cies involved in education, vocational training

10 and civil and criminal justice;

11 ‘‘(2) a prevention and diagnosis program to

12 support clinical studies, demonstrations and other

13 research as appropriate to—

14 ‘‘(A) develop appropriate medical diag15 nostic methods for identifying Fetal Alcohol

16 Syndrome and Fetal Alcohol Effect; and

17 ‘‘(B) develop effective prevention services

18 and interventions for pregnant, alcohol-depend19 ent women; and

20 ‘‘(3) an applied research program concerning

21 intervention and prevention to support and conduct

22 service demonstration projects, clinical studies and

23 other research models providing advocacy, edu24 cational and vocational training, counseling, medical

25 and mental health, and other supportive services, as
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1 well as models that integrate and coordinate such

2 services, that are aimed at the unique challenges fac3 ing individuals with Fetal Alcohol Syndrome or

4 Fetal Alcohol Effect and their families.

5 ‘‘(b) GRANTS AND TECHNICAL ASSISTANCE.—The

6 Secretary may award grants, cooperative agreements and

7 contracts and provide technical assistance to eligible enti8 ties described in section 399H to carry out subsection (a).

9 ‘‘(c) DISSEMINATION OF CRITERIA.—In carrying out

10 this section, the Secretary shall develop a procedure for

11 disseminating the Fetal Alcohol Syndrome and Fetal Alco12 hol Effect diagnostic criteria developed pursuant to section

13 705 of the ADAMHA Reorganization Act (42 U.S.C. 485n

14 note) to health care providers, educators, social workers,

15 child welfare workers, and other individuals.

16 ‘‘(d) NATIONAL TASK FORCE.—

17 ‘‘(1) IN GENERAL.—The Secretary shall estab18 lish a task force to be known as the National task

19 force on Fetal Alcohol Syndrome and Fetal Alcohol

20 Effect (referred to in this subsection as the ‘task

21 force’) to foster coordination among all govern22 mental agencies, academic bodies and community

23 groups that conduct or support Fetal Alcohol Syn24 drome and Fetal Alcohol Effect research, programs,

25 and surveillance, and otherwise meet the general
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1 needs of populations actually or potentially impacted

2 by Fetal Alcohol Syndrome and Fetal Alcohol Effect.

3 ‘‘(2) MEMBERSHIP.—The Task Force estab4 lished pursuant to paragraph (1) shall—

5 ‘‘(A) be chaired by an individual to be ap6 pointed by the Secretary and staffed by the Ad7 ministration; and

8 ‘‘(B) include the Chairperson of the Inter9 agency Coordinating Committee on Fetal Alco10 hol Syndrome of the Department of Health and

11 Human Services, individuals with Fetal Alcohol

12 Syndrome and Fetal Alcohol Effect, and rep13 resentatives from advocacy and research organi14 zation such as the Research Society on Alcohol15 ism, the FAS Family Resource Institute, the

16 National Organization of Fetal Alcohol Syn17 drome, the Arc, the academic community, and

18 Federal, State and local government agencies

19 and offices.

20 ‘‘(3) FUNCTIONS.—The Task Force shall—

21 ‘‘(A) advise Federal, State and local pro22 grams and research concerning Fetal Alcohol

23 Syndrome and Fetal Alcohol Effect, including

24 programs and research concerning education

25 and public awareness for relevant service pro-
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1 viders, school-age children, women at-risk, and

2 the general public, medical diagnosis, interven3 tions for women at-risk of giving birth to chil4 dren with Fetal Alcohol Syndrome and Fetal

5 Alcohol Effect, and beneficial services for indi6 viduals with Fetal Alcohol Syndrome and Fetal

7 Alcohol Effect and their families;

8 ‘‘(B) coordinate its efforts with the Inter9 agency Coordinating Committee on Fetal Alco10 hol Syndrome of the Department of Health and

11 Human Services; and

12 ‘‘(C) report on a biennial basis to the Sec13 retary and relevant committees of Congress on

14 the current and planned activities of the partici15 pating agencies.

16 ‘‘(4) TIME FOR APPOINTMENT.—The members

17 of the Task Force shall be appointed by the Sec18 retary not later than 6 months after the date of en19 actment of this part.

20 ‘‘SEC. 399H. ELIGIBILITY.

21 ‘‘To be eligible to receive a grant, or enter into a co22 operative agreement or contract under this part, an entity

23 shall—
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1 ‘‘(1) be a State, Indian tribal government, local

2 government, scientific or academic institution, or

3 nonprofit organization; and

4 ‘‘(2) prepare and submit to the Secretary an

5 application at such time, in such manner, and con6 taining such information as the Secretary may pre7 scribe, including a description of the activities that

8 the entity intends to carry out using amounts re9 ceived under this part.

10 ‘‘SEC. 399I. AUTHORIZATION OF APPROPRIATIONS.

11 ‘‘(a) IN GENERAL.—There are authorized to be ap12 propriated to carry out this part, $27,000,000 for each

13 of the fiscal years 1999 through 2003.

14 ‘‘(b) TASK FORCE.—From amounts appropriate for

15 a fiscal year under subsection (a), the Secretary may use

16 not to exceed $2,000,000 of such amounts for the oper17 ations of the National Task Force under section 399G(d).
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1 ‘‘SEC. 399J. SUNSET PROVISION.

2 ‘‘This part shall not apply on the date that is 7 years

3 after the date on which all members of the national task

4 force have been appointed under section 399G(d)(1).’’.

Passed the Senate July 31, 1998.

Attest:

Secretary.
105TH CONGRESS

2D SESSION S. 1754

AN ACT

To amend the Public Health Service Act to consoligrams, and for other purposes. nority and disadvantaged health education pro- date and reauthorize health professions and mi-