Calendar No. 424

105TH CONGRESS

2D SESSION S. 1754

[Report No. 105–220]

A BILL

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 miJUNE 23, 1998

Reported with an amendment
II

Calendar No. 424

105TH CONGRESS

2D SESSION S. 1754

[Report No. 105–220]

To amend the Public Health Service Act to consolidate and reauthorize

health professions and minority and disadvantaged health education programs, and for other purposes.

IN THE SENATE OF THE UNITED STATES

MARCH 12, 1998

Mr. FRIST (for himself, Mr. KENNEDY, Mr. JEFFORDS, Mr. BINGAMAN, Mr.

COCHRAN, Mr. INOUYE, Ms. MIKULSKI, Ms. COLLINS, Mr. FAIRCLOTH,

Mr. SARBANES, and Mr. ENZI) introduced the following bill; which was

read twice and referred to the Committee on Human Resources

JUNE 23, 1998

Reported by Mr. JEFFORDS, with an amendment

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

A BILL

To amend the Public Health Service Act to consolidate and

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

purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,
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1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

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

3 ‘‘Health Professions Education Partnerships Act of

4 1998’’.

5 (b) TABLE OF CONTENTS.—The table of contents of

6 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. Reauthorization.

Sec. 144. HEAL bankruptcy.

Sec. 145. HEAL refinancing.

TITLE II—OFFICE OF MINORITY HEALTH
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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

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. Certain authorities of Centers for Disease Control and Prevention.

Sec. 407. Community programs on domestic violence.

Sec. 408. State loan repayment program.

Sec. 409. Construction of regional centers for research on primates.

Sec. 410. Peer review.

Sec. 411. Funding for trauma care.

Sec. 412. Health information and health promotion.

Sec. 413. Emergency medical services for children.

Sec. 414. Administration of certain requirements.

Sec. 415. Aids drug assistance program.

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:
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1 ‘‘PART B—HEALTH PROFESSIONS TRAINING FOR

2 DIVERSITY

3 ‘‘SEC. 736. CENTERS OF EXCELLENCE.

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

5 to designated health professions schools described in sub6 section (c) for the purpose of assisting the schools in sup7 porting programs of excellence in health professions edu8 cation for under-represented minority individuals.

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

10 may not make a grant under subsection (a) unless the des11 ignated health professions school involved agrees, subject

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

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

14 pool through linkages with institutions of higher

15 education, local school districts, and other commu16 nity-based entities and establish an education pipe17 line for health professions careers;

18 ‘‘(2) to establish, strengthen, or expand pro19 grams to enhance the academic performance of

20 under-represented minority students attending the

21 school;

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

23 train, recruit, and retain under-represented minority

24 faculty including the payment of such stipends and

25 fellowships as the Secretary may determine appro26 priate;
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1 ‘‘(4) to carry out activities to improve the infor2 mation resources, clinical education, curricula and

3 cultural competence of the graduates of the school,

4 as it relates to minority health issues;

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

6 on health issues particularly affecting under-rep7 resented minority groups, including research on

8 issues relating to the delivery of health care; and

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

10 of the school in providing health services to a signifi11 cant number of under-represented minority individ12 uals through training provided to such students at

13 community-based health facilities that—

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

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

16 main site of the teaching facilities of the school.

17 ‘‘(c) CENTERS OF EXCELLENCE.—

18 ‘‘(1) DESIGNATED SCHOOLS.—

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

20 professions schools referred to in subsection (a)

21 are such schools that meet each of the condi22 tions specified in subparagraphs (B) and (C),

23 and that—

24 ‘‘(i) meet each of the conditions speci25 fied in paragraph (2)(A);
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1 ‘‘(ii) meet each of the conditions spec2 ified in paragraph (3);

3 ‘‘(iii) meet each of the conditions

4 specified in paragraph (4); or

5 ‘‘(iv) meet each of the conditions spec6 ified in paragraph (5).

7 ‘‘(B) GENERAL CONDITIONS.—The condi8 tions specified in this subparagraph are that a

9 designated health professions school—

10 ‘‘(i) has a significant number of

11 under-represented minority individuals en12 rolled in the school, including individuals

13 accepted for enrollment in the school;

14 ‘‘(ii) has been effective in assisting

15 under-represented minority students of the

16 school to complete the program of edu17 cation and receive the degree involved;

18 ‘‘(iii) has been effective in recruiting

19 under-represented minority individuals to

20 enroll in and graduate from the school, in21 cluding providing scholarships and other fi22 nancial assistance to such individuals and

23 encouraging under-represented minority

24 students from all levels of the educational
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1 pipeline to pursue health professions ca2 reers; and

3 ‘‘(iv) has made significant recruitment

4 efforts to increase the number of under5 represented minority individuals serving in

6 faculty or administrative positions at the

7 school.

8 ‘‘(C) CONSORTIUM.—The condition speci9 fied in this subparagraph is that, in accordance

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

11 profession school involved has with other health

12 profession schools (designated or otherwise)

13 formed a consortium to carry out the purposes

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

15 consortium.

16 ‘‘(D) APPLICATION OF CRITERIA TO

17 OTHER PROGRAMS.—In the case of any criteria

18 established by the Secretary for purposes of de19 termining whether schools meet the conditions

20 described in subparagraph (B), this section may

21 not, with respect to racial and ethnic minorities,

22 be construed to authorize, require, or prohibit

23 the use of such criteria in any program other

24 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 less than $24,000,000—
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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 exceed

16 $30,000,000, the Secretary shall make avail17 able—

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

19 grants under subsection (a) to health pro20 fessions schools that meet the conditions

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

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

23 grants under subsection (a) to health pro24 fessions schools that meet the conditions

25 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, or al-
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1 lied health, a school offering a graduate pro2 gram in behavioral and mental health practice,

3 or an entity providing programs for the training

4 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) at any health pro3 fessions school, except that such a stipend may

4 not be provided to an individual for more than

5 12 months, and such a stipend shall be in an

6 amount determined appropriate by the Sec7 retary (notwithstanding any other provision of

8 law regarding the amount of stipends);

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) UNDERGRADUATE ASSISTANCE.—For the pur10 pose of grants and contracts under section 739(a)(1),

11 there is authorized to be appropriated $29,400,000 for fis12 cal year 1998, and such sums as may be necessary for

13 each of the fiscal years 1999 through 2002. The Secretary

14 may use not to exceed 20 percent of the amount appro15 priated for a fiscal year under this subsection to provide

16 scholarships under section 739(a)(2)(F).

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

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

19 and submit to the appropriate committees of Congress a

20 report concerning the efforts of the Secretary to address

21 the need for a representative mix of individuals from his22 torically minority health professions schools, or from insti23 tutions or other entities that historically or by geographic

24 location have a demonstrated record of training or educat-
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1 ing underrepresented minorities, within various health

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

3 (b) REPEAL.—

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

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

6 (2) NONTERMINATION OF AUTHORITY.—The

7 amendments made by this section shall not be con8 strued to terminate agreements that, on the day be9 fore the date of enactment of this Act, are in effect

10 pursuant to section 795 of the Public Health Service

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

12 date. Such agreements shall continue in effect in ac13 cordance with the terms of the agreements. With re14 spect to compliance with such agreements, any pe15 riod of practice as a provider of primary health serv16 ices shall be counted towards the satisfaction of the

17 requirement of practice pursuant to such section

18 795.

19 (c) CONFORMING AMENDMENTS.—Section

20 481A(c)(3)(D)(i) of the Public Health Service Act (42

21 U.S.C. 287a–2(c)(3)(D)(i)) is amended by striking ‘‘sec22 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 ‘‘, general internal medicine or gen10 eral pediatrics’’ after ‘‘family medicine’’;

11 (iv) in paragraphs (3) and (4), by in12 serting ‘‘(including geriatrics) after ‘‘fam13 ily medicine’’;

14 (v) in paragraph (3), by striking

15 ‘‘and’’ at the end thereof;

16 (vi) in paragraph (4), by striking the

17 period and inserting a semicolon; and

18 (vii) by adding at the end thereof the

19 following new paragraphs:

20 ‘‘(5) to meet the costs of projects to plan, de21 velop, and operate or maintain programs for the

22 training of physician assistants (as defined in sec23 tion 799B), and for the training of individuals who

24 will teach in programs to provide such training; and
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1 ‘‘(6) to meet the costs of planning, developing,

2 or operating programs, and to provide financial as3 sistance to residents in such programs, of general

4 dentistry or pediatric dentistry.

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

6 grants or contracts shall include entities that have pro7 grams in dental schools, approved residency programs in

8 the general or pediatric practice of dentistry, approved ad9 vanced education programs in the general or pediatric

10 practice of dentistry, or approved residency programs in

11 pediatric dentistry.’’;

12 (C) in subsection (b)—

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

14 inserting ‘‘, general internal medicine, or

15 general pediatrics’’ after ‘‘family medi16 cine’’;

17 (ii) in paragraph (2)—

18 (I) in subparagraph (A), by strik19 ing ‘‘or’’ at the end; and

20 (II) in subparagraph (B), by

21 striking the period and inserting ‘‘;

22 or’’; and

23 (iii) by adding at the end the follow24 ing:
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1 ‘‘(3) PRIORITY IN MAKING AWARDS.—In mak2 ing awards of grants and contracts under paragraph

3 (1), the Secretary shall give priority to any qualified

4 applicant for such an award that proposes a collabo5 rative project between departments of primary

6 care.’’;

7 (D) by redesignating subsections (c) and

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

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

10 following new subsection:

11 ‘‘(c) PRIORITY.—

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

13 for the training of interns or residents, the Secretary

14 shall give priority in awarding grants under this sec15 tion to qualified applicants that have a record of

16 training the greatest percentage of providers, or that

17 have demonstrated significant improvements in the

18 percentage of providers, which enter and remain in

19 primary care practice or general or pediatric den20 tistry.

21 ‘‘(2) DISADVANTAGED INDIVIDUALS.—With re22 spect to programs for the training of interns, resi23 dents, or physician assistants, the Secretary shall

24 give priority in awarding grants under this section

25 to qualified applicants that have a record of training
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1 individuals who are from disadvantaged backgrounds

2 (including racial and ethnic minorities underrep3 resented among primary care practice or general or

4 pediatric dentistry).

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

6 grants under this section the Secretary shall give

7 special consideration to projects which prepare prac8 titioners to care for underserved populations and

9 other high risk groups such as the elderly, individ10 uals with HIV-AIDS, substance abusers, homeless,

11 and victims of domestic violence.’’; and

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

13 by subparagraph (D))—

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

15 ‘‘$54,000,000’’ and all that follows and in16 serting ‘‘$78,300,000 for fiscal year 1998,

17 and such sums as may be necessary for

18 each of the fiscal years 1999 through

19 2002.’’; and

20 (ii) by striking paragraph (2) and in21 serting the following:

22 ‘‘(2) ALLOCATION.—

23 ‘‘(A) IN GENERAL.—Of the amounts ap24 propriated under paragraph (1) for a fiscal

25 year, the Secretary shall make available—
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1 ‘‘(i) not less than $49,300,000 for

2 awards of grants and contracts under sub3 section (a) to programs of family medicine,

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

5 made available for awards of grants and

6 contracts under subsection (b) for family

7 medicine academic administrative units;

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

9 awards of grants and contracts under sub10 section (a) to programs of general internal

11 medicine and general pediatrics;

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

13 awards of grants and contracts under sub14 section (a) to programs relating to physi15 cian assistants; and

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

17 awards of grants and contracts under sub18 section (a) to programs of general or pedi19 atric dentistry.

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

21 appropriated under paragraph (1) for any fiscal

22 year are less than the amount required to com23 ply with subparagraph (A), the Secretary shall

24 ratably reduce the amount to be made available
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1 under each of clauses (i) through (iv) of such

2 subparagraph accordingly.’’; and

3 (4) by repealing sections 748 through 752 (42

4 U.S.C. 293l through 293p) and inserting the follow5 ing:

6 ‘‘SEC. 748. ADVISORY COMMITTEE ON TRAINING IN PRI7 MARY CARE MEDICINE AND DENTISTRY.

8 ‘‘(a) ESTABLISHMENT.—The Secretary shall estab9 lish an advisory committee to be known as the Advisory

10 Committee on Training in Primary Care Medicine and

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

12 Committee’).

13 ‘‘(b) COMPOSITION.—

14 ‘‘(1) IN GENERAL.—The Secretary shall deter15 mine the appropriate number of individuals to serve

16 on the Advisory Committee. Such individuals shall

17 not be officers or employees of the Federal Govern18 ment.

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

20 after the date of enactment of this Act, the Sec21 retary shall appoint the members of the Advisory

22 Committee from among individuals who are health

23 professionals. In making such appointments, the

24 Secretary shall ensure a fair balance between the

25 health professions, that at least 75 percent of the
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1 members of the Advisory Committee are health pro2 fessionals, a broad geographic representation of

3 members and a balance between urban and rural

4 members. Members shall be appointed based on their

5 competence, interest, and knowledge of the mission

6 of the profession involved.

7 ‘‘(3) MINORITY REPRESENTATION.—In appoint8 ing the members of the Advisory Committee under

9 paragraph (2), the Secretary shall ensure the ade10 quate representation of women and minorities.

11 ‘‘(c) TERMS.—

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

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

14 except that of the members first appointed—

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

16 term of 1 year;

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

18 term of 2 years; and

‘‘(C) 1 19 ⁄3 of such members shall serve for a

20 term of 3 years.

21 ‘‘(2) VACANCIES.—

22 ‘‘(A) IN GENERAL.—A vacancy on the Ad23 visory Committee shall be filled in the manner

24 in which the original appointment was made
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1 and shall be subject to any conditions which ap2 plied with respect to the original appointment.

3 ‘‘(B) FILLING UNEXPIRED TERM.—An in4 dividual chosen to fill a vacancy shall be ap5 pointed for the unexpired term of the member

6 replaced.

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

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

9 Secretary concerning policy and program develop10 ment and other matters of significance concerning

11 the activities under section 747; and

12 ‘‘(2) not later than 3 years after the date of en13 actment of this section, and annually thereafter, pre14 pare and submit to the Secretary, and the Commit15 tee on Labor and Human Resources of the Senate,

16 and the Committee on Commerce of the House of

17 Representatives, a report describing the activities of

18 the Committee, including findings and recommenda19 tions made by the Committee concerning the activi20 ties under section 747.

21 ‘‘(e) MEETINGS AND DOCUMENTS.—

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

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

24 meetings shall be held jointly with other related enti25 ties established under this title where appropriate.
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1 ‘‘(2) DOCUMENTS.—Not later than 14 days

2 prior to the convening of a meeting under paragraph

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

4 available an agenda of the matters to be considered

5 by the Advisory Committee at such meeting. At any

6 such meeting, the Advisory Council shall distribute

7 materials with respect to the issues to be addressed

8 at the meeting. Not later than 30 days after the ad9 journing of such a meeting, the Advisory Committee

10 shall prepare and make available a summary of the

11 meeting and any actions taken by the Committee

12 based upon the meeting.

13 ‘‘(f) COMPENSATION AND EXPENSES.—

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

15 Advisory Committee shall be compensated at a rate

16 equal to the daily equivalent of the annual rate of

17 basic pay prescribed for level IV of the Executive

18 Schedule under section 5315 of title 5, United

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

20 during which such member is engaged in the per21 formance of the duties of the Committee.

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

23 Committee shall be allowed travel expenses, includ24 ing per diem in lieu of subsistence, at rates author25 ized for employees of agencies under subchapter I of
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1 chapter 57 of title 5, United States Code, while

2 away from their homes or regular places of business

3 in the performance of services for the Committee.

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

5 shall apply to the Advisory Committee under this section

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

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

8 SEC. 103. INTERDISCIPLINARY, COMMUNITY-BASED LINK9 AGES.

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

11 (42 U.S.C. 294 et seq.) is amended to read as follows:

12 ‘‘PART D—INTERDISCIPLINARY, COMMUNITY13 BASED LINKAGES

14 ‘‘SEC. 750. GENERAL PROVISIONS.

15 ‘‘(a) COLLABORATION.—To be eligible to receive as16 sistance under this part, an academic institution shall use

17 such assistance in collaboration with 2 or more disciplines.

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

19 under this part to carry out innovative demonstration

20 projects for strategic workforce supplementation activities

21 as needed to meet national goals for interdisciplinary,

22 community-based linkages. Such assistance may be used

23 consistent with this part—

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

25 ‘‘(2) for faculty development;
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1 ‘‘(3) for model demonstration programs;

2 ‘‘(4) for the provision of stipends for fellowship

3 trainees;

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

5 ‘‘(6) for other activities that will produce out6 comes consistent with the purposes of this part.

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

8 ‘‘(a) AUTHORITY FOR PROVISION OF FINANCIAL AS9 SISTANCE.—

10 ‘‘(1) ASSISTANCE FOR PLANNING, DEVELOP11 MENT, AND OPERATION OF PROGRAMS.—

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

13 award grants to and enter into contracts with

14 schools of medicine and osteopathic medicine,

15 and incorporated consortia made up of such

16 schools, or the parent institutions of such

17 schools, for projects for the planning, develop18 ment and operation of area health education

19 center programs that—

20 ‘‘(i) improve the recruitment, distribu21 tion, supply, quality and efficiency of per22 sonnel providing health services in under23 served rural and urban areas and person24 nel providing health services to populations
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1 having demonstrated serious unmet health

2 care needs;

3 ‘‘(ii) increase the number of primary

4 care physicians and other primary care

5 providers who provide services in under6 served areas through the offering of an

7 educational continuum of health career re8 cruitment through clinical education con9 cerning underserved areas in a comprehen10 sive health workforce strategy;

11 ‘‘(iii) carry out recruitment and health

12 career awareness programs to recruit indi13 viduals from underserved areas and under14 represented populations, including minority

15 and other elementary or secondary stu16 dents, into the health professions;

17 ‘‘(iv) prepare individuals to more ef18 fectively provide health services to under19 served areas or underserved populations

20 through field placements, preceptorships,

21 the conduct of or support of community22 based primary care residency programs,

23 and agreements with community-based or24 ganizations such as community health cen25 ters, migrant health centers, Indian health
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1 centers, public health departments and

2 others;

3 ‘‘(v) conduct health professions edu4 cation and training activities for students

5 of health professions schools and medical

6 residents;

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

8 medical student required clinical education

9 at sites remote to the primary teaching fa10 cility of the contracting institution; and

11 ‘‘(vii) provide information dissemina12 tion and educational support to reduce pro13 fessional isolation, increase retention,

14 enhance the practice environment, and im15 prove health care through the timely dis16 semination of research findings using rel17 evant resources.

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

19 respect to a State in which no area health edu20 cation center program is in operation, the Sec21 retary may award a grant or contract under

22 subparagraph (A) to a school of nursing.

23 ‘‘(C) PROJECT TERMS.—

24 ‘‘(i) IN GENERAL.—Except as pro25 vided in clause (ii), the period during
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1 which payments may be made under an

2 award under subparagraph (A) may not

3 exceed—

4 ‘‘(I) in the case of a project, 12

5 years or

6 ‘‘(II) in the case of a center with7 in a project, 6 years.

8 ‘‘(ii) EXCEPTION.—The periods de9 scribed in clause (i) shall not apply to

10 projects that have completed the initial pe11 riod of Federal funding under this section

12 and that desire to compete for model

13 awards under paragraph (2)(A).

14 ‘‘(2) ASSISTANCE FOR OPERATION OF MODEL

15 PROGRAMS.—

16 ‘‘(A) IN GENERAL.—In the case of any en17 tity described in paragraph (1)(A) that—

18 ‘‘(i) has previously received funds

19 under this section;

20 ‘‘(ii) is operating an area health edu21 cation center program; and

22 ‘‘(iii) is no longer receiving financial

23 assistance under paragraph (1);

24 the Secretary may provide financial assistance

25 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

11 required 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, an 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) have a degree in internal medicine,

11 family practice, or behavioral or mental health

12 science;

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 ‘‘(c) OBLIGATION OF CERTAIN AMOUNTS.—

7 ‘‘(1) AREA HEALTH EDUCATION CENTER PRO8 GRAMS.—Of the amounts made available under sub9 section (b)(1)(A) for each fiscal year, the Secretary

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

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

12 amounts in fiscal year 1998;

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

14 amounts in fiscal year 1999;

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

16 amounts in fiscal year 2000;

17 ‘‘(D) not less than 40 percent of such

18 amounts in fiscal year 2001; and

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

20 amounts in fiscal year 2002.

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

22 the Congress that—

23 ‘‘(A) every State have an area health edu24 cation center program in effect under this sec25 tion; and
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1 ‘‘(B) the ratio of Federal funding for the

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

3 increase over time and that Federal funding for

4 other awards under this section shall decrease

5 so that the national program will become en6 tirely comprised of programs that are funded at

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

8 SEC. 104. HEALTH PROFESSIONS WORKFORCE INFORMA9 TION AND ANALYSIS.

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

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

12 to read as follows:

13 ‘‘PART E—HEALTH PROFESSIONS AND PUBLIC

14 HEALTH WORKFORCE

15 ‘‘Subpart 1—Health Professions Workforce

16 Information and Analysis

17 ‘‘SEC. 761. HEALTH PROFESSIONS WORKFORCE INFORMA18 TION AND ANALYSIS.

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

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

21 describing the health professions workforce and the

22 analysis of workforce related issues; and

23 ‘‘(2) provide necessary information for decision24 making regarding future directions in health profes-
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1 sions and nursing programs in response to societal

2 and professional needs.

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

4 award grants or contracts to State or local governments,

5 health professions schools, schools of nursing, academic

6 health centers, community-based health facilities, and

7 other appropriate public or private nonprofit entities to

8 provide for—

9 ‘‘(1) targeted information collection and analy10 sis activities related to the purposes described in

11 subsection (a);

12 ‘‘(2) research on high priority workforce ques13 tions;

14 ‘‘(3) the development of a non-Federal analytic

15 and research infrastructure related to the purposes

16 described in subsection (a); and

17 ‘‘(4) the conduct of program evaluation and as18 sessment.

19 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—

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

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

22 fiscal year 1998, and such sums as may be nec23 essary for each of the fiscal years 1999 through

24 2002.
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1 ‘‘(2) RESERVATION.—Of the amounts appro2 priated under subsection (a) for a fiscal year, the

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

4 conducting health professions research and for car5 rying out data collection and analysis in accordance

6 with section 792.

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

8 Amounts otherwise appropriated for programs or ac9 tivities under this title may be used for activities

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

11 activities from which such amounts were made avail12 able.’’.

13 (b) COUNCIL ON GRADUATE MEDICAL EDU14 CATION.—Section 301 of the Health Professions Edu15 cation Extension Amendments of 1992 (Public Law 102-

16 408) is amended—

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

18 inserting ‘‘2002’’;

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

20 inserting ‘‘2002’’;

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

22 new subsection:

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

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

25 the activities of the Council.’’;
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1 (4) by transferring such section to part E of

2 title VII of the Public Health Service Act (as

3 amended by subsection (a));

4 (5) by redesignating such section as section

5 763; and

6 (6) by inserting such section after section 762.

7 SEC. 105. PUBLIC HEALTH WORKFORCE DEVELOPMENT.

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

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

10 at the end the following:

11 ‘‘Subpart 2—Public Health Workforce

12 ‘‘SEC. 765. GENERAL PROVISIONS.

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

14 or contracts to eligible entities to increase the number of

15 individuals in the public health workforce, to enhance the

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

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

18 care needs.

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

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

21 ‘‘(1) be—

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

23 an accredited school or program of public

24 health, health administration, preventive medi-
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1 cine, or dental public health or a school provid2 ing health management programs;

3 ‘‘(B) an academic health center;

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

5 ‘‘(D) any other appropriate public or pri6 vate nonprofit entity; and

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

8 application at such time, in such manner, and con9 taining such information as the Secretary may re10 quire.

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

12 under this section the Secretary may grant a preference

13 to entities—

14 ‘‘(1) serving individuals who are from disadvan15 taged backgrounds (including underrepresented ra16 cial and ethnic minorities); and

17 ‘‘(2) graduating large proportions of individuals

18 who serve in underserved communities.

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

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

21 ‘‘(1) the costs of planning, developing, or oper22 ating demonstration training programs;

23 ‘‘(2) faculty development;

24 ‘‘(3) trainee support;

25 ‘‘(4) technical assistance;
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1 ‘‘(5) to meet the costs of projects—

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

3 training programs and to maintain or improve

4 existing residency training programs in preven5 tive medicine and dental public health, that

6 have available full-time faculty members with

7 training and experience in the fields of preven8 tive medicine and dental public health; and

9 ‘‘(B) to provide financial assistance to resi10 dency trainees enrolled in such programs;

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

12 workers as well as for increasing the supply of new

13 practitioners to address priority public health, pre14 ventive medicine, public health dentistry, and health

15 administration needs;

16 ‘‘(7) preparing public health professionals for

17 employment at the State and community levels; or

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

19 that are consistent with the purposes of this section

20 ‘‘(e) TRAINEESHIPS.—

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

22 used under this section for the training of health

23 professionals, such training programs shall be de24 signed to—
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1 ‘‘(A) make public health education more

2 accessible to the public and private health work3 force;

4 ‘‘(B) increase the relevance of public

5 health academic preparation to public health

6 practice in the future;

7 ‘‘(C) provide education or training for stu8 dents from traditional on-campus programs in

9 practice-based sites; or

10 ‘‘(D) develop educational methods and dis11 tance-based approaches or technology that ad12 dress adult learning requirements and increase

13 knowledge and skills related to community14 based cultural diversity in public health edu15 cation.

16 ‘‘(2) SEVERE SHORTAGE DISCIPLINES.—

17 Amounts provided under grants or contracts under

18 this section may be used for the operation of pro19 grams designed to award traineeships to students in

20 accredited schools of public health who enter edu21 cational programs in fields where there is a severe

22 shortage of public health professionals, including ep23 idemiology, biostatistics, environmental health, toxi24 cology, public health nursing, nutrition, preventive
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1 medicine, maternal and child health, and behavioral

2 and mental health professions.

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

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

5 or contracts for the operation of public health training

6 centers.

7 ‘‘(b) ELIGIBLE ENTITIES.—

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

9 center shall be an accredited school of public health,

10 or another public or nonprofit private institution ac11 credited for the provision of graduate or specialized

12 training in public health, that plans, develops, oper13 ates, and evaluates projects that are in furtherance

14 of the goals established by the Secretary for the year

15 2000 in the areas of preventive medicine, health pro16 motion and disease prevention, or improving access

17 to and quality of health services in medically under18 served communities.

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

20 contracts under this section the Secretary shall give

21 preference to accredited schools of public health.

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

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

24 under subsection (a) unless the program agrees that it—
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1 ‘‘(1) will establish or strengthen field place2 ments for students in public or nonprofit private

3 health agencies or organizations;

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

5 in collaborative projects to enhance public health

6 services to medically underserved communities;

7 ‘‘(3) will specifically designate a geographic

8 area or medically underserved population to be

9 served by the center that shall be in a location re10 moved from the main location of the teaching facility

11 of the school that is participating in the program

12 with such center; and

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

14 the area to be served by the center and assist in the

15 planning and development of training programs to

16 meet such needs.

17 ‘‘SEC. 767. PUBLIC HEALTH TRAINEESHIPS.

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

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

20 or nonprofit private institutions accredited for the provi21 sion of graduate or specialized training in public health,

22 for the purpose of assisting such schools and institutions

23 in providing traineeships to individuals described in sub24 section (b)(3).

25 ‘‘(b) CERTAIN REQUIREMENTS.—
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1 ‘‘(1) AMOUNT.—The amount of any grant

2 under this section shall be determined by the Sec3 retary.

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

5 under grants made under subsection (a) shall pro6 vide for tuition and fees and such stipends and al7 lowances (including travel and subsistence expenses

8 and dependency allowances) for the trainees as the

9 Secretary may deem necessary.

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

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

12 pursuing a course of study in a health professions

13 field in which there is a severe shortage of health

14 professionals (which fields include the fields of epide15 miology, environmental health, biostatistics, toxi16 cology, nutrition, and maternal and child health).

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

18 HEALTH.

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

20 to and enter into contracts with schools of medicine, osteo21 pathic medicine, public health, and dentistry to meet the

22 costs of projects—

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

24 programs and to maintain or improve existing resi-
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1 dency training programs in preventive medicine and

2 dental public health; and

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

4 trainees enrolled in such programs.

5 ‘‘(b) ADMINISTRATION.—

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

7 under subsection (a) shall be determined by the Sec8 retary.

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

10 under subsection (a), the applicant must dem11 onstrate to the Secretary that it has or will have

12 available full-time faculty members with training and

13 experience in the fields of preventive medicine or

14 dental public health and support from other faculty

15 members trained in public health and other relevant

16 specialties and disciplines.

17 ‘‘(3) OTHER FUNDS.—Schools of medicine, os18 teopathic medicine, dentistry, and public health may

19 use funds committed by State, local, or county pub20 lic health officers as matching amounts for Federal

21 grant funds for residency training programs in pre22 ventive medicine.
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1 ‘‘SEC. 769. HEALTH ADMINISTRATION TRAINEESHIPS AND

2 SPECIAL PROJECTS.

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

4 to State or local governments (that have in effect preven5 tive medical and dental public health residency programs)

6 or public or nonprofit private educational entities (includ7 ing graduate schools of social work and business schools

8 that have health management programs) that offer a pro9 gram described in subsection (b)—

10 ‘‘(1) to provide traineeships for students en11 rolled in such a program; and

12 ‘‘(2) to assist accredited programs health ad13 ministration in the development or improvement of

14 programs to prepare students for employment with

15 public or nonprofit private entities.

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

17 to in subsection (a) is an accredited program in health

18 administration, hospital administration, or health policy

19 analysis and planning, which program is accredited by a

20 body or bodies approved for such purpose by the Secretary

21 of Education and which meets such other quality stand22 ards as the Secretary of Health and Human Services by

23 regulation may prescribe.

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

25 grants under subsection (a), the Secretary shall give pref-
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1 erence to qualified applicants that meet the following con2 ditions:

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

4 of the applicant are engaged in full-time practice

5 settings in medically underserved communities.

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

7 from medically underserved communities.

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

9 applicant has established relationships with public

10 and nonprofit providers of health care in the com11 munity involved.

12 ‘‘(4) In training students, the applicant empha13 sizes employment with public or nonprofit private

14 entities.

15 ‘‘(d) CERTAIN PROVISIONS REGARDING

16 TRAINEESHIPS.—

17 ‘‘(1) USE OF GRANT.—Traineeships awarded

18 under grants made under subsection (a) shall pro19 vide for tuition and fees and such stipends and al20 lowances (including travel and subsistence expenses

21 and dependency allowances) for the trainees as the

22 Secretary may deem necessary.

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

24 Each entity applying for a grant under subsection

25 (a) for traineeships shall assure to the satisfaction
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1 of the Secretary that the entity will give priority to

2 awarding the traineeships to students who dem3 onstrate a commitment to employment with public

4 or nonprofit private entities in the fields with respect

5 to which the traineeships are awarded.

6 ‘‘SEC. 770. AUTHORIZATION OF APPROPRIATIONS.

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

8 this subpart, there is authorized to be appropriated

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

10 be necessary for each of the fiscal years 1999 through

11 2002.

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

13 In obligating amounts appropriated under subsection (a),

14 the Secretary may not obligate more than 30 percent for

15 carrying out section 767.’’.

16 SEC. 106. GENERAL PROVISIONS.

17 (a) IN GENERAL.—

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

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

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

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

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

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

24 (i) by striking subsection (b); and
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1 (ii) redesignating subsection (c) as

2 subsection (b);

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

4 295l);

5 (D) by repealing section 798;

6 (E) by redesignating section 799 as section

7 799B; and

8 (F) by inserting after section 794, the fol9 lowing new sections:

10 ‘‘SEC. 796. APPLICATION.

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

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

13 and submit to the Secretary an application that meets the

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

15 and containing such information as the Secretary may re16 quire.

17 ‘‘(b) PLAN.—An application submitted under this

18 section shall contain the plan of the applicant for carrying

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

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

21 regional health professions program plans.

22 ‘‘(c) PERFORMANCE OUTCOME STANDARDS.—An ap23 plication submitted under this section shall contain a spec24 ification by the applicant entity of performance outcome

25 standards that the project to be funded under the grant
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1 or contract will be measured against. Such standards shall

2 address relevant health workforce needs that the project

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

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

5 contract application.

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

7 this section shall contain a description of the linkages with

8 relevant educational and health care entities, including

9 training programs for other health professionals as appro10 priate, that the project to be funded under the grant or

11 contract will establish. To the extent practicable, grantees

12 under this section shall establish linkages with health care

13 providers who provide care for underserved communities

14 and populations.

15 ‘‘SEC. 797. USE OF FUNDS.

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

17 or contract awarded under this title may be used for train18 ing program development and support, faculty develop19 ment, model demonstrations, trainee support including

20 tuition, books, program fees and reasonable living ex21 penses during the period of training, technical assistance,

22 workforce analysis, dissemination of information, and ex23 ploring new policy directions, as appropriate to meet rec24 ognized health workforce objectives, in accordance with

25 this title.
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1 ‘‘(b) MAINTENANCE OF EFFORT.—With respect to

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

3 be expended, the entity shall agree to maintain expendi4 tures of non-Federal amounts for such activities at a level

5 that is not less than the level of such expenditures main6 tained by the entity for the fiscal year preceding the fiscal

7 year for which the entity receives such a grant.

8 ‘‘SEC. 798. MATCHING REQUIREMENT.

9 ‘‘The Secretary may require that an entity that ap10 plies for a grant or contract under this title provide non11 Federal matching funds, as appropriate, to ensure the in12 stitutional commitment of the entity to the projects funded

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

14 non-Federal matching funds may be provided directly or

15 through donations from public or private entities and may

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

17 equipment, or services.

18 ‘‘SEC. 799. GENERALLY APPLICABLE PROVISIONS.

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

20 Secretary shall ensure that grants and contracts under

21 this title are awarded on a competitive basis, as appro22 priate, to carry out innovative demonstration projects or

23 provide for strategic workforce supplementation activities

24 as needed to meet health workforce goals and in accord25 ance with this title. Contracts may be entered into under
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1 this title with public or private entities as may be nec2 essary.

3 ‘‘(b) ELIGIBLE ENTITIES.—Unless specifically re4 quired otherwise in this title, the Secretary shall accept

5 applications for grants or contracts under this title from

6 health professions schools, academic health centers, State

7 or local governments, or other appropriate public or pri8 vate nonprofit entities for funding and participation in

9 health professions and nursing training activities. The

10 Secretary may accept applications from for-profit private

11 entities if determined appropriate by the Secretary.

12 ‘‘(c) INFORMATION REQUIREMENTS.—

13 ‘‘(1) IN GENERAL.—Recipients of grants and

14 contracts under this title shall meet information re15 quirements as specified by the Secretary.

16 ‘‘(2) DATA COLLECTION.—The Secretary shall

17 establish procedures to ensure that, with respect to

18 any data collection required under this title, such

19 data is collected in a manner that takes into account

20 age, gender, race, and ethnicity.

21 ‘‘(3) USE OF FUNDS.—The Secretary shall es22 tablish procedures to permit the use of amounts ap23 propriated under this title to be used for data collec24 tion purposes.
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1 ‘‘(4) EVALUATIONS.—The Secretary shall es2 tablish procedures to ensure the annual evaluation of

3 programs and projects operated by recipients of

4 grants or contracts under this title. Such procedures

5 shall ensure that continued funding for such pro6 grams and projects will be conditioned upon a dem7 onstration that satisfactory progress has been made

8 by the program or project in meeting the objectives

9 of the program or project.

10 ‘‘(d) TRAINING PROGRAMS.—Training programs con11 ducted with amounts received under this title shall meet

12 applicable accreditation and quality standards.

13 ‘‘(e) DURATION OF ASSISTANCE.—

14 ‘‘(1) IN GENERAL.—Subject to paragraph (2),

15 in the case of an award to an entity of a grant, co16 operative agreement, or contract under this title, the

17 period during which payments are made to the en18 tity under the award may not exceed 5 years. The

19 provision of payments under the award shall be sub20 ject to annual approval by the Secretary of the pay21 ments and subject to the availability of appropria22 tions for the fiscal year involved to make the pay23 ments. This paragraph may not be construed as lim24 iting the number of awards under the program in25 volved that may be made to the entity.
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1 ‘‘(2) LIMITATION.—In the case of an award to

2 an entity of a grant, cooperative agreement, or con3 tract under this title, paragraph (1) shall apply only

4 to the extent not inconsistent with any other provi5 sion of this title that relates to the period during

6 which payments may be made under the award.

7 ‘‘(f) PEER REVIEW REGARDING CERTAIN PRO8 GRAMS.—

9 ‘‘(1) IN GENERAL.—Each application for a

10 grant under this title, except any scholarship or loan

11 program, including those under sections 701, 721, or

12 723, shall be submitted to a peer review group for

13 an evaluation of the merits of the proposals made in

14 the application. The Secretary may not approve such

15 an application unless a peer review group has rec16 ommended the application for approval.

17 ‘‘(2) COMPOSITION.—Each peer review group

18 under this subsection shall be composed principally

19 of individuals who are not officers or employees of

20 the Federal Government. In providing for the estab21 lishment of peer review groups and procedures, the

22 Secretary shall ensure gender, racial, ethnic, and ge23 ographic balance among the membership of such

24 groups.
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1 ‘‘(3) ADMINISTRATION.—This subsection shall

2 be carried out by the Secretary acting through the

3 Administrator of the Health Resources and Services

4 Administration.

5 ‘‘(g) PREFERENCE OR PRIORITY CONSIDER6 ATIONS.—In considering a preference or priority for fund7 ing which is based on outcome measures for an eligible

8 entity under this title, the Secretary may also consider the

9 future ability of the eligible entity to meet the outcome

10 preference or priority through improvements in the eligible

11 entity’s program design.

12 ‘‘(h) ANALYTIC ACTIVITIES.—The Secretary shall en13 sure that—

14 ‘‘(1) cross-cutting workforce analytical activities

15 are carried out as part of the workforce information

16 and analysis activities under section 761; and

17 ‘‘(2) discipline-specific workforce information

18 and analytical activities are carried out as part of—

19 ‘‘(A) the community-based linkage pro20 gram under part D; and

21 ‘‘(B) the health workforce development

22 program under subpart 2 of part E.

23 ‘‘(i) OSTEOPATHIC SCHOOLS.—For purposes of this

24 title, any reference to—
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1 ‘‘(1) medical schools shall include osteopathic

2 medical schools; and

3 ‘‘(2) medical students shall include osteopathic

4 medical students.

5 ‘‘SEC. 799A. 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 (b) PROFESSION COUNSELORS AS MENTAL HEALTH

10 PROFESSIONALS.—Section 792(a) of the Public Health

11 Service Act (42 U.S.C. 295k(a)) is amended by inserting

12 ‘‘professional counselors,’’ after ‘‘clinical psychologists,’’.

13 SEC. 107. PREFERENCE IN CERTAIN PROGRAMS.

14 (a) IN GENERAL.—Section 791 of the Public Health

15 Service Act (42 U.S.C. 295j), as amended by section

16 105(a)(2)(B), is further amended by adding at the end

17 thereof the following subsection:

18 ‘‘(c) EXCEPTIONS FOR NEW PROGRAMS.—

19 ‘‘(1) IN GENERAL.—To permit new programs to

20 compete equitably for funding under this section,

21 those new programs that meet at least 4 of the cri22 teria described in paragraph (3) shall qualify for a

23 funding preference under this section.

24 ‘‘(2) DEFINITION.—As used in this subsection,

25 the term ‘new program’ means any program that
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1 has graduated less than three classes. Upon grad2 uating at least three classes, a program shall have

3 the capability to provide the information necessary

4 to qualify the program for the general funding pref5 erences described in subsection (a).

6 ‘‘(3) CRITERIA.—The criteria referred to in

7 paragraph (1) are the following:

8 ‘‘(A) The mission statement of the pro9 gram identifies a specific purpose of the pro10 gram as being the preparation of health profes11 sionals to serve underserved populations.

12 ‘‘(B) The curriculum of the program in13 cludes content which will help to prepare practi14 tioners to serve underserved populations.

15 ‘‘(C) Substantial clinical training experi16 ence is required under the program in medically

17 underserved communities.

18 ‘‘(D) A minimum of 20 percent of the clin19 ical faculty of the program spend at least 50

20 percent of their time providing or supervising

21 care in medically underserved communities.

22 ‘‘(E) The entire program or a substantial

23 portion of the program is physically located in

24 a medically underserved community.
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1 ‘‘(F) Student assistance, which is linked to

2 service in medically underserved communities

3 following graduation, is available to the stu4 dents in the program.

5 ‘‘(G) The program provides a placement

6 mechanism for deploying graduates to medically

7 underserved communities.’’.

8 (b) CONFORMING AMENDMENTS.—Section 791(a) of

9 the Public Health Service Act (42 U.S.C. 295j(a)) is

10 amended—

11 (1) in paragraph (1), by striking ‘‘sections 747’’

12 and all that follows through ‘‘767’’ and inserting

13 ‘‘sections 747 and 750’’; and

14 (2) in paragraph (2), by striking ‘‘under section

15 798(a)’’.

16 SEC. 108. DEFINITIONS.

17 (a) GRADUATE PROGRAM IN BEHAVIORAL AND MEN18 TAL HEALTH PRACTICE.—Section 799B(1)(D) of the

19 Public Health Service Act (42 U.S.C. 295p(1)(D)) (as so

20 redesignated by section 106(a)(2)(E)) is amended—

21 (1) by inserting ‘‘behavioral health and’’ before

22 ‘‘mental’’; and

23 (2) by inserting ‘‘behavioral health and mental

24 health practice,’’ before ‘‘clinical’’.
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1 (b) PROFESSIONAL COUNSELING AS A BEHAVIORAL

2 AND MENTAL HEALTH PRACTICE.—Section 799B of the

3 Public Health Service Act (42 U.S.C. 295p) (as so redes4 ignated by section 106(a)(2)(E)) is amended—

5 (1) in paragraph (1)—

6 (A) in subparagraph (C)—

7 (i) by inserting ‘‘and ‘graduate pro8 gram in professional counseling’ ’’ after

9 ‘‘graduate program in marriage and family

10 therapy’ ’’; and

11 (ii) by inserting before the period the

12 following: ‘‘and a concentration leading to

13 a graduate degree in counseling’’;

14 (B) in subparagraph (D), by inserting

15 ‘‘professional counseling,’’ after ‘‘social work,’’;

16 and

17 (C) in subparagraph (E), by inserting

18 ‘‘professional counseling,’’ after ‘‘social work,’’;

19 and

20 (2) in paragraph (5)(C), by inserting before the

21 period the following: ‘‘or a degree in counseling or

22 an equivalent degree’’.

23 (c) MEDICALLY UNDERSERVED COMMUNITY.—Sec24 tion 799B(6) of the Public Health Service Act (42 U.S.C.
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1 295p(6)) (as so redesignated by section 105(a)(2)(E)) is

2 amended—

3 (1) in subparagraph (B), by striking ‘‘or’’ at

4 the end thereof;

5 (2) in subparagraph (C), by striking the period

6 and inserting ‘‘; or’’; and

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

8 ‘‘(D) is designated by a State Governor (in

9 consultation with the medical community) as a

10 shortage area or medically underserved commu11 nity.’’.

12 (d) PROGRAMS FOR THE TRAINING OF PHYSICIAN

13 ASSISTANTS.—Paragraph (3) of section 799B of the Pub14 lic Health Service Act (42 U.S.C. 295p) (as so redesig15 nated by section 105(a)(2)(E)) is amended to read as fol16 lows:

17 ‘‘(3) The term ‘program for the training of phy18 sician assistants’ means an educational program

19 that—

20 ‘‘(A) has as its objective the education of

21 individuals who will, upon completion of their

22 studies in the program, be qualified to provide

23 primary care under the supervision of a physi24 cian;
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1 ‘‘(B) extends for at least one academic

2 year and consists of—

3 ‘‘(i) supervised clinical practice; and

4 ‘‘(ii) at least four months (in the ag5 gregate) of classroom instruction, directed

6 toward preparing students to deliver health

7 care;

8 ‘‘(C) has an enrollment of not less than

9 eight students; and

10 ‘‘(D) trains students in primary care, dis11 ease prevention, health promotion, geriatric

12 medicine, and home health care.’’.

13 SEC. 109. TECHNICAL AMENDMENT ON NATIONAL HEALTH

14 SERVICE CORPS.

15 Section 338B(b)(1)(B) of the Public Health Service

16 Act (42 U.S.C. 254l–1(b)(1)(B)) is amended by striking

17 ‘‘or other health profession’’ and inserting ‘‘behavioral and

18 mental health, or other health profession’’.

19 SEC. 110. SAVINGS PROVISION.

20 In the case of any authority for making awards of

21 grants or contracts that is terminated by the amendments

22 made by this subtitle, the Secretary of Health and Human

23 Services may, notwithstanding the termination of the au24 thority, continue in effect any grant or contract made

25 under the authority that is in effect on the day before the
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1 date of the enactment of this Act, subject to the duration

2 of any such grant or contract not exceeding the period

3 determined by the Secretary in first approving such finan4 cial assistance, or in approving the most recent request

5 made (before the date of such enactment) for continuation

6 of such assistance, as the case may be.

7 Subtitle B—Nursing Workforce

8 Development

9 SEC. 121. SHORT TITLE.

10 This title may be cited as the ‘‘Nursing Education

11 and Practice Improvement Act of 1998’’.

12 SEC. 122. PURPOSE.

13 It is the purpose of this title to restructure the nurse

14 education authorities of title VIII of the Public Health

15 Service Act to permit a comprehensive, flexible, and effec16 tive approach to Federal support for nursing workforce

17 development.

18 SEC. 123. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.

19 Title VIII of the Public Health Service Act (42

20 U.S.C. 296k et seq.) is amended—

21 (1) by striking the title heading and all that fol22 lows except for subpart II of part B and sections

23 846 and 855; and inserting the following:
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1 ‘‘TITLE VIII—NURSING

2 WORKFORCE DEVELOPMENT’’;

3 (2) in subpart II of part B, by striking the sub4 part heading and inserting the following:

5 ‘‘PART E—STUDENT LOANS’’;

6 (3) by striking section 837;

7 (4) by inserting after the title heading the fol8 lowing new parts:

9 ‘‘PART A—GENERAL PROVISIONS

10 ‘‘SEC. 801. DEFINITIONS.

11 ‘‘As used in this title:

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

13 entities’ means schools of nursing, nursing centers,

14 academic health centers, State or local governments,

15 and other public or private nonprofit entities deter16 mined appropriate by the Secretary that submit to

17 the Secretary an application in accordance with sec18 tion 802.

19 ‘‘(2) SCHOOL OF NURSING.—The term ‘school

20 of nursing’ means a collegiate, associate degree, or

21 diploma school of nursing in a State.

22 ‘‘(3) COLLEGIATE SCHOOL OF NURSING.—The

23 term ‘collegiate school of nursing’ means a depart24 ment, division, or other administrative unit in a col25 lege or university which provides primarily or exclu-
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1 sively a program of education in professional nursing

2 and related subjects leading to the degree of bach3 elor of arts, bachelor of science, bachelor of nursing,

4 or to an equivalent degree, or to a graduate degree

5 in nursing, or to an equivalent degree, and including

6 advanced training related to such program of edu7 cation provided by such school, but only if such pro8 gram, or such unit, college or university is accred9 ited.

10 ‘‘(4) ASSOCIATE DEGREE SCHOOL OF NURS11 ING.—The term ‘associate degree school of nursing’

12 means a department, division, or other administra13 tive unit in a junior college, community college, col14 lege, or university which provides primarily or exclu15 sively a two-year program of education in profes16 sional nursing and allied subjects leading to an asso17 ciate degree in nursing or to an equivalent degree,

18 but only if such program, or such unit, college, or

19 university is accredited.

20 ‘‘(5) DIPLOMA SCHOOL OF NURSING.—The

21 term ‘diploma school of nursing’ means a school af22 filiated with a hospital or university, or an independ23 ent school, which provides primarily or exclusively a

24 program of education in professional nursing and al25 lied subjects leading to a diploma or to equivalent
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1 indicia that such program has been satisfactorily

2 completed, but only if such program, or such affili3 ated school or such hospital or university or such

4 independent school is accredited.

5 ‘‘(6) ACCREDITED.—

6 ‘‘(A) IN GENERAL.—Except as provided in

7 subparagraph (B), the term ‘accredited’ when

8 applied to any program of nurse education

9 means a program accredited by a recognized

10 body or bodies, or by a State agency, approved

11 for such purpose by the Secretary of Education

12 and when applied to a hospital, school, college,

13 or university (or a unit thereof) means a hos14 pital, school, college, or university (or a unit

15 thereof) which is accredited by a recognized

16 body or bodies, or by a State agency, approved

17 for such purpose by the Secretary of Education.

18 For the purpose of this paragraph, the Sec19 retary of Education shall publish a list of recog20 nized accrediting bodies, and of State agencies,

21 which the Secretary of Education determines to

22 be reliable authority as to the quality of edu23 cation offered.

24 ‘‘(B) NEW PROGRAMS.—A new program of

25 nursing that, by reason of an insufficient period
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1 of operation, is not, at the time of the submis2 sion of an application for a grant or contract

3 under this title, eligible for accreditation by

4 such a recognized body or bodies or State agen5 cy, shall be deemed accredited for purposes of

6 this title if the Secretary of Education finds,

7 after consultation with the appropriate accredi8 tation body or bodies, that there is reasonable

9 assurance that the program will meet the ac10 creditation standards of such body or bodies

11 prior to the beginning of the academic year fol12 lowing the normal graduation date of students

13 of the first entering class in such a program.

14 ‘‘(7) NONPROFIT.—The term ‘nonprofit’ as ap15 plied to any school, agency, organization, or institu16 tion means one which is a corporation or association,

17 or is owned and operated by one or more corpora18 tions or associations, no part of the net earnings of

19 which inures, or may lawfully inure, to the benefit

20 of any private shareholder or individual.

21 ‘‘(8) STATE.—The term ‘State’ means a State,

22 the Commonwealth of Puerto Rico, the District of

23 Columbia, the Commonwealth of the Northern Mari24 ana Islands, Guam, American Samoa, the Virgin Is25 lands, or the Trust Territory of the Pacific Islands.
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1 ‘‘SEC. 802. APPLICATION.

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

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

4 and submit to the Secretary an application that meets the

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

6 and containing such information as the Secretary may re7 quire.

8 ‘‘(b) PLAN.—An application submitted under this

9 section shall contain the plan of the applicant for carrying

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

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

12 regional program plans.

13 ‘‘(c) PERFORMANCE OUTCOME STANDARDS.—An ap14 plication submitted under this section shall contain a spec15 ification by the applicant entity of performance outcome

16 standards that the project to be funded under the grant

17 or contract will be measured against. Such standards shall

18 address relevant national nursing needs that the project

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

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

21 contract application.

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

23 this section shall contain a description of the linkages with

24 relevant educational and health care entities, including

25 training programs for other health professionals as appro-
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1 priate, that the project to be funded under the grant or

2 contract will establish.

3 ‘‘SEC. 803. USE OF FUNDS.

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

5 or contract awarded under this title may be used for train6 ing program development and support, faculty develop7 ment, model demonstrations, trainee support including

8 tuition, books, program fees and reasonable living ex9 penses during the period of training, technical assistance,

10 workforce analysis, and dissemination of information, as

11 appropriate to meet recognized nursing objectives, in ac12 cordance with this title.

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

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

15 be expended, the entity shall agree to maintain expendi16 tures of non-Federal amounts for such activities at a level

17 that is not less than the level of such expenditures main18 tained by the entity for the fiscal year preceding the fiscal

19 year for which the entity receives such a grant.

20 ‘‘SEC. 804. MATCHING REQUIREMENT.

21 ‘‘The Secretary may require that an entity that ap22 plies for a grant or contract under this title provide non23 Federal matching funds, as appropriate, to ensure the in24 stitutional commitment of the entity to the projects funded

25 under the grant. Such non-Federal matching funds may
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1 be provided directly or through donations from public or

2 private entities and may be in cash or in-kind, fairly evalu3 ated, including plant, equipment, or services.

4 ‘‘SEC. 805. PREFERENCE.

5 ‘‘In awarding grants or contracts under this title, the

6 Secretary shall give preference to applicants with projects

7 that will substantially benefit rural or underserved popu8 lations, or help meet public health nursing needs in State

9 or local health departments.

10 ‘‘SEC. 806. GENERALLY APPLICABLE PROVISIONS.

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

12 Secretary shall ensure that grants and contracts under

13 this title are awarded on a competitive basis, as appro14 priate, to carry out innovative demonstration projects or

15 provide for strategic workforce supplementation activities

16 as needed to meet national nursing service goals and in

17 accordance with this title. Contracts may be entered into

18 under this title with public or private entities as deter19 mined necessary by the Secretary.

20 ‘‘(b) INFORMATION REQUIREMENTS.—

21 ‘‘(1) IN GENERAL.—Recipients of grants and

22 contracts under this title shall meet information re23 quirements as specified by the Secretary.

24 ‘‘(2) EVALUATIONS.—The Secretary shall es25 tablish procedures to ensure the annual evaluation of
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1 programs and projects operated by recipients of

2 grants under this title. Such procedures shall ensure

3 that continued funding for such programs and

4 projects will be conditioned upon a demonstration

5 that satisfactory progress has been made by the pro6 gram or project in meeting the objectives of the pro7 gram or project.

8 ‘‘(c) TRAINING PROGRAMS.—Training programs con9 ducted with amounts received under this title shall meet

10 applicable accreditation and quality standards.

11 ‘‘(d) DURATION OF ASSISTANCE.—

12 ‘‘(1) IN GENERAL.—Subject to paragraph (2),

13 in the case of an award to an entity of a grant, co14 operative agreement, or contract under this title, the

15 period during which payments are made to the en16 tity under the award may not exceed 5 years. The

17 provision of payments under the award shall be sub18 ject to annual approval by the Secretary of the pay19 ments and subject to the availability of appropria20 tions for the fiscal year involved to make the pay21 ments. This paragraph may not be construed as lim22 iting the number of awards under the program in23 volved that may be made to the entity.

24 ‘‘(2) LIMITATION.—In the case of an award to

25 an entity of a grant, cooperative agreement, or con-
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1 tract under this title, paragraph (1) shall apply only

2 to the extent not inconsistent with any other provi3 sion of this title that relates to the period during

4 which payments may be made under the award.

5 ‘‘(e) PEER REVIEW REGARDING CERTAIN PRO6 GRAMS.—

7 ‘‘(1) IN GENERAL.—Each application for a

8 grant under this title, except advanced nurse

9 traineeship grants under section 811(a)(2), shall be

10 submitted to a peer review group for an evaluation

11 of the merits of the proposals made in the applica12 tion. The Secretary may not approve such an appli13 cation unless a peer review group has recommended

14 the application for approval.

15 ‘‘(2) COMPOSITION.—Each peer review group

16 under this subsection shall be composed principally

17 of individuals who are not officers or employees of

18 the Federal Government. In providing for the estab19 lishment of peer review groups and procedures, the

20 Secretary shall, except as otherwise provided, ensure

21 gender, racial, ethnic, and geographic balance among

22 the membership of such groups.

23 ‘‘(3) ADMINISTRATION.—This subsection shall

24 be carried out by the Secretary acting through the
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1 Administrator of the Health Resources and Services

2 Administration.

3 ‘‘(f) ANALYTIC ACTIVITIES.—The Secretary shall en4 sure that—

5 ‘‘(1) cross-cutting workforce analytical activities

6 are carried out as part of the workforce information

7 and analysis activities under this title; and

8 ‘‘(2) discipline-specific workforce information is

9 developed and analytical activities are carried out as

10 part of—

11 ‘‘(A) the advanced practice nursing activi12 ties under part B;

13 ‘‘(B) the workforce diversity activities

14 under part C; and

15 ‘‘(C) basic nursing education and practice

16 activities under part D.

17 ‘‘(g) STATE AND REGIONAL PRIORITIES.—Activities

18 under grants or contracts under this title shall, to extent

19 practicable, be consistent with related Federal, State, or

20 regional nursing professions program plans and priorities.

21 ‘‘(h) FILING OF APPLICATIONS.—

22 ‘‘(1) IN GENERAL.—Applications for grants or

23 contracts under this title may be submitted by

24 health professions schools, schools of nursing, aca25 demic health centers, State or local governments, or
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1 other appropriate public or private nonprofit entities

2 as determined appropriate by the Secretary in ac3 cordance with this title.

4 ‘‘(2) FOR PROFIT ENTITIES.—Notwithstanding

5 paragraph (1), a for-profit entity may be eligible for

6 a grant or contract under this title as determined

7 appropriated by the Secretary.

8 ‘‘SEC. 807. TECHNICAL ASSISTANCE.

9 ‘‘Funds appropriated under this title may be used by

10 the Secretary to provide technical assistance in relation

11 to any of the authorities under this title.

12 ‘‘PART B—NURSE PRACTITIONERS, NURSE MID13 WIVES, NURSE ANESTHETISTS, AND OTHER

14 ADVANCED PRACTICE NURSES

15 ‘‘SEC. 811. ADVANCED PRACTICE NURSING GRANTS.

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

17 to and enter into contracts with eligible entities to meet

18 the costs of—

19 ‘‘(1) projects that support the enhancement of

20 advanced practice nursing education and practice;

21 and

22 ‘‘(2) traineeships for individuals in advanced

23 practice nursing programs.

24 ‘‘(b) DEFINITION OF ADVANCED PRACTICE

25 NURSES.—For purposes of this section, the term ‘ad-
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1 vanced practice nurses’ means individuals trained in ad2 vanced degree programs including individuals in combined

3 R.N./Master’s degree programs, post-nursing master’s

4 certificate programs, or, in the case of nurse midwives,

5 in certificate programs in existence on the date that is one

6 day prior to the date of enactment of this section, to serve

7 as nurse practitioners, clinical nurse specialists, nurse

8 midwives, nurse anesthetists, nurse educators, nurse ad9 ministrators, or public health nurses, or in other nurse

10 specialties determined by the Secretary to require ad11 vanced education.

12 ‘‘(c) AUTHORIZED NURSE PRACTITIONER AND

13 NURSE-MIDWIFERY PROGRAMS.—Nurse practitioner and

14 nurse midwifery programs eligible for support under this

15 section are educational programs for registered nurses (ir16 respective of the type of school of nursing in which the

17 nurses received their training) that—

18 ‘‘(1) meet guidelines prescribed by the Sec19 retary; and

20 ‘‘(2) have as their objective the education of

21 nurses who will upon completion of their studies in

22 such programs, be qualified to effectively provide

23 primary health care, including primary health care

24 in homes and in ambulatory care facilities, long-term
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1 care facilities, acute care, and other health care set2 tings.

3 ‘‘(d) AUTHORIZED NURSE ANESTHESIA PRO4 GRAMS.—Nurse anesthesia programs eligible for support

5 under this section are education programs that—

6 ‘‘(1) provide registered nurses with full-time an7 esthetist education; and

8 ‘‘(2) are accredited by the Council on Accredita9 tion of Nurse Anesthesia Educational Programs.

10 ‘‘(e) OTHER AUTHORIZED EDUCATIONAL PRO11 GRAMS.—The Secretary shall prescribe guidelines as ap12 propriate for other advanced practice nurse education pro13 grams eligible for support under this section.

14 ‘‘(f) TRAINEESHIPS.—

15 ‘‘(1) IN GENERAL.—The Secretary may not

16 award a grant to an applicant under subsection (a)

17 unless the applicant involved agrees that

18 traineeships provided with the grant will only pay all

19 or part of the costs of—

20 ‘‘(A) the tuition, books, and fees of the

21 program of advanced nursing practice with re22 spect to which the traineeship is provided; and

23 ‘‘(B) the reasonable living expenses of the

24 individual during the period for which the

25 traineeship is provided.
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1 ‘‘(2) DOCTORAL PROGRAMS.—The Secretary

2 may not obligate more than 10 percent of the

3 traineeships under subsection (a) for individuals in

4 doctorate degree programs.

5 ‘‘(3) SPECIAL CONSIDERATION.—In making

6 awards of grants and contracts under subsection

7 (a)(2), the Secretary shall give special consideration

8 to an eligible entity that agrees to expend the award

9 to train advanced practice nurses who will practice

10 in health professional shortage areas designated

11 under section 332.

12 ‘‘PART C—INCREASING NURSING WORKFORCE

13 DIVERSITY

14 ‘‘SEC. 821. WORKFORCE DIVERSITY GRANTS.

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

16 to and enter into contracts with eligible entities to meet

17 the costs of special projects to increase nursing education

18 opportunities for individuals who are from disadvantaged

19 backgrounds (including racial and ethnic minorities under20 represented among registered nurses) by providing stu21 dent scholarships or stipends, pre-entry preparation, and

22 retention activities.

23 ‘‘(b) GUIDANCE.—In carrying out subsection (a), the

24 Secretary shall take into consideration the recommenda25 tions of the First, Second and Third Invitational Con-
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1 gresses for Minority Nurse Leaders on ‘Caring for the

2 Emerging Majority,’ in 1992, 1993 and 1997, and consult

3 with nursing associations including the American Nurses

4 Association, the National League for Nursing, the Amer5 ican Association of Colleges of Nursing, the National

6 Black Nurses Association, the National Association of

7 Hispanic Nurses, the Association of Asian American and

8 Pacific Islander Nurses, the Native American Indian and

9 Alaskan Nurses Association, and the National Council of

10 State Boards of Nursing.

11 ‘‘(c) REQUIRED INFORMATION AND CONDITIONS FOR

12 AWARD RECIPIENTS.—

13 ‘‘(1) IN GENERAL.—Recipients of awards under

14 this section may be required, where requested, to re15 port to the Secretary concerning the annual admis16 sion, retention, and graduation rates for individuals

17 from disadvantaged backgrounds and ethnic and ra18 cial minorities in the school or schools involved in

19 the projects.

20 ‘‘(2) FALLING RATES.—If any of the rates re21 ported under paragraph (1) fall below the average of

22 the two previous years, the grant or contract recipi23 ent shall provide the Secretary with plans for imme24 diately improving such rates.
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1 ‘‘(3) INELIGIBILITY.—A recipient described in

2 paragraph (2) shall be ineligible for continued fund3 ing under this section if the plan of the recipient

4 fails to improve the rates within the 1-year period

5 beginning on the date such plan is implemented.

6 ‘‘PART D—STRENGTHENING CAPACITY FOR

7 BASIC NURSE EDUCATION AND PRACTICE

8 ‘‘SEC. 831. BASIC NURSE EDUCATION AND PRACTICE

9 GRANTS.

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

11 to and enter into contracts with eligible entities for

12 projects to strengthen capacity for basic nurse education

13 and practice.

14 ‘‘(b) PRIORITY AREAS.—In awarding grants or con15 tracts under this section the Secretary shall give priority

16 to entities that will use amounts provided under such a

17 grant or contract to enhance the educational mix and utili18 zation of the basic nursing workforce by strengthening

19 programs that provide basic nurse education, such as

20 through—

21 ‘‘(1) establishing or expanding nursing practice

22 arrangements in noninstitutional settings to dem23 onstrate methods to improve access to primary

24 health care in medically underserved communities;
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1 ‘‘(2) providing care for underserved populations

2 and other high-risk groups such as the elderly, indi3 viduals with HIV-AIDS, substance abusers, the

4 homeless, and victims of domestic violence;

5 ‘‘(3) providing managed care, quality improve6 ment, and other skills needed to practice in existing

7 and emerging organized health care systems;

8 ‘‘(4) developing cultural competencies among

9 nurses;

10 ‘‘(5) expanding the enrollment in baccalaureate

11 nursing programs;

12 ‘‘(6) promoting career mobility for nursing per13 sonnel in a variety of training settings and cross

14 training or specialty training among diverse popu15 lation groups;

16 ‘‘(7) providing education in informatics, includ17 ing distance learning methodologies; or

18 ‘‘(8) other priority areas as determined by the

19 Secretary.’’;

20 (5) by adding at the end the following:

21 ‘‘PART F—AUTHORIZATION OF APPROPRIATIONS

22 ‘‘SEC. 841. AUTHORIZATION OF APPROPRIATIONS.

23 ‘‘There are authorized to be appropriated to carry out

24 sections 811, 821, and 831, $65,000,000 for fiscal year
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1 1998, and such sums as may be necessary in each of the

2 fiscal years 1999 through 2002.

3 ‘‘PART G—NATIONAL ADVISORY COUNCIL ON

4 NURSE EDUCATION AND PRACTICE

5 ‘‘SEC. 845. NATIONAL ADVISORY COUNCIL ON NURSE EDU6 CATION AND PRACTICE.

7 ‘‘(a) ESTABLISHMENT.—The Secretary shall estab8 lish an advisory council to be known as the National Advi9 sory Council on Nurse Education and Practice (in this sec10 tion referred to as the ‘Advisory Council’).

11 ‘‘(b) COMPOSITION.—

12 ‘‘(1) IN GENERAL.—The Advisory Council shall

13 be composed of

14 ‘‘(A) not less than 21, nor more than 23

15 individuals, who are not officers or employees of

16 the Federal Government, appointed by the Sec17 retary without regard to the Federal civil serv18 ice laws, of which—

19 ‘‘(i) 2 shall be selected from full-time

20 students enrolled in schools of nursing;

21 ‘‘(ii) 2 shall be selected from the gen22 eral public;

23 ‘‘(iii) 2 shall be selected from practic24 ing professional nurses; and
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1 ‘‘(iv) 9 shall be selected from among

2 the leading authorities in the various fields

3 of nursing, higher, and secondary edu4 cation, and from representatives of ad5 vanced practice nursing groups (such as

6 nurse practitioners, nurse midwives, and

7 nurse anesthetists), hospitals, and other in8 stitutions and organizations which provide

9 nursing services; and

10 ‘‘(B) the Secretary (or the delegate of the

11 Secretary (who shall be an ex officio member

12 and shall serve as the Chairperson)).

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

14 after the date of enactment of this Act, the Sec15 retary shall appoint the members of the Advisory

16 Council and each such member shall serve a 4 year

17 term. In making such appointments, the Secretary

18 shall ensure a fair balance between the nursing pro19 fessions, a broad geographic representation of mem20 bers and a balance between urban and rural mem21 bers. Members shall be appointed based on their

22 competence, interest, and knowledge of the mission

23 of the profession involved. A majority of the mem24 bers shall be nurses.
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1 ‘‘(3) MINORITY REPRESENTATION.—In appoint2 ing the members of the Advisory Council under

3 paragraph (1), the Secretary shall ensure the ade4 quate representation of minorities.

5 ‘‘(c) VACANCIES.—

6 ‘‘(1) IN GENERAL.—A vacancy on the Advisory

7 Council shall be filled in the manner in which the

8 original appointment was made and shall be subject

9 to any conditions which applied with respect to the

10 original appointment.

11 ‘‘(2) FILLING UNEXPIRED TERM.—An individ12 ual chosen to fill a vacancy shall be appointed for

13 the unexpired term of the member replaced.

14 ‘‘(d) DUTIES.—The Advisory Council shall—

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

16 Secretary and Congress concerning policy matters

17 arising in the administration of this title, including

18 the range of issues relating to the nurse workforce,

19 education, and practice improvement;

20 ‘‘(2) provide advice to the Secretary and Con21 gress in the preparation of general regulations and

22 with respect to policy matters arising in the adminis23 tration of this title, including the range of issues re24 lating to nurse supply, education and practice im25 provement; and
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1 ‘‘(3) not later than 3 years after the date of en2 actment of this section, and annually thereafter, pre3 pare and submit to the Secretary, the Committee on

4 Labor and Human Resources of the Senate, and the

5 Committee on Commerce of the House of Represent6 atives, a report describing the activities of the Coun7 cil, including findings and recommendations made by

8 the Council concerning the activities under this title.

9 ‘‘(e) MEETINGS AND DOCUMENTS.—

10 ‘‘(1) MEETINGS.—The Advisory Council shall

11 meet not less than 2 times each year. Such meetings

12 shall be held jointly with other related entities estab13 lished under this title where appropriate.

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

15 prior to the convening of a meeting under paragraph

16 (1), the Advisory Council shall prepare and make

17 available an agenda of the matters to be considered

18 by the Advisory Council at such meeting. At any

19 such meeting, the Advisory Council shall distribute

20 materials with respect to the issues to be addressed

21 at the meeting. Not later than 30 days after the ad22 journing of such a meeting, the Advisory Council

23 shall prepare and make available a summary of the

24 meeting and any actions taken by the Council based

25 upon the meeting.
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1 ‘‘(f) COMPENSATION AND EXPENSES.—

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

3 Advisory Council shall be compensated at a rate

4 equal to the daily equivalent of the annual rate of

5 basic pay prescribed for level IV of the Executive

6 Schedule under section 5315 of title 5, United

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

8 during which such member is engaged in the per9 formance of the duties of the Council. All members

10 of the Council who are officers or employees of the

11 United States shall serve without compensation in

12 addition to that received for their services as officers

13 or employees of the United States.

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

15 Council shall be allowed travel expenses, including

16 per diem in lieu of subsistence, at rates authorized

17 for employees of agencies under subchapter I of

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

19 away from their homes or regular places of business

20 in the performance of services for the Council.

21 ‘‘(g) FUNDING.—Amounts appropriated under this

22 title may be utilized by the Secretary to support the nurse

23 education and practice activities of the Council.

24 ‘‘(h) FACA.—The Federal Advisory Committee Act

25 shall apply to the Advisory Committee under this section
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1 only to the extent that the provisions of such Act do not

2 conflict with the requirements of this section.’’; and

3 (6) by redesignating section 855 as section 810,

4 and transferring such section so as to appear after

5 section 809 (as added by the amendment made by

6 paragraph (5)).

7 SEC. 124. SAVINGS PROVISION.

8 In the case of any authority for making awards of

9 grants or contracts that is terminated by the amendment

10 made by section 123, the Secretary of Health and Human

11 Services may, notwithstanding the termination of the au12 thority, continue in effect any grant or contract made

13 under the authority that is in effect on the day before the

14 date of the enactment of this Act, subject to the duration

15 of any such grant or contract not exceeding the period

16 determined by the Secretary in first approving such finan17 cial assistance, or in approving the most recent request

18 made (before the date of such enactment) for continuation

19 of such assistance, as the case may be.

20 Subtitle C—Financial Assistance

21 CHAPTER 1—SCHOOL-BASED REVOLVING LOAN

22 FUNDS

23 SEC. 131. PRIMARY CARE LOAN PROGRAM.

24 (a) REQUIREMENT FOR SCHOOLS.—Section

25 723(b)(1) of the Public Health Service Act (42 U.S.C.
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1 292s(b)(1)), as amended by section 2014(c)(2)(A)(ii) of

2 Public Law 103–43 (107 Stat. 216), is amended by strik3 ing ‘‘3 years before’’ and inserting ‘‘4 years before’’.

4 (b) NONCOMPLIANCE.—Section 723(a)(3) of the

5 Public Health Service Act (42 U.S.C. 292s(a)(3)) is

6 amended to read as follows:

7 ‘‘(3) NONCOMPLIANCE BY STUDENT.—Each

8 agreement entered into with a student pursuant to

9 paragraph (1) shall provide that, if the student fails

10 to comply with such agreement, the loan involved

11 will begin to accrue interest at a rate of 18 percent

12 per year beginning on the date of such noncompli13 ance.’’.

14 (c) REPORT REQUIREMENT.—Section 723 of the

15 Public Health Service Act (42 U.S.C. 292s) is amended—

16 (1) by striking subsection (c); and

17 (2) by redesignating subsection (d) as sub18 section (c).

19 SEC. 132. LOANS FOR DISADVANTAGED STUDENTS.

20 (a) AUTHORIZATION OF APPROPRIATIONS.—Section

21 724(f)(1) of the Public Health Service Act (42 U.S.C.

22 292t(f)(1)) is amended by striking ‘‘$15,000,000 for fiscal

23 year 1993’’ and inserting ‘‘$8,000,000 for each of the fis24 cal years 1998 through 2002’’.
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1 (b) REPEAL.—Effective October 1, 2002, paragraph

2 (1) of section 724(f) of the Public Health Service Act (42

3 U.S.C. 292t(f)(1)) is repealed.

4 SEC. 133. STUDENT LOANS REGARDING SCHOOLS OF

5 NURSING.

6 (a) IN GENERAL.—Section 836(b) of the Public

7 Health Service Act (42 U.S.C. 297b(b)) is amended—

8 (1) in paragraph (1), by striking the period at

9 the end and inserting a semicolon;

10 (2) in paragraph (2)—

11 (A) in subparagraph (A), by striking

12 ‘‘and’’ at the end; and

13 (B) by inserting before the semicolon at

14 the end the following: ‘‘, and (C) such addi15 tional periods under the terms of paragraph (8)

16 of this subsection’’;

17 (3) in paragraph (7), by striking the period at

18 the end and inserting ‘‘; and’’; and

19 (4) by adding at the end the following para20 graph:

21 ‘‘(8) pursuant to uniform criteria established by

22 the Secretary, the repayment period established

23 under paragraph (2) for any student borrower who

24 during the repayment period failed to make consecu25 tive payments and who, during the last 12 months
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1 of the repayment period, has made at least 12 con2 secutive payments may be extended for a period not

3 to exceed 10 years.’’.

4 (b) MINIMUM MONTHLY PAYMENTS.—Section 836(g)

5 of the Public Health Service Act (42 U.S.C. 297b(g)) is

6 amended by striking ‘‘$15’’ and inserting ‘‘$40’’.

7 (c) ELIMINATION OF STATUTE OF LIMITATION FOR

8 LOAN COLLECTIONS.—

9 (1) IN GENERAL.—Section 836 of the Public

10 Health Service Act (42 U.S.C. 297b) is amended by

11 adding at the end the following new subsection:

12 ‘‘(l) ELIMINATION OF STATUTE OF LIMITATION FOR

13 LOAN COLLECTIONS.—

14 ‘‘(1) PURPOSE.—It is the purpose of this sub15 section to ensure that obligations to repay loans

16 under this section are enforced without regard to

17 any Federal or State statutory, regulatory, or ad18 ministrative limitation on the period within which

19 debts may be enforced.

20 ‘‘(2) PROHIBITION.—Notwithstanding any other

21 provision of Federal or State law, no limitation shall

22 terminate the period within which suit may be filed,

23 a judgment may be enforced, or an offset, garnish24 ment, or other action may be initiated or taken by

25 a school of nursing that has an agreement with the
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1 Secretary pursuant to section 835 that is seeking

2 the repayment of the amount due from a borrower

3 on a loan made under this subpart after the default

4 of the borrower on such loan.’’.

5 (2) EFFECTIVE DATE.—The amendment made

6 by paragraph (1) shall be effective with respect to

7 actions pending on or after the date of enactment of

8 this Act.

9 (d) BREACH OF AGREEMENTS.—Section 338D of the

10 Public Health Service Act is amended by adding at the

11 end thereof the following new subsection:

12 ‘‘(g) BREACH OF AGREEMENT.—

13 ‘‘(1) IN GENERAL.—In the case of any program

14 under this section under which an individual makes

15 an agreement to provide health services for a period

16 of time in accordance with such program in consid17 eration of receiving an award of Federal funds re18 garding education as a nurse (including an award

19 for the repayment of loans), the following applies if

20 the agreement provides that this subsection is appli21 cable:

22 ‘‘(A) In the case of a program under this

23 section that makes an award of Federal funds

24 for attending an accredited program of nursing

25 (in this section referred to as a ‘nursing pro-
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1 gram’), the individual is liable to the Federal

2 Government for the amount of such award (in3 cluding amounts provided for expenses related

4 to such attendance), and for interest on such

5 amount at the maximum legal prevailing rate,

6 if the individual—

7 ‘‘(i) fails to maintain an acceptable

8 level of academic standing in the nursing

9 program (as indicated by the program in

10 accordance with requirements established

11 by the Secretary);

12 ‘‘(ii) is dismissed from the nursing

13 program for disciplinary reasons; or

14 ‘‘(iii) voluntarily terminates the nurs15 ing program.

16 ‘‘(B) The individual is liable to the Federal

17 Government for the amount of such award (in18 cluding amounts provided for expenses related

19 to such attendance), and for interest on such

20 amount at the maximum legal prevailing rate,

21 if the individual fails to provide health services

22 in accordance with the program under this sec23 tion for the period of time applicable under the

24 program.
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1 ‘‘(2) WAIVER OR SUSPENSION OF LIABILITY.—

2 In the case of an individual or health facility making

3 an agreement for purposes of paragraph (1), the

4 Secretary shall provide for the waiver or suspension

5 of liability under such subsection if compliance by

6 the individual or the health facility, as the case may

7 be, with the agreements involved is impossible, or

8 would involve extreme hardship to the individual or

9 facility, and if enforcement of the agreements with

10 respect to the individual or facility would be uncon11 scionable.

12 ‘‘(3) DATE CERTAIN FOR RECOVERY.—Subject

13 to paragraph (2), any amount that the Federal Gov14 ernment is entitled to recover under paragraph (1)

15 shall be paid to the United States not later than the

16 expiration of the 3-year period beginning on the date

17 the United States becomes so entitled.

18 ‘‘(4) AVAILABILITY.—Amounts recovered under

19 paragraph (1) with respect to a program under this

20 section shall be available for the purposes of such

21 program, and shall remain available for such pur22 poses until expended.’’.

23 (e) TECHNICAL AMENDMENTS.—Section 839 of the

24 Public Health Service Act (42 U.S.C. 297e) is amended—

25 (1) in subsection (a)—
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1 (A) by striking the matter preceding para2 graph (1) and inserting the following:

3 ‘‘(a) If a school terminates a loan fund established

4 under an agreement pursuant to section 835(b), or if the

5 Secretary for good cause terminates the agreement with

6 the school, there shall be a capital distribution as fol7 lows:’’; and

8 (B) in paragraph (1), by striking ‘‘at the

9 close of September 30, 1999,’’ and inserting

10 ‘‘on the date of termination of the fund’’; and

11 (2) in subsection (b), to read as follows:

12 ‘‘(b) If a capital distribution is made under sub13 section (a), the school involved shall, after such capital dis14 tribution, pay to the Secretary, not less often than quar15 terly, the same proportionate share of amounts received

16 by the school in payment of principal or interest on loans

17 made from the loan fund established under section 835(b)

18 as determined by the Secretary under subsection (a).’’.

19 SEC. 134. GENERAL PROVISIONS.

20 (a) MAXIMUM STUDENT LOAN PROVISIONS AND

21 MINIMUM PAYMENTS.—

22 (1) IN GENERAL.—Section 722(a)(1) of the

23 Public Health Service Act (42 U.S.C. 292r(a)(1)),

24 as amended by section 2014(b)(1) of Public Law

25 103–43, is amended by striking ‘‘the sum of’’ and
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1 all that follows through the end thereof and insert2 ing ‘‘the cost of attendance (including tuition, other

3 reasonable educational expenses, and reasonable liv4 ing costs) for that year at the educational institution

5 attended by the student (as determined by such edu6 cational institution).’’.

7 (2) THIRD AND FOURTH YEARS.—Section

8 722(a)(2) of the Public Health Service Act (42

9 U.S.C. 292r(a)(2)), as amended by section

10 2014(b)(1) of Public Law 103–43, is amended by

11 striking ‘‘the amount $2,500’’ and all that follows

12 through ‘‘including such $2,500’’ and inserting ‘‘the

13 amount of the loan may, in the case of the third or

14 fourth year of a student at a school of medicine or

15 osteopathic medicine, be increased to the extent nec16 essary’’.

17 (3) REPAYMENT PERIOD.—Section 722(c) of

18 the Public Health Service Act (42 U.S.C. 292r(c)),

19 as amended by section 2014(b)(1) of Public Law

20 103–43, is amended—

21 (A) in the subsection heading by striking

22 ‘‘TEN-YEAR’’ and inserting ‘‘REPAYMENT’’;

23 (B) by striking ‘‘ten-year period which be24 gins’’ and inserting ‘‘period of not less than 10
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1 years nor more than 25 years, at the discretion

2 of the institution, which begins’’; and

3 (C) by striking ‘‘such ten-year period’’ and

4 inserting ‘‘such period’’.

5 (4) MINIMUM PAYMENTS.—Section 722(j) of

6 the Public Health Service Act (42 U.S.C. 292r(j)),

7 as amended by section 2014(b)(1) of Public Law

8 103–43, is amended by striking ‘‘$15’’ and inserting

9 $40’’.

10 (b) ELIMINATION OF STATUTE OF LIMITATION FOR

11 LOAN COLLECTIONS.—

12 (1) IN GENERAL.—Section 722 of the Public

13 Health Service Act (42 U.S.C. 292r), as amended by

14 section 2014(b)(1) of Public Law 103–43, is amend15 ed by adding at the end the following new sub16 section:

17 ‘‘(m) ELIMINATION OF STATUTE OF LIMITATION FOR

18 LOAN COLLECTIONS.—

19 ‘‘(1) PURPOSE.—It is the purpose of this sub20 section to ensure that obligations to repay loans

21 under this section are enforced without regard to

22 any Federal or State statutory, regulatory, or ad23 ministrative limitation on the period within which

24 debts may be enforced.
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1 ‘‘(2) PROHIBITION.—Notwithstanding any other

2 provision of Federal or State law, no limitation shall

3 terminate the period within which suit may be filed,

4 a judgment may be enforced, or an offset, garnish5 ment, or other action may be initiated or taken by

6 a school that has an agreement with the Secretary

7 pursuant to section 721 that is seeking the repay8 ment of the amount due from a borrower on a loan

9 made under this subpart after the default of the bor10 rower on such loan.’’.

11 (2) EFFECTIVE DATE.—The amendment made

12 by paragraph (1) shall be effective with respect to

13 actions pending on or after the date of enactment of

14 this Act.

15 (c) DATE CERTAIN FOR CONTRIBUTIONS.—Para16 graph (2) of section 735(e) of the Public Health Service

17 Act (42 U.S.C. 292y(e)(2)) is amended to read as follows:

18 ‘‘(2) DATE CERTAIN FOR CONTRIBUTIONS.—

19 Amounts described in paragraph (1) that are re20 turned to the Secretary shall be obligated before the

21 end of the succeeding fiscal year.’’.
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1 CHAPTER 2—INSURED HEALTH EDUCATION

2 ASSISTANCE LOANS TO GRADUATE STUDENTS

3 SEC. 141. HEALTH EDUCATION ASSISTANCE LOAN PRO4 GRAM.

5 (a) HEALTH EDUCATION ASSISTANCE LOAN

6 DEFERMENT FOR BORROWERS PROVIDING HEALTH

7 SERVICES TO INDIANS.—

8 (1) IN GENERAL.—Section 705(a)(2)(C) of the

9 Public Health Service Act (42 U.S.C.

10 292d(a)(2)(C)) is amended by striking ‘‘and (x)’’

11 and inserting ‘‘(x) not in excess of three years, dur12 ing which the borrower is providing health care serv13 ices to Indians through an Indian health program

14 (as defined in section 108(a)(2)(A) of the Indian

15 Health Care Improvement Act (25 U.S.C.

16 1616a(a)(2)(A)); and (xi)’’.

17 (2) CONFORMING AMENDMENTS.—Section

18 705(a)(2)(C) of the Public Health Service Act (42

19 U.S.C. 292d(a)(2)(C)) is further amended—

20 (A) in clause (xi) (as so redesignated) by

21 striking ‘‘(ix)’’ and inserting ‘‘(x)’’; and

22 (B) in the matter following such clause

23 (xi), by striking ‘‘(x)’’ and inserting ‘‘(xi)’’.

24 (3) EFFECTIVE DATE.—The amendments made

25 by this subsection shall apply with respect to serv26 ices provided on or after the first day of the third
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1 month that begins after the date of the enactment

2 of this Act.

3 (b) REPORT REQUIREMENT.—Section 709(b) of the

4 Public Health Service Act (42 U.S.C. 292h(b)) is

5 amended—

6 (1) in paragraph (4)(B), by adding ‘‘and’’ after

7 the semicolon;

8 (2) in paragraph (5), by striking ‘‘; and’’ and

9 inserting a period; and

10 (3) by striking paragraph (6).

11 (c) COLLECTION FROM ESTATES.—Section 714 of

12 the Public Health Service Act (42 U.S.C. 292m) is amend13 ed by adding at the end the following new sentence: ‘‘Not14 withstanding the first sentence, the Secretary may, in the

15 case of a borrower who dies, collect any remaining unpaid

16 balance owed to the lender, the holder of the loan, or the

17 Federal Government from the borrower’s estate.’’.

18 (d) PROGRAM ELIGIBILITY.—

19 (1) LIMITATIONS ON LOANS.—Section 703(a) of

20 the Public Health Service Act (42 U.S.C. 292b(a))

21 is amended by striking ‘‘or clinical psychology’’ and

22 inserting ‘‘or behavioral and mental health practice,

23 including clinical psychology’’.

24 (2) DEFINITION OF ELIGIBLE INSTITUTION.—

25 Section 719(1) of the Public Health Service Act (42
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1 U.S.C. 292o(1)) is amended by striking ‘‘or clinical

2 psychology’’ and inserting ‘‘or behavioral and mental

3 health practice, including clinical psychology’’.

4 SEC. 142. HEAL LENDER AND HOLDER PERFORMANCE

5 STANDARDS.

6 (a) GENERAL AMENDMENTS.—Section 707(a) of the

7 Public Health Service Act (42 U.S.C. 292f) is amended—

8 (1) by striking the last sentence;

9 (2) by striking ‘‘determined.’’ and inserting

10 ‘‘determined, except that, if the insurance bene11 ficiary including any servicer of the loan is not des12 ignated for ‘exceptional performance’, as set forth in

13 paragraph (2), the Secretary shall pay to the bene14 ficiary a sum equal to 98 percent of the amount of

15 the loss sustained by the insured upon that loan.’’;

16 (3) by striking ‘‘Upon’’ and inserting:

17 ‘‘(1) IN GENERAL.—Upon’’; and

18 (4) by adding at the end the following new

19 paragraph:

20 ‘‘(2) EXCEPTIONAL PERFORMANCE.—

21 ‘‘(A) AUTHORITY.—Where the Secretary

22 determines that an eligible lender, holder, or

23 servicer has a compliance performance rating

24 that equals or exceeds 97 percent, the Secretary

25 shall designate that eligible lender, holder, or
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1 servicer, as the case may be, for exceptional

2 performance.

3 ‘‘(B) COMPLIANCE PERFORMANCE RAT4 ING.—For purposes of subparagraph (A), a

5 compliance performance rating is determined

6 with respect to compliance with due diligence in

7 the disbursement, servicing, and collection of

8 loans under this subpart for each year for

9 which the determination is made. Such rating

10 shall be equal to the percentage of all due dili11 gence requirements applicable to each loan, on

12 average, as established by the Secretary, with

13 respect to loans serviced during the period by

14 the eligible lender, holder, or servicer.

15 ‘‘(C) ANNUAL AUDITS FOR LENDERS,

16 HOLDERS, AND SERVICERS.—Each eligible lend17 er, holder, or servicer desiring a designation

18 under subparagraph (A) shall have an annual

19 financial and compliance audit conducted with

20 respect to the loan portfolio of such eligible

21 lender, holder, or servicer, by a qualified inde22 pendent organization from a list of qualified or23 ganizations identified by the Secretary and in

24 accordance with standards established by the

25 Secretary. The standards shall measure the
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1 lender’s, holder’s, or servicer’s compliance with

2 due diligence standards and shall include a de3 fined statistical sampling technique designed to

4 measure the performance rating of the eligible

5 lender, holder, or servicer for the purpose of

6 this section. Each eligible lender, holder, or

7 servicer shall submit the audit required by this

8 section to the Secretary.

9 ‘‘(D) SECRETARY’S DETERMINATIONS.—

10 The Secretary shall make the determination

11 under subparagraph (A) based upon the audits

12 submitted under this paragraph and any infor13 mation in the possession of the Secretary or

14 submitted by any other agency or office of the

15 Federal Government.

16 ‘‘(E) QUARTERLY COMPLIANCE AUDIT.—

17 To maintain its status as an exceptional per18 former, the lender, holder, or servicer shall un19 dergo a quarterly compliance audit at the end

20 of each quarter (other than the quarter in

21 which status as an exceptional performer is es22 tablished through a financial and compliance

23 audit, as described in subparagraph (C)), and

24 submit the results of such audit to the Sec25 retary. The compliance audit shall review com-
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1 pliance with due diligence requirements for the

2 period beginning on the day after the ending

3 date of the previous audit, in accordance with

4 standards determined by the Secretary.

5 ‘‘(F) REVOCATION AUTHORITY.—The Sec6 retary shall revoke the designation of a lender,

7 holder, or servicer under subparagraph (A) if

8 any quarterly audit required under subpara9 graph (E) is not received by the Secretary by

10 the date established by the Secretary or if the

11 audit indicates the lender, holder, or servicer

12 has failed to meet the standards for designation

13 as an exceptional performer under subpara14 graph (A). A lender, holder, or servicer receiv15 ing a compliance audit not meeting the stand16 ard for designation as an exceptional performer

17 may reapply for designation under subpara18 graph (A) at any time.

19 ‘‘(G) DOCUMENTATION.—Nothing in this

20 section shall restrict or limit the authority of

21 the Secretary to require the submission of

22 claims documentation evidencing servicing per23 formed on loans, except that the Secretary may

24 not require exceptional performers to submit

25 greater documentation than that required for
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1 lenders, holders, and servicers not designated

2 under subparagraph (A).

3 ‘‘(H) COST OF AUDITS.—Each eligible

4 lender, holder, or servicer shall pay for all the

5 costs associated with the audits required under

6 this section.

7 ‘‘(I) ADDITIONAL REVOCATION AUTHOR8 ITY.—Notwithstanding any other provision of

9 this section, a designation under subparagraph

10 (A) may be revoked at any time by the Sec11 retary if the Secretary determines that the eligi12 ble lender, holder, or servicer has failed to

13 maintain an overall level of compliance consist14 ent with the audit submitted by the eligible

15 lender, holder, or servicer under this paragraph

16 or if the Secretary asserts that the lender, hold17 er, or servicer may have engaged in fraud in se18 curing designation under subparagraph (A) or

19 is failing to service loans in accordance with

20 program requirements.

21 ‘‘(J) NONCOMPLIANCE.—A lender, holder,

22 or servicer designated under subparagraph (A)

23 that fails to service loans or otherwise comply

24 with applicable program regulations shall be
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1 considered in violation of the Federal False

2 Claims Act.’’.

3 (b) DEFINITION.—Section 707(e) of the Public

4 Health Service Act (42 U.S.C. 292f(e)) is amended by

5 adding at the end the following new paragraph:

6 ‘‘(4) The term ‘servicer’ means any agency act7 ing on behalf of the insurance beneficiary.’’.

8 (c) EFFECTIVE DATE.—The amendments made by

9 subsections (a) and (b) shall apply with respect to loans

10 submitted to the Secretary for payment on or after the

11 first day of the sixth month that begins after the date

12 of enactment of this Act.

13 SEC. 143. REAUTHORIZATION.

14 (a) LOAN PROGRAM.—Section 702(a) of the Public

15 Health Service Act (42 U.S.C. 292a(a)) is amended—

16 (1) by striking ‘‘$350,000,000’’ and all that fol17 lows through ‘‘1995’’ and inserting ‘‘$350,000,000

18 for fiscal year 1998, $375,000,000 for fiscal year

19 1999, and $425,000,000 for each of the fiscal years

20 2000 through 2002’’;

21 (2) by striking ‘‘obtained prior loans insured

22 under this subpart’’ and inserting ‘‘obtained loans

23 insured under this subpart in fiscal year 2002 or in

24 prior fiscal years’’;
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1 (3) by adding at the end thereof the following

2 new sentence: ‘‘The Secretary may establish guide3 lines and procedures that lenders must follow in dis4 tributing funds under this subpart.’’; and

5 (4) by striking ‘‘September 30, 1998’’ and in6 serting ‘‘September 30, 2005’’.

7 (b) INSURANCE PROGRAM.—Section 710(a)(2)(B) of

8 the Public Health Service Act (42 U.S.C. 292i(a)(2)(B))

9 is amended by striking ‘‘any of the fiscal years 1993

10 through 1996’’ and inserting ‘‘fiscal year 1993 and subse11 quent fiscal years’’.

12 SEC. 144. HEAL BANKRUPTCY.

13 (a) IN GENERAL.—Section 707(g) of the Public

14 Health Service Act (42 U.S.C. 292f(g)) is amended in the

15 first sentence by striking ‘‘A debt which is a loan insured’’

16 and inserting ‘‘Notwithstanding any other provision of

17 Federal or State law, a debt that is a loan insured’’.

18 (b) APPLICATION.—The amendment made by sub19 section (a) shall apply to any loan insured under the au20 thority of subpart I of part A of title VII of the Public

21 Health Service Act (42 U.S.C. 292 et seq.) that is listed

22 or scheduled by the debtor in a case under title XI, United

23 States Code, filed—

24 (1) on or after the date of enactment of this

25 Act; or
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1 (2) prior to such date of enactment in which a

2 discharge has not been granted.

3 SEC. 145. HEAL REFINANCING.

4 Section 706 of the Public Health Service Act (42

5 U.S.C. 292e) is amended—

6 (1) in subsection (d)—

7 (A) in the subsection heading, by striking

8 ‘‘CONSOLIDATION’’ and inserting ‘‘REFINANC9 ING OR CONSOLIDATION’’; and

10 (B) in the first sentence, by striking ‘‘in11 debtedness’’ and inserting ‘‘indebtedness or the

12 refinancing of a single loan’’; and

13 (2) in subsection (e)—

14 (A) in the subsection heading, by striking

15 ‘‘DEBTS’’ and inserting ‘‘DEBTS AND REFI16 NANCING’’;

17 (B) in the first sentence, by striking ‘‘all

18 of the borrower’s debts into a single instru19 ment’’ and inserting ‘‘all of the borrower’s loans

20 insured under this subpart into a single instru21 ment (or, if the borrower obtained only 1 loan

22 insured under this subpart, refinancing the loan

23 1 time)’’; and
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1 (C) in the second sentence, by striking

2 ‘‘consolidation’’ and inserting ‘‘consolidation or

3 refinancing’’.

4 TITLE II—OFFICE OF MINORITY

5 HEALTH

6 SEC. 201. REVISION AND EXTENSION OF PROGRAMS OF OF7 FICE OF MINORITY HEALTH.

8 (a) DUTIES AND REQUIREMENTS.—Section 1707 of

9 the Public Health Service Act (42 U.S.C. 300u–6) is

10 amended by striking subsection (b) and all that follows

11 and inserting the following:

12 ‘‘(b) DUTIES.—With respect to improving the health

13 of racial and ethnic minority groups, the Secretary, acting

14 through the Deputy Assistant Secretary for Minority

15 Health (in this section referred to as the ‘Deputy Assist16 ant Secretary’), shall carry out the following:

17 ‘‘(1) Establish short-range and long-range goals

18 and objectives and coordinate all other activities

19 within the Public Health Service that relate to dis20 ease prevention, health promotion, service delivery,

21 and research concerning such individuals. The heads

22 of each of the agencies of the Service shall consult

23 with the Deputy Assistant Secretary to ensure the

24 coordination of such activities.
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1 ‘‘(2) Enter into interagency agreements with

2 other agencies of the Public Health Service.

3 ‘‘(3) Support research, demonstrations and

4 evaluations to test new and innovative models.

5 ‘‘(4) Increase knowledge and understanding of

6 health risk factors.

7 ‘‘(5) Develop mechanisms that support better

8 information dissemination, education, prevention,

9 and service delivery to individuals from disadvan10 taged backgrounds, including individuals who are

11 members of racial or ethnic minority groups.

12 ‘‘(6) Ensure that the National Center for

13 Health Statistics collects data on the health status

14 of each minority group.

15 ‘‘(7) With respect to individuals who lack pro16 ficiency in speaking the English language, enter into

17 contracts with public and nonprofit private providers

18 of primary health services for the purpose of increas19 ing the access of the individuals to such services by

20 developing and carrying out programs to provide bi21 lingual or interpretive services.

22 ‘‘(8) Support a national minority health re23 source center to carry out the following:

24 ‘‘(A) Facilitate the exchange of informa25 tion regarding matters relating to health infor-
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1 mation and health promotion, preventive health

2 services, and education in the appropriate use

3 of health care.

4 ‘‘(B) Facilitate access to such information.

5 ‘‘(C) Assist in the analysis of issues and

6 problems relating to such matters.

7 ‘‘(D) Provide technical assistance with re8 spect to the exchange of such information (in9 cluding facilitating the development of materials

10 for such technical assistance).

11 ‘‘(9) Carry out programs to improve access to

12 health care services for individuals with limited pro13 ficiency in speaking the English language. Activities

14 under the preceding sentence shall include develop15 ing and evaluating model projects.

16 ‘‘(c) ADVISORY COMMITTEE.—

17 ‘‘(1) IN GENERAL.—The Secretary shall estab18 lish an advisory committee to be known as the Advi19 sory Committee on Minority Health (in this sub20 section referred to as the ‘Committee’).

21 ‘‘(2) DUTIES.—The Committee shall provide

22 advice to the Deputy Assistant Secretary carrying

23 out this section, including advice on the development

24 of goals and specific program activities under para-
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1 graphs (1) through (9) of subsection (b) for each ra2 cial and ethnic minority group.

3 ‘‘(3) CHAIR.—The chairperson of the Commit4 tee shall be selected by the Secretary from among

5 the members of the voting members of the Commit6 tee. The term of office of the chairperson shall be

7 2 years.

8 ‘‘(4) COMPOSITION.—

9 ‘‘(A) The Committee shall be composed of

10 12 voting members appointed in accordance

11 with subparagraph (B), and nonvoting, ex offi12 cio members designated in subparagraph (C).

13 ‘‘(B) The voting members of the Commit14 tee shall be appointed by the Secretary from

15 among individuals who are not officers or em16 ployees of the Federal Government and who

17 have expertise regarding issues of minority

18 health. The racial and ethnic minority groups

19 shall be equally represented among such mem20 bers.

21 ‘‘(C) The nonvoting, ex officio members of

22 the Committee shall be such officials of the De23 partment of Health and Human Services as the

24 Secretary determines to be appropriate.
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1 ‘‘(5) TERMS.—Each member of the Committee

2 shall serve for a term of 4 years, except that the

3 Secretary shall initially appoint a portion of the

4 members to terms of 1 year, 2 years, and 3 years.

5 ‘‘(6) VACANCIES.—If a vacancy occurs on the

6 Committee, a new member shall be appointed by the

7 Secretary within 90 days from the date that the va8 cancy occurs, and serve for the remainder of the

9 term for which the predecessor of such member was

10 appointed. The vacancy shall not affect the power of

11 the remaining members to execute the duties of the

12 Committee.

13 ‘‘(7) COMPENSATION.—Members of the Com14 mittee who are officers or employees of the United

15 States shall serve without compensation. Members of

16 the Committee who are not officers or employees of

17 the United States shall receive compensation, for

18 each day (including travel time) they are engaged in

19 the performance of the functions of the Committee.

20 Such compensation may not be in an amount in ex21 cess of the daily equivalent of the annual maximum

22 rate of basic pay payable under the General Sched23 ule (under title 5, United States Code) for positions

24 above GS–15.
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1 ‘‘(d) CERTAIN REQUIREMENTS REGARDING DU2 TIES.—

3 ‘‘(1) RECOMMENDATIONS REGARDING LAN4 GUAGE AS IMPEDIMENT TO HEALTH CARE.—The

5 Deputy Assistant Secretary for Minority Health

6 shall consult with the Director of the Office of Refu7 gee Health, the Director of the Office of Civil

8 Rights, and the Directors of other appropriate De9 partmental entities regarding recommendations for

10 carrying out activities under subsection (b)(9).

11 ‘‘(2) EQUITABLE ALLOCATION REGARDING AC12 TIVITIES.—

13 ‘‘(A) IN GENERAL.—In making awards of

14 grants, cooperative agreements, or contracts

15 under this section or section 338A, 338C,

16 340A, 404, or 724, or part B of title VII, the

17 Secretary, acting as appropriate through the

18 Deputy Assistant Secretary or the Adminis19 trator of the Health Resources and Services Ad20 ministration, shall ensure that such awards are

21 equitably allocated with respect to the various

22 racial and minority populations.

23 ‘‘(B) REQUIREMENTS.—With respect to

24 grants, cooperative agreements, and contracts
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1 that are available under the sections specified in

2 subparagraph (A), the Secretary shall—

3 ‘‘(i) carry out activities to inform enti4 ties, as appropriate, that the entities may

5 be eligible for awards of such assistance;

6 ‘‘(ii) provide technical assistance to

7 such entities in the process of preparing

8 and submitting applications for the awards

9 in accordance with the policies of the Sec10 retary regarding such application; and

11 ‘‘(iii) inform populations, as appro12 priate, that members of the populations

13 may be eligible to receive services or other14 wise participate in the activities carried out

15 with such awards.

16 ‘‘(3) CULTURAL COMPETENCY OF SERVICES.—

17 The Secretary shall ensure that information and

18 services provided pursuant to subsection (b) are pro19 vided in the language, educational, and cultural con20 text that is most appropriate for the individuals for

21 whom the information and services are intended.

22 ‘‘(e) GRANTS AND CONTRACTS REGARDING DU23 TIES.—

24 ‘‘(1) IN GENERAL.—In carrying out subsection

25 (b), the Secretary acting through the Deputy Assist-
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1 ant Secretary may make awards of grants, coopera2 tive agreements, and contracts to public and non3 profit private entities.

4 ‘‘(2) PROCESS FOR MAKING AWARDS.—The

5 Deputy Assistant Secretary shall ensure that awards

6 under paragraph (1) are made only on a competitive

7 basis, and that a grant is awarded for a proposal

8 only if the proposal has been recommended for such

9 an award through a process of peer review.

10 ‘‘(3) EVALUATION AND DISSEMINATION.—The

11 Deputy Assistant Secretary, directly or through con12 tracts with public and private entities, shall provide

13 for evaluations of projects carried out with awards

14 made under paragraph (1) during the preceding 2

15 fiscal years. The report shall be included in the re16 port required under subsection (f) for the fiscal year

17 involved.

18 ‘‘(f) REPORTS.—

19 ‘‘(1) IN GENERAL.—Not later than February 1

20 of fiscal year 1999 and of each second year there21 after, the Secretary shall submit to the Committee

22 on Energy and Commerce of the House of Rep23 resentatives, and to the Committee on Labor and

24 Human Resources of the Senate, a report describing

25 the activities carried out under this section during
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1 the preceding 2 fiscal years and evaluating the ex2 tent to which such activities have been effective in

3 improving the health of racial and ethnic minority

4 groups. Each such report shall include the biennial

5 reports submitted under sections 201(e)(3) and

6 201(f)(2) for such years by the heads of the Public

7 Health Service agencies.

8 ‘‘(2) AGENCY REPORTS.—Not later than Feb9 ruary 1, 1999, and biennially thereafter, the heads

10 of the Public Health Service agencies shall submit to

11 the Deputy Assistant Secretary a report summariz12 ing the minority health activities of each of the re13 spective agencies.

14 ‘‘(g) DEFINITION.—For purposes of this section:

15 ‘‘(1) The term ‘racial and ethnic minority

16 group’ means American Indians (including Alaska

17 Natives, Eskimos, and Aleuts); Asian Americans and

18 Pacific Islanders; Blacks; and Hispanics.

19 ‘‘(2) The term ‘Hispanic’ means individuals

20 whose origin is Mexican, Puerto Rican, Cuban, Cen21 tral or South American, or any other Spanish-speak22 ing country.

23 ‘‘(h) FUNDING.—

24 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—

25 For the purpose of carrying out this section, there
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1 are authorized to be appropriated $30,000,000 for

2 fiscal year 1998, such sums as may be necessary for

3 each of the fiscal years 1999 through 2002.

4 ‘‘(2) NATIONAL CENTER FOR HEALTH STATIS5 TICS.—For the purpose of enabling the National

6 Center for Health Statistics to collect data on His7 panics and major Hispanic subpopulation groups,

8 American Indians, and to develop special area popu9 lation studies on major Asian American and Pacific

10 Islander populations, there are authorized to be ap11 propriated $1,000,000 for fiscal year 1998, such

12 sums as may be necessary for each of the fiscal

13 years 1999 through 2002.’’.

14 (b) MISCELLANEOUS AMENDMENTS.—Section 1707

15 of the Public Health Service Act (42 U.S.C. 300u–6) is

16 amended—

17 (1) in the heading for the section by striking

18 ‘‘ESTABLISHMENT OF’’; and

19 (2) in subsection (a), by striking ‘‘Office of the

20 Assistant Secretary for Health’’ and inserting ‘‘Of21 fice of Public Health and Science’’.
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1 TITLE III—SELECTED

2 INITIATIVES

3 SEC. 301. STATE OFFICES OF RURAL HEALTH.

4 (a) IN GENERAL.—Section 338J of the Public Health

5 Service Act (42 U.S.C. 254r) is amended—

6 (1) in subsection (b)(1), in the matter preced7 ing subparagraph (A), by striking ‘‘in cash’’; and

8 (2) in subsection (j)(1)—

9 (A) by striking ‘‘and’’ after ‘‘1992,’’; and

10 (B) by inserting before the period the fol11 lowing: ‘‘, and such sums as may be necessary

12 for each of the fiscal years 1998 through

13 2002’’; and

14 (3) in subsection (k), by striking

15 ‘‘$10,000,000’’ and inserting ‘‘$20,000,000’’.

16 (b) REPEAL.—Effective on October 1, 2002, section

17 338J of the Public Health Service Act is repealed.

18 SEC. 302. DEMONSTRATION PROJECTS REGARDING ALZ19 HEIMER’S DISEASE.

20 (a) IN GENERAL.—Section 398(a) of the Public

21 Health Service Act (42 U.S.C. 280c–3(a)) is amended—

22 (1) in the matter preceding paragraph (1), by

23 striking ‘‘not less than 5, and not more than 15,’’;

24 (2) in paragraph (2)—
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1 (A) by inserting after ‘‘disorders’’ the fol2 lowing: ‘‘who are living in single family homes

3 or in congregate settings’’; and

4 (B) by striking ‘‘and’’ at the end;

5 (3) by redesignating paragraph (3) as para6 graph (4); and

7 (4) by inserting after paragraph (2) the follow8 ing:

9 ‘‘(3) to improve the access of such individuals

10 to home-based or community-based long-term care

11 services (subject to the services being provided by

12 entities that were providing such services in the

13 State involved as of October 1, 1995), particularly

14 such individuals who are members of racial or ethnic

15 minority groups, who have limited proficiency in

16 speaking the English language, or who live in rural

17 areas; and’’.

18 (b) DURATION.—Section 398A of the Public Health

19 Service Act (42 U.S.C. 280c–4) is amended—

20 (1) in the heading for the section, by striking

21 ‘‘LIMITATION’’ and all that follows and inserting

22 ‘‘REQUIREMENT OF MATCHING

23 FUNDS’’;

24 (2) by striking subsection (a);
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1 (3) by redesignating subsections (b) and (c) as

2 subsections (a) and (b), respectively;

3 (4) in subsection (a) (as so redesignated), in

4 each of paragraphs (1)(C) and (2)(C), by striking

5 ‘‘third year’’ and inserting ‘‘third or subsequent

6 year’’.

7 (c) AUTHORIZATION OF APPROPRIATIONS.—Section

8 398B(e) of the Public Health Service Act (42 U.S.C.

9 280c–5(e)) is amended—

10 (1) by striking ‘‘and such sums’’ and inserting

11 ‘‘such sums’’; and

12 (2) by inserting before the period the following:

13 ‘‘, $8,000,000 for fiscal year 1998, and such sums

14 as may be necessary for each of the fiscal years

15 1999 through 2002’’.

16 SEC. 303. PROJECT GRANTS FOR IMMUNIZATION SERVICES.

17 Section 317(j) of the Public Health Service Act (42

18 U.S.C. 247b(j)) is amended—

19 (1) in paragraph (1), by striking ‘‘individuals

20 against vaccine-preventable diseases’’ and all that

21 follows through the first period and inserting the fol22 lowing: ‘‘children, adolescents, and adults against

23 vaccine-preventable diseases, there are authorized to

24 be appropriated such sums as may be necessary for

25 each of the fiscal years 1998 through 2002.’’; and
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1 (2) in paragraph (2), by striking ‘‘1990’’ and

2 inserting ‘‘1997’’.

3 TITLE IV—MISCELLANEOUS

4 PROVISIONS

5 SEC. 401. TECHNICAL CORRECTIONS REGARDING PUBLIC

6 LAW 103–183.

7 (a) AMENDATORY INSTRUCTIONS.—Public Law 103–

8 183 is amended—

9 (1) in section 601—

10 (A) in subsection (b), in the matter preced11 ing paragraph (1), by striking ‘‘Section 1201 of

12 the Public Health Service Act (42 U.S.C.

13 300d)’’ and inserting ‘‘Title XII of the Public

14 Health Service Act (42 U.S.C. 300d et seq.)’’;

15 and

16 (B) in subsection (f)(1), by striking ‘‘in

17 section 1204(c)’’ and inserting ‘‘in section

18 1203(c) (as redesignated by subsection (b)(2) of

19 this section)’’;

20 (2) in section 602, by striking ‘‘for the pur21 pose’’ and inserting ‘‘For the purpose’’; and

22 (3) in section 705(b), by striking ‘‘317D((l)(1)’’

23 and inserting ‘‘317D(l)(1)’’.
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1 (b) PUBLIC HEALTH SERVICE ACT.—The Public

2 Health Service Act, as amended by Public Law 103–183

3 and by subsection (a) of this section, is amended—

4 (1) in section 317E(g)(2), by striking ‘‘making

5 grants under subsection (b)’’ and inserting ‘‘carrying

6 out subsection (b)’’;

7 (2) in section 318, in subsection (e) as in effect

8 on the day before the date of the enactment of Pub9 lic Law 103–183, by redesignating the subsection as

10 subsection (f);

11 (3) in subpart 6 of part C of title IV—

12 (A) by transferring the first section 447

13 (added by section 302 of Public Law 103–183)

14 from the current placement of the section;

15 (B) by redesignating the section as section

16 447A; and

17 (C) by inserting the section after section

18 447;

19 (4) in section 1213(a)(8), by striking ‘‘provides

20 for for’’ and inserting ‘‘provides for’’;

21 (5) in section 1501, by redesignating the second

22 subsection (c) (added by section 101(f) of Public

23 Law 103–183) as subsection (d); and

24 (6) in section 1505(3), by striking ‘‘nonprivate’’

25 and inserting ‘‘private’’.
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1 (c) MISCELLANEOUS CORRECTION.—Section

2 401(c)(3) of Public Law 103–183 is amended in the mat3 ter preceding subparagraph (A) by striking ‘‘(d)(5)’’ and

4 inserting ‘‘(e)(5)’’.

5 (d) EFFECTIVE DATE.—This section is deemed to

6 have taken effect immediately after the enactment of Pub7 lic Law 103–183.

8 SEC. 402. MISCELLANEOUS AMENDMENTS REGARDING PHS

9 COMMISSIONED OFFICERS.

10 (a) ANTI-DISCRIMINATION LAWS.—Amend section

11 212 of the Public Health Service Act (42 U.S.C. 213) by

12 adding the following new subsection at the end thereof:

13 ‘‘(f) Active service of commissioned officers of the

14 Service shall be deemed to be active military service in

15 the Armed Forces of the United States for purposes of

16 all laws related to discrimination on the basis of race,

17 color, gender, ethnicity, age, religion, and disability.’’

18 (b) TRAINING IN LEAVE WITHOUT PAY STATUS.—

19 Section 218 of the Public Health Service Act (42 U.S.C.

20 218a) is amended by adding at the end the following:

21 ‘‘(c) A commissioned officer may be placed in leave

22 without pay status while attending an educational institu23 tion or training program whenever the Secretary deter24 mines that such status is in the best interest of the Serv25 ice. For purposes of computation of basic pay, promotion,
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1 retirement, compensation for injury or death, and the ben2 efits provided by sections 212 and 224, an officer in such

3 status pursuant to the preceding sentence shall be consid4 ered as performing service in the Service and shall have

5 an active service obligation as set forth in subsection (b)

6 of this section.’’.

7 (c) UTILIZATION OF ALCOHOL AND DRUG ABUSE

8 RECORDS THAT APPLY TO THE ARMED FORCES.—Sec9 tion 543(e) of the Public Health Service Act (42 U.S.C.

10 290dd–2(e)) is amended by striking ‘‘Armed Forces’’ each

11 place that such term appears and inserting ‘‘Uniformed

12 Services’’.

13 SEC. 403. CLINICAL TRAINEESHIPS.

14 Section 303(d)(1) of the Public Health Service Act

15 (42 U.S.C. 242a(d)(1)) is amended by inserting ‘‘counsel16 ing,’’ after ‘‘family therapy,’’.

17 SEC. 404. PROJECT GRANTS FOR SCREENINGS, REFERRALS,

18 AND EDUCATION REGARDING LEAD POISON19 ING.

20 Section 317A(l)(1) of the Public Health Service Act

21 (42 U.S.C. 247b–1(l)(1)) is amended by striking ‘‘1998’’

22 and inserting ‘‘2004’’.
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1 SEC. 405. PROJECT GRANTS FOR PREVENTIVE HEALTH

2 SERVICES REGARDING TUBERCULOSIS.

3 Section 317E(g)(1) of the Public Health Service Act

4 (42 U.S.C. 247b–6(g)(1)) is amended—

5 (1) in subparagraph (A), by striking ‘‘1998’’

6 and inserting ‘‘2004’’; and

7 (2) in subparagraph (B), by striking

8 ‘‘$50,000,000’’ and inserting ‘‘25 percent’’.

9 SEC. 406. CERTAIN AUTHORITIES OF CENTERS FOR DIS10 EASE CONTROL AND PREVENTION.

11 (a) IN GENERAL.—Part B of title III of the Public

12 Health Service Act is amended by inserting after section

13 317H the following section:

14 ‘‘MISCELLANEOUS AUTHORITIES REGARDING CENTERS

15 FOR DISEASE CONTROL AND PREVENTION

16 ‘‘SEC. 317I. The Secretary, acting through the Direc17 tor of the Centers for Disease Control and Prevention,

18 may, without regard to the provisions of title 5, United

19 States Code, governing appointments in the competitive

20 service, and without regard to the provisions of chapter

21 51 and subchapter III of chapter 53 of such title relating

22 to classification and General Schedule pay rates, establish

23 such technical and scientific peer review groups and sci24 entific program advisory committees as are needed to

25 carry out the functions of such Centers and appoint and

26 pay the members of such groups, except that officers and
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1 employees of the United States shall not receive additional

2 compensation for service as members of such groups. The

3 Federal Advisory Committee Act shall not apply to the

4 duration of such peer review groups. Not more than one5 fourth of the members of any such group shall be officers

6 or employees of the United States.’’.

7 (b) EFFECTIVE DATE.—This section is deemed to

8 have taken effect July 1, 1995.

9 SEC. 407. COMMUNITY PROGRAMS ON DOMESTIC VIO10 LENCE.

11 (a) IN GENERAL.—Section 318(h)(2) of the Family

12 Violence Prevention and Services Act (42 U.S.C.

13 10418(h)(2)) is amended by striking ‘‘fiscal year 1997’’

14 and inserting ‘‘for each of the fiscal years 1997 through

15 2002’’.

16 (b) STUDY.—The Secretary of Health and Human

17 Services shall request that the Institute of Medicine con18 duct a study concerning the training needs of health pro19 fessionals with respect to the detection and referral of vic20 tims of family or acquaintance violence. Not later than 2

21 years after the date of enactment of this Act, the Institute

22 of Medicine shall prepare and submit to Congress a report

23 concerning the study conducted under this subsection.
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1 SEC. 408. STATE LOAN REPAYMENT PROGRAM.

2 Section 338I(i)(1) of the Public Health Service Act

3 (42 U.S.C. 254q–1(i)(1)) is amended by inserting before

4 the period ‘‘, and such sums as may be necessary for each

5 of the fiscal years 1998 through 2002’’.

6 SEC. 409. CONSTRUCTION OF REGIONAL CENTERS FOR RE7 SEARCH ON PRIMATES.

8 Section 481B(a) of the Public Health Service Act (42

9 U.S.C. 287a–3(a)) is amended—

10 (1) by striking ‘‘shall’’ and inserting ‘‘may’’;

11 and

12 (2) by striking ‘‘$5,000,000’’ and inserting ‘‘up

13 to $2,500,000’’.

14 SEC. 410. PEER REVIEW.

15 Section 504(d)(2) of the Public Health Service Act

16 (42 U.S.C. 290aa–3(d)(2)) is amended by striking ‘‘coop17 erative agreement, or contract’’ each place that such ap18 pears and inserting ‘‘or cooperative agreement’’.

19 SEC. 411. FUNDING FOR TRAUMA CARE.

20 Section 1232(a) of the Public Health Service Act (42

21 U.S.C. 300d–32) is amended by striking ‘‘and 1996’’ and

22 inserting ‘‘through 2002’’.
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1 SEC. 412. HEALTH INFORMATION AND HEALTH PRO2 MOTION.

3 Section 1701(b) of the Public Health Service Act (42

4 U.S.C. 300u(b)) is amended by striking ‘‘through 1996’’

5 and inserting ‘‘through 2002’’.

6 SEC. 413. EMERGENCY MEDICAL SERVICES FOR CHILDREN.

7 Section 1910 of the Public Health Service Act (42

8 U.S.C. 300w–9) is amended—

9 (1) in subsection (a)—

10 (A) by striking ‘‘two-year period’’ and in11 serting ‘‘3-year period (with an optional 4th

12 year based on performance)’’; and

13 (B) by striking ‘‘one grant’’ and inserting

14 ‘‘3 grants’’; and

15 (2) in subsection (d), by striking ‘‘1997’’ and

16 inserting ‘‘2005’’.

17 SEC. 414. ADMINISTRATION OF CERTAIN REQUIREMENTS.

18 (a) IN GENERAL.—Section 2004 of Public Law 103–

19 43 (107 Stat. 209) is amended by striking subsection (a).

20 (b) CONFORMING AMENDMENTS.—Section 2004 of

21 Public Law 103–43, as amended by subsection (a) of this

22 section, is amended—

23 (1) by striking ‘‘(b) SENSE’’ and all that follows

24 through ‘‘In the case’’ and inserting the following:
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1 ‘‘(a) SENSE OF CONGRESS REGARDING PURCHASE

2 OF AMERICAN-MADE EQUIPMENT AND PRODUCTS.—In

3 the case’’;

4 (2) by striking ‘‘(2) NOTICE TO RECIPIENTS OF

5 ASSISTANCE’’ and inserting the following:

6 ‘‘(b) NOTICE TO RECIPIENTS OF ASSISTANCE’’; and

7 (3) in subsection (b), as redesignated by para8 graph (2) of this subsection, by striking ‘‘paragraph

9 (1)’’ and inserting ‘‘subsection (a)’’.

10 (c) EFFECTIVE DATE.—This section is deemed to

11 have taken effect immediately after the enactment of Pub12 lic Law 103–43.

13 SEC. 415. AIDS DRUG ASSISTANCE PROGRAM.

14 Section 2618(b)(3) of the Public Health Service Act

15 (42 U.S.C. 300ff–28(b)(3)) is amended—

16 (1) in paragraph (1), by striking ‘‘and the

17 Commonwealth of Puerto Rico’’ and inserting ‘‘, the

18 Commonwealth of Puerto Rico, the Virgin Islands,

19 and Guam’’; and

20 (2) in paragraph (2), by striking ‘‘the Virgin Is21 lands, Guam’’.

22 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

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

24 ‘‘Health Professions Education Partnerships Act of 1998’’.
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1 (b) TABLE OF CONTENTS.—The table of contents of this

2 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. Reauthorization.

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.
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TITLE IV—MISCELLANEOUS PROVISIONS

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.

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 to

10 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 purpose

2 of assisting the schools in supporting programs of excellence

3 in health professions education for under-represented mi4 nority individuals.

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

6 not make a grant under subsection (a) unless the designated

7 health professions school involved agrees, subject to sub8 section (c)(1)(C), to expend the grant—

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

10 pool through linkages with institutions of higher edu11 cation, local school districts, and other community12 based entities and establish an education pipeline for

13 health professions careers;

14 ‘‘(2) to establish, strengthen, or expand programs

15 to enhance the academic performance of under-rep16 resented minority students attending the school;

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

18 train, recruit, and retain under-represented minority

19 faculty including the payment of such stipends and

20 fellowships as the Secretary may determine appro21 priate;

22 ‘‘(4) to carry out activities to improve the infor23 mation resources, clinical education, curricula and

24 cultural competence of the graduates of the school, as

25 it relates to minority health issues;
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1 ‘‘(5) to facilitate faculty and student research on

2 health issues particularly affecting under-represented

3 minority groups, including research on issues relating

4 to the delivery of health care;

5 ‘‘(6) to carry out a program to train students of

6 the school in providing health services to a significant

7 number of under-represented minority individuals

8 through training provided to such students at commu9 nity-based health facilities that—

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

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

12 main site of the teaching facilities of the school;

13 and

14 ‘‘(7) to provide stipends as the Secretary deter15 mines appropriate, in amounts as the Secretary de16 termines appropriate.

17 ‘‘(c) CENTERS OF EXCELLENCE.—

18 ‘‘(1) DESIGNATED SCHOOLS.—

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

20 professions schools referred to in subsection (a)

21 are such schools that meet each of the conditions

22 specified in subparagraphs (B) and (C), and

23 that—

24 ‘‘(i) meet each of the conditions speci25 fied in paragraph (2)(A);
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1 ‘‘(ii) meet each of the conditions speci2 fied in paragraph (3);

3 ‘‘(iii) meet each of the conditions speci4 fied in paragraph (4); or

5 ‘‘(iv) meet each of the conditions speci6 fied in paragraph (5).

7 ‘‘(B) GENERAL CONDITIONS.—The condi8 tions specified in this subparagraph are that a

9 designated health professions school—

10 ‘‘(i) has a significant number of under11 represented minority individuals enrolled in

12 the school, including individuals accepted

13 for enrollment in the school;

14 ‘‘(ii) has been effective in assisting

15 under-represented minority students of the

16 school to complete the program of education

17 and receive the degree involved;

18 ‘‘(iii) has been effective in recruiting

19 under-represented minority individuals to

20 enroll in and graduate from the school, in21 cluding providing scholarships and other fi22 nancial assistance to such individuals and

23 encouraging under-represented minority

24 students from all levels of the educational
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1 pipeline to pursue health professions ca2 reers; and

3 ‘‘(iv) has made significant recruitment

4 efforts to increase the number of under-rep5 resented minority individuals serving in

6 faculty or administrative positions at the

7 school.

8 ‘‘(C) CONSORTIUM.—The condition specified

9 in this subparagraph is that, in accordance with

10 subsection (e)(1), the designated health profession

11 school involved has with other health profession

12 schools (designated or otherwise) formed a con13 sortium to carry out the purposes described in

14 subsection (b) at the schools of the consortium.

15 ‘‘(D) APPLICATION OF CRITERIA TO OTHER

16 PROGRAMS.—In the case of any criteria estab17 lished by the Secretary for purposes of determin18 ing whether schools meet the conditions described

19 in subparagraph (B), this section may not, with

20 respect to racial and ethnic minorities, be con21 strued to authorize, require, or prohibit the use

22 of such criteria in any program other than the

23 program established in this section.

24 ‘‘(2) CENTERS OF EXCELLENCE AT CERTAIN HIS25 TORICALLY BLACK COLLEGES AND UNIVERSITIES.—
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1 ‘‘(A) CONDITIONS.—The conditions specified

2 in this subparagraph are that a designated

3 health professions school—

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

5 799B(1); and

6 ‘‘(ii) received a contract under section

7 788B for fiscal year 1987, as such section

8 was in effect for such fiscal year.

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

10 purposes described in subsection (b), a grant

11 under subsection (a) to a designated health pro12 fessions school meeting the conditions described

13 in subparagraph (A) may be expended—

14 ‘‘(i) to develop a plan to achieve insti15 tutional improvements, including financial

16 independence, to enable the school to sup17 port programs of excellence in health profes18 sions education for under-represented mi19 nority individuals; and

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

21 library and informational resources of the

22 school.

23 ‘‘(C) EXCEPTION.—The requirements of

24 paragraph (1)(C) shall not apply to a histori-
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1 cally black college or university that receives

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

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

4 conditions specified in this paragraph are that—

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

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

7 (1)(B) applies to the designated health profes8 sions school involved;

9 ‘‘(B) the school agrees, as a condition of re10 ceiving a grant under subsection (a), that the

11 school will, in carrying out the duties described

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

13 the duties with respect to Hispanic individuals;

14 and

15 ‘‘(C) the school agrees, as a condition of re16 ceiving a grant under subsection (a), that—

17 ‘‘(i) the school will establish an ar18 rangement with 1 or more public or non19 profit community based Hispanic serving

20 organizations, or public or nonprofit pri21 vate institutions of higher education, in22 cluding schools of nursing, whose enrollment

23 of students has traditionally included a sig24 nificant number of Hispanic individuals,
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1 the purposes of which will be to carry out

2 a program—

3 ‘‘(I) to identify Hispanic students

4 who are interested in a career in the

5 health profession involved; and

6 ‘‘(II) to facilitate the educational

7 preparation of such students to enter

8 the health professions school; and

9 ‘‘(ii) the school will make efforts to re10 cruit Hispanic students, including students

11 who have participated in the undergraduate

12 or other matriculation program carried out

13 under arrangements established by the

14 school pursuant to clause (i)(II) and will

15 assist Hispanic students regarding the com16 pletion of the educational requirements for

17 a degree from the school.

18 ‘‘(4) NATIVE AMERICAN CENTERS OF EXCEL19 LENCE.—Subject to subsection (e), the conditions spec20 ified in this paragraph are that—

21 ‘‘(A) with respect to Native Americans, each

22 of clauses (i) through (iv) of paragraph (1)(B)

23 applies to the designated health professions

24 school involved;
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1 ‘‘(B) the school agrees, as a condition of re2 ceiving a grant under subsection (a), that the

3 school will, in carrying out the duties described

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

5 the duties with respect to Native Americans; and

6 ‘‘(C) the school agrees, as a condition of re7 ceiving a grant under subsection (a), that—

8 ‘‘(i) the school will establish an ar9 rangement with 1 or more public or non10 profit private institutions of higher edu11 cation, including schools of nursing, whose

12 enrollment of students has traditionally in13 cluded a significant number of Native

14 Americans, the purpose of which arrange15 ment will be to carry out a program—

16 ‘‘(I) to identify Native American

17 students, from the institutions of high18 er education referred to in clause (i),

19 who are interested in health professions

20 careers; and

21 ‘‘(II) to facilitate the educational

22 preparation of such students to enter

23 the designated health professions school;

24 and
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1 ‘‘(ii) the designated health professions

2 school will make efforts to recruit Native

3 American students, including students who

4 have participated in the undergraduate pro5 gram carried out under arrangements estab6 lished by the school pursuant to clause (i)

7 and will assist Native American students

8 regarding the completion of the educational

9 requirements for a degree from the des10 ignated health professions school.

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

12 conditions specified in this paragraph are—

13 ‘‘(A) with respect to other centers of excel14 lence, the conditions described in clauses (i)

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

16 ‘‘(B) that the health professions school in17 volved has an enrollment of under-represented

18 minorities above the national average for such

19 enrollments of health professions schools.

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

21 ‘‘(1) IN GENERAL.—Any designated health pro22 fessions school receiving a grant under subsection (a)

23 and meeting the conditions described in paragraph

24 (2) or (5) of subsection (c) shall, for purposes of this

25 section, be designated by the Secretary as a Center of
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1 Excellence in Under-Represented Minority Health

2 Professions Education.

3 ‘‘(2) HISPANIC CENTERS OF EXCELLENCE.—Any

4 designated health professions school receiving a grant

5 under subsection (a) and meeting the conditions de6 scribed in subsection (c)(3) shall, for purposes of this

7 section, be designated by the Secretary as a Hispanic

8 Center of Excellence in Health Professions Education.

9 ‘‘(3) NATIVE AMERICAN CENTERS OF EXCEL10 LENCE.—Any designated health professions school re11 ceiving a grant under subsection (a) and meeting the

12 conditions described in subsection (c)(4) shall, for

13 purposes of this section, be designated by the Sec14 retary as a Native American Center of Excellence in

15 Health Professions Education. Any consortium receiv16 ing such a grant pursuant to subsection (e) shall, for

17 purposes of this section, be so designated.

18 ‘‘(e) AUTHORITY REGARDING NATIVE AMERICAN CEN19 TERS OF EXCELLENCE.—With respect to meeting the condi20 tions specified in subsection (c)(4), the Secretary may make

21 a grant under subsection (a) to a designated health profes22 sions school that does not meet such conditions if—

23 ‘‘(1) the school has formed a consortium in ac24 cordance with subsection (d)(1); and
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1 ‘‘(2) the schools of the consortium collectively

2 meet such conditions, without regard to whether the

3 schools individually meet such conditions.

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

5 payments are made under a grant under subsection (a)

6 may not exceed 5 years. Such payments shall be subject to

7 annual approval by the Secretary and to the availability

8 of appropriations for the fiscal year involved to make the

9 payments.

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

11 ‘‘(1) DESIGNATED HEALTH PROFESSIONS

12 SCHOOL.—

13 ‘‘(A) IN GENERAL.—The term ‘health profes14 sions school’ means, except as provided in sub15 paragraph (B), a school of medicine, a school of

16 osteopathic medicine, a school of dentistry, a

17 school of pharmacy, or a graduate program in

18 behavioral or mental health.

19 ‘‘(B) EXCEPTION.—The definition estab20 lished in subparagraph (A) shall not apply to

21 the use of the term ‘designated health professions

22 school’ for purposes of subsection (c)(2).

23 ‘‘(2) PROGRAM OF EXCELLENCE.—The term ‘pro24 gram of excellence’ means any program carried out

25 by a designated health professions school with a grant
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1 made under subsection (a), if the program is for pur2 poses for which the school involved is authorized in

3 subsection (b) or (c) to expend the grant.

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

5 Americans’ means American Indians, Alaskan Na6 tives, Aleuts, and Native Hawaiians.

7 ‘‘(h) FUNDING.—

8 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—For

9 the purpose of making grants under subsection (a),

10 there authorized to be appropriated $26,000,000 for

11 fiscal year 1998, and such sums as may be necessary

12 for each of the fiscal years 1999 through 2002.

13 ‘‘(2) ALLOCATIONS.—Based on the amount ap14 propriated under paragraph (1) for a fiscal year, one

15 of the following subparagraphs shall apply:

16 ‘‘(A) IN GENERAL.—If the amounts appro17 priated under paragraph (1) for a fiscal year

18 are $24,000,000 or less—

19 ‘‘(i) the Secretary shall make available

20 $12,000,000 for grants under subsection (a)

21 to health professions schools that meet the

22 conditions described in subsection (c)(2)(A);

23 and
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1 ‘‘(ii) and available after grants are

2 made with funds under clause (i), the Sec3 retary shall make available—

4 ‘‘(I) 60 percent of such amount

5 for grants under subsection (a) to

6 health professions schools that meet the

7 conditions described in paragraph (3)

8 or (4) of subsection (c) (including

9 meeting the conditions under sub10 section (e)); and

11 ‘‘(II) 40 percent of such amount

12 for grants under subsection (a) to

13 health professions schools that meet the

14 conditions described in subsection

15 (c)(5).

16 ‘‘(B) FUNDING IN EXCESS OF

17 $24,000,000.—If amounts appropriated under

18 paragraph (1) for a fiscal year exceed

19 $24,000,000 but are less than $30,000,000—

20 ‘‘(i) 80 percent of such excess amounts

21 shall be made available for grants under

22 subsection (a) to health professions schools

23 that meet the requirements described in

24 paragraph (3) or (4) of subsection (c) (in-
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1 cluding meeting conditions pursuant to sub2 section (e)); and

3 ‘‘(ii) 20 percent of such excess amount

4 shall be made available for grants under

5 subsection (a) to health professions schools

6 that meet the conditions described in sub7 section (c)(5).

8 ‘‘(C) FUNDING IN EXCESS OF

9 $30,000,000.—If amounts appropriated under

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

11 or more, the Secretary shall make available—

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

13 grants under subsection (a) to health profes14 sions schools that meet the conditions de15 scribed in subsection (c)(2)(A);

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

17 grants under subsection (a) to health profes18 sions schools that meet the conditions de19 scribed in paragraph (3) or (4) of sub20 section (c) (including meeting conditions

21 pursuant to subsection (e));

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

23 grants under subsection (a) to health profes24 sions schools that meet the conditions de25 scribed in subsection (c)(5); and
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1 ‘‘(iv) after grants are made with funds

2 under clauses (i) through (iii), any remain3 ing funds for grants under subsection (a) to

4 health professions schools that meet the con5 ditions described in paragraph (2)(A), (3),

6 (4), or (5) of subsection (c).

7 ‘‘(3) NO LIMITATION.—Nothing in this subsection

8 shall be construed as limiting the centers of excellence

9 referred to in this section to the designated amount,

10 or to preclude such entities from competing for other

11 grants under this section.

12 ‘‘(4) MAINTENANCE OF EFFORT.—

13 ‘‘(A) IN GENERAL.—With respect to activi14 ties for which a grant made under this part are

15 authorized to be expended, the Secretary may not

16 make such a grant to a center of excellence for

17 any fiscal year unless the center agrees to main18 tain expenditures of non-Federal amounts for

19 such activities at a level that is not less than the

20 level of such expenditures maintained by the cen21 ter for the fiscal year preceding the fiscal year

22 for which the school receives such a grant.

23 ‘‘(B) USE OF FEDERAL FUNDS.—With re24 spect to any Federal amounts received by a cen25 ter of excellence and available for carrying out
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1 activities for which a grant under this part is

2 authorized to be expended, the Secretary may not

3 make such a grant to the center for any fiscal

4 year unless the center agrees that the center will,

5 before expending the grant, expend the Federal

6 amounts obtained from sources other than the

7 grant.

8 ‘‘SEC. 737. SCHOLARSHIPS FOR DISADVANTAGED STU9 DENTS.

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

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

12 this section for the awarding of scholarships by schools to

13 any full-time student who is an eligible individual as de14 fined in subsection (d). Such scholarships may be expended

15 only for tuition expenses, other reasonable educational ex16 penses, and reasonable living expenses incurred in the at17 tendance of such school.

18 ‘‘(b) PREFERENCE IN PROVIDING SCHOLARSHIPS.—

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

20 subsection (a) unless the health professions and nursing

21 schools involved agree that, in providing scholarships pur22 suant to the grant, the schools will give preference to stu23 dents for whom the costs of attending the schools would con24 stitute a severe financial hardship and, notwithstanding

25 other provisions of this section, to former recipients of schol-
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1 arships under sections 736 and 740(d)(2)(B) (as such sec2 tions existed on the day before the date of enactment of this

3 section).

4 ‘‘(c) AMOUNT OF AWARD.—In awarding grants to eli5 gible entities that are health professions and nursing

6 schools, the Secretary shall give priority to eligible entities

7 based on the proportion of graduating students going into

8 primary care, the proportion of underrepresented minority

9 students, and the proportion of graduates working in medi10 cally underserved communities.

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

12 ‘‘(1) ELIGIBLE ENTITIES.—The term ‘eligible en13 tities’ means an entity that—

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

15 medicine, dentistry, nursing (as defined in sec16 tion 801), pharmacy, podiatric medicine, optom17 etry, veterinary medicine, public health, chiro18 practic, or allied health, a school offering a grad19 uate program in behavioral and mental health

20 practice, or an entity providing programs for the

21 training of physician assistants; and

22 ‘‘(B) is carrying out a program for recruit23 ing and retaining students from disadvantaged

24 backgrounds, including students who are mem25 bers of racial and ethnic minority groups.
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1 ‘‘(2) ELIGIBLE INDIVIDUAL.—The term ‘eligible

2 individual’ means an individual who—

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

4 ‘‘(B) has a financial need for a scholarship;

5 and

6 ‘‘(C) is enrolled (or accepted for enrollment)

7 at an eligible health professions or nursing school

8 as a full-time student in a program leading to

9 a degree in a health profession or nursing.

10 ‘‘SEC. 738. LOAN REPAYMENTS AND FELLOWSHIPS REGARD11 ING FACULTY POSITIONS.

12 ‘‘(a) LOAN REPAYMENTS.—

13 ‘‘(1) ESTABLISHMENT OF PROGRAM.—The Sec14 retary shall establish a program of entering into con15 tracts with individuals described in paragraph (2)

16 under which the individuals agree to serve as mem17 bers of the faculties of schools described in paragraph

18 (3) in consideration of the Federal Government agree19 ing to pay, for each year of such service, not more

20 than $20,000 of the principal and interest of the edu21 cational loans of such individuals.

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

23 referred to in paragraph (1) are individuals from dis24 advantaged backgrounds who—
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1 ‘‘(A) have a degree in medicine, osteopathic

2 medicine, dentistry, nursing, or another health

3 profession;

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

5 training program in medicine, osteopathic medi6 cine, dentistry, nursing, or other health profes7 sion; or

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

9 ‘‘(i) in an accredited (as determined by

10 the Secretary) school described in para11 graph (3); and

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

13 study or program, offered by such institu14 tion and approved by the Secretary, leading

15 to a degree from such a school.

16 ‘‘(3) ELIGIBLE HEALTH PROFESSIONS

17 SCHOOLS.—The schools described in this paragraph

18 are schools of medicine, nursing (as schools of nursing

19 are defined in section 801), osteopathic medicine, den20 tistry, pharmacy, allied health, podiatric medicine,

21 optometry, veterinary medicine, or public health, or

22 schools offering graduate programs in behavioral and

23 mental health.
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1 ‘‘(4) REQUIREMENTS REGARDING FACULTY POSI2 TIONS.—The Secretary may not enter into a contract

3 under paragraph (1) unless—

4 ‘‘(A) the individual involved has entered

5 into a contract with a school described in para6 graph (3) to serve as a member of the faculty of

7 the school for not less than 2 years; and

8 ‘‘(B) the contract referred to in subpara9 graph (A) provides that—

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

11 which the individual will serve as a member

12 of the faculty under the contract with the

13 school, make payments of the principal and

14 interest due on the educational loans of the

15 individual for such year in an amount

16 equal to the amount of such payments made

17 by the Secretary for the year;

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

19 pursuant to clause (i) on behalf of the indi20 vidual will be in addition to the pay that

21 the individual would otherwise receive for

22 serving as a member of such faculty; and

23 ‘‘(iii) the school, in making a deter24 mination of the amount of compensation to

25 be provided by the school to the individual
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1 for serving as a member of the faculty, will

2 make the determination without regard to

3 the amount of payments made (or to be

4 made) to the individual by the Federal Gov5 ernment under paragraph (1).

6 ‘‘(5) APPLICABILITY OF CERTAIN PROVISIONS.—

7 The provisions of sections 338C, 338G, and 338I shall

8 apply to the program established in paragraph (1) to

9 the same extent and in the same manner as such pro10 visions apply to the National Health Service Corps

11 Loan Repayment Program established in subpart III

12 of part D of title III, including the applicability of

13 provisions regarding reimbursements for increased tax

14 liability and regarding bankruptcy.

15 ‘‘(6) WAIVER REGARDING SCHOOL CONTRIBU16 TIONS.—The Secretary may waive the requirement es17 tablished in paragraph (4)(B) if the Secretary deter18 mines that the requirement will impose an undue fi19 nancial hardship on the school involved.

20 ‘‘(b) FELLOWSHIPS.—

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

22 grants to and enter into contracts with eligible enti23 ties to assist such entities in increasing the number

24 of underrepresented minority individuals who are

25 members of the faculty of such schools.
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1 ‘‘(2) APPLICATIONS.—To be eligible to receive a

2 grant or contract under this subsection, an entity

3 shall provide an assurance, in the application sub4 mitted by the entity, that—

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

6 or contract will be used to award a fellowship to

7 an individual only if the individual meets the

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

9 ‘‘(B) each fellowship awarded pursuant to

10 the grant or contract will include—

11 ‘‘(i) a stipend in an amount not ex12 ceeding 50 percent of the regular salary of

13 a similar faculty member for not to exceed

14 3 years of training; and

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

16 such as travel to professional meetings and

17 costs related to specialized training.

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

19 grant or contract under paragraph (1), an applicant

20 shall demonstrate to the Secretary that such applicant

21 has or will have the ability to—

22 ‘‘(A) identify, recruit and select underrep23 resented minority individuals who have the po24 tential for teaching, administration, or conduct25 ing research at a health professions institution;
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1 ‘‘(B) provide such individuals with the

2 skills necessary to enable them to secure a

3 tenured faculty position at such institution,

4 which may include training with respect to ped5 agogical skills, program administration, the de6 sign and conduct of research, grants writing,

7 and the preparation of articles suitable for publi8 cation in peer reviewed journals;

9 ‘‘(C) provide services designed to assist such

10 individuals in their preparation for an academic

11 career, including the provision of counselors; and

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

13 medically underserved populations.

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

15 grant or contract under paragraph (1) an applicant

16 shall—

17 ‘‘(A) provide an assurance that such appli18 cant will make available (directly through cash

19 donations) $1 for every $1 of Federal funds re20 ceived under this section for the fellowship;

21 ‘‘(B) provide an assurance that institu22 tional support will be provided for the individ23 ual for the second and third years at a level that

24 is equal to the total amount of institutional
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1 funds provided in the year in which the grant or

2 contract was awarded;

3 ‘‘(C) provide an assurance that the individ4 ual that will receive the fellowship will be a

5 member of the faculty of the applicant school;

6 and

7 ‘‘(D) provide an assurance that the individ8 ual that will receive the fellowship will have, at

9 a minimum, appropriate advanced preparation

10 (such as a master’s or doctoral degree) and spe11 cial skills necessary to enable such individual to

12 teach and practice.

13 ‘‘(5) DEFINITION.—For purposes of this sub14 section, the term ‘underrepresented minority individ15 uals’ means individuals who are members of racial or

16 ethnic minority groups that are underrepresented in

17 the health professions including nursing.

18 ‘‘SEC. 739. EDUCATIONAL ASSISTANCE IN THE HEALTH PRO19 FESSIONS REGARDING INDIVIDUALS FROM

20 DISADVANTAGED BACKGROUNDS.

21 ‘‘(a) IN GENERAL.—

22 ‘‘(1) AUTHORITY FOR GRANTS.—For the purpose

23 of assisting individuals from disadvantaged back24 grounds, as determined in accordance with criteria

25 prescribed by the Secretary, to undertake education to
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1 enter a health profession, the Secretary may make

2 grants to and enter into contracts with schools of

3 medicine, osteopathic medicine, public health, den4 tistry, veterinary medicine, optometry, pharmacy, al5 lied health, chiropractic, and podiatric medicine, pub6 lic and nonprofit private schools that offer graduate

7 programs in behavioral and mental health, programs

8 for the training of physician assistants, and other

9 public or private nonprofit health or educational enti10 ties to assist in meeting the costs described in para11 graph (2).

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

13 contract under paragraph (1) may be used by the en14 tity to meet the cost of—

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

16 individuals from disadvantaged backgrounds, as

17 so determined, for education and training in a

18 health profession;

19 ‘‘(B) facilitating the entry of such individ20 uals into such a school;

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

22 other services designed to assist such individuals

23 to complete successfully their education at such a

24 school;
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1 ‘‘(D) providing, for a period prior to the

2 entry of such individuals into the regular course

3 of education of such a school, preliminary edu4 cation and health research training designed to

5 assist them to complete successfully such regular

6 course of education at such a school, or referring

7 such individuals to institutions providing such

8 preliminary education;

9 ‘‘(E) publicizing existing sources of finan10 cial aid available to students in the education

11 program of such a school or who are undertaking

12 training necessary to qualify them to enroll in

13 such a program;

14 ‘‘(F) paying such scholarships as the Sec15 retary may determine for such individuals for

16 any period of health professions education at a

17 health professions school;

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

19 may approve for such individuals for any period

20 of education in student-enhancement programs

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

22 stipend may not be provided to an individual for

23 more than 12 months, and such a stipend shall

24 be in an amount determined appropriate by the
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1 Secretary (notwithstanding any other provision

2 of law regarding the amount of stipends);

3 ‘‘(H) carrying out programs under which

4 such individuals gain experience regarding a ca5 reer in a field of primary health care through

6 working at facilities of public or private non7 profit community-based providers of primary

8 health services; and

9 ‘‘(I) conducting activities to develop a larg10 er and more competitive applicant pool through

11 partnerships with institutions of higher edu12 cation, school districts, and other community13 based entities.

14 ‘‘(3) DEFINITION.—In this section, the term ‘reg15 ular course of education of such a school’ as used in

16 subparagraph (D) includes a graduate program in be17 havioral or mental health.

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

19 awards to eligible entities under subsection (a)(1), the Sec20 retary shall give preference to approved applications for

21 programs that involve a comprehensive approach by several

22 public or nonprofit private health or educational entities

23 to establish, enhance and expand educational programs that

24 will result in the development of a competitive applicant

25 pool of individuals from disadvantaged backgrounds who
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1 desire to pursue health professions careers. In considering

2 awards for such a comprehensive partnership approach, the

3 following shall apply with respect to the entity involved:

4 ‘‘(1) The entity shall have a demonstrated com5 mitment to such approach through formal agreements

6 that have common objectives with institutions of high7 er education, school districts, and other community8 based entities.

9 ‘‘(2) Such formal agreements shall reflect the co10 ordination of educational activities and support serv11 ices, increased linkages, and the consolidation of re12 sources within a specific geographic area.

13 ‘‘(3) The design of the educational activities in14 volved shall provide for the establishment of a com15 petitive health professions applicant pool of individ16 uals from disadvantaged backgrounds by enhancing

17 the total preparation (academic and social) of such

18 individuals to pursue a health professions career.

19 ‘‘(4) The programs or activities under the award

20 shall focus on developing a culturally competent

21 health care workforce that will serve the unserved and

22 underserved populations within the geographic area.

23 ‘‘(c) EQUITABLE ALLOCATION OF FINANCIAL ASSIST24 ANCE.—The Secretary, to the extent practicable, shall en25 sure that services and activities under subsection (a) are
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1 adequately allocated among the various racial and ethnic

2 populations who are from disadvantaged backgrounds.

3 ‘‘(d) MATCHING REQUIREMENTS.—The Secretary may

4 require that an entity that applies for a grant or contract

5 under subsection (a), provide non-Federal matching funds,

6 as appropriate, to ensure the institutional commitment of

7 the entity to the projects funded under the grant or contract.

8 As determined by the Secretary, such non-Federal matching

9 funds may be provided directly or through donations from

10 public or private entities and may be in cash or in-kind,

11 fairly evaluated, including plant, equipment, or services.

12 ‘‘SEC. 740. AUTHORIZATION OF APPROPRIATION.

13 ‘‘(a) SCHOLARSHIPS.—There are authorized to be ap14 propriated to carry out section 737, $37,000,000 for fiscal

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

16 of the fiscal years 1999 through 2002. Of the amount appro17 priated in any fiscal year, the Secretary shall ensure that

18 not less than 16 percent shall be distributed to schools of

19 nursing.

20 ‘‘(b) LOAN REPAYMENTS AND FELLOWSHIPS.—For the

21 purpose of carrying out section 738, there is authorized to

22 be appropriated $1,100,000 for fiscal year 1998, and such

23 sums as may be necessary for each of the fiscal years 1999

24 through 2002.
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1 ‘‘(c) EDUCATIONAL ASSISTANCE IN HEALTH PROFES2 SIONS REGARDING INDIVIDUALS FOR DISADVANTAGED

3 BACKGROUNDS.—For the purpose of grants and contracts

4 under section 739(a)(1), there is authorized to be appro5 priated $29,400,000 for fiscal year 1998, and such sums

6 as may be necessary for each of the fiscal years 1999

7 through 2002. The Secretary may use not to exceed 20 per8 cent of the amount appropriated for a fiscal year under

9 this subsection to provide scholarships under section

10 739(a)(2)(F).

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

12 of enactment of this part, the Secretary shall prepare and

13 submit to the appropriate committees of Congress a report

14 concerning the efforts of the Secretary to address the need

15 for a representative mix of individuals from historically mi16 nority health professions schools, or from institutions or

17 other entities that historically or by geographic location

18 have a demonstrated record of training or educating under19 represented minorities, within various health professions

20 disciplines, on peer review councils.’’.

21 (b) REPEAL.—

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

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

24 (2) NONTERMINATION OF AUTHORITY.—The

25 amendments made by this section shall not be con-
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1 strued to terminate agreements that, on the day before

2 the date of enactment of this Act, are in effect pursu3 ant to section 795 of the Public Health Service Act

4 (42 U.S.C. 795) as such section existed on such date.

5 Such agreements shall continue in effect in accord6 ance with the terms of the agreements. With respect

7 to compliance with such agreements, any period of

8 practice as a provider of primary health services shall

9 be counted towards the satisfaction of the requirement

10 of practice pursuant to such section 795.

11 (c) CONFORMING AMENDMENTS.—Section

12 481A(c)(3)(D)(i) of the Public Health Service Act (42

13 U.S.C. 287a–2(c)(3)(D)(i)) is amended by striking ‘‘section

14 739’’ and inserting ‘‘part B of title VII’’.

15 SEC. 102. TRAINING IN PRIMARY CARE MEDICINE AND DEN16 TISTRY.

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

18 (42 U.S.C. 293 et seq.) is amended—

19 (1) in the part heading by striking ‘‘PRI20 MARY HEALTH CARE’’ and inserting ‘‘FAM21 ILY MEDICINE, GENERAL INTERNAL

22 MEDICINE, GENERAL PEDIATRICS,

23 PHYSICIAN ASSISTANTS, GENERAL

24 DENTISTRY, AND PEDIATRIC DEN25 TISTRY’’;
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1 (2) by repealing section 746 (42 U.S.C. 293j);

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

3 (A) by striking the section heading and in4 serting the following:

5 ‘‘SEC. 747. FAMILY MEDICINE, GENERAL INTERNAL MEDI6 CINE, GENERAL PEDIATRICS, GENERAL DEN7 TISTRY, PEDIATRIC DENTISTRY, AND PHYSI8 CIAN ASSISTANTS.’’;

9 (B) in subsection (a)—

10 (i) in paragraph (1)—

11 (I) by inserting ‘‘, internal medi12 cine, or pediatrics’’ after ‘‘family med13 icine’’; and

14 (II) by inserting before the semi15 colon the following: ‘‘that emphasizes

16 training for the practice of family

17 medicine, general internal medicine, or

18 general pediatrics (as defined by the

19 Secretary)’’;

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

21 general internal medicine, or general pedi22 atrics’’ before the semicolon;

23 (iii) in paragraphs (3) and (4), by in24 serting ‘‘(including geriatrics), general in-
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1 ternal medicine or general pediatrics’’ after

2 ‘‘family medicine’’;

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

4 ‘‘and’’ at the end thereof;

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

6 period and inserting a semicolon; and

7 (vii) by adding at the end thereof the

8 following new paragraphs:

9 ‘‘(5) to meet the costs of projects to plan, develop,

10 and operate or maintain programs for the training of

11 physician assistants (as defined in section 799B), and

12 for the training of individuals who will teach in pro13 grams to provide such training; and

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

15 operating programs, and to provide financial assist16 ance to residents in such programs, of general den17 tistry or pediatric dentistry.

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

19 grants or contracts shall include entities that have pro20 grams in dental schools, approved residency programs in

21 the general or pediatric practice of dentistry, approved ad22 vanced education programs in the general or pediatric

23 practice of dentistry, or approved residency programs in

24 pediatric dentistry.’’;

25 (C) in subsection (b)—
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1 (i) in paragraphs (1) and (2)(A), by

2 inserting ‘‘, general internal medicine, or

3 general pediatrics’’ after ‘‘family medicine’’;

4 (ii) in paragraph (2)—

5 (I) in subparagraph (A), by strik6 ing ‘‘or’’ at the end; and

7 (II) in subparagraph (B), by

8 striking the period and inserting ‘‘;

9 or’’; and

10 (iii) by adding at the end the follow11 ing:

12 ‘‘(3) PRIORITY IN MAKING AWARDS.—In making

13 awards of grants and contracts under paragraph (1),

14 the Secretary shall give priority to any qualified ap15 plicant for such an award that proposes a collabo16 rative project between departments of primary care.’’;

17 (D) by redesignating subsections (c) and (d)

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

19 (E) by inserting after subsection (b), the fol20 lowing new subsection:

21 ‘‘(c) PRIORITY.—

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

23 the training of interns or residents, the Secretary

24 shall give priority in awarding grants under this sec25 tion to qualified applicants that have a record of
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1 training the greatest percentage of providers, or that

2 have demonstrated significant improvements in the

3 percentage of providers, which enter and remain in

4 primary care practice or general or pediatric den5 tistry.

6 ‘‘(2) DISADVANTAGED INDIVIDUALS.—With re7 spect to programs for the training of interns, resi8 dents, or physician assistants, the Secretary shall give

9 priority in awarding grants under this section to

10 qualified applicants that have a record of training in11 dividuals who are from disadvantaged backgrounds

12 (including racial and ethnic minorities underrep13 resented among primary care practice or general or

14 pediatric dentistry).

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

16 grants under this section the Secretary shall give spe17 cial consideration to projects which prepare practi18 tioners to care for underserved populations and other

19 high risk groups such as the elderly, individuals with

20 HIV-AIDS, substance abusers, homeless, and victims

21 of domestic violence.’’; and

22 (F) in subsection (e) (as so redesignated by

23 subparagraph (D))—

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

25 ‘‘$54,000,000’’ and all that follows and in-
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1 serting ‘‘$78,300,000 for fiscal year 1998,

2 and such sums as may be necessary for each

3 of the fiscal years 1999 through 2002.’’; and

4 (ii) by striking paragraph (2) and in5 serting the following:

6 ‘‘(2) ALLOCATION.—

7 ‘‘(A) IN GENERAL.—Of the amounts appro8 priated under paragraph (1) for a fiscal year,

9 the Secretary shall make available—

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

11 awards of grants and contracts under sub12 section (a) to programs of family medicine,

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

14 made available for awards of grants and

15 contracts under subsection (b) for family

16 medicine academic administrative units;

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

18 awards of grants and contracts under sub19 section (a) to programs of general internal

20 medicine and general pediatrics;

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

22 awards of grants and contracts under sub23 section (a) to programs relating to physi24 cian assistants; and
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1 ‘‘(iv) not less than $4,500,000 for

2 awards of grants and contracts under sub3 section (a) to programs of general or pedi4 atric dentistry.

5 ‘‘(B) RATABLE REDUCTION.—If amounts

6 appropriated under paragraph (1) for any fiscal

7 year are less than the amount required to com8 ply with subparagraph (A), the Secretary shall

9 ratably reduce the amount to be made available

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

11 subparagraph accordingly.’’; and

12 (4) by repealing sections 748 through 752 (42

13 U.S.C. 293l through 293p) and inserting the follow14 ing:

15 ‘‘SEC. 748. ADVISORY COMMITTEE ON TRAINING IN PRI16 MARY CARE MEDICINE AND DENTISTRY.

17 ‘‘(a) ESTABLISHMENT.—The Secretary shall establish

18 an advisory committee to be known as the Advisory Com19 mittee on Training in Primary Care Medicine and Den20 tistry (in this section referred to as the ‘Advisory Commit21 tee’).

22 ‘‘(b) COMPOSITION.—

23 ‘‘(1) IN GENERAL.—The Secretary shall deter24 mine the appropriate number of individuals to serve

25 on the Advisory Committee. Such individuals shall
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1 not be officers or employees of the Federal Govern2 ment.

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

4 after the date of enactment of this Act, the Secretary

5 shall appoint the members of the Advisory Committee

6 from among individuals who are health professionals.

7 In making such appointments, the Secretary shall en8 sure a fair balance between the health professions,

9 that at least 75 percent of the members of the Advi10 sory Committee are health professionals, a broad geo11 graphic representation of members and a balance be12 tween urban and rural members. Members shall be

13 appointed based on their competence, interest, and

14 knowledge of the mission of the profession involved.

15 ‘‘(3) MINORITY REPRESENTATION.—In appoint16 ing the members of the Advisory Committee under

17 paragraph (2), the Secretary shall ensure the ade18 quate representation of women and minorities.

19 ‘‘(c) TERMS.—

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

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

22 except that of the members first appointed—

‘‘(A) 1 23 ⁄3 of such members shall serve for a

24 term of 1 year;
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‘‘(B) 1 1 ⁄3 of such members shall serve for a

2 term of 2 years; and

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

4 term of 3 years.

5 ‘‘(2) VACANCIES.—

6 ‘‘(A) IN GENERAL.—A vacancy on the Advi7 sory Committee shall be filled in the manner in

8 which the original appointment was made and

9 shall be subject to any conditions which applied

10 with respect to the original appointment.

11 ‘‘(B) FILLING UNEXPIRED TERM.—An indi12 vidual chosen to fill a vacancy shall be ap13 pointed for the unexpired term of the member re14 placed.

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

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

17 Secretary concerning policy and program develop18 ment and other matters of significance concerning the

19 activities under section 747; and

20 ‘‘(2) not later than 3 years after the date of en21 actment of this section, and annually thereafter, pre22 pare and submit to the Secretary, and the Committee

23 on Labor and Human Resources of the Senate, and

24 the Committee on Commerce of the House of Rep25 resentatives, a report describing the activities of the
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1 Committee, including findings and recommendations

2 made by the Committee concerning the activities

3 under section 747.

4 ‘‘(e) MEETINGS AND DOCUMENTS.—

5 ‘‘(1) MEETINGS.—The Advisory Committee shall

6 meet not less than 2 times each year. Such meetings

7 shall be held jointly with other related entities estab8 lished under this title where appropriate.

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

10 to the convening of a meeting under paragraph (1),

11 the Advisory Committee shall prepare and make

12 available an agenda of the matters to be considered by

13 the Advisory Committee at such meeting. At any such

14 meeting, the Advisory Council shall distribute mate15 rials with respect to the issues to be addressed at the

16 meeting. Not later than 30 days after the adjourning

17 of such a meeting, the Advisory Committee shall pre18 pare and make available a summary of the meeting

19 and any actions taken by the Committee based upon

20 the meeting.

21 ‘‘(f) COMPENSATION AND EXPENSES.—

22 ‘‘(1) COMPENSATION.—Each member of the Advi23 sory Committee shall be compensated at a rate equal

24 to the daily equivalent of the annual rate of basic pay

25 prescribed for level IV of the Executive Schedule
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1 under section 5315 of title 5, United States Code, for

2 each day (including travel time) during which such

3 member is engaged in the performance of the duties

4 of the Committee.

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

6 Committee shall be allowed travel expenses, including

7 per diem in lieu of subsistence, at rates authorized for

8 employees of agencies under subchapter I of chapter

9 57 of title 5, United States Code, while away from

10 their homes or regular places of business in the per11 formance of services for the Committee.

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

13 shall apply to the Advisory Committee under this section

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

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

16 SEC. 103. INTERDISCIPLINARY, COMMUNITY-BASED LINK17 AGES.

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

19 (42 U.S.C. 294 et seq.) is amended to read as follows:

20 ‘‘PART D—INTERDISCIPLINARY, COMMUNITY21 BASED LINKAGES

22 ‘‘SEC. 750. GENERAL PROVISIONS.

23 ‘‘(a) COLLABORATION.—To be eligible to receive assist24 ance under this part, an academic institution shall use such

25 assistance in collaboration with 2 or more disciplines.
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1 ‘‘(b) ACTIVITIES.—An entity shall use assistance under

2 this part to carry out innovative demonstration projects for

3 strategic workforce supplementation activities as needed to

4 meet national goals for interdisciplinary, community-based

5 linkages. Such assistance may be used consistent with this

6 part—

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

8 ‘‘(2) for faculty development;

9 ‘‘(3) for model demonstration programs;

10 ‘‘(4) for the provision of stipends for fellowship

11 trainees;

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

13 ‘‘(6) for other activities that will produce out14 comes consistent with the purposes of this part.

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

16 ‘‘(a) AUTHORITY FOR PROVISION OF FINANCIAL AS17 SISTANCE.—

18 ‘‘(1) ASSISTANCE FOR PLANNING, DEVELOPMENT,

19 AND OPERATION OF PROGRAMS.—

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

21 award grants to and enter into contracts with

22 schools of medicine and osteopathic medicine,

23 and incorporated consortia made up of such

24 schools, or the parent institutions of such schools,

25 for projects for the planning, development and
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1 operation of area health education center pro2 grams that—

3 ‘‘(i) improve the recruitment, distribu4 tion, supply, quality and efficiency of per5 sonnel providing health services in under6 served rural and urban areas and personnel

7 providing health services to populations

8 having demonstrated serious unmet health

9 care needs;

10 ‘‘(ii) increase the number of primary

11 care physicians and other primary care

12 providers who provide services in under13 served areas through the offering of an edu14 cational continuum of health career recruit15 ment through clinical education concerning

16 underserved areas in a comprehensive

17 health workforce strategy;

18 ‘‘(iii) carry out recruitment and health

19 career awareness programs to recruit indi20 viduals from underserved areas and under21 represented populations, including minority

22 and other elementary or secondary students,

23 into the health professions;

24 ‘‘(iv) prepare individuals to more effec25 tively provide health services to underserved
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1 areas or underserved populations through

2 field placements, preceptorships, the conduct

3 of or support of community-based primary

4 care residency programs, and agreements

5 with community-based organizations such

6 as community health centers, migrant

7 health centers, Indian health centers, public

8 health departments and others;

9 ‘‘(v) conduct health professions edu10 cation and training activities for students

11 of health professions schools and medical

12 residents;

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

14 medical student required clinical education

15 at sites remote to the primary teaching fa16 cility of the contracting institution; and

17 ‘‘(vii) provide information dissemina18 tion and educational support to reduce pro19 fessional isolation, increase retention,

20 enhance the practice environment, and im21 prove health care through the timely dis22 semination of research findings using rel23 evant resources.

24 ‘‘(B) OTHER ELIGIBLE ENTITIES.—With re25 spect to a State in which no area health edu-
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1 cation center program is in operation, the Sec2 retary may award a grant or contract under

3 subparagraph (A) to a school of nursing.

4 ‘‘(C) PROJECT TERMS.—

5 ‘‘(i) IN GENERAL.—Except as provided

6 in clause (ii), the period during which pay7 ments may be made under an award under

8 subparagraph (A) may not exceed—

9 ‘‘(I) in the case of a project, 12

10 years or

11 ‘‘(II) in the case of a center with12 in a project, 6 years.

13 ‘‘(ii) EXCEPTION.—The periods de14 scribed in clause (i) shall not apply to

15 projects that have completed the initial pe16 riod of Federal funding under this section

17 and that desire to compete for model awards

18 under paragraph (2)(A).

19 ‘‘(2) ASSISTANCE FOR OPERATION OF MODEL

20 PROGRAMS.—

21 ‘‘(A) IN GENERAL.—In the case of any en22 tity described in paragraph (1)(A) that—

23 ‘‘(i) has previously received funds

24 under this section;
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1 ‘‘(ii) is operating an area health edu2 cation center program; and

3 ‘‘(iii) is no longer receiving financial

4 assistance under paragraph (1);

5 the Secretary may provide financial assistance

6 to such entity to pay the costs of operating and

7 carrying out the requirements of the program as

8 described in paragraph (1).

9 ‘‘(B) MATCHING REQUIREMENT.—With re10 spect to the costs of operating a model program

11 under subparagraph (A), an entity, to be eligible

12 for financial assistance under subparagraph (A),

13 shall make available (directly or through con14 tributions from State, county or municipal gov15 ernments, or the private sector) recurring non16 Federal contributions in cash toward such costs

17 in an amount that is equal to not less than 50

18 percent of such costs.

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

20 of awards provided under subparagraph (A) to

21 entities in a State for a fiscal year may not ex22 ceed the lesser of—

23 ‘‘(i) $2,000,000; or

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

25 of $250,000 and the aggregate number of
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1 area health education centers operated in

2 the State by such entities.

3 ‘‘(b) REQUIREMENTS FOR CENTERS.—

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

5 health education center that receives funds under this

6 section shall encourage the regionalization of health

7 professions schools through the establishment of part8 nerships with community-based organizations.

9 ‘‘(2) SERVICE AREA.—Each area health edu10 cation center that receives funds under this section

11 shall specifically designate a geographic area or medi12 cally underserved population to be served by the cen13 ter. Such area or population shall be in a location re14 moved from the main location of the teaching facili15 ties of the schools participating in the program with

16 such center.

17 ‘‘(3) OTHER REQUIREMENTS.—Each area health

18 education center that receives funds under this section

19 shall—

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

21 area to be served by the center and assist in the

22 planning and development of training programs

23 to meet such needs;

24 ‘‘(B) arrange and support rotations for stu25 dents and residents in family medicine, general
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1 internal medicine or general pediatrics, with at

2 least one center in each program being affiliated

3 with or conducting a rotating osteopathic intern4 ship or medical residency training program in

5 family medicine (including geriatrics), general

6 internal medicine (including geriatrics), or gen7 eral pediatrics in which no fewer than 4 individ8 uals are enrolled in first-year positions;

9 ‘‘(C) conduct and participate in inter10 disciplinary training that involves physicians

11 and other health personnel including, where

12 practicable, public health professionals, physi13 cian assistants, nurse practitioners, nurse mid14 wives, and behavioral and mental health provid15 ers; and

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

17 percent of the members of which shall be individ18 uals, including both health service providers and

19 consumers, from the area served by the center.

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

21 ‘‘(1) ALLOCATION TO CENTER.—Not less than 75

22 percent of the total amount of Federal funds provided

23 to an entity under this section shall be allocated by

24 an area health education center program to the area

25 health education center. Such entity shall enter into
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1 an agreement with each center for purposes of specify2 ing the allocation of such 75 percent of funds.

3 ‘‘(2) OPERATING COSTS.—With respect to the op4 erating costs of the area health education center pro5 gram of an entity receiving funds under this section,

6 the entity shall make available (directly or through

7 contributions from State, county or municipal gov8 ernments, or the private sector) non-Federal contribu9 tions in cash toward such costs in an amount that is

10 equal to not less than 50 percent of such costs, except

11 that the Secretary may grant a waiver for up to 75

12 percent of the amount of the required non-Federal

13 match in the first 3 years in which an entity receives

14 funds under this section.

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

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

17 section, a health education training center shall be an en18 tity otherwise eligible for funds under section 751 that—

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

20 health care needs in States along the border between

21 the United States and Mexico and in the State of

22 Florida, and in other urban and rural areas with

23 populations with serious unmet health care needs;
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1 ‘‘(2) establishes an advisory board comprised of

2 health service providers, educators and consumers

3 from the service area;

4 ‘‘(3) conducts training and education programs

5 for health professions students in these areas;

6 ‘‘(4) conducts training in health education serv7 ices, including training to prepare community health

8 workers; and

9 ‘‘(5) supports health professionals (including

10 nursing) practicing in the area through educational

11 and other services.

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

13 make available 50 percent of the amounts appropriated for

14 each fiscal year under section 752 for the establishment or

15 operation of health education training centers through

16 projects in States along the border between the United

17 States and Mexico and in the State of Florida.

18 ‘‘SEC. 753. EDUCATION AND TRAINING RELATING TO GERI19 ATRICS.

20 ‘‘(a) GERIATRIC EDUCATION CENTERS.—

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

22 grants or contracts under this section to entities de23 scribed in paragraphs (1), (3), or (4) of section 799B,

24 and section 853(2), for the establishment or operation

25 of geriatric education centers.
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1 ‘‘(2) REQUIREMENTS.—A geriatric education

2 center is a program that—

3 ‘‘(A) improves the training of health profes4 sionals in geriatrics, including geriatric

5 residencies, traineeships, or fellowships;

6 ‘‘(B) develops and disseminates curricula

7 relating to the treatment of the health problems

8 of elderly individuals;

9 ‘‘(C) supports the training and retraining

10 of faculty to provide instruction in geriatrics;

11 ‘‘(D) supports continuing education of

12 health professionals who provide geriatric care;

13 and

14 ‘‘(E) provides students with clinical train15 ing in geriatrics in nursing homes, chronic and

16 acute disease hospitals, ambulatory care centers,

17 and senior centers.

18 ‘‘(b) GERIATRIC TRAINING REGARDING PHYSICIANS

19 AND DENTISTS.—

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

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

22 medicine, schools of osteopathic medicine, teaching

23 hospitals, and graduate medical education programs,

24 for the purpose of providing support (including

25 residencies, traineeships, and fellowships) for geriatric
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1 training projects to train physicians, dentists and be2 havioral and mental health professionals who plan to

3 teach geriatric medicine, geriatric behavioral or men4 tal health, or geriatric dentistry.

5 ‘‘(2) REQUIREMENTS.—Each project for which a

6 grant or contract is made under this subsection

7 shall—

8 ‘‘(A) be staffed by full-time teaching physi9 cians who have experience or training in geri10 atric medicine or geriatric behavioral or mental

11 health;

12 ‘‘(B) be staffed, or enter into an agreement

13 with an institution staffed by full-time or part14 time teaching dentists who have experience or

15 training in geriatric dentistry;

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

17 with an institution staffed by full-time or part18 time teaching behavioral mental health profes19 sionals who have experience or training in geri20 atric behavioral or mental health;

21 ‘‘(D) be based in a graduate medical edu22 cation program in internal medicine or family

23 medicine or in a department of geriatrics or be24 havioral or mental health;
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1 ‘‘(E) provide training in geriatrics and ex2 posure to the physical and mental disabilities of

3 elderly individuals through a variety of service

4 rotations, such as geriatric consultation services,

5 acute care services, dental services, geriatric be6 havioral or mental health units, day and home

7 care programs, rehabilitation services, extended

8 care facilities, geriatric ambulatory care and

9 comprehensive evaluation units, and community

10 care programs for elderly mentally retarded in11 dividuals; and

12 ‘‘(F) provide training in geriatrics through

13 one or both of the training options described in

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

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

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

17 shall be as follows:

18 ‘‘(A) A 1-year retraining program in geri19 atrics for—

20 ‘‘(i) physicians who are faculty mem21 bers in departments of internal medicine,

22 family medicine, gynecology, geriatrics, and

23 behavioral or mental health at schools of

24 medicine and osteopathic medicine;
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1 ‘‘(ii) dentists who are faculty members

2 at schools of dentistry or at hospital depart3 ments of dentistry; and

4 ‘‘(iii) behavioral or mental health pro5 fessionals who are faculty members in de6 partments of behavioral or mental health;

7 and

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

9 medicine fellowship program providing emphasis

10 in geriatrics, which shall be designed to provide

11 training in clinical geriatrics and geriatrics re12 search for—

13 ‘‘(i) physicians who have completed

14 graduate medical education programs in in15 ternal medicine, family medicine, behav16 ioral or mental health, neurology, gyne17 cology, or rehabilitation medicine;

18 ‘‘(ii) dentists who have demonstrated a

19 commitment to an academic career and who

20 have completed postdoctoral dental training,

21 including postdoctoral dental education pro22 grams or who have relevant advanced train23 ing or experience; and

24 ‘‘(iii) behavioral or mental health pro25 fessionals who have completed graduate
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1 medical education programs in behavioral

2 or mental health.

3 ‘‘(4) DEFINITIONS.—For purposes of this sub4 section:

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

6 program’ means a program sponsored by a

7 school of medicine, a school of osteopathic medi8 cine, a hospital, or a public or private institu9 tion that—

10 ‘‘(i) offers postgraduate medical train11 ing in the specialties and subspecialties of

12 medicine; and

13 ‘‘(ii) has been accredited by the Accred14 itation Council for Graduate Medical Edu15 cation or the American Osteopathic Associa16 tion through its Committee on Postdoctoral

17 Training.

18 ‘‘(B) The term ‘post-doctoral dental edu19 cation program’ means a program sponsored by

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

21 private institution that—

22 ‘‘(i) offers post-doctoral training in the

23 specialties of dentistry, advanced education

24 in general dentistry, or a dental general

25 practice residency; and
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1 ‘‘(ii) has been accredited by the Com2 mission on Dental Accreditation.

3 ‘‘(c) GERIATRIC FACULTY FELLOWSHIPS.—

4 ‘‘(1) ESTABLISHMENT OF PROGRAM.—The Sec5 retary shall establish a program to provide Geriatric

6 Academic Career Awards to eligible individuals to

7 promote the career development of such individuals as

8 academic geriatricians.

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

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

11 shall—

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

13 internal medicine, family practice, or psychia14 try;

15 ‘‘(B) have completed an approved fellowship

16 program in geriatrics; and

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

18 an accredited (as determined by the Secretary)

19 school of medicine or osteopathic medicine.

20 ‘‘(3) LIMITATIONS.—No Award under paragraph

21 (1) may be made to an eligible individual unless the

22 individual—

23 ‘‘(A) has submitted to the Secretary an ap24 plication, at such time, in such manner, and

25 containing such information as the Secretary
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1 may require, and the Secretary has approved

2 such application; and

3 ‘‘(B) provides, in such form and manner as

4 the Secretary may require, assurances that the

5 individual will meet the service requirement de6 scribed in subsection (e).

7 ‘‘(4) AMOUNT AND TERM.—

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

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

10 year 1998, adjusted for subsequent fiscal years to

11 reflect the increase in the Consumer Price Index.

12 ‘‘(B) TERM.—The term of any Award made

13 under this subsection shall not exceed 5 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 pro18 fessionals. The provision of such training shall con19 stitute at least 75 percent of the obligations of such

20 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 authorized

24 activities under an application approved under subsection

25 (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 services

7 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 in

16 rural areas; and

17 ‘‘(E) increase the recruitment and retention

18 of health care practitioners from rural areas and

19 make rural practice a more attractive career

20 choice for health care practitioners.

21 ‘‘(2) METHODS.—A recipient of funds under sub22 section (a) may use various methods in carrying out

23 the projects described in paragraph (1), including—

24 ‘‘(A) the distribution of stipends to students

25 of eligible applicants;
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1 ‘‘(B) the establishment of a post-doctoral fel2 lowship program;

3 ‘‘(C) the training of faculty in the economic

4 and logistical problems confronting rural health

5 care delivery systems; or

6 ‘‘(D) the purchase or rental of transpor7 tation and telecommunication equipment where

8 the need for such equipment due to unique char9 acteristics of the rural area is demonstrated by

10 the recipient.

11 ‘‘(3) ADMINISTRATION.—

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

13 use more than 10 percent of the funds made

14 available to such applicant under subsection (a)

15 for administrative expenses.

16 ‘‘(B) TRAINING.—Not more than 10 percent

17 of the individuals receiving training with funds

18 made available to an applicant under subsection

19 (a) shall be trained as doctors of medicine or

20 doctors of osteopathy.

21 ‘‘(C) LIMITATION.—An institution that re22 ceives a grant under this section shall use

23 amounts received under such grant to supple24 ment, not supplant, amounts made available by

25 such institution for activities of the type de-
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1 scribed in subsection (b)(1) in the fiscal year

2 preceding the year for which the grant is re3 ceived.

4 ‘‘(c) APPLICATIONS.—Applications submitted for as5 sistance under this section shall—

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

7 applicants with the express purpose of assisting indi8 viduals in academic institutions in establishing long9 term collaborative relationships with health care pro10 viders in rural areas; and

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

12 agencies for clinical treatment or training, including

13 hospitals, community health centers, migrant health

14 centers, rural health clinics, community behavioral

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

16 Native Hawaiian health centers, or facilities operated

17 by the Indian Health Service or an Indian tribe or

18 tribal organization or Indian organization under a

19 contract with the Indian Health Service under the In20 dian Self-Determination Act.

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

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

23 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 asso8 ciated with expanding or establishing programs that

9 will increase the number of individuals trained in al10 lied health professions. Programs and activities fund11 ed under this paragraph may include—

12 ‘‘(A) those that expand enrollments in allied

13 health professions with the greatest shortages or

14 whose services are most needed by the elderly;

15 ‘‘(B) those that provide rapid transition

16 training programs in allied health fields to indi17 viduals who have baccalaureate degrees in

18 health-related sciences;

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

20 allied health training programs that link aca21 demic centers to rural clinical settings;

22 ‘‘(D) those that provide career advancement

23 training for practicing allied health profes24 sionals;

25 ‘‘(E) those that expand or establish clinical

26 training sites for allied health professionals in
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1 medically underserved or rural communities in

2 order to increase the number of individuals

3 trained;

4 ‘‘(F) those that develop curriculum that will

5 emphasize knowledge and practice in the areas of

6 prevention and health promotion, geriatrics,

7 long-term care, home health and hospice care,

8 and ethics;

9 ‘‘(G) those that expand or establish inter10 disciplinary training programs that promote the

11 effectiveness of allied health practitioners in geri12 atric assessment and the rehabilitation of the el13 derly;

14 ‘‘(H) those that expand or establish dem15 onstration centers to emphasize innovative mod16 els to link allied health clinical practice, edu17 cation, and research;

18 ‘‘(I) those that provide financial assistance

19 (in the form of traineeships) to students who are

20 participants in any such program; and

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

22 allied health field that has a demonstrated

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

2 training program to practice in a medically

3 underserved community;

4 that shall be utilized to assist in the payment of

5 all or part of the costs associated with tuition,

6 fees and such other stipends as the Secretary

7 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 pre13 ventive and primary care training for podiatric phy14 sicians in approved or provisionally approved resi15 dency programs that shall provide financial assist16 ance in the form of traineeships to residents who par17 ticipate in such projects and who plan to specialize

18 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 establish

4 an advisory committee to be known as the Advisory Com5 mittee on Interdisciplinary, Community-Based Linkages

6 (in this section referred to as the ‘Advisory Committee’).

7 ‘‘(b) COMPOSITION.—

8 ‘‘(1) IN GENERAL.—The Secretary shall deter9 mine the appropriate number of individuals to serve

10 on the Advisory Committee. Such individuals shall

11 not be officers or employees of the Federal Govern12 ment.

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

14 after the date of enactment of this Act, the Secretary

15 shall appoint the members of the Advisory Committee

16 from among individuals who are health professionals

17 from schools of the types described in sections

18 751(a)(1)(A), 751(a)(1)(B), 753(b), 754(3)(A), and

19 755(b). In making such appointments, the Secretary

20 shall ensure a fair balance between the health profes21 sions, that at least 75 percent of the members of the

22 Advisory Committee are health professionals, a broad

23 geographic representation of members and a balance

24 between urban and rural members. Members shall be

25 appointed based on their competence, interest, and

26 knowledge of the mission of the profession involved.
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1 ‘‘(3) MINORITY REPRESENTATION.—In appoint2 ing the members of the Advisory Committee under

3 paragraph (2), the Secretary shall ensure the ade4 quate representation of women and minorities.

5 ‘‘(c) TERMS.—

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

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

8 except that of the members first appointed—

‘‘(A) 1 9 ⁄3 of the members shall serve for a

10 term of 1 year;

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

12 term of 2 years; and

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

14 term of 3 years.

15 ‘‘(2) VACANCIES.—

16 ‘‘(A) IN GENERAL.—A vacancy on the Advi17 sory Committee shall be filled in the manner in

18 which the original appointment was made and

19 shall be subject to any conditions which applied

20 with respect to the original appointment.

21 ‘‘(B) FILLING UNEXPIRED TERM.—An indi22 vidual chosen to fill a vacancy shall be ap23 pointed for the unexpired term of the member re24 placed.

25 ‘‘(d) DUTIES.—The Advisory Committee shall—
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1 ‘‘(1) provide advice and recommendations to the

2 Secretary concerning policy and program develop3 ment and other matters of significance concerning the

4 activities under this part; and

5 ‘‘(2) not later than 3 years after the date of en6 actment of this section, and annually thereafter, pre7 pare and submit to the Secretary, and the Committee

8 on Labor and Human Resources of the Senate, and

9 the Committee on Commerce of the House of Rep10 resentatives, a report describing the activities of the

11 Committee, including findings and recommendations

12 made by the Committee concerning the activities

13 under this part.

14 ‘‘(e) MEETINGS AND DOCUMENTS.—

15 ‘‘(1) MEETINGS.—The Advisory Committee shall

16 meet not less than 3 times each year. Such meetings

17 shall be held jointly with other related entities estab18 lished under this title where appropriate.

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

20 to the convening of a meeting under paragraph (1),

21 the Advisory Committee shall prepare and make

22 available an agenda of the matters to be considered by

23 the Advisory Committee at such meeting. At any such

24 meeting, the Advisory Council shall distribute mate25 rials with respect to the issues to be addressed at the
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1 meeting. Not later than 30 days after the adjourning

2 of such a meeting, the Advisory Committee shall pre3 pare and make available a summary of the meeting

4 and any actions taken by the Committee based upon

5 the meeting.

6 ‘‘(f) COMPENSATION AND EXPENSES.—

7 ‘‘(1) COMPENSATION.—Each member of the Advi8 sory Committee shall be compensated at a rate equal

9 to the daily equivalent of the annual rate of basic pay

10 prescribed for level IV of the Executive Schedule

11 under section 5315 of title 5, United States Code, for

12 each day (including travel time) during which such

13 member is engaged in the performance of the duties

14 of the Committee.

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

16 Committee shall be allowed travel expenses, including

17 per diem in lieu of subsistence, at rates authorized for

18 employees of agencies under subchapter I of chapter

19 57 of title 5, United States Code, while away from

20 their homes or regular places of business in the per21 formance of services for the Committee.

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

23 shall apply to the Advisory Committee under this section

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

25 conflict with the requirements of this section.
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1 ‘‘SEC. 757. AUTHORIZATION OF APPROPRIATIONS.

2 ‘‘(a) IN GENERAL.—There are authorized to be appro3 priated to carry out this part, $55,600,000 for fiscal year

4 1998, and such sums as may be necessary for each of the

5 fiscal years 1999 through 2002.

6 ‘‘(b) ALLOCATION.—

7 ‘‘(1) IN GENERAL.—Of the amounts appro8 priated under subsection (a) for a fiscal year, the Sec9 retary shall make available—

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

11 of grants and contracts under section 751;

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

13 grants and contracts under section 752, of which

14 not less than 50 percent of such amount shall be

15 made available for centers described in sub16 section (a)(1) of such section; and

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

18 of grants and contracts under sections 753, 754,

19 and 755.

20 ‘‘(2) RATABLE REDUCTION.—If amounts appro21 priated under subsection (a) for any fiscal year are

22 less than the amount required to comply with para23 graph (1), the Secretary shall ratably reduce the

24 amount to be made available under each of subpara25 graphs (A) through (C) of such paragraph accord26 ingly.
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1 ‘‘(3) INCREASE IN AMOUNTS.—If amounts appro2 priated for a fiscal year under subsection (a) exceed

3 the amount authorized under such subsection for such

4 fiscal year, the Secretary may increase the amount to

5 be made available for programs and activities under

6 this part without regard to the amounts specified in

7 each of subparagraphs (A) through (C) of paragraph

8 (2).

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

10 ‘‘(1) AREA HEALTH EDUCATION CENTER PRO11 GRAMS.—Of the amounts made available under sub12 section (b)(1)(A) for each fiscal year, the Secretary

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

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

15 amounts in fiscal year 1998;

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

17 amounts in fiscal year 1999;

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

19 amounts in fiscal year 2000;

20 ‘‘(D) not less than 40 percent of such

21 amounts in fiscal year 2001; and

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

23 amounts in fiscal year 2002.

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

25 Congress that—
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1 ‘‘(A) every State have an area health edu2 cation center program in effect under this sec3 tion; and

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

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

6 increase over time and that Federal funding for

7 other awards under this section shall decrease so

8 that the national program will become entirely

9 comprised of programs that are funded at least

10 50 percent by State and local partners.’’.

11 SEC. 104. HEALTH PROFESSIONS WORKFORCE INFORMA12 TION AND ANALYSIS.

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

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

15 read as follows:

16 ‘‘PART E—HEALTH PROFESSIONS AND PUBLIC

17 HEALTH WORKFORCE

18 ‘‘Subpart 1—Health Professions Workforce

19 Information and Analysis

20 ‘‘SEC. 761. HEALTH PROFESSIONS WORKFORCE INFORMA21 TION AND ANALYSIS.

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

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

24 describing the health professions workforce and the

25 analysis of workforce related issues; and
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1 ‘‘(2) provide necessary information for decision2 making regarding future directions in health profes3 sions and nursing programs in response to societal

4 and professional needs.

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

6 award grants or contracts to State or local governments,

7 health professions schools, schools of nursing, academic

8 health centers, community-based health facilities, and other

9 appropriate public or private nonprofit entities to provide

10 for—

11 ‘‘(1) targeted information collection and analysis

12 activities related to the purposes described in sub13 section (a);

14 ‘‘(2) research on high priority workforce ques15 tions;

16 ‘‘(3) the development of a non-Federal analytic

17 and research infrastructure related to the purposes de18 scribed in subsection (a); and

19 ‘‘(4) the conduct of program evaluation and as20 sessment.

21 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—

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

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

24 fiscal year 1998, and such sums as may be necessary

25 for each of the fiscal years 1999 through 2002.
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1 ‘‘(2) RESERVATION.—Of the amounts appro2 priated under subsection (a) for a fiscal year, the Sec3 retary shall reserve not less than $600,000 for con4 ducting health professions research and for carrying

5 out data collection and analysis in accordance with

6 section 792.

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

8 Amounts otherwise appropriated for programs or ac9 tivities under this title may be used for activities

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

11 activities from which such amounts were made avail12 able.’’.

13 (b) COUNCIL ON GRADUATE MEDICAL EDUCATION.—

14 Section 301 of the Health Professions Education Extension

15 Amendments of 1992 (Public Law 102–408) is amended—

16 (1) in subsection (j), by striking ‘‘1995’’ and in17 serting ‘‘2002’’;

18 (2) in subsection (k), by striking ‘‘1995’’ and in19 serting ‘‘2002’’;

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

21 new subsection:

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

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

24 the activities of the Council.’’;
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1 (4) by transferring such section to part E of title

2 VII of the Public Health Service Act (as amended by

3 subsection (a));

4 (5) by redesignating such section as section 762;

5 and

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

7 SEC. 105. PUBLIC HEALTH WORKFORCE DEVELOPMENT.

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

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

10 at the end the following:

11 ‘‘Subpart 2—Public Health Workforce

12 ‘‘SEC. 765. GENERAL PROVISIONS.

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

14 or contracts to eligible entities to increase the number of

15 individuals in the public health workforce, to enhance the

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

17 workforce to meet national, State, and local health care

18 needs.

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

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

21 ‘‘(1) be—

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

23 an accredited school or program of public health,

24 health administration, preventive medicine, or
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1 dental public health or a school providing health

2 management programs;

3 ‘‘(B) an academic health center;

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

5 ‘‘(D) any other appropriate public or pri6 vate nonprofit entity; and

7 ‘‘(2) prepare and submit to the Secretary an ap8 plication at such time, in such manner, and contain9 ing such information as the Secretary may require.

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

11 under this section the Secretary may grant a preference to

12 entities—

13 ‘‘(1) serving individuals who are from disadvan14 taged backgrounds (including underrepresented racial

15 and ethnic minorities); and

16 ‘‘(2) graduating large proportions of individuals

17 who serve in underserved communities.

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

19 contract awarded under this section may be used for—

20 ‘‘(1) the costs of planning, developing, or operat21 ing demonstration training programs;

22 ‘‘(2) faculty development;

23 ‘‘(3) trainee support;

24 ‘‘(4) technical assistance;

25 ‘‘(5) to meet the costs of projects—
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1 ‘‘(A) to plan and develop new residency

2 training programs and to maintain or improve

3 existing residency training programs in preven4 tive medicine and dental public health, that have

5 available full-time faculty members with train6 ing and experience in the fields of preventive

7 medicine and dental public health; and

8 ‘‘(B) to provide financial assistance to resi9 dency trainees enrolled in such programs;

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

11 workers as well as for increasing the supply of new

12 practitioners to address priority public health, pre13 ventive medicine, public health dentistry, and health

14 administration needs;

15 ‘‘(7) preparing public health professionals for

16 employment at the State and community levels; or

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

18 that are consistent with the purposes of this section

19 ‘‘(e) TRAINEESHIPS.—

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

21 used under this section for the training of health pro22 fessionals, such training programs shall be designed

23 to—
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1 ‘‘(A) make public health education more ac2 cessible to the public and private health work3 force;

4 ‘‘(B) increase the relevance of public health

5 academic preparation to public health practice

6 in the future;

7 ‘‘(C) provide education or training for stu8 dents from traditional on-campus programs in

9 practice-based sites; or

10 ‘‘(D) develop educational methods and dis11 tance-based approaches or technology that ad12 dress adult learning requirements and increase

13 knowledge and skills related to community-based

14 cultural diversity in public health education.

15 ‘‘(2) SEVERE SHORTAGE DISCIPLINES.—Amounts

16 provided under grants or contracts under this section

17 may be used for the operation of programs designed

18 to award traineeships to students in accredited

19 schools of public health who enter educational pro20 grams in fields where there is a severe shortage of

21 public health professionals, including epidemiology,

22 biostatistics, environmental health, toxicology, public

23 health nursing, nutrition, preventive medicine, mater24 nal and child health, and behavioral and mental

25 health professions.
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1 ‘‘SEC. 766. PUBLIC HEALTH TRAINING CENTERS.

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

3 or contracts for the operation of public health training cen4 ters.

5 ‘‘(b) ELIGIBLE ENTITIES.—

6 ‘‘(1) IN GENERAL.—A public health training cen7 ter shall be an accredited school of public health, or

8 another public or nonprofit private institution ac9 credited for the provision of graduate or specialized

10 training in public health, that plans, develops, oper11 ates, and evaluates projects that are in furtherance of

12 the goals established by the Secretary for the year

13 2000 in the areas of preventive medicine, health pro14 motion and disease prevention, or improving access to

15 and quality of health services in medically under16 served communities.

17 ‘‘(2) PREFERENCE.—In awarding grants or con18 tracts under this section the Secretary shall give pref19 erence to accredited schools of public health.

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

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

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

23 ‘‘(1) will establish or strengthen field placements

24 for students in public or nonprofit private health

25 agencies or organizations;
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1 ‘‘(2) will involve faculty members and students

2 in collaborative projects to enhance public health serv3 ices to medically underserved communities;

4 ‘‘(3) will specifically designate a geographic area

5 or medically underserved population to be served by

6 the center that shall be in a location removed from the

7 main location of the teaching facility of the school

8 that is participating in the program with such center;

9 and

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

11 area to be served by the center and assist in the plan12 ning and development of training programs to meet

13 such needs.

14 ‘‘SEC. 767. PUBLIC HEALTH TRAINEESHIPS.

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

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

17 or nonprofit private institutions accredited for the provi18 sion of graduate or specialized training in public health,

19 for the purpose of assisting such schools and institutions

20 in providing traineeships to individuals described in sub21 section (b)(3).

22 ‘‘(b) CERTAIN REQUIREMENTS.—

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

24 this section shall be determined by the Secretary.
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1 ‘‘(2) USE OF GRANT.—Traineeships awarded

2 under grants made under subsection (a) shall provide

3 for tuition and fees and such stipends and allowances

4 (including travel and subsistence expenses and de5 pendency allowances) for the trainees as the Secretary

6 may deem necessary.

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

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

9 pursuing a course of study in a health professions

10 field in which there is a severe shortage of health pro11 fessionals (which fields include the fields of epidemiol12 ogy, environmental health, biostatistics, toxicology,

13 nutrition, and maternal and child health).

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

15 HEALTH.

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

17 to and enter into contracts with schools of medicine, osteo18 pathic medicine, public health, and dentistry to meet the

19 costs of projects—

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

21 programs and to maintain or improve existing resi22 dency training programs in preventive medicine and

23 dental public health; and

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

25 trainees enrolled in such programs.
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1 ‘‘(b) ADMINISTRATION.—

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

3 subsection (a) shall be determined by the Secretary.

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

5 under subsection (a), the applicant must demonstrate

6 to the Secretary that it has or will have available full7 time faculty members with training and experience in

8 the fields of preventive medicine or dental public

9 health and support from other faculty members

10 trained in public health and other relevant specialties

11 and disciplines.

12 ‘‘(3) OTHER FUNDS.—Schools of medicine, osteo13 pathic medicine, dentistry, and public health may use

14 funds committed by State, local, or county public

15 health officers as matching amounts for Federal grant

16 funds for residency training programs in preventive

17 medicine.

18 ‘‘SEC. 769. HEALTH ADMINISTRATION TRAINEESHIPS AND

19 SPECIAL PROJECTS.

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

21 to State or local governments (that have in effect preventive

22 medical and dental public health residency programs) or

23 public or nonprofit private educational entities (including

24 graduate schools of social work and business schools that
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1 have health management programs) that offer a program

2 described in subsection (b)—

3 ‘‘(1) to provide traineeships for students enrolled

4 in such a program; and

5 ‘‘(2) to assist accredited programs health admin6 istration in the development or improvement of pro7 grams to prepare students for employment with pub8 lic or nonprofit private entities.

9 ‘‘(b) RELEVANT PROGRAMS.—The program referred to

10 in subsection (a) is an accredited program in health admin11 istration, hospital administration, or health policy analysis

12 and planning, which program is accredited by a body or

13 bodies approved for such purpose by the Secretary of Edu14 cation and which meets such other quality standards as the

15 Secretary of Health and Human Services by regulation

16 may prescribe.

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

18 grants under subsection (a), the Secretary shall give pref19 erence to qualified applicants that meet the following condi20 tions:

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

22 the applicant are engaged in full-time practice set23 tings in medically underserved communities.

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

25 from medically underserved communities.
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1 ‘‘(3) For the purpose of training students, the

2 applicant has established relationships with public

3 and nonprofit providers of health care in the commu4 nity involved.

5 ‘‘(4) In training students, the applicant empha6 sizes employment with public or nonprofit private en7 tities.

8 ‘‘(d) CERTAIN PROVISIONS REGARDING

9 TRAINEESHIPS.—

10 ‘‘(1) USE OF GRANT.—Traineeships awarded

11 under grants made under subsection (a) shall provide

12 for tuition and fees and such stipends and allowances

13 (including travel and subsistence expenses and de14 pendency allowances) for the trainees as the Secretary

15 may deem necessary.

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

17 Each entity applying for a grant under subsection (a)

18 for traineeships shall assure to the satisfaction of the

19 Secretary that the entity will give priority to award20 ing the traineeships to students who demonstrate a

21 commitment to employment with public or nonprofit

22 private entities in the fields with respect to which the

23 traineeships are awarded.
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1 ‘‘SEC. 770. AUTHORIZATION OF APPROPRIATIONS.

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

3 this subpart, there is authorized to be appropriated

4 $9,100,000 for fiscal year 1998, and such sums as may be

5 necessary for each of the fiscal years 1999 through 2002.

6 ‘‘(b) LIMITATION REGARDING CERTAIN PROGRAM.—In

7 obligating amounts appropriated under subsection (a), the

8 Secretary may not obligate more than 30 percent for carry9 ing out section 767.’’.

10 SEC. 106. GENERAL PROVISIONS.

11 (a) IN GENERAL.—

12 (1) Part F of title VII of the Public Health Serv13 ice Act (42 U.S.C. 295 et seq.) is repealed.

14 (2) Part G of title VII of the Public Health Serv15 ice Act (42 U.S.C. 295j et seq.) is amended—

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

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

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

19 (ii) redesignating subsection (c) as sub20 section (b);

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

22 295l);

23 (D) by repealing section 798;

24 (E) by redesignating section 799 as section

25 799B; and
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1 (F) by inserting after section 794, the fol2 lowing new sections:

3 ‘‘SEC. 796. APPLICATION.

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

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

6 and submit to the Secretary an application that meets the

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

8 and containing such information as the Secretary may re9 quire.

10 ‘‘(b) PLAN.—An application submitted under this sec11 tion shall contain the plan of the applicant for carrying

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

13 plan shall be consistent with relevant Federal, State, or re14 gional health professions program plans.

15 ‘‘(c) PERFORMANCE OUTCOME STANDARDS.—An ap16 plication submitted under this section shall contain a speci17 fication by the applicant entity of performance outcome

18 standards that the project to be funded under the grant or

19 contract will be measured against. Such standards shall ad20 dress relevant health workforce needs that the project will

21 meet. The recipient of a grant or contract under this section

22 shall meet the standards set forth in the grant or contract

23 application.

24 ‘‘(d) LINKAGES.—An application submitted under this

25 section shall contain a description of the linkages with rel-
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1 evant educational and health care entities, including train2 ing programs for other health professionals as appropriate,

3 that the project to be funded under the grant or contract

4 will establish. To the extent practicable, grantees under this

5 section shall establish linkages with health care providers

6 who provide care for underserved communities and popu7 lations.

8 ‘‘SEC. 797. USE OF FUNDS.

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

10 or contract awarded under this title may be used for train11 ing program development and support, faculty develop12 ment, model demonstrations, trainee support including tui13 tion, books, program fees and reasonable living expenses

14 during the period of training, technical assistance, work15 force analysis, dissemination of information, and exploring

16 new policy directions, as appropriate to meet recognized

17 health workforce objectives, in accordance with this title.

18 ‘‘(b) MAINTENANCE OF EFFORT.—With respect to ac19 tivities for which a grant awarded under this title is to

20 be expended, the entity shall agree to maintain expenditures

21 of non-Federal amounts for such activities at a level that

22 is not less than the level of such expenditures maintained

23 by the entity for the fiscal year preceding the fiscal year

24 for which the entity receives such a grant.
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1 ‘‘SEC. 798. MATCHING REQUIREMENT.

2 ‘‘The Secretary may require that an entity that ap3 plies for a grant or contract under this title provide non4 Federal matching funds, as appropriate, to ensure the insti5 tutional commitment of the entity to the projects funded

6 under the grant. As determined by the Secretary, such non7 Federal matching funds may be provided directly or

8 through donations from public or private entities and may

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

10 equipment, or services.

11 ‘‘SEC. 799. GENERALLY APPLICABLE PROVISIONS.

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

13 Secretary shall ensure that grants and contracts under this

14 title are awarded on a competitive basis, as appropriate,

15 to carry out innovative demonstration projects or provide

16 for strategic workforce supplementation activities as needed

17 to meet health workforce goals and in accordance with this

18 title. Contracts may be entered into under this title with

19 public or private entities as may be necessary.

20 ‘‘(b) ELIGIBLE ENTITIES.—Unless specifically re21 quired otherwise in this title, the Secretary shall accept ap22 plications for grants or contracts under this title from

23 health professions schools, academic health centers, State or

24 local governments, or other appropriate public or private

25 nonprofit entities for funding and participation in health

26 professions and nursing training activities. The Secretary
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1 may accept applications from for-profit private entities if

2 determined appropriate by the Secretary.

3 ‘‘(c) INFORMATION REQUIREMENTS.—

4 ‘‘(1) IN GENERAL.—Recipients of grants and

5 contracts under this title shall meet information re6 quirements as specified by the Secretary.

7 ‘‘(2) DATA COLLECTION.—The Secretary shall es8 tablish procedures to ensure that, with respect to any

9 data collection required under this title, such data is

10 collected in a manner that takes into account age, sex,

11 race, and ethnicity.

12 ‘‘(3) USE OF FUNDS.—The Secretary shall estab13 lish procedures to permit the use of amounts appro14 priated under this title to be used for data collection

15 purposes.

16 ‘‘(4) EVALUATIONS.—The Secretary shall estab17 lish procedures to ensure the annual evaluation of

18 programs and projects operated by recipients of

19 grants or contracts under this title. Such procedures

20 shall ensure that continued funding for such pro21 grams and projects will be conditioned upon a dem22 onstration that satisfactory progress has been made

23 by the program or project in meeting the objectives of

24 the program or project.
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1 ‘‘(d) TRAINING PROGRAMS.—Training programs con2 ducted with amounts received under this title shall meet ap3 plicable accreditation and quality standards.

4 ‘‘(e) DURATION OF ASSISTANCE.—

5 ‘‘(1) IN GENERAL.—Subject to paragraph (2), in

6 the case of an award to an entity of a grant, coopera7 tive agreement, or contract under this title, the period

8 during which payments are made to the entity under

9 the award may not exceed 5 years. The provision of

10 payments under the award shall be subject to annual

11 approval by the Secretary of the payments and sub12 ject to the availability of appropriations for the fiscal

13 year involved to make the payments. This paragraph

14 may not be construed as limiting the number of

15 awards under the program involved that may be

16 made to the entity.

17 ‘‘(2) LIMITATION.—In the case of an award to

18 an entity of a grant, cooperative agreement, or con19 tract under this title, paragraph (1) shall apply only

20 to the extent not inconsistent with any other provi21 sion of this title that relates to the period during

22 which payments may be made under the award.

23 ‘‘(f) PEER REVIEW REGARDING CERTAIN PRO24 GRAMS.—
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1 ‘‘(1) IN GENERAL.—Each application for a grant

2 under this title, except any scholarship or loan pro3 gram, including those under sections 701, 721, or 723,

4 shall be submitted to a peer review group for an eval5 uation of the merits of the proposals made in the ap6 plication. The Secretary may not approve such an

7 application unless a peer review group has rec8 ommended the application for approval.

9 ‘‘(2) COMPOSITION.—Each peer review group

10 under this subsection shall be composed principally of

11 individuals who are not officers or employees of the

12 Federal Government. In providing for the establish13 ment of peer review groups and procedures, the Sec14 retary shall ensure sex, racial, ethnic, and geographic

15 balance among the membership of such groups.

16 ‘‘(3) ADMINISTRATION.—This subsection shall be

17 carried out by the Secretary acting through the Ad18 ministrator of the Health Resources and Services Ad19 ministration.

20 ‘‘(g) PREFERENCE OR PRIORITY CONSIDERATIONS.—

21 In considering a preference or priority for funding which

22 is based on outcome measures for an eligible entity under

23 this title, the Secretary may also consider the future ability

24 of the eligible entity to meet the outcome preference or prior-
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1 ity through improvements in the eligible entity’s program

2 design.

3 ‘‘(h) ANALYTIC ACTIVITIES.—The Secretary shall en4 sure that—

5 ‘‘(1) cross-cutting workforce analytical activities

6 are carried out as part of the workforce information

7 and analysis activities under section 761; and

8 ‘‘(2) discipline-specific workforce information

9 and analytical activities are carried out as part of—

10 ‘‘(A) the community-based linkage program

11 under part D; and

12 ‘‘(B) the health workforce development pro13 gram under subpart 2 of part E.

14 ‘‘(i) OSTEOPATHIC SCHOOLS.—For purposes of this

15 title, any reference to—

16 ‘‘(1) medical schools shall include osteopathic

17 medical schools; and

18 ‘‘(2) medical students shall include osteopathic

19 medical students.

20 ‘‘SEC. 799A. TECHNICAL ASSISTANCE.

21 ‘‘Funds appropriated under this title may be used by

22 the Secretary to provide technical assistance in relation to

23 any of the authorities under this title.’’.

24 (b) PROFESSIONAL COUNSELORS AS MENTAL HEALTH

25 PROFESSIONALS.—Section 792(a) of the Public Health
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1 Service Act (42 U.S.C. 295k(a)) is amended by inserting

2 ‘‘professional counselors,’’ after ‘‘clinical psychologists,’’.

3 SEC. 107. PREFERENCE IN CERTAIN PROGRAMS.

4 (a) IN GENERAL.—Section 791 of the Public Health

5 Service Act (42 U.S.C. 295j), as amended by section

6 105(a)(2)(B), is further amended by adding at the end

7 thereof the following subsection:

8 ‘‘(c) EXCEPTIONS FOR NEW PROGRAMS.—

9 ‘‘(1) IN GENERAL.—To permit new programs to

10 compete equitably for funding under this section,

11 those new programs that meet at least 4 of the cri12 teria described in paragraph (3) shall qualify for a

13 funding preference under this section.

14 ‘‘(2) DEFINITION.—As used in this subsection,

15 the term ‘new program’ means any program that has

16 graduated less than three classes. Upon graduating at

17 least three classes, a program shall have the capabil18 ity to provide the information necessary to qualify the

19 program for the general funding preferences described

20 in subsection (a).

21 ‘‘(3) CRITERIA.—The criteria referred to in

22 paragraph (1) are the following:

23 ‘‘(A) The mission statement of the program

24 identifies a specific purpose of the program as
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1 being the preparation of health professionals to

2 serve underserved populations.

3 ‘‘(B) The curriculum of the program in4 cludes content which will help to prepare practi5 tioners to serve underserved populations.

6 ‘‘(C) Substantial clinical training experi7 ence is required under the program in medically

8 underserved communities.

9 ‘‘(D) A minimum of 20 percent of the clini10 cal faculty of the program spend at least 50 per11 cent of their time providing or supervising care

12 in medically underserved communities.

13 ‘‘(E) The entire program or a substantial

14 portion of the program is physically located in

15 a medically underserved community.

16 ‘‘(F) Student assistance, which is linked to

17 service in medically underserved communities

18 following graduation, is available to the students

19 in the program.

20 ‘‘(G) The program provides a placement

21 mechanism for deploying graduates to medically

22 underserved communities.’’.

23 (b) CONFORMING AMENDMENTS.—Section 791(a) of

24 the Public Health Service Act (42 U.S.C. 295j(a)) is amend25 ed—
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1 (1) in paragraph (1), by striking ‘‘sections 747’’

2 and all that follows through ‘‘767’’ and inserting ‘‘sec3 tions 747 and 750’’; and

4 (2) in paragraph (2), by striking ‘‘under section

5 798(a)’’.

6 SEC. 108. DEFINITIONS.

7 (a) GRADUATE PROGRAM IN BEHAVIORAL AND MEN8 TAL HEALTH PRACTICE.—Section 799B(1)(D) of the Public

9 Health Service Act (42 U.S.C. 295p(1)(D)) (as so redesig10 nated by section 106(a)(2)(E)) is amended—

11 (1) by inserting ‘‘behavioral health and’’ before

12 ‘‘mental’’; and

13 (2) by inserting ‘‘behavioral health and mental

14 health practice,’’ before ‘‘clinical’’.

15 (b) PROFESSIONAL COUNSELING AS A BEHAVIORAL

16 AND MENTAL HEALTH PRACTICE.—Section 799B of the

17 Public Health Service Act (42 U.S.C. 295p) (as so redesig18 nated by section 106(a)(2)(E)) is amended—

19 (1) in paragraph (1)—

20 (A) in subparagraph (C)—

21 (i) by inserting ‘‘and ‘graduate pro22 gram in professional counseling’ ’’ after

23 ‘‘graduate program in marriage and family

24 therapy’ ’’; and
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1 (ii) by inserting before the period the

2 following: ‘‘and a concentration leading to a

3 graduate degree in counseling’’;

4 (B) in subparagraph (D), by inserting

5 ‘‘professional counseling,’’ after ‘‘social work,’’;

6 and

7 (C) in subparagraph (E), by inserting ‘‘pro8 fessional counseling,’’ after ‘‘social work,’’; and

9 (2) in paragraph (5)(C), by inserting before the

10 period the following: ‘‘or a degree in counseling or an

11 equivalent degree’’.

12 (c) MEDICALLY UNDERSERVED COMMUNITY.—Section

13 799B(6) of the Public Health Service Act (42 U.S.C.

14 295p(6)) (as so redesignated by section 105(a)(2)(E)) is

15 amended—

16 (1) in subparagraph (B), by striking ‘‘or’’ at the

17 end thereof;

18 (2) in subparagraph (C), by striking the period

19 and inserting ‘‘; or’’; and

20 (3) by adding at the end the following:

21 ‘‘(D) is designated by a State Governor (in

22 consultation with the medical community) as a

23 shortage area or medically underserved commu24 nity.’’.
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1 (d) PROGRAMS FOR THE TRAINING OF PHYSICIAN AS2 SISTANTS.—Paragraph (3) of section 799B of the Public

3 Health Service Act (42 U.S.C. 295p) (as so redesignated

4 by section 105(a)(2)(E)) is amended to read as follows:

5 ‘‘(3) The term ‘program for the training of phy6 sician assistants’ means an educational program

7 that—

8 ‘‘(A) has as its objective the education of in9 dividuals who will, upon completion of their

10 studies in the program, be qualified to provide

11 primary care under the supervision of a physi12 cian;

13 ‘‘(B) extends for at least one academic year

14 and consists of—

15 ‘‘(i) supervised clinical practice; and

16 ‘‘(ii) at least four months (in the ag17 gregate) of classroom instruction, directed

18 toward preparing students to deliver health

19 care;

20 ‘‘(C) has an enrollment of not less than

21 eight students; and

22 ‘‘(D) trains students in primary care, dis23 ease prevention, health promotion, geriatric med24 icine, and home health care.’’.
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1 (e) PSYCHOLOGIST.—Section 799B of the Public

2 Health Service Act (42 U.S.C. 295p) (as so redesignated

3 by section 105(a)(2)(E)) is amended by adding at the end

4 the following:

5 ‘‘(11) The term ‘psychologist’ means an individ6 ual who—

7 ‘‘(A) holds a doctoral degree in psychology;

8 and

9 ‘‘(B) is licensed or certified on the basis of

10 the doctoral degree in psychology, by the State in

11 which the individual practices, at the independ12 ent practice level of psychology to furnish diag13 nostic, assessment, preventive, and therapeutic

14 services directly to individuals.’’.

15 SEC. 109. TECHNICAL AMENDMENT ON NATIONAL HEALTH

16 SERVICE CORPS.

17 Section 338B(b)(1)(B) of the Public Health Service Act

18 (42 U.S.C. 254l–1(b)(1)(B)) is amended by striking ‘‘or

19 other health profession’’ and inserting ‘‘behavioral and

20 mental health, or other health profession’’.

21 SEC. 110. SAVINGS PROVISION.

22 In the case of any authority for making awards of

23 grants or contracts that is terminated by the amendments

24 made by this subtitle, the Secretary of Health and Human

25 Services may, notwithstanding the termination of the au-
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1 thority, continue in effect any grant or contract made under

2 the authority that is in effect on the day before the date

3 of the enactment of this Act, subject to the duration of any

4 such grant or contract not exceeding the period determined

5 by the Secretary in first approving such financial assist6 ance, or in approving the most recent request made (before

7 the date of such enactment) for continuation of such assist8 ance, as the case may be.

9 Subtitle B—Nursing Workforce

10 Development

11 SEC. 121. SHORT TITLE.

12 This title may be cited as the ‘‘Nursing Education and

13 Practice Improvement Act of 1998’’.

14 SEC. 122. PURPOSE.

15 It is the purpose of this title to restructure the nurse

16 education authorities of title VIII of the Public Health Serv17 ice Act to permit a comprehensive, flexible, and effective ap18 proach to Federal support for nursing workforce develop19 ment.

20 SEC. 123. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.

21 Title VIII of the Public Health Service Act (42 U.S.C.

22 296k et seq.) is amended—

23 (1) by striking the title heading and all that fol24 lows except for subpart II of part B and sections 846

25 and 855; and inserting the following:
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1 ‘‘TITLE VIII—NURSING

2 WORKFORCE DEVELOPMENT’’;

3 (2) in subpart II of part B, by striking the sub4 part heading and inserting the following:

5 ‘‘PART E—STUDENT LOANS’’;

6 (3) by striking section 837;

7 (4) by inserting after the title heading the follow8 ing new parts:

9 ‘‘PART A—GENERAL PROVISIONS

10 ‘‘SEC. 801. DEFINITIONS.

11 ‘‘As used in this title:

12 ‘‘(1) ELIGIBLE ENTITIES.—The term ‘eligible en13 tities’ means schools of nursing, nursing centers, aca14 demic health centers, State or local governments, and

15 other public or private nonprofit entities determined

16 appropriate by the Secretary that submit to the Sec17 retary an application in accordance with section 802.

18 ‘‘(2) SCHOOL OF NURSING.—The term ‘school of

19 nursing’ means a collegiate, associate degree, or di20 ploma school of nursing in a State.

21 ‘‘(3) COLLEGIATE SCHOOL OF NURSING.—The

22 term ‘collegiate school of nursing’ means a depart23 ment, division, or other administrative unit in a col24 lege or university which provides primarily or exclu25 sively a program of education in professional nursing
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1 and related subjects leading to the degree of bachelor

2 of arts, bachelor of science, bachelor of nursing, or to

3 an equivalent degree, or to a graduate degree in nurs4 ing, or to an equivalent degree, and including ad5 vanced training related to such program of education

6 provided by such school, but only if such program, or

7 such unit, college or university is accredited.

8 ‘‘(4) ASSOCIATE DEGREE SCHOOL OF NURS9 ING.—The term ‘associate degree school of nursing’

10 means a department, division, or other administra11 tive unit in a junior college, community college, col12 lege, or university which provides primarily or exclu13 sively a two-year program of education in profes14 sional nursing and allied subjects leading to an asso15 ciate degree in nursing or to an equivalent degree, but

16 only if such program, or such unit, college, or univer17 sity is accredited.

18 ‘‘(5) DIPLOMA SCHOOL OF NURSING.—The term

19 ‘diploma school of nursing’ means a school affiliated

20 with a hospital or university, or an independent

21 school, which provides primarily or exclusively a pro22 gram of education in professional nursing and allied

23 subjects leading to a diploma or to equivalent indicia

24 that such program has been satisfactorily completed,

25 but only if such program, or such affiliated school or
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1 such hospital or university or such independent school

2 is accredited.

3 ‘‘(6) ACCREDITED.—

4 ‘‘(A) IN GENERAL.—Except as provided in

5 subparagraph (B), the term ‘accredited’ when

6 applied to any program of nurse education

7 means a program accredited by a recognized

8 body or bodies, or by a State agency, approved

9 for such purpose by the Secretary of Education

10 and when applied to a hospital, school, college,

11 or university (or a unit thereof) means a hos12 pital, school, college, or university (or a unit

13 thereof) which is accredited by a recognized body

14 or bodies, or by a State agency, approved for

15 such purpose by the Secretary of Education. For

16 the purpose of this paragraph, the Secretary of

17 Education shall publish a list of recognized ac18 crediting bodies, and of State agencies, which the

19 Secretary of Education determines to be reliable

20 authority as to the quality of education offered.

21 ‘‘(B) NEW PROGRAMS.—A new program of

22 nursing that, by reason of an insufficient period

23 of operation, is not, at the time of the submission

24 of an application for a grant or contract under

25 this title, eligible for accreditation by such a rec-
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1 ognized body or bodies or State agency, shall be

2 deemed accredited for purposes of this title if the

3 Secretary of Education finds, after consultation

4 with the appropriate accreditation body or bod5 ies, that there is reasonable assurance that the

6 program will meet the accreditation standards of

7 such body or bodies prior to the beginning of the

8 academic year following the normal graduation

9 date of students of the first entering class in such

10 a program.

11 ‘‘(7) NONPROFIT.—The term ‘nonprofit’ as ap12 plied to any school, agency, organization, or institu13 tion means one which is a corporation or association,

14 or is owned and operated by one or more corporations

15 or associations, no part of the net earnings of which

16 inures, or may lawfully inure, to the benefit of any

17 private shareholder or individual.

18 ‘‘(8) STATE.—The term ‘State’ means a State,

19 the Commonwealth of Puerto Rico, the District of Co20 lumbia, the Commonwealth of the Northern Mariana

21 Islands, Guam, American Samoa, the Virgin Islands,

22 or the Trust Territory of the Pacific Islands.

23 ‘‘SEC. 802. APPLICATION.

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

25 or contract under this title, an eligible entity shall prepare
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1 and submit to the Secretary an application that meets the

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

3 and containing such information as the Secretary may re4 quire.

5 ‘‘(b) PLAN.—An application submitted under this sec6 tion shall contain the plan of the applicant for carrying

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

8 plan shall be consistent with relevant Federal, State, or re9 gional program plans.

10 ‘‘(c) PERFORMANCE OUTCOME STANDARDS.—An ap11 plication submitted under this section shall contain a speci12 fication by the applicant entity of performance outcome

13 standards that the project to be funded under the grant or

14 contract will be measured against. Such standards shall ad15 dress relevant national nursing needs that the project will

16 meet. The recipient of a grant or contract under this section

17 shall meet the standards set forth in the grant or contract

18 application.

19 ‘‘(d) LINKAGES.—An application submitted under this

20 section shall contain a description of the linkages with rel21 evant educational and health care entities, including train22 ing programs for other health professionals as appropriate,

23 that the project to be funded under the grant or contract

24 will establish.
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1 ‘‘SEC. 803. 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 tui6 tion, books, program fees and reasonable living expenses

7 during the period of training, technical assistance, work8 force analysis, and dissemination of information, as appro9 priate to meet recognized nursing objectives, in accordance

10 with this title.

11 ‘‘(b) MAINTENANCE OF EFFORT.—With respect to ac12 tivities for which a grant awarded under this title is to

13 be expended, the entity shall agree to maintain expenditures

14 of non-Federal amounts for such activities at a level that

15 is not less than the level of such expenditures maintained

16 by the entity for the fiscal year preceding the fiscal year

17 for which the entity receives such a grant.

18 ‘‘SEC. 804. MATCHING REQUIREMENT.

19 ‘‘The Secretary may require that an entity that ap20 plies for a grant or contract under this title provide non21 Federal matching funds, as appropriate, to ensure the insti22 tutional commitment of the entity to the projects funded

23 under the grant. Such non-Federal matching funds may be

24 provided directly or through donations from public or pri25 vate entities and may be in cash or in-kind, fairly evalu26 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 this

10 title are awarded on a competitive basis, as appropriate,

11 to carry out innovative demonstration projects or provide

12 for strategic workforce supplementation activities as needed

13 to meet national nursing service goals and in accordance

14 with this title. Contracts may be entered into under this

15 title with public or private entities as determined necessary

16 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 estab22 lish 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 ap6 plicable accreditation and quality standards.

7 ‘‘(d) DURATION OF ASSISTANCE.—

8 ‘‘(1) IN GENERAL.—Subject to paragraph (2), in

9 the case of an award to an entity of a grant, coopera10 tive agreement, or contract under this title, the period

11 during which payments are made to the entity under

12 the award may not exceed 5 years. The provision of

13 payments under the award shall be subject to annual

14 approval by the Secretary of the payments and sub15 ject to the availability of appropriations for the fiscal

16 year involved to make the payments. This paragraph

17 may not be construed as limiting the number of

18 awards under the program involved that may be

19 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 grant

4 under this title, except advanced nurse traineeship

5 grants under section 811(a)(2), shall be submitted to

6 a peer review group for an evaluation of the merits

7 of the proposals made in the application. The Sec8 retary may not approve such an application unless a

9 peer review group has recommended the application

10 for approval.

11 ‘‘(2) COMPOSITION.—Each peer review group

12 under this subsection shall be composed principally of

13 individuals who are not officers or employees of the

14 Federal Government. In providing for the establish15 ment of peer review groups and procedures, the Sec16 retary shall, except as otherwise provided, ensure sex,

17 racial, ethnic, and geographic representation among

18 the membership of such groups.

19 ‘‘(3) ADMINISTRATION.—This subsection shall be

20 carried out by the Secretary acting through the Ad21 ministrator of the Health Resources and Services Ad22 ministration.

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 under

10 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 extent

15 practicable, be consistent with related Federal, State, or re16 gional nursing professions program plans and priorities.

17 ‘‘(h) FILING OF APPLICATIONS.—

18 ‘‘(1) IN GENERAL.—Applications for grants or

19 contracts under this title may be submitted by health

20 professions schools, schools of nursing, academic

21 health centers, State or local governments, or other

22 appropriate public or private nonprofit entities as de23 termined appropriate by the Secretary in accordance

24 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 ap4 propriated 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 to

8 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 the

15 costs of—

16 ‘‘(1) projects that support the enhancement of ad17 vanced practice nursing education and practice; and

18 ‘‘(2) traineeships for individuals in advanced

19 practice nursing programs.

20 ‘‘(b) DEFINITION OF ADVANCED PRACTICE NURSES.—

21 For purposes of this section, the term ‘advanced practice

22 nurses’ means individuals trained in advanced degree pro23 grams including individuals in combined R.N./Master’s de24 gree programs, post-nursing master’s certificate programs,

25 or, in the case of nurse midwives, in certificate programs
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1 in existence on the date that is one day prior to the date

2 of enactment of this section, to serve as nurse practitioners,

3 clinical nurse specialists, nurse midwives, nurse anes4 thetists, nurse educators, nurse administrators, or public

5 health nurses, or in other nurse specialties determined by

6 the Secretary to require advanced education.

7 ‘‘(c) AUTHORIZED NURSE PRACTITIONER AND NURSE8 MIDWIFERY PROGRAMS.—Nurse practitioner and nurse

9 midwifery programs eligible for support under this section

10 are educational programs for registered nurses (irrespective

11 of the type of school of nursing in which the nurses received

12 their training) that—

13 ‘‘(1) meet guidelines prescribed by the Secretary;

14 and

15 ‘‘(2) have as their objective the education of

16 nurses who will upon completion of their studies in

17 such programs, be qualified to effectively provide pri18 mary health care, including primary health care in

19 homes and in ambulatory care facilities, long-term

20 care facilities, acute care, and other health care set21 tings.

22 ‘‘(d) AUTHORIZED NURSE ANESTHESIA PROGRAMS.—

23 Nurse anesthesia programs eligible for support under this

24 section are education programs that—
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1 ‘‘(1) provide registered nurses with full-time an2 esthetist education; and

3 ‘‘(2) are accredited by the Council on Accredita4 tion of Nurse Anesthesia Educational Programs.

5 ‘‘(e) OTHER AUTHORIZED EDUCATIONAL PRO6 GRAMS.—The Secretary shall prescribe guidelines as appro7 priate for other advanced practice nurse education pro8 grams eligible for support under this section.

9 ‘‘(f) TRAINEESHIPS.—

10 ‘‘(1) IN GENERAL.—The Secretary may not

11 award a grant to an applicant under subsection (a)

12 unless the applicant involved agrees that traineeships

13 provided with the grant will only pay all or part of

14 the costs of—

15 ‘‘(A) the tuition, books, and fees of the pro16 gram of advanced nursing practice with respect

17 to which the traineeship is provided; and

18 ‘‘(B) the reasonable living expenses of the

19 individual during the period for which the

20 traineeship is provided.

21 ‘‘(2) DOCTORAL PROGRAMS.—The Secretary may

22 not obligate more than 10 percent of the traineeships

23 under subsection (a) for individuals in doctorate de24 gree programs.
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1 ‘‘(3) SPECIAL CONSIDERATION.—In making

2 awards of grants and contracts under subsection

3 (a)(2), the Secretary shall give special consideration

4 to an eligible entity that agrees to expend the award

5 to train advanced practice nurses who will practice

6 in health professional shortage areas designated under

7 section 332.

8 ‘‘PART C—INCREASING NURSING WORKFORCE

9 DIVERSITY

10 ‘‘SEC. 821. WORKFORCE DIVERSITY GRANTS.

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

12 to and enter into contracts with eligible entities to meet the

13 costs of special projects to increase nursing education op14 portunities for individuals who are from disadvantaged

15 backgrounds (including racial and ethnic minorities under16 represented among registered nurses) by providing student

17 scholarships or stipends, pre-entry preparation, and reten18 tion activities.

19 ‘‘(b) GUIDANCE.—In carrying out subsection (a), the

20 Secretary shall take into consideration the recommenda21 tions of the First, Second and Third Invitational Congresses

22 for Minority Nurse Leaders on ‘Caring for the Emerging

23 Majority,’ in 1992, 1993 and 1997, and consult with nurs24 ing associations including the American Nurses Associa25 tion, the National League for Nursing, the American Asso-
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1 ciation of Colleges of Nursing, the National Black Nurses

2 Association, the National Association of Hispanic Nurses,

3 the Association of Asian American and Pacific Islander

4 Nurses, the Native American Indian and Alaskan Nurses

5 Association, and the National Council of State Boards of

6 Nursing.

7 ‘‘(c) REQUIRED INFORMATION AND CONDITIONS FOR

8 AWARD RECIPIENTS.—

9 ‘‘(1) IN GENERAL.—Recipients of awards under

10 this section may be required, where requested, to re11 port to the Secretary concerning the annual admis12 sion, retention, and graduation rates for individuals

13 from disadvantaged backgrounds and ethnic and ra14 cial minorities in the school or schools involved in the

15 projects.

16 ‘‘(2) FALLING RATES.—If any of the rates re17 ported under paragraph (1) fall below the average of

18 the two previous years, the grant or contract recipient

19 shall provide the Secretary with plans for imme20 diately improving such rates.

21 ‘‘(3) INELIGIBILITY.—A recipient described in

22 paragraph (2) shall be ineligible for continued fund23 ing under this section if the plan of the recipient fails

24 to improve the rates within the 1-year period begin25 ning on the date such plan is implemented.
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1 ‘‘PART D—STRENGTHENING CAPACITY FOR BASIC

2 NURSE EDUCATION AND PRACTICE

3 ‘‘SEC. 831. BASIC NURSE EDUCATION AND PRACTICE

4 GRANTS.

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

6 to and enter into contracts with eligible entities for projects

7 to strengthen capacity for basic nurse education and prac8 tice.

9 ‘‘(b) PRIORITY AREAS.—In awarding grants or con10 tracts under this section the Secretary shall give priority

11 to entities that will use amounts provided under such a

12 grant or contract to enhance the educational mix and utili13 zation of the basic nursing workforce by strengthening pro14 grams that provide basic nurse education, such as

15 through—

16 ‘‘(1) establishing or expanding nursing practice

17 arrangements in noninstitutional settings to dem18 onstrate methods to improve access to primary health

19 care in medically underserved communities;

20 ‘‘(2) providing care for underserved populations

21 and other high-risk groups such as the elderly, indi22 viduals with HIV-AIDS, substance abusers, the home23 less, and victims of domestic violence;

24 ‘‘(3) providing managed care, quality improve25 ment, and other skills needed to practice in existing

26 and emerging organized health care systems;
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1 ‘‘(4) developing cultural competencies among

2 nurses;

3 ‘‘(5) expanding the enrollment in baccalaureate

4 nursing programs;

5 ‘‘(6) promoting career mobility for nursing per6 sonnel in a variety of training settings and cross

7 training or specialty training among diverse popu8 lation groups;

9 ‘‘(7) providing education in informatics, includ10 ing distance learning methodologies; or

11 ‘‘(8) other priority areas as determined by the

12 Secretary.’’;

13 (5) by adding at the end the following:

14 ‘‘PART F—AUTHORIZATION OF APPROPRIATIONS

15 ‘‘SEC. 841. AUTHORIZATION OF APPROPRIATIONS.

16 ‘‘There are authorized to be appropriated to carry out

17 sections 811, 821, and 831, $65,000,000 for fiscal year

18 1998, and such sums as may be necessary in each of the

19 fiscal years 1999 through 2002.

20 ‘‘PART G—NATIONAL ADVISORY COUNCIL ON

21 NURSE EDUCATION AND PRACTICE

22 ‘‘SEC. 845. NATIONAL ADVISORY COUNCIL ON NURSE EDU23 CATION AND PRACTICE.

24 ‘‘(a) ESTABLISHMENT.—The Secretary shall establish

25 an advisory council to be known as the National Advisory
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1 Council on Nurse Education and Practice (in this section

2 referred to as the ‘Advisory Council’).

3 ‘‘(b) COMPOSITION.—

4 ‘‘(1) IN GENERAL.—The Advisory Council shall

5 be composed of

6 ‘‘(A) not less than 21, nor more than 23 in7 dividuals, who are not officers or employees of

8 the Federal Government, appointed by the Sec9 retary without regard to the Federal civil service

10 laws, of which—

11 ‘‘(i) 2 shall be selected from full-time

12 students enrolled in schools of nursing;

13 ‘‘(ii) 2 shall be selected from the gen14 eral public;

15 ‘‘(iii) 2 shall be selected from practic16 ing professional nurses; and

17 ‘‘(iv) 9 shall be selected from among

18 the leading authorities in the various fields

19 of nursing, higher, secondary education,

20 and associate degree schools of nursing, and

21 from representatives of advanced practice

22 nursing groups (such as nurse practitioners,

23 nurse midwives, and nurse anesthetists),

24 hospitals, and other institutions and orga-
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1 nizations which provide nursing services;

2 and

3 ‘‘(B) the Secretary (or the delegate of the

4 Secretary (who shall be an ex officio member and

5 shall serve as the Chairperson)).

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

7 after the date of enactment of this Act, the Secretary

8 shall appoint the members of the Advisory Council

9 and each such member shall serve a 4 year term. In

10 making such appointments, the Secretary shall ensure

11 a fair balance between the nursing professions, a

12 broad geographic representation of members and a

13 balance between urban and rural members. Members

14 shall be appointed based on their competence, interest,

15 and knowledge of the mission of the profession in16 volved. A majority of the members shall be nurses.

17 ‘‘(3) MINORITY REPRESENTATION.—In appoint18 ing the members of the Advisory Council under para19 graph (1), the Secretary shall ensure the adequate

20 representation of minorities.

21 ‘‘(c) VACANCIES.—

22 ‘‘(1) IN GENERAL.—A vacancy on the Advisory

23 Council shall be filled in the manner in which the

24 original appointment was made and shall be subject
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1 to any conditions which applied with respect to the

2 original appointment.

3 ‘‘(2) FILLING UNEXPIRED TERM.—An individual

4 chosen to fill a vacancy shall be appointed for the un5 expired term of the member replaced.

6 ‘‘(d) DUTIES.—The Advisory Council shall—

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

8 Secretary and Congress concerning policy matters

9 arising in the administration of this title, including

10 the range of issues relating to the nurse workforce,

11 education, and practice improvement;

12 ‘‘(2) provide advice to the Secretary and Con13 gress in the preparation of general regulations and

14 with respect to policy matters arising in the adminis15 tration of this title, including the range of issues re16 lating to nurse supply, education and practice im17 provement; and

18 ‘‘(3) not later than 3 years after the date of en19 actment of this section, and annually thereafter, pre20 pare and submit to the Secretary, the Committee on

21 Labor and Human Resources of the Senate, and the

22 Committee on Commerce of the House of Representa23 tives, a report describing the activities of the Council,

24 including findings and recommendations made by the

25 Council concerning the activities under this title.
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1 ‘‘(e) MEETINGS AND DOCUMENTS.—

2 ‘‘(1) MEETINGS.—The Advisory Council shall

3 meet not less than 2 times each year. Such meetings

4 shall be held jointly with other related entities estab5 lished under this title where appropriate.

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

7 to the convening of a meeting under paragraph (1),

8 the Advisory Council shall prepare and make avail9 able an agenda of the matters to be considered by the

10 Advisory Council at such meeting. At any such meet11 ing, the Advisory Council shall distribute materials

12 with respect to the issues to be addressed at the meet13 ing. Not later than 30 days after the adjourning of

14 such a meeting, the Advisory Council shall prepare

15 and make available a summary of the meeting and

16 any actions taken by the Council based upon the

17 meeting.

18 ‘‘(f) COMPENSATION AND EXPENSES.—

19 ‘‘(1) COMPENSATION.—Each member of the Advi20 sory Council shall be compensated at a rate equal to

21 the daily equivalent of the annual rate of basic pay

22 prescribed for level IV of the Executive Schedule

23 under section 5315 of title 5, United States Code, for

24 each day (including travel time) during which such

25 member is engaged in the performance of the duties
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1 of the Council. All members of the Council who are

2 officers or employees of the United States shall serve

3 without compensation in addition to that received for

4 their services as officers or employees of the United

5 States.

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

7 Council shall be allowed travel expenses, including

8 per diem in lieu of subsistence, at rates authorized for

9 employees of agencies under subchapter I of chapter

10 57 of title 5, United States Code, while away from

11 their homes or regular places of business in the per12 formance of services for the Council.

13 ‘‘(g) FUNDING.—Amounts appropriated under this

14 title may be utilized by the Secretary to support the nurse

15 education and practice activities of the Council.

16 ‘‘(h) FACA.—The Federal Advisory Committee Act

17 shall apply to the Advisory Committee under this section

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

19 conflict with the requirements of this section.’’; and

20 (6) by redesignating section 855 as section 810,

21 and transferring such section so as to appear after

22 section 809 (as added by the amendment made by

23 paragraph (5)).
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1 SEC. 124. SAVINGS PROVISION.

2 In the case of any authority for making awards of

3 grants or contracts that is terminated by the amendment

4 made by section 123, the Secretary of Health and Human

5 Services may, notwithstanding the termination of the au6 thority, continue in effect any grant or contract made under

7 the authority that is in effect on the day before the date

8 of the enactment of this Act, subject to the duration of any

9 such grant or contract not exceeding the period determined

10 by the Secretary in first approving such financial assist11 ance, or in approving the most recent request made (before

12 the date of such enactment) for continuation of such assist13 ance, as the case may be.

14 Subtitle C—Financial Assistance

15 CHAPTER 1—SCHOOL-BASED REVOLVING LOAN

16 FUNDS

17 SEC. 131. PRIMARY CARE LOAN PROGRAM.

18 (a) REQUIREMENT FOR SCHOOLS.—Section 723(b)(1)

19 of the Public Health Service Act (42 U.S.C. 292s(b)(1)), as

20 amended by section 2014(c)(2)(A)(ii) of Public Law 103–

21 43 (107 Stat. 216), is amended by striking ‘‘3 years before’’

22 and inserting ‘‘4 years before’’.

23 (b) NONCOMPLIANCE.—Section 723(a)(3) of the Public

24 Health Service Act (42 U.S.C. 292s(a)(3)) is amended to

25 read as follows:
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1 ‘‘(3) NONCOMPLIANCE BY STUDENT.—Each

2 agreement entered into with a student pursuant to

3 paragraph (1) shall provide that, if the student fails

4 to comply with such agreement, the loan involved will

5 begin to accrue interest at a rate of 18 percent per

6 year beginning on the date of such noncompliance.’’.

7 (c) REPORT REQUIREMENT.—Section 723 of the Pub8 lic Health Service Act (42 U.S.C. 292s) is amended—

9 (1) by striking subsection (c); and

10 (2) by redesignating subsection (d) as subsection

11 (c).

12 SEC. 132. LOANS FOR DISADVANTAGED STUDENTS.

13 (a) AUTHORIZATION OF APPROPRIATIONS.—Section

14 724(f)(1) of the Public Health Service Act (42 U.S.C.

15 292t(f)(1)) is amended by striking ‘‘$15,000,000 for fiscal

16 year 1993’’ and inserting ‘‘$8,000,000 for each of the fiscal

17 years 1998 through 2002’’.

18 (b) REPEAL.—Effective October 1, 2002, paragraph

19 (1) of section 724(f) of the Public Health Service Act (42

20 U.S.C. 292t(f)(1)) is repealed.

21 SEC. 133. STUDENT LOANS REGARDING SCHOOLS OF

22 NURSING.

23 (a) IN GENERAL.—Section 836(b) of the Public Health

24 Service Act (42 U.S.C. 297b(b)) is amended—
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1 (1) in paragraph (1), by striking the period at

2 the end and inserting a semicolon;

3 (2) in paragraph (2)—

4 (A) in subparagraph (A), by striking ‘‘and’’

5 at the end; and

6 (B) by inserting before the semicolon at the

7 end the following: ‘‘, and (C) such additional pe8 riods under the terms of paragraph (8) of this

9 subsection’’;

10 (3) in paragraph (7), by striking the period at

11 the end and inserting ‘‘; and’’; and

12 (4) by adding at the end the following para13 graph:

14 ‘‘(8) pursuant to uniform criteria established by

15 the Secretary, the repayment period established under

16 paragraph (2) for any student borrower who during

17 the repayment period failed to make consecutive pay18 ments and who, during the last 12 months of the re19 payment period, has made at least 12 consecutive

20 payments may be extended for a period not to exceed

21 10 years.’’.

22 (b) MINIMUM MONTHLY PAYMENTS.—Section 836(g) of

23 the Public Health Service Act (42 U.S.C. 297b(g)) is

24 amended by striking ‘‘$15’’ and inserting ‘‘$40’’.
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1 (c) ELIMINATION OF STATUTE OF LIMITATION FOR

2 LOAN COLLECTIONS.—

3 (1) IN GENERAL.—Section 836 of the Public

4 Health Service Act (42 U.S.C. 297b) is amended by

5 adding at the end the following new subsection:

6 ‘‘(l) ELIMINATION OF STATUTE OF LIMITATION FOR

7 LOAN COLLECTIONS.—

8 ‘‘(1) PURPOSE.—It is the purpose of this sub9 section to ensure that obligations to repay loans

10 under this section are enforced without regard to any

11 Federal or State statutory, regulatory, or administra12 tive limitation on the period within which debts may

13 be enforced.

14 ‘‘(2) PROHIBITION.—Notwithstanding any other

15 provision of Federal or State law, no limitation shall

16 terminate the period within which suit may be filed,

17 a judgment may be enforced, or an offset, garnish18 ment, or other action may be initiated or taken by a

19 school of nursing that has an agreement with the Sec20 retary pursuant to section 835 that is seeking the re21 payment of the amount due from a borrower on a

22 loan made under this subpart after the default of the

23 borrower on such loan.’’.
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1 (2) EFFECTIVE DATE.—The amendment made by

2 paragraph (1) shall be effective with respect to actions

3 pending on or after the date of enactment of this Act.

4 (d) BREACH OF AGREEMENTS.—Section 846 of the

5 Public Health Service Act (42 U.S.C. 297n) is amended by

6 adding at the end thereof the following new subsection:

7 ‘‘(h) BREACH OF AGREEMENT.—

8 ‘‘(1) IN GENERAL.—In the case of any program

9 under this section under which an individual makes

10 an agreement to provide health services for a period

11 of time in accordance with such program in consider12 ation of receiving an award of Federal funds regard13 ing education as a nurse (including an award for the

14 repayment of loans), the following applies if the

15 agreement provides that this subsection is applicable:

16 ‘‘(A) In the case of a program under this

17 section that makes an award of Federal funds for

18 attending an accredited program of nursing (in

19 this section referred to as a ‘nursing program’),

20 the individual is liable to the Federal Govern21 ment for the amount of such award (including

22 amounts provided for expenses related to such at23 tendance), and for interest on such amount at

24 the maximum legal prevailing rate, if the indi25 vidual—
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1 ‘‘(i) fails to maintain an acceptable

2 level of academic standing in the nursing

3 program (as indicated by the program in

4 accordance with requirements established by

5 the Secretary);

6 ‘‘(ii) is dismissed from the nursing

7 program for disciplinary reasons; or

8 ‘‘(iii) voluntarily terminates the nurs9 ing program.

10 ‘‘(B) The individual is liable to the Federal

11 Government for the amount of such award (in12 cluding amounts provided for expenses related to

13 such attendance), and for interest on such

14 amount at the maximum legal prevailing rate, if

15 the individual fails to provide health services in

16 accordance with the program under this section

17 for the period of time applicable under the pro18 gram.

19 ‘‘(2) WAIVER OR SUSPENSION OF LIABILITY.—In

20 the case of an individual or health facility making an

21 agreement for purposes of paragraph (1), the Sec22 retary shall provide for the waiver or suspension of

23 liability under such subsection if compliance by the

24 individual or the health facility, as the case may be,

25 with the agreements involved is impossible, or would
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1 involve extreme hardship to the individual or facility,

2 and if enforcement of the agreements with respect to

3 the individual or facility would be unconscionable.

4 ‘‘(3) DATE CERTAIN FOR RECOVERY.—Subject to

5 paragraph (2), any amount that the Federal Govern6 ment is entitled to recover under paragraph (1) shall

7 be paid to the United States not later than the expi8 ration of the 3-year period beginning on the date the

9 United States becomes so entitled.

10 ‘‘(4) AVAILABILITY.—Amounts recovered under

11 paragraph (1) with respect to a program under this

12 section shall be available for the purposes of such pro13 gram, and shall remain available for such purposes

14 until expended.’’.

15 (e) TECHNICAL AMENDMENTS.—Section 839 of the

16 Public Health Service Act (42 U.S.C. 297e) is amended—

17 (1) in subsection (a)—

18 (A) by striking the matter preceding para19 graph (1) and inserting the following:

20 ‘‘(a) If a school terminates a loan fund established

21 under an agreement pursuant to section 835(b), or if the

22 Secretary for good cause terminates the agreement with the

23 school, there shall be a capital distribution as follows:’’; and
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1 (B) in paragraph (1), by striking ‘‘at the

2 close of September 30, 1999,’’ and inserting ‘‘on

3 the date of termination of the fund’’; and

4 (2) in subsection (b), to read as follows:

5 ‘‘(b) If a capital distribution is made under subsection

6 (a), the school involved shall, after such capital distribution,

7 pay to the Secretary, not less often than quarterly, the same

8 proportionate share of amounts received by the school in

9 payment of principal or interest on loans made from the

10 loan fund established under section 835(b) as determined

11 by the Secretary under subsection (a).’’.

12 SEC. 134. GENERAL PROVISIONS.

13 (a) MAXIMUM STUDENT LOAN PROVISIONS AND MINI14 MUM PAYMENTS.—

15 (1) IN GENERAL.—Section 722(a)(1) of the Pub16 lic Health Service Act (42 U.S.C. 292r(a)(1)), as

17 amended by section 2014(b)(1) of Public Law 103–43,

18 is amended by striking ‘‘the sum of’’ and all that fol19 lows through the end thereof and inserting ‘‘the cost

20 of attendance (including tuition, other reasonable

21 educational expenses, and reasonable living costs) for

22 that year at the educational institution attended by

23 the student (as determined by such educational insti24 tution).’’.
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1 (2) THIRD AND FOURTH YEARS.—Section

2 722(a)(2) of the Public Health Service Act (42 U.S.C.

3 292r(a)(2)), as amended by section 2014(b)(1) of Pub4 lic Law 103–43, is amended by striking ‘‘the amount

5 $2,500’’ and all that follows through ‘‘including such

6 $2,500)’’ and inserting ‘‘the amount of the loan may,

7 in the case of the third or fourth year of a student

8 at a school of medicine or osteopathic medicine, be in9 creased to the extent necessary’’.

10 (3) REPAYMENT PERIOD.—Section 722(c) of the

11 Public Health Service Act (42 U.S.C. 292r(c)), as

12 amended by section 2014(b)(1) of Public Law 103–43,

13 is amended—

14 (A) in the subsection heading by striking

15 ‘‘TEN-YEAR’’ and inserting ‘‘REPAYMENT’’;

16 (B) by striking ‘‘ten-year period which be17 gins’’ and inserting ‘‘period of not less than 10

18 years nor more than 25 years, at the discretion

19 of the institution, which begins’’; and

20 (C) by striking ‘‘such ten-year period’’ and

21 inserting ‘‘such period’’.

22 (4) MINIMUM PAYMENTS.—Section 722(j) of the

23 Public Health Service Act (42 U.S.C. 292r(j)), as

24 amended by section 2014(b)(1) of Public Law 103–43,

25 is amended by striking ‘‘$15’’ and inserting $40’’.
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1 (b) ELIMINATION OF STATUTE OF LIMITATION FOR

2 LOAN COLLECTIONS.—

3 (1) IN GENERAL.—Section 722 of the Public

4 Health Service Act (42 U.S.C. 292r), as amended by

5 section 2014(b)(1) of Public Law 103–43, is amended

6 by adding at the end the following new subsection:

7 ‘‘(m) ELIMINATION OF STATUTE OF LIMITATION FOR

8 LOAN COLLECTIONS.—

9 ‘‘(1) PURPOSE.—It is the purpose of this sub10 section to ensure that obligations to repay loans

11 under this section are enforced without regard to any

12 Federal or State statutory, regulatory, or administra13 tive limitation on the period within which debts may

14 be enforced.

15 ‘‘(2) PROHIBITION.—Notwithstanding any other

16 provision of Federal or State law, no limitation shall

17 terminate the period within which suit may be filed,

18 a judgment may be enforced, or an offset, garnish19 ment, or other action may be initiated or taken by a

20 school that has an agreement with the Secretary pur21 suant to section 721 that is seeking the repayment of

22 the amount due from a borrower on a loan made

23 under this subpart after the default of the borrower on

24 such loan.’’.
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1 (2) EFFECTIVE DATE.—The amendment made by

2 paragraph (1) shall be effective with respect to actions

3 pending on or after the date of enactment of this Act.

4 (c) DATE CERTAIN FOR CONTRIBUTIONS.—Paragraph

5 (2) of section 735(e) of the Public Health Service Act (42

6 U.S.C. 292y(e)(2)) is amended to read as follows:

7 ‘‘(2) DATE CERTAIN FOR CONTRIBUTIONS.—

8 Amounts described in paragraph (1) that are re9 turned to the Secretary shall be obligated before the

10 end of the succeeding fiscal year.’’.

11 CHAPTER 2—INSURED HEALTH EDUCATION

12 ASSISTANCE LOANS TO GRADUATE STUDENTS

13 SEC. 141. HEALTH EDUCATION ASSISTANCE LOAN PRO14 GRAM.

15 (a) HEALTH EDUCATION ASSISTANCE LOAN

16 DEFERMENT FOR BORROWERS PROVIDING HEALTH SERV17 ICES TO INDIANS.—

18 (1) IN GENERAL.—Section 705(a)(2)(C) of the

19 Public Health Service Act (42 U.S.C. 292d(a)(2)(C))

20 is amended by striking ‘‘and (x)’’ and inserting ‘‘(x)

21 not in excess of three years, during which the bor22 rower is providing health care services to Indians

23 through an Indian health program (as defined in sec24 tion 108(a)(2)(A) of the Indian Health Care Improve25 ment Act (25 U.S.C. 1616a(a)(2)(A)); and (xi)’’.
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1 (2) CONFORMING AMENDMENTS.—Section

2 705(a)(2)(C) of the Public Health Service Act (42

3 U.S.C. 292d(a)(2)(C)) is further amended—

4 (A) in clause (xi) (as so redesignated) by

5 striking ‘‘(ix)’’ and inserting ‘‘(x)’’; and

6 (B) in the matter following such clause (xi),

7 by striking ‘‘(x)’’ and inserting ‘‘(xi)’’.

8 (3) EFFECTIVE DATE.—The amendments made

9 by this subsection shall apply with respect to services

10 provided on or after the first day of the third month

11 that begins after the date of the enactment of this Act.

12 (b) REPORT REQUIREMENT.—Section 709(b) of the

13 Public Health Service Act (42 U.S.C. 292h(b)) is

14 amended—

15 (1) in paragraph (4)(B), by adding ‘‘and’’ after

16 the semicolon;

17 (2) in paragraph (5), by striking ‘‘; and’’ and

18 inserting a period; and

19 (3) by striking paragraph (6).

20 (c) COLLECTION FROM ESTATES.—Section 714 of the

21 Public Health Service Act (42 U.S.C. 292m) is amended

22 by adding at the end the following new sentence: ‘‘Notwith23 standing the first sentence, the Secretary may, in the case

24 of a borrower who dies, collect any remaining unpaid bal-
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1 ance owed to the lender, the holder of the loan, or the Fed2 eral Government from the borrower’s estate.’’.

3 (d) PROGRAM ELIGIBILITY.—

4 (1) LIMITATIONS ON LOANS.—Section 703(a) of

5 the Public Health Service Act (42 U.S.C. 292b(a)) is

6 amended by striking ‘‘or clinical psychology’’ and in7 serting ‘‘or behavioral and mental health practice, in8 cluding clinical psychology’’.

9 (2) DEFINITION OF ELIGIBLE INSTITUTION.—

10 Section 719(1) of the Public Health Service Act (42

11 U.S.C. 292o(1)) is amended by striking ‘‘or clinical

12 psychology’’ and inserting ‘‘or behavioral and mental

13 health practice, including clinical psychology’’.

14 SEC. 142. HEAL LENDER AND HOLDER PERFORMANCE

15 STANDARDS.

16 (a) GENERAL AMENDMENTS.—Section 707(a) of the

17 Public Health Service Act (42 U.S.C. 292f) is amended—

18 (1) by striking the last sentence;

19 (2) by striking ‘‘determined.’’ and inserting ‘‘de20 termined, except that, if the insurance beneficiary in21 cluding any servicer of the loan is not designated for

22 ‘exceptional performance’, as set forth in paragraph

23 (2), the Secretary shall pay to the beneficiary a sum

24 equal to 98 percent of the amount of the loss sustained

25 by the insured upon that loan.’’;
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1 (3) by striking ‘‘Upon’’ and inserting:

2 ‘‘(1) IN GENERAL.—Upon’’; and

3 (4) by adding at the end the following new para4 graph:

5 ‘‘(2) EXCEPTIONAL PERFORMANCE.—

6 ‘‘(A) AUTHORITY.—Where the Secretary de7 termines that an eligible lender, holder, or

8 servicer has a compliance performance rating

9 that equals or exceeds 97 percent, the Secretary

10 shall designate that eligible lender, holder, or

11 servicer, as the case may be, for exceptional per12 formance.

13 ‘‘(B) COMPLIANCE PERFORMANCE RAT14 ING.—For purposes of subparagraph (A), a com15 pliance performance rating is determined with

16 respect to compliance with due diligence in the

17 disbursement, servicing, and collection of loans

18 under this subpart for each year for which the

19 determination is made. Such rating shall be

20 equal to the percentage of all due diligence re21 quirements applicable to each loan, on average,

22 as established by the Secretary, with respect to

23 loans serviced during the period by the eligible

24 lender, holder, or servicer.
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1 ‘‘(C) ANNUAL AUDITS FOR LENDERS, HOLD2 ERS, AND SERVICERS.—Each eligible lender,

3 holder, or servicer desiring a designation under

4 subparagraph (A) shall have an annual finan5 cial and compliance audit conducted with re6 spect to the loan portfolio of such eligible lender,

7 holder, or servicer, by a qualified independent

8 organization from a list of qualified organiza9 tions identified by the Secretary and in accord10 ance with standards established by the Secretary.

11 The standards shall measure the lender’s, hold12 er’s, or servicer’s compliance with due diligence

13 standards and shall include a defined statistical

14 sampling technique designed to measure the per15 formance rating of the eligible lender, holder, or

16 servicer for the purpose of this section. Each eli17 gible lender, holder, or servicer shall submit the

18 audit required by this section to the Secretary.

19 ‘‘(D) SECRETARY’S DETERMINATIONS.—The

20 Secretary shall make the determination under

21 subparagraph (A) based upon the audits submit22 ted under this paragraph and any information

23 in the possession of the Secretary or submitted

24 by any other agency or office of the Federal Gov25 ernment.
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1 ‘‘(E) QUARTERLY COMPLIANCE AUDIT.—To

2 maintain its status as an exceptional performer,

3 the lender, holder, or servicer shall undergo a

4 quarterly compliance audit at the end of each

5 quarter (other than the quarter in which status

6 as an exceptional performer is established

7 through a financial and compliance audit, as de8 scribed in subparagraph (C)), and submit the re9 sults of such audit to the Secretary. The compli10 ance audit shall review compliance with due

11 diligence requirements for the period beginning

12 on the day after the ending date of the previous

13 audit, in accordance with standards determined

14 by the Secretary.

15 ‘‘(F) REVOCATION AUTHORITY.—The Sec16 retary shall revoke the designation of a lender,

17 holder, or servicer under subparagraph (A) if

18 any quarterly audit required under subpara19 graph (E) is not received by the Secretary by the

20 date established by the Secretary or if the audit

21 indicates the lender, holder, or servicer has failed

22 to meet the standards for designation as an ex23 ceptional performer under subparagraph (A). A

24 lender, holder, or servicer receiving a compliance

25 audit not meeting the standard for designation
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1 as an exceptional performer may reapply for

2 designation under subparagraph (A) at any

3 time.

4 ‘‘(G) DOCUMENTATION.—Nothing in this

5 section shall restrict or limit the authority of the

6 Secretary to require the submission of claims

7 documentation evidencing servicing performed on

8 loans, except that the Secretary may not require

9 exceptional performers to submit greater docu10 mentation than that required for lenders, holders,

11 and servicers not designated under subparagraph

12 (A).

13 ‘‘(H) COST OF AUDITS.—Each eligible lend14 er, holder, or servicer shall pay for all the costs

15 associated with the audits required under this

16 section.

17 ‘‘(I) ADDITIONAL REVOCATION AUTHOR18 ITY.—Notwithstanding any other provision of

19 this section, a designation under subparagraph

20 (A) may be revoked at any time by the Secretary

21 if the Secretary determines that the eligible lend22 er, holder, or servicer has failed to maintain an

23 overall level of compliance consistent with the

24 audit submitted by the eligible lender, holder, or

25 servicer under this paragraph or if the Secretary
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1 asserts that the lender, holder, or servicer may

2 have engaged in fraud in securing designation

3 under subparagraph (A) or is failing to service

4 loans in accordance with program requirements.

5 ‘‘(J) NONCOMPLIANCE.—A lender, holder, or

6 servicer designated under subparagraph (A) that

7 fails to service loans or otherwise comply with

8 applicable program regulations shall be consid9 ered in violation of the Federal False Claims

10 Act.’’.

11 (b) DEFINITION.—Section 707(e) of the Public Health

12 Service Act (42 U.S.C. 292f(e)) is amended by adding at

13 the end the following new paragraph:

14 ‘‘(4) The term ‘servicer’ means any agency act15 ing on behalf of the insurance beneficiary.’’.

16 (c) EFFECTIVE DATE.—The amendments made by sub17 sections (a) and (b) shall apply with respect to loans sub18 mitted to the Secretary for payment on or after the first

19 day of the sixth month that begins after the date of enact20 ment of this Act.

21 SEC. 143. REAUTHORIZATION.

22 (a) LOAN PROGRAM.—Section 702(a) of the Public

23 Health Service Act (42 U.S.C. 292a(a)) is amended—

24 (1) by striking ‘‘$350,000,000’’ and all that fol25 lows through ‘‘1995’’ and inserting ‘‘$350,000,000 for
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1 fiscal year 1998, $375,000,000 for fiscal year 1999,

2 and $425,000,000 for each of the fiscal years 2000

3 through 2002’’;

4 (2) by striking ‘‘obtained prior loans insured

5 under this subpart’’ and inserting ‘‘obtained loans in6 sured under this subpart in fiscal year 2002 or in

7 prior fiscal years’’;

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

9 new sentence: ‘‘The Secretary may establish guidelines

10 and procedures that lenders must follow in distribut11 ing funds under this subpart.’’; and

12 (4) by striking ‘‘September 30, 1998’’ and insert13 ing ‘‘September 30, 2005’’.

14 (b) INSURANCE PROGRAM.—Section 710(a)(2)(B) of

15 the Public Health Service Act (42 U.S.C. 292i(a)(2)(B)) is

16 amended by striking ‘‘any of the fiscal years 1993 through

17 1996’’ and inserting ‘‘fiscal year 1993 and subsequent fiscal

18 years’’.

19 SEC. 144. HEAL BANKRUPTCY.

20 (a) IN GENERAL.—Section 707(g) of the Public Health

21 Service Act (42 U.S.C. 292f(g)) is amended in the first sen22 tence by striking ‘‘A debt which is a loan insured’’ and in23 serting ‘‘Notwithstanding any other provision of Federal or

24 State law, a debt that is a loan insured’’.
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1 (b) APPLICATION.—The amendment made by sub2 section (a) shall apply to any loan insured under the au3 thority of subpart I of part A of title VII of the Public

4 Health Service Act (42 U.S.C. 292 et seq.) that is listed

5 or scheduled by the debtor in a case under title XI, United

6 States Code, filed—

7 (1) on or after the date of enactment of this Act;

8 or

9 (2) prior to such date of enactment in which a

10 discharge has not been granted.

11 SEC. 145. HEAL REFINANCING.

12 Section 706 of the Public Health Service Act (42

13 U.S.C. 292e) is amended—

14 (1) in subsection (d)—

15 (A) in the subsection heading, by striking

16 ‘‘CONSOLIDATION’’ and inserting ‘‘REFINANCING

17 OR CONSOLIDATION’’; and

18 (B) in the first sentence, by striking ‘‘in19 debtedness’’ and inserting ‘‘indebtedness or the

20 refinancing of a single loan’’; and

21 (2) in subsection (e)—

22 (A) in the subsection heading, by striking

23 ‘‘DEBTS’’ and inserting ‘‘DEBTS AND REFINANC24 ING’’;
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1 (B) in the first sentence, by striking ‘‘all of

2 the borrower’s debts into a single instrument’’

3 and inserting ‘‘all of the borrower’s loans insured

4 under this subpart into a single instrument (or,

5 if the borrower obtained only 1 loan insured

6 under this subpart, refinancing the loan 1

7 time)’’; and

8 (C) in the second sentence, by striking ‘‘con9 solidation’’ and inserting ‘‘consolidation or refi10 nancing’’.

11 TITLE II—OFFICE OF MINORITY

12 HEALTH

13 SEC. 201. REVISION AND EXTENSION OF PROGRAMS OF OF14 FICE OF MINORITY HEALTH.

15 (a) DUTIES AND REQUIREMENTS.—Section 1707 of the

16 Public Health Service Act (42 U.S.C. 300u–6) is amended

17 by striking subsection (b) and all that follows and inserting

18 the following:

19 ‘‘(b) DUTIES.—With respect to improving the health

20 of racial and ethnic minority groups, the Secretary, acting

21 through the Deputy Assistant Secretary for Minority

22 Health (in this section referred to as the ‘Deputy Assistant

23 Secretary’), shall carry out the following:

24 ‘‘(1) Establish short-range and long-range goals

25 and objectives and coordinate all other activities with-
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1 in the Public Health Service that relate to disease

2 prevention, health promotion, service delivery, and re3 search concerning such individuals. The heads of each

4 of the agencies of the Service shall consult with the

5 Deputy Assistant Secretary to ensure the coordination

6 of such activities.

7 ‘‘(2) Enter into interagency agreements with

8 other agencies of the Public Health Service.

9 ‘‘(3) Support research, demonstrations and eval10 uations to test new and innovative models.

11 ‘‘(4) Increase knowledge and understanding of

12 health risk factors.

13 ‘‘(5) Develop mechanisms that support better in14 formation dissemination, education, prevention, and

15 service delivery to individuals from disadvantaged

16 backgrounds, including individuals who are members

17 of racial or ethnic minority groups.

18 ‘‘(6) Ensure that the National Center for Health

19 Statistics collects data on the health status of each

20 minority group.

21 ‘‘(7) With respect to individuals who lack pro22 ficiency in speaking the English language, enter into

23 contracts with public and nonprofit private providers

24 of primary health services for the purpose of increas25 ing the access of the individuals to such services by
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1 developing and carrying out programs to provide bi2 lingual or interpretive services.

3 ‘‘(8) Support a national minority health re4 source center to carry out the following:

5 ‘‘(A) Facilitate the exchange of information

6 regarding matters relating to health information

7 and health promotion, preventive health services,

8 and education in the appropriate use of health

9 care.

10 ‘‘(B) Facilitate access to such information.

11 ‘‘(C) Assist in the analysis of issues and

12 problems relating to such matters.

13 ‘‘(D) Provide technical assistance with re14 spect to the exchange of such information (in15 cluding facilitating the development of materials

16 for such technical assistance).

17 ‘‘(9) Carry out programs to improve access to

18 health care services for individuals with limited pro19 ficiency in speaking the English language. Activities

20 under the preceding sentence shall include developing

21 and evaluating model projects.

22 ‘‘(c) ADVISORY COMMITTEE.—

23 ‘‘(1) IN GENERAL.—The Secretary shall establish

24 an advisory committee to be known as the Advisory
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1 Committee on Minority Health (in this subsection re2 ferred to as the ‘Committee’).

3 ‘‘(2) DUTIES.—The Committee shall provide ad4 vice to the Deputy Assistant Secretary carrying out

5 this section, including advice on the development of

6 goals and specific program activities under para7 graphs (1) through (9) of subsection (b) for each ra8 cial and ethnic minority group.

9 ‘‘(3) CHAIR.—The chairperson of the Committee

10 shall be selected by the Secretary from among the

11 members of the voting members of the Committee. The

12 term of office of the chairperson shall be 2 years.

13 ‘‘(4) COMPOSITION.—

14 ‘‘(A) The Committee shall be composed of 12

15 voting members appointed in accordance with

16 subparagraph (B), and nonvoting, ex officio

17 members designated in subparagraph (C).

18 ‘‘(B) The voting members of the Committee

19 shall be appointed by the Secretary from among

20 individuals who are not officers or employees of

21 the Federal Government and who have expertise

22 regarding issues of minority health. The racial

23 and ethnic minority groups shall be equally rep24 resented among such members.
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1 ‘‘(C) The nonvoting, ex officio members of

2 the Committee shall be such officials of the De3 partment of Health and Human Services as the

4 Secretary determines to be appropriate.

5 ‘‘(5) TERMS.—Each member of the Committee

6 shall serve for a term of 4 years, except that the Sec7 retary shall initially appoint a portion of the mem8 bers to terms of 1 year, 2 years, and 3 years.

9 ‘‘(6) VACANCIES.—If a vacancy occurs on the

10 Committee, a new member shall be appointed by the

11 Secretary within 90 days from the date that the va12 cancy occurs, and serve for the remainder of the term

13 for which the predecessor of such member was ap14 pointed. The vacancy shall not affect the power of the

15 remaining members to execute the duties of the Com16 mittee.

17 ‘‘(7) COMPENSATION.—Members of the Commit18 tee who are officers or employees of the United States

19 shall serve without compensation. Members of the

20 Committee who are not officers or employees of the

21 United States shall receive compensation, for each

22 day (including travel time) they are engaged in the

23 performance of the functions of the Committee. Such

24 compensation may not be in an amount in excess of

25 the daily equivalent of the annual maximum rate of
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1 basic pay payable under the General Schedule (under

2 title 5, United States Code) for positions above GS–

3 15.

4 ‘‘(d) CERTAIN REQUIREMENTS REGARDING DUTIES.—

5 ‘‘(1) RECOMMENDATIONS REGARDING LANGUAGE

6 AS IMPEDIMENT TO HEALTH CARE.—The Deputy As7 sistant Secretary for Minority Health shall consult

8 with the Director of the Office of International and

9 Refugee Health, the Director of the Office of Civil

10 Rights, and the Directors of other appropriate De11 partmental entities regarding recommendations for

12 carrying out activities under subsection (b)(9).

13 ‘‘(2) EQUITABLE ALLOCATION REGARDING AC14 TIVITIES.—In carrying out subsection (b), the Sec15 retary shall ensure that services provided under such

16 subsection are equitably allocated among all groups

17 served under this section by the Secretary.

18 ‘‘(3) CULTURAL COMPETENCY OF SERVICES.—

19 The Secretary shall ensure that information and serv20 ices provided pursuant to subsection (b) are provided

21 in the language, educational, and cultural context

22 that is most appropriate for the individuals for whom

23 the information and services are intended.

24 ‘‘(e) GRANTS AND CONTRACTS REGARDING DUTIES.—
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1 ‘‘(1) IN GENERAL.—In carrying out subsection

2 (b), the Secretary acting through the Deputy Assist3 ant Secretary may make awards of grants, coopera4 tive agreements, and contracts to public and non5 profit private entities.

6 ‘‘(2) PROCESS FOR MAKING AWARDS.—The Dep7 uty Assistant Secretary shall ensure that awards

8 under paragraph (1) are made, to the extent prac9 tical, only on a competitive basis, and that a grant

10 is awarded for a proposal only if the proposal has

11 been recommended for such an award through a proc12 ess of peer review.

13 ‘‘(3) EVALUATION AND DISSEMINATION.—The

14 Deputy Assistant Secretary, directly or through con15 tracts with public and private entities, shall provide

16 for evaluations of projects carried out with awards

17 made under paragraph (1) during the preceding 2 fis18 cal years. The report shall be included in the report

19 required under subsection (f) for the fiscal year in20 volved.

21 ‘‘(f) REPORTS.—

22 ‘‘(1) IN GENERAL.—Not later than February 1 of

23 fiscal year 1999 and of each second year thereafter,

24 the Secretary shall submit to the Committee on En25 ergy and Commerce of the House of Representatives,
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1 and to the Committee on Labor and Human Re2 sources of the Senate, a report describing the activi3 ties carried out under this section during the preced4 ing 2 fiscal years and evaluating the extent to which

5 such activities have been effective in improving the

6 health of racial and ethnic minority groups. Each

7 such report shall include the biennial reports submit8 ted under sections 201(e)(3) and 201(f)(2) for such

9 years by the heads of the Public Health Service agen10 cies.

11 ‘‘(2) AGENCY REPORTS.—Not later than Feb12 ruary 1, 1999, and biennially thereafter, the heads of

13 the Public Health Service agencies shall submit to the

14 Deputy Assistant Secretary a report summarizing the

15 minority health activities of each of the respective

16 agencies.

17 ‘‘(g) DEFINITION.—For purposes of this section:

18 ‘‘(1) The term ‘racial and ethnic minority group’

19 means American Indians (including Alaska Natives,

20 Eskimos, and Aleuts); Asian Americans and Pacific

21 Islanders; Blacks; and Hispanics.

22 ‘‘(2) The term ‘Hispanic’ means individuals

23 whose origin is Mexican, Puerto Rican, Cuban, Cen24 tral or South American, or any other Spanish-speak25 ing country.
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1 ‘‘(h) FUNDING.—

2 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—For

3 the purpose of carrying out this section, there are au4 thorized to be appropriated $30,000,000 for fiscal

5 year 1998, such sums as may be necessary for each

6 of the fiscal years 1999 through 2002.’’.

7 (b) AUTHORIZATION FOR NATIONAL CENTER FOR

8 HEALTH STATISTICS.—Section 306 of the Public Health

9 Service Act (42 U.S.C. 242k) is amended—

10 (1) in subsection (m), by adding at the end the

11 following:

12 ‘‘(4)(A) Subject to subparagraph (B), the Secretary,

13 acting through the Center, shall collect data on Hispanics

14 and major Hispanic subpopulation groups and American

15 Indians, and for developing special area population studies

16 on major Asian American and Pacific Islander popu17 lations.

18 ‘‘(B) The provisions of subparagraph (A) shall be effec19 tive with respect to a fiscal year only to the extent that

20 funds are appropriated pursuant to paragraph (3) of sub21 section (n), and only if the amounts appropriated for such

22 fiscal year pursuant to each of paragraphs (1) and (2) of

23 subsection (n) equal or exceed the amounts so appropriated

24 for fiscal year 1997.’’;
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1 (2) in subsection (n)(1), by striking ‘‘through

2 1998’’ and inserting ‘‘through 2003’’; and

3 (3) in subsection (n)

4 (A) in the first sentence of paragraph (2)—

5 (i) by striking ‘‘authorized in sub6 section (m)’’ and inserting ‘‘authorized in

7 paragraphs (1) through (3) of subsection

8 (m)’’; and

9 (ii) by striking ‘‘$5,000,000’’ and all

10 that follows through the period and insert11 ing ‘‘such sums as may be necessary for

12 each of the fiscal years 1999 through 2003.’’;

13 and

14 (B) by adding at the end the following:

15 ‘‘(3) For activities authorized in subsection (m)(4),

16 there are authorized to be appropriated $1,000,000 for fiscal

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

18 of the fiscal years 1999 through 2002.’’.

19 (c) MISCELLANEOUS AMENDMENTS.—Section 1707 of

20 the Public Health Service Act (42 U.S.C. 300u–6) is

21 amended—

22 (1) in the heading for the section by striking

23 ‘‘ESTABLISHMENT OF’’; and
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1 (2) in subsection (a), by striking ‘‘Office of the

2 Assistant Secretary for Health’’ and inserting ‘‘Office

3 of Public Health and Science’’.

4 TITLE III—SELECTED

5 INITIATIVES

6 SEC. 301. STATE OFFICES OF RURAL HEALTH.

7 Section 338J of the Public Health Service Act (42

8 U.S.C. 254r) is amended—

9 (1) in subsection (b)(1), in the matter preceding

10 subparagraph (A), by striking ‘‘in cash’’; and

11 (2) in subsection (j)(1)—

12 (A) by striking ‘‘and’’ after ‘‘1992,’’; and

13 (B) by inserting before the period the follow14 ing: ‘‘, and such sums as may be necessary for

15 each of the fiscal years 1998 through 2002’’; and

16 (3) in subsection (k), by striking ‘‘$10,000,000’’

17 and inserting ‘‘$36,000,000’’.

18 SEC. 302. DEMONSTRATION PROJECTS REGARDING ALZ19 HEIMER’S DISEASE.

20 (a) IN GENERAL.—Section 398(a) of the Public Health

21 Service Act (42 U.S.C. 280c–3(a)) is amended—

22 (1) in the matter preceding paragraph (1), by

23 striking ‘‘not less than 5, and not more than 15,’’;

24 (2) in paragraph (2)—
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1 (A) by inserting after ‘‘disorders’’ the fol2 lowing: ‘‘who are living in single family homes

3 or in congregate settings’’; and

4 (B) by striking ‘‘and’’ at the end;

5 (3) by redesignating paragraph (3) as para6 graph (4); and

7 (4) by inserting after paragraph (2) the follow8 ing:

9 ‘‘(3) to improve the access of such individuals to

10 home-based or community-based long-term care serv11 ices (subject to the services being provided by entities

12 that were providing such services in the State in13 volved as of October 1, 1995), particularly such indi14 viduals who are members of racial or ethnic minority

15 groups, who have limited proficiency in speaking the

16 English language, or who live in rural areas; and’’.

17 (b) DURATION.—Section 398A of the Public Health

18 Service Act (42 U.S.C. 280c–4) is amended—

19 (1) in the heading for the section, by striking

20 ‘‘LIMITATION’’ and all that follows and inserting

21 ‘‘REQUIREMENT OF MATCHING

22 FUNDS’’;

23 (2) by striking subsection (a);

24 (3) by redesignating subsections (b) and (c) as

25 subsections (a) and (b), respectively; and
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1 (4) in subsection (a) (as so redesignated), in each

2 of paragraphs (1)(C) and (2)(C), by striking ‘‘third

3 year’’ and inserting ‘‘third or subsequent year’’.

4 (c) AUTHORIZATION OF APPROPRIATIONS.—Section

5 398B(e) of the Public Health Service Act (42 U.S.C. 280c–

6 5(e)) is amended—

7 (1) by striking ‘‘and such sums’’ and inserting

8 ‘‘such sums’’; and

9 (2) by inserting before the period the following:

10 ‘‘, $8,000,000 for fiscal year 1998, and such sums as

11 may be necessary for each of the fiscal years 1999

12 through 2002’’.

13 SEC. 303. PROJECT GRANTS FOR IMMUNIZATION SERVICES.

14 Section 317(j) of the Public Health Service Act (42

15 U.S.C. 247b(j)) is amended—

16 (1) in paragraph (1), by striking ‘‘individuals

17 against vaccine-preventable diseases’’ and all that fol18 lows through the first period and inserting the follow19 ing: ‘‘children, adolescents, and adults against vac20 cine-preventable diseases, there are authorized to be

21 appropriated such sums as may be necessary for each

22 of the fiscal years 1998 through 2002.’’; and

23 (2) in paragraph (2), by striking ‘‘1990’’ and in24 serting ‘‘1997’’.
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1 TITLE IV—MISCELLANEOUS

2 PROVISIONS

3 SEC. 401. TECHNICAL CORRECTIONS REGARDING PUBLIC

4 LAW 103–183.

5 (a) AMENDATORY INSTRUCTIONS.—Public Law 103–

6 183 is amended—

7 (1) in section 601—

8 (A) in subsection (b), in the matter preced9 ing paragraph (1), by striking ‘‘Section 1201 of

10 the Public Health Service Act (42 U.S.C. 300d)’’

11 and inserting ‘‘Title XII of the Public Health

12 Service Act (42 U.S.C. 300d et seq.)’’; and

13 (B) in subsection (f)(1), by striking ‘‘in sec14 tion 1204(c)’’ and inserting ‘‘in section 1203(c)

15 (as redesignated by subsection (b)(2) of this sec16 tion)’’;

17 (2) in section 602, by striking ‘‘for the purpose’’

18 and inserting ‘‘For the purpose’’; and

19 (3) in section 705(b), by striking ‘‘317D((l)(1)’’

20 and inserting ‘‘317D(l)(1)’’.

21 (b) PUBLIC HEALTH SERVICE ACT.—The Public

22 Health Service Act, as amended by Public Law 103–183

23 and by subsection (a) of this section, is amended—
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1 (1) in section 317E(g)(2), by striking ‘‘making

2 grants under subsection (b)’’ and inserting ‘‘carrying

3 out subsection (b)’’;

4 (2) in section 318, in subsection (e) as in effect

5 on the day before the date of the enactment of Public

6 Law 103–183, by redesignating the subsection as sub7 section (f);

8 (3) in subpart 6 of part C of title IV—

9 (A) by transferring the first section 447

10 (added by section 302 of Public Law 103–183)

11 from the current placement of the section;

12 (B) by redesignating the section as section

13 447A; and

14 (C) by inserting the section after section

15 447;

16 (4) in section 1213(a)(8), by striking ‘‘provides

17 for for’’ and inserting ‘‘provides for’’;

18 (5) in section 1501, by redesignating the second

19 subsection (c) (added by section 101(f) of Public Law

20 103–183) as subsection (d); and

21 (6) in section 1505(3), by striking ‘‘nonprofit’’.

22 (c) MISCELLANEOUS CORRECTION.—Section 401(c)(3)

23 of Public Law 103–183 is amended in the matter preceding

24 subparagraph (A) by striking ‘‘(d)(5)’’ and inserting

25 ‘‘(e)(5)’’.
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1 (d) CONFORMING AMENDMENT.—Section 308(b) of the

2 Public Health Service Act (42 U.S.C. 242m(b)) is amend3 ed—

4 (1) in paragraph (2)(A), by striking ‘‘306(n)’’

5 and inserting ‘‘306(m)’’; and

6 (2) in paragraph (2)(C), by striking ‘‘306(n)’’

7 and inserting ‘‘306(m)’’.

8 (e) EFFECTIVE DATE.—This section is deemed to have

9 taken effect immediately after the enactment of Public Law

10 103–183.

11 SEC. 402. MISCELLANEOUS AMENDMENTS REGARDING PHS

12 COMMISSIONED OFFICERS.

13 (a) ANTI-DISCRIMINATION LAWS.—Amend section 212

14 of the Public Health Service Act (42 U.S.C. 213) by adding

15 the following new subsection at the end thereof:

16 ‘‘(f) Active service of commissioned officers of the Serv17 ice shall be deemed to be active military service in the

18 Armed Forces of the United States for purposes of all laws

19 related to discrimination on the basis of race, color, sex,

20 ethnicity, age, religion, and disability.’’

21 (b) TRAINING IN LEAVE WITHOUT PAY STATUS.—Sec22 tion 218 of the Public Health Service Act (42 U.S.C. 218a)

23 is amended by adding at the end the following:

24 ‘‘(c) A commissioned officer may be placed in leave

25 without pay status while attending an educational institu-
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1 tion or training program whenever the Secretary deter2 mines that such status is in the best interest of the Service.

3 For purposes of computation of basic pay, promotion, re4 tirement, compensation for injury or death, and the benefits

5 provided by sections 212 and 224, an officer in such status

6 pursuant to the preceding sentence shall be considered as

7 performing service in the Service and shall have an active

8 service obligation as set forth in subsection (b) of this sec9 tion.’’.

10 (c) UTILIZATION OF ALCOHOL AND DRUG ABUSE

11 RECORDS THAT APPLY TO THE ARMED FORCES.—Section

12 543(e) of the Public Health Service Act (42 U.S.C. 290dd–

13 2(e)) is amended by striking ‘‘Armed Forces’’ each place

14 that such term appears and inserting ‘‘Uniformed Serv15 ices’’.

16 SEC. 403. CLINICAL TRAINEESHIPS.

17 Section 303(d)(1) of the Public Health Service Act (42

18 U.S.C. 242a(d)(1)) is amended by inserting ‘‘counseling,’’

19 after ‘‘family therapy,’’.

20 SEC. 404. PROJECT GRANTS FOR SCREENINGS, REFERRALS,

21 AND EDUCATION REGARDING LEAD POISON22 ING.

23 Section 317A(l)(1) of the Public Health Service Act

24 (42 U.S.C. 247b–1(l)(1)) is amended by striking ‘‘1998’’

25 and inserting ‘‘2002’’.
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1 SEC. 405. PROJECT GRANTS FOR PREVENTIVE HEALTH

2 SERVICES REGARDING TUBERCULOSIS.

3 Section 317E(g) of the Public Health Service Act (42

4 U.S.C. 247b–6(g)(1)) is amended—

5 (1) in paragraph (1)—

6 (A) in subparagraph (A), by striking

7 ‘‘1998’’ and inserting ‘‘2002’’; and

8 (B) in subparagraph (B), by striking

9 ‘‘$50,000,000’’ and inserting ‘‘25 percent’’; and

10 (2) in paragraph (2), by striking ‘‘1998’’ and in11 serting ‘‘2002’’.

12 SEC. 406. CDC LOAN REPAYMENT PROGRAM.

13 Section 317F of the Public Health Service Act (42

14 U.S.C. 247b-7) is amended—

15 (1) in subsection (a)(1), by striking ‘‘$20,000’’

16 and inserting ‘‘$35,000’’;

17 (2) in subsection (c), by striking ‘‘1998’’ and in18 serting ‘‘2002’’; and

19 (3) by adding at the end the following:

20 ‘‘(d) AVAILABILITY OF APPROPRIATIONS.—Amounts

21 appropriated for a fiscal year for contracts under subsection

22 (a) shall remain available until the expiration of the second

23 fiscal year beginning after the fiscal year for which the

24 amounts were appropriated.’’.
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1 SEC. 407. COMMUNITY PROGRAMS ON DOMESTIC VIOLENCE.

2 (a) IN GENERAL.—Section 318(h)(2) of the Family Vi3 olence Prevention and Services Act (42 U.S.C. 10418(h)(2))

4 is amended by striking ‘‘fiscal year 1997’’ and inserting

5 ‘‘for each of the fiscal years 1997 through 2002’’.

6 (b) STUDY.—The Secretary of Health and Human

7 Services shall request that the Institute of Medicine conduct

8 a study concerning the training needs of health profes9 sionals with respect to the detection and referral of victims

10 of family or acquaintance violence. Not later than 2 years

11 after the date of enactment of this Act, the Institute of Medi12 cine shall prepare and submit to Congress a report concern13 ing the study conducted under this subsection.

14 SEC. 408. STATE LOAN REPAYMENT PROGRAM.

15 Section 338I(i)(1) of the Public Health Service Act (42

16 U.S.C. 254q–1(i)(1)) is amended by inserting before the pe17 riod ‘‘, and such sums as may be necessary for each of the

18 fiscal years 1998 through 2002’’.

19 SEC. 409. AUTHORITY OF THE DIRECTOR OF NIH.

20 Section 402(b) of the Public Health Service Act (42

21 U.S.C. 282(b)) is amended—

22 (1) in paragraph (11), by striking ‘‘and’’ at the

23 end thereof;

24 (2) in paragraph (12), by striking the period

25 and inserting a semicolon; and
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1 (3) by adding after paragraph (12), the follow2 ing new paragraphs:

3 ‘‘(13) may conduct and support research train4 ing—

5 ‘‘(A) for which fellowship support is not

6 provided under section 487; and

7 ‘‘(B) which does not consist of residency

8 training of physicians or other health profes9 sionals; and

10 ‘‘(14) may appoint physicians, dentists, and

11 other health care professionals, subject to the provi12 sions of title 5, United States Code, relating to ap13 pointments and classifications in the competitive

14 service, and may compensate such professionals sub15 ject to the provisions of chapter 74 of title 38, United

16 States Code.’’.

17 SEC. 410. RAISE IN MAXIMUM LEVEL OF LOAN REPAY18 MENTS.

19 (a) REPAYMENT PROGRAMS WITH RESPECT TO

20 AIDS.—Section 487A of the Public Health Service Act (42

21 U.S.C. 288–1) is amended—

22 (1) in subsection (a), by striking ‘‘$20,000’’ and

23 inserting ‘‘$35,000’’; and

24 (2) in subsection (c), by striking ‘‘1996’’ and in25 serting ‘‘2001’’.
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1 (b) REPAYMENT PROGRAMS WITH RESPECT TO CON2 TRACEPTION AND INFERTILITY.—Section 487B(a) of the

3 Public Health Service Act (42 U.S.C. 288–2(a)) is amended

4 by striking ‘‘$20,000’’ and inserting ‘‘$35,000’’.

5 (c) REPAYMENT PROGRAMS WITH RESPECT TO RE6 SEARCH GENERALLY.—Section 487C(a)(1) of the Public

7 Health Service Act (42 U.S.C. 288–3(a)(1)) is amended by

8 striking ‘‘$20,000’’ and inserting ‘‘$35,000’’.

9 (d) REPAYMENT PROGRAMS WITH RESPECT TO CLINI10 CAL RESEARCHERS FROM DISADVANTAGED BACK11 GROUNDS.—Section 487E(a) of the Public Health Service

12 Act (42 U.S.C. 288–5(a)) is amended—

13 (1) in paragraph (1), by striking ‘‘$20,000’’ and

14 inserting ‘‘$35,000’’; and

15 (2) in paragraph (3), by striking ‘‘338C’’ and

16 inserting ‘‘338B, 338C’’.

17 SEC. 411. CONSTRUCTION OF REGIONAL CENTERS FOR RE18 SEARCH ON PRIMATES.

19 Section 481B(a) of the Public Health Service Act (42

20 U.S.C. 287a–3(a)) is amended—

21 (1) by striking ‘‘shall’’ and inserting ‘‘may’’;

22 and

23 (2) by striking ‘‘$5,000,000’’ and inserting ‘‘up

24 to $2,500,000’’.
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1 SEC. 412. PEER REVIEW.

2 Section 504(d)(2) of the Public Health Service Act (42

3 U.S.C. 290aa–3(d)(2)) is amended by striking ‘‘cooperative

4 agreement, or contract’’ each place that such appears and

5 inserting ‘‘or cooperative agreement’’.

6 SEC. 413. FUNDING FOR TRAUMA CARE.

7 Section 1232(a) of the Public Health Service Act (42

8 U.S.C. 300d–32) is amended by striking ‘‘and 1996’’ and

9 inserting ‘‘through 2002’’.

10 SEC. 414. HEALTH INFORMATION AND HEALTH PRO11 MOTION.

12 Section 1701(b) of the Public Health Service Act (42

13 U.S.C. 300u(b)) is amended by striking ‘‘through 1996’’

14 and inserting ‘‘through 2002’’.

15 SEC. 415. EMERGENCY MEDICAL SERVICES FOR CHILDREN.

16 Section 1910 of the Public Health Service Act (42

17 U.S.C. 300w–9) is amended—

18 (1) in subsection (a)—

19 (A) by striking ‘‘two-year period’’ and in20 serting ‘‘3-year period (with an optional 4th

21 year based on performance)’’; and

22 (B) by striking ‘‘one grant’’ and inserting

23 ‘‘3 grants’’; and

24 (2) in subsection (d), by striking ‘‘1997’’ and in25 serting ‘‘2005’’.
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1 SEC. 416. ADMINISTRATION OF CERTAIN REQUIREMENTS.

2 (a) IN GENERAL.—Section 2004 of Public Law 103–

3 43 (107 Stat. 209) is amended by striking subsection (a).

4 (b) CONFORMING AMENDMENTS.—Section 2004 of

5 Public Law 103–43, as amended by subsection (a) of this

6 section, is amended—

7 (1) by striking ‘‘(b) SENSE’’ and all that follows

8 through ‘‘In the case’’ and inserting the following:

9 ‘‘(a) SENSE OF CONGRESS REGARDING PURCHASE OF

10 AMERICAN-MADE EQUIPMENT AND PRODUCTS.—In the

11 case’’;

12 (2) by striking ‘‘(2) NOTICE TO RECIPIENTS OF

13 ASSISTANCE’’ and inserting the following:

14 ‘‘(b) NOTICE TO RECIPIENTS OF ASSISTANCE’’; and

15 (3) in subsection (b), as redesignated by para16 graph (2) of this subsection, by striking ‘‘paragraph

17 (1)’’ and inserting ‘‘subsection (a)’’.

18 (c) EFFECTIVE DATE.—This section is deemed to have

19 taken effect immediately after the enactment of Public Law

20 103–43.

21 SEC. 417. AIDS DRUG ASSISTANCE PROGRAM.

22 Section 2618(b)(3) of the Public Health Service Act

23 (42 U.S.C. 300ff–28(b)(3)) is amended—

24 (1) in subparagraph (A), by striking ‘‘and the

25 Commonwealth of Puerto Rico’’ and inserting ‘‘, the
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1 Commonwealth of Puerto Rico, the Virgin Islands,

2 and Guam’’; and

3 (2) in subparagraph (B), by striking ‘‘the Virgin

4 Islands, Guam’’.

5 SEC. 418. NATIONAL FOUNDATION FOR BIOMEDICAL RE6 SEARCH.

7 Part I of title IV of the Public Health Service Act (42

8 U.S.C. 290b et seq.) is amended—

9 (1) by striking the part heading and inserting

10 the following:

11 ‘‘PART I—FOUNDATION FOR THE NATIONAL

12 INSTITUTES OF HEALTH’’;

13 and

14 (2) in section 499—

15 (A) in subsection (a), by striking ‘‘National

16 Foundation for Biomedical Research’’ and in17 serting ‘‘Foundation for the National Institutes

18 of Health’’;

19 (B) in subsection (k)(10)—

20 (i) by striking ‘‘not’’; and

21 (ii) by adding at the end the following:

22 ‘‘Any funds transferred under this para23 graph shall be subject to all Federal limita24 tions relating to Federally-funded re25 search.’’; and
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1 (C) in subsection (m)(1), by striking

2 ‘‘$200,000’’ and all that follows through ‘‘1995’’

3 and inserting ‘‘$500,000 for each fiscal year’’.