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[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 1880 Enrolled Bill (ENR)]

        S.1880

                       One Hundred Sixth Congress

                                 of the

                        United States of America

                          AT THE SECOND SESSION

           Begun and held at the City of Washington on Monday,
             the twenty-fourth day of January, two thousand

                                 An Act

 
To amend the Public Health Service Act to improve the health of minority 
                              individuals.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Minority Health 
and Health Disparities Research and Education Act of 2000''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings.

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

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

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

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

        TITLE III--DATA COLLECTION RELATING TO RACE OR ETHNICITY

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

                 TITLE IV--HEALTH PROFESSIONS EDUCATION

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

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

Sec. 501. Public awareness and information dissemination.

                   TITLE VI--MISCELLANEOUS PROVISIONS

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

SEC. 2. FINDINGS.

    The Congress finds as follows:
        (1) Despite notable progress in the overall health of the 
    Nation, there are continuing disparities in the burden of illness 
    and death experienced by African Americans, Hispanics, Native 
    Americans, Alaska Natives, and Asian Pacific Islanders, compared to 
    the United States population as a whole.
        (2) The largest numbers of the medically underserved are white 
    individuals, and many of them have the same health care access 
    problems as do members of minority groups. Nearly 20,000,000 white 
    individuals live below the poverty line with many living in 
    nonmetropolitan, rural areas such as Appalachia, where the high 
    percentage of counties designated as health professional shortage 
    areas (47 percent) and the high rate of poverty contribute to 
    disparity outcomes. However, there is a higher proportion of racial 
    and ethnic minorities in the United States represented among the 
    medically underserved.
        (3) There is a national need for minority scientists in the 
    fields of biomedical, clinical, behavioral, and health services 
    research. Ninety percent of minority physicians educated at 
    Historically Black Medical Colleges live and serve in minority 
    communities.
        (4) Demographic trends inspire concern about the Nation's 
    ability to meet its future scientific, technological, and 
    engineering workforce needs. Historically, non-Hispanic white males 
    have made up the majority of the United States scientific, 
    technological, and engineering workers.
        (5) The Hispanic and Black population will increase 
    significantly in the next 50 years. The scientific, technological, 
    and engineering workforce may decrease if participation by 
    underrepresented minorities remains the same.
        (6) Increasing rates of Black and Hispanic workers can help 
    ensure a strong scientific, technological, and engineering 
    workforce.
        (7) Individuals such as underrepresented minorities and women 
    in the scientific, technological, and engineering workforce enable 
    society to address its diverse needs.
        (8) If there had not been a substantial increase in the number 
    of science and engineering degrees awarded to women and 
    underrepresented minorities over the past few decades, the United 
    States would be facing even greater shortages in scientific, 
    technological, and engineering workers.
        (9) In order to effectively promote a diverse and strong 21st 
    century scientific, technological, and engineering workforce, 
    Federal agencies should expand or add programs that effectively 
    overcome barriers such as educational transition from one level to 
    the next and student requirements for financial resources.
        (10) Federal agencies should work in concert with the private 
    nonprofit sector to emphasize the recruitment and retention of 
    qualified individuals from ethnic and gender groups that are 
    currently underrepresented in the scientific, technological, and 
    engineering workforce.
        (11) Behavioral and social sciences research has increased 
    awareness and understanding of factors associated with health care 
    utilization and access, patient attitudes toward health services, 
    and risk and protective behaviors that affect health and illness. 
    These factors have the potential to then be modified to help close 
    the health disparities gap among ethnic minority populations. In 
    addition, there is a shortage of minority behavioral science 
    researchers and behavioral health care professionals. According to 
    the National Science Foundation, only 15.5 percent of behavioral 
    research-oriented psychology doctorate degrees were awarded to 
    minority students in 1997. In addition, only 17.9 percent of 
    practice-oriented psychology doctorate degrees were awarded to 
    ethnic minorities.

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

    SEC. 101. ESTABLISHMENT OF NATIONAL CENTER ON MINORITY HEALTH AND 
      HEALTH DISPARITIES.
    (a) In General.--Part E of title IV of the Public Health Service 
Act (42 U.S.C. 287 et seq.) is amended by adding at the end the 
following subpart:

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

``SEC. 485E. PURPOSE OF CENTER.

    ``(a) In General.--The general purpose of the National Center on 
Minority Health and Health Disparities (in this subpart referred to as 
the `Center') is the conduct and support of research, training, 
dissemination of information, and other programs with respect to 
minority health conditions and other populations with health 
disparities.
    ``(b) Priorities.--The Director of the Center shall in expending 
amounts appropriated under this subpart give priority to conducting and 
supporting minority health disparities research.
    ``(c) Minority Health Disparities Research.--For purposes of this 
subpart:
        ``(1) The term `minority health disparities research' means 
    basic, clinical, and behavioral research on minority health 
    conditions (as defined in paragraph (2)), including research to 
    prevent, diagnose, and treat such conditions.
        ``(2) The term `minority health conditions', with respect to 
    individuals who are members of minority groups, means all diseases, 
    disorders, and conditions (including with respect to mental health 
    and substance abuse)--
            ``(A) unique to, more serious, or more prevalent in such 
        individuals;
            ``(B) for which the factors of medical risk or types of 
        medical intervention may be different for such individuals, or 
        for which it is unknown whether such factors or types are 
        different for such individuals; or
            ``(C) with respect to which there has been insufficient 
        research involving such individuals as subjects or insufficient 
        data on such individuals.
        ``(3) The term `minority group' has the meaning given the term 
    `racial and ethnic minority group' in section 1707.
        ``(4) The terms `minority' and `minorities' refer to 
    individuals from a minority group.
    ``(d) Health Disparity Populations.--For purposes of this subpart:
        ``(1) A population is a health disparity population if, as 
    determined by the Director of the Center after consultation with 
    the Director of the Agency for Healthcare Research and Quality, 
    there is a significant disparity in the overall rate of disease 
    incidence, prevalence, morbidity, mortality, or survival rates in 
    the population as compared to the health status of the general 
    population.
        ``(2) The Director shall give priority consideration to 
    determining whether minority groups qualify as health disparity 
    populations under paragraph (1).
        ``(3) The term `health disparities research' means basic, 
    clinical, and behavioral research on health disparity populations 
    (including individual members and communities of such populations) 
    that relates to health disparities as defined under paragraph (1), 
    including the causes of such disparities and methods to prevent, 
    diagnose, and treat such disparities.
    ``(e) Coordination of Activities.--The Director of the Center shall 
act as the primary Federal official with responsibility for 
coordinating all minority health disparities research and other health 
disparities research conducted or supported by the National Institutes 
of Health, and--
        ``(1) shall represent the health disparities research program 
    of the National Institutes of Health, including the minority health 
    disparities research program, at all relevant Executive branch task 
    forces, committees and planning activities; and
        ``(2) shall maintain communications with all relevant Public 
    Health Service agencies, including the Indian Health Service, and 
    various other departments of the Federal Government to ensure the 
    timely transmission of information concerning advances in minority 
    health disparities research and other health disparities research 
    between these various agencies for dissemination to affected 
    communities and health care providers.
    ``(f) Collaborative Comprehensive Plan and Budget.--
        ``(1) In general.--Subject to the provisions of this section 
    and other applicable law, the Director of NIH, the Director of the 
    Center, and the directors of the other agencies of the National 
    Institutes of Health in collaboration (and in consultation with the 
    advisory council for the Center) shall--
            ``(A) establish a comprehensive plan and budget for the 
        conduct and support of all minority health disparities research 
        and other health disparities research activities of the 
        agencies of the National Institutes of Health (which plan and 
        budget shall be first established under this subsection not 
        later than 12 months after the date of the enactment of this 
        subpart);
            ``(B) ensure that the plan and budget establish priorities 
        among the health disparities research activities that such 
        agencies are authorized to carry out;
            ``(C) ensure that the plan and budget establish objectives 
        regarding such activities, describes the means for achieving 
        the objectives, and designates the date by which the objectives 
        are expected to be achieved;
            ``(D) ensure that, with respect to amounts appropriated for 
        activities of the Center, the plan and budget give priority in 
        the expenditure of funds to conducting and supporting minority 
        health disparities research;
            ``(E) ensure that all amounts appropriated for such 
        activities are expended in accordance with the plan and budget;
            ``(F) review the plan and budget not less than annually, 
        and revise the plan and budget as appropriate;
            ``(G) ensure that the plan and budget serve as a broad, 
        binding statement of policies regarding minority health 
        disparities research and other health disparities research 
        activities of the agencies, but do not remove the 
        responsibility of the heads of the agencies for the approval of 
        specific programs or projects, or for other details of the 
        daily administration of such activities, in accordance with the 
        plan and budget; and
            ``(H) promote coordination and collaboration among the 
        agencies conducting or supporting minority health or other 
        health disparities research.
        ``(2) Certain components of plan and budget.--With respect to 
    health disparities research activities of the agencies of the 
    National Institutes of Health, the Director of the Center shall 
    ensure that the plan and budget under paragraph (1) provide for--
            ``(A) basic research and applied research, including 
        research and development with respect to products;
            ``(B) research that is conducted by the agencies;
            ``(C) research that is supported by the agencies;
            ``(D) proposals developed pursuant to solicitations by the 
        agencies and for proposals developed independently of such 
        solicitations; and
            ``(E) behavioral research and social sciences research, 
        which may include cultural and linguistic research in each of 
        the agencies.
        ``(3) Minority health disparities research.--The plan and 
    budget under paragraph (1) shall include a separate statement of 
    the plan and budget for minority health disparities research.
    ``(g) Participation in Clinical Research.--The Director of the 
Center shall work with the Director of NIH and the directors of the 
agencies of the National Institutes of Health to carry out the 
provisions of section 492B that relate to minority groups.
    ``(h) Research Endowments.--
        ``(1) In general.--The Director of the Center may carry out a 
    program to facilitate minority health disparities research and 
    other health disparities research by providing for research 
    endowments at centers of excellence under section 736.
        ``(2) Eligibility.--The Director of the Center may provide for 
    a research endowment under paragraph (1) only if the institution 
    involved meets the following conditions:
            ``(A) The institution does not have an endowment that is 
        worth in excess of an amount equal to 50 percent of the 
        national average of endowment funds at institutions that 
        conduct similar biomedical research or training of health 
        professionals.
            ``(B) The application of the institution under paragraph 
        (1) regarding a research endowment has been recommended 
        pursuant to technical and scientific peer review and has been 
        approved by the advisory council under subsection (j).
    ``(i) Certain Activities.--In carrying out subsection (a), the 
Director of the Center--
        ``(1) shall assist the Director of the National Center for 
    Research Resources in carrying out section 481(c)(3) and in 
    committing resources for construction at Institutions of Emerging 
    Excellence;
        ``(2) shall establish projects to promote cooperation among 
    Federal agencies, State, local, tribal, and regional public health 
    agencies, and private entities in health disparities research; and
        ``(3) may utilize information from previous health initiatives 
    concerning minorities and other health disparity populations.
    ``(j) Advisory Council.--
        ``(1) In general.--The Secretary shall, in accordance with 
    section 406, establish an advisory council to advise, assist, 
    consult with, and make recommendations to the Director of the 
    Center on matters relating to the activities described in 
    subsection (a), and with respect to such activities to carry out 
    any other functions described in section 406 for advisory councils 
    under such section. Functions under the preceding sentence shall 
    include making recommendations on budgetary allocations made in the 
    plan under subsection (f), and shall include reviewing reports 
    under subsection (k) before the reports are submitted under such 
    subsection.
        ``(2) Membership.--With respect to the membership of the 
    advisory council under paragraph (1), a majority of the members 
    shall be individuals with demonstrated expertise regarding minority 
    health disparity and other health disparity issues; representatives 
    of communities impacted by minority and other health disparities 
    shall be included; and a diversity of health professionals shall be 
    represented. The membership shall in addition include a 
    representative of the Office of Behavioral and Social Sciences 
    Research under section 404A.
    ``(k) Annual Report.--The Director of the Center shall prepare an 
annual report on the activities carried out or to be carried out by the 
Center, and shall submit each such report to the Committee on Health, 
Education, Labor, and Pensions of the Senate, the Committee on Commerce 
of the House of Representatives, the Secretary, and the Director of 
NIH. With respect to the fiscal year involved, the report shall--
        ``(1) describe and evaluate the progress made in health 
    disparities research conducted or supported by the national 
    research institutes;
        ``(2) summarize and analyze expenditures made for activities 
    with respect to health disparities research conducted or supported 
    by the National Institutes of Health;
        ``(3) include a separate statement applying the requirements of 
    paragraphs (1) and (2) specifically to minority health disparities 
    research; and
        ``(4) contain such recommendations as the Director considers 
    appropriate.
    ``(l) Authorization of Appropriations.--For the purpose of carrying 
out this subpart, there are authorized to be appropriated $100,000,000 
for fiscal year 2001, and such sums as may be necessary for each of the 
fiscal years 2002 through 2005. Such authorization of appropriations is 
in addition to other authorizations of appropriations that are 
available for the conduct and support of minority health disparities 
research or other health disparities research by the agencies of the 
National Institutes of Health.''.
    (b) Conforming Amendment.--Part A of title IV of the Public Health 
Service Act (42 U.S.C. 281 et seq.) is amended--
        (1) in section 401(b)(2)--
            (A) in subparagraph (F), by moving the subparagraph two ems 
        to the left; and
            (B) by adding at the end the following subparagraph:
        ``(G) The National Center on Minority Health and Health 
    Disparities.''; and
        (2) by striking section 404.
    SEC. 102. CENTERS OF EXCELLENCE FOR RESEARCH EDUCATION AND 
      TRAINING.
    Subpart 6 of part E of title IV of the Public Health Service Act, 
as added by section 101(a) of this Act, is amended by adding at the end 
the following section:
``SEC. 485F. CENTERS OF EXCELLENCE FOR RESEARCH EDUCATION AND TRAINING.
    ``(a) In General.--The Director of the Center shall make awards of 
grants or contracts to designated biomedical and behavioral research 
institutions under paragraph (1) of subsection (c), or to consortia 
under paragraph (2) of such subsection, for the purpose of assisting 
the institutions in supporting programs of excellence in biomedical and 
behavioral research training for individuals who are members of 
minority health disparity populations or other health disparity 
populations.
    ``(b) Required Use of Funds.--An award may be made under subsection 
(a) only if the applicant involved agrees that the grant will be 
expended--
        ``(1) to train members of minority health disparity populations 
    or other health disparity populations as professionals in the area 
    of biomedical or behavioral research or both; or
        ``(2) to expand, remodel, renovate, or alter existing research 
    facilities or construct new research facilities for the purpose of 
    conducting minority health disparities research and other health 
    disparities research.
    ``(c) Centers of Excellence.--
        ``(1) In general.--For purposes of this section, a designated 
    biomedical and behavioral research institution is a biomedical and 
    behavioral research institution that--
            ``(A) has a significant number of members of minority 
        health disparity populations or other health disparity 
        populations enrolled as students in the institution (including 
        individuals accepted for enrollment in the institution);
            ``(B) has been effective in assisting such students of the 
        institution to complete the program of education or training 
        and receive the degree involved;
            ``(C) has made significant efforts to recruit minority 
        students to enroll in and graduate from the institution, which 
        may include providing means-tested scholarships and other 
        financial assistance as appropriate; and
            ``(D) has made significant recruitment efforts to increase 
        the number of minority or other members of health disparity 
        populations serving in faculty or administrative positions at 
        the institution.
        ``(2) Consortium.--Any designated biomedical and behavioral 
    research institution involved may, with other biomedical and 
    behavioral institutions (designated or otherwise), including tribal 
    health programs, form a consortium to receive an award under 
    subsection (a).
        ``(3) Application of criteria to other programs.--In the case 
    of any criteria established by the Director of the Center for 
    purposes of determining whether institutions meet the conditions 
    described in paragraph (1), this section may not, with respect to 
    minority health disparity populations or other health disparity 
    populations, be construed to authorize, require, or prohibit the 
    use of such criteria in any program other than the program 
    established in this section.
    ``(d) Duration of Grant.--The period during which payments are made 
under a grant under subsection (a) may not exceed 5 years. Such 
payments shall be subject to annual approval by the Director of the 
Center and to the availability of appropriations for the fiscal year 
involved to make the payments.
    ``(e) Maintenance of Effort.--
        ``(1) In general.--With respect to activities for which an 
    award under subsection (a) is authorized to be expended, the 
    Director of the Center may not make such an award to a designated 
    research institution or consortium for any fiscal year unless the 
    institution, or institutions in the consortium, as the case may be, 
    agree to maintain expenditures of non-Federal amounts for such 
    activities at a level that is not less than the level of such 
    expenditures maintained by the institutions involved for the fiscal 
    year preceding the fiscal year for which such institutions receive 
    such an award.
        ``(2) Use of federal funds.--With respect to any Federal 
    amounts received by a designated research institution or consortium 
    and available for carrying out activities for which an award under 
    subsection (a) is authorized to be expended, the Director of the 
    Center may make such an award only if the institutions involved 
    agree that the institutions will, before expending the award, 
    expend the Federal amounts obtained from sources other than the 
    award.
    ``(f) Certain Expenditures.--The Director of the Center may 
authorize a designated biomedical and behavioral research institution 
to expend a portion of an award under subsection (a) for research 
endowments.
    ``(g) Definitions.--For purposes of this section:
        ``(1) The term `designated biomedical and behavioral research 
    institution' has the meaning indicated for such term in subsection 
    (c)(1). Such term includes any health professions school receiving 
    an award of a grant or contract under section 736.
        ``(2) The term `program of excellence' means any program 
    carried out by a designated biomedical and behavioral research 
    institution with an award under subsection (a), if the program is 
    for purposes for which the institution involved is authorized in 
    subsection (b) to expend the grant.
    ``(h) Authorization of Appropriations.--For the purpose of making 
grants under subsection (a), there are authorized to be appropriated 
such sums as may be necessary for each of the fiscal years 2001 through 
2005.''.
    SEC. 103. EXTRAMURAL LOAN REPAYMENT PROGRAM FOR MINORITY HEALTH 
      DISPARITIES RESEARCH.
    Subpart 6 of part E of title IV of the Public Health Service Act, 
as amended by section 102 of this Act, is amended by adding at the end 
the following section:
``SEC. 485G. LOAN REPAYMENT PROGRAM FOR MINORITY HEALTH DISPARITIES 
RESEARCH.
    ``(a) In General.--The Director of the Center shall establish a 
program of entering into contracts with qualified health professionals 
under which such health professionals agree to engage in minority 
health disparities research or other health disparities research in 
consideration of the Federal Government agreeing to repay, for each 
year of engaging in such research, not more than $35,000 of the 
principal and interest of the educational loans of such health 
professionals.
    ``(b) Service Provisions.--The provisions of sections 338B, 338C, 
and 338E shall, except as inconsistent with subsection (a), apply to 
the program established in such subsection to the same extent and in 
the same manner as such provisions apply to the National Health Service 
Corps Loan Repayment Program established in subpart III of part D of 
title III.
    ``(c) Requirement Regarding Health Disparity Populations.--The 
Director of the Center shall ensure that not fewer than 50 percent of 
the contracts entered into under subsection (a) are for appropriately 
qualified health professionals who are members of a health disparity 
population.
    ``(d) Priority.--With respect to minority health disparities 
research and other health disparities research under subsection (a), 
the Secretary shall ensure that priority is given to conducting 
projects of biomedical research.
    ``(e) Funding.--
        ``(1) Authorization of appropriations.--For the purpose of 
    carrying out this section, there are authorized to be appropriated 
    such sums as may be necessary for each of the fiscal years 2001 
    through 2005.
        ``(2) Availability of appropriations.--Amounts available for 
    carrying out this section shall remain available until the 
    expiration of the second fiscal year beginning after the fiscal 
    year for which the amounts were made available.''.

SEC. 104. GENERAL PROVISIONS REGARDING THE CENTER.

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

``SEC. 485H. GENERAL PROVISIONS REGARDING THE CENTER.

    ``(a) Administrative Support for Center.--The Secretary, acting 
through the Director of the National Institutes of Health, shall 
provide administrative support and support services to the Director of 
the Center and shall ensure that such support takes maximum advantage 
of existing administrative structures at the agencies of the National 
Institutes of Health.
    ``(b) Evaluation and Report.--
        ``(1) Evaluation.--Not later than 5 years after the date of the 
    enactment of this subpart, the Secretary shall conduct an 
    evaluation to--
            ``(A) determine the effect of this subpart on the planning 
        and coordination of health disparities research programs at the 
        agencies of the National Institutes of Health;
            ``(B) evaluate the extent to which this subpart has 
        eliminated the duplication of administrative resources among 
        such Institutes, centers and divisions; and
            ``(C) provide, to the extent determined by the Secretary to 
        be appropriate, recommendations concerning future legislative 
        modifications with respect to this subpart, for both minority 
        health disparities research and other health disparities 
        research.
        ``(2) Minority health disparities research.--The evaluation 
    under paragraph (1) shall include a separate statement that applies 
    subparagraphs (A) and (B) of such paragraph to minority health 
    disparities research.
        ``(3) Report.--Not later than 1 year after the date on which 
    the evaluation is commenced under paragraph (1), the Secretary 
    shall prepare and submit to the Committee on Health, Education, 
    Labor, and Pensions of the Senate, and the Committee on Commerce of 
    the House of Representatives, a report concerning the results of 
    such evaluation.''.
    SEC. 105. REPORT REGARDING RESOURCES OF NATIONAL INSTITUTES OF 
      HEALTH DEDICATED TO MINORITY AND OTHER HEALTH DISPARITIES 
      RESEARCH.
    Not later than December 1, 2003, the Director of the National 
Center on Minority Health and Health Disparities (established by the 
amendment made by section 101(a)), after consultation with the advisory 
council for such Center, shall submit to the Congress, the Secretary of 
Health and Human Services, and the Director of the National Institutes 
of Health a report that provides the following:
        (1) Recommendations for the methodology that should be used to 
    determine the extent of the resources of the National Institutes of 
    Health that are dedicated to minority health disparities research 
    and other health disparities research, including determining the 
    amount of funds that are used to conduct and support such research. 
    With respect to such methodology, the report shall address any 
    discrepancies between the methodology used by such Institutes as of 
    the date of the enactment of this Act and the methodology used by 
    the Institute of Medicine as of such date.
        (2) A determination of whether and to what extent, relative to 
    fiscal year 1999, there has been an increase in the level of 
    resources of the National Institutes of Health that are dedicated 
    to minority health disparities research, including the amount of 
    funds used to conduct and support such research. The report shall 
    include provisions describing whether and to what extent there have 
    been increases in the number and amount of awards to minority 
    serving institutions.

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

    SEC. 201. HEALTH DISPARITIES RESEARCH BY AGENCY FOR HEALTHCARE 
      RESEARCH AND QUALITY.
    (a)  In General.--Part A of title IX of the Public Health Service 
Act (42 U.S.C. 299 et seq.) is amended--
        (1) in section 902, by striking subsection (g); and
        (2) by adding at the end the following:

``SEC. 903. RESEARCH ON HEALTH DISPARITIES.

    ``(a) In General.--The Director shall--
        ``(1) conduct and support research to identify populations for 
    which there is a significant disparity in the quality, outcomes, 
    cost, or use of health care services or access to and satisfaction 
    with such services, as compared to the general population;
        ``(2) conduct and support research on the causes of and 
    barriers to reducing the health disparities identified in paragraph 
    (1), taking into account such factors as socioeconomic status, 
    attitudes toward health, the language spoken, the extent of formal 
    education, the area or community in which the population resides, 
    and other factors the Director determines to be appropriate;
        ``(3) conduct and support research and support demonstration 
    projects to identify, test, and evaluate strategies for reducing or 
    eliminating health disparities, including development or 
    identification of effective service delivery models, and 
    disseminate effective strategies and models;
        ``(4) develop measures and tools for the assessment and 
    improvement of the outcomes, quality, and appropriateness of health 
    care services provided to health disparity populations;
        ``(5) in carrying out section 902(c), provide support to 
    increase the number of researchers who are members of health 
    disparity populations, and the health services research capacity of 
    institutions that train such researchers; and
        ``(6) beginning with fiscal year 2003, annually submit to the 
    Congress a report regarding prevailing disparities in health care 
    delivery as it relates to racial factors and socioeconomic factors 
    in priority populations.
    ``(b) Research and Demonstration Projects.--
        ``(1) In general.--In carrying out subsection (a), the Director 
    shall conduct and support research and support demonstrations to--
            ``(A) identify the clinical, cultural, socioeconomic, 
        geographic, and organizational factors that contribute to 
        health disparities, including minority health disparity 
        populations, which research shall include behavioral research, 
        such as examination of patterns of clinical decisionmaking, and 
        research on access, outreach, and the availability of related 
        support services (such as cultural and linguistic services);
            ``(B) identify and evaluate clinical and organizational 
        strategies to improve the quality, outcomes, and access to care 
        for health disparity populations, including minority health 
        disparity populations;
            ``(C) test such strategies and widely disseminate those 
        strategies for which there is scientific evidence of 
        effectiveness; and
            ``(D) determine the most effective approaches for 
        disseminating research findings to health disparity 
        populations, including minority populations.
        ``(2) Use of certain strategies.--In carrying out this section, 
    the Director shall implement research strategies and mechanisms 
    that will enhance the involvement of individuals who are members of 
    minority health disparity populations or other health disparity 
    populations, health services researchers who are such individuals, 
    institutions that train such individuals as researchers, members of 
    minority health disparity populations or other health disparity 
    populations for whom the Agency is attempting to improve the 
    quality and outcomes of care, and representatives of appropriate 
    tribal or other community-based organizations with respect to 
    health disparity populations. Such research strategies and 
    mechanisms may include the use of--
            ``(A) centers of excellence that can demonstrate, either 
        individually or through consortia, a combination of multi-
        disciplinary expertise in outcomes or quality improvement 
        research, linkages to relevant sites of care, and a 
        demonstrated capacity to involve members and communities of 
        health disparity populations, including minority health 
        disparity populations, in the planning, conduct, dissemination, 
        and translation of research;
            ``(B) provider-based research networks, including health 
        plans, facilities, or delivery system sites of care (especially 
        primary care), that make extensive use of health care providers 
        who are members of health disparity populations or who serve 
        patients in such populations and have the capacity to evaluate 
        and promote quality improvement;
            ``(C) service delivery models (such as health centers under 
        section 330 and the Indian Health Service) to reduce health 
        disparities; and
            ``(D) innovative mechanisms or strategies that will 
        facilitate the translation of past research investments into 
        clinical practices that can reasonably be expected to benefit 
        these populations.
    ``(c) Quality Measurement Development.--
        ``(1) In general.--To ensure that health disparity populations, 
    including minority health disparity populations, benefit from the 
    progress made in the ability of individuals to measure the quality 
    of health care delivery, the Director shall support the development 
    of quality of health care measures that assess the experience of 
    such populations with health care systems, such as measures that 
    assess the access of such populations to health care, the cultural 
    competence of the care provided, the quality of the care provided, 
    the outcomes of care, or other aspects of health care practice that 
    the Director determines to be important.
        ``(2) Examination of certain practices.--The Director shall 
    examine the practices of providers that have a record of reducing 
    health disparities or have experience in providing culturally 
    competent health services to minority health disparity populations 
    or other health disparity populations. In examining such practices 
    of providers funded under the authorities of this Act, the Director 
    shall consult with the heads of the relevant agencies of the Public 
    Health Service.
        ``(3) Report.--Not later than 36 months after the date of the 
    enactment of this section, the Secretary, acting through the 
    Director, shall prepare and submit to the appropriate committees of 
    Congress a report describing the state-of-the-art of quality 
    measurement for minority and other health disparity populations 
    that will identify critical unmet needs, the current activities of 
    the Department to address those needs, and a description of related 
    activities in the private sector.
    ``(d) Definition.--For purposes of this section:
        ``(1) The term `health disparity population' has the meaning 
    given such term in section 485E, except that in addition to the 
    meaning so given, the Director may determine that such term 
    includes populations for which there is a significant disparity in 
    the quality, outcomes, cost, or use of health care services or 
    access to or satisfaction with such services as compared to the 
    general population.
        ``(2) The term `minority', with respect to populations, refers 
    to racial and ethnic minority groups as defined in section 1707.''.
    (b) Funding.--Section 927 of the Public Health Service Act (42 
U.S.C. 299c-6) is amended by adding at the end the following:
    ``(d) Health Disparities Research.--For the purpose of carrying out 
the activities under section 903, there are authorized to be 
appropriated $50,000,000 for fiscal year 2001, and such sums as may be 
necessary for each of the fiscal years 2002 through 2005.''.

        TITLE III--DATA COLLECTION RELATING TO RACE OR ETHNICITY

SEC. 301. STUDY AND REPORT BY NATIONAL ACADEMY OF SCIENCES.

    (a) Study.--The National Academy of Sciences shall conduct a 
comprehensive study of the Department of Health and Human Services' 
data collection systems and practices, and any data collection or 
reporting systems required under any of the programs or activities of 
the Department, relating to the collection of data on race or 
ethnicity, including other Federal data collection systems (such as the 
Social Security Administration) with which the Department interacts to 
collect relevant data on race and ethnicity.
    (b) Report.--Not later than 1 year after the date of enactment of 
this Act, the National Academy of Sciences shall prepare and submit to 
the Committee on Health, Education, Labor, and Pensions of the Senate 
and the Committee on Commerce of the House of Representatives, a report 
that--
        (1) identifies the data needed to support efforts to evaluate 
    the effects of socioeconomic status, race and ethnicity on access 
    to health care and other services and on disparity in health and 
    other social outcomes and the data needed to enforce existing 
    protections for equal access to health care;
        (2) examines the effectiveness of the systems and practices of 
    the Department of Health and Human Services described in subsection 
    (a), including pilot and demonstration projects of the Department, 
    and the effectiveness of selected systems and practices of other 
    Federal, State, and tribal agencies and the private sector, in 
    collecting and analyzing such data;
        (3) contains recommendations for ensuring that the Department 
    of Health and Human Services, in administering its entire array of 
    programs and activities, collects, or causes to be collected, 
    reliable and complete information relating to race and ethnicity; 
    and
        (4) includes projections about the costs associated with the 
    implementation of the recommendations described in paragraph (3), 
    and the possible effects of the costs on program operations.
    (c) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary for fiscal year 2001.

                 TITLE IV--HEALTH PROFESSIONS EDUCATION

SEC. 401. HEALTH PROFESSIONS EDUCATION IN HEALTH DISPARITIES.

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

``SEC. 741. GRANTS FOR HEALTH PROFESSIONS EDUCATION.

    ``(a) Grants for Health Professions Education in Health Disparities 
and Cultural Competency.--
        ``(1) In general.--The Secretary, acting through the 
    Administrator of the Health Resources and Services Administration, 
    may make awards of grants, contracts, or cooperative agreements to 
    public and nonprofit private entities (including tribal entities) 
    for the purpose of carrying out research and demonstration projects 
    (including research and demonstration projects for continuing 
    health professions education) for training and education of health 
    professionals for the reduction of disparities in health care 
    outcomes and the provision of culturally competent health care.
        ``(2) Eligible entities.--Unless specifically required 
    otherwise in this title, the Secretary shall accept applications 
    for grants or contracts under this section from health professions 
    schools, academic health centers, State or local governments, or 
    other appropriate public or private nonprofit entities (or 
    consortia of entities, including entities promoting 
    multidisciplinary approaches) for funding and participation in 
    health professions training activities. The Secretary may accept 
    applications from for-profit private entities as determined 
    appropriate by the Secretary.
    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out subsection (a), $3,500,000 for fiscal year 
2001, $7,000,000 for fiscal year 2002, $7,000,000 for fiscal year 2003, 
and $3,500,000 for fiscal year 2004.''.
    (b) Nursing Education.--Part A of title VIII of the Public Health 
Service Act (42 U.S.C. 296 et seq.) is amended--
        (1) by redesignating section 807 as section 808; and
        (2) by inserting after section 806 the following:

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

    ``(a) Grants for Health Professions Education in Health Disparities 
and Cultural Competency.--The Secretary, acting through the 
Administrator of the Health Resources and Services Administration, may 
make awards of grants, contracts, or cooperative agreements to eligible 
entities for the purpose of carrying out research and demonstration 
projects (including research and demonstration projects for continuing 
health professions education) for training and education for the 
reduction of disparities in health care outcomes and the provision of 
culturally competent health care. Grants under this section shall be 
the same as provided in section 741.''.
    ``(b) Authorization of Appropriations.--There are to be 
appropriated to carry out subsection (a) such sums as may be necessary 
for each of the fiscal years 2001 through 2004.''.
    SEC. 402. NATIONAL CONFERENCE ON HEALTH PROFESSIONS EDUCATION AND 
      HEALTH DISPARITIES.
    (a) In General.--Not later than 1 year after the date of enactment 
of this Act, the Secretary of Health and Human Services (in this 
section referred to as the ``Secretary''), acting through the 
Administrator of the Health Resources and Services Administration, 
shall convene a national conference on health professions education as 
a method for reducing disparities in health outcomes.
    (b) Participants.--The Secretary shall include in the national 
conference convened under subsection (a) advocacy groups and 
educational entities as described in section 741 of the Public Health 
Service Act (as added by section 401), tribal health programs, health 
centers under section 330 of such Act, and other interested parties.
    (c) Issues.--The national conference convened under subsection (a) 
shall include, but is not limited to, issues that address the role and 
impact of health professions education on the reduction of disparities 
in health outcomes, including the role of education on cultural 
competency. The conference shall focus on methods to achieve reductions 
in disparities in health outcomes through health professions education 
(including continuing education programs) and strategies for outcomes 
measurement to assess the effectiveness of education in reducing 
disparities.
    (d) Publication of Findings.--Not later than 6 months after the 
national conference under subsection (a) has convened, the Secretary 
shall publish in the Federal Register a summary of the proceedings and 
findings of the conference.
    (e) Authorization of Appropriations.--There is authorized to be 
appropriated such sums as may be necessary to carry out this section.
    SEC. 403. ADVISORY RESPONSIBILITIES IN HEALTH PROFESSIONS EDUCATION 
      IN HEALTH DISPARITIES AND CULTURAL COMPETENCY.
    Section 1707 of the Public Health Service Act (42 U.S.C. 300u-6) is 
amended--
        (1) in subsection (b), by adding at the end the following 
    paragraph:
        ``(10) Advise in matters related to the development, 
    implementation, and evaluation of health professions education in 
    decreasing disparities in health care outcomes, including cultural 
    competency as a method of eliminating health disparities.'';
        (2) in subsection (c)(2), by striking ``paragraphs (1) through 
    (9)'' and inserting ``paragraphs (1) through (10)''; and
        (3) in subsection (d), by amending paragraph (1) to read as 
    follows:
        ``(1) Recommendations regarding language.--
            ``(A) Proficiency in speaking english.--The Deputy 
        Assistant Secretary shall consult with the Director of the 
        Office of International and Refugee Health, the Director of the 
        Office of Civil Rights, and the Directors of other appropriate 
        departmental entities regarding recommendations for carrying 
        out activities under subsection (b)(9).
            ``(B) Health professions education regarding health 
        disparities.--The Deputy Assistant Secretary shall carry out 
        the duties under subsection (b)(10) in collaboration with 
        appropriate personnel of the Department of Health and Human 
        Services, other Federal agencies, and other offices, centers, 
        and institutions, as appropriate, that have responsibilities 
        under the Minority Health and Health Disparities Research and 
        Education Act of 2000.''.

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

SEC. 501. PUBLIC AWARENESS AND INFORMATION DISSEMINATION.

    (a) Public Awareness on Health Disparities.--The Secretary of 
Health and Human Services (in this section referred to as the 
``Secretary'') shall conduct a national campaign to inform the public 
and health care professionals about health disparities in minority and 
other underserved populations by disseminating information and 
materials available on specific diseases affecting these populations 
and programs and activities to address these disparities. The campaign 
shall--
        (1) have a specific focus on minority and other underserved 
    communities with health disparities; and
        (2) include an evaluation component to assess the impact of the 
    national campaign in raising awareness of health disparities and 
    information on available resources.
    (b) Dissemination of Information on Health Disparities.--The 
Secretary shall develop and implement a plan for the dissemination of 
information and findings with respect to health disparities under 
titles I, II, III, and IV of this Act. The plan shall--
        (1) include the participation of all agencies of the Department 
    of Health and Human Services that are responsible for serving 
    populations included in the health disparities research; and
        (2) have agency-specific strategies for disseminating relevant 
    findings and information on health disparities and improving health 
    care services to affected communities.

                   TITLE VI--MISCELLANEOUS PROVISIONS

    SEC. 601. DEPARTMENTAL DEFINITION REGARDING MINORITY INDIVIDUALS.
    Section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 
300u-6) is amended--
        (1) by striking ``Asian Americans and'' and inserting ``Asian 
    Americans;''; and
        (2) by inserting ``Native Hawaiians and other'' before 
    ``Pacific Islanders;''.

SEC. 602. CONFORMING PROVISION REGARDING DEFINITIONS.

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

SEC. 603. EFFECTIVE DATE.

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

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.
```