II 

110TH CONGRESS 

1ST SESSION S. 1576 

To amend the Public Health Service Act to improve the health and healthcare 

of racial and ethnic minority groups. 

IN THE SENATE OF THE UNITED STATES 

JUNE 7, 2007 

Mr. KENNEDY (for himself, Mr. COCHRAN, Mr. OBAMA, Mr. BINGAMAN, Mrs. 

CLINTON, Mr. BROWN, and Mr. DURBIN) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to improve the 

health and healthcare of racial and ethnic minority groups. 

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

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

5 ‘‘Minority Health Improvement and Health Disparity 

6 Elimination Act’’. 

7 (b) TABLE OF CONTENTS.— 

Sec. 1. Short title; table of contents. 


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Sec. 2. Definitions. 

TITLE I—INCREASING DIVERSITY AND CULTURAL COMPETENCY 

IN THE HEALTHCARE WORKFORCE THROUGH EDUCATION AND 

TRAINING 

Sec. 101. Cultural competency and communication for providers. 

Sec. 102. Healthcare workforce composition and placement. 

Sec. 103. Workforce training to achieve diversity. 

Sec. 104. Mid-career health professions scholarship program. 

Sec. 105. Cultural competency training. 

Sec. 106. Authorization of appropriations; reauthorizations. 

TITLE II—PROMOTING HEALTH AND HEALTHCARE AWARENESS 

AND ACCESS 

Sec. 201. Care and access. 

Sec. 202. Authorization of appropriations. 

TITLE III—RESEARCH TO REDUCE AND ELIMINATE HEALTH 

DISPARITIES 

Sec. 301. Agency for healthcare research and quality. 

Sec. 302. Genetic variation and health. 

Sec. 303. Evaluations by the Institute of Medicine. 

Sec. 304. National Center for Minority Health and Health Disparities reauthorization. 

Sec. 305. Authorization of appropriations. 

TITLE IV—DATA COLLECTION, ANALYSIS, AND QUALITY 

Sec. 401. Data collection, analysis, and quality. 

TITLE V—LEADERSHIP, COLLABORATION, AND NATIONAL 

ACTION PLAN 

Sec. 501. Office of Minority Health. 

1 SEC. 2. DEFINITIONS. 

2 In this Act and the amendments made by this Act: 

3 (1) CULTURAL COMPETENCY.—The term ‘‘cul4 turally competent’’— 

5 (A) with respect to health-related services, 

6 means the ability to provide healthcare tailored 

7 to meet the social, cultural, and linguistic needs 

8 of patients from diverse backgrounds; and 


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1 (B) when used to describe education or 

2 training, means education or training designed 

3 to prepare those receiving the education or 

4 training to provide health-related services tai5 lored to meet the social, cultural, and linguistic 

6 needs of patients from diverse backgrounds. 

7 (2) HEALTH DISPARITY POPULATION.—The 

8 term ‘‘health disparity population’’ has the meaning 

9 given such term in section 903(d)(1) of the Public 

10 Health Service Act (42 U.S.C. 299a–1(d)(1)). 

11 (3) HEALTH LITERACY.—The term ‘‘health lit12 eracy’’ means the degree to which an individual has 

13 the capacity to obtain, communicate, process, and 

14 understand health information (including the reg15 ister and language in which the information is pro16 vided) and services in order to make appropriate 

17 health decisions. 

18 (4) INDIANS; INDIAN TRIBE; TRIBAL ORGANIZA19 TION; URBAN INDIAN ORGANIZATION.—The terms 

20 ‘‘Indian’’, ‘‘Indian tribe’’, ‘‘tribal organization’’, and 

21 ‘‘urban Indian organization’’ have the meanings 

22 given such terms in section 4 of the Indian Health 

23 Care Improvement Act (25 U.S.C. 1603). 

24 (5) MINORITY GROUP.—The term ‘‘minority 

25 group’’ has the meaning given the term ‘‘racial and 


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1 ethnic minority group’’ in section 1707 of the Public 

2 Health Service Act (42 U.S.C. 300u–6) (as amended 

3 by section 501). 

4 (6) PRACTICE-BASED RESEARCH NETWORKS.— 

5 The term ‘‘practice-based research network’’ means 

6 a group of ambulatory practices devoted principally 

7 to the primary care of patients, and affiliated in 

8 their mission to investigate questions related to com9 munity-based practice and to improve the quality of 

10 primary care. 

11 (7) SECRETARY.—The term ‘‘Secretary’’ means 

12 the Secretary of Health and Human Services. 

13 TITLE I—INCREASING DIVER14 SITY AND CULTURAL COM15 PETENCY IN THE 

16 HEALTHCARE WORKFORCE 

17 THROUGH EDUCATION AND 

18 TRAINING 

19 SEC. 101. CULTURAL COMPETENCY AND COMMUNICATION 

20 FOR PROVIDERS. 

21 Title II of the Public Health Service Act (42 U.S.C. 

22 202 et seq.) is amended by adding at the end the fol23 lowing: 


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1 ‘‘SEC. 270. INTERNET CLEARINGHOUSE TO IMPROVE CUL2 TURAL COMPETENCY AND COMMUNICATION 

3 BY HEALTHCARE PROVIDERS. 

4 ‘‘(a) ESTABLISHMENT.—Not later than 1 year after 

5 the date of enactment of the Minority Health Improve6 ment and Health Disparity Elimination Act, the Sec7 retary, acting through the Deputy Assistant Secretary for 

8 Minority Health, shall develop and maintain an Internet 

9 Clearinghouse within the Office of Minority Health to as10 sist providers in improving the health and healthcare of 

11 racial and ethnic minority groups, with the goal of— 

12 ‘‘(1) increasing cultural competency; 

13 ‘‘(2) improving communication between 

14 healthcare providers, staff, and their patients, in15 cluding those patients with low health literacy; 

16 ‘‘(3) improving healthcare quality and patient 

17 satisfaction; 

18 ‘‘(4) reducing medical errors and healthcare 

19 costs; and 

20 ‘‘(5) reducing duplication of effort regarding 

21 translation of materials. 

22 ‘‘(b) INTERNET CLEARINGHOUSE.—Not later than 1 

23 year after the date of enactment of this section the Sec24 retary, acting through the Deputy Assistant Secretary for 

25 Minority Health, and in consultation with the Director of 


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1 the Office for Civil Rights, shall carry out subsection (a) 

2 by— 

3 ‘‘(1) developing and maintaining, through the 

4 Office of Minority Health, an accessible library and 

5 database on the Internet with easily searchable, 

6 clinically-relevant information regarding culturally 

7 competent healthcare for racial and ethnic minority 

8 groups, including Internet links to additional re9 sources that fulfill the purpose of this section; 

10 ‘‘(2) developing and making templates for vis11 ual aids and standard documents with clear expla12 nations that can help patients and consumers access 

13 and make informed decisions about healthcare, in14 cluding— 

15 ‘‘(A) administrative and legal documents, 

16 including informed consent and advanced direc17 tives; 

18 ‘‘(B) clinical information, including infor19 mation pertaining to treatment adherence, self20 management training for chronic conditions, 

21 preventing transmission of disease, and dis22 charge instructions; 

23 ‘‘(C) patient education and outreach mate24 rials, including immunization or screening no25 tices and health warnings; and 


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1 ‘‘(D) Federal health forms and notices; 

2 ‘‘(3) ensuring that documents described in 

3 paragraph (2) are posted in English and non4 English languages and are culturally appropriate; 

5 ‘‘(4) encouraging healthcare providers to cus6 tomize such documents for their use; 

7 ‘‘(5) facilitating access to such documents, in8 cluding distribution in both paper and electronic for9 mats; 

10 ‘‘(6) providing technical assistance to healthcare 

11 providers with respect to the access and use of infor12 mation described in paragraph (1) including infor13 mation to help healthcare providers— 

14 ‘‘(A) understand the concept of cultural 

15 competence; 

16 ‘‘(B) implement culturally competent prac17 tices; 

18 ‘‘(C) care for patients with low health lit19 eracy, including helping such patients under20 stand and participate in healthcare decisions; 

21 ‘‘(D) understand and apply Federal guid22 ance and directives regarding healthcare for ra23 cial and ethnic minority groups; 

24 ‘‘(E) obtain reimbursement for provision of 

25 culturally competent services; 


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1 ‘‘(F) understand and implement 

2 bioinformatics and health information tech3 nology in order to improve healthcare for racial 

4 and ethnic minority groups; and 

5 ‘‘(G) conduct other activities determined 

6 appropriate by the Secretary; 

7 ‘‘(7) providing culturally appropriate dissemina8 tion strategies to provide educational materials to 

9 patients, representatives of community-based organi10 zations, and the public with respect to the access 

11 and use of information described in paragraph (1), 

12 including— 

13 ‘‘(A) information to help such individ14 uals— 

15 ‘‘(i) understand the concept of cul16 tural competence, and the role of cultural 

17 competence in the delivery of healthcare; 

18 ‘‘(ii) work with healthcare providers to 

19 implement culturally competent practices; 

20 ‘‘(iii) provide options for providers 

21 and consumers to promote increased un22 derstanding of health literacy and self23 management concepts, as well as the bene24 fits of improved provider-patient commu25 nications; and 


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1 ‘‘(iv) understand the concept of low 

2 health literacy, and the barriers it presents 

3 to care; and 

4 ‘‘(B) if determined appropriate, materials 

5 and information identified by community-based 

6 organizations, including other non-profit organi7 zations, that are beneficial in assisting 

8 healthcare providers and patients in making de9 cisions regarding health, healthcare, and patient 

10 recovery; and 

11 ‘‘(C) other material determined appro12 priate by the Secretary; and 

13 ‘‘(8) supporting initiatives that the Secretary 

14 determines to be useful to fulfill the purposes of the 

15 Internet Clearinghouse. 

16 ‘‘(c) DEFINITIONS.—The definitions contained in sec17 tion 2 of the Minority Health Improvement and Health 

18 Disparity Elimination Act shall apply for purposes of this 

19 section.’’. 

20 SEC. 102. HEALTHCARE WORKFORCE COMPOSITION AND 

21 PLACEMENT. 

22 (a) IN GENERAL.—Part F of title VII of the Public 

23 Health Service Act (42 U.S.C. 295j et seq.) is amended 

24 by inserting after section 792 the following: 


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1 ‘‘SEC. 793. HEALTHCARE WORKFORCE, EDUCATION, AND 

2 TRAINING. 

3 ‘‘(a) IN GENERAL.—The Secretary, acting through 

4 the Administrator of the Health Resources and Services 

5 Administration and the Deputy Assistant Secretary for 

6 Minority Health, shall establish a database that can 

7 produce aggregated and disaggregated statistics on health 

8 professional students, including applicants, matriculates, 

9 and graduates. 

10 ‘‘(b) REQUIREMENT TO COLLECT DATA.— 

11 ‘‘(1) IN GENERAL.—Each health professions 

12 school described in paragraph (2) that receives Fed13 eral funds shall collect race and ethnicity data, pri14 mary language data, and where feasible, other health 

15 disparity data pursuant to subsection (d), con16 cerning the students described in subsection (a), as 

17 well as intended geographical site of practice and in18 tended discipline of practice for graduates. In col19 lecting race and ethnicity data, a school shall— 

20 ‘‘(A) at a minimum, use the categories for 

21 race and ethnicity established by the Director of 

22 the Office of Management and Budget in effect 

23 on the date of enactment of the Minority 

24 Health Improvement and Health Disparity 

25 Elimination Act; and 


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1 ‘‘(B) if practicable, collect data on addi2 tional population groups if such data can be ag3 gregated into the minimum race and ethnicity 

4 data categories. 

5 ‘‘(2) HEALTH PROFESSIONS SCHOOL.—A health 

6 professions school described under this paragraph is 

7 a school of medicine or osteopathic medicine, public 

8 health, nursing, dentistry, optometry, pharmacy, al9 lied health, podiatric medicine, or veterinary medi10 cine, or a graduate program in mental health prac11 tice. 

12 ‘‘(c) REPORTING.—Each school or program described 

13 under subsection (b), shall, on an annual basis, report 

14 data on race and ethnicity and primary language collected 

15 under this section to the Secretary for inclusion in the 

16 database established under subsection (a). The Secretary 

17 shall ensure that such disparity data is reported to Con18 gress and made available to the public. 

19 ‘‘(d) HEALTH DISPARITY MEASURES.—The Sec20 retary shall develop, report, and disseminate measures of 

21 the other health data referenced in section 793(b)(1), to 

22 ensure uniform and consistent collection and reporting of 

23 these measures by health professions schools. In devel24 oping such measures, the Secretary shall take into considVerDate Aug 31 2005 23:13 Jun 11, 2007 Jkt 059196 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1576.IS S1576

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1 eration health disparity indicators developed pursuant to 

2 section 2901(c). 

3 ‘‘(e) USE OF DATA.—Data reported pursuant to sub4 section (c) shall be used by the Secretary to conduct ongo5 ing short- and long-term analyses of diversity within 

6 health professions schools and the health professions. The 

7 Secretary shall ensure that such analyses are reported to 

8 Congress and made available to the public. 

9 ‘‘(f) CULTURAL COMPETENCY TRAINING.—The Sec10 retary shall mandate the collection and reporting of data 

11 from health professions schools regarding the extent to 

12 which cultural competency training is provided to health 

13 professions students, that may include the duration, con14 tent and timing of the training, and conduct periodic as15 sessments regarding the preparedness of such students to 

16 care for patients from racial and ethnic minority groups. 

17 ‘‘(g) PRIVACY.—The Secretary shall ensure that all 

18 data collected under this section is protected from inap19 propriate internal and external use by any entity that col20 lects, stores, or receives the data and that such data is 

21 collected without personally identifiable information. 

22 ‘‘(h) PARTNERSHIP.—The Secretary may contract 

23 with external entities to fulfill the requirements under this 

24 section if such entities have demonstrated expertise and 

25 experience collecting, analyzing, and reporting data reVerDate Aug 31 2005 23:13 Jun 11, 2007 Jkt 059196 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S1576.IS S1576

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1 quired under this section for health professional stu2 dents.’’. 

3 (b) NATIONAL HEALTH SERVICE CORPS PRO4 GRAM.— 

5 (1) ASSIGNMENT OF CORPS PERSONNEL.—Sec6 tion 333(a)(3) of the Public Health Service Corps 

7 (42 U.S.C. 254f(a)(3)) is amended to read as fol8 lows: 

9 ‘‘(3)(A) In approving applications for assign10 ment of members of the Corps, the Secretary shall 

11 not discriminate against application from entities 

12 which are not receiving Federal financial assistance 

13 under this Act. 

14 ‘‘(B) In approving such applications, the Sec15 retary shall— 

16 ‘‘(i) give preference to applications in 

17 which a nonprofit entity or public entity shall 

18 provide a site to which Corps members may be 

19 assigned; and 

20 ‘‘(ii) give highest preference to applica21 tions— 

22 ‘‘(I) from entities described in clause 

23 (i) that are federally qualified health cen24 ters as defined in section 1905(l)(2)(B) of 

25 the Social Security Act; and 


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1 ‘‘(II) from entities described in clause 

2 (i) that primarily serve racial and ethnic 

3 minority groups with annual incomes at or 

4 below twice those set forth in the most re5 cent poverty guidelines issued by the Sec6 retary pursuant to section 673(2) of the 

7 Community Services Block Grant Act (42 

8 U.S.C. 9902(2)).’’. 

9 (2) PRIORITIES IN ASSIGNMENT OF CORPS PER10 SONNEL.—Section 333A of the Public Health Serv11 ice Act (42 U.S.C. 254f–1) is amended— 

12 (A) in subsection (a)— 

13 (i) by redesignating paragraphs (1), 

14 (2), and (3) as paragraphs (2), (3), and 

15 (4), respectively; and 

16 (ii) by striking ‘‘shall—’’ and insert17 ing ‘‘shall— 

18 ‘‘(1) give preference to applications as set forth 

19 in subsection (a)(3) of section 333;’’; and 

20 (B) by striking ‘‘subsection (a)(1)’’ each 

21 place it appears and inserting ‘‘subsection 

22 (a)(2)’’. 

23 (3) CONFORMING AMENDMENT.—Section 

24 338I(c)(3)(B)(ii) of the Public Health Service Act 

25 (42 U.S.C. 254q–1(c)(3)(B)(ii)) is amended by 


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1 striking ‘‘section 333A(a)(1)’’ and inserting ‘‘section 

2 333A(a)(2)’’. 

3 SEC. 103. WORKFORCE TRAINING TO ACHIEVE DIVERSITY. 

4 (a) CENTERS OF EXCELLENCE.—Section 736 of the 

5 Public Health Service Act (42 U.S.C. 293) is amended— 

6 (1) by striking subsection (a) and inserting the 

7 following: 

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

9 to, and enter into contracts with, public and nonprofit pri10 vate health or educational entities, including designated 

11 health professions schools described in subsection (c), for 

12 the purpose of assisting the entities in supporting pro13 grams of excellence in health professions education for 

14 underrepresented minorities in health professions.’’; 

15 (2) by striking subsection (b) and inserting the 

16 following: 

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

18 may not make a grant under subsection (a) unless the des19 ignated health professions school agrees, subject to sub20 section (c)(1)(C), to use the funds awarded under the 

21 grant to— 

22 ‘‘(1) develop a large competitive applicant pool 

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1 based entities and establish an education pipeline for 

2 health professions careers; 

3 ‘‘(2) establish, strengthen, or expand programs 

4 to enhance the academic performance of underrep5 resented minority in health professions students at6 tending the school; 

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

8 train, recruit, and retain underrepresented minority 

9 faculty members including the payment of such sti10 pends and fellowships as the Secretary may deter11 mine appropriate; 

12 ‘‘(4) carry out activities to improve the informa13 tion resources, clinical education, curricula, and cul14 tural and linguistic competence of the graduates of 

15 the school, as it relates to minority health issues; 

16 ‘‘(5) facilitate faculty and student research on 

17 health issues particularly affecting racial and ethnic 

18 minority groups, including research on issues relat19 ing to the delivery of culturally competent healthcare 

20 (as defined in section 270); 

21 ‘‘(6) establish and implement a program to 

22 train students of the school in providing health serv23 ices to racial and ethnic minority individuals through 

24 training provided to such students at community25 based health facilities that— 


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

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

3 main site of the teaching facilities of the school; 

4 ‘‘(7) provide stipends as the Secretary deter5 mines appropriate, in amounts as the Secretary de6 termines appropriate; and 

7 ‘‘(8) conduct accountability and other reporting 

8 activities, as required by the Secretary in subsection 

9 (i).’’; 

10 (3) in subsection (c)— 

11 (A) by amending paragraph (1) to read as 

12 follows: 

13 ‘‘(1) DESIGNATED SCHOOLS.— 

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

15 professions schools referred to in subsection (a) 

16 are such schools that meet each of the condi17 tions specified in subparagraphs (B) and (C), 

18 and that— 

19 ‘‘(i) meet each of the conditions speci20 fied in paragraph (2)(A); 

21 ‘‘(ii) meet each of the conditions spec22 ified in paragraph (3); 

23 ‘‘(iii) meet each of the conditions 

24 specified in paragraph (4); or 


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1 ‘‘(iv) meet each of the conditions spec2 ified in paragraph (5). 

3 ‘‘(B) GENERAL CONDITIONS.—The condi4 tions specified in this subparagraph are that a 

5 designated health professions school— 

6 ‘‘(i) has a significant number of 

7 underrepresented minority in health pro8 fessions students enrolled in the school, in9 cluding individuals accepted for enrollment 

10 in the school; 

11 ‘‘(ii) has been effective in assisting 

12 such students of the school to complete the 

13 program of education and receive the de14 gree involved; 

15 ‘‘(iii) has been effective in recruiting 

16 such students to enroll in and graduate 

17 from the school, including providing schol18 arships and other financial assistance to 

19 such students and encouraging such stu20 dents from all levels of the educational 

21 pipeline to pursue health professions ca22 reers; and 

23 ‘‘(iv) has made significant recruitment 

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1 dividuals serving in faculty or administra2 tive positions at the school. 

3 ‘‘(C) CONSORTIUM.—The condition speci4 fied in this subparagraph is that, in accordance 

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

6 profession school involved has with other health 

7 profession schools (designated or otherwise) 

8 formed a consortium to carry out the purposes 

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

10 consortium. 

11 ‘‘(D) APPLICATION OF CRITERIA TO

12 OTHER PROGRAMS.—In the case of any criteria 

13 established by the Secretary for purposes of de14 termining whether schools meet the conditions 

15 described in subparagraph (B), this section may 

16 not, with respect to racial and ethnic minorities, 

17 be construed to authorize, require, or prohibit 

18 the use of such criteria in any program other 

19 than the program established in this section.’’; 

20 (B) by amending paragraph (2) to read as 

21 follows: 

22 ‘‘(2) CENTERS OF EXCELLENCE AT CERTAIN

23 HISTORICALLY BLACK COLLEGES AND UNIVER24 SITIES.— 


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1 ‘‘(A) CONDITIONS.—The conditions speci2 fied in this subparagraph are that a designated 

3 health professions school is a school described 

4 in section 799B(1). 

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

6 purposes described in subsection (b), a grant 

7 under subsection (a) to a designated health pro8 fessions school meeting the conditions described 

9 in subparagraph (A) may be expended— 

10 ‘‘(i) to develop a plan to achieve insti11 tutional improvements, including financial 

12 independence, to enable the school to sup13 port programs of excellence in health pro14 fessions education for underrepresented 

15 minority individuals; and 

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

17 library and informational resources of the 

18 school. 

19 ‘‘(C) EXCEPTION.—The requirements of 

20 paragraph (1)(C) shall not apply to a histori21 cally black college or university that receives 

22 funding under this paragraph or paragraph 

23 (5).’’; and 

24 (C) by amending paragraphs (3) through 

25 (5) to read as follows: 


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

2 The conditions specified in this paragraph are 

3 that— 

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

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

6 (1)(B) applies to the designated health profes7 sions school involved; 

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

9 receiving a grant under subsection (a) of this 

10 section, that the school will, in carrying out the 

11 duties described in subsection (b) of this sec12 tion, give priority to carrying out the duties 

13 with respect to Hispanic individuals; and 

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

15 receiving a grant under subsection (a) of this 

16 section, 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 enroll23 ment of students has traditionally included 

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1 uals, the purposes of which will be to carry 

2 out 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 

10 recruit Hispanic students, including stu11 dents who have participated in the under12 graduate or other matriculation program 

13 carried out under arrangements established 

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

15 will assist Hispanic students regarding the 

16 completion of the educational requirements 

17 for a degree from the school. 

18 ‘‘(4) NATIVE AMERICAN CENTERS OF EXCEL19 LENCE.—Subject to subsection (e), the conditions 

20 specified in this paragraph are that— 

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

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

23 (1)(B) applies to the designated health profes24 sions school involved; 


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

2 receiving a grant under subsection (a) of this 

3 section, that the school will, in carrying out the 

4 duties described in subsection (b) of this sec5 tion, give priority to carrying out the duties 

6 with respect to Native Americans; and 

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

8 receiving a grant under subsection (a) of this 

9 section, that— 

10 ‘‘(i) the school will establish an ar11 rangement with 1 or more public or non12 profit private institutions of higher edu13 cation, including schools of nursing, whose 

14 enrollment of students has traditionally in15 cluded a significant number of Native 

16 Americans, the purpose of which arrange17 ment will be to carry out a program— 

18 ‘‘(I) to identify Native American 

19 students, from the institutions of 

20 higher education referred to in clause 

21 (i), who are interested in health pro22 fessions careers; and 

23 ‘‘(II) to facilitate the educational 

24 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 underrepresented 

20 minorities in health professions significantly 

21 above the national average for such enrollments 

22 of health professions schools.’’; and 

23 (4) by striking subsection (h) and inserting the 

24 following: 

25 ‘‘(h) FORMULAFOR ALLOCATIONS.— 


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1 ‘‘(1) ALLOCATIONS.—Based on the amount ap2 propriated under section 106(a) of the Minority 

3 Health Improvement and Health Disparity Elimi4 nation Act for a fiscal year, the following subpara5 graphs shall apply as appropriate: 

6 ‘‘(A) IN GENERAL.—If the amounts appro7 priated under section 106(a) of the Minority 

8 Health Improvement and Health Disparity 

9 Elimination Act for a fiscal year are 

10 $24,000,000 or less— 

11 ‘‘(i) the Secretary shall make available 

12 $12,000,000 for grants under subsection 

13 (a) to health professions schools that meet 

14 the conditions described in subsection 

15 (c)(2)(A); and 

16 ‘‘(ii) and available after grants are 

17 made with funds under clause (i), the Sec18 retary shall make available— 

19 ‘‘(I) 60 percent of such amount 

20 for grants under subsection (a) to 

21 health professions schools that meet 

22 the conditions described in paragraph 

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

24 meeting the conditions under sub25 section (e)); and 


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1 ‘‘(II) 40 percent of such amount 

2 for grants under subsection (a) to 

3 health professions schools that meet 

4 the conditions described in subsection 

5 (c)(5). 

6 ‘‘(B) FUNDING IN EXCESS OF

7 $24,000,000.—If amounts appropriated under 

8 section 106(a) of the Minority Health Improve9 ment and Health Disparity Elimination Act for 

10 a fiscal year exceed $24,000,000 but are less 

11 than $30,000,000— 

12 ‘‘(i) 80 percent of such excess 

13 amounts shall be made available for grants 

14 under subsection (a) to health professions 

15 schools that meet the requirements de16 scribed in paragraph (3) or (4) of sub17 section (c) (including meeting conditions 

18 pursuant to subsection (e)); and 

19 ‘‘(ii) 20 percent of such excess 

20 amount shall be made available for grants 

21 under subsection (a) to health professions 

22 schools that meet the conditions described 

23 in subsection (c)(5). 

24 ‘‘(C) FUNDING IN EXCESS OF

25 $30,000,000.—If amounts appropriated under 


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1 section 106(a) of the Minority Health Improve2 ment and Health Disparity Elimination Act for 

3 a fiscal year exceed $30,000,000 but are less 

4 than $40,000,000, the Secretary shall make 

5 available— 

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

7 grants under subsection (a) to health pro8 fessions schools that meet the conditions 

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

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

11 grants under subsection (a) to health pro12 fessions schools that meet the conditions 

13 described in paragraph (3) or (4) of sub14 section (c) (including meeting conditions 

15 pursuant to subsection (e)); 

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

17 grants under subsection (a) to health pro18 fessions schools that meet the conditions 

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

20 ‘‘(iv) after grants are made with 

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

22 remaining excess amount for grants under 

23 subsection (a) to health professions schools 

24 that meet the conditions described in paraVerDate Aug 31 2005 23:13 Jun 11, 2007 Jkt 059196 PO 00000 Frm 00027 Fmt 6652 Sfmt 6201 E:\BILLS\S1576.IS S1576

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1 graph (2)(A), (3), (4), or (5) of subsection 

2 (c). 

3 ‘‘(D) FUNDING IN EXCESS OF

4 $40,000,000.—If amounts appropriated under 

5 section 106(a) of the Minority Health Improve6 ment and Health Disparity Elimination Act for 

7 a fiscal year are $40,000,000 or more, the Sec8 retary shall make available— 

9 ‘‘(i) not less than $16,000,000 for 

10 grants under subsection (a) to health pro11 fessions schools that meet the conditions 

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

13 ‘‘(ii) not less than $16,000,000 for 

14 grants under subsection (a) to health pro15 fessions schools that meet the conditions 

16 described in paragraph (3) or (4) of sub17 section (c) (including meeting conditions 

18 pursuant to subsection (e)); 

19 ‘‘(iii) not less than $8,000,000 for 

20 grants under subsection (a) to health pro21 fessions schools that meet the conditions 

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

23 ‘‘(iv) after grants are made with 

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

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1 section (a) to health professions schools 

2 that meet the conditions described in para3 graph (2)(A), (3), (4), or (5) of subsection 

4 (c). 

5 ‘‘(2) NO LIMITATION.—Nothing in this sub6 section shall be construed as limiting the centers of 

7 excellence referred to in this section to the des8 ignated amount, or to preclude such entities from 

9 competing for grants under this section. 

10 ‘‘(3) MAINTENANCE OF EFFORT.— 

11 ‘‘(A) IN GENERAL.—With respect to activi12 ties for which a grant made under this part are 

13 authorized to be expended, the Secretary may 

14 not make such a grant to a center of excellence 

15 for any fiscal year unless the center agrees to 

16 maintain expenditures of non-Federal amounts 

17 for such activities at a level that is not less 

18 than the level of such expenditures maintained 

19 by the center for the fiscal year preceding the 

20 fiscal year for which the school receives such a 

21 grant. 

22 ‘‘(B) USE OF FEDERAL FUNDS.—With re23 spect to any Federal amounts received by a cen24 ter of excellence and available for carrying out 

25 activities for which a grant under this part is 


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1 authorized to be expended, the center shall, be2 fore expending the grant, expend the Federal 

3 amounts obtained from sources other than the 

4 grant, unless given prior approval from the Sec5 retary. 

6 ‘‘(i) EVALUATIONS.— 

7 ‘‘(1) ADVISORY COMMITTEE.— 

8 ‘‘(A) IN GENERAL.—Not later than 90 

9 days after the date of enactment of the Minor10 ity Health Improvement and Health Disparity 

11 Elimination Act, the Secretary shall establish 

12 and appoint the members of an advisory com13 mittee composed of representatives of govern14 ment agencies, including the Health Resources 

15 and Services Administration, the Office of Mi16 nority Health, and the Indian Health Service, 

17 community stakeholders and experts in identi18 fying and addressing the health concerns of ra19 cial and ethnic minority groups, and designees 

20 from health professions schools described in 

21 subsection (b). 

22 ‘‘(B) DUTIES.—The advisory committee 

23 shall develop and recommend performance 

24 measures with which to assess, based on data to 

25 be compiled by recipients of grants or contracts 


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1 under this section or section 736, 737, 738, or 

2 739, the extent to which the program described 

3 in this section and sections 736, 737, 738, and 

4 739 has met the purpose of this part. The advi5 sory committee shall submit such recommenda6 tions to the Administrator of the Health Re7 sources and Services Administration not later 

8 than 6 months after the appointment of the ad9 visory committee. 

10 ‘‘(C) NOTIFICATION.—Not later than 30 

11 days after the submission of the recommenda12 tions, the Administrator of the Health Re13 sources and Services Administration shall re14 view the recommendations and establish per15 formance measures described in subparagraph 

16 (B), and the Administrator shall notify recipi17 ents of grants or contracts under this section or 

18 section 736, 737, 738, or 739 of the new per19 formance measures and make requirements re20 lated to the performance measures publicly 

21 available both on the website of the Administra22 tion and as part of any notifications of awards 

23 released to entities receiving the grants or con24 tracts. 


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1 ‘‘(2) DATA COLLECTION AND ANNUAL EVALUA2 TIONS.— 

3 ‘‘(A) IN GENERAL.—The Administrator of 

4 the Health Resources and Services Administra5 tion shall collect data on an annual basis from 

6 recipients of grants or contracts under this sec7 tion or section 736, 737, 738, or 739 on the 

8 performance measures established under para9 graph (1). 

10 ‘‘(B) BIANNUAL MEETING.—The Adminis11 trator of the Health Resources and Services Ad12 ministration shall convene a meeting of the ad13 visory committee established under paragraph 

14 (1) not less than twice per year. At the meet15 ing, the advisory committee shall recommend 

16 any necessary changes to such performance 

17 measures to improve data collection and short18 term evaluation with respect to the programs 

19 carried out under this section or section 736, 

20 737, 738, or 739, and provide technical assist21 ance as necessary. 

22 ‘‘(3) UPDATES.—The Administrator of the 

23 Health Resources and Services Administration shall 

24 determine whether to incorporate the recommended 

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1 vide technical assistance as necessary. The Adminis2 trator shall not penalize a current recipient of a 

3 grant or contract under this section or section 736, 

4 737, 738, or 739 for failing to comply with the re5 vised data collection or performance measure re6 quirements if the recipient demonstrates an inability 

7 to provide additional data mandated under the re8 quirements. 

9 ‘‘(4) ACCOUNTABILITY.—The Administrator 

10 shall review and take into consideration performance 

11 measurement data previously collected from recipi12 ents of grants or contracts under this section or sec13 tion 736, 737, 738, or 739 when deciding to renew 

14 the grants or contracts of such recipients.’’. 

15 (b) COOPERATIVE AGREEMENTS FOR ONLINE DE16 GREE PROGRAMS AT SCHOOLS OF PUBLIC HEALTH AND

17 SCHOOLS OF ALLIED HEALTH.—Part B of title VII of 

18 the Public Health Service Act (42 U.S.C. 293 et seq.) is 

19 amended by adding at the end the following: 

20 ‘‘SEC. 742. COOPERATIVE AGREEMENTS FOR ONLINE DE21 GREE PROGRAMS. 

22 ‘‘(a) COOPERATIVE AGREEMENTS.—The Secretary 

23 shall award cooperative agreements to accredited schools 

24 of public health, schools of allied health, and public health 

25 programs to design and implement a degree program over 


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1 the Internet (referred to in this section as an ‘online de2 gree program’). 

3 ‘‘(b) APPLICATION.—To be eligible to receive a coop4 erative agreement under subsection (a), an accredited 

5 school of public health, school of allied health, or public 

6 health program shall submit an application at such time, 

7 in such manner, and containing such information as the 

8 Secretary may require. 

9 ‘‘(c) PRIORITY.—In awarding cooperative agreements 

10 under this section, the Secretary shall give priority to any 

11 accredited school of public health, school of allied health, 

12 or public health program that serves a disproportionate 

13 number of individuals from racial and ethnic minority 

14 groups. 

15 ‘‘(d) REQUIREMENTS.—Awardees shall use an award 

16 under subsection (a) to design and implement an online 

17 degree program that meets the following conditions: 

18 ‘‘(1) Limiting enrollment to individuals who 

19 have obtained a secondary school diploma or a rec20 ognized equivalent. 

21 ‘‘(2) Maintaining significant enrollment and 

22 graduation of underrepresented minorities in health 

23 professions.’’. 


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1 (c) DEFINITION.—Part B of title VII of the Public 

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

3 by inserting after the part heading the following: 

4 ‘‘SEC. 735A. APPLICATION OF DEFINITION. 

5 ‘‘The definition contained in section 738(b)(5) shall 

6 apply for purposes of this part, except that such definition 

7 shall also apply in the case of references to ‘underrep8 resented minority students’, ‘underrepresented minority 

9 faculty members’, ‘underrepresented minority faculty ad10 ministrators’, and ‘underrepresented minorities in health 

11 professions’.’’. 

12 SEC. 104. MID-CAREER HEALTH PROFESSIONS SCHOLAR13 SHIP PROGRAM. 

14 Subpart 2 of part E of title VII of the Public Health 

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

16 (1) in section 770, by inserting ‘‘(other than 

17 section 771)’’ after ‘‘this subpart’’; 

18 (2) by redesignating section 770 as section 771; 

19 and 

20 (3) by inserting after section 769 the following: 

21 ‘‘SEC. 770. MID-CAREER HEALTH PROFESSIONS SCHOLAR22 SHIP PROGRAM. 

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

24 to eligible schools to award scholarships to eligible individ25 uals to attend the school involved, for the purpose of enaVerDate Aug 31 2005 23:13 Jun 11, 2007 Jkt 059196 PO 00000 Frm 00035 Fmt 6652 Sfmt 6201 E:\BILLS\S1576.IS S1576

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1 bling the individuals to make a career change from a non2 health profession to a health profession. 

3 ‘‘(b) APPLICATION.—To receive a grant under this 

4 section, an eligible school shall submit to the Secretary 

5 an application at such time, in such manner, and con6 taining such information as the Secretary may require. 

7 ‘‘(c) USE OF FUNDS.—Amounts awarded as a schol8 arship under this section may be expended only for tuition 

9 expenses, other reasonable educational expenses, and rea10 sonable living expenses incurred in the attendance of the 

11 school involved. 

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

13 ‘‘(1) ELIGIBLE SCHOOL.—The term ‘eligible 

14 school’ means an accredited school of medicine, os15 teopathic medicine, dentistry, nursing, pharmacy, 

16 podiatric medicine, optometry, veterinary medicine, 

17 public health, chiropractic, allied health, a school of18 fering a graduate program in behavioral and mental 

19 health practice, or an entity providing programs for 

20 the training of physician assistants. 

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

22 individual’ means an individual who is an underrep23 resented minority who has obtained a secondary 

24 school diploma or its recognized equivalent.’’. 


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1 SEC. 105. CULTURAL COMPETENCY TRAINING. 

2 Part B of title VII of the Public Health Service Act 

3 (42 U.S.C. 293 et seq.), as amended by section 104, is 

4 amended by adding at the end the following: 

5 ‘‘SEC. 743. CULTURAL COMPETENCY TRAINING. 

6 ‘‘(a) IN GENERAL.—The Secretary, acting through 

7 the Administrator of the Health Resources and Services 

8 Administration and in collaboration with the Office of Mi9 nority Health and Agency for Healthcare Research and 

10 Quality, shall support the development, evaluation, and 

11 dissemination of model curricula for cultural competency 

12 training for use in health professions schools and con13 tinuing education programs, and other purposes deter14 mined appropriate by the Secretary. 

15 ‘‘(b) CURRICULA.—In carrying out subsection (a), 

16 the Secretary shall collaborate with health professional so17 cieties, licensing and accreditation entities, health profes18 sions schools, and experts in minority health and cultural 

19 competency, community-based organizations, and other 

20 organizations as determined appropriate by the Secretary. 

21 Such curricula shall include a focus on cultural com22 petency measures and cultural competency self-assessment 

23 methodology for health providers, systems and institu24 tions. 

25 ‘‘(c) DISSEMINATION.— 


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1 ‘‘(1) IN GENERAL.—Such model curricula 

2 should be disseminated through the Internet Clear3 inghouse under section 270 and other means as de4 termined appropriate by the Secretary. 

5 ‘‘(2) EVALUATION.—The Secretary shall evalu6 ate adoption and the implementation of cultural 

7 competency training curricula, and facilitate inclu8 sion of cultural competency measures in quality 

9 measurement systems as appropriate.’’. 

10 SEC. 106. AUTHORIZATION OF APPROPRIATIONS; REAU11 THORIZATIONS. 

12 (a) AUTHORIZATION OF APPROPRIATIONS.—There 

13 are authorized to be appropriated— 

14 (1) such sums as may be necessary for each of 

15 fiscal years 2008 through 2012, to carry out the 

16 amendments made by sections 101 and 102 of this 

17 title (adding sections 270 and 793 to the Public 

18 Health Service Act); 

19 (2) $45,000,000 for fiscal year 2008 and such 

20 sums as may be necessary for each of fiscal years 

21 2009 through 2012, to carry out the amendments 

22 made by section 103(a) (relating to centers of excel23 lence in section 736 of the Public Health Service 

24 Act); 


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1 (3) such sums as may be necessary for each of 

2 fiscal years 2008 through 2012, to carry out the 

3 amendments made by section 103(b) (adding section 

4 742 to the Public Health Service Act); 

5 (4) such sums as may be necessary for each of 

6 fiscal years 2008 through 2012, to carry out the 

7 amendments made by section 104(b) (adding section 

8 770 to the Public Health Service Act); and 

9 (5) such sums as may be necessary for each of 

10 fiscal years 2008 through 2012, to carry out the 

11 amendment made by section 105 (adding section 

12 743 to the Public Health Service Act). 

13 (b) REAUTHORIZATIONS.—The following programs 

14 are reauthorized as follows: 

15 (1) EDUCATIONAL ASSISTANCE IN THE HEALTH

16 PROFESSIONS REGARDING INDIVIDUALS FROM DIS17 ADVANTAGED BACKGROUND.—Section 740(c) of the 

18 Public Health Service Act (42 U.S.C. 293a(c)) is 

19 amended by striking the first sentence and inserting 

20 the following: ‘‘For the purpose of grants and con21 tracts under section 739(a)(1), there is authorized to 

22 be appropriated $60,000,000 for fiscal year 2008 

23 and such sums as may be necessary for each of fis24 cal years 2009 through 2012.’’. 


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1 (2) SCHOLARSHIPS FOR DISADVANTAGED STU2 DENTS.—Section 740(a) of the Public Health Serv3 ice Act (42 U.S.C. 293a(a)) is amended by striking 

4 ‘‘$37,000,000’’ and all that follows through 

5 ‘‘through 2002’’ and inserting ‘‘$51,000,000 for fis6 cal year 2008, and such sums as may be necessary 

7 for each of fiscal years 2009 through 2012’’. 

8 (3) LOAN REPAYMENTS AND FELLOWSHIPS.— 

9 Section 740(b) of the Public Health Service Act (42 

10 U.S.C. 293a(b)) is amended by striking 

11 ‘‘$1,100,000’’ and all that follows through ‘‘through 

12 2002’’ and inserting ‘‘$1,700,000 for fiscal year 

13 2008, and such sums as may be necessary for each 

14 of fiscal years 2009 through 2012’’. 

15 (4) GRANTS FOR HEALTH PROFESSIONS EDU16 CATION.—Section 741 of the Public Health Service 

17 Act (42 U.S.C. 293e) is amended in subsection (b), 

18 by striking ‘‘$3,500,000’’ and all that follows 

19 through the period and inserting ‘‘such sums as may 

20 be necessary for each of fiscal years 2008 through 

21 2012.’’. 


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1 TITLE II—PROMOTING HEALTH 

2 AND HEALTHCARE AWARE3 NESS AND ACCESS 

4 SEC. 201. CARE AND ACCESS. 

5 Part P of title III of the Public Health Service Act 

6 (42 U.S.C. 280g et seq.) is amended by adding at the end 

7 the following: 

8 ‘‘SEC. 399R. ACCESS, AWARENESS, AND OUTREACH ACTIVI9 TIES. 

10 ‘‘(a) DEMONSTRATION PROJECTS.—The Secretary 

11 shall award multiyear contracts or competitive grants to 

12 eligible entities to support demonstration projects de13 signed to improve the health and healthcare of racial and 

14 ethnic minority groups through improved access to 

15 healthcare, patient navigators, primary prevention activi16 ties, health promotion and disease prevention activities, 

17 and health literacy education and services. 

18 ‘‘(b) ELIGIBILITY.—In this section: 

19 ‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en20 tity’ means an organization or a community-based 

21 consortium. 

22 ‘‘(2) ORGANIZATION.—The term ‘organization’ 

23 means— 

24 ‘‘(A) a hospital, health plan, or clinic; 

25 ‘‘(B) an academic institution; 


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1 ‘‘(C) a State health agency; 

2 ‘‘(D) an Indian Health Service hospital or 

3 clinic, Indian tribal health facility, or urban In4 dian facility; 

5 ‘‘(E) a nonprofit organization, including a 

6 faith-based organization or consortium, to the 

7 extent that a contract or grant awarded to such 

8 an entity is consistent with the requirements of 

9 section 1955; 

10 ‘‘(F) a primary care practice-based re11 search network; and 

12 ‘‘(G) any other similar entity determined 

13 to be appropriate by the Secretary. 

14 ‘‘(3) COMMUNITY-BASED CONSORTIUM.—The 

15 term ‘community-based consortium’ means a part16 nership that— 

17 ‘‘(A) includes— 

18 ‘‘(i) individuals who are representa19 tives of organizations of racial and ethnic 

20 minority groups; 

21 ‘‘(ii) community leaders and leaders of 

22 community-based organizations; 

23 ‘‘(iii) healthcare providers, including 

24 providers who treat racial and ethnic mi25 nority groups; and 


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1 ‘‘(iv) experts in the area of social and 

2 behavioral science, who have knowledge, 

3 training, or practical experience in health 

4 policy, advocacy, cultural or linguistic com5 petency, or other relevant areas as deter6 mined by the Secretary; and 

7 ‘‘(B) is located within a federally- or State8 designated medically underserved area, a feder9 ally designated health provider shortage area, 

10 or an area with a significant population of ra11 cial and ethnic minorities. 

12 ‘‘(c) APPLICATION.—An eligible entity seeking a con13 tract or grant under this section shall submit an applica14 tion to the Secretary at such time, in such manner, and 

15 containing such information as the Secretary may require, 

16 including assurances that the eligible entity will— 

17 ‘‘(1) target populations that are members of ra18 cial and ethnic minority groups and health disparity 

19 populations through specific outreach activities; 

20 ‘‘(2) collaborate with appropriate community 

21 organizations and include meaningful community 

22 participation in planning, implementation, and eval23 uation of activities; 


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1 ‘‘(3) demonstrate capacity to promote culturally 

2 competent and appropriate care for target popu3 lations with consideration for health literacy; 

4 ‘‘(4) develop a plan for long-term sustainability; 

5 ‘‘(5) evaluate the effectiveness of activities 

6 under this section, within an appropriate time 

7 frame, which shall include a focus on quality and 

8 outcomes performance measures to ensure that the 

9 activities are meeting the intended goals, and that 

10 the entity is able to disseminate findings from such 

11 evaluations; 

12 ‘‘(6) provide ongoing outreach and education to 

13 the health disparity populations served; 

14 ‘‘(7) demonstrate coordination between public 

15 and private entities; and 

16 ‘‘(8) assist individuals and groups in accessing 

17 public and private programs that will help eliminate 

18 disparities in health and healthcare. 

19 ‘‘(d) PRIORITIES.—In awarding contracts and grants 

20 under this section, the Secretary shall give priority to ap21 plicants that are— 

22 ‘‘(1) safety net hospitals, defined as hospitals 

23 with a low income utilization rate greater than 25 

24 percent (as defined in section 1923(b)(3) of the So25 cial Security Act (42 U.S.C. 1396r–4(b)(3))); 


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1 ‘‘(2) a federally qualified health center as de2 fined in section 1905(l)(2)(B) of the Social Security 

3 Act with the ability to establish and lead a collabo4 rative partnership; 

5 ‘‘(3) a community-based consortium as de6 scribed in subsection (b)(3)(A); 

7 ‘‘(4) safety net health plans that are in coordi8 nation with local health centers; 

9 ‘‘(5) an Indian tribe, tribal organization, or 

10 urban Indian organization; and 

11 ‘‘(6) other health systems that— 

12 ‘‘(A) by legal mandate or explicitly adopted 

13 mission, provide patients with access to services 

14 regardless of their ability to pay; 

15 ‘‘(B) provide care or treatment for a sub16 stantial number of patients who are uninsured, 

17 are receiving assistance under a State program 

18 under title XIX of the Social Security Act, or 

19 are members of vulnerable populations, as de20 termined by the Secretary; 

21 ‘‘(C) serve a disproportionate percentage of 

22 patients from racial and ethnic minority groups; 

23 ‘‘(D) provide an assurance that amounts 

24 received under the grant or contract will be 

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1 tients’ linguistic needs, where necessary, and re2 cruit and maintain diverse staff and leadership; 

3 and 

4 ‘‘(E) provide an assurance that amounts 

5 received under the grant or contract will be 

6 used to support quality improvement activities 

7 for patients from racial and ethnic minority 

8 groups. 

9 ‘‘(e) USE OF FUNDS.—An eligible entity shall use 

10 such amounts received under this section for demonstra11 tion projects to— 

12 ‘‘(1) address health disparities in the United 

13 States-Mexico Border Area, as defined in section 8 

14 of the United States-Mexico Border Health Commis15 sion Act (22 U.S.C. 290n–6), relating to health dis16 parities in the areas of— 

17 ‘‘(A) maternal and child health; 

18 ‘‘(B) primary care and preventive health, 

19 including health education and promotion; 

20 ‘‘(C) public health and the built environ21 ment; 

22 ‘‘(D) oral health; 

23 ‘‘(E) behavioral and mental health and 

24 substance abuse; 


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1 ‘‘(F) health conditions that have a dis2 proportionate impact on racial and ethnic mi3 norities and a high prevalence in the Border 

4 Area; 

5 ‘‘(G) health services research; 

6 ‘‘(H) environmental health; 

7 ‘‘(I) workforce training and development; 

8 or 

9 ‘‘(J) other areas determined appropriate by 

10 the Secretary; 

11 ‘‘(2) implement the best practices in disease 

12 management, including those that address primary 

13 prevention and co-occurring chronic conditions, as 

14 defined by the public-private partnership established 

15 under section 918(b), that target patients with low 

16 health literacy, and, as feasible, incorporate health 

17 information technology; 

18 ‘‘(3) evaluate methods for strengthening the 

19 health coverage and continuity of coverage of migra20 tory and seasonal agricultural workers, as such 

21 terms are defined in section 330(g), and workers in 

22 other industries with traditionally low rates of em23 ployer-sponsored health insurance; and 


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1 ‘‘(4) identify, educate, and enroll eligible pa2 tients from racial and ethnic minorities and other 

3 health disparity populations into clinical trials. 

4 ‘‘(f) REPORT.—Not later than 3 years after the date 

5 an entity receives a contract or grant under this section 

6 and annually thereafter, the entity shall provide to the 

7 Secretary a report containing the results of any evaluation 

8 conducted pursuant to subsection (c)(5). 

9 ‘‘(g) DISSEMINATION OF FINDINGS.—The Secretary 

10 shall, as appropriate, disseminate to public and private en11 tities, including Congress, the findings made in evalua12 tions described under subsection (f). 

13 ‘‘SEC. 399S. GRANTS TO PROMOTE POSITIVE HEALTH BE14 HAVIORS. 

15 ‘‘(a) GRANTS AUTHORIZED.—The Secretary, in col16 laboration with the Director of the Centers for Disease 

17 Control and Prevention and other Federal officials deter18 mined appropriate by the Secretary, may award grants to 

19 State or local governments, Indian tribes (including Alas20 ka Native villages), tribal organizations, or urban Indian 

21 organizations, to promote positive health behaviors for ra22 cial and ethnic minority populations, especially in medi23 cally underserved communities. 


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1 ‘‘(b) USE OF FUNDS.—Grants awarded under sub2 section (a) may be used to provide support to community 

3 health workers— 

4 ‘‘(1) to educate, guide, and provide outreach in 

5 a community setting regarding health problems prev6 alent among racial and ethnic minority populations, 

7 especially in medically underserved communities; 

8 ‘‘(2) to educate, guide, and provide experiential 

9 learning opportunities that target behavioral risk 

10 factors including— 

11 ‘‘(A) poor nutrition; 

12 ‘‘(B) physical inactivity; 

13 ‘‘(C) being overweight or obese; 

14 ‘‘(D) tobacco use; 

15 ‘‘(E) alcohol and substance use; 

16 ‘‘(F) injury and violence; 

17 ‘‘(G) risky sexual behavior; 

18 ‘‘(H) mental health problems; 

19 ‘‘(I) poor oral health; 

20 ‘‘(3) to educate and provide guidance regarding 

21 effective strategies to promote positive health behav22 iors within the family; 

23 ‘‘(4) to educate and provide outreach regarding 

24 enrollment in health insurance including the State 

25 Children’s Health Insurance Program under title 


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1 XXI of the Social Security Act, Medicare under title 

2 XVIII of such Act and Medicaid under title XIX of 

3 such Act; 

4 ‘‘(5) to promote community wellness and aware5 ness; 

6 ‘‘(6) to educate and refer racial and ethnic mi7 norities to appropriate healthcare agencies and com8 munity-based programs and organizations in order 

9 to increase access to quality healthcare services, in10 cluding preventive health services; or 

11 ‘‘(7) to educate, guide, and provide home visita12 tion services to improve maternal and child health 

13 outcomes. 

14 ‘‘(c) APPLICATION.— 

15 ‘‘(1) IN GENERAL.—Each State or local govern16 ment, Indian tribe (including Alaska Native vil17 lages), tribal organizations, or urban Indian organi18 zations that desires to receive a grant under sub19 section (a) shall submit an application to the Sec20 retary, at such time, in such manner, and accom21 panied by such information as the Secretary may re22 quire. 

23 ‘‘(2) CONTENTS.—Each application submitted 

24 pursuant to paragraph (1) shall— 


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1 ‘‘(A) describe the activities for which as2 sistance is sought under this section; 

3 ‘‘(B) contain an assurance that, with re4 spect to each community health worker pro5 gram receiving funds under the grant, such pro6 gram will provide training and supervision to 

7 community health workers to enable such work8 ers to provide authorized program services; 

9 ‘‘(C) contain an assurance that the appli10 cant will evaluate the effectiveness of commu11 nity health worker programs receiving funds 

12 under the grant; 

13 ‘‘(D) contain an assurance that each com14 munity health worker program receiving funds 

15 under the grant will provide services in the cul16 tural context most appropriate for the individ17 uals served by the program; 

18 ‘‘(E) contain a plan to document and dis19 seminate project descriptions and results to 

20 other States and organizations as identified by 

21 the Secretary; and 

22 ‘‘(F) describe plans to enhance the capac23 ity of individuals to utilize health services and 

24 health-related social services under Federal, 

25 State, and local programs by— 


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1 ‘‘(i) assisting individuals in estab2 lishing eligibility under the programs and 

3 in receiving the services or other benefits 

4 of the programs; and 

5 ‘‘(ii) providing other services as the 

6 Secretary determines to be appropriate, 

7 that may include transportation and trans8 lation services. 

9 ‘‘(d) PRIORITY.—In awarding grants under sub10 section (a), the Secretary shall give priority to applicants 

11 that— 

12 ‘‘(1) propose to target geographic areas— 

13 ‘‘(A) with a high percentage of residents 

14 who are eligible for health insurance but are 

15 uninsured or underinsured; and 

16 ‘‘(B) with a high percentage of families for 

17 whom English is not their primary language; 

18 ‘‘(2) have experience in providing health or 

19 health-related social services to individuals who are 

20 underserved with respect to such services; and 

21 ‘‘(3) have documented community activity and 

22 experience with community health workers. 

23 ‘‘(e) COLLABORATION WITH ACADEMIC INSTITU24 TIONS.—The Secretary shall encourage community health 

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1 laborate with academic institutions. Nothing in this sec2 tion shall be construed to require such collaboration. 

3 ‘‘(f) QUALITY ASSURANCE AND COST EFFECTIVE4 NESS.—The Secretary shall establish guidelines for assur5 ing the quality of the training and supervision of commu6 nity health workers under the programs funded under this 

7 section and for assuring the cost-effectiveness of such pro8 grams. 

9 ‘‘(g) MONITORING.—The Secretary shall monitor 

10 community health worker programs identified in approved 

11 applications under this section and shall determine wheth12 er such programs are in compliance with the guidelines 

13 established under subsection (f). 

14 ‘‘(h) TECHNICAL ASSISTANCE.—The Secretary may 

15 provide technical assistance to community health worker 

16 programs identified in approved applications under this 

17 section with respect to planning, developing, and operating 

18 programs under the grant. 

19 ‘‘(i) REPORT TO CONGRESS.— 

20 ‘‘(1) IN GENERAL.—Not later than 4 years 

21 after the date on which the Secretary first awards 

22 grants under subsection (a), the Secretary shall sub23 mit to Congress a report regarding the grant 

24 project. 


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1 ‘‘(2) CONTENTS.—The report required under 

2 paragraph (1) shall include the following: 

3 ‘‘(A) A description of the programs for 

4 which grant funds were used. 

5 ‘‘(B) The number of individuals served 

6 under such programs. 

7 ‘‘(C) An evaluation of— 

8 ‘‘(i) the effectiveness of such pro9 grams; 

10 ‘‘(ii) the cost of such programs; and 

11 ‘‘(iii) the impact of the programs on 

12 the health outcomes of the community resi13 dents. 

14 ‘‘(D) Recommendations for sustaining the 

15 community health worker programs developed 

16 or assisted under this section. 

17 ‘‘(E) Recommendations regarding training 

18 to enhance career opportunities for community 

19 health workers. 

20 ‘‘(j) DEFINITIONS.—In this section: 

21 ‘‘(1) COMMUNITY HEALTH WORKER.—The term 

22 ‘community health worker’ means an individual who 

23 promotes health or nutrition within the community 

24 in which the individual resides— 


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1 ‘‘(A) by serving as a liaison between com2 munities and healthcare agencies; 

3 ‘‘(B) by providing guidance and social as4 sistance to community residents; 

5 ‘‘(C) by enhancing community residents’ 

6 ability to effectively communicate with 

7 healthcare providers; 

8 ‘‘(D) by providing culturally and linguis9 tically appropriate health or nutrition edu10 cation; 

11 ‘‘(E) by advocating for individual and com12 munity health, including oral and mental, and 

13 nutrition needs; and 

14 ‘‘(F) by providing referral and follow-up 

15 services. 

16 ‘‘(2) COMMUNITY SETTING.—The term ‘commu17 nity setting’ means a home or a community organi18 zation located in the neighborhood in which a partic19 ipant resides. 

20 ‘‘(3) MEDICALLY UNDERSERVED COMMUNITY.— 

21 The term ‘medically underserved community’ means 

22 a community identified by a State— 

23 ‘‘(A) that has a substantial number of in24 dividuals who are members of a medically unVerDate Aug 31 2005 23:13 Jun 11, 2007 Jkt 059196 PO 00000 Frm 00055 Fmt 6652 Sfmt 6201 E:\BILLS\S1576.IS S1576

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1 derserved population, as defined by section 

2 330(b)(3); and 

3 ‘‘(B) a significant portion of which is a 

4 health professional shortage area as designated 

5 under section 332. 

6 ‘‘(4) SUPPORT.—The term ‘support’ means the 

7 provision of training, supervision, and materials 

8 needed to effectively deliver the services described in 

9 subsection (b), reimbursement for services, and 

10 other benefits. 

11 ‘‘SEC. 399T. GRANTS FOR RACIAL AND ETHNIC AP12 PROACHES TO COMMUNITY HEALTH. 

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

14 provide for the awarding of grants to assist communities 

15 in mobilizing and organizing resources in support of effec16 tive and sustainable programs that will reduce or eliminate 

17 disparities in health and healthcare experienced by racial 

18 and ethnic minority individuals. 

19 ‘‘(b) AUTHORITY TO AWARD GRANTS.—The Sec20 retary, acting through the Centers for Disease Control and 

21 Prevention, in consultation with the Office of Minority 

22 Health, shall award grants to eligible entities to assist in 

23 designing, implementing, and evaluating culturally and 

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1 driven sustainable strategies to eliminate racial and ethnic 

2 health and healthcare disparities. 

3 ‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive 

4 a grant under this section, an entity shall— 

5 ‘‘(1) represent a coalition— 

6 ‘‘(A) whose principal purpose is to develop 

7 and implement interventions to reduce or elimi8 nate a health or healthcare disparity in a tar9 geted racial or ethnic minority group in the 

10 community served by the coalition; and 

11 ‘‘(B) that includes— 

12 ‘‘(i) at least 3 members selected from 

13 among— 

14 ‘‘(I) public health departments; 

15 ‘‘(II) community-based organiza16 tions; 

17 ‘‘(III) university and research or18 ganizations; 

19 ‘‘(IV) Indian tribes, tribal organi20 zations, urban Indian organizations, 

21 national or regional Indian organiza22 tions, or the Indian Health Service; 

23 ‘‘(V) organizations serving Native 

24 Hawaiians; 


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1 ‘‘(VI) organizations serving Pa2 cific Islanders; and 

3 ‘‘(VII) interested public or pri4 vate healthcare providers or organiza5 tions as deemed appropriate by the 

6 Secretary; and 

7 ‘‘(ii) at least 1 member from a com8 munity-based organization that represents 

9 the targeted racial or ethnic minority 

10 group; and 

11 ‘‘(2) submit to the Secretary an application at 

12 such time, in such manner, and containing such in13 formation as the Secretary may require, which shall 

14 include— 

15 ‘‘(A) a description of the targeted racial or 

16 ethnic populations in the community to be 

17 served under the grant; 

18 ‘‘(B) a description of at least 1 health dis19 parity that exists in the racial or ethnic tar20 geted populations, including infant mortality, 

21 breast and cervical cancer screening and man22 agement, cardiovascular disease, diabetes, child 

23 and adult immunization levels, HIV/AIDS, hep24 atitis B, tuberculosis, asthma, or other health 


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1 priority areas as designated by the Secretary; 

2 and 

3 ‘‘(C) a demonstration of a proven record of 

4 accomplishment of the coalition members in 

5 serving and working with the targeted commu6 nity. 

7 ‘‘(d) SUSTAINABILITY.—The Secretary shall give pri8 ority to an eligible entity under this section if the entity 

9 agrees that, with respect to the costs to be incurred by 

10 the entity in carrying out the activities for which the grant 

11 was awarded, the entity (and each of the participating 

12 partners in the coalition represented by the entity) will 

13 maintain its expenditures of non-Federal funds for such 

14 activities at a level that is not less than the level of such 

15 expenditures during the fiscal year immediately preceding 

16 the first fiscal year for which the grant is awarded. 

17 ‘‘(e) NONDUPLICATION.—Funds provided through 

18 this grant program should supplement, not supplant, ex19 isting Federal funding, and the funds should not be used 

20 to duplicate the activities of the other health disparity 

21 grant programs in this Act. 

22 ‘‘(f) TECHNICAL ASSISTANCE.—The Secretary may, 

23 either directly or by grant or contract, provide any entity 

24 that receives a grant under this section with technical and 


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1 other non-financial assistance necessary to meet the re2 quirements of this section. 

3 ‘‘(g) DISSEMINATION.—The Secretary shall encour4 age and enable grantees to share best practices, evaluation 

5 results, and reports using the Internet, conferences, and 

6 other pertinent information regarding the projects funded 

7 by this section, including the outreach efforts of the Office 

8 of Minority Health and the Centers for Disease Control 

9 and Prevention. Such information shall be publicly avail10 able, and posted on the Internet website of relevant gov11 ernment agencies. 

12 ‘‘(h) ADMINISTRATIVE BURDENS.—The Secretary 

13 shall make every effort to minimize duplicative or unneces14 sary administrative burdens on grantees. 

15 ‘‘SEC. 399U. GRANTS FOR HEALTH DISPARITY 

16 COLLABORATIVES. 

17 ‘‘(a) PURPOSE.—The Secretary, acting through the 

18 Administrator of the Health Resources and Services Ad19 ministration, shall award grants to eligible entities to as20 sist in implementing systems of primary care practices to 

21 eliminate disparities in the delivery of healthcare and im22 prove the healthcare provided to all patients. 

23 ‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive 

24 a grant under this section, an entity shall— 


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1 ‘‘(1) be a federally qualified health center as de2 fined in section 1861(aa)(4) or 1905(l)(2)(B) of the 

3 Social Security Act with the ability to establish and 

4 lead a collaborative partnership; and 

5 ‘‘(2) submit to the Secretary an application, at 

6 such time, in such manner, and containing such in7 formation as the Secretary may require, which shall 

8 include plans to implement collaboratives in one or 

9 more of the following areas: 

10 ‘‘(A) Diabetes. 

11 ‘‘(B) Asthma. 

12 ‘‘(C) Depression. 

13 ‘‘(D) Cardiovascular disease. 

14 ‘‘(E) Cancer. 

15 ‘‘(F) Preventive health, including 

16 screenings. 

17 ‘‘(G) Perinatal health. 

18 ‘‘(H) Patient safety. 

19 ‘‘(I) Oral health. 

20 ‘‘(J) Finance and redesign of health cen21 ters to implement planned care. 

22 ‘‘(K) Other areas as designated by the Sec23 retary. 

24 ‘‘(c) NONDUPLICATION.—Funds provided through 

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1 isting Federal funding, and the funds should not be used 

2 to duplicate the activities of the other health disparity 

3 grant programs in this Act. 

4 ‘‘(d) TECHNICAL ASSISTANCE.—The Secretary may, 

5 either directly or by grant or contract, provide any entity 

6 that receives a grant under this section with technical and 

7 other non-financial assistance necessary to meet the re8 quirements of this section. 

9 ‘‘(e) ADMINISTRATIVE BURDENS.—The Secretary 

10 shall make every effort to minimize duplicative or unneces11 sary administrative burdens on grantees. 

12 ‘‘SEC. 399V. HEALTH ACTION ZONES. 

13 ‘‘(a) PURPOSE.—The Secretary shall establish the 

14 Health Action Zone Initiative demonstration program to 

15 support comprehensive State, tribal, or local initiatives to 

16 improve the health of racial and ethnic minority groups. 

17 ‘‘(b) HEALTH ACTION ZONE INITIATIVE PRO18 GRAM.— 

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

20 Health Action Zone Initiative Program grants to 

21 State and local public health agencies and Indian 

22 tribes and tribal organizations of eligible commu23 nities. Each grant shall be funded for 5 years. 

24 ‘‘(2) ELIGIBLE COMMUNITIES.— 


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1 ‘‘(A) IDENTIFICATION.—The Secretary 

2 shall develop, after opportunity for public re3 view and comment, and implement a metric for 

4 identifying and notifying eligible communities 

5 pursuant to subparagraph (B), and report such 

6 findings to Congress and the public. 

7 ‘‘(B) ELIGIBILITY.—Eligible communities 

8 shall be communities that are most at risk, or 

9 at greatest disproportionate risk, for adverse 

10 health outcomes, as measured by— 

11 ‘‘(i) overall burden of disease and 

12 health conditions; 

13 ‘‘(ii) accessibility to and availability of 

14 health and economic resources; 

15 ‘‘(iii) proportion of individuals from 

16 racial and ethnic minority groups; and 

17 ‘‘(iv) other factors as determined ap18 propriate by the Secretary. 

19 ‘‘(3) AGENCY COLLABORATION.—The Secretary, 

20 in collaboration with the Deputy Assistant Secretary 

21 for Minority Health, the Director of the Centers for 

22 Disease Control and Prevention, the Administrator 

23 of the Health Resources and Services Administra24 tion, the Director of the Indian Health Service, the 

25 Director of the Centers for Medicare & Medicaid 


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1 Services, the Director of the Substance Abuse and 

2 Mental Health Services Administration, and heads 

3 of other Federal agencies as appropriate, shall deter4 mine, with respect to the Health Action Zone Initia5 tive Program— 

6 ‘‘(A) core goals, objectives and reasonable 

7 time lines for implementing, evaluating and sus8 taining comprehensive and effective health and 

9 healthcare improvement activities in eligible 

10 communities; 

11 ‘‘(B) current programmatic and research 

12 initiatives in which eligible communities may 

13 participate; 

14 ‘‘(C) existing agency resources that can be 

15 targeted to eligible communities; and 

16 ‘‘(D) mechanisms to facilitate joint appli17 cation, or establish a common application, to 

18 multiple grant programs, as appropriate. 

19 ‘‘(4) APPLICATIONS.— 

20 ‘‘(A) IN GENERAL.—The State and local 

21 public health agencies of eligible communities 

22 shall jointly submit an application to the Sec23 retary at such time, in such manner, and ac24 companied by such information as the Secretary 


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1 may require, including a strategic plan that 

2 shall— 

3 ‘‘(i) describe the proposed activities 

4 pursuant to paragraph (5); 

5 ‘‘(ii) report the extent to which local 

6 institutions and organizations and commu7 nity residents have participated in the stra8 tegic plan development; 

9 ‘‘(iii) identify established public-pri10 vate partnerships, and State, local, and 

11 private resources that will be available; 

12 ‘‘(iv) identify Federal funding needed 

13 to support the proposed activities; and 

14 ‘‘(v) report the baselines, methods, 

15 and benchmarks for measuring the success 

16 of activities proposed in the strategic plan. 

17 ‘‘(B) COMMUNITY ADVISORY BOARD.— 

18 ‘‘(i) IN GENERAL.—In order to receive 

19 a Health Action Zone Initiative Program 

20 grant under this section, an eligible com21 munity shall have a community advisory 

22 board. 

23 ‘‘(ii) MEMBERS.— 

24 ‘‘(I) COMMUNITY.—The majority 

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1 sory board under clause (i) shall be 

2 individuals that will benefit from the 

3 activities or services provided by the 

4 grants under this section. 

5 ‘‘(II) REPRESENTATIVES.—A 

6 community advisory board shall in7 clude representatives from the State 

8 health department and county or local 

9 health department, community-based 

10 organizations, environmental and pub11 lic health experts, healthcare profes12 sionals and providers, nonprofit lead13 ers, community organizers, elected of14 ficials, private payers, employers, and 

15 consumers. 

16 ‘‘(iii) DUTIES.—A community advi17 sory board shall— 

18 ‘‘(I) oversee the functions and 

19 operations of Health Action Zone Ini20 tiative Program grant activities; 

21 ‘‘(II) assist in the evaluation of 

22 such activities; and 

23 ‘‘(III) prepare an annual report 

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1 ommends time lines and future 

2 courses of action. 

3 ‘‘(5) USE OF FUNDS.—An eligible community 

4 that receives a grant under this section shall use the 

5 funding to support activities to achieve stated core 

6 goals and objectives, pursuant to paragraph (3), 

7 which may include initiatives that— 

8 ‘‘(A) promote disease prevention and 

9 health promotion for racial and ethnic minority 

10 groups; 

11 ‘‘(B) facilitate partnerships between 

12 healthcare providers, public and health agen13 cies, academic institutions, community based or 

14 advocacy organizations, elected officials, profes15 sional societies, and other stakeholder groups; 

16 ‘‘(C) enhance the local capacity for health 

17 data collection and reporting in a manner that 

18 can be aggregated and disaggregated to en19 hance understanding of the racial and ethnic di20 versity of the Health Action Zone; 

21 ‘‘(D) coordinate and integrate community22 based activities including education, city plan23 ning, transportation initiatives, environmental 

24 changes, and other related activities at the local 


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1 level that help improve public health and ad2 dress health concerns; 

3 ‘‘(E) mobilize financial and other resources 

4 from the public and private sector to increase 

5 local capacity to address health issues; 

6 ‘‘(F) support the training of staff in com7 munication and outreach to the general public, 

8 particularly those at disproportionate risk for 

9 health and healthcare disparities; 

10 ‘‘(G) assist eligible communities in meeting 

11 Healthy People 2010 objectives; and 

12 ‘‘(H) aid eligible communities in providing 

13 employment, and cultural and recreational re14 sources that enable healthy lifestyles. 

15 ‘‘(6) EVALUATION.—The Secretary, directly or 

16 through contract, shall conduct and report an eval17 uation of the Health Action Zone Initiative Program 

18 that shall be available to the public. 

19 ‘‘(7) SUPPLEMENT NOT SUPPLANT.—Grant 

20 funds received under this section shall be used to 

21 supplement, and not supplant, funding that would 

22 otherwise be used for activities described under this 

23 section. 

24 ‘‘(c) PUERTO RICO.—For purposes of this section, 

25 the term ‘State’ includes Puerto Rico. 


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1 ‘‘SEC. 399W. OUTREACH. 

2 ‘‘(a) IN GENERAL.—The Secretary, in collaboration 

3 with the Office for Minority Health, the Centers for Medi4 care and Medicaid Services, the Indian Health Service, 

5 and the Health Resources and Services Administration, 

6 shall establish a grant program to improve outreach, par7 ticipation, and enrollment by eligible entities with respect 

8 to available healthcare programs. 

9 ‘‘(b) ELIGIBILITY.—In this section, the term ‘eligible 

10 entity’ means any of the following: 

11 ‘‘(1) A State or local government. 

12 ‘‘(2) A Federal health safety net organization. 

13 ‘‘(3) A national, local, or community-based pub14 lic or nonprofit private organization. 

15 ‘‘(4) A faith-based organization or consortia, to 

16 the extent that a grant awarded to such an entity 

17 is consistent with the requirements of section 1955 

18 relating to a grant award to non-governmental enti19 ties. 

20 ‘‘(5) An elementary or secondary school. 

21 ‘‘(c) DEFINITION.—In this section: 

22 ‘‘(1) FEDERAL HEALTH SAFETY NET ORGANI23 ZATION.—The term ‘Federal health safety net orga24 nization’ means— 

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1 ganization or urban Indian organization (as 

2 those terms are defined in section 4 of the In3 dian Health Care Improvement Act (25 U.S.C. 

4 1603); 

5 ‘‘(B) a federally qualified health center, as 

6 defined in section 1905(l)(2)(B) of the Social 

7 Security Act, with the ability to establish and 

8 lead a collaborative partnership; 

9 ‘‘(C) a safety net hospital, defined as a 

10 hospital with a low income utilization rate 

11 greater than 25 percent (as defined in section 

12 1923(b)(3) of the Social Security Act (42 

13 U.S.C. 1396r–4(b)(3))); 

14 ‘‘(D) a covered entity described in section 

15 340B(a)(4); 

16 ‘‘(E) a safety net health plan defined as a 

17 managed care organization that— 

18 ‘‘(i) is exempt from or not subject to 

19 Federal income tax, or is owned by an en20 tity or entities exempt from or not subject 

21 to Federal income tax; and 

22 ‘‘(ii) enrolls not less than 75 percent 

23 of its members in a plan or program fund24 ed in whole or in part under a Federal, 

25 State, or local healthcare program (other 


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1 than a program for government employ2 ees); and 

3 ‘‘(F) any other entity or a consortium that 

4 serves children under a federally funded pro5 gram, including the special supplemental nutri6 tion program for women, infants, and children 

7 (WIC) established under section 17 of the Child 

8 Nutrition Act of 1966 (42 U.S.C. 1786), the 

9 head start and early head start programs under 

10 the Head Start Act (42 U.S.C. 9831 et seq.), 

11 the school lunch program established under the 

12 Richard B. Russell National School Lunch Act 

13 (42 U.S.C. 1751 et seq.), and an elementary or 

14 secondary school. 

15 ‘‘(2) INDIANS; INDIAN TRIBE; TRIBAL ORGANI16 ZATION; URBAN INDIAN ORGANIZATION.—The terms 

17 ‘Indian’, ‘Indian tribe’, ‘tribal organization’, and 

18 ‘urban Indian organization’ have the meanings given 

19 such terms in section 4 of the Indian Health Care 

20 Improvement Act (25 U.S.C. 1603). 

21 ‘‘(d) PRIORITY FOR AWARD OF GRANTS.— 

22 ‘‘(1) IN GENERAL.—In making grants under 

23 subsection (a), the Secretary shall give priority to— 

24 ‘‘(A) eligible entities that propose to target 

25 geographic areas with high rates of— 


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1 ‘‘(i) eligible but unenrolled children, 

2 including such children who reside in rural 

3 areas; or 

4 ‘‘(ii) racial and ethnic minorities and 

5 health disparity populations, including 

6 those proposals that address cultural and 

7 linguistic barriers to enrollment; and 

8 ‘‘(B) eligible entities that plan to engage in 

9 outreach efforts with respect to individuals de10 scribed in subparagraph (A) and that are— 

11 ‘‘(i) safety net hospitals, defined as 

12 hospitals with a low income utilization rate 

13 greater than 25 percent (as defined in sec14 tion 1923(b)(3) of the Social Security Act 

15 (42 U.S.C. 1396r–4(b)(3))); 

16 ‘‘(ii) federally qualified health centers 

17 as defined in section 1905(1)(2)(B) of the 

18 Social Security Act with the ability to es19 tablish and lead a collaborative partner20 ship; 

21 ‘‘(iii) community-based consortiums as 

22 described in section 399R(b) (3)(A) and 

23 (4); 

24 ‘‘(iv) safety net health plans that are 

25 in coordination with local health centers; 


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1 ‘‘(v) Indian tribes, tribal organiza2 tions, or urban Indian organizations; 

3 ‘‘(vi) other health systems that as de4 scribed in section 399R(d)(5); or 

5 ‘‘(vii) faith-based organizations or 

6 consortia. 

7 ‘‘(2) TEN PERCENT SET ASIDE FOR OUTREACH

8 TO INDIAN CHILDREN.—An amount equal to 10 per9 cent of the funds appropriated under section 202(3) 

10 of the Minority Health Improvement and Health 

11 Disparity Elimination Act to carry out this section 

12 for a fiscal year shall be used by the Secretary to 

13 award grants to health programs operated by the In14 dian Health Service, an Indian tribe, tribal organiza15 tion, or urban Indian organization (as those terms 

16 are defined in section 4 of the Indian Health Care 

17 Improvement Act (25 U.S.C. 1603)) for outreach to, 

18 and enrollment of, children who are Indians. 

19 ‘‘SEC. 399X. DELTA HEALTH INITIATIVE. 

20 ‘‘(a) IN GENERAL.—The Secretary shall award a 

21 grant to fund the Delta Health Initiative Rural Health, 

22 Education, and Workforce Infrastructure Demonstration 

23 Program for the purpose of addressing longstanding, 

24 unmet health needs in the Mississippi Delta, including 

25 health education, access and research, and job training. 


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

2 under this section, an entity shall— 

3 ‘‘(1) include a nonprofit alliance of not less 

4 than 4 academic institutions that have a history of 

5 collaboration, along with their State Hospital Asso6 ciation and 2 community-based organizations; 

7 ‘‘(2) solicit and fund proposals from local gov8 ernments, hospitals, healthcare clinics, academic in9 stitutions, and rural public health-related entities 

10 and organizations for research development, edu11 cational programs, healthcare services, job training, 

12 planning, construction, and the equipment of public 

13 health-related facilities; 

14 ‘‘(3) have experience working with federally 

15 qualified health centers and local health depart16 ments; and 

17 ‘‘(4) have experience in diabetes education and 

18 management, promoting healthy communities, health 

19 education, and wellness. 

20 ‘‘(c) DEFINITION.—In this section, the term ‘alliance’ 

21 means an entity composed of— 

22 ‘‘(1) an academic health and research center; 

23 ‘‘(2) at least 2 regional universities; 

24 ‘‘(3) a school of nursing; and 


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1 ‘‘(4) a strong economic development entity, as 

2 determined by the Secretary. 

3 ‘‘(d) FEDERAL INTEREST IN PROPERTY.—With re4 spect to funds used under this subsection for construction 

5 or alteration of property, the Federal interest in the prop6 erty shall last for a period of 1 year following completion 

7 or until the Federal Government is compensated for its 

8 proportionate interest in the property use changes or the 

9 property is transferred or sold, whichever time period is 

10 less. At the conclusion of such period, the notice of Fed11 eral interest in such property shall be removed.’’. 

12 SEC. 202. AUTHORIZATION OF APPROPRIATIONS. 

13 There are authorized to be appropriated— 

14 (1) such sums as may be necessary for each of 

15 fiscal years 2008 through 2012, to carry out section 

16 399R of the Public Health Service Act (as added by 

17 section 201); 

18 (2) $52,000,000 for fiscal year 2008, and such 

19 sums as may be necessary for each of fiscal years 

20 2009 through 2012, to carry out section 399T of the 

21 Public Health Service Act (as added by section 201); 

22 and 

23 (3) such sums as necessary for each of fiscal 

24 years 2008 through 2012, to carry out sections 


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1 399S, 399U, 399V, 399W, and 399X of the Public 

2 Health Service Act (as added by section 201). 

3 TITLE III—RESEARCH TO RE4 DUCE AND ELIMINATE 

5 HEALTH DISPARITIES 

6 SEC. 301. AGENCY FOR HEALTHCARE RESEARCH AND 

7 QUALITY. 

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

9 Health Service Act (42 U.S.C. 299b et seq.) is amended 

10 by adding at the end the following: 

11 ‘‘SEC. 918. ENHANCED RESEARCH WITH RESPECT TO 

12 HEALTHCARE DISPARITIES. 

13 ‘‘(a) ACCELERATING THE ELIMINATION OF DISPARI14 TIES.— 

15 ‘‘(1) STRATEGIC PLAN.—The Secretary, acting 

16 through the Director, and in collaboration with the 

17 Deputy Assistant Secretary for Minority Health, 

18 shall develop a strategic plan regarding research 

19 supported by the agency to improve healthcare and 

20 eliminate healthcare disparities among racial and 

21 ethnic minority groups. In developing such plan, the 

22 Secretary shall— 

23 ‘‘(A) determine which areas of research 

24 focus would have the greatest impact on 

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1 parities, taking into consideration the overall 

2 health status of various populations, dispropor3 tionate burden of diseases or health conditions, 

4 and types of interventions for which data on ef5 fectiveness is limited; 

6 ‘‘(B) establish measurable goals and objec7 tives which will allow assessment of progress; 

8 ‘‘(C) solicit public review and comment 

9 from experts in healthcare, minority health and 

10 health disparities, health services research, and 

11 other areas as determined appropriate by the 

12 Secretary; 

13 ‘‘(D) incorporate recommendations from 

14 the Institute of Medicine, pursuant to section 

15 303 of the Minority Health Improvement and 

16 Health Disparity Elimination Act, as appro17 priate; 

18 ‘‘(E) complete such plan within 12 months 

19 of enactment of the Minority Health Improve20 ment and Health Disparity Elimination Act; 

21 and 

22 ‘‘(F) update such plan and report on 

23 progress in meeting established goals and objec24 tives incorporating recommendations from the 

25 Institute of Medicine as described in section 


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1 303(b) and (c) of the Minority Health Improve2 ment and Health Disparity Elimination Act not 

3 less than every 2 years and include in annual 

4 performance budget submissions, an update of 

5 progress in meeting plan goals and objectives; 

6 ‘‘(G) ensure coordination and integration 

7 with the National Plan to Improve Minority 

8 Health and Eliminate Health Disparities, as de9 scribed in section 1707(c) and other Depart10 ment-wide initiatives, as feasible; and 

11 ‘‘(H) report the plan to the Congress and 

12 make available to the public in print and elec13 tronic format. 

14 ‘‘(2) ESTABLISHMENT OF GRANTS.—The Sec15 retary, acting through the Director, and in collabo16 ration with the Deputy Assistant Secretary for Mi17 nority Health, may award grants or contracts to eli18 gible entities for research to improve the health of 

19 racial and ethnic minority groups. 

20 ‘‘(3) APPLICATION; ELIGIBLE ENTITIES.— 

21 ‘‘(A) APPLICATION.—To receive a grant or 

22 contract under this section, an eligible entity 

23 shall submit to the Secretary an application at 

24 such time, in such manner, and containing such 

25 information as the Secretary may require. 


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1 ‘‘(B) ELIGIBLE ENTITIES.—To be eligible 

2 to receive a grant or contract under this sec3 tion, an entity shall be a health center, hospital, 

4 health system, community clinic, university, 

5 community-based organization, or other health 

6 entity determined appropriate by the Secretary, 

7 that— 

8 ‘‘(i) by legal mandate or explicitly 

9 adopted mission, provides patients with ac10 cess to services regardless of their ability 

11 to pay; 

12 ‘‘(ii) provides care or treatment for a 

13 substantial number of patients who are un14 insured, are receiving assistance under a 

15 State program under title XIX of the So16 cial Security Act, or are members of vul17 nerable populations, as determined by the 

18 Secretary; 

19 ‘‘(iii) serves a disproportionate per20 centage of patients from racial and ethnic 

21 minority groups; 

22 ‘‘(iv) provides an assurance that 

23 amounts received under the grant or con24 tract will be used to implement strategies 

25 that address patients’ linguistic needs, 


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1 where necessary, and recruit and maintain 

2 diverse staff and leadership; and 

3 ‘‘(v) include a focus on community4 based participation in research and dem5 onstrations, as well as research analysis, 

6 interpretation, solutions and partnerships 

7 for patients from racial and ethnic minor8 ity groups. 

9 ‘‘(C) PREFERENCE.—Consortia of 3 or 

10 more eligible entities, particularly those entities 

11 that partner with health plans, shall be given a 

12 preference for grant or contract funding. 

13 ‘‘(4) RESEARCH.—The research funded under 

14 paragraph (2), with respect to racial and ethnic mi15 nority groups, shall— 

16 ‘‘(A) prioritize the translation of existing 

17 research into practical interventions for improv18 ing health and healthcare and reducing dispari19 ties; 

20 ‘‘(B) target areas of need as identified in 

21 the strategic plan pursuant to subsection (a)(1), 

22 the National Healthcare Disparities Report 

23 published by the Agency for Healthcare Re24 search and Quality, the Unequal Treatment: 

25 Confronting Racial and Ethnic Disparities in 


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1 Health Care Report, and other relevant reports 

2 by the Institute of Medicine, and other reports 

3 issued by Federal health agencies; 

4 ‘‘(C) include a focus on community-based 

5 participatory research solutions and partner6 ships as appropriate; 

7 ‘‘(D) expand practice-based research net8 works (primary care and larger delivery sys9 tems) to include networks of delivery sites serv10 ing large numbers of minority and health dis11 parity populations including— 

12 ‘‘(i) public hospitals and private non13 profit hospitals; 

14 ‘‘(ii) health centers; 

15 ‘‘(iii) health plans; 

16 ‘‘(iv) an Indian tribe, tribal organiza17 tion, or urban Indian organization; and 

18 ‘‘(v) other sites as determined appro19 priate by the Director. 

20 ‘‘(5) DISSEMINATION OF RESEARCH FIND21 INGS.—To ensure that findings from the research 

22 described in paragraph (4) are disseminated and ap23 plied promptly, the Director shall— 

24 ‘‘(A) develop outreach and training pro25 grams for healthcare providers with respect to 


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1 the practical and effective interventions that re2 sult from research programs carried out with 

3 grants or contracts awarded under this section; 

4 and 

5 ‘‘(B) provide technical assistance for the 

6 implementation of evidence-based practices that 

7 will improve health and healthcare and reduce 

8 disparities. 

9 ‘‘(b) REALIZING THE POTENTIAL OF DISEASE MAN10 AGEMENT.— 

11 ‘‘(1) PUBLIC-PRIVATE SECTOR PARTNERSHIP

12 TO ASSESS EFFECTIVENESS OF EXISTING DISEASE

13 MANAGEMENT STRATEGIES.— 

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

15 establish a public-private partnership to iden16 tify, evaluate, and disseminate effective disease 

17 management strategies, tailored to improve 

18 healthcare and health outcomes for patients 

19 from racial and ethnic minority groups. Such 

20 strategies shall reflect established healthcare 

21 quality standards and benchmarks and other 

22 evidence-based recommendations. 

23 ‘‘(B) PARTNERSHIP COMPOSITION.—The 

24 partnership’s members shall include the fol25 lowing: 


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1 ‘‘(i) Representatives from the fol2 lowing: 

3 ‘‘(I) The Office of Minority 

4 Health. 

5 ‘‘(II) The Centers for Disease 

6 Control and Prevention. 

7 ‘‘(III) The Agency for Healthcare 

8 Research and Quality. 

9 ‘‘(IV) The Centers for Medicare 

10 and Medicaid Services. 

11 ‘‘(V) The Health Resources and 

12 Services Administration. 

13 ‘‘(VI) The Indian Health Service. 

14 ‘‘(VII) The Substance Abuse and 

15 Mental Health Services Administra16 tion. 

17 ‘‘(VIII) The Office of Behavioral 

18 Health. 

19 ‘‘(IX) Other agencies as des20 ignated by the Secretary. 

21 ‘‘(ii) Representatives of health plans, 

22 employers, or other private entities that 

23 have implemented disease management 

24 programs. 


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1 ‘‘(iii) Representatives of hospitals; 

2 community health centers; large, small, or 

3 solo provider groups; or other organiza4 tions that provide healthcare and have im5 plemented disease management programs. 

6 ‘‘(iv) Representatives of national mi7 nority advocacy organizations, as well as 

8 community-based representatives who have 

9 been involved with establishing, imple10 menting, or evaluating health promotion, 

11 disease prevention and disease manage12 ment programs. 

13 ‘‘(v) Other individuals as designated 

14 by the Secretary. 

15 ‘‘(C) PARTNERSHIP DUTIES.— 

16 ‘‘(i) IN GENERAL.—Not later than 18 

17 months after the date of enactment of the 

18 Minority Health Improvement and Health 

19 Disparity Elimination Act, the partnership 

20 shall release a best practices report with 

21 respect to disease management practices, 

22 with a particular focus on the following: 

23 ‘‘(I) Self-management training. 


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1 ‘‘(II) Increasing patient partici2 pation in and satisfaction with 

3 healthcare encounters. 

4 ‘‘(III) Helping patients use qual5 ity performance and cost information 

6 to choose appropriate healthcare pro7 viders for their care. 

8 ‘‘(IV) Interventions outside of a 

9 traditional healthcare environment, in10 cluding the workplace, school, commu11 nity, or home. 

12 ‘‘(V) Interventions utilizing com13 munity health workers and case man14 agers. 

15 ‘‘(VI) Interventions that imple16 ment integrated disease management 

17 and treatment strategies to address 

18 multiple chronic co-occurring condi19 tions. 

20 ‘‘(VII) Other interventions as 

21 identified by the Secretary. 

22 ‘‘(2) REPORT.— 

23 ‘‘(A) IN GENERAL.—Not later than Sep24 tember 30, 2010, the partnership shall submit 

25 to the Secretary and the relevant committees of 


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1 Congress a report that describes the extent to 

2 which the activities and research funded under 

3 this section have been successful in reducing 

4 and eliminating disparities in health and 

5 healthcare in targeted populations. 

6 ‘‘(B) AVAILABILITY.—The Secretary shall 

7 ensure that the report is made available on the 

8 Internet websites of the Office of Minority 

9 Health, the Agency for Healthcare Research 

10 and Quality, and other agencies as appro11 priate.’’. 

12 (b) ANNUAL REPORTS.—The Secretary, acting 

13 through the Director of the Agency for Healthcare Re14 search and Quality, shall continue to carry out the report15 ing requirements of sections 903(a)(6) and 913(b)(2) of 

16 the Public Health Service Act. 

17 SEC. 302. GENETIC VARIATION AND HEALTH. 

18 (a) IN GENERAL.—The Secretary shall ensure that 

19 any current, proposed, or future research and pro20 grammatic activities regarding genomics include focus on 

21 genetic variation within and between populations, with a 

22 focus on racial and ethnic minority populations, that may 

23 affect risk of disease or response to drug therapy and 

24 other treatments, in order to ensure that all populations 

25 are able to derive full benefit from genomic tests and 


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1 treatments that may improve their health and healthcare. 

2 The Secretary shall encourage, with respect to racial and 

3 ethnic minority populations, efforts to— 

4 (1) increase awareness, access, availability, and 

5 utilization of genomic tests and treatments; 

6 (2) determine and monitor appropriateness of 

7 use of genomic tests and treatments; 

8 (3) increase awareness of the importance of 

9 knowing one’s family history and the relationships 

10 between genes, the social and physical environment, 

11 and health; and 

12 (4) expand genomics research that would help 

13 to— 

14 (A) improve tests to facilitate earlier and 

15 more accurate diagnoses; 

16 (B) enhance the safety of drugs, particu17 larly for drugs that pose an elevated risk for 

18 adverse drug events in such populations; 

19 (C) increase the effectiveness of drugs, 

20 particularly for diseases and conditions that dis21 proportionately affect such populations; and 

22 (D) augment the current understanding of 

23 the interactions between genomic, social and 

24 physical environmental factors, and their influ25 ence on the causality, prevention, control, and 


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1 treatment of diseases common in such popu2 lations. 

3 (b) GENETIC VARIATION, ENVIRONMENT, AND

4 HEALTH SUMMIT.— 

5 (1) SUMMIT.—Not later than 1 year after the 

6 date of enactment of this Act, the Director of the 

7 National Human Genome Research Institute, in col8 laboration with the Director of the Office of 

9 Genomics and Disease Prevention at the Centers for 

10 Disease Control and Prevention, the Director of the 

11 Office of Behavioral and Social Science Research at 

12 the National Institutes of Health, and the Deputy 

13 Assistant Secretary of the Office of Minority Health, 

14 shall convene a Summit for the purpose of providing 

15 leadership and guidance to Secretary, Congress, and 

16 other public and private entities on current and fu17 ture areas of focus for genomics research, including 

18 translation of findings from such research, relating 

19 to improving the health of racial and ethnic minority 

20 populations and reducing health disparities. 

21 (2) PARTICIPATION.—The Summit shall in22 clude— 

23 (A) representatives from the Federal 

24 health agencies, including the National Insti25 tutes of Health, the Centers for Disease Control 


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1 and Prevention, the Office of Minority Health, 

2 the Food and Drug Administration, the Health 

3 Resources and Services Administration, the 

4 Centers for Medicare & Medicaid Services, the 

5 Substance Abuse and Mental Health Services 

6 Administration, and additional agencies and de7 partments as determined appropriate by the 

8 Secretary; 

9 (B) independent experts and stakeholders 

10 from relevant industry and academic institu11 tions, particularly those that have demonstrated 

12 expertise in both genomics and minority health 

13 and serve a disproportionate number of racial 

14 and ethnic minority patients; and 

15 (C) leaders of community organizations 

16 and Indian tribal epidemiology centers that 

17 work to reduce and eliminate health disparities. 

18 (3) REPORT.—Not later than 90 days after the 

19 conclusion of the Summit, the Director of the Na20 tional Human Genome Research Institute shall sub21 mit to Congress and make available to the public a 

22 report detailing recommendations on— 

23 (A) an appropriate description of human 

24 diversity, incorporating available information on 

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1 grams operated or supported by the Federal 

2 Government; 

3 (B) guiding ethics, principles, and proto4 cols for the inclusion and designation of racial 

5 and ethnic minority populations in genomics re6 search, particularly clinical trials programs op7 erated or supported by the Federal Govern8 ment; 

9 (C) ways to increase awareness of, access 

10 to, and utilization of effective pharmacogenomic 

11 and other genetic screening and services for ra12 cial and ethnic minority populations; 

13 (D) research opportunities and funding 

14 support in the area of genomic variation that 

15 may improve the health and healthcare of mi16 nority populations; 

17 (E) ways to enhance integration of Federal 

18 Government-wide efforts and activities per19 taining to genetic variation, environment, and 

20 health; and 

21 (F) need for additional privacy protections 

22 in preventing stigmatization and inappropriate 

23 use of genetic information. 

24 (c) PHARMACOGENOMICS AND EMERGING ISSUES

25 ADVISORY COMMITTEE.— 


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1 (1) IN GENERAL.—The Secretary, under section 

2 222 of the Public Health Service Act (42 U.S.C. 

3 217a), shall convene and consult an advisory com4 mittee on issues relating to pharmacogenomics (re5 ferred to in this subsection as the ‘‘Advisory Com6 mittee’’). 

7 (2) DUTIES.— 

8 (A) IN GENERAL.—The Advisory Com9 mittee shall advise and make recommendations 

10 to the Secretary, through the Commissioner of 

11 Food and Drugs and in consultation with the 

12 Director of the National Institutes of Health, 

13 on the evolving science of pharmacogenomics 

14 and inter-individual variability in drug re15 sponse, as it relates to the health of racial and 

16 ethnic minorities. 

17 (B) MATTERS CONSIDERED.—The rec18 ommendations under subparagraph (A) shall in19 clude recommendations on— 

20 (i) the ethics, design, and analysis of 

21 clinical trials involving racial and ethnic 

22 minorities conducted under section 351, 

23 409I, or 499 of the Public Health Service 

24 Act or section 505(i), 505A, 505B, or 


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1 515(g) of the Federal Food, Drug, and 

2 Cosmetic Act; 

3 (ii) general policy and guidance with 

4 respect to the development, approval or 

5 clearance, and labeling of medical products 

6 for racial and ethnic minorities; 

7 (iii) the role of pharmacogenomics 

8 during the development of drugs, biological 

9 products, and diagnostics; 

10 (iv) the understanding of inter-indi11 vidual variability in drug response; 

12 (v) diagnostics or treatments for dis13 eases or conditions common in racial and 

14 ethnic minorities; and 

15 (vi) the identification of other areas of 

16 unmet medical need. 

17 (3) COMPOSITION.—The Advisory Committee 

18 shall include— 

19 (A) experts in the fields of— 

20 (i) minority health and health dispari21 ties; 

22 (ii) genomics; 

23 (iii) pharmaceutical and diagnostic re24 search and development; 


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1 (iv) ethical, legal, and social issues re2 lating to clinical trials; and 

3 (v) bioinformatics and information 

4 technology; 

5 (B) representatives from minority health 

6 organizations and relevant patient organiza7 tions; and 

8 (C) other experts as deemed appropriate 

9 by the Secretary. 

10 (4) COORDINATION WITH OTHER ADVISORY

11 COMMITTEES.—The Advisory Committee may con12 sult and coordinate with other advisory committees 

13 of the Department of Health and Human Services 

14 as determined appropriate by the Secretary. 

15 (5) RECOMMENDATIONS.—The Advisory Com16 mittee shall submit recommendations to the Sec17 retary with respect to each of the matters described 

18 under paragraph (2)(B) prior to the development of 

19 the report by the Secretary as described under para20 graph (6). 

21 (6) REPORT.—Not later than 180 days after 

22 the date of enactment of this Act, the Secretary— 

23 (A) shall, acting through the Commissioner 

24 of Food and Drugs and in consultation with the 

25 Director of the National Institutes of Health, 


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1 and taking into consideration the recommenda2 tions of the Advisory Committee submitted 

3 under paragraph (5), submit to the Committee 

4 on Health, Education, Labor, and Pensions of 

5 the Senate and the Committee on Energy and 

6 Commerce of the House of Representatives, a 

7 report on the evolving science of 

8 pharmacogenomics as it relates to racial and 

9 ethnic minorities, including a review of the 

10 guidance of the Food and Drug Administration 

11 on the participation of racial and ethnic minori12 ties in clinical trials; and 

13 (B) shall ensure that such report is made 

14 publicly available in both paper and electronic 

15 formats. 

16 SEC. 303. EVALUATIONS BY THE INSTITUTE OF MEDICINE. 

17 (a) HEALTH DISPARITIES SUMMIT.— 

18 (1) IN GENERAL.—Not later than 270 days 

19 after the date of enactment of this Act, the Institute 

20 of Medicine shall convene a summit on health dis21 parities (referred to this section as the ‘‘Summit’’). 

22 (2) PURPOSE.—The purposes of the Summit in23 clude— 

24 (A) reviewing current activities of the Fed25 eral Government in addressing health and 


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1 healthcare disparities as experienced by racial 

2 and ethnic minority populations, and the out3 comes of those activities, as practicable; and 

4 (B) assessing progress made since the 

5 2002 Institute of Medicine National Healthcare 

6 Disparities Report and the 2002 Institute of 

7 Medicine Unequal Treatment: Confronting Ra8 cial and Ethnic Disparities in Health Care. 

9 (3) AREAS OF FOCUS.—The Summit shall ex10 amine the activities of the Federal Government to 

11 reduce and eliminate health disparities, with a focus 

12 on— 

13 (A) education and training, including 

14 health professions programs that increase mi15 nority representation in medicine, the health 

16 professions, and health-related research careers; 

17 (B) aggregated and disaggregated data col18 lection and analysis, including successful strate19 gies to collect and report data on minority small 

20 or sub-populations for whom data are limited; 

21 (C) coordination among agencies and de22 partments in addressing healthcare disparities; 

23 (D) research into the causes of and strate24 gies to eliminate health disparities; and 


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1 (E) programs that increase access to care 

2 and improve health outcomes for health dis3 parity populations. 

4 (4) PARTICIPATION.—Summit participants shall 

5 include— 

6 (A) representatives of the Federal Govern7 ment; 

8 (B) experts with research experience in 

9 identifying and addressing healthcare dispari10 ties among racial and ethnic minority groups; 

11 and 

12 (C) representatives from community-based 

13 organizations, Indian tribal epidemiology cen14 ters, and nonprofit groups that address the 

15 issues of racial and ethnic minority groups. 

16 (5) SUMMIT PROCEEDINGS.—Not later than 

17 180 days after the conclusion of the Summit, the 

18 Secretary shall offer to enter into a contract with 

19 the Institute of Medicine to publish a report summa20 rizing the discussions of the Summit and review of 

21 current Federal activities to address healthcare dis22 parities for racial and ethnic minority groups. 

23 (b) NATIONAL PLAN TO ELIMINATE DISPARITIES.— 

24 (1) PLAN.—Not later than 2 years after the 

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1 cine shall develop an evidence-based, strategic, na2 tional plan to eliminate disparities which shall— 

3 (A) include goals, interventions, and re4 sources needed to eliminate disparities; 

5 (B) establish a reasonable timetable to 

6 reach selected priorities; 

7 (C) inform and complement the National 

8 Plan to Improve Minority Health and Eliminate 

9 Health Disparities, pursuant to section 

10 1707(c)(2) of the Public Health Service Act (as 

11 added by section 501 of this Act); and 

12 (D) inform the development of criteria for 

13 evaluation of the effectiveness of programs au14 thorized under this Act (and the amendments 

15 made by this Act), pursuant to subsection (c). 

16 (2) REPORT.—The Secretary shall offer to 

17 enter into a contract with the Institute of Medicine 

18 to publish the National Plan to Eliminate Dispari19 ties. 

20 (c) INSTITUTE OF MEDICINE EVALUATION.— 

21 (1) IN GENERAL.—Not later than 3 years after 

22 the date of enactment of this Act, the Secretary 

23 shall offer to enter into a contract with the Institute 

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1 ments made by this Act) in addressing and reducing 

2 health disparities experienced by racial and ethnic 

3 minority groups. In making such an evaluation, the 

4 Institute of Medicine shall consult— 

5 (A) representatives of the Federal Govern6 ment; 

7 (B) experts with research and policy expe8 rience in identifying and addressing healthcare 

9 disparities among racial and ethnic minority 

10 groups; and 

11 (C) representatives from community-based 

12 organizations and nonprofit groups that address 

13 racial and ethnic minority health disparity 

14 issues. 

15 (2) REPORT.—Not later than 2 years after the 

16 Secretary enters into the contract under paragraph 

17 (1), the Institute of Medicine shall submit to the 

18 Secretary and relevant committees of Congress a re19 port that contains the results of the evaluation de20 scribed under such subparagraph, and any rec21 ommendations of such Institute. 

22 (3) RESPONSE.—Not later than 180 days after 

23 the date the Institute of Medicine submits the report 

24 under this subsection, the Secretary shall publish a 

25 response to such recommendations, which shall be 


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1 provided to the relevant committees of Congress and 

2 made publicly available through the Internet Clear3 inghouse under section 270 of the Public Health 

4 Service Act (as added by section 101). 

5 (d) HEALTH INFORMATION TECHNOLOGY.— 

6 (1) IN GENERAL.—Not later than 180 days 

7 after the date of enactment of this Act, the Sec8 retary, acting through the Director of the National 

9 Library of Medicine and the head of the Office of 

10 the National Coordinator for Health Information 

11 Technology and in consultation with the Director of 

12 the Office of Mental Health and the Director of the 

13 Agency for Healthcare Research and Quality, shall 

14 offer to enter into a contract with the Institute of 

15 Medicine to study and make recommendations re16 garding the use of health information technology 

17 and bioinformatics to improve the health and 

18 healthcare of racial and ethnic minority groups. 

19 (2) STUDY.—The study under paragraph (1), 

20 with respect to increasing access and quality of 

21 healthcare for racial and ethnic minority groups, 

22 shall assess and make recommendations regarding— 

23 (A) effective applications of health infor24 mation technology, including telemedicine and 

25 telepsychiatry; 


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1 (B) status of development of health infor2 mation technology standards that will permit 

3 healthcare information of the type required to 

4 support patient care; 

5 (C) inclusion of organizations with exper6 tise in minority health and health disparities in 

7 the development and implementation of health 

8 information technology policies, standards, ap9 plications, and monitoring; 

10 (D) priority areas for research to improve 

11 the dissemination, management, and use of bio12 medical knowledge that address identified and 

13 unmet needs; 

14 (E) educational and training needs and op15 portunities to assist health professionals under16 stand and apply health information technology; 

17 (F) ways to increase recruitment and re18 tention of racial and ethnic minorities into the 

19 field of medical informatics; and 

20 (G) ways to increase and ensure the pri21 vacy of health information technology. 

22 (3) REPORT.—Not later than 2 years after the 

23 Secretary enters into the contract under paragraph 

24 (1), the Institute of Medicine shall submit to the 

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1 port that contains the findings and recommendations 

2 of this study. 

3 SEC. 304. NATIONAL CENTER FOR MINORITY HEALTH AND 

4 HEALTH DISPARITIES REAUTHORIZATION. 

5 Section 485E of the Public Health Service Act (42 

6 U.S.C. 287c–31) is amended— 

7 (1) by striking subsection (e) and inserting the 

8 following: 

9 ‘‘(e) DUTIES OF THE DIRECTOR.— 

10 ‘‘(1) INTERAGENCY COORDINATION OF MINOR11 ITY HEALTH AND HEALTH DISPARITIES ACTIVI12 TIES.—With respect to minority health and health 

13 disparities, the Director of the Center shall plan, co14 ordinate, and evaluate research and other activities 

15 conducted or supported by the agencies of the Na16 tional Institutes of Health. In carrying out the pre17 ceding sentence, the Director of the Center shall 

18 evaluate the minority health and health disparity ac19 tivities of each of such agencies and shall provide for 

20 the timely periodic re-evaluation of such activities. 

21 ‘‘(2) CONSULTATIONS.—The Director of the 

22 Center shall carry out this subpart (including devel23 oping and revising the plan and budget required in 

24 subsection (f)) in consultation with the Directors of 

25 the agencies (or a designee of the Directors) of the 


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1 National Institutes of Health, with the advisory 

2 councils of the agencies, and with the advisory coun3 cil established under section (j). 

4 ‘‘(3) COORDINATION OF ACTIVITIES.—The Di5 rector of the Center shall act as the primary Federal 

6 official with responsibility for coordinating all minor7 ity health disparities research and other health dis8 parities research conducted or supported by the Na9 tional Institutes of Health and shall— 

10 ‘‘(A) represent the health disparities re11 search program of the National Institutes of 

12 Health including the minority health disparities 

13 research program at all relevant executive 

14 branch task forces, committees, and planning 

15 activities; 

16 ‘‘(B) maintain communications with all rel17 evant Public Health Service agencies, including 

18 the Indian Health Service and various other de19 partments of the Federal Government, to en20 sure the timely transmission of information con21 cerning advances in minority health disparities 

22 research and other health disparities research 

23 between these various agencies for dissemina24 tion to affected communities and healthcare 

25 providers; 


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1 ‘‘(C) undertake research to further refine 

2 and develop the conceptual, definitional, and 

3 methodological issues involved in health dispari4 ties research and to further the understanding 

5 of the cause of disparities; and 

6 ‘‘(D) engage with national and community7 based organizations and health provider groups, 

8 led by and serving racial and ethnic minorities, 

9 to— 

10 ‘‘(i) increase education, awareness, 

11 and participation with respect to the Cen12 ter’s activities and areas of research focus; 

13 and 

14 ‘‘(ii) accelerate the translation of re15 search findings into programs including 

16 those carried out by community-based or17 ganizations.’’; 

18 (2) in subsection (f)— 

19 (A) by striking the subsection heading and 

20 inserting the following: 

21 ‘‘(f) COMPREHENSIVE PLAN FOR RESEARCH; BUDG22 ET ESTIMATE; ALLOCATION OF APPROPRIATIONS.—’’; 

23 (B) in paragraph (1)— 


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1 (i) by striking the matter preceding 

2 subparagraph (A) and subparagraph (A) 

3 and inserting the following: 

4 ‘‘(1) IN GENERAL.—Subject to the provisions of 

5 this section and other applicable law, the Director of 

6 the Center, in consultation with the Director of 

7 NIH, the Directors of the other agencies of the Na8 tional Institutes of Health, and the advisory council 

9 established under subsection (j) shall— 

10 ‘‘(A) annually review and revise a com11 prehensive plan (referred to in this section as 

12 ‘the Plan’) and budget for the conduct and sup13 port of all minority health and health dispari14 ties research and other health disparities re15 search activities of the agencies of the National 

16 Institutes of Health that includes time-based 

17 targeted objectives with measurable outcomes 

18 and assure that the annual review and revision 

19 of the Plan uses an established trans-NIH proc20 ess subject to timely review, approval, and dis21 semination;’’; 

22 (ii) in subparagraph (D), by striking 

23 ‘‘, with respect to amounts appropriated 

24 for activities of the Center,’’; 


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1 (iii) by striking subparagraph (F) and 

2 inserting the following: 

3 ‘‘(F) ensure that the Plan and budget are 

4 presented to and considered by the Director in 

5 a clear and timely process during the formula6 tion of the overall annual budget for the Na7 tional Institutes of Health;’’; 

8 (iv) by redesignating subparagraphs 

9 (G) and (H) as subparagraphs (I) and (J), 

10 respectively; and 

11 (v) by inserting after subparagraph 

12 (F), the following: 

13 ‘‘(G) annually submit to Congress a report 

14 on the progress made with respect to the Plan; 

15 ‘‘(H) creating and implementing a plan for 

16 the systematic review of research activities sup17 ported by the National Institutes of Health that 

18 are within the mission of both the Center and 

19 other agencies of the National Institutes of 

20 Health, by establishing mechanisms for— 

21 ‘‘(i) tracking minority health and 

22 health disparity research conducted within 

23 the agencies and assessing the appropriate24 ness of this research with regard to the 

25 overall goals and objectives of the Plan; 


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1 ‘‘(ii) the early identification of appli2 cations and proposals for grants, contracts, 

3 and cooperative agreements supporting ex4 tramural training, research, and develop5 ment, that are submitted to the agencies 

6 and that are within the mission of the Cen7 ter; 

8 ‘‘(iii) providing the Center with the 

9 written descriptions and scientific peer re10 view results of such applications and pro11 posals; 

12 ‘‘(iv) enabling the agencies to consult 

13 with the Director of the Center prior to 

14 final approval of such applications and 

15 proposals; and 

16 ‘‘(v) reporting to the Director of the 

17 Center all such applications and proposals 

18 that are approved for funding by the agen19 cies;’’; and 

20 (C) in paragraph (2)— 

21 (i) in subparagraph (D), by striking 

22 ‘‘and’’ at the end; 

23 (ii) in subparagraph (E), by striking 

24 the period and inserting ‘‘; and’’; and 


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1 (iii) by adding at the end the fol2 lowing: 

3 ‘‘(F) the number and type of personnel 

4 needs of the Center.’’; 

5 (3) in subsection (h)— 

6 (A) in paragraph (1), by striking ‘‘endow7 ments at centers of excellence under section 

8 736.’’ and inserting the following: ‘‘endowments 

9 at— 

10 ‘‘(A) centers of excellence under section 

11 736; and 

12 ‘‘(B) centers of excellence under section 

13 485F.’’; and 

14 (B) in paragraph (2)(A), by striking ‘‘aver15 age’’ and inserting ‘‘median’’; 

16 (4) by redesignating subsections (k) and (l) as 

17 subsections (m) and (n), respectively; 

18 (5) by inserting after subsection (j), the fol19 lowing: 

20 ‘‘(k) REPRESENTATION OF MINORITIES AMONG RE21 SEARCHERS.—The Secretary, in collaboration with the Di22 rector of the Center, shall determine, by means of the col23 lection and reporting of aggregated and disaggregated 

24 data, the extent to which racial and ethnic minority groups 

25 are represented among senior physicians and scientists of 


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1 the national research institutes and among physicians and 

2 scientists conducting research with funds provided by such 

3 institutes, and as appropriate, carry out activities to in4 crease the extent of such representation, including devel5 oping a pipeline of minority researchers interested in the 

6 study of health and health disparities, as well as attracting 

7 minority scientists in social and behavioral science fields 

8 who can bring their expertise to the study of health dis9 parities. 

10 ‘‘(l) CANCER RESEARCH.—The Secretary, in collabo11 ration with the Director of the Center, shall designate and 

12 support a cancer prevention, control, and population 

13 science center to address the significantly elevated rate of 

14 morbidity and mortality from cancer in racial and ethnic 

15 minority populations. Such designated center shall be 

16 housed within an existing, stand-alone cancer center at a 

17 historically black college and university that has a demon18 strable commitment to and expertise in cancer research 

19 in the basic, clinical, and population sciences.’’; 

20 (6) in subsection (l)(1) (as so redesignated), by 

21 inserting before the semicolon the following: ‘‘, with 

22 a particular focus on evaluation of progress made to23 ward fulfillment of the goals of the Plan’’; and 

24 (7) by striking subsection (m) (as so redesig25 nated). 


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1 SEC. 305. AUTHORIZATION OF APPROPRIATIONS. 

2 (a) SECTIONS 301, 302, AND 303.—There are au3 thorized to be appropriated such sums as may be nec4 essary for each of fiscal years 2008 through 2012, to carry 

5 out sections 301, 302, and 303 (and the amendments 

6 made by such sections). 

7 (b) SECTION 304.— 

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

9 appropriated $240,000,000 for fiscal year 2008, 

10 such sums as may be necessary for each of fiscal 

11 years 2009 through 2012, to carry out section 304. 

12 (2) ALLOCATION OF FUNDS.—Subject to sec13 tion 485E of the Public Health Service Act (as 

14 amended by section 304) and other applicable law, 

15 the Director of the Center under such section 485E 

16 shall direct all amounts appropriated for activities 

17 under such section and in collaboration with the Di18 rector of National Institutes of Health and the di19 rectors of other institutes and centers of the Na20 tional Institutes of Health. 

21 (3) MANAGEMENT OF ALLOCATIONS.—All 

22 amounts allocated or expended for minority health 

23 and health disparities research activities under this 

24 subsection shall be reported programmatically to and 

25 approved by the Director of the Center under such 


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1 section 485E, in accordance with the Plan described 

2 under such section 485E. 

3 TITLE IV—DATA COLLECTION, 

4 ANALYSIS, AND QUALITY 

5 SEC. 401. DATA COLLECTION, ANALYSIS, AND QUALITY. 

6 The Public Health Service Act (42 U.S.C. 201 et 

7 seq.) is amended by adding at the end the following: 

8 ‘‘TITLE XXX—DATA COLLECTION, 

9 ANALYSIS, AND QUALITY 

10 ‘‘SEC. 3001. DATA COLLECTION, ANALYSIS, AND QUALITY. 

11 ‘‘(a) DATA COLLECTION AND REPORTING.—The Sec12 retary shall ensure that not later than 3 years after the 

13 date of enactment of the Minority Health Improvement 

14 and Health Disparity Elimination Act any ongoing or new 

15 federally conducted or supported health programs (includ16 ing surveys) achieve the— 

17 ‘‘(1) collection and reporting of data by race 

18 and ethnicity using, at a minimum, Office of Man19 agement and Budget standards in effect on the date 

20 of enactment of the Minority Health Improvement 

21 and Health Disparity Elimination Act; 

22 ‘‘(2) collection and reporting of data by geo23 graphic location, socioeconomic position (such as em24 ployment, income, and education), primary language, 


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1 and, when determined practicable by the Secretary, 

2 health literacy; 

3 ‘‘(3) if practicable, collection and reporting of 

4 race and ethnicity data on additional population 

5 groups if such data can be aggregated into the min6 imum race and ethnicity data categories; and 

7 ‘‘(4) collection and reporting of data at the 

8 smallest practicable geographic level such as State, 

9 local, or institutional levels if such data can be ag10 gregated. 

11 ‘‘(b) DATA ANALYSIS AND DISSEMINATION.— 

12 ‘‘(1) DATA ANALYSIS.— 

13 ‘‘(A) IN GENERAL.—For each federally 

14 conducted or supported program, the Secretary 

15 shall analyze data collected under subsection (a) 

16 to detect and monitor trends in disparities in 

17 health and healthcare, including those reported 

18 under subparagraph (B), for racial and ethnic 

19 minority groups at the Federal and State levels, 

20 and examine the interaction between various 

21 disparity indicators. 

22 ‘‘(B) QUALITY ANALYSIS.—The Secretary 

23 shall ensure that the analyses under subpara24 graph (A) incorporate data reported according 

25 to quality measurement systems. 


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1 ‘‘(2) QUALITY MEASURES.—When the Sec2 retary, by statutory or regulatory authority, adopts 

3 and implements any quality measures or any quality 

4 measurement system, the Secretary shall ensure the 

5 quality measures or quality measurement system 

6 comply with the following: 

7 ‘‘(A) MEASURES.—Measures selected shall, 

8 to the extent practicable— 

9 ‘‘(i) assess the effectiveness, timeli10 ness, patient self-management, patient 

11 centeredness, equity, and efficiency of care 

12 received by patients, including patients 

13 from racial and ethnic minority groups; 

14 ‘‘(ii) are evidence-based, reliable, and 

15 valid; and 

16 ‘‘(iii) include measures of clinical 

17 processes and outcomes, patient experience 

18 and efficiency. 

19 ‘‘(B) CONSULTATION.—In selecting quality 

20 measures or a quality measurement system or 

21 systems for adoption and implementation, the 

22 Secretary shall consult with— 

23 ‘‘(i) individuals from racial and ethnic 

24 minority groups; and 


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1 ‘‘(ii) experts in the identification and 

2 elimination of disparities in health and 

3 healthcare among racial and ethnic minor4 ity groups. 

5 ‘‘(3) DISSEMINATION.— 

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

7 make the measures, data, and analyses de8 scribed in paragraphs (1) and (2) available to— 

9 ‘‘(i) the Office of Minority Health; 

10 ‘‘(ii) the National Center on Minority 

11 Health and Health Disparities; 

12 ‘‘(iii) the Agency for Healthcare Re13 search and Quality for inclusion in the 

14 Agency’s reports; 

15 ‘‘(iv) the Centers for Disease Control 

16 and Prevention; 

17 ‘‘(v) the Centers for Medicare and 

18 Medicaid Services; 

19 ‘‘(vi) the Indian Health Service; 

20 ‘‘(vii) other agencies within the De21 partment of Health and Human Services; 

22 ‘‘(viii) the public through posting on 

23 the Secretary’s Internet website; and 

24 ‘‘(ix) other entities as determined ap25 propriate by the Secretary. 


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1 ‘‘(B) ADDITIONAL RESEARCH.—The Sec2 retary may, as the Secretary determines appro3 priate, make the measures, data, and analysis 

4 described in paragraphs (1) and (2) available 

5 for additional research, analysis, and dissemina6 tion to non-governmental entities and the pub7 lic. 

8 ‘‘(c) RESEARCH.— 

9 ‘‘(1) DISPARITY INDICATORS.— 

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

11 award grants or contracts for research to de12 velop appropriate methods, indicators, and 

13 measures that will enable the detection and as14 sessment of disparities in healthcare. Such re15 search shall prioritize research with respect to 

16 the following: 

17 ‘‘(i) Race and ethnicity. 

18 ‘‘(ii) Geographic location (such as 

19 geocoding). 

20 ‘‘(iii) Socioeconomic position (such as 

21 income or education level). 

22 ‘‘(iv) Health literacy. 

23 ‘‘(v) Cultural competency. 

24 ‘‘(vi) Additional measures as deter25 mined appropriate by the Secretary. 


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1 ‘‘(B) APPLIED RESEARCH.—The Secretary 

2 shall use the results of the research from grants 

3 awarded under subparagraph (A) to improve 

4 the data collection described under subsection 

5 (a). 

6 ‘‘(2) STRATEGIC PARTNERSHIPS TO ENCOUR7 AGE AND IMPROVE DATA COLLECTION.— 

8 ‘‘(A) IN GENERAL.—The Secretary may 

9 award not more than 20 grants to eligible enti10 ties for the purposes of— 

11 ‘‘(i) enhancing and improving methods 

12 for the collection, reporting, analysis, and 

13 dissemination of data, as required under 

14 the Minority Health Improvement and 

15 Health Disparity Elimination Act; and 

16 ‘‘(ii) encouraging the collection, re17 porting, analysis, and dissemination of 

18 data to identify and address disparities in 

19 health and healthcare. 

20 ‘‘(B) DEFINITION OF ELIGIBLE ENTITY.— 

21 In this paragraph, the term ‘eligible entity’ 

22 means a health plan, federally qualified health 

23 center, hospital, rural health clinic, academic 

24 institution, policy research organization, or 

25 other entity, including an Indian Health Service 


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1 hospital or clinic, Indian tribal health facility, 

2 or urban Indian facility, that the Secretary de3 termines to be appropriate. 

4 ‘‘(C) APPLICATION.—An eligible entity de5 siring a grant under this paragraph shall sub6 mit an application to the Secretary at such 

7 time, in such manner, and containing such in8 formation as the Secretary may require. 

9 ‘‘(D) PRIORITY IN AWARDING GRANTS.—In 

10 awarding grants under this paragraph, the Sec11 retary shall give priority to eligible entities that 

12 represent collaboratives with— 

13 ‘‘(i) hospitals, health plans, or health 

14 centers; and 

15 ‘‘(ii) at least 1 community-based orga16 nization or patient advocacy group. 

17 ‘‘(E) USE OF FUNDS.—An eligible entity 

18 that receives a grant under this paragraph shall 

19 use grant funds to— 

20 ‘‘(i) collect, analyze, or report data by 

21 race, ethnicity, geographic location, socio22 economic position, health literacy, primary 

23 language, or other health disparity indi24 cator; 


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1 ‘‘(ii) conduct and report analyses of 

2 quality of healthcare and disparities in 

3 health and healthcare for racial and ethnic 

4 minority groups, including disparities in di5 agnosis, management and treatment, and 

6 health outcomes for acute and chronic dis7 ease; 

8 ‘‘(iii) improve health data collection, 

9 analysis, and reporting for subpopulations 

10 and categories; 

11 ‘‘(iv) modify, implement, and evaluate 

12 use of health information technology sys13 tems that facilitate data collection, analysis 

14 and reporting for racial and ethnic minor15 ity groups, and support healthcare inter16 ventions; 

17 ‘‘(v) develop educational programs to 

18 inform patients, providers, purchasers, and 

19 other individuals served about the legality 

20 and importance of the collection, analysis, 

21 and reporting of data by race, ethnicity, 

22 socioeconomic position, geographic loca23 tion, and health literacy, for eliminating 

24 disparities in health; and 


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1 ‘‘(vi) evaluate the activities conducted 

2 under this paragraph. 

3 ‘‘(d) TECHNICAL ASSISTANCE.—The Secretary may 

4 provide technical assistance to promote compliance with 

5 the data collection and reporting requirements of the Mi6 nority Health Improvement and Health Disparity Elimi7 nation Act. 

8 ‘‘(e) PRIVACY AND SECURITY.—The Secretary shall 

9 ensure all appropriate privacy and security protections for 

10 health data collected, reported, analyzed, and dissemi11 nated pursuant to the Minority Health Improvement and 

12 Health Disparity Elimination Act. 

13 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For the 

14 purpose of carrying out this section, there are authorized 

15 to be appropriated such sums as may be necessary for 

16 each of fiscal years 2008 through 2012.’’. 

17 TITLE V—LEADERSHIP, COL18 LABORATION, AND NATIONAL 

19 ACTION PLAN 

20 SEC. 501. OFFICE OF MINORITY HEALTH. 

21 Section 1707 of the Public Health Service Act (42 

22 U.S.C. 300u–6) is amended to read as follows: 


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1 ‘‘SEC. 1707. OFFICE OF MINORITY HEALTH. 

2 ‘‘(a) DUTIES.—With respect to racial and ethnic mi3 nority groups, the Secretary, acting through the Deputy 

4 Assistant Secretary, shall carry out the following: 

5 ‘‘(1) Coordinate and provide input on activities 

6 within the Public Health Service that relate to dis7 ease prevention, health promotion, health service de8 livery, health workforce, and research concerning ra9 cial and ethnic minority groups. The Secretary shall 

10 ensure that the heads of each of the agencies of the 

11 Service collaborate with the Deputy Assistant Sec12 retary on the development and conduct of such ac13 tivities. 

14 ‘‘(2) Not later than 1 year after the date of en15 actment of the Minority Health Improvement and 

16 Health Disparity Elimination Act, develop and im17 plement a comprehensive Department-wide plan to 

18 improve minority health and eliminate health dis19 parities in the United States, to be known as the 

20 National Plan to Improve Minority Health and 

21 Eliminate Health Disparities, (referred to in this 

22 section as the ‘National Plan’). With respect to de23 velopment and implementation of the National Plan, 

24 the Secretary shall carry out the following: 

25 ‘‘(A) Consult with the following: 


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1 ‘‘(i) The Director of the Centers for 

2 Disease Control and Prevention. 

3 ‘‘(ii) The Director of the National In4 stitutes of Health. 

5 ‘‘(iii) The Director of the National 

6 Center on Minority Health and Health 

7 Disparities of the National Institutes of 

8 Health. 

9 ‘‘(iv) The Director of the Agency for 

10 Healthcare Research and Quality. 

11 ‘‘(v) The National Coordinator for 

12 Health Information Technology. 

13 ‘‘(vi) The Administrator of the Health 

14 Resources and Services Administration. 

15 ‘‘(vii) The Administrator of the Cen16 ters for Medicare & Medicaid Services. 

17 ‘‘(viii) The Director of the Office for 

18 Civil Rights. 

19 ‘‘(ix) The Secretary of Veterans Af20 fairs. 

21 ‘‘(x) The Administrator of the Sub22 stance Abuse and Mental Health Services 

23 Administration. 

24 ‘‘(xi) The Secretary of Defense. 


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1 ‘‘(xii) The Commissioner of the Food 

2 and Drug Administration. 

3 ‘‘(xiii) The Director of the Indian 

4 Health Service. 

5 ‘‘(xiv) The Secretary of Education. 

6 ‘‘(xv) The Secretary of Labor. 

7 ‘‘(xvi) The heads of other public and 

8 private entities, as determined appropriate 

9 by the Secretary. 

10 ‘‘(B) Review and integrate existing infor11 mation and recommendations as appropriate, 

12 such as Healthy People 2010, Institute of Medi13 cine studies, and Surgeon General Reports. 

14 ‘‘(C) Ensure inclusion of measurable short15 and long-range goals and objectives, a descrip16 tion of the means for achieving such goals and 

17 objectives, and a designated date by which such 

18 goals and objectives are expected to be 

19 achieved. 

20 ‘‘(D) Ensure that all amounts appro21 priated for such activities are expended in ac22 cordance with the National Plan. 

23 ‘‘(E) Review the National Plan on at least 

24 an annual basis, and report to the public and 


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1 appropriate committees of Congress on 

2 progress. 

3 ‘‘(F) Revise such Plan as appropriate. 

4 ‘‘(G) Ensure that the National Plan will 

5 serve as a binding statement of policy with re6 spect to the agencies’ activities related to im7 proving health and eliminating disparities in 

8 health and healthcare. 

9 ‘‘(3) Work with Federal agencies and depart10 ments outside of the Department of Health and 

11 Human Services as appropriate to maximize re12 sources available to increase understanding about 

13 why disparities exist, and effective ways to improve 

14 health and eliminate health disparities. 

15 ‘‘(4) In cooperation with the appropriate agen16 cies, support research, demonstrations, and evalua17 tions to test new and innovative models for— 

18 ‘‘(A) expanding healthcare access; 

19 ‘‘(B) improving healthcare quality; 

20 ‘‘(C) increasing educational opportunity in 

21 the field of healthcare; and 

22 ‘‘(D) increasing the capacity of racial and 

23 ethnic minority organizations to improve health 

24 and eliminate health disparities. 


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1 ‘‘(5) Develop mechanisms that support better 

2 dissemination of information, education, prevention, 

3 and service delivery to individuals from disadvan4 taged backgrounds, including individuals who are 

5 members of racial or ethnic minority groups. 

6 ‘‘(6) Increase awareness of disparities in 

7 healthcare, and knowledge and understanding of 

8 health risk factors, and ways to reduce and eliminate 

9 health disparities, among healthcare providers, 

10 health plans, and the public. 

11 ‘‘(7) Advise in matters related to the develop12 ment, implementation, and evaluation of health pro13 fessions education on improving healthcare outcomes 

14 and decreasing disparities in healthcare outcomes, 

15 with a focus on cultural competence. 

16 ‘‘(8) Assist healthcare professionals, community 

17 and advocacy organizations, academic medical cen18 ters and other health entities and public health de19 partments in the design and implementation of pro20 grams that will improve health outcomes by 

21 strengthening the patient-provider relationship. 

22 ‘‘(9) Carry out programs to improve access to 

23 healthcare services and to improve the quality of 

24 healthcare services for individuals with low health 

25 literacy. 


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1 ‘‘(10) Facilitate the classification and collection 

2 of healthcare data to allow for ongoing analysis to 

3 identify and determine the causes of disparities and 

4 the monitoring of progress toward improving health 

5 and eliminating health disparities. 

6 ‘‘(11) Ensure that the National Center for 

7 Health Statistics collects data on the health status 

8 of each racial or ethnic minority group pursuant to 

9 section 2901. 

10 ‘‘(12) Support a national minority health re11 source center to carry out the following: 

12 ‘‘(A) Facilitate the exchange of informa13 tion regarding matters relating to health infor14 mation and health promotion, preventive health 

15 services, and education in the appropriate use 

16 of healthcare. 

17 ‘‘(B) Facilitate access to such information. 

18 ‘‘(C) Assist in the analysis of issues and 

19 problems relating to such matters. 

20 ‘‘(D) Provide technical assistance with re21 spect to the exchange of such information (in22 cluding facilitating the development of materials 

23 for such technical assistance). 

24 ‘‘(13) Support a center for cultural and lin25 guistic competence to carry out the following: 


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1 ‘‘(A) With respect to individuals who lack 

2 proficiency in speaking the English language, 

3 enter into contracts with public and nonprofit 

4 private providers of primary health services for 

5 the purpose of increasing the access of such in6 dividuals to such services by developing and 

7 carrying out programs to improve health lit8 eracy and cultural competency. 

9 ‘‘(B) Carry out programs to improve ac10 cess to healthcare services for individuals with 

11 limited proficiency in speaking the English lan12 guage. Activities under this subparagraph shall 

13 include developing and evaluating model 

14 projects. 

15 ‘‘(14) At the discretion of the Director, support 

16 a center or program for the improvement of geo17 graphic minority health and health disparities to 

18 carry out the following for rural disadvantaged mi19 nority populations: 

20 ‘‘(A) Increase awareness on health care 

21 issues impacting and effective interventions for 

22 these populations. 

23 ‘‘(B) Increase access to quality healthcare. 


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1 ‘‘(C) Increase access to quality healthcare 

2 personnel available to provide services to these 

3 populations. 

4 ‘‘(D) Improve health care outcomes. 

5 ‘‘(E) Develop a model that can be rep6 licated to address national policies and pro7 grams to improve the health of these rural dis8 advantaged minority communities. This model 

9 should include research, health services, edu10 cation/awareness, and health information com11 ponents, with priority given to existing pro12 grams or programs in areas with the most need 

13 and have a Community Advisory Board to pro14 vide recommendations on projects to benefit the 

15 health of minority populations. 

16 ‘‘(15) Enter into interagency agreements with 

17 other agencies of the Public Health Service, as ap18 propriate. 

19 ‘‘(16) Collaborate with the Office for Civil 

20 Rights to— 

21 ‘‘(A) assist healthcare providers with appli22 cation of guidance and directives regarding 

23 healthcare for racial and ethnic minority 

24 groups, including— 


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1 ‘‘(i) reviewing cases that have been 

2 closed without a finding of discrimination 

3 with the Office of Inspector General and 

4 the Office for Civil Rights to determine if 

5 there exists a pattern or practice of activi6 ties that could lead to discrimination, and 

7 if such a pattern or practice is identified, 

8 provide technical assistance or education, 

9 as applicable, to the relevant provider or to 

10 a group of providers located within a par11 ticular geographic area; 

12 ‘‘(ii) biannually publishing informa13 tion on cases filed with the Office for Civil 

14 Rights which have resulted in a finding of 

15 discrimination, including the name and lo16 cation of the entity found to have discrimi17 nated, and any findings and agreements 

18 entered into between the Office for Civil 

19 Rights and the entity; and 

20 ‘‘(iii) monitoring and analysis of 

21 trends in cases reported to the Office for 

22 Civil Rights to ensure that the Office of 

23 Minority Health acts to educate and assist 

24 healthcare providers as necessary; and 


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1 ‘‘(B) provide technical assistance or edu2 cation, as applicable, to the relevant provider or 

3 to a group of providers located within a par4 ticular geographic area. 

5 ‘‘(17) Promote and expand efforts to increase 

6 racial and ethnic minority enrollment in clinical 

7 trials. 

8 ‘‘(18) Establish working groups— 

9 ‘‘(A) to examine and report recommenda10 tions to the Secretary regarding— 

11 ‘‘(i) emergency preparedness and re12 sponse for underserved populations; 

13 ‘‘(ii) development and implementation 

14 of health information technology that can 

15 assist providers to deliver culturally com16 petent healthcare; 

17 ‘‘(iii) outreach and education of health 

18 disparity groups about new Federal health 

19 programs, as appropriate, including the 

20 programs under part D of title XVIII of 

21 the Social Security Act and chronic care 

22 management programs under the Medicare 

23 Prescription Drug, Improvement, and 

24 Modernization Act of 2003 (and the 

25 amendments made by such Act); 


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1 ‘‘(iv) leadership development in public 

2 health; 

3 ‘‘(v) the training of behavioral and so4 cial science researchers to address health 

5 disparities; and 

6 ‘‘(vi) other emerging health issues at 

7 the discretion of the Secretary; and 

8 ‘‘(B) that include representation from the 

9 relevant health agencies, centers and offices, as 

10 well as public and private entities as appro11 priate. 

12 ‘‘(b) ADVISORY COMMITTEE.— 

13 ‘‘(1) IN GENERAL.—The Secretary shall estab14 lish an advisory committee to be known as the Advi15 sory Committee on Minority Health (in this sub16 section referred to as the ‘Committee’). 

17 ‘‘(2) DUTIES.—The Committee shall provide 

18 advice to the Deputy Assistant Secretary carrying 

19 out this section, including advice on the development 

20 of goals and specific program activities under sub21 section (c) for racial and ethnic minority groups and 

22 health disparity population. 

23 ‘‘(3) CHAIR.—The chairperson of the Com24 mittee shall be selected by the Secretary from among 

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1 mittee. The term of office of the chairperson shall be 

2 2 years. 

3 ‘‘(4) COMPOSITION.— 

4 ‘‘(A) The Committee shall be composed of 

5 12 voting members appointed in accordance 

6 with subparagraph (B), and nonvoting, ex-offi7 cio members designated in subparagraph (C). 

8 ‘‘(B) The voting members of the Com9 mittee shall be appointed by the Secretary from 

10 among individuals who are not officers or em11 ployees of the Federal Government and who 

12 have expertise regarding issues of minority 

13 health and health disparities. Racial and ethnic 

14 minority groups shall be appropriately rep15 resented among such members. 

16 ‘‘(C) The nonvoting, ex officio members of 

17 the Committee shall be such officials of the De18 partment of Health and Human Services, in19 cluding the Director of the Office of Minority 

20 Health and the Office for Civil Rights, and 

21 other officials as the Secretary determines to be 

22 appropriate. 

23 ‘‘(D) The Secretary shall provide an oppor24 tunity for the Chairman and Ranking Member 

25 of the Committee on Health, Education, Labor, 


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1 and Pensions of the Senate to submit to the 

2 Secretary names of potential Committee mem3 bers under this section for consideration. 

4 ‘‘(5) TERMS.—Each member of the Committee 

5 shall serve for a term of 4 years, except that the 

6 Secretary shall initially appoint a portion of the 

7 members to terms of 1 year, 2 years, and 3 years. 

8 ‘‘(6) VACANCIES.—If a vacancy occurs on the 

9 Committee, a new member shall be appointed by the 

10 Secretary within 90 days from the date that the va11 cancy occurs, and serve for the remainder of the 

12 term for which the predecessor of such member was 

13 appointed. The vacancy shall not affect the power of 

14 the remaining members to execute the duties of the 

15 Committee. 

16 ‘‘(7) COMPENSATION.—Members of the Com17 mittee who are officers or employees of the United 

18 States shall serve without additional compensation. 

19 Members of the Committee who are not officers or 

20 employees of the United States shall receive com21 pensation, for each day (including travel time) they 

22 are engaged in the performance of the functions of 

23 the Committee. Such compensation may not be in an 

24 amount in excess of the daily equivalent of the an25 nual maximum rate of basic pay payable under the 


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1 General Schedule for positions above GS–15 under 

2 title 5, United States Code. 

3 ‘‘(c) CERTAIN REQUIREMENTS REGARDING DU4 TIES.— 

5 ‘‘(1) RECOMMENDATIONS REGARDING LAN6 GUAGE.— 

7 ‘‘(A) PROFICIENCY IN SPEAKING

8 ENGLISH.—The Deputy Assistant Secretary 

9 shall consult with the Director of the Office of 

10 International and Refugee Health, the Director 

11 of the Office for Civil Rights, and the Directors 

12 of other appropriate departmental entities re13 garding recommendations for carrying out ac14 tivities under subsection (c)(9). 

15 ‘‘(B) HEALTH PROFESSIONS EDUCATION

16 REGARDING HEALTH DISPARITIES.—The Dep17 uty Assistant Secretary shall carry out the du18 ties under subsection (a)(7) in collaboration 

19 with appropriate personnel of the Department 

20 of Health and Human Services, other Federal 

21 agencies, and other offices, centers, and institu22 tions, as appropriate, that have responsibilities 

23 under the Minority Health and Health Dispari24 ties Research and Education Act of 2000. 


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1 ‘‘(2) EQUITABLE ALLOCATION REGARDING AC2 TIVITIES.—In carrying out subsection (b), the Sec3 retary shall ensure that services provided under such 

4 subsection are equitably allocated among all groups 

5 served under this section by the Secretary. 

6 ‘‘(3) CULTURAL COMPETENCY OF SERVICES.— 

7 The Secretary shall ensure that information and 

8 services provided pursuant to subsection (c) consider 

9 the unique cultural or linguistic issues facing such 

10 populations and are provided in the language, edu11 cational, and cultural context that is most appro12 priate for the individuals for whom the information 

13 and services are intended. 

14 ‘‘(4) AGENCY COORDINATION.—In carrying out 

15 subsection (c), the Secretary shall ensure that new 

16 or existing agency offices of minority health report 

17 current and proposed activities to the Deputy Assist18 ant Secretary, and provide, to the extent practicable, 

19 an opportunity for input in the development of such 

20 activities by the Deputy Assistant Secretary. 

21 ‘‘(d) GRANTS AND CONTRACTS REGARDING DU22 TIES.— 

23 ‘‘(1) IN GENERAL.—In carrying out subsection 

24 (c), the Secretary acting through the Deputy Assist25 ant Secretary, may make awards of grants, cooperaVerDate Aug 31 2005 23:13 Jun 11, 2007 Jkt 059196 PO 00000 Frm 00133 Fmt 6652 Sfmt 6201 E:\BILLS\S1576.IS S1576

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1 tive agreements, and contracts to public and non2 profit private entities. 

3 ‘‘(2) PROCESS FOR MAKING AWARDS.—The 

4 Deputy Assistant Secretary shall ensure that awards 

5 under paragraph (1) are made, to the extent prac6 ticable, only on a competitive basis, and that a grant 

7 is awarded for a proposal only if the proposal has 

8 been recommended for such an award through a 

9 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 (g) for the fiscal year 

17 involved. 

18 ‘‘(e) STATE OFFICES OF MINORITY HEALTH.—The 

19 Deputy Assistant Secretary shall assist the voluntary es20 tablishment and functions of State offices of minority 

21 health in order to expand and coordinate State efforts to 

22 improve the health of racial and ethnic minority groups. 

23 ‘‘(1) PRIORITIES.—The Deputy Assistant Sec24 retary may facilitate, with respect to racial and eth25 nic minority groups— 


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1 ‘‘(A) integration and coordination of State 

2 and national efforts, including those pertaining 

3 to the National Plan pursuant to subsection 

4 (b); 

5 ‘‘(B) strategic plan development within 

6 States to assess and respond to local health 

7 concerns; 

8 ‘‘(C) education and engagement of key 

9 stakeholders within States, including represent10 atives from public health agencies, hospitals, 

11 clinics, provider groups, elected officials, com12 munity-based organizations, advocacy groups, 

13 media, and the private sector; 

14 ‘‘(D) development and implementation of 

15 accepted standards, core competencies, and 

16 minimum infrastructure requirements for State 

17 offices; 

18 ‘‘(E) access to State level health data for 

19 racial and ethnic minority groups, which may 

20 include State data collection and analysis; 

21 ‘‘(F) development, implementation, and 

22 evaluation of State programs and policies, as 

23 appropriate; 

24 ‘‘(G) communication and networking 

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1 grams and practices with respect to increasing 

2 access and quality of care; 

3 ‘‘(H) recognition and reporting of State 

4 successes and challenges; and 

5 ‘‘(I) identification of Federal grant pro6 grams and other funding for which States could 

7 apply to carry out health improvement activi8 ties. 

9 ‘‘(2) RESOURCES.—The Deputy Assistant Sec10 retary may provide grants and technical assistance 

11 for the voluntary establishment or capacity develop12 ment of State offices of minority health. 

13 ‘‘(3) COLLABORATION.—To the extent prac14 ticable, the Deputy Assistant Secretary may encour15 age and facilitate collaboration between State offices 

16 of minority health and State offices addressing the 

17 needs of other health disparity or disadvantaged 

18 populations, including offices of rural health. 

19 ‘‘(4) DEFINITION.—For the purpose of this 

20 subsection, ‘State offices of minority health’ include 

21 offices, councils, commissions, or advisory panels 

22 designated by States or territories to address the 

23 health of minority populations. 

24 ‘‘(f) REPORTS.— 


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1 ‘‘(1) IN GENERAL.—Not later than 1 year after 

2 the date of enactment of the Minority Health Im3 provement and Health Disparity Elimination Act, 

4 the Secretary shall submit to the appropriate com5 mittees of Congress, a report on the National Plan 

6 developed under subsection (c). 

7 ‘‘(2) REPORT ON ACTIVITIES.—Not later than 

8 February 1 of fiscal year 2009 and of each second 

9 year thereafter, the Secretary shall submit to the ap10 propriate committees of Congress, a report describ11 ing the activities carried out under this section dur12 ing the preceding 2 fiscal years and evaluating the 

13 extent to which such activities have been effective in 

14 improving the health of racial and ethnic minority 

15 groups. Each such report shall include the biennial 

16 reports submitted under subsection (f)(3) for such 

17 years by the heads of the Public Health Service 

18 agencies. 

19 ‘‘(3) AGENCY REPORTS.—Not later than Feb20 ruary 1, 2009, and on a biannual basis thereafter, 

21 the heads of the Public Health Service shall submit 

22 to the Deputy Assistant Secretary a report that 

23 summarizes the minority health and health disparity 

24 activities of each of the respective agencies. 

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


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1 ‘‘(1) The term ‘racial and ethnic minority 

2 group’ means American Indians (including Alaska 

3 Natives, Eskimos, and Aleuts), Asian Americans, 

4 Native Hawaiians and other Pacific Islanders, 

5 Blacks, and Hispanics. 

6 ‘‘(2) The term ‘Hispanic’ means individuals 

7 whose origin is Mexican, Puerto Rican, Cuban, Cen8 tral or South American, or of any other Spanish9 speaking country. 

10 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—For the 

11 purpose of carrying out this section, there are authorized 

12 to be appropriated $110,000,000 for fiscal year 2008, 

13 such sums as may be necessary for each of fiscal years 

14 2009 through 2012.’’. 

Æ 


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