```

[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 487 Introduced in House (IH)]

105th CONGRESS
  1st Session
                                H. R. 487

 To amend the Public Health Service Act with respect to the health of 
individuals who are members of minority groups, and for other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                            January 21, 1997

Mr. Richardson introduced the following bill; which was referred to the 
                         Committee on Commerce

_______________________________________________________________________

                                 A BILL

 
 To amend the Public Health Service Act with respect to the health of 
individuals who are members of minority groups, and for other purposes.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Minority Health 
Improvement Act of 1997''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
  TITLE I--OFFICES OF MINORITY HEALTH; ASSISTANT SECRETARY FOR CIVIL 
                                 RIGHTS

Sec. 101. Revision and extension of programs of Office of Minority 
                            Health.
Sec. 102. Establishment of individual offices of minority health within 
                            agencies of Public Health Service.
Sec. 103. Assistant Secretary of Health and Human Services for Civil 
                            Rights.
                 TITLE II--HEALTH PROFESSIONS PROGRAMS

Sec. 201. Primary care scholarships for students from disadvantaged 
                            backgrounds.
Sec. 202. Scholarships generally; certain other purposes.
Sec. 203. Loan repayments and fellowships regarding faculty positions.
Sec. 204. Centers of Excellence.
Sec. 205. Educational assistance regarding undergraduates.
Sec. 206. Student loans regarding schools of nursing.
Sec. 207. Federally-supported student loans funds.
Sec. 208. Area health education centers.
                          TITLE III--RESEARCH

Sec. 301. Office of Research on Minority Health.
Sec. 302. Activities of Agency for Health Care Policy and Research.
Sec. 303. Data collection by National Center for Health Statistics.

   TITLE I--OFFICE OF MINORITY HEALTH; ASSISTANT SECRETARY FOR CIVIL 
                                 RIGHTS

SEC. 101. REVISION AND EXTENSION OF PROGRAMS OF OFFICE OF MINORITY 
              HEALTH.

    (a) In General.--Section 1707 of the Public Health Service Act (42 
U.S.C. 300u-6) is amended by striking subsection (b) and all that 
follows and inserting the following:
    ``(b) Duties.--With respect to improving the health of racial and 
ethnic minority groups, the Secretary, acting through the Deputy 
Assistant Secretary for Minority Health (in this section referred to as 
the `Deputy Assistant Secretary'), shall carry out the following:
            ``(1) Establish short-range and long-range goals and 
        objectives and coordinate all other activities within the 
        Public Health Service that relate to disease prevention, health 
        promotion, service delivery, and research concerning such 
        individuals. The heads of each of the agencies of the Service 
        shall consult with the Deputy Assistant Secretary to ensure the 
        coordination of such activities.
            ``(2) Carry out the following types of activities by 
        entering into interagency agreements with other agencies of the 
        Public Health Service:
                    ``(A) Support research, demonstrations and 
                evaluations to test new and innovative models.
                    ``(B) Increase knowledge and understanding of 
                health risk factors.
                    ``(C) Develop mechanisms that support better 
                information dissemination, education, prevention, and 
                service delivery to individuals from disadvantaged 
                backgrounds, including individiuals who are members of 
                racial or ethnic minority groups.
                    ``(D) Ensure that the National Center for Health 
                Statistics collects data on the health status of each 
                minority group.
                    ``(E) With respect to individuals who lack 
                proficiency in speaking the English language, enter 
                into contracts with public and nonprofit private 
                providers of primary health services for the purpose of 
                increasing the access of the individuals to such 
                services by developing and carrying out programs to 
                provide bilingual or interpretive services.
            ``(3) Support a national minority health resource center to 
        carry out the following:
                    ``(A) Facilitate the exchange of information 
                regarding matters relating to health information and 
                health promotion, preventive health services, and 
                education in the appropriate use of health care.
                    ``(B) Facilitate access to such information.
                    ``(C) Assist in the analysis of issues and problems 
                relating to such matters.
                    ``(D) Provide technical assistance with respect to 
                the exchange of such information (including 
                facilitating the development of materials for such 
                technical assistance).
            ``(4) Carry out programs to improve access to health care 
        services for individuals with limited proficiency in speaking 
        the English language by facilitating the removal of impediments 
        to the receipt of health care that result from such limitation. 
        Activities under the preceding sentence shall include 
        conducting research and developing and evaluating model 
        projects.
            ``(5) Not later than June 8 of each year, the Deputy 
        Assistant Secretary shall submit to the Secretary a report 
        summarizing the activities of each of the minority health 
        offices under section 1707A.
    ``(c) Advisory Committee.--
            ``(1) In general.--The Secretary shall establish an 
        advisory committee to be known as the Advisory Committee on 
        Minority Health (in this subsection referred to as the 
        `Committee'). The Deputy Assistant Secretary shall consult with 
        the Committee in carrying out this section.
            ``(2) Duties.--The Committee shall provide advice to the 
        Deputy Assistant Secretary carrying out this section, including 
        advice on the development of goals and specific program 
        activities under paragraphs (1) and (2) of subsection (b) for 
        each racial and ethnic minority group.
            ``(3) Chair.--The Deputy Assistant Secretary shall serve as 
        the chair of the Committee.
            ``(4) Composition.--
                    ``(A) The Committee shall be composed of 12 voting 
                members appointed in accordance with subparagraph (B), 
                and nonvoting, ex officio members designated in 
                subparagraph (C).
                    ``(B) The voting members of the Committee shall be 
                appointed by the Secretary from among individuals who 
                are not officers or employees of the Federal Government 
                and who have expertise regarding issues of minority 
                health. The racial and ethnic minority groups shall be 
                equally represented among such members.
                    ``(C) The nonvoting, ex officio members of the 
                Committee shall be the directors of each of the 
                minority health offices established under section 
                1707A, and such additional officials of the Department 
                of Health and Human Services as the Secretary 
                determines to be appropriate.
            ``(5) Terms.--Each member of the Committee shall serve for 
        a term of 4 years, except that the Secretary shall initially 
        appoint a portion of the members to terms of 1 year, 2 years, 
        and 3 years.
            ``(6) Vacancies.--If a vacancy occurs on the Committee, a 
        new member shall be appointed by the Secretary within 90 days 
        from the date that the vacancy occurs, and serve for the 
        remainder of the term for which the predecessor of such member 
        was appointed. The vacancy shall not affect the power of the 
        remaining members to execute the duties of the Committee.
            ``(7) Compensation.--Members of the Committee who are 
        officers or employees of the United States shall serve without 
        compensation. Members of the Committee who are not officers or 
        employees of the United States shall receive, for each day 
        (including travel time) they are engaged in the performance of 
        the functions of the Committee. Such compensation may not be in 
        an amount in excess of the daily equivalent of the annual 
        maximum rate of basic pay payable under the General Schedule 
        (under title 5, United States Code) for positions above GS-15.
    ``(d) Certain Requirements Regarding Duties.--
            ``(1) Recommendations regarding language as impediment to 
        health care.--The Secretary, acting through the Director of the 
        Office of Refugee Health, the Director of the Office of Civil 
        Rights, and the Director of the Office of Minority Health of 
        the Health Resources and Services Administration, shall make 
        recommendations to the Deputy Assistant Secretary regarding 
        activities under subsection (b)(4).
            ``(2) Equitable allocation regarding activities.--
                    ``(A) In making awards of grants, cooperative 
                agreements, or contracts under this section or section 
                338A, 338B, 340A, 404, 724, 736, 737, 738, or 740, the 
                Secretary, acting as appropriate through the Deputy 
                Assistant Secretary or the Administrator of the Health 
                Resources and Services Administration, shall ensure 
                that such awards are equitably allocated with respect 
                to the various racial and minority populations.
                    ``(B) With respect to grants, cooperative 
                agreements, and contracts that are available under the 
sections specified in subparagraph (A), the Secretary shall--
                            ``(i) carry out activities to inform 
                        entities, as appropriate, that the entities may 
                        be eligible for awards of such assistance;
                            ``(ii) provide technical assistance to such 
                        entities in the process of preparing and 
                        submitting applications for the awards in 
                        accordance with the policies of the Secretary 
                        regarding such application; and
                            ``(iii) inform populations, as appropriate, 
                        that members of the populations may be eligible 
                        to receive services or otherwise participate in 
                        the activities carried out with such awards.
            ``(3) Cultural competency of services.--The Secretary shall 
        ensure that information and services provided pursuant to 
        subsection (b) are provided in the language and cultural 
        context that is most appropriate for the individuals for whom 
        the information and services are intended.
    ``(e) Grants and Contracts Regarding Duties.--
            ``(1) In general.--In carrying out subsection (b), the 
        Deputy Assistant Secretary may make awards of grants, 
        cooperative agreements, and contracts to public and nonprofit 
        private entities.
            ``(2) Process for making awards.--The Deputy Assistant 
        Secretary shall ensure that awards under paragraph (1) are made 
        only on a competitive basis, and that an award is made for a 
        proposal only if the proposal has been recommended for such an 
        award through a process of peer review and has been so 
        recommended by the advisory committee established under 
        subsection (c).
            ``(3) Evaluation and dissemination.--The Deputy Assistant 
        Secretary, directly or through contracts with public and 
        private entities, shall provide for evaluations of projects 
        carried out with awards made under paragraph (1) during the 
        preceding 2 fiscal years. The report shall be included in the 
        report required under subsection (f) for the fiscal year 
        involved.
    ``(f) Biennial Reports.--Not later than February 1 of fiscal year 
1998 and of each second year thereafter, the Deputy Assistant Secretary 
shall submit to the Committee on Energy and Commerce of the House of 
Representatives, and to the Committee on Labor and Human Resources of 
the Senate, a report describing the activities carried out under this 
section during the preceding 2 fiscal years and evaluating the extent 
to which such activities have been effective in improving the health of 
racial and ethnic minority groups. Each such report shall include the 
biennial reports submitted to the Deputy Assistant Secretary under 
section 1707A(e) for such years by the heads of the minority health 
offices.
    ``(g) Definition.--For purposes of this section:
            ``(1) The term `racial and ethnic minority group' means 
        American Indians (including Alaskan Natives, Eskimos, and 
        Aleuts); Asian Americans and Pacific Islanders; Blacks; and 
        Hispanics.
            ``(2) The term `Hispanic' means individuals whose origin is 
        Mexican, Puerto Rican, Cuban, Central or South American, or any 
        other Spanish-speaking country.
    ``(h) Funding.--
            ``(1) Authorization of appropriations.--For the purpose of 
        carrying out this section, there are authorized to be 
        appropriated $21,000,000 for fiscal year 1998, $25,000,000 for 
        fiscal year 1999, and $28,000,000 for fiscal year 2000.
            ``(2) Allocation of funds by secretary.--Of the amounts 
        appropriated under paragraph (1) for a fiscal year in excess of 
        $15,000,000, the Secretary shall make available not less than 
        $3,000,000 for carrying out subsection (b)(2)(E).''.
    (b) Miscellaneous Amendment.--Section 1707 of the Public Health 
Service Act (42 U.S.C. 300u-6) is amended in the heading for the 
section by striking ``establishment of''.

SEC. 102. ESTABLISHMENT OF INDIVIDUAL OFFICES OF MINORITY HEALTH WITHIN 
              AGENCIES OF PUBLIC HEALTH SERVICE.

    Title XVII of the Public Health Service Act (42 U.S.C. 300u et 
seq.) is amended by inserting after section 1707 the following section:

  ``individual offices of minority health within public health service

    ``Sec. 1707A. (a) In General.--The head of each agency specified in 
subsection (b)(1) shall establish within the agency an office to be 
known as the Office of Minority Health. Each such Office shall be 
headed by a director, who shall be appointed by the head of the agency 
within which the Office is established, and who shall report directly 
to the head of the agency. The head of such agency shall carry out this 
section (as this section relates to the agency) acting through such 
Director.
    ``(b) Specified Agencies.--
            ``(1) In general.--The agencies referred to in subsection 
        (a) are the following:
                    ``(A) The Centers for Disease Control and 
                Prevention.
                    ``(B) The Agency for Health Care Policy and 
                Research.
                    ``(C) The Health Resources and Services 
                Administration.
                    ``(D) The Substance Abuse and Mental Health 
                Services Administration.
            ``(2) National institutes of health.--For purposes of 
        subsection (c) and the subsequent provisions of this section, 
        the term `minority health office' includes the Office of 
        Research on Minority Health established within the National 
        Institutes of Health. The Director of the National Institutes 
        of Health shall carry out this section (as this section relates 
        to the agency) acting through the Director of such Office.
    ``(c) Composition.--The head of each specified agency shall ensure 
that the officers and employees of the minority health office of the 
agency are, collectively, experienced in carrying out community-based 
health programs for each of the various racial and ethnic minority 
groups that are present in significant numbers in the United States. 
The head of such agency shall ensure that, of such officers and 
employees who are members of racial and ethnic minority groups, no such 
group is disproportionately represented.
    ``(d) Duties.--Each Director of a minority health office shall 
monitor the programs of the specified agency of such office in order to 
carry out the following:
            ``(1) Determine the extent to which the purposes of the 
        programs are being carried out with respect to racial and 
        ethnic minority groups;
            ``(2) Determine the extent to which members of such groups 
        are represented among the Federal officers and employees who 
        administer the programs; and
            ``(3) Make recommendations to the head of such agency on 
        carrying out the programs with respect to such groups. In the 
        case of programs that provide services, such recommendations 
        shall include recommendations toward ensuring that--
                    ``(A) the services are equitably delivered with 
                respect to racial and ethnic minority groups;
                    ``(B) the programs provide the services in the 
                language and cultural context that is most appropriate 
                for the individuals for whom the services are intended; 
                and
                    ``(C) the programs utilize racial and ethnic 
                minority community-based organizations to deliver the 
                services.
    ``(e) Biennial Reports to Secretary.--The head of each specified 
agency shall submit to the Secretary for inclusion in each biennial 
report under section 1707(g) (without change) a biennial report 
describing--
            ``(1) the extent to which the minority health office of the 
        agency employs individuals who are members of racial and ethnic 
        minority groups, including a specification by minority group of 
        the number of such individuals employed by such office; and
            ``(2) the manner in which the agency is complying with 
        Public Law 94-311 (relating to data on Americans of Spanish 
        origin or descent).
    ``(f) Definitions.--For purposes of this section:
            ``(1) The term `minority health office' means an office 
        established under subsection (a), subject to subsection (b)(2).
            ``(2) The term `racial and ethnic minority group' has the 
        meaning given such term in section 1707(g).
            ``(3) The term `specified agency' means--
                    ``(A) an agency specified in subsection (b)(1); and
                    ``(B) the National Institutes of Health.
    ``(g) Funding.--
            ``(1) Allocations.--Of the amounts appropriated for a 
        specified agency for a fiscal year, the Secretary may reserve 
        not more than 0.5 percent for the purpose of carrying out 
        activities under this section through the minority health 
        office of the agency. In reserving an amount under the 
        preceding sentence for a minority health office for a fiscal 
        year, the Secretary shall reduce, by substantially the same 
        percentage, the amount that otherwise would be available for 
        each of the programs of the designated agency involved.
            ``(2) Availability of funds for staffing.--The purposes for 
        which amounts made available under paragraph (1) may be 
        expended by a minority health office include the costs of 
        employing staff for such office.''.

SEC. 103. ASSISTANT SECRETARY OF HEALTH AND HUMAN SERVICES FOR CIVIL 
              RIGHTS.

    (a) In General.--Part A of title II of the Public Health Service 
Act (42 U.S.C. 202 et seq.) is amended by adding at the end the 
following new section:

                 ``assistant secretary for civil rights

    ``Sec. 229. (a) Establishment of Position.--There shall be in the 
Department of Health and Human Services an Assistant Secretary for 
Civil Rights, who shall be appointed by the President, by and with the 
advice and consent of the Senate.
    ``(b) Responsibilities.--The Assistant Secretary shall perform such 
functions relating to civil rights as the Secretary may assign.''.
    (b) Conforming Amendment.--Section 5315 of title 5, United States 
Code, is amended, in the item relating to Assistant Secretaries of 
Health and Human Services, by striking ``(5)'' and inserting ``(6)''.

                 TITLE II--HEALTH PROFESSIONS PROGRAMS

SEC. 201. PRIMARY CARE SCHOLARSHIPS FOR STUDENTS FROM DISADVANTAGED 
              BACKGROUNDS.

    (a) In General.--Section 736 of the Public Health Service Act (42 
U.S.C. 293) is amended to read as follows:

``SEC. 736. CESAR CHAVEZ PROGRAM FOR PRIMARY CARE SCHOLARSHIPS.

    ``(a) In General.--The Secretary may in accordance with this 
section award scholarships to individuals described in subsection (b) 
for the purpose of assisting the individuals with the costs of 
attending schools of medicine or osteopathic medicine, schools of 
dentistry, schools of nursing (as defined in section 853), and graduate 
programs in mental health practice.
    ``(b) Eligible Individuals.--An individual referred to in 
subsection (a) is any individual meeting the following conditions:
            ``(1) The individual is from a disadvantaged background.
            ``(2) The individual has a financial need for a scholarship 
        under such subsection.
            ``(3) The individual is enrolled (or accepted for 
        enrollment) at an eligible school as a full-time student in a 
        program leading to a degree in a health profession.
            ``(4) The individual enters into the contract required 
        pursuant to subsection (d) as a condition of receiving the 
        scholarship (relating to an agreement to provide primary health 
        services in a health professional shortage area designated 
        under section 332).
    ``(c) Preferences Regarding Awards.--
            ``(1) In general.--In awarding scholarships under 
        subsection (a), the Secretary shall give preference to eligible 
        individuals for whom the costs of attending the school involved 
        would constitute a severe financial hardship.
            ``(2) Additional preferences.--Of the eligible individuals 
        receiving preference for purposes of paragraph (1), the 
        Secretary shall give additional preference to individuals 
        meeting any of the following conditions:
                    ``(A) The individuals received scholarships 
                pursuant to this section, section 737, or section 
                740(d)(2) for fiscal year 1997.
                    ``(B) The individuals are seeking scholarships for 
                attendance at eligible schools that received a grant 
                under any of such sections for such fiscal year.
                    ``(C) The individuals are bilingual.
                    ``(D) The individuals participate in a program or 
                activity carried out under section 739 by a grantee 
                under such section.
    ``(d) Applicability of Certain Provisions.--
            ``(1) In general.--Except as provided in paragraph (2), and 
        except as otherwise inconsistent with this section, the 
        provisions of subpart III of part D of title III apply to an 
        award of a scholarship under subsection (a) to the same extent 
        and in the same manner as such provisions apply to an award of 
        a scholarship under section 338A. This section shall be carried 
        out by the bureau that administers such subpart III.
            ``(2) Option regarding certain medical fields.--
                    ``(A) With respect to amounts that the Secretary 
                reserves for scholarships under subsection (a) for 
                attendance at schools of medicine or osteopathic 
                medicine, the Secretary shall obligate 30 percent for 
                such scholarships for individuals whose contracts made 
                pursuant to paragraph (1) provide to the individuals, 
                subject to subparagraph (B), the option of performing 
                obligated service under the contract in a medical field 
                not providing primary health services.
                    ``(B) In the case of an individual whose contract 
                made pursuant to paragraph (1) provides the option 
                described in subparagraph (A), the contract shall 
                provide that, in the event that the individual 
                exercises the option, the period of obligated service 
                applicable under the contract is 2 years for each 
                school year for which the scholarship involved is 
                provided.
    ``(e) Definitions.--For purposes of this section:
            ``(1) The term `eligible individual' means an individual 
        described in subsection (b).
            ``(2) The term `eligible school' means a school or program 
        specified in subsection (a).
    ``(f) Funding.--
            ``(1) Authorization of appropriations.--For the purpose of 
        carrying out this section, there are authorized to be 
        appropriated $25,000,000 for fiscal year 1998, $38,000,000 for 
        fiscal year 1999, and $48,000,000 for fiscal year 2000. Such 
        authorization is in addition to the authorization of 
        appropriations established in section 740(f)(2)(B).
            ``(2) Allocations by secretary.--
                    ``(A) Of the amounts appropriated under paragraph 
                (1) for a fiscal year and of the amounts available 
                under section 740(f)(2)(B) for the year, the Secretary 
                shall obligate amounts in accordance with the 
                following:
                            ``(i) 19 percent shall be obligated for 
                        scholarships under subsection (a) for 
                        attendance at schools of dentistry.
                            ``(ii) 16 percent shall be obligated for 
                        scholarships under such subsection for 
                        attendance at schools of nursing.
                            ``(iii) 10 percent shall be obligated for 
                        scholarships under such subsection for 
                        attendance at graduate programs in mental 
                        health practice.
                    ``(B) The requirements of subparagraph (A) apply 
                only to the extent that a sufficient number of eligible 
                individuals seeks the scholarships involved.''.
    (b) Certain Programs of Obligated Service.--
            (1) Repeal.--Section 795 of the Public Health Service Act 
        (42 U.S.C. 295n) is repealed.
            (2) Rule of construction.--Paragraph (1) does not terminate 
        agreements that, on the day before the effective date under 
        section 901, are in effect pursuant to section 795 of the 
        Public Health Service Act. Such agreements continue in effect 
        in accordance with the terms of the agreements. With respect to 
        compliance with such agreements, any period of practice as a 
        provider of primary health services (whether provided pursuant 
        to other agreements with the Federal Government or whether 
        provided otherwise) counts toward satisfaction of the 
        requirement of practice pursuant to such section 795.

SEC. 202. SCHOLARSHIPS GENERALLY; CERTAIN OTHER PURPOSES.

    Section 737 of the Public Health Service Act (42 U.S.C. 293a) is 
amended to read as follows:

``SEC. 737. THURGOOD MARSHALL PROGRAM FOR HEALTH SERVICES SCHOLARSHIPS.

    ``(a) In General.--The Secretary may in accordance with this 
section award scholarships to individuals described in subsection (b) 
for the purpose of assisting the individuals with the costs of 
attending the health professions schools described in subsection (c).
    ``(b) Eligible Individuals.--An individual referred to in 
subsection (a) is any individual meeting the following conditions:
            ``(1) The individual is from a disadvantaged background.
            ``(2) The individual has a financial need for a scholarship 
        under such subsection.
            ``(3) The individual is enrolled (or accepted for 
        enrollment) at an eligible school as a full-time student in a 
        program leading to a degree in a health profession.
            ``(4) The individual enters into the contract required 
        pursuant to subsection (e) as a condition of receiving the 
        scholarship (relating to an agreement to provide primary health 
        services in a health professional shortage area designated 
        under section 332).
    ``(c) Eligible Schools.--A health professions school referred to in 
subsection (a) is a health professions school meeting the following 
conditions:
            ``(1) The school is a school of veterinary medicine, 
        optometry, pharmacy, podiatric medicine, or public health, or a 
        designated school of allied health (as defined in subsection 
        (f)).
            ``(2) The school is carrying out a program for recruiting 
        and retaining students from disadvantaged backgrounds, 
        including students who are members of racial and ethnic 
        minority groups.
    ``(d) Preferences Regarding Awards.--
            ``(1) In general.--In awarding scholarships under 
        subsection (a), the Secretary shall give preference to eligible 
        individuals for whom the costs of attending the school involved 
        would constitute a severe financial hardship.
            ``(2) Additional preferences.--Of the eligible individuals 
        receiving preference for purposes of paragraph (1), the 
        Secretary shall give additional preference to individuals 
        meeting any of the following conditions:
                    ``(A) The individuals received scholarships 
                pursuant to this section for fiscal year 1997.
                    ``(B) The individuals are seeking scholarships for 
                attendance at eligible schools that received a grant 
                under this section for such fiscal year.
                    ``(C) The individuals are bilingual.
                    ``(D) The individuals participate in a program or 
                activity carried out under section 739 by a grantee 
                under such section.
    ``(e) Applicability of Certain Provisions.--
            ``(1) In general.--Except as provided in paragraph (2), and 
        except as otherwise inconsistent with this section, the 
        provisions of subpart III of part D of title III apply to an 
        award of a scholarship under subsection (a) to the same extent 
        and in the same manner as such provisions apply to an award of 
        a scholarship under section 338A.
            ``(2) Certain individuals.--
                    ``(A) In the case of an individual who receives a 
                scholarship under subsection (a) for attendance at a 
                school of veterinary medicine, the contract made 
                pursuant to paragraph (1) shall provide that the 
                individual agrees that, after completing training in 
                such medicine, the individual will, in accordance with 
                requirements established under subparagraph (B)--
                            ``(i) serve in a position in which the 
                        individual conducts or assists in the conduct 
                        of research regarding human health or safety; 
                        or
                            ``(ii) serve in a position with a public 
                        health agency of a State or a political 
                        subdivision of a State.
                    ``(B) The Secretary shall establish requirements 
                regarding contracts under subparagraph (A).
    ``(f) Definitions.--For purposes of this section:
            ``(1) The term `designated school of allied health' means a 
        school of allied health providing training in occupational 
        therapy, physical therapy, dental hygiene, medical technology, 
        or radiologic technology.
            ``(2) The term `eligible individual' means an individual 
        described in subsection (b).
            ``(3) The term `eligible school' means a school described 
        in subsection (c).
    ``(g) Funding.--
            ``(1) Authorization of appropriations.--For the purpose of 
        carrying out this section, there are authorized to be 
        appropriated $5,000,000 for fiscal year 1998, $8,000,000 for 
        fiscal year 1999, and $10,000,000 for fiscal year 2000.
            ``(2) Allocations by secretary.--With respect to 
        scholarships under subsection (a) for attendance at designated 
        schools of allied health, the Secretary shall obligate for such 
        scholarships 25 percent of the amounts appropriated under 
        paragraph (1) for each of the fiscal years 1998 through 2000. 
        The requirement of the preceding sentence applies only to the 
        extent that a sufficient number of eligible individuals seeks 
        such scholarships.''.

SEC. 203. LOAN REPAYMENTS AND FELLOWSHIPS REGARDING FACULTY POSITIONS.

    (a) Loan Repayments.--Section 738(a) of the Public Health Service 
Act (42 U.S.C. 293b(a)) is amended--
            (1) by striking paragraphs (4) and (6);
            (2) by redesignating paragraphs (5) and (7) as paragraphs 
        (4) and (5), respectively; and
            (3) in paragraph (4) (as so redesignated), by amending 
        subparagraph (B) to read as follows:
                    ``(B) the contract referred to in subparagraph (A) 
                provides that the school, in making a determination of 
                the amount of compensation to be provided by the school 
                to the individual for serving as a member of the 
                faculty, will make the determination without regard to 
                the amount of payments made (or to be made) to the 
                individual by the Federal Government under paragraph 
                (1).''.
    (b) Fellowships.--
            (1) In general.--Section 738(b) of the Public Health 
        Service Act (42 U.S.C. 293b(b)) is amended--
                    (A) in paragraph (2)(B), by striking ``$30,000'' 
                and inserting ``$50,000''; and
                    (B) in paragraph (3)--
                            (i) in subparagraph (B), by inserting 
                        ``and'' after the semicolon at the end;
                            (ii) in subparagraph (C), by striking ``; 
                        and'' and inserting a period; and
                            (iii) by striking subparagraph (D).
            (2) Definition.--Section 738(b) of the Public Health 
        Service Act (42 U.S.C. 293b(b)) is amended--
                    (A) in paragraph (1), by striking ``the number'' 
                and all that follows and inserting the following: ``the 
                number of underrepresented minority individuals who are 
                members of the faculty of the schools.'';
                    (B) in paragraph (3)(A), by striking ``individuals 
                from underrepresented minorities in the health 
                professions'' and inserting ``underrepresented minority 
                individuals''; and
                    (C) in paragraph (5), by striking ``the term'' and 
                all that follows and inserting the following: ``the 
                term `underrepresented minority individuals' means 
                individuals who are members of racial or ethnic 
                minority groups that are underrepresented in the health 
                professions.''.
    (c) Authorization of Appropriations.--Section 738(c) of the Public 
Health Service Act (42 U.S.C. 293b(c)) is amended by striking ``there 
is'' and all that follows and inserting the following: ``there is 
authorized to be appropriated $1,100,000 for each of the fiscal years 
1998 through 2000.''.

SEC. 204. CENTERS OF EXCELLENCE.

    (a) References to Schools.--Section 739 of the Public Health 
Service Act (42 U.S.C. 293c) is amended--
            (1) by striking ``health professions schools'' each place 
        such term appears and inserting ``designated health professions 
        schools''; and
            (2) by striking ``health professions school'' each place 
        such term appears and inserting ``designated health professions 
        school''.
    (b) Required Uses of Funds.--Section 739(b) of the Public Health 
Service Act (42 U.S.C. 293c(b)), as amended by subsection (a), is 
amended--
            (1) by striking paragraph (2);
            (2) by redesignating paragraph (1) as paragraph (2);
            (3) by inserting before paragraph (2) (as so redesignated) 
        the following paragraph:
            ``(1) to collaborate with public and nonprofit private 
        entities to carry out community-based programs to interest 
        students of secondary schools and institutions of higher 
        education in pursuing careers in the health professions, and to 
        prepare interested students academically for such careers;'';
            (4) in paragraph (5)--
                    (A) by striking ``faculty and student research'' 
                and inserting ``student research''; and
                    (B) by inserting before the period the following: 
                ``, including research on issues relating to the 
                delivery of health care''; and
            (5)(A) in paragraph (4), by striking ``and'' after the 
        semicolon at the end;
            (B) in paragraph (5), by striking the period at the end and 
        inserting ``; and''; and
            (C) by adding at the end the following paragraph:
            ``(6) to carry out a program to train students of the 
        school in providing health services through training provided 
        at community-based health facilities that provide such services 
        to a significant number of disadvantaged individuals and that 
        are located at a site remote from the main site of the teaching 
        facilities of the school.''.
    (c) Requirements Regarding Consortia.--
            (1) In general.--Section 739(c)(1) of the Public Health 
        Service Act (42 U.S.C. 293c(c)(1)), as amended by subsection 
        (a), is amended--
                    (A) in subparagraph (A), in the matter preceding 
                clause (i), by striking ``specified in subparagraph 
                (B)'' and inserting ``specified in subparagraphs (B) 
                and (C)'';
                    (B) by redesignating subparagraph (C) as 
                subparagraph (D); and
                    (C) by inserting after subparagraph (B) the 
                following subparagraph:
                    ``(C) The condition specified in this subparagraph 
                is that, in accordance with subsection (e)(1), the 
                designated health professions school involved has with 
                other health profession schools (designated or 
                otherwise) formed a consortium to carry out the 
                purposes described in subsection (b) at the schools of 
                the consortium. The grant involved may be expended with 
                respect to the other schools without regard to whether 
                such schools meet the conditions specified in 
                subparagraph (B).''.
            (2) Certain requirements.--Section 739(e) of the Public 
        Health Service Act (42 U.S.C. 293c(e)), as amended by 
        subsection (a), is amended to read as follows:
    ``(e) Provisions Regarding Consortia.--
            ``(1) Requirements.--For purposes of subsection (c)(1)(C), 
        a consortium of schools has been formed in accordance with this 
        subsection if--
                    ``(A) the consortium consists of--
                            ``(i) the designated health professions 
                        school seeking the grant under subsection (a); 
                        and
                            ``(ii) 1 or more schools of medicine, 
                        osteopathic medicine, dentistry, pharmacy, 
                        nursing, allied health, or public health, or 
                        graduate programs in mental health practice;
                    ``(B) the schools of the consortium have entered 
                into an agreement for the allocation of such grant 
                among the schools; and
                    ``(C) each of the schools agrees to expend the 
                grant in accordance with this section.
            ``(2) Authority regarding native americans centers of 
        excellence.--With respect to meeting the conditions specified 
        in subsection (c)(4), the Secretary may make a grant under 
        subsection (a) to a designated health professions school that 
        does not meet such conditions if--
                    ``(A) the school has formed a consortium in 
                accordance with paragraph (1); and
                    ``(B) the schools of the consortium collectively 
                meet such conditions, without regard to whether the 
                schools individually meet such conditions.''.
            (3) Conforming amendments.--Section 739 of the Public 
        Health Service Act (42 U.S.C. 293c), as amended by subsection 
        (a), is amended--
                    (A) in subsection (b), in the matter preceding 
                paragraph (1), by inserting ``, subject to subsection 
                (c)(1)(C),'' after ``agrees''; and
                    (B) in subsection (d)--
                            (i) in paragraph (3), by striking ``(e)'' 
                        and inserting ``(e)(2)''; and
                            (ii) by adding at the end the following 
                        paragraph:
            ``(4) Rule of construction.--Except as provided in 
        paragraph (3) regarding a consortium under subsection (e)(2), a 
        health professions school that does not meet the conditions 
        specified in subsection (c)(1)(B) may not be designated as a 
        center of excellence for purposes of this section. The 
        preceding sentence applies without regard to whether a grant 
        under subsection (a) is, pursuant to subsection (c)(1)(C), 
        being expended with respect to the school.''.
    (d) Definition of Health Professions School.--
            (1) Graduate programs in mental health practice.--Section 
        739(h)(1)(A) of the Public Health Service Act (42 U.S.C. 
        293c(h)(1)(A)), as amended by subsection (a), is amended by--
                    (A) by striking ``or'' after ``dentistry''; and
                    (B) by inserting before the period the following: 
                ``, or a graduate program in mental health practice''.
            (2) Limitation.--During the fiscal years 1998 through 2000, 
        the Secretary of Health and Human Services may not make more 
        than one grant under section 739 of the Public Health Service 
        Act directly to a graduate program in mental health practice 
        (as defined in section 799 of such Act).
    (e) Funding.--Section 739(i) of the Public Health Service Act (42 
U.S.C. 293c(i)), as amended by subsection (a), is amended to read as 
follows:
    ``(i) Funding.--
            ``(1) Authorization of appropriations.--For the purpose of 
        making grants under subsection (a), there are authorized to be 
        appropriated $24,000,000 for fiscal year 1998, $28,000,000 for 
        fiscal year 1999, and $33,000,000 for fiscal year 2000.
            ``(2) Allocations by secretary.--
                    ``(A) Of the amounts appropriated under paragraph 
                (1) for a fiscal year, the Secretary shall make 
                available $12,000,000 for grants under subsection (a) 
                to health professions schools that are eligible for 
                such grants pursuant to meeting the conditions 
                described in paragraph (2)(A) of subsection (c).
                    ``(B) Of the amounts appropriated under paragraph 
                (1) for a fiscal year and available after compliance 
                with subparagraph (A), the Secretary shall make 
                available 65 percent for grants under subsection (a) to 
                health professions schools that are eligible for such 
                grants pursuant to meeting the conditions described in 
                paragraph (3) or (4) of subsection (c) (including 
                meeting conditions pursuant to subsection (e)(2)).
                    ``(C)(i) Of the amounts appropriated under 
                paragraph (1) for a fiscal year and available after 
                compliance with subparagraph (A), the Secretary shall 
                make available 35 percent for grants under subsection 
                (a) to health professions schools that are eligible for 
                such grants pursuant to meeting the conditions 
                described in paragraph (5) of subsection (c).
                    ``(ii) With respect to a fiscal year, a grant under 
                subsection (a) that includes amounts available under 
                subparagraph (A) may not include amounts available 
                under clause (i) unless each of the following 
                conditions is met:
                            ``(I) In the case of amounts available 
                        under subparagraph (B) or clause (i) and 
                        included in grants made pursuant to subsection 
                        (c)(3), the aggregate number of such grants is 
                        not less than such aggregate number for the 
                        preceding fiscal year, and one or more of such 
                        grants is made in an amount that is not less 
                        than the lowest amount among grants made from 
                        amounts available under subparagraph (A).
                            ``(II) In the case of amounts available 
                        under subparagraph (B) or clause (i) and 
                        included in grants made pursuant to subsection 
                        (c)(4), the aggregate number of such grants is 
                        not less than such aggregate number for the 
                        preceding fiscal year, and one or more of such 
                        grants is made in an amount that is not less 
                        than the lowest amount among grants made from 
                        amounts available under subparagraph (A).
                            ``(III) In the case of amounts available 
                        under clause (i) and included in grants made 
                        pursuant to subsection (c)(5) (exclusive of 
                        grants that include amounts available under 
                        subparagraph (A) or (B)), the aggregate number 
                        of such grants is not less than such aggregate 
                        number for the preceding fiscal year, and one 
                        or more of such grants is made in an amount 
                        that is not less than the lowest amount among 
                        grants made from amounts available under 
                        subparagraph (A).
                            ``(IV) The aggregate amount of grants under 
                        subsection (a) made from amounts available 
                        under subparagraph (B) and clause (i) (other 
                        than grants that include amounts available 
                        under subparagraph (A)) is, in the case of 
                        fiscal year 1998, not less than the sum of such 
                        aggregate amount for fiscal year 1997 and the 
                        total amount by which grants are required under 
                        subclauses (I) through (III) to be increased; 
                        and is, in the case of fiscal year 1999 and 
                        each subsequent fiscal year, not less than such 
                        aggregate amount for the preceding fiscal 
                        year.''.
    (f) Conforming Amendments.--Section 739(c) of the Public Health 
Service Act (42 U.S.C. 293c(c)), as amended by subsection (a), is 
amended--
            (1) in paragraph (3)(B), by striking ``the designated 
        health professions school'' and inserting ``the school''; and
            (2) in paragraph (4), in each of subparagraphs (B) and (C), 
        by striking ``the designated health professions school'' and 
        inserting ``the school''.
    (g) Transitional and Savings Provisions.--
            (1) In general.--During the period specified in paragraph 
        (2)--
                    (A) the amendments made by subsections (a) through 
                (f) do not apply to any entity that received a grant 
                for fiscal year 1997 under section 739 of the Public 
                Health Service Act; and
                    (B) such a grant to the entity for fiscal year 1997 
                or subsequent fiscal years shall be made and expended 
                in accordance with the provisions of such section as in 
                effect on the day before the date of the enactment of 
                this Act.
            (2) Relevant period.--In the case of an entity that 
        received a grant for fiscal year 1997 under section 739 of the 
        Public Health Service Act, the period referred to in paragraph 
        (1) is the period that, in first approving the grant, the 
        Secretary specified as the duration of the grant.

SEC. 205. EDUCATIONAL ASSISTANCE REGARDING UNDERGRADUATES.

    (a) In General.--Section 740 of the Public Health Service Act (42 
U.S.C. 293d) is amended to read as follows:

``SEC. 740. HEALTH CAREERS OPPORTUNITY PROGRAM.

    ``(a) In General.--Subject to the provisions of this section, the 
Secretary may make grants and enter into cooperative agreements and 
contracts for any of the following purposes:
            ``(1) Identifying and recruiting individuals who--
                    ``(A) are students of elementary schools, or 
                students or graduates of secondary schools or of 
                institutions of higher education;
                    ``(B) are from disadvantaged backgrounds; and
                    ``(C) are interested in a career in the health 
                professions.
            ``(2) Facilitating the entry of such individuals into a 
        health professions school.
            ``(3) Providing counseling or other services designed to 
        assist such individuals in successfully completing their 
        education at such a school.
            ``(4) Providing, for a period prior to the entry of such 
        individuals into the regular course of education of such a 
        school, preliminary education designed to assist the 
        individuals in successfully completing such regular course of 
        education at such a school, or referring such individuals to 
        institutions providing such preliminary education.
            ``(5) Paying such stipends as the Secretary may approve for 
        such individuals for any period of education in student-
        enhancement programs (other than regular courses) at a health 
        professions schools, except that such a stipend may not be 
        provided to an individual for more than 12 months, and such a 
        stipend may not exceed $25 per day (notwithstanding any other 
        provision of law regarding the amount of stipends).
            ``(6) Carrying out programs under which such individuals 
        both--
                    ``(A) gain experience regarding a career in a field 
                of primary health care through working at facilities of 
                nonprofit private community-based providers of primary 
                health services; and
                    ``(B) receive academic instruction to assist in 
                preparing the individuals to enter health professions 
                schools in such fields.
    ``(b) Receipt of Award.--
            ``(1) Eligible entities; requirement of consortium.--The 
        Secretary may make an award under subsection (a) only if the 
        following conditions are met:
                    ``(A) The applicant for the award is a public or 
                nonprofit private entity, and the applicant has 
                established a consortium consisting of nonprofit 
                private community-based organizations and health 
                professions schools.
                    ``(B) The health professions schools of the 
                consortium are schools of medicine or osteopathic 
                medicine, public health, dentistry, veterinary 
                medicine, optometry, pharmacy, allied health, 
                chiropractic, or podiatric medicine, or graduate 
                programs in mental health practice (including such 
                programs in clinical psychology).
                    ``(C) Except as provided in subparagraph (D), the 
                membership of the consortium includes not less than one 
                nonprofit private community-based organization and not 
                less than three health professions schools.
                    ``(D) In the case of an applicant whose exclusive 
                activity under the award will be carrying out one or 
                more programs described in subsection (a)(6), the 
                membership of the consortium includes not less than one 
                nonprofit private community-based organization and not 
                less than one health professions schools.
                    ``(E) The members of the consortium have entered 
                into an agreement specifying--
                            ``(i) that each of the members will comply 
                        with the conditions upon which the award is 
                        made; and
                            ``(ii) whether and to what extent the award 
                        will be allocated among the members.
            ``(2) Requirement of competitive awards.--Awards under 
        subsection (a) shall be made only on a competitive basis.
    ``(c) Financial Requirements.--
            ``(1) Assurances regarding capacity.--The Secretary may 
        make an award under subsection (a) only if the Secretary 
        determines that, in the case of activities carried out under 
        the award that prove to be effective toward achieving the 
        purposes of the activities--
                    ``(A) the members of the consortium involved have 
                or will have the financial capacity to continue the 
                activities, regardless of whether financial assistance 
                under subsection (a) continues to be available; and
                    ``(B) the members of the consortium demonstrate to 
                the satisfaction of the Secretary a commitment to 
                continue such activities, regardless of whether such 
                assistance continues to be available.
            ``(2) Matching funds.--
                    ``(A) With respect to the costs of the activities 
                to be carried out under subsection (a) by an applicant, 
                the Secretary may make an award under such subsection 
                only if the applicant agrees to make available in cash 
                (directly or through donations from public or private 
                entities) non-Federal contributions toward such costs 
                in an amount that, for any fourth or subsequent fiscal 
                year for which the applicant receives such an award, is 
                not less than 50 percent of such costs.
                    ``(B) Amounts provided by the Federal Government 
                may not be included in determining the amount of non-
                Federal contributions required in subparagraph (A).
                    ``(C) The Secretary may not require non-Federal 
                contributions for the first three fiscal years for 
                which an applicant receives a grant under subsection 
                (a).
    ``(d) Preference in Making Awards.--
            ``(1) In general.--
                    ``(A) In making awards under subsection (a), the 
                Secretary shall, subject to paragraph (3), give 
                preference to any applicant that, for the purpose 
                described in subparagraph (B), has made an arrangement 
                with not less than one entity from each of the 
                following categories of entities: Community-based 
                organizations, elementary schools, secondary schools, 
                institutions of higher education, and health 
                professions schools.
                    ``(B) The purpose of arrangements under 
                subparagraph (A) is to establish a program for 
                individuals identified under subsection (a) under 
                which--
                            ``(i) the activities described in such 
                        subsection are carried out on behalf of the 
                        individuals; and
                            ``(ii) health professions schools make a 
                        commitment to admit as students of the schools 
                        such individuals who participate in the 
                        program, subject to the individuals meeting 
                        reasonable academic standards for admission to 
                        the schools.
            ``(2) Additional preferences.--Of the applicants under 
        subsection (a) that are receiving preference for purposes of 
        paragraph (1), the Secretary shall, subject to paragraph (3), 
        give additional preference to applicants whose consortium under 
        subsection (b) includes as members one or more health 
        professions schools that have not previously received any award 
        under this section (including this section as in effect prior 
        to fiscal year 1997).
            ``(3) Limitation.--An applicant may not receive preference 
        for purposes of paragraph (1) or (2) unless the consortium 
        under subsection (b) includes not less than one health 
        professions school that has demonstrated success in enrolling 
        students from disadvantaged backgrounds.
    ``(e) Objectives Under Awards.--
            ``(1) Establishment of objectives.--Before making a first 
        award to an applicant under subsection (a), the Secretary shall 
        establish objectives regarding the activities to be carried out 
        under the award, which objectives are applicable until the next 
        fiscal year for which such award is made after a competitive 
        process of review. In making an award after such a review, the 
        Secretary shall establish additional objectives for the 
        applicant.
            ``(2) Precondition for subsequent awards.--In the case of 
        an applicant seeking an award under subsection (a) pursuant to 
        a competitive process of review, the Secretary may make the 
        award only if the applicant demonstrates to the satisfaction of 
        the Secretary that the applicant has met the objectives that 
        were applicable under paragraph (1) to the preceding awards 
        under such subsection.
    ``(f) Funding.--
            ``(1) Authorization of appropriations.--For the purpose of 
        carrying out this section and section 736, there are authorized 
        to be appropriated $33,000,000 for fiscal year 1998, 
        $37,000,000 for fiscal year 1999, and $40,000,000 for fiscal 
        year 2000.
            ``(2) Allocations.--Of the amounts appropriated under 
        paragraph (1) for a fiscal year, the Secretary shall obligate 
        amounts as follows:
                    ``(A) For carrying out subsection (a)(6), not less 
                than 20 percent.
                    ``(B) For providing scholarships under section 736, 
                an amount equal to the amount provided for such purpose 
                under this section for fiscal year 1997, plus an amount 
                for offsetting the effects of inflation occurring after 
                October 1, 1997.''.
    (b) Transitional and Savings Provisions.--
            (1) In general.--During the period specified in paragraph 
        (2)--
                    (A) the amendment made by subsection (a) does not 
                apply to any entity that received a grant for fiscal 
                year 1997 under section 740 of the Public Health 
                Service Act; and
                    (B) such a grant to the entity for fiscal year 1998 
                or subsequent fiscal years shall be made and expended 
                in accordance with the provisions of such section as in 
                effect on the day before the date of the enactment of 
                this Act.
            (2) Relevant period.--In the case of an entity that 
        received a grant for fiscal year 1997 under section 740 of the 
        Public Health Service Act, the period referred to in paragraph 
        (1) is the period that, in first approving the grant, the 
        Secretary specified as the duration of the grant.

SEC. 206. STUDENT LOANS REGARDING SCHOOLS OF NURSING.

    Section 836(b) of the Public Health Service Act (42 U.S.C. 297b(b)) 
is amended--
            (1) in paragraph (1), by striking the period at the end and 
        inserting a semicolon;
            (2) in paragraph (2)--
                    (A) in subparagraph (A), by striking ``and'' at the 
                end; and
                    (B) by inserting before the semicolon at the end 
                the following: ``, and (C) such additional periods 
                under the terms of paragraph (8) of this subsection'';
            (3) in paragraph (7), by striking the period at the end and 
        inserting ``; and''; and
            (4) by adding at the end the following paragraph:
            ``(8) pursuant to uniform criteria established by the 
        Secretary, the repayment period established under paragraph (2) 
        for any student borrower who during the repayment period failed 
        to make consecutive payments and who, during the last 12 months 
        of the repayment period, has made at least 12 consecutive 
        payments may be extended for a period not to exceed 10 
        years.''.

SEC. 207. FEDERALLY-SUPPORTED STUDENT LOAN FUNDS.

    (a) Authorization of Appropriations Regarding Certain Medical 
Schools.--
            (1) In general.--Subpart II of part A of title VII of the 
        Public Health Service Act (42 U.S.C. 292q et seq.) is amended--
                    (A) by transferring subsection (f) of section 735 
                from the current placement of the subsection;
                    (B) by adding the subsection at the end of section 
                723;
                    (C) by redesignating the subsection as subsection 
                (e); and
                    (D) in subsection (e)(1) of section 723 (as so 
                redesignated), by striking ``1996'' and inserting 
                ``2000''.
            (2) Conforming amendments.--Section 723 of the Public 
        Health Service Act (42 U.S.C. 292s), as amended by paragraph 
        (1) of this subsection, is amended in subsection (e)(2)(A)--
                    (A) by striking ``section 723(b)(2)'' and inserting 
                ``subsection (b)(2)''; and
                    (B) by striking ``such section'' and inserting 
                ``such subsection''.
    (b) Authorization of Appropriations Regarding Individuals From 
Disadvantaged Backgrounds.--Section 724(f)(1) of the Public Health 
Service Act (42 U.S.C. 292t(f)(1)) is amended to read as follows:
            ``(1) In general.--With respect to making Federal capital 
        contributions to student loan funds for purposes of subsection 
        (a), other than the student loan fund of any school of medicine 
        or osteopathic medicine, there is authorized to be appropriated 
        $8,000,000 for each of the fiscal years 1998 through 2000.''.

SEC. 208. AREA HEALTH EDUCATION CENTERS.

    (a) Requirements for Centers.--Section 746(d)(2)(D) of the Public 
Health Service Act (42 U.S.C. 293j(d)(2)(D)) is amended by inserting 
``and minority health'' after ``disease prevention''.
    (b) Funding.--Section 746(i)(2)(C) of the Public Health Service Act 
(42 U.S.C. 293j(i)(2)(C)) is amended in the second sentence by 
inserting before the period the following: ``(except that in the case 
of fiscal year 1998, amounts appropriated in excess of the amount 
appropriated for fiscal year 1997 shall be obligated for carrying out 
subsection (a)(1) in rural States without an area health education 
center program)''.

                          TITLE III--RESEARCH

SEC. 301. OFFICE OF RESEARCH ON MINORITY HEALTH.

    Section 404 of the Public Health Service Act (42 U.S.C. 283(b)) is 
amended by adding at the end the following subsections:
    ``(c) Plan.--The Director of the Office, in consultation with the 
advisory committee established under subsection (d), shall develop and 
implement a plan for carrying out the duties established in subsection 
(b). The Director shall review the plan not less than annually, and 
revise the plan as appropriate.
    ``(d) Equity Regarding Various Groups.--The Director of the Office 
shall ensure that activities under subsection (b) equitably address all 
racial and ethnic minority groups.
    ``(e) Advisory Committee.--
            ``(1) Establishment.--In carrying out subsection (b), the 
        Secretary shall establish an advisory committee to be known as 
        the Advisory Committee on Research on Minority Health (in this 
        subsection referred to as the `Advisory Committee').
            ``(2) Composition.--
                    ``(A) Voting and nonvoting members.--The Advisory 
                Committee shall be composed of voting members appointed 
                in accordance with subparagraph (B) and the ex officio 
                nonvoting members described in subparagraph (C).
                    ``(B) Voting members.--The Advisory Committee shall 
                include 12 voting members who are not officers or 
                employees of the Federal Government. The Director of 
                the Office shall appoint such members to the Advisory 
                Committee from among physicians, practitioners, 
                scientists, consumers and other health professionals, 
                whose clinical practices, research specialization, or 
                professional expertise includes a significant focus on 
                research on minority health or on the barriers that 
                minorities must overcome to participate in clinical 
                trials. The racial and ethnic minority groups shall be 
                equally represented among such members.
                    ``(C) Ex officio nonvoting members.--The Deputy 
                Assistant Secretary for Minority Health and the 
                Directors of each of the national research entities 
                shall serve as ex officio nonvoting members of the 
                Advisory Committee (except that any of such Directors 
                may designate an official of the institute involved to 
                serve as such member of the Committee in lieu of the 
                Director).
            ``(3) Chair.--The Director of the Office shall serve as the 
        chair of the Advisory Committee.
            ``(4) Duties.--The Advisory Committee shall--
                    ``(A) advise the Director of the Office on 
                appropriate research activities to be undertaken by the 
                national research institutes with respect to--
                            ``(i) research on minority health;
                            ``(ii) research on racial and ethnic 
                        differences in clinical drug trials, including 
                        responses to pharmacological drugs;
                            ``(iii) research on racial and ethnic 
                        differences in disease etiology, course, and 
                        treatment; and
                            ``(iv) research on minority health 
                        conditions which require a multidisciplinary 
                        approach;
                    ``(B) report to the Director of the Office on such 
                research;
                    ``(C) provide recommendations to such Director 
                regarding activities of the Office (including 
                recommendations on priorities in carrying out research 
                described in subparagraph (A)); and
                    ``(D) assist in monitoring compliance with section 
                492B regarding the inclusion of minorities in clinical 
                research.
            ``(5) Biennial report.--
                    ``(A) Preparation.--The Advisory Committee shall 
                prepare a biennial report describing the activities of 
                the Committee, including findings made by the Committee 
                regarding--
                            ``(i) compliance with section 492B;
                            ``(ii) the extent of expenditures made for 
                        research on minority health by the agencies of 
the National Institutes of Health; and
                            ``(iii) the level of funding needed for 
                        such research.
                    ``(B) Submission.--The report required in 
                subparagraph (A) shall be submitted to the Director of 
                the National Institutes of Health for inclusion in the 
                report required in section 403.
    ``(f) Representatives of Minorities Among Researchers.--The 
Secretary, acting through the Assistant Secretary for Personnel 
Administration and in collaboration with the Director of the Office, 
shall determine the extent to which minorities are represented among 
senior physicians and scientists of the national research institutes 
and among physicians and scientists conducting research with funds 
provided by such institutes, and as appropriate, carry out activities 
to increase the extent of such representation.
    ``(g) Requirement Regarding Grants and Contracts.--Any award of a 
grant, cooperative agreement, or contract that the Director of the 
Office is authorized to make shall be made only on a competitive basis.
    ``(h) Definitions.--For purposes of this part:
            ``(1) The term `minority health conditions', with respect 
        to individuals who are members of minority groups, means all 
        diseases, disorders, and conditions (including with respect to 
        mental health)--
                    ``(A) unique to, more serious, or more prevalent in 
                such individuals;
                    ``(B) for which the factors of medical risk or 
                types of medical intervention are different for such 
                individuals, or for which it is unknown whether such 
                factors or types are different for such individuals; or
                    ``(C) with respect to which there has been 
                insufficient research involving such individuals as 
                subjects or insufficient data on such individuals.
            ``(2) The term `research on minority health' means research 
        on minority health conditions, including research on preventing 
        such conditions.
            ``(3) The term `racial and ethnic minority group' has the 
        meaning given such term in section 1707(g).''.

SEC. 302. ACTIVITIES OF AGENCY FOR HEALTH CARE POLICY AND RESEARCH.

    Title IX of the Public Health Service Act (42 U.S.C. 299 et seq.) 
is amended--
            (1) in section 902, by amending subsection (b) to read as 
        follows:
    ``(b) Requirements With Respect to Certain Populations.--In 
carrying out subsection (a), the Administrator shall undertake and 
support research, demonstration projects, and evaluations with respect 
to the health status of, and the delivery of health care to--
            ``(1) the populations of medically underserved urban or 
        rural areas (including frontier areas); and
            ``(2) low-income groups, racial and ethnic minority groups, 
        and the elderly.''; and
            (2) in section 926(a), by adding at the end the following 
        sentence: ``Of the amounts appropriated under the preceding 
        sentence for a fiscal year, the Administrator shall reserve not 
        less than 8 percent for carrying out section 902(b)(2).''.

SEC. 303. DATA COLLECTION BY NATIONAL CENTER FOR HEALTH STATISTICS.

    Section 306(n) of the Public Health Service Act (42 U.S.C. 
242k(n)), as redesignated by section 501(a)(5)(B) of Public Law 103-183 
(107 Stat. 2237), is amended to read as follows:
    ``(n)(1) For health statistical and epidemiological activities 
undertaken or supported under this section, there are authorized to be 
appropriated such sums as may be necessary for each of the fiscal years 
1998 through 2001.
    ``(2) Of the amounts appropriated under paragraph (1) for a fiscal 
year, the Secretary shall obligate not less than an aggregate 
$5,000,000 for carrying out subsections (h), (l), and (m) with respect 
to particular racial and ethnic population groups.''.
                                 <all>
```