I

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.

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 Act of 1997’’.

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

7 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.
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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.

1 TITLE I—OFFICE OF MINORITY

2 HEALTH; ASSISTANT SEC3 RETARY FOR CIVIL RIGHTS

4 SEC. 101. REVISION AND EXTENSION OF PROGRAMS OF OF5 FICE OF MINORITY HEALTH.

6 (a) IN GENERAL.—Section 1707 of the Public Health

7 Service Act (42 U.S.C. 300u–6) is amended by striking

8 subsection (b) and all that follows and inserting the follow9 ing:

10 ‘‘(b) DUTIES.—With respect to improving the health

11 of racial and ethnic minority groups, the Secretary, acting

12 through the Deputy Assistant Secretary for Minority

13 Health (in this section referred to as the ‘Deputy Assist14 ant Secretary’), shall carry out the following:

15 ‘‘(1) Establish short-range and long-range goals

16 and objectives and coordinate all other activities
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1 within the Public Health Service that relate to dis2 ease prevention, health promotion, service delivery,

3 and research concerning such individuals. The heads

4 of each of the agencies of the Service shall consult

5 with the Deputy Assistant Secretary to ensure the

6 coordination of such activities.

7 ‘‘(2) Carry out the following types of activities

8 by entering into interagency agreements with other

9 agencies of the Public Health Service:

10 ‘‘(A) Support research, demonstrations and

11 evaluations to test new and innovative models.

12 ‘‘(B) Increase knowledge and understand13 ing of health risk factors.

14 ‘‘(C) Develop mechanisms that support

15 better information dissemination, education,

16 prevention, and service delivery to individuals

17 from disadvantaged backgrounds, including

18 individiuals who are members of racial or ethnic

19 minority groups.

20 ‘‘(D) Ensure that the National Center for

21 Health Statistics collects data on the health

22 status of each minority group.

23 ‘‘(E) With respect to individuals who lack

24 proficiency in speaking the English language,

25 enter into contracts with public and nonprofit
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1 private providers of primary health services for

2 the purpose of increasing the access of the indi3 viduals to such services by developing and car4 rying out programs to provide bilingual or in5 terpretive services.

6 ‘‘(3) Support a national minority health re7 source center to carry out the following:

8 ‘‘(A) Facilitate the exchange of informa9 tion regarding matters relating to health infor10 mation and health promotion, preventive health

11 services, and education in the appropriate use

12 of health care.

13 ‘‘(B) Facilitate access to such information.

14 ‘‘(C) Assist in the analysis of issues and

15 problems relating to such matters.

16 ‘‘(D) Provide technical assistance with re17 spect to the exchange of such information (in18 cluding facilitating the development of materials

19 for such technical assistance).

20 ‘‘(4) Carry out programs to improve access to

21 health care services for individuals with limited pro22 ficiency in speaking the English language by facili23 tating the removal of impediments to the receipt of

24 health care that result from such limitation. Activi25 ties under the preceding sentence shall include con-
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1 ducting research and developing and evaluating

2 model projects.

3 ‘‘(5) Not later than June 8 of each year, the

4 Deputy Assistant Secretary shall submit to the Sec5 retary a report summarizing the activities of each of

6 the minority health offices under section 1707A.

7 ‘‘(c) ADVISORY COMMITTEE.—

8 ‘‘(1) IN GENERAL.—The Secretary shall estab9 lish an advisory committee to be known as the Advi10 sory Committee on Minority Health (in this sub11 section referred to as the ‘Committee’). The Deputy

12 Assistant Secretary shall consult with the Committee

13 in carrying out this section.

14 ‘‘(2) DUTIES.—The Committee shall provide

15 advice to the Deputy Assistant Secretary carrying

16 out this section, including advice on the development

17 of goals and specific program activities under para18 graphs (1) and (2) of subsection (b) for each racial

19 and ethnic minority group.

20 ‘‘(3) CHAIR.—The Deputy Assistant Secretary

21 shall serve as the chair of the Committee.

22 ‘‘(4) COMPOSITION.—

23 ‘‘(A) The Committee shall be composed of

24 12 voting members appointed in accordance

25 with subparagraph (B), and nonvoting, ex
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1 officio members designated in subparagraph

2 (C).

3 ‘‘(B) The voting members of the Commit4 tee shall be appointed by the Secretary from

5 among individuals who are not officers or em6 ployees of the Federal Government and who

7 have expertise regarding issues of minority

8 health. The racial and ethnic minority groups

9 shall be equally represented among such mem10 bers.

11 ‘‘(C) The nonvoting, ex officio members of

12 the Committee shall be the directors of each of

13 the minority health offices established under

14 section 1707A, and such additional officials of

15 the Department of Health and Human Services

16 as the Secretary determines to be appropriate.

17 ‘‘(5) TERMS.—Each member of the Committee

18 shall serve for a term of 4 years, except that the

19 Secretary shall initially appoint a portion of the

20 members to terms of 1 year, 2 years, and 3 years.

21 ‘‘(6) VACANCIES.—If a vacancy occurs on the

22 Committee, a new member shall be appointed by the

23 Secretary within 90 days from the date that the va24 cancy occurs, and serve for the remainder of the

25 term for which the predecessor of such member was
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1 appointed. The vacancy shall not affect the power of

2 the remaining members to execute the duties of the

3 Committee.

4 ‘‘(7) COMPENSATION.—Members of the Com5 mittee who are officers or employees of the United

6 States shall serve without compensation. Members of

7 the Committee who are not officers or employees of

8 the United States shall receive, for each day (includ9 ing travel time) they are engaged in the performance

10 of the functions of the Committee. Such compensa11 tion may not be in an amount in excess of the daily

12 equivalent of the annual maximum rate of basic pay

13 payable under the General Schedule (under title 5,

14 United States Code) for positions above GS–15.

15 ‘‘(d) CERTAIN REQUIREMENTS REGARDING DU16 TIES.—

17 ‘‘(1) RECOMMENDATIONS REGARDING LAN18 GUAGE AS IMPEDIMENT TO HEALTH CARE.—The

19 Secretary, acting through the Director of the Office

20 of Refugee Health, the Director of the Office of Civil

21 Rights, and the Director of the Office of Minority

22 Health of the Health Resources and Services Admin23 istration, shall make recommendations to the Deputy

24 Assistant Secretary regarding activities under sub25 section (b)(4).
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1 ‘‘(2) EQUITABLE ALLOCATION REGARDING AC2 TIVITIES.—

3 ‘‘(A) In making awards of grants, coopera4 tive agreements, or contracts under this section

5 or section 338A, 338B, 340A, 404, 724, 736,

6 737, 738, or 740, the Secretary, acting as ap7 propriate through the Deputy Assistant Sec8 retary or the Administrator of the Health Re9 sources and Services Administration, shall en10 sure that such awards are equitably allocated

11 with respect to the various racial and minority

12 populations.

13 ‘‘(B) With respect to grants, cooperative

14 agreements, and contracts that are available

15 under the sections specified in subparagraph

16 (A), the Secretary shall—

17 ‘‘(i) carry out activities to inform enti18 ties, as appropriate, that the entities may

19 be eligible for awards of such assistance;

20 ‘‘(ii) provide technical assistance to

21 such entities in the process of preparing

22 and submitting applications for the awards

23 in accordance with the policies of the Sec24 retary regarding such application; and
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1 ‘‘(iii) inform populations, as appro2 priate, that members of the populations

3 may be eligible to receive services or other4 wise participate in the activities carried out

5 with such awards.

6 ‘‘(3) CULTURAL COMPETENCY OF SERVICES.—

7 The Secretary shall ensure that information and

8 services provided pursuant to subsection (b) are pro9 vided in the language and cultural context that is

10 most appropriate for the individuals for whom the

11 information and services are intended.

12 ‘‘(e) GRANTS AND CONTRACTS REGARDING DU13 TIES.—

14 ‘‘(1) IN GENERAL.—In carrying out subsection

15 (b), the Deputy Assistant Secretary may make

16 awards of grants, cooperative agreements, and con17 tracts to public and nonprofit private entities.

18 ‘‘(2) PROCESS FOR MAKING AWARDS.—The

19 Deputy Assistant Secretary shall ensure that awards

20 under paragraph (1) are made only on a competitive

21 basis, and that an award is made for a proposal only

22 if the proposal has been recommended for such an

23 award through a process of peer review and has been

24 so recommended by the advisory committee estab25 lished under subsection (c).
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1 ‘‘(3) EVALUATION AND DISSEMINATION.—The

2 Deputy Assistant Secretary, directly or through con3 tracts with public and private entities, shall provide

4 for evaluations of projects carried out with awards

5 made under paragraph (1) during the preceding 2

6 fiscal years. The report shall be included in the re7 port required under subsection (f) for the fiscal year

8 involved.

9 ‘‘(f) BIENNIAL REPORTS.—Not later than February

10 1 of fiscal year 1998 and of each second year thereafter,

11 the Deputy Assistant Secretary shall submit to the Com12 mittee on Energy and Commerce of the House of Rep13 resentatives, and to the Committee on Labor and Human

14 Resources of the Senate, a report describing the activities

15 carried out under this section during the preceding 2 fiscal

16 years and evaluating the extent to which such activities

17 have been effective in improving the health of racial and

18 ethnic minority groups. Each such report shall include the

19 biennial reports submitted to the Deputy Assistant Sec20 retary under section 1707A(e) for such years by the heads

21 of the minority health offices.

22 ‘‘(g) DEFINITION.—For purposes of this section:

23 ‘‘(1) The term ‘racial and ethnic minority

24 group’ means American Indians (including Alaskan
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1 Natives, Eskimos, and Aleuts); Asian Americans and

2 Pacific Islanders; Blacks; and Hispanics.

3 ‘‘(2) The term ‘Hispanic’ means individuals

4 whose origin is Mexican, Puerto Rican, Cuban,

5 Central or South American, or any other Spanish6 speaking country.

7 ‘‘(h) FUNDING.—

8 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—

9 For the purpose of carrying out this section, there

10 are authorized to be appropriated $21,000,000 for

11 fiscal year 1998, $25,000,000 for fiscal year 1999,

12 and $28,000,000 for fiscal year 2000.

13 ‘‘(2) ALLOCATION OF FUNDS BY SECRETARY.—

14 Of the amounts appropriated under paragraph (1)

15 for a fiscal year in excess of $15,000,000, the Sec16 retary shall make available not less than $3,000,000

17 for carrying out subsection (b)(2)(E).’’.

18 (b) MISCELLANEOUS AMENDMENT.—Section 1707 of

19 the Public Health Service Act (42 U.S.C. 300u–6) is

20 amended in the heading for the section by striking ‘‘ES21 TABLISHMENT OF’’.
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1 SEC. 102. ESTABLISHMENT OF INDIVIDUAL OFFICES OF MI2 NORITY HEALTH WITHIN AGENCIES OF PUB3 LIC HEALTH SERVICE.

4 Title XVII of the Public Health Service Act (42

5 U.S.C. 300u et seq.) is amended by inserting after section

6 1707 the following section:

7 ‘‘INDIVIDUAL OFFICES OF MINORITY HEALTH WITHIN

8 PUBLIC HEALTH SERVICE

9 ‘‘SEC. 1707A. (a) IN GENERAL.—The head of each

10 agency specified in subsection (b)(1) shall establish within

11 the agency an office to be known as the Office of Minority

12 Health. Each such Office shall be headed by a director,

13 who shall be appointed by the head of the agency within

14 which the Office is established, and who shall report di15 rectly to the head of the agency. The head of such agency

16 shall carry out this section (as this section relates to the

17 agency) acting through such Director.

18 ‘‘(b) SPECIFIED AGENCIES.—

19 ‘‘(1) IN GENERAL.—The agencies referred to in

20 subsection (a) are the following:

21 ‘‘(A) The Centers for Disease Control and

22 Prevention.

23 ‘‘(B) The Agency for Health Care Policy

24 and Research.

25 ‘‘(C) The Health Resources and Services

26 Administration.
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1 ‘‘(D) The Substance Abuse and Mental

2 Health Services Administration.

3 ‘‘(2) NATIONAL INSTITUTES OF HEALTH.—For

4 purposes of subsection (c) and the subsequent provi5 sions of this section, the term ‘minority health office’

6 includes the Office of Research on Minority Health

7 established within the National Institutes of Health.

8 The Director of the National Institutes of Health

9 shall carry out this section (as this section relates to

10 the agency) acting through the Director of such Of11 fice.

12 ‘‘(c) COMPOSITION.—The head of each specified

13 agency shall ensure that the officers and employees of the

14 minority health office of the agency are, collectively, expe15 rienced in carrying out community-based health programs

16 for each of the various racial and ethnic minority groups

17 that are present in significant numbers in the United

18 States. The head of such agency shall ensure that, of such

19 officers and employees who are members of racial and eth20 nic minority groups, no such group is disproportionately

21 represented.

22 ‘‘(d) DUTIES.—Each Director of a minority health of23 fice shall monitor the programs of the specified agency of

24 such office in order to carry out the following:
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1 ‘‘(1) Determine the extent to which the pur2 poses of the programs are being carried out with re3 spect to racial and ethnic minority groups;

4 ‘‘(2) Determine the extent to which members of

5 such groups are represented among the Federal offi6 cers and employees who administer the programs;

7 and

8 ‘‘(3) Make recommendations to the head of

9 such agency on carrying out the programs with re10 spect to such groups. In the case of programs that

11 provide services, such recommendations shall include

12 recommendations toward ensuring that—

13 ‘‘(A) the services are equitably delivered

14 with respect to racial and ethnic minority

15 groups;

16 ‘‘(B) the programs provide the services in

17 the language and cultural context that is most

18 appropriate for the individuals for whom the

19 services are intended; and

20 ‘‘(C) the programs utilize racial and ethnic

21 minority community-based organizations to de22 liver the services.

23 ‘‘(e) BIENNIAL REPORTS TO SECRETARY.—The head

24 of each specified agency shall submit to the Secretary for
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1 inclusion in each biennial report under section 1707(g)

2 (without change) a biennial report describing—

3 ‘‘(1) the extent to which the minority health of4 fice of the agency employs individuals who are mem5 bers of racial and ethnic minority groups, including

6 a specification by minority group of the number of

7 such individuals employed by such office; and

8 ‘‘(2) the manner in which the agency is comply9 ing with Public Law 94–311 (relating to data on

10 Americans of Spanish origin or descent).

11 ‘‘(f) DEFINITIONS.—For purposes of this section:

12 ‘‘(1) The term ‘minority health office’ means an

13 office established under subsection (a), subject to

14 subsection (b)(2).

15 ‘‘(2) The term ‘racial and ethnic minority

16 group’ has the meaning given such term in section

17 1707(g).

18 ‘‘(3) The term ‘specified agency’ means—

19 ‘‘(A) an agency specified in subsection

20 (b)(1); and

21 ‘‘(B) the National Institutes of Health.

22 ‘‘(g) FUNDING.—

23 ‘‘(1) ALLOCATIONS.—Of the amounts appro24 priated for a specified agency for a fiscal year, the

25 Secretary may reserve not more than 0.5 percent for
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1 the purpose of carrying out activities under this sec2 tion through the minority health office of the agen3 cy. In reserving an amount under the preceding sen4 tence for a minority health office for a fiscal year,

5 the Secretary shall reduce, by substantially the same

6 percentage, the amount that otherwise would be

7 available for each of the programs of the designated

8 agency involved.

9 ‘‘(2) AVAILABILITY OF FUNDS FOR STAFF10 ING.—The purposes for which amounts made avail11 able under paragraph (1) may be expended by a mi12 nority health office include the costs of employing

13 staff for such office.’’.

14 SEC. 103. ASSISTANT SECRETARY OF HEALTH AND HUMAN

15 SERVICES FOR CIVIL RIGHTS.

16 (a) IN GENERAL.—Part A of title II of the Public

17 Health Service Act (42 U.S.C. 202 et seq.) is amended

18 by adding at the end the following new section:

19 ‘‘ASSISTANT SECRETARY FOR CIVIL RIGHTS

20 ‘‘SEC. 229. (a) ESTABLISHMENT OF POSITION.—

21 There shall be in the Department of Health and Human

22 Services an Assistant Secretary for Civil Rights, who shall

23 be appointed by the President, by and with the advice and

24 consent of the Senate.
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1 ‘‘(b) RESPONSIBILITIES.—The Assistant Secretary

2 shall perform such functions relating to civil rights as the

3 Secretary may assign.’’.

4 (b) CONFORMING AMENDMENT.—Section 5315 of

5 title 5, United States Code, is amended, in the item relat6 ing to Assistant Secretaries of Health and Human Serv7 ices, by striking ‘‘(5)’’ and inserting ‘‘(6)’’.

8 TITLE II—HEALTH PROFESSIONS

9 PROGRAMS

10 SEC. 201. PRIMARY CARE SCHOLARSHIPS FOR STUDENTS

11 FROM DISADVANTAGED BACKGROUNDS.

12 (a) IN GENERAL.—Section 736 of the Public Health

13 Service Act (42 U.S.C. 293) is amended to read as follows:

14 ‘‘SEC. 736. CESAR CHAVEZ PROGRAM FOR PRIMARY CARE

15 SCHOLARSHIPS.

16 ‘‘(a) IN GENERAL.—The Secretary may in accord17 ance with this section award scholarships to individuals

18 described in subsection (b) for the purpose of assisting the

19 individuals with the costs of attending schools of medicine

20 or osteopathic medicine, schools of dentistry, schools of

21 nursing (as defined in section 853), and graduate pro22 grams in mental health practice.

23 ‘‘(b) ELIGIBLE INDIVIDUALS.—An individual re24 ferred to in subsection (a) is any individual meeting the

25 following conditions:
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1 ‘‘(1) The individual is from a disadvantaged

2 background.

3 ‘‘(2) The individual has a financial need for a

4 scholarship under such subsection.

5 ‘‘(3) The individual is enrolled (or accepted for

6 enrollment) at an eligible school as a full-time stu7 dent in a program leading to a degree in a health

8 profession.

9 ‘‘(4) The individual enters into the contract re10 quired pursuant to subsection (d) as a condition of

11 receiving the scholarship (relating to an agreement

12 to provide primary health services in a health profes13 sional shortage area designated under section 332).

14 ‘‘(c) PREFERENCES REGARDING AWARDS.—

15 ‘‘(1) IN GENERAL.—In awarding scholarships

16 under subsection (a), the Secretary shall give pref17 erence to eligible individuals for whom the costs of

18 attending the school involved would constitute a se19 vere financial hardship.

20 ‘‘(2) ADDITIONAL PREFERENCES.—Of the eligi21 ble individuals receiving preference for purposes of

22 paragraph (1), the Secretary shall give additional

23 preference to individuals meeting any of the follow24 ing conditions:
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1 ‘‘(A) The individuals received scholarships

2 pursuant to this section, section 737, or section

3 740(d)(2) for fiscal year 1997.

4 ‘‘(B) The individuals are seeking scholar5 ships for attendance at eligible schools that re6 ceived a grant under any of such sections for

7 such fiscal year.

8 ‘‘(C) The individuals are bilingual.

9 ‘‘(D) The individuals participate in a pro10 gram or activity carried out under section 739

11 by a grantee under such section.

12 ‘‘(d) APPLICABILITY OF CERTAIN PROVISIONS.—

13 ‘‘(1) IN GENERAL.—Except as provided in para14 graph (2), and except as otherwise inconsistent with

15 this section, the provisions of subpart III of part D

16 of title III apply to an award of a scholarship under

17 subsection (a) to the same extent and in the same

18 manner as such provisions apply to an award of a

19 scholarship under section 338A. This section shall

20 be carried out by the bureau that administers such

21 subpart III.

22 ‘‘(2) OPTION REGARDING CERTAIN MEDICAL

23 FIELDS.—

24 ‘‘(A) With respect to amounts that the

25 Secretary reserves for scholarships under sub-
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1 section (a) for attendance at schools of medi2 cine or osteopathic medicine, the Secretary shall

3 obligate 30 percent for such scholarships for in4 dividuals whose contracts made pursuant to

5 paragraph (1) provide to the individuals, sub6 ject to subparagraph (B), the option of per7 forming obligated service under the contract in

8 a medical field not providing primary health

9 services.

10 ‘‘(B) In the case of an individual whose

11 contract made pursuant to paragraph (1) pro12 vides the option described in subparagraph (A),

13 the contract shall provide that, in the event that

14 the individual exercises the option, the period of

15 obligated service applicable under the contract

16 is 2 years for each school year for which the

17 scholarship involved is provided.

18 ‘‘(e) DEFINITIONS.—For purposes of this section:

19 ‘‘(1) The term ‘eligible individual’ means an in20 dividual described in subsection (b).

21 ‘‘(2) The term ‘eligible school’ means a school

22 or program specified in subsection (a).

23 ‘‘(f) FUNDING.—

24 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—

25 For the purpose of carrying out this section, there
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1 are authorized to be appropriated $25,000,000 for

2 fiscal year 1998, $38,000,000 for fiscal year 1999,

3 and $48,000,000 for fiscal year 2000. Such author4 ization is in addition to the authorization of appro5 priations established in section 740(f)(2)(B).

6 ‘‘(2) ALLOCATIONS BY SECRETARY.—

7 ‘‘(A) Of the amounts appropriated under

8 paragraph (1) for a fiscal year and of the

9 amounts available under section 740(f)(2)(B)

10 for the year, the Secretary shall obligate

11 amounts in accordance with the following:

12 ‘‘(i) 19 percent shall be obligated for

13 scholarships under subsection (a) for at14 tendance at schools of dentistry.

15 ‘‘(ii) 16 percent shall be obligated for

16 scholarships under such subsection for at17 tendance at schools of nursing.

18 ‘‘(iii) 10 percent shall be obligated for

19 scholarships under such subsection for at20 tendance at graduate programs in mental

21 health practice.

22 ‘‘(B) The requirements of subparagraph

23 (A) apply only to the extent that a sufficient

24 number of eligible individuals seeks the scholar25 ships involved.’’.
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1 (b) CERTAIN PROGRAMS OF OBLIGATED SERVICE.—

2 (1) REPEAL.—Section 795 of the Public Health

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

4 (2) RULE OF CONSTRUCTION.—Paragraph (1)

5 does not terminate agreements that, on the day be6 fore the effective date under section 901, are in ef7 fect pursuant to section 795 of the Public Health

8 Service Act. Such agreements continue in effect in

9 accordance with the terms of the agreements. With

10 respect to compliance with such agreements, any pe11 riod of practice as a provider of primary health serv12 ices (whether provided pursuant to other agreements

13 with the Federal Government or whether provided

14 otherwise) counts toward satisfaction of the require15 ment of practice pursuant to such section 795.

16 SEC. 202. SCHOLARSHIPS GENERALLY; CERTAIN OTHER

17 PURPOSES.

18 Section 737 of the Public Health Service Act (42

19 U.S.C. 293a) is amended to read as follows:

20 ‘‘SEC. 737. THURGOOD MARSHALL PROGRAM FOR HEALTH

21 SERVICES SCHOLARSHIPS.

22 ‘‘(a) IN GENERAL.—The Secretary may in accord23 ance with this section award scholarships to individuals

24 described in subsection (b) for the purpose of assisting the
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1 individuals with the costs of attending the health profes2 sions schools described in subsection (c).

3 ‘‘(b) ELIGIBLE INDIVIDUALS.—An individual re4 ferred to in subsection (a) is any individual meeting the

5 following conditions:

6 ‘‘(1) The individual is from a disadvantaged

7 background.

8 ‘‘(2) The individual has a financial need for a

9 scholarship under such subsection.

10 ‘‘(3) The individual is enrolled (or accepted for

11 enrollment) at an eligible school as a full-time stu12 dent in a program leading to a degree in a health

13 profession.

14 ‘‘(4) The individual enters into the contract re15 quired pursuant to subsection (e) as a condition of

16 receiving the scholarship (relating to an agreement

17 to provide primary health services in a health profes18 sional shortage area designated under section 332).

19 ‘‘(c) ELIGIBLE SCHOOLS.—A health professions

20 school referred to in subsection (a) is a health professions

21 school meeting the following conditions:

22 ‘‘(1) The school is a school of veterinary medi23 cine, optometry, pharmacy, podiatric medicine, or

24 public health, or a designated school of allied health

25 (as defined in subsection (f)).
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1 ‘‘(2) The school is carrying out a program for

2 recruiting and retaining students from disadvan3 taged backgrounds, including students who are

4 members of racial and ethnic minority groups.

5 ‘‘(d) PREFERENCES REGARDING AWARDS.—

6 ‘‘(1) IN GENERAL.—In awarding scholarships

7 under subsection (a), the Secretary shall give pref8 erence to eligible individuals for whom the costs of

9 attending the school involved would constitute a se10 vere financial hardship.

11 ‘‘(2) ADDITIONAL PREFERENCES.—Of the eligi12 ble individuals receiving preference for purposes of

13 paragraph (1), the Secretary shall give additional

14 preference to individuals meeting any of the follow15 ing conditions:

16 ‘‘(A) The individuals received scholarships

17 pursuant to this section for fiscal year 1997.

18 ‘‘(B) The individuals are seeking scholar19 ships for attendance at eligible schools that re20 ceived a grant under this section for such fiscal

21 year.

22 ‘‘(C) The individuals are bilingual.

23 ‘‘(D) The individuals participate in a pro24 gram or activity carried out under section 739

25 by a grantee under such section.
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1 ‘‘(e) APPLICABILITY OF CERTAIN PROVISIONS.—

2 ‘‘(1) IN GENERAL.—Except as provided in para3 graph (2), and except as otherwise inconsistent with

4 this section, the provisions of subpart III of part D

5 of title III apply to an award of a scholarship under

6 subsection (a) to the same extent and in the same

7 manner as such provisions apply to an award of a

8 scholarship under section 338A.

9 ‘‘(2) CERTAIN INDIVIDUALS.—

10 ‘‘(A) In the case of an individual who re11 ceives a scholarship under subsection (a) for at12 tendance at a school of veterinary medicine, the

13 contract made pursuant to paragraph (1) shall

14 provide that the individual agrees that, after

15 completing training in such medicine, the indi16 vidual will, in accordance with requirements es17 tablished under subparagraph (B)—

18 ‘‘(i) serve in a position in which the

19 individual conducts or assists in the con20 duct of research regarding human health

21 or safety; or

22 ‘‘(ii) serve in a position with a public

23 health agency of a State or a political sub24 division of a State.
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1 ‘‘(B) The Secretary shall establish require2 ments regarding contracts under subparagraph

3 (A).

4 ‘‘(f) DEFINITIONS.—For purposes of this section:

5 ‘‘(1) The term ‘designated school of allied

6 health’ means a school of allied health providing

7 training in occupational therapy, physical therapy,

8 dental hygiene, medical technology, or radiologic

9 technology.

10 ‘‘(2) The term ‘eligible individual’ means an in11 dividual described in subsection (b).

12 ‘‘(3) The term ‘eligible school’ means a school

13 described in subsection (c).

14 ‘‘(g) FUNDING.—

15 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—

16 For the purpose of carrying out this section, there

17 are authorized to be appropriated $5,000,000 for

18 fiscal year 1998, $8,000,000 for fiscal year 1999,

19 and $10,000,000 for fiscal year 2000.

20 ‘‘(2) ALLOCATIONS BY SECRETARY.—With re21 spect to scholarships under subsection (a) for at22 tendance at designated schools of allied health, the

23 Secretary shall obligate for such scholarships 25 per24 cent of the amounts appropriated under paragraph

25 (1) for each of the fiscal years 1998 through 2000.
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1 The requirement of the preceding sentence applies

2 only to the extent that a sufficient number of eligible

3 individuals seeks such scholarships.’’.

4 SEC. 203. LOAN REPAYMENTS AND FELLOWSHIPS REGARD5 ING FACULTY POSITIONS.

6 (a) LOAN REPAYMENTS.—Section 738(a) of the Pub7 lic Health Service Act (42 U.S.C. 293b(a)) is amended—

8 (1) by striking paragraphs (4) and (6);

9 (2) by redesignating paragraphs (5) and (7) as

10 paragraphs (4) and (5), respectively; and

11 (3) in paragraph (4) (as so redesignated), by

12 amending subparagraph (B) to read as follows:

13 ‘‘(B) the contract referred to in subpara14 graph (A) provides that the school, in making

15 a determination of the amount of compensation

16 to be provided by the school to the individual

17 for serving as a member of the faculty, will

18 make the determination without regard to the

19 amount of payments made (or to be made) to

20 the individual by the Federal Government under

21 paragraph (1).’’.

22 (b) FELLOWSHIPS.—

23 (1) IN GENERAL.—Section 738(b) of the Public

24 Health Service Act (42 U.S.C. 293b(b)) is amend25 ed—
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1 (A) in paragraph (2)(B), by striking

2 ‘‘$30,000’’ and inserting ‘‘$50,000’’; and

3 (B) in paragraph (3)—

4 (i) in subparagraph (B), by inserting

5 ‘‘and’’ after the semicolon at the end;

6 (ii) in subparagraph (C), by striking

7 ‘‘; and’’ and inserting a period; and

8 (iii) by striking subparagraph (D).

9 (2) DEFINITION.—Section 738(b) of the Public

10 Health Service Act (42 U.S.C. 293b(b)) is amend11 ed—

12 (A) in paragraph (1), by striking ‘‘the

13 number’’ and all that follows and inserting the

14 following: ‘‘the number of underrepresented mi15 nority individuals who are members of the fac16 ulty of the schools.’’;

17 (B) in paragraph (3)(A), by striking ‘‘indi18 viduals from underrepresented minorities in the

19 health professions’’ and inserting ‘‘underrep20 resented minority individuals’’; and

21 (C) in paragraph (5), by striking ‘‘the

22 term’’ and all that follows and inserting the fol23 lowing: ‘‘the term ‘underrepresented minority

24 individuals’ means individuals who are members
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1 of racial or ethnic minority groups that are

2 underrepresented in the health professions.’’.

3 (c) AUTHORIZATION OF APPROPRIATIONS.—Section

4 738(c) of the Public Health Service Act (42 U.S.C.

5 293b(c)) is amended by striking ‘‘there is’’ and all that

6 follows and inserting the following: ‘‘there is authorized

7 to be appropriated $1,100,000 for each of the fiscal years

8 1998 through 2000.’’.

9 SEC. 204. CENTERS OF EXCELLENCE.

10 (a) REFERENCES TO SCHOOLS.—Section 739 of the

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

12 (1) by striking ‘‘health professions schools’’

13 each place such term appears and inserting ‘‘des14 ignated health professions schools’’; and

15 (2) by striking ‘‘health professions school’’ each

16 place such term appears and inserting ‘‘designated

17 health professions school’’.

18 (b) REQUIRED USES OF FUNDS.—Section 739(b) of

19 the Public Health Service Act (42 U.S.C. 293c(b)), as

20 amended by subsection (a), is amended—

21 (1) by striking paragraph (2);

22 (2) by redesignating paragraph (1) as para23 graph (2);

24 (3) by inserting before paragraph (2) (as so re25 designated) the following paragraph:
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•HR 487 IH

1 ‘‘(1) to collaborate with public and nonprofit

2 private entities to carry out community-based pro3 grams to interest students of secondary schools and

4 institutions of higher education in pursuing careers

5 in the health professions, and to prepare interested

6 students academically for such careers;’’;

7 (4) in paragraph (5)—

8 (A) by striking ‘‘faculty and student re9 search’’ and inserting ‘‘student research’’; and

10 (B) by inserting before the period the fol11 lowing: ‘‘, including research on issues relating

12 to the delivery of health care’’; and

13 (5)(A) in paragraph (4), by striking ‘‘and’’

14 after the semicolon at the end;

15 (B) in paragraph (5), by striking the period at

16 the end and inserting ‘‘; and’’; and

17 (C) by adding at the end the following para18 graph:

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

20 of the school in providing health services through

21 training provided at community-based health facili22 ties that provide such services to a significant num23 ber of disadvantaged individuals and that are located

24 at a site remote from the main site of the teaching

25 facilities of the school.’’.
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1 (c) REQUIREMENTS REGARDING CONSORTIA.—

2 (1) IN GENERAL.—Section 739(c)(1) of the

3 Public Health Service Act (42 U.S.C. 293c(c)(1)), as

4 amended by subsection (a), is amended—

5 (A) in subparagraph (A), in the matter

6 preceding clause (i), by striking ‘‘specified in

7 subparagraph (B)’’ and inserting ‘‘specified in

8 subparagraphs (B) and (C)’’;

9 (B) by redesignating subparagraph (C) as

10 subparagraph (D); and

11 (C) by inserting after subparagraph (B)

12 the following subparagraph:

13 ‘‘(C) The condition specified in this sub14 paragraph is that, in accordance with sub15 section (e)(1), the designated health professions

16 school involved has with other health profession

17 schools (designated or otherwise) formed a con18 sortium to carry out the purposes described in

19 subsection (b) at the schools of the consortium.

20 The grant involved may be expended with re21 spect to the other schools without regard to

22 whether such schools meet the conditions speci23 fied in subparagraph (B).’’.

24 (2) CERTAIN REQUIREMENTS.—Section 739(e)

25 of the Public Health Service Act (42 U.S.C.
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•HR 487 IH

1 293c(e)), as amended by subsection (a), is amended

2 to read as follows:

3 ‘‘(e) PROVISIONS REGARDING CONSORTIA.—

4 ‘‘(1) REQUIREMENTS.—For purposes of sub5 section (c)(1)(C), a consortium of schools has been

6 formed in accordance with this subsection if—

7 ‘‘(A) the consortium consists of—

8 ‘‘(i) the designated health professions

9 school seeking the grant under subsection

10 (a); and

11 ‘‘(ii) 1 or more schools of medicine,

12 osteopathic medicine, dentistry, pharmacy,

13 nursing, allied health, or public health, or

14 graduate programs in mental health prac15 tice;

16 ‘‘(B) the schools of the consortium have

17 entered into an agreement for the allocation of

18 such grant among the schools; and

19 ‘‘(C) each of the schools agrees to expend

20 the grant in accordance with this section.

21 ‘‘(2) AUTHORITY REGARDING NATIVE AMERI22 CANS CENTERS OF EXCELLENCE.—With respect to

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

24 the Secretary may make a grant under subsection
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•HR 487 IH

1 (a) to a designated health professions school that

2 does not meet such conditions if—

3 ‘‘(A) the school has formed a consortium

4 in accordance with paragraph (1); and

5 ‘‘(B) the schools of the consortium collec6 tively meet such conditions, without regard to

7 whether the schools individually meet such con8 ditions.’’.

9 (3) CONFORMING AMENDMENTS.—Section 739

10 of the Public Health Service Act (42 U.S.C. 293c),

11 as amended by subsection (a), is amended—

12 (A) in subsection (b), in the matter preced13 ing paragraph (1), by inserting ‘‘, subject to

14 subsection (c)(1)(C),’’ after ‘‘agrees’’; and

15 (B) in subsection (d)—

16 (i) in paragraph (3), by striking ‘‘(e)’’

17 and inserting ‘‘(e)(2)’’; and

18 (ii) by adding at the end the following

19 paragraph:

20 ‘‘(4) RULE OF CONSTRUCTION.—Except as pro21 vided in paragraph (3) regarding a consortium

22 under subsection (e)(2), a health professions school

23 that does not meet the conditions specified in sub24 section (c)(1)(B) may not be designated as a center

25 of excellence for purposes of this section. The pre-
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•HR 487 IH

1 ceding sentence applies without regard to whether a

2 grant under subsection (a) is, pursuant to subsection

3 (c)(1)(C), being expended with respect to the

4 school.’’.

5 (d) DEFINITION OF HEALTH PROFESSIONS

6 SCHOOL.—

7 (1) GRADUATE PROGRAMS IN MENTAL HEALTH

8 PRACTICE.—Section 739(h)(1)(A) of the Public

9 Health Service Act (42 U.S.C. 293c(h)(1)(A)), as

10 amended by subsection (a), is amended by—

11 (A) by striking ‘‘or’’ after ‘‘dentistry’’; and

12 (B) by inserting before the period the fol13 lowing: ‘‘, or a graduate program in mental

14 health practice’’.

15 (2) LIMITATION.—During the fiscal years 1998

16 through 2000, the Secretary of Health and Human

17 Services may not make more than one grant under

18 section 739 of the Public Health Service Act directly

19 to a graduate program in mental health practice (as

20 defined in section 799 of such Act).

21 (e) FUNDING.—Section 739(i) of the Public Health

22 Service Act (42 U.S.C. 293c(i)), as amended by subsection

23 (a), is amended to read as follows:

24 ‘‘(i) FUNDING.—
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1 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—

2 For the purpose of making grants under subsection

3 (a), there are authorized to be appropriated

4 $24,000,000 for fiscal year 1998, $28,000,000 for

5 fiscal year 1999, and $33,000,000 for fiscal year

6 2000.

7 ‘‘(2) ALLOCATIONS BY SECRETARY.—

8 ‘‘(A) Of the amounts appropriated under

9 paragraph (1) for a fiscal year, the Secretary

10 shall make available $12,000,000 for grants

11 under subsection (a) to health professions

12 schools that are eligible for such grants pursu13 ant to meeting the conditions described in para14 graph (2)(A) of subsection (c).

15 ‘‘(B) Of the amounts appropriated under

16 paragraph (1) for a fiscal year and available

17 after compliance with subparagraph (A), the

18 Secretary shall make available 65 percent for

19 grants under subsection (a) to health profes20 sions schools that are eligible for such grants

21 pursuant to meeting the conditions described in

22 paragraph (3) or (4) of subsection (c) (includ23 ing meeting conditions pursuant to subsection

24 (e)(2)).
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1 ‘‘(C)(i) Of the amounts appropriated under

2 paragraph (1) for a fiscal year and available

3 after compliance with subparagraph (A), the

4 Secretary shall make available 35 percent for

5 grants under subsection (a) to health profes6 sions schools that are eligible for such grants

7 pursuant to meeting the conditions described in

8 paragraph (5) of subsection (c).

9 ‘‘(ii) With respect to a fiscal year, a grant

10 under subsection (a) that includes amounts

11 available under subparagraph (A) may not in12 clude amounts available under clause (i) unless

13 each of the following conditions is met:

14 ‘‘(I) In the case of amounts available

15 under subparagraph (B) or clause (i) and

16 included in grants made pursuant to sub17 section (c)(3), the aggregate number of

18 such grants is not less than such aggregate

19 number for the preceding fiscal year, and

20 one or more of such grants is made in an

21 amount that is not less than the lowest

22 amount among grants made from amounts

23 available under subparagraph (A).

24 ‘‘(II) In the case of amounts available

25 under subparagraph (B) or clause (i) and
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•HR 487 IH

1 included in grants made pursuant to sub2 section (c)(4), the aggregate number of

3 such grants is not less than such aggregate

4 number for the preceding fiscal year, and

5 one or more of such grants is made in an

6 amount that is not less than the lowest

7 amount among grants made from amounts

8 available under subparagraph (A).

9 ‘‘(III) In the case of amounts avail10 able under clause (i) and included in

11 grants made pursuant to subsection (c)(5)

12 (exclusive of grants that include amounts

13 available under subparagraph (A) or (B)),

14 the aggregate number of such grants is not

15 less than such aggregate number for the

16 preceding fiscal year, and one or more of

17 such grants is made in an amount that is

18 not less than the lowest amount among

19 grants made from amounts available under

20 subparagraph (A).

21 ‘‘(IV) The aggregate amount of

22 grants under subsection (a) made from

23 amounts available under subparagraph (B)

24 and clause (i) (other than grants that in25 clude amounts available under subpara-
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•HR 487 IH

1 graph (A)) is, in the case of fiscal year

2 1998, not less than the sum of such aggre3 gate amount for fiscal year 1997 and the

4 total amount by which grants are required

5 under subclauses (I) through (III) to be in6 creased; and is, in the case of fiscal year

7 1999 and each subsequent fiscal year, not

8 less than such aggregate amount for the

9 preceding fiscal year.’’.

10 (f) CONFORMING AMENDMENTS.—Section 739(c) of

11 the Public Health Service Act (42 U.S.C. 293c(c)), as

12 amended by subsection (a), is amended—

13 (1) in paragraph (3)(B), by striking ‘‘the des14 ignated health professions school’’ and inserting

15 ‘‘the school’’; and

16 (2) in paragraph (4), in each of subparagraphs

17 (B) and (C), by striking ‘‘the designated health pro18 fessions school’’ and inserting ‘‘the school’’.

19 (g) TRANSITIONAL AND SAVINGS PROVISIONS.—

20 (1) IN GENERAL.—During the period specified

21 in paragraph (2)—

22 (A) the amendments made by subsections

23 (a) through (f) do not apply to any entity that

24 received a grant for fiscal year 1997 under sec25 tion 739 of the Public Health Service Act; and
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•HR 487 IH

1 (B) such a grant to the entity for fiscal

2 year 1997 or subsequent fiscal years shall be

3 made and expended in accordance with the pro4 visions of such section as in effect on the day

5 before the date of the enactment of this Act.

6 (2) RELEVANT PERIOD.—In the case of an en7 tity that received a grant for fiscal year 1997 under

8 section 739 of the Public Health Service Act, the pe9 riod referred to in paragraph (1) is the period that,

10 in first approving the grant, the Secretary specified

11 as the duration of the grant.

12 SEC. 205. EDUCATIONAL ASSISTANCE REGARDING UNDER13 GRADUATES.

14 (a) IN GENERAL.—Section 740 of the Public Health

15 Service Act (42 U.S.C. 293d) is amended to read as fol16 lows:

17 ‘‘SEC. 740. HEALTH CAREERS OPPORTUNITY PROGRAM.

18 ‘‘(a) IN GENERAL.—Subject to the provisions of this

19 section, the Secretary may make grants and enter into co20 operative agreements and contracts for any of the follow21 ing purposes:

22 ‘‘(1) Identifying and recruiting individuals

23 who—
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•HR 487 IH

1 ‘‘(A) are students of elementary schools, or

2 students or graduates of secondary schools or of

3 institutions of higher education;

4 ‘‘(B) are from disadvantaged backgrounds;

5 and

6 ‘‘(C) are interested in a career in the

7 health professions.

8 ‘‘(2) Facilitating the entry of such individuals

9 into a health professions school.

10 ‘‘(3) Providing counseling or other services de11 signed to assist such individuals in successfully com12 pleting their education at such a school.

13 ‘‘(4) Providing, for a period prior to the entry

14 of such individuals into the regular course of edu15 cation of such a school, preliminary education de16 signed to assist the individuals in successfully com17 pleting such regular course of education at such a

18 school, or referring such individuals to institutions

19 providing such preliminary education.

20 ‘‘(5) Paying such stipends as the Secretary may

21 approve for such individuals for any period of edu22 cation in student-enhancement programs (other than

23 regular courses) at a health professions schools, ex24 cept that such a stipend may not be provided to an

25 individual for more than 12 months, and such a sti-
41

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1 pend may not exceed $25 per day (notwithstanding

2 any other provision of law regarding the amount of

3 stipends).

4 ‘‘(6) Carrying out programs under which such

5 individuals both—

6 ‘‘(A) gain experience regarding a career in

7 a field of primary health care through working

8 at facilities of nonprofit private community9 based providers of primary health services; and

10 ‘‘(B) receive academic instruction to assist

11 in preparing the individuals to enter health pro12 fessions schools in such fields.

13 ‘‘(b) RECEIPT OF AWARD.—

14 ‘‘(1) ELIGIBLE ENTITIES; REQUIREMENT OF

15 CONSORTIUM.—The Secretary may make an award

16 under subsection (a) only if the following conditions

17 are met:

18 ‘‘(A) The applicant for the award is a pub19 lic or nonprofit private entity, and the applicant

20 has established a consortium consisting of non21 profit private community-based organizations

22 and health professions schools.

23 ‘‘(B) The health professions schools of the

24 consortium are schools of medicine or osteo25 pathic medicine, public health, dentistry, veteri-
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1 nary medicine, optometry, pharmacy, allied

2 health, chiropractic, or podiatric medicine, or

3 graduate programs in mental health practice

4 (including such programs in clinical psychol5 ogy).

6 ‘‘(C) Except as provided in subparagraph

7 (D), the membership of the consortium includes

8 not less than one nonprofit private community9 based organization and not less than three

10 health professions schools.

11 ‘‘(D) In the case of an applicant whose ex12 clusive activity under the award will be carrying

13 out one or more programs described in sub14 section (a)(6), the membership of the consor15 tium includes not less than one nonprofit pri16 vate community-based organization and not less

17 than one health professions schools.

18 ‘‘(E) The members of the consortium have

19 entered into an agreement specifying—

20 ‘‘(i) that each of the members will

21 comply with the conditions upon which the

22 award is made; and

23 ‘‘(ii) whether and to what extent the

24 award will be allocated among the mem25 bers.
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1 ‘‘(2) REQUIREMENT OF COMPETITIVE

2 AWARDS.—Awards under subsection (a) shall be

3 made only on a competitive basis.

4 ‘‘(c) FINANCIAL REQUIREMENTS.—

5 ‘‘(1) ASSURANCES REGARDING CAPACITY.—The

6 Secretary may make an award under subsection (a)

7 only if the Secretary determines that, in the case of

8 activities carried out under the award that prove to

9 be effective toward achieving the purposes of the ac10 tivities—

11 ‘‘(A) the members of the consortium in12 volved have or will have the financial capacity

13 to continue the activities, regardless of whether

14 financial assistance under subsection (a) contin15 ues to be available; and

16 ‘‘(B) the members of the consortium dem17 onstrate to the satisfaction of the Secretary a

18 commitment to continue such activities, regard19 less of whether such assistance continues to be

20 available.

21 ‘‘(2) MATCHING FUNDS.—

22 ‘‘(A) With respect to the costs of the ac23 tivities to be carried out under subsection (a)

24 by an applicant, the Secretary may make an

25 award under such subsection only if the appli-
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1 cant agrees to make available in cash (directly

2 or through donations from public or private en3 tities) non-Federal contributions toward such

4 costs in an amount that, for any fourth or sub5 sequent fiscal year for which the applicant re6 ceives such an award, is not less than 50 per7 cent of such costs.

8 ‘‘(B) Amounts provided by the Federal

9 Government may not be included in determin10 ing the amount of non-Federal contributions re11 quired in subparagraph (A).

12 ‘‘(C) The Secretary may not require non13 Federal contributions for the first three fiscal

14 years for which an applicant receives a grant

15 under subsection (a).

16 ‘‘(d) PREFERENCE IN MAKING AWARDS.—

17 ‘‘(1) IN GENERAL.—

18 ‘‘(A) In making awards under subsection

19 (a), the Secretary shall, subject to paragraph

20 (3), give preference to any applicant that, for

21 the purpose described in subparagraph (B), has

22 made an arrangement with not less than one

23 entity from each of the following categories of

24 entities: Community-based organizations, ele25 mentary schools, secondary schools, institutions
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1 of higher education, and health professions

2 schools.

3 ‘‘(B) The purpose of arrangements under

4 subparagraph (A) is to establish a program for

5 individuals identified under subsection (a)

6 under which—

7 ‘‘(i) the activities described in such

8 subsection are carried out on behalf of the

9 individuals; and

10 ‘‘(ii) health professions schools make

11 a commitment to admit as students of the

12 schools such individuals who participate in

13 the program, subject to the individuals

14 meeting reasonable academic standards for

15 admission to the schools.

16 ‘‘(2) ADDITIONAL PREFERENCES.—Of the ap17 plicants under subsection (a) that are receiving pref18 erence for purposes of paragraph (1), the Secretary

19 shall, subject to paragraph (3), give additional pref20 erence to applicants whose consortium under sub21 section (b) includes as members one or more health

22 professions schools that have not previously received

23 any award under this section (including this section

24 as in effect prior to fiscal year 1997).
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1 ‘‘(3) LIMITATION.—An applicant may not re2 ceive preference for purposes of paragraph (1) or (2)

3 unless the consortium under subsection (b) includes

4 not less than one health professions school that has

5 demonstrated success in enrolling students from dis6 advantaged backgrounds.

7 ‘‘(e) OBJECTIVES UNDER AWARDS.—

8 ‘‘(1) ESTABLISHMENT OF OBJECTIVES.—Before

9 making a first award to an applicant under sub10 section (a), the Secretary shall establish objectives

11 regarding the activities to be carried out under the

12 award, which objectives are applicable until the next

13 fiscal year for which such award is made after a

14 competitive process of review. In making an award

15 after such a review, the Secretary shall establish ad16 ditional objectives for the applicant.

17 ‘‘(2) PRECONDITION FOR SUBSEQUENT

18 AWARDS.—In the case of an applicant seeking an

19 award under subsection (a) pursuant to a competi20 tive process of review, the Secretary may make the

21 award only if the applicant demonstrates to the sat22 isfaction of the Secretary that the applicant has met

23 the objectives that were applicable under paragraph

24 (1) to the preceding awards under such subsection.

25 ‘‘(f) FUNDING.—
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1 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—

2 For the purpose of carrying out this section and sec3 tion 736, there are authorized to be appropriated

4 $33,000,000 for fiscal year 1998, $37,000,000 for

5 fiscal year 1999, and $40,000,000 for fiscal year

6 2000.

7 ‘‘(2) ALLOCATIONS.—Of the amounts appro8 priated under paragraph (1) for a fiscal year, the

9 Secretary shall obligate amounts as follows:

10 ‘‘(A) For carrying out subsection (a)(6),

11 not less than 20 percent.

12 ‘‘(B) For providing scholarships under sec13 tion 736, an amount equal to the amount pro14 vided for such purpose under this section for

15 fiscal year 1997, plus an amount for offsetting

16 the effects of inflation occurring after October

17 1, 1997.’’.

18 (b) TRANSITIONAL AND SAVINGS PROVISIONS.—

19 (1) IN GENERAL.—During the period specified

20 in paragraph (2)—

21 (A) the amendment made by subsection (a)

22 does not apply to any entity that received a

23 grant for fiscal year 1997 under section 740 of

24 the Public Health Service Act; and
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•HR 487 IH

1 (B) such a grant to the entity for fiscal

2 year 1998 or subsequent fiscal years shall be

3 made and expended in accordance with the pro4 visions of such section as in effect on the day

5 before the date of the enactment of this Act.

6 (2) RELEVANT PERIOD.—In the case of an en7 tity that received a grant for fiscal year 1997 under

8 section 740 of the Public Health Service Act, the pe9 riod referred to in paragraph (1) is the period that,

10 in first approving the grant, the Secretary specified

11 as the duration of the grant.

12 SEC. 206. STUDENT LOANS REGARDING SCHOOLS OF NURS13 ING.

14 Section 836(b) of the Public Health Service Act (42

15 U.S.C. 297b(b)) is amended—

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

17 the end and inserting a semicolon;

18 (2) in paragraph (2)—

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

20 ‘‘and’’ at the end; and

21 (B) by inserting before the semicolon at

22 the end the following: ‘‘, and (C) such addi23 tional periods under the terms of paragraph (8)

24 of this subsection’’;
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1 (3) in paragraph (7), by striking the period at

2 the end and inserting ‘‘; and’’; and

3 (4) by adding at the end the following para4 graph:

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

6 the Secretary, the repayment period established

7 under paragraph (2) for any student borrower who

8 during the repayment period failed to make consecu9 tive payments and who, during the last 12 months

10 of the repayment period, has made at least 12 con11 secutive payments may be extended for a period not

12 to exceed 10 years.’’.

13 SEC. 207. FEDERALLY-SUPPORTED STUDENT LOAN FUNDS.

14 (a) AUTHORIZATION OF APPROPRIATIONS REGARD15 ING CERTAIN MEDICAL SCHOOLS.—

16 (1) IN GENERAL.—Subpart II of part A of title

17 VII of the Public Health Service Act (42 U.S.C.

18 292q et seq.) is amended—

19 (A) by transferring subsection (f) of sec20 tion 735 from the current placement of the sub21 section;

22 (B) by adding the subsection at the end of

23 section 723;

24 (C) by redesignating the subsection as sub25 section (e); and
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1 (D) in subsection (e)(1) of section 723 (as

2 so redesignated), by striking ‘‘1996’’ and in3 serting ‘‘2000’’.

4 (2) CONFORMING AMENDMENTS.—Section 723

5 of the Public Health Service Act (42 U.S.C. 292s),

6 as amended by paragraph (1) of this subsection, is

7 amended in subsection (e)(2)(A)—

8 (A) by striking ‘‘section 723(b)(2)’’ and in9 serting ‘‘subsection (b)(2)’’; and

10 (B) by striking ‘‘such section’’ and insert11 ing ‘‘such subsection’’.

12 (b) AUTHORIZATION OF APPROPRIATIONS REGARD13 ING INDIVIDUALS FROM DISADVANTAGED BACK14 GROUNDS.—Section 724(f)(1) of the Public Health Serv15 ice Act (42 U.S.C. 292t(f)(1)) is amended to read as fol16 lows:

17 ‘‘(1) IN GENERAL.—With respect to making

18 Federal capital contributions to student loan funds

19 for purposes of subsection (a), other than the stu20 dent loan fund of any school of medicine or osteo21 pathic medicine, there is authorized to be appro22 priated $8,000,000 for each of the fiscal years 1998

23 through 2000.’’.
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1 SEC. 208. AREA HEALTH EDUCATION CENTERS.

2 (a) REQUIREMENTS FOR CENTERS.—Section

3 746(d)(2)(D) of the Public Health Service Act (42 U.S.C.

4 293j(d)(2)(D)) is amended by inserting ‘‘and minority

5 health’’ after ‘‘disease prevention’’.

6 (b) FUNDING.—Section 746(i)(2)(C) of the Public

7 Health Service Act (42 U.S.C. 293j(i)(2)(C)) is amended

8 in the second sentence by inserting before the period the

9 following: ‘‘(except that in the case of fiscal year 1998,

10 amounts appropriated in excess of the amount appro11 priated for fiscal year 1997 shall be obligated for carrying

12 out subsection (a)(1) in rural States without an area

13 health education center program)’’.

14 TITLE III—RESEARCH

15 SEC. 301. OFFICE OF RESEARCH ON MINORITY HEALTH.

16 Section 404 of the Public Health Service Act (42

17 U.S.C. 283(b)) is amended by adding at the end the fol18 lowing subsections:

19 ‘‘(c) PLAN.—The Director of the Office, in consulta20 tion with the advisory committee established under sub21 section (d), shall develop and implement a plan for carry22 ing out the duties established in subsection (b). The Direc23 tor shall review the plan not less than annually, and revise

24 the plan as appropriate.

25 ‘‘(d) EQUITY REGARDING VARIOUS GROUPS.—The

26 Director of the Office shall ensure that activities under
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1 subsection (b) equitably address all racial and ethnic mi2 nority groups.

3 ‘‘(e) ADVISORY COMMITTEE.—

4 ‘‘(1) ESTABLISHMENT.—In carrying out sub5 section (b), the Secretary shall establish an advisory

6 committee to be known as the Advisory Committee

7 on Research on Minority Health (in this subsection

8 referred to as the ‘Advisory Committee’).

9 ‘‘(2) COMPOSITION.—

10 ‘‘(A) VOTING AND NONVOTING MEM11 BERS.—The Advisory Committee shall be com12 posed of voting members appointed in accord13 ance with subparagraph (B) and the ex officio

14 nonvoting members described in subparagraph

15 (C).

16 ‘‘(B) VOTING MEMBERS.—The Advisory

17 Committee shall include 12 voting members

18 who are not officers or employees of the Fed19 eral Government. The Director of the Office

20 shall appoint such members to the Advisory

21 Committee from among physicians, practition22 ers, scientists, consumers and other health pro23 fessionals, whose clinical practices, research

24 specialization, or professional expertise includes

25 a significant focus on research on minority
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1 health or on the barriers that minorities must

2 overcome to participate in clinical trials. The

3 racial and ethnic minority groups shall be

4 equally represented among such members.

5 ‘‘(C) EX OFFICIO NONVOTING MEMBERS.—

6 The Deputy Assistant Secretary for Minority

7 Health and the Directors of each of the na8 tional research entities shall serve as ex officio

9 nonvoting members of the Advisory Committee

10 (except that any of such Directors may des11 ignate an official of the institute involved to

12 serve as such member of the Committee in lieu

13 of the Director).

14 ‘‘(3) CHAIR.—The Director of the Office shall

15 serve as the chair of the Advisory Committee.

16 ‘‘(4) DUTIES.—The Advisory Committee

17 shall—

18 ‘‘(A) advise the Director of the Office on

19 appropriate research activities to be undertaken

20 by the national research institutes with respect

21 to—

22 ‘‘(i) research on minority health;

23 ‘‘(ii) research on racial and ethnic dif24 ferences in clinical drug trials, including

25 responses to pharmacological drugs;
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1 ‘‘(iii) research on racial and ethnic

2 differences in disease etiology, course, and

3 treatment; and

4 ‘‘(iv) research on minority health con5 ditions which require a multidisciplinary

6 approach;

7 ‘‘(B) report to the Director of the Office

8 on such research;

9 ‘‘(C) provide recommendations to such Di10 rector regarding activities of the Office (includ11 ing recommendations on priorities in carrying

12 out research described in subparagraph (A));

13 and

14 ‘‘(D) assist in monitoring compliance with

15 section 492B regarding the inclusion of minori16 ties in clinical research.

17 ‘‘(5) BIENNIAL REPORT.—

18 ‘‘(A) PREPARATION.—The Advisory Com19 mittee shall prepare a biennial report describing

20 the activities of the Committee, including find21 ings made by the Committee regarding—

22 ‘‘(i) compliance with section 492B;

23 ‘‘(ii) the extent of expenditures made

24 for research on minority health by the
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1 agencies of the National Institutes of

2 Health; and

3 ‘‘(iii) the level of funding needed for

4 such research.

5 ‘‘(B) SUBMISSION.—The report required in

6 subparagraph (A) shall be submitted to the Di7 rector of the National Institutes of Health for

8 inclusion in the report required in section 403.

9 ‘‘(f) REPRESENTATIVES OF MINORITIES AMONG RE10 SEARCHERS.—The Secretary, acting through the Assist11 ant Secretary for Personnel Administration and in collabo12 ration with the Director of the Office, shall determine the

13 extent to which minorities are represented among senior

14 physicians and scientists of the national research insti15 tutes and among physicians and scientists conducting re16 search with funds provided by such institutes, and as ap17 propriate, carry out activities to increase the extent of

18 such representation.

19 ‘‘(g) REQUIREMENT REGARDING GRANTS AND CON20 TRACTS.—Any award of a grant, cooperative agreement,

21 or contract that the Director of the Office is authorized

22 to make shall be made only on a competitive basis.

23 ‘‘(h) DEFINITIONS.—For purposes of this part:

24 ‘‘(1) The term ‘minority health conditions’, with

25 respect to individuals who are members of minority
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1 groups, means all diseases, disorders, and conditions

2 (including with respect to mental health)—

3 ‘‘(A) unique to, more serious, or more

4 prevalent in such individuals;

5 ‘‘(B) for which the factors of medical risk

6 or types of medical intervention are different

7 for such individuals, or for which it is unknown

8 whether such factors or types are different for

9 such individuals; or

10 ‘‘(C) with respect to which there has been

11 insufficient research involving such individuals

12 as subjects or insufficient data on such individ13 uals.

14 ‘‘(2) The term ‘research on minority health’

15 means research on minority health conditions, in16 cluding research on preventing such conditions.

17 ‘‘(3) The term ‘racial and ethnic minority

18 group’ has the meaning given such term in section

19 1707(g).’’.

20 SEC. 302. ACTIVITIES OF AGENCY FOR HEALTH CARE POL21 ICY AND RESEARCH.

22 Title IX of the Public Health Service Act (42 U.S.C.

23 299 et seq.) is amended—

24 (1) in section 902, by amending subsection (b)

25 to read as follows:
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1 ‘‘(b) REQUIREMENTS WITH RESPECT TO CERTAIN

2 POPULATIONS.—In carrying out subsection (a), the Ad3 ministrator shall undertake and support research, dem4 onstration projects, and evaluations with respect to the

5 health status of, and the delivery of health care to—

6 ‘‘(1) the populations of medically underserved

7 urban or rural areas (including frontier areas); and

8 ‘‘(2) low-income groups, racial and ethnic mi9 nority groups, and the elderly.’’; and

10 (2) in section 926(a), by adding at the end the

11 following sentence: ‘‘Of the amounts appropriated

12 under the preceding sentence for a fiscal year, the

13 Administrator shall reserve not less than 8 percent

14 for carrying out section 902(b)(2).’’.

15 SEC. 303. DATA COLLECTION BY NATIONAL CENTER FOR

16 HEALTH STATISTICS.

17 Section 306(n) of the Public Health Service Act (42

18 U.S.C. 242k(n)), as redesignated by section 501(a)(5)(B)

19 of Public Law 103–183 (107 Stat. 2237), is amended to

20 read as follows:

21 ‘‘(n)(1) For health statistical and epidemiological ac22 tivities undertaken or supported under this section, there

23 are authorized to be appropriated such sums as may be

24 necessary for each of the fiscal years 1998 through 2001.
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1 ‘‘(2) Of the amounts appropriated under paragraph

2 (1) for a fiscal year, the Secretary shall obligate not less

3 than an aggregate $5,000,000 for carrying out subsections

4 (h), (l), and (m) with respect to particular racial and eth5 nic population groups.’’.

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