II 

109TH CONGRESS 

2D SESSION S. 4024 

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

of racial and ethnic minority and other health disparity populations. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 29, 2006 

Mr. FRIST (for himself, Mr. KENNEDY, Mr. OBAMA, and Mr. BINGAMAN) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to improve the 

health and healthcare of racial and ethnic minority and 

other health disparity populations. 

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

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

5 ‘‘Minority Health Improvement and Health Disparity 

6 Elimination Act’’. 

7 (b) TABLE OF CONTENTS.— 

Sec. 1. Short title; table of contents. 

Sec. 2. Definitions. 

TITLE I—EDUCATION AND TRAINING 


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Sec. 101. Cultural competency and communication for providers. 

Sec. 102. Healthcare workforce, education, and training. 

Sec. 103. Workforce training to achieve diversity. 

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

Sec. 105. Cultural competency training. 

Sec. 106. Authorization of appropriations; reauthorizations. 

TITLE II—CARE AND ACCESS 

Sec. 201. Care and access. 

Sec. 202. Authorization of appropriations. 

TITLE III—RESEARCH 

Sec. 301. Agency for healthcare research and quality. 

Sec. 302. Genetic variation and health. 

Sec. 303. Evaluations by the Institute of Medicine. 

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

Sec. 305. Authorization of appropriations. 

TITLE IV—DATA COLLECTION, ANALYSIS, AND QUALITY 

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

TITLE V—LEADERSHIP, COLLABORATION, AND NATIONAL 

ACTION PLAN 

Sec. 501. Office of Minority Health and Health Disparity Elimination. 

1 SEC. 2. DEFINITIONS. 

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

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

5 (A) when used to describe health-related 

6 services, means providing healthcare tailored to 

7 meet the social, cultural, and linguistic needs of 

8 patients from diverse backgrounds; and 

9 (B) when used to describe education or 

10 training, means education or training designed 

11 to prepare those receiving the education or 

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1 lored to meet the social, cultural, and linguistic 

2 needs of patients from diverse backgrounds. 

3 (2) HEALTH DISPARITY POPULATION.—The 

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

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

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

7 (3) HEALTH LITERACY.—The term ‘‘health lit8 eracy’’ means the degree to which an individual has 

9 the capacity to obtain, communicate, process, and 

10 understand health information (including the lan11 guage in which the information is provided) and 

12 services in order to make appropriate health deci13 sions. 

14 (4) MINORITY GROUP.—The term ‘‘minority 

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

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

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

18 by section 501). 

19 (5) PRACTICE-BASED RESEARCH NETWORKS.— 

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

21 a group of ambulatory practices devoted principally 

22 to the primary care of patients, and affiliated in 

23 their mission to investigate questions related to com24 munity-based practice and to improve the quality of 

25 primary care. 


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1 (6) SECRETARY.—The term ‘‘Secretary’’ means 

2 the Secretary of Health and Human Services. 

3 TITLE I—EDUCATION AND 

4 TRAINING 

5 SEC. 101. CULTURAL COMPETENCY AND COMMUNICATION 

6 FOR PROVIDERS. 

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

8 202 et seq.) is amended by adding at the end the fol9 lowing: 

10 ‘‘SEC. 270. INTERNET CLEARINGHOUSE TO IMPROVE CUL11 TURAL COMPETENCY AND COMMUNICATION 

12 BY HEALTHCARE PROVIDERS. 

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

14 the date of enactment of the Minority Health Improve15 ment and Health Disparity Elimination Act, the Sec16 retary, acting through the Deputy Assistant Secretary for 

17 Minority Health and Health Disparity Elimination, shall 

18 assist providers to improve the health and healthcare of 

19 racial and ethnic minority and other health disparity pop20 ulations by developing and maintaining an Internet Clear21 inghouse within the Office of Minority Health and Health 

22 Disparity Elimination that— 

23 ‘‘(1) increases cultural competency; 

24 ‘‘(2) improves communication between 

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1 cluding those patients with low functional health lit2 eracy; 

3 ‘‘(3) improves healthcare quality and patient 

4 satisfaction; 

5 ‘‘(4) reduces medical errors and healthcare 

6 costs; and 

7 ‘‘(5) reduces duplication of effort regarding 

8 translation of materials. 

9 ‘‘(b) INTERNET CLEARINGHOUSE.—Not later than 

10 12 months after the date of enactment of this section the 

11 Secretary, acting through the Deputy Assistant Secretary 

12 for Minority Health and Health Disparity Elimination, 

13 and in consultation with the Director of the Office for Civil 

14 Rights, shall carry out subsection (a) by— 

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

16 Office of Minority Health and Health Disparity 

17 Elimination, an accessible library and database on 

18 the Internet with easily searchable, clinically-relevant 

19 information regarding culturally competent 

20 healthcare for racial and ethnic minority and other 

21 health disparity populations, including Internet links 

22 to additional resources that fulfill the purpose of this 

23 section; 

24 ‘‘(2) developing and making templates for vis25 ual aids and standard documents with clear explaVerDate Aug 31 2005 04:23 Oct 05, 2006 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S4024.IS S4024

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1 nations that can help patients and consumers access 

2 and make informed decisions about healthcare, in3 cluding— 

4 ‘‘(A) administrative and legal documents, 

5 including informed consent and advanced direc6 tives; 

7 ‘‘(B) clinical information, including infor8 mation pertaining to treatment adherence, self9 management training for chronic conditions, 

10 preventing transmission of disease, and dis11 charge instructions; 

12 ‘‘(C) patient education and outreach mate13 rials, including immunization or screening no14 tices and health warnings; and 

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

16 ‘‘(3) ensuring that documents described in 

17 paragraph (2) are posted in English and non18 English languages and are culturally appropriate; 

19 ‘‘(4) encouraging healthcare providers to cus20 tomize such documents for their use; 

21 ‘‘(5) facilitating access to such documents, in22 cluding distribution in both paper and electronic for23 mats; 

24 ‘‘(6) providing technical assistance to healthcare 

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1 mation described in paragraph (1) including infor2 mation to help healthcare providers— 

3 ‘‘(A) understand the concept of cultural 

4 competence; 

5 ‘‘(B) implement culturally competent prac6 tices; 

7 ‘‘(C) care for patients with low functional 

8 health literacy, including helping such patients 

9 understand and participate in healthcare deci10 sions; 

11 ‘‘(D) understand and apply Federal guid12 ance and directives regarding healthcare for ra13 cial and ethnic minority and other health dis14 parity populations; 

15 ‘‘(E) obtain reimbursement for provision of 

16 culturally competent services; 

17 ‘‘(F) understand and implement 

18 bioinformatics and health information tech19 nology in order to improve healthcare for racial 

20 and ethnic minority and other health disparity 

21 populations; and 

22 ‘‘(G) conduct other activities determined 

23 appropriate by the Secretary; 

24 ‘‘(7) providing educational materials to pa25 tients, representatives of community-based organizaVerDate Aug 31 2005 04:23 Oct 05, 2006 Jkt 059200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S4024.IS S4024

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1 tions, and the public with respect to the access and 

2 use of information described in paragraph (1), in3 cluding— 

4 ‘‘(A) information to help such individ5 uals— 

6 ‘‘(i) understand the concept of cul7 tural competence, and the role of cultural 

8 competence in the delivery of healthcare; 

9 ‘‘(ii) work with healthcare providers to 

10 implement culturally competent practices; 

11 and 

12 ‘‘(iii) understand the concept of low 

13 functional health literacy, and the barriers 

14 it presents to care; and 

15 ‘‘(B) other material determined appro16 priate by the Secretary; and 

17 ‘‘(8) supporting initiatives that the Secretary 

18 determines to be useful to fulfill the purposes of the 

19 Internet Clearinghouse. 

20 ‘‘(c) DEFINITIONS.—The definitions contained in sec21 tion 2 of the Minority Health Improvement and Health 

22 Disparity Elimination Act shall apply for purposes of this 

23 section.’’. 


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1 SEC. 102. HEALTHCARE WORKFORCE, EDUCATION, AND 

2 TRAINING. 

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

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

5 by inserting after section 792 the following: 

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

7 TRAINING. 

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

9 the Administrator of the Health Resources and Services 

10 Administration and the Deputy Assistant Secretary for 

11 Minority Health and Health Disparity Elimination, shall 

12 establish an aggregated and disaggregated database on 

13 health professional students, including applicants, matric14 ulates, and graduates. 

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

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

17 school described in paragraph (2) that receives Fed18 eral funds, shall collect race and ethnicity data, pri19 mary language data, and other health disparity data, 

20 as feasible and pursuant to subsection (d), con21 cerning the students described in subsection (a), as 

22 well as intended geographical site of practice and in23 tended discipline of practice for graduates. In col24 lecting such data, a school shall— 

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

26 race and ethnicity established by the Director of 


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1 the Office of Management and Budget in effect 

2 on the date of enactment of the Minority 

3 Health Improvement and Health Disparity 

4 Elimination Act; and 

5 ‘‘(B) if practicable, collect data on addi6 tional population groups if such data can be ag7 gregated into the minimum race and ethnicity 

8 data categories. 

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

10 professions school described under this paragraph is 

11 a school of medicine or osteopathic medicine, public 

12 health, nursing, dentistry, optometry, pharmacy, al13 lied health, podiatric medicine, or veterinary medi14 cine, or a graduate program in mental health prac15 tice. 

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

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

18 the Secretary data on race and ethnicity and primary lan19 guage collected under this section for inclusion in the 

20 database established under subsection (a). The Secretary 

21 shall ensure that such disparity data is reported to Con22 gress and made available to the public. 

23 ‘‘(d) HEALTH DISPARITY MEASURES.—The Sec24 retary shall develop, report, and disseminate measures of 

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


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1 ensure uniform and consistent collection and reporting of 

2 these measures by health professions schools. In devel3 oping such measures, the Secretary shall take into consid4 eration health disparity indicators developed pursuant to 

5 section 2901(c). 

6 ‘‘(e) USE OF DATA.—Data reported pursuant to sub7 section (c) shall be used by the Secretary to conduct ongo8 ing short- and long-term analyses of diversity within 

9 health professions schools and the health professions. The 

10 Secretary shall ensure that such analyses are reported to 

11 Congress and made available to the public. 

12 ‘‘(f) CULTURAL COMPETENCY TRAINING.—The Sec13 retary shall collect and report data from health professions 

14 schools regarding the extent to which cultural competency 

15 training is provided to health professions students, and 

16 conduct periodic assessments regarding the preparedness 

17 of such students to care for patients from racial and ethnic 

18 minority and other health disparity populations. 

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

20 data collected under this section is protected from inap21 propriate internal and external use by any entity that col22 lects, stores, or receives the data and that such data is 

23 collected without personally identifiable information. 

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

25 with external entities to fulfill the requirements under this 


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1 section if such entities have demonstrated expertise and 

2 experience collecting, analyzing, and reporting data re3 quired under this section for health professional stu4 dents.’’. 

5 (b) NATIONAL HEALTH SERVICE CORPS PRO6 GRAM.— 

7 (1) ASSIGNMENT OF CORPS PERSONNEL.—Sec8 tion 333(a)(3) of the Public Health Service Corps 

9 (42 U.S.C. 254f(a)(3)) is amended to read as fol10 lows: 

11 ‘‘(3)(A) In approving applications for assign12 ment of members of the Corps the Secretary shall 

13 not discriminate against application from entities 

14 which are not receiving Federal financial assistance 

15 under this Act. 

16 ‘‘(B) In approving such applications, the Sec17 retary shall— 

18 ‘‘(i) give preference to applications in 

19 which a nonprofit entity or public entity shall 

20 provide a site to which Corps members may be 

21 assigned; and 

22 ‘‘(ii) give highest preference to applica23 tions— 

24 ‘‘(I) from entities described in clause 

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1 ters as defined in section 1905(l)(2)(B) of 

2 the Social Security Act; and 

3 ‘‘(II) from entities described in clause 

4 (i) that primarily serve racial and ethnic 

5 minority and other health disparity popu6 lations with annual incomes at or below 

7 twice those set forth in the most recent 

8 poverty guidelines issued by the Secretary 

9 pursuant to section 673(2) of the Commu10 nity Services Block Grant Act (42 U.S.C. 

11 9902(2)).’’. 

12 (2) PRIORITIES IN ASSIGNMENT OF CORPS PER13 SONNEL.—Section 333A of the Public Health Serv14 ice Act (42 U.S.C. 254f–1) is amended— 

15 (A) in subsection (a)— 

16 (i) by redesignating paragraphs (1), 

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

18 (4), respectively; and 

19 (ii) by striking ‘‘shall—’’ and insert20 ing ‘‘shall— 

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

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

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

24 place it appears and inserting ‘‘subsection 

25 (a)(2)’’. 


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1 (3) CONFORMING AMENDMENT.—Section 

2 338I(c)(3)(B)(ii) of the Public Health Service Act 

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

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

5 333A(a)(2)’’. 

6 SEC. 103. WORKFORCE TRAINING TO ACHIEVE DIVERSITY. 

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

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

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

10 following: 

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

12 to, and enter into contracts with, public and nonprofit pri13 vate health or educational entities, including designated 

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

15 the purpose of assisting the entities in supporting pro16 grams of excellence in health professions education for 

17 underrepresented minorities in health professions.’’; 

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

19 following: 

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

21 may not make a grant under subsection (a) unless the des22 ignated health professions school involved agrees, subject 

23 to subsection (c)(1)(C), to use the funds awarded under 

24 the grant to— 


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

2 through linkages with institutions of higher edu3 cation, local school districts, and other community4 based entities and establish an education pipeline for 

5 health professions careers; 

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

7 to enhance the academic performance of underrep8 resented minority in health professions students at9 tending the school; 

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

11 train, recruit, and retain underrepresented minority 

12 faculty members including the payment of such sti13 pends and fellowships as the Secretary may deter14 mine appropriate; 

15 ‘‘(4) carry out activities to improve the informa16 tion resources, clinical education, curricula, and cul17 tural and linguistic competence of the graduates of 

18 the school, as it relates to minority health and other 

19 health disparity issues; 

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

21 health issues particularly affecting racial and ethnic 

22 minority and other health disparity populations, in23 cluding research on issues relating to the delivery of 

24 culturally competent healthcare (as defined in sec25 tion 270); 


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1 ‘‘(6) carry out a program to train students of 

2 the school in providing health services to racial and 

3 ethnic minority and other health disparity popu4 lations (as defined in section 903(d)(1)) through 

5 training provided to such students at community6 based health facilities that— 

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

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

9 main site of the teaching facilities of the school; 

10 ‘‘(7) provide stipends as the Secretary deter11 mines appropriate, in amounts as the Secretary de12 termines appropriate; and 

13 ‘‘(8) conduct accountability and other reporting 

14 activities, as required by the Secretary in subsection 

15 (i).’’; 

16 (3) in subsection (c)— 

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

18 follows: 

19 ‘‘(1) DESIGNATED SCHOOLS.— 

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

21 professions schools referred to in subsection (a) 

22 are such schools that meet each of the condi23 tions specified in subparagraphs (B) and (C), 

24 and that— 


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1 ‘‘(i) meet each of the conditions speci2 fied in paragraph (2)(A); 

3 ‘‘(ii) meet each of the conditions spec4 ified in paragraph (3); 

5 ‘‘(iii) meet each of the conditions 

6 specified in paragraph (4); or 

7 ‘‘(iv) meet each of the conditions spec8 ified in paragraph (5). 

9 ‘‘(B) GENERAL CONDITIONS.—The condi10 tions specified in this subparagraph are that a 

11 designated health professions school— 

12 ‘‘(i) has a significant number of 

13 underrepresented minority in health pro14 fessions students enrolled in the school, in15 cluding individuals accepted for enrollment 

16 in the school; 

17 ‘‘(ii) has been effective in assisting 

18 such students of the school to complete the 

19 program of education and receive the de20 gree involved; 

21 ‘‘(iii) has been effective in recruiting 

22 such students to enroll in and graduate 

23 from the school, including providing schol24 arships and other financial assistance to 

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1 dents from all levels of the educational 

2 pipeline to pursue health professions ca3 reers; and 

4 ‘‘(iv) has made significant recruitment 

5 efforts to increase the number of underrep6 resented minority in health professions in7 dividuals serving in faculty or administra8 tive positions at the school. 

9 ‘‘(C) CONSORTIUM.—The condition speci10 fied in this subparagraph is that, in accordance 

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

12 profession school involved has with other health 

13 profession schools (designated or otherwise) 

14 formed a consortium to carry out the purposes 

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

16 consortium. 

17 ‘‘(D) APPLICATION OF CRITERIA TO

18 OTHER PROGRAMS.—In the case of any criteria 

19 established by the Secretary for purposes of de20 termining whether schools meet the conditions 

21 described in subparagraph (B), this section may 

22 not, with respect to racial and ethnic minorities, 

23 be construed to authorize, require, or prohibit 

24 the use of such criteria in any program other 

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


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

2 follows: 

3 ‘‘(2) CENTERS OF EXCELLENCE AT CERTAIN

4 HISTORICALLY BLACK COLLEGES AND UNIVER5 SITIES.— 

6 ‘‘(A) CONDITIONS.—The conditions speci7 fied in this subparagraph are that a designated 

8 health professions school is a school described 

9 in section 799B(1). 

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

11 purposes described in subsection (b), a grant 

12 under subsection (a) to a designated health pro13 fessions school meeting the conditions described 

14 in subparagraph (A) may be expended— 

15 ‘‘(i) to develop a plan to achieve insti16 tutional improvements, including financial 

17 independence, to enable the school to sup18 port programs of excellence in health pro19 fessions education for underrepresented 

20 minority individuals; and 

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

22 library and informational resources of the 

23 school. 

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

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1 cally black college or university that receives 

2 funding under this paragraph or paragraph 

3 (5).’’; and 

4 (C) by amending paragraphs (3) through 

5 (5) to read as follows: 

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

7 The conditions specified in this paragraph are 

8 that— 

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

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

11 (1)(B) applies to the designated health profes12 sions school involved; 

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

14 receiving a grant under subsection (a) of this 

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

16 duties described in subsection (b) of this sec17 tion, give priority to carrying out the duties 

18 with respect to Hispanic individuals; and 

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

20 receiving a grant under subsection (a) of this 

21 section, that— 

22 ‘‘(i) the school will establish an ar23 rangement with 1 or more public or non24 profit community-based Hispanic serving 

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1 vate institutions of higher education, in2 cluding schools of nursing, whose enroll3 ment of students has traditionally included 

4 a significant number of Hispanic individ5 uals, the purposes of which will be to cary 

6 out a program— 

7 ‘‘(I) to identify Hispanic students 

8 who are interested in a career in the 

9 health profession involved; and 

10 ‘‘(II) to facilitate the educational 

11 preparation of such students to enter 

12 the health professions school; and 

13 ‘‘(ii) the school will make efforts to 

14 recruit Hispanic students, including stu15 dents who have participated in the under16 graduate or other matriculation program 

17 carried out under arrangements established 

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

19 will assist Hispanic students regarding the 

20 completion of the educational requirements 

21 for a degree from the school. 

22 ‘‘(4) NATIVE AMERICAN CENTERS OF EXCEL23 LENCE.—Subject to subsection (e), the conditions 

24 specified in this paragraph are that— 


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

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

3 (1)(B) applies to the designated health profes4 sions school involved; 

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

6 receiving a grant under subsection (a) of this 

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

8 duties described in subsection (b) of this sec9 tion, give priority to carrying out the duties 

10 with respect to Native Americans; and 

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

12 receiving a grant under subsection (a) of this 

13 section, that— 

14 ‘‘(i) the school will establish an ar15 rangement with 1 or more public or non16 profit private institutions of higher edu17 cation, including schools of nursing, whose 

18 enrollment of students has traditionally in19 cluded a significant number of Native 

20 Americans, the purpose of which arrange21 ment will be to carry out a program— 

22 ‘‘(I) to identify Native American 

23 students, from the institutions of 

24 higher education referred to in clause 


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1 (i), who are interested in health pro2 fessions careers; and 

3 ‘‘(II) to facilitate the educational 

4 preparation of such students to enter 

5 the designated health professions 

6 school; and 

7 ‘‘(ii) the designated health professions 

8 school will make efforts to recruit Native 

9 American students, including students who 

10 have participated in the undergraduate 

11 program carried out under arrangements 

12 established by the school pursuant to 

13 clause (i) and will assist Native American 

14 students regarding the completion of the 

15 educational requirements for a degree from 

16 the designated health professions school. 

17 ‘‘(5) OTHER CENTERS OF EXCELLENCE.—The 

18 conditions specified in this paragraph are— 

19 ‘‘(A) with respect to other centers of excel20 lence, the conditions described in clauses (i) 

21 through (iv) of paragraph (1)(B); and 

22 ‘‘(B) that the health professions school in23 volved has an enrollment of underrepresented 

24 minorities in health professions significantly 


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1 above the national average for such enrollments 

2 of health professions schools.’’; and 

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

4 following: 

5 ‘‘(h) FORMULA FOR ALLOCATIONS.— 

6 ‘‘(1) ALLOCATIONS.—Based on the amount ap7 propriated under section 106(a) of the Minority 

8 Health Improvement and Health Disparity Elimi9 nation Act for a fiscal year, the following subpara10 graphs shall apply as appropriate: 

11 ‘‘(A) IN GENERAL.—If the amounts appro12 priated under section 106(a) of the Minority 

13 Health Improvement and Health Disparity 

14 Elimination Act for a fiscal year are 

15 $24,000,000 or less— 

16 ‘‘(i) the Secretary shall make available 

17 $12,000,000 for grants under subsection 

18 (a) to health professions schools that meet 

19 the conditions described in subsection 

20 (c)(2)(A); and 

21 ‘‘(ii) and available after grants are 

22 made with funds under clause (i), the Sec23 retary shall make available— 

24 ‘‘(I) 60 percent of such amount 

25 for grants under subsection (a) to 


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1 health professions schools that meet 

2 the conditions described in paragraph 

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

4 meeting the conditions under sub5 section (e)); and 

6 ‘‘(II) 40 percent of such amount 

7 for grants under subsection (a) to 

8 health professions schools that meet 

9 the conditions described in subsection 

10 (c)(5). 

11 ‘‘(B) FUNDING IN EXCESS OF

12 $24,000,000.—If amounts appropriated under 

13 section 106(a) of the Minority Health Improve14 ment and Health Disparity Elimination Act for 

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

16 than $30,000,000— 

17 ‘‘(i) 80 percent of such excess 

18 amounts shall be made available for grants 

19 under subsection (a) to health professions 

20 schools that meet the requirements de21 scribed in paragraph (3) or (4) of sub22 section (c) (including meeting conditions 

23 pursuant to subsection (e)); and 

24 ‘‘(ii) 20 percent of such excess 

25 amount shall be made available for grants 


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1 under subsection (a) to health professions 

2 schools that meet the conditions described 

3 in subsection (c)(5). 

4 ‘‘(C) FUNDING IN EXCESS OF

5 $30,000,000.—If amounts appropriated under 

6 section 106(a) of the Minority Health Improve7 ment and Health Disparity Elimination Act for 

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

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

10 available— 

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

12 grants under subsection (a) to health pro13 fessions schools that meet the conditions 

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

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

16 grants under subsection (a) to health pro17 fessions schools that meet the conditions 

18 described in paragraph (3) or (4) of sub19 section (c) (including meeting conditions 

20 pursuant to subsection (e)); 

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

22 grants under subsection (a) to health pro23 fessions schools that meet the conditions 

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


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1 ‘‘(iv) after grants are made with 

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

3 remaining excess amount for grants under 

4 subsection (a) to health professions schools 

5 that meet the conditions described in para6 graph (2)(A), (3), (4), or (5) of subsection 

7 (c). 

8 ‘‘(D) FUNDING IN EXCESS OF

9 $40,000,000.—If amounts appropriated under 

10 section 106(a) of the Minority Health Improve11 ment and Health Disparity Elimination Act for 

12 a fiscal year are $40,000,000 or more, the Sec13 retary shall make available— 

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

15 grants under subsection (a) to health pro16 fessions schools that meet the conditions 

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

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

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

21 described in paragraph (3) or (4) of sub22 section (c) (including meeting conditions 

23 pursuant to subsection (e)); 

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

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1 fessions schools that meet the conditions 

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

3 ‘‘(iv) after grants are made with 

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

5 remaining funds for grants under sub6 section (a) to health professions schools 

7 that meet the conditions described in para8 graph (2)(A), (3), (4), or (5) of subsection 

9 (c). 

10 ‘‘(2) NO LIMITATION.—Nothing in this sub11 section shall be construed as limiting the centers of 

12 excellence referred to in this section to the des13 ignated amount, or to preclude such entities from 

14 competing for grants under this section. 

15 ‘‘(3) MAINTENANCE OF EFFORT.— 

16 ‘‘(A) IN GENERAL.—With respect to activi17 ties for which a grant made under this part are 

18 authorized to be expended, the Secretary may 

19 not make such a grant to a center of excellence 

20 for any fiscal year unless the center agrees to 

21 maintain expenditures of non-Federal amounts 

22 for such activities at a level that is not less 

23 than the level of such expenditures maintained 

24 by the center for the fiscal year preceding the 


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1 fiscal year for which the school receives such a 

2 grant. 

3 ‘‘(B) USE OF FEDERAL FUNDS.—With re4 spect to any Federal amounts received by a cen5 ter of excellence and available for carrying out 

6 activities for which a grant under this part is 

7 authorized to be expended, the center shall, be8 fore expending the grant, expend the Federal 

9 amounts obtained from sources other than the 

10 grant, unless given prior approval from the Sec11 retary. 

12 ‘‘(i) EVALUATIONS.— 

13 ‘‘(1) ADVISORY COMMITTEE.— 

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

15 days after the date of enactment of the Minor16 ity Health Improvement and Health Disparity 

17 Elimination Act, the Secretary shall establish 

18 and appoint the members of an advisory com19 mittee composed of representatives of govern20 ment agencies, including the Health Resources 

21 and Services Administration, the Office of Mi22 nority Health and Health Disparity Elimi23 nation, and the Indian Health Service, commu24 nity stakeholders and experts in identifying and 

25 addressing the health concerns of racial and 


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1 ethnic minority and other health disparity pop2 ulations, and designees from health professions 

3 schools described in subsection (b). 

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

5 shall develop and recommend performance 

6 measures with which to assess, based on data to 

7 be compiled by recipients of grants or contracts 

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

9 739, the extent to which the program described 

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

11 739 has met the purpose of this part. The advi12 sory committee shall submit such recommenda13 tions to the Administrator of the Health Re14 sources and Services Administration not later 

15 than 6 months after the appointment of the ad16 visory committee. 

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

18 days after the submission of the recommenda19 tions, the Administrator of the Health Re20 sources and Services Administration shall re21 view the recommendations and establish per22 formance measures described in subparagraph 

23 (B), and the Administrator shall notify recipi24 ents of grants or contracts under this section or 

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1 formance measures and make requirements re2 lated to the performance measures publicly 

3 available both on the website of the Administra4 tion and as part of any notifications of awards 

5 released to entities receiving the grants or con6 tracts. 

7 ‘‘(2) DATA COLLECTION AND ANNUAL EVALUA8 TIONS.— 

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

10 the Health Resources and Services Administra11 tion shall collect annual data from recipients of 

12 grants or contracts under this section or section 

13 736, 737, 738, or 739 on the performance 

14 measures established under paragraph (1). 

15 ‘‘(B) BIANNUAL MEETING.—The Adminis16 trator of the Health Resources and Services Ad17 ministration shall convene a meeting of the ad18 visory committee established under paragraph 

19 (1) not less than twice per year. At the meet20 ing, the advisory committee shall recommend 

21 any necessary changes to such performance 

22 measures to improve data collection and short23 term evaluation with respect to the programs 

24 carried out under this section or section 736, 


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1 737, 738, or 739, and provide technical assist2 ance as necessary. 

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

4 Health Resources and Services Administration shall 

5 determine whether to incorporate the recommended 

6 changes as described in paragraph (2)(B) and pro7 vide technical assistance as necessary. The Adminis8 trator shall not penalize a current recipient of a 

9 grant or contract under this section or section 736, 

10 737, 738, or 739 for failing to comply with the re11 vised data collection or performance measure re12 quirements if the recipient demonstrates an inability 

13 to provide additional data mandated under the re14 quirements. 

15 ‘‘(4) ACCOUNTABILITY.—The Administrator 

16 shall review and take into consideration performance 

17 measurement data previously collected from recipi18 ents of grants or contracts under this section or sec19 tion 736, 737, 738, or 739 when deciding to renew 

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

21 (b) COOPERATIVE AGREEMENTS FOR ONLINE DE22 GREE PROGRAMS AT SCHOOLS OF PUBLIC HEALTH AND

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

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

25 amended by adding at the end the following: 


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1 ‘‘SEC. 742. COOPERATIVE AGREEMENTS FOR ONLINE DE2 GREE PROGRAMS. 

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

4 shall award cooperative agreements to accredited schools 

5 of public health, schools of allied health, and public health 

6 programs to design and implement a degree program over 

7 the Internet (referred to in this section as an ‘online de8 gree program’). 

9 ‘‘(b) APPLICATION.—To be eligible to receive a coop10 erative agreement under subsection (a), an accredited 

11 school of public health, school of allied health, or public 

12 health program shall submit an application at such time, 

13 in such manner, and containing such information as the 

14 Secretary may require. 

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

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

17 accredited school of public health, school of allied health, 

18 or public health program that serves a disproportionate 

19 number of individuals from racial and ethnic minority and 

20 other health disparity populations. 

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

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

23 degree program that meets the following conditions: 

24 ‘‘(1) Limiting enrollment to individuals who 

25 have obtained a secondary school diploma or a rec26 ognized equivalent. 


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1 ‘‘(2) Maintaining significant enrollment and 

2 graduation of underrepresented minorities in health 

3 professions.’’. 

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

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

6 by inserting after the part heading the following: 

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

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

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

10 shall also apply in the case of references to ‘underrep11 resented minority students’, ‘underrepresented minority 

12 faculty members’, ‘underrepresented minority faculty ad13 ministrators’, and ‘underrepresented minorities in health 

14 professions’.’’. 

15 SEC. 104. MID-CAREER HEALTH PROFESSIONS SCHOLAR16 SHIP PROGRAM. 

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

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

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

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

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

22 and 

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


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1 ‘‘SEC. 770. MID-CAREER HEALTH PROFESSIONS SCHOLAR2 SHIP PROGRAM. 

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

4 to eligible schools to award scholarships to eligible individ5 uals to attend the school involved, for the purpose of ena6 bling the individuals to make a career change from a non7 health profession to a health profession. 

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

9 section, an eligible school shall submit to the Secretary 

10 an application at such time, in such manner, and con11 taining such information as the Secretary may require. 

12 ‘‘(c) USE OF FUNDS.—Amounts awarded as a schol13 arship under this section may be expended only for tuition 

14 expenses, other reasonable educational expenses, and rea15 sonable living expenses incurred in the attendance of the 

16 school involved. 

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

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

19 school’ means an accredited school of medicine, os20 teopathic medicine, dentistry, nursing, pharmacy, 

21 podiatric medicine, optometry, veterinary medicine, 

22 public health, chiropractic, allied health, a school of23 fering a graduate program in behavioral and mental 

24 health practice, or an entity providing programs for 

25 the training of physician assistants. 


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

2 individual’ means an individual who is an underrep3 resented minority individual who has obtained a sec4 ondary school diploma or its recognized equivalent.’’. 

5 SEC. 105. CULTURAL COMPETENCY TRAINING. 

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

7 (42 U.S.C. 293 et seq.), as amended by section 104, is 

8 amended by adding at the end the following: 

9 ‘‘SEC. 743. CULTURAL COMPETENCY TRAINING. 

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

11 the Administrator of the Health Resources and Services 

12 Administration and in collaboration with the Office of Mi13 nority Health and Health Disparity Elimination and 

14 Agency for Healthcare Research and Quality, shall sup15 port the development, evaluation, and dissemination of 

16 model curricula for cultural competency training for use 

17 in health professions schools and continuing education 

18 programs, and other purposes determined appropriate by 

19 the Secretary. 

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

21 the Secretary shall collaborate with health professional so22 cieties, licensing and accreditation entities, health profes23 sions schools, and experts in minority health and cultural 

24 competency, and other organizations as determined appro25 priate by the Secretary. Such curricula shall include a 


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1 focus on cultural competency measures and cultural com2 petency self-assessment methodology for health providers, 

3 systems and institutions. 

4 ‘‘(c) DISSEMINATION.— 

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

6 should be disseminated through the Internet Clear7 inghouse under section 270 and other means as de8 termined appropriate by the Secretary. 

9 ‘‘(2) EVALUATION.—The Secretary shall evalu10 ate adoption and the implementation of cultural 

11 competency training curricula, and facilitate inclu12 sion of cultural competency measures in quality 

13 measurement systems as appropriate.’’. 

14 SEC. 106. AUTHORIZATION OF APPROPRIATIONS; REAU15 THORIZATIONS. 

16 (a) AUTHORIZATION OF APPROPRIATIONS.—There 

17 are authorized to be appropriated— 

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

19 fiscal years 2007 through 2011, to carry out the 

20 amendments made by sections 101 and 102 of this 

21 title (adding sections 270 and 793 to the Public 

22 Health Service Act); 

23 (2) $45,000,000 for fiscal year 2007, and such 

24 sums as may be necessary for each of fiscal years 

25 2008 through 2011, to carry out the amendments 


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1 made by section 103(a) (relating to centers of excel2 lence in section 736 of the Public Health Service 

3 Act); 

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

5 fiscal years 2007 through 2011, to carry out the 

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

7 742 to the Public Health Service Act); 

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

9 fiscal years 2007 through 2011, to carry out the 

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

11 770 to the Public Health Service Act); and 

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

13 fiscal years 2007 through 2011, to carry out the 

14 amendment made by section 105 (adding section 

15 743 to the Public Health Service Act). 

16 (b) REAUTHORIZATIONS.—The following programs 

17 are reauthorized as follows: 

18 (1) EDUCATIONAL ASSISTANCE IN THE HEALTH

19 PROFESSIONS REGARDING INDIVIDUALS FROM DIS20 ADVANTAGED BACKGROUND.—Section 740(c) of the 

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

22 amended by striking the first sentence and inserting 

23 the following: ‘‘For the purpose of grants and con24 tracts under section 739(a)(1), there is authorized to 

25 be appropriated $60,000,000 for fiscal year 2007 


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1 and such sums as may be necessary for each of fis2 cal years 2008 through 2011.’’. 

3 (2) SCHOLARSHIPS FOR DISADVANTAGED STU4 DENTS.—Section 740(a) of the Public Health Serv5 ice Act (42 U.S.C. 293a(a)) is amended by striking 

6 ‘‘$37,000,000’’ and all that follows through 

7 ‘‘through 2002’’ and inserting ‘‘$51,000,000 for fis8 cal year 2007, and such sums as may be necessary 

9 for each of fiscal years 2008 through 2011’’. 

10 (3) LOAN REPAYMENTS AND FELLOWSHIPS.— 

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

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

13 ‘‘$1,100,000’’ and all that follows through ‘‘through 

14 2002’’ and inserting ‘‘$1,700,000 for fiscal year 

15 2007, and such sums as may be necessary for each 

16 of fiscal years 2008 through 2011’’. 

17 (4) GRANTS FOR HEALTH PROFESSIONS EDU18 CATION.—Section 741 of the Public Health Service 

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

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

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

22 be necessary for each of fiscal years 2007 through 

23 2011.’’. 


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1 TITLE II—CARE AND ACCESS 

2 SEC. 201. CARE AND ACCESS. 

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

4 (42 U.S.C. 280g et seq.) is amended by— 

5 (1) redesignating the second section 339O (as 

6 added by section 504 of the Violence Against 

7 Women and Department of Justice Reauthorization 

8 Act of 2005) as section 399P; and 

9 (2) adding at the end the following: 

10 ‘‘SEC. 399Q. ACCESS, AWARENESS, AND OUTREACH ACTIVI11 TIES. 

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

13 shall award multiyear contracts or competitive grants to 

14 eligible entities to support demonstration projects de15 signed to improve the health and healthcare of racial and 

16 ethnic minority and other health disparity populations 

17 through improved access to healthcare, patient navigators, 

18 and health literacy education and services. 

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

20 ‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en21 tity’ means an organization or a community-based 

22 consortium. 

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

24 means— 

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


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1 ‘‘(B) an academic institution; 

2 ‘‘(C) a State health agency; 

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

4 clinic, Indian tribal health facility, or urban In5 dian facility; 

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

7 faith-based organization or consortium, to the 

8 extent that a contract or grant awarded to such 

9 an entity is consistent with the requirements of 

10 section 1955; 

11 ‘‘(F) a primary care practice-based re12 search network; and 

13 ‘‘(G) any other similar entity determined 

14 to be appropriate by the Secretary. 

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

16 term ‘community-based consortium’ means a part17 nership that— 

18 ‘‘(A) includes— 

19 ‘‘(i) individuals who are representa20 tives of organizations of racial and ethnic 

21 minority and other health disparity popu22 lations; 

23 ‘‘(ii) community leaders and leaders of 

24 community-based organizations; 


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1 ‘‘(iii) healthcare providers, including 

2 providers who treat racial and ethnic mi3 nority and other health disparity popu4 lations; and 

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

6 behavioral science, who have knowledge, 

7 training, or practical experience in health 

8 policy, advocacy, cultural or linguistic com9 petency, or other relevant areas as deter10 mined by the Secretary; and 

11 ‘‘(B) is located within a federally- or State12 designated medically underserved area, a feder13 ally designated health provider shortage area, 

14 or an area with a significant population of ra15 cial and ethnic minorities. 

16 ‘‘(c) APPLICATION.—An eligible entity seeking a con17 tract or grant under this section shall submit an applica18 tion to the Secretary at such time, in such manner, and 

19 containing such information as the Secretary may require, 

20 including assurances that the eligible entity will— 

21 ‘‘(1) target populations that are members of ra22 cial and ethnic minority groups and health disparity 

23 populations through specific outreach activities; 

24 ‘‘(2) collaborate with appropriate community 

25 organizations and include meaningful community 


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1 participation in planning, implementation, and eval2 uation of activities; 

3 ‘‘(3) demonstrate capacity to promote culturally 

4 competent and appropriate care for target popu5 lations with consideration for health literacy; 

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

7 ‘‘(5) evaluate the effectiveness of activities 

8 under this section, within an appropriate timeframe, 

9 which shall include a focus on quality and outcomes 

10 performance measures to ensure that the activities 

11 are meeting the intended goals, and that the entity 

12 is able to disseminate findings from such evalua13 tions; 

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

15 the health disparity populations served; 

16 ‘‘(7) demonstrate coordination between public 

17 and private entities; and 

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

19 public and private programs that will help eliminate 

20 disparities in health and healthcare. 

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

22 under this section, the Secretary shall give priority to ap23 plicants that are— 

24 ‘‘(1) safety-net hospitals, defined as hospitals 

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1 tion 1923(b)(3) of the Social Security Act (42 U.S.C 

2 1396r–4(b)(3))) greater than 25 percent; 

3 ‘‘(2) community health centers, as defined in 

4 section 1905(l)(2)(B) of the Social Security Act (42 

5 U.S.C. 1396d(l)(2)(B)); and 

6 ‘‘(3) other health systems that— 

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

8 mission, provide patients with access to services 

9 regardless of their ability to pay; 

10 ‘‘(B) provide care or treatment for a sub11 stantial number of patients who are uninsured, 

12 are receiving assistance under a State program 

13 under title XIX of the Social Security Act, or 

14 are members of vulnerable populations, as de15 termined by the Secretary; 

16 ‘‘(C) serve a disproportionate percentage of 

17 patients from racial and ethnic minority and 

18 other health disparity populations; 

19 ‘‘(D) provide an assurance that amounts 

20 received under the grant or contract will be 

21 used to implement strategies that address pa22 tients’ linguistic needs, where necessary, and re23 cruit and maintain diverse staff and leadership; 

24 and 


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1 ‘‘(E) provide an assurance that amounts 

2 received under the grant or contract will be 

3 used to support quality improvement activities 

4 for patients from racial and ethnic minority and 

5 other health disparity populations. 

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

7 such amounts received under this section for demonstra8 tion projects to— 

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

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

11 of the United States-Mexico Border Health Commis12 sion Act (22 U.S.C. 290n–6), relating to health dis13 parities in the areas of— 

14 ‘‘(A) maternal and child health; 

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

16 including health education and promotion; 

17 ‘‘(C) public health and public infrastruc18 ture; 

19 ‘‘(D) oral health; 

20 ‘‘(E) behavioral and mental health and 

21 substance abuse; 

22 ‘‘(F) health conditions that have a dis23 proportionate impact on racial and ethnic mi24 norities and a high prevalence in the Border 

25 Area; 


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1 ‘‘(G) health services research; 

2 ‘‘(H) the health impacts of exposure to en3 vironmental hazards; 

4 ‘‘(I) workforce training and development; 

5 or 

6 ‘‘(J) other areas determined appropriate by 

7 the Secretary; 

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

9 management, including those that address co-occur10 ring chronic conditions, as defined by the public- pri11 vate partnership established under section 918(b), 

12 target patients with low functional health literacy, 

13 and, as feasible, incorporate health information tech14 nology; 

15 ‘‘(3) evaluate methods for strengthening the 

16 health coverage of, and continuity of coverage of, mi17 gratory agricultural workers and seasonal agricul18 tural workers, as such terms are defined in section 

19 330(g), and workers in other industries with tradi20 tionally low rates of employer-sponsored health in21 surance; 

22 ‘‘(4) train community health workers to edu23 cate, guide, and provide outreach in a community 

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1 cally underserved populations (as defined in section 

2 330(b)); or 

3 ‘‘(5) identify, educate, and enroll eligible pa4 tients from racial and ethnic minorities and other 

5 health disparity populations into clinical trials. 

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

7 an entity receives a contract or grant under this section 

8 and annually thereafter, the entity shall provide to the 

9 Secretary a report containing the results of any evaluation 

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

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

12 shall, as appropriate, disseminate to public and private en13 tities, including Congress, the findings made in evalua14 tions described under subsection (f). 

15 ‘‘SEC. 399R. GRANTS FOR RACIAL AND ETHNIC AP16 PROACHES TO COMMUNITY HEALTH. 

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

18 provide for the awarding of grants to assist communities 

19 in mobilizing and organizing resources in support of effec20 tive and sustainable programs that will reduce or eliminate 

21 disparities in health and healthcare experienced by racial 

22 and ethnic minority individuals. 

23 ‘‘(b) AUTHORITY TO AWARD GRANTS.—The Sec24 retary, acting through the Centers for Disease Control and 

25 Prevention and the Office of Minority Health and Health 


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1 Disparity Elimination, shall award planning, implementa2 tion, and evaluation grants to eligible entities to assist in 

3 designing, implementing, and evaluating culturally and 

4 linguistically appropriate, science-based and community5 driven sustainable strategies to eliminate racial and ethnic 

6 health and healthcare disparities. 

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

8 a grant under this section, an entity shall— 

9 ‘‘(1) represent a coalition— 

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

11 and implement interventions to reduce or elimi12 nate a health or healthcare disparity in a tar13 geted racial or ethnic minority group in the 

14 community served by the coalition; and 

15 ‘‘(B) that includes— 

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

17 among— 

18 ‘‘(I) public health departments; 

19 ‘‘(II) community-based organiza20 tions; 

21 ‘‘(III) university and research or22 ganizations; 

23 ‘‘(IV) American Indian tribal or24 ganizations, national American Indian 

25 organizations, Indian Health Service, 


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1 or organizations serving Alaska Na2 tives; 

3 ‘‘(V) organizations serving Native 

4 Hawaiians; 

5 ‘‘(VI) organizations serving Pa6 cific Islanders; and 

7 ‘‘(VII) interested public or pri8 vate healthcare providers or organiza9 tions as deemed appropriate by the 

10 Secretary; and 

11 ‘‘(ii) at least 1 member from a com12 munity-based organization that represents 

13 the targeted racial or ethnic minority 

14 group; and 

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

16 such time, in such manner, and containing such in17 formation as the Secretary may require, which shall 

18 include— 

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

20 ethnic population in the community to be served 

21 under the grant; 

22 ‘‘(B) a description of at least 1 health dis23 parity that exists in the racial or ethnic tar24 geted population, including infant mortality, 

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1 agement, cardiovascular disease, diabetes, child 

2 and adult immunization levels, or HIV/AIDS; 

3 and 

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

5 accomplishment of the coalition members in 

6 serving and working with the targeted commu7 nity. 

8 ‘‘(d) PLANNING GRANTS.— 

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

10 one-time grants to eligible entities described in sub11 section (c) to support the planning and development 

12 of culturally and linguistically appropriate programs 

13 that utilize science-based and community-driven 

14 strategies to reduce or eliminate a health or 

15 healthcare disparity in the targeted population. Such 

16 grants may be used to— 

17 ‘‘(A) expand the coalition that is rep18 resented by the eligible entity through the iden19 tification of additional partners, particularly 

20 among the targeted community, and establish 

21 linkages with national, State, tribal, or local 

22 public and private partners which may include 

23 community health workers, advocacy, and policy 

24 organizations; 

25 ‘‘(B) establish community working groups; 


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1 ‘‘(C) conduct a needs assessment of the 

2 community and targeted population to deter3 mine a health disparity and the factors contrib4 uting to that disparity, using input from the 

5 targeted community; 

6 ‘‘(D) participate in workshops sponsored 

7 by the Office of Minority Health and Health 

8 Disparity Elimination or the Centers for Dis9 ease Control and Prevention for technical as10 sistance, planning, evaluation, and other pro11 grammatic issues; 

12 ‘‘(E) identify promising intervention strat13 egies; and 

14 ‘‘(F) develop a plan with the input of the 

15 targeted community that includes strategies 

16 for— 

17 ‘‘(i) implementing intervention strate18 gies that have the greatest potential for re19 ducing the health disparity in the target 

20 population; 

21 ‘‘(ii) identifying other sources of rev22 enue and integrating current and proposed 

23 funding sources to ensure long-term sus24 tainability of the program; and 


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1 ‘‘(iii) evaluating the program, includ2 ing collecting data and measuring progress 

3 toward reducing or eliminating the health 

4 disparity in the targeted population that 

5 takes into account the evaluation model de6 veloped by the Centers for Disease Control 

7 and Prevention in collaboration with the 

8 Office of Minority Health and Health Dis9 parity Elimination. 

10 ‘‘(2) DURATION.—The period during which 

11 payments may be made under a grant under para12 graph (1) shall not exceed 1 year, except where the 

13 Secretary determines that extraordinary cir14 cumstances exist as described in section 340(c)(3). 

15 ‘‘(e) IMPLEMENTATION GRANTS.— 

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

17 grants to eligible entities that have received a plan18 ning grant under subsection (d) to enable such enti19 ty to— 

20 ‘‘(A) implement a plan to address the se21 lected health disparity for the target population, 

22 in an effective and timely manner; 

23 ‘‘(B) collect data appropriate for moni24 toring and evaluating the program carried out 

25 under the grant; 


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1 ‘‘(C) analyze and interpret data, or col2 laborate with academic or other appropriate in3 stitutions, for such analysis and collection; 

4 ‘‘(D) participate in conferences and work5 shops for the purpose of informing and edu6 cating others regarding the experiences and les7 sons learned from the project; 

8 ‘‘(E) collaborate with appropriate partners 

9 to publish the results of the project for the ben10 efit of the public health community; 

11 ‘‘(F) establish mechanisms with other pub12 lic or private groups to maintain financial sup13 port for the program after the grant termi14 nates; and 

15 ‘‘(G) maintain relationships with local 

16 partners and continue to develop new relation17 ships with national and State partners. 

18 ‘‘(2) DURATION.—The period during which 

19 payments may be made under a grant under para20 graph (1) shall not exceed 4 years. Such payments 

21 shall be subject to annual approval by the Secretary 

22 and to the availability of appropriations for the fis23 cal year involved. 

24 ‘‘(f) EVALUATION GRANTS.— 


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1 ‘‘(1) IN GENERAL.—The Secretary may award 

2 grants to eligible entities that have received an im3 plementation grant under subsection (e) that require 

4 additional assistance for the purpose of rigorous 

5 data analysis, program evaluation (including process 

6 and outcome measures), or dissemination of find7 ings. 

8 ‘‘(2) PRIORITY.—In awarding grants under this 

9 subsection, the Secretary shall give priority to— 

10 ‘‘(A) entities that in previous funding cy11 cles— 

12 ‘‘(i) have received a planning grant 

13 under subsection (d); or 

14 ‘‘(ii) implemented activities of the 

15 type described in subsection (e)(1); and 

16 ‘‘(B) entities that incorporate best prac17 tices or build on successful models in their ac18 tion plan, including the use of community 

19 health workers. 

20 ‘‘(g) SUSTAINABILITY.—The Secretary shall give pri21 ority to an eligible entity under this section if the entity 

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

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

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

25 partners in the coalition represented by the entity) will 


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1 maintain its expenditures of non-Federal funds for such 

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

3 expenditures during the fiscal year immediately preceding 

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

5 ‘‘(h) NONDUPLICATION.—Funds provided through 

6 this grant program should supplement, not supplant, ex7 isting Federal funding, and the funds should not be used 

8 to duplicate the activities of the other health disparity 

9 grant programs in this Act. 

10 ‘‘(i) TECHNICAL ASSISTANCE.—The Secretary may, 

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

12 that receives a grant under this section with technical and 

13 other nonfinancial assistance necessary to meet the re14 quirements of this section. 

15 ‘‘(j) DISSEMINATION.—The Secretary shall enable 

16 grantees to share best practices, evaluation results, and 

17 reports using the Internet, conferences, and other perti18 nent information regarding the projects funded by this 

19 section, including the outreach efforts of the Office of Mi20 nority Health and Health Disparity Elimination. 

21 ‘‘(k) ADMINISTRATIVE BURDENS.—The Secretary 

22 shall make every effort to minimize duplicative or unneces23 sary administrative burdens on grantees. 


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1 ‘‘SEC. 399S. GRANTS FOR HEALTH DISPARITY 

2 COLLABORATIVES. 

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

4 Administrator of the Health Resources and Services Ad5 ministration, shall award grants to eligible entities to as6 sist in implementing systems of primary care practices 

7 through which to eliminate disparities in the delivery of 

8 healthcare and improve the healthcare provided to all pa9 tients. 

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

11 a grant under this section, an entity shall— 

12 ‘‘(1) be a federally qualified health center as de13 fined in section 1905(l)(2)(B) of the Social Security 

14 Act with the ability to establish and lead a collabo15 rative partnership; and 

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

17 such time, in such manner, and containing such in18 formation as the Secretary may require, which shall 

19 include plans to implement collaboratives in one or 

20 more of the following areas: 

21 ‘‘(A) Diabetes. 

22 ‘‘(B) Asthma. 

23 ‘‘(C) Depression. 

24 ‘‘(D) Cardiovascular disease. 

25 ‘‘(E) Cancer. 


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1 ‘‘(F) Preventive health, including 

2 screenings. 

3 ‘‘(G) Perinatal health. 

4 ‘‘(H) Patient safety. 

5 ‘‘(I) Other areas as designated by the Sec6 retary. 

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

8 this grant program should supplement, not supplant, ex9 isting Federal funding, and the funds should not be used 

10 to duplicate the activities of the other health disparity 

11 grant programs in this Act. 

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

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

14 that receives a grant under this section with technical and 

15 other nonfinancial assistance necessary to meet the re16 quirements of this section. 

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

18 shall make every effort to minimize duplicative or unneces19 sary administrative burdens on grantees. 

20 ‘‘SEC. 399T. COMMUNITY HEALTH INITIATIVES. 

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

22 Community Health Initiative demonstration program to 

23 support comprehensive State, tribal, or local initiatives to 

24 improve the health of racial and ethnic minority and other 

25 health disparity populations. 


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1 ‘‘(b) COMMUNITY HEALTH INITIATIVE PROGRAM.— 

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

3 Community Health Initiative Program grants to 

4 State and local public health agencies of eligible 

5 communities. Each grant shall be funded for 5 

6 years. 

7 ‘‘(2) ELIGIBLE COMMUNITIES.— 

8 ‘‘(A) IDENTIFICATION.—The Secretary 

9 shall develop, after opportunity for public re10 view and comment, and implement a metric for 

11 identifying and notifying eligible communities 

12 pursuant to subparagraph (B), and report such 

13 findings to Congress and the public. 

14 ‘‘(B) ELIGIBILITY.—Eligible communities 

15 shall be communities that are most at risk, or 

16 at greatest disproportionate risk, for adverse 

17 health outcomes, as measured by— 

18 ‘‘(i) overall burden of disease and 

19 health conditions; 

20 ‘‘(ii) accessibility to and availability of 

21 health and economic resources; 

22 ‘‘(iii) proportion of individuals from 

23 racial and ethnic minority and other health 

24 disparity populations; and 


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1 ‘‘(iv) other factors as determined ap2 propriate by the Secretary. 

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

4 in collaboration with the Deputy Assistant Secretary 

5 for Minority Health and Health Disparity Elimi6 nation, the Director of the Centers for Disease Con7 trol and Prevention, the Administrator of the Health 

8 Resources and Services Administration, the Director 

9 of the Indian Health Service, and heads of other 

10 Federal agencies as appropriate, shall determine, 

11 with respect to the Community Health Initiative 

12 Program— 

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

14 timelines for implementing, evaluating and sus15 taining comprehensive and effective health and 

16 healthcare improvement activities in eligible 

17 communities; 

18 ‘‘(B) current programmatic and research 

19 initiatives in which eligible communities may 

20 participate; 

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

22 targeted to eligible communities; and 

23 ‘‘(D) mechanisms to facilitate joint appli24 cation, or establish a common application, to 

25 multiple grant programs, as appropriate. 


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1 ‘‘(4) APPLICATIONS.— 

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

3 public health agencies of eligible communities 

4 shall jointly submit an application to the Sec5 retary at such time, in such manner, and ac6 companied by such information as the Secretary 

7 may require, including a strategic plan that 

8 shall— 

9 ‘‘(i) describe the proposed activities 

10 pursuant to paragraph (5); 

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

12 institutions and organizations and commu13 nity residents have participated in the stra14 tegic plan development; 

15 ‘‘(iii) identify established public-pri16 vate partnerships, and State, local, and 

17 private resources that will be available; 

18 ‘‘(iv) identify Federal funding needed 

19 to support the proposed activities; and 

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

21 and benchmarks for measuring the success 

22 of activities proposed in the strategic plan. 

23 ‘‘(B) COMMUNITY ADVISORY BOARD.— 

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

25 a Community Health Initiative Program 


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1 grant under this section, an eligible com2 munity shall have a community advisory 

3 board. 

4 ‘‘(ii) MEMBERS.— 

5 ‘‘(I) COMMUNITY.—The majority 

6 of the members of a community advi7 sory board under clause (i) shall be 

8 individuals that will benefit from the 

9 activities or services provided by the 

10 grants under this section. 

11 ‘‘(II) REPRESENTATIVES.—A 

12 community advisory board shall in13 clude representatives from the State 

14 health department and county or local 

15 health department, community-based 

16 organizations, environmental and pub17 lic health experts, healthcare profes18 sionals and providers, nonprofit lead19 ers, community organizers, elected of20 ficials, private payers, employers, and 

21 consumers. 

22 ‘‘(iii) DUTIES.—A community advi23 sory board shall— 


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1 ‘‘(I) oversee the functions and 

2 operations of Community Health Ini3 tiative Program grant activities; 

4 ‘‘(II) assist in the evaluation of 

5 such activities; and 

6 ‘‘(III) prepare an annual report 

7 that describes the progress made to8 wards achieving stated goals and rec9 ommends future courses of action. 

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

11 that receives a grant under this section shall use the 

12 funding to support activities to achieve stated core 

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

14 which may include initiatives that— 

15 ‘‘(A) promote disease prevention and 

16 health promotion, particularly for racial and 

17 ethnic minority and other health disparity pop18 ulations; 

19 ‘‘(B) facilitate partnerships between 

20 healthcare providers, public and health agen21 cies, academic institutions, community based or 

22 advocacy organizations, elected officials, profes23 sional societies, and other stakeholder groups; 


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1 ‘‘(C) enhance the local capacity for aggre2 gated and disaggregated health data collection 

3 and reporting; 

4 ‘‘(D) coordinate and integrate community5 based activities including education, city plan6 ning, transportation initiatives, environmental 

7 changes, and other related activities at the local 

8 level that help improve public health and ad9 dress health concerns; 

10 ‘‘(E) mobilize financial and other resources 

11 from the public and private sector to increase 

12 local capacity to address health issues; 

13 ‘‘(F) support the training of staff in com14 munication and outreach to the general public, 

15 particularly those at disproportionate risk for 

16 health and healthcare disparities; 

17 ‘‘(G) assist eligible communities in meeting 

18 Healthy People 2010 objectives; and 

19 ‘‘(H) aid eligible communities in providing 

20 employment, and cultural and recreational re21 sources that enable healthy lifestyles. 

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

23 through contract, shall conduct and report an eval24 uation of the Community Health Initiative Program 

25 that shall be available to the public. 


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

2 funds received under this section shall be used to 

3 supplement, and not supplant, funding that would 

4 otherwise be used for activities described under this 

5 section. 

6 ‘‘SEC. 399U. OUTREACH. 

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

8 with the Office for Minority Health and Health Disparity 

9 Elimination, the Centers for Medicare and Medicaid Serv10 ices, and the Health Resources and Services Administra11 tion, shall establish a grant program to improve outreach, 

12 participation, and enrollment by eligible entities with re13 spect to available healthcare programs. 

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

15 entity’ means any of the following: 

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

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

18 ‘‘(3) A national, local, or community-based pub19 lic or nonprofit private organization. 

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

21 the extent that a grant awarded to such an entity 

22 is consistent with the requirements of section 1955 

23 relating to a grant award to nongovernmental enti24 ties. 

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


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1 ‘‘(c) DEFINITION.—In this section: 

2 ‘‘(1) FEDERAL HEALTH SAFETY NET ORGANI3 ZATION.—The term ‘Federal health safety net orga4 nization’ means— 

5 ‘‘(A) an Indian tribe, tribal organization, 

6 or an urban Indian organization receiving funds 

7 under title V of the Indian Health Care Im8 provement Act (25 U.S.C. 1651 et seq.), or an 

9 Indian Health Service provider; 

10 ‘‘(B) a Federally-qualified health center 

11 (as defined in section 330); 

12 ‘‘(C) a hospital defined as a dispropor13 tionate share hospital; 

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

15 340B(a)(4); and 

16 ‘‘(E) any other entity or a consortium that 

17 serves children under a federally funded pro18 gram, including the special supplemental nutri19 tion program for women, infants, and children 

20 (WIC) established under section 17 of the Child 

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

22 head start and early head start programs under 

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

24 the school lunch program established under the 

25 Richard B. Russell National School Lunch Act 


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1 (42 U.S.C. 1751 et seq.), and an elementary or 

2 secondary school. 

3 ‘‘(2) INDIANS; INDIAN TRIBE; TRIBAL ORGANI4 ZATION; URBAN INDIAN ORGANIZATION.—The terms 

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

6 ‘urban Indian organization’ have the meanings given 

7 such terms in section 4 of the Indian Health Care 

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

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

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

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

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

13 geographic areas with high rates of— 

14 ‘‘(i) eligible but unenrolled children, 

15 including such children who reside in rural 

16 areas; or 

17 ‘‘(ii) racial and ethnic minorities and 

18 health disparity populations, including 

19 those proposals that address cultural and 

20 linguistic barriers to enrollment; and 

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

22 outreach efforts with respect to individuals de23 scribed in subparagraph (A) and that are— 

24 ‘‘(i) Federal health safety net organi25 zations; or 


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1 ‘‘(ii) faith-based organizations or con2 sortia. 

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

4 TO INDIAN CHILDREN.—An amount equal to 10 per5 cent of the funds appropriated under section 202(3) 

6 of the Minority Health Improvement and Health 

7 Disparity Elimination Act to carry out this section 

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

9 award grants to Indian Health Service providers and 

10 urban Indian organizations receiving funds under 

11 title V of the Indian Health Care Improvement Act 

12 (25 U.S.C. 1651 et seq.) for outreach to, and enroll13 ment of, children who are Indians.’’. 

14 SEC. 202. AUTHORIZATION OF APPROPRIATIONS. 

15 There are authorized to be appropriated— 

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

17 fiscal years 2007 through 2011, to carry out section 

18 399Q of the Public Health Service Act (as added by 

19 section 201); 

20 (2) $52,000,000 for fiscal year 2007, and such 

21 sums as may be necessary for each of fiscal years 

22 2008 through 2011, to carry out section 399R of the 

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

24 and 


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

2 years 2007 through 2011, to carry out sections 

3 399S, 399T, and 399U of the Public Health Service 

4 Act (as added by section 201). 

5 TITLE III—RESEARCH 

6 SEC. 301. AGENCY FOR HEALTHCARE RESEARCH AND 

7 QUALITY. 

8 Part B of title IX of the Public Health Service Act 

9 (42 U.S.C. 299b et seq.) is amended by adding at the end 

10 the following: 

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

12 HEALTHCARE DISPARITIES. 

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

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

16 through the Director, and in collaboration with the 

17 Deputy Assistant Secretary for Minority Health and 

18 Health Disparity Elimination, shall develop a stra19 tegic plan regarding research supported by the agen20 cy to improve healthcare and eliminate healthcare 

21 disparities among racial and ethnic minority and 

22 other health disparity populations. In developing 

23 such plan, the Secretary shall— 

24 ‘‘(A) determine which areas of research 

25 focus would have the greatest impact on 


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1 healthcare improvement and elimination of dis2 parities, taking into consideration the overall 

3 health status of various populations, dispropor4 tionate burden of diseases or health conditions, 

5 and types of interventions for which data on ef6 fectiveness is limited; 

7 ‘‘(B) establish measurable goals and objec8 tives which will allow assessment of progress; 

9 ‘‘(C) solicit public review and comment 

10 from experts in healthcare, minority health and 

11 health disparities, health services research, and 

12 other areas as determined appropriate by the 

13 Secretary; 

14 ‘‘(D) incorporate recommendations from 

15 the Institute of Medicine, pursuant to section 

16 303 of the Minority Health Improvement and 

17 Health Disparity Elimination Act, as appro18 priate; 

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

20 of enactment of the Minority Health Improve21 ment and Health Disparity Elimination Act, 

22 and update such plan and report on progress 

23 meeting established goals and objectives not 

24 less than every 2 years; 


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1 ‘‘(F) include progress meeting plan goals 

2 and objectives in annual performance budget 

3 submissions; 

4 ‘‘(G) ensure coordination and integration 

5 with the National Plan to Improve Minority 

6 Health and Eliminate Health Disparities, as de7 scribed in section 1707(c) and other Depart8 ment-wide initiatives, as feasible; and 

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

10 make available to the public in print and elec11 tronic format. 

12 ‘‘(2) ESTABLISHMENT OF GRANTS.—The Sec13 retary, acting through the Director, and in collabo14 ration with the Deputy Assistant Secretary for Mi15 nority Health and Health Disparity Elimination, 

16 may award grants or contracts to eligible entities for 

17 research to improve the health of racial and ethnic 

18 minority and other health disparity populations (as 

19 defined in section 903(d)). 

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

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

22 contract under this section, an eligible entity 

23 shall submit to the Secretary an application at 

24 such time, in such manner, and containing such 

25 information as the Secretary may require. 


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

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

4 health plan, health system, community clinic, or 

5 other health entity determined appropriate by 

6 the Secretary, that— 

7 ‘‘(i) by legal mandate or explicitly 

8 adopted mission, provides patients with ac9 cess to services regardless of their ability 

10 to pay; 

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

12 substantial number of patients who are un13 insured, are receiving assistance under a 

14 State program under title XIX of the So15 cial Security Act, or are members of vul16 nerable populations, as determined by the 

17 Secretary; 

18 ‘‘(iii) serves a disproportionate per19 centage of patients from racial and ethnic 

20 minority and other health disparity popu21 lations; 

22 ‘‘(iv) provides an assurance that 

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

25 that address patients’ linguistic needs, 


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1 where necessary, and recruit and maintain 

2 diverse staff and leadership; and 

3 ‘‘(v) provides an assurance that 

4 amounts received under the grant or con5 tract will be used to support quality im6 provement activities for patients from ra7 cial and ethnic minority and other health 

8 disparity populations. 

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

10 more eligible entities shall be given a preference 

11 for grant or contract funding. 

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

13 paragraph (2), with respect to racial and ethnic mi14 nority and other health disparity populations, 

15 shall— 

16 ‘‘(A) prioritize the translation of existing 

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

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

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

22 the National Healthcare Disparities Report 

23 published by the Agency for Healthcare Re24 search and Quality, relevant reports by the InVerDate Aug 31 2005 04:23 Oct 05, 2006 Jkt 059200 PO 00000 Frm 00072 Fmt 6652 Sfmt 6201 E:\BILLS\S4024.IS S4024

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1 stitute of Medicine, and other reports issued by 

2 Federal health agencies; 

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

4 solutions and partnerships as appropriate; 

5 ‘‘(D) expand practice-based research net6 works (primary care and larger delivery sys7 tems) to include networks of delivery sites serv8 ing large numbers of minority and health dis9 parity populations including— 

10 ‘‘(i) public hospitals and private non11 profit hospitals; 

12 ‘‘(ii) health centers; 

13 ‘‘(iii) health plans; and 

14 ‘‘(iv) other sites as determined appro15 priate by the Director. 

16 ‘‘(5) DISSEMINATION OF RESEARCH FIND17 INGS.—To ensure that findings from the research 

18 described in paragraph (4) are disseminated and ap19 plied promptly, the Director shall— 

20 ‘‘(A) develop outreach and training pro21 grams for healthcare providers with respect to 

22 the practical and effective interventions that re23 sult from research programs carried out with 

24 grants or contracts awarded under this section; 

25 and 


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1 ‘‘(B) provide technical assistance for the 

2 implementation of evidence-based practices that 

3 will improve health and healthcare and reduce 

4 disparities. 

5 ‘‘(b) REALIZING THE POTENTIAL OF DISEASE MAN6 AGEMENT.— 

7 ‘‘(1) PUBLIC-PRIVATE SECTOR PARTNERSHIP

8 TO ASSESS EFFECTIVENESS OF EXISTING DISEASE

9 MANAGEMENT STRATEGIES.— 

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

11 establish a public-private partnership to iden12 tify, evaluate, and disseminate effective disease 

13 management strategies, tailored to improve 

14 healthcare and health outcomes for patients 

15 from racial and ethnic minority and other 

16 health disparity populations. Such strategies 

17 shall reflect established healthcare quality 

18 standards and benchmarks and other evidence19 based recommendations. 

20 ‘‘(B) PARTNERSHIP COMPOSITION.—The 

21 partnership’s members shall include the fol22 lowing: 

23 ‘‘(i) Representatives from the fol24 lowing: 


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1 ‘‘(I) The Office of Minority 

2 Health and Health Disparity Elimi3 nation. 

4 ‘‘(II) The Centers for Disease 

5 Control and Prevention. 

6 ‘‘(III) The Agency for Healthcare 

7 Research and Quality. 

8 ‘‘(IV) The Centers for Medicare 

9 and Medicaid Services. 

10 ‘‘(V) The Health Resources and 

11 Services Administration. 

12 ‘‘(VI) The Indian Health Service. 

13 ‘‘(VII) Other agencies as des14 ignated by the Secretary. 

15 ‘‘(ii) Representatives of health plans, 

16 employers, or other private entities that 

17 have implemented disease management 

18 programs. 

19 ‘‘(iii) Representatives of hospitals, 

20 community health centers, large, small, or 

21 solo provider groups, or other organiza22 tions that provide healthcare and have im23 plemented disease management programs. 

24 ‘‘(iv) Community-based representa25 tives who have been involved with estabVerDate Aug 31 2005 04:23 Oct 05, 2006 Jkt 059200 PO 00000 Frm 00075 Fmt 6652 Sfmt 6201 E:\BILLS\S4024.IS S4024

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1 lishing, implementing, or evaluating dis2 ease management programs. 

3 ‘‘(v) Other individuals as designated 

4 by the Secretary. 

5 ‘‘(C) PARTNERSHIP DUTIES.— 

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

7 months after the date of enactment of the 

8 Minority Health Improvement and Health 

9 Disparity Elimination Act, the partnership 

10 shall release a best practices report, with a 

11 particular focus on the following: 

12 ‘‘(I) Self-management training. 

13 ‘‘(II) Increasing patient partici14 pation in and satisfaction with 

15 healthcare encounters. 

16 ‘‘(III) Helping patients use qual17 ity performance and cost information 

18 to choose appropriate healthcare pro19 viders for their care. 

20 ‘‘(IV) Interventions outside of a 

21 traditional healthcare environment, in22 cluding the workplace, school, commu23 nity, or home. 


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1 ‘‘(V) Interventions utilizing com2 munity health workers and case man3 agers. 

4 ‘‘(VI) Interventions that imple5 ment integrated disease management 

6 and treatment strategies to address 

7 multiple chronic co-occurring condi8 tions. 

9 ‘‘(VII) Other interventions as 

10 identified by the Secretary. 

11 ‘‘(2) REPORT.— 

12 ‘‘(A) IN GENERAL.—Not later than Sep13 tember 30, 2010, the partnership shall submit 

14 to the Secretary and the relevant committees of 

15 Congress a report that describes the extent to 

16 which the activities and research funded under 

17 this section have been successful in reducing 

18 and eliminating disparities in health and 

19 healthcare in targeted populations. 

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

21 ensure that the report is made available on the 

22 Internet websites of the Office of Minority 

23 Health and Health Disparity Elimination, the 

24 Agency for Healthcare Research and Quality, 

25 and other agencies as appropriate.’’. 


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1 SEC. 302. GENETIC VARIATION AND HEALTH. 

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

3 any current, proposed, or future research and pro4 grammatic activities regarding genomics include focus on 

5 genetic variation within and between populations, with a 

6 focus on racial and ethnic minority populations, that may 

7 affect risk of disease or response to drug therapy and 

8 other treatments, in order to ensure that all populations 

9 are able to derive full benefit from genomic tests and 

10 treatments that may improve their health and healthcare. 

11 The Secretary shall encourage, with respect to racial and 

12 ethnic minority populations, efforts to— 

13 (1) increase access, availability, and utilization 

14 of genomic tests and treatments; 

15 (2) determine and monitor appropriateness of 

16 use of genomic tests and treatments; 

17 (3) increase awareness of the importance of 

18 knowing one’s family history and the relationships 

19 between genes, the social and physical environment, 

20 and health; and 

21 (4) expand genomics research that would help 

22 to— 

23 (A) improve tests to facilitate earlier and 

24 more accurate diagnoses; 


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1 (B) enhance the safety of drugs, particu2 larly for drugs that pose an elevated risk for 

3 adverse drug events in such populations; 

4 (C) increase the effectiveness of drugs, 

5 particularly for diseases and conditions that dis6 proportionately affect such populations; and 

7 (D) augment the current understanding of 

8 the interactions between genomic, social and 

9 physical environmental factors and their influ10 ence on the causality, prevention, and treatment 

11 of diseases common in such populations. 

12 (b) GENETIC VARIATION, ENVIRONMENT, AND

13 HEALTH SUMMIT.— 

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

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

16 National Human Genome Research Institute, in col17 laboration with the Director of the Office of 

18 Genomics and Disease Prevention at the Centers for 

19 Disease Control and Prevention, the Director of the 

20 Office of Behavioral and Social Science Research at 

21 the National Institutes of Health, and the Deputy 

22 Assistant Secretary of the Office of Minority Health 

23 and Health Disparity Elimination, shall convene a 

24 Summit for the purpose of providing leadership and 

25 guidance to Secretary, Congress, and other public 


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1 and private entities on current and future areas of 

2 focus for genomics research, including translation of 

3 findings from such research, relating to improving 

4 the health of racial and ethnic minority populations 

5 and reducing health disparities. 

6 (2) PARTICIPATION.—The Summit shall in7 clude— 

8 (A) representatives from the Federal 

9 health agencies, including the National Insti10 tutes of Health, the Centers for Disease Control 

11 and Prevention, the Food and Drug Adminis12 tration, the Health Resources and Services Ad13 ministration, and additional agencies and de14 partments as determined appropriate by the 

15 Secretary; 

16 (B) independent experts and stakeholders 

17 from relevant industry and academic institu18 tions, particularly those that have demonstrated 

19 expertise in both genomics and minority health 

20 and serve a disproportionate number of racial 

21 and ethnic minority patients; and 

22 (C) leaders of community organizations 

23 that work to reduce and eliminate health dis24 parities. 


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

2 conclusion of the Summit, the Director of the Na3 tional Human Genome Research Institute shall sub4 mit to Congress and make available to the public a 

5 report detailing recommendations on— 

6 (A) an appropriate description of human 

7 diversity, incorporating available information on 

8 genetics, for use in genomic research and pro9 grams operated or supported by the Federal 

10 Government; 

11 (B) guiding ethics, principles, and proto12 cols for the inclusion and designation of racial 

13 and ethnic minority populations in genomics re14 search, particularly clinical trials programs op15 erated or supported by the Federal Govern16 ment; 

17 (C) ways to increase access to and utiliza18 tion of effective pharmacogenomic and other ge19 netic screening and services for racial and eth20 nic minority populations; 

21 (D) research opportunities and funding 

22 support in the area of genomic variation that 

23 may improve the health and healthcare of mi24 nority populations; 


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1 (E) ways to enhance integration of Federal 

2 Government-wide efforts and activities per3 taining to race, genomics, and health; and 

4 (F) need for additional privacy protections 

5 in preventing stigmatization and inappropriate 

6 use of genetic information. 

7 (c) PHARMACOGENOMICS AND EMERGING ISSUES

8 ADVISORY COMMITTEE.— 

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

10 222 of the Public Health Service Act (42 U.S.C. 

11 217a), shall convene and consult an advisory com12 mittee on issues relating to pharmacogenomics (re13 ferred to in this subsection as the ‘‘Advisory Com14 mittee’’). 

15 (2) DUTIES.— 

16 (A) IN GENERAL.—The Advisory Com17 mittee shall advise and make recommendations 

18 to the Secretary, through the Commissioner of 

19 Food and Drugs and in consultation with the 

20 Director of the National Institutes of Health, 

21 on the evolving science of pharmacogenomics 

22 and interindividual variability in drug response, 

23 as it relates to the health of racial and ethnic 

24 minorities. 


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1 (B) MATTERS CONSIDERED.—The rec2 ommendations under subparagraph (A) shall in3 clude recommendations on— 

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

5 clinical trials involving racial and ethnic 

6 minorities conducted under section 351, 

7 409I, or 499 of the Public Health Service 

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

9 515(g) of the Federal Food, Drug, and 

10 Cosmetic Act; 

11 (ii) general policy and guidance with 

12 respect to the development, approval or 

13 clearance, and labeling of medical products 

14 for racial and ethnic minorities; 

15 (iii) the role of pharmacogenomics 

16 during the development of drugs, biological 

17 products, and diagnostics; 

18 (iv) the understanding of interindi19 vidual variability in drug response; 

20 (v) diagnostics or treatments for dis21 eases or conditions common in racial and 

22 ethnic minorities; and 

23 (vi) the identification of other areas of 

24 unmet medical need. 


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1 (3) COMPOSITION.—The Advisory Committee 

2 shall include— 

3 (A) experts in the fields of— 

4 (i) minority health and health dispari5 ties; 

6 (ii) genomics; 

7 (iii) pharmaceutical and diagnostic re8 search and development; 

9 (iv) ethical, legal, and social issues re10 lating to clinical trials; and 

11 (v) bioinformatics and information 

12 technology; 

13 (B) representatives from minority health 

14 organizations and relevant patient organiza15 tions; and 

16 (C) other experts as deemed appropriate 

17 by the Secretary. 

18 (4) COORDINATION WITH OTHER ADVISORY

19 COMMITTEES.—The Advisory Committee may con20 sult and coordinate with other advisory committees 

21 of the Department of Health and Human Services 

22 as determined appropriate by the Secretary. 

23 (5) RECOMMENDATIONS.—The Advisory Com24 mittee shall submit recommendations to the Sec25 retary with respect to each of the matters described 


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1 under paragraph (2)(B) prior to the development by 

2 the Secretary of the report described under para3 graph (6). 

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

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

6 (A) shall, acting through the Commissioner 

7 of Food and Drugs and in consultation with the 

8 Director of the National Institutes of Health, 

9 and taking into consideration the recommenda10 tions of the Advisory Committee submitted 

11 under paragraph (5), submit to the Committee 

12 on Health, Education, Labor, and Pensions of 

13 the Senate and the Committee on Energy and 

14 Commerce of the House of Representatives, a 

15 report on the evolving science of 

16 pharmacogenomics as it relates to racial and 

17 ethnic minorities, including a review of the 

18 guidance of the Food and Drug Administration 

19 on the participation of racial and ethnic minori20 ties in clinical trials; and 

21 (B) shall ensure that such report is made 

22 publicly available. 

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

24 (a) HEALTH DISPARITIES SUMMIT.— 


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

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

3 of Medicine shall convene a summit on health dis4 parities (referred to this section as the ‘‘Summit’’). 

5 (2) PURPOSE.—The purposes of the Summit in6 clude— 

7 (A) reviewing current activities of the Fed8 eral Government in addressing health and 

9 healthcare disparities as experienced by racial 

10 and ethnic minority populations, and other 

11 health disparity populations as practicable; and 

12 (B) assessing progress made since the 

13 2002 Institute of Medicine National Healthcare 

14 Disparities Report. 

15 (3) AREAS OF FOCUS.—The Summit shall ex16 amine the activities of the Federal Government to 

17 reduce and eliminate health disparities, with a focus 

18 on— 

19 (A) education and training, including 

20 health professions programs that increase mi21 nority representation in medicine and the health 

22 professions; 

23 (B) data collection and analysis; 

24 (C) coordination among agencies and de25 partments in addressing healthcare disparities; 


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1 (D) research into the causes of and strate2 gies to eliminate health disparities; and 

3 (E) programs that increase access to care 

4 and improve health outcomes for health dis5 parity populations. 

6 (4) PARTICIPATION.—Summit participants shall 

7 include— 

8 (A) representatives of the Federal Govern9 ment; 

10 (B) experts with research experience in 

11 identifying and addressing healthcare dispari12 ties among racial and ethnic minority and other 

13 health disparity populations; and 

14 (C) representatives from community-based 

15 organizations and nonprofit groups that address 

16 the issues of racial and ethnic minority and 

17 other health disparity populations. 

18 (5) SUMMIT PROCEEDINGS.—Not later than 

19 180 days after the conclusion of the Summit, the 

20 Secretary shall offer to enter into a contract with 

21 the Institute of Medicine to publish a report summa22 rizing the discussions of the Summit and review of 

23 current Federal activities to address healthcare dis24 parities for racial and ethnic minority and other 

25 health disparity populations. 


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1 (b) NATIONAL PLAN TO ELIMINATE DISPARITIES.— 

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

3 date of enactment of this Act, the Institute of Medi4 cine shall develop an evidence-based, strategic, na5 tional plan to eliminate disparities which shall— 

6 (A) include goals, interventions, and re7 sources needed to eliminate disparities; 

8 (B) establish a reasonable timetable to 

9 reach selected priorities; 

10 (C) inform and complement the National 

11 Plan to Improve Minority Health and Eliminate 

12 Health Disparities, pursuant to section 

13 1707(c)(2) of the Public Health Service Act (as 

14 added by section 501 of this Act); and 

15 (D) inform the development of criteria for 

16 evaluation of the effectiveness of programs au17 thorized under this Act (and the amendments 

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

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

20 enter into a contract with the Institute of Medicine 

21 to publish the National Plan to Eliminate Dispari22 ties. 

23 (c) INSTITUTE OF MEDICINE EVALUATION.— 

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

25 the date of enactment of this Act, the Secretary 


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1 shall offer to enter into a contract with the Institute 

2 of Medicine to evaluate the effectiveness of the pro3 grams authorized under this Act (and the amend4 ments made by this Act) in addressing and reducing 

5 health disparities experienced by racial and ethnic 

6 minority and other health disparity populations. In 

7 making such an evaluation, the Institute of Medicine 

8 shall consult— 

9 (A) representatives of the Federal Govern10 ment; 

11 (B) experts with research and policy expe12 rience in identifying and addressing healthcare 

13 disparities among racial and ethnic minority 

14 and other health disparity populations; and 

15 (C) representatives from community-based 

16 organizations and nonprofit groups that address 

17 health disparity issues. 

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

19 Secretary enters into the contract under paragraph 

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

21 Secretary and relevant committees of Congress a re22 port that contains the results of the evaluation de23 scribed under such subparagraph, and any rec24 ommendations of such Institute. 


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

2 the date the Institute of Medicine submits the report 

3 under this subsection, the Secretary shall publish a 

4 response to such recommendations, which shall be 

5 provided to the relevant committees of Congress and 

6 made publicly available through the Internet Clear7 inghouse under section 270 of the Public Health 

8 Service Act (as added by section 101). 

9 (d) HEALTH INFORMATION TECHNOLOGY.— 

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

11 after the date of enactment of this Act, the Sec12 retary, acting through the Director of the National 

13 Library of Medicine, shall offer to enter into a con14 tract with the Institute of Medicine to study and 

15 make recommendations regarding the use of health 

16 information technology and bioinformatics to im17 prove the health and healthcare of racial and ethnic 

18 minority and other health disparity populations. 

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

20 with respect to increasing access and quality of 

21 healthcare for racial and ethnic minority and other 

22 health disparity populations, shall assess and make 

23 recommendations regarding— 


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1 (A) effective applications of health infor2 mation technology, including telemedicine and 

3 telepsychiatry; 

4 (B) status of development of health infor5 mation technology standards that will permit 

6 healthcare information of the type required to 

7 support patient care; 

8 (C) inclusion of organizations with exper9 tise in minority health and health disparities in 

10 the development of health information tech11 nology standards and applications; 

12 (D) priority areas for research to improve 

13 the dissemination, management, and use of bio14 medical knowledge that address identified and 

15 unmet needs; 

16 (E) educational and training needs and op17 portunities to assist health professionals under18 stand and apply health information technology; 

19 and 

20 (F) ways to increase recruitment and re21 tention of racial and ethnic minorities into the 

22 field of medical informatics. 

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

24 Secretary enters into the contract under paragraph 

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


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1 Secretary and relevant committees of Congress a re2 port that contains the findings and recommendations 

3 of this study. 

4 SEC. 304. NATIONAL CENTER FOR MINORITY HEALTH AND 

5 HEALTH DISPARITIES REAUTHORIZATION. 

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

7 U.S.C. 287c–31) is amended— 

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

9 following: 

10 ‘‘(e) DUTIES OF THE DIRECTOR.— 

11 ‘‘(1) INTERAGENCY COORDINATION OF MINOR12 ITY HEALTH AND HEALTH DISPARITIES ACTIVI13 TIES.—With respect to minority health and health 

14 disparities, the Director of the Center shall plan, co15 ordinate, and evaluate research and other activities 

16 conducted or supported by the agencies of the Na17 tional Institutes of Health. In carrying out the pre18 ceding sentence, the Director of the Center shall 

19 evaluate the minority health and health disparity ac20 tivities of each of such agencies and shall provide for 

21 the periodic reevaluation of such activities. 

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

23 Center shall carry out this subpart (including devel24 oping and revising the plan and budget required in 

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


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

2 National Institutes of Health, with the advisory 

3 councils of the agencies, and with the advisory coun4 cil established under section (j). 

5 ‘‘(3) COORDINATION OF ACTIVITIES.—The Di6 rector of the Center shall act as the primary Federal 

7 official with responsibility for coordinating all minor8 ity health disparities research and other health dis9 parities research conducted or supported by the Na10 tional Institutes of Health and shall— 

11 ‘‘(A) represent the health disparities re12 search program of the National Institutes of 

13 Health including the minority health disparities 

14 research program at all relevant executive 

15 branch task forces, committees, and planning 

16 activities; 

17 ‘‘(B) maintain communications with all rel18 evant Public Health Service agencies, including 

19 the Indian Health Service and various other de20 partments of the Federal Government, to en21 sure the timely transmission of information con22 cerning advances in minority health disparities 

23 research and other health disparities research 

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1 tion to affected communities and healthcare 

2 providers; and 

3 ‘‘(C) engage with community-based organi4 zations and health provider groups to— 

5 ‘‘(i) increase education and awareness 

6 about the Center’s activities and areas of 

7 research focus; and 

8 ‘‘(ii) accelerate the translation of re9 search findings into programs including 

10 those carried out by community-based or11 ganizations.’’; 

12 (2) in subsection (f)— 

13 (A) by striking the subsection heading and 

14 inserting the following: 

15 ‘‘(f) COMPREHENSIVE PLAN FOR RESEARCH; BUDG16 ET ESTIMATE; ALLOCATION OF APPROPRIATIONS.—’’; 

17 (B) in paragraph (1)— 

18 (i) by striking the matter preceding 

19 subparagraph (A) and subparagraph (A) 

20 and inserting the following: 

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

22 this section and other applicable law, the Director of 

23 the Center, in consultation with the Director of 

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1 tional Institutes of Health, and the advisory council 

2 established under subsection (j) shall— 

3 ‘‘(A) annually review and revise a com4 prehensive plan (referred to in this section as 

5 ‘the Plan’) and budget for the conduct and sup6 port of all minority health and health dispari7 ties research and other health disparities re8 search activities of the agencies of the National 

9 Institutes of Health;’’; 

10 (ii) in subparagraph (D), by striking 

11 ‘‘, with respect to amounts appropriated 

12 for activities of the Center,’’; 

13 (iii) by striking subparagraph (F) and 

14 inserting the following: 

15 ‘‘(F) ensure that the Plan and budget are 

16 presented to and considered by the Director 

17 during the formulation of the overall annual 

18 budget for the National Institutes of Health;’’; 

19 (iv) by redesignating subparagraphs 

20 (G) and (H) as subparagraphs (I) and (J), 

21 respectively; and 

22 (v) by inserting after subparagraph 

23 (F), the following: 

24 ‘‘(G) annually submit to Congress a report 

25 on the progress made with respect to the Plan; 


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1 ‘‘(H) creating and implementing a plan for 

2 the systematic review of research activities sup3 ported by the National Institutes of Health that 

4 are within the mission of both the Center and 

5 other agencies of the National Institutes of 

6 Health, by establishing mechanisms for— 

7 ‘‘(i) tracking minority health and 

8 health disparity research conducted within 

9 the agencies; 

10 ‘‘(ii) the early identification of appli11 cations and proposals for grants, contracts, 

12 and cooperative agreements supporting ex13 tramural training, research, and develop14 ment, that are submitted to the agencies 

15 and that are within the mission of the Cen16 ter; 

17 ‘‘(iii) providing the Center with the 

18 written descriptions and scientific peer re19 view results of such applications and pro20 posals; 

21 ‘‘(iv) enabling the agencies to consult 

22 with the Director of the Center prior to 

23 final approval of such applications and 

24 proposals; and 


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1 ‘‘(v) reporting to the Director of the 

2 Center all such applications and proposals 

3 that are approved for funding by the agen4 cies;’’; and 

5 (C) in paragraph (2)— 

6 (i) in subparagraph (D), by striking 

7 ‘‘and’’ at the end; 

8 (ii) in subparagraph (E), by striking 

9 the period and inserting ‘‘; and’’; and 

10 (iii) by adding at the end the fol11 lowing: 

12 ‘‘(F) the number and type of personnel 

13 needs of the Center.’’; 

14 (3) in subsection (h)— 

15 (A) in paragraph (1), by striking ‘‘endow16 ments at centers of excellence under section 

17 736.’’ and inserting the following: ‘‘endowments 

18 at— 

19 ‘‘(A) centers of excellence under section 

20 736; and 

21 ‘‘(B) centers of excellence under section 

22 485F.’’; and 

23 (B) in paragraph (2)(A), by striking ‘‘aver24 age’’ and inserting ‘‘median’’; 


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1 (4) by redesignating subsections (k) and (l) as 

2 subsections (m) and (n), respectively; 

3 (5) by inserting after subsection (j), the fol4 lowing: 

5 ‘‘(k) REPRESENTATION OF MINORITIES AMONG RE6 SEARCHERS.—The Secretary, in collaboration with the Di7 rector of the Center, shall determine the extent to which 

8 racial and ethnic minority and other health disparity pop9 ulations are represented among senior physicians and sci10 entists of the national research institutes and among phy11 sicians and scientists conducting research with funds pro12 vided by such institutes, and as appropriate, carry out ac13 tivities to increase the extent of such representation. 

14 ‘‘(l) CANCER RESEARCH.—The Secretary, in collabo15 ration with the Director of the Center, shall designate and 

16 support a cancer prevention, control, and population 

17 science center to address the significantly elevated rate of 

18 morbidity and mortality from cancer in racial and ethnic 

19 minority populations. Such designated center shall be 

20 housed within an existing, stand-alone cancer center at a 

21 historically black college and university that has a demon22 strable commitment to and expertise in cancer research 

23 in the basic, clinical, and population sciences.’’; 

24 (6) in subsection (l)(1) (as so redesignated), by 

25 inserting before the semicolon the following: ‘‘, with 


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1 a particular focus on evaluation of progress made to2 ward fulfillment of the goals of the Plan’’; and 

3 (7) by striking subsection (m) (as so redesig4 nated). 

5 SEC. 305. AUTHORIZATION OF APPROPRIATIONS. 

6 (a) SECTIONS 301, 302, AND 303.—There are au7 thorized to be appropriated such sums as may be nec8 essary for each of fiscal years 2007 through 2011, to carry 

9 out sections 301, 302, and 303 (and the amendments 

10 made by such sections). 

11 (b) SECTION 304.— 

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

13 appropriated $240,000,000 for fiscal year 2007, 

14 such sums as may be necessary for each of fiscal 

15 years 2008 through 2011, to carry out section 304. 

16 (2) ALLOCATION OF FUNDS.—Subject to sec17 tion 485E of the Public Health Service Act (as 

18 amended by section 304) and other applicable law, 

19 the Director of the Center under such section 485E 

20 shall direct all amounts appropriated for activities 

21 under such section and in collaboration with the Di22 rector of National Institutes of Health and the di23 rectors of other institutes and centers of the Na24 tional Institutes of Health. 


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1 (3) MANAGEMENT OF ALLOCATIONS.—All 

2 amounts allocated or expended for minority health 

3 and health disparities research activities under this 

4 subsection shall be reported programmatically to and 

5 approved by the Director of the Center under such 

6 section 485E, in accordance with the Plan described 

7 under such section 485E. 

8 TITLE IV—DATA COLLECTION, 

9 ANALYSIS, AND QUALITY 

10 SEC. 401. DATA COLLECTION, ANALYSIS, AND QUALITY. 

11 The Public Health Service Act (42 U.S.C. 201 et 

12 seq.) is amended by adding at the end the following: 

13 ‘‘TITLE XXIX—DATA COLLEC14 TION, ANALYSIS, AND QUAL15 ITY 

16 ‘‘SEC. 2901. DATA COLLECTION, ANALYSIS, AND QUALITY. 

17 ‘‘(a) DATA COLLECTION AND REPORTING.—The Sec18 retary shall ensure that not later than 3 years after the 

19 date of enactment of the Minority Health Improvement 

20 and Health Disparity Elimination Act any ongoing or new 

21 federally conducted or supported health programs (includ22 ing surveys) result in the— 

23 ‘‘(1) collection and reporting of data by race 

24 and ethnicity using, at a minimum, Office of Budget 

25 and Management standards in effect on the date of 


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1 enactment of the Minority Health Improvement and 

2 Health Disparity Elimination Act; 

3 ‘‘(2) collection and reporting of data by geo4 graphic location, socioeconomic position (such as em5 ployment, income, and education), primary language, 

6 and, when determined practicable by the Secretary, 

7 health literacy; and 

8 ‘‘(3) if practicable, collection and reporting of 

9 data on additional population groups if such data 

10 can be aggregated into the minimum race and eth11 nicity data categories. 

12 ‘‘(b) DATA ANALYSIS AND DISSEMINATION.— 

13 ‘‘(1) DATA ANALYSIS.— 

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

15 analyze data collected under subsection (a) to 

16 detect and monitor trends in disparities in 

17 health and healthcare for racial and ethnic mi18 nority and other health disparity populations, 

19 and examine the interaction between various 

20 disparity indicators. 

21 ‘‘(B) QUALITY ANALYSIS.—The Secretary 

22 shall ensure that the analyses under subpara23 graph (A) incorporate data reported according 

24 to quality measurement systems. 


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1 ‘‘(2) QUALITY MEASURES.—When the Sec2 retary, by statutory or regulatory authority, adopts 

3 and implements any quality measures or any quality 

4 measurement system, the Secretary shall ensure the 

5 quality measures or quality measurement system 

6 comply with the following: 

7 ‘‘(A) MEASURES.—Measures selected shall, 

8 to the extent practicable— 

9 ‘‘(i) assess the effectiveness, timeli10 ness, patient self-management, patient 

11 centeredness, equity, and efficiency of care 

12 received by patients, including patients 

13 from racial and ethnic minority and other 

14 health disparity populations; 

15 ‘‘(ii) are evidence based, reliable, and 

16 valid; and 

17 ‘‘(iii) include measures of clinical 

18 processes and outcomes, patient experience 

19 and efficiency. 

20 ‘‘(B) CONSULTATION.—In selecting quality 

21 measures or a quality measurement system or 

22 systems for adoption and implementation, the 

23 Secretary shall consult with— 


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1 ‘‘(i) individuals from racial and ethnic 

2 minority and other health disparity popu3 lations; and 

4 ‘‘(ii) experts in the identification and 

5 elimination of disparities in health and 

6 healthcare among racial and ethnic minor7 ity and other health disparity populations. 

8 ‘‘(3) DISSEMINATION.— 

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

10 make the measures, data, and analyses de11 scribed in paragraph (1) and (2) available to— 

12 ‘‘(i) the Office of Minority Health and 

13 Health Disparity Elimination; 

14 ‘‘(ii) the National Center on Minority 

15 Health and Health Disparities; 

16 ‘‘(iii) the Agency for Healthcare Re17 search and Quality for inclusion in the 

18 Agency’s reports; 

19 ‘‘(iv) the Centers for Disease Control 

20 and Prevention; 

21 ‘‘(v) the Centers for Medicare and 

22 Medicaid Services; 

23 ‘‘(vi) the Indian Health Service; 


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1 ‘‘(vii) other agencies within the De2 partment of Health and Human Services; 

3 and 

4 ‘‘(viii) other entities as determined ap5 propriate by the Secretary. 

6 ‘‘(B) ADDITIONAL RESEARCH.—The Sec7 retary may, as the Secretary determines appro8 priate, make the measures, data, and analysis 

9 described in paragraphs (1) and (2) available 

10 for additional research, analysis, and dissemina11 tion to nongovernmental entities and the public. 

12 ‘‘(c) RESEARCH.— 

13 ‘‘(1) DISPARITY INDICATORS.— 

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

15 award grants or contracts for research to de16 velop appropriate methods, indicators, and 

17 measures that will enable the detection and as18 sessment of disparities in healthcare. Such re19 search shall prioritize research with respect to 

20 the following: 

21 ‘‘(i) Race and ethnicity. 

22 ‘‘(ii) Geographic location (such as 

23 geocoding). 

24 ‘‘(iii) Socioeconomic position (such as 

25 income or education level). 


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1 ‘‘(iv) Health literacy. 

2 ‘‘(v) Cultural competency. 

3 ‘‘(vi) Additional measures as deter4 mined appropriate by the Secretary. 

5 ‘‘(B) APPLIED RESEARCH.—The Secretary 

6 shall use the results of the research from grants 

7 awarded under subparagraph (A) to improve 

8 the data collection described under subsection 

9 (a). 

10 ‘‘(2) STRATEGIC PARTNERSHIPS TO ENCOUR11 AGE AND IMPROVE DATA COLLECTION.— 

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

13 award not more than 20 grants to eligible enti14 ties for the purposes of— 

15 ‘‘(i) enhancing and improving methods 

16 for the collection, reporting, analysis, and 

17 dissemination of data, as required under 

18 the Minority Health Improvement and 

19 Health Disparity Elimination Act; and 

20 ‘‘(ii) encouraging the collection, re21 porting, analysis, and dissemination of 

22 data to identify and address disparities in 

23 health and healthcare. 

24 ‘‘(B) DEFINITION OF ELIGIBLE ENTITY.— 

25 In this paragraph, the term ‘eligible entity’ 


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1 means a health plan, federally qualified health 

2 center, hospital, rural health clinic, academic 

3 institution, policy research organization, or 

4 other entity, including an Indian Health Service 

5 hospital or clinic, Indian tribal health facility, 

6 or urban Indian facility, that the Secretary de7 termines to be appropriate. 

8 ‘‘(C) APPLICATION.—An eligible entity de9 siring a grant under this paragraph shall sub10 mit an application to the Secretary at such 

11 time, in such manner, and containing such in12 formation as the Secretary may require. 

13 ‘‘(D) PRIORITY IN AWARDING GRANTS.—In 

14 awarding grants under this paragraph, the Sec15 retary shall give priority to eligible entities that 

16 represent collaboratives with— 

17 ‘‘(i) hospitals, health plans, or health 

18 centers; and 

19 ‘‘(ii) at least 1 community-based orga20 nization or patient advocacy group. 

21 ‘‘(E) USE OF FUNDS.—An eligible entity 

22 that receives a grant under this paragraph shall 

23 use grant funds to— 

24 ‘‘(i) collect, analyze, or report data by 

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1 economic position, health literacy, or other 

2 health disparity indicator; 

3 ‘‘(ii) conduct and report analyses of 

4 quality of healthcare and disparities in 

5 health and healthcare for racial and ethnic 

6 minority and other health disparity popu7 lations, including disparities in diagnosis, 

8 management and treatment, and health 

9 outcomes for acute and chronic disease; 

10 ‘‘(iii) improve health data collection, 

11 analysis, and reporting for subpopulations 

12 and categories; 

13 ‘‘(iv) modify, implement, and evaluate 

14 use of health information technology sys15 tems that facilitate data collection, analysis 

16 and reporting for racial and ethnic minor17 ity and other health disparity populations, 

18 and support healthcare interventions; 

19 ‘‘(v) develop educational programs to 

20 inform patients, providers, purchasers, and 

21 other individuals served about the legality 

22 and importance of the collection, analysis, 

23 and reporting of data by race, ethnicity, 

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1 tion, and health literacy, for eliminating 

2 disparities in health; and 

3 ‘‘(vi) evaluate the activities conducted 

4 under this paragraph. 

5 ‘‘(d) TECHNICAL ASSISTANCE.—The Secretary may 

6 provide technical assistance to promote compliance with 

7 the data collection and reporting requirements of the Mi8 nority Health Improvement and Health Disparity Elimi9 nation Act. 

10 ‘‘(e) PRIVACY AND SECURITY.—The Secretary shall 

11 ensure all appropriate privacy and security protections for 

12 health data collected, reported, analyzed, and dissemi13 nated pursuant to the Minority Health Improvement and 

14 Health Disparity Elimination Act. 

15 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For the 

16 purpose of carrying out this section, there are authorized 

17 to be appropriated such sums as may be necessary for 

18 each of fiscal years 2007 through 2011.’’. 


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1 TITLE V—LEADERSHIP, COL2 LABORATION, AND NATIONAL 

3 ACTION PLAN 

4 SEC. 501. OFFICE OF MINORITY HEALTH AND HEALTH DIS5 PARITY ELIMINATION. 

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

7 Service Act (42 U.S.C. 300u–6) is amended to read as 

8 follows: 

9 ‘‘SEC. 1707. OFFICE OF MINORITY HEALTH AND HEALTH 

10 DISPARITY ELIMINATION. 

11 ‘‘(a) ESTABLISHMENT.—For the purpose of improv12 ing the health of racial and ethnic minority populations 

13 and other health disparity populations, as described in 

14 subsection (b), there is established an Office of Minority 

15 Health and Health Disparity Elimination within the Office 

16 of Public Health and Science. There shall be in the De17 partment of Health and Human Services a Deputy Assist18 ant Secretary for Minority Health and Health Disparity 

19 Elimination, who shall be the head of the Office of Minor20 ity Health and Health Disparity Elimination. The Sec21 retary, acting through such Deputy Assistant Secretary, 

22 shall carry out this section. 

23 ‘‘(b) POPULATIONS TO BE SERVED.—The Secretary 

24 shall ensure that services provided under this section are 

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1 nority groups. To the extent that services are provided to 

2 other health disparity populations, such populations, as 

3 compared to the general population, must experience a— 

4 ‘‘(1) disproportionate burden of disease, par5 ticularly chronic conditions such as hepatitis B, dia6 betes, heart disease, stroke, high blood pressure, 

7 mental illness, asthma, obesity, HIV/AIDS, and can8 cer; 

9 ‘‘(2) significantly elevated risk for poor health 

10 outcomes, including disability and premature mor11 tality; 

12 ‘‘(3) disproportionate lack of access to local 

13 health resources, including hospitals, clinics, and 

14 health professionals; and 

15 ‘‘(4) lower socioeconomic position. 

16 ‘‘(c) DUTIES.—With respect to racial and ethnic mi17 nority groups, and other health disparity groups, the Sec18 retary, acting through the Deputy Assistant Secretary, 

19 shall carry out the following: 

20 ‘‘(1) Coordinate and provide input on activities 

21 within the Public Health Service that relate to dis22 ease prevention, health promotion, health service de23 livery, health workforce, and research concerning ra24 cial and ethnic minority populations, and other 

25 health disparity populations. The Secretary shall enVerDate Aug 31 2005 04:23 Oct 05, 2006 Jkt 059200 PO 00000 Frm 00110 Fmt 6652 Sfmt 6201 E:\BILLS\S4024.IS S4024

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1 sure that the heads of each of the agencies of the 

2 Service collaborate with the Deputy Assistant Sec3 retary on the development and conduct of such ac4 tivities. 

5 ‘‘(2) Not later than 1 year after the date of en6 actment of the Minority Health Improvement and 

7 Health Disparity Elimination Act, develop and im8 plement a comprehensive Department-wide plan to 

9 improve minority health and eliminate health dis10 parities in the United States, to be known as the 

11 National Plan to Improve Minority Health and 

12 Eliminate Health Disparities, (referred to in this 

13 section as the ‘National Plan’). With respect to de14 velopment and implementation of the National Plan, 

15 the Secretary shall carry out the following: 

16 ‘‘(A) Consult with the following: 

17 ‘‘(i) The Director of the Centers for 

18 Disease Control and Prevention. 

19 ‘‘(ii) The Director of the National In20 stitutes of Health. 

21 ‘‘(iii) The Director of the National 

22 Center on Minority Health and Health 

23 Disparities of the National Institutes of 

24 Health. 


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1 ‘‘(iv) The Director of the Agency for 

2 Healthcare Research and Quality. 

3 ‘‘(v) The National Coordinator for 

4 Health Information Technology. 

5 ‘‘(vi) The Administrator of the Health 

6 Resources and Services Administration. 

7 ‘‘(vii) The Administrator of the Cen8 ters for Medicare & Medicaid Services. 

9 ‘‘(viii) The Director of the Office for 

10 Civil Rights. 

11 ‘‘(ix) The Secretary of Veterans Af12 fairs. 

13 ‘‘(x) The Administrator of the Sub14 stance Abuse and Mental Health Services 

15 Administration. 

16 ‘‘(xi) The Secretary of Defense. 

17 ‘‘(xii) The Commissioner of the Food 

18 and Drug Administration. 

19 ‘‘(xiii) The Director of the Indian 

20 Health Service. 

21 ‘‘(xiv) The Secretary of Education. 

22 ‘‘(xv) The Secretary of Labor. 

23 ‘‘(xvi) The heads of other public and 

24 private entities, as determined appropriate 

25 by the Secretary. 


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1 ‘‘(B) Review and integrate existing infor2 mation and recommendations as appropriate, 

3 such as Healthy People 2010, Institute of Medi4 cine studies, and Surgeon General Reports. 

5 ‘‘(C) Ensure inclusion of measurable short6 range and long-range goals and objectives, a de7 scription of the means for achieving such goals 

8 and objectives, and a designated date by which 

9 such goals and objectives are expected to be 

10 achieved. 

11 ‘‘(D) Ensure that all amounts appro12 priated for such activities are expended in ac13 cordance with the National Plan. 

14 ‘‘(E) Review the National Plan on at least 

15 an annual basis, and report to the public and 

16 appropriate committees of Congress on 

17 progress. 

18 ‘‘(F) Revise such Plan as appropriate. 

19 ‘‘(G) Ensure that the National Plan will 

20 serve as a binding statement of policy with re21 spect to the agencies’ activities related to im22 proving health and eliminating disparities in 

23 health and healthcare. 

24 ‘‘(3) Work with Federal agencies and depart25 ments outside of the Department of Health and 


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1 Human Services as appropriate to maximize re2 sources available to increase understanding about 

3 why disparities exist, and effective ways to improve 

4 health and eliminate health disparities. 

5 ‘‘(4) In cooperation with the appropriate agen6 cies, support research, demonstrations, and evalua7 tions to test new and innovative models for— 

8 ‘‘(A) expanding healthcare access; 

9 ‘‘(B) improving healthcare quality; and 

10 ‘‘(C) increasing healthcare educational op11 portunity. 

12 ‘‘(5) Develop mechanisms that support better 

13 information dissemination, education, prevention, 

14 and service delivery to individuals from disadvan15 taged backgrounds, including individuals who are 

16 members of racial or ethnic minority groups or 

17 health disparity populations. 

18 ‘‘(6) Increase awareness of disparities in 

19 healthcare, and knowledge and understanding of 

20 health risk factors, among healthcare providers, 

21 health plans, and the public. 

22 ‘‘(7) Advise in matters related to the develop23 ment, implementation, and evaluation of health pro24 fessions education on improving healthcare outcomes 


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1 and decreasing disparities in healthcare outcomes, 

2 with focus on cultural competence. 

3 ‘‘(8) Assist healthcare professionals, community 

4 and advocacy organizations, academic medical cen5 ters and other health entities and public health de6 partments in the design and implementation of pro7 grams that will improve health outcomes by 

8 strengthening the patient-provider relationship. 

9 ‘‘(9) Carry out programs to improve access to 

10 healthcare services and to improve the quality of 

11 healthcare services for individuals with low func12 tional health literacy. 

13 ‘‘(10) Facilitate the classification and collection 

14 of healthcare data to allow for ongoing analysis to 

15 identify and determine the causes of disparities and 

16 monitoring of progress toward improving health and 

17 eliminating health disparities. 

18 ‘‘(11) Ensure that the National Center for 

19 Health Statistics collects data on the health status 

20 of each racial or ethnic minority group or health dis21 parity population pursuant to section 2901. 

22 ‘‘(12) Support a national minority health re23 source center to carry out the following: 

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1 mation and health promotion, preventive health 

2 services, and education in the appropriate use 

3 of healthcare. 

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

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

6 problems relating to such matters. 

7 ‘‘(D) Provide technical assistance with re8 spect to the exchange of such information (in9 cluding facilitating the development of materials 

10 for such technical assistance). 

11 ‘‘(13) Support a center for linguistic and cul12 tural competence to carry out the following: 

13 ‘‘(A) With respect to individuals who lack 

14 proficiency in speaking the English language, 

15 enter into contracts with public and nonprofit 

16 private providers of primary health services for 

17 the purpose of increasing the access of such in18 dividuals to such services by developing and 

19 carrying out programs to improve health lit20 eracy and cultural competency. 

21 ‘‘(B) Carry out programs to improve ac22 cess to healthcare services for individuals with 

23 limited proficiency in speaking the English lan24 guage. Activities under this subparagraph shall 


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1 include developing and evaluating model 

2 projects. 

3 ‘‘(14) Enter into interagency agreements with 

4 other agencies of the Public Health Service, as ap5 propriate. 

6 ‘‘(15) Collaborate with the Office for Civil 

7 Rights to— 

8 ‘‘(A) assist healthcare providers with appli9 cation of guidance and directives regarding 

10 healthcare for racial and ethnic minority and 

11 other health disparity populations, including— 

12 ‘‘(i) reviewing cases with the Office of 

13 Inspector General and the Office for Civil 

14 Rights which have been closed without a 

15 finding of discrimination to determine if a 

16 pattern or practice of activities that could 

17 lead to discrimination exists, and if such a 

18 pattern or practice is identified, provide 

19 technical assistance or education, as appli20 cable, to the relevant provider or to a 

21 group of providers located within a par22 ticular geographic area; 

23 ‘‘(ii) biannually publishing informa24 tion on cases filed with the Office for Civil 

25 Rights which have resulted in a finding of 


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1 discrimination, including the name and lo2 cation of the entity found to have discrimi3 nated, and any findings and agreements 

4 entered into between the Office for Civil 

5 Rights and the entity; and 

6 ‘‘(iii) monitoring and analysis of 

7 trends in cases reported to the Office for 

8 Civil Rights to ensure that the Office of 

9 Minority Health and Health Disparity 

10 Elimination acts to educate and assist 

11 healthcare providers as necessary; and 

12 ‘‘(B) provide technical assistance or edu13 cation, as applicable, to the relevant provider or 

14 to a group of providers located within a par15 ticular geographic area. 

16 ‘‘(16) Promote and expand efforts to increase 

17 racial and ethnic minority enrollment in clinical 

18 trials. 

19 ‘‘(17) Establish working groups— 

20 ‘‘(A) to examine and report recommenda21 tions to the Secretary regarding— 

22 ‘‘(i) emergency preparedness and re23 sponse for underserved populations; 

24 ‘‘(ii) development and implementation 

25 of health information technology that can 


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1 assist providers to deliver culturally com2 petent healthcare; 

3 ‘‘(iii) outreach and education of health 

4 disparity groups about new Federal health 

5 programs, as appropriate, including the 

6 programs under part D of title XVIII of 

7 the Social Security Act and chronic care 

8 management programs under the Medicare 

9 Prescription Drug, Improvement, and 

10 Modernization Act of 2003 (and the 

11 amendments made by such Act); 

12 ‘‘(iv) leadership development in public 

13 health; and 

14 ‘‘(v) other emerging health issues at 

15 the discretion of the Secretary; and 

16 ‘‘(B) that include representation from the 

17 relevant health agencies, centers and offices, as 

18 well as public and private entities as appro19 priate. 

20 ‘‘(d) ADVISORY COMMITTEE.— 

21 ‘‘(1) IN GENERAL.—The Secretary shall estab22 lish an advisory committee to be known as the Advi23 sory Committee on Minority Health and Health Dis24 parities (in this subsection referred to as the ‘Com25 mittee’). 


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

2 advice to the Deputy Assistant Secretary carrying 

3 out this section, including advice on the development 

4 of goals and specific program activities under sub5 section (c) for racial and ethnic minority groups and 

6 health disparity population. 

7 ‘‘(3) CHAIR.—The chairperson of the Com8 mittee shall be selected by the Secretary from among 

9 the members of the voting members of the Com10 mittee. The term of office of the chairperson shall be 

11 2 years. 

12 ‘‘(4) COMPOSITION.— 

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

14 12 voting members appointed in accordance 

15 with subparagraph (B), and nonvoting, ex-offi16 cio members designated in subparagraph (C). 

17 ‘‘(B) The voting members of the Com18 mittee shall be appointed by the Secretary from 

19 among individuals who are not officers or em20 ployees of the Federal Government and who 

21 have expertise regarding issues of minority 

22 health and health disparities. Racial and ethnic 

23 minority groups and health disparity popu24 lations shall be appropriately represented 

25 among such members. 


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

2 the Committee shall be such officials of the De3 partment of Health and Human Services, in4 cluding the Director of the Office of Minority 

5 Health and Health Disparity Elimination and 

6 the Office for Civil Rights, and other officials 

7 as the Secretary determines to be appropriate. 

8 ‘‘(D) The Secretary shall provide an oppor9 tunity for the Chairman and Ranking Member 

10 of the Committee on Health, Education, Labor, 

11 and Pensions of the Senate to submit to the 

12 Secretary names of potential Committee mem13 bers under this section for consideration. 

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

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

16 Secretary shall initially appoint a portion of the 

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

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

19 Committee, a new member shall be appointed by the 

20 Secretary within 90 days from the date that the va21 cancy occurs, and serve for the remainder of the 

22 term for which the predecessor of such member was 

23 appointed. The vacancy shall not affect the power of 

24 the remaining members to execute the duties of the 

25 Committee. 


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1 ‘‘(7) COMPENSATION.—Members of the Com2 mittee who are officers or employees of the United 

3 States shall serve without additional compensation. 

4 Members of the Committee who are not officers or 

5 employees of the United States shall receive com6 pensation, for each day (including travel time) they 

7 are engaged in the performance of the functions of 

8 the Committee. Such compensation may not be in an 

9 amount in excess of the daily equivalent of the an10 nual maximum rate of basic pay payable under the 

11 General Schedule for positions above GS–15 under 

12 title 5, United States Code. 

13 ‘‘(e) CERTAIN REQUIREMENTS REGARDING DU14 TIES.— 

15 ‘‘(1) RECOMMENDATIONS REGARDING LAN16 GUAGE.— 

17 ‘‘(A) PROFICIENCY IN SPEAKING

18 ENGLISH.—The Deputy Assistant Secretary 

19 shall consult with the Director of the Office of 

20 International and Refugee Health, the Director 

21 of the Office for Civil Rights, and the Directors 

22 of other appropriate departmental entities re23 garding recommendations for carrying out ac24 tivities under subsection (c)(9). 


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1 ‘‘(B) HEALTH PROFESSIONS EDUCATION

2 REGARDING HEALTH DISPARITIES.—The Dep3 uty Assistant Secretary shall carry out the du4 ties under subsection (c)(7) in collaboration 

5 with appropriate personnel of the Department 

6 of Health and Human Services, other Federal 

7 agencies, and other offices, centers, and institu8 tions, as appropriate, that have responsibilities 

9 under the Minority Health and Health Dispari10 ties Research and Education Act of 2000. 

11 ‘‘(2) RESOURCE ALLOCATION.— 

12 ‘‘(A) FUNDING.—In carrying out sub13 section (c), the Secretary shall ensure that such 

14 funding and other resources directed to health 

15 disparity populations that are not racial and 

16 ethnic minority populations are used to supple17 ment, not supplant, funding and other re18 sources currently or historically allocated for 

19 services provided to such populations. 

20 ‘‘(B) ACTIVITIES.—When carrying out ac21 tivities for health disparity populations that are 

22 not racial and ethnic minority populations, the 

23 Secretary shall ensure that such activities car24 ried out by the Office of Minority Health and 

25 Health Disparity Elimination supplement, not 


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1 supplant, the activities of other offices or agen2 cies whose primary mission by established man3 date, or current or historical practice is to serve 

4 such populations. 

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

6 The Secretary shall ensure that information and 

7 services provided pursuant to subsection (c) consider 

8 the unique cultural or linguistic issues facing such 

9 populations and are provided in the language, edu10 cational, and cultural context that is most appro11 priate for the individuals for whom the information 

12 and services are intended. 

13 ‘‘(4) AGENCY COORDINATION.—In carrying out 

14 subsection (c), the Secretary shall ensure that new 

15 or existing agency offices of minority health, or 

16 other health disparity offices, report current and 

17 proposed activities to the Deputy Assistant Sec18 retary, and provide, to the extent practicable, an op19 portunity for input in the development of such ac20 tivities by the Deputy Assistant Secretary. 

21 ‘‘(f) GRANTS AND CONTRACTS REGARDING DU22 TIES.— 

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

24 (c), the Secretary acting through the Deputy Assist25 ant Secretary, may make awards of grants, cooperaVerDate Aug 31 2005 04:23 Oct 05, 2006 Jkt 059200 PO 00000 Frm 00124 Fmt 6652 Sfmt 6201 E:\BILLS\S4024.IS S4024

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1 tive agreements, and contracts to public and non2 profit private entities. 

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

4 Deputy Assistant Secretary shall ensure that awards 

5 under paragraph (1) are made, to the extent prac6 tical, only on a competitive basis, and that a grant 

7 is awarded for a proposal only if the proposal has 

8 been recommended for such an award through a 

9 process of peer review. 

10 ‘‘(3) EVALUATION AND DISSEMINATION.—The 

11 Deputy Assistant Secretary, directly or through con12 tracts with public and private entities, shall provide 

13 for evaluations of projects carried out with awards 

14 made under paragraph (1) during the preceding 2 

15 fiscal years. The report shall be included in the re16 port required under subsection (g) for the fiscal year 

17 involved. 

18 ‘‘(g) STATE OFFICES OF MINORITY HEALTH.—The 

19 Deputy Assistant Secretary shall assist the voluntary es20 tablishment and functions of State offices of minority 

21 health in order to expand and coordinate State efforts to 

22 improve the health of minority and other health disparity 

23 populations. 


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1 ‘‘(1) PRIORITIES.—The Deputy Assistant Sec2 retary may facilitate, with respect to minority and 

3 health disparity populations— 

4 ‘‘(A) integration and coordination of State 

5 and national efforts, including those pertaining 

6 to the National Plan pursuant to subsection 

7 (b); 

8 ‘‘(B) strategic plan development within 

9 States to assess and respond to local health 

10 concerns; 

11 ‘‘(C) education and engagement of key 

12 stakeholders within States, including represent13 atives from public health agencies, hospitals, 

14 clinics, provider groups, elected officials, com15 munity-based organizations, advocacy groups, 

16 media, and the private sector; 

17 ‘‘(D) development and implementation of 

18 accepted standards, core competencies, and 

19 minimum infrastructure requirements for State 

20 offices; 

21 ‘‘(E) access to State level health data for 

22 minority and health disparity populations, 

23 which may include State data collection and 

24 analysis; 


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1 ‘‘(F) development, implementation, and 

2 evaluation of State programs and policies, as 

3 appropriate; 

4 ‘‘(G) communication and networking 

5 among States to share effective policies, pro6 grams and practices with respect to increasing 

7 access and quality of care; 

8 ‘‘(H) recognition and reporting of State 

9 successes and challenges; and 

10 ‘‘(I) identification of Federal grant pro11 grams and other funding for which States could 

12 apply to carry out health improvement activi13 ties. 

14 ‘‘(2) RESOURCES.—The Deputy Assistant Sec15 retary may provide grants and technical assistance 

16 for the voluntary establishment or capacity develop17 ment of State offices of minority health. 

18 ‘‘(3) COLLABORATION.—To the extent prac19 ticable, the Deputy Assistant Secretary may encour20 age and facilitate collaboration between State offices 

21 of minority health and State offices addressing the 

22 needs of other health disparity or disadvantaged 

23 populations, including offices of rural health. 

24 ‘‘(4) DEFINITION.—For the purpose of this 

25 subsection, ‘State offices of minority health’ include 


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1 offices, councils, commissions, or advisory panels 

2 designated by States or territories to address the 

3 health of minority populations. 

4 ‘‘(h) REPORTS.— 

5 ‘‘(1) IN GENERAL.—Not later than 1 year after 

6 the date of enactment of the Minority Health Im7 provement and Health Disparity Elimination Act, 

8 the Secretary shall submit to the appropriate com9 mittees of Congress, a report on the National Plan 

10 developed under subsection (c). 

11 ‘‘(2) REPORT ON ACTIVITIES.—Not later than 

12 February 1 of fiscal year 2008 and of each second 

13 year thereafter, the Secretary shall submit to the ap14 propriate committees of Congress, a report describ15 ing the activities carried out under this section dur16 ing the preceding 2 fiscal years and evaluating the 

17 extent to which such activities have been effective in 

18 improving the health of racial and ethnic minority 

19 groups and health disparity populations. Each such 

20 report shall include the biennial reports submitted 

21 under subsection (f)(3) for such years by the heads 

22 of the Public Health Service agencies. 

23 ‘‘(3) AGENCY REPORTS.—Not later than Feb24 ruary 1, 2007, and on a biannual basis thereafter, 

25 the heads of the Public Health Service shall submit 


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1 to the Deputy Assistant Secretary a report that 

2 summarizes the minority health and health disparity 

3 activities of each of the respective agencies. 

4 ‘‘(i) DEFINITIONS.—In this section: 

5 ‘‘(1) The term ‘health disparity population’ has 

6 the meaning given the term in section 903(d)(1). 

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

8 group’ means American Indians (including Alaska 

9 Natives, Eskimos, and Aleuts), Asian Americans, 

10 Native Hawaiians and other Pacific Islanders, 

11 Blacks, and Hispanics. 

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

13 whose origin is Mexican, Puerto Rican, Cuban, Cen14 tral or South American, or of any other Spanish15 speaking country. 

16 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—For the 

17 purpose of carrying out this section, there are authorized 

18 to be appropriated $110,000,000 for fiscal year 2007, 

19 such sums as may be necessary for each of fiscal years 

20 2008 through 2011.’’. 

21 (b) TRANSFER OF FUNCTIONS; REFERENCES.— 

22 (1) TRANSFER OF FUNCTIONS.— 

23 (A) OFFICE OF MINORITY HEALTH AND

24 HEALTH DISPARITY ELIMINATION.—The func25 tions of the Office of Minority Health under 


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•S 4024 IS

1 section 1707 of the Public Health Service Act 

2 (42 U.S.C. 300u–6) as in effect the day before 

3 the date of enactment of this Act are trans4 ferred to the Office of Minority Health and 

5 Health Disparity Elimination under such sec6 tion 1707 (as amended by subsection (a)). 

7 (B) DEPUTY ASSISTANT SECRETARY FOR

8 MINORITY HEALTH AND HEALTH DISPARITY

9 ELIMINATION.—The functions of the Deputy 

10 Assistant Secretary for Minority Health of the 

11 Office of Minority Health under section 1707 of 

12 the Public Health Service Act (42 U.S.C. 

13 300u–6) as in effect the day before the date of 

14 enactment of this Act are transferred to the 

15 Deputy Assistant Secretary for Minority Health 

16 and Health Disparity Elimination of the Office 

17 of Minority Health and Health Disparity Elimi18 nation under such section 1707 (as amended by 

19 subsection (a)). 

20 (2) REFERENCES.— 

21 (A) OFFICE OF MINORITY HEALTH AND

22 HEALTH DISPARITY ELIMINATION.—Any ref23 erence in any Federal law, Executive order, 

24 rule, regulation, or delegation of authority, or 

25 any document of or pertaining to the Office of 


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1 Minority Health under section 1707 of the Pub2 lic Health Service Act (42 U.S.C. 300u–6) as in 

3 effect the day before the enactment of this Act 

4 is deemed to be a reference to the Office of Mi5 nority Health and Health Disparity Elimination 

6 under such section 1707 (as amended by sub7 section (a)). 

8 (B) DEPUTY ASSISTANT SECRETARY FOR

9 MINORITY HEALTH AND HEALTH DISPARITY

10 ELIMINATION.—Any reference in any Federal 

11 law, Executive order, rule, regulation, or delega12 tion of authority, or any document of or per13 taining to the Deputy Assistant Secretary for 

14 Minority Health of the Office of Minority 

15 Health under section 1707 of the Public Health 

16 Service Act (42 U.S.C. 300u–6) as in effect the 

17 day before the enactment of this Act is deemed 

18 to be a reference to the Deputy Assistant Sec19 retary for Minority Health and Health Dis20 parity Elimination of the Office of Minority 

21 Health and Health Disparity Elimination under 

22 such section 1707 (as amended by subsection 

23 (a)). 

Æ 


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