I
103D CONGRESS
2D SESSION
H. R. 4841
To establish a fund for various programs to strengthen and expand the
capacity of State and local governments and other entities to improve
the public health.
IN THE HOUSE OF REPRESENTATIVES
JULY 27, 1994
Mr. MORAN (for himself, Mr. STOKES, Mr. DELLUMS, Mr. HILLIARD, Mr.
FARR of California, Mr. NEAL of North Carolina, Mr. STUDDS, Ms.
PELOSI, Mr. SERRANO, Mr. FILNER, Mr. FOGLIETTA, Mr. SANDERS,
Mrs. MALONEY, and Mr. PAYNE of New Jersey) introduced the following
bill; which was referred jointly to the Committees on Energy and Com-
merce, Education and Labor, and Ways and Means
A BILL
To establish a fund for various programs to strengthen and
expand the capacity of State and local governments and
other entities to improve the public health.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the
‘‘Public Health Improvement Act of 1994’’.
(b) TABLE OF CONTENTS.—The table of titles and
subtitles for this Act is as follows:
TITLE I—PROGRAMS UNDER PUBLIC HEALTH
IMPROVEMENT TRUST FUND
Subtitle A—Programs of Public Health Service Act
Subtitle B—Comprehensive School Health Education
TITLE II—AMENDMENTS TO INTERNAL REVENUE CODE
OF 1986
TITLE 
I—PROGRAMS 
UNDER
PUBLIC 
HEALTH 
IMPROVE-
MENT TRUST FUND
Subtitle A—Programs of Public
Health Service Act
SEC. 101. TABLE OF CONTENTS REGARDING NEW TITLE
XXVII OF PUBLIC HEALTH SERVICE ACT.
A table describing the contents of title XXVII of the
Public Health Service Act, as added by section 102 of this
Act, is as follows:
TITLE XXVII—PROGRAMS UNDER PUBLIC HEALTH
IMPROVEMENT TRUST FUND
Subtitle A—Establishment of Fund; Advisory Commission
Sec. 2701. Public Health Improvement Trust Fund.
Sec. 2702. Public Health Advisory Commission.
Subtitle B—Core Functions of Public Health Programs
PART 1—FORMULA GRANTS TO STATES
Sec. 2711. Authorizations of appropriations from Fund.
Sec. 2712. Formula grants to States for core health functions.
Sec. 2713. Number of functions; planning.
Sec. 2714. Submission of information; reports.
Sec. 2715. Application for grant.
Sec. 2716. Determination of amount of allotment.
Sec. 2717. Allocations for certain activities.
PART 2—COMPREHENSIVE EVALUATION OF DISEASE PREVENTION AND
HEALTH PROMOTION PROGRAMS
Sec. 2718. Authorizations of appropriations from Fund.
Sec. 2719. Evaluation of programs.
Subtitle C—Opportunities for Education and Training in
Public Health
PART 1—SCHOLARSHIP AND LOAN REPAYMENT PROGRAMS REGARDING
SERVICE IN PUBLIC HEALTH POSITIONS
Sec. 2721. Authorizations of appropriations from Fund.
Sec. 2722. Scholarship program.
Sec. 2723. Loan repayment program.
Sec. 2724. Approved public health positions.
Sec. 2725. Allocation of funds; special considerations.
PART 2—EDUCATIONAL INSTITUTIONS REGARDING PUBLIC HEALTH
Sec. 2731. Authorizations of appropriations from Fund.
Sec. 2732. Grants for expanding capacity of institutions.
Sec. 2733. Coordination of grant activities with national priorities.
Sec. 2734. Certain requirements for grants.
PART 3—EXPANSION OF COMPETENCY IN PUBLIC HEALTH
Sec. 2736. Authorizations of appropriations from Fund.
Sec. 2737. Grants to States.
PART 4—GENERAL PROVISIONS REGARDING EDUCATION AND TRAINING
Sec. 2740. Underrepresented minorities regarding fields of public health.
Sec. 2740A. Coordination of programs.
Subtitle D—Regional Poison Control Centers
Sec. 2741. Authorizations of appropriations from Fund.
Sec. 2742. Grants for regional centers.
Sec. 2743. Requirements regarding certification.
Sec. 2744. General provisions.
Subtitle E—School-Related Health Services
PART 1—PROJECTS FOR PROVISION OF SERVICES
SUBPART A—DEVELOPMENT AND OPERATION OF PROJECTS
Sec. 2746. Authorizations of appropriations from Fund.
Sec. 2747. Eligibility for development and operation grants.
Sec. 2748. Preferences.
Sec. 2749. Grants for development of projects.
Sec. 2750. Grants for operation of projects.
Sec. 2751. Federal administrative costs.
SUBPART B—CAPITAL COSTS OF DEVELOPING PROJECTS
Sec. 2753. Loans and loan guarantees regarding projects.
Sec. 2754. Funding.
PART 2—SCHOLARSHIP AND LOAN REPAYMENT PROGRAMS REGARDING
SCHOOL NURSES
Sec. 2755. Authorizations of appropriations from Fund.
Sec. 2755A. Scholarship program regarding upgrade in skills.
Sec. 2755B. Loan repayment program.
Sec. 2755C. School-nurse positions.
Subtitle F—Expansion of Access to Health Services
PART 1—COMMUNITY AND MIGRANT HEALTH CENTERS
Sec. 2756. Authorizations of appropriations from Fund.
Sec. 2757. Grants to community and migrant health centers.
PART 2—QUALIFIED COMMUNITY HEALTH PLANS AND PRACTICE NETWORKS
SUBPART A—FUNDING; PURPOSES
Sec. 2761. Authorizations of appropriations from Fund.
Sec. 2762. Purposes.
SUBPART B—DEVELOPMENT OF QUALIFIED COMMUNITY HEALTH PLANS AND
PRACTICE NETWORKS
Sec. 2763. Grants and contracts for development of plans and networks.
Sec. 2764. Preferences in making awards of assistance.
Sec. 2765. Certain uses of awards.
Sec. 2766. Accessibility of services.
Sec. 2767. Additional agreements.
Sec. 2768. Submission of certain information.
Sec. 2769. Reports; audits.
Sec. 2770. Application for assistance.
Sec. 2771. General provisions.
SUBPART C—CAPITAL COST OF DEVELOPMENT OF QUALIFIED COMMUNITY
HEALTH PLANS AND PRACTICE NETWORKS
Sec. 2773. Loans and loan guarantees regarding plans and networks.
Sec. 2774. Certain requirements.
Sec. 2775. Defaults; right of recovery.
Sec. 2776. Provisions regarding construction or expansion of facilities.
Sec. 2777. Application for assistance.
Sec. 2778. Administration of programs.
PART 3—ENABLING SERVICES
Sec. 2779. Authorizations of appropriations from Fund.
Sec. 2780. Grants and contracts for enabling services.
PART 4—NATIONAL HEALTH SERVICE CORPS
Sec. 2781. Authorizations of appropriations from Fund.
PART 5—SATELLITE CLINICS REGARDING PRIMARY HEALTH CARE
Sec. 2783. Authorizations of appropriations from Fund.
Sec. 2783A. Grants to States for development and operation of satellite clinics.
PART 6—COMMUNITY HEALTH ADVISORS
Sec. 2784. Authorizations of appropriations from Fund.
Sec. 2785. Formula grants regarding community health advisor programs.
Sec. 2786. Requirements regarding community health advisor programs.
Sec. 2787. Additional agreements.
Sec. 2788. Application for assistance; State plan.
Sec. 2789. Determination of amount of allotment.
Sec. 2790. Quality assurance; cost-effectiveness.
Sec. 2791. Evaluations; technical assistance.
Sec. 2792. Rule of construction regarding programs of Indian Health Service.
Sec. 2793. Definitions.
Sec. 2794. Effect of insufficient appropriations for minimum allotments.
PART 7—MENTAL HEALTH; SUBSTANCE ABUSE
Sec. 2795. Authorizations of appropriations from Fund.
Sec. 2796. Supplemental formula grants for States regarding activities under
part B of title XIX.
Sec. 2797. Capital costs of development of certain centers and clinics.
Subtitle E—General Provisions
Sec. 2798. Requirement regarding accreditation of schools, departments, and
programs.
Sec. 2799. Definitions.
SEC. 102. ESTABLISHMENT OF NEW TITLE XXVII REGARD-
ING PUBLIC HEALTH PROGRAMS.
The Public Health Service Act (42 U.S.C. 201 et
seq.) is amended by adding at the end the following title:
‘‘TITLE 
XXVII—PROGRAMS
UNDER PUBLIC HEALTH IM-
PROVEMENT TRUST FUND
‘‘Subtitle A—Establishment of
Fund; Advisory Commission
‘‘SEC. 2701. PUBLIC HEALTH IMPROVEMENT TRUST FUND.
‘‘(a) ESTABLISHMENT OF FUND.—There is estab-
lished in the Treasury of the United States a fund to be
known as the Public Health Improvement Trust Fund (in
this title referred to as the ‘Fund’), consisting of the
amounts appropriated in subsection (b) and subsection
(d)(3). Amounts in the Fund are available until expended.
‘‘(b) TRANSFERS TO FUND.—There are hereby ap-
propriated to the Fund amounts equivalent to the increase
in the revenues received in the Treasury by reason of the
amendments made by section 201 of the Public Health
Improvement Act of 1994.
‘‘(c) EXPENDITURES FROM FUND.—Amounts in the
Fund are available for carrying out this title, and for car-
rying out subtitle B of title I of the Public Health Im-
provement Act of 1994 (relating to comprehensive school
health education), subject to the extent of amounts made
available in advance in appropriations Act pursuant to the
authorizations of appropriations established in the other
subtitles of this title and in section 2702. This section does
not establish any authorization of appropriations.
‘‘(d) INVESTMENT.—
‘‘(1) IN
GENERAL.—The Secretary of the
Treasury shall invest such amounts of the Fund as
such Secretary determines are not required to meet
current withdrawals from the Fund. Such invest-
ments may be made only in interest-bearing obliga-
tions of the United States. For such purpose, such
obligations may be acquired on original issue at the
issue price, or by purchase of outstanding obliga-
tions at the market price.
‘‘(2) SALE
OF
OBLIGATIONS.—Any obligation
acquired by the Fund may be sold by the Secretary
of the Treasury at the market price.
‘‘(3) AVAILABILITY OF INCOME.—Any interest
derived from obligations acquired by the Fund, and
proceeds from any sale or redemption of such obliga-
tions, are hereby appropriated to the Fund.
‘‘SEC. 2702. PUBLIC HEALTH ADVISORY COMMISSION.
‘‘(a) IN GENERAL.—The Secretary shall establish
within the Office of the Assistant Secretary for Health an
advisory commission to be known as the National Public
Health Advisory Commission (in this title referred to as
the ‘Commission’). The first meeting of the Commission
shall be held not later than 90 days after the date of the
enactment of the Public Health Improvement Act of 1994.
‘‘(b) DUTIES.—
‘‘(1) IN GENERAL.—The Commission shall pro-
vide to the Secretary advice on carrying out this title
(including advice on the amount of funds that
should be made available for each of the programs
of this title and including advice on improving such
programs) and advice on other Federal policies re-
garding the public health (including the rec-
ommendations of the Commission for changes in
such policies). In carrying out the preceding sen-
tence, the Commission shall monitor the develop-
ment and operation of the programs of this title.
‘‘(2) CERTAIN ACTIVITIES.—The activities car-
ried out under paragraph (1) by the Commission
shall include the following:
‘‘(A) Assessing the effectiveness and cost-
effectiveness of public health programs on im-
proving health status of communities.
‘‘(B) Assessing the effectiveness and cost-
effectiveness of public health interventions at
the community level.
‘‘(C) Assessing the impact of health care
reform on access to clinical preventive services,
early detection services, and health promotion
services.
‘‘(c) COMPOSITION.—
‘‘(1) EX
OFFICIO
MEMBERS.—The heads of
each of the agencies of the Public Health Service (or
the designees of such heads) shall serve as nonvoting
members of the Commission. The Secretary may
designate additional Federal officials to so serve.
‘‘(2) APPOINTED
MEMBERS.—The Secretary
shall appoint to the Commission 9 individuals who
are not officers or employees of the Federal Govern-
ment, which individuals shall serve as voting mem-
bers of the Commission. Individuals appointed under
the preceding sentence shall include—
‘‘(A) individuals who are experienced or
specially trained in a field of public health;
‘‘(B) members of professional organiza-
tions regarding the public health;
‘‘(C) members of the general public; and
‘‘(D) members of organizations represent-
ing the general public.
‘‘(3) 
REQUIREMENT
REGARDING
MINORITY
GROUPS.—The Secretary shall ensure that the mem-
bership of the Commission includes individuals who
are members of racial and ethnic minority groups.
‘‘(d) CHAIR.—From among the members of the Com-
mission appointed under subsection (c)(2), the President
shall designate an individual to serve as the chair of the
Commission.
‘‘(e) TERMS.—
‘‘(1) IN GENERAL.—The term of a member of
the Commission appointed under subsection (c)(2) is
3 years, except that, of such members first ap-
pointed to the Commission, the Secretary shall speci-
fy varying terms of membership to achieve the result
that not more than 1⁄3 of the terms of members so
appointed expire in any 1 year.
‘‘(2) SERVICE AFTER EXPIRATION OF TERM.—
A member of the Commission may continue to serve
after the expiration of the term of the member until
a successor is appointed.
‘‘(f) VACANCIES.—
‘‘(1) AUTHORITY OF COMMISSION.—A vacancy
in the membership of the Commission does not af-
fect the power of the remaining members to carry
out the duties under subsection (b).
‘‘(2) APPOINTMENT
OF
SUCCESSORS.—A va-
cancy in the membership of the Commission shall be
filled in the manner in which the original appoint-
ment was made.
‘‘(3) INCOMPLETE TERM.—If a member of the
Commission does not serve the full term applicable
to the member, the individual appointed to fill the
resulting vacancy shall be appointed for the remain-
der of the term of the predecessor of the individual.
‘‘(g) MEETINGS.—The Commission shall meet at the
call of the Chair or a majority of the members, except
that the Commission shall meet not fewer than 3 times
each fiscal year.
‘‘(h) COMPENSATION; REIMBURSEMENT
OF
EX-
PENSES.—
$150,000,000 for fiscal year 1995, $400,000,000 for fis-
cal year 1996, $550,000,000 for fiscal year 1997,
$650,000,000 for fiscal year 1998, $750,000,000 for fis-
cal year 1999, $850,000,000 for fiscal year 2000,
$900,000,000 for fiscal year 2001, and $900,000,000 for
fiscal year 2002.
‘‘SEC. 2712. FORMULA GRANTS TO STATES FOR CORE
HEALTH FUNCTIONS.
‘‘(a) IN GENERAL.—In the case of each State that
submits to the Secretary an application in accordance with
section 2715 for a fiscal year, the Secretary of Health and
Human Services, acting through the Director of the Cen-
ters for Disease Control and Prevention, shall make a
grant to the State for carrying out the activities described
in subsection (c). The award shall consist of the allotment
determined under section 2716 for the State.
‘‘(b) GENERAL PURPOSE.—The purpose of this sub-
title is to provide for improvements in the health status
of the public through carrying out the activities described
in subsection (b) toward attaining the Healthy People
2000 Objectives (as defined in section 2799). A funding
agreement for a grant under subsection (a) is that—
‘‘(1) the grant will be expended for such activi-
ties; and
‘‘(2) the activities will be carried out by the
State in collaboration with local public health de-
partments, health education and training centers,
neighborhood health centers, and other community
health providers.
‘‘(c) CORE FUNCTIONS OF PUBLIC HEALTH PRO-
GRAMS.—Subject to the purpose described in subsection
(b), the activities referred to in subsection (a) are the
following:
‘‘(1) Data collection, and analytical activities,
related to population-based status and outcomes
monitoring, including the following:
‘‘(A) The regular collection and analysis of
public health data (including the 10 leading
causes of death and their costs to society).
‘‘(B) Vital statistics.
‘‘(C) Personal health services data.
‘‘(D) The supply and distribution of health
professionals.
‘‘(2) Activities to reduce environmental risk and
to assure the safety of housing, schools, workplaces,
day-care centers, food and water, including the fol-
lowing activities:
‘‘(A) Monitoring the overall public health
status and safety of communities.
‘‘(B) Assessing exposure to high lead levels
and other environmental contaminants; and ac-
tivities for abatement of toxicant hazards, in-
cluding lead-related hazards.
‘‘(C) Monitoring the quality of community
water supplies used for consumption or for rec-
reational purposes.
‘‘(D) Monitoring sewage and solid waste
disposal, radiation exposure, radon exposure,
and noise levels.
‘‘(E) Monitoring indoor and ambient air
quality and related risks to vulnerable popu-
lations.
‘‘(F) Assuring recreation, worker, and
school safety.
‘‘(G) Enforcing public health safety and
sanitary codes.
‘‘(H) Monitoring community access to ap-
propriate health services.
‘‘(I) Other activities relating to promoting
and protecting the public health of commu-
nities.
‘‘(3) Investigation, control, and public-aware-
ness activities regarding adverse health conditions
(such as emergency treatment preparedness, commu-
nity efforts to reduce violence, outbreaks of commu-
nicable diseases within communities, chronic disease
and dysfunction exposure-related conditions, toxic
environmental pollutants, occupational and rec-
reational hazards, motor vehicle accidents, and other
threats to the health status of individuals).
‘‘(4) Public information and education pro-
grams to reduce risks to health (such as use of to-
bacco, alcohol and other drugs; unintentional injury
from accidents, including motor vehicle accidents;
sexual activities that increase the risk to HIV trans-
mission and sexually transmitted diseases; poor diet;
physical inactivity; stress-related illness; mental
health problems; genetic disorders; and low child-
hood immunization levels).
‘‘(5) Provision of public health laboratory serv-
ices to complement private clinical laboratory serv-
ices and that screen for diseases and conditions
(such as metabolic diseases in newborns, provide as-
sessments of blood lead levels and other environ-
mental toxicants, diagnose and contact tracing of
sexually transmitted diseases, tuberculosis and other
diseases requiring partner notification, test for infec-
tious and food-borne diseases, and monitor the safe-
ty of water and food supplies).
(6) Training and education of new and existing
health professionals in the field of public health,
with special emphasis on epidemiology, biostatistics,
health education, public health administration, pub-
lic health nursing and dentistry, environmental and
occupational health sciences, public health nutrition,
social and behavioral health sciences, operations re-
search, and laboratory technology.
‘‘(7) Leadership, policy development and admin-
istration activities, including assessing needs and the
supply and distribution of health professionals; the
setting of public health standards; the development
of community public health policies; and the develop-
ment of community public health coalitions.
‘‘(d) RESTRICTIONS ON USE OF GRANT.—
‘‘(1) IN GENERAL.—A funding agreement for a
grant under subsection (a) for a State is that the
grant will not be expended—
‘‘(A) to provide inpatient services;
‘‘(B) to make cash payments to intended
recipients of health services;
‘‘(C) to purchase or improve land, pur-
chase, construct, or permanently improve (other
than minor remodeling) any building or other
facility, or purchase major medical equipment;
‘‘(D) to satisfy any requirement for the ex-
penditure of non-Federal funds as a condition
for the receipt of Federal funds; or
‘‘(E) to provide financial assistance to any
entity other than a public or nonprofit private
entity.
‘‘(2) LIMITATION
ON
ADMINISTRATIVE
EX-
PENSES.—A funding agreement for a grant under
subsection (a) is that the State involved will not ex-
pend more than 20 percent of the grant for adminis-
trative expenses with respect to the grant.
‘‘(e) MAINTENANCE OF EFFORT.—A funding agree-
ment for a grant under subsection (a) is that the State
involved will maintain expenditures of non-Federal
amounts for core health functions at a level that is not
less than the level of such expenditures maintained by the
State for the fiscal year preceding the first fiscal year for
which the State receives such a grant.
‘‘SEC. 2713. NUMBER OF FUNCTIONS; PLANNING.
‘‘(a) NUMBER
OF FUNCTIONS.—Subject to sub-
section (b), a funding agreement for a grant under section
2712 is that the State involved will carry out each of the
activities described in subsection (c) of such section.
‘‘(b) PLANNING.—In making grants under section
2712, the Secretary shall for each State designate a period
during which the State is to engage in planning to meet
the responsibilities of the State under subsection (a). The
period so designated may not exceed 18 months. With re-
spect to such period for a State, a funding agreement for
a grant under section 2712 for any fiscal year containing
any portion of the period is that, during the period, the
State will expend the grant only for such planning.
‘‘SEC. 2714. SUBMISSION OF INFORMATION; REPORTS.
(a) SUBMISSION OF INFORMATION.—The Secretary
may make a grant under section 2712 only if the State
involved submits to the Secretary the following informa-
tion:
‘‘(1) A description of the relationship between
community health providers, public and private
health plans, and the public health system of the
State.
‘‘(2) A description of existing deficiencies in the
public health system at the State level and the local
level, using standards under the Healthy People
2000 Objectives.
‘‘(3) A description of public health priorities
identified at the State level and local levels, includ-
ing the 10 leading causes of death and their respec-
tive direct and indirect costs to the State and the
Federal Government.
‘‘(4) Measurable outcomes and process objec-
tives (using criteria under the Healthy People 2000
Objectives) which indicate improvements in health
status as a result of the activities carried out under
section 2712(c).
‘‘(5) Information regarding each such activity,
which—
‘‘(A) identifies the amount of State and
local funding expended on each such activity for
the fiscal year preceding the fiscal year for
which the grant is sought; and
‘‘(B) provides a detailed description of how
additional Federal funding will improve each
such activity by both the State and local public
health agencies.
‘‘(6) A description of activities under section
2712(c) to be carried out at the local level, and a
specification for each such activity of—
‘‘(A) the communities in which the activity
will be carried out and any collaborating agen-
cies;
‘‘(B) the amount of the grant to be ex-
pended for the activity in each community so
specified; and
‘‘(C) the integration of community health
advisors (as defined in 2786(d)) with such ac-
tivities under section 2712(c).
‘‘(7) A description of how such activities have
been coordinated with activities supported under
title V of the Social Security Act (relating to mater-
nal and child health).
‘‘(b) REPORTS.—A funding agreement for a grant
under section 2712 is that the States involved will, not
later than the date specified by the Secretary, submit to
the Secretary a report describing—
‘‘(1) the purposes for which the grant was
expended;
‘‘(2) the health status of the population of the
State, as measured by criteria under the Healthy
People 2000 Objectives; and
‘‘(3) the progress achieved and obstacles en-
countered in using uniform data sets under such
Objectives.
‘‘SEC. 2715. APPLICATION FOR GRANT.
‘‘The Secretary may make a grant under section
2712 only if an application for the grant is submitted to
the Secretary, the application contains each agreement de-
scribed in this part, the application contains the informa-
tion required in section 205, and the application is in such
form, is made in such manner, and contains such agree-
ments, assurances, and information as the Secretary de-
termines to be necessary to carry out this part.
‘‘SEC. 2716. DETERMINATION OF AMOUNT OF ALLOTMENT.
‘‘For purposes of section 2712, the allotment under
this section for a State for a fiscal year shall be deter-
mined through a formula established by the Secretary on
the basis of the population, economic indicators, and
health status of each State. Such allotment shall be the
product of—
‘‘(1) a percentage determined under the for-
mula; and
‘‘(2) the amount appropriated under section
2711 for the fiscal year, less any amounts reserved
under section 2717.
‘‘SEC. 2717. ALLOCATIONS FOR CERTAIN ACTIVITIES.
‘‘Of the amounts made available under section 2711
for a fiscal year for carrying out this part, the Secretary
may reserve not more than 15 percent for carrying out
the following activities:
‘‘(1) Technical assistance with respect to plan-
ning, development, and operation of activities under
section 2712(b), including provision of biostatistical
and epidemiological expertise, provision of laboratory
expertise, and the development of uniform data sets
under the Health People 2000 Objectives.
‘‘(2) Development and operation of a national
information network among State and local health
agencies for utilizing such uniform data sets.
‘‘(3) Program monitoring and evaluation of ac-
tivities carried out under section 2712(b).
‘‘(4) Development of a unified electronic report-
ing mechanism to improve the efficiency of adminis-
trative management requirements regarding the
provision of Federal grants to State public health
agencies.
‘‘PART 2—COMPREHENSIVE EVALUATION OF DIS-
EASE 
PREVENTION 
AND 
HEALTH 
PRO-
MOTION PROGRAMS
‘‘SEC. 2718. AUTHORIZATIONS OF APPROPRIATIONS FROM
FUND.
‘‘For the purpose of carrying out this part, there
are authorized to be appropriated from the Fund
$100,000,000 for fiscal year 1995, $150,000,000 for each
of the fiscal years 1996 through 1999, and $100,000,000
for fiscal year 2000.
‘‘SEC. 2719. EVALUATION OF PROGRAMS.
‘‘(a) GRANTS.—The Secretary may make grants to,
or enter into cooperative agreements or contracts with, eli-
gible entities for the purpose of enabling such entities to
carry out evaluations of the type described in subsection
(c). The Secretary shall carry out this section acting
through the Director of the Centers for Disease Control
and Prevention, subject to subsection (g).
‘‘(b) REQUIREMENTS.—
‘‘(1) ELIGIBLE ENTITIES.—To be eligible to re-
ceive an award of a grant, cooperative agreement, or
contract under subsection (a), an entity must—
‘‘(A) be a public, nonprofit, or private en-
tity or a university;
‘‘(B) prepare and submit to the Secretary
an application at such time, in such form, and
containing such information as the Secretary
may require, including a plan for the conduct of
the evaluation under the grant;
‘‘(C) provide assurances that any informa-
tion collected while conducting evaluations
under this section will be maintained in a con-
fidential manner with respect to the identities
of the individuals from which such information
is obtained; and
‘‘(D) meet any other requirements that the
Secretary determines to be appropriate.
‘‘(2) TYPES OF ENTITIES.—In making awards
under subsection (a), the Secretary shall consider
applications from entities proposing to conduct eval-
uations using community programs, managed care
programs, State and county health departments,
public education campaigns, school programs, and
other appropriate programs. The Secretary shall en-
sure that not less than 25 percent of the amounts
appropriated under section 2718 for a fiscal year are
used for making such awards to entities that will use
the amounts to conduct evaluations in the work-
place.
‘‘(c) USE OF FUNDS.—
‘‘(1) EVALUATIONS.—An award under sub-
section (a) shall be used to—
‘‘(A) conduct evaluations to determine the
extent to which clinical preventive services,
health promotion and unintentional injury pre-
vention activities, and interpersonal and com-
munity violence prevention activities, achieve
short-term and long-term health care cost re-
ductions and health status improvement with
respect to the Healthy People 2000 Objectives;
and
‘‘(B) evaluate other areas determined ap-
propriate by the Secretary.
‘‘(2) INCLUSION
OF
CERTAIN
POPULATION
GROUPS.—In carrying out this section, the Secretary
shall ensure that data concerning women, children,
minorities, older individuals with different income
levels, retirees, and individuals from diverse geo-
graphical backgrounds, are obtained.
‘‘(3) MINIMUM
SERVICES.—The evaluations
that the Secretary may provide for under this sec-
tion include (but are not limited to) evaluations of
programs that provide one or more of the following
services:
‘‘(A) Blood pressure screening and control
(to detect and control hypertension and coro-
nary health disease).
‘‘(B) Early cancer screening.
‘‘(C) Blood cholesterol screening and con-
trol.
‘‘(D) Smoking cessation programs.
‘‘(E) Substance abuse programs.
‘‘(F) Dietary and nutrition counseling, in-
cluding nutrition
‘‘(G) Physical fitness counseling.
‘‘(H) Stress management.
‘‘(I) Diabetes education and screening.
‘‘(J) Intraocular pressure screening.
‘‘(K) Monitoring of prescription drug use.
‘‘(L) Violence and injury prevention pro-
grams.
‘‘(N) Health education.
‘‘(O) Immunization rates.
‘‘(4) ENVIRONMENTAL DATA.—Evaluations con-
ducted under this section may consider the health ef-
fects and cost-effectiveness of certain environmental
programs, including fluoridation programs, traffic
safety programs, pollution control programs, acci-
dent prevention programs, and antismoking pro-
grams.
‘‘(5) PUBLIC POLICIES.—Evaluations conducted
under this section may consider the effects of pre-
vention-oriented social and economic policies on im-
provement of health status and their long-term cost
effectiveness.
‘‘(6) USE OF EXISTING DATA.—In conducting
evaluations under this section, entities shall use ex-
isting data and health promotion and screening pro-
grams where practicable.
‘‘(7) COOPERATION.—In providing for an eval-
uation under this section, the Secretary shall encour-
age the recipient of the award and public and pri-
vate entities with relevant expertise (including State
and local agencies) to collaborate for purposes of
conducting the evaluation.
‘‘(d) SITES.—Recipients of awards under subsection
(a) shall select evaluation sites under the award that
present the greatest potential for new and relevant knowl-
edge. Such recipients, in selecting such sites, shall ensure
that—
‘‘(1) the sites provide evidence of pilot testing,
process evaluation, formative evaluation, availability
assessment strategies and results;
‘‘(2) the sites provide evidence of a clear defini-
tion of the program and protocols for the implemen-
tation of the evaluation; and
‘‘(3) the sites provide evidence of valid, appro-
priate and feasible assessment methods and tools
and a willingness to use common data items and in-
struments across such sites.
‘‘(e) REPORTING REQUIREMENTS.—Not later than 1
year after an entity first receives an award under sub-
section (a), and not less than once during each 1-year pe-
riod thereafter for which such an award is made to the
entity, the entity shall prepare and submit to the Sec-
retary a report containing a description of the activities
under this section conducted during the period for which
the report is prepared, and the findings derived as a result
of such activities.
‘‘(f) TERM
OF
EVALUATIONS.—Evaluations con-
ducted under this section shall be for a period of not less
than 3 years and may continue as necessary to permit the
grantee to adequately measure the full benefit of the
evaluations.
‘‘(g) DISSEMINATION AND GUIDELINES.—
‘‘(1) CONSULTATION.—The Secretary shall
carry out this subsection acting through the Director
of the Centers for Disease Control and Prevention
and the Administrator for Health Care Policy and
Research.
‘‘(2) GUIDELINES.—The Secretary shall, where
feasible and practical, develop and issue practice
guidelines that are based on the results of evalua-
tions conducted under this section. The practice
guidelines shall be developed by the Secretary utiliz-
ing expert practitioners to assist in the development
and implementation of these guidelines.
‘‘(3) DATA.—
‘‘(A) IN
GENERAL.—The Secretary shall
collect, store, analyze, and make available data
related to the formulation of the guidelines that
is provided to the Centers for Disease Control
and Prevention by entities conducting evalua-
tions under this section.
‘‘(B) 
USE
OF
DATA.—The 
Secretary
shall—
‘‘(i) identify activities that prevent
disease, illness, injury and disability, and
promote good health practices; ascertain
their cost-effectiveness; and identify their
potential to overall health status with re-
spect to Healthy People 2000 Objectives;
‘‘(ii) disseminate practice guidelines to
State and county health departments,
State insurance departments, insurance
companies, employers, professional medical
organizations, and others determined ap-
propriate by the Secretary; and
‘‘(iii) provide information with respect
to recidivism rates of participation in the
evaluations.
‘‘(4) DISSEMINATION.—The Secretary may dis-
seminate information collected from evaluations
under this section.
‘‘(h) LIMITATION.—Amounts appropriated for carry-
ing out this section shall not be utilized to provide services.
‘‘Subtitle 
C—Opportunities 
for
Education and Training in Pub-
lic Health
‘‘Part 1—SCHOLARSHIP AND LOAN REPAYMENT
PROGRAMS REGARDING SERVICE IN PUBLIC
HEALTH POSITIONS
‘‘SEC. 2721. AUTHORIZATIONS OF APPROPRIATIONS FROM
FUND.
‘‘For the purpose of carrying out this part, there are
authorized 
to 
be 
appropriated 
from 
the 
Fund
$100,000,000 for fiscal year 1995, $125,000,000 for fis-
cal year 1996, $150,000,000 for fiscal year 1997,
$150,000,000 for fiscal year 1998, $150,000,000 for fis-
cal year 1999, and $175,000,000 for each of the fiscal
years 2000 through 2002.
‘‘SEC. 2722. SCHOLARSHIP PROGRAM.
‘‘(a) IN GENERAL.—The Secretary, acting through
the Administrator of the Health Resources and Services
Administration and in consultation with the Director of
the Centers for Disease Control and Prevention, shall
carry out a program under which the Secretary awards
scholarships to individuals described in subsection (b) for
the purpose of assisting the individuals with the costs of
attending public and nonprofit private schools of public
health (or other public or nonprofit private institutions
providing graduate or specialized training in public
health).
‘‘(b) ELIGIBLE
INDIVIDUALS.—An individual re-
ferred to in subsection (a) is any individual meeting the
following conditions:
‘‘(1) The individual is enrolled (or accepted for
enrollment) at a school or other institution referred
to in subsection (a) as a full-time or part-time stu-
dent in a program providing training in a health
profession in a field of public health (including the
fields of epidemiology, biostatistics, environmental
health, health administration and planning, behav-
ioral sciences, maternal and child health, occupa-
tional safety, public health nursing, nutrition, and
toxicology).
‘‘(2) The individual enters into the contract re-
quired pursuant to subsection (d) as a condition of
receiving the scholarship (relating to an agreement
to provide services in approved public health posi-
tions, as defined in section 2724).
‘‘(c) ELIGIBLE SCHOOLS.—For fiscal year 1997 and
subsequent fiscal years, the Secretary may make an award
of a scholarship under subsection (a) only if the Secretary
determines that—
‘‘(1) the school or other institution with respect
to which the award is to be provided has coordinated
the activities of the school or institution with rel-
evant activities of the Health Resources and Services
Administration and the Centers for Disease Control
and Prevention; and
‘‘(2) not fewer than 60 percent of the graduates
of the school or institution are in public health posi-
tions determined by the Secretary to be consistent
with the needs of the United States regarding such
professionals.
‘‘(d) APPLICABILITY OF CERTAIN PROVISIONS.—Ex-
cept as inconsistent with this section or section 2724, the
provisions of subpart III of part D of title III (relating
to the Scholarship and Loan Repayment Programs of the
National Health Service Corps) apply to an award of a
scholarship under subsection (a) to the same extent and
in the same manner as such provisions apply to an award
of a scholarship under section 338A.
‘‘SEC. 2723. LOAN REPAYMENT PROGRAM.
‘‘(a) IN GENERAL.—The Secretary, acting through
the Administrator of the Health Resources and Services
Administration and in consultation with the Director of
the Centers for Disease Control and Prevention, shall
carry out a program under which the Federal Government
enters into agreements to repay all or part of the edu-
cational loans of individuals meeting the following condi-
tions:
‘‘(1) The individual involved is a graduate of a
school or other institution described in section
2722(a).
‘‘(2) The individual meets the applicable legal
requirements to provide services as a public health
professional (including a professional in any of the
fields specified in section 2722(b)(1)).
‘‘(3) The individual enters into the contract re-
quired pursuant to subsection (b) as a condition of
the Federal Government repaying such loans (relat-
ing to an agreement to provide services in approved
public health positions, as defined in section 2724).
‘‘(b) APPLICABILITY OF CERTAIN PROVISIONS.—Ex-
cept as inconsistent with this section or section 2724, the
provisions of subpart III of part D of title III (relating
to the Scholarship and Loan Repayment Programs of the
National Health Service Corps) apply to an agreement re-
garding repayment under subsection (a) to the same ex-
tent and in the same manner as such provisions apply to
an agreement regarding repayment under section 338B.
‘‘(c) AMOUNT OF REPAYMENTS.—For each year for
which an individual contracts to serve in an approved pub-
lic health position pursuant to subsection (b), the Sec-
retary may repay not more than $20,000 of the principal
and interest of the educational loans of the individual.
‘‘SEC. 2724. APPROVED PUBLIC HEALTH POSITIONS.
‘‘(a) POSITION REGARDING POPULATIONS WITH SIG-
NIFICANT NEED FOR SERVICES.—
‘‘(1) IN GENERAL.—With respect to the pro-
grams under this part, the obligated service of a
program participant pursuant to sections 2722(d)
and 2723(b) shall be provided through an assign-
ment, to an entity described in subsection (b), for a
position in which the participant provides services as
a public health professional to a population deter-
mined by the Secretary to have a significant unmet
need for the services of such a professional.
‘‘(2) PERIOD
OF
SERVICE.—For purposes of
sections 2722(d) and 2723(d), the period of obli-
gated service is the following, as applicable to the
program participant involved:
‘‘(A) In the case of scholarships under sec-
tion 2722 for full-time students, the greater
of—
‘‘(i) 1 year for each year for which
such a scholarship is provided; or
‘‘(ii) 2 years.
‘‘(B) In the case of scholarships under sec-
tion 2722 for part-time students, a period de-
termined by the Secretary on the basis of the
number of hours of education or training re-
ceived under the scholarship, considering the
percentage constituted by the ratio of such
number to the number of hours for a full-time
student in the program involved.
‘‘(C) In the case of the loan repayments
under section 2723, such period as the Sec-
retary and the participant may agree, except
that the period may not be less than 2 years.
‘‘(b) APPROVAL OF ENTITIES FOR ASSIGNMENT OF
PROGRAM PARTICIPANTS.—The entities referred to in
subsection (a) are public and nonprofit private entities ap-
proved by the Secretary as meeting such requirements for
the assignment of a program participant as the Secretary
may establish. The entities that the Secretary may so ap-
prove include State and local departments of health, public
hospitals, community and neighborhood health clinics, mi-
grant health clinics, community-based health-related orga-
nizations, certified regional poison control centers, pur-
chasing cooperatives regarding health insurance, and any
other public or nonprofit private entity.
‘‘(c) DEFINITIONS.—For purposes of this part:
‘‘(1) The term ‘approved public health position’,
with respect to a program participant, means a posi-
tion to which the participant is assigned pursuant to
subsection (a).
‘‘(2) The term ‘program participant’ means an
individual who enters into a contract pursuant to
section 2722(b)(2) or 2723(a)(3).
‘‘SEC. 2725. ALLOCATION OF FUNDS; SPECIAL CONSIDER-
ATIONS.
‘‘(a) ALLOCATIONS REGARDING NEW PARTICIPANTS
IN SCHOLARSHIP PROGRAM.—Of the amounts appro-
priated under section 2721 for a fiscal year, the Secretary
shall obligate not less than 30 percent for the purpose of
providing awards for scholarships under section 2722 to
individuals who have not previously received such scholar-
ships.
‘‘(b) SPECIAL CONSIDERATION FOR CERTAIN INDI-
VIDUALS.—In making awards of scholarships under sec-
tion 2722 and making repayments under section 2723, the
Secretary shall give special consideration to individuals
who are in the armed forces of the United States or who
are veterans of the armed forces.
‘‘(c) SCHOOL HEALTH EDUCATION PROGRAMS.—The
Secretary shall ensure that the approved public health po-
sitions to which the Secretary assigns program partici-
pants under this part include positions in programs that
provide education on the promotion of health and the pre-
vention of diseases and that are carried out on the prem-
ises of public or nonprofit private elementary and second-
ary schools, including comprehensive school health edu-
cation programs under subtitle B of title I of the Public
Health Improvement Act of 1994.
‘‘PART 2—EDUCATIONAL INSTITUTIONS
REGARDING PUBLIC HEALTH
‘‘SEC. 2731. AUTHORIZATIONS OF APPROPRIATIONS FROM
FUND.
‘‘For the purpose of carrying out this part, there are
authorized 
to 
be 
appropriated 
from 
the 
Fund
$100,000,000 for fiscal year 1995, $125,000,000 for fis-
cal year 1996, $150,000,000 for each of the fiscal years
1997 through 2000, and $175,000,000 for each of the fis-
cal years 2001 and 2002.
‘‘SEC. 2732. GRANTS FOR EXPANDING CAPACITY OF INSTI-
TUTIONS.
‘‘(a) IN GENERAL.—The Secretary may make grants
to institutions described in subsection (b) for the purpose
of expanding the educational capacities of the institutions
through recruiting and retaining faculty, curriculum devel-
opment, and coordinating the activities of the institutions
regarding education, training, and field placements.
‘‘(b) RELEVANT INSTITUTIONS.—The institutions
referred to in subsection (a) are public and nonprofit
private—
‘‘(1) schools of public health;
‘‘(2) departments of community and preventive
medicine that—
‘‘(A) are within schools of medicine and
schools of osteopathic medicine; and
‘‘(B) have established formal arrangements
with schools of public health in order to award
joint degrees in public health and another
health profession; and
‘‘(3) schools of nursing or dentistry that have
established formal arrangements with schools of
public health in order to carry out educational pro-
grams in public health at the schools of nursing or
dentistry, respectively.
‘‘(c) REQUIREMENTS REGARDING CURRICULUM DE-
VELOPMENT.—A funding agreement for a grant under
subsection (a) for an institution is that, to the extent de-
termined to be appropriate by the Secretary, the curricu-
lum of institution will include the following:
‘‘(1) Subject to subsection (d)(1), part-time
nondegree programs for public health professionals
who need further training in fields of public health.
‘‘(2) With respect to the program of community
health advisors established in part 5 of subtitle F,
a program to train individuals to serve as super-
visors under such part (including training and evalu-
ating the community health advisors), which pro-
gram is carried out in collaboration with local public
health departments and health education and train-
ing centers.
‘‘(3) A program under which the institution col-
laborates with health departments and elementary
and secondary schools to develop a health education
curriculum for use in the program established under
subtitle B of title I of the Public Health Improve-
ment Act of 1964.
‘‘(d) ADDITIONAL REQUIREMENTS.—Funding agree-
ments for a grant under subsection (a) for an institution
are as follows:
‘‘(1) In developing the curriculum under the
grant, the institution will consult with the health de-
partments in the State involved, and will follow the
relevant priorities of such departments;
‘‘(2) The institution will, as appropriate in the
determination of the Secretary, coordinate the activi-
ties of the institution under the grant with relevant
activities of the Health Resources and Services Ad-
ministration and the Centers for Disease Control
and Prevention.
‘‘SEC. 2733. COORDINATION OF GRANT ACTIVITIES WITH
NATIONAL PRIORITIES.
The Secretary shall—
‘‘(1) determine the needs of the United States
regarding the education and geographic distribution
of public health professionals;
‘‘(2) determine priorities among such needs;
and
‘‘(3) in making grants under section 2732, en-
sure that the curricula developed under such section,
and the expertise of the faculty recruited and re-
tained under such section, are consistent with such
priorities.
‘‘SEC. 2734. CERTAIN REQUIREMENTS FOR GRANTS.
For fiscal year 1997 and subsequent fiscal years, the
Secretary may make a grant under section 2732 only if
the institution involved is in compliance with the following:
‘‘(1) The institution has coordinated the activi-
ties of the school or institution with relevant activi-
ties of the Health Resources and Services Adminis-
tration and the Centers for Disease Control and
Prevention.
‘‘(2) A significant number of the faculty of the
institution has served as practitioners in public
health.
‘‘(3) The institution has consulted with public
health departments and public hospital systems in
the State involved in order to develop a curriculum
that reflects the needs and priorities of the State re-
garding the public health.
‘‘(4) The institution has coordinated the activi-
ties of the institution with the activities of the health
departments and of community groups.
‘‘(5) The institution carries out a program for
part-time students to receive training in fields of
public health.
‘‘(6) Not less than 60 percent of the graduates
of the school or institution are in public health posi-
tions determined by the Secretary to be consistent
with the needs of the United States regarding such
professionals.
‘‘PART 3—EXPANSION OF COMPETENCY IN
PUBLIC HEALTH
‘‘SEC. 2736. AUTHORIZATIONS OF APPROPRIATIONS FROM
FUND.
‘‘For the purpose of carrying out this section, there
is authorized to be appropriated from the Fund
$60,000,000 for each of the fiscal years 1995 through
2002.
‘‘SEC. 2737. GRANTS TO STATES.
‘‘(a) STATES LACKING TRAINING PROGRAMS.—
‘‘(1) IN GENERAL.—The Secretary may make
grants to States in which there is no program of
training in a field of public health but in which there
are 1 or more schools of medicine, osteopathic medi-
cine, nursing, dentistry, social work, pharmacy, or
health administration. A funding agreement for such
a grant is that the purpose of the grant is for the
State involved to assist 1 or more of such schools in
developing and integrating public health curricula
for the schools.
‘‘(2) SPECIAL
CONSIDERATIONS
IN
MAKING
GRANTS.—In making grants under paragraph (1),
the Secretary shall give special consideration to
States that agree to consult with 1 or more schools
of public health in carrying out the purpose de-
scribed in such subsection.
‘‘(b) STATES WITH NONACCREDITED SCHOOLS.—
The Secretary may make grants to States in which there
are 1 or more nonaccredited schools of public health. A
funding agreement for such a grant is that the purpose
of the grant is for the State involved to assist 1 or more
of such schools in improving the schools.
‘‘(d) AMOUNT OF GRANT; LIMITATION REGARDING
INDIVIDUAL EDUCATIONAL ENTITIES.—
‘‘(1) AMOUNT.—The amount of a grant under
this section to a State may not exceed $600,000.
‘‘(2) LIMITATION.—A funding agreement for a
grant under this section for a State is that, with re-
spect to the school involved, the State will not pro-
vide more than 2 years of assistance to the school
from grants under this section.
‘‘PART 4—GENERAL PROVISIONS REGARDING
EDUCATION AND TRAINING PROGRAMS
‘‘SEC. 2740. UNDERREPRESENTED MINORITIES REGARDING
FIELDS OF PUBLIC HEALTH.
‘‘In providing for the education and training of indi-
viduals in a field of public health through the programs
of this subtitle, the Secretary shall give special consider-
ation to individuals who are members of a racial or ethnic
minority group that is underrepresented in the field.
‘‘SEC. 2740A. COORDINATION OF PROGRAMS.
‘‘The Secretary shall ensure that activities under each
program of this subtitle are coordinated with activities
under each other such program, including activities re-
garding the number and variety of public health profes-
sionals educated or trained pursuant to this subtitle.
‘‘Subtitle D—Regional Poison
Control Centers
‘‘SEC. 2741. AUTHORIZATIONS OF APPROPRIATIONS FROM
FUND.
‘‘For the purpose of carrying out this subtitle, there
is authorized to be appropriated from the Fund
$50,000,000 for each of the fiscal years 1995 through
1997.
‘‘SEC. 2742. GRANTS FOR REGIONAL CENTERS.
‘‘(a) IN GENERAL.—The Secretary may make grants
to public and nonprofit private entities for centers to carry
out activities regarding—
‘‘(1) the prevention and treatment of poisoning;
and
‘‘(2) such other activities regarding the control
of poisons as the Secretary determines to be appro-
priate.
‘‘(b) 
REGIONAL
CONSIDERATIONS.—In 
making
grants under subsection (a), the Secretary shall determine
the need in each of the principal geographic regions of
the United States for a center under such subsection, and
shall make the grants according to priorities established
by the Secretary on the basis of the extent of such need
in each of the regions. In carrying out the preceding sen-
tence, the Secretary shall ensure that no two centers re-
ceive grants for the same geographic service area.
‘‘(c) MATCHING FUNDS.—
‘‘(1) IN GENERAL.—With respect to the costs of
an entity in providing for centers under subsection
(a), the Secretary may make a grant under such
subsection only if the State in which the center is to
operate, or other public entities in the State, agree
to make available (directly or through donations
from public or private entities) non-Federal con-
tributions toward such costs in an amount deter-
mined by the Secretary.
‘‘(2) DETERMINATION
OF
AMOUNT
CONTRIB-
UTED.—Non-Federal contributions required under
paragraph (1) may be in cash or in kind, fairly eval-
uated, including plant, equipment, or services.
Amounts provided by the Federal Government, or
services assisted or subsidized to any significant ex-
tent by the Federal Government, may not be in-
cluded in determining the amount of such non-Fed-
eral contributions.
‘‘SEC. 2743. REQUIREMENTS REGARDING CERTIFICATION.
‘‘(a) IN GENERAL.—Subject to subsection (b), the
Secretary may make a grant under section 2742 only if
the center involved has been certified by a professional or-
ganization in the field of poison control, and the Secretary
has approved the organization as having in effect stand-
ards for certification that reasonably provide for the pro-
tection of the public health with respect to poisoning. In
carrying out the preceding sentence, the Secretary shall
consider the standards established by the American Asso-
ciation of Poison Control Centers.
‘‘(b) TEMPORARY
WAIVER.—The Secretary may
waive the requirement of subsection (a) for a center for
a period not exceeding 1 year.
‘‘SEC. 2744. GENERAL PROVISIONS.
‘‘(a) DURATION
OF GRANT.—The period during
which payments are made under a grant under section
2742 may not exceed 3 years. The provision of such pay-
ments is subject to annual approval by the Secretary of
the payments and subject to the availability of appropria-
tions for the fiscal year involved to make the payments.
The preceding sentence may not be construed as establish-
ing a limitation on the number of such grants that may
be made to an entity.
‘‘(b) STUDY REGARDING NEED FOR CENTERS.—
‘‘(1) IN GENERAL.—The Secretary shall con-
duct a study of each of the centers for which a grant
under section 2742 has been provided. The purpose
of the study shall be to determine the effectiveness
of the centers in carrying out the activities described
in such section and the extent to which the activities
have been carried out in a cost-effective manner.
‘‘(2) ALTERNATIVES TO CENTERS.—In carrying
out the study under paragraph (1), the Secretary
shall determine the extent to which the activities de-
scribed in section 2742 can be effectively carried out
through means other than centers under such sec-
tion. The alternative means considered by the Sec-
retary under the preceding sentence shall include the
alternative of requiring public and private health
plans to carry out such activities.
‘‘(3) DATE
CERTAIN
FOR
COMPLETION.—Not
later than November 1, 1996, the Secretary shall
submit to the Congress a report describing the find-
ings made in the study under paragraph (1).
‘‘(4) NOTICE
TO
CENTERS.—Not later than
February 1, 1997, the Secretary shall notify each
grantee under section 2742 whether the Secretary
considers the continued operation of the center in-
volved to be necessary in meeting the needs of the
geographic region involved for the activities de-
scribed in such section.
‘‘Subtitle E—School-Related Health
Services
‘‘PART 1—PROJECTS FOR PROVISION OF
SERVICES
‘‘Subpart A—Development and Operation of Projects
‘‘SEC. 2746. AUTHORIZATIONS OF APPROPRIATIONS FROM
FUND.
‘‘For the purpose of carrying out this part, there
are authorized to be appropriated from the Fund
$100,000,000 for fiscal year 1996, $275,000,000 for fis-
cal year 1997, $350,000,000 for fiscal year 1998, and
$400,000,000 for fiscal year 1999, $450,000,000 for each
of the fiscal years 2000 through 2002.
‘‘SEC. 2747. ELIGIBILITY FOR DEVELOPMENT AND OPER-
ATION GRANTS.
‘‘(a) IN GENERAL.—Entities eligible to apply for
and receive grants under section 2749 or 2750 are the
following:
‘‘(1) State health agencies that apply on behalf
of local community partnerships for communities in
need of health services within the State.
‘‘(2) Local community partnerships in States in
which health agencies have not applied.
‘‘(b) LOCAL COMMUNITY PARTNERSHIPS.—
‘‘(1) IN GENERAL.—A local community partner-
ship under subsection (a)(2) is an entity that, at a
minimum, includes—
‘‘(A) a local health care provider with expe-
rience in delivering services to pre-adolescents
and adolescents;
‘‘(B) one or more local public schools; and
‘‘(C) at least one community based organi-
zation located in the community to be served
that has a history of providing services to at-
risk youth in the community.
‘‘(2) PARTICIPATION.—A partnership described
in paragraph (1) shall, to the maximum extent fea-
sible, involve broad based community participation
from parents and youth to be served, health and so-
cial service providers (including regional alliance
health plans and corporate alliance health plans in
which families in the community are enrolled),
teachers and other public school and school board
personnel, youth development and service organiza-
tions, and interested business leaders. Such partici-
pation may be evidenced through an expanded part-
nership, or an advisory board to such partnership.
118
‘‘(7) The term ‘State involved’, with respect to
an applicant for an award under section 2785,
means the State in which the applicant is to carry
out a community health advisor program.
‘‘SEC. 2794. EFFECT OF INSUFFICIENT APPROPRIATIONS
FOR MINIMUM ALLOTMENTS.
‘‘(a) IN GENERAL.—If the amounts made available
under section 2784 for a fiscal year are insufficient for
providing each State (or entity designated by the State
pursuant to section 2785, as the case may be) with an
award under section 2785 in an amount equal to or great-
er than the amount specified in section 2789(a)(2), the
Secretary shall, from such amounts as are made available
under subsection (a), make such awards on a discretionary
basis.
‘‘(b) RULE
OF CONSTRUCTION.—For purposes of
subsection (a), awards under section 2785 are made on
a discretionary basis if the Secretary determines which
States (or entities designated by States pursuant to such
section, as the case may be) are to receive such awards,
subject to meeting the requirements of this subtitle for
such an award, and the Secretary determines the amount
of such awards.