244
health empowerment zone program established with 
a grant under subsection (a), if such priority would 
further the purpose of the health empowerment zone 
program. 
(c) HEALTH EMPOWERMENT ZONE COORDINATING 
COMMITTEE.—
(1) ESTABLISHMENT.—For each health em-
powerment zone program established with a grant 
under subsection (a), the Secretary acting through 
the Director of Office of Minority Health and the 
Administrator of the Health Resources and Services 
Administration shall establish a health empowerment 
zone coordinating committee. 
(2) DUTIES.—Each coordinating committee es-
tablished, in coordination with the Director of the 
Office of Minority Health and the Administrator of 
the Health Resources and Services Administration, 
shall provide technical assistance and evidence-based 
strategies to the grant recipient involved, including 
providing guidance on research, strategies, health 
outcomes, program goals, management, implementa-
tion, monitoring, assessment, and evaluation proc-
esses. 
(3) MEMBERSHIP.—
245
(A) APPOINTMENT.—The Director of the 
Office of Minority Health and the Adminis-
trator of the Health Resources and Services Ad-
ministration, in consultation with the respective 
grant recipient shall appoint the members of 
each coordinating committee. 
(B) COMPOSITION.—The Director of the 
Office of Minority Health, and the Adminis-
trator of the Health Resources and Services Ad-
ministration shall ensure that each coordinating 
committee established—
(i) has not more than 20 members; 
(ii) includes individuals from commu-
nities that disproportionately experience 
disparities in health status and healthcare; 
(iii) includes community leaders and 
leaders of community-based organizations; 
(iv) includes representatives of aca-
demia and lay and professional organiza-
tions and associations including those hav-
ing expertise in medicine, technical, social 
and behavioral science, health policy, advo-
cacy, cultural and linguistic competency, 
research management, and organization; 
and
246
(v) represents a reasonable cross-sec-
tion of knowledge, views, and application 
of expertise on societal, ethical, behavioral, 
educational, policy, legal, cultural, lin-
guistic, and workforce issues related to 
eliminating 
disparities 
in 
health 
and 
healthcare. 
(C) INDIVIDUAL
QUALIFICATIONS.—The 
Director of the Office of Minority Health and 
the Administrator of the Health Resources and 
Services Administration may not appoint an in-
dividual to serve on a coordinating committee 
unless the individual meets the following quali-
fications: 
(i) The individual is not employed by 
the Federal Government. 
(ii) The individual has appropriate ex-
perience, including experience in the areas 
of community development, cultural and 
linguistic competency, reducing and elimi-
nating racial and ethnic disparities in 
health and health care, or minority health. 
(D) SELECTION.—In selecting individuals 
to serve on a coordinating committee, the Di-
rector of Office of Minority Health and the Ad-
247
ministrator Health Resources and Services Ad-
ministration shall give due consideration to the 
recommendations of the Congress, industry 
leaders, the scientific community (including the 
Institute of Medicine), academia, community 
based non-profit organizations, minority health 
and related organizations, the education com-
munity, State and local governments, and other 
appropriate organizations. 
(E) CHAIRPERSON.—The Director of the 
Office of Minority Health and the Adminis-
trator of the Health Resources and Services Ad-
ministration, in consultation with the members 
of the coordinating committee involved, shall 
designate a chairperson of the coordinating 
committee, who shall serve for a term of 3 
years and who may be reappointed at the expi-
ration of each such term. 
(F) TERMS.—Each member of a coordi-
nating committee shall be appointed for a term 
of 1 to 3 years in overlapping staggered terms, 
as determined by the Director of the Office of 
Minority Health and the Administrator of the 
Health Resources and Services Administration
248
at the time of appointment, and may be re-
appointed at the expiration of each such term. 
(G) VACANCIES.—A vacancy on a coordi-
nating committee shall be filled in the same 
manner in which the original appointment was 
made. 
(H) COMPENSATION.—Each member of a 
coordinating committee shall be compensated at 
a rate equal to the daily equivalent of the an-
nual rate of basic pay for level IV of the Execu-
tive Schedule for each day (including travel 
time) during which such member is engaged in 
the performance of the duties of the coordi-
nating committee. 
(I) TRAVEL EXPENSES.—Each member of 
a coordinating committee shall receive travel ex-
penses, including per diem in lieu of subsist-
ence, in accordance with applicable provisions 
under subchapter I of chapter 57 of title 5, 
United States Code. 
(4) MEETINGS.—A coordinating committee 
shall meet 3 to 5 times each year, at the call of the 
coordinating committee’s chairperson and in con-
sultation with the Director of Office of Minority
249
Health and the Administrator Health Resources and 
Services Administration. 
(5) REPORT.—Each coordinating committee 
shall transmit to the Congress an annual report 
that, with respect to the health empowerment zone 
program involved, includes the following: 
(A) A review of the program’s effectiveness 
in achieving stated goals and outcomes. 
(B) A review of the program’s manage-
ment and the coordination of the entities in-
volved. 
(C) A review of the activities in the pro-
gram’s portfolio and components. 
(D) An identification of policy issues raised 
by the program. 
(E) An assessment of the program’s capac-
ity, infrastructure, and number of underserved 
minority communities reached. 
(F) Recommendations for new program 
goals, research areas, enhanced approaches, 
partnerships, coordination and management 
mechanisms, and projects to be established to 
achieve the program’s stated goals, to improve 
outcomes, monitoring, and evaluation.
251
(1) IN GENERAL.—Section 1510(a) of the Pub-
lic Health Service Act (42 U.S.C. 300n–5(a)) is 
amended by striking ‘‘2003’’ and inserting ‘‘2008’’. 
(2) SUPPLEMENTAL GRANTS FOR ADDITIONAL 
PREVENTIVE
HEALTH
SERVICES.—Section 
1509(d)(1) of the Public Health Service Act (42 
U.S.C. 300n–4a(d)(1)) is amended by striking 
‘‘2003’’ and inserting ‘‘2008’’. 
(b) TREATMENT AND PREVENTION.—Title XXIX of 
the Public Health Service Act, as amended by section 302, 
is further amended by adding at the end the following: 
‘‘Subtitle C—Reducing Disease and 
Disease-Related Complications 
‘‘CHAPTER 1—CANCER REDUCTION 
‘‘SEC. 2921. CANCER PREVENTION AND TREATMENT FOR 
UNDERSERVED MINORITY OR OTHER POPU-
LATIONS. 
‘‘(a) GRANTS.—The Secretary may make grants to 
qualifying health centers, non-profit organizations, and 
public institutions for the development, expansion, or oper-
ation of programs that, for individuals otherwise served 
by such centers, provide—
‘‘(1) information and education on cancer pre-
vention; 
‘‘(2) screenings for cancer;
252
‘‘(3) counseling on cancer, including counseling 
upon a diagnosis of cancer; and 
‘‘(4) treatment for cancer. 
‘‘(b) QUALIFYING HEALTH CENTERS AND PUBLIC 
INSTITUTIONS.—For purposes of this section: 
‘‘(1) QUALIFYING
HEALTH
CENTERS.—The 
term ‘qualifying health center’ includes community 
health centers, migrant health centers, health cen-
ters for the homeless, health centers for residents of 
public housing, and community clinics. 
‘‘(2) QUALIFYING PUBLIC INSTITUTIONS.—The 
term ‘qualifying public institutions’ means an entity 
that meets the requirements of section 2971(b)(1). 
‘‘(c) PREFERENCE IN MAKING GRANTS.—In making 
grants under subsection (a), the Secretary shall give pref-
erence to applicants that—
‘‘(1) have service populations that include a sig-
nificant number of low-income minority individuals 
who are at-risk for cancer; 
‘‘(2) will, through programs under subsection 
(b)—
‘‘(A) emphasize early detection of and com-
prehensive treatment for cancer; 
‘‘(B) provide comprehensive treatment 
services for cancer in its earliest stages; and
253
‘‘(C) carry out subparagraphs (A) and (B) 
for two or more types of cancer; and 
‘‘(3) in order to provide treatment for cancer, 
have established or will establish referral arrange-
ments with entities that provide screenings for low-
income individuals. 
‘‘(d) APPROPRIATE CULTURAL CONTEXT.—As a con-
dition for the receipt of a grant under subsection (a), the 
applicant shall agree that, in the program carried out with 
the grant, services will be provided in the languages most 
appropriate for, and with consideration for the cultural 
background of, the individuals for whom the services are 
provided. 
‘‘(e) OUTREACH SERVICES.—As a condition for the 
receipt of a grant under subsection (a), the applicant shall 
agree to provide outreach activities to inform the public 
of the services of the program, and to provide information 
on cancer; and 
‘‘(f) APPLICATION FOR GRANT.—A grant may be 
made under subsection (a) only if an application for the 
grant is submitted to the Secretary and the application 
is in such form, is made in such manner, and contains 
such agreements, assurances, and information as the Sec-
retary determines to be necessary to carry out this section.
254
‘‘(g) DESIGNATION OF TYPE OF CANCER.—In mak-
ing a grant under subsection (a), the Secretary shall des-
ignate the type or types of cancer with respect to which 
the grant is being made. 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for 
each of the fiscal years 2005 through 2010.’’. 
CHAPTER 2—HIV/AIDS REDUCTION 
SEC. 442. HIV/AIDS REDUCTION. 
Subtitle C of title XXIX of the Public Health Service 
Act, as added by section 441, is amended by adding at 
the end the following: 
‘‘CHAPTER 2—HIV/AIDS REDUCTION 
‘‘SEC. 2922. HIV/AIDS REDUCTION IN THE MINORITY COM-
MUNITY. 
‘‘(a) EXPANDED FUNDING.—The Secretary, in col-
laboration with the Director of the Office of Minority 
Health, the Director of the Centers for Disease Control 
and Prevention, the Administrator of the Health Re-
sources and Services Administration, and the Adminis-
trator of the Substance Abuse and Mental Health Admin-
istration, shall provide funds and carry out activities to 
expand the Minority HIV/AIDS Initiative.
255
‘‘(b) USE OF FUNDS.—The additional funds made 
available under this section may be used, through the Mi-
nority HIV/AIDS Initiative, to support the following ac-
tivities: 
‘‘(1) The provision of technical assistance and 
infrastructure support to reduce HIV/AIDS in mi-
nority populations. 
‘‘(2) To increase minority populations’ access to 
HIV/AIDS prevention and care services. 
‘‘(3) To build stronger community programs 
and partnerships to address HIV prevention and the 
healthcare needs of specific minority racial and eth-
nic populations. 
‘‘(c) PRIORITY INTERVENTIONS.—Within the minor-
ity populations referred to in subsection (b), priority in 
conducting intervention services shall be given to—
‘‘(1) women; 
‘‘(2) youth; 
‘‘(3) men who engage in homosexual activity; 
‘‘(4) persons who engage in intravenous drug 
abuse; 
‘‘(5) homeless individuals; and 
‘‘(6) individuals incarcerated or in the penal 
system.
256
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated $610,000,000 for fiscal year 2005, and 
such sums as may be necessary for each of the fiscal years 
2006 through 2010.’’. 
CHAPTER 3—INFANT MORTALITY 
REDUCTION 
SEC. 443. INFANT MORTALITY REDUCTION. 
Subtitle C of title XXIX of the Public Health Service 
Act, as amended by section 442, is further amended by 
adding at the end the following: 
‘‘CHAPTER 3—INFANT MORTALITY 
REDUCTION 
‘‘SEC. 2923. INFANT MORTALITY REDUCTION. 
‘‘(a) BACK TO SLEEP CAMPAIGN.—
‘‘(1) IN GENERAL.—The Secretary shall sup-
port collaborations through the National Institute of 
Child Health and Human Development. 
‘‘(2) USE
OF
FUNDS.—Collaborations funded 
under paragraph (1) shall be directed towards the 
goal of reducing the incidence of Sudden Infant 
Death Syndrome in minority communities, particu-
larly the African American and American Indian and 
Native Alaskan communities, through increased edu-
cation on the importance of back sleeping for in-
257
fants. Such increased education shall include child 
care centers and other secondary child caregivers. 
‘‘(b) GUIDELINES FOR CHILD CARE LICENSURE.—
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the National Institute of 
Child Health and Human Development, shall con-
vene a working group to develop health guidelines 
relating to infant mortality reduction for use by 
child care licensing entities, including State, terri-
torial, tribal, and local governments. 
‘‘(2) FOCUS.—The guidelines developed under 
paragraph (1) shall focus specifically on appropriate 
actions to reduce the incidence of Sudden Infant 
Death Syndrome in child care settings. 
‘‘(3) REPORT.—Not later than 1 year after the 
date of enactment of this title, the Secretary shall 
submit to the appropriate committees of Congress 
and the States a report that describes the guidelines 
developed under this subsection. 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2005 through 2010.’’.
258
CHAPTER 4—FETAL ALCOHOL SYNDROME 
TREATMENT AND DIAGNOSIS 
SEC. 444. FETAL ALCOHOL SYNDROME. 
Subtitle C of title XXIX of the Public Health Service 
Act, as amended added by section 443, is further amended 
by adding at the end the following: 
‘‘CHAPTER 4—FETAL ALCOHOL 
SYNDROME TREATMENT AND DIAGNOSIS 
‘‘SEC. 2924. FETAL ALCOHOL SYNDROME. 
‘‘(a) SURVEILLANCE
AND
IDENTIFICATION
RE-
SEARCH.—The Secretary shall direct the National Center 
for Birth Defects and Developmental Disabilities (referred 
to in this section as the ‘Center’) to—
‘‘(1) develop a uniform surveillance case defini-
tion for Fetal Alcohol Syndrome (referred to in this 
section as ‘FAS’) and a uniform surveillance defini-
tion for Alcohol Related Neurodevelopmental Dis-
order (referred to in this section as ‘ARND’); 
‘‘(2) develop a comprehensive screening process 
for FAS and ARND to include all age groups; and 
‘‘(3) disseminate the screening process devel-
oped under paragraph (2) to—
‘‘(A) hospitals, outpatient programs, and 
other healthcare providers;
259
‘‘(B) incarceration and detainment facili-
ties; 
‘‘(C) primary and secondary schools; 
‘‘(D) social work and child welfare offices; 
‘‘(E) State offices and others providing 
services to individuals with disabilities; and 
‘‘(F) others determined appropriate by the 
Secretary. 
‘‘(b) CLINICAL CHARACTERIZATION OF FAS AND RE-
LATED DISEASES.—The Secretary shall direct the Na-
tional Institute of Alcohol Abuse and Alcoholism to—
‘‘(1) research methods to quantify the central 
nervous system impairments associated with fetal al-
cohol exposure and to develop clinical diagnostic 
tools for the intellectual and behavioral problems as-
sociated with FAS and related diseases; 
‘‘(2) develop a neurocognitive phenotype for 
FAS and ARND; and 
‘‘(3) include all relevant scientific and clinical 
characterizations of FAS and related diseases in rel-
evant diagnostic codes. 
‘‘(c) COMMUNITY-BASED
AND SUPPORT SERVICES 
COORDINATION GRANTS.—The Secretary shall award 
grants to States, Indian tribes and tribal organizations,
260
and nongovernmental organizations for the establishment 
of—
‘‘(1) pilot projects to identify and implement 
best practices for—
‘‘(A) educating children with fetal alcohol 
spectrum disorders, including—
‘‘(i) activities and programs designed 
specifically for the identification, treat-
ment, and education of such children; and 
‘‘(ii) 
curricula 
development 
and 
credentialing of teachers, administrators, 
and social workers who implement such 
programs; 
‘‘(B) educating judges, attorneys, child ad-
vocates, law enforcement officers, prison war-
dens, alternative incarceration administrators, 
and incarceration officials on how to treat and 
support individuals suffering from a fetal alco-
hol spectrum disorder within the criminal jus-
tice system, including—
‘‘(i) programs designed specifically for 
the identification, treatment, and education 
of those with a fetal alcohol spectrum dis-
order; and
261
‘‘(ii) 
curricula 
development 
and 
credentialing within justice system for indi-
viduals who implement such programs; and 
‘‘(C) educating adoption or foster care 
agency officials about available and necessary 
services for children with fetal alcohol spectrum 
disorders, including—
‘‘(i) programs designed specifically for 
the identification, treatment, and education 
of those with a fetal alcohol spectrum dis-
order; and 
‘‘(ii) education and training for poten-
tial parents of an adopted child with a 
fetal alcohol spectrum disorder; 
‘‘(2) nationally coordinated systems that inte-
grate transitional services for those affected by pre-
natal alcohol exposure such as housing assistance, 
vocational training and placement, and medication 
monitoring by—
‘‘(A) providing training and support to 
family services programs, children’s mental 
health programs, and other local efforts; 
‘‘(B) recruiting and training mentors for 
teenagers with a fetal alcohol spectrum dis-
order; and
262
‘‘(C) maintaining a clearinghouse including 
all relevant neurobehavioral information needed 
for supporting individuals with a fetal alcohol 
spectrum disorder; and 
‘‘(3) programs to disseminate and coordinate 
fetal alcohol spectrum disorder awareness and iden-
tification efforts by community health centers, in-
cluding—
‘‘(A) education of health professionals re-
garding available support services; and 
‘‘(B) implementation of a tracking system 
targeting the rates of fetal alcohol spectrum 
disorders among individuals from certain racial, 
ethnic, and economic backgrounds. 
‘‘(d) APPLICATION.—To be eligible to receive a grant 
under subsection (d), an entity shall submit to the Sec-
retary an application in such form, in such manner, and 
containing such agreements, assurances, and information 
as the Secretary determines to be necessary to carry out 
this section. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2005 through 2010.’’.
263
CHAPTER 5—DIABETES PREVENTION AND 
TREATMENT 
SEC 445. MONITORING THE QUALITY OF AND DISPARITIES 
IN DIABETES CARE. 
Part A of title IX of the Public Health Service Act 
(42 U.S.C. 299 et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 904. AREAS OF SPECIAL EMPHASIS. 
‘‘The Secretary, acting through the Director, shall in-
corporate within the annual quality report required under 
section 913(b)(2) and the annual disparities report re-
quired under section 903(a)(6), scientific evidence and in-
formation appropriate for monitoring the quality and safe-
ty of diabetes care and identifying, understanding, and re-
ducing disparities in care.’’. 
SEC. 446. DIABETES PREVENTION, TREATMENT, AND CON-
TROL. 
(a) DETERMINATION.—The Secretary, in consulta-
tion with Indian tribes and tribal organizations, shall de-
termine—
(1) by tribe, tribal organization, and service 
unit of the Service, the prevalence of, and the types 
of complications resulting from, diabetes among In-
dians; and
264
(2) based on paragraph (1), the measures (in-
cluding patient education) each service unit should 
take to reduce the prevalence of, and prevent, treat, 
and control the complications resulting from, diabe-
tes among Indian tribes within that service unit. 
(b) SCREENING.—The Secretary shall screen each In-
dian who receives services from the Service for diabetes 
and for conditions which indicate a high risk that the indi-
vidual will become diabetic. Such screening may be done 
by an Indian tribe or tribal organization operating 
healthcare programs or facilities with funds from the Serv-
ice under the Indian Self-Determination and Education 
Assistance Act. 
(c) CONTINUED FUNDING.—The Secretary shall con-
tinue to fund, through fiscal year 2015, each effective 
model diabetes project in existence on the date of the en-
actment of this Act and such other diabetes programs op-
erated by the Secretary or by Indian tribes and tribal or-
ganizations and any additional programs added to meet 
existing diabetes needs. Indian tribes and tribal organiza-
tions shall receive recurring funding for the diabetes pro-
grams which they operate pursuant to this section. Model 
diabetes projects shall consult, on a regular basis, with 
tribes and tribal organizations in their regions regarding 
diabetes needs and provide technical expertise as needed.
265
(d) DIALYSIS PROGRAMS.—The Secretary shall pro-
vide funding through the Service, Indian tribes and tribal 
organizations to establish dialysis programs, including 
funds to purchase dialysis equipment and provide nec-
essary staffing. 
(e) OTHER ACTIVITIES.—The Secretary shall, to the 
extent funding is available—
(1) in each area office of the Service, consult 
with Indian tribes and tribal organizations regarding 
programs for the prevention, treatment, and control 
of diabetes; 
(2) establish in each area office of the Service 
a registry of patients with diabetes to track the 
prevalence of diabetes and the complications from 
diabetes in that area; and 
(3) ensure that data collected in each area of-
fice regarding diabetes and related complications 
among Indians is disseminated to tribes, tribal orga-
nizations, and all other area offices. 
(f) DEFINITIONS.—For purposes of this section, the 
definitions contained in section 4 of the Indian Health 
Care Improvement Act shall apply.
266
SEC. 447. GENETICS OF DIABETES. 
Title IV of the Public Health Service Act (42 U.S.C. 
281 et seq.) is amended by inserting after section 430 the 
following: 
‘‘SEC. 430A. GENETICS OF DIABETES. 
‘‘The Diabetes Mellitus Interagency Coordinating 
Committee, in collaboration with the Directors of the Na-
tional Human Genome Research Institute, the National 
Institute of Diabetes and Digestive and Kidney Diseases, 
and the National Institute of Environmental Health 
Sciences, and other voluntary organizations and interested 
parties, shall—
‘‘(1) coordinate and assist efforts of the Type 
1 Diabetes Genetics Consortium, which will collect 
and share valuable DNA information from type 1 di-
abetes patients from studies around the world; and 
‘‘(2) provide continued coordination and sup-
port for the consortia of laboratories investigating 
the genomics of diabetes.’’. 
SEC. 448. RESEARCH AND TRAINING ON DIABETES IN UN-
DERSERVED AND MINORITY POPULATIONS. 
(a) RESEARCH.—Subpart 3 of part C of title IV of 
the Public Health Service Act (42 U.S.C. 285c et seq.) 
is amended by adding at the end the following:
267
‘‘SEC. 434B. RESEARCH ON DIABETES IN UNDERSERVED 
AND MINORITY POPULATIONS. 
‘‘(a) IN GENERAL.—The Director of the Institute, in 
coordination with the Director of the National Center on 
Minority Health and Health Disparities, the Director of 
the Office of Minority Health, and other appropriate insti-
tutes and centers, shall expand, intensify, and coordinate 
research programs on pre-diabetes, type 1 diabetes and 
type 2 diabetes in underserved populations and minority 
groups. 
‘‘(b) RESEARCH.—The research described in sub-
section (a) shall include research on—
‘‘(1) behavior, including diet and physical activ-
ity and other aspects of behavior; 
‘‘(2) environmental factors related to type 2 di-
abetes that are unique to, more serious, or more 
prevalent, among underserved or high-risk popu-
lations; 
‘‘(3) research on the prevention of complica-
tions, which are unique to, more serious, or more 
prevalent among minorities, as well as research on 
how to effectively translate the findings of clinical 
trials and research to improve methods for self-man-
agement and health-care delivery; and 
‘‘(4) genetic studies of diabetes, consistent with 
research conducted under section 430A.
268
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated for purposes of carrying 
out this section, such sums as may be necessary for each 
of fiscal years 2005 through 2010.’’. 
(b) DIVISION DIRECTORS.—Section 428(b)(1) of the 
Public Health Service Act (42 U.S.C. 285c–2(b)(1)) is 
amended by inserting ‘‘(including research training of 
members of minority populations in order to facilitate 
their conduct of diabetes-related research in underserved 
populations and minority groups)’’ after ‘‘research pro-
grams’’. 
SEC. 449. AUTHORIZATION OF APPROPRIATIONS. 
Subpart 3 of part C of title IV of the Public Health 
Service Act (42 U.S.C. 285c et seq.) (as amended by sec-
tion 448(a)) is amended by adding at the end the fol-
lowing: 
‘‘SEC. 434C. AUTHORIZATION OF APPROPRIATIONS. 
‘‘For the purpose of carrying out this subpart with 
respect to the programs of the National Institute of Diabe-
tes and Digestive and Kidney Diseases, other than section 
434B, there are authorized to be appropriated such sums 
as may be necessary for each of fiscal years 2005 through 
2010.’’.
269
SEC. 450. MODEL COMMUNITY DIABETES AND CHRONIC 
DISEASE CARE AND PREVENTION AMONG PA-
CIFIC ISLANDERS AND NATIVE HAWAIIANS. 
Part P of title III of the Public Health Service Act 
(42 U.S.C. 280g et seq.), as amended by section 432, is 
further amended by adding at the end the following: 
‘‘SEC. 399P. MODEL COMMUNITY DIABETES AND CHRONIC 
DISEASE CARE AND PREVENTION AMONG PA-
CIFIC ISLANDERS AND NATIVE HAWAIIANS. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, may award grants and enter into cooperative 
agreements and contracts with eligible entities to establish 
a model community demonstration project to provide 
training and support for community-based prevention and 
control programs targeting diabetes, hypertension, cardio-
vascular disease, and other related health problems in 
American Samoa, the Commonwealth of the Northern 
Mariana Islands, Guam, the Federated States of Micro-
nesia, Hawaii, the Republic of the Marshall Islands, and 
the Republic of Palau. 
‘‘(b) ELIGIBLE ENTITY DEFINED.—In this section 
the term ‘eligible entity’ means any organization described 
in section 501(c)(3) of the Internal Revenue Code of 1986 
and exempt from tax under section 501(a) of such Code.
270
‘‘(c) PRIORITY.—The Secretary shall give priority for 
grants, agreements, and contracts under this section to 
eligible entities that have previously administered cul-
turally appropriate Centers for Disease Control and Pre-
vention programs intended to prevent and control diabetes 
in the areas described in subsection (a). 
‘‘(d) REGULATIONS.—The Secretary is authorized to 
promulgate such regulations as may be necessary to carry 
out this section. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section, 
such sums as may be necessary for fiscal years 2005 
through 2010.’’. 
SEC. 451. PROGRAMS OF CENTERS FOR DISEASE CONTROL 
AND PREVENTION. 
Part B of title III of the Public Health Service Act 
(42 U.S.C. 243 et seq.) is amended by striking section 
317H and inserting the following: 
‘‘SEC. 317H. DIABETES IN CHILDREN AND YOUTH. 
‘‘(a) SURVEILLANCE ON TYPE 1 DIABETES.—The 
Secretary, acting through the Director of the Centers for 
Disease Control and Prevention and in consultation with 
the Director of the National Institutes of Health, shall de-
velop a sentinel system to collect data on type 1 diabetes,
271
including the incidence and prevalence of type 1 diabetes 
and shall establish a national database for such data. 
‘‘(b) TYPE 2 DIABETES IN YOUTH.—The Secretary 
shall implement a national public health effort to address 
type 2 diabetes in youth, including—
‘‘(1) enhancing surveillance systems and ex-
panding research to better assess the prevalence and 
incidence of type 2 diabetes in youth and determine 
the extent to which type 2 diabetes is incorrectly di-
agnosed as type 1 diabetes among children; 
‘‘(2) standardizing and improving methods to 
assist in diagnosis, treatment, and prevention of dia-
betes including developing less invasive ways to mon-
itor blood glucose to prevent hypoglycemia such as 
nonmydriatic retinal imaging and improving existing 
glucometers that measure blood glucose; and 
‘‘(3) developing methods to identify obstacles 
facing children in traditionally underserved popu-
lations to obtain care to prevent or treat type 2 dia-
betes. 
‘‘(c) LONG-TERM EPIDEMIOLOGICAL STUDIES ON DI-
ABETES IN CHILDREN.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention and the Director of the National Institute of Dia-
betes and Digestive and Kidney Diseases, shall conduct
272
or support long-term epidemiology studies in children with 
diabetes or at risk for diabetes. Such studies shall inves-
tigate the causes and characteristics of the disease and 
its complications. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2005 through 2010.’’. 
CHAPTER 6—HEART DISEASE AND 
STROKE PREVENTION AND TREATMENT 
SEC. 455. SYSTEMS FOR HEART DISEASE AND STROKE. 
Title XXIX of the Public Health Service Act, as 
amended by section 443, is further amended by adding 
at the end the following: 
‘‘Subtitle D—Systems for Heart 
Disease and Stroke 
‘‘CHAPTER 1—HEART DISEASE 
‘‘SEC. 2941. HEART DISEASE. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the National Heart, Lung and Blood Institute and the 
Centers for Disease Control, shall award competitive 
grants to eligible entities to provide for community-based 
interventions to encourage healthy lifestyles to reduce 
morbidity and mortality from heart disease.
273
‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive 
a grant under subsection (a), an entity shall—
‘‘(1) be a community-based or non-profit orga-
nization, academic medical institution, hospital, 
health center, health plan, health department, or 
other health-related entity determined appropriate 
by the Secretary; and 
‘‘(2) prepare and submit to the Secretary an 
application at such time, in such manner, and con-
taining such information as the Secretary may re-
quire. 
‘‘(c) USE OF FUNDS.—An entity shall use amounts 
received under a grant under this section to—
‘‘(1) carry out interventions that address pri-
mary prevention of heart disease in the minority 
community, including educational outreach efforts 
concerning risk factors for, and the prevention of, 
heart disease; 
‘‘(2) carry out activities to facilitate healthy 
lifestyles in minority populations through—
‘‘(A) behavioral change interventions to in-
crease physical activity and improve nutrition; 
‘‘(B) the increased use of community facili-
ties and public spaces for exercise;
274
‘‘(C) school, after-school, or intramural 
physical activity or sports programs for children 
and youth; 
‘‘(D) employment-based interventions to 
increase physical activity or nutrition; or 
‘‘(3) expand or evaluate existing programs of 
the type described in paragraphs (1) and (2). 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2005 through 2010. 
‘‘CHAPTER 2—STROKE EDUCATION 
CAMPAIGN 
‘‘SEC. 2945. STROKE EDUCATION CAMPAIGN. 
‘‘(a) IN GENERAL.—The Secretary shall carry out a 
national education and information campaign to promote 
stroke prevention and increase the number of stroke pa-
tients who seek immediate treatment. In implementing 
such education and information campaign, the Secretary 
shall avoid duplicating existing stroke education efforts by 
other Federal Government agencies and may consult with 
national and local associations that are dedicated to in-
creasing the public awareness of stroke, consumers of 
stroke awareness products, and providers of stroke care.
275
‘‘(b) USE
OF FUNDS.—The Secretary may use 
amounts appropriated to carry out the campaign described 
in subsection (a)—
‘‘(1) to make public service announcements 
about the warning signs of stroke and the impor-
tance of treating stroke as a medical emergency; 
‘‘(2) to provide education regarding ways to 
prevent stroke and the effectiveness of stroke treat-
ment; 
‘‘(3) to purchase media time and space; 
‘‘(4) to pay for advertising production costs; 
‘‘(5) to test and evaluate advertising and edu-
cational materials for effectiveness, especially among 
groups at high risk for stroke, including women, 
older adults, and African-Americans; 
‘‘(6) to develop alternative campaigns that are 
targeted to unique communities, including rural and 
urban communities, and States with a particularly 
high incidence of stroke; 
‘‘(7) to measure public awareness prior to the 
start of the campaign on a national level and in tar-
geted communities to provide baseline data that will 
be used to evaluate the effectiveness of the public 
awareness efforts; and
276
‘‘(8) to carry out other activities that the Sec-
retary determines will promote prevention practices 
among the general public and increase the number 
of stroke patients who seek immediate care. 
‘‘(c) CONSULTATIONS.—In carrying out this section, 
the Secretary shall consult with medical, surgical, rehabili-
tation, and nursing specialty groups, hospital associations, 
voluntary health organizations, emergency medical serv-
ices, State directors, and associations, experts in the use 
of telecommunication technology to provide stroke care, 
national disability, minority health professional organiza-
tions and consumer organizations representing individuals 
with disabilities and chronic illnesses, concerned advo-
cates, and other interested parties. 
‘‘(d) STROKE.—In this section, the term ‘stroke’ 
means a ‘brain attack’ in which blood flow to the brain 
is interrupted or in which a blood vessel or aneurysm in 
the brain breaks or ruptures. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out subsection 
(b), such sums as may be necessary for each of fiscal years 
2005 through 2010.’’.
277
CHAPTER 7—OBESITY AND OVERWEIGHT 
REDUCTION 
SEC. 461. OVERWEIGHT AND OBESITY PREVENTION AND 
TREATMENT. 
(a) IN GENERAL.—The Secretary, in collaboration 
with the Director of the Centers for Disease Control and 
Prevention, the Administrator of the National Center for 
Minority Health and Health Disparities, and the Adminis-
trator of the Health Resources and Services Administra-
tion, shall establish grant programs for the purpose of pre-
venting and treating overweight and obesity in under-
served minority populations. 
(b) DEFINITIONS.—In this section, with respect to an 
individual: 
(1) OBESITY.—The term ‘‘obesity’’ means a 
Body Mass Index greater than or equal to 30.0 kg/
m2. 
(2) OVERWEIGHT.—The term ‘‘overweight’’ 
means a Body Mass Index of 25 to 29.9 kg/m2. 
(c) CENTERS FOR DISEASE CONTROL AND PREVEN-
TION.—The Director of the Centers for Disease Control 
and Prevention shall expand overweight and obesity reduc-
tion activities that include the following: 
(1) Surveillance in minority racial and ethnic 
populations.
278
(2) Communication strategies, including the use 
of social marketing for minority populations, about 
the dangers of obesity. 
(3) Creation of partnerships with State health 
departments in developing obesity prevention and 
treatment interventions. 
(4) Development of work-based wellness pro-
grams to encourage adoption of healthy lifestyles by 
employees. 
(d) NATIONAL CENTER FOR MINORITY HEALTH AND 
HEALTH DISPARITIES.—The Director of the Centers for 
Disease Control and Prevention shall establish and imple-
ment a grant program to support research in the following 
areas: 
(1) Behavioral and environmental causes of 
overweight and obesity in minority populations. 
(2) Prevention and treatment interventions for 
overweight and obesity, tailored for minority popu-
lations. 
(3) Disparities in the prevalence of overweight 
and obesity among racial and ethnic minority 
groups. 
(4) Development and dissemination of best 
practice guidelines for treatment of overweight and
279
obesity, tailored for gender and age groups within 
minority populations. 
(5) Data collection and reporting relating to 
overweight and obesity in minority populations. 
(e) HEALTH RESOURCES AND SERVICES ADMINIS-
TRATION.—The Administrator of the Health Resources 
and Services Administration, in collaboration with the Di-
rector of the Office of Minority Health, the Secretary of 
Education, and the Secretary of Agriculture, shall estab-
lish and implement a school-based obesity prevention and 
treatment program that may include the following activi-
ties: 
(1) Projects to change the perception of over-
weight and obesity of children from racially and eth-
nically diverse backgrounds at all ages. 
(2) Culturally appropriate student education 
about healthy eating habits, based on the Dietary 
Guidelines for Americans. 
(3) Student programs to increase knowledge, 
attitudes, skills, behaviors, and confidence needed to 
be physically active for life. 
(4) Student peer advisor programs to increase 
awareness and model healthy lifestyles among fellow 
students.
280
(5) Teacher education using scientifically evalu-
ated physical education and nutrition curricula tai-
lored to minority populations. 
(6) Family-focused initiatives to encourage the 
adoption of strategies relating to healthy lifestyles 
for parents (or guardians) and children. 
(7) The creation of partnerships with commu-
nity, fitness, or health organizations that will pro-
mote healthy eating and physical activity among 
children. 
(8) Incentive programs to ensure the provision 
of healthful foods and beverages on school campuses 
and at school events. 
(f) EVALUATION.—A grantee under this section shall 
submit to the Secretary an evaluation, in collaboration 
with an academic health center or other qualified entity, 
that describes activities carried out with funds received 
under the grant and the effectiveness of such activities in 
preventing or treating overweight and obesity. 
(g) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2005 through 2010.
281
CHAPTER 8—TUBERCULOSIS CONTROL, 
PREVENTION, AND TREATMENT 
SEC. 465. ADVISORY COUNCIL FOR THE ELIMINATION OF 
TUBERCULOSIS. 
Section 317E(f) of the Public Health Service Act (42 
U.S.C. 247b–6(f)) is amended—
(1) by redesignating paragraph (5) as para-
graph (6); and 
(2) by striking paragraphs (2) through (4), and 
inserting the following: 
‘‘(2) DUTIES.—For the purpose of making 
progress toward the goal of eliminating tuberculosis 
from the United States, the Council shall provide to 
the Secretary and other appropriate Federal officials 
advice on coordinating the activities of the Public 
Health Service and other Federal agencies that re-
late to such disease and on efficiently utilizing the 
Federal resources involved. 
‘‘(3) NATIONAL PLAN.—In carrying out para-
graph (2), the Council, in consultation with appro-
priate public and private entities, shall make rec-
ommendations on the development, revision, and im-
plementation of a national plan to eliminate tuber-
culosis in the United States. In carrying out this 
paragraph, the Council shall—
282
‘‘(A) consider the recommendations of the 
Institute of Medicine regarding the elimination 
of tuberculosis; 
‘‘(B) address the development and applica-
tion of new technologies; and 
‘‘(C) review the extent to which progress 
has been made toward eliminating tuberculosis. 
‘‘(4) GLOBAL
ACTIVITIES.—In carrying out 
paragraph (2), the Council, in consultation with ap-
propriate public and private entities, shall make rec-
ommendations for the development and implementa-
tion of a plan to guide the involvement of the United 
States in global and cross border tuberculosis-control 
activities, including recommendations regarding poli-
cies, strategies, objectives, and priorities. Such rec-
ommendations for the plan shall have a focus on 
countries where a high incidence of tuberculosis di-
rectly affects the United States, such as Mexico, and 
on access to a comprehensive package of tuberculosis 
control measures, as defined by the World Health 
Organization directly observed treatment, short 
course strategy (commonly known as DOTS). 
‘‘(5) COMPOSITION.—The Council shall be com-
posed of—
283
‘‘(A) representatives from the Centers for 
Disease Control and Prevention, the National 
Institutes of Health, the Agency for Healthcare 
Research and Quality, the Health Resources 
and Services Administration, the U.S.-Mexico 
Border Health Commission, and other Federal 
departments and agencies that carry out signifi-
cant activities relating to tuberculosis; and 
‘‘(B) members appointed from among indi-
viduals who are not officers or employees of the 
Federal Government.’’. 
SEC. 466. NATIONAL PROGRAM FOR TUBERCULOSIS ELIMI-
NATION. 
Section 317E of the Public Health Service Act (42 
U.S.C. 247b–6) is amended—
(1) by striking the heading for the section and 
inserting the following: 
‘‘NATIONAL PROGRAM FOR TUBERCULOSIS 
ELIMINATION’’; 
(2) by amending subsection (b) to read as fol-
lows: 
‘‘(b) RESEARCH, DEMONSTRATION PROJECTS, EDU-
CATION, AND TRAINING.—With respect to the prevention, 
control, and elimination of tuberculosis, the Secretary 
may, directly or through grants to public or nonprofit pri-
vate entities, carry out the following:
284
‘‘(1) Research, with priority given to research 
concerning—
‘‘(A) diagnosis and treatment of latent in-
fection of tuberculosis; 
‘‘(B) strains of tuberculosis resistant to 
drugs; 
‘‘(C) cases of tuberculosis that affect cer-
tain high-risk populations; and 
‘‘(D) clinical trials, including those con-
ducted through the Tuberculosis Trials Consor-
tium. 
‘‘(2) Demonstration projects, including for—
‘‘(A) the development of regional capabili-
ties for the prevention, control, and elimination 
of tuberculosis particularly in low-incidence re-
gions; and 
‘‘(B) collaboration with the Immigration 
and Naturalization Service to identify and treat 
immigrants with active or latent tuberculosis in-
fection. 
‘‘(3) Public information and education pro-
grams. 
‘‘(4) Education, training and clinical skills im-
provement activities for health professionals, includ-
ing allied health personnel.
285
‘‘(5) Support of model centers to carry out ac-
tivities under paragraphs (2) through (4). 
‘‘(6) Collaboration with international organiza-
tions and foreign countries, including Mexico, in co-
ordination with the United States Agency for Inter-
national Development, in carrying out such activi-
ties, including coordinating activities through the 
Advisory Council for the Elimination of Tuber-
culosis. 
‘‘(7) Capacity support to States and large cities 
for strengthening tuberculosis programs.’’; and 
(3) by striking subsection (g) and inserting the 
following: 
‘‘(g) REPORTS.—The Secretary, acting through the 
Director of the Centers for Disease Control and Preven-
tion and in consultation with the Advisory Council for the 
Elimination of Tuberculosis, shall biennially prepare and 
submit to the Committee on Health, Education, Labor, 
and Pensions of the Senate and the Committee on Energy 
and Commerce of the House of Representatives, a report 
on the activities carried out under this section. Each re-
port shall include the opinion of the Council on the extent 
to which its recommendations under section 317E(f)(3) 
regarding tuberculosis have been implemented.
286
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for 
each of the fiscal years 2005 through 2010.’’. 
SEC. 467. INCLUSION OF INPATIENT HOSPITAL SERVICES 
FOR THE TREATMENT OF TB-INFECTED INDI-
VIDUALS. 
(a) IN GENERAL.—Section 1902(z)(2) of the Social 
Security Act (42 U.S.C. 1396a(z)(2)) is amended by add-
ing at the end the following: 
‘‘(G) Inpatient hospital services.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) takes effect on October 1, 2004. 
CHAPTER 9—ASTHMA 
SEC. 471. PROVISIONS REGARDING NATIONAL ASTHMA 
EDUCATION AND PREVENTION PROGRAM OF 
NATIONAL HEART, LUNG, AND BLOOD INSTI-
TUTE. 
In addition to any other authorization of appropria-
tions that is available to the National Heart, Lung, and 
Blood Institute for the purpose of carrying out the Na-
tional Asthma Education and Prevention Program, there 
is authorized to be appropriated to such Institute for such 
purpose such sums as may be necessary for each of fiscal 
years 2005 through 2010. Amounts appropriated under
288
(1) conduct local asthma surveillance activities 
to collect data on the prevalence and severity of 
asthma and the quality of asthma management, in-
cluding—
(A) telephone surveys to collect sample 
household data on the local burden of asthma; 
and 
(B) health care facility specific surveillance 
to collect asthma data on the prevalence and se-
verity of asthma, and on the quality of asthma 
care; and 
(2) compile and annually publish data on—
(A) the prevalence of children suffering 
from asthma in each State; and 
(B) the childhood mortality rate associated 
with asthma nationally and in each State. 
(c) ADDITIONAL FUNDING.—In addition to any other 
authorization of appropriations that is available to the 
Centers for Disease Control and Prevention for the pur-
pose of carrying out this section, there is authorized to 
be appropriated to such Centers for such purpose such 
sums as may be necessary for each of fiscal years 2005 
through 2010.
289
SEC. 473. GRANTS FOR COMMUNITY OUTREACH REGARD-
ING 
ASTHMA 
INFORMATION, 
EDUCATION, 
AND SERVICES. 
(a) IN GENERAL.—The Secretary may make grants 
to nonprofit private entities for projects to carry out, in 
communities identified by entities applying for the grants, 
outreach activities to provide for residents of the commu-
nities the following: 
(1) Information and education on asthma. 
(2) Referrals to health programs of public and 
nonprofit private entities that provide asthma-re-
lated services, including such services for low-income 
individuals. The grant may be expended to make ar-
rangements to coordinate the activities of such enti-
ties in order to establish and operate networks or 
consortia regarding such referrals. 
(b) PREFERENCES IN MAKING GRANTS.—In making 
grants under subsection (a), the Secretary shall give pref-
erence to applicants that will carry out projects under such 
subsection in communities that are disproportionately af-
fected by asthma or underserved with respect to the activi-
ties described in such subsection and in which a significant 
number of low-income individuals reside. 
(c) EVALUATIONS.—A condition for a grant under 
subsection (a) is that the applicant for the grant agree 
to provide for the evaluation of the projects carried out
290
under such subsection by the applicant to determine the 
extent to which the projects have been effective in carrying 
out the activities referred to in such subsection. 
(d) FUNDING.—For the purpose of carrying out this 
section, there is authorized to be appropriated such sums 
as may be necessary for each of fiscal years 2005 through 
2010. 
SEC. 474. ACTION PLANS OF LOCAL EDUCATIONAL AGEN-
CIES REGARDING ASTHMA. 
(a) IN GENERAL.—
(1) SCHOOL-BASED ASTHMA ACTIVITIES.—The 
Secretary of Education (in this section referred to as 
the ‘‘Secretary’’), in consultation with the Director 
of the Centers for Disease Control and Prevention 
and the Director of the National Institutes of 
Health, may make grants to local educational agen-
cies for programs to carry out at elementary and 
secondary schools specified in paragraph (2) asthma-
related activities for children who attend such 
schools. 
(2) ELIGIBLE SCHOOLS.—The elementary and 
secondary schools referred to in paragraph (1) are 
such schools that are located in communities with a 
significant number of low-income or underserved in-
dividuals (as defined by the Secretary).
291
(b) DEVELOPMENT OF PROGRAMS.—Programs under 
subsection (a) shall include grants under which local edu-
cation agencies and State public health officials collabo-
rate to develop programs to improve the management of 
asthma in school settings. 
(c) CERTAIN GUIDELINES.—Programs under sub-
section (a) shall be carried out in accordance with applica-
ble guidelines or other recommendations of the National 
Institutes of Health (including the National Heart, Lung, 
and Blood Institute) and the Environmental Protection 
Agency. 
(d) CERTAIN ACTIVITIES.—Activities that may be 
carried out in programs under subsection (a) include the 
following: 
(1) Identifying and working directly with local 
hospitals, community clinics, advocacy organizations, 
parent-teacher associations, minority health organi-
zations, and asthma coalitions. 
(2) Identifying asthmatic children and training 
them and their families in asthma self-management. 
(3) Purchasing asthma equipment. 
(4) Hiring school nurses. 
(5) Training teachers, nurses, coaches, and 
other school personnel in asthma-symptom recogni-
tion and emergency responses.
292
(6) Simplifying procedures to improve students’ 
safe access to their asthma medications. 
(7) Such other asthma-related activities as the 
Secretary determines to be appropriate. 
(e) DEFINITIONS.—For purposes of this section, the 
terms ‘‘elementary school’’, ‘‘local educational agency’’, 
and ‘‘secondary school’’ have the meanings given such 
terms in the Elementary and Secondary Education Act of 
1965. 
(f) FUNDING.—For the purpose of carrying out this 
section, there is authorized to be appropriated such sums 
as may be necessary for each of fiscal years 2005 through 
2010. 
CHAPTER 10—SICKLE CELL DISEASE 
SEC. 481. DEMONSTRATION PROGRAM FOR THE DEVELOP-
MENT AND ESTABLISHMENT OF SYSTEMIC 
MECHANISMS FOR THE PREVENTION AND 
TREATMENT OF SICKLE CELL DISEASE. 
(a) AUTHORITY TO CONDUCT DEMONSTRATION PRO-
GRAM.—
(1) IN GENERAL.—The Administrator, through 
the Bureau of Primary Health Care and the Mater-
nal and Child Health Bureau, shall conduct a dem-
onstration program by making grants to up to 40 el-
igible entities for each fiscal year in which the pro-
293
gram is conducted under this section for the purpose 
of developing and establishing systemic mechanisms 
to improve the prevention and treatment of Sickle 
Cell Disease, including through—
(A) the coordination of service delivery for 
individuals with Sickle Cell Disease; 
(B) genetic counseling and testing; 
(C) bundling of technical services related 
to the prevention and treatment of Sickle Cell 
Disease; 
(D) training of health professionals; and 
(E) identifying and establishing other ef-
forts related to the expansion and coordination 
of education, treatment, pain management, and 
continuity of care programs for individuals with 
Sickle Cell Disease. 
(2) GRANT AWARD REQUIREMENTS.—
(A) GEOGRAPHIC
DIVERSITY.—The Ad-
ministrator shall, to the extent practicable, 
award grants under this section to eligible enti-
ties located in different regions of the United 
States. 
(B) PRIORITY.—In awarding grants under 
this section, the Administrator shall give pri-
294
ority to awarding grants to eligible entities that 
are—
(i) Federally-qualified health centers 
that have a partnership or other arrange-
ment with a comprehensive Sickle Cell Dis-
ease treatment center that does not receive 
funds from the National Institutes of 
Health; or 
(ii) Federally-qualified health centers 
that intend to develop a partnership or 
other arrangement with a comprehensive 
Sickle Cell Disease treatment center that 
does not receive funds from the National 
Institutes of Health. 
(b) ADDITIONAL REQUIREMENTS.—An eligible entity 
awarded a grant under this section shall use funds made 
available under the grant to carry out, in addition to the 
activities described in subsection (a)(1), the following ac-
tivities: 
(1) To facilitate and coordinate the delivery of 
education, treatment, and continuity of care for indi-
viduals with Sickle Cell Disease under—
(A) the entity’s collaborative agreement 
with a community-based Sickle Cell Disease or-
295
ganization or a nonprofit entity that works with 
individuals who have Sickle Cell Disease; 
(B) the Sickle Cell Disease newborn 
screening program for the State in which the 
entity is located; and 
(C) the maternal and child health program 
under title V of the Social Security Act (42 
U.S.C. 701 et seq.) for the State in which the 
entity is located. 
(2) To train nursing and other health staff who 
specialize in pediatrics, obstetrics, internal medicine, 
or family practice to provide healthcare and genetic 
counseling for individuals with the sickle cell trait. 
(3) To enter into a partnership with adult or 
pediatric hematologists in the region and other re-
gional experts in Sickle Cell Disease at tertiary and 
academic health centers and State and county health 
offices. 
(c) NATIONAL COORDINATING CENTER.—
(1) ESTABLISHMENT.—The Administrator shall 
enter into a contract with an entity to serve as the 
National Coordinating Center for the demonstration 
program conducted under this section. 
(2) ACTIVITIES DESCRIBED.—The National Co-
ordinating Center shall—
296
(A) collect, coordinate, monitor, and dis-
tribute data, best practices, and findings re-
garding the activities funded under grants made 
to eligible entities under the demonstration pro-
gram; 
(B) develop a model protocol for eligible 
entities with respect to the prevention and 
treatment of Sickle Cell Disease; 
(C) develop educational materials regard-
ing the prevention and treatment of Sickle Cell 
Disease; and 
(D) prepare and submit to Congress a 
final report that includes recommendations re-
garding the effectiveness of the demonstration 
program conducted under this section and such 
direct outcome measures as—
(i) the number and type of healthcare 
resources utilized (such as emergency room 
visits, hospital visits, length of stay, and 
physician visits for individuals with Sickle 
Cell Disease); and 
(ii) the number of individuals that 
were tested and subsequently received ge-
netic counseling for the sickle cell trait.
297
(d) APPLICATION.—An eligible entity desiring a 
grant under this section shall submit an application to the 
Administrator at such time, in such manner, and con-
taining such information as the Administrator may re-
quire. 
(e) DEFINITIONS.—In this section: 
(1) ADMINISTRATOR.—The term ‘‘Adminis-
trator’’ means the Administrator of the Health Re-
sources and Services Administration. 
(2) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means a Federally-qualified health center, a non-
profit hospital or clinic, or a university health center 
that provides primary healthcare, that—
(A) has a collaborative agreement with a 
community-based Sickle Cell Disease organiza-
tion or a nonprofit entity with experience in 
working with individuals who have Sickle Cell 
Disease; and 
(B) demonstrates to the Administrator 
that either the Federally-qualified health center, 
the nonprofit hospital or clinic, the university 
health center, the organization or entity de-
scribed in subparagraph (A), or the experts de-
scribed in subsection (b)(3), has at least 5
298
years of experience in working with individuals 
who have Sickle Cell Disease. 
(3) 
FEDERALLY-QUALIFIED
HEALTH
CEN-
TER.—The term ‘‘Federally-qualified health center’’ 
has the meaning given that term in section 
1905(l)(2)(B) of the Social Security Act (42 U.S.C. 
1396d(l)(2)(B)). 
(f) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2005 through 2010. 
CHAPTER 11—AUTOIMMUNE DISEASE IN 
MINORITY POPULATIONS 
SEC. 482. RESEARCH FUNDING FOR AUTOIMMUNE DISEASE 
IN MINORITY POPULATIONS. 
Part B of title IV of the Public Health Service Act 
is amended by inserting after section 409E (42 U.S.C. 
284i) the following: 
‘‘SEC. 490E–1. RESEARCH FUNDING FOR AUTOIMMUNE DIS-
EASE IN MINORITY POPULATIONS. 
‘‘(a) EXPANSION AND INTENSIFICATION OF ACTIVI-
TIES REGARDING AUTOIMMUNE DISEASES ON MINORI-
TIES.—With respect to the plan under section 409E(c)(1), 
the Coordinating Committee shall ensure that provisions
299
of the plan developed under paragraph (2) of such sub-
section include provisions for the following: 
‘‘(1)(A) Basic research, epidemiological re-
search, and other appropriate research concerning 
the etiology and causes of autoimmune diseases in 
all minorities, including genetic, hormonal, and envi-
ronmental factors. 
‘‘(B)(i) Giving priority under subparagraph (A) 
to research regarding environmental factors. 
‘‘(ii) The coordination of (to the extent prac-
ticable and appropriate), and providing additional 
support for, research described in clause (i) that is 
conducted by public or nonprofit private entities. 
‘‘(2)(A) The development of information and 
education programs for patients, healthcare pro-
viders, and others as appropriate on genetic, hor-
monal, and environmental risk factors associated 
with autoimmune diseases in minorities, and on the 
importance of the prevention or control of such risk 
factors and timely referral with appropriate diag-
nosis and treatment. 
‘‘(B) The inclusion in programs under subpara-
graph (A) of information and education on the prev-
alence and nature of autoimmune diseases, on risk
300
factors, and on health-related behaviors that can im-
prove health status in minority populations. 
‘‘(3) Outreach programs for purposes of para-
graphs (1) and (2) that—
‘‘(A) are directed toward minority individ-
uals, particularly those who are at-risk for auto-
immune diseases; and 
‘‘(B) are carried out through community 
health centers, community clinics, or other 
health centers under section 330, through 
State, territory, or local health departments, In-
dian tribes, or through primary care physicians. 
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2005 through 2010.’’. 
CHAPTER 
12—PREVENTION 
AND 
CON-
TROL OF SEXUALLY TRANSMITTED 
DISEASES 
SEC. 485. PREVENTION AND CONTROL OF SEXUALLY 
TRANSMITTED DISEASES. 
(a) IN GENERAL.—Section 318(e)(1) of the Public 
Health Service Act (42 U.S.C. 247c(e)(1)) is amended by 
striking ‘‘1998’’ and inserting ‘‘2008’’.
301
(b) PREVENTABLE CASES OF INFERTILITY.—Section 
318A of the Public Health Service Act (42 U.S.C. 247c–
1) is amended—
(1) in subsection (q), by striking ‘‘1998’’ and 
inserting ‘‘2010’’; and 
(2) in subsection (r)(2), by striking ‘‘1998’’ and 
inserting ‘‘2010’’. 
CHAPTER 13—DENTAL DISEASE 
SEC. 486. GRANTS TO IMPROVE THE PROVISION OF DENTAL 
SERVICES UNDER MEDICAID AND SCHIP. 
Title V of the Social Security Act (42 U.S.C. 701 
et seq.) is amended by adding at the end the following: 
‘‘SEC. 511. GRANTS TO IMPROVE THE PROVISION OF DEN-
TAL SERVICES UNDER MEDICAID AND SCHIP. 
‘‘(a) AUTHORITY TO MAKE GRANTS.—In addition to 
any other payments made under this title to a State, the 
Secretary shall award grants to States that satisfy the re-
quirements of subsection (b) to improve the provision of 
dental services to children who are enrolled in a State plan 
under title XIX or a State child health plan under title 
XXI (in this section, collectively referred to as the ‘State 
plans’). 
‘‘(b) REQUIREMENTS.—In order to be eligible for a 
grant under this section, a State shall provide the Sec-
retary with the following assurances:
302
‘‘(1) 
IMPROVED
SERVICE
DELIVERY.—The 
State shall have a plan to improve the delivery of 
dental services to children, including children with 
special health care needs, who are enrolled in the 
State plans, including providing outreach and ad-
ministrative case management, improving collection 
and reporting of claims data, and providing incen-
tives, in addition to raising reimbursement rates, to 
increase provider participation. 
‘‘(2) ADEQUATE PAYMENT RATES.—The State 
has provided for payment under the State plans for 
dental services for children at levels consistent with 
the market-based rates and sufficient enough to en-
list providers to treat children in need of dental serv-
ices. 
‘‘(3) ENSURED ACCESS.—The State shall en-
sure it will make dental services available to children 
enrolled in the State plans to the same extent as 
such services are available to the general population 
of the State. 
‘‘(c) USE OF FUNDS.—
‘‘(1) IN GENERAL.—Funds provided under this 
section may be used to provide administrative re-
sources (such as program development, provider 
training, data collection and analysis, and research-
303
related tasks) to assist States in providing and as-
sessing services that include preventive and thera-
peutic dental care regimens. 
‘‘(2) LIMITATION.—Funds provided under this 
section may not be used for payment of direct den-
tal, medical, or other services or to obtain Federal 
matching funds under any Federal program. 
‘‘(d) APPLICATION.—A State shall submit an applica-
tion to the Secretary for a grant under this section in such 
form and manner and containing such information as the 
Secretary may require. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to make grants under 
this section, such sums as may be necessary for fiscal year 
2005 and each fiscal year thereafter. 
‘‘(f) APPLICATION
OF
OTHER
PROVISIONS
OF 
TITLE.—
‘‘(1) IN GENERAL.—Except as provided in para-
graph (2), the other provisions of this title shall not 
apply to a grant made under this section. 
‘‘(2) EXCEPTIONS.—The following provisions of 
this title shall apply to a grant made under sub-
section (a) to the same extent and in the same man-
ner as such provisions apply to allotments made 
under section 502(c):
304
‘‘(A) Section 504(b)(6) (relating to prohi-
bition on payments to excluded individuals and 
entities). 
‘‘(B) Section 504(c) (relating to the use of 
funds for the purchase of technical assistance).
‘‘(C) Section 504(d) (relating to a limita-
tion on administrative expenditures). 
‘‘(D) Section 506 (relating to reports and 
audits), but only to the extent determined by 
the Secretary to be appropriate for grants made 
under this section. 
‘‘(E) Section 507 (relating to penalties for 
false statements).
‘‘(F) 
Section 
508 
(relating 
to 
non-
discrimination). 
‘‘(G) Section 509 (relating to the adminis-
tration of the grant program).’’. 
SEC. 487. STATE OPTION TO PROVIDE WRAP-AROUND 
SCHIP COVERAGE TO CHILDREN WHO HAVE 
OTHER HEALTH COVERAGE. 
(a) IN GENERAL.—
(1) SCHIP.—
(A) STATE
OPTION
TO
PROVIDE
WRAP-
AROUND
COVERAGE.—Section 2110(b) of the
305
Social Security Act (42 U.S.C. 1397jj(b)) is 
amended—
(i) in paragraph (1)(C), by inserting 
‘‘, subject to paragraph (5),’’ after ‘‘under 
title XIX or’’; and 
(ii) by adding at the end the fol-
lowing: 
‘‘(5) STATE OPTION TO PROVIDE WRAP-AROUND 
COVERAGE.—A State may waive the requirement of 
paragraph (1)(C) that a targeted low-income child 
may not be covered under a group health plan or 
under health insurance coverage, if the State satis-
fies the conditions described in subsection (c)(8). 
The State may waive such requirement in order to 
provide—
‘‘(A) dental services; 
‘‘(B) cost-sharing protection; or 
‘‘(C) all services. 
In waiving such requirement, a State may limit the 
application of the waiver to children whose family in-
come does not exceed a level specified by the State, 
so long as the level so specified does not exceed the 
maximum income level otherwise established for 
other children under the State child health plan.’’.
306
(B) 
CONDITIONS
DESCRIBED.—Section 
2105(c) of the Social Security Act (42 U.S.C. 
1397ee(c)) is amended by adding at the end the 
following: 
‘‘(8) CONDITIONS
FOR
PROVISION
OF
WRAP-
AROUND
COVERAGE.—For 
purposes 
of 
section 
2110(b)(5), the conditions described in this para-
graph are the following: 
‘‘(A) INCOME
ELIGIBILITY.—The State 
child health plan (whether implemented under 
title XIX or this XXI)—
‘‘(i) has the highest income eligibility 
standard permitted under this title as of 
January 1, 2002; 
‘‘(ii) subject to subparagraph (B), 
does not limit the acceptance of applica-
tions for children; and 
‘‘(iii) provides benefits to all children 
in the State who apply for and meet eligi-
bility standards. 
‘‘(B) NO WAITING LIST IMPOSED.—With 
respect to children whose family income is at or 
below 200 percent of the poverty line, the State 
does not impose any numerical limitation, wait-
ing list, or similar limitation on the eligibility of
307
such children for child health assistance under 
such State plan. 
‘‘(C) NO MORE FAVORABLE TREATMENT.—
The State child health plan may not provide 
more favorable coverage of dental services to 
the children covered under section 2110(b)(5) 
than to children otherwise covered under this 
title.’’. 
(C) STATE OPTION TO WAIVE WAITING PE-
RIOD.—Section 2102(b)(1)(B) of the Social Se-
curity Act (42 U.S.C. 1397bb(b)(1)(B)) is 
amended—
(i) in clause (i), by striking ‘‘and’’ at 
the end; 
(ii) in clause (ii), by striking the pe-
riod and inserting ‘‘; and’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(iii) at State option, may not apply 
a waiting period in the case of a child de-
scribed in section 2110(b)(5), if the State 
satisfies 
the 
requirements 
of 
section 
2105(c)(8).’’.
308
(2) APPLICATION OF ENHANCED MATCH UNDER 
MEDICAID.—Section 1905 of the Social Security Act 
(42 U.S.C. 1396d) is amended—
(A) in subsection (b), in the fourth sen-
tence, by striking ‘‘or subsection (u)(3)’’ and 
inserting ‘‘(u)(3), or (u)(4)’’; and 
(B) in subsection (u)—
(i) by redesignating paragraph (4) as 
paragraph (5); and 
(ii) by inserting after paragraph (3) 
the following: 
‘‘(4) For purposes of subsection (b), the ex-
penditures described in this paragraph are expendi-
tures for items and services for children described in 
section 2110(b)(5), but only in the case of a State 
that 
satisfies 
the 
requirements 
of 
section 
2105(c)(8).’’. 
(3) APPLICATION OF SECONDARY PAYOR PROVI-
SIONS.—Section 2107(e)(1) of the Social Security 
Act (42 U.S.C. 1397gg(e)(1)) is amended—
(A) by redesignating subparagraphs (B) 
through (D) as subparagraphs (C) through (E), 
respectively; and 
(B) by inserting after subparagraph (A) 
the following:
309
‘‘(B) Section 1902(a)(25) (relating to co-
ordination of benefits and secondary payor pro-
visions) with respect to children covered under 
a waiver described in section 2110(b)(5).’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall take effect on January 1, 2004, and 
shall apply to child health assistance and medical assist-
ance provided on or after that date. 
SEC. 488. GRANTS TO IMPROVE THE PROVISION OF DENTAL 
HEALTH SERVICES THROUGH COMMUNITY 
HEALTH CENTERS AND PUBLIC HEALTH DE-
PARTMENTS. 
Part D of title III of the Public Health Service Act 
(42 U.S.C. 254b et seq.) is amended by insert before sec-
tion 330, the following: 
‘‘SEC. 329. GRANT PROGRAM TO EXPAND THE AVAIL-
ABILITY OF SERVICES. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Health Resources and Services Administration, shall 
establish a program under which the Secretary may award 
grants to eligible entities and eligible individuals to expand 
the availability of primary dental care services in dental 
health professional shortage areas or medically under-
served areas. 
‘‘(b) ELIGIBILITY.—
310
‘‘(1) ENTITIES.—To be eligible to receive a 
grant under this section an entity—
‘‘(A) shall be—
‘‘(i) a health center receiving funds 
under section 330 or designated as a Fed-
erally qualified health center; 
‘‘(ii) a county or local public health 
department, if located in a federally-des-
ignated dental health professional shortage 
area; 
‘‘(iii) an Indian tribe or tribal organi-
zation (as defined in section 4 of the In-
dian Self-Determination and Education 
Assistance Act (25 U.S.C. 450b)); 
‘‘(iv) a dental education program ac-
credited by the Commission on Dental Ac-
creditation; or 
‘‘(v) 
a 
community-based 
program 
whose child service population is made up 
of at least 33 percent of children who are 
eligible children, including at least 25 per-
cent of such children being children with 
mental retardation or related develop-
mental disabilities, unless specific docu-
311
mentation of a lack of need for access by 
this sub-population is established; and 
‘‘(B) shall prepare and submit to the Sec-
retary an application at such time, in such 
manner, and containing such information as the 
Secretary may require, including information 
concerning dental provider capacity to serve in-
dividuals with developmental disabilities. 
‘‘(2) INDIVIDUALS.—To be eligible to receive a 
grant under this section an individual shall—
‘‘(A) be a dental health professional li-
censed or certified in accordance with the laws 
of State in which such individual provides den-
tal services;
‘‘(B) prepare and submit to the Secretary 
an application at such time, in such manner, 
and containing such information as the Sec-
retary may require; and 
‘‘(C) provide assurances that—
‘‘(i) the individual will practice in a 
federally-designated dental health profes-
sional shortage area; or 
‘‘(ii) not less than 25 percent of the 
patients of such individual are—
312
‘‘(I) receiving assistance under a 
State plan under title XIX of the So-
cial Security Act (42 U.S.C. 1396 et 
seq.); 
‘‘(II) receiving assistance under a 
State plan under title XXI of the So-
cial Security Act (42 U.S.C. 1397aa 
et seq.); or 
‘‘(III) uninsured. 
‘‘(c) USE OF FUNDS.—
‘‘(1) ENTITIES.—An entity shall use amounts 
received under a grant under this section to provide 
for the increased availability of primary dental serv-
ices in the areas described in subsection (a). Such 
amounts may be used to supplement the salaries of-
fered for individuals accepting employment as den-
tists in such areas. 
‘‘(2) INDIVIDUALS.—A grant to an individual 
under subsection (a) shall be in the form of a 
$1,000 bonus payment for each month in which such 
individual is in compliance with the eligibility re-
quirements of subsection (b)(2)(C). 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) IN GENERAL.—Notwithstanding any other 
amounts appropriated under section 330 for health
313
centers, there is authorized to be appropriated such 
sums as may be necessary for each of fiscal years 
2005 through 2010 to hire and retain dental 
healthcare providers under this section. 
‘‘(2) USE OF FUNDS.—Of the amount appro-
priated for a fiscal year under paragraph (1), the 
Secretary shall use—
‘‘(A) not less than 65 percent of such 
amount to make grants to eligible entities; and 
‘‘(B) not more than 35 percent of such 
amount to make grants to eligible individuals.’’. 
CHAPTER 14—PREVENTION AND 
CONTROL OF INJURIES 
SEC. 491. PREVENTION AND CONTROL OF INJURIES. 
(a) IN GENERAL.—Section 394A of the Public 
Health Service Act (42 U.S.C. 280b–3) is amended—
(1) by striking ‘‘and’’ after ‘‘1994,’’; 
(2) by striking ‘‘and’’ after ‘‘1998,’’; and 
(3) by striking ‘‘through 2005’’ and all that fol-
lows and inserting the following: ‘‘through 2004, 
$300,000,000 for fiscal year 2005, and such sums 
as may be necessary for each of the fiscal years 
2006 through 2010.’’. 
(b) DEMONSTRATION PROJECTS IN URBAN AREAS.—
Section 394A of the Public Health Service Act (42 U.S.C.
314
280b–3) is amended by adding at the end the following 
sentence: ‘‘For the purpose of carrying out section 
393(a)(6) in urban areas, there are authorized to be ap-
propriated such sums as may be necessary for each of the 
fiscal years 2005 through 2010, in addition to amounts 
available for such purpose pursuant to the preceding sen-
tence.’’. 
(c) DEMONSTRATION PROJECTS REGARDING VIO-
LENCE.—Section 393 of the Public Health Service Act (42 
U.S.C. 280b–1a) is amended—
(1) by redesignating subsection (b) as sub-
section (c); and 
(2) by inserting after subsection (a) the fol-
lowing subsection: 
‘‘(b) Grants under subsection (a)(6) shall include 
grants to public or nonprofit private trauma centers for 
demonstration projects to reduce violence.’’. 
CHAPTER 15—UTERINE FIBROID 
RESEARCH AND EDUCATION 
SEC. 
495. 
RESEARCH 
WITH 
RESPECT 
TO 
UTERINE 
FIBROIDS. 
(a) IN GENERAL.—The Director of the National In-
stitutes of Health (in this section referred to as the ‘‘Di-
rector of NIH’’) shall expand, intensify, and coordinate
315
programs for the conduct and support of research with 
respect to uterine fibroids. 
(b) ADMINISTRATION.—
(1) IN GENERAL.—The Director of NIH shall 
carry out this section through the appropriate insti-
tutes, offices, and centers, including the National In-
stitute of Child Health and Human Development, 
the National Institute of Environmental Health 
Sciences, the Office of Research on Women’s Health, 
the National Center on Minority Health and Health 
Disparities, and any other agencies that the Director 
of NIH determines to be appropriate. 
(2) COORDINATION OF ACTIVITIES.—The Office 
of Research on Women’s Health shall coordinate ac-
tivities under paragraph (1) among the institutes, 
offices, and centers of the National Institutes of 
Health. 
(c) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for 
each of the fiscal years 2005 through 2010. 
SEC. 496. INFORMATION AND EDUCATION WITH RESPECT 
TO UTERINE FIBROIDS. 
(a) UTERINE FIBROIDS PUBLIC EDUCATION PRO-
GRAM.—
316
(1) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the 
‘‘Secretary’’), acting through the Director of the 
Centers for Disease Control and Prevention, shall 
develop and disseminate to the public information 
regarding uterine fibroids, including information 
on—
(A) the incidence and prevalence of uterine 
fibroids; 
(B) the elevated risk for minority women; 
and 
(C) the availability, as medically appro-
priate, of a range of treatment options for 
symptomatic uterine fibroids. 
(2) DISSEMINATION.—The Secretary may dis-
seminate information under paragraph (1) directly, 
or through arrangements with nonprofit organiza-
tions, consumer groups, institutions of higher edu-
cation (as defined in section 101 of the Higher Edu-
cation Act of 1965 (20 U.S.C. 1001)), Federal, 
State, or local agencies, or the media. 
(3) AUTHORIZATION OF APPROPRIATIONS.—For 
the purpose of carrying out this subsection, there 
are authorized to be appropriated such sums as may
317
be necessary for each of the fiscal years 2005 
through 2010. 
(b) UTERINE FIBROIDS INFORMATION PROGRAM FOR 
HEALTH CARE PROVIDERS.—
(1) 
IN
GENERAL.—The 
Secretary, 
acting 
through the Administrator of the Health Resources 
and Services Administration, shall develop and dis-
seminate to health care providers information on 
uterine fibroids, including information on the ele-
vated risk for minority women and the range of 
available options for the treatment of symptomatic 
uterine fibroids. 
(2) AUTHORIZATION OF APPROPRIATIONS.—For 
the purpose of carrying out this subsection, there 
are authorized to be appropriated such sums as may 
be necessary for each of the fiscal years 2005 
through 2010. 
(c) DEFINITION.—For purposes of this section, the 
term ‘‘minority’’, with respect to women, means women 
who are members of racial or ethnic minority groups with-
in the meaning of section 1707 of the Public Health Serv-
ice Act (42 U.S.C. 300u–6).
318
TITLE V—DATA COLLECTION 
AND REPORTING. 
Subtitle A—General Provisions 
SEC. 501. AMENDMENT TO THE PUBLIC HEALTH SERVICE 
ACT. 
(a) PURPOSE.—It is the purpose of this section to 
promote data collection, analysis, and reporting by race, 
ethnicity, and primary language among federally sup-
ported health programs. 
(b) AMENDMENT.—Title XXIX of the Public Health 
Service Act, as amended by section 463, is further amend-
ed by adding at the end the following: 
‘‘Subtitle E—Data Collection and 
Reporting 
‘‘SEC. 2951. DATA ON RACE, ETHNICITY AND PRIMARY LAN-
GUAGE. 
‘‘(a) REQUIREMENTS.—
‘‘(1) IN
GENERAL.—Each health-related pro-
gram operated by or that receives funding or reim-
bursement, in whole or in part, either directly or in-
directly from the Department of Health and Human 
Services shall—
‘‘(A) require the collection, by the agency 
or program involved, of data on the race, eth-
nicity, and primary language of each applicant
319
for and recipient of health-related assistance 
under such program—
‘‘(i) using, at a minimum, the cat-
egories for race and ethnicity described in 
the 1997 Office of Management and Budg-
et Standards for Maintaining, Collecting, 
and Presenting Federal Data on Race and 
Ethnicity; 
‘‘(ii) using the standards developed 
under subsection (e) for the collection of 
language data; 
‘‘(iii) where practicable, collecting 
data for additional population groups if 
such groups can be aggregated into the 
minimum race and ethnicity categories; 
and 
‘‘(iv) where practicable, through self-
report; 
‘‘(B) with respect to the collection of the 
data described in subparagraph (A) for appli-
cants and recipients who are minors or other-
wise legally incapacitated, require that—
‘‘(i) such data be collected from the 
parent or legal guardian of such an appli-
cant or recipient; and
320
‘‘(ii) the preferred language of the 
parent or legal guardian of such an appli-
cant or recipient be collected; 
‘‘(C) systematically analyze such data 
using the smallest appropriate units of analysis 
feasible to detect racial and ethnic disparities in 
health and healthcare and when appropriate, 
for men and women separately, and report the 
results of such analysis to the Secretary, the 
Director of the Office for Civil Rights, the Com-
mittee on Health, Education, Labor, and Pen-
sions and the Committee on Finance of the 
Senate, and the Committee on Energy and 
Commerce and the Committee on Ways and 
Means of the House of Representatives; 
‘‘(D) provide such data to the Secretary on 
at least an annual basis; and 
‘‘(E) ensure that the provision of assist-
ance to an applicant or recipient of assistance 
is not denied or otherwise adversely affected be-
cause of the failure of the applicant or recipient 
to provide race, ethnicity, and primary language 
data. 
‘‘(2) RULES
OF
CONSTRUCTION.—Nothing in 
this subsection shall be construed to—
321
‘‘(A) permit the use of information col-
lected under this subsection in a manner that 
would adversely affect any individual providing 
any such information; and 
‘‘(B) require health care providers to col-
lect data. 
‘‘(b) PROTECTION OF DATA.—The Secretary shall 
ensure (through the promulgation of regulations or other-
wise) that all data collected pursuant to subsection (a) is 
protected—
‘‘(1) under the same privacy protections as the 
Secretary applies to other health data under the reg-
ulations promulgated under section 264(c) of the 
Health Insurance Portability and Accountability Act 
of 1996 (Public Law 104–191; 110 Stat. 2033) re-
lating to the privacy of individually identifiable 
health information and other protections; and 
‘‘(2) from all inappropriate internal use by any 
entity that collects, stores, or receives the data, in-
cluding use of such data in determinations of eligi-
bility (or continued eligibility) in health plans, and 
from other inappropriate uses, as defined by the 
Secretary. 
‘‘(c) NATIONAL PLAN OF THE DATA COUNCIL.—The 
Secretary shall develop and implement a national plan to
322
improve the collection, analysis, and reporting of racial, 
ethnic, and primary language data at the Federal, State, 
territorial, Tribal, and local levels, including data to be 
collected under subsection (a). The Data Council of the 
Department of Health and Human Services, in consulta-
tion with the National Committee on Vital Health Statis-
tics, the Office of Minority Health, and other appropriate 
public and private entities, shall make recommendations 
to the Secretary concerning the development, implementa-
tion, and revision of the national plan. Such plan shall 
include recommendations on how to—
‘‘(1) implement subsection (a) while minimizing 
the cost and administrative burdens of data collec-
tion and reporting; 
‘‘(2) expand awareness among Federal agencies, 
States, territories, Indian tribes, health providers, 
health plans, health insurance issuers, and the gen-
eral public that data collection, analysis, and report-
ing by race, ethnicity, and primary language is legal 
and necessary to assure equity and non-discrimina-
tion in the quality of healthcare services; 
‘‘(3) ensure that future patient record systems 
have data code sets for racial, ethnic, and primary 
language identifiers and that such identifiers can be
323
retrieved from clinical records, including records 
transmitted electronically; 
‘‘(4) improve health and healthcare data collec-
tion and analysis for more population groups if such 
groups can be aggregated into the minimum race 
and ethnicity categories, including exploring the fea-
sibility of enhancing collection efforts in States for 
racial and ethnic groups that comprise a significant 
proportion of the population of the State; 
‘‘(5) provide researchers with greater access to 
racial, ethnic, and primary language data, subject to 
privacy and confidentiality regulations; and 
‘‘(6) safeguard and prevent the misuse of data 
collected under subsection (a). 
‘‘(d) COMPLIANCE WITH STANDARDS.—Data col-
lected under subsection (a) shall be obtained, maintained, 
and presented (including for reporting purposes) in ac-
cordance with the 1997 Office of Management and Budget 
Standards for Maintaining, Collecting, and Presenting 
Federal Data on Race and Ethnicity (at a minimum). 
‘‘(e) LANGUAGE
COLLECTION
STANDARDS.—Not 
later than 1 year after the date of enactment of this title, 
the Director of the Office of Minority Health, in consulta-
tion with the Office for Civil Rights of the Department 
of Health and Human Services, shall develop and dissemi-
324
nate Standards for the Classification of Federal Data on 
Preferred Written and Spoken Language. 
‘‘(f) TECHNICAL ASSISTANCE FOR THE COLLECTION 
AND REPORTING OF DATA.—
‘‘(1) IN GENERAL.—The Secretary may, either 
directly or through grant or contract, provide tech-
nical assistance to enable a healthcare program or 
an entity operating under such program to comply 
with the requirements of this section. 
‘‘(2) TYPES OF ASSISTANCE.—Assistance pro-
vided under this subsection may include assistance 
to—
‘‘(A) enhance or upgrade computer tech-
nology that will facilitate racial, ethnic, and pri-
mary language data collection and analysis; 
‘‘(B) improve methods for health data col-
lection and analysis including additional popu-
lation groups beyond the Office of Management 
and Budget categories if such groups can be 
aggregated into the minimum race and ethnicity 
categories; 
‘‘(C) develop mechanisms for submitting 
collected data subject to existing privacy and 
confidentiality regulations; and
325
‘‘(D) develop educational programs to in-
form health insurance issuers, health plans, 
health providers, health-related agencies, and 
the general public that data collection and re-
porting by race, ethnicity, and preferred lan-
guage are legal and essential for eliminating 
health and healthcare disparities. 
‘‘(g) ANALYSIS OF RACIAL AND ETHNIC DATA.—The 
Secretary, acting through the Director of the Agency for 
Healthcare Research and Quality and in coordination with 
the Administrator of the Centers for Medicare and Med-
icaid Services, shall provide technical assistance to agen-
cies of the Department of Health and Human Services in 
meeting Federal standards for race, ethnicity, and pri-
mary language data collection and analysis of racial and 
ethnic disparities in health and healthcare in public pro-
grams by—
‘‘(1) identifying appropriate quality assurance 
mechanisms to monitor for health disparities; 
‘‘(2) specifying the clinical, diagnostic, or thera-
peutic measures which should be monitored; 
‘‘(3) developing new quality measures relating 
to racial and ethnic disparities in health and 
healthcare;
326
‘‘(4) identifying the level at which data analysis 
should be conducted; and 
‘‘(5) sharing data with external organizations 
for research and quality improvement purposes. 
‘‘(h) NATIONAL CONFERENCE.—
‘‘(1) IN GENERAL.—The Secretary shall spon-
sor a biennial national conference on racial, ethnic, 
and primary language data collection to enhance co-
ordination, build partnerships, and share best prac-
tices in racial, ethnic, and primary language data 
collection, analysis, and reporting. 
‘‘(2) REPORTS.—Not later than 6 months after 
the date on which a national conference has con-
vened under paragraph (1), the Secretary shall pub-
lish in the Federal Register and submit to the Com-
mittee on Health, Education, Labor, and Pensions 
and the Committee on Finance of the Senate and 
the Committee on Energy and Commerce and the 
Committee on Ways and Means of the House of 
Representatives a report concerning the proceedings 
and findings of the conference. 
‘‘(i) REPORT.—Not later than 2 years after the date 
of enactment of this title, and biennially thereafter, the 
Secretary shall submit to the appropriate committees of 
Congress a report on the effectiveness of data collection,
327
analysis, and reporting on race, ethnicity, and primary 
language under the programs and activities of the Depart-
ment of Health and Human Services and under other Fed-
eral data collection systems with which the Department 
interacts to collect relevant data on race and ethnicity. 
The report shall evaluate the progress made in the De-
partment with respect to the national plan under sub-
section (c) or subsequent revisions thereto. 
‘‘(j) GRANTS FOR DATA COLLECTION BY HEALTH 
PLANS, HEALTH CENTERS, AND HOSPITALS.—
‘‘(1) IN GENERAL.—The Secretary, in consulta-
tion with the Administrator of the Centers for Medi-
care and Medicaid Services, is authorized to award 
grants for the conduct of 20 demonstration pro-
grams by health plans, health centers, or hospitals 
to enhance their ability to collect, analyze, and re-
port the data required under subsection (a). 
‘‘(2) ELIGIBILITY.—To be eligible to receive a 
grant under paragraph (1), a health plan or hospital 
shall—
‘‘(A) prepare and submit to the Secretary 
an application at such time, in such manner, 
and containing such information as the Sec-
retary may require, including a plan to elimi-
nate racial, ethnic, and primary language dis-
328
parities in health and healthcare through one or 
more of the activities described in paragraph 
(3); and 
‘‘(B) provide assurances that the health 
plan or hospital will use, at a minimum, the ra-
cial and ethnic categories and the standards for 
collection described in the 1997 Office of Man-
agement and Budget Standards for Maintain-
ing, Collecting, and Presenting Federal Data on 
Race and Ethnicity and available standards for 
language. 
‘‘(3) ACTIVITIES.—A grantee shall use amounts 
received under a grant under paragraph (1) to—
‘‘(A) collect, analyze, and report data by 
race, ethnicity, and primary language for pa-
tients served by the hospital (including emer-
gency room patients and patients served on an 
outpatient basis) or health center, or, in the 
case of a private health plan, such data for en-
rollees; 
‘‘(B) enhance or upgrade computer tech-
nology that will facilitate racial, ethnic, and pri-
mary language data collection and analysis; 
‘‘(C) provide analyses of racial and ethnic 
disparities in health and healthcare, including
329
specific disease conditions, diagnostic and 
therapeutic procedures, or outcomes; 
‘‘(D) improve health data collection and 
analysis for additional population groups be-
yond the Office of Management and Budget 
categories if such groups can be aggregated into 
the minimum race and ethnicity categories; 
‘‘(E) develop mechanisms for sharing col-
lected data subject to privacy and confiden-
tiality regulations; 
‘‘(F) develop educational programs to in-
form health insurance issuers, health plans, 
health providers, health-related agencies, pa-
tients, enrollees, and the general public that 
data collection, analysis, and reporting by race, 
ethnicity, and preferred language are legal and 
essential for eliminating disparities in health 
and healthcare; and 
‘‘(G) develop quality assurance systems de-
signed to track disparities and quality improve-
ment systems designed to eliminate disparities. 
‘‘(l) DEFINITION.—In this section, the term ‘health-
related program’ mean a program—
330
‘‘(1) under the Social Security Act (42 U.S.C. 
301 et seq.) that pay for healthcare and services; 
and 
‘‘(2) under this Act that provide Federal finan-
cial assistance for healthcare, biomedical research, 
health services research, and programs designed to 
improve the public’s health. 
‘‘(m) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2005 through 2010. 
‘‘SEC. 2952. PROVISIONS RELATING TO NATIVE AMERICANS. 
‘‘(a) EPIDEMIOLOGY CENTERS.—
‘‘(1) ESTABLISHMENT.—
‘‘(A) IN GENERAL.—In addition to those 
centers operating 1 day prior to the date of en-
actment of this title, (including those centers 
for which funding is currently being provided 
through funding agreements under the Indian 
Self-Determination and Education Assistance 
Act), the Secretary shall, not later than 180 
days after such date of enactment, establish 
and fund an epidemiology center in each service 
area which does not have such a center to carry 
out the functions described in subparagraph
331
(B). Any centers established under the pre-
ceding sentence may be operated by Indian 
tribes or tribal organizations pursuant to fund-
ing agreements under the Indian Self-Deter-
mination and Education Assistance Act, but 
funding under such agreements may not be di-
visible. 
‘‘(B) FUNCTIONS.—In consultation with 
and upon the request of Indian tribes, tribal or-
ganizations and urban Indian organizations, 
each area epidemiology center established under 
this subsection shall, with respect to such area 
shall—
‘‘(i) collect data related to the health 
status objective described in section 3(b) of 
the Indian Health Care Improvement Act, 
and monitor the progress that the Service, 
Indian tribes, tribal organizations, and 
urban Indian organizations have made in 
meeting such health status objective; 
‘‘(ii) evaluate existing delivery sys-
tems, data systems, and other systems that 
impact the improvement of Indian health; 
‘‘(iii) assist Indian tribes, tribal orga-
nizations, and urban Indian organizations
332
in identifying their highest priority health 
status objectives and the services needed to 
achieve such objectives, based on epidemio-
logical data; 
‘‘(iv) make recommendations for the 
targeting of services needed by tribal, 
urban, and other Indian communities; 
‘‘(v) make recommendations to im-
prove healthcare delivery systems for Indi-
ans and urban Indians; 
‘‘(vi) provide requested technical as-
sistance to Indian tribes and urban Indian 
organizations in the development of local 
health service priorities and incidence and 
prevalence rates of disease and other ill-
ness in the community; and 
‘‘(vii) provide disease surveillance and 
assist Indian tribes, tribal organizations, 
and urban Indian organizations to promote 
public health. 
‘‘(C) TECHNICAL ASSISTANCE.—The direc-
tor of the Centers for Disease Control and Pre-
vention shall provide technical assistance to the 
centers in carrying out the requirements of this 
subsection.
333
‘‘(2) FUNDING.—The Secretary may make 
funding available to Indian tribes, tribal organiza-
tions, and eligible intertribal consortia or urban In-
dian organizations to conduct epidemiological studies 
of Indian communities. 
‘‘(b) DEFINITIONS.—For purposes of this section, the 
definitions contained in section 4 of the Indian Health 
Care Improvement Act shall apply.’’. 
SEC. 502. COLLECTION OF RACE AND ETHNICITY DATA BY 
THE SOCIAL SECURITY ADMINISTRATION. 
Part A of title XI of the Social Security Act (42 
U.S.C. 1301 et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 1150A. COLLECTION OF RACE AND ETHNICITY DATA 
BY THE SOCIAL SECURITY ADMINISTRATION. 
‘‘(a) REQUIREMENT.—The Commissioner of the So-
cial Security Administration in consultation with the Ad-
ministrator of the Centers for Medicare and Medicaid 
Services shall—
‘‘(1) require the collection of data on the race, 
ethnicity, and primary language of all applicants for 
social security numbers, social security income, so-
cial security disability, and medicare—
‘‘(A) using, at a minimum, the categories 
for race and ethnicity described in the 1997 Of-
334
fice of Management and Budget Standards for 
Maintaining, Collecting, and Presenting Federal 
Data on Race and Ethnicity and available lan-
guage standards; and 
‘‘(B) where practicable, collecting data for 
additional population groups if such groups can 
be aggregated into the minimum race and eth-
nicity categories; 
‘‘(2) with respect to the collection of the data 
described in paragraph (1) for applicants who are 
under 18 years of age or otherwise legally incapaci-
tated, require that—
‘‘(A) such data be collected from the par-
ent or legal guardian of such an applicant; and 
‘‘(B) the primary language of the parent 
or legal guardian of such an applicant or recipi-
ent be used; 
‘‘(3) require that such data be uniformly ana-
lyzed and reported at least annually to the Commis-
sioner of Social Security; 
‘‘(4) be responsible for storing the data re-
ported under paragraph (3); 
‘‘(5) ensure transmission to the Centers for 
Medicare and Medicaid Services and other Federal 
health agencies;
335
‘‘(6) provide such data to the Secretary on at 
least an annual basis; and 
‘‘(7) ensure that the provision of assistance to 
an applicant is not denied or otherwise adversely af-
fected because of the failure of the applicant to pro-
vide race, ethnicity, and primary language data. 
‘‘(b) PROTECTION OF DATA.—The Commissioner of 
Social Security shall ensure (through the promulgation of 
regulations or otherwise) that all data collected pursuant 
subsection (a) is protected—
‘‘(1) under the same privacy protections as the 
Secretary applies to other health data under the reg-
ulations promulgated under section 264(c) of the 
Health Insurance Portability and Accountability Act 
of 1996 (Public Law 104–191; 110 Stat. 2033) re-
lating to the privacy of individually identifiable 
health information and other protections; and 
‘‘(2) from all inappropriate internal use by any 
entity that collects, stores, or receives the data, in-
cluding use of such data in determinations of eligi-
bility (or continued eligibility) in health plans, and 
from other inappropriate uses, as defined by the 
Secretary. 
‘‘(c) NATIONAL EDUCATION PROGRAM.—Not later 
than 18 months after the date of enactment of this sec-
336
tion, the Secretary, acting through the Director of the Of-
fice of Minority Health and in collaboration with the Com-
missioner of the Social Security Administration, shall de-
velop and implement a program to educate all populations 
about the purpose and uses of racial, ethnic, and primary 
language health data collection. 
‘‘(d) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to permit the use of information 
collected under this section in a manner that would ad-
versely affect any individual providing any such informa-
tion. 
‘‘(e) TECHNICAL ASSISTANCE.—The Secretary may, 
either directly or by grant or contract, provide technical 
assistance to enable any health entity to comply with the 
requirements of this section. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2005 through 2010.’’. 
SEC. 503. REVISION OF HIPAA CLAIMS STANDARDS. 
(a) IN GENERAL.—Not later than 1 year after the 
date of enactment of this Act, the Secretary of Health and 
Human Services shall revise the regulations promulgated 
under part C of title XI of the Social Security Act (42 
U.S.C. 1320d et seq.), as added by the Health Insurance
337
Portability and Accountability Act of 1996 (Public Law 
104–191), relating to the collection of data on race, eth-
nicity, and primary language in a health-related trans-
action to require—
(1) the use, at a minimum, of the categories for 
race and ethnicity described in the 1997 Office of 
Management and Budget Standards for Maintain-
ing, Collecting, and Presenting Federal Data on 
Race and Ethnicity; 
(2) the establishment of a new data code set for 
primary language; and 
(3) the designation of the racial, ethnic, and 
primary language code sets as ‘‘required’’ for claims 
and enrollment data. 
(b) DISSEMINATION.—The Secretary of Health and 
Human Services shall disseminate the new standards de-
veloped under subsection (a) to all health entities that are 
subject to the regulations described in such subsection and 
provide technical assistance with respect to the collection 
of the data involved. 
(c) COMPLIANCE.—The Secretary of Health and 
Human Services shall require that health entities comply 
with the new standards developed under subsection (a) not 
later than 2 years after the final promulgation of such 
standards.
338
SEC. 504. NATIONAL CENTER FOR HEALTH STATISTICS. 
Section 306(n) of the Public Health Service Act (42 
U.S.C. 242k(n)) is amended—
(1) in paragraph (1), by striking ‘‘2003’’ and 
inserting ‘‘2010’’; 
(2) in paragraph (2), in the first sentence, by 
striking ‘‘2003’’ and inserting ‘‘2010’’; and 
(3) in paragraph (3), by striking ‘‘2002’’ and 
inserting ‘‘2010’’. 
Subtitle B—Minority Health and 
Genomics Commission 
SEC. 511. SHORT TITLE. 
This subtitle may be cited as the ‘‘Minority Health 
and Genomics Act of 2003’’. 
SEC. 512. MINORITY HEALTH AND GENOMICS COMMISSION. 
(a) ESTABLISHMENT.—There is established a com-
mission to be known as the Minority Health and Genomics 
Commission (in this subtitle referred to as the ‘‘Commis-
sion’’). 
(b) DUTIES.—
(1) STUDY.—The Commission shall conduct a 
thorough study of, and develop recommendations on, 
issues relating to genomic research as applied to mi-
nority groups and, under section 516, submit a re-
port to the appropriate committees of Congress that 
recommends policies that the Commission finds will
339
ultimately improve healthcare and promote the elimi-
nation of health disparities. 
(2) ISSUES.—The study under paragraph (1) 
shall address specific issues and the needs of each 
minority group described in subparagraph (A) in ad-
dition to issues involving genomic research that af-
fect the groups as a whole. In conducting such study 
the Commission shall carry out the following: 
(A) Establish standards in genomic re-
search and services that will promote the im-
provement of health and health-related services 
for the following groups: American Indians and 
Alaska Natives, African Americans, Asian 
Americans, Hispanics, and Native Hawaiians 
and other Pacific Islanders. 
(B) Recommend minimum requirements 
and standards for the equitable use of genetics 
research in patient care and public health serv-
ices for racial and ethnic minority patients. 
(C) Examine the accessibility, effective-
ness, availability, and cost efficiency of genomic 
research, genetic testing, genetic counseling, 
and genetic screening to minority populations. 
(D) Determine and recommend procedures 
and policies to address the need for cultural,
340
linguistic, and religious sensitivity training for 
genetic counselors and researchers who work 
with minority groups. 
(E) Evaluate whether minority persons are 
provided with informed consent that is cul-
turally and linguistically appropriate to allow a 
fully informed decision about their healthcare, 
availability of treatments or options, or partici-
pation in any clinical trial involving the collec-
tion of genetic material. 
(F) Recommend how population sampling 
studies of genetic information can be improved 
to aid in the elimination of health disparities 
and improve healthcare for minority commu-
nities. 
(G) Examine how genetic material or in-
formation derived from individual minorities is 
used the help minority groups with the use of 
highly specific drug therapies. 
(H) Identify the accessibility, effectiveness, 
availability, privacy, and benefit of genetic data-
bases and depositories to minority communities. 
(I) Identify the accessibility, effectiveness, 
and affordability of reproductive technologies to 
minority groups.
341
(J) Recommend an incentives program for 
genomic researchers that will encourage the 
study of disease and genetic ailments that dis-
proportionately affect minority communities. 
SEC. 513. REPORT. 
Not later than 2 years after the date of the enact-
ment of this Act, the Commission shall prepare and sub-
mit to the appropriate committees of Congress, the Presi-
dent, and the general public a report containing a detailed 
statement of the findings and conclusions of the Commis-
sion with respect to matters described in section 
512(b)(2), together with such recommendations as the 
Commission considers appropriate that may be specific to 
each minority group. 
SEC. 514. MEMBERSHIP. 
(a) NUMBER AND APPOINTMENT.—The Commission 
shall be composed of 17 members to be appointed as fol-
lows: 
(1) Four members shall be appointed by the 
Speaker of the House of Representatives. 
(2) Four members shall be appointed by the mi-
nority leader of the House of Representatives. 
(3) Four members shall be appointed by the 
majority leader of the Senate.
342
(4) Four members shall be appointed by the mi-
nority leader of the Senate. 
(5) One member shall be appointed by the 
President. 
(b) PERSONS ELIGIBLE.—
(1) IN GENERAL.—The members of the Com-
mission shall be individuals who have knowledge or 
expertise, whether by experience or training, in mat-
ters to be studied by the Commission. The members 
may be from the public or private sector, and may 
include employees of the Federal Government or of 
State, territory, tribal, or local governments, mem-
bers of academia, legal scholars and practitioners, 
tribal leaders, representatives of nonprofit organiza-
tions, or other interested individuals who dem-
onstrate a dedication to the use of genomics to im-
prove minority healthcare and the elimination of 
health disparities among minorities. 
(2) DIVERSITY.—It is the intent of Congress 
that individuals appointed to the Commission rep-
resent diverse interests, ethnicities, various profes-
sional backgrounds, and are from different regions 
of the United States. 
(c) CONSULTATION AND APPOINTMENT.—
343
(1) IN GENERAL.—The President, Speaker of 
the House of Representatives, minority leader of the 
House of Representatives, majority leader of the 
Senate, and minority leader of the Senate shall con-
sult among themselves before appointing the mem-
bers of the Commission in order to achieve, to the 
maximum extent practicable, fair and equitable rep-
resentation of various points of view with respect to 
matters studied by the Commission. 
(2) DATE
OF
APPOINTMENT.—The appoint-
ments of the members of the Commission shall be 
made not later than 90 days after the date of enact-
ment of this Act. 
(d) TERMS.—
(1) IN GENERAL.—Each member of the Com-
mission shall be appointed for the life of the Com-
mission. 
(2) VACANCIES.—A vacancy in the Commission 
shall be filled in the manner in which the original 
appointment was made. 
(e) BASIC PAY.—Members of the Commission shall 
serve without pay. 
(f) TRAVEL EXPENSES.—Each member of the Com-
mission shall receive travel expenses, including per diem 
in lieu of subsistence, in accordance with applicable provi-
363
‘‘(H) the training, recruitment, and reten-
tion of minority health professionals; 
‘‘(I) programs to expand and facilitate ac-
cess to healthcare services, including the use of 
telemedicine, National Health Service Scholars, 
community health workers, and case managers; 
‘‘(J) public and health provider awareness 
of racial and ethnic disparities in healthcare; 
‘‘(K) methods to evaluate and measure 
progress toward the goal of eliminating dispari-
ties in health and healthcare in racial and eth-
nic minority populations; 
‘‘(L) the promotion of interagency and 
intra-agency coordination and collaboration and 
public-private and community partnerships; and 
‘‘(M) the preparedness of health profes-
sionals to care for racially, ethnically, and lin-
guistically diverse populations and low func-
tional health literacy populations including eval-
uations as required under section 606 of the 
Healthcare Equality and Accountability Act.’’; 
(4) in subsection (d) (as so redesignated)—
(A) in paragraph (1), by inserting ‘‘and 
Racial, Ethnic, and Primary Language Health
390
‘‘(E) physician or patient reminder sys-
tems; 
‘‘(F) educational interventions; or 
‘‘(G) other activities determined appro-
priate by the Secretary. 
‘‘(d) USE OF FUNDS.—An entity shall use amounts 
received under a grant under subsection (a) to support 
the implementation and evaluation of healthcare quality 
improvement activities or minority health and healthcare 
disparity reduction activities that include—
‘‘(1) with respect to healthcare systems, activi-
ties relating to improving—
‘‘(A) patient safety; 
‘‘(B) timeliness of care; 
‘‘(C) effectiveness of care; 
‘‘(D) efficiency of care; and 
‘‘(E) patient centeredness; and 
‘‘(2) with respect to patients, activities relating 
to—
‘‘(A) staying healthy; 
‘‘(B) getting well; 
‘‘(C) living with illness or disability; and 
‘‘(D) coping with end of life issues. 
‘‘(e) COMMON DATA SYSTEMS.—The Secretary shall 
provide financial and other technical assistance to grant-
398
‘‘(d) REVIEW OF NEED FOR FACILITIES.—
‘‘(1) REPORT.—Beginning in 2005, the Sec-
retary shall annually submit to the President and 
Congress a report which sets forth the needs of the 
Service and all Indian tribes and tribal organiza-
tions, including urban Indian organizations, for in-
patient, outpatient and specialized care facilities, in-
cluding the needs for renovation and expansion of 
existing facilities. 
‘‘(2) CONSULTATION.—In preparing each report 
required under paragraph (1) (other than the initial 
report), the Secretary shall consult with Indian 
tribes and tribal organizations including those tribes 
or tribal organizations operating health programs or 
facilities under any funding agreement entered into 
with the Service under the Indian Self-Determina-
tion and Education Assistance Act, and with urban 
Indian organizations. 
‘‘(3) CRITERIA.—For purposes of this sub-
section, the Secretary shall, in evaluating the needs 
of facilities operated under any funding agreement 
entered into with the Service under the Indian Self-
Determination and Education Assistance Act, use 
the same criteria that the Secretary uses in evalu-