H. R. 2498—11
involved with the various responsibilities and capabilities needed
to respond to acts of bioterrorism upon the civilian population.
Such awards shall be made on a competitive basis and pursuant
to scientific and technical review.
‘‘(b) ELIGIBLE ENTITIES.—Eligible entities for grants under sub-
section (a) are States, political subdivisions of States, and public
or private non-profit organizations.
‘‘(c) SPECIFIC CRITERIA.—In making grants under subsection
(a), the Secretary shall take into account the following factors:
‘‘(1) Whether the eligible entity involved is proximate to,
and collaborates with, a major research university with exper-
tise in scientific training, identification of biological agents,
medicine, and life sciences.
‘‘(2) Whether the entity is proximate to, and collaborates
with, a laboratory that has expertise in the identification of
biological agents.
‘‘(3) Whether the entity demonstrates, in the application
for the program, support and participation of State and local
governments and research institutions in the conduct of the
program.
‘‘(4) Whether the entity is proximate to, and collaborates
with, or is, an academic medical center that has the capacity
to serve an uninsured or underserved population, and is
equipped to educate medical personnel.
‘‘(5) Such other factors as the Secretary determines to
be appropriate.
‘‘(d) DURATION OF AWARD.—The period during which payments
are made under a grant under subsection (a) may not exceed
5 years. The provision of such payments shall be subject to annual
approval by the Secretary of the payments and subject to the
availability of appropriations for the fiscal year involved to make
the payments.
‘‘(e) SUPPLEMENT NOT SUPPLANT.—Grants under subsection (a)
shall be used to supplement, and not supplant, other Federal,
State, or local public funds provided for the activities described
in such subsection.
‘‘(f ) GENERAL ACCOUNTING OFFICE REPORT.—Not later than
180 days after the conclusion of the demonstration programs carried
out under subsection (a), the Comptroller General of the United
States shall submit to the Committee on Health, Education, Labor,
and Pensions and the Committee on Appropriations of the Senate,
and the Committee on Commerce and the Committee on Appropria-
tions of the House of Representatives, a report that describes the
ability of grantees under such subsection to detect pathogens likely
to be used in a bioterrorist attack, develop plans and measures
for dealing with such threats, and train personnel involved with
the various responsibilities and capabilities needed to deal with
bioterrorist threats.
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There is authorized
to be appropriated to carry out this section $6,000,000 for fiscal
year 2001, and such sums as may be necessary through fiscal
year 2006.’’.
H. R. 2498—12
TITLE II—CLINICAL RESEARCH
ENHANCEMENT
SEC. 201. SHORT TITLE.
This title may be cited as the ‘‘Clinical Research Enhancement
Act of 2000’’.
SEC. 202. FINDINGS AND PURPOSE.
(a) FINDINGS.—Congress makes the following findings:
(1) Clinical research is critical to the advancement of sci-
entific knowledge and to the development of cures and improved
treatment for disease.
(2) Tremendous advances in biology are opening doors to
new insights into human physiology, pathophysiology and dis-
ease, creating extraordinary opportunities for clinical research.
(3) Clinical research includes translational research which
is an integral part of the research process leading to general
human applications. It is the bridge between the laboratory
and new methods of diagnosis, treatment, and prevention and
is thus essential to progress against cancer and other diseases.
(4) 
The 
United 
States 
will 
spend 
more 
than
$1,200,000,000,000 on health care in 1999, but the Federal
budget for health research at the National Institutes of Health
was $15,600,000,000 only 1 percent of that total.
(5) Studies at the Institute of Medicine, the National
Research Council, and the National Academy of Sciences have
all addressed the current problems in clinical research.
(6) The Director of the National Institutes of Health has
recognized the current problems in clinical research and
appointed a special panel, which recommended expanded sup-
port for existing National Institutes of Health clinical research
programs and the creation of new initiatives to recruit and
retain clinical investigators.
(7) The current level of training and support for health
professionals in clinical research is fragmented, undervalued,
and underfunded.
(8) Young investigators are not only apprentices for future
positions but a crucial source of energy, enthusiasm, and ideas
in the day-to-day research that constitutes the scientific enter-
prise. Serious questions about the future of life-science research
are raised by the following:
(A) The number of young investigators applying for
grants dropped by 54 percent between 1985 and 1993.
(B) The number of physicians applying for first-time
National Institutes of Health research project grants fell
from 1226 in 1994 to 963 in 1998, a 21 percent reduction.
(C) Newly independent life-scientists are expected to
raise funds to support their new research programs and
a substantial proportion of their own salaries.
(9) The following have been cited as reasons for the decline
in the number of active clinical researchers, and those choosing
this career path:
(A) A medical school graduate incurs an average debt
of $85,619, as reported in the Medical School Graduation
Questionnaire by the Association of American Medical Col-
leges (AAMC).
H. R. 2498—13
(B) The prolonged period of clinical training required
increases the accumulated debt burden.
(C) The decreasing number of mentors and role models.
(D) The perceived instability of funding from the
National Institutes of Health and other Federal agencies.
(E) The almost complete absence of clinical research
training in the curriculum of training grant awardees.
(F) Academic Medical Centers are experiencing difficul-
ties in maintaining a proper environment for research in
a highly competitive health care marketplace, which are
compounded by the decreased willingness of third party
payers to cover health care costs for patients engaged in
research studies and research procedures.
(10) In 1960, general clinical research centers were estab-
lished under the Office of the Director of the National Institutes
of Health with an initial appropriation of $3,000,000.
(11) Appropriations for general clinical research centers
in fiscal year 1999 equaled $200,500,000.
(12) Since the late 1960s, spending for general clinical
research centers has declined from approximately 3 percent
to 1 percent of the National Institutes of Health budget.
(13) In fiscal year 1999, there were 77 general clinical
research centers in operation, supplying patients in the areas
in which such centers operate with access to the most modern
clinical research and clinical research facilities and tech-
nologies.
(b) PURPOSE.—It is the purpose of this title to provide additional
support for and to expand clinical research programs.
SEC. 203. INCREASING THE INVOLVEMENT OF THE NATIONAL
INSTITUTES OF HEALTH IN CLINICAL RESEARCH.
Part B of title IV of the Public Health Service Act (42 U.S.C.
284 et seq.) is amended by adding at the end the following:
‘‘SEC. 409C. CLINICAL RESEARCH.
‘‘(a) IN GENERAL.—The Director of National Institutes of Health
shall undertake activities to support and expand the involvement
of the National Institutes of Health in clinical research.
‘‘(b) REQUIREMENTS.—In carrying out subsection (a), the
Director of National Institutes of Health shall—
‘‘(1) consider the recommendations of the Division of
Research Grants Clinical Research Study Group and other rec-
ommendations for enhancing clinical research; and
‘‘(2) establish intramural and extramural clinical research
fellowship programs directed specifically at medical and dental
students and a continuing education clinical research training
program at the National Institutes of Health.
‘‘(c) SUPPORT FOR THE DIVERSE NEEDS OF CLINICAL RESEARCH.—
The Director of National Institutes of Health, in cooperation with
the Directors of the Institutes, Centers, and Divisions of the
National Institutes of Health, shall support and expand the
resources available for the diverse needs of the clinical research
community, including inpatient, outpatient, and critical care clinical
research.
‘‘(d) PEER REVIEW.—The Director of National Institutes of
Health shall establish peer review mechanisms to evaluate applica-
tions for the awards and fellowships provided for in subsection
(b)(2) and section 409D. Such review mechanisms shall include
H. R. 2498—14
individuals who are exceptionally qualified to appraise the merits
of potential clinical research training and research grant pro-
posals.’’.
SEC. 204. GENERAL CLINICAL RESEARCH CENTERS.
(a) GRANTS.—Subpart 1 of part E of title IV of the Public
Health Service Act (42 U.S.C. 287 et seq.) is amended by adding
at the end the following:
‘‘SEC. 481C. GENERAL CLINICAL RESEARCH CENTERS.
‘‘(a) GRANTS.—The Director of the National Center for Research
Resources shall award grants for the establishment of general clin-
ical research centers to provide the infrastructure for clinical
research including clinical research training and career enhance-
ment. Such centers shall support clinical studies and career develop-
ment in all settings of the hospital or academic medical center
involved.
‘‘(b) ACTIVITIES.—In carrying out subsection (a), the Director
of National Institutes of Health shall expand the activities of the
general clinical research centers through the increased use of tele-
communications and telemedicine initiatives.
‘‘(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 fiscal year.’’.
(b) ENHANCEMENT AWARDS.—Part B of title IV of the Public
Health Service Act (42 U.S.C. 284 et seq.), as amended by section
203, is further amended by adding at the end the following:
‘‘SEC. 409D. ENHANCEMENT AWARDS.
‘‘(a) 
MENTORED
PATIENT-ORIENTED
RESEARCH
CAREER
DEVELOPMENT AWARDS.—
‘‘(1) GRANTS.—
‘‘(A) IN
GENERAL.—The Director of the National
Institutes of Health shall make grants (to be referred to
as ‘Mentored Patient-Oriented Research Career Develop-
ment Awards’) to support individual careers in clinical
research at general clinical research centers or at other
institutions that have the infrastructure and resources
deemed appropriate for conducting patient-oriented clinical
research.
‘‘(B) USE.—Grants under subparagraph (A) shall be
used to support clinical investigators in the early phases
of their independent careers by providing salary and such
other support for a period of supervised study.
‘‘(2) APPLICATIONS.—An application for a grant under this
subsection shall be submitted by an individual scientist at
such time as the Director may require.
‘‘(3) 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 fiscal
year.
‘‘(b) MID-CAREER INVESTIGATOR AWARDS IN PATIENT-ORIENTED
RESEARCH.—
‘‘(1) GRANTS.—
‘‘(A) IN
GENERAL.—The Director of the National
Institutes of Health shall make grants (to be referred to
as ‘Mid-Career Investigator Awards in Patient-Oriented
Research’) to support individual clinical research projects
H. R. 2498—15
at general clinical research centers or at other institutions
that have the infrastructure and resources deemed appro-
priate for conducting patient-oriented clinical research.
‘‘(B) USE.—Grants under subparagraph (A) shall be
used to provide support for mid-career level clinicians to
allow such clinicians to devote time to clinical research
and to act as mentors for beginning clinical investigators.
‘‘(2) APPLICATIONS.—An application for a grant under this
subsection shall be submitted by an individual scientist at
such time as the Director requires.
‘‘(3) 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 fiscal
year.
‘‘(c) GRADUATE TRAINING IN CLINICAL INVESTIGATION AWARD.—
‘‘(1) IN GENERAL.—The Director of the National Institutes
of Health shall make grants (to be referred to as ‘Graduate
Training in Clinical Investigation Awards’) to support individ-
uals pursuing master’s or doctoral degrees in clinical investiga-
tion.
‘‘(2) APPLICATIONS.—An application for a grant under this
subsection shall be submitted by an individual scientist at
such time as the Director may require.
‘‘(3) LIMITATIONS.—Grants under this subsection shall be
for terms of 2 years or more and shall provide stipend, tuition,
and institutional support for individual advanced degree pro-
grams in clinical investigation.
‘‘(4) DEFINITION.—As used in this subsection, the term
‘advanced degree programs in clinical investigation’ means pro-
grams that award a master’s or Ph.D. degree in clinical inves-
tigation after 2 or more years of training in areas such as
the following:
‘‘(A) Analytical methods, biostatistics, and study
design.
‘‘(B) Principles of clinical pharmacology and pharmaco-
kinetics.
‘‘(C) Clinical epidemiology.
‘‘(D) 
Computer 
data 
management 
and 
medical
informatics.
‘‘(E) Ethical and regulatory issues.
‘‘(F) Biomedical writing.
‘‘(5) 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 fiscal
year.
‘‘(d) CLINICAL RESEARCH CURRICULUM AWARDS.—
‘‘(1) IN GENERAL.—The Director of the National Institutes
of Health shall make grants (to be referred to as ‘Clinical
Research Curriculum Awards’) to institutions for the develop-
ment and support of programs of core curricula for training
clinical investigators, including medical students. Such core
curricula may include training in areas such as the following:
‘‘(A) Analytical methods, biostatistics, and study
design.
‘‘(B) Principles of clinical pharmacology and pharmaco-
kinetics.
‘‘(C) Clinical epidemiology.
H. R. 2498—16
‘‘(D) 
Computer 
data 
management 
and 
medical
informatics.
‘‘(E) Ethical and regulatory issues.
‘‘(F) Biomedical writing.
‘‘(2) APPLICATIONS.—An application for a grant under this
subsection shall be submitted by an individual institution or
a consortium of institutions at such time as the Director may
require. An institution may submit only one such application.
‘‘(3) LIMITATIONS.—Grants under this subsection shall be
for terms of up to 5 years and may be renewable.
‘‘(4) 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 fiscal
year.’’.
SEC. 
205. 
LOAN 
REPAYMENT 
PROGRAM 
REGARDING 
CLINICAL
RESEARCHERS.
Part G of title IV of the Public Health Service Act is amended
by inserting after section 487E (42 U.S.C. 288–5) the following:
‘‘SEC. 487F. LOAN REPAYMENT PROGRAM REGARDING CLINICAL
RESEARCHERS.
‘‘(a) IN GENERAL.—The Secretary, acting through the Director
of the National Institutes of Health, shall establish a program
to enter into contracts with qualified health professionals under
which such health professionals agree to conduct clinical research,
in consideration of the Federal Government agreeing to repay,
for each year of service conducting such research, not more than
$35,000 of the principal and interest of the educational loans of
such health professionals.
‘‘(b) APPLICATION OF PROVISIONS.—The provisions of sections
338B, 338C, and 338E shall, except as inconsistent with subsection
(a) of this section, apply to the program established under subsection
(a) to the same extent and in the same manner as such provisions
apply to the National Health Service Corps Loan Repayment Pro-
gram established in subpart III of part D of title III.
‘‘(c) FUNDING.—
‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—For the purpose
of carrying out this section, there are authorized to be appro-
priated such sums as may be necessary for each fiscal year.
‘‘(2) AVAILABILITY.—Amounts appropriated for carrying out
this section shall remain available until the expiration of the
second fiscal year beginning after the fiscal year for which
the amounts were made available.’’.
SEC. 206. DEFINITION.
Section 409 of the Public Health Service Act (42 U.S.C. 284d)
is amended—
(1) by striking ‘‘For purposes’’ and inserting ‘‘(a) HEALTH
SERVICE RESEARCH.—For purposes’’; and
(2) by adding at the end the following:
‘‘(b) CLINICAL RESEARCH.—As used in this title, the term ‘clin-
ical research’ means patient oriented clinical research conducted
with human subjects, or research on the causes and consequences
of disease in human populations involving material of human origin
(such as tissue specimens and cognitive phenomena) for which
an investigator or colleague directly interacts with human subjects
in an outpatient or inpatient setting to clarify a problem in human
H. R. 2498—17
physiology, pathophysiology or disease, or epidemiologic or behav-
ioral studies, outcomes research or health services research, or
developing new technologies, therapeutic interventions, or clinical
trials.’’.
SEC. 207. OVERSIGHT BY GENERAL ACCOUNTING OFFICE.
Not later than 18 months after the date of the enactment
of this Act, the Comptroller General of the United States shall
submit to the Congress a reporting describing the extent to which
the National Institutes of Health has complied with the amend-
ments made by this title.
TITLE III—RESEARCH LABORATORY
INFRASTRUCTURE
SEC. 301. SHORT TITLE.
This title may be cited as the ‘‘Twenty-First Century Research
Laboratories Act’’.
SEC. 302. FINDINGS.
Congress finds that—
(1) the National Institutes of Health is the principal source
of Federal funding for medical research at universities and
other research institutions in the United States;
(2) the National Institutes of Health has received a substan-
tial increase in research funding from Congress for the purpose
of expanding the national investment of the United States
in behavioral and biomedical research;
(3) the infrastructure of our research institutions is central
to the continued leadership of the United States in medical
research;
(4) as Congress increases the investment in cutting-edge
basic and clinical research, it is critical that Congress also
examine the current quality of the laboratories and buildings
where research is being conducted, as well as the quality of
laboratory equipment used in research;
(5) many of the research facilities and laboratories in the
United States are outdated and inadequate;
(6) the National Science Foundation found, in a 1998 report
on the status of biomedical research facilities, that over 60
percent of research-performing institutions indicated that they
had an inadequate amount of medical research space;
(7) the National Science Foundation reports that academic
institutions have deferred nearly $11,000,000,000 in renovation
and construction projects because of a lack of funds; and
(8) future increases in Federal funding for the National
Institutes of Health must include increased support for the
renovation and construction of extramural research facilities
in the United States and the purchase of state-of-the-art labora-
tory instrumentation.
SEC. 303. BIOMEDICAL AND BEHAVIORAL RESEARCH FACILITIES.
Section 481A of the Public Health Service Act (42 U.S.C. 287a–
2 et seq.) is amended to read as follows:
‘‘SEC. 481A. BIOMEDICAL AND BEHAVIORAL RESEARCH FACILITIES.
‘‘(a) MODERNIZATION AND CONSTRUCTION OF FACILITIES.—
H. R. 2498—18
‘‘(1) IN
GENERAL.—The Director of NIH, acting through
the Director of the Center, may make grants or contracts to
public and nonprofit private entities to expand, remodel, ren-
ovate, or alter existing research facilities or construct new
research facilities, subject to the provisions of this section.
‘‘(2) CONSTRUCTION AND COST OF CONSTRUCTION.—For pur-
poses of this section, the terms ‘construction’ and ‘cost of
construction’ include the construction of new buildings and
the expansion, renovation, remodeling, and alteration of
existing buildings, including architects’ fees, but do not include
the cost of acquisition of land or off-site improvements.
‘‘(b) SCIENTIFIC AND TECHNICAL REVIEW BOARDS FOR MERIT-
BASED REVIEW OF PROPOSALS.—
‘‘(1) IN GENERAL: APPROVAL AS PRECONDITION TO GRANTS.—
‘‘(A) ESTABLISHMENT.—There is established within the
Center a Scientific and Technical Review Board on Bio-
medical and Behavioral Research Facilities (referred to
in this section as the ‘Board’).
‘‘(B) REQUIREMENT.—The Director of the Center may
approve an application for a grant under subsection (a)
only if the Board has under paragraph (2) recommended
the application for approval.
‘‘(2) DUTIES.—
‘‘(A) ADVICE.—The Board shall provide advice to the
Director of the Center and the advisory council established
under section 480 (in this section referred to as the
‘Advisory Council’) in carrying out this section.
‘‘(B) DETERMINATION
OF
MERIT.—In carrying out
subparagraph (A), the Board shall make a determination
of the merit of each application submitted for a grant
under subsection (a), after consideration of the require-
ments established in subsection (c), and shall report the
results of the determination to the Director of the Center
and the Advisory Council. Such determinations shall be
conducted in a manner consistent with procedures estab-
lished under section 492.
‘‘(C) AMOUNT.—In carrying out subparagraph (A), the
Board shall, in the case of applications recommended for
approval, make recommendations to the Director and the
Advisory Council on the amount that should be provided
under the grant.
‘‘(D) ANNUAL REPORT.—In carrying out subparagraph
(A), the Board shall prepare an annual report for the
Director of the Center and the Advisory Council describing
the activities of the Board in the fiscal year for which
the report is made. Each such report shall be available
to the public, and shall—
‘‘(i) summarize and analyze expenditures made
under this section;
‘‘(ii) provide a summary of the types, numbers,
and amounts of applications that were recommended
for grants under subsection (a) but that were not
approved by the Director of the Center; and
‘‘(iii) contain the recommendations of the Board
for any changes in the administration of this section.
‘‘(3) MEMBERSHIP.—
H. R. 2498—19
‘‘(A) IN GENERAL.—Subject to subparagraph (B), the
Board shall be composed of 15 members to be appointed
by the Director of the Center, and such ad-hoc or temporary
members as the Director of the Center determines to be
appropriate. All members of the Board, including temporary
and ad-hoc members, shall be voting members.
‘‘(B) LIMITATION.—Not more than three individuals who
are officers or employees of the Federal Government may
serve as members of the Board.
‘‘(4) CERTAIN REQUIREMENTS REGARDING MEMBERSHIP.—In
selecting individuals for membership on the Board, the Director
of the Center shall ensure that the members are individuals
who, by virtue of their training or experience, are eminently
qualified to perform peer review functions. In selecting such
individuals for such membership, the Director of the Center
shall ensure that the members of the Board collectively—
‘‘(A) are experienced in the planning, construction,
financing, and administration of entities that conduct bio-
medical or behavioral research sciences;
‘‘(B) are knowledgeable in making determinations of
the need of entities for biomedical or behavioral research
facilities, including such facilities for the dentistry, nursing,
pharmacy, and allied health professions;
‘‘(C) are knowledgeable in evaluating the relative prior-
ities for applications for grants under subsection (a) in
view of the overall research needs of the United States;
and
‘‘(D) are experienced with emerging centers of excel-
lence, as described in subsection (c)(2).
‘‘(5) CERTAIN AUTHORITIES.—
‘‘(A) WORKSHOPS AND CONFERENCES.—In carrying out
paragraph (2), the Board may convene workshops and con-
ferences, and collect data as the Board considers appro-
priate.
‘‘(B) SUBCOMMITTEES.—In carrying out paragraph (2),
the Board may establish subcommittees within the Board.
Such subcommittees may hold meetings as determined nec-
essary to enable the subcommittee to carry out its duties.
‘‘(6) TERMS.—
‘‘(A) IN GENERAL.—Except as provided in subparagraph
(B), each appointed member of the Board shall hold office
for a term of 4 years. Any member appointed to fill a
vacancy occurring prior to the expiration of the term for
which such member’s predecessor was appointed shall be
appointed for the remainder of the term of the predecessor.
‘‘(B) STAGGERED
TERMS.—Members appointed to the
Board shall serve staggered terms as specified by the
Director of the Center when making the appointments.
‘‘(C) REAPPOINTMENT.—No member of the Board shall
be eligible for reappointment to the Board until 1 year
has elapsed after the end of the most recent term of the
member.
‘‘(7) COMPENSATION.—Members of the Board who are not
officers or employees of the United States shall receive for
each day the members are engaged in the performance of
the functions of the Board compensation at the same rate
H. R. 2498—20
received by members of other national advisory councils estab-
lished under this title.
‘‘(c) REQUIREMENTS FOR GRANTS.—
‘‘(1) IN GENERAL.—The Director of the Center may make
a grant under subsection (a) only if the applicant for the grant
meets the following conditions:
‘‘(A) The applicant is determined by such Director to
be competent to engage in the type of research for which
the proposed facility is to be constructed.
‘‘(B) The applicant provides assurances satisfactory to
the Director that—
‘‘(i) for not less than 20 years after completion
of the construction involved, the facility will be used
for the purposes of the research for which it is to
be constructed;
‘‘(ii) sufficient funds will be available to meet the
non-Federal share of the cost of constructing the
facility;
‘‘(iii) sufficient funds will be available, when
construction is completed, for the effective use of the
facility for the research for which it is being con-
structed; and
‘‘(iv) the proposed construction will expand the
applicant’s capacity for research, or is necessary to
improve or maintain the quality of the applicant’s
research.
‘‘(C) The applicant meets reasonable qualifications
established by the Director with respect to—
‘‘(i) the relative scientific and technical merit of
the applications, and the relative effectiveness of the
proposed facilities, in expanding the capacity for bio-
medical or behavioral research and in improving the
quality of such research;
‘‘(ii) the quality of the research or training, or
both, to be carried out in the facilities involved;
‘‘(iii) the congruence of the research activities to
be carried out within the facility with the research
and investigator manpower needs of the United States;
and
‘‘(iv) the age and condition of existing research
facilities.
‘‘(D) The applicant has demonstrated a commitment
to enhancing and expanding the research productivity of
the applicant.
‘‘(2) INSTITUTIONS OF EMERGING EXCELLENCE.—From the
amount appropriated under subsection (i) for a fiscal year up
to $50,000,000, the Director of the Center shall make available
25 percent of such amount, and from the amount appropriated
under such subsection for a fiscal year that is over $50,000,000,
the Director of the Center shall make available up to 25 percent
of such amount, for grants under subsection (a) to applicants
that in addition to meeting the requirements established in
paragraph (1), have demonstrated emerging excellence in bio-
medical or behavioral research, as follows:
‘‘(A) The applicant has a plan for research or training
advancement and possesses the ability to carry out the
plan.
H. R. 2498—21
‘‘(B) The applicant carries out research and research
training programs that have a special relevance to a
problem, concern, or unmet health need of the United
States.
‘‘(C) The applicant has been productive in research
or research development and training.
‘‘(D) The applicant—
‘‘(i) has been designated as a center of excellence
under section 739;
‘‘(ii) is located in a geographic area whose popu-
lation includes a significant number of individuals with
health status deficit, and the applicant provides health
services to such individuals; or
‘‘(iii) is located in a geographic area in which a
deficit in health care technology, services, or research
resources may adversely affect the health status of
the population of the area in the future, and the
applicant is carrying out activities with respect to pro-
tecting the health status of such population.
‘‘(d) REQUIREMENT OF APPLICATION.—The Director of the Center
may make a grant under subsection (a) only if an application
for the grant is submitted to the Director and the application
is in such form, is made in such manner, and contains such agree-
ments, assurances, and information as the Director determines
to be necessary to carry out this section.
‘‘(e) AMOUNT OF GRANT; PAYMENTS.—
‘‘(1) AMOUNT.—The amount of any grant awarded under
subsection (a) shall be determined by the Director of the Center,
except that such amount shall not exceed—
‘‘(A) 50 percent of the necessary cost of the construction
of a proposed facility as determined by the Director; or
‘‘(B) in the case of a multipurpose facility, 40 percent
of that part of the necessary cost of construction that
the Director determines to be proportionate to the con-
templated use of the facility.
‘‘(2) RESERVATION OF AMOUNTS.—On the approval of any
application for a grant under subsection (a), the Director of
the Center shall reserve, from any appropriation available for
such grants, the amount of such grant, and shall pay such
amount, in advance or by way of reimbursement, and in such
installments consistent with the construction progress, as the
Director may determine appropriate. The reservation of any
amount by the Director under this paragraph may be amended
by the Director, either on the approval of an amendment of
the application or on the revision of the estimated cost of
construction of the facility.
‘‘(3) EXCLUSION
OF
CERTAIN
COSTS.—In determining the
amount of any grant under subsection (a), there shall be
excluded from the cost of construction an amount equal to
the sum of—
‘‘(A) the amount of any other Federal grant that the
applicant has obtained, or is assured of obtaining, with
respect to construction that is to be financed in part by
a grant authorized under this section; and
‘‘(B) the amount of any non-Federal funds required
to be expended as a condition of such other Federal grant.
H. R. 2498—22
‘‘(4) WAIVER
OF
LIMITATIONS.—The limitations imposed
under paragraph (1) may be waived at the discretion of the
Director for applicants meeting the conditions described in sub-
section (c).
‘‘(f ) RECAPTURE
OF PAYMENTS.—If, not later than 20 years
after the completion of construction for which a grant has been
awarded under subsection (a)—
‘‘(1) the applicant or other owner of the facility shall cease
to be a public or non profit private entity; or
‘‘(2) the facility shall cease to be used for the research
purposes for which it was constructed (unless the Director
determines, in accordance with regulations, that there is good
cause for releasing the applicant or other owner from obligation
to do so),
the United States shall be entitled to recover from the applicant
or other owner of the facility the amount bearing the same ratio
to the current value (as determined by an agreement between
the parties or by action brought in the United States District
Court for the district in which such facility is situated) of the
facility as the amount of the Federal participation bore to the
cost of the construction of such facility.
‘‘(g) GUIDELINES.—Not later than 6 months after the date of
the enactment of this section, the Director of the Center, after
consultation with the Advisory Council, shall issue guidelines with
respect to grants under subsection (a).
‘‘(h) REPORT TO CONGRESS.—The Director of the Center shall
prepare and submit to the appropriate committees of Congress
a biennial report concerning the status of the biomedical and behav-
ioral research facilities and the availability and condition of techno-
logically sophisticated laboratory equipment in the United States.
Such reports shall be developed in concert with the report prepared
by the National Science Foundation on the needs of research facili-
ties of universities as required under section 108 of the National
Science Foundation Authorization Act for Fiscal Year 1986 (42
U.S.C. 1886).
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
$250,000,000 for fiscal year 2001, and such sums as may be nec-
essary for each of the fiscal years 2002 and 2003.’’.
SEC. 
304. 
CONSTRUCTION 
PROGRAM 
FOR 
NATIONAL 
PRIMATE
RESEARCH CENTERS.
Section 481B(a) of the Public Health Service Act (42 U.S.C.
287a–3(a)) is amended by striking ‘‘1994’’ and all that follows
through ‘‘$5,000,000’’ and inserting ‘‘2000 through 2002, reserve
from the amounts appropriated under section 481A(i) such sums
as necessary’’.
SEC. 305. SHARED INSTRUMENTATION GRANT PROGRAM.
(a) AUTHORIZATION OF APPROPRIATIONS.—There is authorized
to be appropriated $100,000,000 for fiscal year 2000, and such
sums as may be necessary for each subsequent fiscal year, to
enable the Secretary of Health and Human Services, acting through
the Director of the National Center for Research Resources, to
provide for the continued operation of the Shared Instrumentation
Grant Program (initiated in fiscal year 1992 under the authority
of section 479 of the Public Health Service Act (42 U.S.C. 287
et seq.)).
H. R. 2498—23
(b) REQUIREMENTS FOR GRANTS.—In determining whether to
award a grant to an applicant under the program described in
subsection (a), the Director of the National Center for Research
Resources shall consider—
(1) the extent to which an award for the specific instrument
involved would meet the scientific needs and enhance the
planned research endeavors of the major users by providing
an instrument that is unavailable or to which availability is
highly limited;
(2) with respect to the instrument involved, the availability
and commitment of the appropriate technical expertise within
the major user group or the applicant institution for use of
the instrumentation;
(3) the adequacy of the organizational plan for the use
of the instrument involved and the internal advisory committee
for oversight of the applicant, including sharing arrangements
if any;
(4) the applicant’s commitment for continued support of
the utilization and maintenance of the instrument; and
(5) the extent to which the specified instrument will be
shared and the benefit of the proposed instrument to the overall
research community to be served.
(c) PEER REVIEW.—In awarding grants under the program
described in subsection (a) Director of the National Center for
Research Resources shall comply with the peer review requirements
in section 492 of the Public Health Service Act (42 U.S.C. 289a).
TITLE IV—CARDIAC ARREST SURVIVAL
Subtitle A—Recommendations for Federal
Buildings
SEC. 401. SHORT TITLE.
This subtitle may be cited as the ‘‘Cardiac Arrest Survival
Act of 2000’’.
SEC. 402. FINDINGS.
Congress makes the following findings:
(1) Over 700 lives are lost every day to sudden cardiac
arrest in the United States alone.
(2) Two out of every three sudden cardiac deaths occur
before a victim can reach a hospital.
(3) More than 95 percent of these cardiac arrest victims
will die, many because of lack of readily available life saving
medical equipment.
(4) With current medical technology, up to 30 percent of
cardiac arrest victims could be saved if victims had access
to immediate medical response, including defibrillation and
cardiopulmonary resuscitation.
(5) Once a victim has suffered a cardiac arrest, every
minute that passes before returning the heart to a normal
rhythm decreases the chance of survival by 10 percent.
(6) Most cardiac arrests are caused by abnormal heart
rhythms called ventricular fibrillation. Ventricular fibrillation
occurs when the heart’s electrical system malfunctions, causing
H. R. 2498—24
a chaotic rhythm that prevents the heart from pumping oxygen
to the victim’s brain and body.
(7) Communities that have implemented programs ensuring
widespread public access to defibrillators, combined with appro-
priate training, maintenance, and coordination with local emer-
gency medical systems, have dramatically improved the sur-
vival rates from cardiac arrest.
(8) Automated external defibrillator devices have been dem-
onstrated to be safe and effective, even when used by lay
people, since the devices are designed not to allow a user
to administer a shock until after the device has analyzed a
victim’s heart rhythm and determined that an electric shock
is required.
(9) Increasing public awareness regarding automated
external defibrillator devices and encouraging their use in Fed-
eral buildings will greatly facilitate their adoption.
(10) Limiting the liability of Good Samaritans and acquirers
of automated external defibrillator devices in emergency situa-
tions may encourage the use of automated external defibrillator
devices, and result in saved lives.
SEC. 403. RECOMMENDATIONS AND GUIDELINES OF SECRETARY OF
HEALTH AND HUMAN SERVICES REGARDING AUTO-
MATED 
EXTERNAL 
DEFIBRILLATORS 
FOR 
FEDERAL
BUILDINGS.
Part B of title II of the Public Health Service Act (42 U.S.C.
238 et seq.) is amended by adding at the end the following:
‘‘RECOMMENDATIONS AND GUIDELINES REGARDING AUTOMATED
EXTERNAL DEFIBRILLATORS FOR FEDERAL BUILDINGS
‘‘SEC. 247. (a) GUIDELINES ON PLACEMENT.—The Secretary shall
establish guidelines with respect to placing automated external
defibrillator devices in Federal buildings. Such guidelines shall
take into account the extent to which such devices may be used
by lay persons, the typical number of employees and visitors in
the buildings, the extent of the need for security measures regarding
the buildings, buildings or portions of buildings in which there
are special circumstances such as high electrical voltage or extreme
heat or cold, and such other factors as the Secretary determines
to be appropriate.
‘‘(b) RELATED RECOMMENDATIONS.—The Secretary shall publish
in the Federal Register the recommendations of the Secretary on
the appropriate implementation of the placement of automated
external defibrillator devices under subsection (a), including proce-
dures for the following:
‘‘(1) Implementing appropriate training courses in the use
of such devices, including the role of cardiopulmonary resuscita-
tion.
‘‘(2) Proper maintenance and testing of the devices.
‘‘(3) Ensuring coordination with appropriate licensed profes-
sionals in the oversight of training of the devices.
‘‘(4) Ensuring coordination with local emergency medical
systems regarding the placement and incidents of use of the
devices.
‘‘(c) 
CONSULTATIONS; 
CONSIDERATION
OF
CERTAIN
REC-
OMMENDATIONS.—In carrying out this section, the Secretary shall—
‘‘(1) consult with appropriate public and private entities;