Union Calendar No. 183
106TH CONGRESS
1ST SESSION
H. R. 2506
[Report No. 106–305]
A BILL
To amend title of the Public Health Service Act to
revise and extent the Agency for Health Care
Policy and Research.
SEPTEMBER 8, 1999
Reported with an amendment, committed to the Commit-
tee of the Whole House on the State of the Union, and
order to be printed
IB
Union Calendar No. 183
106TH CONGRESS
1ST SESSION
H. R. 2506
[Report No. 106–305]
To amend title IX of the Public Health Service Act to revise and extend
the Agency for Health Care Policy and Research.
IN THE HOUSE OF REPRESENTATIVES
JULY 14, 1999
Mr. BILIRAKIS (for himself, Mr. BROWN of Ohio, Mr. GREENWOOD, and Mrs.
THURMAN) introduced the following bill; which was referred to the Com-
mittee on Commerce
SEPTEMBER 8, 1999
Additional sponsors: Mr. WAXMAN, Mr. BONIOR, Mr. WHITFIELD, Mr. FARR
of California, and Mr. DAVIS of Florida
SEPTEMBER 8, 1999
Reported with an amendment, committed to the Committee of the Whole
House on the State of the Union, and ordered to be printed
[Strike out all after the enacting clause and insert the part printed in italic]
[For text of introduced bill, see copy of bill as introduced on July 14, 1999]
A BILL
To amend title IX of the Public Health Service Act to
revise and extend the Agency for Health Care Policy
and Research.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Health Research and
Quality Act of 1999’’.
SEC. 2. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.
(a) IN GENERAL.—Title IX of the Public Health Serv-
ice Act (42 U.S.C. 299 et seq.) is amended to read as follows:
‘‘TITLE IX—AGENCY FOR HEALTH
RESEARCH AND QUALITY
‘‘PART A—ESTABLISHMENT AND GENERAL
DUTIES
‘‘SEC. 901. MISSION AND DUTIES.
‘‘(a) IN GENERAL.—There is established within the
Public Health Service an agency to be known as the Agency
for Health Research and Quality, which shall be headed by
a director appointed by the Secretary. The Secretary shall
carry out this title acting through the Director.
‘‘(b) MISSION.—The purpose of the Agency is to en-
hance the quality, appropriateness, and effectiveness of
health services, and access to such services, through the es-
tablishment of a broad base of scientific research and
through the promotion of improvements in clinical and
health system practices, including the prevention of diseases
and other health conditions. The Agency shall promote
health care quality improvement by—
‘‘(1) conducting and supporting research that de-
velops and presents scientific evidence regarding all
aspects of health, including—
‘‘(A) the development and assessment of
methods for enhancing patient participation in
their own care and for facilitating shared pa-
tient-physician decision-making;
‘‘(B) the outcomes, effectiveness, and cost-ef-
fectiveness of health care practices, including
preventive measures and long-term care;
‘‘(C) existing and innovative technologies;
‘‘(D) the costs and utilization of, and access
to health care;
‘‘(E) the ways in which health care services
are organized, delivered, and financed and the
interaction and impact of these factors on the
quality of patient care;
‘‘(F) methods for measuring quality and
strategies for improving quality; and
‘‘(G) ways in which patients, consumers,
purchasers, and practitioners acquire new infor-
mation about best practices and health benefits,
the determinants and impact of their use of this
information;
‘‘(2) synthesizing and disseminating available
scientific evidence for use by patients, consumers,
practitioners, providers, purchasers, policy makers,
and educators; and
‘‘(3) advancing private and public efforts to im-
prove health care quality.
‘‘(c) REQUIREMENTS
WITH
RESPECT
TO
RURAL
AREAS AND PRIORITY POPULATIONS.—In carrying out sub-
section (b), the Director shall undertake and support re-
search, demonstration projects, and evaluations with respect
to—
‘‘(1) the delivery of health services in rural areas
(including frontier areas);
‘‘(2) health services for low-income groups, and
minority groups;
‘‘(3) the health of children;
‘‘(4) the elderly; and
‘‘(5) people with special health care needs, in-
cluding disabilities, chronic care and end-of-life
health care.
‘‘SEC. 902. GENERAL AUTHORITIES.
‘‘(a) IN GENERAL.—In carrying out section 901(b), the
Director shall support demonstration projects, conduct and
support research, evaluations, training, research networks,
multi-disciplinary centers, technical assistance, and the dis-
semination of information, on health care, and on systems
for the delivery of such care, including activities with re-
spect to—
‘‘(1) the quality, effectiveness, efficiency, appro-
priateness and value of health care services;
‘‘(2) quality measurement and improvement;
‘‘(3) the outcomes, cost, cost-effectiveness, and use
of health care services and access to such services;
‘‘(4) clinical practice, including primary care
and practice-oriented research;
‘‘(5) health care technologies, facilities, and
equipment;
‘‘(6) health care costs, productivity, organization,
and market forces;
‘‘(7) health promotion and disease prevention,
including clinical preventive services;
‘‘(8) health statistics, surveys, database develop-
ment, and epidemiology; and
‘‘(9) medical liability.
‘‘(b) HEALTH SERVICES TRAINING GRANTS.—
‘‘(1) IN GENERAL.—The Director may provide
training grants in the field of health services research
related to activities authorized under subsection (a),
to include pre- and post-doctoral fellowships and
training programs, young investigator awards, and
other programs and activities as appropriate. In car-
rying out this subsection, the Director shall make use
of funds made available under section 487.
‘‘(2) REQUIREMENTS.—In developing priorities
for the allocation of training funds under this sub-
section, the Director shall take into consideration
shortages in the number of trained researchers ad-
dressing the priority populations.
‘‘(c) MULTIDISCIPLINARY
CENTERS.—The Director
may provide financial assistance to assist in meeting the
costs of planning and establishing new centers, and operat-
ing existing and new centers, for multidisciplinary health
services research, demonstration projects, evaluations,
training, and policy analysis with respect to the matters
referred to in subsection (a).
‘‘(d) RELATION TO CERTAIN AUTHORITIES REGARD-
ING SOCIAL SECURITY.—Activities authorized in this sec-
tion shall be appropriately coordinated with experiments,
demonstration projects, and other related activities author-
ized by the Social Security Act and the Social Security
Amendments of 1967. Activities under subsection (a)(2) of
this section that affect the programs under titles XVIII, XIX