I
103D CONGRESS
1ST SESSION
H. R. 3699
To amend the Public Health Service Act to establish, reauthorize and revise
provisions to improve the health of individuals from disadvantaged back-
grounds, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
NOVEMBER 22, 1993
Mr. STOKES (for himself, Mr. CLAY, Mrs. MEEK, Mr. LEWIS of Georgia, Mr.
DELLUMS, Mr. HILLIARD, Mr. MFUME, Mr. JEFFERSON, Mr. TOWNS,
Mr. BISHOP, Ms. NORTON, and Mr. THOMPSON of Mississippi) intro-
duced the following bill; which was referred jointly to the Committees on
Education and Labor and Energy and Commerce
A BILL
To amend the Public Health Service Act to establish, reau-
thorize and revise provisions to improve the health of
individuals from disadvantaged backgrounds, and for
other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; AMENDATORY REFERENCES;
TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the
‘‘Minority Health Improvement Act of 1993’’.
Sec. 505. Waivers regarding obligated service in primary health care.
SEC. 2. FINDINGS.
Section 1(b) of the Disadvantaged Minority Health
Improvement Act of 1990 (42 U.S.C. 300u–6 note) is
amended to read as follows—
‘‘(b) FINDINGS.—Congress finds that—
‘‘(1) the health status of individuals from racial
and ethnic minorities in the United States is signifi-
cantly lower than the health status of the general
population and has not improved significantly since
the issuance of the 1985 report entitled ‘‘Report of
the Secretary’s Task Force on Black and Minority
Health’’;
‘‘(2) racial and ethnic minorities are dispropor-
tionately represented among the poor;
‘‘(3) racial and ethnic minorities suffer dis-
proportionately high rates of cancer, heart disease,
diabetes, substance abuse, acquired immune defi-
ciency syndrome, and other diseases and disorders;
‘‘(4) the incidence of infant mortality among
African Americans is almost double that for the gen-
eral population;
‘‘(5) Mexican-American and Puerto Rican
adults have diabetes rates twice that of non-His-
panic whites;
‘‘(6) a third of American Indian deaths occur
before the age of 45;
‘‘(7) the crisis in minority health continues
while the United States has the most sophisticated
and elaborate medical system in the world; while
medical and technological breakthroughs are afford-
ing Americans a longer life expectancy; and while
the United States continues to witness unprece-
dented explosion in scientific knowledge and a phe-
nomenal capacity to treat and cure disease;
‘‘(8) according to the 1990 Census, African
Americans, Hispanics, American Indians, Alaskan
Natives, and Asian/Pacific Islanders constitute ap-
proximately 12.1 percent, 9 percent, 0.08 percent,
and 2.9 percent, respectively, of the population of
the United States;
‘‘(9) minority health professionals have histori-
cally tended to practice in low-income areas, medi-
cally underserved areas, and to serve racial and eth-
nic minorities;
‘‘(10) minority health professionals have histori-
cally tended to engage in the general practice of
medicine and specialties providing primary care;
‘‘(11) reports published in leading medical jour-
nals indicate that access to health care among mi-
norities can be substantially improved by increasing
the number of minority professionals;
‘‘(12) diversity in the faculty and student body
of health professions schools enhances the quality of
education for all students attending the schools; and
‘‘(13) health professionals need greater access
to continuing medical education programs to enable
such professionals to upgrade their skills (including
linguistic and cultural competence skills) and im-
prove the quality of medical care rendered in minor-
ity communities.’’.
TITLE I—HEALTH POLICY
SEC. 101. OFFICE OF MINORITY HEALTH.
Section 1707 (42 U.S.C. 300u–6) is amended by
striking subsection (b) and all that follows and inserting
the following:
‘‘(b) DUTIES.—With respect to improving the health
of racial and ethnic minority groups, the Secretary, acting
through the Deputy Assistant Secretary for Minority
Health, shall carry out the following:
‘‘(1) Establish short-range and long-range goals
and objectives and coordinate all other activities
within the Department of Health and Human Serv-
ices that relate to disease prevention, health pro-
motion, service delivery, and research concerning
such individuals. The heads of the operating divi-
sions of the Department of Health and Human
Services and the heads of Public Health Service
agencies shall consult with the Deputy Assistant
Secretary for Minority Health to assist in the coordi-
nation of all activities within the Department as
they relate to disease prevention, health promotion,
service delivery, and research concerning such indi-
viduals.
‘‘(2) Carry out the following types of activities
by entering into interagency agreements with other
agencies of the public health service:
‘‘(A) Support research, demonstrations and
evaluations to test new and innovative models.
‘‘(B) Increase knowledge and understand-
ing of health risk factors.
‘‘(C) Develop mechanisms that support
better information dissemination, education,
prevention, and service delivery to individuals
from disadvantaged backgrounds, including ra-
cial and ethnic minority groups.
‘‘(3) Establish a national minority health re-
source center to carry out the following:
‘‘(A) Facilitate the exchange of informa-
tion regarding matters relating to health infor-
mation and health promotion, preventive health
services, and education in the appropriate use
of health care.
‘‘(B) Target the most prevalent morbidity
and mortality concerns of the various racial and
ethnic minorities.
‘‘(C) Facilitate access to such information.
‘‘(D) Assist in the analysis of issues and
problems relating to such matters.
‘‘(E) Provide technical assistance with re-
spect to the exchange of such information (in-
cluding facilitating the development of materials
for such technical assistance).
‘‘(F) Improve access to health care services
for racial and ethnic minorities, including those
with limited English proficiency, by facilitating
the removal of impediments to the receipt of
health care.
‘‘(4) With respect to awards of grants and con-
tracts that are available under certain minority
health programs, establish a program—
‘‘(A) to inform entities, as appropriate,
that the entities may be eligible for the awards;
‘‘(B) to provide technical assistance to
such entities in the process of preparing and
submitting applications for the awards in ac-
cordance with the policies of the Secretary re-
garding such application; and
‘‘(C) to inform populations, as appropriate,
that members of the populations may be eligible
to receive services or otherwise participate in
the activities carried out with such awards.
‘‘(c) ADVISORY COMMITTEE.—
‘‘(1) IN GENERAL.—The Secretary shall estab-
lish an advisory committee to be known as the Advi-
sory Committee on Minority Health (in this sub-
section referred to as the ‘Committee’).
‘‘(2) DUTIES.—The Committee shall provide
advice to the Secretary on carrying out this section,
including advice on the development of goals and
specific program activities under subsection (b)(1)
for each racial and ethnic minority group.
‘‘(3) CHAIRPERSON.—The Deputy Assistant
Secretary for Minority Health shall serve as the
Chairperson of the Committee.
‘‘(4) COMPOSITION.—The Committee shall be
composed of no fewer than 12, and not more than
18 individuals, who are not officers or employees of
the Federal Government. The Secretary shall ap-
point the members of the Committee from among in-
dividuals with expertise regarding issues of minority
health. The membership of the Committee shall be
equitably representative of the various racial and
ethnic minority groups. The Secretary may appoint
representatives from selected Federal agencies to
serve as ex officio, non-voting members of the Com-
mittee.
‘‘(5) TERMS.—Each member of the Committee
shall serve for a term of 4 years, except that the
Secretary shall initially appoint a portion of the
members to terms of 1 year, 2 years, and 3 years.
‘‘(6) VACANCIES.—If a vacancy occurs on the
Committee, a new member shall be appointed by the
Secretary within 90 days from the date that the va-
cancy occurs, and serve for the remainder of the
term for which the predecessor of such member was
appointed. The vacancy shall not affect the power of
the remaining members to execute the duties of the
Committee.
‘‘(7) COMPENSATION.—Members of the Com-
mittee who are officers or employees of the United
States shall serve without compensation. Members of
the Committee who are not officers or employees of
the United States shall receive, for each day (includ-
ing travel time) they are engaged in the performance
of the functions of the Committee, compensation at
rates that do not exceed the daily equivalent of the
annual rate in effect for grade GS–18 of the General
Schedule under title 5, United States Code.
‘‘(d) CERTAIN
REQUIREMENTS
REGARDING
DU-
TIES.—
‘‘(1) EQUITABLE ALLOCATION REGARDING AC-
TIVITIES.—In awarding grants or contracts or coop-
erative agreements under section 340A, 724, 737,
738, or 1707, the Secretary shall ensure that such
awards are allocated to address the most prevalent
morbidity and mortality concerns of the various ra-
cial and ethnic minority groups.
‘‘(2) CULTURAL COMPETENCY OF SERVICES.—
The Secretary shall ensure that information and
services provided pursuant to subsection (b) are pro-
vided in the language and cultural context that is
most appropriate for the individuals for whom the
information and services are intended.
‘‘(3) PEER REVIEW.—The Secretary shall en-
sure that each application for a grant, contract or
cooperative agreement under section 340A, 724,
737, or 1707 undergoes appropriate peer review.
‘‘(e) REPORTS.—Not later than January 31 of fiscal
year 1995 and of each second year thereafter, the Sec-
retary shall submit to the Congress a report describing
the activities carried out under this section during the pre-
ceding 2 fiscal years and evaluating the extent to which
such activities have been effective in improving the health
of racial and ethnic minority groups.
‘‘(f) GRANTS AND CONTRACTS AND COOPERATIVE
AGREEMENTS REGARDING DUTIES.—
‘‘(1) AUTHORITY.—In carrying out subsection
(b), the Secretary may make grants to and enter
into contracts and cooperative agreements with pub-
lic and nonprofit private entities for activities de-
scribed in paragraphs (3) of subsection (b).
‘‘(2) EVALUATION AND DISSEMINATION.—The
Secretary shall, directly or through contracts with
public and private entities, provide for evaluations of
projects carried out with financial assistance pro-
vided under paragraph (1) during the preceding 2
fiscal years. The report shall be included in the re-
port required under subsection (e) for the fiscal year
involved.
‘‘(g) DEFINITION.—As used in this section, the term
‘racial and ethnic minority group’ means Hispanics,
Blacks, Asian Americans, Pacific Islanders, Native Ameri-
cans, and Alaskan Natives.
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there is authorized
to be appropriated such sums as may be necessary for
each of the fiscal years 1994 through 1998.’’.
SEC. 102. AGENCY OFFICES OF MINORITY HEALTH.
Title XVII (42 U.S.C. 300u et seq.) is amended by
adding at the end the following new section:
‘‘SEC. 1709. AGENCY OFFICES OF MINORITY HEALTH.
‘‘(a) IN GENERAL.—The Secretary, acting through
the Deputy Assistant Secretary for Minority Health, shall
ensure that an Office of Minority Health is established
and operating at the Centers for Disease Control and Pre-
vention, the Health Resources and Services Administra-
tion, the Substance Abuse and Mental Health Administra-
tion, and the Agency for Health Care Policy and Research.
Such Offices shall be established to ensure that services
and programs carried out within each such respective
agency or office—
‘‘(1) address the most prevalent morbidity and
mortality concerns of racial and ethnic minority
groups;
‘‘(2) provide culturally competent services; and
‘‘(3) utilize racial and ethnic minority commu-
nity-based organizations to deliver services.
‘‘(b) REPORTS.—Each Office of Minority Health
within the Department of Health and Human Services
shall submit a report, not later than May 1 of each year,
to the Deputy Assistant Secretary for Minority Health (as
provided for in section 1707(a)) describing the accom-
plishments or programs of the plan, the budget allocation
and expenditures for, and the development and implemen-
tation of, such health programs targeting racial and ethnic
minority populations. The Secretary shall ensure the par-
ticipation and cooperation of each Agency in the develop-
ment of the annual report.
‘‘(c) FUNDING.—Of the amounts appropriated for fis-
cal year 1995 or any subsequent fiscal year for an agency
for which an Office of Minority Health is established
under subsection (a), the Secretary shall reserve not less
than 10 percent for the purpose of such Office to carry
out minority health program activities.
SEC. 103. STATE OFFICES OF MINORITY HEALTH.
Title XVII (42 U.S.C. 300u et seq.), as amended by
section 102, is further amended by adding at the end the
following new section:
‘‘SEC. 1710. GRANTS TO STATES FOR OPERATION OF OF-
FICES OF MINORITY HEALTH.
‘‘(a) IN GENERAL.—The Secretary, acting through
the Deputy Assistant Secretary for Minority Health (as
provided for in section 1707), may make grants to States
for the purpose of improving the health status in minority
communities, through the operation of State offices of mi-
nority health established to monitor and facilitate the
achievement of the Health Objectives for the Year 2000
as they affect minority populations.
‘‘(b) ADMINISTRATION OF PROGRAM.—The Secretary
may not make a grant to a State under subsection (a)
unless such State agrees that the program carried out by
the State with amounts received under the grant will be
administered directly by a single State agency.
‘‘(c) CERTAIN REQUIRED ACTIVITIES.—The Sec-
retary may not make a grant to a State under subsection
(a) unless such State agrees that activities carried out by
an office operated under the grant received pursuant to
such subsection will—
‘‘(1) establish and maintain within the State a
clearinghouse for collecting and disseminating infor-
mation on—
‘‘(A) minority health issues, including
health care issues;
‘‘(B) research findings relating to minority
health, including findings relating to health
care; and
‘‘(C) innovative approaches to the delivery
of health care and social services in minority
communities;
‘‘(2) coordinate the activities carried out in the
State that relate to minority health, including activi-
ties relating to health care, which activities include
providing coordination for the purpose of avoiding
redundancy in such activities;
‘‘(3) identify Federal and State programs re-
garding minority health, and providing technical as-
sistance to public and nonprofit entities regarding
participation in such program; and
‘‘(4) develop additional Healthy People 2000
objectives for the State that are necessary to address
the most prevalent morbidity and mortality concerns
of racial and ethnic minority groups in the State.
‘‘(d) REQUIREMENT REGARDING ANNUAL BUDGET
OFFICE.—The Secretary may not make a grant to a State
under subsection (a) unless such State agrees that, for any
fiscal year for which the State receives such a grant, the
office operated under such grant will be provided with an
annual budget of not less than $75,000.
‘‘(e) CERTAIN USES OF FUNDS.—
‘‘(1) RESTRICTIONS.—The Secretary may not
make a grant to a State under subsection (a) unless
such State agrees that—
‘‘(A) if research with respect to minority
health is conducted pursuant to the grant, not
more than 10 percent of the amount received
under the grant will be expended for such re-
search; and
‘‘(B) amounts provided under the grant
will not be expended—
‘‘(i) to provide health care (including
providing cash payments regarding such
care);
‘‘(ii) to conduct activities for which
Federal funds are expended—
‘‘(I) within the State to provide
technical and other nonfinancial as-
sistance under subsection (m) of sec-
tion 340A;
‘‘(II) under a memorandum of
agreement entered into with the State
under subsection (h) of such section;
or
‘‘(III) under a grant under sec-
tion 388I;
‘‘(iii) to purchase medical equipment,
to purchase ambulances, aircraft, or other
vehicles, or to purchase major communica-
tions equipment;
‘‘(iv) to purchase or improve real
property; or
‘‘(v) to carry out any activity regard-
ing a certificate of need.
‘‘(2) AUTHORITIES.—Activities for which a
State may expend amounts received under a grant
under subsection (a) include—
‘‘(A) paying the costs of establishing an of-
fice of minority health for purposes of sub-
section (a);
‘‘(B) subject to paragraph (1)(B)(ii)(III),
paying the costs of any activity carried out with
respect to recruiting and retaining health pro-
fessionals to serve in minority communities or
underserved areas in the State; and
‘‘(C) providing grants and contracts to
public and nonprofit entities to carry out activi-
ties authorized in this section.
‘‘(f) REPORTS.—The Secretary may not make a
grant to a State under subsection (a) unless such State
agrees—
‘‘(1) to submit to the Secretary reports contain-
ing such information as the Secretary may require
regarding activities carried out under this section by
the State; and
‘‘(2) to submit a report not later than January
10 of each fiscal year immediately following any fis-
cal year for which the State has received such a
grant.
‘‘(g) APPLICATION FOR GRANT.—The Secretary may
not make a grant to a State under subsection (a) unless
an application for the grant is submitted to the Secretary
and the application in such form, is made in such manner,
and contains such agreements, assurances, and informa-
tion as the Secretary determines to be necessary to carry
out such subsection.
‘‘(h) NONCOMPLIANCE.—The Secretary may not
make payments under subsection (a) to a State for any
fiscal year subsequent to the first fiscal year of such pay-
ments unless the Secretary determines that, for the imme-
diately preceding fiscal year, the State has complied with
each of the agreements made by the State under this sec-
tion.
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) IN
GENERAL.—For purposes of making
grants under subsection (a) there are authorized to
be appropriated $3,000,000 for fiscal year 1995,
$4,000,000 for fiscal year 1996, and $3,000,000 for
fiscal year 1997.
‘‘(2) 
AVAILABILITY.—Amounts 
appropriated
under paragraph (1) shall remain available until ex-
pended.
‘‘(j) TERMINATION OF PROGRAM.—No grant may be
made under this section after the aggregate amounts ap-
propriated 
under 
subsection 
(i)(1) 
are 
equal 
to
$10,000,000.’’.
SEC. 104. ASSISTANT SECRETARY OF HEALTH AND HUMAN
SERVICES FOR CIVIL RIGHTS.
(a) IN GENERAL.—Part A of title II (42 U.S.C. 202
et seq.), as amended by section 2010 of Public Law 103–
43, is amended by adding at the end the following new
section:
‘‘SEC. 229. ASSISTANT SECRETARY FOR CIVIL RIGHTS.
‘‘(a) ESTABLISHMENT OF POSITION.—There shall be
in the Department of Health and Human Services an As-
sistant Secretary for Civil Rights, who shall be appointed
by the President, by and with the advice and consent of
the Senate.
‘‘(b) RESPONSIBILITIES.—The Assistant Secretary
shall perform such functions relating to civil rights as the
Secretary may assign.’’.
(b) CONFORMING AMENDMENT.—Section 5315 of
title 5, United States Code, is amended, in the item relat-
ing to Assistant Secretaries of Health and Human Serv-
ices, by striking ‘‘(5)’’ and inserting ‘‘(6)’’.
TITLE II—HEALTH SERVICES
SEC. 201. COMMUNITY SCHOLARSHIP PROGRAMS.
Section 338L (42 U.S.C. 254t) is amended—
(1) in subsection (a), by striking ‘‘health man-
power shortage areas’’ and inserting ‘‘Federally-des-
ignated health professional shortage areas’’;
(2) in subsection (c)—
(A) by striking ‘‘health manpower shortage
areas’’ and inserting ‘‘Federally-designated
health professional shortage areas’’ in the mat-
ter preceding paragraph (1); and
(B) by striking ‘‘in the health manpower
shortage areas in which the community organi-
zations are located,’’ and inserting ‘‘in a Feder-
ally-designated health professional shortage
area that is served by the community organiza-
tion awarding the scholarship,’’ in paragraph
(2);
(3) in subsection (e)(1)—
(B) in paragraph (3)—
(i) by striking ‘‘manpower’’ and in-
serting ‘‘care providers’’; and
(ii) by striking ‘‘by—’’ and all that
follows through the end thereof and insert-
ing a semicolon;
(C) by striking paragraphs (5) and (6);
(D) by redesignating paragraphs (7), and
(8) as paragraphs (5) and (6), respectively;
(E) in paragraph (5) (as so redesignated),
by striking ‘‘and’’ at the end thereof;
(F) in paragraph (6) (as so redesignated),
by striking the period and inserting a semi-
colon; and
(G) by inserting after paragraph (6) (as so
redesignated), the following new paragraphs:
‘‘(7) to provide primary health care, preventive
health care, and related training to American Sa-
moan health care professionals; and
‘‘(8) to improve access to health promotion and
disease prevention services for rural American
Samoa.’’;
(2) in subsection (f)—
(A) by striking ‘‘there is’’ and inserting
‘‘there are’’; and
(B) by striking ‘‘$10,000,000’’ and all that
follows through ‘‘1993’’ and inserting ‘‘such
sums as may be necessary for each of the fiscal
years 1994 through 1996’’; and
(3) by adding at the end thereof the following
new subsection:
‘‘(g) STUDY AND REPORT.—
‘‘(1) STUDY.—Not later than 180 days after
the date of enactment of this subsection, the Sec-
retary, acting through the Administrator of the
Health Resources and Services Administration, shall
enter into a contract with a public or nonprofit pri-
vate entity for the conduct of a study to determine
the effectiveness of projects funded under this sec-
tion.
‘‘(2) REPORT.—Not later than July 1, 1995,
the Secretary shall prepare and submit to the Com-
mittee on Energy and Commerce and the Committee
on Appropriations of the House of Representatives,
and to the Committee on Labor and Human Re-
sources and the Committee on Appropriations of the
Senate, a report describing the findings made with
respect to the study conducted under paragraph
(1).’’.
TITLE III—HEALTH
PROFESSIONS
SEC. 301. LOANS FOR DISADVANTAGED STUDENTS.
Subpart II of part A of title VII (42 U.S.C. 292q)
is amended—
(1) in section 723—
(A) in subsection (a)(2), by adding at the
end the following subparagraph:
‘‘(C) The requirement established in para-
graph (1) regarding a a student does not apply
to students from disadvantaged backgrounds
who are underrepresented in the health profes-
sions.’’; and
(B) in subsection (b), by adding at the end
the following paragraph:
‘‘(7) INAPPLICABILITY TO CERTAIN SCHOOLS.—
The requirement established in paragraph (1) re-
garding a school does not apply if the school is a
historically black college or university.’’; and
(2) in section 724(f)(1)—
(A) by striking ‘‘there is’’ and inserting
‘‘there are’’; and
(B) by striking ‘‘$15,000,000 for fiscal
year 1993’’ and inserting ‘‘such sums as may
be necessary for each of the fiscal years 1994,
1995, and 1996’’.
SEC. 302. CESAR CHAVEZ SCHOLARSHIP PROGRAM.
Section 736 (42 U.S.C. 293) is amended—
(1) by striking the section heading and insert-
ing the following:
‘‘SEC. 736. CESAR CHAVEZ SCHOLARSHIP PROGRAM.’’;
(2) in subsection (a), by striking ‘‘need, subject
to’’ and all that follows and inserting ‘‘need.’’; and
(3) in subsection (c)—
(A) by striking ‘‘there is’’ and inserting
‘‘there are’’; and
(B) by striking ‘‘$11,000,000 for fiscal
year 1993’’ and inserting ‘‘such sums as may
be necessary for each fiscal year 1994, 1995,
and 1996’’.
SEC. 303. THURGOOD MARSHALL SCHOLARSHIP PROGRAM.
Section 737 (42 U.S.C. 293a) is amended—
(1) by striking the section heading and insert-
ing the following:
‘‘SEC. 737. THURGOOD MARSHALL SCHOLARSHIP PRO-
GRAM.’’;
(2) in subsection (a)—
(A) in paragraph (1), by inserting ‘‘(to be
known as Thurgood Marshall Scholars)’’ after
‘‘providing scholarships to individuals’’; and
(B) by adding at the end the following
paragraph:
‘‘(4) INAPPLICABILITY OF CERTAIN REQUIRE-
MENTS.—Any obligation under this section regard-
ing practicing in primary health care is waived for
students from disadvantaged backgrounds who are
underrepresented in the health professions.’’; and
(3) in subsection (h), by striking paragraph (1)
and inserting the following new paragraph:
‘‘(1) 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 1994, 1995,
and 1996.’’.
SEC. 304. LOAN REPAYMENTS AND FELLOWSHIPS REGARD-
ING FACULTY POSITIONS AT HEALTH PRO-
FESSIONS SCHOOLS.
Section 738 (42 U.S.C. 293b) is amended—
(1) in subsection (a)—
(A) in paragraph (2), by striking ‘‘dis-
advantaged backgrounds who—’’ and inserting
‘‘racial 
or 
ethnic 
groups 
that 
are
underrepresented in the health professions
who—’’
(B) in paragraph (5)—
(i) by striking ‘‘; and’’ in subpara-
graph (A) and inserting a period;
(ii) by striking ‘‘unless—’’ and all
that follows through ‘‘the individual in-
volved’’ in subparagraph (A) and inserting
‘‘unless the individual involved’’; and
(iii) striking subparagraph (B);
(C) by striking paragraph (6); and
(D) by redesignating paragraph (7) as
paragraph (6); and
(2) 
in 
subsection 
(b)(2)(B), 
by 
striking
‘‘$30,000’’ and inserting ‘‘$50,000’’;
(3) in subsection (c)—
(A) by striking ‘‘there is’’ and inserting
‘‘there are’’; and
(B) by striking ‘‘$4,000,000 for fiscal year
1993’’ and inserting ‘‘such sums as may be nec-
essary for each of the fiscal years 1994, 1995,
and 1996’’.
SEC. 305. CENTERS OF EXCELLENCE.
Section 739 (42 U.S.C. 293c) is amended—
(1) in subsection (b)—
(A) in paragraph (2), by inserting before
the semicolon the following: ‘‘through collabora-
tion with public and nonprofit private entities
to carry out community-based programs to pre-
pare students in secondary schools and institu-
tions of higher education for attendance at the
health professions school’’;
(B) in paragraph (4), by striking ‘‘and’’ at
the end thereof;
(C) in paragraph (5), by striking the pe-
riod and inserting ‘‘; and’’; and
(D) by adding at the end thereof the fol-
lowing new paragraph:
‘‘(6) to carry out a program to provide training
to the students of the school to enable such students
to provide health services to minority individuals at
community-based health facilities that provide such
services to a significant number of minority individ-
uals and that are located at a site remote from the
main site of the teaching facilities of the school.’’;
(2) in subsection (c)—
(A) in paragraph (1)(B), by amending
clause (i) to read as follows:
‘‘(i) whose most recent graduating
class included a significant number of mi-
nority individuals, which number con-
stituted (except as provided in paragraph
(4)(A)) not less than 25 percent of such
class;’’; and
(B) in paragraph (4)(A), by inserting be-
fore the semicolon the following: ‘‘(except that
the requirement in paragraph (1)(B)(i) regard-
ing 25 percent does not apply for purposes of
this subparagraph)’’;
(3) in subsection (e)—
(A) by striking the subsection heading and
inserting ‘‘AUTHORITY REGARDING CONSOR-
TIA.—’’;
(B) by striking paragraph (1) and insert-
ing the following new paragraph:
‘‘(1) IN GENERAL.—The Secretary may make a
grant under subsection (a) to a school of medicine,
a school of osteopathic medicine, a school of den-
tistry, or a school or pharmacy, that has in accord-
ance with paragraph (2) formed a consortium of
schools.’’;
(C) in paragraph (2), by striking subpara-
graphs (A) through (D) and inserting the fol-
lowing new subparagraphs:
‘‘(A) the consortium consists of—
‘‘(i) the health professions school
seeking the grant under subsection (a);
and
‘‘(ii) one or more schools of medicine
or osteopathic medicine, schools of nursing
(as defined in section 853), schools of den-
tistry, schools of pharmacy, schools of
podiatric medicine, schools of optometry,
schools of veterinary medicine, schools of
public health, schools of allied health, or
graduate programs in mental health prac-
tice;
‘‘(B) the schools of the consortium have
entered into an agreement for the allocation of
such grant among the schools; and
‘‘(C) each of the schools agrees to expend
the grant in accordance with this section.’’; and
(D) by adding at the end the following
paragraph:
‘‘(3) AUTHORITY FOR COLLECTIVELY MEETING
RELEVANT
REQUIREMENTS
IN
CERTAIN
CASES.—
With respect to meeting the conditions specified in
subsection (c)(4) for Native American Centers of
Excellence, the Secretary may make a grant to any
school that has in accordance with paragraphs (1)
and (2) formed a consortium of schools that meets
such conditions (without regard to whether the
schools of the consortium individually meet such
conditions).’’;
(4)(A) by redesignating subsections (h) and (i)
as subsections (i) and (j), respectively; and
(B) by inserting after subsection (g) the follow-
ing subsection:
‘‘(h) COLLABORATION WITH NATIONAL INSTITUTES
OF HEALTH.—The Director of the National Institutes of
Health, acting through the Director of the Office of Re-
search on Minority Health (or as appropriate through
other officials of such Institutes), may enter into collabo-
rative grant programs and other program initiatives with
Centers of Excellence under this section for the purposes
of collaborative research efforts, research program activ-
ity, training, and supplemental biomedical and health serv-
ices research linkages between the National Institutes of
Health and the Health Resources and Services Adminis-
tration.’’; and
(5) in subsection (j) (as redesignated by para-
graph (4) of this subsection)—
(A) in paragraph (1), by striking ‘‘such
sums as may be necessary for fiscal year 1993’’
and inserting ‘‘such sums as may be necessary
for each of the fiscal years 1994, 1995, and
1996’’; and
(B) in paragraph (2)(C) by adding at the
end the following: ‘‘Health professions schools
described in subsection (c)(2)(A) shall be eligi-
ble for grants under this subparagraph in a fis-
cal year if the amount appropriated for the fis-
cal year under paragraph (1) is greater than
$23,500,000. Such schools shall be eligible to
apply only for grants made from the portion of
such amount that exceeds $23,500,000.’’.
SEC. 306. EDUCATIONAL ASSISTANCE REGARDING UNDER-
GRADUATES.
Section 740 (42 U.S.C. 293d) is amended—
(1) in subsection (a)(1), by adding at the end
the following new sentence: ‘‘To be eligible for such
a grant, a school shall have in place a program
which with supplemental support may assist individ-
uals from disadvantaged backgrounds in gaining
entry into a health professions school or completing
the course of study at such a school.’’; and
(2) in subsection (d)—
(A) in paragraph (1)—
(i) by striking ‘‘there is’’ and inserting
‘‘there are’’; and
(ii) by striking ‘‘1993’’ and inserting
‘‘such sums as may be necessary for each
of the fiscal years 1994, 1995, and 1996’’;
and
(B) in paragraph (2)(B), by striking ‘‘The
provision of’’ and all that follows through
‘‘health care).’’.
SEC. 307. AREA HEALTH EDUCATION CENTERS.
Section 746(d)(2)(D) (42 U.S.C. 293j(d)(2)(D)) is
amended by inserting ‘‘and minority health’’ after ‘‘dis-
ease prevention’’.
TITLE IV—RESEARCH AND DATA
COLLECTION
SEC. 401. OFFICE OF RESEARCH ON MINORITY HEALTH.
Section 404 (42 U.S.C. 283b), as added by section
151 of Public Law 103–43, is amended by adding at the
end the following subsections:
‘‘(c) PLAN.—The Director of the Office, shall collabo-
rate with the Deputy Assistant Secretary for Minority
Health (as provided for in section 1707), to develop and
implement a plan for carrying out the duties required by
subsection (b).
‘‘(d) EQUITY REGARDING VARIOUS GROUPS.—The
Director of the Office shall ensure that activities under
subsection (b) address health research and research train-
ing needs of minorities with respect to the most prevalent
morbidity and mortality concerns of the various racial and
ethnic minority groups.
‘‘(e) ADVISORY SUBCOMMITTEE.—
‘‘(1) ESTABLISHMENT.—In carrying out sub-
section (b), the Secretary shall establish a sub-
committee of the Advisory Committee to the Direc-
tor of the National Institutes of Health, an advisory
subcommittee to be known as the Advisory Sub-
committee on Research on Minority Health (in this
subsection referred to as the ‘Advisory Subcommit-
tee’).
‘‘(2) COMPOSITION.—
‘‘(A) VOTING
AND
NONVOTING
MEM-
BERS.—The Advisory Subcommittee shall be
composed of voting members appointed in ac-
cordance with subparagraph (B) and the ex
officio nonvoting members described in subpara-
graph (C).
‘‘(B) VOTING
MEMBERS.—The Advisory
Subcommittee shall include not fewer than 12,
and not more than 18, voting members who are
not officers or employees of the Federal Gov-
ernment. The Director of the Office shall ap-
point such members to the Advisory Sub-
committee from among physicians, practition-
ers, scientists, consumers and other health pro-
fessionals, whose clinical practices, research
specialization, or professional expertise includes
a significant focus on research on minority
health or on the barriers that minorities must
overcome to participate in clinical trials. The
membership of the Advisory Subcommittee shall
be equitably representative of the minority
groups served by the Office.
‘‘(C) EX OFFICIO NONVOTING MEMBERS.—
The Deputy Assistant Secretary for Minority
Health and the Directors of each of the na-
tional research entities shall serve as ex officio
nonvoting members of the Advisory Subcommit-
tee (except that any of such Directors may des-
ignate an official of the institute involved to
serve as such member of the Subcommittee in
lieu of the Director).
‘‘(3) CHAIRPERSON.—The Director of the Of-
fice shall serve as the chairperson of the Advisory
Subcommittee.
‘‘(4) DUTIES.—The Advisory Subcommittee
shall—
‘‘(A) advise the Director of the Office on
appropriate 
research 
activities 
to 
be
undertaken by the national research institutes
with respect to—
‘‘(i) research on minority health;
‘‘(ii) research on racial and ethnic dif-
ferences in clinical drug trials, including
responses to pharmacological drugs;
‘‘(iii) research on racial and ethnic
differences in d isease etiology, course, and
treatment; and
‘‘(iv) research on minority health con-
ditions which require a multidisciplinary
approach;
‘‘(B) report to the Director of the Office
on such research;
‘‘(C) provide recommendations to such Di-
rector regarding activities of the Office (includ-
ing recommendations on priorities in carrying
out research described in subparagraph (A));
and
‘‘(D) assist in monitoring compliance with
section 492B regarding the inclusion of minori-
ties in clinical research.
‘‘(5) BIENNIAL REPORT.—
‘‘(A) PREPARATION.—The Advisory Sub-
committee shall prepare a biennial report de-
scribing the activities of the Subcommittee, in-
cluding findings made by the Subcommittee re-
garding—
‘‘(i) compliance with section 492B;
‘‘(ii) the extent of expenditures made
for research on minority health by the
agencies of the National Institutes of
Health; and
‘‘(iii) the level of funding needed for
such research.
‘‘(B) SUBMISSION.—The report required in
subparagraph (A) shall be submitted to the Di-
rector of the National Institutes of Health for
inclusion in the report required in section 403.
‘‘(f) REPRESENTATIVES OF MINORITIES AMONG RE-
SEARCHERS.—The Secretary, acting through the Assist-
ant Secretary for Personnel Administration and in collabo-
ration with the Director of the Office, shall determine the
extent to which minorities are represented among senior
physicians and scientists employed by the national re-
search institutes and among physicians and scientists em-
ployed by and conducting research with funds provided by
such institutes, and as appropriate, carry out activities to
increase the extent of such representation and the number
of minorities receiving doctorates in the biomedical
sciences, including targeting minorities at all points in the
education pipeline to increase minority participation in
general in biomedical research.
‘‘(g) DEFINITIONS.—For purposes of this part:
‘‘(1) MINORITY
HEALTH
CONDITIONS.—The
term ‘minority health conditions’, with respect to in-
dividuals who are members of minority groups,
means all diseases, disorders, and conditions (includ-
ing with respect to mental health and substance
abuse)—
‘‘(A) unique to, more serious, or more
prevalent in such individuals;
‘‘(B) for which the factors of medical risk
or types of medical intervention are different
for such individuals, or for which it is unknown
whether such factors or types are different for
such individuals; or
‘‘(C) with respect to which there has been
insufficient research involving such individuals
as subjects or insufficient data on such individ-
uals.
‘‘(2) RESEARCH ON MINORITY HEALTH.—The
term ‘research on minority health’ means research
on minority health conditions, including research on
preventing such conditions.
‘‘(3) MINORITY GROUPS.—The term ‘minority
groups’ means Blacks, American Indians, Alaskan
Natives, Asian/Pacific Islanders, and Hispanics.’’.
SEC. 402. NATIONAL CENTER FOR HEALTH STATISTICS.
(a) IN GENERAL.—Section 306 (42 U.S.C. 242k) is
amended—
(1) in subsection (c), by striking ‘‘Committee on
Human Resources’’ and inserting ‘‘Committee on
Labor and Human Resources’’;
(2) in subsection (g), by striking ‘‘data which
shall be published’’ and all that follows and inserting
‘‘data.’’;
(3) in subsection (k)(2)—
(A) in subparagraph (A)—
(i) by striking the subparagraph des-
ignation; and
(ii) by striking ‘‘Except as provided in
subparagraph (B), members’’ and inserting
‘‘Members’’; and
(B) by striking subparagraph (B);
(4) in subsection (l)—
(A) by striking paragraph (3);
(B) by redesignating paragraph (4) as
paragraph (3); and
(C) in paragraph (3) (as so redesignated),
by striking ‘‘paragraphs (1), (2), and (3),’’ and
inserting ‘‘paragraphs (1) and (2),’’; and
(5) in subsection (o)—
(A) in paragraph (1), by striking ‘‘1991
through 1993’’ and inserting ‘‘1994 through
1997’’; and
(B) 
in 
paragraph 
(2), 
by 
striking
‘‘$5,000,000’’ and all that follows through
‘‘1993’’ and inserting ‘‘such sums as may be
necessary for each of the fiscal years 1994
through 1997’’.
(b) GENERAL AUTHORITY RESPECTING RESEARCH,
EVALUATIONS, AND DEMONSTRATIONS.—Section 304 (42
U.S.C. 242b) is amended by striking subsection (d).
(c) GENERAL PROVISIONS RESPECTING EFFECTIVE-
NESS, EFFICIENCY, AND QUALITY OF HEALTH SERV-
ICES.—Section 308 (42 U.S.C. 242m) is amended—
(1) in subsection (a)—
(A) in paragraph (1)—
(i) by striking subparagraph (A); and
(ii) by redesignating subparagraphs
(B) through (E) as subparagraphs (A)
through (D), respectively; and
(B) in paragraph (2), by striking ‘‘reports
required by subparagraphs’’ and all that follows
through ‘‘Center’’ and inserting the following:
‘‘reports required in paragraph (1) shall be pre-
pared through the National Center’’;
(2)(A) by striking subsection (c);
(B) by transferring paragraph (2) of subsection
(g) from the current location of the paragraph;
(C) by redesignating such paragraph as sub-
section (c);
(D) by inserting subsection (c) (as so redesig-
nated) after subsection (b); and
(E) by striking the remainder of subsection (g);
(3) in subsection (c) (as so redesignated)—
(A) by striking ‘‘shall (A) take’’ and in-
serting ‘‘shall take’’; and
(B) by striking ‘‘and (B) publish’’ and in-
serting ‘‘and shall publish’’;
(4) in subsection (f), by striking ‘‘sections
3648’’ and all that follows and inserting ‘‘section
3324 of title 31, United States Code, and section
3709 of the Revised Statutes (41 U.S.C. 5).’’; and
(5) by striking subsection (h).
SEC. 403. ACTIVITIES OF AGENCY FOR HEALTH CARE POL-
ICY AND RESEARCH.
Section 902(b) (42 U.S.C. 299a(b)) is amended to
read as follows:
‘‘(b) REQUIREMENTS WITH RESPECT TO CERTAIN
POPULATIONS.—In carrying out subsection (a), the Ad-
ministrator shall undertake and support research, dem-
onstration projects, and evaluations with respect to the
health status of, and the delivery of health care to—
‘‘(1) racial and ethnic minority groups residing
in medically underserved urban or rural areas (in-
cluding frontier areas); and
‘‘(2) low-income groups, including the elderly,
women, and children with low incomes.’’.
TITLE V—MISCELLANEOUS
SEC. 501. MEDICALLY UNDERSERVED AREA STUDY.
(a) IN GENERAL.—The Secretary of Health and
Human Services shall conduct a study concerning the fea-
sibility and desirability of, and the criteria to be used for,
combining the designations of ‘‘health professional short-
age area’’ and ‘‘medically underserved area’’ into a single
health professional shortage area designation.
(b) REQUIREMENTS.—As part of the study conducted
under subsection (a), the Secretary of Health and Human
Services, in considering the statutory and regulatory re-
quirements necessary for the creation of a single health
professional shortage area designation, shall—
(1) review and report on the application of cur-
rent statutory and regulatory criteria used—
(A) in designating an area as a health pro-
fessional shortage area;
(B) in designating an area as a medically
underserved area; and
(C) by a State in the determination of the
health professional shortage area designations
of such State; and
(2) review the suggestions of public health and
primary care experts.
(c) REPORT.—Not later than 1 year after the date
of enactment of this Act, the Secretary of Health and
Human Services shall prepare and submit to the appro-
priate committees of Congress a report concerning the
findings of the study conducted under subsection (a) to-
gether with the recommendations of the Secretary.
(d) RECOMMENDATIONS.—In making recommenda-
tions under subsection (c), the Secretary of Health and
Human Services shall give special consideration to (and
describe in the report) the unique impact of designation
criteria on different rural and urban populations, and eth-
nic and racial minorities, including—
(1) rational service areas, and their application
to frontier areas and inner-city communities;
(2) indicators of high medical need, including
fertility rates, infant mortality rates, pediatric popu-
lation, elderly population, poverty rates, and physi-
cian to population ratios; and
(3) indicators of insufficient service capacity,
including language proficiency criteria for ethnic
populations, annual patient visits per physician,
waiting times for appointments, waiting times in a
primary care physician office, excessive use of emer-
gency facilities, low annual office visit rate, and de-
mand on physicians in contiguous rural or urban
areas.
SEC. 502. FEDERAL AND STATE OFFICES REGARDING
URBAN HEALTH.
(a) FEDERAL OFFICE OF URBAN HEALTH POLICY.—
Title XVII, as amended by section 103 of this Act, is
amended by adding at the end the following section:
‘‘SEC. 1711. OFFICE OF URBAN HEALTH POLICY.
‘‘(a) IN GENERAL.—There is established in the De-
partment of Health and Human Services an office to be
known as the Office of Urban Health Policy (in this sec-
tion referred to as the ‘Office’). The Office shall be headed
by a director, who shall be appointed by the Secretary.
The Secretary shall carry out this section acting through
the Director of the Office.
‘‘(b) ADVICE REGARDING PROGRAMS POLICIES AND
CHANGES.—With respect to current policies on and pro-
posed statutory, regulatory, administrative, and budgetary
changes in Federal health programs, the Director of the
Office shall advise the Secretary on the effects of such
policies and changes on the ability of underserved urban
areas to attract and retain physicians and other health
professionals, and access to (and the quality of) health
care in such areas.
‘‘(c) CLEARINGHOUSE.—The Director of the Office
shall, with respect to underserved urban areas, establish
and maintain a clearinghouse for collecting and dissemi-
nating information on—
‘‘(1) health care issues relating to such areas;
‘‘(2) research findings relating to the health
care needs of such areas; and
‘‘(3) innovative approaches to the delivery of
health care in such areas.
‘‘(d) OTHER DUTIES.—The Director of the Office
shall—
‘‘(1) coordinate activities within the Depart-
ment of Health and Human Services that relate to
health care for residents of underserved urban areas;
and
‘‘(2) provide information to the Secretary and
others in such Department with respect to the activi-
ties of other Federal departments and agencies that
relate to health care for such residents (including ac-
tivities relating to mental health, infant mortality,
occupational safety, and the promotion of preventive
health services).’’.
(b) STATE OFFICES OF URBAN HEALTH.—Subpart
III of part D of title III (42 U.S.C. 254 et seq.) is amend-
ed by adding at the end the following section:
‘‘SEC. 338M. GRANTS TO STATES FOR OPERATION OF OF-
FICES OF URBAN HEALTH.
‘‘(a) IN GENERAL.—The Secretary, acting through
the Director of the Office of Urban Health Policy, may
make grants to States for the purpose of improving health
care in underserved urban areas through the operation of
State offices of urban health.
‘‘(b) REQUIREMENT OF MATCHING FUNDS.—
‘‘(1) IN GENERAL.—With respect to the costs to
be incurred by a State in carrying out the purpose
described in subsection (a), the Secretary may not
make a grant under such subsection unless the State
agrees to provide non-Federal contributions toward
such costs in an amount equal to—
‘‘(A) for the first fiscal year of payments
under the grant, not less than $1 for each $3
of Federal funds provided in the grant;
‘‘(B) for any second fiscal year of such
payments, not less than $1 for each $1 of Fed-
eral funds provided in the grant; and
‘‘(C) for any third fiscal year of such pay-
ments, not less than $3 for each $1 of Federal
funds provided in the grant.
‘‘(2) DETERMINATION
OF
AMOUNT
OF
NON-
FEDERAL CONTRIBUTION.—
‘‘(A) Subject to subparagraph (B), non-
Federal contributions required in paragraph (1)
may be in cash or in kind, fairly evaluated, in-
cluding plant, equipment, or services. Amounts
provided by the Federal Government, or serv-
ices assisted or subsidized to any significant ex-
tent by the Federal Government, may not be in-
cluded in determining the amount of such non-
Federal contributions.
‘‘(B) The Secretary may not make a grant
under subsection (a) unless the State involved
agrees that—
‘‘(i) for the first fiscal year of pay-
ments under the grant, 100 percent or less
of the non-Federal contributions required
in paragraph (1) will be provided in the
form of in-kind contributions;
‘‘(ii) for any second fiscal year of such
payments, not more than 50 percent of
such non-Federal contributions will be pro-
vided in the form of in-kind contributions;
and
‘‘(iii) for any third fiscal year of such
payments, such non-Federal contributions
will be provided solely in the form of cash.
‘‘(c) CERTAIN REQUIRED ACTIVITIES.—The Sec-
retary may not make a grant under subsection (a) unless
the State involved agrees that activities carried out by an
office operated pursuant to such subsection will, with re-
spect to underserved urban areas, include—
‘‘(1) establishing and maintaining within the
State a clearinghouse for collecting and disseminat-
ing information on—
‘‘(A) health care issues relating to such
areas;
‘‘(B) research findings relating to the
health care needs of such areas; and
‘‘(C) innovative approaches to the delivery
of health care in such areas;
‘‘(2) coordinating the activities carried out in
the State that relate to the health care needs in such
areas, including providing coordination for the pur-
pose of avoiding redundancy in such activities; and
‘‘(3) identifying Federal and State programs re-
lating to the health care needs of residents of such
areas, and providing technical assistance to public
and nonprofit private entities regarding participation
in such programs.
‘‘(d) REQUIREMENT REGARDING ANNUAL BUDGET
FOR OFFICE.—The Secretary may not make a grant
under subsection (a) unless the State involved agrees that,
for any fiscal year for which the State receives such a
grant, the office operated pursuant to subsection (a) will
be provided with an annual budget of not less than
$75,000.
‘‘(e) CERTAIN USES OF FUNDS.—
‘‘(1) RESTRICTIONS.—The Secretary may not
make a grant under subsection (a) unless the State
involved agrees that—
‘‘(A) if research with respect to the health
of residents of underserved urban areas is con-
ducted pursuant to the grant, not more than 10
percent of the grant will be expended for such
research; and
‘‘(B) the grant will not be expended—
‘‘(i) to provide health care (including
providing cash payments regarding such
care);
‘‘(ii) to conduct activities for which
Federal funds are expended—
‘‘(I) within the State to provide
technical and other nonfinancial as-
sistance under subsection (f) of sec-
tion 330;
‘‘(II) under a memorandum of
agreement entered into with the State
under subsection (h) of such section;
or
‘‘(III) under a grant under sec-
tion 338I;
‘‘(iii) to purchase medical equipment,
to purchase ambulances, aircraft, or other
vehicles, or to purchase major communica-
tions equipment;
‘‘(iv) to purchase or improve real
property; or
‘‘(v) to carry out any activity regard-
ing a certificate of need.
‘‘(2) AUTHORITIES.—Activities for which a
State may expend a grant under subsection (a) in-
clude—
‘‘(A) paying the costs of establishing an of-
fice of urban health for purposes of subsection
(a);
‘‘(B) subject to paragraph (1)(B)(ii)(III),
paying the costs of any activity carried out with
respect to recruiting and retaining health pro-
fessionals to serve in underserved urban areas
of the State; and
‘‘(C) providing grants and contracts to
public and nonprofit private entities to carry
out activities authorized in this section.
‘‘(f) REPORTS.—The Secretary may not make a
grant under subsection (a) unless the State involved
agrees—
‘‘(1) to submit to the Secretary reports contain-
ing such information as the Secretary may require
regarding activities carried out under this section by
the State; and
‘‘(2) to submit such a report not later than
January 10 of each fiscal year immediately following
any fiscal year for which the State has received such
a grant.
‘‘(g) REQUIREMENT
OF APPLICATION.—The Sec-
retary may not make a grant under subsection (a) unless
an application for the grant is submitted to the Secretary
and the application is in such form, is made in such man-
ner, and contains such agreements, assurances, and infor-
mation as the Secretary determines to be necessary to
carry out such subsection.
‘‘(h) NONCOMPLIANCE.—The Secretary may not
make payments under subsection (a) to a State for any
fiscal year subsequent to the first fiscal year of such pay-
ments unless the Secretary determines that, for the imme-
diately preceding fiscal year, the State has complied with
each of the agreements made by the State under this
section.
‘‘(i) DEFINITIONS.—For purposes of this section, the
term ‘State’ means each of the several States.
‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) IN GENERAL.—For the purpose of making
grants under subsection (a), there are authorized to
be appropriated $3,000,000 for fiscal year 1994,
$4,000,000 for fiscal year 1995, and $3,000,000 for
fiscal year 1996.
‘‘(2) 
AVAILABILITY.—Amounts 
appropriated
under paragraph (1) shall remain available until ex-
pended.
‘‘(k) TERMINATION OF PROGRAM.—No grant may be
made under this section after the aggregate amounts ap-
propriated 
under 
subsection 
(j)(1) 
are 
equal 
to
$10,000,000.’’.
SEC. 503. GRANTS AND CONTRACTS REGARDING ORGAN
AND 
BONE 
MARROW 
TRANSPLANTATION
WITH RESPECT TO MINORITY POPULATIONS.
(a) TRANSPLANTATION OF ORGANS.—Section 371(a)
(42 U.S.C. 273(a)) is amended—
(1) by striking paragraphs (2) and (3); and
(2) by inserting after paragraph (1) the follow-
ing paragraph:
‘‘(2)(A) The Secretary may make grants to, and enter
into contracts with, qualified organ procurement organiza-
tions described in subsection (b) and other public or non-
profit private entities for the purpose of—
‘‘(i) planning and conducting programs to pro-
vide information and education to the public on the
need for organ and tissues donations, with priority
given to such information and education for mem-
bers of racial and ethnic minority groups; and
‘‘(ii) training individuals in requesting such do-
nations.
‘‘(B) In making awards of grants and contracts
under subparagraph (A), the Secretary shall give priority
to carrying out the purpose described in such subpara-
graph with respect to minority populations. For purposes
of complying with the preceding sentence, the Secretary
shall reserve not less than 50 percent of the amounts ap-
propriated for such grants and contracts for a fiscal year.
‘‘(C) In making awards of grants and contracts under
subparagraph (A), the Secretary shall give preference to
community-based organizations.’’.
(b) TRANSPLANTATION OF BONE MARROW.—Part I
of title III (42 U.S.C. 274k et seq.) is amended by insert-
ing after section 379A the following section:
‘‘INFORMATION, EDUCATION, AND TRAINING
‘‘SEC. 379B. (a) IN GENERAL.—The Secretary may
make grants to, and enter into contracts with, public or
nonprofit private entities for the purpose of—
‘‘(1) planning and conducting programs to pro-
vide information and education to the public on the
need for donations of bone marrow, with priority
given to such information and education for mem-
bers of racial and ethnic minority groups; and
‘‘(2) training individuals in requesting such do-
nations.
‘‘(b) PRIORITIES
REGARDING
CERTAIN
ACTIVI-
TIES.—In making awards of grants and contracts under
subsection (a), the Secretary shall give priority to carrying
out the purpose described in such subsection with respect
to minority populations. For purposes of complying with
the preceding sentence, the Secretary shall reserve not less
than 50 percent of the amounts appropriated for such
grants and contracts for a fiscal year.
‘‘(c) PREFERENCES REGARDING CERTAIN APPLI-
CANTS.—In making awards of grants and contracts under
subsection (a), the Secretary shall give preference to com-
munity-based organizations.’’.
SEC. 504. DEMONSTRATION PROJECT GRANTS TO STATES
FOR ALZHEIMER’S DISEASE.
Section 398(a) (42 U.S.C. 280c–3(a)) is amended—
(1) in the matter preceding paragraph (1), by
striking ‘‘not less than 5, and not more than 15,’’;
(2) in paragraph (2)—
(A) by inserting after ‘‘disorders’’ the fol-
lowing: ‘‘who are living in single family homes
or in congregate settings’’; and
(B) by striking ‘‘and’’ at the end;
(3) by redesignating paragraph (3) as para-
graph (4); and
(4) by inserting after paragraph (2) the follow-
ing:
‘‘(3) to improve access for individuals with Alz-
heimer’s disease or related disorders, particularly
such individuals from ethnic, cultural, or language
minorities and such individuals who are living in iso-
lated rural areas, to services that are home-based or
community-based long-term care services; and’’.
SEC. 505. WAIVERS REGARDING OBLIGATED SERVICE IN
PRIMARY HEALTH CARE.
Section 795 (42 U.S.C. 295N) is amended by adding
at the end the following subsection:
‘‘(c) INAPPLICABILITY TO CERTAIN INDIVIDUALS.—
Any obligation under this section regarding training or
practicing in primary health care is waived for individuals
from 
disadvantaged 
backgrounds 
who 
are 
under-
represented in the health professions.’’.
Æ
HR 3699 IH——2
HR 3699 IH——3 HR 3699 [H——4 eHR 3699 TH 57