Sec. 502. Amendment of Native Hawaiian Health Care Improvement Act to re-
flect 1992 agreement.
Sec. 503. Repeal of Public Health Service Act provision.
TITLE VI—WOMEN’S HEALTH
Sec. 601. Establishment of Office of Women’s Health.
Sec. 602. Women’s scientific employment regarding National Institutes of Health.
Sec. 603. Information and education regarding female genital mutilation.
Sec. 604. Study regarding curricula of medical schools and women’s health condi-
tions.
TITLE VII—TRAUMATIC BRAIN INJURY
Sec. 701. Programs of Centers for Disease Control and Prevention.
Sec. 702. Programs of National Institutes of Health.
Sec. 703. Programs of Health Resources and Services Administration.
Sec. 704. Study; consensus conference.
TITLE VIII—MISCELLANEOUS PROVISIONS
Sec. 801. Technical amendment to Indian Health Care Improvement Act.
Sec. 802. Health services for Pacific Islanders.
Sec. 803. Technical corrections regarding Public Law 103–183.
Sec. 804. Certain authorities of Centers for Disease Control and Prevention.
Sec. 805. Establishment of public health analytical laboratory.
Sec. 806. Administration of certain requirements.
Sec. 807. Revisions to eligibility requirements for entities subject to drug pricing
limitations.
TITLE IX—GENERAL PROVISIONS
Sec. 901. Effective date.
TITLE I—OFFICE OF MINORITY
HEALTH
SEC. 101. REVISION AND EXTENSION OF PROGRAMS OF OF-
FICE OF MINORITY HEALTH.
(a) IN GENERAL.—Section 1707 of the Public Health
Service Act (42 U.S.C. 300u–6) is amended by striking sub-
section (b) and all that follows and inserting the following:
‘‘(b) DUTIES.—With respect to improving the health
of minority groups, the Secretary shall carry out the follow-
ing:
‘‘(1) In consultation with the advisory council
under subsection (c), establish goals and objectives re-
garding disease prevention, health promotion, service
delivery, and research, and coordinate all activities
within the Department of Health and Human Serv-
ices that relate to such goals and objectives.
‘‘(2) In consultation with such council, enter
into interagency agreements with other agencies of the
Service, and under such agreements provide amounts
to such agencies, to carry out the following:
‘‘(A) Support research, demonstrations and
evaluations to test new and innovative models of
delivering services.
‘‘(B) Increase knowledge and understanding
of health risk factors.
‘‘(C) Ensure that the National Center for
Health Statistics collects data on the health sta-
tus of each minority group.
‘‘(D) With respect to individuals who lack
proficiency in speaking the English language,
enter into contracts with public and nonprofit
private providers of primary health services for
the purpose of increasing the access of the indi-
viduals to such services by developing and carry-
ing out programs to provide bilingual or inter-
pretive services.
‘‘(3) Establish by contract a center to carry out
the following:
‘‘(A) Facilitate the exchange of information
regarding matters relating to health information
and health promotion, preventive health services,
and education in the appropriate use of health
care.
‘‘(B) Facilitate access to such information.
‘‘(C) Assist in the analysis of issues and
problems relating to such matters.
‘‘(D) Provide technical assistance with re-
spect to the exchange of such information (in-
cluding facilitating the development of materials
for such technical assistance).
‘‘(4)(A) Establish by contract a center for the
purpose of carrying out programs to improve access
to health care services for individuals who lack pro-
ficiency in speaking the English language by develop-
ing and carrying out programs to provide bilingual
or interpretive services.
‘‘(B) In carrying out subparagraph (A), ensure
that—
‘‘(i) the center under such subparagraph
conducts research, develops and evaluates model
projects, and provides technical assistance to
health care providers; and
‘‘(ii) such center is not operated by the en-
tity that operates the center established under
paragraph (3).
‘‘(c) ADVISORY COMMITTEE.—
‘‘(1) IN GENERAL.—The Secretary shall establish
an advisory committee to be known as the Advisory
Committee on Minority Health (in this subsection re-
ferred to as the ‘Committee’).
‘‘(2) DUTIES.—The Committee shall provide ad-
vice to the Secretary on carrying out this section, in-
cluding advice on carrying out paragraphs (1) and
(2) of subsection (b) for each minority group.
‘‘(3) COMPOSITION.—
‘‘(A) The Committee shall be composed of 12
voting members appointed in accordance with
subparagraph (B) and the nonvoting, ex officio
members designated under subparagraph (C).
‘‘(B) The voting members of the Committee
shall be appointed from among individuals who
have expertise regarding the health status of mi-
nority groups and the access of such groups to
health services, which individuals are not officers
or employees of the Federal Government. The ap-
pointed membership of the Committee shall be
broadly representative of the various minority
groups.
‘‘(C) The Secretary shall designate as ex
officio members of the Committee the heads of the
minority health offices referred to in section
1707A.
‘‘(d) APPROPRIATE CONTEXT OF SERVICES.—The Sec-
retary shall ensure that information and services provided
pursuant to subsection (b) are provided in the language and
cultural context that is most appropriate for the individuals
for whom the information and services are intended.
‘‘(e) EQUITABLE ALLOCATION OF SERVICES.—The Sec-
retary shall ensure that services provided under subsection
(b) are equitably allocated among the various minority
groups.
‘‘(f) CONSULTATION
WITH
INDIVIDUAL
MINORITY
HEALTH OFFICES.—In carrying out subsection (b) regard-
ing a specified agency, the Secretary shall consult with the
head of the minority health office of the agency. For pur-
poses of the preceding sentence, the terms ‘specified agency’
and ‘minority health office’ have the meaning given such
terms in section 1707A(f).
‘‘(g) BIENNIAL REPORTS.—Not later than February 1
of fiscal year 1996 and of each second year thereafter, the
Secretary shall submit to the Committee on Energy and
Commerce of the House of Representatives, and to the Com-
mittee on Labor and Human Resources of the Senate, a
report describing the activities carried out under this sec-
tion during the preceding 2 fiscal years and evaluating the
extent to which such activities have been effective in improv-
ing the health of minority groups. Each such report shall
include the biennial reports submitted to the Secretary
under section 1707A(e) for such years by the heads of the
minority health offices.
‘‘(h) DEFINITION.—For purposes of this section, the
term ‘minority groups’ means African Americans, Amer-
ican Indians, Asian Americans, Hispanics, and Pacific Is-
landers.
‘‘(i) FUNDING.—
‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—For
the purpose of carrying out this section, there is au-
thorized to be appropriated $21,000,000 for each of
the fiscal years 1995 through 1997.
‘‘(2) ALLOCATION OF FUNDS BY SECRETARY.—Of
the amounts appropriated under paragraph (1) for a
fiscal year, the Secretary shall make available not less
than 
$3,000,000 
for 
carrying 
out 
subsection
(b)(2)(D).’’.
(b) MISCELLANEOUS AMENDMENT.—Section 1707 of
the Public Health Service Act (42 U.S.C. 300u–6) is
amended in the heading for the section by striking ‘‘ESTAB-
LISHMENT OF’’.
SEC. 102. ESTABLISHMENT OF INDIVIDUAL OFFICES OF MI-
NORITY HEALTH WITHIN AGENCIES OF PUB-
LIC HEALTH SERVICE.
Title XVII of the Public Health Service Act (42 U.S.C.
300u et seq.) is amended by inserting after section 1707
the following section:
‘‘INDIVIDUAL OFFICES OF MINORITY HEALTH WITHIN
PUBLIC HEALTH SERVICE
‘‘SEC. 1707A. (a) IN GENERAL.—The head of each
agency specified in subsection (b)(1) shall establish within
the agency an office to be known as the Office of Minority
Health. Each such Office shall be headed by a director, who
shall be appointed by the head of the agency within which
the Office is established, and who shall report directly to
the head of the agency. The head of such agency shall carry
out this section (as this section relates to the agency) acting
through such Director.
‘‘(b) SPECIFIED AGENCIES.—
‘‘(1) IN GENERAL.—The agencies referred to in
subsection (a) are the following:
‘‘(A) The Centers for Disease Control and
Prevention.
‘‘(B) The Agency for Health Care Policy
and Research.
‘‘(C) The Health Resources and Services Ad-
ministration.
‘‘(D) The Substance Abuse and Mental
Health Services Administration.
‘‘(2) NATIONAL
INSTITUTES
OF
HEALTH.—For
purposes of subsection (c) and the subsequent provi-
sions of this section, the term ‘minority health office’’
includes the Office of Research on Minority Health es-
tablished within the National Institutes of Health.
The Director of the National Institutes of Health shall
carry out this section (as this section relates to the
agency) acting through the Director of such Office.
‘‘(c) COMPOSITION.—The head of each specified agency
shall ensure that the officers and employees of the minority
health office of the agency are, collectively, experienced in
carrying out community-based health programs for each of
the various minority groups that are present in significant
numbers in the United States. The head of such agency shall
ensure that, of such officers and employees who are members
of minority groups, no such group is disproportionately
represented.
‘‘(d) DUTIES.—Each Director of a minority health of-
fice shall monitor the programs of the specified agency of
such office in order to—
‘‘(1) determine the extent to which the purposes
of the programs are being carried out with respect to
minority groups;
‘‘(2) determine the extent to which members of
such groups are represented among the Federal offi-
cers and employees who administer the programs; and
‘‘(3) make recommendations to the head of such
agency on carrying out the programs with respect to
such groups.
‘‘(e) BIENNIAL REPORTS TO SECRETARY.—The head of
each specified agency shall submit to the Secretary for in-
clusion in each biennial report under section 1707(g) (with-
out change) a biennial report describing—
‘‘(1) the extent to which the minority health of-
fice of the agency employs individuals who are mem-
bers of minority groups, including a specification by
minority group of the number of such individuals em-
ployed by such office; and
‘‘(2) the manner in which the agency is comply-
ing with Public Law 94–311 (relating to data on
Americans of Spanish origin or descent).
‘‘(f) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘minority health office’ means an
office established under subsection (a), subject to sub-
section (b)(2).
‘‘(2) The term ‘minority group’ has the meaning
given such term in section 1707(h).
‘‘(3) The term ‘specified agency’ means—
‘‘(A) an agency specified in subsection
(b)(1); and
‘‘(B) the National Institutes of Health.
‘‘(g) FUNDING.—
‘‘(1) ALLOCATIONS.—Of the amounts appro-
priated for a specified agency for a fiscal year, the
Secretary may reserve not more than 0.5 percent for
the purpose of carrying out activities under this sec-
tion through the minority health office of the agency.
In reserving an amount under the preceding sentence
for a minority health office for a fiscal year, the Sec-
retary shall reduce, by substantially the same percent-
age, the amount that otherwise would be available for
each of the programs of the designated agency in-
volved.
‘‘(2) AVAILABILITY OF FUNDS FOR STAFFING.—
The purposes for which amounts made available
under paragraph (1) may be expended by a minority
health office include the costs of employing staff for
such office.’’.
TITLE II—PRIMARY HEALTH
SERVICES
SEC. 
201. 
MIGRANT 
HEALTH 
CENTERS; 
COMMUNITY
HEALTH CENTERS.
(a) MIGRANT HEALTH CENTERS.—
(1) TREATMENT OF PREGNANT WOMEN FOR SUB-
STANCE ABUSE.—Section 329(a) of the Public Health
Service Act (42 U.S.C. 254b(a)) is amended—
(A) in paragraph (1)(C)—
(i) by inserting ‘‘(i)’’ after ‘‘(C)’’;
(ii) in clause (i) (as so designated), by
adding ‘‘and’’ after the comma at the end;
and
(iii) by adding at the end the following
clause:
‘‘(ii) to the State official responsible for carrying
out programs under subpart II of part B of title XIX,
and in accordance with the provisions of section 543
regarding the disclosure of information, a notification
if a pregnant woman is provided a referral for the
treatment of substance abuse but the entity involved
does not have the capacity to admit additional indi-
viduals for treatment,’’; and
(B) in paragraph (7)—
(i) in subparagraph (L), by striking
‘‘and’’ at the end;
(ii) by redesignating subparagraph
(M) as subparagraph (N); and
(iii) by inserting after subparagraph
(L) the following subparagraph:
‘‘(M) treatment of pregnant women for substance
abuse; and’’.
(2) OVERLAP
IN
CATCHMENT
AREAS.—Section
329(a) of the Public Health Service Act (42 U.S.C.
254b(a)) is amended by adding at the end the follow-
ing paragraph:
‘‘(8) In making grants under subsections (c)(1) and
(d)(1), the Secretary may provide for the development and
operation of more than one migrant health center in a
catchment area in any case in which the Secretary deter-
mines that in such area there are workers or other individ-
uals described in subsection (a)(1) (in the matter after and
below subparagraph (H)) who otherwise will have a short-
age of personal health services. The preceding sentence may
not be construed as requiring that, in such a case, the
catchment areas of the centers involved be identical.’’.
(3) OFFSITE ACTIVITIES.—Section 329(a) of the
Public Health Service Act, as amended by paragraph
(2) of this subsection, is amended by adding at the
end the following paragraph:
‘‘(9) In making grants under this section, the Sec-
retary may, to the extent determined by the Secretary to
be appropriate, authorize migrant health centers to provide
services at locations other than the center.’’.
(4) AMOUNT
OF
GRANT; 
USE
OF
CERTAIN
FUNDS.—Section 329(d)(4) of the Public Health Serv-
ice Act (42 U.S.C. 254b(d)(4)) is amended to read as
follows:
‘‘(4)(A) The amount of a grant under paragraph (1)
or under subsection (c) for a migrant health center shall
be determined by the Secretary, taking into account (for
the period for which the grant is made)—
‘‘(i) the costs that the center may reasonably be
expected to incur in carrying out the plan approved
by the Secretary pursuant to subsection (f)(3)(H),
and
‘‘(ii) the amounts that the center may reasonably
be expected to receive as State, local, and other oper-
ational funding (exclusive of amounts to be provided
in the grant under this section) and as fees, pre-
miums, and third-party reimbursements.
‘‘(B)(i) Subject to clause (ii), the Secretary may not
restrict the purposes for which a migrant health center ex-
pends the amounts described in subparagraph (A)(ii) (in-
cluding restrictions imposed pursuant to Federal cost prin-
ciples).
‘‘(ii) The Secretary may require that amounts de-
scribed in subparagraph (A)(ii) be expended for purposes
that are consistent with the purposes specified in this sec-
tion.
‘‘(C)(i) Payments under a grant under this section
shall be made in advance or by way of reimbursement and
in such installments as the Secretary finds necessary. Ad-
justments in such payments may be made for overpayments
or underpayments, subject to clause (ii).
‘‘(ii) If, for the period for which a grant is made under
paragraph (1) to a migrant health center, the sum of the
amount of the grant and the amounts described in subpara-
graph (A)(ii) that the center actually received exceeded the
costs of the center in carrying out the plan approved by
the Secretary pursuant to subsection (f)(3)(H), then the cen-
ter is entitled to retain such excess amount if the center
agrees to expend such amount only for the following pur-
poses:
‘‘(I) To expand and improve services.
‘‘(II) To increase the number of persons served.
‘‘(III) To acquire, modernize, or expand facili-
ties, or to construct facilities.
‘‘(IV) To improve the administration of service
programs.
‘‘(V) To establish financial reserves.
‘‘(D) With respect to funds that are amounts described
in subparagraph (A)(ii) or excess amounts described in sub-
paragraph (C)(ii), this paragraph may not be construed as
limiting the authority of the Secretary to require the sub-
mission of such plans, budgets, and other information as
may be necessary to ensure that the funds are expended in
accordance with subparagraph (B)(ii), or clauses (I)
through (V) of subparagraph (C)(ii), respectively.’’.
(5) AUTHORIZATION OF APPROPRIATIONS.—Sec-
tion 329(h) of the Public Health Service Act (42
U.S.C. 254b(h)) is amended—
(A) in paragraph (1)(A), by striking
‘‘1994’’ and inserting ‘‘1998’’; and
(B) in paragraph (2)(A), by striking
‘‘1994’’ and inserting ‘‘1998’’.
(b) COMMUNITY HEALTH CENTERS.—
(1) TREATMENT OF PREGNANT WOMEN FOR SUB-
STANCE ABUSE.—Section 330 of the Public Health
Service Act (42 U.S.C. 254c) is amended—
(A) in subsection (a)(3)—
(i) by inserting ‘‘(A)’’ after ‘‘(3)’’;
(ii) in subparagraph (A) (as so des-
ignated), by adding ‘‘and’’ after the comma
at the end; and
(iii) by adding at the end the following
subparagraph:
‘‘(B) to the State official responsible for carrying
out programs under subpart II of part B of title XIX,
and in accordance with the provisions of section 543
regarding the disclosure of information, a notification
if a pregnant woman is provided a referral for the
treatment of substance abuse but the entity involved
does not have the capacity to admit additional indi-
viduals for treatment,’’; and
(B) in subsection (b)(2)—
(i) in subparagraph (L), by striking
‘‘and’’ at the end;
(ii) by redesignating subparagraph
(M) as subparagraph (N); and
(iii) by inserting after subparagraph
(L) the following subparagraph:
‘‘(M) treatment of pregnant women for substance
abuse; and’’.
(2) OVERLAP
IN
CATCHMENT
AREAS.—Section
330(b) of the Public Health Service Act (42 U.S.C.
254c(b)) is amended by adding at the end the follow-
ing paragraph:
‘‘(7) In making grants under subsections (c)(1) and
(d)(1), the Secretary may provide for the development and
operation of more than one community health center in a
catchment area in any case in which the Secretary deter-
mines that there is a population group in such area that
otherwise will have a shortage of personal health services.
The preceding sentence may not be construed as requiring
that, in such a case, the catchment areas of the centers in-
volved be identical.’’.
(3) OFFSITE ACTIVITIES.—Section 330(b) of the
Public Health Service Act, as amended by paragraph
(2) of this subsection, is amended by adding at the
end the following paragraph:
‘‘(8) In making grants under this section, the Sec-
retary may, to the extent determined by the Secretary to
be appropriate, authorize community health centers to pro-
vide services at locations other than the center.’’.
(4) AMOUNT
OF
GRANT; 
USE
OF
CERTAIN
FUNDS.—Section 330(d)(4) of the Public Health Serv-
ice Act (42 U.S.C. 254c(d)(4)) is amended to read as
follows:
‘‘(4)(A) The amount of a grant under paragraph (1)
or under subsection (c) for a community health center shall
be determined by the Secretary, taking into account (for
the period for which the grant is made)—
‘‘(i) the costs that the center may reasonably be
expected to incur in carrying out the plan approved
by the Secretary pursuant to subsection (e)(3)(H),
and
‘‘(ii) the amounts that the center may reasonably
be expected to receive as State, local, and other oper-
ational funding (exclusive of amounts to be provided
in the grant under this section) and as fees, pre-
miums, and third-party reimbursements.
‘‘(B)(i) Subject to clause (ii), the Secretary may not
restrict the purposes for which a community health center
expends the amounts described in subparagraph (A)(ii) (in-
cluding restrictions imposed pursuant to Federal cost prin-
ciples).
‘‘(ii) The Secretary may require that amounts de-
scribed in subparagraph (A)(ii) be expended for purposes
that are consistent with the purposes specified in this sec-
tion.
‘‘(C)(i) Payments under a grant under this section
shall be made in advance or by way of reimbursement and
in such installments as the Secretary finds necessary. Ad-
justments in such payments may be made for overpayments
or underpayments, subject to clause (ii).
‘‘(ii) If, for the period for which a grant is made under
paragraph (1) to a community health center, the sum of
the amount of the grant and the amounts described in sub-
paragraph (A)(ii) that the center actually received exceeded
the costs of the center in carrying out the plan approved
by the Secretary pursuant to subsection (e)(3)(H), then the
center is entitled to retain such excess amount if the center
agrees to expend such amount only for the following pur-
poses:
‘‘(I) To expand and improve services.
‘‘(II) To increase the number of persons served.
‘‘(III) To acquire, modernize, or expand facili-
ties, or to construct facilities.
‘‘(IV) To improve the administration of service
programs.
‘‘(V) To establish financial reserves.
‘‘(D) With respect to funds that are amounts described
in subparagraph (A)(ii) or excess amounts described in sub-
paragraph (C)(ii), this paragraph may not be construed as
limiting the authority of the Secretary to require the sub-
mission of such plans, budgets, and other information as
may be necessary to ensure that the funds are expended in
accordance with subparagraph (B)(ii), or clauses (I)
through (V) of subparagraph (C)(ii), respectively.’’.
(5) AUTHORIZATION OF APPROPRIATIONS.—Sec-
tion 330(g) of the Public Health Service Act (42
U.S.C. 254c(g)) is amended—
(A) in paragraph (1)(A), by striking
‘‘1994’’ and inserting ‘‘1998’’; and
(B) in paragraph (2)(A), by striking
‘‘1994’’ and inserting ‘‘1998’’.
SEC. 202. HEALTH SERVICES FOR THE HOMELESS.
Section 340(q)(1) of the Public Health Service Act (42
U.S.C. 256(q)(1)) is amended by striking ‘‘and 1994’’ and
inserting ‘‘through 1998’’.
SEC. 203. HEALTH SERVICES FOR RESIDENTS OF PUBLIC
HOUSING.
Section 340A(p)(1) of the Public Health Service Act
(42 U.S.C. 256a(p)(1)) is amended by striking ‘‘and 1993’’
and inserting ‘‘through 1998’’.
SEC. 204. GRANTS TO STATES FOR LOAN REPAYMENT PRO-
GRAMS REGARDING OBLIGATED SERVICE OF
HEALTH PROFESSIONALS.
Section 338I(c) of the Public Health Service Act (42
U.S.C. 254q–1(c)) is amended by adding at the end the fol-
lowing paragraph:
‘‘(4) PRIVATE PRACTICE.—
‘‘(A) In carrying out the program operated
with a grant under subsection (a), a State may
waive the requirement of paragraph (1) regard-
ing the assignment of a health professional if,
subject to subparagraph (B), the health profes-
sional enters into an agreement with the State to
provide primary health services in a full-time
private clinical practice in a health professional
shortage area.
‘‘(B) The Secretary may not make a grant
under subsection (a) unless the State involved
agrees that, if the State provides a waiver under
subparagraph (A) for a health professional, sec-
tion 338D(b)(1) will apply to the agreement
under such subparagraph between the State and
the health professional to the same extent and in
the same manner as such section applies to an
agreement between the Secretary and a health
professional regarding a full-time private clini-
cal practice.’’.
SEC. 205. GRANTS TO STATES FOR OPERATION OF STATE
OFFICES OF RURAL HEALTH.
Section 338J of the Public Health Service Act (42
U.S.C. 254r) is amended—
(1) in subsection (b)(1), in the matter preceding
subparagraph (A), by striking ‘‘in cash’’; and
(2) in subsection (j)(1)—
(A) by striking ‘‘and’’ after ‘‘1992,’’; and
(B) by inserting before the period the follow-
ing: ‘‘, and such sums as may be necessary for
each of the fiscal years 1995 through 1997’’.
SEC. 206. DEMONSTRATION GRANTS TO STATES FOR COM-
MUNITY SCHOLARSHIP PROGRAMS REGARD-
ING OBLIGATED SERVICE OF HEALTH PRO-
FESSIONALS.
Section 338L of the Public Health Service Act (42
U.S.C. 254t) is amended—
(1) by striking ‘‘health manpower shortage’’ each
place such term appears and inserting ‘‘health profes-
sional shortage’’;
(2) in subsection (e)—
(A) by striking paragraph (1);
(B) 
by 
redesignating 
paragraphs 
(2)
through (6) as paragraphs (1) through (5), re-
spectively; and
(C) in paragraph (1) (as so redesignated),
by inserting after ‘‘the individual’’ the following:
‘‘who is to receive the scholarship under the con-
tract’’;
(3) in subsection (k)(2), by striking ‘‘internal
medicine, pediatrics,’’ and inserting ‘‘general internal
medicine, general pediatrics,’’; and
(4) in subsection (l)(1)—
(A) by striking ‘‘and’’ after ‘‘1992,’’; and
(B) by inserting before the period the follow-
ing: ‘‘, and such sums as may be necessary for
each of the fiscal years 1995 through 1997’’.
SEC. 207. PROGRAMS REGARDING BIRTH DEFECTS.
Section 317C of the Public Health Service Act (42
U.S.C. 247b–4) is amended to read as follows:
‘‘PROGRAMS REGARDING BIRTH DEFECTS
‘‘SEC. 317C. (a) The Secretary, acting through the Di-
rector of the Centers for Disease Control and Prevention,
shall carry out programs—
‘‘(1) to collect, analyze, and make available data
on birth defects (in a manner that facilitates compli-
ance with subsection (d)(2)), including data on the
causes of such defects and on the incidence and preva-
lence of such defects;
‘‘(2) to support primary birth-defect prevention,
including information and education to the public on
the prevention of such defects;
‘‘(3) to improve the education, training, and
clinical skills of health professionals with respect to
the prevention of such defects;
‘‘(4) to carry out demonstration projects for the
prevention of such defects; and
‘‘(5) to operate regional centers for the conduct
of applied epidemiological research on the prevention
of such defects.
‘‘(b) ADDITIONAL PROVISIONS REGARDING COLLEC-
TION OF DATA.—
‘‘(1) IN GENERAL.—In carrying out subsection
(a)(1), the Secretary—
‘‘(A) shall collect and analyze data by gen-
der and by racial and ethnic group, including
Hispanics, non-Hispanic whites, African Ameri-
cans, Native Americans, Asian Americans, and
Pacific Islanders;
‘‘(B) shall collect data under subparagraph
(A) from birth certificates, death certificates, hos-
pital records, and such other sources as the Sec-
retary determines to be appropriate; and
‘‘(C) shall encourage States to establish or
improve programs for the collection and analysis
of epidemiological data on birth defects, and to
make the data available.
‘‘(2) NATIONAL
CLEARINGHOUSE.—In carrying
out subsection (a)(1), the Secretary shall establish and
maintain a National Information Clearinghouse on
Birth Defects to collect and disseminate to health pro-
fessionals and the general public information on birth
defects, including the prevention of such defects.
‘‘(c) GRANTS AND CONTRACTS.—
‘‘(1) IN GENERAL.—In carrying out subsection
(a), the Secretary may make grants to and enter into
contracts with public and nonprofit private entities.
‘‘(2) SUPPLIES
AND
SERVICES
IN
LIEU
OF
AWARD FUNDS.—
‘‘(A) Upon the request of a recipient of an
award of a grant or contract under paragraph
(1), the Secretary may, subject to subparagraph
(B), provide supplies, equipment, and services
for the purpose of aiding the recipient in carry-
ing out the purposes for which the award is
made and, for such purposes, may detail to the
recipient any officer or employee of the Depart-
ment of Health and Human Services.
‘‘(B) With respect to a request described in
subparagraph (A), the Secretary shall reduce the
amount of payments under the award involved
by an amount equal to the costs of detailing per-
sonnel and the fair market value of any supplies,
equipment, or services provided by the Secretary.
The Secretary shall, for the payment of expenses
incurred in complying with such request, expend
the amounts withheld.
‘‘(3) APPLICATION FOR AWARD.—The Secretary
may make an award of a grant or contract under
paragraph (1) only if an application for the award
is submitted to the Secretary and the application is
in such form, is made in such manner, and contains
such agreements, assurances, and information as the
Secretary determines to be necessary to carry out the
purposes for which the award is to be made.
‘‘(d) BIENNIAL REPORT.—Not later than February 1
of fiscal year 1995 and of every second such year thereafter,
the Secretary shall submit to the Committee on Energy and
Commerce of the House of Representatives, and the Commit-
tee on Labor and Human Resources of the Senate, a report
that, with respect to the preceding 2 fiscal years—
‘‘(1) contains information regarding the inci-
dence and prevalence of birth defects and the extent
to which birth defects have contributed to the inci-
dence and prevalence of infant mortality;
‘‘(2) contains information under paragraph (1)
that is specific to various racial and ethnic groups
(including Hispanics, non-Hispanic whites, African
Americans, Native Americans, and Asian Americans);
‘‘(3) contains an assessment of the extent to
which various approaches of preventing birth defects
have been effective;
‘‘(4) describes the activities carried out under
this section; and
‘‘(5) contains any recommendations of the Sec-
retary regarding this section.
‘‘(e) 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 1995 through 1997.’’.
SEC. 208. HEALTHY START FOR INFANTS.
(a) TECHNICAL CORRECTION REGARDING AMEND-
ATORY INSTRUCTIONS.—Part D of title III of the Public
Health Service Act (42 U.S.C 254b et seq.), as amended
by section 104 of Public Law 103–183 (107 Stat. 2230),
is amended in the heading for subpart VIII by striking
‘‘Bulk’’ and all that follows and inserting the following:
‘‘Miscellaneous Provisions Regarding Primary Health
Care’’. The amendment made by the preceding sentence is
deemed to have taken effect immediately after the enactment
of Public Law 103–183.
(b) HEALTHY START FOR INFANTS.—Part D of title
III of the Public Health Service Act, as amended by sub-
section (a) of this section, is amended by adding at the end
of subpart VIII the following section:
‘‘HEALTHY START FOR INFANTS
‘‘SEC. 340E. (a) GRANTS FOR COMPREHENSIVE SERV-
ICES.—
‘‘(1) IN
GENERAL.—The Secretary may make
grants for the operation of not more than 19 dem-
onstration projects to provide the services described in
subsection (b) for the purpose of reducing, in the geo-
graphic areas in which the projects are carried out—
‘‘(A) the incidence of infant mortality and
morbidity;
‘‘(B) the incidence of fetal deaths;
‘‘(C) the incidence of maternal mortality;
‘‘(D) the incidence of fetal alcohol syn-
drome; and
‘‘(E) the incidence of low-birthweight births.
‘‘(2) ACHIEVEMENT OF YEAR 2000 HEALTH STA-
TUS OBJECTIVES.—With respect to the objectives es-
tablished by the Secretary for the health status of the
population of the United States for the year 2000, the
Secretary shall, in providing for a demonstration
project under paragraph (1) in a geographic area,
seek to meet the objectives that are applicable to the
purpose described in such paragraph and the popu-
lations served by the project.
‘‘(b) AUTHORIZED SERVICES.—
‘‘(1) IN GENERAL.—Subject to subsection (h), the
services referred to in this subsection are comprehen-
sive services (including preventive and primary
health services for pregnant women and infants and
childhood immunizations in accordance with the
schedule recommended by the Secretary) for carrying
out the purpose described in subsection (a), including
services other than health services.
‘‘(2) CERTAIN PROVIDERS.—The Secretary may
make a grant under subsection (a) only if the appli-
cant involved agrees that, in making any arrange-
ments under which other entities provide authorized
services in the demonstration project involved, the ap-
plicant will include among the entities with which the
arrangements are made grantees under any of sec-
tions 329, 330, 340, and 340A, if such grantees are
providing services in the service area of such project
and the grantees are willing to make such arrange-
ments with the applicant.
‘‘(c) ELIGIBLE GEOGRAPHIC AREAS.—The Secretary
may make a grant under subsection (a) only if—
‘‘(1) the applicant for the grant specifies the geo-
graphic area in which the demonstration project
under such subsection is to be carried out and agrees
that the project will not be carried out in other areas;
and
‘‘(2) for the fiscal year preceding the first fiscal
year for which the applicant is to receive such a
grant, the rate of infant mortality in the geographic
area equals or exceeds 150 percent of the national av-
erage in the United States of such rates.
‘‘(d) MINIMUM QUALIFICATIONS OF GRANTEES.—
‘‘(1) PUBLIC
OR
NONPROFIT
PRIVATE
ENTI-
TIES.—The Secretary may make a grant under sub-
section (a) only if the applicant for the grant is a
State or local department of health, or other public or
nonprofit private entity, or a consortium of public or
nonprofit private entities.
‘‘(2) APPROVAL OF POLITICAL SUBDIVISIONS.—
With respect to a proposed demonstration project
under subsection (a), the Secretary may make a grant
under such subsection only if—
‘‘(A) the chief executive officer of each polit-
ical subdivision in the service area of such
project approves the applicant for the grant as
being qualified to carry out the project; and
‘‘(B) the leadership of any Indian tribe or
tribal organization with jurisdiction over any
portion of such area so approves the applicant.
‘‘(3) STATUS AS MEDICAID PROVIDER.—
‘‘(A) In the case of any service described in
subsection (b) that is available pursuant to the
State plan approved under title XIX of the So-
cial Security Act for a State in which a dem-
onstration project under subsection (a) is carried
out, the Secretary may make a grant under such
subsection for the project only if, subject to sub-
paragraph (B)—
‘‘(i) the applicant for the grant will
provide the service directly, and the appli-
cant has entered into a participation agree-
ment under the State plan and is qualified
to receive payments under such plan; or
‘‘(ii) the applicant will enter into an
agreement with a public or private entity
under which the entity will provide the
service, and the entity has entered into such
a participation agreement under the State
plan and is qualified to receive such pay-
ments.
‘‘(B)(i) In the case of an entity making an
agreement pursuant to subparagraph (A)(ii) re-
garding the provision of services, the requirement
established in such subparagraph regarding a
participation agreement shall be waived by the
Secretary if the entity does not, in providing
health care services, impose a charge or accept
reimbursement available from any third-party
payor, including reimbursement under any in-
surance policy or under any Federal or State
health benefits plan.
‘‘(ii) A determination by the Secretary of
whether an entity referred to in clause (i) meets
the criteria for a waiver under such clause shall
be made without regard to whether the entity ac-
cepts voluntary donations regarding the provi-
sion of services to the public.
‘‘(e) STATE APPROVAL OF PROJECT.—With respect to
a proposed demonstration project under subsection (a), the
Secretary may make a grant under such subsection to the
applicant involved only if—
‘‘(1) the chief executive officer of the State in
which the project is to be carried out approves the
proposal of the applicant for carrying out the project;
and
‘‘(2) the leadership of any Indian tribe or tribal
organization with jurisdiction over any portion of the
service area of the project so approves the proposal.
‘‘(f) ELIGIBILITY
FOR SERVICES PROVIDED WITH
GRANT FUNDS.—The Secretary may make a grant under
subsection (a) only if the applicant involved agrees as fol-
lows:
‘‘(1) With respect to any authorized service
under subsection (b), if the service is a service that the
State involved is required or has elected to provide
under title XIX of the Social Security Act, the grant
will not be expended to provide the service to any in-
dividual to whom the State is required or has elected
under such title to provide the service.
‘‘(2) The grant will not be expended to make
payment for any item or service to the extent that
payment has been made, or can reasonably be ex-
pected to be made, with respect to such item or serv-
ice—
‘‘(A) under a health insurance policy or
plan (including a group health plan or a pre-
paid health plan);
‘‘(B) under any Federal or State health ben-
efits program, including any program under
title V, XVIII, or XIX of the Social Security Act;
or
‘‘(C) under subpart II of part B of title XIX
of this Act.
‘‘(g) MAINTENANCE OF EFFORT.—
‘‘(1) GRANTEE.—With respect to authorized serv-
ices under subsection (b), the Secretary may make a
grant under subsection (a) only if the applicant in-
volved agrees to maintain expenditures of non-Federal
amounts for such services at a level that is not less
than the level of such expenditures maintained by the
applicant for fiscal year 1991.
‘‘(2) RELEVANT POLITICAL SUBDIVISIONS.—With
respect to authorized services under subsection (b), the
Secretary may make a grant under subsection (a)
only if each political subdivision in the service area
of the demonstration project involved agrees to main-
tain expenditures of non-Federal amounts for such
services at a level that is not less than the level of
such expenditures maintained by the political sub-
division for fiscal year 1991.
‘‘(h) RESTRICTIONS ON EXPENDITURE OF GRANT.—
‘‘(1) IN GENERAL.—Except as provided in para-
graph (3), the Secretary may make a grant under
subsection (a) only if the applicant involved agrees
that the grant will not be expended—
‘‘(A) to provide inpatient services, except
with respect to residential treatment for sub-
stance abuse provided in settings other than hos-
pitals;
‘‘(B) to make cash payments to intended re-
cipients of health services or mental health serv-
ices; or
‘‘(C) to purchase or improve real property
(other than minor remodeling of existing im-
provements to real property) or to purchase
major medical equipment (other than mobile
medical units for providing ambulatory prenatal
services).
‘‘(2) ADMINISTRATIVE EXPENSES; DATA COLLEC-
TION.—The Secretary may make a grant under sub-
section (a) only if the applicant involved agrees that
not more than an aggregate 10 percent of the grant
will be expended for administering the grant and the
collection and analysis of data.
‘‘(3) WAIVER.—If the Secretary finds that the
purpose described in subsection (a) cannot otherwise
be carried out, the Secretary may, with respect to an
otherwise qualified applicant, waive the restriction es-
tablished in paragraph (1)(C).
‘‘(i) 
DETERMINATION
OF
CAUSE
OF
INFANT
DEATHS.—The Secretary may make a grant under sub-
section (a) only if the applicant involved—
‘‘(1) agrees to provide for a determination of the
cause of each infant death in the service area of the
demonstration project involved; and
‘‘(2) the applicant has made such arrangements
with public entities as may be necessary to carry out
paragraph (1).
‘‘(j) ANNUAL REPORTS
TO SECRETARY.—The Sec-
retary may make a grant under subsection (a) only if the
applicant involved agrees that, for each fiscal year for
which the applicant operates a demonstration project under
such subsection the applicant will, not later than April 1
of the subsequent fiscal year, submit to the Secretary a re-
port providing the following information with respect to the
project:
‘‘(1) The number of individuals that received au-
thorized services, and the demographic characteristics
of the population of such individuals.
‘‘(2) The types of authorized services provided,
including the types of ambulatory prenatal services
provided and the trimester of the pregnancy in which
the services were provided.
‘‘(3) The sources of payment for the authorized
services provided.
‘‘(4) The extent to which children under age 2 re-
ceiving authorized services have received the appro-
priate number and variety of immunizations against
vaccine-preventable diseases.
‘‘(5) An analysis of the causes of death deter-
mined under subsection (i).
‘‘(6) The extent of progress being made toward
meeting the health status objectives specified in sub-
section (a)(2).
‘‘(7) The extent to which, in the service area in-
volved, progress is being made toward meeting the
participation goals established for the State by the
Secretary under section 1905(r) of the Social Security
Act (relating to early periodic screening, diagnostic,
and treatment services for children under the age of
21).
‘‘(k) COMMUNITY PARTICIPATION.—The Secretary may
make a grant under subsection (a) only if the applicant
involved agrees that, in preparing the proposal of the appli-
cant for the demonstration project involved, and in the op-
eration of the project, the applicant will consult with the
residents of the service area for the project and with public
and nonprofit private entities that provide authorized serv-
ices to such residents.
‘‘(l) APPLICATION FOR GRANT.—The Secretary may
make a grant under subsection (a) only if an application
for the grant is submitted to the Secretary and the applica-
tion is in such form, is made in such manner, and contains
such agreements, assurances, and information as the Sec-
retary determines to be necessary to carry out this sub-
section.
‘‘(m) REPORT TO CONGRESS.—Not later than Feb-
ruary 1, 1998, the Secretary shall submit to the Committee
on Energy and Commerce of the House of Representatives,
and the Committee on Labor and Human Resources of the
Senate, a report—
‘‘(1) summarizing the reports received by the
Secretary under subsection (j);
‘‘(2) describing the extent to which the Secretary
has, in the service areas of such projects, been success-
ful in meeting the health status objectives specified in
subsection (a)(2); and
‘‘(3) describing the extent to which demonstra-
tion projects under subsection (a) have been cost effec-
tive.
‘‘(n) LIMITATION ON CERTAIN EXPENSES OF SEC-
RETARY.—Of the amounts appropriated under subsection
(p) for a fiscal year, the Secretary may not obligate more
than an aggregate 5 percent for the administrative costs
of the Secretary in carrying out this section, for the provi-
sion of technical assistance regarding demonstration
projects under subsection (a), and for evaluations of such
projects.
‘‘(o) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘authorized services’ means the
services specified in subsection (b).
‘‘(2) The terms ‘Indian tribe’ and ‘tribal organi-
zation’ have the meaning given such terms in section
4(b) and section 4(c) of the Indian Self-Determina-
tion and Education Assistance Act.
‘‘(3) The term ‘service area’, with respect to a
demonstration project under subsection (a), means the
geographic area specified in subsection (c).
‘‘(p) 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 1995 through 1997.
‘‘(q) SUNSET.—Effective October 1, 1997, this section
is repealed.’’.
(b) CERTAIN PROVISIONS REGARDING REPORTS.—
(1) FISCAL YEAR 1995.—With respect to grants
under section 340E of the Public Health Service Act
(as added by subsection (b) of this section), the Sec-
retary of Health and Human Services may make a
grant under such section for fiscal year 1995 only if
the applicant for the grant agrees to submit to the
Secretary, not later than April 1 of such year, a re-
port on any federally-supported project of the appli-
cant that is substantially similar to the demonstra-
tion projects authorized in such section 340E, which
report provides, to the extent practicable, the informa-
tion described in subsection (j) of such section.
(2) FISCAL YEAR 1997.—With respect to grants
for fiscal year 1997 under section 340E of the Public
Health Service Act (as added by subsection (b) of this
section), the requirement under subsection (j) of such
section that a report be submitted not later than
April 1, 1998, remains in effect notwithstanding the
repeal of such section pursuant to subsection (q) of
such section.
(c) LAPSE OF FUNDS.—Effective October 1, 1997, all
unexpended portions of amounts appropriated for grants
under 340E of the Public Health Service Act (as added by
subsection (b) of this section) are unavailable for obligation
or expenditure, without regard to whether the amounts have
been received by the grantees involved.
(d) USE OF GENERAL AUTHORITY UNDER PUBLIC
HEALTH SERVICE ACT.—With respect to the program es-
tablished in section 340E of the Public Health Service Act
(as added by subsection (b) of this section), section 301 of
such Act may not be construed as providing to the Secretary
of Health and Human Services any authority to carry out,
during any fiscal year in which such program is in oper-
ation, any demonstration project to provide any of the serv-
ices specified in subsection (b) of such section 340E.
SEC. 209. DEMONSTRATION PROJECTS REGARDING DIA-
BETIC-RETINOPATHY.
(a) IN GENERAL.—The Secretary of Health and
Human Services, acting through the Director of the Centers
for Disease Control and Prevention and in consultation
with the Director of the National Eye Institute, may make
grants to public and nonprofit private entities for dem-
onstration projects to serve the populations specified in sub-
section (b) by carrying out, with respect to the eye disorder
known as diabetic retinopathy, activities regarding infor-
mation, identification, dissemination, education, and pre-
vention.
(b) RELEVANT POPULATIONS.—The populations re-
ferred to in subsection (a) are minority populations that
are at significant risk of contracting diabetes mellitus.
(c) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there is authorized to
be appropriated $1,000,000 for each of the fiscal years 1995
through 1997.
TITLE III—HEALTH
PROFESSIONS PROGRAMS
SEC. 301. PRIMARY CARE SCHOLARSHIPS FOR STUDENTS
FROM DISADVANTAGED BACKGROUNDS.
(a) IN GENERAL.—Section 736 of the Public Health
Service Act (42 U.S.C. 293) is amended to read as follows:
‘‘SEC. 736. PRIMARY CARE SCHOLARSHIPS FOR STUDENTS
FROM DISADVANTAGED BACKGROUNDS.
‘‘(a) IN GENERAL.—The Secretary may in accordance
with this section award scholarships to individuals de-
scribed in subsection (b) for the purpose of assisting the in-
dividuals with the costs of attending schools of medicine or
osteopathic medicine, schools of dentistry, schools of nursing
(as defined in section 853), graduate programs in mental
health practice, and programs for the training of physician
assistants.
‘‘(b) ELIGIBLE INDIVIDUALS.—An individual referred
to in subsection (a) is any individual meeting the following
conditions:
‘‘(1) The individual is from a disadvantaged
background.
‘‘(2) The individual is enrolled (or accepted for
enrollment) at an eligible school as a full-time student
in a program leading to a degree in a health profes-
sion.
‘‘(3) The individual enters into the contract re-
quired pursuant to subsection (d) as a condition of
receiving the scholarship (relating to an agreement to
provide primary health services in a health profes-
sional shortage area designated under section 332).
‘‘(c) PREFERENCES REGARDING AWARDS; SPECIAL
CONSIDERATION.—In awarding scholarships under sub-
section (a), the Secretary shall—
‘‘(1) give preference to eligible individuals for
whom the costs of attending the school involved would
constitute a severe financial hardship; and
‘‘(2) give special consideration to eligible indi-
viduals who received scholarships pursuant to this
section, section 737, or section 740(d)(2) for fiscal
year 1993 or 1994 and are seeking scholarships for
attendance at eligible schools that received a grant
under any of such sections for any of such fiscal
years.
‘‘(d) APPLICABILITY OF CERTAIN PROVISIONS.—Ex-
cept as inconsistent with this section, the provisions of sub-
part III of part D of title III apply to an award of a schol-
arship under subsection (a) to the same extent and in the
same manner as such provisions apply to an award of a
scholarship under section 338A. This section shall be car-
ried out by the bureau that administers such subpart III.
‘‘(e) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘eligible individual’ means an in-
dividual described in subsection (b).
‘‘(2) The term ‘eligible school’ means a school or
program specified in subsection (a).
‘‘(f) FUNDING.—
‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—For
the purpose of carrying out this section, there are au-
thorized to be appropriated $28,000,000 for fiscal
year 1995, $38,000,000 for fiscal year 1996, and
$48,000,000 for fiscal year 1997. Such authorization
is in addition to the authorization of appropriations
established in section 740(e).
‘‘(2) ALLOCATIONS
BY
SECRETARY.—Of the
amounts appropriated for a fiscal year under para-
graph (1), the Secretary shall make available—
‘‘(A) 20 percent for scholarships under sub-
section (a) for attendance at schools of nursing;
and
‘‘(B) 15 percent for scholarships under such
subsection for attendance at graduate programs
in mental health practice.’’.
(b) CERTAIN PROGRAMS OF OBLIGATED SERVICE.—
(1) REPEAL.—Section 795 of the Public Health
Service Act (42 U.S.C. 295n) is repealed.
(2) RULE
OF
CONSTRUCTION.—Paragraph (1)
does not terminate agreements that, on the day before
the effective date under section 901, are in effect pur-
suant to section 795 of the Public Health Service Act.
Such agreements continue in effect in accordance with
the terms of the agreements. With respect to compli-
ance with such agreements, any period of practice as
a provider of primary health services (whether pro-
vided pursuant to other agreements with the Federal
Government or whether provided otherwise) counts to-
ward satisfaction of the requirement of practice pur-
suant to such section 795.
SEC. 302. SCHOLARSHIPS GENERALLY; CERTAIN OTHER
PURPOSES.
(a) RELEVANT HEALTH PROFESSIONS SCHOOLS.—
Section 737(a)(3) of the Public Health Service Act (42
U.S.C. 293a(a)(3)) is amended—
(1) by striking ‘‘medicine,’’ and all that follows
through ‘‘dentistry,’’; and
(2) by striking ‘‘allied health,’’ and all that fol-
lows and inserting ‘‘allied health.’’.
(b) ELIGIBLE INDIVIDUALS.—
(1) IN GENERAL.—Section 737(a)(2) of the Pub-
lic Health Service Act (42 U.S.C. 293a(a)(2)) is
amended to read as follows:
‘‘(2) ELIGIBLE INDIVIDUALS.—An individual re-
ferred to in paragraph (1) is any individual meeting
the following conditions:
‘‘(A) The individual is from a disadvan-
taged background.
‘‘(B) The individual is enrolled (or accepted
for enrollment) as a full-time student in a health
professions school specified in paragraph (3).
‘‘(C) The individual enters into the contract
required pursuant to subsection (e) as a condi-
tion of receiving the scholarship under para-
graph (1) (relating to an agreement to provide
services).’’.
(2) CERTAIN REQUIREMENT.—Section 737 of the
Public Health Service Act (42 U.S.C. 293a) is
amended—
(A) in subsection (a)(1), by striking ‘‘sub-
section (e)’’ and inserting ‘‘subsection (f)’’;
(B) by redesignating subsections (e) through
(h) as subsections (f) through (i), respectively;
and
(C) by inserting after subsection (d) the fol-
lowing subsection:
‘‘(e) APPLICABILITY OF CERTAIN PROVISIONS.—
‘‘(1) IN GENERAL.—Except as inconsistent with
this section, and subject to paragraph (2), the provi-
sions of subpart III of part D of title III apply to
an award of a scholarship under subsection (a) to the
same extent and in the same manner as such provi-
sions apply to an award of a scholarship under sec-
tion 338A. This section shall be carried out by the bu-
reau that administers such subpart III.
‘‘(2) CERTAIN INDIVIDUALS.—
‘‘(A) In the case of an individual who re-
ceives a scholarship under subsection (a) for at-
tendance at a school of veterinary medicine, the
contract referred to in subsection (a)(2)(C) is a
contract under which the individual agrees that,
after completing training in such medicine, the
individual will, in accordance with requirements
established under subparagraph (B), conduct or
assist in the conduct of research regarding
human health or safety. Except as inconsistent
with this section, the provisions specified in
paragraph (1) with respect to title III apply to
such a scholarship to the same extent and in the
same manner as such provisions apply to an
award of a scholarship under section 338A.
‘‘(B) The Secretary shall establish require-
ments regarding contracts under subparagraph
(A).’’.
(c) FUNDING.—Section 737(i) of the Public Health
Service Act, as redesignated by subsection (b)(2) of this sec-
tion, is amended—
(1) in paragraph (1), by inserting before the pe-
riod the following: ‘‘, and $6,000,000 for each of the
fiscal years 1994 through 1997’’; and
(2) in paragraph (2)(A), by striking ‘‘30 per-
cent’’ and all that follows and inserting the following:
‘‘50 percent for such grants to schools of allied health;
and’’.
SEC. 303. LOAN REPAYMENTS AND FELLOWSHIPS REGARD-
ING FACULTY POSITIONS.
(a) LOAN REPAYMENTS.—Section 738(a) of the Public
Health Service Act (42 U.S.C. 293b(a)) is amended—
(1) by striking paragraphs (4) and (6);
(2) by redesignating paragraphs (5) and (7) as
paragraphs (4) and (5), respectively; and
(3) in paragraph (4) (as so redesignated), by
amending subparagraph (B) to read as follows:
‘‘(B) the contract referred to in subpara-
graph (A) provides that the school, in making a
determination of the amount of compensation to
be provided by the school to the individual for
serving as a member of the faculty, will make the
determination without regard to the amount of
payments made (or to be made) to the individual
by the Federal Government under paragraph
(1).’’.
(b) AUTHORIZATION OF APPROPRIATIONS REGARDING
LOAN REPAYMENTS AND FELLOWSHIPS.—Section 738(c) of
the Public Health Service Act (42 U.S.C. 293b(c)) is
amended by striking ‘‘there is’’ and all that follows and in-
serting the following: ‘‘there is authorized to be appro-
priated $1,000,000 for each of the fiscal years 1995 through
1997.’’.
SEC. 304. CENTERS OF EXCELLENCE.
(a) REFERENCES TO SCHOOLS.—Section 739 of the
Public Health Service Act (42 U.S.C. 293c) is amended—
(1) by striking ‘‘health professions schools’’ each
place such term appears and inserting ‘‘designated
health professions schools’’; and
(2) by striking ‘‘health professions school’’ each
place such term appears and inserting ‘‘designated
health professions school’’.
(b) REQUIRED USES OF FUNDS.—Section 739(b) of the
Public Health Service Act (42 U.S.C. 293c(b)), as amended
by subsection (a), is amended—
(1) by striking paragraph (2);
(2) by redesignating paragraph (1) as para-
graph (2);
(3) by inserting before paragraph (2) (as so re-
designated) the following paragraph:
‘‘(1) to collaborate with public and nonprofit
private entities to carry out community-based pro-
grams to recruit students of secondary schools and in-
stitutions of higher education and to prepare the stu-
dents academically for pursuing a career in the
health professions;’’;
(4) in paragraph (5)—
(A) by striking ‘‘faculty and student re-
search’’ and inserting ‘‘student research’’; and
(B) by inserting before the period the follow-
ing: ‘‘, including research on issues relating to
the delivery of health care’’; and
(5)(A) in paragraph (4), by striking ‘‘and’’ after
the semicolon at the end;
(B) in paragraph (5), by striking the period at
the end and inserting ‘‘; and’’; and
(C) by adding at the end the following para-
graph:
‘‘(6) to carry out a program to train students of
the school in providing health services through train-
ing provided at community-based health facilities
that provide such services to a significant number of
disadvantaged individuals and that are located at a
site remote from the main site of the teaching facili-
ties of the school.’’.
(c) REQUIREMENTS REGARDING CONSORTIA.—
(1) IN GENERAL.—Section 739(c)(1) of the Pub-
lic Health Service Act (42 U.S.C. 293c(c)(1)), as
amended by subsection (a), is amended—
(A) in subparagraph (A), in the matter pre-
ceding clause (i), by striking ‘‘specified in sub-
paragraph (B)’’ and inserting ‘‘specified in sub-
paragraphs (B) and (C)’’;
(B) by redesignating subparagraph (C) as
subparagraph (D); and
(C) by inserting after subparagraph (B) the
following subparagraph:
‘‘(C) The condition specified in this sub-
paragraph is that, in accordance with subsection
(e)(1), the designated health professions school
involved has with other health profession schools
(designated or otherwise) formed a consortium to
carry out the purposes described in subsection
(b) at the schools of the consortium. The grant
involved may be expended with respect to the
other schools without regard to whether such
schools meet the conditions specified in subpara-
graph (B).’’.
(2) CERTAIN REQUIREMENTS.—Section 739(e) of
the Public Health Service Act (42 U.S.C. 293c(e)), as
amended by subsection (a), is amended to read as fol-
lows:
‘‘(e) PROVISIONS REGARDING CONSORTIA.—
‘‘(1) REQUIREMENTS.—For purposes of sub-
section (c)(1)(C), a consortium of schools has been
formed in accordance with this subsection if—
‘‘(A) the consortium consists of—
‘‘(i) the designated health professions
school seeking the grant under subsection
(a); and
‘‘(ii) 1 or more schools of medicine, os-
teopathic medicine, dentistry, pharmacy,
nursing, allied health, or public health, or
graduate programs in mental health prac-
tice;
‘‘(B) the schools of the consortium have en-
tered 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.
‘‘(2) AUTHORITY REGARDING NATIVE AMERICANS
CENTERS OF EXCELLENCE.—With respect to meeting
the conditions specified in subsection (c)(4), the Sec-
retary may make a grant under subsection (a) to a
designated health professions school that does not meet
such conditions if—
‘‘(A) the school has formed a consortium in
accordance with paragraph (1); and
‘‘(B) the schools of the consortium collec-
tively meet such conditions, without regard to
whether the schools individually meet such condi-
tions.’’.
(3) CONFORMING AMENDMENTS.—Section 739 of
the Public Health Service Act (42 U.S.C. 293c), as
amended by subsection (a), is amended—
(A) in subsection (b), in the matter preced-
ing paragraph (1), by inserting ‘‘, subject to sub-
section (c)(1)(C),’’ after ‘‘agrees’’; and
(B) in subsection (d)—
(i) in paragraph (3), by striking ‘‘(e)’’
and inserting ‘‘(e)(2)’’; and
(ii) by adding at the end the following
paragraph:
‘‘(4) RULE OF CONSTRUCTION.—Except as pro-
vided in paragraph (3) regarding a consortium under
subsection (e)(2), a health professions school that does
not meet the conditions specified in subsection
(c)(1)(B) may not be designated as a center of excel-
lence for purposes of this section. The preceding sen-
tence applies without regard to whether a grant under
subsection (a) is, pursuant to subsection (c)(1)(C),
being expended with respect to the school.’’.
(d) DEFINITION OF HEALTH PROFESSIONS SCHOOL.—
(1) GRADUATE PROGRAMS IN MENTAL HEALTH
PRACTICE.—Section 739(h)(1)(A) of the Public Health
Service Act (42 U.S.C. 293c(h)(1)(A)), as amended by
subsection (a), is amended by—
(A) by striking ‘‘or’’ after ‘‘dentistry’’; and
(B) by inserting before the period the follow-
ing: ‘‘, or a graduate program in mental health
practice’’.
(2) LIMITATION.—During the fiscal years 1995
through 1997, the Secretary of Health and Human
Services may not make more than one grant under
section 739 of the Public Health Service Act directly
to a graduate program in mental health practice (as
defined in section 799 of such Act).
(e) FUNDING.—Section 739(i) of the Public Health
Service Act (42 U.S.C. 293c(i)), as amended by subsection
(a), is amended to read as follows:
‘‘(i) FUNDING.—
‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—For
the purpose of making grants under subsection (a),
there are authorized to be appropriated $28,000,000
for fiscal year 1995, $30,000,000 for fiscal year 1996,
and $32,000,000 for fiscal year 1997.
‘‘(2) ALLOCATIONS BY SECRETARY.—
‘‘(A) Of the amounts appropriated under
paragraph (1) for a fiscal year, the Secretary
shall make available $12,000,000 for grants
under subsection (a) to health professions schools
that are eligible for such grants pursuant to
meeting the conditions described in paragraph
(2)(A) of subsection (c).
‘‘(B) Of the amounts appropriated under
paragraph (1) for a fiscal year and available
after compliance with subparagraph (A), the
Secretary shall make available 65 percent for
grants under subsection (a) to health professions
schools that are eligible for such grants pursuant
to meeting the conditions described in paragraph
(3) or (4) of subsection (c) (including meeting
conditions pursuant to subsection (e)(2)).
‘‘(C)(i) Of the amounts appropriated under
paragraph (1) for a fiscal year and available
after compliance with subparagraph (A), the
Secretary shall make available 35 percent for
grants under subsection (a) to health professions
schools that are eligible for such grants pursuant
to meeting the conditions described in paragraph
(5) of subsection (c).
‘‘(ii) With respect to a fiscal year, a grant
under subsection (a) that includes amounts
available under subparagraph (A) may not in-
clude amounts available under clause (i) unless
each of the following conditions is met:
‘‘(I) In the case of amounts available
under subparagraph (B) or clause (i) and
included in grants made pursuant to sub-
section (c)(3), the aggregate number of such
grants is not less than such aggregate num-
ber for the preceding fiscal year, and one or
more of such grants is made in an amount
that is not less than the lowest amount
among grants made from amounts available
under subparagraph (A).
‘‘(II) In the case of amounts available
under subparagraph (B) or clause (i) and
included in grants made pursuant to sub-
section (c)(4), the aggregate number of such
grants is not less than such aggregate num-
ber for the preceding fiscal year, and one or
more of such grants is made in an amount
that is not less than the lowest amount
among grants made from amounts available
under subparagraph (A).
‘‘(III) In the case of amounts available
under clause (i) and included in grants
made pursuant to subsection (c)(5) (exclu-
sive of grants that include amounts avail-
able under subparagraph (A) or (B)), the
aggregate number of such grants is not less
than such aggregate number for the preced-
ing fiscal year, and one or more of such
grants is made in an amount that is not
less than the lowest amount among grants
made from amounts available under sub-
paragraph (A).
‘‘(IV) The aggregate amount of grants
under subsection (a) made from amounts
available under subparagraph (B) and
clause (i) (other than grants that include
amounts available under subparagraph (A))
is, in the case of fiscal year 1995, not less
than the sum of such aggregate amount for
fiscal year 1994 and the total amount by
which grants are required under subclauses
(I) through (III) to be increased; and is, in
the case of fiscal year 1996 and each subse-
quent fiscal year, not less than such aggre-
gate amount for the preceding fiscal year.’’.
(f) CONFORMING AMENDMENTS.—Section 739(c) of the
Public Health Service Act (42 U.S.C. 293c(c)), as amended
by subsection (a), is amended—
(1) in paragraph (3)(B), by striking ‘‘the des-
ignated health professions school’’ and inserting ‘‘the
school’’; and
(2) in paragraph (4), in each of subparagraphs
(B) and (C), by striking ‘‘the designated health pro-
fessions school’’ and inserting ‘‘the school’’.
(g) TRANSITIONAL AND SAVINGS PROVISIONS.—
(1) IN GENERAL.—In the case of any entity re-
ceiving a grant under section 739 of the Public
Health Service Act for fiscal year 1994, the Secretary
of Health and Human Services shall, during the pe-
riod specified in paragraph (2), waive any or all of
the additional requirements established pursuant to
this section for the receipt or expenditure of such a
grant, subject to the entity providing assurances satis-
factory to the Secretary that the entity is making
progress toward meeting such requirements.
(2) RELEVANT PERIOD.—In the case of any en-
tity receiving a grant under section 739 of the Public
Health Service Act for fiscal year 1994, the period re-
ferred to in paragraph (1) is the period that, in first
approving the grant, the Secretary specified as the
duration of the grant.
SEC. 305. EDUCATIONAL ASSISTANCE REGARDING UNDER-
GRADUATES.
(a) IN GENERAL.—Section 740 of the Public Health
Service Act (42 U.S.C. 293d) is amended to read as follows:
‘‘SEC. 740. ASSISTANCE REGARDING HEALTH PROFESSIONS
AS CAREER CHOICE.
‘‘(a) IN GENERAL.—
‘‘(1) ACADEMIC PREPARATION OF STUDENTS.—
Subject to the provisions of this section, the Secretary
may make grants and enter into contracts for pur-
poses of—
‘‘(A) identifying individuals who—
‘‘(i) are students of elementary schools,
or students or graduates of secondary
schools or of institutions of higher edu-
cation;
‘‘(ii) are from disadvantaged back-
grounds; and
‘‘(iii) are interested in a career in the
health professions; and
‘‘(B) providing to such individuals aca-
demic assistance, counseling, and other services
to prepare the students to meet the academic re-
quirements for entry into health professions
schools.
‘‘(2) RECIPIENTS OF GRANTS AND CONTRACTS.—
The Secretary may make an award of a grant or con-
tract under paragraph (1) only if the applicant for
the award is a nonprofit private community-based or-
ganization or other public or nonprofit private entity.
Such other entities include schools of medicine, osteo-
pathic medicine, public health, dentistry, veterinary
medicine, optometry, pharmacy, allied health, chiro-
practic, and podiatric medicine, and include grad-
uate programs in mental health practice.
‘‘(3) CERTAIN USES OF AWARDS.—The purposes
for which the Secretary may authorize an award
under paragraph (1) to be expended include the fol-
lowing:
‘‘(A) Assisting elementary and secondary
schools and institutions of higher education in
developing or improving programs to prepare
students to meet the academic requirements for
entry into health professions schools.
‘‘(B) Establishing arrangements with non-
profit private community-based providers of pri-
mary health services under which students are
provided with opportunities to visit or work at
facilities of such providers and gain experience
regarding a career in a field of primary health
care.
‘‘(C) Developing or improving programs to
enhance the academic preparation of advanced,
prehealth 
professions 
students 
or
postbaccalaureate individuals to successfully
enter a health professions school.
‘‘(D) In the case of an award under para-
graph (1) that the Secretary has authorized to be
expended for the purpose described in subpara-
graph (B) or (C), paying such stipends as the
Secretary may approve for individuals from dis-
advantaged backgrounds for any period of edu-
cation in student-enhancement programs (other
than regular courses), except that such a stipend
may not be provided to an individual for more
than 12 months, and such a stipend shall be in
an amount of $25 per day (notwithstanding any
other provision of law regarding the amount of
stipends).
‘‘(b) MINIMUM REQUIREMENTS FOR AWARDS.—
‘‘(1) ASSURANCES REGARDING FINANCIAL CAPAC-
ITY.—The Secretary may make an award of a grant
or contract under subsection (a) only if the applicant
provides assurances satisfactory to the Secretary that,
with respect to the activities for which the award is
to be made, the applicant has or will have the finan-
cial capacity to continue the activities after the eligi-
bility of the applicant for such awards for such ac-
tivities is terminated pursuant to subsection (d).
‘‘(2) COLLABORATION
AMONG
VARIOUS
ENTI-
TIES.—The Secretary may make an award of a grant
or contract under subsection (a) only if the applicant
for the award has entered into an agreement with any
schools, institutions, community-based organizations,
or other entities with which the applicant will col-
laborate in carrying out activities under the award,
and the agreement specifies whether and to what ex-
tent the award will be allocated among the applicant
and the entities.
‘‘(3) MATCHING FUNDS.—
‘‘(1) meet the requirements of section 338A(b) of
the Public Health Service Act (42 U.S.C. 254l(b));
and
‘‘(2) are Native Hawaiians.
‘‘(b) TERMS AND CONDITIONS.—(1) Scholarship grants
provided under subsection (a) shall be provided under the
same terms and subject to the same conditions, regulations,
and rules that apply to scholarship grants provided under
section 338A of the Public Health Service Act (42 U.S.C.
254l), except that—
‘‘(A) the provision of scholarships in each type
of health care profession training shall correspond to
the need for each type of health care professional to
serve Native Hawaiian health care systems, as identi-
fied by Papa Ola Lokahi;
‘‘(B) in selecting scholarship recipients, the Sec-
retary shall give priority to individuals included on
a list of eligible applicants submitted by the Kameha-
meha Schools/Bishop Estate; and
‘‘(C) the obligated service requirement for each
scholarship recipient shall be fulfilled through service,
in order of priority, in—
‘‘(i) any one of the five Native Hawaiian
health care systems which, during the fiscal year
in which the obligated service requirement is as-