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(2) the number of reported cases of tuberculosis
has risen from 22,201 in 1985 to 26,673 in 1992, rep-
resenting 51,000 more cases than those that would
have been expected since 1985;
(3) a recent national survey discovered that 14.4
percent of all active tuberculosis cases were resistant
to at least one drug;
(4) drug resistant tuberculosis strains can cost
more than $150,000 to treat, and even then, between
40 and 60 percent of the patients receiving such treat-
ment die;
(5) in 1992, tuberculosis cases were reported to
the Centers for Disease Control and Prevention by all
50 States, and cases resistant to one or more tuber-
culosis drugs were reported in at least 36 States, the
District of Columbia and Puerto Rico;
(6) in 1992, 27 percent of the reported cases of
tuberculosis occurred in foreign born persons;
(7) one third of the world’s population harbors
tuberculosis; and
(8) among infectious diseases tuberculosis is still
the number one killer in the world with an estimated
8,000,000 new cases each year and 2,900,000 deaths.
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SEC. 103. PROGRAMS OF CENTERS FOR DISEASE CONTROL
AND PREVENTION.
(a) PROVISION OF SERVICES FOR PREVENTION, CON-
TROL, AND ELIMINATION.—Section 317(j)(2) of the Public
Health Service Act (42 U.S.C. 247b(j)(2)) is amended—
(1) by inserting ‘‘(A)’’ after the paragraph des-
ignation;
(2) in the first sentence by striking ‘‘and’’ after
‘‘1991,’’ and all that follows through ‘‘1995’’ and in-
serting the following: ‘‘, $200,000,000 for fiscal year
1994, and such sums as may be necessary for each of
the fiscal years 1995 through 1997, of which not more
than $50,000,000 may be made available in each such
fiscal year for grants under subparagraph (B)’’; and
(3) by adding at the end thereof the following
new subparagraph:
‘‘(B) With respect to amounts made available to carry
out this subparagraph, the Secretary, acting through the
Director of the Centers for Disease Control and Prevention,
may use such amounts to make emergency grants for the
prevention, control, and elimination of tuberculosis. The
Secretary may make such a grant only if the geographic
area in which activities under the grant are to be carried
out has, relative to other areas, a substantial incidence of
cases of tuberculosis or a substantial rate of increase in such
cases.’’.
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(b) STATE TUBERCULOSIS PLAN.—Section 317(j) of
the Public Health Service Act (42 U.S.C. 247b(j)) is amend-
ed by adding at the end thereof the following new para-
graph:
‘‘(3)(A) With respect to an application submitted by
a State for a grant under this section for the prevention,
control and elimination of tuberculosis, such application
shall contain a State plan that demonstrates that amounts
received under the grant will be expended in a manner that
ensures that tuberculosis services will be provided to those
at the highest risk of contracting tuberculosis, or in those
areas with the highest rates of tuberculosis infection.
‘‘(B) Such plans shall demonstrate that the applicant
will work closely with and provide support to entities re-
ceiving funds under sections 329, 330, 340, 340A, or titles
V or XIX, and to correctional facilities, and nongovern-
mental organizations such as community-based organiza-
tions and describe how the State intends to carry out the
requirements of section 1924(a).
‘‘(C) Such plans shall demonstrate that grant funds
will be used for directly observed therapy or other effective
interventions with respect to populations with the highest
rates of active infection with tuberculosis.
‘‘(D) In developing the State plan, each State shall en-
sure that the entities described in subparagraph (B), the
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single State agency for drug and alcohol services and any
other State agency that has responsibility for individuals
in need of tuberculosis services are consulted during the
planning process.’’.
(c) RESEARCH, DEMONSTRATION PROJECTS, EDU-
CATION, AND TRAINING.—
(1) IN GENERAL.—Section 317(k)(2) of the Pub-
lic Health Service Act (42 U.S.C. 247b(k)(2)) is
amended—
(A) by redesignating subparagraphs (A)
through (D) as clauses (i) through (iv), respec-
tively;
(B) by inserting ‘‘(A)’’ after the paragraph
designation; and
(C) by adding at the end thereof the follow-
ing new subparagraphs:
‘‘(B) In support of grants referred to in subparagraph
(A), the Secretary may conduct or support applied research
and training regarding the surveillance, diagnostic meth-
odologies, prevention, control, and treatment of tuberculosis,
including intramural projects and extramural projects.
‘‘(C) For the purpose of carrying out subparagraphs
(A) and (B), there are authorized to be appropriated
$26,000,000 for fiscal year 1994, and such sums as may
be necessary for each of the fiscal years 1995 through 1997.
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The authorization of appropriations established in the pre-
ceding sentence is in addition to the authorization of appro-
priations established in subsection (j)(2) for carrying out
this paragraph.’’.
(2) TECHNICAL AMENDMENT.—Section 317(j)(2)
of the Public Health Service Act (42 U.S.C.
247b(j)(2)) is amended by striking the last sentence.
SEC. 104. RESEARCH THROUGH NATIONAL INSTITUTE OF
ALLERGY AND INFECTIOUS DISEASES.
(a) CERTAIN DUTIES.—
(1) IN GENERAL.—Subpart 6 of part C of title
IV of the Public Health Service Act (42 U.S.C. 285f)
is amended by inserting after section 446 the follow-
ing section:
‘‘RESEARCH AND RESEARCH TRAINING REGARDING
TUBERCULOSIS
‘‘SEC. 447. In carrying out section 446, the Director
of the Institute shall conduct or support basic research and
research training regarding the cause, diagnosis, early de-
tection, prevention and treatment of tuberculosis.’’.
(2) CONFORMING AMENDMENT.—Section 446 of
the Public Health Service Act (42 U.S.C. 285f) is
amended by inserting after ‘‘Diseases’’ the following:
‘‘(hereafter in this subpart referred to as the ‘Insti-
tute’)’’.
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(b) AUTHORIZATION
OF APPROPRIATIONS.—Section
408(a) of the Public Health Service Act (42 U.S.C. 284c(a))
is amended by adding at the end the following new para-
graph:
‘‘(3) For the purpose of carrying out section 447
(relating to research on tuberculosis through the Na-
tional Institute on Allergy and Infectious Diseases),
there are authorized to be appropriated $46,000,000
for fiscal year 1994, and such sums as may be nec-
essary for each of the fiscal years 1995 through 1997.
The authorization of appropriations established in the
preceding sentence may not be construed as terminat-
ing the availability for such purpose of any other au-
thorization of appropriations.’’.
SEC. 105. RESEARCH THROUGH THE FOOD AND DRUG AD-
MINISTRATION.
Chapter V of the Food, Drug and Cosmetic Act is
amended by inserting after section 512 (21 U.S.C. 360b)
the following new section:
‘‘SEC. 512A. TUBERCULOSIS DRUG AND DEVICE RESEARCH.
‘‘(a) AUTHORITY.—The Commissioner of Food and
Drugs shall implement a tuberculosis drug and device re-
search program under which the Commissioner shall—
‘‘(1) provide assistance to other Federal agencies
for the development of tuberculosis protocols;
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‘‘(2) review and evaluate medical devices de-
signed for the diagnosis and control of airborne tuber-
culosis; and
‘‘(3) conduct research concerning drugs or de-
vices to be used in diagnosing, controlling and pre-
venting tuberculosis.
‘‘(b) AUTHORIZATION
OF APPROPRIATIONS.—There
are authorized to be appropriated to carry out this section,
$5,000,000 for each of the fiscal years 1994 through 1997.’’.
SEC. 
106. 
CONVERSION 
OR 
RENOVATION 
OF 
PUBLIC
HEALTH FACILITIES.
Section 1610 of the Public Health Service Act (42
U.S.C. 300r) is amended by adding at the end the following
subsection:
‘‘(c)(1) With respect to services for the prevention, con-
trol, and elimination of tuberculosis, the Secretary may
make grants to public and nonprofit private entities for—
‘‘(A) conversion of existing facilities into out-
patient medical facilities or facilities for long-term
care to provide such services for such populations;
‘‘(B) renovation of inpatient facilities; or
‘‘(C) renovation of facilities to provide such serv-
ices with respect to incarceration.
‘‘(2) The amount of any grant under paragraph (1)
may not exceed 50 percent of the cost of the project for which
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the grant is made unless the project is located in an area
determined by the Secretary to be an urban or rural poverty
area, in which case the grant may cover up to 75 percent
of such costs.
‘‘(3) There are authorized to be appropriated for
grants under paragraph (1), $25,000,000 for fiscal year
1994, and such sums as may be necessary for each of the
fiscal years 1995 through 1997.’’.
TITLE II—SEXUALLY
TRANSMITTED DISEASES
SEC. 201. SHORT TITLE.
This title may be cited as the ‘‘Sexually Transmitted
Diseases Amendments of 1993’’.
SEC. 202. EXTENSION OF PROGRAM OF GRANTS REGARDING
PREVENTION AND CONTROL OF SEXUALLY
TRANSMITTED DISEASES.
(a) EXTENSION OF PROGRAM.—Section 318(d)(1) of
the Public Health Service Act (42 U.S.C. 247c(d)(1)) is
amended in the first sentence—
(1) by striking ‘‘(b) and (c)’’ and inserting ‘‘(b)
and (c) of this section and section 318B’’; and
(2) by striking ‘‘there are authorized’’ and all
that follows and inserting the following: ‘‘there are
authorized to be appropriated $132,000,000 for fiscal
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year 1994, and such sums as may be necessary for
each of the fiscal years 1995 through 1997.’’.
(b) TECHNICAL CORRECTIONS.—Section 318 of the
Public Health Service Act (42 U.S.C. 247c) is amended—
(1) in subsection (b)(3), by striking ‘‘, and’’ and
inserting ‘‘; and’’; and
(2) in subsection (d)(5)—
(A) in subparagraph (A), by striking ‘‘form,
or’’ and inserting ‘‘form; or’’; and
(B) in subparagraph (B), by striking ‘‘pur-
poses,’’ and inserting ‘‘purposes;’’.
SEC. 203. EXTENSION OF PROGRAM REGARDING PREVENT-
ABLE CASES OF INFERTILITY ARISING AS RE-
SULT OF SEXUALLY TRANSMITTED DISEASES.
(a) TECHNICAL CORRECTION.—Section 318A of the
Public Health Service Act (42 U.S.C. 247c–1), as added by
section 304 of Public Law 102–531 (106 Stat. 3490), is
amended in subsection (o)(2) by striking ‘‘subsection (s)’’
and inserting ‘‘subsection (q)’’.
(b) EXTENSION OF PROGRAM.—Section 318A of the
Public Health Service Act (42 U.S.C. 247c–1), as added by
section 304 of Public Law 102–531 (106 Stat. 3490), is
amended—
(1) in subsection (q), by striking ‘‘and 1995’’
and inserting ‘‘through 1997’’; and
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(2) in subsection (r)(2), by striking ‘‘through
1995’’ and inserting ‘‘through 1997’’.
SEC. 204. SEXUALLY TRANSMITTED DISEASE ACCELERATED
PREVENTION CAMPAIGNS.
Part B of title III of the Public Health Service Act
is amended by inserting after section 318A (42 U.S.C. 247c-
1) the following new section:
‘‘SEC. 318B. SEXUALLY TRANSMITTED DISEASE ACCELER-
ATED PREVENTION CAMPAIGNS.
‘‘(a) GRANTS.—The Secretary is authorized to award
grants to States and political subdivisions of States for the
development, implementation, and evaluation of innovative,
interdisciplinary approaches to the prevention and control
of sexually transmitted diseases and their sequelae by—
‘‘(1) expanding access to sexually transmitted
disease services through collaborations with other pub-
lic health programs and with nongovernmental part-
ners;
‘‘(2) implementing community-based behavioral
interventions to prevent disease transmission; and
‘‘(3) establishing collaborations between health
departments and university-based experts to strength-
en sexually transmitted diseases prevention programs.
‘‘(b) APPLICATION.—To be eligible to receive a grant
under subsection (a), a State or political subdivision of a
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State, shall prepare and submit to the Secretary an appli-
cation at such time, in such manner, and containing such
information as the Secretary may require.
‘‘(c) PRIORITY.—In awarding grants under subsection
(a), the Secretary shall give priority to applications that
seek to conduct activities with grant funds that focus on
the prevention of sexually transmitted diseases among
women and other populations that are disproportionately
affected by these diseases.’’.
TITLE III—INJURY CONTROL
AND VIOLENCE PREVENTION
SEC. 301. SHORT TITLE.
This title may be cited as the ‘‘Injury Control and Vio-
lence Prevention Act of 1993’’.
SEC. 302. FINDINGS.
Congress finds that—
(1) violence or the threat of violence has adverse
effects on the health and safety of Americans of all
ages, races, ethnicities and economic conditions;
(2) the majority of homicides and violent as-
saults are committed by people who have relationships
with their victims and are not committed by strang-
ers;
(3) violence is being committed in private as
well as public, in homes, schools, and neighborhoods;
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(4) interventions by law enforcement and crimi-
nal justice systems have limited ability to prevent vi-
olence;
(5) family and interpersonal violence represent
serious threats to the health and well-being of millions
of women in the United States;
(6) violence against women has serious health
consequences for its victims, including fatality, severe
trauma, repeated physical injuries, and chronic
stress-related disorder;
(7) violence against women has serious mental
health consequences for its victims, including sub-
stance abuse, severe psychological trauma, and sui-
cide;
(8) fewer than 5 percent of injured women are
correctly diagnosed by medical personnel as being vic-
tims of domestic violence;
(9) hospitals and clinics do not have a uniform
set of protocols for the identification and referral of
victims of family and interpersonal violence, or for
the training of health care professionals to perform
such functions;
(10) a national surveillance system for monitor-
ing the health effects of injury should be established
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to determine the nature and extent of family and
interpersonal violence in the United States; and
(11) the Surgeon General has identified domestic
violence as a public health problem to which all
health care providers must actively and vigorously re-
spond.
SEC. 303. FAMILY AND INTERPERSONAL VIOLENCE PREVEN-
TION.
Section 393 of the Public Health Service Act (42
U.S.C. 280b–2) is amended to read as follows:
‘‘SEC. 393. PREVENTION OF FAMILY AND INTERPERSONAL
VIOLENCE.
‘‘(a) RESEARCH AND TECHNICAL ASSISTANCE.—The
Secretary, acting through the Director of the Centers for
Disease Control and Prevention, may conduct research and
provide technical assistance to appropriate public and non-
profit private entities and to academic institutions to assist
such entities in performing research in, and conducting
training and public health programs for, the prevention of
injuries and deaths associated with family and inter-
personal violence.
‘‘(b) GRANTS.—The Secretary, acting through the Di-
rector of the Centers for Disease Control and Prevention,
may award grants to States, political subdivisions of
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States, and any other public and nonprofit private entity
for—
‘‘(1) the conduct of research into identifying ef-
fective strategies to prevent interpersonal violence
within the family and among acquaintances;
‘‘(2) the development, implementation, and eval-
uation of demonstration projects for the prevention of
interpersonal violence within families and among ac-
quaintances;
‘‘(3) the implementation of public information
and education programs for prevention of family and
interpersonal violence and to broaden public aware-
ness of the public health consequences of family and
interpersonal violence; and
‘‘(4) the provision of education, training and
clinical skills improvement programs for health care
professionals to—
‘‘(A) routinely interview and identify indi-
viduals whose medical condition or statements
indicate that the individuals are victims of do-
mestic violence or sexual assault; and
‘‘(B) refer the individuals to entities that
provide services regarding such violence and as-
sault, including referrals for counseling, housing,
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legal services, and services of community organi-
zations.
‘‘(c) INJURY SURVEILLANCE PROGRAM.—The Sec-
retary, acting through the Director of the Centers for Dis-
ease Control and Prevention, shall support the establish-
ment of national systematic surveillance of injuries, includ-
ing those caused by family and interpersonal violence.
‘‘(d) DEFINITION.—As used in this section, the term
‘interpersonal violence within families and acquaintances’
means any intentional violence, controlling, or coercive be-
havior or pattern of behavior by an individual who is cur-
rently or who was previously, in an intimate or acquaint-
ance relationship with the victim. Such behavior may occur
at any stage of the lifecycle and may encompass single acts
or a syndrome of actual or threatened physical injury, sex-
ual assault, rape, psychological abuse, or neglect. Such term
includes behavior which currently may be described as
‘child neglect’, ‘child abuse’, ‘spousal abuse’, ‘domestic vio-
lence’, ‘woman battering’, ‘partner abuse’, ‘elder abuse’, and
‘date rape’.
‘‘(e) APPLICATION.—To be eligible to receive assistance
under subsection (a) or (b), an entity shall prepare and
submit to the Secretary an application at such time, in
such manner, and containing such information as the Sec-
retary may require.’’.
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SEC. 304. ADVISORY COMMITTEE; REPORTS.
Part J of title III of the Public Health Service Act
(as amended by Public Law 103-43) is amended by insert-
ing after section 393 (42 U.S.C. 280b-2) the following new
section:
‘‘SEC. 393A. GENERAL PROVISIONS.
‘‘(a) ADVISORY COMMITTEE.—The Secretary, acting
through the Director of the Centers for Disease Control and
Prevention, shall establish an advisory committee to advise
the Secretary and such Director with respect to the preven-
tion and control of injuries.
‘‘(b) REPORT.—Not later than February 1 of 1996 and
of every second year thereafter, the Secretary, acting
through the Director of the Centers for Disease Control and
Prevention, 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 part
during the preceding 2 fiscal years. Such report shall in-
clude a description of such activities that were carried out
with respect to domestic violence and sexual assault and
with respect to rural areas.’’.
SEC. 305. TECHNICAL CORRECTIONS.
(a) TERMINOLOGY.—Part J of title III of the Public
Health Service Act (42 U.S.C. 280b et seq.) (as amended
by Public Law 103-43) is amended—
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(1) in the heading for such part, by striking ‘‘IN-
JURY CONTROL’’ and inserting ‘‘PREVENTION
AND
CONTROL OF INJURIES’’; and
(2) in section 392—
(A) in the heading for such section, by in-
serting ‘‘PREVENTION AND’’ before ‘‘CONTROL AC-
TIVITIES’’;
(B) in subsection (a)(1), by inserting ‘‘and
control’’ after ‘‘prevention’’; and
(C) in subsection (b)(1), by striking ‘‘inju-
ries and injury control’’ and inserting ‘‘the pre-
vention and control of injuries’’.
(b) PROVISIONS RELATING
TO PUBLIC LAW 102–
531.—Part J of title III of the Public Health Service Act
(42 U.S.C. 280b et seq.) (as amended by Public Law 103–
43 (106 Stat. 3482), is amended—
(1) in section 392(b)(2), by striking ‘‘to promote
injury control’’ and all that follows and inserting ‘‘to
promote activities regarding the prevention and con-
trol of injuries; and’’; and
(2) in section 391(b), by adding at the end the
following sentence: ‘‘In carrying out the preceding
sentence, the Secretary shall disseminate such infor-
mation to the public, including through elementary
and secondary schools.’’.
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SEC. 306. AUTHORIZATION OF APPROPRIATIONS.
Section 394 of the Public Health Service Act (42
U.S.C. 280b–3) is amended—
(1) by striking ‘‘391 and 392’’ and inserting
‘‘391, 392, and 393’’; and
(2) by striking ‘‘$10,000,000’’ and all that fol-
lows through the period and inserting ‘‘$60,000,000’’
for fiscal year 1994, and such sums as may be nec-
essary for each of the fiscal years 1995 through
1997.’’.
TITLE 
IV—BREAST 
AND 
CER-
VICAL CANCER AMENDMENTS
SEC. 401. SHORT TITLE.
This title may be cited as the ‘‘Breast and Cervical
Cancer Amendments of 1993’’.
SEC. 402. REVISIONS IN PROGRAM OF STATE GRANTS RE-
GARDING BREAST AND CERVICAL CANCER.
(a) LIMITED AUTHORITY REGARDING FOR-PROFIT
ENTITIES.—
(1) IN GENERAL.—Section 1501(b) of the Public
Health Service Act (42 U.S.C. 300k(b)) is amended—
(A) by striking ‘‘STATES.—A State’’ and all
that follows through ‘‘may expend’’ and inserting
the following: ‘‘STATES.—
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‘‘(1) IN GENERAL.—A State receiving a grant
under subsection (a) may, subject to paragraphs (2)
and (3), expend’’; and
(B) by adding at the end the following
paragraphs:
‘‘(2) LIMITED
AUTHORITY
REGARDING
OTHER
ENTITIES.—In addition to the authority established
in paragraph (1) for a State with respect to grants
and contracts, the State may provide for screenings
under subsection (a)(1) through entering into con-
tracts with private entities.
‘‘(3) PAYMENTS FOR SCREENINGS.—The amount
paid by a State to an entity under this subsection for
a screening procedure under subsection (a)(1) may
not exceed the amount that would be paid under part
B of title XVIII of the Social Security Act if payment
were made under such part for furnishing the proce-
dure to a woman enrolled under such part.’’.
(2) CONFORMING AMENDMENT.—Section 1505(3)
of the Public Health Service Act (42 U.S.C. 300n-
1(3)) is amended by inserting before the semicolon the
following: ‘‘(and additionally, in the case of services
and activities under section 1501(a)(1), with any
similar services or activities of private entities)’’.
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(b) SPECIAL CONSIDERATION FOR GRANTS.—Section
1501 of the Public Health Service Act (42 U.S.C. 300k) is
amended by adding at the end thereof the following new
subsection:
‘‘(c) SPECIAL CONSIDERATION.—In making grants
under subsection (a) after the date of enactment of this sub-
section, the Secretary shall give special consideration to
projects that have been peer reviewed and approved and
that involve areas that—
‘‘(1) have high cervical or breast cancer mortal-
ity rates; or
‘‘(2) have a high incidence of cervical or breast
cancer.’’.
(c) EXEMPTION FROM MATCHING REQUIREMENTS.—
Section 1502(b)(1) of the Public Health Service Act (42
U.S.C. 300l(b)(1)) is amended to read as follows:
‘‘(1) TYPES OF CONTRIBUTIONS.—
‘‘(A) GENERAL
RULE.—Non-Federal con-
tributions required in subsection (a) may be in
cash or in kind, fairly evaluated, including
equipment or services (and excluding indirect or
overhead costs). Amounts provided by the Fed-
eral Government, or services assisted or sub-
sidized to any significant extent by the Federal
Government, may not be included in determin-
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ing the amount of such non-Federal contribu-
tions.
‘‘(B) DONATED TREATMENT SERVICES.—In
meeting the non-Federal contribution require-
ment of this section, the State involved—
‘‘(i) may, with respect to a grant
awarded for a program under paragraph
(1) or (2) of section 1501(a), use the value
of any donated outreach services associated
with the delivery of breast and cervical can-
cer screenings conducted under the program,
and the value of any additional donated
breast or cervical cancer diagnostic or treat-
ment services provided subsequent to the
screening conducted under the program; and
‘‘(ii) may not, with respect to a grant
awarded for a program under paragraph
(3), (4), (5) or (6) of section 1501(a), in-
clude the value of any donated breast or cer-
vical cancer outreach, diagnosis, or treat-
ment services.’’.
(d) REQUIREMENTS WITH RESPECT TO TYPE AND
QUALITY OF SERVICES.—
(1) IN GENERAL.—Section 1503 of the Public
Health Service Act (42 U.S.C. 300m) is amended—
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(A) in subsection (a)—
(i) in paragraph (1), to read as fol-
lows:
‘‘(1) to ensure that, after a limited period of time
and thereafter throughout the period during which
amounts are received pursuant to the grant, except for
the period of the first year when a 50 percent mini-
mum shall apply, not less than 60 percent of the
grant is expended to provide each of the services or
activities described in paragraphs (1) and (2) of sec-
tion 1501(a), including making available screening
procedures for both breast and cervical cancers;’’; and
(ii) in paragraph (4), to read as fol-
lows:
‘‘(4) to ensure that not more than 40 percent of
the grant is expended to provide the services or activi-
ties described in paragraphs (3) through (6) of section
1501(a), except in the case of the first year during
which the maximum expended for these purposes shall
not exceed 50 percent of the grant.’’; and
(B) by striking subsections (c) through (e)
and inserting the following:
‘‘(c) QUALITY ASSURANCE REGARDING SCREENING
PROCEDURES.—The Secretary may not make a grant
under section 1501 unless the State involved agrees that the
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State will, in accordance with applicable law, assure the
quality of screening procedures conducted pursuant to such
section.’’.
(2) 
TRANSITION
RULE
REGARDING
MAMMOGRAPHIES.—With respect to the screening pro-
cedure for breast cancer known as a mammography,
the requirements in effect on the day before the date
of the enactment of this Act under section 1503(c) of
the Public Health Service Act remain in effect (for an
individual or facility conducting such procedures
pursuant to a grant to a State under section 1501 of
such Act) until there is in effect for the facility a cer-
tificate (or provisional certificate) issued under sec-
tion 354 of such Act.
(e) STATEWIDE PROVISION
OF SERVICES.—Section
1504(c) of the Public Health Service Act (42 U.S.C.
300n(c)) is amended by adding at the end the following
paragraph:
‘‘(3) GRANTS TO TRIBES AND TRIBAL ORGANIZA-
TIONS.—
‘‘(A) The Secretary, acting through the Di-
rector of the Centers for Disease Control and
Prevention, may make grants to tribes and tribal
organizations (as such terms are used in para-
graph (1)) for the purpose of carrying out pro-
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grams described in section 1501(a). This title ap-
plies to such a grant (in relation to the jurisdic-
tion of the tribe or organization) to the same ex-
tent and in the same manner as such title ap-
plies to a grant to a State under section 1501
(in relation to the jurisdiction of the State).
‘‘(B) If a tribe or tribal organization is re-
ceiving a grant under subparagraph (A) and the
State in which the tribe or organization is lo-
cated is receiving a grant under section 1501, the
requirement established in paragraph (1) for the
State regarding the tribe or organization is
deemed to have been waived under paragraph
(2).’’.
(f) EVALUATIONS AND REPORTS.—Section 1508 of the
Public Health Service Act (42 U.S.C. 300n–4) is amend-
ed—
(1) in subsection (a), by adding at the end the
following sentence: ‘‘Such evaluations shall include
evaluations of the extent to which States carrying out
such programs are in compliance with section
1501(a)(2) and with section 1504(c).’’; and
(2) in subsection (b), by inserting before the pe-
riod the following: ‘‘, including recommendations re-
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garding compliance by the States with section
1501(a)(2) and with section 1504(c)’’.
(g) TECHNICAL CORRECTIONS.—Title XV of the Public
Health Service Act (42 U.S.C. 300k et seq.) is amended—
(1) in section 1501(a), in the matter preceding
paragraph (1), by striking ‘‘Control,’’ and inserting
‘‘Control and Prevention,’’; and
(2) in section 1505—
(A) 
in 
paragraph 
(3), 
by 
striking
‘‘nonprivate’’ and inserting ‘‘nonprofit private’’;
and
(B) in paragraph (4), by inserting ‘‘will’’
before ‘‘be used’’.
SEC. 403. ESTABLISHMENT OF DEMONSTRATION PROGRAM
OF GRANTS FOR ADDITIONAL PREVENTIVE
HEALTH SERVICES FOR WOMEN.
(a) IN GENERAL.—Title XV of the Public Health Serv-
ice Act (42 U.S.C. 300k et seq.) is amended—
(1) by redesignating section 1509 as section
1510; and
(2) by inserting after section 1508 the following
section:
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‘‘SEC. 1509. SUPPLEMENTAL GRANTS FOR ADDITIONAL PRE-
VENTIVE HEALTH SERVICES.
‘‘(a) DEMONSTRATION PROJECTS.—In the case of
States receiving grants under section 1501, the Secretary,
acting through the Director of the Centers for Disease Con-
trol and Prevention, may make grants to not more than
3 such States to carry out demonstration projects for the
purpose of—
‘‘(1) providing preventive health services in ad-
dition to the services authorized in such section, in-
cluding screenings regarding blood pressure and cho-
lesterol, and including health education;
‘‘(2) providing appropriate referrals for medical
treatment of women receiving services pursuant to
paragraph (1) and ensuring, to the extent practicable,
the provision of appropriate follow-up services; and
‘‘(3) evaluating activities conducted under para-
graphs (1) and (2) through appropriate surveillance
or program-monitoring activities.
‘‘(b) STATUS AS PARTICIPANT IN PROGRAM REGARD-
ING BREAST AND CERVICAL CANCER.—The Secretary may
not make a grant under subsection (a) unless the State in-
volved agrees that services under the grant will be provided
only through entities that are screening women for breast
or cervical cancer pursuant to a grant under section 1501.
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‘‘(c) APPLICABILITY OF PROVISIONS OF GENERAL PRO-
GRAM.—This title applies to a grant under subsection (a)
to the same extent and in the same manner as such title
applies to a grant under section 1501.
‘‘(d) FUNDING.—
‘‘(1) IN GENERAL.—Subject to paragraph (2), for
the purpose of carrying out this section, there are au-
thorized to be appropriated $3,000,000 for fiscal year
1994, and such sums as may be necessary for each of
the fiscal years 1995 through 1997.
‘‘(2) LIMITATION REGARDING FUNDING WITH RE-
SPECT TO BREAST AND CERVICAL CANCER.—The au-
thorization of appropriations established in para-
graph (1) is not effective for a fiscal year unless the
amount appropriated under section 1510(a) for the
fiscal year equals or exceeds $100,000,000.’’.
(b) CONFORMING AMENDMENT.—Section 1510(a) of
the Public Health Service Act, as redesignated by subsection
(a)(1) of this section, is amended in the heading for the
section by striking ‘‘FUNDING.’’ and inserting ‘‘FUNDING
FOR GENERAL PROGRAM.’’.
SEC. 404. FUNDING FOR GENERAL PROGRAM.
Section 1510(a) of the Public Health Service Act (as
amended by section 403(a)(2)) is amended—
(1) by striking ‘‘and’’ after ‘‘1991,’’; and
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(2) by inserting before the period the following:
‘‘, $200,000,000 for fiscal year 1994, and such sums
as may be necessary for each of the fiscal years 1995
through 1997’’.
TITLE V—MISCELLANEOUS
PROVISIONS
SEC. 501. EVALUATIONS.
Section 2711 of the Public Health Service Act (42
U.S.C. 300aaa-10) is amended to read as follows:
‘‘EVALUATION OF PROGRAMS
‘‘SEC. 2711. (a) IN GENERAL.—Such portion as the
Secretary shall determine, but not less than .2 percent nor
more than 1 percent, of any amounts appropriated for pro-
grams authorized under this Act for any fiscal year begin-
ning after September 20, 1993, shall be made available for
the evaluation (directly, or by grants of contracts) of the
implementation and effectiveness of such programs.
‘‘(b) REPORT ON EVALUATIONS.—
‘‘(1) IN GENERAL.—To provide information for
legislative deliberations concerning Federal health
programs, the Secretary shall, not later than January
1 of each year, prepare and submit to the Committee
on Labor and Human Resources of the Senate and
the Committee on Energy and Commerce of the House
of Representatives a report that identifies and synthe-
sizes the findings of the evaluations conducted under
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subsection (a) by program area. Such report shall
also include the plans of the Secretary for the subse-
quent year’s evaluations, including programs and
issue areas.
‘‘(2) FIVE YEAR REVIEW.—A report submitted
under paragraph (1) shall contain a description of
the findings of the Secretary with respect to evalua-
tions conducted under subsection (a) or other provi-
sions of law, during the 5-year period prior to the
year for which the report is being submitted. Such de-
scription shall provide the Committees referred to in
paragraph (1) with information concerning program
changes that the Secretary intends to implement in
response to such findings in order to improve the
health of the American people and their receipt of
needed and effective public health services.’’.
SEC. 502. FEDERAL BENEFITS FOR OVERSEAS ASSIGNEES.
Section 307 of the Public Health Service Act (42
U.S.C. 242l) is amended by adding at the end thereof the
following new subsection:
‘‘(c) The Secretary may provide to personnel ap-
pointed or assigned by the Secretary to serve abroad, allow-
ances and benefits similar to those provided under chapter
9 of title I of the Foreign Service Act of 1990 (22 U.S.C.
4081 et seq.). Leaves of absence for personnel under this
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subsection shall be on the same basis as that provided under
subchapter I of chapter 63 of title 5, United States Code
to individuals serving in the Foreign Service.’’.
SEC. 503. LOAN REPAYMENT PROGRAM.
Part J of title III of the Public Health Service Act
(as amended by section 2008 of Public Law 103-43) is
amended by inserting after section 393A (as added by sec-
tion 304) the following new section:
‘‘SEC. 393B. LOAN REPAYMENT PROGRAM.
‘‘(a) IN GENERAL.—
‘‘(1) AUTHORITY.—Subject to paragraph (2), the
Secretary may carry out a program of entering into
contracts with appropriately qualified health profes-
sionals under which such health professionals agree to
conduct prevention activities, as employees of the Cen-
ters for Disease Control and Prevention and the Agen-
cy for Toxic Substances and Disease Registry, in con-
sideration of the Federal Government agreeing to
repay, for each year of such service, not more than
$20,000 of the principal and interest of the edu-
cational loans of such health professionals.
‘‘(2) LIMITATION.—The Secretary may not enter
into an agreement with a health professional pursu-
ant to paragraph (1) unless such professional—