‘‘(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 $5,000,000 for fiscal year 1995, and
such sums as may be necessary for each of the fiscal years
1996 and 1997.’’.
SEC. 208. HEALTHY START FOR INFANTS.
(a) IN GENERAL.—Part D of title III of the Public
Health Service Act (42 U.S.C. 254b et seq.) is amended
by inserting after section 330 the following section:
‘‘HEALTHY START FOR INFANTS
‘‘SEC. 330A. (a) GRANTS
FOR COMPREHENSIVE
SERVICES.—
‘‘(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
geographic 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 dem-
onstration project under paragraph (1) in a geo-
graphic area, seek to meet the objectives that are
applicable to the purpose described in such para-
graph and the populations served by the project.
‘‘(b) AUTHORIZED SERVICES.—
‘‘(1) IN GENERAL.—Subject to subsection (h),
the services referred to in this subsection are com-
prehensive services (including preventive and pri-
mary health services for pregnant women and in-
fants 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
applicant will include among the entities with which
the arrangements are made grantees under any of
sections 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
arrangements 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
geographic 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
average 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 po-
litical 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
Social Security Act for a State in which a dem-
onstration project under subsection (a) is car-
ried out, the Secretary may make a grant under
such subsection for the project only if, subject
to subparagraph (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
payments.
‘‘(B)(i) In the case of an entity making an
agreement pursuant to subparagraph (A)(ii) re-
garding the provision of services, the require-
ment established in such subparagraph regard-
ing a participation agreement shall be waived
by the Secretary if the entity does not, in pro-
viding health care services, impose a charge or
accept reimbursement available from any third-
party payor, including reimbursement under
any insurance 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
accepts voluntary donations regarding the pro-
vision 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 pro-
vide under title XIX of the Social Security Act, the
grant will not be expended to provide the service to
any individual to whom the State is required or has
elected under such title to provide the service.
section (a) only if each political subdivision in the
service area of the demonstration project involved
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 political subdivision 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
hospitals;
‘‘(B) to make cash payments to intended
recipients of health services or mental health
services; 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
COL-
LECTION.—The Secretary may make a grant under
subsection (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
established 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 Sec-
retary a report providing the following information with
respect to the project:
‘‘(1) The number of individuals that received
authorized services, and the demographic character-
istics 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
receiving authorized services have received the ap-
propriate 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 Secu-
rity Act (relating to early periodic screening, diag-
nostic, 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 appli-
cant involved agrees that, in preparing the proposal of the
applicant for the demonstration project involved, and in
the operation 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 author-
ized services 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 appli-
cation is in such form, is made in such manner, and con-
tains such agreements, assurances, and information as the
Secretary 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 Commit-
tee on Energy and Commerce of the House of Representa-
tives, 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 Sec-
retary has, in the service areas of such projects,
been successful in meeting the health status objec-
tives specified in subsection (a)(2); and
‘‘(3) describing the extent to which demonstra-
tion projects under subsection (a) have been cost ef-
fective.
‘‘(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 sec-
tion is repealed.’’.
(b) CERTAIN PROVISIONS REGARDING REPORTS.—
(1) FISCAL YEAR 1995.—With respect to grants
under section 330A of the Public Health Service Act
(as added by subsection (a) 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 330A, which
report provides, to the extent practicable, the infor-
mation described in subsection (j) of such section.
(2) FISCAL YEAR 1997.—With respect to grants
for fiscal year 1997 under section 330A of the Pub-
lic Health Service Act (as added by subsection (a)
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 notwithstand-
ing 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 330A of the Public Health Service Act (as
added by subsection (a) 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 330A of the Public Health Service Act
(as added by subsection (a) of this section), section 301
of such Act may not be construed as providing to the Sec-
retary of Health and Human Services any authority to
carry out, during any fiscal year in which such program
is in operation, any demonstration project to provide any
of the services specified in subsection (b) of such section
330A.
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 accord-
ance with this section award scholarships to individuals
described in subsection (b) for the purpose of assisting the
individuals 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 re-
ferred 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 stu-
dent in a program leading to a degree in a health
profession.
‘‘(3) The costs of attending such school would
constitute a severe financial hardship for the individ-
ual.
‘‘(4) The individual enters into the contract re-
quired pursuant to (d) as a condition of receiving
the scholarship (relating to an agreement to provide
primary health services in a health professional
shortage area designated under section 332).
‘‘(c) SPECIAL CONSIDERATION REGARDING CERTAIN
AWARDS.—In awarding scholarships under subsection (a),
the Secretary shall give special consideration to eligible in-
dividuals who received scholarships pursuant to this sec-
tion or section 737 for fiscal year 1993 or 1994 and are
seeking scholarships for attendance at eligible schools that
received a grant under either of such sections for either
of such fiscal years.
‘‘(d) APPLICABILITY OF CERTAIN PROVISIONS.—Ex-
cept as inconsistent with this section, the provisions 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 provisions apply to an award
of a scholarship under section 338A. This section shall be
carried 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 authorized to be appropriated $34,000,000 for
fiscal year 1995, $50,000,000 for fiscal year 1996,
and $65,000,000 for fiscal year 1997.
‘‘(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
subsection (a) for attendance at schools of
nursing; and
‘‘(B) 15 percent for scholarships under
such subsection for attendance at graduate pro-
grams 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 in effect on the day
before the date of the enactment of this Act pursu-
ant 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
compliance with such agreements, any period of
practice as a provider of primary health services
(whether provided pursuant to other agreements
with the Federal Government or whether provided
otherwise) counts toward satisfaction of the require-
ment of practice pursuant 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) FUNDING.—Section 737(h) of the Public Health
Service Act (42 U.S.C. 293a(h)) 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 follow-
ing: ‘‘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 Pub-
lic 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 REGARD-
ING 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 inserting the following: ‘‘there is authorized
to be appropriated $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 ‘‘des-
ignated 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
institutions of higher education and to prepare the
students academically for attendance at the des-
ignated health professions school;’’;
(4) in paragraph (5)—
(A) by striking ‘‘faculty and student re-
search’’ and inserting ‘‘student research’’; and
(B) by inserting before the period the fol-
lowing: ‘‘, 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 to minority
individuals, which program includes training pro-
vided at community-based health facilities that pro-
vide such services to a significant number of minor-
ity individuals and that are located at a site remote
from the main site of the teaching facilities of the
school.’’.
(c) REQUIREMENTS REGARDING CONSORTIA.—
(1) IN
GENERAL.—Section 739(c)(1) of the
Public Health Service Act (42 U.S.C. 293c(c)(1)), as
amended by subsection (a), is amended—
(A) in subparagraph (A), in the matter
preceding clause (i), by striking ‘‘specified in
subparagraph (B)’’ and inserting ‘‘specified in
subparagraphs (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 sub-
section (e)(1), the designated health professions
school involved has with other health profession
schools (designated or otherwise) formed a con-
sortium to carry out the purposes described in
subsection (b) at the schools of the consortium.
The grant involved may be expended with re-
spect to the other schools without regard to
whether such schools meet the conditions speci-
fied in subparagraph (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 follows:
‘‘(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,
osteopathic medicine, dentistry, pharmacy,
nursing, allied health, or public health, or
graduate programs in mental health prac-
tice;
‘‘(B) the schools of the consortium have
entered into an agreement for the allocation of
such grant among the schools; and
‘‘(C) each of the schools agrees to expend
the grant in accordance with this section.
‘‘(2) AUTHORITY
REGARDING
NATIVE
AMERI-
CANS CENTERS OF EXCELLENCE.—With respect to
meeting the conditions specified in subsection (c)(4),
the Secretary 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 con-
ditions.’’.
(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
subsection (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 sub-
section (c)(1)(B) may not be designated as a center
of excellence for purposes of this section. The pre-
ceding sentence 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) MODIFICATIONS
REGARDING
HISTORICALLY
BLACK
COLLEGES
AND
UNIVERSITIES.—Section
739(c)(2) of the Public Health Service Act (42 U.S.C.
293c(c)(2), as amended by subsection (a), is amended to
read as follows:
‘‘(2) AFRICAN-AMERICAN CENTERS OF EXCEL-
LENCE.—
‘‘(A) The conditions specified in this para-
graph are that—
‘‘(i) with respect to African American
individuals, each of clauses (i) through (iv)
of paragraph (1)(B) applies to the des-
ignated health professions school involved;
and
‘‘(ii) the school agree, as a condition
of receiving a grant under subsection (a),
that the school will, in carrying out the du-
ties described in subsection (b), give prior-
ity to carrying out the duties with respect
to African American individuals.
‘‘(B) The following historically black col-
leges or universities shall be considered to meet
the conditions specified in subparagraph (A):
Meharry Medical College School of Medicine.
Meharry Medical College School of Dentistry.
Morehouse School of Medicine. Tuskegee Uni-
versity School of Veterinary Medicine. Florida
A&M University College of Pharmacy. Texas
Southern University College of Pharmacy. Xa-
vier University College of Pharmacy. Howard
Medical College. Charles R. Drew University of
Medicine and Science.’’.
(e) 
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 fol-
lowing: ‘‘, 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).
(f) 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
$24,000,000 for fiscal year 1995, $26,000,000 for
fiscal year 1996, and $28,000,000 for fiscal year
1997.
‘‘(2) ALLOCATIONS BY SECRETARY.—
‘‘(A) Of the amounts appropriated under
paragraph (1) for a fiscal year, the Secretary
shall reserve an amount equal to the amount
appropriated for carrying out this section for
fiscal year 1994, and shall make the amount so
reserved available as follows:
‘‘(i) The Secretary shall make avail-
able $13,700,000 for grants under sub-
section (a) to designated health professions
schools that are eligible for such grants
pursuant to meeting the conditions de-
scribed in paragraph (2) of subsection (c).
‘‘(ii) Of the amounts so reserved and
available after compliance with clause (i),
the 
Secretary 
shall 
make 
available
$7,200,000 for grants under subsection (a)
to designated health professions schools
that are eligible for such grants pursuant
to meeting the conditions described in
paragraph (3) or (4) of subsection (c) (in-
cluding meeting conditions pursuant to
subsection (e)(2)).
‘‘(iii)(I) Of the amounts so reserved
and available after compliance with clause
(i), 
the 
Secretary 
shall, 
subject 
to
subclause (II), make available $2,500,000
for grants under subsection (a) to des-
ignated health professions schools that are
eligible for such grants pursuant to meet-
ing the conditions described in paragraph
(5) of subsection (c).
‘‘(II) A grant under subsection (a)
that includes amounts available under
clause (i) or (ii) may not include amounts
available under this clause.
‘‘(B) In the case of amounts appropriated
under paragraph (1) for a fiscal year and avail-
able after the Secretary reserves the amount re-
quired in subparagraph (A), the following ap-
plies: Grants under subsection (a) from such
amounts may be made to a designated health
professions school only if—
‘‘(i) the school has not previously re-
ceived any grant under such subsection (or
under section 782 as in effect on the day
before the date of the enactment of Public
Law 102–408); or
‘‘(ii) the amount of the most recent
grant under subsection (a) (or under such
section 782, as the case may be) that the
school received before such year is below
the mean average amount of the grants
that were made under such subsection for
the fiscal year involved.’’.
(g) CONFORMING AMENDMENTS.—Section 739(b) of
the Public Health Service Act (42 U.S.C. 293c(b)), 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’’.
(h) 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 Sec-
retary of Health and Human Services may, during
the period specified in paragraph (2), waive any or
all of the additional requirements established pursu-
ant to this section for the receipt or expenditure of
such a grant, subject to the entity providing assur-
ances satisfactory 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 Pub-
lic Health Service Act for fiscal year 1994, the pe-
riod referred 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 fol-
lows:
‘‘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 Sec-
retary may make grants and enter into contracts for
purposes of—
‘‘(A) identifying individuals who—
‘‘(i) 
are 
students 
of 
elementary
schools, or students or graduates of sec-
ondary schools or of institutions of higher
education;
‘‘(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
requirements for entry into health professions
schools.
‘‘(2) RECIPIENTS
OF
GRANTS
AND
CON-
TRACTS.—The Secretary may make an award of a
grant or contract under paragraph (1) only if the
applicant for the award is a nonprofit private com-
munity-based organization or other public or non-
profit private entity. Such other entities include
schools of medicine, osteopathic medicine, public
health, dentistry, veterinary medicine, optometry,
pharmacy, allied health, chiropractic, and podiatric
medicine, and include graduate programs in mental
health practice.
‘‘(3) CERTAIN
USES
OF
AWARDS.—The pur-
poses for which the Secretary may authorize an
award under paragraph (1) to be expended include
the following:
‘‘(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 sub-
paragraph (B) or (C), paying such stipends as
the Secretary may approve for individuals from
disadvantaged backgrounds for any period of
education 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 (notwith-
standing any other provision of law regarding
the amount of stipends).
‘‘(b) MINIMUM REQUIREMENTS FOR AWARDS.—
‘‘(1) ASSURANCES REGARDING FINANCIAL CA-
PACITY.—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 financial capacity to continue the ac-
tivities after the eligibility of the applicant for such
awards for such activities is terminated pursuant to
subsection (e).
‘‘(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 agree-
ment with any schools, institutions, community-
based organizations, or other entities with which the
applicant will collaborate in carrying out activities
under the award, and the agreement specifies wheth-
er and to what extent the award will be allocated
among the applicant and the entities.
‘‘(3) MATCHING FUNDS.—
‘‘(A) With respect to the costs of the ac-
tivities to be carried out under subsection (a)
by an applicant, the Secretary may make an
award of a grant or contract under such sub-
section only if the applicant agrees to make
available (directly or through donations from
public or private entities), in cash, non-Federal
contributions toward such costs in an amount
that—
‘‘(i) for any second fiscal year for
which the applicant receives such a grant,
is not less than 20 percent of such costs;
‘‘(ii) for any third such fiscal year, is
not less than 20 percent of such costs;
‘‘(iii) for any fourth such fiscal year,
is not less than 40 percent of such costs;
‘‘(iv) for any fifth such fiscal year, is
not less than 60 percent of such costs; and
‘‘(v) for any sixth or subsequent such
fiscal year, is not less than 80 percent of
such costs.
‘‘(B) Amounts provided by the Federal
Government may not be included in determin-
ing the amount of non-Federal contributions re-
quired in subparagraph (A).
‘‘(C) The Secretary may not require non-
Federal contributions for the first fiscal year
for which an applicant receives a grant under
subsection (a).
‘‘(c) PREFERENCE IN MAKING AWARDS.—
‘‘(1) IN GENERAL.—Subject to paragraph (2),
in making awards of grants and contracts under
subsection (a), the Secretary shall give preference to
any applicant that has made an arrangement with 1
or more elementary schools, an arrangement with 1
or more secondary schools, an arrangement with 1
or more institutions of higher education, an arrange-
ment with 1 or more health professions schools, and
an arrangement with 1 or more community-based or-
ganizations, the purpose of which arrangements is to
establish a program as follows:
‘‘(A) With respect to the elementary
schools involved, the program carries out the
purposes described in subsection (a)(1).
‘‘(B) After a student identified pursuant to
paragraph (1) enters the secondary school in-
volved, the program continues to carry out such
purposes with respect to the student.
‘‘(C) After graduating from the secondary
school, the student enters the institution of
higher education involved, subject to meeting
reasonable academic requirements, and the pro-
gram continues to carry out such purposes with
respect to the student.
‘‘(D) After graduating from the institution
of higher education, the student enters the
health professions school involved, subject to
meeting reasonable academic requirements.
‘‘(2) REQUIREMENT REGARDING SCHOOLS AND
INSTITUTIONS.—For purposes of paragraph (1), an
applicant may not receive preference unless the
schools or institutions with which arrangements have
been made are schools or institutions whose enroll-
ment of students includes a significant number of
individuals from disadvantaged backgrounds.
‘‘(d) LIMITATION ON YEARS OF FUNDING FOR PAR-
TICULAR ACTIVITIES.—With respect to a particular activ-
ity carried out under paragraph (1) or (3) of subsection
(a) by an entity, the Secretary may not, for the activity
involved, provide more than 6 years of financial assistance
under such subsection to the entity.
‘‘(e) FUNDING.—
‘‘(1) AUTHORIZATION
OF
APPROPRIATIONS.—
For the purpose of carrying out this section and sec-
tion 736, there are authorized to be appropriated
$32,000,000 for fiscal year 1995, $36,000,000 for
fiscal year 1996, and $38,000,000 for fiscal year
1997.
‘‘(2) ALLOCATIONS.—Of the amounts appro-
priated under paragraph (1) for a fiscal year, the
Secretary shall obligate not less than 20 percent for
carrying out subsection (a)(3)(B) and not less than
20 percent for providing scholarships under section
736.’’.
(b) TRANSITIONAL AND SAVINGS PROVISION.—In the
case of an entity that received an award of a grant or
contract for fiscal year 1994 under section 740 of the Pub-
lic Health Service Act, the Secretary of Health and
Human Services may continue in effect the award in ac-
cordance with the terms of the award, subject to the dura-
tion of the award not exceeding the period determined by
the Secretary in first approving the award. The preceding
sentence applies notwithstanding the amendment made by
subsection (a) of this section.
SEC. 306. STUDENT LOANS REGARDING SCHOOLS OF NURS-
ING.
Section 836(b) of the Public Health Service Act (42
U.S.C. 297b(b)) is amended—
(1) in paragraph (1), by striking the period at
the end and inserting a semicolon;
(2) in paragraph (2)—
(A) in subparagraph (A), by striking
‘‘and’’ at the end; and
(B) by inserting before the semicolon at
the end the following: ‘‘, and (C) such addi-
tional periods under the terms of paragraph (8)
of this subsection’’;
(3) in paragraph (7), by striking the period at
the end and inserting ‘‘; and’’; and
(4) by adding at the end the following para-
graph:
‘‘(8) pursuant to uniform criteria established by
the Secretary, the repayment period established
under paragraph (2) for any student borrower who
during the repayment period failed to make consecu-
tive payments and who, during the last 12 months
of the repayment period, has made at least 12 con-
secutive payments may be extended for a period not
to exceed 10 years.’’.
SEC. 307. FEDERALLY-SUPPORTED STUDENT LOAN FUNDS.
(a) AUTHORIZATION OF APPROPRIATIONS REGARD-
ING CERTAIN MEDICAL SCHOOLS.—
(1) IN GENERAL.—Subpart II of part A of title
VII of the Public Health Service Act (42 U.S.C.
292q et seq.) is amended—
(A) by transferring subsection (f) of sec-
tion 735 from the current placement of the sub-
section;
(B) by adding the subsection at the end of
section 723;
(C) by redesignating the subsection as sub-
section (e); and
(D) in subsection (e)(1) of section 723 (as
so redesignated), by striking ‘‘1996’’ and in-
serting ‘‘1997’’.
(2) CONFORMING AMENDMENTS.—Section 723
of the Public Health Service Act (42 U.S.C. 292s),
as amended by paragraph (1) of this subsection, is
amended in subsection (e)(2)(A)—
(A) by striking ‘‘section 723(b)(2)’’ and in-
serting ‘‘subsection (b)(2)’’; and
(B) by striking ‘‘such section’’ and insert-
ing ‘‘such subsection’’.
(b) AUTHORIZATION OF APPROPRIATIONS REGARD-
ING
INDIVIDUALS
FROM
DISADVANTAGED
BACK-
GROUNDS.—Section 724(f)(1) of the Public Health Serv-
ice Act (42 U.S.C. 292t(f)(1)) is amended to read as fol-
lows:
‘‘(1) IN
GENERAL.—With respect to making
Federal capital contributions to student loan funds
for purposes of subsection (a), other than the stu-
dent loan fund of any school of medicine or osteo-
pathic medicine, there is authorized to be appro-
priated $5,000,000 for each of the fiscal years 1995
through 1997.’’.
TITLE IV—RESEARCH
SEC. 401. OFFICE OF RESEARCH ON MINORITY HEALTH.
Section 404 of the Public Health Service Act, as
added by section 151 of Public Law 103–43, is amended
by adding at the end the following subsections:
‘‘(c) PLAN.—Subject to applicable law, the Director
of the Office, in consultation with the advisory committee
established under subsection (d), shall develop and imple-
ment a plan for carrying out the duties established in sub-
section (b). The Director shall review the plan not less
than annually, and revise the plan as appropriate.
‘‘(d) ADVISORY COMMITTEE.—
‘‘(1) In carrying out subsection (b), the Direc-
tor of the Office shall establish an advisory commit-
tee to be known as the Advisory Committee on Re-
search on Minority Health (in this subsection re-
ferred to as the ‘Committee’).
‘‘(2)(A) The Committee shall be composed of
nonvoting, ex offico members designated in accord-
ance with subparagraph (B) and voting members ap-
pointed in accordance with subparagraph (C).
‘‘(B) The Secretary shall designate as ex officio
members of the Committee the Directors of each of
the national research institutes and the Deputy As-
sistant Secretary for Minority Health (except that
any of such officials may designate another officer
or employee of the office or agency involved to serve
as a member of the Committee in lieu of the offi-
cial).
‘‘(C) The Director of the Office shall appoint as
voting members of the Committee not fewer than 12
and not more than 18 individuals who are not offi-
cers or employees of the Federal Government. The
appointments shall be made from among scientists
and health professionals whose clinical practice, re-
search specialization, or professional expertise in-
cludes significant expertise in research on minority
health. The appointed membership of the Advisory
Committee shall be broadly representative of the
various minority groups.
‘‘(3) The Director of the Office shall serve as
the chair of the Committee.
‘‘(4) The Committee shall—
‘‘(A) advise the Director of the Office on
appropriate research activities to be undertaken
by the national research institutes with respect
to—
‘‘(i) research on minority health;
‘‘(ii) research on racial and ethnic dif-
ferences in clinical drug trials, including
responses to pharmacological drugs;
‘‘(iii) research on racial and ethnic
differences in disease etiology, course, and
treatment; and
‘‘(iv) research on minority health con-
ditions which require a multidisciplinary
approach;
‘‘(B) report to the Director of the Office
on such research;
‘‘(C) provide recommendations to such Di-
rector regarding activities of the Office (includ-
ing recommendations on priorities in carrying
out research described in subparagraph (A));
and
‘‘(D) assist in monitoring compliance with
section 492B regarding the inclusion of minori-
ties in clinical research.
‘‘(5)(A) The Advisory Committee shall prepare
biennial reports describing the activities of the Com-
mittee, including findings made by the Committee
regarding—
‘‘(i) compliance with section 492B;
‘‘(ii) the extent of expenditures made for
research on minority health by the agencies of
the National Institutes of Health; and
‘‘(iii) the level of funding needed for such
research.
‘‘(B) Each report under subparagraph (A) shall
be submitted to the Director of NIH for inclusion in
the report required in section 403 for the period in-
volved.
‘‘(e) REPRESENTATION OF MINORITIES AMONG RE-
SEARCHERS.—The Secretary, acting through the Assist-
ant Secretary for Personnel and in collaboration with the
Director of the Office, shall determine the extent to which
the various minority groups are represented among admin-
istrators, senior physicians, and scientists of the national
research institutes and among physicians and scientists
conducting research with funds provided by such insti-
tutes, and as appropriate, carry out activities to increase
the extent of such representation.
‘‘(f) REQUIREMENT REGARDING GRANTS AND CON-
TRACTS.—Any award of a grant, cooperative agreement,
or contract that the Director of the Office is authorized
to make shall be made only on a competitive basis.
‘‘(g) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘minority health conditions’, with
respect to individuals who are members of minority
groups, means all diseases, disorders, and conditions
(including with respect to mental health)—
‘‘(A) unique to, more serious, or more
prevalent in such individuals;
‘‘(B) for which the factors of medical risk
or types of medical intervention are different
for such individuals, or for which it is unknown
whether such factors or types are different for
such individuals; or
‘‘(C) with respect to which there has been
insufficient clinical research involving such indi-
viduals as subjects or insufficient clinical data
on such individuals.
‘‘(2) The term ‘research on minority health’
means research on minority health conditions, in-
cluding research on preventing such conditions.
‘‘(3) The term ‘minority groups’ has the mean-
ing given such term in section 1707(h).’’.
SEC. 402. ACTIVITIES OF AGENCY FOR HEALTH CARE POL-
ICY AND RESEARCH.
Title IX of the Public Health Service Act (42 U.S.C.
299 et seq.) is amended—
(1) in section 902, by amending subsection (b)
to read as follows:
‘‘(b) REQUIREMENTS WITH RESPECT TO CERTAIN
POPULATIONS.—In carrying out subsection (a), the Ad-
ministrator shall undertake and support research, dem-
onstration projects, and evaluations with respect to the
health status of, and the delivery of health care to—
‘‘(1) the populations of medically underserved
urban or rural areas (including frontier areas); and
‘‘(2) low-income groups, minority groups, and
the elderly.’’; and
(2) in section 926(a), by adding at the end the
following sentence: ‘‘Of the amounts appropriated
under the preceding sentence for a fiscal year, the
Administrator shall reserve not less than 8 percent
for carrying out section 902(b)(2).’’.
TITLE V—NATIVE HAWAIIAN
HEALTH CARE
SEC. 501. CLARIFICATION OF 1992 AMENDMENTS.
(a) CLARIFICATION OF DATE OF PASSAGE.—Section
9168 of the Department of Defense Appropriations Act,
1993 (106 Stat. 1948) is amended by striking ‘‘September
12, 1992,’’ and inserting ‘‘August 7, 1992,’’.
(b) EFFECTIVE DATE.—The amendment made by
subsection (a) shall take effect as of October 6, 1992.
SEC. 502. AMENDMENT OF NATIVE HAWAIIAN HEALTH
CARE IMPROVEMENT ACT TO REFLECT 1992
AGREEMENT.
Effective on the date of enactment of this Act, the
Native Hawaiian Health Care Improvement Act (42
U.S.C.11701 et seq.) is amended to read as follows:
‘‘SECTION 1. SHORT TITLE.
‘‘This Act may be cited as the ‘Native Hawaiian
Health Care Improvement Act’.
‘‘SEC. 2. FINDINGS; DECLARATION OF POLICY; INTENT OF
CONGRESS.
‘‘(a) FINDINGS.—The Congress finds that—
‘‘(1) the United States retains the legal respon-
sibility to enforce the administration of the public
trust responsibility of the State of Hawaii for the
betterment of the conditions of Native Hawaiians
under section 5(f) of Public Law 86–3 (73 Stat. 6;
commonly referred to as the ‘Hawaii Statehood Ad-
missions Act’);
‘‘(2) in furtherance of the State of Hawaii’s
public trust responsibility for the betterment of the
conditions of Native Hawaiians, contributions by the
United States to the provision of comprehensive
health promotion and disease prevention services to
maintain and improve the health status of Native
Hawaiians are consistent with the historical and
unique legal relationship of the United States with
the government that represented the indigenous na-
tive people of Hawaii; and
‘‘(3) it is the policy of the United States to
raise the health status of Native Hawaiians to the
highest possible level and to encourage the maximum
participation of Native Hawaiians in order to
achieve this objective.
‘‘(b) DECLARATION OF POLICY.—The Congress here-
by declares that it is the policy of the United States in
fulfillment of its special responsibilities and legal obliga-
tions to the indigenous people of Hawaii resulting from
the unique and historical relationship between the United
States and the Government of the indigenous people of
Hawaii—
‘‘(1) to raise the health status of Native Hawai-
ians to the highest possible health level; and
‘‘(2) to provide existing Native Hawaiian health
care programs with all resources necessary to effec-
tuate this policy.
‘‘(c) INTENT OF CONGRESS.—It is the intent of the
Congress that the Nation meet the following health objec-
tives with respect to Native Hawaiians by the year 2000:
‘‘(1) Reduce coronary heart disease deaths to
no more than 100 per 100,000.
‘‘(2) Reduce stroke deaths to no more than 20
per 100,000.
‘‘(3) Increase control of high blood pressure to
at least 50 percent of people with high blood pres-
sure.
‘‘(4) Reduce blood cholesterol to an average of
no more than 200 mg/dl.
‘‘(5) Slow the rise in lung cancer deaths to
achieve a rate of no more than 42 per 100,000.
‘‘(6) Reduce breast cancer deaths to no more
than 20.6 per 100,000 women.
‘‘(7) Increase Pap tests every 1 to 3 years to
at least 85 percent of women age 18 and older.
‘‘(8) Increase fecal occult blood testing every 1
to 2 years to at least 50 percent of people age 50
and older.
‘‘(9) Reduce diabetes-related deaths to no more
than 34 per 100,000.
‘‘(10) Reduce the most severe complications of
diabetes as follows:
‘‘(A) End-stage renal disease to no more
than 1.4 in 1,000.
‘‘(B) Blindness to no more than 1.4 in
1,000.
‘‘(C) Lower extremity amputation to no
more than 4.9 in 1,000.
‘‘(D) Perinatal mortality to no more than
2 percent.
‘‘(E) Major congenital malformations to no
more than 4 percent.
‘‘(11) Reduce infant mortality to no more than
7 deaths per 1,000 live births.
‘‘(12) Reduce low birth weight to no more than
5 percent of live births.
‘‘(13) Increase first trimester prenatal care to
at least 90 percent of live births.
‘‘(14) Reduce teenage pregnancies to no more
than 50 per 1,000 girls age 17 and younger.
‘‘(15) Reduce unintended pregnancies to no
more than 30 percent of pregnancies.
‘‘(16) Increase to at least 60 percent the pro-
portion of primary care providers who provide age-
appropriate preconception care and counseling.
‘‘(17) Increase years of healthy life to at least
65 years.
‘‘(18) Eliminate financial barriers to clinical
preventive services.
‘‘(19) Increase childhood immunization levels to
at least 90 percent of 2-year-olds.
‘‘(20) Reduce the prevalence of dental caries to
no more than 35 percent of children by age 8.
‘‘(21) Reduce untreated dental caries so that
the proportion of children with untreated caries (in
permanent or primary teeth) is no more than 20
percent among children age 6 through 8 and no
more than 15 percent among adolescents age 15.
‘‘(22) Reduce edentulism to no more than 20
percent in people age 65 and older.
‘‘(23) Increase moderate daily physical activity
to at least 30 percent of the population.
‘‘(24) Reduce sedentary lifestyles to no more
than 15 percent of the population.
‘‘(25) Reduce overweight to a prevalence of no
more than 20 percent of the population.
‘‘(26) Reduce dietary fat intake to an average
of 30 percent of calories or less.
‘‘(27) Increase to at least 75 percent the pro-
portion of primary care providers who provide nutri-
tion assessment and counseling or referral to quali-
fied nutritionists or dieticians.
‘‘(28) Reduce cigarette smoking prevalence to
no more than 15 percent of adults.
‘‘(29) Reduce initiation of smoking to no more
than 15 percent by age 20.
‘‘(30) Reduce alcohol-related motor vehicle
crash deaths to no more than 8.5 per 100,000 ad-
justed for age.
‘‘(31) Reduce alcohol use by school children age
12 to 17 to less than 13 percent.
‘‘(32) Reduce marijuana use by youth age 18 to
25 to less than 8 percent.
‘‘(33) Reduce cocaine use by youth age 18 to
25 to less than 3 percent.
‘‘(34) Confine HIV infection to no more than
800 per 100,000.
‘‘(35) Reduce gonorrhea infections to no more
than 225 per 100,000.
‘‘(36) Reduce syphilis infections to no more
that 10 per 100,000.
‘‘(37) Reduce significant hearing impairment to
a prevalance of no more than 82 per 1,000.
‘‘(38) Reduce acute middle ear infections
among children age 4 and younger, as measured by
days of restricted activity or school absenteeism, to
no more than 105 days per 100 children.
‘‘(39) Reduce indigenous cases of vaccine-pre-
ventable diseases as follows:
‘‘(A) Diphtheria among individuals age 25
and younger to 0.
‘‘(B) Tetanus among individuals age 25
and younger to 0.
‘‘(C) Polio (wild-type virus) to 0.
‘‘(D) Measles to 0.
‘‘(E) Rubella to 0.
‘‘(F) Congenital Rubella Syndrome to 0.
‘‘(G) Mumps to 500.
‘‘(H) Pertussis to 1,000.
‘‘(40) Reduce significant visual impairment to a
prevalence of no more than 30 per 1,000.
‘‘(d) REPORT.—The Secretary shall submit to the
President, for inclusion in each report required to be
transmitted to the Congress under section 9, a report on
the progress made toward meeting each of the objectives
described in subsection (c).
‘‘SEC. 3. COMPREHENSIVE HEALTH CARE MASTER PLAN
FOR NATIVE HAWAIIANS.
‘‘The Secretary may make a grant to, or enter into
a contract with, Papa Ola Lokahi for the purpose of co-
ordinating, implementing, and updating a Native Hawai-
ian comprehensive health care master plan designed to
promote comprehensive health promotion and disease pre-
vention services and to maintain and improve the health
status of Native Hawaiians. The master plan shall be
based upon an assessment of the health care status and
health care needs of Native Hawaiians. To the extent
practicable, assessments made as of the date of such grant
or contract shall be used by Papa Ola Lokahi, except that
any such assessment shall be updated as appropriate.
‘‘SEC. 4. NATIVE HAWAIIAN HEALTH CARE SYSTEMS.
‘‘(a) COMPREHENSIVE HEALTH PROMOTION, DIS-
EASE PREVENTION, AND PRIMARY HEALTH SERVICES.—
(1)(A) The Secretary, in consultation with Papa Ola
Lokahi, may make grants to, or enter into contracts with,
any qualified entity for the purpose of providing com-
prehensive health promotion and disease prevention serv-
ices as well as primary health services to Native Hawai-
ians.
‘‘(B) In making grants and entering into contracts
under this paragraph, the Secretary shall give preference
to Native Hawaiian health care systems and Native Ha-
waiian organizations, and, to the extent feasible, health
promotion and disease prevention services shall be per-
formed through Native Hawaiian health care systems.
‘‘(2) In addition to paragraph (1), the Secretary may
make a grant to, or enter into a contract with, Papa Ola
Lokahi for the purpose of planning Native Hawaiian
health care systems to serve the health needs of Native
Hawaiian communities on the islands of O’ahu, Moloka’i,
Maui, Hawai’i, Lana’i, Kaua’i, and Ni’ihau in the State
of Hawaii.
‘‘(b) QUALIFIED ENTITY.—An entity is a qualified
entity for purposes of subsection (a)(1) if the entity is a
Native Hawaiian health care system.
‘‘(c) SERVICES TO BE PROVIDED.—(1) Each recipi-
ent of funds under subsection (a)(1) shall provide the fol-
lowing services:
‘‘(A) Outreach services to inform Native Hawai-
ians of the availability of health services.
‘‘(B) Education in health promotion and disease
prevention of the Native Hawaiian population by
(wherever possible) Native Hawaiian health care
practitioners, community outreach workers, coun-
selors, and cultural educators.
‘‘(C) Services of physicians, physicians’ assist-
ants, or nurse practitioners.
‘‘(D) Immunizations.
‘‘(E) Prevention and control of diabetes, high
blood pressure, and otitis media.
‘‘(F) Pregnancy and infant care.
‘‘(G) Improvement of nutrition.
‘‘(2) In addition to the mandatory services under
paragraph (1), the following services may be provided pur-
suant to subsection (a)(1):
‘‘(A) Identification, treatment, control, and re-
duction of the incidence of preventable illnesses and
conditions endemic to Native Hawaiians.
‘‘(B) Collection of data related to the preven-
tion of diseases and illnesses among Native Hawai-
ians.
‘‘(C) Services within the meaning of the terms
‘health promotion’, ‘disease prevention’, and ‘pri-
mary health services’, as such terms are defined in
section 10, which are not specifically referred to in
paragraph (1) of this subsection.
‘‘(3) The health care services referred to in para-
graphs (1) and (2) which are provided under grants or
contracts under subsection (a)(1) may be provided by tra-
ditional Native Hawaiian healers.
‘‘(d) LIMITATION ON NUMBER OF ENTITIES.—Dur-
ing a fiscal year, the Secretary under this Act may make
a grant to, or hold a contract with, not more than 5 Native
Hawaiian health care systems.
‘‘(e) MATCHING FUNDS.—(1) The Secretary may not
make a grant or provide funds pursuant to a contract
under subsection (a)(1) to an entity—
‘‘(A) in an amount exceeding 75 percent of the
costs of providing health services under the grant or
contract; and
‘‘(B) unless the entity agrees that the entity
will make available, directly or through donations to
the entity, non-Federal contributions toward such
costs in an amount equal to not less than $1 (in
cash or in kind under paragraph (2)) for each $3 of
Federal funds provided in such grant or contract.
‘‘(2) Non-Federal contributions required in para-
graph (1) may be in cash or in kind, fairly evaluated, in-
cluding plant, equipment, or services. Amounts provided
by the Federal Government or services assisted or sub-
sidized to any significant extent by the Federal Govern-
ment may not be included in determining the amount of
such non-Federal contributions.
‘‘(3) The Secretary may waive the requirement estab-
lished in paragraph (1) if—
‘‘(A) the entity involved is a nonprofit private
entity described in subsection (b); and
‘‘(B) the Secretary, in consultation with Papa
Ola Lokahi, determines that it is not feasible for the
entity to comply with such requirement.
‘‘(f) RESTRICTION ON USE OF GRANT AND CON-
TRACT FUNDS.—The Secretary may not make a grant to,
or enter into a contract with, an entity under subsection
(a)(1) unless the entity agrees that amounts received pur-
suant to such subsection will not, directly or through con-
tract, be expended—
‘‘(1) for any purpose other than the purposes
described in subsection (c);
‘‘(2) to provide inpatient services;
‘‘(3) to make cash payments to intended recipi-
ents of health services; or
‘‘(4) to purchase or improve real property
(other than minor remodeling of existing improve-
ments to real property) or to purchase major medi-
cal equipment.
‘‘(g) LIMITATION ON CHARGES FOR SERVICES.—The
Secretary may not make a grant, or enter into a contract
with, an entity under subsection (a)(1) unless the entity
agrees that, whether health services are provided directly
or through contract—
‘‘(1) health services under the grant or contract
will be provided without regard to ability to pay for
the health services; and
‘‘(2) the entity will impose a charge for the de-
livery of health services, and such charge—
‘‘(A) will be made according to a schedule
of charges that is made available to the public,
and
‘‘(B) will be adjusted to reflect the income
of the individual involved.
‘‘SEC. 5. FUNCTIONS OF, AND GRANTS TO, PAPA OLA
LOKAHI.
‘‘(a) FUNCTIONS.—Papa Ola Lokahi shall—
‘‘(1) coordinate, implement, and update, as ap-
propriate, the comprehensive health care master
plan developed pursuant to section 3;
‘‘(2) to the maximum extent possible, coordi-
nate and assist the health care programs and serv-
ices provided to Native Hawaiians;
‘‘(3) provide for the training of the persons de-
scribed in section 4(c)(1)(B);
‘‘(4) develop an action plan outlining the con-
tributions that each member organization of Papa
Ola Lokahi will make in carrying out this Act;
‘‘(5) serve as a clearinghouse for—
‘‘(A) the collection and maintenance of
data associated with the health status of Native
Hawaiians;
‘‘(B) the identification of and research into
diseases affecting Native Hawaiians;
‘‘(C) the availability of Native Hawaiian
project funds, research projects, and publica-
tions;
‘‘(D) the timely dissemination of informa-
tion relating to Native Hawaiian health care
systems;
‘‘(6) perform the recognition and certification
functions 
specified 
in 
sections 
10(6)(F) 
and
10(6)(G); and
‘‘(7) provide technical support and coordination
of training and technical assistance to Native Ha-
waiian health care systems.
‘‘(b) SPECIAL PROJECT FUNDS.—Papa Ola Lokahi
may receive project funds that may be appropriated for
the purpose of research on the health status of Native Ha-
waiians or for the purpose of addressing the health care
needs of Native Hawaiians.
‘‘(c) GRANTS.—In addition to any other grant or con-
tract under this Act, the Secretary may make grants to,
or enter into contracts with, Papa Ola Lokahi for—
‘‘(1) carrying out the functions described in
subsection (a); and
‘‘(2) administering any special project funds re-
ceived under the authority of subsection (b).
‘‘(d) RELATIONSHIPS WITH OTHER AGENCIES.—
Papa Ola Lokahi may enter into agreements or memo-
randa of understanding with relevant agencies or organi-
zations that are capable of providing resources or services
to Native Hawaiian health care systems.
‘‘SEC. 6. ADMINISTRATION OF GRANTS AND CONTRACTS.
‘‘(a) TERMS AND CONDITIONS.—The Secretary shall
include in any grant made or contract entered into under
this Act such terms and conditions as the Secretary con-
siders necessary or appropriate to ensure that the objec-
tives of such grant or contract are achieved.
‘‘(b) PERIODIC REVIEW.—The Secretary shall peri-
odically evaluate the performance of, and compliance with,
grants and contracts under this Act.
‘‘(c) ADMINISTRATIVE REQUIREMENTS.—The Sec-
retary may not make a grant or enter into a contract
under this Act with an entity unless the entity—
‘‘(1) agrees to establish such procedures for fis-
cal control and fund accounting as may be necessary
to ensure proper disbursement and accounting with
respect to the grant or contract;
‘‘(2) agrees to ensure the confidentiality of
records maintained on individuals receiving health
services under the grant or contract;
‘‘(3) with respect to providing health services to
any population of Native Hawaiians a substantial
portion of which has a limited ability to speak the
English language—
‘‘(A) has developed and has the ability to
carry out a reasonable plan to provide health
services under the grant or contract through in-
dividuals who are able to communicate with the
population involved in the language and cultural
context that is most appropriate; and
‘‘(B) has designated at least one individ-
ual, fluent in both English and the appropriate
language, to assist in carrying out the plan;
‘‘(4) with respect to health services that are
covered in the plan of the State of Hawaii approved
under title XIX of the Social Security Act—
‘‘(A) if the entity will provide under the
grant or contract any such health services di-
rectly—
‘‘(i) the entity has entered into a par-
ticipation agreement under such plan; and
‘‘(ii) the entity is qualified to receive
payments under such plan; and
‘‘(B) if the entity will provide under the
grant or contract any such health services
through a contract with an organization—
‘‘(i) the organization has entered into
a participation agreement under such plan;
and
‘‘(ii) the organization is qualified to
receive payments under such plan; and
‘‘(5) agrees to submit to the Secretary and to
Papa Ola Lokahi an annual report that describes
the utilization and costs of health services provided
under the grant or contract (including the average
cost of health services per user) and that provides
such other information as the Secretary determines
to be appropriate.
‘‘(d) CONTRACT EVALUATION.—(1) If, as a result of
evaluations conducted by the Secretary, the Secretary de-
termines that an entity has not complied with or satisfac-
torily performed a contract entered into under section 4,
the Secretary shall, prior to renewing such contract, at-
tempt to resolve the areas of noncompliance or unsatisfac-
tory performance and modify such contract to prevent fu-
ture occurrences of such noncompliance or unsatisfactory
performance. If the Secretary determines that such non-
compliance or unsatisfactory performance cannot be re-
solved and prevented in the future, the Secretary shall not
renew such contract with such entity and is authorized
to enter into a contract under section 4 with another en-
tity referred to in section 4(b) that provides services to
the same population of Native Hawaiians which is served
by the entity whose contract is not renewed by reason of
this subsection.
‘‘(2) In determining whether to renew a contract en-
tered into with an entity under this Act, the Secretary
shall consider the results of evaluation under this section.
‘‘(3) All contracts entered into by the Secretary under
this Act shall be in accordance with all Federal contract-
ing laws and regulations except that, in the discretion of
the Secretary, such contracts may be negotiated without
advertising and may be exempted from the provisions of
the Act of August 24, 1935 (40 U.S.C. 270a et seq.).
‘‘(4) Payments made under any contract entered into
under this Act may be made in advance, by means of reim-
bursement, or in installments and shall be made on such
conditions as the Secretary deems necessary to carry out
the purposes of this Act.
‘‘(e) LIMITATION ON USE OF FUNDS FOR ADMINIS-
TRATIVE EXPENSES.—Except for grants and contracts
under section 5(c), the Secretary may not make a grant
to, or enter into a contract with, an entity under this Act
unless the entity agrees that the entity will not expend
more than 10 percent of amounts received pursuant to this
Act for the purpose of administering the grant or contract.
‘‘(f) REPORT.—(1) For each fiscal year during which
an entity receives or expends funds pursuant to a grant
or contract under this Act, such entity shall submit to the
Secretary and to Papa Ola Lokahi a quarterly report on—
‘‘(A) activities conducted by the entity under
the grant or contract;
‘‘(B) the amounts and purposes for which Fed-
eral funds were expended; and
‘‘(C) such other information as the Secretary
may request.
‘‘(2) The reports and records of any entity which con-
cern any grant or contract under this Act shall be subject
to audit by the Secretary, the Inspector General of Health
and Human Services, and the Comptroller General of the
United States.
‘‘(g) ANNUAL PRIVATE AUDIT.—The Secretary shall
allow as a cost of any grant made or contract entered into
under this Act the cost of an annual private audit con-
ducted by a certified public accountant.
‘‘SEC. 7. ASSIGNMENT OF PERSONNEL.
‘‘(a) IN GENERAL.—The Secretary is authorized to
enter into an agreement with any entity under which the
Secretary is authorized to assign personnel of the Depart-
ment of Health and Human Services with expertise identi-
fied by such entity to such entity on detail for the purposes
of providing comprehensive health promotion and disease
prevention services to Native Hawaiians.
‘‘(b) APPLICABLE FEDERAL PERSONNEL PROVI-
SIONS.—Any assignment of personnel made by the Sec-
retary under any agreement entered into under the au-
thority of subsection (a) shall be treated as an assignment
of Federal personnel to a local government that is made
in accordance with subchapter VI of chapter 33 of title
5, United States Code.
‘‘SEC. 8. NATIVE HAWAIIAN HEALTH SCHOLARSHIPS.
‘‘(a) ELIGIBILITY.—The Secretary is authorized to
make scholarship grants to students who—
‘‘(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 iden-
tified by Papa Ola Lokahi;
‘‘(B) in selecting scholarship recipients, the
Secretary shall give priority to individuals included
on a list of eligible applicants submitted by the Ka-
mehameha Schools/Bishop Estate;
‘‘(C) the obligated service requirement for each
scholarship recipient shall be fulfilled through serv-
ice, 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 assigned, has received a grant or entered into
a contract pursuant to section 4; or
‘‘(ii) health professions shortage areas,
medically underserved areas, or geographic
areas or facilities similarly designated by the
United States Public Health Service in the
State of Hawaii.
‘‘(2) The Secretary shall enter into a cooperative
agreement with the Kamehameha Schools/Bishop Estate
under which such organization shall provide recruitment,
retention, counseling, and other support services intended
to improve the operation of the scholarship program estab-
lished under this section.
‘‘(3) The Native Hawaiian Health Scholarship pro-
gram shall not be administered by or through the Indian
Health Service.
‘‘SEC. 9. REPORT.
‘‘The President shall, at the time the budget is sub-
mitted under section 1105 of title 31, United States Code,
for each fiscal year transmit to the Congress the report
required pursuant to section 2(d).
‘‘SEC. 10. DEFINITIONS.
‘‘For purposes of this Act:
‘‘(1) DISEASE PREVENTION.—The term ‘disease
prevention’ includes—
‘‘(A) immunizations,
‘‘(B) control of high blood pressure,
‘‘(C) control of sexually transmittable dis-
eases,
‘‘(D) prevention and control of diabetes,
‘‘(E) control of toxic agents,
‘‘(F) occupational safety and health,
‘‘(G) accident prevention,
‘‘(H) fluoridation of water,
‘‘(I) control of infectious agents, and
‘‘(J) provision of mental health care.
‘‘(2) HEALTH PROMOTION.—The term ‘health
promotion’ includes—
‘‘(A) pregnancy and infant care, including
prevention of fetal alcohol syndrome,
‘‘(B) cessation of tobacco smoking,
‘‘(C) reduction in the misuse of alcohol and
drugs,
‘‘(D) improvement of nutrition,
‘‘(E) improvement in physical fitness,
‘‘(F) family planning, and
‘‘(G) control of stress.
‘‘(3) NATIVE
HAWAIIAN.—The term ‘Native
Hawaiian’ means any individual who is—
‘‘(A) a citizen of the United States; and
‘‘(B) a descendant of the aboriginal people,
who prior to 1778, occupied and exercised sov-
ereignty in the area that now constitutes the
State of Hawaii, as evidenced by—
‘‘(i) genealogical records;
‘‘(ii) Kupuna (elders) or Kama’aina
(long-term community residents) verifica-
tion; or
‘‘(iii) birth records of the State of Ha-
waii.
‘‘(4) NATIVE HAWAIIAN HEALTH CENTER.—The
term ‘Native Hawaiian health center’ means an en-
tity—
‘‘(A) which is organized under the laws of
the State of Hawaii,
‘‘(B) which provides or arranges for health
care services through practitioners licensed by
the State of Hawaii, where licensure require-
ments are applicable,
‘‘(C) which is a public or nonprofit private
entity, and
‘‘(D) in which Native Hawaiian health
practitioners significantly participate in the
planning, management, monitoring, and evalua-
tion of health services.
‘‘(5) NATIVE
HAWAIIAN
ORGANIZATION.—The
term ‘Native Hawaiian organization’ means any or-
ganization—
‘‘(A) which serves the interests of Native
Hawaiians,
‘‘(B) which is—
‘‘(i) recognized by Papa Ola Lokahi
for the purpose of planning, conducting, or
administering programs (or portions of
programs) authorized under this Act for
the benefit of Native Hawaiians, and
‘‘(ii) certified by Papa Ola Lokahi as
having the qualifications and capacity to
provide the services, and meet the require-
ments, under the contract the organization
enters into with, or grant the organization
receives from, the Secretary under this
Act,
‘‘(C) in which Native Hawaiian health
practitioners significantly participate in the
planning, management, monitoring, and evalua-
tion of health services, and
‘‘(D) which is a public or nonprofit private
entity.
‘‘(6) NATIVE
HAWAIIAN
HEALTH
CARE
SYS-
TEM.—The term ‘Native Hawaiian health care sys-
tem’ means an entity—
‘‘(A) which is organized under the laws of
the State of Hawaii;
‘‘(B) which provides or arranges for health
care services through practitioners licensed by
the State of Hawaii, where licensure require-
ments are applicable;
‘‘(C) which is a public or nonprofit private
entity;
‘‘(D) in which Native Hawaiian health
practitioners significantly participate in the
planning, management, monitoring, and evalua-
tion of health care services;
‘‘(E) which may be composed of as many
Native Hawaiian health centers as necessary to
meet the health care needs of Native Hawaiians
residing on the island or islands served by such
entity;
100
‘‘(F) which is recognized by Papa Ola
Lokahi for the purpose of providing comprehen-
sive health promotion and disease prevention
services as well as primary health services to
Native Hawaiians under this Act; and
‘‘(G) which is certified by Papa Ola Lokahi
as having the qualifications and the capacity to
provide the services and meet the requirements
of a contract entered into, or a grant received,
under section 4.
‘‘(7) PAPA OLA LOKAHI.—(A) Subject to sub-
paragraph (B), the term ‘Papa Ola Lokahi’ means
an organization composed of—
‘‘(i) E Ola Mau;
‘‘(ii) the Office of Hawaiian Affairs of the
State of Hawaii;
‘‘(iii) Alu Like Inc.;
‘‘(iv) the University of Hawaii;
‘‘(v) the Office of Hawaiian Health of the
Hawaii State Department of Health;
‘‘(vi) Ho’ola Lahui Hawaii, or a health
care system serving the islands of Kaua’i and
Ni’ihau;
‘‘(vii) Ke Ola Mamo, or a health care sys-
tem serving the island of O’ahu;
101
‘‘(viii) Na Pu’uwai or a health care system
serving the islands of Moloka’i and Lana’i;
‘‘(ix) Hui No Ke Ola Pono, or a health
care system serving the island of Maui;
‘‘(x) Hui Malama Ola Ha’Oiwi or a health
care system serving the island of Hawaii; and
‘‘(xi) such other member organizations as
the Board of Papa Ola Lokahi may admit from
time to time, based upon satisfactory dem-
onstration of a record of contribution to the
health and well-being of Native Hawaiians, and
upon satisfactory development of a mission
statement in relation to this Act, including
clearly defined goals and objectives, a 5-year ac-
tion plan outlining the contributions that each
organization will make in carrying out the pol-
icy of this Act, and an estimated budget.
‘‘(B) Such term does not include any organiza-
tion identified in subparagraph (A) if the Secretary
determines that such organization does not have a
mission statement with clearly defined goals and ob-
jectives for the contributions the organization will
make to Native Hawaiian health care systems and
an action plan for carrying out such goals and objec-
tives.
102
‘‘(8) PRIMARY HEALTH SERVICES.—The term
‘primary health services’ means—
‘‘(A) services of physicians, physicians’ as-
sistants and nurse practitioners;
‘‘(B) diagnostic laboratory and radiologic
services;
‘‘(C) preventive health services (including
children’s eye and ear examinations to deter-
mine the need for vision and hearing correction,
perinatal services, well child services, and family
planning services);
‘‘(D) emergency medical services;
‘‘(E) transportation services as required
for adequate patient care;
‘‘(F) preventive dental services; and
‘‘(G) pharmaceutical services, as may be
appropriate for particular health centers.
‘‘(9) SECRETARY.—The term ‘Secretary’ means
the Secretary of Health and Human Services.
‘‘(10) TRADITIONAL NATIVE HAWAIIAN HEAL-
ER.—The term ‘traditional Native Hawaiian healer’
means a practitioner—
‘‘(A) who—
‘‘(i) is of Hawaiian ancestry, and
103
‘‘(ii) has the knowledge, skills, and ex-
perience in direct personal health care of
individuals, and
‘‘(B) whose knowledge, skills, and experi-
ence are based on a demonstrated learning of
Native Hawaiian healing practices acquired
by—
‘‘(i) direct practical association with
Native Hawaiian elders, and
‘‘(ii) oral traditions transmitted from
generation to generation.
‘‘SEC. 11. RULE OF CONSTRUCTION.
‘‘Nothing in this Act shall be construed to restrict
the authority of the State of Hawaii to license health prac-
titioners.
‘‘SEC. 12. COMPLIANCE WITH BUDGET ACT.
‘‘Any new spending authority (described in subsection
(c)(2) (A) or (B) of section 401 of the Congressional
Budget Act of 1974) which is provided under this Act
shall be effective for any fiscal year only to such extent
or in such amounts as are provided in appropriation Acts.
‘‘SEC. 13. SEVERABILITY.
‘‘If any provision of this Act, or the application of
any such provision to any person or circumstances is held
to be invalid, the remainder of this Act, and the applica-
104
tion of such provision or amendment to persons or cir-
cumstances other than those to which it is held invalid,
shall not be affected thereby.
‘‘SEC. 14. AUTHORIZATION OF APPROPRIATIONS.
‘‘There is authorized to be appropriated for each of
the fiscal years 1994, 1995, 1996, 1997, 1998, 1999, and
2000 such sums as may be necessary to carry out the pur-
poses of this Act.
‘‘SEC. 15. PROHIBITION AGAINST EXCLUSION FROM PAR-
TICIPATION.
‘‘Notwithstanding any other provision of this Act, no
person shall, on the basis of race, color, or national origin,
be excluded from participation in, or be denied the benefits
of, or be subjected to discrimination under, any program
or activity receiving Federal financial assistance under
this Act.’’.
SEC. 503. REPEAL OF PUBLIC HEALTH SERVICE ACT PROVI-
SION.
The Public Health Service Act (42 U.S.C. 201 et
seq.), as amended by section 206 of this Act, is amended
by repealing section 338K and redesignating section 338L
as section 338K. Such repeal shall not be construed to
terminate contracts in effect under such section on the
date of the enactment of this Act. Any such contracts shall
105
continue according to the terms and conditions of such
contracts.
TITLE VI—MISCELLANEOUS
PROVISIONS
SEC. 601. TECHNICAL AMENDMENT TO INDIAN HEALTH
CARE IMPROVEMENT ACT.
The last sentence of section 818(e)(3) of the Indian
Health Care Improvement Act (25 U.S.C. 1680h(e)(3))
is amended—
(1) by striking ‘‘services,’’ and inserting ‘‘serv-
ices’’; and
(2) by striking ‘‘, shall be recoverable.’’ and in-
serting a period.
SEC. 602. HEALTH SERVICES FOR PACIFIC ISLANDERS.
Section 10 of the Disadvantaged Minority Health Im-
provement Act of 1990 (42 U.S.C. 254c–1) is amended—
(1) in subsection (b)—
(A) by striking paragraphs (5) and (6);
(B) by redesignating paragraphs (7) and
(8) as paragraphs (5) and (6), respectively;
(C) in paragraph (1) (as so redesig-
nated)—
(i) by inserting ‘‘substance abuse’’
after ‘‘availability of health’’; and
106
(ii) by striking ‘‘, including improved
health data systems’’; and
(D) in paragraph (2) (as so redesig-
nated)—
(i) by striking ‘‘manpower’’ and in-
serting ‘‘care providers’’; and
(ii) by striking ‘‘by—’’ and all that
follows through the end thereof and insert-
ing a semicolon; and
(2) in subsection (f)—
(A) by striking ‘‘there is’’ and inserting
‘‘there are’’; and
(B) by striking ‘‘$10,000,000’’ and all that
follows 
through 
‘‘1993’’ 
and 
inserting
‘‘$3,000,000 for each of the fiscal years 1995
through 1997’’.
SEC. 603. TECHNICAL CORRECTIONS REGARDING PUBLIC
LAW 103–183.
(a) AMENDATORY INSTRUCTIONS.—Public Law 103–
183 is amended—
(1) in section 301(a), by striking ‘‘(42 U.S.C.
242 et seq.)’’ and inserting ‘‘(42 U.S.C. 243 et
seq.)’’;
(2) in section 601—