344
sions under subchapter I of chapter 57 of title 5, United 
States Code. 
(g) CHAIRPERSON AND VICE CHAIRPERSON.—The 
members of the Commission shall elect a Chairperson and 
Vice Chairperson of the Commission from among the 
members. 
(h) MEETINGS.—
(1) IN GENERAL.—The Commission shall meet 
at the call of the Chairperson or a majority of its 
members. 
(2) INITIAL MEETING.—Not later than 30 days 
after the date on which all members of the Commis-
sion have been appointed, the Commission shall hold 
its first meeting. 
SEC. 515. POWERS OF COMMISSION. 
(a) HEARINGS
AND SESSIONS.—The Commission 
may, for the purpose of carrying out this subtitle, hold 
hearings, sit and act at times and places, take testimony, 
and receive evidence as the Commission considers appro-
priate to carry out this subtitle. 
(b) POWERS OF MEMBERS AND AGENTS.—Any mem-
ber or agent of the Commission may, if authorized by the 
Commission, take any action that the Commission is au-
thorized to take by this section.
345
(c) OBTAINING OFFICIAL DATA.—Notwithstanding 
sections 552 and 552a of title 5, United States Code, the 
Commission may secure directly from any department or 
agency of the United States information necessary to en-
able it to carry out this subtitle. Upon request of the Com-
mission, the head of that department or agency shall fur-
nish that information to the Commission. 
(d) POSTAL SERVICES.—The Commission may use 
the United States mails in the same manner and under 
the same conditions as other departments and agencies of 
the United States. 
(e) WEBSITE.—For purposes of conducting the study 
under section 512(b)(1), the Commission shall establish 
and maintain a website to facilitate public comment and 
participation. 
(f) STAFF OF FEDERAL AGENCIES.—Upon request 
of the Commission, the head of any Federal department 
or agency may detail, on a nonreimbursable basis, any of 
the personnel of that department or agency to the Com-
mission to assist it in carrying out its duties under this 
subtitle. 
(g) ADMINISTRATIVE SUPPORT SERVICES.—Upon 
the request of the Commission, the Administrator of Gen-
eral Services may provide to the Commission, on a non-
reimbursable basis, the administrative support services
346
necessary for the Commission to carry out its responsibil-
ities under this subtitle. 
SEC. 516. TERMINATION. 
The Commission shall terminate 1 year after submit-
ting its final report pursuant to section 513. 
TITLE VI—ACCOUNTABILITY 
SEC. 601. REPORT ON WORKFORCE DIVERSITY. 
(a) IN GENERAL.—Not later than July 1, 2005, and 
annually thereafter, the Secretary, acting through the di-
rector of each entity within the Department of Health and 
Human Services, shall prepare and submit to the Com-
mittee on Health, Education, Labor, and Pensions of the 
Senate and the Committee on Energy and Commerce of 
the House of Representatives a report on healthcare work-
force diversity. 
(b) REQUIREMENT.—The report under subsection (a) 
shall contain the following information: 
(1) The response of the entity involved to the 
upcoming 2004 Institute of Medicine report on 
workforce diversity, the 2002 Institute of Medicine 
report entitled The Future of the Public Health in 
the 21st Century, and the Healthy People 2010 ini-
tiative.
347
(2) A description of the personnel in each such 
entity who are responsible for overseeing workforce 
diversity initiatives. 
(3) The level of workforce diversity achieved 
within each such entity, including absolute numbers 
and percentages of minority employees as well as the 
rank of such employees. 
(4) A description of any grant support that is 
provided by each entity for workforce diversity ini-
tiatives, including the amount of the grants and the 
percentage of grant funds as compared to overall en-
tity funding; 
(c) PUBLIC AVAILABILITY.—The report under sub-
section (a) shall be made available for public review and 
comment. 
SEC. 602. FEDERAL AGENCY PLAN TO ELIMINATE DISPARI-
TIES AND IMPROVE THE HEALTH OF MINOR-
ITY POPULATIONS. 
(a) IN GENERAL.—Not later than September 1, 
2005, each Federal health agency shall develop and imple-
ment a national strategic action plan to eliminate dispari-
ties on the basis of race, ethnicity, and primary language 
and improve the health and healthcare of minority popu-
lations, through programs relevant to the mission of the 
agency.
348
(b) PUBLICATION.—Each action plan described in 
paragraph (1) shall—
(1) be publicly reported in draft form for public 
review and comment; 
(2) include a response to the review and com-
ment described in paragraph (1) in the final plan; 
(3) include the agency response to the 2002 In-
stitute of Medicine report, Unequal Treatment—
Confronting Racial and Ethnic Disparities in 
Healthcare; 
(4) demonstrate progress in meeting the 
Healthy People 2010 objectives; and 
(5) be updated, including progress reports, for 
inclusion in an annual report to Congress. 
SEC. 603. ACCOUNTABILITY WITHIN THE DEPARTMENT OF 
HEALTH AND HUMAN SERVICES. 
Title XXIX of the Public Health Service Act, as 
amended by section 502(b), is further amended by adding 
at the end the following: 
‘‘Subtitle F—Accountability 
‘‘SEC. 2961. ELEVATION OF THE OFFICE OF CIVIL RIGHTS. 
‘‘(a) IN GENERAL.—The Secretary shall establish 
within the Office for Civil Rights an Office of Health Dis-
parities, which shall be headed by a director to be ap-
pointed by the Secretary.
349
‘‘(b) PURPOSE.—The Office of Health Disparities 
shall ensure that the health programs, activities, and oper-
ations of health entities which receive Federal financial as-
sistance are in compliance with title VI of the Civil Rights 
Act, which prohibits discrimination on the basis of race, 
color, or national origin. The activities of the Office shall 
include the following: 
‘‘(1) The development and implementation of 
an action plan to address racial and ethnic 
healthcare disparities, which shall address concerns 
relating to the Office for Civil Rights as released by 
the United States Commission on Civil Rights in the 
report entitled ‘Health Care Challenge: Acknowl-
edging Disparity, Confronting Discrimination, and 
Ensuring Equity’ (September, 1999). This plan shall 
be publicly disclosed for review and comment and 
the final plan shall address any comments or con-
cerns that are received by the Office. 
‘‘(2) Investigative and enforcement actions 
against intentional discrimination and policies and 
practices that have a disparate impact on minorities. 
‘‘(3) The review of racial, ethnic, and primary 
language health data collected by Federal health 
agencies to assess healthcare disparities related to
350
intentional discrimination and policies and practices 
that have a disparate impact on minorities. 
‘‘(4) Outreach and education activities relating 
to compliance with title VI of the Civil Rights Act. 
‘‘(5) The provision of technical assistance for 
health entities to facilitate compliance with title VI 
of the Civil Rights Act. 
‘‘(6) Coordination and oversight of activities of 
the civil rights compliance offices established under 
section 2962. 
‘‘(7) Ensuring compliance with the 1997 Office 
of Management and Budget Standards for Maintain-
ing, Collecting, and Presenting Federal Data on 
Race, Ethnicity and the available language stand-
ards. 
‘‘(c) FUNDING AND STAFF.—The Secretary shall en-
sure the effectiveness of the Office of Health Disparities 
by ensuring that the Office is provided with—
‘‘(1) adequate funding to enable the Office to 
carry out its duties under this section; and 
‘‘(2) staff with expertise in—
‘‘(A) epidemiology; 
‘‘(B) statistics; 
‘‘(C) health quality assurance;
351
‘‘(D) minority health and health dispari-
ties; and 
‘‘(E) civil rights. 
‘‘(d) REPORT.—Not later than December 31, 2005, 
and annually thereafter, the Secretary, in collaboration 
with the Director of the Office for Civil Rights, shall sub-
mit a report to the Committee on Health, Education, 
Labor, and Pensions of the Senate and the Committee on 
Energy and Commerce of the House of Representatives 
that includes—
‘‘(1) the number of cases filed, broken down by 
category; 
‘‘(2) the number of cases investigated and 
closed by the office; 
‘‘(3) the outcomes of cases investigated; and 
‘‘(4) the staffing levels of the office including 
staff credentials. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2005 through 2010.
352
‘‘SEC. 2962. ESTABLISHMENT OF HEALTH PROGRAM OF-
FICES FOR CIVIL RIGHTS WITHIN FEDERAL 
HEALTH AND HUMAN SERVICES AGENCIES. 
‘‘(a) IN GENERAL.—The Secretary shall establish 
civil rights compliance offices in each agency within the 
Department of Health and Human Services that admin-
isters health programs. 
‘‘(b) PURPOSE OF OFFICES.—Each office established 
under subsection (a) shall ensure that recipients of Fed-
eral financial assistance under Federal health programs 
administer their programs, services, and activities in a 
manner that— 
‘‘(1) does not discriminate, either intentionally 
or in effect, on the basis of race, national origin, lan-
guage, ethnicity, sex, age, or disability; and 
‘‘(2) promotes the reduction and elimination of 
disparities in health and healthcare based on race, 
national origin, language, ethnicity, sex, age, and 
disability. 
‘‘(c) POWERS AND DUTIES.—The offices established 
in subsection (a) shall have the following powers and du-
ties: 
‘‘(1) The establishment of compliance and pro-
gram participation standards for recipients of Fed-
eral financial assistance under each program admin-
istered by an agency within the Department of
353
Health and Human Services including the establish-
ment of disparity reduction standards to encompass 
disparities in health and healthcare related to race, 
national origin, language, ethnicity, sex, age, and 
disability. 
‘‘(2) The development and implementation of 
program-specific guidelines that interpret and apply 
Department of Health and Human Services guid-
ance under title VI of the Civil Rights Act of 1964 
to each Federal health program administered by the 
agency. 
‘‘(3) The development of a disparity-reduction 
impact analysis methodology that shall be applied to 
every rule issued by the agency and published as 
part of the formal rulemaking process under sections 
555, 556, and 557 of title 5, United States Code. 
‘‘(4) Oversight of data collection, analysis, and 
publication requirements for all recipients of Federal 
financial assistance under each Federal health pro-
gram administered by the agency, and compliance 
with the 1997 Office of Management and Budget 
Standards for Maintaining, Collecting, and Pre-
senting Federal Data on Race and Ethnicity and the 
available language standards.
354
‘‘(5) The conduct of publicly available studies 
regarding discrimination within Federal health pro-
grams administered by the agency as well as dis-
parity reduction initiatives by recipients of Federal 
financial assistance under Federal health programs. 
‘‘(6) Annual reports to the Committee on 
Health, Education, Labor, and Pensions and the 
Committee on Finance of the Senate and the Com-
mittee on Energy and Commerce and the Committee 
on Ways and Means of the House of Representatives 
on the progress in reducing disparities in health and 
healthcare through the Federal programs adminis-
tered by the agency. 
‘‘(d) RELATIONSHIP TO OFFICE FOR CIVIL RIGHTS 
IN THE DEPARTMENT OF JUSTICE.—
‘‘(1) DEPARTMENT
OF
HEALTH
AND
HUMAN 
SERVICES.—The Office for Civil Rights in the De-
partment of Health and Human Services shall pro-
vide standard-setting and compliance review inves-
tigation support services to the Civil Rights Compli-
ance Office for each agency. 
‘‘(2) DEPARTMENT
OF
JUSTICE.—The Office 
for Civil Rights in the Department of Justice shall 
continue to maintain the power to institute formal 
proceedings when an agency Office for Civil Rights
355
determines that a recipient of Federal financial as-
sistance is not in compliance with the disparity re-
duction standards of the agency. 
‘‘(e) DEFINITION.—In this section, the term ‘Federal 
health programs’ mean programs—
‘‘(1) under the Social Security Act (42 U.S.C. 
301 et seq.) that pay for healthcare and services; 
and 
‘‘(2) under this Act that provide Federal finan-
cial assistance for healthcare, biomedical research, 
health services research, and programs designed to 
improve the public’s health.’’. 
SEC. 604. OFFICE OF MINORITY HEALTH. 
Section 1707 of the Public Health Service Act (42 
U.S.C. 300u–6) is amended—
(1) by striking the section heading and insert-
ing the following: 
‘‘OFFICE OF MINORITY HEALTH AND RACIAL, ETHNIC, 
AND PRIMARY LANGUAGE HEALTH DISPARITY ELIMI-
NATION’’; 
(2) by striking ‘‘Office of Minority Health’’ 
each place that such appears and inserting ‘‘Office 
of Minority Health and Racial, Ethnic, and Primary 
Language Health Disparities Elimination’’; 
(3) by striking subsection (b) and inserting the 
following:
356
‘‘(b) DUTIES.—With respect to improving the health 
of racial and ethnic minority groups, the Secretary, acting 
through the Deputy Assistant Secretary for Minority 
Health and Racial, Ethnic, and Primary Language Health 
Disparities Elimination (in this section referred to as the 
‘Deputy Assistant Secretary’), shall carry out the fol-
lowing: 
‘‘(1) Establish, implement, monitor, and evalu-
ate short-range and long-range goals and objectives 
and oversee all other activities within the Public 
Health Service that relate to disease prevention, 
health promotion, service delivery, and research con-
cerning minority groups. The heads of each of the 
agencies of the Service shall consult with the Deputy 
Assistant Secretary to ensure the coordination of 
such activities. 
‘‘(2) Oversee all activities within the Depart-
ment of Health and Human Services that relate to 
reducing or eliminating disparities in health and 
healthcare in racial and ethnic minority populations, 
including coordinating—
‘‘(A) the design of programs, support for 
programs, and the evaluation of programs; 
‘‘(B) the monitoring of trends in health 
and healthcare;
357
‘‘(C) research efforts; 
‘‘(D) the training of health providers; and 
‘‘(E) information and education programs 
and campaigns. 
‘‘(3) Enter into interagency and intra-agency 
agreements with other agencies of the Public Health 
Service. 
‘‘(4) Ensure that the Federal health agencies 
and the National Center for Health Statistics collect 
data on the health status and healthcare of each mi-
nority group, using at a minimum the categories 
specified in the 1997 OMB Standards for Maintain-
ing, Collecting, and Presenting Federal Data on 
Race and Ethnicity as required under subtitle B and 
available language standards. 
‘‘(5) Provide technical assistance to States, 
local agencies, territories, Indian tribes, and entities 
for activities relating to the elimination of racial and 
ethnic disparities in health and healthcare. 
‘‘(6) Support a national minority health re-
source center to carry out the following: 
‘‘(A) Facilitate the exchange of informa-
tion regarding matters relating to health infor-
mation, health promotion and wellness, preven-
358
tive health services, and education in the appro-
priate use of health services. 
‘‘(B) Facilitate timely access to culturally 
and linguistically appropriate information. 
‘‘(C) Assist in the analysis of such infor-
mation. 
‘‘(D) Provide technical assistance with re-
spect to the exchange of such information (in-
cluding facilitating the development of materials 
for such technical assistance). 
‘‘(7) Carry out programs to improve access to 
healthcare services for individuals with limited 
English proficiency, including developing and car-
rying out programs to provide bilingual or interpre-
tive services through the development and support of 
a National Center for Cultural and Linguistic Com-
petence in Healthcare as provided for in section 
2903. 
‘‘(8) Carry out programs to improve access to 
healthcare services and to improve the quality of 
healthcare services for individuals with low func-
tional health literacy. As used in the preceding sen-
tence, the term ‘functional health literacy’ means the 
ability to obtain, process, and understand basic
359
health information and services needed to make ap-
propriate health decisions. 
‘‘(9) Advise in matters related to the develop-
ment, implementation, and evaluation of health pro-
fessions education on decreasing disparities in 
healthcare outcomes, with focus on cultural com-
petency as a method of eliminating disparities in 
health and healthcare in racial and ethnic minority 
populations. 
‘‘(10) Assist healthcare professionals, commu-
nity and advocacy organizations, academic centers 
and public health departments in the design and im-
plementation of programs that will improve the qual-
ity of health outcomes by strengthening the pro-
vider-patient relationship.’’. 
(2) by redesignating subsections (c) through (f) 
and subsections (g) and (h) as subsections (d) 
through (g) and subsections (j) and (k), respectively; 
(3) by inserting after subsection (b), the fol-
lowing: 
‘‘(c) NATIONAL PLAN TO ELIMINATE RACIAL AND 
ETHNIC HEALTH AND HEALTHCARE DISPARITIES.—
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Deputy Assistant Secretary, shall—
360
‘‘(A) not later than 1 year after the date 
of enactment of the Healthcare Equality and 
Accountability Act, establish and implement a 
comprehensive plan to achieve the goal of 
Healthy People 2010 to eliminate health dis-
parities in the United States; 
‘‘(B) establish the plan referred to in sub-
paragraph (A) in consultation with—
‘‘(i) the Director of the Centers for 
Disease Control and Prevention; 
‘‘(ii) the Director of the National In-
stitutes of Health; 
‘‘(iii) the Director of the National 
Center on Minority Health and Health 
Disparities; 
‘‘(iv) the Director of the Agency for 
Healthcare Research and Quality; 
‘‘(v) the Administrator of the Health 
Resources and Services Administration; 
‘‘(vi) the Administrator of the Centers 
for Medicare and Medicaid Services; 
‘‘(vii) the Director of the Office for 
Civil Rights;
361
‘‘(viii) the Administrator of the Sub-
stance Abuse and Mental Health Services 
Administration; 
‘‘(ix) the Commissioner of the Food 
and Drug Administration; and 
‘‘(x) the heads of other appropriate 
public and private entities; 
‘‘(C) ensure that the plan includes measur-
able objectives, describes the means for achiev-
ing such objectives, and designates a date by 
which such objectives are expected to be 
achieved; 
‘‘(D) ensure that all amounts appropriated 
for such activities are expended in accordance 
with the plan; 
‘‘(E) review the plan on at least an annual 
basis and revise the plan as appropriate; 
‘‘(F) ensure that the plan will serve as a 
binding statement of policy with respect to the 
agencies’ activities related to disparities in 
health and healthcare; and 
‘‘(G) not later than March 1 of each year, 
submit the plan (or any revisions to the plan), 
to the Committee on Health, Education, Labor, 
and Pensions of the Senate and the Committee
362
on Energy and Commerce of the House of Rep-
resentatives. 
‘‘(2) COMPONENTS OF THE PLAN.—The Deputy 
Assistant Secretary shall ensure that the comprehen-
sive plan established under paragraph (1) address-
es—
‘‘(A) the recommendations of the 2002 In-
stitute of Medicine report (Unequal Treatment) 
with respect to racial and ethnic disparities in 
healthcare; 
‘‘(B) health and disease prevention edu-
cation for racial, ethnic, and primary language 
health disparity populations; 
‘‘(C) research to identify sources of health 
and healthcare disparities in minority groups; 
‘‘(D) the implementation and assessment 
of promising intervention strategies; 
‘‘(E) data collection and the monitoring of 
the healthcare and health status of health dis-
parity populations; 
‘‘(F) care of individuals who lack pro-
ficiency with the English language; 
‘‘(G) care of individuals with low func-
tional health literacy;