(4) assess the feasibility and the costs of associ-
ated with the use of health information technology 
in these communities. 
(b) REPORT.—Not later than 18 months after the 
date of the enactment of this Act, the National Coordi-
nator for Health Information Technology shall submit to 
the Congress a report on the study conducted under sub-
section (a) and shall include in such report such rec-
ommendations for legislation or administrative action as 
the Coordinator determines appropriate. 
SEC. 309. HEALTH INFORMATION TECHNOLOGY IN MEDI-
CALLY UNDERSERVED COMMUNITIES. 
The National Coordinator for Health Information 
Technology shall— 
(1) identify sources of funds that will be made 
available to promote and support the planning and 
adoption of health information technology in medi-
cally underserved communities (as defined in section 
799B of the Public Health Service Act (42 U.S.C. 
295p)), including in urban and rural areas, either 
through grants or technical assistance; 
(2) coordinate with the funding sources to help 
such communities connect to identified funding; and 
(3) collaborate with the Agency for Healthcare 
Research and Quality, the Health Resources and 
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Services Administration, and other Federal agencies 
to support technical assistance, knowledge dissemi-
nation, and resource development, to such commu-
nities seeking to plan for and adopt technology and 
establish electronic health information networks 
across providers. 
SEC. 310. DATA COLLECTION AND ANALYSIS GRANTS TO MI-
NORITY-SERVING INSTITUTIONS. 
(a) AUTHORITY.—The Secretary of Health and 
Human Services, acting through the Center on Minority 
Health and Health Disparities and the Office of Minority 
Health, may award grants to access and analyze racial and 
ethnic, and where possible, primary language data to mon-
itor and report on progress to reduce and eliminate racial 
and ethnic disparities in health and health care. 
(b) ELIGIBLE ENTITY.—In this section, the term ‘‘el-
igible entity’’ means a historically Black college or univer-
sity, an Hispanic-serving institution, a tribal college or 
university, or an Asian American and Pacific Islander- 
serving institution with an accredited public health, health 
policy, or health services research program. 
SEC. 311. HEALTH INFORMATION TECHNOLOGY GRANTS 
FOR RURAL HEALTH CARE PROVIDERS. 
Title II of the Public Health Service Act is amended 
by adding at the end the following new part: 
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‘‘PART D—HEALTH INFORMATION TECHNOLOGY 
GRANTS 
‘‘SEC. 271. GRANTS TO FACILITATE THE WIDESPREAD 
ADOPTION OF INTEROPERABLE HEALTH IN-
FORMATION TECHNOLOGY IN RURAL AREAS. 
‘‘(a) COMPETITIVE GRANTS TO ELIGIBLE ENTITIES 
IN RURAL AREAS.— 
‘‘(1) IN GENERAL.—The Secretary may award 
competitive grants to eligible entities in rural areas 
to facilitate the purchase and enhance the utilization 
of qualified health information technology systems to 
improve the quality and efficiency of health care. 
‘‘(2) ELIGIBILITY.—To be eligible to receive a 
grant under paragraph (1) an entity shall— 
‘‘(A) submit to the Secretary an applica-
tion at such time, in such manner, and con-
taining such information as the Secretary may 
require; 
‘‘(B) submit to the Secretary a strategic 
plan for the implementation of data sharing 
and interoperability measures; 
‘‘(C) be a rural health care provider; 
‘‘(D) adopt any applicable core interoper-
ability guidelines (endorsed under other provi-
sions of law); 
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‘‘(E) agree to notify patients if their indi-
vidually 
identifiable 
health 
information 
is 
wrongfully disclosed; 
‘‘(F) 
demonstrate 
significant 
financial 
need; and 
‘‘(G) provide matching funds in accordance 
with paragraph (4). 
‘‘(3) USE OF FUNDS.—Amounts received under 
a grant under this subsection shall be used to facili-
tate the purchase and enhance the utilization of 
qualified health information technology systems and 
training personnel in the use of such technology. 
‘‘(4) MATCHING REQUIREMENT.—To be eligible 
for a grant under this subsection an entity shall con-
tribute non-Federal contributions to the costs of car-
rying out the activities for which the grant is award-
ed in an amount equal to $1 for each $3 of Federal 
funds provided under the grant. 
‘‘(5) LIMIT ON GRANT AMOUNT.—In no case 
shall the payment amount under this subsection with 
respect to the purchase or enhanced utilization of 
qualified health information technology for a rural 
health care provider, in addition to the amount of 
any loan made to the provider from a grant to a 
State under subsection (b) for such purpose, exceed 
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100 percent of the provider’s costs for such purchase 
or enhanced utilization (taking into account costs for 
training, implementation, and maintenance). 
‘‘(6) PREFERENCE IN AWARDING GRANTS.—In 
awarding grants to eligible entities under this sub-
section, the Secretary shall give preference to each 
of the following types of applicants: 
‘‘(A) An entity that is located in a frontier 
or other rural underserved area as determined 
by the Secretary. 
‘‘(B) An entity that will link, to the extent 
practicable, the qualified health information 
system to a local or regional health information 
plan or plans. 
‘‘(C) A rural health care provider that is a 
nonprofit hospital or a Federally qualified 
health center. 
‘‘(D) A rural health care provider that is 
an individual practice or group practice. 
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN
GENERAL.—For the purpose of car-
rying out this section, there is authorized to be ap-
propriated $20,000,000 for fiscal year 2008, 
$30,000,000 for fiscal year 2009, and such sums as 
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may be necessary, but not to exceed $30,000,000 for 
each of fiscal years 2010 through 2012. 
‘‘(2) 
AVAILABILITY.—Amounts 
appropriated 
under paragraph (1) shall remain available through 
fiscal year 2011. 
‘‘(c) DEFINITIONS.—In this section: 
‘‘(1) FEDERALLY
QUALIFIED
HEALTH
CEN-
TER.—The term ‘Federally qualified health center’ 
has the meaning given that term in section 
1861(aa)(4) of the Social Security Act (42 U.S.C. 
1395x(aa)(4)). 
‘‘(2) GROUP PRACTICE.—The term ‘group prac-
tice’ has the meaning given that term in section 
1877(h)(4) of the Social Security Act (42 U.S.C. 
1395nn(h)(4)). 
‘‘(3) HEALTH
CARE
PROVIDER.—The term 
‘health care provider’ means a hospital, skilled nurs-
ing facility, home health agency (as defined in sub-
section (o) of section 1861 of the Social Security 
Act, 42 U.S.C. 1395x), health care clinic, rural 
health clinic, Federally qualified health center, group 
practice, a pharmacist, a pharmacy, a laboratory, a 
physician (as defined in subsection (r) of such sec-
tion), 
a 
practitioner 
(as 
defined 
in 
section 
1842(b)(18)(CC) 
of 
such 
Act, 
U.S.C. 
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1395u(b)(18)(CC)), a health facility operated by or 
pursuant to a contract with the Indian Health Serv-
ice, and any other category of facility or clinician de-
termined appropriate by the Secretary. 
‘‘(4) HEALTH
INFORMATION; 
INDIVIDUALLY 
IDENTIFIABLE HEALTH INFORMATION.—The terms 
‘health information’ and ‘individually identifiable 
health information’ have the meanings given those 
terms in paragraphs (4) and (6), respectively, of sec-
tion 1171 of the Social Security Act (42 U.S.C. 
1320d). 
‘‘(5) LABORATORY.—The term ‘laboratory’ has 
the meaning given that term in section 353. 
‘‘(6) PHARMACIST.—The term ‘pharmacist’ has 
the meaning given that term in section 804(a)(2) of 
the Federal Food, Drug, and Cosmetic Act (21 
U.S.C. 384(a)(2)). 
‘‘(7) QUALIFIED HEALTH INFORMATION TECH-
NOLOGY.—The term ‘qualified health information 
technology’ means a system or components of health 
information technology that meet any applicable core 
interoperability guidelines (endorsed under applica-
ble provisions of law) when in use or that use inter-
face software that allows for interoperability in ac-
cordance with such guidelines. 
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‘‘(8) RURAL AREA.—The term ‘rural area’ has 
the meaning given such term for purposes of section 
1886(d)(2)(D) of the Social Security Act (42 U.S.C. 
1395ww(d)(2)(D)). 
‘‘(9) RURAL
HEALTH
CARE
PROVIDER.—The 
term ‘rural health care provider’ means a health 
care provider that is located in a rural area.’’. 
TITLE IV—ACCOUNTABILITY 
AND EVALUATION 
Subtitle A—General Provisions 
SEC. 401. FEDERAL AGENCY PLAN TO ELIMINATE DISPARI-
TIES AND IMPROVE THE HEALTH OF MINOR-
ITY POPULATIONS. 
(a) IN GENERAL.—Not later than September 1, 
2008, 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 health care of minority popu-
lations, through programs relevant to the mission of the 
agency. 
(b) PUBLICATION.—Each action plan described in 
paragraph (1) shall— 
(1) be publicly reported in draft form for public 
review and comment; 
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(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) respond to data and analyses presented in 
the National Healthcare Disparities Report and the 
National Healthcare Quality Report published annu-
ally by the Agency for Healthcare Research and 
Quality; 
(5) demonstrate progress in meeting the 
Healthy People 2010 objectives; and 
(6) be updated, including progress reports, for 
inclusion in an annual report to Congress. 
SEC. 402. ACCOUNTABILITY WITHIN THE DEPARTMENT OF 
HEALTH AND HUMAN SERVICES. 
Title XXX of the Public Health Service Act, as 
amended by titles II and III of this Act, is further amend-
ed by adding at the end the following: 
‘‘Subtitle C—Strengthening 
Accountability 
‘‘SEC. 3041. 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-
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100 
parities, which shall be headed by a director to be ap-
pointed by the Secretary. 
‘‘(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 health 
care disparities, which shall address concerns relat-
ing to the Office for Civil Rights as released by the 
United States Commission on Civil Rights in the re-
port entitled ‘Health Care Challenge: Acknowledging 
Disparity, Confronting Discrimination, and Ensur-
ing Equity’ (September, 1999) in conjunction with 
the reports by the Institute of Medicine entitled ‘Un-
equal Treatment: Confronting Racial and Ethnic 
Disparities in Health Care’, ‘Crossing the Quality 
Chasm: A New Health System for the 21st Cen-
tury’, and ‘In the Nation’s Compelling Interest: En-
suring Diversity in the Health Care Workforce’ and 
other related reports by the Institute of Medicine. 
This plan shall be publicly disclosed for review and 
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101 
comment and the final plan shall address any com-
ments or concerns 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 health care disparities related to 
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 3042. 
‘‘(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. 
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102 
‘‘(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; 
‘‘(D) minority health and health dispari-
ties; 
‘‘(E) cultural and linguistic competency; 
and 
‘‘(F) civil rights. 
‘‘(d) REPORT.—Not later than December 31, 2008, 
and annually thereafter, the Secretary, in collaboration 
with the Director of the Office for Civil Rights and the 
Director of the Office of Minority Health, shall submit 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 in-
cludes— 
‘‘(1) the number of cases filed, broken down by 
category; 
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103 
‘‘(2) the number of cases investigated and 
closed by the office; 
‘‘(3) the outcomes of cases investigated; 
‘‘(4) the staffing levels of the office including 
staff credentials; 
‘‘(5) the number of other lingering and emerg-
ing cases in which civil rights inequities can be dem-
onstrated; and 
‘‘(6) the number of cases remaining open and 
an explanation for their open status. 
‘‘(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 
2008 through 2013. 
‘‘SEC. 3042. 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 
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104 
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 health care 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 
Health and Human Services including the establish-
ment of disparity reduction standards to encompass 
disparities in health and health care 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 
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105 
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. 
‘‘(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 
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106 
on the progress in reducing disparities in health and 
health care 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 
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 health care and services; 
and 
‘‘(2) under this Act that provide Federal finan-
cial assistance for health care, biomedical research, 
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