(2) NONEXCLUSIVE LIST.—Nothing in this sub-
section shall be construed as limiting the application
of subsection (a) to the programs specified in para-
graph (1).
SEC. 6. RESTRICTION ON USE OF OTHER FEDERAL FUNDS.
(a) IN GENERAL.—Subject to section 3(b) (relating
to construction and treatment of certain services) and sub-
section (b) of this section, no funds appropriated by the
Congress shall be used to provide, procure, furnish, or
fund any item, good, benefit, activity, or service, furnished
or performed for the purpose of causing, or assisting in
causing, the suicide, euthanasia, or mercy killing of any
individual.
(b) NONDUPLICATION.—Subsection (a) shall not
apply to funds to which section 3, 4, or 5 applies, except
that subsection (a), rather than section 3, shall apply to
funds appropriated to carry out title 10, United States
Code (other than chapter 55), title 18, United States Code
(other than section 4005(a)), and chapter 37 of title 28,
United States Code.
SEC. 7. CLARIFICATION WITH RESPECT TO ADVANCE DI-
RECTIVES.
Subject to section 3(b) (relating to construction and
treatment of certain services), sections 1866(f) and
1902(w) of the Social Security Act shall not be con-
strued—
(1) to require any provider or organization, or
any employee of such a provider or organization, to
inform or counsel any individual regarding any right
to obtain an item or service furnished for the pur-
pose of causing, or the purpose of assisting in caus-
ing, the death of the individual, such as by assisted
suicide, euthanasia, or mercy killing; or
(2) to apply to or to affect any requirement
with respect to a portion of an advance directive
that directs the purposeful causing of, or the pur-
poseful assisting in causing, the death of any indi-
vidual, such as by assisted suicide, euthanasia, or
mercy killing.
SEC. 8. APPLICATION TO DISTRICT OF COLUMBIA.
For purposes of this Act, the term ‘‘funds appro-
priated by Congress’’ includes funds appropriated to the
District of Columbia pursuant to an authorization of ap-
propriations under title V of the District of Columbia Self-
Government and Governmental Reorganization Act and
the term ‘‘Federal government’’ includes the government
of the District of Columbia.
SEC. 9. CONFORMING AMENDMENTS.
(a) MEDICARE PROGRAM.—
(1) FUNDING.—Section 1862(a) of the Social
Security Act (42 U.S.C. 1395y(a)) is amended—
(A) by striking ‘‘or’’ at the end of para-
graph (14);
(B) by striking the period at the end of
paragraph (15) and inserting ‘‘; or’’; and
(C) by inserting after paragraph (15) the
following new paragraph:
‘‘(16) in the case in which funds may not be
used for such items and services under the Assisted
Suicide Funding Restriction Act of 1997.’’.
(2) ADVANCE DIRECTIVES.—Section 1866(f) of
such Act (42 U.S.C. 1395cc(f)) is amended by add-
ing at the end the following new paragraph:
‘‘(4) For construction relating to this subsection, see
section 7 of the Assisted Suicide Funding Restriction Act
of 1997 (relating to clarification respecting assisted sui-
cide, euthanasia, and mercy killing).’’.
(b) MEDICAID PROGRAM.—
(1) FUNDING.—Section 1903(i) of the Social
Security Act (42 U.S.C. 1396b(i)) is amended—
(A) by striking ‘‘or’’ at the end of para-
graph (14);
(B) by striking the period at the end of
paragraph (15) and inserting ‘‘; or’’; and
(C) by inserting after paragraph (15) the
following new paragraph:
‘‘(16) with respect to any amount expended for
which funds may not be used under the Assisted
Suicide Funding Restriction Act of 1997.’’.
(2) ADVANCE DIRECTIVES.—Section 1902(w) of
such Act (42 U.S.C. 1396a(w)) is amended by add-
ing at the end the following new paragraph:
‘‘(5) For construction relating to this subsection, see
section 7 of the Assisted Suicide Funding Restriction Act
of 1997 (relating to clarification respecting assisted sui-
cide, euthanasia, and mercy killing).’’.
(c) TITLE XX BLOCK GRANT PROGRAM.—Section
2005(a) of the Social Security Act (42 U.S.C. 1397d(a))
is amended—
(1) by striking ‘‘or’’ at the end of paragraph
(8);
(2) by striking the period at the end of para-
graph (9) and inserting ‘‘; or’’; and
(3) by adding at the end the following:
‘‘(10) in a manner inconsistent with the As-
sisted Suicide Funding Restriction Act of 1997.’’.
(d) MATERNAL AND CHILD HEALTH BLOCK GRANT
PROGRAM.—Section 501(a) of the Social Security Act (42
U.S.C. 701(a)) is amended by adding at the end the fol-
lowing:
‘‘Funds appropriated under this section may only be used
in a manner consistent with the Assisted Suicide Funding
Restriction Act of 1997.’’.
(e) PUBLIC HEALTH SERVICE ACT.—Title II of the
Public Health Service Act (42 U.S.C. 201 et seq.) is
amended by adding at the end thereof the following new
section:
‘‘SEC. 246. RESTRICTION ON USE OF FUNDS FOR ASSISTED
SUICIDE, EUTHANASIA, AND MERCY KILLING.
‘‘Appropriations for carrying out the purposes of this
Act shall not be used in a manner inconsistent with the
Assisted Suicide Funding Restriction Act of 1997.’’.
(f) INDIAN HEALTH CARE IMPROVEMENT ACT.—
Title II of the Indian Health Care Improvement Act (25
U.S.C. 1621 et seq.) is amended by adding at the end
the following new section:
‘‘LIMITATION ON USE OF FUNDS
‘‘SEC. 225. Amounts appropriated to carry out this
title may not be used in a manner inconsistent with the
Assisted Suicide Funding Restriction Act of 1997.’’.
(g) FEDERAL EMPLOYEES HEALTH BENEFIT PRO-
GRAM.—Section 8902 of title 5, United States Code, is
amended by adding at the end the following:
‘‘(o) A contract may not be made or a plan approved
which includes coverage for any benefit, item, or service
for which funds may not be used under the Assisted Sui-
cide Funding Restriction Act of 1997.’’.
(h) MILITARY HEALTH CARE PROGRAM.—Section
1073 of title 10, United States Code, is amended by add-
ing at the end the following: ‘‘This chapter shall be admin-
istered consistent with the Assisted Suicide Funding Re-
striction Act of 1997.’’.
(i) VETERANS’ MEDICAL CARE PROGRAM.—
(1) IN GENERAL.—Subchapter I of chapter 17
of title 38, United States Code, is amended by add-
ing at the end the following new section:
‘‘§ 1707. Restriction on use of funds for assisted sui-
cide, euthanasia, or mercy killing
‘‘Funds appropriated to carry out this chapter may
not be used for purposes that are inconsistent with the
Assisted Suicide Funding Restriction Act of 1997.’’.
(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of such chapter is amended
by inserting after the item relating to section 1706
the following new item:
‘‘1707. Restriction on use of funds for assisted suicide, euthanasia, or mercy
killing.’’.
(j) HEALTH CARE PROVIDED FOR PEACE CORPS
VOLUNTEERS.—Section 5(e) of the Peace Corps Act (22
U.S.C. 2504(e)) is amended by adding at the end the fol-
lowing: ‘‘Health care may not be provided under this sub-
section in a manner inconsistent with the Assisted Suicide
Funding Restriction Act of 1997.’’.
(k) MEDICAL
SERVICES
FOR
FEDERAL
PRIS-
ONERS.—Section 4005(a) of title 18, United States Code,
is amended by inserting ‘‘and to the extent consistent with
the Assisted Suicide Funding Restriction Act of 1997’’
after ‘‘Upon request of the Attorney General’’.
(l) DEVELOPMENTAL DISABILITIES
AND BILL
OF
RIGHTS ACT.—
(1) STATE PLANS REGARDING DEVELOPMENTAL
DISABILITIES
COUNCILS.—Section 122(c)(5)(A) of
the Developmental Disabilities Assistance and Bill of
Rights Act (42 U.S.C. 6022(c)(5)(A)) is amended—
(A) in clause (vi), by striking ‘‘and’’ after
the semicolon at the end;
(B) in clause (vii), by striking the period
at the end and inserting ‘‘; and’’; and
(C) by adding at the end the following
clause:
‘‘(viii) such funds will be used consist-
ent with the section 4 of the Assisted Sui-
cide Funding Restriction Act of 1997.’’.
(2) LEGAL ACTIONS BY PROTECTION AND AD-
VOCACY SYSTEMS.—Section 142(h) of such Act (42
U.S.C. 6042(h)) is amended by adding at the end
the following new paragraph:
‘‘(3) LIMITATION.—The systems may only use
assistance provided under this chapter consistent
with section 5 of the Assisted Suicide Funding Re-
striction Act of 1997.’’.
(3) UNIVERSITY AFFILIATED PROGRAMS.—Sec-
tion 152(b)(5) of such Act (42 U.S.C. 6062(b)(5))
is amended by adding at the end the following:
‘‘Such grants shall not be used in a manner incon-
sistent with section 4 of the Assisted Suicide Fund-
ing Restriction Act of 1997.’’.
(4) GRANTS OF NATIONAL SIGNIFICANCE.—Sec-
tion 162(c) of such Act (42 U.S.C. 6082(c)) is
amended—
(A) by striking ‘‘and’’ at the end of para-
graph (4),
(B) by striking the period at the end of
paragraph (5) and inserting ‘‘; and’’, and
(C) by adding at the end the following new
paragraph:
‘‘(6) the applicant provides assurances that the
grant will not be used in a manner inconsistent with
section 4 of the Assisted Suicide Funding Restric-
tion Act of 1997.’’.
(m) PROTECTION AND ADVOCACY FOR MENTALLY
ILL INDIVIDUALS ACT OF 1986.—Section 105(a) of the
Protection and Advocacy for Mentally Ill Individuals Act
of 1986 (42 U.S.C. 10805(a)) is amended—
(1) in paragraph (8), by striking ‘‘and’’ at the
end;
(2) in paragraph (9), by striking the period and
inserting ‘‘; and’’; and
(3) by adding at the end thereof the following
new paragraph:
‘‘(10) not use allotments provided to a system
in a manner inconsistent with section 5 of the As-
sisted Suicide Funding Restriction Act of 1997.’’.
(n) PROTECTION AND ADVOCACY SYSTEMS UNDER
THE REHABILITATION ACT OF 1973.—Section 509(f) of
the Rehabilitation Act of 1973 (29 U.S.C. 794e(f)) is
amended—
(1) in paragraph (6), by striking ‘‘and’’ after
the semicolon at the end;
(2) in paragraph (7), by striking the period at
the end and inserting ‘‘; and’’; and
(3) by adding at the end the following para-
graph:
‘‘(8) not use allotments provided under this sec-
tion in a manner inconsistent with section 5 of the
Assisted Suicide Funding Restriction Act of 1997.’’.
(o) LEGAL SERVICES PROGRAM.—Section 1007(b) of
the Legal Services Corporation Act (42 U.S.C. 2996f(b))
is amended—
(1) by striking ‘‘or’’ at the end of paragraph
(9);
(2) by striking the period at the end of para-
graph (10) and inserting ‘‘; or’’; and
(3) by adding after paragraph (10) the follow-
ing:
‘‘(11) to provide legal assistance in a manner
inconsistent with the Assisted Suicide Funding Re-
striction Act of 1997.’’.
(p) CONSTRUCTION
ON
CONFORMING
AMEND-
MENTS.—The fact that a law is not amended under this
section shall not be construed as indicating that the provi-
sions of this Act do not apply to such a law.
SEC. 10. RELATION TO OTHER LAWS.
The provisions of this Act supersede other Federal
laws (including laws enacted after the date of the enact-
ment of this Act) except to the extent such laws specifi-
cally supersede the provisions of this Act.
SEC. 11. EFFECTIVE DATE.
(a) IN GENERAL.— The provisions of this Act (and
the amendments made by this Act) take effect upon its
enactment and apply, subject to subsection (b), to Federal
payments made pursuant to obligations incurred after the
date of the enactment of this Act for items and services
provided on or after such date.
(b) APPLICATION TO CONTRACTS.—Such provisions
shall apply with respect to contracts entered into, renewed,
or extended after the date of the enactment of this Act
and shall also apply to a contract entered into before such
date to the extent permitted under such contract.
SEC. 12. SUICIDE PREVENTION (INCLUDING ASSISTED SUI-
CIDE).
(a) PURPOSE.—The purpose of this section is to re-
duce the rate of suicide (including assisted suicide) among
persons with disabilities or terminal or chronic illness by
furthering knowledge and practice of pain management,
depression identification and treatment, and issues related
to palliative care and suicide prevention.
(b) RESEARCH AND DEMONSTRATION PROJECTS.—
Section 781 of the Public Health Service Act (42 U.S.C.
295) is amended—
(1) by redesignating subsection (e) as sub-
section (f); and
(2) by inserting after subsection (d) the follow-
ing new subsection:
‘‘(e) RESEARCH AND DEMONSTRATION PROJECTS ON
SUICIDE
PREVENTION
(INCLUDING
ASSISTED
SUI-
CIDE).—
‘‘(1) RESEARCH.—The Secretary may make
grants to and enter into contracts with public and
private entities for conducting research intended to
reduce the rate of suicide (including assisted suicide)
among persons with disabilities or terminal or chron-
ic illness. The Secretary shall give preference to re-
search that aims—
‘‘(A) to assess the quality of care received
by patients with disabilities or terminal or
chronic illness by measuring and reporting spe-
cific outcomes;
‘‘(B) to compare coordinated health care
(which may include coordinated rehabilitation
services, symptom control, psychological sup-
port, and community-based support services) to
traditional health care delivery systems; or
‘‘(C) to advance biomedical knowledge of
pain management.
‘‘(2) TRAINING.—The Secretary may make
grants and enter into contracts to assist public and
private entities, schools, academic health science cen-
ters, and hospitals in meeting the costs of projects
intended to reduce the rate of suicide (including as-
sisted suicide) among persons with disabilities or
terminal or chronic illness. The Secretary shall give
preference to qualified projects that will—
‘‘(A) train health care practitioners in pain
management, 
depression 
identification 
and
treatment, and issues related to palliative care
and suicide prevention;
‘‘(B) train the faculty of health professions
schools in pain management, depression identi-
fication and treatment, and issues related to
palliative care and suicide prevention; or
‘‘(C) develop and implement curricula re-
garding disability issues, including living with
disabilities, living with chronic or terminal ill-
ness, attendant and personal care, assistive
technology, and social support services.
‘‘(3) DEMONSTRATION
PROJECTS.—The Sec-
retary may make grants to and enter into contracts
with public and nonprofit private entities for the
purpose of conducting demonstration projects that
will—
‘‘(A) reduce restrictions on access to hos-
pice programs; or
‘‘(B) fund home health care services, com-
munity living arrangements, and attendant care
services.
‘‘(4) PALLIATIVE
MEDICINE.—The Secretary
shall emphasize palliative medicine among its fund-
ing and research priorities.’’.
(c) REPORT BY GENERAL ACCOUNTING OFFICE.—
Not later than 1 year after the date of enactment of this
Act, the Comptroller General of the United States shall
submit to the Congress a report providing an assessment
of programs under subsection (e) of section 781 of the
Public Health Service Act (as added by subsection (b) of
this section) to conduct research, provide training, and de-
velop curricula and of the curricula offered and used by
schools of medicine and osteopathic medicine in pain man-
agement, depression identification and treatment, and is-
sues related to palliative care and suicide prevention. The
purpose of the assessment shall be to determine the extent
to which such programs have furthered knowledge and
practice of pain management, depression identification
and treatment, and issues related to palliative care and
suicide prevention.
Passed the House of Representatives April 10, 1997.
Attest:
Clerk.