IB
Union Calendar No. 581
106TH CONGRESS
2D SESSION
H. R. 3250
[Report No. 106–986]
To amend the Public Health Service Act to improve the health of minority
individuals.
IN THE HOUSE OF REPRESENTATIVES
NOVEMBER 8, 1999
Mr. THOMPSON of Mississippi (for himself, Mr. LEWIS of Georgia, Mr. NOR-
WOOD, Mr. JACKSON of Illinois, Mr. BROWN of Ohio, Mr. TOWNS, Ms.
ROYBAL-ALLARD, Mr. RODRIGUEZ, Mr. UNDERWOOD, Mr. FILNER, Mrs.
CHRISTENSEN, Mr. CONYERS, Mr. WYNN, Mr. GONZALEZ, Mr. HILL-
IARD, Ms. CARSON, Ms. EDDIE BERNICE JOHNSON of Texas, Mr. SCOTT,
Ms. KILPATRICK, Mr. CLYBURN, Mr. RUSH, Mr. CUMMINGS, Mr. PAYNE,
Mr. DIXON, Mr. FORD, Ms. MILLENDER-MCDONALD, Ms. WATERS, Mr.
MEEKS of New York, Mr. BISHOP, Mrs. MEEK of Florida, Mrs. JONES
of Ohio, Mr. DAVIS
of Illinois, Ms. LEE, Ms. MCKINNEY, Mrs.
NAPOLITANO, Ms. JACKSON-LEE of Texas, Mrs. CLAYTON, Mr. WATT of
North Carolina, Mr. FATTAH, Ms. PELOSI, Mr. ABERCROMBIE, and Mr.
GEORGE MILLER of California) introduced the following bill; which was
referred to the Committee on Commerce
OCTOBER 18, 2000
Additional sponsors: Mr. WAXMAN, Mr. WATTS of Oklahoma, Mr. GREEN of
Texas, Mr. JEFFERSON, Ms. BROWN of Florida, Mr. OWENS, Mr. FROST,
Mr. STARK, Ms. HOOLEY of Oregon, Mr. MATSUI, Mr. HASTINGS of Flor-
ida, Ms. NORTON, Mr. LAHOOD, Mr. KENNEDY of Rhode Island, Mr.
KILDEE, Mr. TIERNEY, Mr. BRADY of Pennsylvania, Mr. SANDLIN, Mr.
BONIOR, Mr. EVANS, Mrs. THURMAN, Mr. CARDIN, Mr. BERMAN, Mr.
MEEHAN, Mr. RANGEL, Mr. CLAY, Mr. STRICKLAND, Mr. BACA, Ms.
ESHOO, Mr. DEFAZIO, Mr. DEUTSCH, Mr. BENTSEN, Mr. HAYWORTH,
Mr. UPTON, Mr. NEAL of Massachusetts, Mr. BLAGOJEVICH, Mr. RA-
HALL, Mr. FALEOMAVAEGA, Mr. BAIRD, Mr. WAMP, Mr. LANTOS, Mr.
DICKEY, Mr. ENGEL, Ms. DEGETTE, and Mr. LAMPSON
Deleted sponsor: Mr. COBURN (added May 25, 2000; deleted July 25, 2000)
OCTOBER 18, 2000
Reported with an amendment, committed to the Committee of the Whole
House on the State of the Union, and ordered to be printed
[Strike out all after the enacting clause and insert the part printed in italic]
[For text of introduced bill, see copy of bill as introduced on November 8, 1999]
A BILL
To amend the Public Health Service Act to improve the
health of minority individuals.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the
‘‘Health Care Fairness Act of 2000’’.
(b) TABLE OF CONTENTS.—The table of contents of this
Act is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings.
TITLE I—IMPROVING MINORITY HEALTH THROUGH THE NATIONAL
INSTITUTES OF HEALTH; ESTABLISHMENT OF NATIONAL CENTER
Sec. 101. Establishment of National Center for Research on Minority Health and
Health Disparities.
Sec. 102. Centers of excellence for research education and training.
Sec. 103. Extramural loan repayment program for minority health research.
Sec. 104. General provisions regarding the Center.
Sec. 105. Report regarding resources of National Institutes of Health dedicated to
research on minority health.
TITLE II—HEALTH DISPARITIES RESEARCH BY AGENCY FOR
HEALTHCARE RESEARCH AND QUALITY
Sec. 201. Health disparities research by Agency for Healthcare Research and
Quality.
TITLE III—DATA COLLECTION RELATING TO RACE OR ETHNICITY
Sec. 301. Study and report by National Academy of Sciences.
TITLE IV—MEDICAL EDUCATION AND OTHER HEALTH
PROFESSIONS EDUCATION
Sec. 401. Grants for health care education curriculum development.
Sec. 402. National conference on continuing health professional education and
disparities in health outcomes.
Sec. 403. Continuing medical education incentive program.
Sec. 404. Advisory committee.
Sec. 405. Cultural competency clearinghouse.
TITLE V—MISCELLANEOUS PROVISIONS
Sec. 501. Office for Civil Rights.
Sec. 502. Development of outcome measures; study to measure patient outcomes
under the medicare and medicaid programs by race and eth-
nicity.
Sec. 503. Departmental definition regarding minority individuals.
Sec. 504. Conforming provision regarding definitions.
TITLE VI—EFFECTIVE DATE
Sec. 601. Effective date.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) Despite notable progress in the overall health
of the Nation, there are continuing disparities in the
burden of illness and death experienced by African
Americans, Indians, Alaska Natives, and Asian Pa-
cific Islanders, compared to the United States popu-
lation as a whole.
(2) Minority Americans lag behind on nearly
every health indicator, including health care coverage,
access to care, life expectancy, and disease rates. More
detailed data on health disparities is needed to evalu-
ate the impact that race, ethnicity, and socioeconomic
status have on health status, access to care, and the
quality of care. More data is also needed to enforce
existing protections for equal access to care.
(3) Despite substantial overall improvements in
Americans’ health, racial and ethnic disparities per-
sist across age, sex, and income categories. Some
striking examples are as follows: (A) The black infant
mortality rate, which is twice that of all U.S. infants.
(B) A higher breast cancer mortality rate for black
women than white women (even though black women
have a lower incidence rate). (C) Nearly twice as
many Hispanics adults report they do not have a reg-
ular doctor compared to white adults.
(4) Minority adults are more likely to lack
health insurance than are white adults, a consistent
trend over the past decade. Nearly two of five (38 per-
cent) Hispanic adults, one of four (24 percent) black
adults, and one of four (24 percent) Asian American
adults are uninsured, compared with one of seven (14
percent) white adults.
(5) Differences in the socioeconomic status
among U.S. ethnic groups exist. When examined col-
lectively, African Americans and Hispanics are three
times as likely as whites to be poor. Low socio-
economic and ethnic minority status are not synony-
mous, but many members of ethnic minority who also
have low income comprise an important proportion of
underserved populations in the United States.
(6) The largest numbers of the medically under-
served are white, and many of them have the same
health care access problems as do members of minor-
ity groups. Nearly 20,000,000 white Americans live
below the poverty line with many living in non-met-
ropolitan, rural areas. However, there is a higher pro-
portion of racial and ethnic minorities in the United
States represented among the medically underserved.
(7) Despite suffering disproportionate rates of
illness, death and disability, minorities have not been
proportionately represented in many clinical trials,
except in studies of behavioral risk factors associated
with negative stereotypes.
(8) Many minority groups suffer disproportion-
ately from cancer. Mortality rates remain the most
important measure of the overall progress against
cancer. Decreasing rates of death from cancer reflect
improvements in both prevention and treatment.
Among all ethnic groups in the United States, Afri-
can American males have the highest overall rate of
mortality from cancer. Some specific forms of cancer
affect other ethnic minority communities at rates up
to several times higher than the national averages
(such as stomach and liver cancers among Asian
American populations, colon and rectal cancer among
Alaska natives, and cervical cancer among Hispanic
and Vietnamese-American women).
(9) In Appalachian Kentucky, a region charac-
terized by high rates of poverty, the incidence of lung
cancer among white males was 127 per 100,000 in
1992, a rate higher than that for any ethnic minority
groups in the United States during the same period.
(10) Major disparities exist among population
groups, with a disproportionate burden of death and
disability from cardiovascular disease in minority
and low-income populations. Compared with rates for
whites, coronary heart disease mortality was 40 per-
cent lower for Asian Americans but 40 percent higher
for African-Americans.
(11) While racial and ethnic groups account only
for about 25 percent of the U.S. population, they ac-
count for more than 50 percent of all AIDS cases.
While overall AIDS deaths are down dramatically,
AIDS remains the leading killer of African-Ameri-
cans age 25–44. The death rate from HIV/AIDS for
African Americans is more than seven times that of
whites.
(12) The prevalence of diabetes in African-Amer-
icans is approximately 70 percent higher than whites
and the prevalence in Hispanics is nearly double that
of whites.
(13) American Indians and Alaska Natives have
an infant mortality rate almost double that of whites.
The rate of diabetes for this population group is more
than twice that for whites. The Pima of Arizona have
one of the highest rates of diabetes in the world.
American Indians living in North and South Dakota
have an average life expectancy that is 11 years less
than that for the rest of the U.S. population. Overall,
the life expectancy for American Indians and Alaska
Native is 71 years of age—nearly five years less than
the U.S. Races populations.
(14) Asian and Pacific Islanders, on average,
have indicators of being one of the healthiest popu-
lation groups in the United States. However, there is
great diversity within this population group, and
health disparities for some specific groups are quite
marked. Vietnamese women suffer from cervical can-
cer at nearly five times the rate of white women. New
cases of hepatitis and tuberculosis are also higher in
Asian and Pacific Islanders living in the United
States than in whites.
(15) Minority populations have a disproportion-
ately higher infection rate of hepatitis C virus than
the general United States Population. The prevalence
rate of hepatitis C virus among African Americans is
more than twice that of the general population (3.5
to 5 percent and 1.8 percent, respectively).
(16) There is a national need for minority sci-
entists in the fields of biomedical, clinical, behavioral,
and health services research. Ninety percent of minor-
ity physicians produced by Historically Black Med-
ical Colleges live and serve in minority communities.
(17) The proportion of minorities in high aca-
demic ranks, such as professors and associate profes-
sors, decreased from 1980 to 1990. Only 1 percent of
full professors were minority persons in 1990.
(18) Demographic trends inspire concern about
the Nation’s ability to meet its future scientific, tech-
nological and engineering workforce needs. Histori-
cally, non-Hispanic white males have made up the
majority of the United States scientific, technological,
and engineering workers.
(19) The Hispanic and Black population will
increase significantly in the next 50 years. The sci-
entific, technological, and engineering workforce may
decrease if participation by underepresented minori-
ties remains the same.
(20) Increasing rates of Black and Hispanic
workers must occur in order to ensure strong sci-
entific, technological, and engineering workforce.
(21) Individuals such as underepresented mi-
norities and women in the scientific, technological,
and engineering workforce enable society to address
its diverse needs.
(22) If there had not been a substantial increase
in the number of science and engineering degrees
awarded to women and underepresented minorities
over the past few decades, the United States would be
facing even greater shortages in scientific, techno-
logical, and engineering workers.
(23) In order to effectively promote a diverse and
strong 21st Century scientific, technological, and en-
gineering workforce: agencies should expand or add
programs that effectively overcome barriers such as
educational transition from one level to the next and
student requirements for financial resources.
(24) Federal agencies should work in concert
with the private sector to emphasize the recruitment
and retention of qualified individuals from ethnic
and gender groups that are currently underrep-
resented in the scientific, technological, and engineer-
ing workforce.
(25) Cultural competency training in medical
schools and residency training programs has the po-
tential to reduce disparities in health care and health
outcomes.
(26) Culturally sensitive approaches to research
are needed to encourage participation of minorities
and the socioeconomically disadvantages in research
studies.
(27) African Americans with identical com-
plaints of chest pain are less likely than white Ameri-
cans to be referred by physicians for sophisticated
cardiac tests.
(28) Behavioral and social sciences research has
increased awareness and understanding of factors as-
sociated with health care utilization and access, pa-
tient attitudes toward health services, and risk and
protective behaviors that affect health and illness.
These factors have the potential to then be modified
to help close the health disparities gap among ethnic
minority populations. In addition, there is a shortage
of minority behavioral science researchers and behav-
ioral health care professionals. According to the Na-
tional Science Foundation, only 15.5 percent of be-
havioral research-oriented psychology doctorate de-
grees were awarded to minority students in 1997. In
addition, only 17.9 percent of practice-oriented psy-
chology doctorate degrees were awarded to ethnic mi-
norities.
TITLE I—IMPROVING MINORITY
HEALTH THROUGH NATIONAL
INSTITUTES OF HEALTH; ES-
TABLISHMENT OF NATIONAL
CENTER
SEC. 101. ESTABLISHMENT OF NATIONAL CENTER FOR RE-
SEARCH ON MINORITY HEALTH AND HEALTH
DISPARITIES.
(a) IN GENERAL.—Part E of title IV of the Public
Health Service Act (42 U.S.C. 287 et seq.) is amended by
adding at the end the following subpart:
‘‘Subpart 6—National Center for Research on Minority
Health and Health Disparities
‘‘SEC. 485E. PURPOSE OF CENTER.
‘‘(a) IN GENERAL.—The general purpose of the Na-
tional Center for Research on Minority Health and Health
Disparities (in this subpart referred to as the ‘Center’) is
the conduct and support of basic and clinical research,
training, the dissemination of health information, and
other programs with respect to the health of racial and eth-
nic minority groups and other health disparity popu-
lations.
‘‘(b) PRIORITIES.—The Director of the Center shall in
expending amounts appropriated under this section give
priority to conducting and supporting minority health re-
search.
‘‘(c) MINORITY HEALTH RESEARCH.—For purposes of
this subpart:
‘‘(1) The term ‘minority health research’ means
research on minority health conditions (as defined in
paragraph (2)), including research on preventing
such conditions; research on access, outreach, treat-
ment, and the quality of health care; and research on
cultural and linguistic services for decreasing the ex-
tent of health problems associated with such condi-
tions.
‘‘(2) The term ‘minority health conditions’, with
respect to individuals who are members of racial and
ethnic minority groups, means all diseases, disorders,
and conditions (including with respect to mental
health and substance abuse)—
‘‘(A) unique to, more serious, or more prev-
alent 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 research involving such individuals
as subjects or insufficient data on such individ-
uals.
‘‘(3) The term ‘racial and ethnic minority group’
has the meaning given such term in section 1707.
‘‘(4) The term ‘minorities’ means individuals
from a racial or ethnic minority group.
‘‘(d) HEALTH DISPARITY POPULATIONS.—
‘‘(1) IN GENERAL.—For purposes of this subpart:
‘‘(A) A population is a health disparity
population if, as determined by the Director of
the Center after consultation with the Director of
the Agency for Healthcare Research and Quality,
there is a significant disparity in the overall
rate of disease incidence, morbidity, mortality,
or survival rates in the population as compared
to the health status of the general population.
‘‘(B) The term ‘health disparity popu-
lations’ includes racial and ethnic minority
groups.
‘‘(C) The term ‘health disparities research’
means research on health disparity populations
(and individual members and communities of
such populations) that relates to the health dis-
parities involved, including basic and applied
biomedical and behavioral research on the nature
of health disparities, the causes of such dispari-
ties, and remedies for such disparities. Such
term includes minority health research.
‘‘(2) PRIORITY.—With amounts available under
this section for a fiscal year after providing for mi-
nority health research in accordance with subsection
(b), the Secretary shall conduct and support health
disparities research on other health disparity popu-
lations, with priority given to such research on health
disparity populations for which socioeconomic status
is one of the principal causal factors with respect to
being a health disparity population.
‘‘(e) COORDINATION OF ACTIVITIES.—The Director of
the Center shall act as the primary Federal official with
responsibility for overseeing all minority health and other
health disparities research conducted or supported by the
National Institutes of Health, and—
‘‘(1) shall represent the health disparities re-
search program of the National Institutes of Health,
including the minority health research program, at
all relevant Executive branch task forces, committees
and planning activities; and
‘‘(2) shall maintain communications with all
relevant Public Health Service agencies and with var-
ious other departments of the Federal Government, to
ensure the timely transmission of information con-
cerning advances in minority health and other health
disparities research between these various agencies for
dissemination to affected communities and health care
providers.
‘‘(f) COLLABORATIVE
COMPREHENSIVE
PLAN
AND
BUDGET.—
‘‘(1) IN GENERAL.—Subject to the provisions of
this section and other applicable law, the Director of
NIH, the Director of the Center, and the directors of
the national research institutes in collaboration (and
in consultation with the advisory council for the Cen-
ter) shall—
‘‘(A) establish a comprehensive plan and
budget for the conduct and support of all minor-
ity health and other health disparities research
activities of the agencies of the National Insti-
tutes of Health (which plan and budget shall be
first established under this subsection not later
than 12 months after the date of the enactment
of this subpart);
‘‘(B) ensure that the plan and budget dem-
onstrate how health disparities research activities
address the health needs of specific health dis-
parity populations, taking into account socio-
economic status; the areas in which the popu-
lation involved resides; attitudes toward health;
the language spoken, the extent of formal edu-
cation; and such other factors as the Director of
the Center determines to be appropriate;
‘‘(C) ensure that the plan and budget estab-
lish priorities among the health disparities re-
search activities that such agencies are author-
ized to carry out;
‘‘(D) ensure that the plan and budget estab-
lish objectives regarding such activities, describes
the means for achieving the objectives, and des-
ignates the date by which the objectives are ex-
pected to be achieved;
‘‘(E) ensure that, with respect to amounts
appropriated for activities of the Center, the
plan and budget give priority in the expenditure
of funds to conducting and supporting minority
health research;
‘‘(F) ensure that all amounts appropriated
for such activities are expended in accordance
with the plan and budget;
‘‘(G) review the plan and budget not less
than annually, and revise the plan and budget
as appropriate; and
‘‘(H) ensure that the plan and budget serve
as a broad, binding statement of policies regard-
ing minority health and other health disparities
research activities of the agencies, but do not re-
move the responsibility of the heads of the agen-
cies for the approval of specific programs or
projects, or for other details of the daily adminis-
tration of such activities, in accordance with the
plan and budget.
‘‘(2) CERTAIN COMPONENTS OF PLAN AND BUDG-
ET.—With respect to health disparities research ac-
tivities of the agencies of the National Institutes of
Health, the Director of the Center shall ensure that
the plan and budget under paragraph (1) provide
for—
‘‘(A) basic research and applied research,
including research and development with respect
to products;
‘‘(B) research that is conducted by the agen-
cies;
‘‘(C) research that is supported by the agen-
cies;
‘‘(D) proposals developed pursuant to solici-
tations by the agencies and for proposals devel-
oped independently of such solicitations; and
‘‘(E) behavioral research and social sciences
research, which may include cultural and lin-
guistic research in each of the agencies.
‘‘(3) MINORITY HEALTH RESEARCH.—The plan
and budget under paragraph (1) shall include a sepa-
rate statement of the plan and budget for minority
health research.
‘‘(g) CLINICAL RESEARCH EQUITY.—The Director of
the Center shall assist in the administration of section 492B
with respect to the inclusion of members of minority groups
as subjects in clinical research.
‘‘(h) RESEARCH ENDOWMENTS.—The Director of the
Center may carry out a program to facilitate minority
health research by providing for research endowments at
centers of excellence under section 736.
‘‘(i) CERTAIN ACTIVITIES.—In carrying out subsection
(a), the Director of the Center—
‘‘(1) shall assist the Director of the National
Center for Research Resources in carrying out section
481(c)(3) and in committing resources for construc-
tion at Institutions of Emerging Excellence;
‘‘(2) shall establish projects to promote coopera-
tion among Federal agencies, State, local, and re-
gional public health agencies, and private entities in
health disparities research;
‘‘(3) may conduct or support research on the use
of service delivery models (such as health centers
under section 330) to reduce health disparities; and
‘‘(4) may utilize information from previous
health initiatives concerning minorities and other
health disparity populations.
‘‘(j) ADVISORY COUNCIL.—
‘‘(1) IN GENERAL.—The Secretary shall, in ac-
cordance with section 406, establish an advisory
council to advise, assist, consult with, and make rec-
ommendations to the Director of the Center on mat-
ters relating to the activities described in subsection
(a), and with respect to such activities to carry out
any other functions described in section 406 for advi-
sory councils under such section. Functions under the
preceding sentence shall include making recommenda-
tions on budgetary allocations made in the plan
under subsection (f), and shall include reviewing re-
ports under subjection (k) before the reports are sub-
mitted under such subsection.
‘‘(2) MEMBERSHIP.—With respect to the mem-
bership of the advisory council under paragraph (1),
a majority of the members shall be representatives of
the various racial and ethnic minority groups; rep-
resentatives of other health disparity populations
shall be included; and a diversity of health profes-
sionals shall be represented. The membership shall in
addition include a representative of the Office of Be-
havioral and Social Sciences Research under section
404A.
‘‘(k) ANNUAL REPORT.—The Director of the Center
shall prepare an annual report on the activities carried out
or to be carried out by the Center, and shall submit each
such report to the Congress, the Secretary, and the Director
of NIH. With respect to the fiscal year involved, the report
shall—
‘‘(1) describe and evaluate the progress made in
health disparities research conducted or supported by
the national research institutes;
‘‘(2) summarize and analyze expenditures made
for activities with respect to health disparities re-
search conducted or supported by the National Insti-
tutes of Health;
‘‘(3) include a separate statement applying the
requirements of paragraphs (1) and (2) specifically to
minority health research; and
‘‘(4) contain such recommendations as the Direc-
tor considers appropriate.
‘‘(l) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this subpart, there are authorized
to be appropriated $100,000,000 for fiscal year 2001, and
such sums as may be necessary for each of the fiscal years
2002 through 2005. Such authorization of appropriations
is in addition to other authorizations of appropriations
that are available for the conduct and support of minority
health or other health disparities research by the national
research institutes and other agencies of the National Insti-
tutes of Health.’’.
(b) CONFORMING AMENDMENT.—Part A of title IV of
the Public Health Service Act (42 U.S.C. 281 et seq.) is
amended—
(1) in section 401(b)(2)—
(A) in subparagraph (F), by moving the
subparagraph two ems to the left; and
(B) by adding at the end the following sub-
paragraph:
‘‘(G) The National Center for Research on Mi-
nority Health and Health Disparities.’’; and
(2) by striking section 404.
SEC. 102. CENTERS OF EXCELLENCE FOR RESEARCH EDU-
CATION AND TRAINING.
Subpart 6 of part E of title IV of the Public Health
Service Act, as added by section 101 of this Act, is amended
by adding at the end the following section:
‘‘SEC. 485F. CENTERS OF EXCELLENCE FOR RESEARCH EDU-
CATION AND TRAINING.
‘‘(a) IN GENERAL.—The Director of the Center shall
make awards of grants or contracts to designated bio-
medical and behavioral research institutions under para-
graph (1) of subsection (c), or to consortia under paragraph
(2) of such subsection, for the purpose of assisting the insti-
tutions in supporting programs of excellence in biomedical
and behavioral research education for individuals who are
members of health disparity populations, including minori-
ties.
‘‘(b) REQUIRED USE OF FUNDS.—An award may be
made under subsection (a) only if the applicant involved
agrees that the grant will be expended—
‘‘(1) to conduct minority health research, includ-
ing research on the use of service delivery models
(such as health centers under section 330) with re-
spect to minority health conditions;
‘‘(2) to train minorities and other members of
health disparities populations as professionals in the
area of biomedical or behavioral research or both; or
‘‘(3) to expand, remodel, renovate, or alter exist-
ing research facilities or construct new research facili-
ties for the purpose of conducting minority health re-
search.
‘‘(c) CENTERS OF EXCELLENCE.—
‘‘(1) IN GENERAL.—For purposes of this section,
a designated biomedical and behavioral research in-
stitution is a biomedical and behavioral research in-
stitution that—
‘‘(A) has a significant number of health dis-
parity students, including minorities, enrolled in
the institution (including individuals accepted
for enrollment in the institution);
‘‘(B) has been effective in assisting such stu-
dents of the institution to complete the program
of education and receive the degree involved;
‘‘(C) has been effective in recruiting mem-
bers of health disparity populations, including
minorities, to enroll in and graduate from the
institution, including providing scholarships and
other financial assistance to such individuals
and encouraging health disparity students from
all levels of the educational pipeline to pursue
biomedical research careers; and
‘‘(D) has made significant recruitment ef-
forts to increase the number of members of health
disparities populations, including minorities,
serving in faculty or administrative positions at
the institution.
‘‘(2) CONSORTIUM.—Any designated biomedical
and behavioral research institution involved may,
with other biomedical and behavioral institutions
(designated or otherwise), form a consortium to re-
ceive an award under subsection (a).
‘‘(3) APPLICATION OF CRITERIA TO OTHER PRO-
GRAMS.—In the case of any criteria established by the
Director of the Center for purposes of determining
whether institutions meet the conditions described in
paragraph (1), this section may not, with respect to
minorities, be construed to authorize, require, or pro-
hibit the use of such criteria in any program other
than the program established in this section.
‘‘(d) DURATION OF GRANT.—The period during which
payments are made under a grant under subsection (a)
may not exceed 5 years. Such payments shall be subject to
annual approval by the Director of the Center and to the
availability of appropriations for the fiscal year involved
to make the payments.
‘‘(e) MAINTENANCE OF EFFORT.—
‘‘(1) IN GENERAL.—With respect to activities for
which an award under subsection (a) is authorized to
be expended, the Director of the Center may not make
such an award to a designated research institution or
consortium for any fiscal year unless the institution,
or institutions in the consortium, as the case may be,
agree to maintain expenditures of non-Federal
amounts for such activities at a level that is not less
than the level of such expenditures maintained by the
institutions involved for the fiscal year preceding the
fiscal year for which such institutions receive such an
award.
‘‘(2) USE OF FEDERAL FUNDS.—With respect to
any Federal amounts received by a designated re-
search institution or consortium and available for
carrying out activities for which an award under sub-
section (a) is authorized to be expended, the Director
of the Center may make such an award only if the
institutions involved agree that the institutions will,
before expending the award, expend the Federal
amounts obtained from sources other than the award.
‘‘(f) CERTAIN EXPENDITURES.—The Director of the
Center may authorize a designated biomedical and behav-
ioral research institution to expend a portion of an award
under subsection (a) for research endowments.
‘‘(g) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘designated biomedical and behav-
ioral research institution’ has the meaning indicated
for such term in subsection (c)(1). Such term includes
any health professions school receiving an award of a
grant or contract under section 736.
‘‘(2) The term ‘program of excellence’ means any
program carried out by a designated biomedical and
behavioral research institution with an award under
subsection (a), if the program is for purposes for
which the institution involved is authorized in sub-
section (b) to expend the grant.
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of making grants under subsection (a), there are
authorized to be appropriated such sums as may be nec-
essary for each of the fiscal years 2001 through 2005.’’.
SEC. 103. EXTRAMURAL LOAN REPAYMENT PROGRAM FOR
MINORITY HEALTH RESEARCH.
Subpart 6 of part E of title IV of the Public Health
Service Act, as amended by section 102 of this Act, is
amended by adding at the end the following section:
‘‘SEC. 485G. LOAN REPAYMENT PROGRAM FOR MINORITY
HEALTH RESEARCH.
‘‘(a) IN GENERAL.—The Director of the Center shall
establish a program of entering into contracts with quali-
fied health professionals under which such health profes-
sionals agree to engage in minority health research in con-
sideration of the Federal Government agreeing to repay, for
each year of engaging in such research, not more than
$35,000 of the principal and interest of the educational
loans of such health professionals.
‘‘(b) SERVICE PROVISIONS.—The provisions of sections
338B, 338C, and 338E shall, except as inconsistent with
subsection (a), apply to the program established in such
subsection to the same extent and in the same manner as
such provisions apply to the National Health Service Corps
Loan Repayment Program established in subpart III of
part D of title III.
‘‘(c) REQUIREMENT REGARDING HEALTH DISPARITY
POPULATIONS.—The Director of the Center shall ensure
that not fewer than 50 percent of the contracts entered into
under subsection (a) are for appropriately qualified health
professionals who are members of a health disparity popu-
lation.
‘‘(d) PRIORITY.—With respect to minority health re-
search under subsection (a), the Secretary shall ensure that
priority is given to conducting projects of biomedical re-
search.
‘‘(e) FUNDING.—
‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—For
the purpose of carrying out this section, there are au-
thorized to be appropriated such sums as may be nec-
essary for each of the fiscal years 2001 through 2005.
‘‘(2) 
AVAILABILITY
OF
APPROPRIATIONS.—
Amounts available for carrying out this section shall
remain available until the expiration of the second
fiscal year beginning after the fiscal year for which
the amounts were made available.’’.
SEC. 104. GENERAL PROVISIONS REGARDING THE CENTER.
Subpart 6 of part E of title IV of the Public Health
Service Act, as amended by section 103 of this Act, is
amended by adding at the end the following section:
‘‘SEC. 485H. GENERAL PROVISIONS REGARDING THE CEN-
TER.
‘‘(a) ADMINISTRATIVE SUPPORT FOR CENTER.—The
Secretary, acting through the Director of the National Insti-
tutes of Health, shall provide administrative support and
support services to the Director of the Center and shall en-
sure that such support takes maximum advantage of exist-
ing administrative structures at the agencies of the Na-
tional Institutes of Health.
‘‘(b) EVALUATION AND REPORT.—
‘‘(1) EVALUATION.—Not later than 5 years after
the date of the enactment of this part, the Secretary
shall conduct an evaluation to—
‘‘(A) determine the effect of this section on
the planning and coordination of the health dis-
parities research programs at the institutes, cen-
ters and divisions of the National Institutes of
Health;
‘‘(B) evaluate the extent to which this part
has eliminated the duplication of administrative
resources among such Institutes, centers and di-
visions; and
‘‘(C) provide recommendations concerning
future legislative and administrative modifica-
tions with respect to this part, for both minority
health research and research on other health dis-
parity populations.
‘‘(2) MINORITY HEALTH RESEARCH.—The eval-
uation under paragraph (1) shall include a separate
statement that applies subparagraphs (A) and (B) of
such paragraph to minority health research.
‘‘(3) REPORT.—Not later than 1 year after the
date on which the evaluation is commenced under
paragraph (1), the Secretary shall prepare and sub-
mit to the Committee on Health, Education, Labor,
and Pensions of the Senate, and the Committee on
Commerce of the House of Representatives, a report
concerning the results of such evaluation.’’.
SEC. 105. REPORT REGARDING RESOURCES OF NATIONAL
INSTITUTES OF HEALTH DEDICATED TO RE-
SEARCH ON MINORITY HEALTH.
Not later than December 1, 2003, the Director of the
National Center for Research on Minority Health and
Health Disparities (established by the amendment made by
section 101(a)), after consultation with the advisory council
for such Center, shall submit to the Congress, the Secretary
of Health and Human Services, and the Director of the Na-
tional Institutes of Health a report that provides the fol-
lowing:
(1) Recommendations for the methodology that
should be used to determine the extent of the resources
of the National Institutes of Health that are dedicated
to research on minority health, including determining
the amount of funds that are used to conduct and
support such research. With respect to such method-
ology, the report shall address the discrepancies be-
tween the methodology used by such Institutes as of
the date of the enactment of this Act and the method-
ology used by the Institute of Medicine as of such
date.
(2) A determination of whether and to what ex-
tent, relative to fiscal year 1999, there has been an
increase in the level of resources of the National Insti-
tutes of Health that are dedicated to research on mi-
nority health, including the amount of funds used to
conduct and support such research. The report shall
include provisions describing whether and to what ex-
tent there have been increases in the number and
amount of awards to minority serving institutions.
TITLE II—HEALTH DISPARITIES
RESEARCH BY AGENCY FOR
HEALTHCARE RESEARCH AND
QUALITY
SEC. 201. HEALTH DISPARITIES RESEARCH BY AGENCY FOR
HEALTHCARE RESEARCH AND QUALITY.
(a) GENERAL.—Part A of title IX of the Public Health
Service Act (42 U.S.C. 299 et seq.) is amended by adding
at the end the following:
‘‘SEC. 903. RESEARCH ON HEALTH DISPARITIES.
‘‘(a) IN GENERAL.—The Director shall—
‘‘(1) conduct and support research to identify
how to improve the quality and outcomes of health
care services for health disparity populations and the
causes of the health disparities involved, including
identifying barriers to health care access and environ-
mental factors leading to health problems;
‘‘(2) conduct and support research and support
demonstration projects to identify, test, and evaluate
strategies for eliminating health disparities and pro-
moting effective interventions;
‘‘(3) develop measures for the assessment and im-
provement of the quality and appropriateness of
health care services provided to health disparity pop-
ulations; and
‘‘(4) in carrying out 902(c), provide support to
increase the number of researchers who are members
of health disparity populations, and the health serv-
ices research capacity of institutions that train such
researchers.
‘‘(b) RESEARCH AND DEMONSTRATION PROJECTS.—
‘‘(1) IN GENERAL.—In carrying out subsection
(a), the Director shall conduct and support research
to—
‘‘(A) identify the clinical, cultural, socio-
economic, and organizational factors that con-
tribute to health disparities, including for mi-
nority populations, which factors include exam-
ination of patterns of clinical decisionmaking
and of the availability of support services;
‘‘(B) identify and evaluate clinical and or-
ganizational strategies to improve the quality,
outcomes, and access to care for health disparity
populations, including minority populations;
‘‘(C) support demonstrations to test such
strategies; and
‘‘(D) widely disseminate strategies for
which there is scientific evidence of effectiveness.
‘‘(2) USE
OF
CERTAIN
STRATEGIES.—In car-
rying out this section, the Director shall implement
research strategies and mechanisms that will enhance
the involvement of individuals who are members of
health disparity populations (including minority
populations), health services researchers who are such
individuals, institutions that train such individuals
as researchers, members of health disparity popu-
lations (including minority populations) for whom
the Agency is attempting to improve the quality and
outcomes of care, and representatives of appropriate
community-based organizations with respect to health
disparity populations. Such research strategies and
mechanisms may include the use of—
‘‘(A) centers of excellence that can dem-
onstrate, either individually or through con-
sortia, a combination of multi-disciplinary ex-
pertise in outcomes or quality improvement re-
search and a demonstrated capacity to engage
members and communities of health disparity
populations, including minority populations, in
the planning, conduct and translation of re-
search, with linkages to relevant sites of care;
‘‘(B) provider-based research networks, in-
cluding health plans, facilities, or delivery sys-
tem sites of care (especially primary care), that
make extensive use of health care providers who
are members of health disparity populations or
who serve patients in such populations and have
the capacity to evaluate and promote quality im-
provement;
‘‘(C) service delivery models (such as health
centers under section 330) to reduce health dis-
parities; and
‘‘(D) other innovative mechanisms or strate-
gies that will facilitate the translation of past re-
search investments into clinical practices that
can reasonably be expected to benefit these popu-
lations.
‘‘(c) QUALITY MEASUREMENT DEVELOPMENT.—
‘‘(1) IN GENERAL.—To ensure that health dis-
parity populations, including minority populations,
benefit from the progress made in the ability of indi-
viduals to measure the quality of health care delivery,
the Director shall support the development of quality
of health care measures that assess the experience of
such populations with health care systems, such as
measures that assess the access of such populations to
health care, the cultural competence of the care pro-
vided, the quality of the care provided, the outcomes
of care, or other aspects of health care practice that
the Director determines to be important. In carrying
out the preceding sentence, the Director shall in con-
sultation with the Administrator of the Health Re-
sources and Services Administration examine the
practices of providers (such as health centers under
section 330) that have a record of reducing health dis-
parities or have experience in providing culturally
competent health services to minority or other health
disparity populations.
‘‘(2) REPORT.—Not later than 24 months after
the date of the enactment of this section, the Sec-
retary, acting through the Director, shall prepare and
submit to the appropriate committees of Congress a
report describing the state-of-the-art of quality meas-
urement for minority and other health disparity pop-
ulations that will identify critical unmet needs, the
current activities of the Department to address those
needs, and a description of related activities in the
private sector.
‘‘(d) DEFINITION.—For purposes of this section:
‘‘(1) The term ‘health disparity population’ has
the meaning given such term in section 485E.
‘‘(2) The term ‘minority’, with respect to popu-
lations, refers to racial and ethnic minority groups as
defined in section 1707.’’.
(b) FUNDING.—Section 927 of the Public Health Serv-
ice Act (42 U.S.C. 299c–6) is amended by adding at the
end the following:
‘‘(d) HEALTH DISPARITIES RESEARCH.—For the pur-
pose of carrying out the activities under section 903, there
are authorized to be appropriated such sums as may be nec-
essary for each of the fiscal years 2001 through 2005.’’.
TITLE 
III—DATA 
COLLECTION
RELATING TO RACE OR ETH-
NICITY
SEC. 301. STUDY AND REPORT BY NATIONAL ACADEMY OF
SCIENCES.
(a) STUDY.—The National Academy of Sciences shall
conduct a comprehensive study of the Department of Health
and Human Services’ data collection systems and practices,
and any data collection or reporting systems required under
any of the programs or activities of the Department, relat-
ing to the collection of data on race or ethnicity, including
other Federal data collection systems (such as the Social
Security Administration) with which the Department inter-
acts to collect relevant data on race and ethnicity.
(b) REPORT.—Not later than 1 year after the date of
enactment of this Act, the National Academy of Sciences
shall prepare and submit to the Committee on Health, Edu-
cation, Labor, and Pensions of the Senate and the Com-
mittee on Commerce of the House of Representatives, a re-
port that—
(1) identifies the data needed to support efforts
to evaluate the effects of race and ethnicity on access
to health care and other services and on disparity in
health and other social outcomes and the data needed
to enforce existing protections for equal access to
health care;
(2) examines the effectiveness of the systems and
practices of the Department of Health and Human
Services described in subsection (a), including pilot
and demonstration projects of the Department, and
the effectiveness of selected systems and practices of
other Federal and State agencies and the private sec-
tor, in collecting and analyzing such data;
(3) contains recommendations for ensuring that
the Department of Health and Human Services, in
administering its entire array of programs and ac-
tivities, collects, or causes to be collected, reliable and
complete information relating to race and ethnicity;
and
(4) includes projections about the costs associated
with the implementation of the recommendations de-
scribed in paragraph (3), and the possible effects of
the costs on program operations.
(c) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there are authorized
to be appropriated such sums as may be necessary for fiscal
year 2001.
TITLE IV—MEDICAL EDUCATION
AND OTHER HEALTH PROFES-
SIONS EDUCATION
SEC. 401. GRANTS FOR HEALTH CARE EDUCATION CUR-
RICULUM DEVELOPMENT.
Part F of title VII of the Public Health Service Act
(42 U.S.C. 295j et seq.) is amended by inserting after sec-
tion 791 the following:
‘‘SEC. 791A. GRANTS FOR HEALTH PROFESSIONAL EDU-
CATION CURRICULUM DEVELOPMENT.
‘‘(a) GRANTS
FOR
GRADUATE
EDUCATION
CUR-
RICULUM DEVELOPMENT.—
‘‘(1) 
IN
GENERAL.—The 
Secretary, 
acting
through the Administrator of the Health Resources
and Services Administration and in collaboration
with the Director of the Agency for Healthcare Re-
search and Quality and the Deputy Assistant Sec-
retary for Minority Health, may make awards of
grants, contracts, or cooperative agreements to public
and nonprofit private entities for the purpose of car-
rying out research projects and demonstration
projects to develop curricula to reduce disparities in
health care outcomes, including curricula for cultural
competency in graduate health professions education.
‘‘(2) ELIGIBILITY.—To be eligible to receive an
award under paragraph (1), an entity shall—
‘‘(A) be a school of medicine, school of osteo-
pathic medicine, school of dentistry, school of
public health, school of nursing, graduate pro-
gram in behavioral health and mental health
practice, or other recognized health profession
school; and
‘‘(B) prepare and submit to the Secretary
an application at such time, in such manner,
and containing such information as the Sec-
retary may require.
‘‘(3) USE
OF
FUNDS.—An entity shall use
amounts received under an award under paragraph
(1) to carry out research projects and demonstration
projects to develop curricula to reduce disparity in
health care outcomes, including curricula for cultural
competency in graduate health professions education.
‘‘(4) NUMBER OF GRANTS AND GRANT TERM.—
The Secretary shall award grants, contracts or coop-
erative agreements (or combination thereof) under
paragraph (1) in each of the first and second fiscal
years for which funds are available under subsection
(f). The term of each such grant, contract or coopera-
tive agreement shall be 3 years.
‘‘(b) GRANTS
FOR CONTINUING HEALTH PROFES-
SIONAL EDUCATION CURRICULUM DEVELOPMENT.—
‘‘(1) 
IN
GENERAL.—The 
Secretary, 
acting
through the Health Resources and Services Adminis-
tration and the Agency for Healthcare Research Qual-
ity and in collaboration with the Office of Minority
Health, shall award grants to eligible entities for the
establishment of demonstration and pilot projects to
develop curricula to reduce disparity in health care
and health outcomes, including curricula for cultural
competency, in continuing health professions edu-
cation.
‘‘(2) ELIGIBILITY.—To be eligible to receive a
grant under paragraph (1) an entity shall—
‘‘(A) be a school of medicine, osteopathic
medicine, public health, dentistry, optometry,
pharmacy, allied health, chiropractic, podiatric
medicine, nursing, and public health and health
administration, public or nonprofit private
school that offers a graduate program in clinical
social work or other graduate programs in be-
havioral health and mental health practice, pro-
gram for the training of physician assistants,
health professional association, or other public or
nonprofit health educational entity, or any con-
sortium of entities described in this subpara-
graph; and
‘‘(B) prepare and submit to the Secretary
an application at such time, in such manner,
and containing such information as the Sec-
retary may require.
‘‘(3) USE
OF
FUNDS.—An entity shall use
amounts received under a grant under paragraph (1)
to develop and evaluate the effect of curricula for con-
tinuing health professions education courses or pro-
grams to provide education concerning issues relating
to disparity in health care and health outcomes, in-
cluding cultural competency of health professionals.
Such curricula shall focus on the need to remove bias
from health care at a personal level as well as at a
systemic level.
‘‘(4) NUMBER OF GRANTS AND GRANT TERM.—
The Secretary shall award grants under paragraph
(1) in each of the first and second fiscal years for
which funds are available under subsection (f). The
term of each such grant shall be 3 years.
‘‘(c) DISTRIBUTION
OF PROJECTS.—The Secretary
shall ensure that, to the extent practicable, projects under
subsections (a) and (b) are carried out in each of the prin-
cipal geographic regions of the United States and involve
different health disparity populations (as defined in section
485E) and health professions.
‘‘(d) MONITORING.—An entity that receives a grant,
contract or cooperative agreement under subsection (a) or
(b) shall ensure that procedures are in place to monitor ac-
tivities undertaken using grant, contract or cooperative
agreement funds. Such entity shall annually prepare and
submit to the Secretary a report concerning the effectiveness
of curricula developed under the grant contract or coopera-
tive agreement.
‘‘(e) REPORT TO CONGRESS.—Not later than January
1, 2002, the Secretary shall prepare and submit to the ap-
propriate committees of Congress, a report concerning the
effectiveness of programs funded under this section and a
plan to encourage the implementation and utilization of
curricula to reduce disparities in health care and health
outcomes. A final report shall be submitted by the Secretary
not later than January 1, 2004.
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There is
authorized to be appropriated to carry out this section,
$3,500,000 for fiscal year 2001, $7,000,000 for fiscal year
2002, $7,000,000 for fiscal year 2003, and $3,500,000 for
fiscal year 2004.’’.
SEC. 
402. 
NATIONAL 
CONFERENCE 
ON 
CONTINUING
HEALTH 
PROFESSIONAL 
EDUCATION 
AND
DISPARITIES IN HEALTH OUTCOMES.
(a) IN GENERAL.—Not later than 1 year after the date
of enactment of this Act, the Secretary of Health and
Human Services shall convene a national conference on
continuing medical education as a method for reducing dis-
parities in health care and health outcomes, including con-
tinuing medical education on cultural competency. The con-
ference shall include sessions to address measurements of
outcomes to assess the effectiveness of curricula in reducing
disparities.
(b) PARTICIPANTS.—The Secretary of Health and
Human Services shall invite minority and other health dis-
parity populations advocacy groups, health education enti-
ties described in section 791A(b)(2)(A) of the Public Health
Service Act (as added by section 401), health centers under
section 330 of such Act, and other interested parties to at-
tend the conference under subsection (a).
(c) ISSUES.—The national conference convened under
subsection (a) shall address issues relating to the role of con-
tinuing medical education in the effort to reduce disparities
in health care and health outcomes, including the role of
continuing medical education in improving the cultural
competency of health professionals. The conference shall
focus on methods to achieve reductions in the disparities
in health care and health outcomes through continuing med-
ical education courses or programs and on strategies for
measuring the effectiveness of curricula to reduce dispari-
ties.
(d) PUBLICATION OF FINDINGS.—Not later than 6
months after the convening of the national conference under
subsection (a), the Secretary of Health and Human Services
shall publish in the Federal Register a summary of the pro-
ceedings and the findings of the conference.
(e) AUTHORIZATION OF APPROPRIATIONS.—There is
authorized to be appropriated such sums as may be nec-
essary to carry out this section.
SEC. 403. CONTINUING MEDICAL EDUCATION INCENTIVE
PROGRAM.
(a) IN GENERAL.—The Secretary of Health and
Human Services shall develop and implement a program
to provide incentives to health maintenance organizations,
community health centers, rural health centers, and other
entities providing services under title XVIII or XIX of the
Social Security Act (42 U.S.C. 1395 et seq. or 1396 et seq.)
to encourage health care professionals employed by, or
under contract with, such entities to participate in con-
tinuing medical education programs designed to reduce
health disparities.
(b) EFFECTIVE PROGRAMS.—In developing the pro-
gram under subsection (a), the Secretary of Health and
Human Services shall ensure that incentives are targeted
at programs that address each of the following issues:
(1) Implementing new curricula or strategies for
continuing medical education programs designed to
reduce health disparities, or continuing medical edu-
cation curricula or strategies that have been proven
effective in reducing such disparities.
(2) Encouraging health professionals to partici-
pate in such curricula.
(3) Monitoring health care and health outcomes
as a way to evaluate the effectiveness of continuing
medical education programs in reducing health dis-
parities.
(c) DEFINITION.—For purposes of this section, the
term ‘‘health disparities’’ has the meaning given such term
in section 485E of the Public Health Service Act.
(d) AUTHORIZATION OF APPROPRIATIONS.—There is
authorized to be appropriated such sums as may be nec-
essary to carry out this section.
SEC. 404. ADVISORY COMMITTEE.
(a) ESTABLISHMENT.—The Secretary of Health and
Human Services shall establish an advisory committee to
provide advice to the Secretary on matters related to the
development, implementation, and evaluation of graduate
and continuing education curricula for health care profes-
sionals to decrease disparities in health care and health out-
comes, including curricula on cultural competency as a
method of eliminating health disparities.
(b) MEMBERSHIP.—Not later than 3 months after the
date on which amounts are appropriated to carry out this
section, the Secretary of Health and Human Services shall
appoint the members of the advisory committee. Such mem-
bers shall be appointed from among individuals who—
(1) are not officers or employees of the Federal
Government;
(2) are experienced in issues relating to health
disparities;
(3) are minorities or representatives of racial
and ethnic minority groups or other health disparity
populations; and
(4) meet such other requirements as the Sec-
retary determines appropriate;
Such committee shall include individuals who are experi-
enced in providing health services to racial and ethnic mi-
nority groups or other health disparity populations, includ-
ing representatives of health centers under section 330 of
the Public Health Service Act. The committee shall in addi-
tion include a representative of the Office of Minority
Health under section 1707 of such Act, a representative of
the Health Resources and Services Administration, and
such other representatives of offices and agencies of the Pub-
lic Health Service as the Secretary determines to be appro-
priate. Such representatives shall include one or more indi-
viduals who serve on the advisory committee under section
1707(c) of such Act.
(c) COLLABORATION.—The advisory committee shall
carry out its duties under this section in collaboration with
the Office of Minority Health of the Department of Health
and Human Services, and other offices, centers, and insti-
tutes of the Department of Health and Human Services,
and other Federal agencies.
(d) TERMINATION.—The advisory committee shall ter-
minate on the date that is 4 years after the date on which
the first member of the committee is appointed.
(e) EXISTING COMMITTEE.—The Secretary may des-
ignate an existing advisory committee operating under the
authority of the Office of Minority Health of the Depart-
ment of Health and Human Services to serve as the advi-
sory committee under this section.
SEC. 405. CULTURAL COMPETENCY CLEARINGHOUSE.
(a) ESTABLISHMENT.—The Director of the Office of
Minority Health of the Department of Health and Human
Services shall establish within the Resource Center of the
Office of Minority Health, or through the awarding of a
grant provide for the establishment of, an information
clearinghouse for curricula to reduce disparities in health
care and health outcomes. The clearinghouse shall facilitate
and enhance, through the effective dissemination of infor-
mation, knowledge and understanding of practices that lead
to reductions in health disparities (as defined in section
485E of the Public Health Service Act), including curricula
for continuing medical education to develop cultural com-
petency in health care professionals.
(b) AVAILABILITY
OF
INFORMATION.—Information
contained in the clearinghouse shall be made available to
minority health advocacy groups and other organizations
representing health disparity populations, health education
entities described in section 791A(b)(2)(A) of the Public
Health Service Act (as added by section 401), health main-
tenance organizations, and other interested parties.
(c) AUTHORIZATION OF APPROPRIATIONS.—There is
authorized to be appropriated such sums as may be nec-
essary to carry out this section.
TITLE V—MISCELLANEOUS
PROVISIONS
SEC. 501. OFFICE FOR CIVIL RIGHTS.
(a) PUBLIC AWARENESS CAMPAIGN.—
(1) IN GENERAL.—The Secretary of Health and
Human Services shall conduct a national media cam-
paign for the purpose of informing the public of the
programs and activities of the Office for Civil Rights,
Department of Health and Human Services. The
campaign shall—
(A) have a specific focus on racial and eth-
nic minority communities, as well as the general
public; and
(B) involve racial and ethnic minority
media as participants in the design and conduct
of the campaign.
(2) AUTHORIZATION OF APPROPRIATIONS.—For
the purpose of carrying out paragraph (1), there are
authorized to be appropriated such sums as may be
necessary for fiscal year 2001.
(b) OMBUDSMAN DEMONSTRATION PROGRAM.—
(1) IN GENERAL.—The Secretary of Health and
Human Services (in this subsection referred to as the
‘‘Secretary’’) shall carry out a demonstration pro-
gram under which the Secretary makes grants to
States for the purpose of establishing and operating
State offices to identify, investigate, and facilitate the
resolution of complaints relating to civil rights, and
to carry out functions authorized pursuant to para-
graph (3) (which office is referred to in this sub-
section as the ‘‘State Ombudsman Office’’).
(2) OMBUDSMAN.—The Secretary shall require
that each State Ombudsman Office under paragraph
(1) be headed by an individual with expertise and ex-
perience in the field of civil rights and advocacy.
(3) CERTAIN
REQUIREMENTS
AND
AUTHORI-
TIES.—In carrying out paragraph (1), the Secretary
shall consider the requirements and authorities that
apply to the operation of State offices under chapter
2 of subtitle A of title VII of the Older Americans Act
of 1965 (relating to State Long-Term Care Ombuds-
man Programs). In providing for State Ombudsman
Offices under paragraph (1), the Secretary may estab-
lish requirements and authorities with respect to civil
rights that are the same as or similar to the require-
ments and authorities that apply under such chapter
2 with respect to residents of long-term care facilities.
(c) FUNDING.—There are authorized to be appro-
priated for the Office for Civil Rights, Department of
Health and Human Services, $36,000,000 for fiscal year
2001 and each subsequent fiscal year.
SEC. 502. DEVELOPMENT OF OUTCOME MEASURES; STUDY
TO MEASURE PATIENT OUTCOMES UNDER
THE MEDICARE AND MEDICAID PROGRAMS BY
RACE AND ETHNICITY.
(a) DEVELOPMENT
OF OUTCOME MEASURES.—Not
later than 1 year after the date of the enactment of this
Act, the Secretary of Health and Human Services, acting
through the Administrator of the Health Care Financing
Administration, shall develop outcome measures to evaluate,
by race and ethnicity, and on an age-specific and sex-spe-
cific basis, the performance of health care programs and
projects that provide health care to individuals under the
medicare and medicaid programs (under titles XVIII and
XIX, respectively, of the Social Security Act (42 U.S.C.
1395 et seq. and 1396 et seq.).
(b) STUDY.—After the Secretary develops the outcome
measures under subsection (a), the Secretary shall conduct
a study that evaluates, by race and ethnicity, and on an
age-specific and sex-specific basis, the performance of health
care programs and projects referred to in subsection (a) in
relation to such outcome measures.
(c) REPORT TO CONGRESS.—Not later than 2 years
after the date of the enactment of this Act, the Secretary
of Health and Human Services shall submit to Congress
a report describing the outcome measures developed under
subsection (a), and the results of the study conducted pursu-
ant to subsection (b).
SEC. 503. DEPARTMENTAL DEFINITION REGARDING MINOR-
ITY INDIVIDUALS.
Section 1707(g)(1) of the Public Health Service Act
(42 U.S.C. 300u–6) is amended—
(1) by striking ‘‘Asian Americans and’’ and in-
serting ‘‘Asian Americans;’’; and
(2) by inserting ‘‘Native Hawaiians and other’’
before ‘‘Pacific Islanders;’’.
SEC. 504. CONFORMING PROVISION REGARDING DEFINI-
TIONS.
For purposes of this Act, the term ‘‘racial and ethnic
minority group’’ has the meaning given such term in sec-
tion 1707 of the Public Health Service Act.
TITLE VI—EFFECTIVE DATE
SEC. 601. EFFECTIVE DATE.
This Act and the amendments made by this Act take
effect October 1, 2000, or upon the date of the enactment
of this Act, whichever occurs later.
Union Calendar No. 581
106TH CONGRESS
2D SESSION
H. R. 3250
[Report No. 106–986]
A BILL
To amend the Public Health Service Act to improve
the health of minority individuals.
OCTOBER 18, 2000
Reported with an amendment, committed to the Com-
mittee of the Whole House on the State of the Union,
and ordered to be printed