309 
‘‘(iv) the Director of the Agency for 
Healthcare Research and Quality; 
‘‘(v) the Administrator of the Health 
Resources and Services Administration; 
‘‘(vi) the Administrator of the Centers 
for Medicare and Medicaid Services; 
‘‘(vii) the Director of the Office for 
Civil Rights; 
‘‘(viii) the Administrator of the Sub-
stance Abuse and Mental Health Services 
Administration; 
‘‘(ix) the Commissioner of Food and 
Drugs; and 
‘‘(x) the heads of other appropriate 
public and private entities; 
‘‘(C) ensure that the plan includes measur-
able objectives, describes the means for achiev-
ing such objectives, and designates a date by 
which such objectives are expected to be 
achieved; 
‘‘(D) ensure that all amounts appropriated 
for such activities are expended in accordance 
with the plan; 
‘‘(E) review the plan on at least an annual 
basis and revise the plan as appropriate;
310 
‘‘(F) ensure that the plan will serve as a 
binding statement of policy with respect to the 
agencies’ activities related to disparities in 
health and healthcare; and 
‘‘(G) not later than March 1 of each year, 
submit the plan (or any revisions to the plan), 
to the Committee on Health, Education, Labor, 
and Pensions of the Senate and the Committee 
on Energy and Commerce of the House of Rep-
resentatives. 
‘‘(2) COMPONENTS OF THE PLAN.—The Deputy 
Assistant Secretary shall ensure that the comprehen-
sive plan established under paragraph (1) address-
es— 
‘‘(A) the recommendations of the 2002 In-
stitute of Medicine report (Unequal Treatment) 
with respect to racial and ethnic disparities in 
healthcare; 
‘‘(B) health and disease prevention edu-
cation for racial, ethnic, and primary language 
health disparity populations; 
‘‘(C) research to identify sources of health 
and healthcare disparities in minority groups; 
‘‘(D) the implementation and assessment 
of promising intervention strategies;
311 
‘‘(E) data collection and the monitoring of 
the healthcare and health status of health dis-
parity populations; 
‘‘(F) care of individuals who lack pro-
ficiency with the English language; 
‘‘(G) care of individuals with low func-
tional health literacy; 
‘‘(H) the training, recruitment, and reten-
tion of minority health professionals; 
‘‘(I) programs to expand and facilitate ac-
cess to healthcare services, including the use of 
telemedicine, National Health Service Scholars, 
community health workers, and case managers; 
‘‘(J) public and health provider awareness 
of racial and ethnic disparities in healthcare; 
‘‘(K) methods to evaluate and measure 
progress toward the goal of eliminating dispari-
ties in health and healthcare in racial and eth-
nic minority populations; 
‘‘(L) the promotion of interagency and 
intra-agency coordination and collaboration and 
public-private and community partnerships; and 
‘‘(M) the preparedness of health profes-
sionals to care for racially, ethnically, and lin-
guistically diverse populations and low func-
312 
tional health literacy populations including eval-
uations.’’; 
(6) in subsection (d) (as so redesignated)— 
(A) in paragraph (1), by inserting ‘‘and 
Racial, Ethnic, and Primary Language Health 
Disparities 
Elimination’’ 
after 
‘‘Minority 
Health’’; and 
(B) in paragraph (2)— 
(i) by striking ‘‘Deputy Assistant’’; 
and 
(ii) by striking ‘‘(10) of subsection 
(b)’’ and inserting ‘‘(9) of subsection (c)’’; 
(7) in subsection (e)(1) (as so redesignated)— 
(A) in subparagraph (A), by striking ‘‘sub-
section 
(b)(9)’’ 
and 
inserting 
‘‘subsection 
(b)(7)’’; and 
(B) in subparagraph (B), by striking ‘‘sub-
section (b)(10)’’ and inserting ‘‘subsection 
(b)(8)’’; 
(8) in subsection (f)(3) (as so redesignated), by 
striking ‘‘subsection (f)’’ and inserting ‘‘subsection 
(g)’’; 
(9) in subsection (g)(1) (as so redesignated)— 
(A) by striking ‘‘1999 and each second’’ 
and inserting ‘‘2006 and each’’;
313 
(B) by striking ‘‘Labor and Human Re-
sources’’ and inserting ‘‘Health, Education, 
Labor, and Pensions’’; 
(C) by striking ‘‘2 fiscal years’’ and insert-
ing ‘‘fiscal year’’; and 
(D) by inserting after ‘‘improving the 
health of racial and ethnic minority groups’’ the 
following: ‘‘reducing and eliminating disparities 
in health and healthcare in racial and ethnic 
minority populations, in accordance with the 
national plan specified under subsection (c) and 
the goals of Healthy People 2010’’; 
(10) by inserting after subsection (g) (as so re-
designated) the following: 
‘‘(h) FEDERAL PARTNERSHIP WITH ACCREDITATION 
ENTITIES.— 
‘‘(1) IN GENERAL.—Not later than 1 year after 
the date of enactment of the Healthcare Equality 
and Accountability Act, the Secretary, in collabora-
tion with the Director of the Agency for Healthcare 
Research and Quality, the Administrator of the Cen-
ters for Medicare and Medicaid Services, the Direc-
tor of the Office for Minority Health, and the heads 
of appropriate State agencies, shall convene a work-
ing group with members of accreditation organiza-
314 
tions and other quality standard setting organiza-
tions to develop guidelines to evaluate and report on 
the health and healthcare of minority populations 
served by health centers, health plans, hospitals, and 
other federally funded health entities. 
‘‘(2) REPORT.—Not later than 6 months after 
the convening of the working group under paragraph 
(1), the working group shall submit a report to the 
Secretary at such time, in such manner, and con-
taining such information as the Secretary may re-
quire, including guidelines and recommendations on 
how each accreditation body will work with con-
stituent members to ensure the adoption of such 
guidelines. 
‘‘(3) DEMONSTRATION
PROJECTS.—The Sec-
retary, acting through the Administrator of the Cen-
ters for Medicare and Medicaid Services, shall award 
grants for the establishment of demonstration 
projects to assess the impact of providing financial 
incentives for the reporting and analysis of the qual-
ity of minority healthcare by hospitals, health plans, 
health centers, and other healthcare entities. 
‘‘(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated to carry out
315 
this subsection, such sums as may be necessary for 
each of fiscal years 2007 through 2012. 
‘‘(i) PREPARATION OF HEALTH PROFESSIONALS TO 
PROVIDE HEALTHCARE TO MINORITY POPULATIONS.— 
The Secretary, in collaboration with the Director of the 
Bureau of Health Professions and the Director of the Of-
fice of Minority Health, shall require that health profes-
sional schools that receive Federal funds train future 
health professionals to provide culturally and linguistically 
appropriate healthcare to diverse populations.’’; and 
(11) by striking subsection (k) (as so redesig-
nated) and inserting the following: 
‘‘(k) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section (other than subsection 
(h)), there is authorized to be appropriated $100,000,000 
for fiscal year 2006, and such sums as may be necessary 
for each of fiscal years 2007 through 2012.’’. 
SEC. 605. ESTABLISHMENT OF THE INDIAN HEALTH SERV-
ICE AS AN AGENCY OF THE PUBLIC HEALTH 
SERVICE. 
(a) ESTABLISHMENT.— 
(1) IN GENERAL.—In order to more effectively 
and efficiently carry out the responsibilities, authori-
ties, and functions of the United States to provide 
healthcare services to Indians and Indian tribes, as
316 
are or may be hereafter provided by Federal statute 
or treaties, there is established within the Public 
Health Service of the Department of Health and 
Human Services the Indian Health Service. 
(2) 
ASSISTANT
SECRETARY
OF
INDIAN 
HEALTH.—The Service shall be administered by an 
Assistant Secretary of Indian Health, who shall be 
appointed by the President, by and with the advice 
and consent of the Senate. The Assistant Secretary 
shall report to the Secretary. Effective with respect 
to an individual appointed by the President, by and 
with the advice and consent of the Senate the term 
of service of the Assistant Secretary shall be 4 years. 
An Assistant Secretary may serve more than 1 term. 
(b) AGENCY.—The Service shall be an agency within 
the Public Health Service of the Department, and shall 
not be an office, component, or unit of any other agency 
of the Department. 
(c) FUNCTIONS AND DUTIES.—The Secretary shall 
carry out through the Assistant Secretary of the Service— 
(1) all functions which were, on the day before 
the date of enactment of the Indian Health Care 
Amendments of 1988, carried out by or under the 
direction of the individual serving as Director of the 
Service on such day;
317 
(2) all functions of the Secretary relating to the 
maintenance and operation of hospital and health fa-
cilities for Indians and the planning for, and provi-
sion and utilization of, health services for Indians; 
(3) all health programs under which healthcare 
is provided to Indians based upon their status as In-
dians which are administered by the Secretary, in-
cluding programs under— 
(A) the Indian Health Care Improvement 
Act; 
(B) the Act of November 2, 1921 (25 
U.S.C. 13); 
(C) the Act of August 5, 1954 (42 U.S.C. 
2001, et seq.); 
(D) the Act of August 16, 1957 (42 
U.S.C. 2005 et seq.); 
(E) the Indian Self-Determination Act (25 
U.S.C. 450f, et seq.); and 
(F) title XXIX of the Public Health Serv-
ice Act; and 
(4) all scholarship and loan functions carried 
out under title I of the Indian Health Care Improve-
ment Act. 
(d) AUTHORITY.—
318 
(1) 
IN
GENERAL.—The 
Secretary, 
acting 
through the Assistant Secretary, shall have the au-
thority— 
(A) except to the extent provided for in 
paragraph (2), to appoint and compensate em-
ployees for the Service in accordance with title 
5, United States Code; 
(B) to enter into contracts for the procure-
ment of goods and services to carry out the 
functions of the Service; and 
(C) to manage, expend, and obligate all 
funds appropriated for the Service. 
(2) PERSONNEL
ACTIONS.—Notwithstanding 
any other provision of law, the provisions of section 
12 of the Act of June 18, 1934 (48 Stat. 986; 25 
U.S.C. 472), shall apply to all personnel actions 
taken with respect to new positions created within 
the Service as a result of its establishment under 
subsection (a). 
(e) RATE OF PAY.— 
(1) POSITIONS AT LEVEL IV.—Section 5315 of 
title 5, United States Code, is amended by striking 
the following: ‘‘Assistant Secretaries of Health and 
Human Services (6).’’ and inserting ‘‘Assistant Sec-
retaries of Health and Human Services (7).’’.