I
105TH CONGRESS
1ST SESSION
H. R. 487
To amend the Public Health Service Act with respect to the health of
individuals who are members of minority groups, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
JANUARY 21, 1997
Mr. RICHARDSON introduced the following bill; which was referred to the
Committee on Commerce
A BILL
To amend the Public Health Service Act with respect to
the health of individuals who are members of minority
groups, and for other purposes.
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
‘‘Minority Health Improvement Act of 1997’’.
(b) TABLE OF CONTENTS.—The table of contents for
this Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I—OFFICES OF MINORITY HEALTH; ASSISTANT
SECRETARY FOR CIVIL RIGHTS
Sec. 101. Revision and extension of programs of Office of Minority Health.
Sec. 102. Establishment of individual offices of minority health within agencies
of Public Health Service.
Sec. 103. Assistant Secretary of Health and Human Services for Civil Rights.
TITLE II—HEALTH PROFESSIONS PROGRAMS
Sec. 201. Primary care scholarships for students from disadvantaged back-
grounds.
Sec. 202. Scholarships generally; certain other purposes.
Sec. 203. Loan repayments and fellowships regarding faculty positions.
Sec. 204. Centers of Excellence.
Sec. 205. Educational assistance regarding undergraduates.
Sec. 206. Student loans regarding schools of nursing.
Sec. 207. Federally-supported student loans funds.
Sec. 208. Area health education centers.
TITLE III—RESEARCH
Sec. 301. Office of Research on Minority Health.
Sec. 302. Activities of Agency for Health Care Policy and Research.
Sec. 303. Data collection by National Center for Health Statistics.
TITLE I—OFFICE OF MINORITY
HEALTH; 
ASSISTANT 
SEC-
RETARY FOR CIVIL RIGHTS
SEC. 101. REVISION AND EXTENSION OF PROGRAMS OF OF-
FICE OF MINORITY HEALTH.
(a) IN GENERAL.—Section 1707 of the Public Health
Service Act (42 U.S.C. 300u–6) is amended by striking
subsection (b) and all that follows and inserting the follow-
ing:
‘‘(b) DUTIES.—With respect to improving the health
of racial and ethnic minority groups, the Secretary, acting
through the Deputy Assistant Secretary for Minority
Health (in this section referred to as the ‘Deputy Assist-
ant Secretary’), shall carry out the following:
‘‘(1) Establish short-range and long-range goals
and objectives and coordinate all other activities
within the Public Health Service that relate to dis-
ease prevention, health promotion, service delivery,
and research concerning such individuals. The heads
of each of the agencies of the Service shall consult
with the Deputy Assistant Secretary to ensure the
coordination of such activities.
‘‘(2) Carry out the following types of activities
by entering into interagency agreements with other
agencies of the Public Health Service:
‘‘(A) Support research, demonstrations and
evaluations to test new and innovative models.
‘‘(B) Increase knowledge and understand-
ing of health risk factors.
‘‘(C) Develop mechanisms that support
better information dissemination, education,
prevention, and service delivery to individuals
from disadvantaged backgrounds, including
individiuals who are members of racial or ethnic
minority groups.
‘‘(D) Ensure that the National Center for
Health Statistics collects data on the health
status of each minority group.
‘‘(E) With respect to individuals who lack
proficiency in speaking the English language,
enter into contracts with public and nonprofit
private providers of primary health services for
the purpose of increasing the access of the indi-
viduals to such services by developing and car-
rying out programs to provide bilingual or in-
terpretive services.
‘‘(3) Support a national minority health re-
source center to carry out the following:
‘‘(A) Facilitate the exchange of informa-
tion regarding matters relating to health infor-
mation and health promotion, preventive health
services, and education in the appropriate use
of health care.
‘‘(B) Facilitate access to such information.
‘‘(C) Assist in the analysis of issues and
problems relating to such matters.
‘‘(D) Provide technical assistance with re-
spect to the exchange of such information (in-
cluding facilitating the development of materials
for such technical assistance).
‘‘(4) Carry out programs to improve access to
health care services for individuals with limited pro-
ficiency in speaking the English language by facili-
tating the removal of impediments to the receipt of
health care that result from such limitation. Activi-
ties under the preceding sentence shall include con-
‘‘(2) EQUITABLE ALLOCATION REGARDING AC-
TIVITIES.—
‘‘(A) In making awards of grants, coopera-
tive agreements, or contracts under this section
or section 338A, 338B, 340A, 404, 724, 736,
737, 738, or 740, the Secretary, acting as ap-
propriate through the Deputy Assistant Sec-
retary or the Administrator of the Health Re-
sources and Services Administration, shall en-
sure that such awards are equitably allocated
with respect to the various racial and minority
populations.
‘‘(B) With respect to grants, cooperative
agreements, and contracts that are available
under the sections specified in subparagraph
(A), the Secretary shall—
‘‘(i) carry out activities to inform enti-
ties, as appropriate, that the entities may
be eligible for awards of such assistance;
‘‘(ii) provide technical assistance to
such entities in the process of preparing
and submitting applications for the awards
in accordance with the policies of the Sec-
retary regarding such application; and
‘‘(iii) inform populations, as appro-
priate, that members of the populations
may be eligible to receive services or other-
wise participate in the activities carried out
with such awards.
‘‘(3) CULTURAL COMPETENCY OF SERVICES.—
The Secretary shall ensure that information and
services provided pursuant to subsection (b) are pro-
vided in the language and cultural context that is
most appropriate for the individuals for whom the
information and services are intended.
‘‘(e) GRANTS
AND CONTRACTS REGARDING DU-
TIES.—
‘‘(1) IN GENERAL.—In carrying out subsection
(b), the Deputy Assistant Secretary may make
awards of grants, cooperative agreements, and con-
tracts to public and nonprofit private entities.
‘‘(2) PROCESS
FOR
MAKING
AWARDS.—The
Deputy Assistant Secretary shall ensure that awards
under paragraph (1) are made only on a competitive
basis, and that an award is made for a proposal only
if the proposal has been recommended for such an
award through a process of peer review and has been
so recommended by the advisory committee estab-
lished under subsection (c).
‘‘(3) EVALUATION AND DISSEMINATION.—The
Deputy Assistant Secretary, directly or through con-
tracts with public and private entities, shall provide
for evaluations of projects carried out with awards
made under paragraph (1) during the preceding 2
fiscal years. The report shall be included in the re-
port required under subsection (f) for the fiscal year
involved.
‘‘(f) BIENNIAL REPORTS.—Not later than February
1 of fiscal year 1998 and of each second year thereafter,
the Deputy Assistant Secretary shall submit to the Com-
mittee on Energy and Commerce of the House of Rep-
resentatives, and to the Committee on Labor and Human
Resources of the Senate, a report describing the activities
carried out under this section during the preceding 2 fiscal
years and evaluating the extent to which such activities
have been effective in improving the health of racial and
ethnic minority groups. Each such report shall include the
biennial reports submitted to the Deputy Assistant Sec-
retary under section 1707A(e) for such years by the heads
of the minority health offices.
‘‘(g) DEFINITION.—For purposes of this section:
‘‘(1) The term ‘racial and ethnic minority
group’ means American Indians (including Alaskan
Natives, Eskimos, and Aleuts); Asian Americans and
Pacific Islanders; Blacks; and Hispanics.
‘‘(2) The term ‘Hispanic’ means individuals
whose origin is Mexican, Puerto Rican, Cuban,
Central or South American, or any other Spanish-
speaking country.
‘‘(h) FUNDING.—
‘‘(1) AUTHORIZATION
OF
APPROPRIATIONS.—
For the purpose of carrying out this section, there
are authorized to be appropriated $21,000,000 for
fiscal year 1998, $25,000,000 for fiscal year 1999,
and $28,000,000 for fiscal year 2000.
‘‘(2) ALLOCATION OF FUNDS BY SECRETARY.—
Of the amounts appropriated under paragraph (1)
for a fiscal year in excess of $15,000,000, the Sec-
retary shall make available not less than $3,000,000
for carrying out subsection (b)(2)(E).’’.
(b) MISCELLANEOUS AMENDMENT.—Section 1707 of
the Public Health Service Act (42 U.S.C. 300u–6) is
amended in the heading for the section by striking ‘‘ES-
TABLISHMENT OF’’.
SEC. 102. ESTABLISHMENT OF INDIVIDUAL OFFICES OF MI-
NORITY HEALTH WITHIN AGENCIES OF PUB-
LIC HEALTH SERVICE.
Title XVII of the Public Health Service Act (42
U.S.C. 300u et seq.) is amended by inserting after section
1707 the following section:
‘‘INDIVIDUAL OFFICES OF MINORITY HEALTH WITHIN
PUBLIC HEALTH SERVICE
‘‘SEC. 1707A. (a) IN GENERAL.—The head of each
agency specified in subsection (b)(1) shall establish within
the agency an office to be known as the Office of Minority
Health. Each such Office shall be headed by a director,
who shall be appointed by the head of the agency within
which the Office is established, and who shall report di-
rectly to the head of the agency. The head of such agency
shall carry out this section (as this section relates to the
agency) acting through such Director.
‘‘(b) SPECIFIED AGENCIES.—
‘‘(1) IN GENERAL.—The agencies referred to in
subsection (a) are the following:
‘‘(A) The Centers for Disease Control and
Prevention.
‘‘(B) The Agency for Health Care Policy
and Research.
‘‘(C) The Health Resources and Services
Administration.
‘‘(D) The Substance Abuse and Mental
Health Services Administration.
‘‘(2) NATIONAL INSTITUTES OF HEALTH.—For
purposes of subsection (c) and the subsequent provi-
sions of this section, the term ‘minority health office’
includes the Office of Research on Minority Health
established within the National Institutes of Health.
The Director of the National Institutes of Health
shall carry out this section (as this section relates to
the agency) acting through the Director of such Of-
fice.
‘‘(c) COMPOSITION.—The head of each specified
agency shall ensure that the officers and employees of the
minority health office of the agency are, collectively, expe-
rienced in carrying out community-based health programs
for each of the various racial and ethnic minority groups
that are present in significant numbers in the United
States. The head of such agency shall ensure that, of such
officers and employees who are members of racial and eth-
nic minority groups, no such group is disproportionately
represented.
‘‘(d) DUTIES.—Each Director of a minority health of-
fice shall monitor the programs of the specified agency of
such office in order to carry out the following:
‘‘(1) Determine the extent to which the pur-
poses of the programs are being carried out with re-
spect to racial and ethnic minority groups;
‘‘(2) Determine the extent to which members of
such groups are represented among the Federal offi-
cers and employees who administer the programs;
and
‘‘(3) Make recommendations to the head of
such agency on carrying out the programs with re-
spect to such groups. In the case of programs that
provide services, such recommendations shall include
recommendations toward ensuring that—
‘‘(A) the services are equitably delivered
with respect to racial and ethnic minority
groups;
‘‘(B) the programs provide the services in
the language and cultural context that is most
appropriate for the individuals for whom the
services are intended; and
‘‘(C) the programs utilize racial and ethnic
minority community-based organizations to de-
liver the services.
‘‘(e) BIENNIAL REPORTS TO SECRETARY.—The head
of each specified agency shall submit to the Secretary for
inclusion in each biennial report under section 1707(g)
(without change) a biennial report describing—
‘‘(1) the extent to which the minority health of-
fice of the agency employs individuals who are mem-
bers of racial and ethnic minority groups, including
a specification by minority group of the number of
such individuals employed by such office; and
‘‘(2) the manner in which the agency is comply-
ing with Public Law 94–311 (relating to data on
Americans of Spanish origin or descent).
‘‘(f) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘minority health office’ means an
office established under subsection (a), subject to
subsection (b)(2).
‘‘(2) The term ‘racial and ethnic minority
group’ has the meaning given such term in section
1707(g).
‘‘(3) The term ‘specified agency’ means—
‘‘(A) an agency specified in subsection
(b)(1); and
‘‘(B) the National Institutes of Health.
‘‘(g) FUNDING.—
‘‘(1) ALLOCATIONS.—Of the amounts appro-
priated for a specified agency for a fiscal year, the
Secretary may reserve not more than 0.5 percent for
the purpose of carrying out activities under this sec-
tion through the minority health office of the agen-
cy. In reserving an amount under the preceding sen-
tence for a minority health office for a fiscal year,
the Secretary shall reduce, by substantially the same
percentage, the amount that otherwise would be
available for each of the programs of the designated
agency involved.
‘‘(2) AVAILABILITY
OF
FUNDS
FOR
STAFF-
ING.—The purposes for which amounts made avail-
able under paragraph (1) may be expended by a mi-
nority health office include the costs of employing
staff for such office.’’.
SEC. 103. ASSISTANT SECRETARY OF HEALTH AND HUMAN
SERVICES FOR CIVIL RIGHTS.
(a) IN GENERAL.—Part A of title II of the Public
Health Service Act (42 U.S.C. 202 et seq.) is amended
by adding at the end the following new section:
‘‘ASSISTANT SECRETARY FOR CIVIL RIGHTS
‘‘SEC. 229. (a) ESTABLISHMENT
OF POSITION.—
There shall be in the Department of Health and Human
Services an Assistant Secretary for Civil Rights, who shall
be appointed by the President, by and with the advice and
consent of the Senate.
‘‘(b) RESPONSIBILITIES.—The Assistant Secretary
shall perform such functions relating to civil rights as the
Secretary may assign.’’.
(b) CONFORMING AMENDMENT.—Section 5315 of
title 5, United States Code, is amended, in the item relat-
ing to Assistant Secretaries of Health and Human Serv-
ices, by striking ‘‘(5)’’ and inserting ‘‘(6)’’.
TITLE II—HEALTH PROFESSIONS
PROGRAMS
SEC. 201. PRIMARY CARE SCHOLARSHIPS FOR STUDENTS
FROM DISADVANTAGED BACKGROUNDS.
(a) IN GENERAL.—Section 736 of the Public Health
Service Act (42 U.S.C. 293) is amended to read as follows:
‘‘SEC. 736. CESAR CHAVEZ PROGRAM FOR PRIMARY CARE
SCHOLARSHIPS.
‘‘(a) IN GENERAL.—The Secretary may in accord-
ance with this section award scholarships to individuals
described in subsection (b) for the purpose of assisting the
individuals with the costs of attending schools of medicine
or osteopathic medicine, schools of dentistry, schools of
nursing (as defined in section 853), and graduate pro-
grams in mental health practice.
‘‘(b) ELIGIBLE
INDIVIDUALS.—An individual re-
ferred to in subsection (a) is any individual meeting the
following conditions:
‘‘(1) The individual is from a disadvantaged
background.
‘‘(2) The individual has a financial need for a
scholarship under such subsection.
‘‘(3) The individual is enrolled (or accepted for
enrollment) at an eligible school as a full-time stu-
dent in a program leading to a degree in a health
profession.
‘‘(4) The individual enters into the contract re-
quired pursuant to subsection (d) as a condition of
receiving the scholarship (relating to an agreement
to provide primary health services in a health profes-
sional shortage area designated under section 332).
‘‘(c) PREFERENCES REGARDING AWARDS.—
‘‘(1) IN GENERAL.—In awarding scholarships
under subsection (a), the Secretary shall give pref-
erence to eligible individuals for whom the costs of
attending the school involved would constitute a se-
vere financial hardship.
‘‘(2) ADDITIONAL PREFERENCES.—Of the eligi-
ble individuals receiving preference for purposes of
paragraph (1), the Secretary shall give additional
preference to individuals meeting any of the follow-
ing conditions:
‘‘(A) The individuals received scholarships
pursuant to this section, section 737, or section
740(d)(2) for fiscal year 1997.
‘‘(B) The individuals are seeking scholar-
ships for attendance at eligible schools that re-
ceived a grant under any of such sections for
such fiscal year.
‘‘(C) The individuals are bilingual.
‘‘(D) The individuals participate in a pro-
gram or activity carried out under section 739
by a grantee under such section.
‘‘(d) APPLICABILITY OF CERTAIN PROVISIONS.—
‘‘(1) IN GENERAL.—Except as provided in para-
graph (2), and except as otherwise inconsistent with
this section, the provisions of subpart III of part D
of title III apply to an award of a scholarship under
subsection (a) to the same extent and in the same
manner as such provisions apply to an award of a
scholarship under section 338A. This section shall
be carried out by the bureau that administers such
subpart III.
‘‘(2) OPTION
REGARDING
CERTAIN
MEDICAL
FIELDS.—
‘‘(A) With respect to amounts that the
Secretary reserves for scholarships under sub-
section (a) for attendance at schools of medi-
cine or osteopathic medicine, the Secretary shall
obligate 30 percent for such scholarships for in-
dividuals whose contracts made pursuant to
paragraph (1) provide to the individuals, sub-
ject to subparagraph (B), the option of per-
forming obligated service under the contract in
a medical field not providing primary health
services.
‘‘(B) In the case of an individual whose
contract made pursuant to paragraph (1) pro-
vides the option described in subparagraph (A),
the contract shall provide that, in the event that
the individual exercises the option, the period of
obligated service applicable under the contract
is 2 years for each school year for which the
scholarship involved is provided.
‘‘(e) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘eligible individual’ means an in-
dividual described in subsection (b).
‘‘(2) The term ‘eligible school’ means a school
or program specified in subsection (a).
‘‘(f) FUNDING.—
‘‘(1) AUTHORIZATION
OF
APPROPRIATIONS.—
For the purpose of carrying out this section, there
are authorized to be appropriated $25,000,000 for
fiscal year 1998, $38,000,000 for fiscal year 1999,
and $48,000,000 for fiscal year 2000. Such author-
ization is in addition to the authorization of appro-
priations established in section 740(f)(2)(B).
‘‘(2) ALLOCATIONS BY SECRETARY.—
‘‘(A) Of the amounts appropriated under
paragraph (1) for a fiscal year and of the
amounts available under section 740(f)(2)(B)
for the year, the Secretary shall obligate
amounts in accordance with the following:
‘‘(i) 19 percent shall be obligated for
scholarships under subsection (a) for at-
tendance at schools of dentistry.
‘‘(ii) 16 percent shall be obligated for
scholarships under such subsection for at-
tendance at schools of nursing.
‘‘(iii) 10 percent shall be obligated for
scholarships under such subsection for at-
tendance at graduate programs in mental
health practice.
‘‘(B) The requirements of subparagraph
(A) apply only to the extent that a sufficient
number of eligible individuals seeks the scholar-
ships involved.’’.
(b) CERTAIN PROGRAMS OF OBLIGATED SERVICE.—
(1) REPEAL.—Section 795 of the Public Health
Service Act (42 U.S.C. 295n) is repealed.
(2) RULE OF CONSTRUCTION.—Paragraph (1)
does not terminate agreements that, on the day be-
fore the effective date under section 901, are in ef-
fect pursuant to section 795 of the Public Health
Service Act. Such agreements continue in effect in
accordance with the terms of the agreements. With
respect to compliance with such agreements, any pe-
riod of practice as a provider of primary health serv-
ices (whether provided pursuant to other agreements
with the Federal Government or whether provided
otherwise) counts toward satisfaction of the require-
ment of practice pursuant to such section 795.
SEC. 202. SCHOLARSHIPS GENERALLY; CERTAIN OTHER
PURPOSES.
Section 737 of the Public Health Service Act (42
U.S.C. 293a) is amended to read as follows:
‘‘SEC. 737. THURGOOD MARSHALL PROGRAM FOR HEALTH
SERVICES SCHOLARSHIPS.
‘‘(a) IN GENERAL.—The Secretary may in accord-
ance with this section award scholarships to individuals
described in subsection (b) for the purpose of assisting the
individuals with the costs of attending the health profes-
sions schools described in subsection (c).
‘‘(b) ELIGIBLE
INDIVIDUALS.—An individual re-
ferred to in subsection (a) is any individual meeting the
following conditions:
‘‘(1) The individual is from a disadvantaged
background.
‘‘(2) The individual has a financial need for a
scholarship under such subsection.
‘‘(3) The individual is enrolled (or accepted for
enrollment) at an eligible school as a full-time stu-
dent in a program leading to a degree in a health
profession.
‘‘(4) The individual enters into the contract re-
quired pursuant to subsection (e) as a condition of
receiving the scholarship (relating to an agreement
to provide primary health services in a health profes-
sional shortage area designated under section 332).
‘‘(c) ELIGIBLE
SCHOOLS.—A health professions
school referred to in subsection (a) is a health professions
school meeting the following conditions:
‘‘(1) The school is a school of veterinary medi-
cine, optometry, pharmacy, podiatric medicine, or
public health, or a designated school of allied health
(as defined in subsection (f)).
‘‘(2) The school is carrying out a program for
recruiting and retaining students from disadvan-
taged backgrounds, including students who are
members of racial and ethnic minority groups.
‘‘(d) PREFERENCES REGARDING AWARDS.—
‘‘(1) IN GENERAL.—In awarding scholarships
under subsection (a), the Secretary shall give pref-
erence to eligible individuals for whom the costs of
attending the school involved would constitute a se-
vere financial hardship.
‘‘(2) ADDITIONAL PREFERENCES.—Of the eligi-
ble individuals receiving preference for purposes of
paragraph (1), the Secretary shall give additional
preference to individuals meeting any of the follow-
ing conditions:
‘‘(A) The individuals received scholarships
pursuant to this section for fiscal year 1997.
‘‘(B) The individuals are seeking scholar-
ships for attendance at eligible schools that re-
ceived a grant under this section for such fiscal
year.
‘‘(C) The individuals are bilingual.
‘‘(D) The individuals participate in a pro-
gram or activity carried out under section 739
by a grantee under such section.
‘‘(e) APPLICABILITY OF CERTAIN PROVISIONS.—
‘‘(1) IN GENERAL.—Except as provided in para-
graph (2), and except as otherwise inconsistent with
this section, the provisions of subpart III of part D
of title III apply to an award of a scholarship under
subsection (a) to the same extent and in the same
manner as such provisions apply to an award of a
scholarship under section 338A.
‘‘(2) CERTAIN INDIVIDUALS.—
‘‘(A) In the case of an individual who re-
ceives a scholarship under subsection (a) for at-
tendance at a school of veterinary medicine, the
contract made pursuant to paragraph (1) shall
provide that the individual agrees that, after
completing training in such medicine, the indi-
vidual will, in accordance with requirements es-
tablished under subparagraph (B)—
‘‘(i) serve in a position in which the
individual conducts or assists in the con-
duct of research regarding human health
or safety; or
‘‘(ii) serve in a position with a public
health agency of a State or a political sub-
division of a State.
‘‘(B) The Secretary shall establish require-
ments regarding contracts under subparagraph
(A).
‘‘(f) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘designated school of allied
health’ means a school of allied health providing
training in occupational therapy, physical therapy,
dental hygiene, medical technology, or radiologic
technology.
‘‘(2) The term ‘eligible individual’ means an in-
dividual described in subsection (b).
‘‘(3) The term ‘eligible school’ means a school
described in subsection (c).
‘‘(g) FUNDING.—
‘‘(1) AUTHORIZATION
OF
APPROPRIATIONS.—
For the purpose of carrying out this section, there
are authorized to be appropriated $5,000,000 for
fiscal year 1998, $8,000,000 for fiscal year 1999,
and $10,000,000 for fiscal year 2000.
‘‘(2) ALLOCATIONS BY SECRETARY.—With re-
spect to scholarships under subsection (a) for at-
tendance at designated schools of allied health, the
Secretary shall obligate for such scholarships 25 per-
cent of the amounts appropriated under paragraph
(1) for each of the fiscal years 1998 through 2000.
The requirement of the preceding sentence applies
only to the extent that a sufficient number of eligible
individuals seeks such scholarships.’’.
SEC. 203. LOAN REPAYMENTS AND FELLOWSHIPS REGARD-
ING FACULTY POSITIONS.
(a) LOAN REPAYMENTS.—Section 738(a) of the Pub-
lic Health Service Act (42 U.S.C. 293b(a)) is amended—
(1) by striking paragraphs (4) and (6);
(2) by redesignating paragraphs (5) and (7) as
paragraphs (4) and (5), respectively; and
(3) in paragraph (4) (as so redesignated), by
amending subparagraph (B) to read as follows:
‘‘(B) the contract referred to in subpara-
graph (A) provides that the school, in making
a determination of the amount of compensation
to be provided by the school to the individual
for serving as a member of the faculty, will
make the determination without regard to the
amount of payments made (or to be made) to
the individual by the Federal Government under
paragraph (1).’’.
(b) FELLOWSHIPS.—
(1) IN GENERAL.—Section 738(b) of the Public
Health Service Act (42 U.S.C. 293b(b)) is amend-
ed—
(A) in paragraph (2)(B), by striking
‘‘$30,000’’ and inserting ‘‘$50,000’’; and
(B) in paragraph (3)—
(i) in subparagraph (B), by inserting
‘‘and’’ after the semicolon at the end;
(ii) in subparagraph (C), by striking
‘‘; and’’ and inserting a period; and
(iii) by striking subparagraph (D).
(2) DEFINITION.—Section 738(b) of the Public
Health Service Act (42 U.S.C. 293b(b)) is amend-
ed—
(A) in paragraph (1), by striking ‘‘the
number’’ and all that follows and inserting the
following: ‘‘the number of underrepresented mi-
nority individuals who are members of the fac-
ulty of the schools.’’;
(B) in paragraph (3)(A), by striking ‘‘indi-
viduals from underrepresented minorities in the
health professions’’ and inserting ‘‘underrep-
resented minority individuals’’; and
(C) in paragraph (5), by striking ‘‘the
term’’ and all that follows and inserting the fol-
lowing: ‘‘the term ‘underrepresented minority
individuals’ means individuals who are members
of racial or ethnic minority groups that are
underrepresented in the health professions.’’.
(c) AUTHORIZATION OF APPROPRIATIONS.—Section
738(c) of the Public Health Service Act (42 U.S.C.
293b(c)) is amended by striking ‘‘there is’’ and all that
follows and inserting the following: ‘‘there is authorized
to be appropriated $1,100,000 for each of the fiscal years
1998 through 2000.’’.
SEC. 204. CENTERS OF EXCELLENCE.
(a) REFERENCES TO SCHOOLS.—Section 739 of the
Public Health Service Act (42 U.S.C. 293c) is amended—
(1) by striking ‘‘health professions schools’’
each place such term appears and inserting ‘‘des-
ignated health professions schools’’; and
(2) by striking ‘‘health professions school’’ each
place such term appears and inserting ‘‘designated
health professions school’’.
(b) REQUIRED USES OF FUNDS.—Section 739(b) of
the Public Health Service Act (42 U.S.C. 293c(b)), as
amended by subsection (a), is amended—
(1) by striking paragraph (2);
(2) by redesignating paragraph (1) as para-
graph (2);
(3) by inserting before paragraph (2) (as so re-
designated) the following paragraph:
‘‘(1) to collaborate with public and nonprofit
private entities to carry out community-based pro-
grams to interest students of secondary schools and
institutions of higher education in pursuing careers
in the health professions, and to prepare interested
students academically for such careers;’’;
(4) in paragraph (5)—
(A) by striking ‘‘faculty and student re-
search’’ and inserting ‘‘student research’’; and
(B) by inserting before the period the fol-
lowing: ‘‘, including research on issues relating
to the delivery of health care’’; and
(5)(A) in paragraph (4), by striking ‘‘and’’
after the semicolon at the end;
(B) in paragraph (5), by striking the period at
the end and inserting ‘‘; and’’; and
(C) by adding at the end the following para-
graph:
‘‘(6) to carry out a program to train students
of the school in providing health services through
training provided at community-based health facili-
ties that provide such services to a significant num-
ber of disadvantaged individuals and that are located
at a site remote from the main site of the teaching
facilities of the school.’’.
(c) REQUIREMENTS REGARDING CONSORTIA.—
(1) IN
GENERAL.—Section 739(c)(1) of the
Public Health Service Act (42 U.S.C. 293c(c)(1)), as
amended by subsection (a), is amended—
(A) in subparagraph (A), in the matter
preceding clause (i), by striking ‘‘specified in
subparagraph (B)’’ and inserting ‘‘specified in
subparagraphs (B) and (C)’’;
(B) by redesignating subparagraph (C) as
subparagraph (D); and
(C) by inserting after subparagraph (B)
the following subparagraph:
‘‘(C) The condition specified in this sub-
paragraph is that, in accordance with sub-
section (e)(1), the designated health professions
school involved has with other health profession
schools (designated or otherwise) formed a con-
sortium to carry out the purposes described in
subsection (b) at the schools of the consortium.
The grant involved may be expended with re-
spect to the other schools without regard to
whether such schools meet the conditions speci-
fied in subparagraph (B).’’.
(2) CERTAIN REQUIREMENTS.—Section 739(e)
of the Public Health Service Act (42 U.S.C.
293c(e)), as amended by subsection (a), is amended
to read as follows:
‘‘(e) PROVISIONS REGARDING CONSORTIA.—
‘‘(1) REQUIREMENTS.—For purposes of sub-
section (c)(1)(C), a consortium of schools has been
formed in accordance with this subsection if—
‘‘(A) the consortium consists of—
‘‘(i) the designated health professions
school seeking the grant under subsection
(a); and
‘‘(ii) 1 or more schools of medicine,
osteopathic medicine, dentistry, pharmacy,
nursing, allied health, or public health, or
graduate programs in mental health prac-
tice;
‘‘(B) the schools of the consortium have
entered into an agreement for the allocation of
such grant among the schools; and
‘‘(C) each of the schools agrees to expend
the grant in accordance with this section.
‘‘(2) AUTHORITY
REGARDING
NATIVE
AMERI-
CANS CENTERS OF EXCELLENCE.—With respect to
meeting the conditions specified in subsection (c)(4),
the Secretary may make a grant under subsection
ceding sentence applies without regard to whether a
grant under subsection (a) is, pursuant to subsection
(c)(1)(C), being expended with respect to the
school.’’.
(d) 
DEFINITION
OF
HEALTH
PROFESSIONS
SCHOOL.—
(1) GRADUATE PROGRAMS IN MENTAL HEALTH
PRACTICE.—Section 739(h)(1)(A) of the Public
Health Service Act (42 U.S.C. 293c(h)(1)(A)), as
amended by subsection (a), is amended by—
(A) by striking ‘‘or’’ after ‘‘dentistry’’; and
(B) by inserting before the period the fol-
lowing: ‘‘, or a graduate program in mental
health practice’’.
(2) LIMITATION.—During the fiscal years 1998
through 2000, the Secretary of Health and Human
Services may not make more than one grant under
section 739 of the Public Health Service Act directly
to a graduate program in mental health practice (as
defined in section 799 of such Act).
(e) FUNDING.—Section 739(i) of the Public Health
Service Act (42 U.S.C. 293c(i)), as amended by subsection
(a), is amended to read as follows:
‘‘(i) FUNDING.—
‘‘(1) AUTHORIZATION
OF
APPROPRIATIONS.—
For the purpose of making grants under subsection
(a), there are authorized to be appropriated
$24,000,000 for fiscal year 1998, $28,000,000 for
fiscal year 1999, and $33,000,000 for fiscal year
2000.
‘‘(2) ALLOCATIONS BY SECRETARY.—
‘‘(A) Of the amounts appropriated under
paragraph (1) for a fiscal year, the Secretary
shall make available $12,000,000 for grants
under subsection (a) to health professions
schools that are eligible for such grants pursu-
ant to meeting the conditions described in para-
graph (2)(A) of subsection (c).
‘‘(B) Of the amounts appropriated under
paragraph (1) for a fiscal year and available
after compliance with subparagraph (A), the
Secretary shall make available 65 percent for
grants under subsection (a) to health profes-
sions schools that are eligible for such grants
pursuant to meeting the conditions described in
paragraph (3) or (4) of subsection (c) (includ-
ing meeting conditions pursuant to subsection
(e)(2)).
‘‘(C)(i) Of the amounts appropriated under
paragraph (1) for a fiscal year and available
after compliance with subparagraph (A), the
Secretary shall make available 35 percent for
grants under subsection (a) to health profes-
sions schools that are eligible for such grants
pursuant to meeting the conditions described in
paragraph (5) of subsection (c).
‘‘(ii) With respect to a fiscal year, a grant
under subsection (a) that includes amounts
available under subparagraph (A) may not in-
clude amounts available under clause (i) unless
each of the following conditions is met:
‘‘(I) In the case of amounts available
under subparagraph (B) or clause (i) and
included in grants made pursuant to sub-
section (c)(3), the aggregate number of
such grants is not less than such aggregate
number for the preceding fiscal year, and
one or more of such grants is made in an
amount that is not less than the lowest
amount among grants made from amounts
available under subparagraph (A).
‘‘(II) In the case of amounts available
under subparagraph (B) or clause (i) and
included in grants made pursuant to sub-
section (c)(4), the aggregate number of
such grants is not less than such aggregate
number for the preceding fiscal year, and
one or more of such grants is made in an
amount that is not less than the lowest
amount among grants made from amounts
available under subparagraph (A).
‘‘(III) In the case of amounts avail-
able under clause (i) and included in
grants made pursuant to subsection (c)(5)
(exclusive of grants that include amounts
available under subparagraph (A) or (B)),
the aggregate number of such grants is not
less than such aggregate number for the
preceding fiscal year, and one or more of
such grants is made in an amount that is
not less than the lowest amount among
grants made from amounts available under
subparagraph (A).
‘‘(IV) 
The 
aggregate 
amount 
of
grants under subsection (a) made from
amounts available under subparagraph (B)
and clause (i) (other than grants that in-
clude amounts available under subpara-
graph (A)) is, in the case of fiscal year
1998, not less than the sum of such aggre-
gate amount for fiscal year 1997 and the
total amount by which grants are required
under subclauses (I) through (III) to be in-
creased; and is, in the case of fiscal year
1999 and each subsequent fiscal year, not
less than such aggregate amount for the
preceding fiscal year.’’.
(f) CONFORMING AMENDMENTS.—Section 739(c) of
the Public Health Service Act (42 U.S.C. 293c(c)), as
amended by subsection (a), is amended—
(1) in paragraph (3)(B), by striking ‘‘the des-
ignated health professions school’’ and inserting
‘‘the school’’; and
(2) in paragraph (4), in each of subparagraphs
(B) and (C), by striking ‘‘the designated health pro-
fessions school’’ and inserting ‘‘the school’’.
(g) TRANSITIONAL AND SAVINGS PROVISIONS.—
(1) IN GENERAL.—During the period specified
in paragraph (2)—
(A) the amendments made by subsections
(a) through (f) do not apply to any entity that
received a grant for fiscal year 1997 under sec-
tion 739 of the Public Health Service Act; and