Control and Prevention and other Federal officials deter-
mined appropriate by the Secretary, is authorized to 
award grants to States or local or tribal units, to promote 
positive health behaviors for women in target populations, 
especially racial and ethnic minority women in medically 
underserved communities. 
‘‘(b) USE OF FUNDS.—Grants awarded pursuant to 
subsection (a) may be used to support community health 
workers—
‘‘(1) to educate, guide, and provide outreach in 
a community setting regarding health problems prev-
alent among women and especially among racial and 
ethnic minority women; 
‘‘(2) to educate, guide, and provide experiential 
learning opportunities that target behavioral risk 
factors including—
‘‘(A) poor nutrition; 
‘‘(B) physical inactivity; 
‘‘(C) obesity; 
‘‘(D) tobacco use; 
‘‘(E) alcohol and substance use; 
‘‘(F) injury and violence; 
‘‘(G) risky sexual behavior; and 
‘‘(H) mental health problems;
‘‘(3) to educate and guide regarding effective 
strategies to promote positive health behaviors with-
in the family; 
‘‘(4) to educate and provide outreach regarding 
enrollment in health insurance including the State 
Children’s Health Insurance Program under title 
XXI of the Social Security Act, medicare under title
XVIII of such Act and medicaid under title XIX of 
such Act; 
‘‘(5) to promote community wellness and aware-
ness; and 
‘‘(6) to educate and refer target populations to 
appropriate health care agencies and community-
based programs and organizations in order to in-
crease access to quality health care services, includ-
ing preventive health services. 
‘‘(c) APPLICATION.—
‘‘(1) IN GENERAL.—Each State or local or trib-
al unit (including federally recognized tribes and 
Alaska native villages) that desires to receive a grant 
under subsection (a) shall submit an application to 
the Secretary, at such time, in such manner, and ac-
companied by such additional information as the 
Secretary may require.
‘‘(2) CONTENTS.—Each application submitted 
pursuant to paragraph (1) shall—
‘‘(A) describe the activities for which as-
sistance under this section is sought; 
‘‘(B) contain an assurance that with re-
spect to each community health worker pro-
gram receiving funds under the grant awarded, 
such program provides training and supervision 
to community health workers to enable such 
workers to provide authorized program services; 
‘‘(C) contain an assurance that the appli-
cant will evaluate the effectiveness of commu-
nity health worker programs receiving funds 
under the grant; 
‘‘(D) contain an assurance that each com-
munity health worker program receiving funds 
under the grant will provide services in the cul-
tural context most appropriate for the individ-
uals served by the program; 
‘‘(E) contain a plan to document and dis-
seminate project description and results to 
other States and organizations as identified by 
the Secretary; and 
‘‘(F) describe plans to enhance the capac-
ity of individuals to utilize health services and
health-related social services under Federal, 
State, and local programs by—
‘‘(i) assisting individuals in estab-
lishing eligibility under the programs and 
in receiving the services or other benefits 
of the programs; and 
‘‘(ii) providing other services as the 
Secretary determines to be appropriate, 
that may include transportation and trans-
lation services. 
‘‘(d) PRIORITY.—In awarding grants under sub-
section (a), the Secretary shall give priority to those appli-
cants—
‘‘(1) who propose to target geographic areas—
‘‘(A) with a high percentage of residents 
who are eligible for health insurance but are 
uninsured or underinsured; 
‘‘(B) with a high percentage of families for 
whom English is not their primary language; 
and 
‘‘(C) that encompass the United States-
Mexico border region; 
‘‘(2) with experience in providing health or 
health-related social services to individuals who are 
underserved with respect to such services; and
‘‘(3) with documented community activity and 
experience with community health workers. 
‘‘(e) COLLABORATION WITH ACADEMIC INSTITU-
TIONS.—The Secretary shall encourage community health 
worker programs receiving funds under this section to col-
laborate with academic institutions. Nothing in this sec-
tion shall be construed to require such collaboration. 
‘‘(f) QUALITY ASSURANCE
AND COST-EFFECTIVE-
NESS.—The Secretary shall establish guidelines for assur-
ing the quality of the training and supervision of commu-
nity health workers under the programs funded under this 
section and for assuring the cost-effectiveness of such pro-
grams. 
‘‘(g) MONITORING.—The Secretary shall monitor 
community health worker programs identified in approved 
applications and shall determine whether such programs 
are in compliance with the guidelines established under 
subsection (e). 
‘‘(h) TECHNICAL ASSISTANCE.—The Secretary may 
provide technical assistance to community health worker 
programs identified in approved applications with respect 
to planning, developing, and operating programs under the 
grant. 
‘‘(i) REPORT TO CONGRESS.—
‘‘(1) IN
GENERAL.—Not later than 4 years 
after the date on which the Secretary first awards 
grants under subsection (a), the Secretary shall sub-
mit to Congress a report regarding the grant 
project. 
‘‘(2) CONTENTS.—The report required under 
paragraph (1) shall include the following:
‘‘(A) A description of the programs for 
which grant funds were used. 
‘‘(B) The number of individuals served. 
‘‘(C) An evaluation of—
‘‘(i) the effectiveness of these pro-
grams; 
‘‘(ii) the cost of these programs; and 
‘‘(iii) the impact of the project on the 
health outcomes of the community resi-
dents. 
‘‘(D) Recommendations for sustaining the 
community health worker programs developed 
or assisted under this section. 
‘‘(E) Recommendations regarding training 
to enhance career opportunities for community 
health workers. 
‘‘(j) DEFINITIONS.—In this section:
‘‘(1) COMMUNITY HEALTH WORKER.—The term 
‘community health worker’ means an individual who 
promotes health or nutrition within the community 
in which the individual resides—
‘‘(A) by serving as a liaison between com-
munities and health care agencies; 
‘‘(B) by providing guidance and social as-
sistance to community residents; 
‘‘(C) by enhancing community residents’ 
ability to effectively communicate with health 
care providers; 
‘‘(D) by providing culturally and linguis-
tically appropriate health or nutrition edu-
cation; 
‘‘(E) by advocating for individual and com-
munity health or nutrition needs; and 
‘‘(F) by providing referral and followup 
services. 
‘‘(2) COMMUNITY SETTING.—The term ‘commu-
nity setting’ means a home or a community organi-
zation located in the neighborhood in which a partic-
ipant resides. 
‘‘(3) MEDICALLY UNDERSERVED COMMUNITY.—
The term ‘medically underserved community’ means 
a community identified by a State—
‘‘(A) that has a substantial number of in-
dividuals who are members of a medically un-
derserved population, as defined by section 
330(b)(3); and 
‘‘(B) a significant portion of which is a 
health professional shortage area as designated 
under section 332. 
‘‘(4) SUPPORT.—The term ‘support’ means the 
provision of training, supervision, and materials 
needed to effectively deliver the services described in 
subsection (b), reimbursement for services, and 
other benefits. 
‘‘(5) TARGET POPULATION.—The term ‘target 
population’ means women of reproductive age, re-
gardless of their current childbearing status. 
‘‘(k) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$5,000,000 for each of fiscal years 2003, 2004, and 
2005.’’. 
Subtitle H—Patient Navigator, Out-
reach, and Chronic Disease Pre-
vention 
SEC. 271. SHORT TITLE. 
This Act may be cited as the ‘‘Patient Navigator, 
Outreach, and Chronic Disease Prevention Act of 2002’’.
SEC. 272. HRSA GRANTS FOR MODEL COMMUNITY CANCER 
AND CHRONIC DISEASE CARE AND PREVEN-
TION; HRSA GRANTS FOR PATIENT NAVIGA-
TORS. 
Subpart I of part D of title III of the Public Health 
Service Act (42 U.S.C. 254b et seq.) is amended by adding 
at the end the following: 
‘‘SEC. 330I. MODEL COMMUNITY CANCER AND CHRONIC 
DISEASE CARE AND PREVENTION; PATIENT 
NAVIGATORS. 
‘‘(a) MODEL COMMUNITY CANCER
AND CHRONIC 
DISEASE CARE AND PREVENTION.—
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Administrator of the Health Resources 
and Services Administration, may make grants to 
public and nonprofit private health centers (includ-
ing health centers under section 330, Indian Health 
Service Centers, and rural health clinics) for the de-
velopment and operation of model programs that—
‘‘(A) provide to individuals of health dis-
parity populations prevention, early detection, 
treatment, and appropriate follow-up care serv-
ices for cancer and chronic diseases; 
‘‘(B) ensure that the health services are 
provided to such individuals in a culturally com-
petent manner; and
‘‘(C) assign patient navigators, in accord-
ance with applicable criteria of the Secretary, 
for individuals of health disparity populations 
to—
‘‘(i) accomplish, to the extent possible, 
the follow-up and diagnosis of an abnormal 
finding and the treatment and appropriate 
follow-up care of cancer or other chronic 
disease; and 
‘‘(ii) facilitate access to appropriate 
health care services within the health care 
system to ensure optimal patient utiliza-
tion of such services. 
‘‘(2) OUTREACH
SERVICES.—A condition for 
the receipt of a grant under paragraph (1) is that 
the applicant involved agree to provide ongoing out-
reach activities while receiving the grant, in a man-
ner that is culturally competent for the health dis-
parity population served by the program, to inform 
the public of the services of the model program 
under the grant. Such activities shall include facili-
tating access to appropriate health care services and 
patient navigators within the health care system to 
ensure optimal patient utilization of these services.
‘‘(3) APPLICATION FOR GRANT.—A grant may 
be made under paragraph (1) only if an application 
for the grant is submitted to the Secretary and the 
application is in such form, is made in such manner, 
and contains such agreements, assurances, and in-
formation as the Secretary determines to be nec-
essary to carry out this section. 
‘‘(4) EVALUATIONS.—
‘‘(A) IN GENERAL.—The Secretary, acting 
through the Administrator of the Health Re-
sources and Services Administration, shall, di-
rectly or through grants or contracts, provide 
for evaluations to determine which outreach ac-
tivities under paragraph (2) were most effective 
in informing the public of the model program 
services and to determine the extent to which 
such programs were effective in providing cul-
turally competent services to the health dis-
parity population served by the programs. 
‘‘(B) DISSEMINATION OF FINDINGS.—The 
Secretary shall as appropriate disseminate to 
public and private entities the findings made in 
evaluations under subparagraph (A). 
‘‘(5) 
COORDINATION
WITH
OTHER
PRO-
GRAMS.—The Secretary shall coordinate the pro-
gram under this subsection with the program under 
subsection (b), with the program under section 
417D, and to the extent practicable, with programs 
for prevention centers that are carried out by the 
Director of the Centers for Disease Control and Pre-
vention. 
‘‘(b) PROGRAM FOR PATIENT NAVIGATORS.—
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Administrator of the Health Resources 
and Services Administration, may make grants to 
public and nonprofit private health centers (includ-
ing health centers under section 330, Indian Health 
Service Centers, and rural health clinics) for the de-
velopment and operation of programs to pay the 
costs of such health centers in—
‘‘(A) assigning patient navigators, in ac-
cordance with applicable criteria of the Sec-
retary, for individuals of health disparity popu-
lations for the duration of receiving health serv-
ices from the health centers; 
‘‘(B) ensuring that the services provided by 
the patient navigators to such individuals in-
clude case management and psychosocial as-
sessment and care or information and referral 
to such services;
‘‘(C) ensuring that the patient navigators 
provide services to such individuals in a cul-
turally competent manner; and 
‘‘(D) developing model practices for patient 
navigators, including with respect to—
‘‘(i) coordination of health services, 
including 
psychosocial 
assessment 
and 
care; 
‘‘(ii) appropriate follow-up care, in-
cluding psychosocial assessment and care; 
and 
‘‘(iii) 
determining 
coverage 
under 
health insurance and health plans for all 
services. 
‘‘(2) OUTREACH
SERVICES.—A condition for 
the receipt of a grant under paragraph (1) is that 
the applicant involved agree to provide ongoing out-
reach activities while receiving the grant, in a man-
ner that is culturally competent for the health dis-
parity population served by the program, to inform 
the public of the services of the model program 
under the grant. 
‘‘(3) APPLICATION FOR GRANT.—A grant may 
be made under paragraph (1) only if an application 
for the grant is submitted to the Secretary and the
application is in such form, is made in such manner, 
and contains such agreements, assurances, and in-
formation as the Secretary determines to be nec-
essary to carry out this section. 
‘‘(4) EVALUATIONS.—
‘‘(A) IN GENERAL.—The Secretary, acting 
through the Administrator of the Health Re-
sources and Services Administration, shall, di-
rectly or through grants or contracts, provide 
for evaluations to determine the effects of the 
services of patient navigators on the individuals 
of health disparity populations for whom the 
services were provided, taking into account the 
matters referred to in paragraph (1)(C). 
‘‘(B) DISSEMINATION OF FINDINGS.—The 
Secretary shall as appropriate disseminate to 
public and private entities the findings made in 
evaluations under subparagraph (A). 
‘‘(5) 
COORDINATION
WITH
OTHER
PRO-
GRAMS.—The Secretary shall coordinate the pro-
gram under this subsection with the program under 
subsection (a) and with the program under section 
417D. 
‘‘(c) REQUIREMENTS REGARDING FEES.—A condi-
tion for the receipt of a grant under subsection (a)(1) or
(b)(1) is that the program for which the grant is made 
have in effect—
‘‘(1) a schedule of fees or payments for the pro-
vision of its services that is consistent with locally 
prevailing rates or charges and is designed to cover 
its reasonable costs of operation; and 
‘‘(2) a corresponding schedule of discounts to 
be applied to the payment of such fees or payments, 
which discounts are adjusted on the basis of the 
ability of the patient to pay. 
‘‘(d) MODEL.—Not later than three years after the 
date of the enactment of this section, the Secretary shall 
develop a peer-reviewed model of systems for the services 
provided by this section. The Secretary shall update such 
model as may be necessary to ensure that the best prac-
tices are being utilized. 
‘‘(e) DURATION
OF GRANT.—The period during 
which payments are made to an entity from a grant under 
subsection (a)(1) or (b)(1) may not exceed five years. The 
provision of such payments are subject to annual approval 
by the Secretary of the payments and subject to the avail-
ability of appropriations for the fiscal year involved to 
make the payments. This subsection may not be construed 
as establishing a limitation on the number of grants under 
such subsection that may be made to an entity.
‘‘(f) DEFINITIONS.—For purposes of this section: 
‘‘(1) The term ‘culturally competent’, with re-
spect to providing health-related services, means 
services that, in accordance with standards and 
measures of the Secretary, are designed to effec-
tively and efficiently respond to the cultural and lin-
guistic needs of patients. 
‘‘(2) The term ‘appropriate follow-up care’ in-
cludes palliative and end-of-life care. 
‘‘(3) The term ‘health disparity population’ 
means a population where there exists a significant 
disparity in the overall rate of disease incidence, 
morbidity, mortality, or survival rates in the popu-
lation as compared to the health status of the gen-
eral population. Such term includes—
‘‘(A) racial and ethnic minority groups as 
defined in section 1707; and 
‘‘(B) medically underserved groups, such 
as rural and low-income individuals and individ-
uals with low levels of literacy. 
‘‘(4)(A) The term ‘patient navigator’ means an 
individual whose functions include—
‘‘(i) assisting and guiding patients with a 
symptom or an abnormal finding or diagnosis of 
cancer or other chronic disease within the
health care system to accomplish the follow-up 
and diagnosis of an abnormal finding as well as 
the treatment and appropriate follow-up care of 
cancer or other chronic disease; and 
‘‘(ii) identifying, anticipating, and helping 
patients overcome barriers within the health 
care system to ensure prompt diagnostic and 
treatment resolution of an abnormal finding of 
cancer or other chronic disease. 
‘‘(B) Such term includes representatives of the 
target health disparity population, such as nurses, 
social workers, cancer survivors, and patient advo-
cates. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) IN GENERAL.—
‘‘(A) MODEL PROGRAMS.—For the purpose 
of carrying out subsection (a) (other than the 
purpose described in paragraph (2)(A)), there 
are authorized to be appropriated such sums as 
may be necessary for each of the fiscal years 
2003 through 2007. 
‘‘(B) PATIENT NAVIGATORS.—For the pur-
pose of carrying out subsection (b) (other than 
the purpose described in paragraph (2)(B)), 
there are authorized to be appropriated such
sums as may be necessary for each of the fiscal 
years 2003 through 2007. 
‘‘(C) 
BUREAU
OF
PRIMARY
HEALTH 
CARE.—Amounts appropriated under subpara-
graph (A) or (B) shall be administered through 
the Bureau of Primary Health Care. 
‘‘(2) PROGRAMS IN RURAL AREAS.—
‘‘(A) MODEL PROGRAMS.—For the purpose 
of carrying out subsection (a) by making grants 
under such subsection for model programs in 
rural areas, there are authorized to be appro-
priated such sums as may be necessary for each 
of the fiscal years 2003 through 2007. 
‘‘(B) PATIENT NAVIGATORS.—For the pur-
pose of carrying out subsection (b) by making 
grants under such subsection for programs in 
rural areas, there are authorized to be appro-
priated such sums as may be necessary for each 
of the fiscal years 2003 through 2007. 
‘‘(C) OFFICE
OF
RURAL
HEALTH
POL-
ICY.—Amounts appropriated under subpara-
graph (A) or (B) shall be administered through 
the Office of Rural Health Policy. 
‘‘(3) RELATION TO OTHER AUTHORIZATIONS.—
Authorizations of appropriations under paragraphs
(1) and (2) are in addition to other authorizations 
of appropriations that are available for the purposes 
described in such paragraphs.’’. 
SEC. 273. NCI GRANTS FOR MODEL COMMUNITY CANCER 
AND CHRONIC DISEASE CARE AND PREVEN-
TION; NCI GRANTS FOR PATIENT NAVIGA-
TORS. 
Subpart 1 of part C of title IV of the Public Health 
Service Act (42 U.S.C. 285 et seq.) is amended by adding 
at the end following section: 
‘‘SEC. 417D. MODEL COMMUNITY CANCER AND CHRONIC 
DISEASE CARE AND PREVENTION; PATIENT 
NAVIGATORS. 
‘‘(a) MODEL COMMUNITY CANCER
AND CHRONIC 
DISEASE CARE AND PREVENTION.—
‘‘(1) IN GENERAL.—The Director of the Insti-
tute may make grants to eligible entities for the de-
velopment and operation of model programs that—
‘‘(A) provide to individuals of health dis-
parity populations prevention, early detection, 
treatment, and appropriate follow-up care serv-
ices for cancer and chronic diseases; 
‘‘(B) ensure that the health services are 
provided to such individuals in a culturally com-
petent manner; and
‘‘(C) assign patient navigators, in accord-
ance with applicable criteria of the Secretary, 
for individuals of health disparity populations 
to—
‘‘(i) accomplish, to the extent possible, 
the follow-up and diagnosis of an abnormal 
finding and the treatment and appropriate 
follow-up care of cancer or other chronic 
disease; and 
‘‘(ii) facilitate access to appropriate 
health care services within the health care 
system to ensure optimal patient utiliza-
tion of such services. 
‘‘(2) ELIGIBLE ENTITIES.—For purposes of this 
section, an eligible entity is a designated cancer cen-
ter of the Institute, an academic institution, a hos-
pital, a nonprofit organization, or any other public 
or private entity determined to be appropriate by the 
Director of the Institute, that provides services de-
scribed in paragraph (1)(A) for cancer or chronic 
diseases. 
‘‘(3) OUTREACH
SERVICES.—A condition for 
the receipt of a grant under paragraph (1) is that 
the applicant involved agree to provide ongoing out-
reach activities while receiving the grant, in a man-
ner that is culturally competent for the health dis-
parity population served by the program, to inform 
the public of the services of the model program 
under the grant. Such activities shall include facili-
tating access to appropriate health care services and 
patient navigators within the health care system to 
ensure optimal patient utilization of these services. 
‘‘(4) APPLICATION FOR GRANT.—A grant may 
be made under paragraph (1) only if an application 
for the grant is submitted to the Director of the In-
stitute and the application is in such form, is made 
in such manner, and contains such agreements, as-
surances, and information as the Director deter-
mines to be necessary to carry out this section. 
‘‘(5) EVALUATIONS.—
‘‘(A) IN GENERAL.—The Director of the 
Institute, directly or through grants or con-
tracts, shall provide for evaluations to deter-
mine which outreach activities under paragraph 
(3) were most effective in informing the public 
of the model program services and to determine 
the extent to which such programs were effec-
tive in providing culturally competent services 
to the health disparity population served by the 
programs.
‘‘(B) DISSEMINATION OF FINDINGS.—The 
Director of the Institute shall as appropriate 
disseminate to public and private entities the
findings made in evaluations under subpara-
graph (A). 
‘‘(6) 
COORDINATION
WITH
OTHER
PRO-
GRAMS.—The Secretary shall coordinate the pro-
gram under this subsection with the program under 
subsection (b), with the program under section 330I, 
and to the extent practicable, with programs for pre-
vention centers that are carried out by the Director 
of the Centers for Disease Control and Prevention. 
‘‘(b) PROGRAM FOR PATIENT NAVIGATORS.—
‘‘(1) IN GENERAL.—The Director of the Insti-
tute may make grants to eligible entities for the de-
velopment and operation of programs to pay the 
costs of such entities in—
‘‘(A) assigning patient navigators, in ac-
cordance with applicable criteria of the Sec-
retary, for individuals of health disparity popu-
lations for the duration of receiving health serv-
ices from the health centers; 
‘‘(B) ensuring that the services provided by 
the patient navigators to such individuals in-
clude case management and psychosocial as-
sessment and care or information and referral 
to such services; 
‘‘(C) ensuring that the patient navigators 
provide services to such individuals in a cul-
turally competent manner; and 
‘‘(D) developing model practices for patient 
navigators, including with respect to—
‘‘(i) coordination of health services, 
including 
psychosocial 
assessment 
and 
care; 
‘‘(ii) follow-up services, including psy-
chosocial assessment and care; and 
‘‘(iii) 
determining 
coverage 
under 
health insurance and health plans for all 
services. 
‘‘(2) OUTREACH
SERVICES.—A condition for 
the receipt of a grant under paragraph (1) is that 
the applicant involved agree to provide ongoing out-
reach activities while receiving the grant, in a man-
ner that is culturally competent for the health dis-
parity population served by the program, to inform 
the public of the services of the model program 
under the grant. 
‘‘(3) APPLICATION FOR GRANT.—A grant may 
be made under paragraph (1) only if an application
for the grant is submitted to the Director of the In-
stitute and the application is in such form, is made 
in such manner, and contains such agreements, as-
surances, and information as the Director deter-
mines to be necessary to carry out this section. 
‘‘(4) EVALUATIONS.—
‘‘(A) IN GENERAL.—The Director of the 
Institute, directly or through grants or con-
tracts, shall provide for evaluations to deter-
mine the effects of the services of patient navi-
gators on the health disparity population for 
whom the services were provided, taking into 
account the matters referred to in paragraph 
(1)(C).
‘‘(B) DISSEMINATION OF FINDINGS.—The 
Director of the Institute shall as appropriate 
disseminate to public and private entities the 
findings made in evaluations under subpara-
graph (A). 
‘‘(5) 
COORDINATION
WITH
OTHER
PRO-
GRAMS.—The Secretary shall coordinate the pro-
gram under this subsection with the program under 
subsection (a) and with the program under section 
330I.
‘‘(c) REQUIREMENTS REGARDING FEES.—A condi-
tion for the receipt of a grant under subsection (a)(1) or 
(b)(1) is that the program for which the grant is made 
have in effect—
‘‘(1) a schedule of fees or payments for the pro-
vision of its services that is consistent with locally 
prevailing rates or charges and is designed to cover 
its reasonable costs of operation; and 
‘‘(2) a corresponding schedule of discounts to 
be applied to the payment of such fees or payments, 
which discounts are adjusted on the basis of the 
ability of the patient to pay. 
‘‘(d) MODEL.—Not later than three years after the 
date of the enactment of this section, the Director of the 
Institute shall develop a peer-reviewed model of systems 
for the services provided by this section. The Director shall 
update such model as may be necessary to ensure that 
the best practices are being utilized. 
‘‘(e) DURATION
OF GRANT.—The period during 
which payments are made to an entity from a grant under 
subsection (a)(1) or (b)(1) may not exceed five years. The 
provision of such payments are subject to annual approval 
by the Director of the Institute of the payments and sub-
ject to the availability of appropriations for the fiscal year 
involved to make the payments. This subsection may not
100
be construed as establishing a limitation on the number
of grants under such subsection that may be made to an 
entity. 
‘‘(f) DEFINITIONS.—For purposes of this section: 
‘‘(1) The term ‘culturally competent’, with re-
spect to providing health-related services, means 
services that, in accordance with standards and 
measures of the Secretary, are designed to effec-
tively and efficiently respond to the cultural and lin-
guistic needs of patients. 
‘‘(2) the term ‘appropriate follow-up care’ in-
cludes palliative and end-of-life care. 
‘‘(3) the term ‘health disparity population’ 
means a population where there exists a significant 
disparity in the overall rate of disease incidence, 
morbidity, mortality, or survival rates in the popu-
lation as compared to the health status of the gen-
eral population. Such term includes—
‘‘(A) racial and ethnic minority groups as 
defined in section 1707; and 
‘‘(B) medically underserved groups, such 
as rural and low-income individuals and individ-
uals with low levels of literacy. 
‘‘(4)(A) the term ‘patient navigator’ means an 
individual whose functions include—
101
‘‘(i) assisting and guiding patients with a 
symptom or an abnormal finding or diagnosis of 
cancer or other chronic disease within the 
health care system to accomplish the follow-up 
and diagnosis of an abnormal finding as well as 
the treatment and appropriate follow-up care of 
cancer or other chronic disease; and 
‘‘(ii) identifying, anticipating, and helping 
patients overcome barriers within the health 
care system to ensure prompt diagnostic and 
treatment resolution of an abnormal finding of 
cancer or other chronic disease. 
‘‘(B) Such term includes representatives of the 
target health disparity population, such as nurses, 
social workers, cancer survivors, and patient advo-
cates. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) MODEL PROGRAMS.—For the purpose of 
carrying out subsection (a), there are authorized to 
be appropriated such sums as may be necessary for 
each of the fiscal years 2003 through 2007. 
‘‘(2) PATIENT NAVIGATORS.—For the purpose 
of carrying out subsection (b), there are authorized 
to be appropriated such sums as may be necessary 
for each of the fiscal years 2003 through 2007.
102
‘‘(3) RELATION TO OTHER AUTHORIZATIONS.—
Authorizations of appropriations under paragraphs 
(1) and (2) are in addition to other authorizations 
of appropriations that are available for the purposes 
described in such paragraphs.’’. 
TITLE III—HEALTH DISPARITIES 
Subtitle A—Hispanic-Serving 
Health Professions Schools 
SEC. 
301. 
HISPANIC-SERVING 
HEALTH 
PROFESSIONS 
SCHOOLS. 
(a) IN GENERAL.—The Secretary, acting through the 
Administrator of the Health Resources and Services Ad-
ministration, shall make grants to Hispanic-serving health 
professions schools for the purpose of carrying out pro-
grams to recruit Hispanic individuals to enroll in and 
graduate from the schools, which may include providing 
scholarships and other financial assistance as appropriate. 
(b) ELIGIBILITY.—For purposes of subsection (a), an 
entity is a Hispanic-serving health professions school if the 
entity—
(1) is a school or program under section 799B 
of the Public Health Service Act (42 U.S.C. 295p); 
(2) has an enrollment of full-time equivalent 
students that is at least 5 percent Hispanic stu-
dents;
103
(3) has been effective in carrying out programs 
to recruit Hispanic individuals to enroll in and grad-
uate from the school; 
(4) has been effective in recruiting and retain-
ing Hispanic faculty members; and 
(5) has a significant number of graduates who 
are providing health services to medically under-
served populations or to individuals in health profes-
sional shortage areas. 
(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 
each of the fiscal years 2003 through 2007. 
Subtitle B—Health Career 
Opportunity Program 
SEC. 311. EDUCATIONAL ASSISTANCE REGARDING UNDER-
GRADUATES. 
(a) IN GENERAL.—Subpart 2 of part E of title VII 
of the Public Health Service Act (42 U.S.C. 295 et seq) 
is amended by adding at the end the following: 
‘‘SEC. 771. HEALTH CAREERS OPPORTUNITY PROGRAM. 
‘‘(a) IN GENERAL.—Subject to the provisions of this 
section, the Secretary may make grants and enter into co-
operative agreements and contracts for any of the fol-
lowing purposes:
104
‘‘(1) Identifying and recruiting individuals 
who—
‘‘(A) are students of elementary schools, or 
students or graduates of secondary schools or of 
institutions of higher education; 
‘‘(B) are from disadvantaged backgrounds; 
and 
‘‘(C) are interested in a career in the 
health professions. 
‘‘(2) Facilitating the entry of such individuals 
into a health professions school. 
‘‘(3) Providing counseling or other services de-
signed to assist such individuals in successfully com-
pleting their education at such a school. 
‘‘(4) Providing, for a period prior to the entry 
of such individuals into the regular course of edu-
cation of such a school, preliminary education de-
signed to assist the individuals in successfully com-
pleting such regular course of education at such a 
school, or referring such individuals to institutions 
providing such preliminary education. 
‘‘(5) Paying such stipends as the Secretary may 
approve for such individuals for any period of edu-
cation in student-enhancement programs (other than 
regular courses) at a health professions schools, ex-
105
cept that such a stipend may not be provided to an 
individual for more than 12 months, and such a sti-
pend may not exceed $25 per day (notwithstanding 
any other provision of law regarding the amount of 
stipends). 
‘‘(6) Carrying out programs under which such 
individuals both— 
‘‘(A) gain experience regarding a career in 
a field of primary health care through working 
at facilities of nonprofit private community-
based providers of primary health services; and 
‘‘(B) receive academic instruction to assist 
in preparing the individuals to enter health pro-
fessions schools in such fields. 
‘‘(b) RECEIPT OF AWARD.—
‘‘(1) ELIGIBLE
ENTITIES; REQUIREMENT
OF 
CONSORTIUM.—The Secretary may make an award 
under subsection (a) only if the following conditions 
are met: 
‘‘(A) The applicant for the award is a pub-
lic or nonprofit private entity, and the applicant 
has established a consortium consisting of non-
profit private community-based organizations 
and health professions schools.
107
‘‘(ii) whether and to what extent the 
award will be allocated among the mem-
bers.
‘‘(2) 
REQUIREMENT
OF
COMPETITIVE 
AWARDS.—Awards under subsection (a) shall be 
made only on a competitive basis. 
‘‘(c) FINANCIAL REQUIREMENTS.—
‘‘(1) ASSURANCES REGARDING CAPACITY.—The 
Secretary may make an award under subsection (a) 
only if the Secretary determines that, in the case of 
activities carried out under the award that prove to 
be effective toward achieving the purposes of the ac-
tivities—
‘‘(A) the members of the consortium in-
volved have or will have the financial capacity 
to continue the activities, regardless of whether 
financial assistance under subsection (a) con-
tinues to be available; and 
‘‘(B) the members of the consortium dem-
onstrate to the satisfaction of the Secretary a 
commitment to continue such activities, regard-
less of whether such assistance continues to be 
available. 
‘‘(2) MATCHING FUNDS.—
108
‘‘(A) IN GENERAL.—With respect to the 
costs of the activities to be carried out under 
subsection (a) by an applicant, the Secretary 
may make an award under such subsection only 
if the applicant agrees to make available in cash 
(directly or through donations from public or 
private entities) non-Federal contributions to-
ward such costs in an amount that, for any 
fourth or subsequent fiscal year for which the 
applicant receives such an award, is not less 
than 50 percent of such costs. 
‘‘(B) FEDERAL AMOUNTS.—Amounts pro-
vided by the Federal Government may not be 
included in determining the amount of non-Fed-
eral contributions required in subparagraph 
(A). 
‘‘(C) LIMITATION.—The Secretary may not 
require non-Federal contributions for the first 
three fiscal years for which an applicant re-
ceives a grant under subsection (a). 
‘‘(d) PREFERENCE IN MAKING AWARDS.—
‘‘(1) IN GENERAL.—
‘‘(A) REQUIREMENT.—In making awards 
under subsection (a), the Secretary shall, sub-
ject to paragraph (3), give preference to any
109
applicant that, for the purpose described in sub-
paragraph (B), has made an arrangement with 
not less than one entity from each of the fol-
lowing categories of entities: Community-based 
organizations, elementary schools, secondary 
schools, institutions of higher education, and 
health professions schools. 
‘‘(B) PURPOSE.—The purpose of arrange-
ments under subparagraph (A) is to establish a 
program for individuals identified under sub-
section (a) under which—
‘‘(i) the activities described in such 
subsection are carried out on behalf of the 
individuals; and 
‘‘(ii) health professions schools make 
a commitment to admit as students of the 
schools such individuals who participate in 
the program, subject to the individuals 
meeting reasonable academic standards for 
admission to the schools. 
‘‘(2) ADDITIONAL PREFERENCES.—Of the ap-
plicants under subsection (a) that are receiving pref-
erence for purposes of paragraph (1), the Secretary 
shall, subject to paragraph (3), give additional pref-
erence to applicants whose consortium under sub-
110
section (b) includes as members one or more health 
professions schools that have not previously received 
any award under this section (including this section 
as in effect prior to fiscal year 1997). 
‘‘(3) LIMITATION.—An applicant may not re-
ceive preference for purposes of paragraph (1) or (2) 
unless the consortium under subsection (b) includes 
not less than one health professions school that has 
demonstrated success in enrolling students from dis-
advantaged backgrounds. 
‘‘(e) OBJECTIVES UNDER AWARDS.—
‘‘(1) ESTABLISHMENT OF OBJECTIVES.—Before 
making a first award to an applicant under sub-
section (a), the Secretary shall establish objectives 
regarding the activities to be carried out under the 
award, which objectives are applicable until the next 
fiscal year for which such award is made after a 
competitive process of review. In making an award 
after such a review, the Secretary shall establish ad-
ditional objectives for the applicant. 
‘‘(2) 
PRECONDITION
FOR
SUBSEQUENT 
AWARDS.—In the case of an applicant seeking an 
award under subsection (a) pursuant to a competi-
tive process of review, the Secretary may make the 
award only if the applicant demonstrates to the sat-
111
isfaction of the Secretary that the applicant has met 
the objectives that were applicable under paragraph 
(1) to the preceding awards under such subsection. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated $33,000,000 for fiscal year 2003, 
$40,000,000 for fiscal year 2004, and such sums as may 
be necessary for each subsequent fiscal year.’’. 
(b) TECHNICAL AMENDMENT.—Section 770(a) of the 
Public Health Service Act (42 U.S.C. 295e(a)) is amended 
by inserting ‘‘(other than section 771)’’ after ‘‘this sub-
part’’. 
SEC. 312. CENTERS OF EXCELLENCE. 
For the purpose of establishing and operating health 
careers centers of excellence, there are authorized to be 
appropriated $40,000,000 for fiscal year 2003, and such 
sums as may be necessary for each subsequent fiscal year. 
Subtitle C—Bilingual Health 
Professionals 
SEC. 321. TRAINING OF BILINGUAL HEALTH PROFES-
SIONALS 
WITH 
RESPECT 
TO 
MINORITY 
HEALTH CONDITIONS. 
(a) IN GENERAL.—The Secretary, acting through the 
Administrator of the Health Resources and Services Ad-
ministration, shall (directly or through awards of grants
112
or contracts to public or nonprofit private entities) carry 
out a program—
(1) to identify health professionals who speak 
both English and a language used by racial or ethnic 
minority groups in the United States; and 
(2) to train such health professionals with re-
spect to the treatment of minority health conditions, 
such as diabetes, HIV infection, substance abuse, 
and conditions regarding mental health. 
(b) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out subsection (a), there are author-
ized to be appropriated such sums as may be necessary 
for each of the fiscal years 2003 through 2007. 
Subtitle D—Cultural Competence 
SEC. 331. DEFINITION. 
(a) IN GENERAL.—In this Act, the term ‘‘culturally 
competent’’, with respect to the manner in which health-
related services, education, and training are provided, 
means providing the services, education, and training in 
the language and cultural context that is most appropriate 
for the individuals for whom the services, education, and 
training are intended, including as necessary the provision 
of bilingual services. 
(b) MODIFICATION.—The definition established in 
subsection (a) may be modified as needed at the discretion
113
of the Secretary after providing a 30-day notice to Con-
gress. 
SEC. 332. ACTIVITIES OF OFFICE OF MINORITY HEALTH; 
CENTER FOR LINGUISTIC AND CULTURAL 
COMPETENCE IN HEALTH CARE. 
(a) EDUCATIONAL MATERIALS; TECHNICAL ASSIST-
ANCE.—
(1) 
IN
GENERAL.—The 
Secretary, 
acting 
through the Office of Minority Health under section 
1707 of the Public Health Service Act (42 U.S.C. 
300u-6), shall—
(A) provide for the development of edu-
cational materials on providing health services 
in a culturally competent manner; 
(B) provide technical assistance in carrying 
out programs that use such materials; and 
(C) provide technical assistance on other 
matters regarding the provision of health serv-
ices in a culturally competent manner. 
(2) AUTHORIZATION OF APPROPRIATIONS.—For 
the purpose of carrying out paragraph (1), there are 
authorized to be appropriated $1,000,000 for fiscal 
year 2003, and such sums as may be necessary for 
each of the fiscal years 2004 through 2007.
114
(b) CENTER FOR LINGUISTIC AND CULTURAL COM-
PETENCE IN HEALTH CARE.—
(1) 
IN
GENERAL.—The 
Secretary, 
acting 
through the Office of Minority Health under section 
1707 of the Public Health Service Act (42 U.S.C. 
300u-6), shall provide for a Center for Linguistic 
and Cultural Competence in Health Care to carry 
out programs to promote and facilitate the provision 
of health-related services, education, and training in 
a culturally competent manner. 
(2) AUTHORIZATION OF APPROPRIATIONS.—For 
the purpose of carrying out paragraph (1), there are 
authorized to be appropriated $5,000,000 for fiscal 
year 2003, and such sums as may be necessary for 
each of the fiscal years 2004 through 2007. 
SEC. 
333. 
CULTURAL 
COMPETENCE 
DEMONSTRATION 
PROJECTS. 
(a) IN GENERAL.—The Secretary, acting through the 
Administrator of the Health Care Financing Administra-
tion, shall conduct a cultural competence demonstration 
project under which grants are made to two hospitals with 
a history in the medicare program to enable them to im-
plement standards for the culturally competent provision 
of services to address the specific needs of any population
115
that constitutes at least 5 percent of the population served 
by the hospital involved. 
(b) NUMBER AND TYPE.—Of the hospitals provided 
grants under this section, one shall be located in an urban 
and the other in a rural area (as defined in section 
1886(d)(2)(D) of the Social Security Act (42 U.S.C. 
1395ww(d)(2)(d)). The urban hospital shall serve a sig-
nificant limited English proficient population and be with-
in 175 miles of the border with Mexico. In selecting such 
hospitals, the Secretary shall give preference to hospitals 
that serve large immigrant populations. 
(c) AMOUNT AND DURATION OF GRANT.—A grant 
under this section for a hospital shall be in the amount 
of $5,000,000 and shall be for a period of 5 years. 
(d) EVALUATION AND REPORT.—
(1) EVALUATION.—The Secretary shall also 
provide for a grant to an appropriate qualified entity 
in an amount not to exceed $1,000,000 to evaluate 
the demonstration projects conducted under this sec-
tion. 
(2) REPORT.—The Secretary shall submit to 
Congress a report on the projects conducted under 
this section. The Secretary shall include in such re-
port the results of the evaluation conducted under 
paragraph (1) and recommendations on whether on
116
going medicare funding should be provided for im-
plementation of standards for cultural competency in 
hospitals. 
(e) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated from the Federal Hos-
pital Insurance Trust Fund (under section 1817 of the 
Social Security Act (42 U.S.C. 1395i) to carry out this 
section, $11,000,000, which shall remain available until 
expended. 
Subtitle E—Data Regarding Race 
and Ethnicity 
SEC. 341. COLLECTION OF DATA. 
Part A of title III of the Public Health Service Act 
(42 U.S.C. 241 et seq.) is amended by inserting after sec-
tion 306 the following: 
‘‘SEC. 306A. DATA ON RACE AND ETHNICITY. 
‘‘(a) IN GENERAL.—The Secretary shall by regula-
tion provide for the following: 
‘‘(1) Health data collected under programs car-
ried out by the Secretary (whether collected directly 
or pursuant to grants, cooperative agreements, or 
contracts) shall include data on race, ethnicity, and 
spoken and written language and shall, at a min-
imum, use the categories for race and ethnicity de-
scribed in OMB Directive 15.
117
‘‘(2) Data collected by the Secretary pursuant 
to title VI of the Civil Rights Act of 1964 shall in-
clude data on race and ethnicity and shall, at a min-
imum, use such categories. 
‘‘(3) Data on race and ethnicity that is collected 
under paragraph (1) or (2) shall use the procedures 
described in such Directive for collecting data from 
an individual, and shall be maintained and presented 
(including for reporting purposes) in accordance 
with such Directive. 
‘‘(4) For health encounters that require the 
presence of a legal parent or guardian who does not 
speak English or who is limited English proficient, 
health data collected by the Secretary pursuant to 
this section shall also include data on the accom-
panying adult or guardian. 
‘‘(5) Such other data as the Secretary may des-
ignate (including administrative records) shall be 
collected, maintained, and presented in accordance 
with such Directive, to the extent that such data are 
collected by the Secretary and relate to health-re-
lated programs that are carried out by the Sec-
retary. 
‘‘(b) DEFINITION.—In this section, the term ‘OMB 
Directive 15’ means Statistical Policy Directive No. 15,
118
Race and Ethnic Standards for Federal Statistics and Ad-
ministrative Reporting, as established by the Director of 
the Office of Management and Budget through the notice 
issued October 30, 1997 (62 FR 58782). Such term in-
cludes any subsequent revisions to such Directive.’’. 
SEC. 342. DEVELOPMENT OF STANDARDS; STUDY TO MEAS-
URE PATIENT OUTCOMES UNDER MEDICARE 
AND MEDICAID PROGRAMS. 
(a) DEVELOPMENT OF STANDARDS.—Not later than 
1 year after the date of the enactment of this Act, the 
Secretary, acting through the Administrator of the Health 
Care Financing Administration, shall develop outcome 
measures to evaluate, by race and ethnicity, the perform-
ance of health care programs and projects that provide 
health care to individuals under the medicare and med-
icaid programs (under titles XVIII and XIX, respectively, 
of the Social Security Act (42 U.S.C. 1395 et seq.; 1396 
et seq.). 
(b) STUDY.—After the Secretary develops the out-
come measures under subsection (a), the Secretary shall 
conduct a study that evaluates, by race and ethnicity, the 
performance of health care programs and projects referred 
to in subsection (a). 
(c) REPORT TO CONGRESS.—Not later that 2 years 
after the date of the enactment of this Act, the Secretary
119
shall submit to Congress a report describing the outcome 
measures developed under subsection (a), and the results 
of the study conducted pursuant to subsection (b). 
Subtitle F—National Assessment of 
Status of Latino Health 
SEC. 351. NATIONAL ASSESSMENT OF STATUS OF LATINO 
HEALTH. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall establish a national assessment of 
the status of Latino health to be known as the ‘‘Hispanic 
Health 
and 
Nutrition 
Examination 
Survey’’ 
or 
‘‘HHANES II’’. 
(b) GOAL.—The goal of the national assessment 
under subsection (a) shall be to produce estimates of 
health and nutritional status for Mexican Americans, 
Puerto Ricans, Cuban Americans, and other Hispanic sub-
populations. 
(c) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated such sums as may be nec-
essary in each of fiscal years 2003 through 2005 to carry 
out this section.
120
Subtitle G—Office of Minority 
Health 
SEC. 361. REVISION AND EXTENSION OF PROGRAMS OF OF-
FICE OF MINORITY HEALTH. 
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 following: 
‘‘(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.
121
‘‘(B) Increase knowledge and under-
standing of health risk factors. 
‘‘(C) Develop mechanisms that support 
better information dissemination, education, 
prevention, and service delivery to individuals 
from disadvantaged backgrounds, including in-
dividuals 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
122
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-
ducting research and developing and evaluating 
model projects. 
‘‘(5) Not later than June 8 of each year, the 
Deputy Assistant Secretary shall submit to the Sec-
retary a report summarizing the activities of each of 
the minority health offices under section 1707A. 
‘‘(c) ADVISORY COMMITTEE.—
‘‘(1) IN GENERAL.—The Secretary shall estab-
lish an advisory committee to be known as the Advi-
sory Committee on Minority Health (in this sub-
123
section referred to as the ‘Committee’). The Deputy 
Assistant Secretary shall consult with the Committee 
in carrying out this section. 
‘‘(2) DUTIES.—The Committee shall provide 
advice to the Deputy Assistant Secretary carrying 
out this section, including advice on the development 
of goals and specific program activities under para-
graphs (1) and (2) of subsection (b) for each racial 
and ethnic minority group. 
‘‘(3) CHAIR.—The Deputy Assistant Secretary 
shall serve as the chair of the Committee. 
‘‘(4) COMPOSITION.—
‘‘(A) The Committee shall be composed of 
12 voting members appointed in accordance 
with subparagraph (B), and nonvoting, ex offi-
cio members designated in subparagraph (C). 
‘‘(B) The voting members of the Com-
mittee shall be appointed by the Secretary from 
among individuals who are not officers or em-
ployees of the Federal Government and who 
have expertise regarding issues of minority 
health. The racial and ethnic minority groups 
shall be equally represented among such mem-
bers.
124
‘‘(C) The nonvoting, ex officio members of 
the Committee shall be the directors of each of 
the minority health offices established under 
section 1707A, and such additional officials of 
the Department of Health and Human Services 
as the Secretary determines to be appropriate. 
‘‘(5) TERMS.—Each member of the Committee 
shall serve for a term of 4 years, except that the 
Secretary shall initially appoint a portion of the 
members to terms of 1 year, 2 years, and 3 years. 
‘‘(6) VACANCIES.—If a vacancy occurs on the 
Committee, a new member shall be appointed by the 
Secretary within 90 days from the date that the va-
cancy occurs, and serve for the remainder of the 
term for which the predecessor of such member was 
appointed. The vacancy shall not affect the power of 
the remaining members to execute the duties of the 
Committee. 
‘‘(7) COMPENSATION.—Members of the Com-
mittee who are officers or employees of the United 
States shall serve without compensation. Members of 
the Committee who are not officers or employees of 
the United States shall receive, for each day (includ-
ing travel time) they are engaged in the performance 
of the functions of the Committee. Such compensa-
125
tion may not be in an amount in excess of the daily 
equivalent of the annual maximum rate of basic pay 
payable under the General Schedule (under title 5, 
United States Code) for positions above GS–15. 
‘‘(d) CERTAIN
REQUIREMENTS
REGARDING
DU-
TIES.—
‘‘(1) RECOMMENDATIONS
REGARDING
LAN-
GUAGE
AS
IMPEDIMENT
TO
HEALTH
CARE.—The 
Secretary, acting through the Director of the Office 
of Refugee Health, the Director of the Office of Civil 
Rights, and the Director of the Office of Minority 
Health of the Health Resources and Services Admin-
istration, shall make recommendations to the Deputy 
Assistant Secretary regarding activities under sub-
section (b)(4). 
‘‘(2) EQUITABLE ALLOCATION REGARDING AC-
TIVITIES.—
‘‘(A) In making awards of grants, coopera-
tive agreements, or contracts under this section 
or section 338A, 338B, 724, 736, 737, 738, or 
740, the Secretary, acting as appropriate 
through the Deputy Assistant Secretary or the 
Administrator of the Health Resources and 
Services Administration, shall ensure that such
127
‘‘(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-
128
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) RACIAL AND ETHNIC MINORITY GROUP.—
The term ‘racial and ethnic minority group’ means 
American Indians (including Alaskan Natives, Eski-
mos, and Aleuts); Asian Americans and Pacific Is-
landers; Blacks; and Hispanics. 
‘‘(2) HISPANIC.—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
129
fiscal year 2003, $25,000,000 for fiscal year 2004, 
and $28,000,000 for fiscal year 2005. 
‘‘(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).’’. 
SEC. 362. 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: 
‘‘SEC. 1707A. INDIVIDUAL OFFICES OF MINORITY HEALTH 
WITHIN PUBLIC HEALTH SERVICE. 
‘‘(a) IN GENERAL.—The head of each agency speci-
fied 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 directly to the 
head of the agency. The head of such agency shall carry 
out this section (as this section relates to the agency) act-
ing through such Director. 
‘‘(b) SPECIFIED AGENCIES.—
130
‘‘(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 Healthcare Research 
and Quality. 
‘‘(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
131
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