health services, pursuant to section 104, and other 
provisions of this Act in their respective regions and 
local areas; 
(3) carry out such duties of the National 
Health Board as it deems necessary and consistent 
with the timetable given under this Act and the pur-
poses of the Service; and 
(4) provide for the recording of minutes of each 
of its meetings, and shall make such records avail-
able to the public for inspection and copying. 
SEC. 104. REPRESENTATION IN LOCAL AND REGIONAL AU-
THORITIES. 
The governing bodies of the local and regional au-
thorities created pursuant to section 103(b) shall consist 
of representatives of users resident in their local area or 
region and representatives of health workers employed by 
the Service in their local area or region. Representatives 
of such users shall comprise the majority of such rep-
resentatives and representatives of such health workers 
shall comprise a minority. 
SEC. 105. PUBLIC ACCOUNTABILITY AND FINANCIAL DIS-
CLOSURE. 
(a) PROHIBITION OF CONFLICTS OF INTEREST.— 
(1) IN GENERAL.—Individuals with direct or in-
direct conflicts of interest shall not serve on health
boards or authorities. Subject to paragraph (2), such 
conflicts may consist of ownership of, employment 
in, or other financial affiliation with any industry in 
a position to profit or otherwise benefit from the ac-
tivities of the health board. 
(2) EXCEPTION.—Paragraph (1) shall not 
apply to employment as a health worker by the Serv-
ice as specified in this Act. 
(b) DISCLOSURE.—Candidates for health boards or 
authorities shall fully disclose any such potential conflicts 
of interest, and if elected or appointed shall sever any af-
filiations that could result in a conflict. 
SEC. 106. INSPECTOR GENERAL FOR HEALTH SERVICES. 
Within the United States Health Service there shall 
be an Office of the Inspector General for Health Services, 
to be headed by an Inspector General for Health Services, 
that shall have authority to ensure the effective operation 
of the services pursuant to this Act and to investigate and 
pursue any grievances against the National Health Board 
or its local authorities. The Inspector General shall have 
the same authority as an Inspector General has under the 
Inspector General Act of 1978.
SEC. 107. ESTABLISHMENT OF HEALTH CARE DELIVERY RE-
GIONS. 
(a) ESTABLISHMENT OF HEALTH CARE DELIVERY 
REGIONS.—No later than 6 months after the appointment 
of members of the National Health Board, such Board 
shall establish, in accordance with this section, health care 
delivery regions throughout the United States. 
(b) REQUIREMENTS FOR DELIVERY REGIONS.—Each 
health care delivery region shall meet the following re-
quirements: 
(1) The region shall be a contiguous geographic 
area appropriate for the effective governance, plan-
ning, and delivery of all health care and supple-
mental services under this Act for residents of the 
region. 
(2) The region shall have a population of not 
less than 500,000 and of not more than 3,000,000 
individuals, except that— 
(A) the population of a region may be 
more than 3,000,000 if the region includes a 
standard metropolitan statistical area (as deter-
mined by the Office of Management and Budg-
et) with a population of more than 3,000,000; 
and 
(B) the population of a region may be less 
than 500,000 if the National Health Board de-
termines that this is necessary to facilitate the 
delivery of health care and supplemental serv-
ices or the effective governance of the health 
program within such region. 
A region under subparagraph (B) may be a sparsely 
populated frontier area which consists of a very 
large or multi-state geographic area. 
(3) The boundaries of each region shall take 
into account— 
(A) any economic or geographic barrier to 
the receipt of health care and supplemental 
services in nonmetropolitan areas, and 
(B) the differences in needs between non-
metropolitan and metropolitan areas in the 
planning, development, and delivery of health 
care and supplemental services. 
(c) MODIFICATION OF BOUNDARIES.—The National 
Health Board shall review the boundaries of regions no 
later than 2 years after each decennial national census, 
or upon receipt of and at such other times as it deems 
necessary, and may modify the boundary of any region 
in which there has been a substantial shift of population 
justifying such modification or if such modification would 
better carry out the purposes of this Act, and if such modi-
fication is approved in a referendum of residents in an
area whose regional identification would be changed by 
making such modification. 
(d) PROCESS.—At least 60 days prior to the estab-
lishment of the boundaries of any region, or modification 
of the boundaries, the National Health Board shall col-
laborate with its regional authorities to provide for— 
(1) notice in the area which would be affected 
by the establishment of such boundaries of the 
boundaries proposed to be established, and of the 
date, time, and location of the public hearing on 
such establishment as provided in paragraph (2); 
and 
(2) a public hearing at which individuals can 
speak or present written statements relating to the 
establishment of such boundaries. 
TITLE II—DELIVERY OF HEALTH 
CARE 
AND 
SUPPLEMENTAL 
SERVICES 
Subtitle A—Patients’ Rights in 
Health Care Delivery 
SEC. 201. BASIC HEALTH RIGHTS. 
The Service, in its delivery of health care services to 
users, shall ensure that every such individual is given the 
following basic health rights:
(1) The right to receive high quality health care 
and supplemental services from any facility within 
the Service capable of providing such services with-
out charge and without discrimination on account of 
race, sex, age, religion, language, income, marital 
status, sexual orientation, dress, or previous health 
status. 
(2) The right to humane, respectful, dignified, 
and comforting health care, and to the reduction of 
pain and distressful symptoms. 
(3) The right to have all medically necessary or 
appropriate health services delivered in a convenient 
and timely manner. Any decision to deny or post-
pone such necessary or appropriate care shall be 
made only on the basis of temporary and reasonable 
limitations in the availability of service personnel 
and physical facilities. Users shall have the oppor-
tunity for timely and effective appeal of any decision 
to deny or postpone care. 
(4) The right to choose the health workers who 
shall be responsible for, and the health facilities in 
which to receive, the individual’s health care serv-
ices. 
(5) The right of access to all information, in-
cluding the individual’s health records and the med-