(19) Despite suffering disproportionate rates of
illness, death, and disability, minorities have not
been proportionately represented in many clinical re-
search trials, except in studies of behavioral risk fac-
tors associated with negative stereotypes.
(20) Culturally sensitive approaches to research
are needed to encourage minority participation in re-
search studies.
(21) There is a national need for minority sci-
entists in the fields of biomedical, clinical, and
health services research.
(22) In 1990, only 3.3 percent of all United
States medical school facilities were underrep-
resented by minority persons.
(23) Only 1 percent of full professors were
underrepresented by minority persons in 1990.
(24) The proportion of underrepresented mi-
norities in high academic ranks, such a professors
and associate professors, decreased from 1980 to
1990.
(25) African Americans with identical com-
plaints of chest pain are less likely than white Amer-
icans to be referred by physicians for sophisticated
cardiac tests.
(26) Cultural competency training in medical
schools and residency training programs has the po-
tential to reduce disparities in health care and
health outcomes.
(27) More detailed data on health disparities is
needed to—
(A) evaluate the impact that race and eth-
nicity have on health status, access to care, and
quality of care; and
(B) enforce existing protections for equal
access to care.
TITLE I—IMPROVING MINORITY
HEALTH THROUGH THE NA-
TIONAL 
INSTITUTES 
OF
HEALTH; ESTABLISHMENT OF
NATIONAL CENTER
SEC. 101. ESTABLISHMENT OF NATIONAL CENTER FOR RE-
SEARCH ON MINORITY HEALTH AND HEALTH
DISPARITIES.
(a) IN GENERAL.—Part E of title IV of the Public
Health Service Act (42 U.S.C. 287 et seq.), as amended
by section 601 of the Departments of Labor, Health and
Human Services, and Education, and Related Agencies
Appropriations Act, 1999 (as contained in section 101(f)
of Public Law 105–277) (112 Stat. 2681–387), is amend-
ed by adding at the end the following subpart:
‘‘Subpart 6—National Center for Research on Minority
Health and Health Disparities
‘‘SEC. 485E. PURPOSE OF CENTER.
‘‘(a) IN GENERAL.—The general purpose of the Na-
tional Center for Research on Minority Health and Health
Disparities (in this subpart referred to as the ‘Center’)
is the conduct and support of basic and clinical research,
training, the dissemination of health information, and
other programs with respect to minority health.
‘‘(b) COORDINATION OF ACTIVITIES.—The Director
of the Center shall act as the primary Federal official with
responsibility for overseeing all minority health research
conducted or supported by the National Institutes of
Health, and—
‘‘(1) shall serve to represent the National Insti-
tutes of Health minority health research program at
all relevant Executive branch task forces, committees
and planning activities; and
‘‘(2) shall maintain communications with all rel-
evant Public Health Service agencies and with var-
ious other departments of the Federal Government,
to ensure the timely transmission of information
concerning advances in minority health research be-
tween these various agencies for dissemination to af-
fected communities and health care providers.
‘‘(c) COLLABORATIVE COMPREHENSIVE PLAN AND
BUDGET.—
‘‘(1) IN GENERAL.—Subject to the provisions of
this section and other applicable law, the Director of
NIH, the Director of the Center, and the directors
of the national research institutes in collaboration
(and in consultation with the advisory council for the
Center) shall—
‘‘(A) establish a comprehensive plan and
budget for the conduct and support of all mi-
nority health research activities of the agencies
of the National Institutes of Health (which plan
and budget shall be first established under this
subsection not later than 12 months after the
date of the enactment of this subpart);
‘‘(B) ensure that the plan and budget dem-
onstrate how minority research activities ad-
dress the health needs of specific minority pop-
ulations;
‘‘(C) ensure that the plan and budget es-
tablish priorities among the minority health re-
search activities that such agencies are author-
ized to carry out;
‘‘(D) ensure that the plan and budget es-
tablish objectives regarding such activities, de-
scribes the means for achieving the objectives,
and designates the date by which the objectives
are expected to be achieved;
‘‘(E) ensure that all amounts appropriated
for such activities are expended in accordance
with the plan and budget;
‘‘(F) review the plan and budget not less
than annually, and revise the plan and budget
as appropriate; and
‘‘(G) ensure that the plan and budget serve
as a broad, binding statement of policies re-
garding minority health research activities of
the agencies, but do not remove the responsi-
bility of the heads of the agencies for the ap-
proval of specific programs or projects, or for
other details of the daily administration of such
activities, in accordance with the plan and
budget.
‘‘(2) CERTAIN
COMPONENTS
OF
PLAN
AND
BUDGET.—With respect to minority health research
activities of the agencies of the National Institutes
of Health, the Director of the Center shall ensure
that the plan and budget provide for—
‘‘(A) basic research and applied research,
including research and development with re-
spect to products;
‘‘(B) research that is conducted by the
agencies;
‘‘(C) research that is supported by the
agencies;
‘‘(D) proposals developed pursuant to so-
licitations by the agencies and for proposals de-
veloped independently of such solicitations; and
‘‘(E) 
behavioral 
research 
and 
social
sciences research, which may include cultural
and linguistic research in each of the agencies.
‘‘(d) CLINICAL RESEARCH EQUITY.—The Director of
the Center shall assist in the administration of section
492B with respect to the inclusion of members of minority
groups as subjects in clinical research.
‘‘(e) RESEARCH ENDOWMENTS.—The Director of the
Center may carry out a program to facilitate research on
minority health by providing for research endowments at
centers of excellence under section 736.
‘‘(f) CERTAIN ACTIVITIES.—In carrying out sub-
section (a), the Director of the Center—
‘‘(1) shall assist the Director of the National
Center for Research Resources in carrying out sec-
tion 481(c)(3) and in committing resources for con-
struction at Institutions of Emerging Excellence;
‘‘(2) shall establish projects to promote coopera-
tion among Federal agencies, State, local, and re-
gional public health agencies, and private entities, in
minority health research; and
‘‘(3) may utilize information from previous
health initiatives concerning minorities.
‘‘(g) ADVISORY COUNCIL.—The Secretary shall, in
accordance with section 406, establish an advisory council
to advise, assist, consult with, and make recommendations
to the Director of the Center on matters relating to the
activities described in subsection (a), and with respect to
such activities to carry out any other functions described
in section 406 for advisory councils under such section.
Minority groups shall be equally represented among such
members of the advisory council representing a diversity
of health professionals.
‘‘(h) SPECIAL AUTHORITIES.—
‘‘(1) ANNUAL
BUDGET
ESTIMATE.—With re-
spect to a fiscal year, the Director of the Center
shall prepare and submit directly to the President,
for review and transmittal to the Congress, a budget
estimate for the Center for the fiscal year, after rea-
sonable opportunity for comment (but without
‘‘(1) The term ‘minority health conditions’, with
respect to individuals who are members of racial and
ethnic minority groups, means all diseases, dis-
orders, and conditions (including with respect to
mental health and substance abuse)—
‘‘(A) unique to, more serious, or more
prevalent in such individuals;
‘‘(B) for which the factors of medical risk
or types of medical intervention are different
for such individuals, or for which it is unknown
whether such factors or types are different for
such individuals; or
‘‘(C) with respect to which there has been
insufficient research involving such individuals
as subjects or insufficient data on such individ-
uals.
‘‘(2) The term ‘minority health research’ means
research on minority health conditions, including re-
search on preventing such conditions, and including
research on access, outreach, treatment, and re-
search on cultural and linguistic services for decreas-
ing those conditions.
‘‘(3) The term ‘racial and ethnic minority
group’ has the meaning given such term in section
1707.
‘‘(k) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this subpart, there are authorized
to be appropriated $100,000,000 for fiscal year 2000, and
such sums as may be necessary for each of the fiscal years
2001 through 2004. Such authorization of appropriations
is in addition to other authorizations of appropriations
that are available for the conduct and support of research
on minority health by the national research institutes and
other agencies of the National Institutes of Health.’’.
(b) CONFORMING AMENDMENT.—Part A of title IV
of the Public Health Service Act (42 U.S.C. 281 et seq.)
is amended by striking section 404.
SEC. 102. CENTERS OF EXCELLENCE FOR RESEARCH EDU-
CATION 
ON 
HEALTH 
DISPARITIES 
AND
TRAINING.
Subpart 6 of part E of title IV of the Public Health
Service Act, as added by section 101 of this Act, is amend-
ed by adding at the end the following section:
‘‘SEC. 485F. CENTERS OF EXCELLENCE FOR RESEARCH
EDUCATION ON HEALTH DISPARITIES AND
TRAINING.
‘‘(a) IN GENERAL.—The Director of the Center shall
make grants to, and enter into contracts with, designated
biomedical research institutions described in subsection
(c), and other public and nonprofit health or educational
entities, for the purpose of assisting the institutions in
supporting programs of excellence in biomedical research
education for underrepresented minority individuals.
‘‘(b) REQUIRED USE OF FUNDS.—The Director of
the Center may not make a grant under subsection (a)
unless the designated biomedical research institution in-
volved agrees, subject to subsection (c)(1)(B), to expend
the grant—
‘‘(1) to conduct research into the nature of
health disparities and the causes of such disparities,
and conduct basic and applied biomedical research,
into remedies for disparities and specific diseases af-
fecting minorities and other disadvantaged socio-
economic groups;
‘‘(2) to train minorities and other disadvan-
taged socioeconomic groups as professionals in the
area of biomedical research; or
‘‘(3) to expand, remodel, renovate, or alter ex-
isting research facilities or construct new research
facilities for the purpose of conducting biomedical
research related to health disparities.
‘‘(c) CENTERS OF EXCELLENCE.—
‘‘(1) DESIGNATED INSTITUTIONS.—
‘‘(A) GENERAL CONDITIONS.—The condi-
tions specified in this subparagraph are that a
designated biomedical research institution—
‘‘(i) has a significant number of
underrepresented minority individuals en-
rolled in the institution, including individ-
uals accepted for enrollment in the institu-
tion;
‘‘(ii) has been effective in assisting
underrepresented minority students of the
institution to complete the program of edu-
cation and receive the degree involved;
‘‘(iii) has been effective in recruiting
underrepresented minority individuals to
enroll in and graduate from the institution,
including providing scholarships and other
financial assistance to such individuals and
encouraging 
underrepresented 
minority
students from all levels of the educational
pipeline to pursue biomedical research ca-
reers; and
‘‘(iv) has made significant recruitment
efforts to increase the number of underrep-
resented minority individuals serving in
faculty or administrative positions at the
institution.
‘‘(B) CONSORTIUM.—Any designated bio-
medical research institution involved may, with
other biomedical institutions (designated or oth-
erwise) form a consortium to carry out the pur-
poses described in subsection (b) at the institu-
tions of the consortium.
‘‘(C) APPLICATION OF CRITERIA TO OTHER
PROGRAMS.—In the case of any criteria estab-
lished by the Director of the Center for pur-
poses of determining whether institutions meet
the conditions described in subparagraph (A),
this section may not, with respect to racial and
ethnic minorities, be construed to authorize, re-
quire, or prohibit the use of such criteria in any
program other than the program established in
this section.
‘‘(d) DURATION
OF GRANT.—The period during
which payments are made under a grant under subsection
(a) may not exceed 5 years. Such payments shall be sub-
ject to annual approval by the Director of the Center and
to the availability of appropriations for the fiscal year in-
volved to make the payments.
‘‘(e) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘disadvantaged socioeconomic
groups’ means any group, defined by race, ethnicity,
gender, sexual orientation, or economic status that is
underrepresented in health research.
‘‘(2) The term ‘minority’ means an individual
from a racial or ethnic group (as defined in section
1707) that is underrepresented in health research.
‘‘(3) The term ‘program of excellence’ means
any program carried out by a designated biomedical
research institution with a grant made under sub-
section (a), if the program is for purposes for which
the institution involved is authorized in subsection
(b) or (c) to expend the grant.
‘‘(f) FUNDING.—
‘‘(1) AUTHORIZATION
OF
APPROPRIATIONS.—
For the purpose of making grants under subsection
(a), there are authorized to be appropriated such
sums as may be necessary for each of the fiscal
years 2000 through 2004.
‘‘(2) NO
LIMITATION.—Nothing in this sub-
section shall be construed as limiting the centers of
excellence referred to in this section to the des-
ignated amount, or to preclude such entities from
competing for other grants under this section.
‘‘(3) MAINTENANCE OF EFFORT.—
‘‘(A) IN GENERAL.—With respect to activi-
ties for which a grant made under this part are
authorized to be expended, the Director of the
Center may not make such a grant to a center
of excellence for any fiscal year unless the cen-
ter agrees to maintain expenditures of non-Fed-
eral amounts for such activities at a level that
is not less than the level of such expenditures
maintained by the center for the fiscal year pre-
ceding the fiscal year for which the institution
receives such a grant.
‘‘(B) USE OF FEDERAL FUNDS.—With re-
spect to any Federal amounts received by a cen-
ter of excellence and available for carrying out
activities for which a grant under this part is
authorized to be expended, the Director of the
Center may not make such a grant to the cen-
ter for any fiscal year unless the center agrees
that the center will, before expending the grant,
expend the Federal amounts obtained from
sources other than the grant.’’.
SEC. 103. EXTRAMURAL LOAN REPAYMENT PROGRAM FOR
BIOMEDICAL RESEARCH.
Subpart 6 of part E of title IV of the Public Health
Service Act, as amended by section 102 of this Act, is
amended by adding at the end the following section:
‘‘SEC. 485G. EXTRAMURAL LOAN REPAYMENT PROGRAM
FOR BIOMEDICAL RESEARCH.
‘‘(a) IN GENERAL.—The Director of the Center shall
establish a program of entering into contracts with quali-
fied health professionals under which such health profes-
sionals agree to engage in biomedical research, in consid-
eration of the Federal Government agreeing to repay, for
each year of such service, not more than $35,000 of the
principal and interest of the educational loans of such
health professionals.
‘‘(b) SERVICE PROVISIONS.—The provisions of sec-
tions 338B, 338C, and 338E shall, except as inconsistent
with subsection (a), apply to the program established in
such subsection (a) to the same extent and in the same
manner as such provisions apply to the National Health
Service Corps Loan Repayment Program established in
subpart III of part D of title III.
‘‘(c) AVAILABILITY OF APPROPRIATIONS.—Amounts
available for carrying out this section shall remain avail-
able until the expiration of the second fiscal year begin-
ning after the fiscal year for which the amounts were made
available.
‘‘(d) HEALTH DISPARITIES.—In carrying out this
section, the Director of the Center shall ensure that not
less than 50 percent of the contracts entered into under
this section involve appropriately qualified health profes-
sionals who are from disadvantaged backgrounds. Any re-
maining contracts entered into under this section may in-
volve appropriately qualified health professionals who are
pursuing biomedical research in the fields of minority
health research and health disparities.
‘‘(e) 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 2000 through 2002.’’.
SEC. 104. GENERAL PROVISIONS REGARDING THE CENTER.
Subpart 6 of part E of title IV of the Public Health
Service Act, as amended by section 103 of this Act, is
amended by adding at the end the following section:
‘‘SEC. 485H. GENERAL PROVISIONS REGARDING THE CEN-
TER.
‘‘(a) ADMINISTRATIVE SUPPORT FOR CENTER.—The
Secretary, acting through the Director of the National In-
stitutes of Health, shall provide administrative support
and support services to the Director of the Center and
shall ensure that such support takes maximum advantage
of existing administrative structures at the agencies of the
National Institutes of Health.
‘‘(b) EVALUATION AND REPORT.—
‘‘(1) EVALUATION.—Not later than 5 years
after the date of the enactment of this part, the Sec-
retary shall conduct an evaluation to—
‘‘(A) determine the effect of this section on
the planning and coordination of the minority
health research programs at the institutes, cen-
ters and divisions of the National Institutes of
Health;
‘‘(B) evaluate the extent to which this part
has eliminated the duplication of administrative
resources among such Institutes, centers and
divisions; and
‘‘(C) provide recommendations concerning
future alterations with respect to this part.
‘‘(2) REPORT.—Not later than 1 year after the
date on which the evaluation is commenced under
paragraph (1), the Secretary shall prepare and sub-
mit to the Committee on Health, Education, Labor,
and Pensions of the Senate, and the Committee on
Commerce of the House of Representatives, a report
concerning the results of such evaluation.’’.
SEC. 105. REPORT REGARDING METHODOLOGY FOR DE-
TERMINING RESOURCES OF NATIONAL INSTI-
TUTES 
OF 
HEALTH 
DEDICATED 
TO 
RE-
SEARCH ON MINORITY HEALTH.
Not later than one year after the date of the enact-
ment of this Act, the Director of the National Center for
Research on Minority Health and Health Disparities (es-
tablished by the amendment made by section 101(a)),
after consultation with the advisory council for such Cen-
ter, shall submit to the Congress, the Secretary of Health
and Human Services, and the Director of the National In-
stitutes of Health a report that makes recommendations
for the methodology that should be used to determine the
extent of the resources of the National Institutes of Health
that are dedicated to research on minority health, includ-
ing determining the amount of funds that are used to con-
duct and support such research. With respect to such
methodology, the report shall address the discrepancies be-
tween the methodology used by such Institutes as of the
date of the enactment of this Act and the methodology
used by the Institute of Medicine as of such date.
SEC. 106. REPORT BY DIRECTOR OF CENTER REGARDING
RESOURCES OF NATIONAL INSTITUTES OF
HEALTH DEDICATED TO RESEARCH ON MI-
NORITY HEALTH.
Not later than December 1, 2003, the Director of the
National Center for Research on Minority Health and
Health Disparities (established by the amendment made
by section 101(a)), after consultation with the advisory
council for the Center, shall submit to the Congress a re-
port that provides a determination by the Director of
whether and to what extent, relative to fiscal year 1999,
there has been an increase in the level of resources of the
National Institutes of Health that are dedicated to re-
search on minority health, including the amount of funds
used to conduct and support such research. The report
shall include provisions describing whether and to what
extent there have been increases in the number and
amount of awards to minority serving institutions.
TITLE II—MINORITY HEALTH RE-
SEARCH BY THE AGENCY FOR
HEALTH CARE POLICY AND
RESEARCH
SEC. 201. MINORITY HEALTH RESEARCH BY THE AGENCY
FOR HEALTH CARE POLICY AND RESEARCH.
(a) IN GENERAL.—Part A of title IX of the Public
Health Service Act (42 U.S.C. 299 et seq.) is amended
by adding at the end the following:
‘‘SEC. 906. RESEARCH ON MINORITY HEALTH DISPARITIES.
‘‘(a) IN GENERAL.—The Administrator of the Agen-
cy for Health Care Policy and Research shall—
‘‘(1) conduct and support research to identify
how to improve the quality and outcomes of health
care services for minority populations and the causes
of health disparities for minority populations, includ-
ing barriers to health care access;
‘‘(2) conduct and support research and support
demonstration projects to identify, test, and evaluate
strategies for eliminating the disparities described in
paragraph (1) and promoting effective interventions;
‘‘(3) develop measures for the assessment and
improvement of the quality and appropriateness of
health care services provided to minority popu-
lations; and
‘‘(4) in carrying out 902(c), provide support to
increase the number of minority health care re-
searchers and the health services research capacity
of institutions that train minority health care re-
searchers.
‘‘(b) RESEARCH AND DEMONSTRATION PROJECTS.—
‘‘(1) IN GENERAL.—In carrying out subsection
(a), the Administrator shall conduct and support re-
search to—
‘‘(A) identify the clinical, cultural, socio-
economic, and organizational factors that con-
tribute to health disparities for minority popu-
lations (including examination of patterns of
clinical decisionmaking and of the availability of
support services);
‘‘(B) identify and evaluate clinical and or-
ganizational strategies to improve the quality,
outcomes, and access to care for minority popu-
lations;
‘‘(C) support demonstrations to test such
strategies; and
‘‘(D) widely disseminate strategies for
which there is scientific evidence of effective-
ness.
‘‘(2) USE OF CERTAIN STRATEGIES.—In car-
rying out this section the Administrator shall imple-
ment research strategies and mechanisms that will
enhance the involvement of minority health services
researchers, institutions that train minority re-
searchers, and members of minority populations for
whom the Agency is attempting to improve the qual-
ity and outcomes of care, including—
‘‘(A) centers of excellence that can dem-
onstrate, either individually or through con-
sortia, a combination of multi-disciplinary ex-
pertise in outcomes or quality improvement re-
search and a demonstrated capacity to engage
minority populations in the planning, conduct
and translation of research, with linkages to
relevant sites of care;
‘‘(B) provider-based research networks, in-
cluding health plans, facilities, or delivery sys-
tem sites of care (especially primary care), that
make extensive use of minority health care pro-
viders or serve minority patient populations and
have the capacity to evaluate and promote qual-
ity improvement; and
‘‘(C) other innovative mechanisms or strat-
egies that will facilitate the translation of past
research investments into clinical practices that
can reasonably be expected to benefit these pop-
ulations.
‘‘(c) QUALITY MEASUREMENT DEVELOPMENT.—
‘‘(1) IN
GENERAL.—To ensure that minority
populations benefit from the progress made in the
ability of individuals to measure the quality of health
care delivery, the Administrator of the Agency for
Health Care Policy and Research shall support the
development of quality of health care measures that
assess the experience of minority populations with
health care systems, such as measures that assess
the access of minority populations to health care, the
cultural competence of the care provided, the quality
of the care provided, the outcomes of care, or other
aspects of health care practice that the Adminis-
trator determines to be important.
‘‘(2) REPORT.—Not later than 24 months after
the date of enactment of this section, the Secretary,
acting through the Administrator, shall prepare and
submit to the appropriate committees of Congress a
report describing the state-of-the-art of quality
measurement for minority populations which will
identify critical unmet needs, the current activities
of the Department to address those needs, and a de-
scription of related activities in the private sector.
‘‘(d) DEFINITION.—For purposes of this section, the
term ‘minority’, with respect to populations, refers to ra-
cial and ethnic minority groups as defined in section
1707.’’.
(b) FUNDING.—Section 926 of the Public Health
Service Act (42 U.S.C. 299c–5) is amended by adding at
the end the following:
‘‘(f) MINORITY HEALTH DISPARITIES RESEARCH.—
For the purpose of carrying out the activities under sec-
tion 906, there are authorized to be appropriated such
sums as may be necessary for each of the fiscal years 2000
through 2004.’’.
TITLE 
III—DATA 
COLLECTION
RELATING TO RACE OR ETH-
NICITY
SEC. 301. STUDY AND REPORT BY NATIONAL ACADEMY OF
SCIENCES.
(a) STUDY.—The National Academy of Sciences shall
conduct a comprehensive study of the Department of
Health and Human Services’ data collection systems and
practices, and any data collection or reporting systems re-
quired under any of the programs or activities of the De-
partment, relating to the collection of data on race or eth-
nicity, including other Federal data collection systems
(such as the Social Security Administration) with which
the Department interacts to collect relevant data on race
and ethnicity.
(b) REPORT.—Not later than 1 year after the date
of enactment of this Act, the National Academy of
Sciences shall prepare and submit to the Committee on
Health, Education, Labor, and Pensions of the Senate and
the Committee on Commerce of the House of Representa-
tives, a report that—
(1) identifies the data needed to support efforts
to evaluate the effects of race and ethnicity on ac-
cess to health care and other services and on dis-
parity in health and other social outcomes and the
data needed to enforce existing protections for equal
access to health care;
(2) examines the effectiveness of the systems
and practices of the Department of Health and
Human Services described in subsection (a), includ-
ing pilot and demonstration projects of the Depart-
ment, and the effectiveness of selected systems and
practices of other Federal and State agencies and
the private sector, in collecting and analyzing such
data;
(3) contains recommendations for ensuring that
the Department of Health and Human Services, in
administering its entire array of programs and ac-
tivities, collects, or causes to be collected, reliable
and complete information relating to race and eth-
nicity; and
(4) includes projections about the costs associ-
ated with the implementation of the recommenda-
tions described in paragraph (3), and the possible ef-
fects of the costs on program operations.
(c) AUTHORIZATION
OF APPROPRIATIONS.—There
are authorized to be appropriated such sums as may be
necessary for fiscal year 2000 to carry out this section.
TITLE IV—MEDICAL EDUCATION
SEC. 401. GRANTS FOR HEALTH CARE EDUCATION CUR-
RICULUM DEVELOPMENT.
Part F of title VII of the Public Health Service Act
(42 U.S.C. 295j et seq.) is amended by inserting after sec-
tion 791 the following:
‘‘SEC. 791A. GRANTS FOR HEALTH PROFESSIONAL EDU-
CATION CURRICULUM DEVELOPMENT.
‘‘(a) GRANTS
FOR GRADUATE EDUCATION CUR-
RICULUM DEVELOPMENT.—
‘‘(1) IN
GENERAL.—The Secretary, acting
through the Administrator of the Health Resources
and Services Administration and in collaboration
with the Administrator for Health Care Policy and
Research and the Deputy Assistant Secretary for
Minority Health, may make awards of grants, con-
tracts, or cooperative agreements to public and non-
profit private entities for the purpose of carrying out
research projects and demonstration projects to de-
velop curricula to reduce disparity in health care
outcomes, including curricula for cultural com-
petency in graduate medical education.
‘‘(2) ELIGIBILITY.—To be eligible to receive a
grant, contract or cooperative agreements under
paragraph (1), an entity shall—
‘‘(A) be a school of medicine, school or os-
teopathic medicine, school or dentistry, school
of public health, school of nursing, or other rec-
ognized health profession school; and
‘‘(B) prepare and submit to the Secretary
an application at such time, in such manner,
and containing such information as the Sec-
retary may require.
‘‘(3) USE
OF
FUNDS.—An entity shall use
amounts received under a grant under paragraph (1)
to carry out research projects and demonstration
projects to develop curricula to reduce disparity in
health care outcomes, including curricula for cultural
competency in graduate medical education.
‘‘(4) NUMBER OF GRANTS AND GRANT TERM.—
The Secretary shall award 20 grants, contracts or
cooperative agreements (or combination thereof)
under paragraph (1) in each of the first and second
fiscal years for which funds are available under sub-
section (f). The term of each such grant, contract or
cooperative agreement shall be 3 years.
‘‘(b) GRANTS FOR CONTINUING HEALTH PROFES-
SIONAL EDUCATION CURRICULUM DEVELOPMENT.—
‘‘(1) IN
GENERAL.—The Secretary, acting
through the Health Resources and Services Adminis-
tration and the Agency for Health Care Policy and
Research and in collaboration with the Office of Mi-
nority Health, shall award grants to eligible entities
for the establishment of demonstration and pilot
projects to develop curricula to reduce disparity in
health care and health outcomes, including curricula
for cultural competency, in continuing medical edu-
cation.
‘‘(2) ELIGIBILITY.—To be eligible to receive a
grant under paragraph (1) an entity shall—
‘‘(A) be a school of medicine, osteopathic
medicine, public health, dentistry, optometry,
pharmacy, allied health, chiropractic, podiatric
medicine, nursing, and public health and health
administration, public or nonprofit private
school that offers graduate programs in behav-
ioral and mental health, program for the train-
ing of physician assistants, health professional
association, or other public or nonprofit health
educational entity, or any consortium of entities
described in this subparagraph; and
‘‘(B) prepare and submit to the Secretary
an application at such time, in such manner,
and containing such information as the Sec-
retary may require.
‘‘(3) USE
OF
FUNDS.—An entity shall use
amounts received under a grant under paragraph (1)
to develop and evaluate the effect and impact of cur-
ricula for continuing medical education courses or
programs to provide education concerning issues re-
lating to disparity in health care and health out-
comes, including cultural competency of health pro-
fessionals. Such curricula shall focus on the need to
remove bias from health care at a personal level as
well as at a systematic level.
‘‘(4) NUMBER OF GRANTS AND GRANT TERM.—
The Secretary shall award 20 grants under para-
graph (1) in each of the first and second fiscal years
for which funds are available under subsection (f).
The term of each such grant shall be 3 years.
‘‘(c) DISTRIBUTION OF PROJECTS.—The Secretary
shall ensure that, to the extent practicable, projects under
subsections (a) and (b) are carried out in each of the prin-
cipal geographic regions of the United States and involve
different racial and ethnic minority groups and health pro-
fessions.
‘‘(d) MONITORING.—An entity that receives a grant,
contract or cooperative agreement under subsection (a) or
(b) shall ensure that procedures are in place to monitor
activities undertaken using grant, contract or cooperative
agreement funds. Such entity shall annually prepare and
submit to the Secretary a report concerning the effective-
ness of curricula developed under the grant contract or
cooperative agreement.
‘‘(e) REPORT TO CONGRESS.—Not later than Janu-
ary 1, 2002, the Secretary shall prepare and submit to
the appropriate committees of Congress, a report con-
cerning the effectiveness of programs funded under this
section and a plan to encourage the implementation and
utilization of curricula to reduce disparity in health care
and health outcomes. A final report shall be submitted by
the Secretary not later than January 1, 2004.
‘‘(f) DEFINITION.—For purposes of this section, the
term ‘racial and ethnic minority group’ has the meaning
given such term in section 1707.
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There
is authorized to be appropriated to carry out this section,
$3,500,000 for fiscal year 2000, $7,000,000 for fiscal year
2001, $7,000,000 for fiscal year 2002, and $3,500,000
for fiscal year 2003.’’.
SEC. 
402. 
NATIONAL 
CONFERENCE 
ON 
CONTINUING
HEALTH 
PROFESSIONAL 
EDUCATION 
AND
DISPARITY IN HEALTH OUTCOMES.
(a) IN GENERAL.—Not later than 1 year after the
date of enactment of this Act, the Secretary of Health and
Human Services shall convene a national conference on
continuing medical education as a method for reducing
disparity in health care and health outcomes, including
continuing medical education on cultural competency. The
conference shall include sessions to address measurements
of outcomes to assess the effectiveness of curricula in re-
ducing disparity.
(b) PARTICIPANTS.—The Secretary of Health and
Human Services shall invite minority health advocacy
groups, health education entities described in section
741(b)(1) of the Public Health Service Act (as added by
section 401), and other interested parties to attend the
conference under subsection (a).
(c) ISSUES.—The national conference convened under
subsection (a) shall address issues relating to the role of
continuing medical education in the effort to reduce dis-
parity in health care and health outcomes, including the
role of continuing medical education in improving the cul-
tural competency of health professionals. The conference
shall focus on methods to achieve reductions in the dis-
parities in health care and health outcomes through con-
tinuing medical education courses or programs and on
strategies for measuring the effectiveness of curricula to
reduce disparities.
(d) PUBLICATION OF FINDINGS.—Not later than 6
months after the convening of the national conference
under subsection (a), the Secretary of Health and Human
Services shall publish in the Federal Register a summary
of the proceedings and the findings of the conference.
(e) AUTHORIZATION OF APPROPRIATIONS.—There is
authorized to be appropriated such sums as may be nec-
essary to carry out this section.
SEC. 403. CONTINUING MEDICAL EDUCATION INCENTIVE
PROGRAM.
(a) IN GENERAL.—The Secretary of Health and
Human Services shall develop and implement a program
to provide incentives to health maintenance organizations,
community health centers, rural health centers, and other
entities providing services under title XVIII or XIX of the
Social Security Act (42 U.S.C. 1395 et seq. or 1396 et
seq.) to encourage health care professionals employed by,
or under contract with, such entities to participate in con-
tinuing medical education programs designed to decrease
the disparity of health across racial and ethnic minority
groups.
(b) EFFECTIVE PROGRAMS.—In developing the pro-
gram under subsection (a), the Secretary of Health and
Human Services shall ensure that incentives are targeted
at programs that address each of the following issues:
(1) Implementing new curricula or strategies
for continuing medical education programs designed
to decrease the disparity of health across racial and
ethnic minority groups or of continuing medical edu-
cation curricula or strategies that have been proven
effective in decreasing the disparity of health across
racial and ethnic minority groups.
(2) Encouraging health professionals to partici-
pate in such curricula.
(3) Monitoring health care and health outcomes
as a way in which to evaluate the effectiveness of
continuing medical education programs in decreasing
the disparity of health across racial and ethnic mi-
nority groups.
(c) AUTHORIZATION OF APPROPRIATIONS.—There is
authorized to be appropriated such sums as may be nec-
essary to carry out this section.
SEC. 404. ADVISORY COMMITTEE.
(a) ESTABLISHMENT.—The Secretary of Health and
Human Services shall establish an advisory committee the
provide advice to the Secretary on matters related to the
development, implementation, and evaluation of graduate
and continuing education curricula for health care profes-
sionals to decrease the disparity in health care and health
outcomes, including curricula on cultural competency as
a method of eliminating health disparity.
(b) MEMBERSHIP.—Not later than 3 months after
the date on which amounts are appropriated to carry out
this section, the Secretary of Health and Human Services
shall appoint the members of the advisory committee.
Such members shall be appointed from among individuals
who—
(1) are not officers or employees of the Federal
Government;
(2) are experienced in issues relating to health
disparity;
(3) are minorities or representatives of racial
and ethnic minority groups; and
(4) meet such other requirements as the Sec-
retary determines appropriate;
and shall include a representative of the Office of Minority
Health under section 1707 of the Public Health Service
Act (42 U.S.C. 300u–6) and such other representatives
of offices and agencies of the Public Health Service as the
Secretary determines to be appropriate. Such representa-
tives shall include 1 or more individuals who serve on the
advisory committee under section 1707(c) of such Act.
(c) COLLABORATION.—The advisory committee shall
carry out its duties under this section in collaboration with
the Office of Minority Health of the Department of Health
and Human Services, and other offices centers and insti-
tutes of the Department of Health and Human Services,
and other Federal agencies.
(d) TERMINATION.—The advisory committee shall
terminate on the date that is 4 years after the date on
which the first member of the committee is appointed.
(e) EXISTING COMMITTEE.—The Secretary may des-
ignate an existing advisory committee operating under the
authority of the Office of Minority Health of the Depart-
ment of Health and Human Services to serve as the advi-
sory committee under this section.
SEC. 405. CULTURAL COMPETENCY CLEARINGHOUSE.
(a) ESTABLISHMENT.—The Director of the Office of
Minority Health of the Department of Health and Human
Services shall establish within the Resource Center of the
Office of Minority Health, or through the awarding of a
grant provide for the establishment of, an information
clearinghouse for curricula to reduce disparity in health
care and health outcomes. The clearinghouse shall facili-
tate and enhance, through the effective dissemination of
information, knowledge and understanding of practices
that lead to decreases in the disparity of health across ra-
cial and ethnic minority groups, including curricula for
continuing medical education to develop cultural com-
petency in health care professionals.
(b) AVAILABILITY
OF INFORMATION.—Information
contained in the clearinghouse shall be made available to
minority health advocacy groups, health education entities
described in section 791A(b)(2)(A) of the Public Health
Service Act (as added by section 401), health maintenance
organizations, and other interested parties.
(c) AUTHORIZATION OF APPROPRIATIONS.—There is
authorized to be appropriated such sums as may be nec-
essary to carry out this section.
TITLE V—MISCELLANEOUS
PROVISIONS
SEC. 501. OFFICE FOR CIVIL RIGHTS.
(a) PUBLIC AWARENESS CAMPAIGN.—
(1) IN GENERAL.—The Secretary of Health and
Human Services shall conduct a national media
campaign for the purpose of informing the public of
the programs and activities of the Office for Civil
Rights, Department of Health and Human Services.
The campaign shall—
(A) have a specific focus on racial and eth-
nic minority communities, as well as the general
public; and
(B) involve racial and ethnic media as par-
ticipants in the design and conduct of the cam-
paign.
(2) AUTHORIZATION
OF
APPROPRIATIONS.—
For the purpose of carrying out paragraph (1), there
are authorized to be appropriated such sums as may
be necessary for fiscal year 2000.
(b) OMBUDSMAN DEMONSTRATION PROGRAM.—
(1) IN GENERAL.—The Secretary of Health and
Human Services (in this subsection referred to as
the ‘‘Secretary’’) shall carry out a demonstration
program under which the Secretary makes grants to
States for the purpose of establishing and operating
State offices to identify, investigate, and facilitate
the resolution of complaints relating to civil rights,
and to carry out functions authorized pursuant to
paragraph (3) (which office is referred to in this
subsection as the ‘‘State Ombudsman Office’’).
(2) OMBUDSMAN.—The Secretary shall require
that each State Ombudsman Office under paragraph
(1) be headed by an individual with expertise and
experience in the field of civil rights and advocacy.
(3) CERTAIN
REQUIREMENTS
AND
AUTHORI-
TIES.—In carrying out paragraph (1), the Secretary
shall consider the requirements and authorities that
apply to the operation of State offices under chapter
2 of subtitle A of title VII of the Older Americans
Act of 1965 (relating to State Long-Term Care Om-
budsman Programs). In providing for State Om-
budsman Offices under paragraph (1), the Secretary
may establish requirements and authorities with re-
spect to civil rights that are the same as or similar
to the requirements and authorities that apply under
such chapter 2 with respect to residents of long-term
care facilities.
(c) FUNDING.—There are authorized to be appro-
priated for the Office for Civil Rights, Department of
Health and Human Services, $36,000,000 for fiscal year
2000 and each subsequent fiscal year.
SEC. 502. DEVELOPMENT OF STANDARDS; STUDY TO MEAS-
URE PATIENT OUTCOMES UNDER THE MEDI-
CARE AND MEDICAID PROGRAMS BY RACE
AND ETHNICITY.
(a) DEVELOPMENT OF STANDARDS.—Not later than
1 year after the date of the enactment of this Act, the
Secretary of Health and Human Services, acting through
the Administrator of the Health Care Financing Adminis-
tration, shall develop outcome measures to evaluate, by
race and ethnicity, the performance of health care pro-
grams and projects that provide health care to individuals
under the medicare and medicaid programs (under titles
XVIII and XIX, respectively, of the Social Security Act
(42 U.S.C. 1395 et seq. and 1396 et seq.).
(b) STUDY.—After the Secretary develops the 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
of Health and Human Services shall submit to Congress
a report describing the outcome measures developed under
subsection (a), and the results of the study conducted pur-
suant to subsection (b).
SEC. 503. DEPARTMENTAL DEFINITION REGARDING MINOR-
ITY INDIVIDUALS.
Section 1707(g)(1) of the Public Health Service Act
(42 U.S.C. 300u–6) is amended—
(1) by striking ‘‘Asian Americans and’’ and in-
serting ‘‘Asian Americans;’’; and
(2) by inserting ‘‘Native Hawaiians and other’’
before ‘‘Pacific Islanders;’’.
SEC. 504. CONFORMING PROVISION REGARDING DEFINI-
TIONS.
For purposes of this Act, the term ‘‘racial and ethnic
minority group’’ has the meaning given such term in sec-
tion 1707 of the Public Health Service Act.
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