In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.
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Question: -S-E-C-T-I-O-N -1-. -A-C-Q-U-I-S-I-T-I-O-N -O-F -R-O-O-S-E-V-E-L-T 
              -F-A-M-I-L-Y -L-A-N-D-S-.

    -(-a-) -I-n -G-e-n-e-r-a-l-.---
            -(-1-) -G-e-n-e-r-a-l -a-u-t-h-o-r-i-t-y-.----T-h-e 
        -S-e-c-r-e-t-a-r-y -o-f -t-h-e -I-n-t-e-r-i-o-r 
        -(-h-e-r-e-i-n-a-f-t-e-r -r-e-f-e-r-r-e-d -t-o -a-s -t-h-e 
        -`-`-S-e-c-r-e-t-a-r-y-'-'-) -m-a-y -a-c-q-u-i-r-e-, -b-y 
        -p-u-r-c-h-a-s-e -w-i-t-h -d-o-n-a-t-e-d -o-r 
        -a-p-p-r-o-p-r-i-a-t-e-d -f-u-n-d-s-, -d-o-n-a-t-i-o-n-, -o-r 
        -o-t-h-e-r-w-i-s-e-, -l-a-n-d-s -a-n-d -i-n-t-e-r-e-s-t-s -i-n 
        -l-a-n-d -(-i-n-c-l-u-d-i-n-g -d-e-v-e-l-o-p-m-e-n-t 
        -r-i-g-h-t-s -a-n-d -e-a-s-e-m-e-n-t-s-) -i-n -t-h-e 
        -p-r-o-p-e-r-t-i-e-s -l-o-c-a-t-e-d -a-t -H-y-d-e -P-a-r-k-, 
        -N-e-w -Y-o-r-k-, -t-h-a-t -w-e-r-e -o-w-n-e-d -b-y 
        -F-r-a-n-k-l-i-n -D-. -R-o-o-s-e-v-e-l-t -o-r -h-i-s 
        -f-a-m-i-l-y -a-t -t-h-e -t-i-m-e -o-f -h-i-s -d-e-a-t-h-, -a-s 
        -d-e-p-i-c-t-e-d -o-n -t-h-e -m-a-p -e-n-t-i-t-l-e-d 
        -`-`-R-o-o-s-e-v-e-l-t -F-a-m-i-l-y -E-s-t-a-t-e-'-' -a-n-d 
        -d-a-t-e-d -N-o-v-e-m-b-e-r -1-9-, -1-9-9-3-.
            -(-2-) -L-i-m-i-t-a-t-i-o-n-s-.---
                    -(-A-) -R-e-s-i-d-e-n-t-i-a-l -p-r-o-p-e-r-t-y-.---
                -T-h-e -S-e-c-r-e-t-a-r-y -m-a-y -o-n-l-y 
                -a-c-q-u-i-r-e -t-h-o-s-e -r-e-s-i-d-e-n-t-i-a-l 
                -p-r-o-p-e-r-t-i-e-s -o-n -t-h-e -l-a-n-d-s -a-n-d 
                -i-n-t-e-r-e-s-t-s -i-n -l-a-n-d -d-e-p-i-c-t-e-d -o-n 
                -t-h-e -m-a-p -r-e-f-e-r-r-e-d -t-o -i-n 
                -s-u-b-s-e-c-t-i-o-n -(-a-) -t-h-a-t -w-e-r-e 
                -o-w-n-e-d -o-r -o-c-c-u-p-i-e-d -b-y -F-r-a-n-k-l-i-n 
                -D-. -R-o-o-s-e-v-e-l-t -o-r -h-i-s -f-a-m-i-l-y-, 
                -i-n-c-l-u-d-i-n-g -h-i-s -p-a-r-e-n-t-s-, 
                -s-i-b-l-i-n-g-s-, -w-i-f-e-, -a-n-d -c-h-i-l-d-r-e-n-.
                    -(-B-) -S-t-a-t-e -l-a-n-d-s-.----L-a-n-d-s -a-n-d 
                -i-n-t-e-r-e-s-t-s -i-n -l-a-n-d -d-e-p-i-c-t-e-d -o-n 
                -t-h-e -m-a-p -r-e-f-e-r-r-e-d -t-o -i-n 
                -s-u-b-s-e-c-t-i-o-n -(-a-) -t-h-a-t -a-r-e -o-w-n-e-d 
                -b-y -t-h-e -S-t-a-t-e -o-f -N-e-w -Y-o-r-k-, -o-r -a 
                -p-o-l-i-t-i-c-a-l -s-u-b-d-i-v-i-s-i-o-n -o-f -t-h-e 
                -S-t-a-t-e-, -m-a-y -o-n-l-y -b-e -a-c-q-u-i-r-e-d -b-y 
                -d-o-n-a-t-i-o-n-.
            -(-3-) -P-r-i-o-r-i-t-y-.----I-n -a-c-q-u-i-r-i-n-g 
        -l-a-n-d-s -a-n-d -i-n-t-e-r-e-s-t-s -i-n -l-a-n-d 
        -p-u-r-s-u-a-n-t -t-o -t-h-i-s -s-e-c-t-i-o-n-, -t-h-e 
        -S-e-c-r-e-t-a-r-y -s-h-a-l-l-, -t-o -t-h-e -e-x-t-e-n-t 
        -p-o-s-s-i-b-l-e-, -g-i-v-e -p-r-i-o-r-i-t-y -t-o 
        -a-c-q-u-i-r-i-n-g -t-h-e -t-r-a-c-t -o-f -l-a-n-d-s 
        -c-o-m-m-o-n-l-y -k-n-o-w-n -a-s -t-h-e -`-`-O-p-e-n -P-a-r-k 
        -H-o-d-h-o-m-e -T-r-a-c-t-'-'-, -a-s -g-e-n-e-r-a-l-l-y 
        -d-e-p-i-c-t-e-d -o-n -t-h-e -m-a-p -r-e-f-e-r-r-e-d -t-o -i-n 
        -s-u-b-s-e-c-t-i-o-n -(-a-)-.
            -(-4-) -C-o-s-t-s-.----T-h-e -S-e-c-r-e-t-a-r-y -m-a-y 
        -p-a-y -t-h-e -c-o-s-t-s-, -i-n-c-l-u-d-i-n-g -t-i-t-l-e 
        -s-e-a-r-c-h -a-n-d -s-u-r-v-e-y-, -a-s-s-o-c-i-a-t-e-d 
        -w-i-t-h -t-h-e -a-c-q-u-i-s-i-t-i-o-n -o-f -l-a-n-d-s -a-n-d 
        -i-n-t-e-r-e-s-t-s -i-n -l-a-n-d -p-u-r-s-u-a-n-t -t-o -t-h-i-s 
        -s-e-c-t-i-o-n-.
    -(-b-) -A-d-m-i-n-i-s-t-r-a-t-i-o-n-.----L-a-n-d-s -a-n-d 
-i-n-t-e-r-e-s-t-s -i-n -l-a-n-d -a-c-q-u-i-r-e-d -b-y -t-h-e 
-S-e-c-r-e-t-a-r-y -p-u-r-s-u-a-n-t -t-o -t-h-i-s -s-e-c-t-i-o-n 
-s-h-a-l-l -b-e -a-d-d-e-d -t-o-, -a-n-d -a-d-m-i-n-i-s-t-e-r-e-d -a-s 
-p-a-r-t -o-f-, -t-h-e -F-r-a-n-k-l-i-n -D-e-l-a-n-o -R-o-o-s-e-v-e-l-t 
-N-a-t-i-o-n-a-l -H-i-s-t-o-r-i-c -S-i-t-e -o-r -t-h-e -E-l-e-a-n-o-r 
-R-o-o-s-e-v-e-l-t -N-a-t-i-o-n-a-l -H-i-s-t-o-r-i-c -S-i-t-e-, -a-s 
-a-p-p-r-o-p-r-i-a-t-e-.
    -(-c-) -A-u-t-h-o-r-i-z-a-t-i-o-n -o-f 
-A-p-p-r-o-p-r-i-a-t-i-o-n-s-.----T-h-e-r-e -a-r-e -a-u-t-h-o-r-i-z-e-d 
-t-o -b-e -a-p-p-r-o-p-r-i-a-t-e-d -s-u-c-h -s-u-m-s -a-s -a-r-e 
-n-e-c-e-s-s-a-r-y -t-o -c-a-r-r-y -o-u-t -t-h-i-s -A-c-t-.

SECTION 1. ACQUISITION OF LANDS.

    (a) In General.--(1) The Secretary of the Interior (hereinafter 
referred to as the ``Secretary'') is authorized to acquire, by purchase 
with donated or appropriated funds, donation, or otherwise, lands and 
interests therein in the following properties located at Hyde Park, New 
York identified as lands critical for protection as depicted on the map 
entitled ``Roosevelt Family Estate'' and dated September 1994:
            (A) The ``Open Park Hodhome Tract'', consisting of 
        approximately 30 acres, which shall be the highest priority for 
        acquisition.
            (B) The ``Top Cottage Tract'', consisting of approximately 
        30 acres.
            (C) The ``Poughkeepsie Shopping Center, Inc. Tract'', 
        consisting of approximately 55 acres.
    (b) Administration.--Lands and interests therein acquired by the 
Secretary pursuant to this Act shall be added to, and administered by 
the Secretary as part of the Franklin Delano Roosevelt National 
Historic Site or the Eleanor Roosevelt National Historic Site, as 
appropriate.
    (c) Authorization of Appropriations.--There are hereby authorized 
to be appropriated not to exceed $3,000,000 to carry out this Act.

Answer: Authorizes the Secretary of the Interior to acquire lands and interests in specified properties located at Hyde Park, New York, identified as lands critical for protection on the Roosevelt Family Estate to be added to and administered by the Secretary as part of the Franklin Delano Roosevelt National Historic Site or the Eleanor Roosevelt National Historic Site. Authorizes appropriations.


Question: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Taxpayer Debt Buy-Down Act''.

SEC. 2. DESIGNATION OF AMOUNTS FOR REDUCTION OF PUBLIC DEBT.

    (a) In General.--Subchapter A of chapter 61 of the Internal Revenue 
Code of 1986 (relating to returns and records) is amended by adding at 
the end the following new part:

          ``PART IX--DESIGNATION FOR REDUCTION OF PUBLIC DEBT.

                              ``Sec. 6097. Designation.

``SEC. 6097. DESIGNATION.

    ``(a) In General.--Every individual with adjusted income tax 
liability for any taxable year may designate that a portion of such 
liability (not to exceed 10 percent thereof) shall be used to reduce 
the public debt.
    ``(b) Manner and Time of Designation.--A designation under 
subsection (a) may be made with respect to any taxable year only at the 
time of filing the return of tax imposed by chapter 1 for the taxable 
year. The designation shall be made on the first page of the return or 
on the page bearing the taxpayer's signature.
    ``(c) Adjusted Income Tax Liability.--For purposes of this section, 
the term `adjusted income tax liability' means income tax liability (as 
defined in section 6096(b)) reduced by any amount designated under 
section 6096 (relating to designation of income tax payments to 
Presidential Election Campaign Fund).''
    (b) Clerical Amendment.--The table of parts for such subchapter A 
is amended by adding at the end the following new item:

                              ``Part IX. Designation for reduction of 
                                        public debt.''
    (c) Effective Date.--The amendments made by this section shall 
apply to taxable years ending after the date of the enactment of this 
Act.

SEC. 3. PUBLIC DEBT REDUCTION TRUST FUND.

    (a) In General.--Subchapter A of chapter 98 of the Internal Revenue 
Code of 1986 (relating to trust fund code) is amended by adding at the 
end the following section:

``SEC. 9512. PUBLIC DEBT REDUCTION TRUST FUND.

    ``(a) Creation of Trust Fund.--There is established in the Treasury 
of the United States a trust fund to be known as the `Public Debt 
Reduction Trust Fund', consisting of any amount appropriated or 
credited to the Trust Fund as provided in this section or section 
9602(b).
    ``(b) Transfers to Trust Fund.--There are hereby appropriated to 
the Public Debt Reduction Trust Fund amounts equivalent to the amounts 
designated under section 6097 (relating to designation for public debt 
reduction).
    ``(c) Expenditures.--Amounts in the Public Debt Reduction Trust 
Fund shall be available only for purposes of paying at maturity, or to 
redeem or buy before maturity, any obligation of the Federal Government 
included in the public debt. Any obligation which is paid, redeemed, or 
bought with amounts from such Trust Fund shall be canceled and retired 
and may not be reissued.''
    (b) Clerical Amendment.--The table of sections for such subchapter 
is amended by adding at the end the following new item:

                              ``Sec. 9512. Public Debt Reduction Trust 
                                        Fund.''
    (c) Effective Date.--The amendments made by this section shall 
apply to amounts received after the date of the enactment of this Act.

SEC. 4. TAXPAYER-GENERATED SEQUESTRATION OF FEDERAL SPENDING TO REDUCE 
              THE PUBLIC DEBT.

    (a) Sequestration To Reduce the Public Debt.--Part C of the 
Balanced Budget and Emergency Deficit Control Act of 1985 is amended by 
adding after section 253 the following new section:

``SEC. 253A. SEQUESTRATION TO REDUCE THE PUBLIC DEBT.

    ``(a) Sequestration.--Notwithstanding sections 255 and 256, within 
15 days after Congress adjourns to end a session, and on the same day 
as sequestration (if any) under sections 251, 252, and 253, but after 
any sequestration required by those sections, there shall be a 
sequestration equivalent to the estimated aggregate amount designated 
under section 6097 of the Internal Revenue Code of 1986 for the last 
taxable year ending before the beginning of that session of Congress, 
as estimated by the Department of the Treasury on May 1 and as modified 
by the total of (1) any amounts by which net discretionary spending is 
reduced by legislation below the discretionary spending limits (or, in 
the absence of such limits, any net deficit change from the baseline 
amount calculated under section 257, except that such baseline for 
fiscal year 1996 and thereafter shall be based upon fiscal year 1995 
enacted appropriations less any 1995 sequesters) and (2) the net 
deficit change that has resulted from direct spending legislation.
    ``(b) Applicability.--
            ``(1) In general.--Except as provided by paragraph (2), 
        each account of the United States shall be reduced by a dollar 
        amount calculated by multiplying the level of budgetary 
        resources in that account at that time by the uniform 
        percentage necessary to carry out subsection (a). All 
        obligational authority reduced under this section shall be done 
        in a manner that makes such reductions permanent.
            ``(2) Exempt accounts.--No order issued under this part 
        may--
                    ``(A) reduce benefits payable the old-age, 
                survivors, and disability insurance program established 
                under title II of the Social Security Act;
                    ``(B) reduce payments for net interest (all of 
                major functional category 900); or
                    ``(C) make any reduction in the following accounts:
                            ``Federal Deposit Insurance Corporation, 
                        Bank Insurance Fund;
                            ``Federal Deposit Insurance Corporation, 
                        FSLIC Resolution Fund;
                            ``Federal Deposit Insurance Corporation, 
                        Savings Association Insurance Fund;
                            ``National Credit Union Administration, 
                        credit union share insurance fund; or
                            ``Resolution Trust Corporation.''.
    (b) Reports.--Section 254 of the Balanced Budget and Emergency 
Deficit Control Act of 1985 is amended--
            (1) in subsection (a), by inserting before the item 
        relating to August 10 the following:
    ``May 1 . . . Department of Treasury report to Congress estimating 
amount of income tax designated pursuant to section 6097 of the 
Internal Revenue Code of 1986.'';
            (2) in subsection (d)(1), by inserting ``, and 
        sequestration to reduce the public debt,'';
            (3) in subsection (d), by redesignating paragraph (5) as 
        paragraph (6) and by inserting after paragraph (4) the 
        following new paragraph:
            ``(5) Sequestration to reduce the public debt reports.--The 
        preview reports shall set forth for the budget year estimates 
        for each of the following:
                    ``(A) The aggregate amount designated under section 
                6097 of the Internal Revenue Code of 1986 for the last 
                taxable year ending before the budget year.
                    ``(B) The amount of reductions required under 
                section 253A and the deficit remaining after those 
                reductions have been made.
                    ``(C) The sequestration percentage necessary to 
                achieve the required reduction in accounts under 
                section 253A(b).''; and
            (4) in subsection (g), by redesignating paragraphs (4) and 
        (5) as paragraphs (5) and (6), respectively, and by inserting 
        after paragraph (3) the following new paragraph:
            ``(4) Sequestration to reduce the public debt reports.--The 
        final reports shall contain all of the information contained in 
        the public debt taxation designation report required on May 
        1.''.
    (c) Effective Date.--Notwithstanding section 275(b) of the Balanced 
Budget and Emergency Deficit Control Act of 1985, the expiration date 
set forth in that section shall not apply to the amendments made by 
this section. The amendments made by this section shall cease to have 
any effect after the first fiscal year during which there is no public 
debt.

Answer: Taxpayer Debt Buy-Down Act - Amends the Internal Revenue Code to allow every individual with adjusted income tax liability to designate on their tax returns that a portion of such liability (not to exceed ten percent) be used to reduce the public debt. 
Establishes a Public Debt Reduction Trust Fund for the deposit of designated amounts.  Makes amounts in such Trust Fund available only to pay at maturity, or to redeem or buy before maturity, any obligation of the Federal Government included in the public debt.  Prohibits the reissuance of any obligation which is paid, redeemed, or bought with amounts from the Trust Fund. 
Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to provide for the sequestration of amounts designated to the Trust Fund.  Specifies accounts exempt from such sequestration.  Includes aggregated amounts designated to the Trust Fund and amounts sequestered to reduce the public debt in sequestration preview and final reports.


Question: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Rural Health Innovation 
Demonstration Act of 1993''.

SEC. 2. RURAL HEALTH EXTENSION NETWORKS.

    Title XVII of the Public Health Service Act (42 U.S.C. 300u et 
seq.) is amended by adding at the end thereof the following new 
section:

``SEC. 1709. RURAL HEALTH EXTENSION NETWORKS.

    ``(a) Grants.--The Secretary, acting through the Health Resources 
and Services Administration, may award competitive grants to eligible 
entities to enable such entities to facilitate the development of 
networks among rural and urban health care providers to preserve and 
share health care resources and enhance the quality and availability of 
health care in rural areas. Such networks may be statewide or 
regionalized in focus.
    ``(b) Eligible Entities.--To be eligible to receive a grant under 
subsection (a) an entity shall--
            ``(1)(A) be a rural health extension network that meets the 
        requirements of subsection (c); or
            ``(B) be an Area Health Education Center Program;
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such form and containing such information as the 
        Secretary may require; and
            ``(3) meets such other requirements as the Secretary 
        determines appropriate.
    ``(c) Networks.--For purposes of subsection (b)(1), a rural health 
extension network shall be an association or consortium of three or 
more rural health care providers, and may include one or more urban 
health care provider, for the purposes of applying for a grant under 
this section and using amounts received under such grant to provide the 
services described in subsection (d).
    ``(d) Services.--
            ``(1) In general.--An entity that receives a grant under 
        subsection (a) shall use amounts received under such grant to--
                    ``(A) provide education and community 
                decisionmaking support for health care providers in the 
                rural areas served by the network;
                    ``(B) utilize existing health care provider 
                education programs, including but not limited to, the 
                program for area health education centers under section 
                781, to provide educational services to health care 
                providers and trainees including, but not limited to, 
                physicians, nurses and nursing students in the areas 
                served by the network;
                    ``(C) make appropriately trained facilitators 
                available to health care providers located in the areas 
                served by the network to assist such providers in 
                developing cooperative approaches to health care in 
                such area;
                    ``(D) facilitate linkage building through the 
                organization of discussion and planning groups and the 
                dissemination of information concerning the health care 
                resources where available, within the area served by 
                the network;
                    ``(E) support telecommunications and consultative 
                projects to link rural hospitals and other health care 
                providers, and urban or tertiary hospitals in the areas 
                served by the network; or
                    ``(F) carry out any other activity determined 
                appropriate by the Secretary.
            ``(2) Education.--In carrying out activities under 
        paragraph (1)(B), an entity shall support the development of an 
        information and resource sharing system, including elements 
        targeted towards high risk populations and focusing on health 
        promotion, to facilitate the ability of rural health care 
        providers to have access to needed health care information. 
        Such activities may include the provision of training to enable 
        individuals to serve as coordinators of health education 
        programs in rural areas.
            ``(3) Collection and dissemination of data.--The chief 
        executive officer of a State shall designate a State agency 
        that shall be responsible for collecting and regularly 
        disseminating information concerning the activities of the 
        rural health extension networks in that State.
    ``(e) Matching Requirement.--An entity that receives a grant under 
subsection (a) shall make available (directly or through donations from 
public or private entities), non-Federal contributions towards the 
costs of the operations of the network in an amount equal to the amount 
of the grant.
    ``(f) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, $10,000,000 for each of the 
fiscal years 1994 through 1997.
    ``(g) Definition.--As used in this section and section 1710, the 
term `rural health care providers' means health care professionals and 
hospitals located in rural areas. The Secretary shall ensure that for 
purposes of this definition, rural areas shall include any area that 
meets any applicable Federal or State definition of rural area.
    ``(h) Relation to Other Laws.--
            ``(1) In general.--Notwithstanding any provision of the 
        antitrust laws, it shall not be considered a violation of the 
        antitrust laws for entities to develop and operate networks in 
        accordance with this section.
            ``(2) Definition.--For purposes of this subsection, the 
        term `antitrust laws' means--
                    ``(A) the Act entitled `An Act to protect trade and 
                commerce against unlawful restraints and monopolies', 
                approved July 2, 1890, commonly known as the `Sherman 
                Act' (26 Stat. 209; chapter 647; 15 U.S.C. 1 et seq.);
                    ``(B) the Federal Trade Commission Act, approved 
                September 26, 1914 (38 Stat. 717; chapter 311; 15 
                U.S.C. 41 et seq.);
                    ``(C) the Act entitled `An Act to supplement 
                existing laws against unlawful restraints and 
                monopolies, and for other purposes', approved October 
                15, 1914, commonly known as the `Clayton Act' (38 Stat. 
                730; chapter 323; 15 U.S.C. 12 et seq.; 18 U.S.C. 402, 
                660, 3285, 3691; 29 U.S.C. 52, 53);
                    ``(D) the Act of June 19, 1936, commonly known as 
                the Robinson-Patman Antidiscrimination Act (15 U.S.C. 
                13 et seq.); and
                    ``(E) any State antitrust laws that would prohibit 
                the activities described in paragraph (1).''.

SEC. 3. RURAL MANAGED CARE COOPERATIVES.

    Title XVII of the Public Health Service Act (42 U.S.C. 300u et 
seq.) as amended by section 2 is further amended by adding at the end 
thereof the following new section:

``SEC. 1710. RURAL MANAGED CARE COOPERATIVES.

    ``(a) Grants.--The Secretary, acting through the Health Resources 
and Services Administration, may award competitive grants to eligible 
entities to enable such entities to develop and administer cooperatives 
in rural areas that will establish an effective case management and 
reimbursement system designed to support the economic viability of 
essential public or private health services, facilities, health care 
systems and health care resources in such rural areas.
    ``(b) Eligible Entities.--To be eligible to receive a grant under 
subsection (a) an entity shall--
            ``(1) prepare and submit to the Secretary an application at 
        such time, in such form and containing such information as the 
        Secretary may require, including a description of the 
        cooperative that the entity intends to develop and operate 
        using grant funds; and
            ``(2) meet such other requirements as the Secretary 
        determines appropriate.
    ``(c) Cooperatives.--
            ``(1) In general.--Amounts provided under a grant awarded 
        under subsection (a) shall be used to establish and operate a 
        cooperative made up of all types of health care providers, 
        hospitals, primary access hospitals, other alternate rural 
        health care facilities, physicians, rural health clinics, rural 
        nurse practitioners and physician assistant practitioners, 
        public health departments and others located in, but not 
        restricted to, the rural areas to be served by the cooperative.
            ``(2) Board of directors.--A cooperative established under 
        paragraph (1) shall be administered by a board of directors 
        elected by the members of the cooperative, a majority of whom 
        shall represent rural providers from the local community and 
        include representatives from the local community. Such members 
        shall serve at the pleasure of such members.
            ``(3) Executive director.--The members of a cooperative 
        established under paragraph (1) shall elect an executive 
        director who shall serve as the chief operating officer of the 
        cooperative. The executive director shall be responsible for 
        conducting the day the day operation of the cooperative 
        including--
                    ``(A) maintaining an accounting system for the 
                cooperative;
                    ``(B) maintaining the business records of the 
                cooperative;
                    ``(C) negotiating contracts with provider members 
                of the cooperative; and
                    ``(D) coordinating the membership and programs of 
                the cooperative.
            ``(4) Reimbursements.--
                    ``(A) Negotiations.--A cooperative established 
                under paragraph (1) shall facilitate negotiations among 
                member health care providers and third party payors 
                concerning the rates at which such providers will be 
                reimbursed for services provided to individuals for 
                which such payors may be liable.
                    ``(B) Agreements.--Agreements reached under 
                subparagraph (A) shall be binding on the members of the 
                cooperative.
                    ``(C) Employers.--Employer entities may become 
                members of a cooperative established under paragraph 
                (a) in order to provide, through a member third party 
                payor, health insurance coverage for its employees. 
                Deductibles shall only be charged to employees covered 
                under such insurance if such employees receive health 
                care services from a provider that is not a member of 
                the cooperative if similar services would have been 
                available from a member provider.
                    ``(D) Malpractice insurance.--A cooperative 
                established under subsection (a) shall be responsible 
                for identifying and implementing an affordable 
                malpractice insurance program that shall include a 
                requirement that such cooperative assume responsibility 
                for the payment of a portion of the malpractice 
                insurance premium of providers members.
            ``(5) Managed care and practice standards.--A cooperative 
        established under paragraph (1) shall establish joint case 
        management and patient care practice standards programs that 
        health care providers that are members of such cooperative must 
        meet to be eligible to participate in agreements entered into 
        under paragraph (4). Such standards shall be developed by such 
        provider members and shall be subject to the approval of a 
        majority of the board of directors. Such programs shall include 
        cost and quality of care guidelines including a requirement 
        that such providers make available preadmission screening, 
        selective case management services, joint patient care practice 
        standards development and compliance and joint utilization 
        review.
            ``(6) Confidentiality.--
                    ``(A) In general.--Patients records, records of 
                peer review, utilization review, and quality assurance 
                proceedings conducted by the cooperative should be 
                considered confidential and protected from release 
                outside of the cooperative. The provider members of the 
                cooperative shall be indemnified by the cooperative for 
                the good faith participation by such members in such 
                the required activities.
                    ``(B) Quality data.--Notwithstanding any other 
                provision of law, quality data obtained by a hospital 
                or other member of a cooperative in the normal course 
                of the operations of the hospital or member shall be 
                immune from discovery regardless of whether such data 
                is used for purposes other than peer review or is 
                disclosed to other members of the cooperative involved.
    ``(d) Linkages.--A cooperative shall create linkages among member 
health care providers, employers, and payors for the joint consultation 
and formulation of the types, rates, costs, and quality of health care 
provided in rural areas served by the cooperative.
    ``(e) Matching Requirement.--An entity that receives a grant under 
subsection (a) shall make available (directly or through donations from 
public or private entities), non-Federal contributions towards the 
costs of the operations of the network in an amount equal to the amount 
of the grant.
    ``(f) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, $15,000,000 for each of the 
fiscal years 1994 through 1997.
    ``(g) Relation to Other Laws.--
            ``(1) In general.--Notwithstanding any provision of the 
        antitrust laws, it shall not be considered a violation of the 
        antitrust laws for entities to develop and operate cooperatives 
        in accordance with this section.
            ``(2) Definition.--For purposes of this subsection, the 
        term `antitrust laws' means--
                    ``(A) the Act entitled `An Act to protect trade and 
                commerce against unlawful restraints and monopolies', 
                approved July 2, 1890, commonly known as the `Sherman 
                Act' (26 Stat. 209; chapter 647; 15 U.S.C. 1 et seq.);
                    ``(B) the Federal Trade Commission Act, approved 
                September 26, 1914 (38 Stat. 717; chapter 311; 15 
                U.S.C. 41 et seq.);
                    ``(C) the Act entitled `An Act to supplement 
                existing laws against unlawful restraints and 
                monopolies, and for other purposes', approved October 
                15, 1914, commonly known as the `Clayton Act' (38 Stat. 
                730; chapter 323; 15 U.S.C. 12 et seq.; 18 U.S.C. 402, 
                660, 3285, 3691; 29 U.S.C. 52, 53);
                    ``(D) the Act of June 19, 1936, commonly known as 
                the Robinson-Patman Antidiscrimination Act (15 U.S.C. 
                13 et seq.); and
                    ``(E) any State antitrust laws that would prohibit 
                the activities described in paragraph (1).''.

SEC. 4. RURAL MENTAL HEALTH OUTREACH GRANTS.

    Subpart 3 of part B of title V of the Public Health Service Act (42 
U.S.C. 290cc-11 et seq.) is amended by adding at the end thereof the 
following new section:

``SEC. 520C. RURAL MENTAL HEALTH OUTREACH GRANTS.

    ``(a) In General.--The Secretary may award competitive grants to 
eligible entities to enable such entities to develop and implement a 
plan for mental health outreach programs in rural areas.
    ``(b) Eligible Entities.--To be eligible to receive a grant under 
subsection (a) an entity shall--
            ``(1) prepare and submit to the Secretary an application at 
        such time, in such form and containing such information as the 
        Secretary may require, including a description of the 
        activities that the entity intends to undertake using grant 
        funds; and
            ``(2) meet such other requirements as the Secretary 
        determines appropriate.
    ``(c) Priority.--In awarding grants under subsection (a), the 
Secretary shall give priority to applications that place emphasis on 
mental health services for the elderly or children. Priority shall also 
be given to applications that involve relationships between the 
applicant and rural managed care cooperatives.
    ``(d) Matching Requirement.--An entity that receives a grant under 
subsection (a) shall make available (directly or through donations from 
public or private entities), non-Federal contributions toward the costs 
of the operations of the network in an amount equal to the amount of 
the grant.
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, $5,000,000 for each of the 
fiscal years 1994 through 1997.''.

SEC. 5. AREA HEALTH EDUCATION CENTERS.

    (a) Section 746(a) of the Public Health Service Act (42 U.S.C. 
293j(a)) is amended by adding at the end thereof the following new 
paragraph:
            ``(4) Stipends.--
                    ``(A) The Secretary make award grants under this 
                section to rural communities to enable such communities 
                to provide stipends to physicians, nurses, nurse 
                practitioners, physician assistants, and other health 
                professional trainees to encourage such individuals to 
                provide health care services in such rural communities. 
                In addition, the Secretary may award grants under this 
                section to rural communities to enable such communities 
                to provide stipends to physicians, nurses, nurse 
                practitioners, physician assistants, and other health 
                professionals that are practicing in rural areas to 
                retain such individuals in such areas.
                    ``(B) A community that receives a grant under 
                subparagraph (A) shall make available (directly or 
                through donations from public or private entities), 
                non-Federal contributions toward the costs of the 
                operations of the network in an amount equal to the 
                amount of the grant.''.
    (b) Reauthorization.--Section 746(i)(1)(A) of such Act (42 U.S.C. 
293j(i)(1)(A)) is amended by striking out ``$25,000,000'' and all that 
follows through ``1995'' and inserting in lieu thereof ``$25,000,000 
for fiscal year 1993, and $42,000,000 for each of the fiscal years 1994 
through 1997''.

Answer:
Rural Health Innovation Demonstration Act of 1993 - Amends the Public Health Service Act to authorize competitive grants for the development of networks among rural and urban health care providers to preserve and share health care resources and enhance the quality and availability of health care in rural areas.  Allows the networks to be statewide or regional.  Specifies the services for which grant amounts must be used.  Authorizes appropriations. 
Authorizes competitive grants to develop and administer cooperatives in rural areas that will establish an effective case management and reimbursement system designed to support the economic viability of essential public or private health services, facilities, health care systems, and health care resources.  Involves the cooperative in matters such as third party reimbursement, employee health insurance, malpractice insurance, and managed care and practice standards.  Authorizes appropriations. 
Authorizes competitive grants to develop and implement a plan for mental health outreach programs in rural areas.  Authorizes appropriations. 
Authorizes grants to enable rural communities to provide stipends to physicians, nurses, physician assistants, and other health professional trainees to:  (1) encourage such individuals to provide health care services in such communities; and (2) encourage such individuals who are already practicing in such communities to stay in such areas. 
Authorizes appropriations to carry out provisions relating to area health education centers.