An Act to amend the Public Health Service Act to revise and extend the programs of assistance under title VII for training in the health and allied health professions, to revise the National Health Service Corps program and the National Health Service Corps scholarship training program, and for other purposes.
PL 94-484 (H.R.5546), enacted 10/12/1976

PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2243 
Public Uw 94-484 
94th Cpngress 
An Act 
To amend the Public Health Service Act to revise and extend the programs of 
assistance under title VII for training in the health and allied health profes-
sions, to revise the National Health Service Corps program and the National 
Health Service Corps scholarship training program, and for other purposes. 
Be it enacted hy the Senate and House of Representatives of the 
United States of America in Congress assembled^ 
SHORT T I T L E : REFERENCE TO ACT 
SECTION 1. (a) This Act may be cited as the "Health Professions 
Educational Assistance Act of 1976". 
(b) Except as otherwise specifically provided, whenever in this Act 
an amendment or repeal is expressed in terms of an amendment to, or 
repeal of, a section or other provision, the reference shall be considered 
to be made to a section or other provision of the Public Health Service 
Act. 
FINDINGS AND DECLARATION OF POLICY 
SEC. 2. (a) The Congress finds and declares that— 
(1) the availability of high quality health care to all Americans 
is a national goal; 
(2) the availability of high quality health care is, to a substan-
tial extent, dependent upon— 
(A) the availability of qualified health professions per-
sonnel; and 
(B) the availability of adequate numbers of physicians 
engaged in the delivery of primary care, including family 
practice, general internal medicine, and general pediatrics, 
and in the various specialties, but numbers which do not 
exceed the need for physicians in such specialties; 
(3) there are many areas in the United States which are unable 
to attract adequate numbers of health professions personnel to 
meet their health care needs; and 
(4) physician specialization has resulted in inadequate num-
bers of physicians engaged in the delivery of primary care, 
(b) The Congress further finds and declares that— 
(1) health professions personnel are a national health resource 
and the Federal Government shares the responsibility of assuring 
that such qualified personnel are available to meet the health care 
needs of the American people; 
(2) it is therefore appropriate to provide support for the edu-
cation and training of such personnel; and 
(3) at the same time it is appropriate to provide such support 
in a manner which will assure the availability of health profes-
sions personnel to all of the American people. 
(c) The Congress further finds and declares that there is no longer 
an insufficient number of physicians and surgeons in the United States 
such that there is no further need for affording preference to alien 
physicians and surgeons in admission to the United States under the 
Immigration and Nationality Act. 
Oct. 12. 1976 
[H.R. 5546] 
Health 
Professions 
Educational 
Assistance Act of 
1976. 
42 u s e 201 note. 
42 u s e 292 note. 
8 u s e 1101 note. 
90 STAT. 2244 
PUBLIC LAW 94-484—OCT. 12, 1976 
T I T L E I — E X T E N S I O N O F C U R R E N T A U T H O R I T I E S 
T H R O U G H F I S C A L Y E A R 1977 
EXTENSION 
42 use 244-1. 
SEC. 101. (a) (1) Section 312(a) (relating to traineeships for pro-
fessional public health personnel) is amended (A) by striking out 
"and" after "1973,", and (B) by striking out "for the fiscal year end-
ing June 30, 1974" and inserting in lieu thereof "each for the fiscal 
years ending June 30, 1974, June 30, 1975, and June 30, 1976, and 
$9,900,000 for the fiscal year ending September 30,1977". 
42 use 245a. 
(2) Section 313(a) (relating to project grants for graduate train-
ing in public health) is amended (A) by striking out "and" after 
"1973,", and (B) by striking out "for the fiscal year ending June 30, 
1974" and inserting in lieu thereof "each for the fiscal years ending 
June 30, 1974, June 30, 1975, and June 30,1976, and $6,000,000 for the 
fiscal year ending September 1977". 
(3) Section 313(c) is amended (A) by striking out "and" after 
"1973,", and (B) by striking out "for the fiscal year ending June 30, 
1974" and inserting in lieu thereof "each for the fiscal years ending 
June 30, 1974, June 30,1975, and June 30,1976, and $6,400,000 for the 
fiscal year ending September 30,1977". 
42 use 254b. 
(b) Section 329 (h) (relating to the National Health Service Corps) 
is amended (1) by striking out "and" after "1975;", and (2) by strik-
ing out "1976" and inserting in lieu thereof "1976; and $34,000,000 for 
the fiscal year ending September 30,1977". 
42 use 293. 
(c) Section 720 (relating to grants for construction of teaching 
facilities) is amended (1) by striking out "and" after "1973," and (2) 
by striking out "for the fiscal year ending June 30,1974" and inserting 
in lieu thereof "each for the fiscal years ending June 30, 1974, 
June 30, 1975, and June 30, 1976, and $103,000,000 for the fiscal year 
ending September 30, 1977". 
42 use 293i. 
((J) Section 729 (relating to loan guarantees and interest subsidies) 
is amended— 
(1) by striking "June 30,1974" in subsections (a) and (b) and 
inserting in lieu thereof "September 30,1977"; and 
(2) by inserting after "1974" in subsection (e) the following: 
", or in any of the next three fiscal years". 
42 use 294b, 
(e) Section 742 (relating to health professions student loans) is 
294o. 
amended (1) by striking out "and" after "1975," the first time it occurs, 
and (2) by inserting after "1976" the following: ", and $39,100,000 for 
the fiscal year ending September 30,1977". 
42 use 294g. 
(f) Section 747(d) (relating to loans for students in foreign medi-
cal schools) is amended by striking out "two" and inserting in lieu 
thereof "four". 
42 use 295e-l. 
(g) The section 767 entitled "GRANTS FOR TRAINING, TRAINEESHIPS, 
AND FELLOWSHIPS IN FAMILY MEDICINE" is amended (1) by striking out 
"and" after "1973,", and (2) by striking out "for the fiscal year ending 
June 30, 1974" and inserting in lieu thereof "each for the fiscal years 
ending June 30,1974, June 30,1975, and June 30,1976, and $39,000,000 
for the fiscal year ending September 30,1977". 
42 use 295e-2. 
(h) The section 768 entitled "GRANTS FOR SUPPORT OF POST-GRADUATE 
TRAINING PROGRAMS FOR PHYSICIANS AND DENTisTs" is amended— 
(1) by striking out "for the fiscal year ending June 30, 1974" 
in subsection (a) and inserting in lieu thereof "each for the fiscal 
years ending June 30,1974, June 30,1975, and June 30,1976"; and 
(2) by inserting "or in the next two fiscal years" after "1974," 
in subsection (b) (3) ( B ) . 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2245 
(i) Section 769(a) (relating to grants for training for health pro- ^^ USC 295e-3. 
fessions teaching personnel) is amended by striking out "for the fiscal 
year ending June 30,1974" and inserting in lieu thereof "each for the 
fiscal years ending June 30,1974, June 30,1975, and June 30,1976". 
(j) Section 769A (relating to grants for computer technology) is 42 USC 295e-4. 
amended by striking out "for the fiscal year ending June 30, 1974" 
and inserting in lieu thereof "each for the fiscal years ending June 30, 
1974, June 30,1975, June 30,1976, and September 30,1977". 
(k)(l) Paragraph (1) of section 770(j) (relating to capitation 42 USC 295f. 
grants) is amended (A) by striking out "and" after "1973", and (B) 
by striking out "for the fiscal year ending June 30,1974" and inserting 
in lieu thereof "each for the fiscal years ending June 30,1974, June 30, 
1975, and June 30, 1976, and $133,700,000 for the fiscal year ending 
September 30,1977". 
(2) Paragraph (2) of such section is amended (A) by striking 
out "and" after "1973,", and (B) by striking out "for the fiscal year 
ending June 30,1974" and inserting in lieu thereof "each for the 
fiscal 
* 
years ending June 30, 1974, June 30, 1975, and June 30, 1976, and 
$29,300,000 for the fiscal year ending September 30,1977". 
(1) Section 771 (relating to start-up assistance) is amended (1) by 42 USC 295f-l. 
striking out "two fiscal years" in subsection (a) (6) and inserting in 
lieu thereof "four fiscal years, and not to exceed $5,100,000 for the fiscal 
year ending September 30,1977", (2) by striking out "July 1,1974" in 
subsection (b) (2) and inserting in lieu thereof "October 1,1977", and 
(3) by striking out "June 30,1975" in such subsection and inserting in 
lieu thereof "September 30,1978". 
(m) Section 772(d) (relating to special project grants and con- 42 USC 295f-2. 
tracts) is amended (1) by striking out "and" after "1973,", and (2) by 
striking out "for the fiscal year ending June 30, 1974" and inserting 
i 
in lieu thereof "each for the fiscal years ending June 30,1974, June 30, 
1975, and June 30, 1976, and $40,852,000 for the fiscal year ending 
September 30,1977". 
(n) Section 773 (a) (relating to financial distress grants) is amended 42 USC 295f-3. 
(1) by striking out "and" after "1973,", and (2) by striking out "for 
the fiscal year ending June 30, 1974" the first time it appears and 
inserting in lieu thereof "each for the fiscal years ending June 30,1974, 
June 30,1975, and June 30,1976, and $5,400,000 for the fiscal year end-
ing September 30,1977". 
(o) Section 774(e) (relating to education initiative awards) is 42 USC 295f-^l. 
amended (1) by striking out "and" after "1973,", and (2) by striking 
out "for the fiscal year ending June 30, 1974" and inserting in lieu 
thereof "each for the fiscal years ending June 30,1974, June 30, 1975, 
and June 30, 1976, and $41,170,000 for the fiscal year ending Septem-
ber 30, 1977". 
(p) Section 780 (relating to scholarship grants) is amended (1) by 42 USC 295g. 
striking out "the next fiscal year" in subsection (b) and inserting in 
lieu thereof "the next three fiscal years", (2) by striking out "1974" in 
such subsection and subsection (c) (1) (B) and inserting in lieu thereof 
"1976", (3) by striking out in subsections (b) and (c) (1) (B) "June 30, 
1975" and inserting in lieu thereof "September 30, 1977" and (4) 
by striking out "two" in subsection (c) (1) (A) and inserting in lieu 
thereof "four". 
(q) The section 785 entitled "SCHOLARSHIP GRANTS FOR STUDY ABROAD" 
42 U
S
C 
is amended (1) by striking "two" in subsection (e)(1) and inserting in 
295g-ll. 
lieu thereof "four", (2) by striking out "June 30, 1975" in subsection 
(e) (2) and inserting in lieu thereof "September 30,1977", and (3) by 
striking out in such subsection "1974" and inserting in lieu thereof 
, 
"1976". 
90 STAT. 2246 
PUBLIC LAW 94-484—OCT. 12, 1976 
42 use 
^ (r) Section 786 (relating to physician shortage area scholarships) 
295g-23. 
ig amended (1) by striking out "June 30, 1975" in the second sentence 
and inserting in lieu thereof "September 30,1977", and (2) by striking 
out "1974" in that sentence and inserting in lieu thereof "1976". 
42 use 295h-l. 
(s) (1) Section 792(b) (relating to special improvement grants) is 
amended (A) by striking out "and" after "1973,", and (B) by striking 
out "for the fiscal year ending June 30, 1974" and inserting in lieu 
thereof "each for the fiscal yeare ending June 30, 1974, June 30, 
1975, and June 30, 1976, and $11,400,000 for the fiscal year ending 
September 30,1977". 
(2) Section 792(c)(1) (relating to special projects) is amended 
(A) by striking out "and" after "1973,", and (B) by striking out "for 
the fiscal year ending June 30, 1974" and inserting in lieu thereof 
"each for the fiscal years ending June 30, 1974, June 30, 1975, and 
June 30,1976, and $15,400,000 for the fiscal year ending September 30, 
1977". 
42USC295h-2. 
(3) Section 793(a) (relating to traineeships for advanced training) 
is arnended (A) by striking out "and" after "1973;", and (B) by 
striking out "for the fiscal year ending June 30, 1974" and inserting 
in lieu thereof "each for the fiscal years ending June 30,1974, June 30, 
1975, and June 30, 1976, and $3,900,000 for the fiscal year ending Sep-
tember 30, 1977". 
^ 42 use 
(4) Section 794A(b) (relating to assistance for recruitment) is 
295h-3a. 
amended (A) by striking out "and" after "1973;", and (B) by striking 
out "for the fiscal year ending June 30, 1974" and inserting in lieu 
thereof "each for the fiscal years ending June 30, 1974, June 30, 
1975, and June 30, 1976, and $109,000 for the fiscal year ending Sep-
tember 30, 1977". 
42 use 234. 
(t) Section 225 (i) (relating to Public Health and National Health 
Service Corps scholarships) is amended (1) by striking out "and" 
after "1974,", and (2) by striking out "for the fiscal year ending June 
30, 1975" and inserting in lieu thereof "each for the fiscal years end-
ing June 30,1975, and June 30,1976, and $40,000,000 for the fiscal year 
ending September 30,1977". 
TITLE II—GENERAL PROVISIONS 
NEW GENERAL PROVISIONS 
Repeal. 
SEC. 201. (a) Sections 701 through 711 are repealed. 
42 use 
(b) The following section is inserted in part A of title YII: 
292-292J. 
u 
LIMITATION ON USE OF APPROPRIATIONS 
42 use 292. 
"SEC. 700. (a) Notwithstanding any other provisions of law, with 
respect to any fiscal year beginning after September 30,1977, no funds 
appropriated for such fiscal year may be made available for obligation 
or expenditure for the purpose of carrying out any provision of this 
title if the sum of the amounts appropriated for such fiscal year for 
Post, p. 2281. 
scholarships under subj^art IV of part C (relating to National Health 
Service Corps scholarships) and for the purpose of making grants 
Post, p. 2289. 
under section 758 (relating to scholarships for first-year students of 
exceptional financial need) is less than the lesser of— 
"(1) the sum of the amounts authorized to be appropriated for 
such fiscal year under such subpart and section, or 
"(2) 50 percent of the sum of the amounts appropriated for 
such fiscal year under this title. 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2247 
"(b) Subsection (a) shall not apply with respect to a fiscal year 
if less than 75 percent of the sum of the amounts authorized to be 
appropriated for such fiscal year under paragraphs (1), (2), and (3) 
of section 770(e) (relating to capitation grants for medical, osteo-
pathic, and dental schools) is appropriated for such fiscal year under 
such paragraphs.". 
(c) Sections 724, 725, 799, and 799A are transferred to part A, 
inserted after section 700 (added by subsection (b)), and redesignated 
as sections 701, 702, 703, and 704, respectively. 
(d) (1) The heading for part A of title VII is amended to read as 
follows: 
"PART A—GENERAL PROVISIONS". 
(2) The heading for part H of title VII is repealed. 
(e) Section 701 (as so redesignated) is amended— 
(1) by striking out "As used in this part and parts C, E, and 
F—" and inserting in lieu thereof "For purposes of this title:"; 
(2) by inserting "or an equivalent degree" after "degree in 
public health" in paragraph (4); and 
(3) by adding at the end the following new paragraphs: 
"(7) (A) The term 'program for the training of physician 
assistants' means an educational program which (i) has as its 
objective the education of individuals who will, upon completion 
of their studies in the program, be qualified to effectively provide 
health care under the supervision of a physician and (ii) meets 
regulations prescribed by the Secretary in accordance with sub-
paragraph (B). 
"(B) After consultation with appropriate professional orga-
nizations, the Secretary shall (within 180 days after the date of 
enactment of this paragraph) prescribe regulations for programs 
for the training of physician assistants. Such regulations shall, 
as a minimum, require that such a program— 
"(i) extend for at least one academic year and consist of 
(I) supervised clinical practice, and (II) at least four months 
(in the aggregate) of classroom instruction, directed toward 
preparing students to deliver health care; and 
"(ii) have an enrollment of not less than eight students. 
"(8) (A) The term 'program for the training of expanded 
function dental auxiliaries' means an educational program which 
(i) has as its objective the education of individuals who will, upon 
completion of their studies in the program, be qualified to assist 
in the provision of dental care under the supervision of a dentist 
and (ii) meets regulations prescribed by the Secretary in accord-
ance with subparagraph (B). 
"(B) After consultation with appropriate professional orga-
nizations, the Secretary shall (within 180 days after the date of 
enactment of this paragraph) prescribe regulations for programs 
for the training of expanded function dental auxiliaries. Such 
regulations shall, as a minimum, require that such a program— 
"(i) extend for at least one academic year and consist of 
"(I) supervised clinical practice, and 
"(II) at least four months (in the aggregate) of class-
room instruction, 
directed toward preparing students to deliver dental care; 
and 
"(ii) have an enrollment of not less than eight students. 
" (9) The term 'State' includes, in addition to the several States. 
only the District of Columbia, the Commonwealth of Puerto Rico. 
42 u s e 293d, 
293e, 295h-8, 
295h-9. 
42 use 
292a-292d. 
Repeal. 
42 u s e 292a. 
Definitions. 
Consultation; 
regulations. 
Consultation; 
regulations. 
90 STAT. 2248 
PUBLIC LAW 94-484—OCT. 12, 1976 
the Northern Mariana Islands, the Virgin Islands, Guam, Ameri-
can Samoa, and the Trust Territory of the Pacific Islands. 
" (10) The term 'Department' means the Department of Health, 
Education, and Welfare.". 
ADVISORY COUNCIL 
SEC. 202. (a) (1) The second sentence of subsection (a) of section 
42 use 292b. 
702 (as so redesignated) is amended to read as follows: "Of the 
appointed members of the Council (1) twelve shall be representatives 
of the health professions schools assisted under programs authorized 
by this title, including at least six persons experienced in university 
administration and at least four representatives of schools of veteri-
nary medicine, optometry, pharmacy, podiatry, and public health, 
Post, p. 2303. 
and entities which may receive a grant under section 791, (2) two 
shall be full-time students enrolled in health professions schools, and 
(3) six shall be members of the general public". 
(2) Section 702 (as so redesignated) is amended by adding at the 
end thereof the following new subsection: 
5 use app. I. 
"(d) Section 14 of the Federal Advisory Committee Act shall not 
apply with respect to the Council.". 
42 use 292b 
(3) The amendment made by paragraph (1) with respect to the 
"
*
*
*
*
• 
composition of the National Advisory Council on Health Professions 
Education shall apply with respect to appointments made to the Coun-
cil after October 1,1976, and the Secretary of Health, Education, and 
Welfare shall make appointments to the Council after such date in a 
manner which will bring about, at the earliest feasible time, the Council 
composition prescribed by the amendment. 
42 use 292b. 
(b) (1) Section 702 (as so redesignated) is amended by striking out 
"E, and F" in subsection (a) and inserting in lieu thereof "E, F, 
and G". 
(2) Section 702 (as so redesignated) is amended by striking out 
"parts A .and G" in subsections (b) and (c) and inserting in lieu 
thereof "subpart II of part G". 
ADVANCE FUNDING AUTHORITY 
42 use 292c. 
SEC. 203. Section 703 (as so redesignated) is amended to read as 
follows: 
" A D V A N C E 
FUNDING 
"SEC. 703. (a) An appropriation under an authorization of appro-
priations for grants or contracts under this title for any fiscal year 
may be made at any time before that fiscal year and may be included 
in an Act making an appropriation under such authorization for 
another fiscal year; but no funds may be made available from any 
appropriation under such authorization for obligation for such grants 
or contracts before the fiscal year for which such appropriation is 
authorized. 
"(b) Subsection (a) shall not apply with respect to grants under 
Post, p. 2290. 
section 770 (relating to capitation).". 
RECORDS AND AUDITS, CONTRACTS 
SEC. 204. Part A of title VII is amended by adding after section 704 
(as so redesignated) the following new sections: 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2249 
a 
RECORDS AND AUDITS 
42 use 292e. 
"SEC. 705. (a) Each entity which receives a grant, loan, loan guaran-
tee, or interest subsidy or which enters into a contract with the Secre-
tary under this title, shall establish and maintain such records as the 
Secretary shall by regulation or order require. Such records shall 
include, among other things, records which completely disclose the 
amount and disposition of the total amount of funds received by such 
entity, the total cost of any project or undertaking for which funds 
were received, and the total amount of that portion of the total cost 
of any project or undertaking received by or allocated to such entity 
from other sources, and such other records as will facilitate an audit 
conducted in accordance with generally accepted auditing standards. 
" (b) Each entity which received a grant or entered into a contract 
under this title shall have an annual financial audit of any books, 
accounts, financial records, files, and other papers and property which 
relate to the disposition or use of any funds received under such grant 
or contract and such other funds received by or allocated to any project 
or undertaking for which any funds received under this Act were used, 
and any other funds received under this Act. Each such entity shall be 
responsible for providing and paying for such audit. For purposes of 
assuring accurate, current, and complete disclosure of the disposition 
or use of the funds received, each such audit shall be conducted by and 
certified to be accurate by an independent certified public accountant 
utilizing generally accepted auditing standards. A report of each 
such audit shall be filed with the Secretary at such time and in such 
manner as he may require. 
" (c) The Secretary may specify, by regulation, the form and man- Regulation, 
ner in which such records, required by subsection (a), shall be estab-
lished and maintained. 
"(d) A student recipient of a scholarship, traineeship, loan, or 
loan guarantee under this title shall not be required to establish or 
maintain the records required under subsection (a) or provide for an 
audit required under subsection (b). 
"(e)(1) Each entity which is required to establish and maintain rec-
ords or to provide for an audit under this section shall make such 
books, documents, papers, and records available to the Secretary or the 
Comptroller General of the United States, or any of their duly 
authorized representatives, for examination, copying, or mechanical 
reproduction on or off the premises of such entity upon a reasonable 
request therefor. 
"(2) The Secretary and the Comptroller General of the United 
States, or any of their duly authorized representatives, shall have the 
authority to carry out the purposes of this subsection. 
CONTRACTS 
"SEC. 706. Contracts authorized by this title may be entered into 42 USC 292f. 
without regard to sections 3648 and 3709 of the Revised Statutes (31 
U.S.C. 529,41 U.S.C. 5).". 
DELEGATION OF AUTHORITY 
SEC. 205. Part A of title VII is amended by adding after section 706 
(added by section 204) the following new section: 
90 STAT. 2250 
PUBLIC LAW 94-484—OCT. 12, 1976 
u 
DEI^GATION" 
42 use 292g. 
"SEC. 707. The Secretary may delegate the authority to admin-
ister any program authorized by this title to the administrator of a 
central or regional office or offices of the Department, except that the 
authority— 
"(1) to review, and prepare comments on the merit of, any 
application for a grant or contract under any such program for 
purposes of presenting such application to the National Advisory 
Council on Health Professions Education, and 
" (2) to make such a grant or enter into such a contract, 
shall not be delegated to any administrator of, or officer in, a regional 
office or offices of the Department.". 
HEALTH PROFESSIONS DATA 
SEC. 206. Part A of title VII is amended by adding after section 707 
(added by section 205) the following new section: 
ii 
42 use 292h. 
Studies. 
Grants and 
contracts. 
Application. 
HEALTH PROFESSIONS DATA 
"SEC. 708. (a) The Secretary shall establish a program, including a 
uniform health professions data reporting system, to collect, 
compile, and analyze data on health professions personnel which shall 
initially include data respecting all physicians and dentists in the 
United States and its territories and possessions. The Secretary is 
authorized to expand the program to include, whenever he determines 
it necessary, the collection, compilation, and analysis of data respect-
ing pharmacists, optometrists, podiatrists, veterinarians, public health, 
personnel, audiologists, speech pathologists, health care administra-
tion personnel, nurses, allied health personnel, medical technologists, 
and any other health personnel in States designated by the Secretary 
to be included in the program. Such data shall include data respecting 
the training, licensure status (including permanent, temporary, par-
tial, limited, or institutional), place or places of practice, professional 
specialty, practice characteristics, place and date of birth, sex, and 
socio-economic background of health professions personnel and such 
other demographic information regarding health professions per-
sonnel as the Secretary may require. 
"(b) (1) In carrying out subsection (a), the Secretary shall collect 
available information from appropriate local. State, and Federal 
agencies and other appropriate sources. 
"(2) The Secretary shall conduct or enter into contracts for the 
conduct of analytic and descriptive studies of the health professions, 
including evaluations and projections of the supply of, and require-
ments for, the health professions by specialty and geographic location. 
"(3) The Secretary is authorized to make grants and to enter into 
contracts with States (or an appropriate nonprofit private entity in 
any State) for the purpose of participating in the program estab-
lished under subsection (a). The Secretary shall determine the amount 
and scope of any such grant or contract. To be eligible for a grant 
or contract under this paragraph a State or entity shall submit an 
application in such form and manner and containing such information 
as the Secretary shall require. Such application shall include reason-
able assurances, satisfactory to the Secretary, that— 
"(A) such State (or nonprofit entity within a State) will estab-
lish a j)rogram of mandatory annual registration of the health 
professions personnel described in subsection (a) who reside or 
PUBLIC LAW 94-4«4~0CT. 12, 1976 
90 STAT. 2251 
practice in such State and of health institutions licensed by such 
State, which registration shall include such information as the 
Secretary shall determine to be appropriate; 
"(B) such State or entity shall collect such information and 
report it to the Secretary in such form and manner as the Secre-
tary shall prescribe; and 
"(C) such State or entity shall comply with the requirements of 
subsection (e). 
"(c) For purposes of providing the Secretary with information 
under this section, each school which receives financial support under 
section 770 shall annually report to the Secretary information, deter-
mined to be appropriate by the Secretary, respecting the students 
who attend such scnool. The Secretary may collect such additional 
data respecting students of the health professions as he determines to 
be appropriate. 
"(d) The Secretary shall assemble and submit to the President 
and Congress not later than September 1 of each year a report on 
the status of health professions personnel in the United States, which 
report shall include a description and analysis of the data collected 
pursuant to this section. Such report may be included as part of the 
report made under section 308 (a)(2)(C). 
"(e) (1) The Secretary and each program entity shall in securing 
and maintaining any record of individually identifiable personal data 
(hereinafter in this subsection referred to as 'personal data') for pur-
poses of this section— 
"(A) inform any individual who is asked to supply personal 
data whether he is legally required, or may refuse, to sujjply 
such data and inform him of any specific consequences, known 
to the Secretary or program entity, as the case may be, of pro-
viding or not providing such data; 
"(B) upon request, inform any individual if he is the sub-
ject of personal data secured or maintained by the Secretary or 
program entity, as the case may be, and make the data available 
to him in a form comprehensible to him; 
"(C) assure that no use is made of personal data which is not 
within the purposes of this section unless an informed consent 
has been obtained from the individual who is the subject of such 
data; and 
"(D) upon request, inform any individual of the use being 
made of personal data respecting such individual and of the 
identity of the individuals and entities which will use the data 
and their relationship to the programs under this section. 
"(2) Any entity which maintains a record of personal data and 
which receives a request from the Secretary or a program entity for 
such data for purposes of this section shall not transfer any such data 
to the Secretary or to a program entity unless the individual whose 
personal data is to be so transferred gives an informed consent for 
such transfer. 
"(3) (A) Notwithstanding any other provision of law, personal 
data collected by the Secretary or any program entity under this 
section may not be made available or disclosed by the Secretary or 
any program entity to any person other than the individual who is the 
subject of such data unless (i) such person requires such data for 
purposes of this section, or (ii) in response to a demand for such data 
made by means of compulsory legal process. Any individual who is 
the subject of personal data made available or disclosed under clause 
(ii) shall be notified of the demand for such data. 
Report to 
Secretary of 
HEW. 
42 use 295f. 
Report to 
President and 
Congress. 
90 STAT. 2252 
PUBLIC LAW 94-484—OCT. 12, 1976 
"Program 
entity." 
44 use 3501. 
Technical 
assistance. 
"(B) Subject to all applicable laws regarding confidentiality, only 
the data collected by the Secretary under this section which is not 
personal data shall be made available to bona fide researchers and 
policy analysts (including the Congress) for the purposes of assisting 
in the conduct of studies respecting health professions personnel. 
"(4) For purposes of this subsection, the term 'program entity' 
means any public or private entity which collects, compiles, or analyzes 
health professions data under a grant, contract, or other arrangement 
with the Secretary under this section. 
"(f) In carrymg out his responsibilities under this section, the 
Secretary shall not be subject to the provisions of chapter 35 of title 44, 
United States Code. 
"(g) The Secretary shall provide technical assistance to the States 
and political subdivisions thereof in the development of systems 
(including model laws) concerning confidentiality and comparability 
of data collected pursuant to this section.". 
SHARED SCHEDULE RESIDENCIES 
42 use 292i. 
Report to 
Congress. 
"Shared 
scheduled 
position." 
SEC. 207. Part A of title VII is amended by adding after section 708 
(added by section 206) the following new section: 
(( 
SHARED SCHEDULE RESIDENCY TRAINING POSITIONS 
"SEC. 709. (a) Any entity which— 
"(1) maintains a medical residency training program in family 
practice, general internal medicine, general pediatrics, or general 
obstetrics and gynecology, and 
" (2) receives any Federal assistance, 
shall establish or restructure and maintain, to the maximum extent 
feasible, a reasonable number of physician training positions in such 
program as shared schedule positions. 
"(b) The Secretary shall report to Congress not later than Janu-
ary 1, 1979, on entities' compliance with subsection (a) and shall in-
clude in such report recommendations for legislation to ensure 
compliance with such subsection. 
"(c) For purposes of subsection (a), the term 'shared schedule 
position' means a physician training position in a medical residency 
training program which is shared by two individuals and in which each 
individual— 
"(1) engages in at least two-thirds but not more than three-
fourths of the total training prescribed for such position, 
"(2) receives for each year in such position an amount of 
credit for certification in the medical specialty for which the 
position provides training which is equal to the amount of train-
ing engaged in in such year, 
"(3) receives at least one-half of the salary for such position, 
and 
" (4) receives all applicable employee benefits.". 
PAYMENT UNDER GRANTS 
SEC. 208. Part A of title VII is amended by adding after section 
709 (added by section 207) the following new section; 
'PAYMENT UNDER GRANTS 
42 use 292j. 
"SEC, 710. Grants made under this title may be paid (1) except for 
Post, p. 2290. 
grants under section 770, in advance or by way of reimbursement, 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2253 
(2) at such intervals and on such conditions as the Secretary may find 
necessary, and (3) with appropriate adjustments on account of over-
payments or underpayments previously made.". 
PAYMENT FOR TUITION AND OTHER EDUCATIONAL EXPENSES 
SEC. 209. Part A of title VII is amended by adding after section 
710 (added by section 208) the following new section: 
a 
PAYMENT FOR TUITION AND OTHER EDUCATIONAL COSTS 
"SEC. 711. The Secretary shall by regulation establish criteria for Regulation, 
determining allowable increases in tuition and other educational costs 42 USC 292k. 
for which he shall be responsible for payment under any provision of 
this title after the date of enactment of the Health Professions Edu-
cational Assistance Act of 1976.". 
Ante, p. 2243. 
TITLE III—ASSISTANCE FOR CONSTRUCTION OF 
TEACHING FACILITIES 
REGIONAL HEALTH PROFESSIONS PROGRAMS 
SEC. 301. Section 721 is amended by adding after subsection (e) 
42 USC 293a. 
the following new subsection: 
i 
"(f)(1) An application for a grant under subsection (a) for the Application, 
fiscal year ending September 30, 1977, for an affiliated clinical facility 
for the establishment or expansion of a regional health professions 
program may be filed by any public or other nonprofit agency if the 
application is approved by the school of veterinary medicine, optome-
try, podiatry, or pharmacy with which the facility is affiliated. Only 
that portion of the project to construct such a facility which the 
Secretary determines to be reasonably attributable to the need of 
the regional health professions program for the facility for teaching 
purposes shall be regarded as the project with respect to which pay-
ments may be made under section 722. 
Post, p. 2255. 
" (2) In considering applications for grants under subsection (a) for 
the fiscal year ending September 30, 1977, the Secretary shall give 
special consideration to applications for facilities for the establish-
ment or expansion of regional health professions programs. 
"(3) For the purposes of this subsection, the term 'regional health "Regional health 
professions program' refers to an interstate program (A) in which a professions 
State with an existing degree-granting school of veterinary medicine, program, 
optometry, podiatry, or pharmacy sets up a cooperative program with 
another State (or other States) which does not have such a school, 
and (B) which provides for (i) a shared curriculum between two or 
more schools, or (ii) a single campus which is cooperatively financed 
and controlled by two or more States,". 
GRANT A U T H O R I T Y ; 
AUTHORIZATIONS 
SEC. 302. Section 720 is amended to read as follows: 
42 USC 293. 
ii GRANT A U T H O R I T Y ; AUTHORIZATIONS OF APPROPRIATIONS 
"SEC. 720. (a) (1) The Secretary may make grants to assist in the 
construction of teaching facilities for the training of physicians, den-
tists, pharmacists, optometrists, podiatrists, veterinarians, and pro-
fessional public health personnel. 
89-194 O—78—pt. 2 
50 
90 STAT. 2254 
PUBLIC LAW 94-484—OCT. 12, 1976 
"Ambulatory, 
primary care 
teaching 
facilities." 
Appropriation 
authorization. 
42 u s e 293a. 
Supra. 
"(2) (A) The Secretary may make grants to public and nonprofit 
private entities to assist in the construction of ambulatory, primary 
care teaching facilities for the training of physicians and dentists. 
"(B) For purposes of this section, the term 'ambulatory, primary 
care teaching facilities' means areas dedicated for the training of 
students in the diagnosis and treatment of ambulatory patients and 
primarily in the specialties of family practice, general pediatrics, 
general internal medicine, general dentistry, and pedodontics. Such 
areas may include examination rooms, clinical laboratories, libraries, 
classrooms, offices, and other areas for clinical or research purposes 
necessary for, and appropriate to, the conduct of comprehensive 
ambulatory, primary care training of physicians and dentists in such 
specialties. 
"(b) For payments under grants under this part there is authorized 
to be appropriated $40,000,000 for the fiscal year ending September 30, 
1978, |iO,000,000 for the fiscal year ending September 30, 1979, and 
$40,000,000 for the fiscal year ending September 30, 1980. Of the 
sums appropriated under this subsection for any fiscal year 50 percent 
of such sums shall be obligated for grants under subsection (a) (1) 
and 50 percent of such sums shall be obligated for grants under sub-
section (a)(2).". 
APPLICATIONS 
SEC. 303. (a) (1) Section 721(b) (1) is amended by inserting "under 
section 720 (a) (1)" after "for a grant". 
(2) Section 721(b) (2) is amended by inserting "for a grant under 
section 720(a) (1)" after "an application" the first time it appears. 
(3) Sections 721(b) (3) and 721(c) are each amended by striking 
out "grant under this part" and inserting in lieu thereof "grant under 
section 720(a) (1)". 
(4) Section 721(d) is amended by inserting "under section 720(a) 
(1)" after "for grants". 
(5) Section 721(e) is amended by inserting "for a grant under 
section 720(a) (1)" after "of applications". 
(b) Section 721 is amended by adding after subsection (f) (added 
by section 301) the following new subsection: 
"(g) (1) ^ grant under section 720(a) (2) may be made only if the 
application therefor is approved by the Secretary upon his deter-
mination that— 
"(A) the application contains or is supported by reasonable 
assurances that (i) the facility is intended to be used for pur-
poses for which the application has been made, (ii) sufficient 
funds will be available to meet the non-Federal share of the cost 
of constructing the facility, and (iii) sufficient funds will be 
available, when construction is completed, for effective use of the 
facility for the training for which it is being constructed; 
"(B) the plans and specifications are in accordance with regu-
lations relating to minimum standards of construction and 
equipment; and 
"(C) the application contains or is supported by adequate 
assurance that any laborer or mechanic employed by a contractor 
or subcontractors in the performance of work on the construction 
of the facility will be paid wages at rates not less than those pre-
vailing on similar construction in the locality as determined by 
the Secretary of Labor in accordance with the Act of March 3, 
1931 (40 U.S.C. 276a—276a-5, known as the Davis-Bacon Act). 
The Secretary of Labor shall have with respect to the labor standards 
specified in subparagraph (C) the authority and functions set forth 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2255 
in Eeorganization Plan Numbered 14 of 1950 (15 F.R. 3176; 5 U.S.C. 
Appendix) and section 2 of the Act of June 13,1934 (40 U.S.C. 276c). 
"(2) In making grants to entities under section 720(a) (2) the Sec- Ante, p. 2253. 
retary shall give special consideration to entities which have been 
awarded grants or received contracts under section 781, 784, or 786 Post, pp. 2312, 
(relating to area health education centers, general internal medicine 2315, 2316. 
and general pediatrics, and family medicine and the general practice 
of dentistry).". 
(c) Subsection (e) of section 721 is amended by adding at the end 42 USC 293a. 
the following new sentence: "In considering applications submitted 
for a grant under section 720(a)(1) for the cost of construction of 
teaching facilities for the training of physicians, the Secretary shall 
give special consideration to projects m States which have no such 
facilities.". 
GRANT AMOUNTS 
SEC. 304. (a) Subsection (a) of section 722 is amended to read as 42 USC 293b. 
follows: 
"(a)(1) The amount of any grant under section 720(a)(1) for 
construction of a project shall be such amount as the Secretary deter-
mines to be appropriate after obtaining advice from the Council, 
except that no grant for any project may exceed 80 percent of the 
necessary costs of construction, as determined by the Secretary, of 
such project. 
"(2) The amount of any grant under section 720(a)(2) for con-
struction of a facility shall be such amount as the Secretary determines 
to be appropriate, except that no grant for any facility may exceed 
the lesser of— 
" (A) 50 percent of the total cost of such facility, or 
"(B) $1,000,000.". 
(b) (1) Subsection (d) of section 722 is amended by striking out 
, v 
"under this part" and inserting in lieu thereof "under section 720 
(a)(1)". 
(2) Subsection (d) of section 722 is amended by striking out 
"(within the meaning of part A of this title)". 
RECAPTURE 
SEC. 305. Section 723 is amended— 
42 USC 293c. 
(1) by striking out "paid under this part" and inserting in lieu 
thereof "under a grant under section 720 (a) (1)", 
(2) by inserting " (a)" before "If", 
(3) by redesignating paragraphs (a), (b), and (c) as para-
graphs (1), (2), and (3), respectively, and 
(4) by adding at the end the following: 
"(b) If, within 20 years after completion of any construction for 
which funds have been paid under a grant under section 720(a) (2) — 
"(1) the applicant or other owner of the facility shall cease 
to be a public or nonprofit entity; 
"(2) the facility shall cease to be used for the training pur- Regulations, 
poses for which such funds were provided, unless the Secretary 
determines, in accordance with regulations which he shall pro-
mulgate, that there is a significant public purpose and good cause 
for releasing the applicant or other owner from the obligation to 
do so; or 
"(3) the facility is used for sectarian instruction or as a place 
for religious worship, 
the United States shall be entitled to recover from the applicant or 
90 STAT. 2256 
PUBLIC LAW 94-484—OCT. 12, 1976 
other owner of the facility the amount bearing the same ratio to the 
then value (as determined by agreement of the parties or by action 
brought in the United States district court for the district in which 
such facility is situated) of the facility, as the amount of the Federal 
participation bore to the cost of construction of such facility.". 
LOAN GUARANTEES AND INTEREST SUBSIDIES 
42 use 293i. 
SEC. 306. (a) Subsections (a) and (b) of section 729 are each 
amended by striking out "September 30, 1977" and inserting in lieu 
thereof "September 30,1980". 
(b) The second sentence of section 729(e) is amended by striking 
out "and" after "June 30, 1973," and by striking out the period at the 
end thereof and inserting in lieu thereof a comma and the following: 
"$2,000,000 in the fiscal year ending September 30, 1978, $3,000,000 
in the fiscal year ending September 30, 1979, and $3,000,000 in the 
fiscal year ending September 30, 1980.". 
(c) The third sentence of section 729(a) is amended to read as fol-
lows: "N"o such loan guarantee may, except under special circum-
stances and under such conditions as are prescribed by regulations, 
apply to any amount which, when added to any grant under this part 
or any other law of the United States, exceeds 90 percent of the 
cost of the construction of the project.". 
(d) Subsections (a) and (b) of section 729 are each amended 
by inserting "or the Federal Financing Bank" after "non-Federal 
lender". 
EFFECTIVE DATE 
42 use293 note. 
SEC. 307. (a) The amendments made by sections 302 through 305 
shall apply with respect to grants made under part B of title VII 
of the Public Health Service Act from appropriations under sec-
Ante, p. 2253. 
tion 720 of such Act for fiscal years beginning after September 30, 
1977. 
42 use 293i 
(b) The amendment made by section 306(c) shall apply with 
note. 
respect to loans guaranteed under section 729(a) of the Public Health 
Service Act (redesignated section 726(a) by section 308(d) of this 
Act) after September 30,1977. 
TECHNICAL AND CONFORMING AMENDMENTS 
42 use 293a. 
SEC. 308. (a) Section 721(c) is amended— 
(1) by striking out "section 770(f) of this Act" in paragraph 
(2) and inserting in lieu thereof "section 771"; 
(2) by striking out the sentence at the end of paragraph (2); 
(3) by striking out paragraph (5) and redesignating para-
graphs (6) and (7) as paragraphs (5) and (6), respectively; 
(4) by striking out "and" at the end of paragraph (5) (as so 
redesignated), by striking out the period at the end of paragraph 
(6) (as so redesignated) and inserting in lieu thereof "; and", and 
by inserting after paragraph (6) the following: 
"(7) the application contains or is supported by adequate 
assurance that any laborer or mechanic employed by a contractor 
or subcontractors in the performance of work on the construction 
of the facility will be paid wages at rates not less than those pre-
vailing on similar construction in the locality as determined by 
the Secretarv of Labor in accordance with the Act of March 3, 
1931 (40 U.S.C. 276a—276a-5, known as the Davis-Bacon Act). 
The Secretary of Labor shall have, with respect to the labor standards 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2257 
specified in paragraph (7), the authority and functions set forth in 
Eeorganization Plan Numbered 14 of 1950 (15 F.K. 3176; 5 U.S.C. 
Appendix) and section 2 of the Act of June 13, 1934 (40 U.S.C. 
276c)."; and 
(5) by striking out "725" in the last sentence and inserting in 
lieu thereof "702". 
(b) Section 726 is repealed. 
Repeal. 
(c) Section 727(a) is amended by striking out "institutions" each 42 USC 293f. 
time it appears and inserting in lieu thereof "entities". 
42 U
S
C 293g. 
(d) Sections 727, 728, and 729 are redesignated as sections 724, 725, 42 USC 
and 726, respectively. 
293g-293i. 
TITLE IV—STUDENT ASSISTANCE; NATIONAL 
HEALTH SERVICE CORPS 
INSURED 
LOANS 
TO 
STUDENTS 
SEC. 401. (a) Effective October 1,1976, subpart II of part C of title Repeal. 
VII is repealed. 
42 USC 294g, 
(b) Effective October 1, 1977, part C of title VII is amended by— 294g note. 
(1) amending the heading for part C to read as follows: 
"PART C—STUDENT ASSISTANCE" ; 
(2) redesignating subpart I of such part as subpart II, and 
by amending the heading for such subpart to read as follows: 
"Subpart II—Student Loans"; and 
(3) inserting immediately below the heading to such part the 
following new subpart: 
"Subpart I—Federal Program of Insured Loans to Graduate Students 
in Health Professions Schools 
"STATEMENT or PURPOSE AND APPROPRIATIONS AUTHORIZED 
"SEC. 727. (a) The purpose of this subpart is to enable the Secre- 42 USC 294. 
tary to provide a Federal program of student loan insurance for 
students in eligible institutions. 
"(b) For the purpose of carrying out this subpart there are author-
ized to be appropriated (1) for the fiscal year ending September 30, 
1978, to the student loan insurance fund (established by section 734) 
the sum of $1,500,000 and of such further sums, if any, as may become 
* *
^ 
necessary for the adequacy of student loan insurance fund and for the 
purpose of administering this subpart; and (2) for fiscal years there-
after such sums as may be necessary for the purpose of administering 
this subpart. Sums appropriated under this subsection shall remain 
available until expended. 
"SCOPE AND DURATION OF FEDERAL LOAN INSURANCE PROGRAM 
"SEC. 728. (a) The total principal amount of new loans made and 42 U
S
C 294a. 
installments paid pursuant to lines of credit (as defined in section 737) 
to students covered by Federal loan insurance under this subpart shall 
not exceed $500,000,000 for the fiscal year ending September 30,1978; 
$510,000,000 for the fiscal year ending September 30, 1979; and 
$520,000,000 for the fiscal year ending September 30,1980. Thereafter, 
Federal loan insurance pursuant to this subpart may be granted only 
90 STAT. 2258 
PUBLIC LAW 94-484—OCT. 12, 1976 
for loans made (or for loan installments paid pursuant to lines of 
credit) to enable students, who have obtained prior loans insured under 
this subpart, to continue or complete their educational program; but 
no insurance may be granted for any loan made or installment paid 
after September 30,1982. 
"(b) The Secretary may, if necessary to assure an equitable distribu-
tion of the benej&ts of this subpart, assign, within the maximum 
amounts specified in subsection (a). Federal loan insurance quotas 
applicable to eligible lenders, or to States or areas, and may from time 
to time reassign unused portions of these quotas. 
"(c) The Student Loan Marketing Association, established under 
20 use 1071. 
part B of title IV of the Higher Education Act of 1965, is authorized 
to make advances on the security of, purchase, service, sell, or other-
wise deal in, student loans which are msured by the Secretary under 
this subpart. 
"LIMrrATIONS ON INDIVIDUAL FEDERALLY INSURED LOANS AND ON FEDERAL 
LOAN INSURANCE 
42 use 294b. 
"SEC. 729. (a) The total of the loans made to a student in any aca-
demic year or its equivalent (as determined by the Secretary) which 
may be covered by Federal loan insurance under this subpart may not 
exceed $10,000 in the case of a student enrolled in a school of medicine, 
osteopathy, dentistry, veterinary medicine, optometry, podiatry, or 
public health, and $7,500 in the case of a student enrolled in a school 
of pharmacy. The aggregate insured unpaid principal amount for all 
such insured loans made to any student shall not at any time exceed 
$50,000 in the case of a student enrolled in a school of medicine, 
osteopathy, dentistry, veterinary medicine, optometry, podiatry, or 
public health, and $37,500 in the case of a student enrolled in a school 
of pharmacy. The annual insurable limit per student shall not be 
exceeded by a line of credit under which actual payments by the lender 
to the borrower will not be made in any year in excess of the annual 
limit. 
"(b) The insurance liability on any loan insured by the Secretary 
under this subpart shall be 100 percent of the unpaid balance of the 
principal amount of the loan plus interest. The full faith and credit 
of the United States is pledged to the payment of all amounts which 
may be required to be paid under the provisions of section 733 or 738. 
"SOURCES o r FUNDS 
42 use 294c. 
"SEC. 730. Loans made by eligible lenders in accordance with this 
subpart shall be insurable by the Secretary whether made from funds 
fully owned by the lender or from funds held by the lender in a trust 
or similar capacity and available for such loans. 
"ELIGIBILITY OF STUDENT BORROWERS AND TERMS OF FEDERALLY INSURED 
STUDENT LOANS 
42 use 294d. 
"SEC. 731. (a) A loan by an eligible lender shall be insurable by the 
Secretary under the provisions of this subpart only if— 
"(1) made to a student who— 
"(A) has been accepted for enrollment at an eligible 
institution; 
"(B) is in good standing at an eligible institution as deter-
mined by the institution; 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2259 
"(C) is pursuing a full-time course of study at an eligible 
institution; 
"(D) in the case of a student in a school of medicine, oste-
opathy, or dentistry, has been authorized by the institution 
in accordance with section 739(b) (2) to receive a loan under 
this subpart; 
"(E) has agreed that all funds received under such loan 
shall be used solely for tuition and other reasonable educa-
tional expenses, including fees, books, and laboratory 
expenses, incurred by such student; 
"(F) for the school year for which such loan is made, 
receives no funds from a loan insured under a Federal, State, 
or nonprofit program provided or assisted under part B of 
title IV of the Higher Education Act of 1965; and 
20 U
S
C 1071. 
"(G) in the case of a pharmacy student, has satisfactorily 
completed three years of training; and 
"(2) evidenced by a note or other written agreement which— 
"(A) is made without security and without endorsement, 
except that if the borrower is a minor and such note or other 
written agreement executed by him would not, under the 
applicable law, create a binding obligation, an endorsement 
may be required; 
"(B) provides for repayment of the principal amount of 
the loan in installments over a period of not less than 10 years 
(unless sooner repaid) nor more than 15 years beginning not 
earlier than 9 months after the date on which the student 
completes his internship or residency training, and not later 
than the earlier of 12 months after such date or of 3 years 
> 
after the date he ceases to carry, at an eligible institution, the 
normal full-time academic workload as determined by the 
institution, except (i) as provided in clause (C) below, (ii) 
that the period of the loan may not exceed 23 years from the 
date of execution of the note or written agreement evidencing 
it, and (iii) that the note or other written instrument may 
contain such provisions relating to repayment in the event of 
default in the payment of interest or in the payment of the 
cost of insurance premiums, or other default by the borrower, 
as may be authorized by regulations of the Secretary in effect 
at the time the loan is made; 
"(C) provides that periodic installments of principal need 
not be paid, but interest shall accrue and be paid, during any 
period (i) during which the borrower is pursuing a full-time 
course of study at an eligible institution, (ii) not in excess of 
three years during which the borrower is a participant in an 
accredited internship or residency program, (iii) not in 
excess of three yeare, during which the borrower is a member 
of the Armed Forces of the United States, (iv) not in excess 
of three years during which the borrower is in service as a 
volunteer under the Peace Corps Act, (v) not in excess of 
22 USC 2501 
three years during which the borrower is a member of the °o*«-
National Health Service Corps, or (vi) not in excess of three 
years during which the borrower is in service as a full-time 
volunteer under title I of the Domestic Volunteer Service 
Act of 1973, and any such period shall not be included in 42 USC 4951. 
determining the 15-year period or the 23-year period provided 
in clause (B) above; 
"(D) provides for interest on the unpaid principal balance 
Interest rate, 
of the loan at a yearly rate, not exceeding the applicable maxi-
90 STAT. 2260 
PUBLIC LAW 94-484—OCT. 12, 1976 
mum rate prescribed and defined by the Secretary (within 
the limits set forth in subsection (b)) on a national, regional, 
or other appropriate basis, which interest shall be com-
pounded semiannually and payable in installments over the 
period of the loan; 
"(E) entitles the student borrower to accelerate without 
penalty repayment of the whole or any part of the loan; and 
"(F) contains such other terms and conditions consistent 
with the provisions of this subpart and with the regula-
tions issued by the Secretary pursuant to this subpart, as 
may be agreed upon by the parties to such loan, including, if 
agreed upon, a provision requiring the borrower to pay to 
the lender, in addition to principal and interest, amounts 
equal to the insurance premiums payable by the lender to 
the Secretary with respect to such loan. 
"(b) No maximum rate of interest prescribed and defined by the 
Secretary for the purpose of paragraph (2) (D) of subsection (a) may 
exceed 10 percent per annum on the unpaid principal balance of the 
loan. 
"(c) The total of the payments by a borrower during any year of 
any repayment period with respect to the aggregate amount of all 
loans to that borrower which are insured under this subpart shall 
not be less than the annual interest on the outstanding principal. 
"CERTIFICATE or FEDERAL LOAN INSURANCE—EFFECTIVE DATE 
OF 
INSURANCE 
42 use 294e. 
"SEC. 732. (a) (1) If, upon application by an eligible lender, made 
upon such form, containing such information, and supported by such 
evidence as the Secretary may require, and otherwise in conformity 
with this section, the Secretary finds that the applicant has made a 
loan to an eligible student which is insurable under the provisions of 
this subpart, he may issue to the applicant a certificate of insurance 
covering the loan and setting forth the amount and terms of the 
insurance. 
"(2) Insurance evidenced by a certificate of insurance pursuant to 
subsection (a) (1) shall become effective upon the date of issuance of 
the certificate, except that the Secretary is authorized, in accordance 
with regulations, to issue commitments with respect to proposed loans, 
or with respect to lines (or proposed lines) of credit, submitted by 
eligible lenders, and in that event, upon compliance with subsection 
(a) (1) by the lender, the certificate of insurance may be issued effec-
tive as of the date when any loan, or any payment by the lender pur-
suant to a line of credit, to be covered by such insurance was made. 
Such insurance shall cease to be effective upon 60 days' default by the 
lender in the payment of any installment of the premiums payable 
pursuant to subsection (c). 
Application. 
"(3) An application submitted pursuant to subsection (a)(1) shall 
contain (A) an agreement by the applicant to pay, in accordance with 
regulations, the premiums fixed by the Secretary pursuant to subsec-
tion (c), and (B) an agreement IDV the applicant that if the loan is 
covered by insurance the applicant will submit such supplementary 
reports and statements during the effective period of the loan agree-
ment, upon such forms, at such times, and containing such information 
as the Secretary may prescribe by or pursuant to regulation. 
"(b)(1) In lieu of requiring a separate insurance application and 
issuing a separate certificate of insurance for each student loan made 
by an eligible lender as provided in subsection (a), the Secretary 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2261 
may, in accordance with regulations consistent with section 728, issue 
to any eligible lender applying therefor a certificate of compre-
hensive insurance coverage which shall, without further action by the 
Secretary, insure all insurable loans made by that lender, on or after 
the date of the certificate and before a specified cutoff date, within the 
limits of an aggregate maximum amount stated in the certificate. 
Such regulations may provide for conditioning such insurance, with 
respect to any loan, upon compliance by the lender with such require-
ments (to be stated or incorporated by reference in the certificate) as 
in the Secretary's judgment will best achieve the purpose of this sub-
section while protecting the financial interest of the United States and 
promoting the objectives of this subpart, including (but not limited 
to) provisions as to the reporting of such loans and information rele-
vant thereto to the Secretary and as to the payment of initial and other 
premiums and the effect of default therein, and including provision 
for confirmation by the Secretary from time to time (through endorse-
ment of the certificate) of the coverage of specific new loans by such 
certificate, which confirmation shall be incontestable by the Secretary 
in the absence of fraud or misrepresentation of fact or patent error. 
"(2) If the holder of a certificate of comprehensive insurance cov-
erage issued under this subsection grants to a student a line of credit 
extending beyond the cutoff date specified in that certificate, loans or 
payments thereon made by the holder after that date pursuant to the 
line of credit shall not be deemed to be included in the coverage of that 
certificate except as may be specifically provided therein; but, subject 
to the limitations of section 728, the Secretary may, in accordance 
with regulations, make commitments to insure such future loans or 
payments, and such commitments may be honored either as provided 
in subsectioTi (a) or bv inclusion of such insurance in comprehensive 
coverage under this subsection for the period or periods in which such 
future loans or payments are made. 
"(c) The Secretary shall, pursuant to regulations, charge for insur- 
Regulations, 
ance on each loan under this subpart a premium in an amount not to 
exceed 2 percent per year of the unpaid principal amount of such loan 
(excluding interest added to principal), payable in advance, at such 
times and in such manner as may be prescribed by the Secretary. Such 
regulations may provide that such premium shall not be payable, or if 
paid shall be refundable, with respect to any period after default in 
the payment of principal or interest or after the borrower has died or 
become totally and permanently disabled, if (1) notice of such default 
or other event has been duly given, and (2) requests for payment of 
the loss insured against has been made or the Secretary has made such 
payment on his own motion pursuant to section 733(a). 
"(d) The rights of an eligible lender arising under insurance evi-
denced by a certificate of insurance issued to it under this section may 
be assigned as security by such lender only to another eligible lender, 
and subject to regulation by the Secretary. 
"(e) The consolidation of the obligations of two or more federally 
insured loans obtained by a student borrower in any fiscal year into a 
single obligation evidenced by a single instrument of indebtedness 
shall not affect the insurance by the United States. If the loans thus 
consolidated are covered by separate certificates of insurance issued 
under subsection (a), the Secretary may upon surrender of the origi-
nal certificates issue a new certificate of insurance in accordance with 
that subsection upon the consolidated obligation. If the loans thus con-
solidated are covered by a single comprehensive certificate issued under 
subsection (b), the Secretary may amend that certificate accordingly. 
Assignment of 
rights. 
Loan 
consolidation. 
90 STAT. 2262 
PUBLIC LAW 94-4«4—OCT. 12, 1976 
DEPATTLT OP STUDEN^T UNDER FEDERAL LOAN INSURANCE PROGRAM 
42 use 294f. 
"SEC. 733. (a) Upon default by the student borrower on any loan 
covered by Federal loan insurance pursuant to this subpart, and after 
a substantial collection effort (including, if appropriate, commence-
ment of a suit) as determined under regulations of the Secretary, the 
insurance beneficiary shall promptly notify the Secretary and the 
Secretary shall, if requested (at that time or after further collection 
efforts) by the beneficiary, or may on his own motion, if the insurance 
is still in effect, pay to the beneficiary the amount of the loss sustained 
by the insured upon that loan as soon as that amount has been 
determined. 
"(b) Upon payment by the Secretary of the amount of the loss 
pursuant to subsection (a), the United States shall be subrogated for 
all of the rights of the holder of the obligation upon the insured loan 
and shall be entitled to an assignment of the note or other evidence 
of the insured loan by the insurance beneficiary. If the net recovery 
made by the Secretary on a loan after deduction of the cost of that 
recovery (including reasonable administrative costs) exceeds the 
amount of the loss, the excess shall be paid over to the insured. 
"(c) Nothing in this section or in this subpart shall be construed 
to preclude any forbearance for the benefit of the student borrower 
which may be agreed upon by the parties to the insured loan and 
approved by the Secretary or to preclude forbearance by the Secre-
tary in the enforcement of the insured obligation after payment on 
that insurance. 
"(d) Nothing in this section or in this subpart shall be construed 
to excuse the holder of a federally insured loan from exercising 
reasonable care and diligence in the making of loans under the pro-
visions of this subpart and from exercising a substantial effort in the 
collection of loans under the provisions of this subpart. If the Secre-
tary, after reasonable notice and opportunity for hearing to an 
eligible lender, finds that the lender has failed to exercise such care 
and diligence, to exercise such substantial efforts, to make the reports 
and statements required under section 732(a)(3), or to pay the 
required Federal loan insurance premiums, ne shall disqualify that 
lender from obtaining further Federal insurance on loans granted pur-
suant to this subpart until he is satisfied that its failure has ceased and 
finds that there is reasonable assurance that the lender will in the 
future exercise necessary care and diligence, exercise substantial effort, 
or comply with such requirements, as the case may be. 
Definitions. 
" (e) As used in this section— 
"(1) the term 'insurance beneficiary' means the insured or its 
authorized assignee in accordance with section 732(d); 
"(2) the term 'amount of the loss' means, with respect to a 
loan, the unpaid balance of the principal amount and interest on 
such loan; and 
"(3) the term 'default' includes only such defaults as have 
existed for (A) 120 days in the case of a loan which is repayable 
in monthly installments, or (B) 180 days in the case of a loan 
which is repayable in less frequent installments. 
Notice and 
"(f) The Secretary may, after notice and opportunity for a hear-
hearing. 
ing, cause to be reduced Federal reimbursements or payments for 
health services under any Federal law to borrowers who are practicing 
their professions and have defaulted on their loans insured under this 
subpart in amounts up to the remaining balance of such loans. 
"(g) A debt which is a loan insured under the authority of this 
subpart may be released by a discharge in bankruptcy under title 11 of 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2263 
the United States Code only if such discharge is granted after the 
expiration of the five-year period beginning on the first date, as 
specified in section 731(a)(2)(B), when repayment of such loan is 
required. 
"STUDENT LOAN INSURANCE FUND 
11 use letseq. 
Establishment. 
42 use 294g. 
"SEC. 734. (a) There is hereby established a student loan insurance 
fund (hereinafter in this section referred to as the 'fund') which shall 
be available without fiscal year limitation to the Secretary for making 
payments in connection with the default of loans insured by him under 
this subpart. All amounts received by the Secretary as premium 
charges for insurance and as receipts, earnings, or proceeds derived 
from any claim or other assets acquired by the Secretary in connection 
with his operations under this subpart, and any other moneys, prop-
erty, or assets derived by the Secretary from his operations in connec-
tion with this section, shall be deposited in the fund. All payments in 
connection with the default of loans insured by the Secretary under 
this subpart shall be paid from the fund. Moneys in the fund not 
needed for current operations under this section may be invested in 
bonds or other obligations guaranteed as to principal and interest by 
the United States. 
"(b) If at any time the moneys in the fund are insufficient to make 
payments in connection with the default of any loan insured by the 
Secretary under this subpart, the Secretary is authorized to issue to 
the Secretary of the Treasury notes or other obligations in such forms 
and denominations, bearing such maturities, and subject to such terms 
and conditions as may be prescribed by the Secretary with the 
approval of the Secretary of the Treasury, but only in such amounts 
as may be specified from time to time in appropriation Acts. Such 
notes or other obligations shall bear interest at a rate determined by the 
Secretary of the Treasury, taking into consideration the current 
average market yield on outstanding marketable obligations of the 
United States of comparable maturities during the month preceding 
the issuance of the notes or other obligations. The Secretary of the 
Treasury shall purchase any notes and other obligations issued here-
under and for that purpose he is authorized to use as a public debt 
transaction the proceeds from the sale of any securities issued under 
the Second Liberty Bond Act, as amended, and the purposes for which 31 USe 774, 
securities may be issued under that Act, as amended, are extended to 
include any purchase of such notes and obligations. The Secretary of 
the Tieasury may at any time sell any of the notes or other obligations 
acquired by him under this subsection. All redemptions, purchases, 
and sales by the Secretary of the Treasury of such notes or other obli-
§ations shall be treated as public debt transactions of the United 
tates. Sums borrowed under this subsection shall be deposited in the 
fund and redemption of such notes and obligations shall be made by 
the Secretary from such fund. 
"POWERS AND RESPONSIBILITIES 
"SEC. 735. (a) In the performance of, and with respect to, the 42 USe 294h. 
functions, powers, and duties vested in him by this subpart, the Sec-
retary may— 
"(1) prescribe such regulations as may be necessary to carry Regulations, 
out the purposes of this subpart; 
" (2) sue and be sued in any district court of the United States, Civil actions, 
and such district courts shall have jurisdiction of civil actions Jurisdiction, 
arising under this subpart without regard to the amount in con-
90 STAT. 2264 
PUBLIC LAW 94-484—OCT. 12, 1976 
Budget program. 
31 u s e 841 note. 
Contract. 
Post, p. 2285. 
Post, p. 2270. 
troversy, and any action instituted under this subsection by or 
against the Secretary shall survive notwithstanding any change in 
the person occupying the office of Secretary or any vacancy in that 
office. No attachment, injunction, garnishment, or other similar 
process, mesne or final, shall be issued against the Secretary or 
property under his control, and nothing herein shall be construed 
to except litigation arising out of activities under this sub-
part from the application of sections 517 and 547 of title 28 of 
the United States Code; 
"(3) include in any contract for Federal loan insurance such 
terms, conditions, and convenants relating to repayment of prin-
cipal and payment of interest, relating to his obligations and 
rights and to those of eligible lenders, and borrowers in case of 
default, and relating to such other matters as the Secretary deter-
mines to be necessary to assure that the purposes of this sub-
part will be achieved; and any term, condition, and covenant 
made pursuant to this clause or any other provisions of this 
subpart may be modified by the Secretary if he determines that 
modification is necessary to protect the financial interest of the 
United States; 
"(4) subject to the specific limitations in the subpart, consent 
to the modification, with respect to rate of interest, time of pay-
ment of any installment of principal and interest or any portion 
thereof, or any other provision of any note or other instrument 
evidencing a loan which has been insured by him under this 
subpart; and 
" (5) enforce, pay, compromise, waive, or release any right, title, 
claim, lien, or demand, however acquired, including any equity 
or any right or redemption. 
"(b) The Secretary shall, with respect to the financial operations 
arising by reason of this subpart— 
"(l) prepare annually and submit a budget program as pro-
vided for wholly owned Government corporations by the Govern-
ment Corporation Control Act; and 
"(2) maintain with respect to insurance under this subpart an 
integral set of accounts. 
"(c) (1) The Secretary may enter into a written contract with 
a borrower under which the Secretary agrees to assume the obligation 
of paying an amount, not to exceed $10,000 in any 12-month period, 
toward the principal and interest due on any loan made to the borrower 
and insured under this subpart and the borrower agrees to serve, 
either as a member of the National Health Service Corps or in private 
practice pursuant to section 753 (as determined by the Secretary), in a 
health manpower shortage area (designated under section 332) which 
is described in clauses (A) and (B) of section 753(a)(2) for a 
continuous period of (A) not less than 12 months for each 12-month 
period the Secretary assumes such obligation under the agreement, or 
(B) 24 months, whichever is greater. 
"(2) Except as provided in paragraphs (3) and (4), if an individ-
ual, who has entered into a written contract imder paragraph (1), for 
any reason breaches his contract obligations with respect to serving in 
a health manpower shortage area for the period specified in the agree-
ment, the United States shall be entitled to recover damages from such 
individual in an amount equal to three times the amount paid by the 
Secretary under the agreement to or on behalf of such individual. Any 
amount of damages which the United States is entitled to recover 
under this paragraph shall be paid to the United States not later than 
one year after the date of the breach of such contract obligations. 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2265 
" (3) The United States shall not be entitled to recover any damages Recovery 
from an individual under paragraph (2) upon the death of the 
individual. 
"(4) The Secretary shall by regulation provide for the waiver or 
suspension of payment of any or all of the damages to which the 
United States is entitled under paragraph (2) whenever the Secretary 
determines that compliance by an individual with the agreement which 
was breached is impossible or would involve extreme hardship to the 
individual and that recovery of such damages with respect to the 
individual would be unconscionable. 
Waiver. 
Regulation. 
"PARTICIPATION BY FEDERAL CREDIT UNIONS IN FEDERAL, STATE, AND 
PRIVATE STUDENT LOAN INSURANCE PROGRAMS 
"SEC. 736. Notwithstanding any other provision of law, Federal 
credit unions shall, pursuant to regulations of the Director of the 
Bureau of Federal Credit Unions, have power to make insured loans 
to eligible students in accordance with the provisions of this subpart 
relating to Federal insured loans. 
(( 
DEFINITIONS 
"SEC. 737. As used in this subpart: 
"(1) The term 'eligible institution' means, with respect to a fiscal 
year, a school of medicine, osteopathy, dentistry, optometry, phar-
macy, podiatry, veterinary medicine, and public health within the 
United States that is receiving, or the Secretary determines is eligible 
to receive, a grant under section 770 for such fiscal year. 
"(2) The term 'school of medicine, osteopathy, or dentistry, optom-
etry, pharmacy, podiatry, veterinary medicine, and public health' 
means any school legally authorized within a State to train members 
of the professions indicated and accredited by a recognized body or 
bodies approved for such purpose by the Commissioner of Education, 
except that a new school which (by reason of no, or an insufficient, 
period of operation) is not, at the time of application for insurance 
for a loan under this subpart, eligible for accreditation by such a 
recognized body or bodies, shall be deemed accredited for purposes of 
this part if the Commissioner of Education finds, after consultation 
with the appropriate accreditation body or bodies, that there is rea-
sonable assurance that the school will meet the accreditation standards 
of such body or bodies prior to the beginning of the academic year 
following the normal graduation date of the first entering class in 
such school. 
"(3) The term 'eligible lender' means an eligible institution, an 
agency or instrumentality of a State, a financial or credit institution 
(including an insurance company) which is subject to examination 
and supervision by an agency of the United States or of any State, or 
a pension fund approved by the Secretary for this purpose. 
"(4) The term 'line of credit' means an arrangement or agreement 
between the lender and the borrower whereby a loan is paid out by 
the lender to the borrower in annual installments, or whereby the 
lender agrees to make, in addition to the initial loan, additional loans 
in subsequent years. 
42 use 294i,. 
Regulations. 
42 use 294j. 
Post, p. 2290,. 
"REPAYMENT BY THE SECRETARY OF LOANS OF DECEASED OR DISABLED 
BORROWERS 
"SEC. 738. If a student borrower who has received a loan dies or 
becomes permanently and totally disabled (as determined in accord-
42 use 294k. 
90 STAT. 2266 
PUBLIC LAW 94-4«4—OCT. 12, 1976 
ance with regulations of the Secretary), the Secretary shall discharge 
the borrower's liability on the loan by repaying the amount owed on 
the loan from the fund established under section 734. 
ii^ 
ELIGIBILITY OF INSTITUTIONS 
Regulations. 
"SEC. 739. (a) Notwithstanding any other provision of this subpart, 
42 use 294/. 
the Secretary is authorized to prescribe such regulations as may be 
necessary to provide for— 
"(1) a fiscal audit of an eligible institution with regard to any 
funds obtained from a student who has received a loan insured 
under this subpart; 
"(2) the establishment of reasonable standards of financial 
responsibility and appropriate institutional capability for the 
administration by an eligible institution of a program of student 
financial aid with respect to funds obtained from a student who 
has received a loan insured under this subpart; and 
"(3) the limitation, suspension, or termination of the eligi-
bility under this subpart of any otherwise eligible institution, 
whenever the Secretary has determined, after notice and afford-
ing an opportunity for hearing, that such institution has vio-
lated or failed to carry out any regulation prescribed under this 
subpart. 
"(b) The Secretary shall by regulation— 
"(1) require an eligible institution to record, and make avail-
able to a lender and to the Secretary upon request, the name, 
address, postgraduate destination, and other reasonable identify-
ing information for each student of such institution who has a 
loan insured under this subpart; and 
"(2) in the case of an eligible institution which is a school of 
medicine, osteopathy, or dentistry, require such institution to 
establish procedures to insure that no more than 50 percent of 
the students in each class in the institution are authorized to have 
loans insured under this subpart.". 
STUDENT LOAN 
AGREEMENTS 
42 use 294, 
SEC. 402. Section 740 is amended— 
294m. 
(1) by striking out "of Health, Education, and Welfare" in 
subsection (a); 
(2) by striking out ", except as provided in section 746," in 
paragraphs (2) and (3) of subsection (b) ; 
(3) by striking out ", and that while the agreement remains in 
effect" and all that follows through "National Defense Education 
20 use401 note. 
Act of 1958; and" in subsection (b)(4) and inserting in lieu 
thereof a semicolon; and 
(4) by redesi^ating paragraph (5) of subsection (b) as para-
graph (6), and inserting after paragraph (4) of such subsection 
the following new paragraph: 
" (5) provide that the school shall advise, in writing, each appli-
cant for a loan from the student loan fund of the provisions of 
section 741 under which outstanding loans from the student loan 
fund may be paid (in whole or in part) by the Secretary; and". 
LOAN PROVISIONS 
42 use 294a, 
SEC. 403. (a) Subsection (a) of section 741 is amended to read as 
294n. 
follows: 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2267 
"(a) Loans from a student loan fund (established under an agree-
ment with a school under section 740) may not exceed for any student Ante, p. 2266. 
for each school year (or its equivalent) the sum of— 
" (1) the cost of tuition for such year at such school, and 
"(2) $2,500.". 
(b) Subsection (e) of section 741 is amended by striking out ''3 42 USC 294a, 
per centum" and inserting in lieu thereof "7 percent". 
294n. 
(c) The amendments made by subsections (a) and (b) shall apply 42 USC 294n 
with respect to loans made after September 30, 1977, from student note. 
loan funds established under section 740 of the Public Health Service 
Act. 
(d) Subsection (f)(1)(B) of section 741 is amended to read as 
follows: 
"(B) who obtained one or more loans from a loan fund estab-
lished under this subpart; and". 
(e) In the case of any individual who, on or after November 18, 42 USC 294n 
1971, and before the date of enactment of this Act, met the require- note-
ments of subparagraphs (A) and (B) of section 741(f)(1) of the 
Public Health Service Act and who practiced his profession in an 
area described in subparagraph (C) of such section (as in effect before 
the date of the enactment of this Act) as a member of the National 
Health Service Corps or as an officer of the Regular or Reserve Corps 
of the Public Health Service or as a civilian employee of the Public 
Health Service, the individual shall, for purposes of section 741(f) of 
such Act, be deemed to have entered into the agreement required by 
such subparagraph (C) with respect to that practice if such individual 
makes application to the Secretary, not later than January 1,1977, for 
payment by the Secretary under section 741(f) (2) of such Act. 
(f) A student in a school of medicine or osteopathy who will 42 USC 294n 
graduate from such school after June 30, 1979, shall be eligible to note-
receive a loan under section 741 of the Public Health Service Act 
^ 
after October 1, 1977 only if such student is of exceptional financial 
need (as defined by regulations of the Secretary). 
^ 
AUTHORIZATION o r APPROPRIATIONS 
SEC. 404. Effective October 1, 1977, subsection (a) of section 742 is 42 USC 294b, 
amended to read as follows: 
294o. 
"(a) For the purpose of making Federal capital contributions 
into the student loan funds of schools which have established such 
funds under section 740, there are authorized to be appropriated 
$26,000,000 for the fiscal year ending September 30, 1978, $27,000,000 
for the fiscal year ending September 30, 1979, and $28,000,000 for 
the fiscal year ending September 30, 1980. For the fiscal year end-
ing September 30, 1981, and each of the two succeeding fiscal years, 
there are authorized to be appropriated to the Secretary such sums 
as may be necessary to enable students who have received a loan 
under this part for any academic year ending before October 1, 
1980, to continue or complete their education.". 
DISTRIBUTION OF ASSjiTS 
SEC. 405. Section 743 is amended by striking out "June 30, 1977" 42 USC 294c, 
and "September 30, 1977" each place they occur and inserting in lieu 294p. 
thereof "September 30, 1983" and "December 31, 1983", respectively. 
90 STAT. 2268 
PUBLIC LAW 94-484—OCT. 12, 1976 
Repeal. 
42 use 294d, 
294f. 
42 use 294d, 
294q. 
42 use 294q 
note. 
Appropriation 
authorization. 
42 use 294q 
note. 
.42 use 294b, 
294o. 
42 use 294c, 
294p. 
LOANS TO SCHOOLS AND TECHNICAL AND CONFORMING AMENDMENTS 
SEC. 406. (a) (1) Sections 744 and 746 are repealed. 
(2) Section 745 is redesignated as section 744. 
(b) The health professions education fund created within the 
Treasury by section 744(d) (1) of the Public Health Service Act (as 
in effect before the date of enactment of this Act) shall remain avail-
able to the Secretary of Health, Education, and Welfare for the pur-
pose of meeting his responsibilities respecting participations in 
obligations acquired under such section. The Secretary shall continue 
to deposit in such fund all amounts received by him as interest pay-
ments or repayments of principal on loans under such section 744. If 
at any time the Secretary determines the moneys in the fund exceed 
the present and any reasonable prospective future requirements of 
such fund, such excess may be transferred to the general fund of the 
Treasury. 
(c) There are authorized to be appropriated without fiscal year 
limitation such sums as may be necessary to enable the Secretary 
to make payments under agreements entered into under section 744(b) 
of the Public Health Service Act before September 30,1977. 
(d) Section 742(b) is amended (1) by striking out ", and for loans 
pursuant to section 744" in paragraph (1), and (2) by striking out 
"whether as Federal capital contributions or as loans to schools under 
section 744" in paragraph (3). 
(e) Section 743,(b) is amended by striking o u t " (other than so much 
of such fund as relates to payments from the revolving fund estab-
lished by section 744 ( d ) ) " . 
42 use 254b. 
42 use 255, 
256. 
REVISION OF NATIONAL HEALTH SERVICE CORPS PROGRAM 
SEC. 407. (a) Part C of title I I I is amended by inserting immedi-
ately below the heading for such part the following: 
"Subpart I—General Provisions". 
(b) Title I I I is amended— 
^ 1) by striking out section 329; 
(2) by redesignating sections 331 and 332 as sections 339 and 
340, respectively; and 
(3) by inserting immediately after section 330 the following 
new subpart: 
"Subpart II—National Health Service Corps Program 
"NATIONAL HEALTH SERVICE CORPS 
Establishment. 
"SEC. 331. (a) There is established, within the Service, the National 
42 use 254d. 
Health Service Corps (hereinafter in this subpart referred to as the 
'Corps') which (1) shall consist of such officers of the Regular and 
Reserve Corps of the Service and such civilian personnel as the Sec-
retary may designate (such officers and personnel hereinafter in this 
subpart referred to as 'Cor^s members') and (2) shall be utilized by 
the Secretary to improve the delivery of health services in health man-
power shortage areas as defined in section 332(a). 
"(b) The Secretary shall conduct at schools of medicine, osteopa-
thy, dentistry, and, as appropriate, nursing and other schools of the 
health professions and at entities which train allied health personnel, 
recruiting programs for the Corps and the Scholarship Program. 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 22(S9 
"(c) The Secretary may reimburse applicants for positions in the 
Corps for actual and reasonable expenses incurred in traveling to and 
from their places of residence to a health manpower shortage area 
(designated under section 332) in which they may be assigned for 
the purpose of evaluating such area with regard to being assigned in 
such area. The Secretary shall not reimburse an applicant for more 
than one such trip. 
"(d)(1) The Secretary may, under regulations promulgated by 
the Secretary, adjust the monthly pay of each member of the Corps 
who is directly engaged in the delivery of health services in a health 
manpower shortage area as follows: 
"(A) During the first 36 months in which such a member is so 
engaged in the delivery of health services, his monthly pay shall 
be increased by an amount (not to exceed $1,000) which when 
added to the member's monthly pay and allowances will provide a 
monthly income competitive with the average monthly income 
from a practice of an individual who is a member of the profes-
sion of the Corps member, who has equivalent training, and who 
has been in practice for a period ejjuivalent to the period during 
which the Corps member has been in practice. 
"(B) During the period beginning upon the expiration of the 
36 months referred to in subparagraph (A) and ending with the 
month in which the member's monthly pay and allowances are 
equal to or exceed the monthly income he received for the last of 
such 36 months, the member shall receive in addition to his 
monthly pay and allowances an amount which when added to such 
monthly pay and allowances equals the monthly income he 
received for such last month. 
"(C) For each month in which a member is directly engaged 
in the delivery of health services in a health manpower short-
age area in accordance with an agreement with the Secretary 
entered into under section 741(f) (1) (C), under which the Sec- 42 USC 294a. 
retary is obligated to make payments in accordance with section 
741 (f) (2), the amount of any monthly increase under subpara-
graph (A) or (B) with respect to such member shall be decreased 
by an amount equal to one-twelfth of the amount which the Sec-
retary is obligated to pay upon the completion of the year of prac-
tice in which such month occurs. 
For purposes of subparagraphs (A) and (B), the term 'monthly pay' "Monthly pay." 
includes special pay received under chapter 5 of title 37 of the United 
States Code. 
37 USC 301 et 
" (2) In the case of a member of the Corps who is directly engaged in **'• 
the delivery of health services in a health manpower shortage area in 
accordance with a service obligation incurred under the Scholarship 
Program, the adjustment in pay authorized by paragraph (1) may be 
made for such a member only upon satisfactory completion of such 
service obligation, and the first 36 months of such member's being so 
engaged in the delivery of health services shall, for purposes of para-
graph (1) (A), be deemed to begin upon such satisfactory completion. 
"(e) Corps members assigned under section 333 to provide health 
services in health manpower shortage areas shall not be counted against 
any employment ceiling affecting the Department. 
"(f) Sections 214 and 216 shall not apply to members of the National 42 USC 215, 
Health Service Corps during their period of obligated service under 217. 
the Scholarship Program. 
"(g) The administrative unit which administers section 770— 
Post, p. 2290. 
89-194 O—78—pt. 2 
51 
90 STAT. 2270 
PUBLIC LAW 94-4S4—OCT. 12, 1976 
"(1) shall participate in the development of regulations, guide-
lines, funding priorities, and application forms, and 
"(2) shall be consulted by, and may make recommendations to, 
the Secretary in the review of applications and proposals for, and 
the awarding of, grants and contracts, 
with respect to the Corps. 
Definitions. 
"(h) For the purposes of this subpart: 
"(1) The term 'Department' means the Department of Health, 
Education, and Welfare. 
"(2) The term 'Scholarship Program' means the National 
Health Service Corps Scholarship Program established under 
section 751. 
"(3) The term 'State' includes, in addition to the several States, 
only the District of Columbia, the Commonwealth of Puerto Rico, 
the Northern Mariana Islands, the Virgin Islands, Guam, 
American Samoa, and the Trust Territory of the Pacific Islands. 
"Health 
manpower 
shortage area.' 
42 use 254e. 
"Medical 
facility." 
42 use 248,249. 
42 use 250. 
42 use 251. 
42 use 252. 
42 use 253. 
42 use 255. 
Regulation. 
DESIGNATION OF HEALTH MANPOWER SHORTAGE AREAS 
"SEC. 332. (a) (1) For purposes of this subpart the term 'health man-
power shortage area' means (A) an area in an urban or rural area 
(which need not conform to the geographic boundaries of a political 
subdivision and which is a rational area for the delivery of health 
services) which the Secretary determines has a health manpower 
shortage, (B) a population group which the Secretary determines 
has such a shortage, or (C) a public or nonprofit private medical facil-
ity or other public facility which the Secretary determines has such a 
shortage. 
"(2) For purposes of this subsection, the term 'medical facility' 
means a facility for the delivery of health services and includes— 
"(A) a hospital. State mental hospital, public health center, 
outpatient medical facility, rehabilitation facility, facility for 
long-term care, community mental health center, migrant health 
center, and community health center; 
"(B) such a facility of a State correctional institution or of 
the Indian Health Service; 
"(C) such a facility used in connection with the delivery of 
health services under sections 321 (relating to hospitals ), 322 (re-
lating to care and treatment of seamen and others), 323 (relating 
to care and treatment of Federal prisoners), 324 (relating to 
examination and treatment of certain Federal employees), 325 
(relating to examination of aliens), or 326 (relating to services to 
certain Federal employees), or pait D of title III (relating to 
services for persons with Hansen's disease); and 
"(D) a Federal medical facility. 
"(b) The Secretary shall establish by regulation, promulgated not 
later than May 1, 1977, criteria for the designation of areas, popula-
tion groups, medical facilities, and other public facilities, in the States, 
as health manpower shortage areas. In establishing such criteria, the 
Secretary shall take into consideration the following: 
"(1) The ratio of available health manpower to the number of 
individuals in an area or population group, or served by a medical 
facility or other public facility under consideration for designa-
tion. 
"(2) Indicators of a need, notwithstanding the supply of 
health manpower, for health services for the individuals in an 
area or population group or served by a medical facility or other 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2271 
Recommenda-
tions. 
public facility under consideration for designation, with special 
consideration to indicators of— 
" (A) infant mortality, 
"(B) access to health services, and 
"(C) health status. 
"(3) The percentage of physicians serving an area, population 
group, medical facility, or other public facility under considera-
tion for designation who are employed by hospitals and who are 
graduates of foreign medical schools. 
"(c) In determining whether to make a designation, the Secretary 
shall take into consideration the following: 
"(1) (A) The recommendations of each health systems agency 
(designated under section 1515) for a health service area which 42 USC 300/-^!.. 
includes all or any part of the area, population group, medi-
cal facility, or other public facility under consideration for 
designation. 
"(B) The recommendations of the State health planning and 
development agency (designated under section 1521) if such area, 42 U
S
C 300m. 
population group, medical facility, or other public facility is 
within a health service area for which no health systems agency 
has been designated. 
"(2) The recommendations of the Governor of each State in 
which the area, population group, medical facility, or other public 
facility under consideration for designation is in whole or part 
located. 
"(d) In accordance with the criteria established under subsection List, publication. 
(b) and the considerations listed in subsection (c), the Secretary shall 
designate, not later than November 1,1977, health manpower shortage 
areas in the States, publish a descriptive list of the areas, population 
groups, medical facilities, and other public facilities so designated, and 
at least annually review and, as necessary, revise such designations. 
"(e) Prior to the designation of a public facility, including a Fed- Notice, 
eral medical facility, as a health manpower shortage area, the Secre-
tary shall give written notice of such proposed designation to the chief 
administrative officer of such facility and request comiments within 
30 days with respect to such designation. 
"(f) The Secretary shall give written notice of the designation of a Notice, 
health manpower shortage area, not later than 60 days from the date 
of such designation, to— 
"(1) the Governor of each State in which the area, population 
group, medical facility, or other public facility so designated 
is in whole or part located; 
"(2) (A) each health systems agency (designated under section 
1515) for a health service area wnich includes all or any part of 
the area, population group, medical facility, or other public facil-
ity so designated; or 
" (B) the State health planning and development agency of the 
State (designated under section 1521) if there is a part of such 
area, population group, medical facility, or other public facility 
within a health service area for which no health systems agency 
has been designated; and 
" (3) appropriate public or nonprofit private entities which are 
located or which have a demonstrated interest in the area so 
designated. 
"(g) Any person may recommend to the Secretary the designation 
of an area, population group, medical facility, or other public facility 
as a health manpower Mortage area. 
90 STAT. 2272 
PUBLIC LAW 94-484—OCT. 12, 1976 
"(h) The Secretary shall conduct such information programs in 
areas, among population groups, and in medical facilities and other 
public facilities designated under this section as health manpower 
shortage areas as may be necessary to inform public and nonprofit 
private entities which are located or have a demonstrated interest in 
such areas of the assistance available under this title by virtue of the 
designation of such areas. 
u 
ASSIGNMENT OF CORPS PERSONNEL 
Regulations. 
"SEC. 333. (a) (1) The Secretary may assign members of the Corps 
42 use 254f. 
to provide, under regulations promulgated by the Secretary, health 
services in or to a health manpower shortage area during the assign-
ment period (specified in the agreement described in section 334) only 
if— 
Application. 
"(A) a public or nonprofit private entity, which is located or 
has a demonstrated interest in such area makes application to the 
Secretary for such assignment; 
"(B) such application has been approved by the Secretary; 
"(C) an agreement has been entered into between the entity 
which has applied and the Secretary, in accordance with section 
334; and 
"(D) in the case of an application made by an entity which has 
previously been assigned a Corps member for a health manpower 
shortage area under an agreement (entered into under section 334) 
or under section 329 as in effect before October 1, 1977) which 
has expired, the Secretary has (i) conducted an evaluation of the 
continued need for health manpower for the area, the use of Corps 
members previously assigned to the area, community support for 
the assignment of Corps members to the area, the area's efforts to 
secure health manpower for the area, and fiscal management by 
the entity with respect to Corps members previously assigned and 
(ii) on the basis of such evaluation has determined that— 
"(I) there is a continued need for health manpower for the 
area; 
" (II) there has been appropriate and efficient use of Corps 
members previously assigned to the entity for the area; 
"(III) there is general community support for the assign-
ment of Corps members to the entity; 
"(IV) the area has made continued efforts to secure health 
manpower for the area; and 
"(V) there has been sound fiscal management, including 
efficient collection of fee-for-service, third-party, and other 
appropriate funds, by the entity with respect to Corps mem-
bers previously assigned to such entity. 
"(2) Corps members may be assigned to a Federal health care 
facility, but only upon the request of the head of the department or 
agency of which such facility is a part. 
"(b) The Secretary may not approve an application under this sec-
tion for assignment of a Corps member to a health manpower shortage 
area unless the Secretary has afforded— 
"(1) each health systems agency (designated under section 
42 use 300/-4. 
1515) for a health service area which includes all or part of the 
area in which the area, population group, medical facility, or 
other public facility so designated is located, or 
"(2) if there is a part of such area, population group, medical 
facility, or other piiblic facility located within a health service 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2273 
area for which no health systems agency has been designated, the 
State health planning and development agency (designated under 
section 1521) of the State in which such part is located, 
an opportunity to review the application and submit to the Secretary 
its comments respecting the need for, and proposed use of, the Corps 
member requested in the application. 
"(c) In considering, and giving approval to, applications made 
under this section for the assignment of Corps members, the Secretary 
shall— 
"(1) give priority to an application which provides for the 
assignment of Corps members to an area, population group, medi-
cal facility, or other public facility with the greatest health 
manpower shortage, as determined under criteria established 
under section 332(b); 
"(2) give special consideration to an application which pro-
vides for the use of physician assistants, nurse practitioners, or 
expanded function dental auxiliaries; 
"(3) take into consideration the willingness of individuals in 
the area or population group, or at the medical facility or other 
public facility, and of the appropriate governmental agencies or 
health entities, to assist and cooperate with the Corps in provid-
ing effective health services; and 
"(4) take into consideration comments of medical, osteopathic, 
dental, or other health professional societies serving the area, 
population group, medical facility, or other public facility, or, if 
no such societies exist, comments of physicians, dentists, or other 
health professionals serving the area, population group, medical 
facility, or other public facility. 
"(d) The Secretary shall assign Corps members to entities in health 
manpower shortage areas without regard to the ability of the indi-
viduals in such areas, population groups, medical facilities, or other 
public facilities to pay for such services. 
"(e) In making the assignment of a Corps member to an entity in 
a health manpower shortage area which has had an application 
approved under this section, the Secretary shall seek to assign to an 
area a Corps member who has (and whose spouse, if any, has) those 
characteristics which are characteristics which increase the probability 
of the member's remaining to serve the area upon completion of his 
assignment period. 
"(f) (1) The Secretary shall provide technical assistance to a public 
or nonprofit private entity which is located or has a demonstrated 
interest in a health manpower shortage area and which desires to 
make an application under this section for assignment of a Corps mem-
ber to such area. 
"(2) The Secretary shall provide, to public and nonprofit private 
entities which are located or have a demonstrated interest in a health 
manpower shortage area to which area a Corps member has been 
assigned, technical assistance to assist in the retention of such member 
in such area after the completion of such member's assignment to the 
area. 
" (3) The Secretary shall provide, to health manpower shortage areas 
to which no Corps member has been assigned, (A) technical assistance 
to assist in the recruitment of health manpower for such areas, and 
(B) current information on public and private programs which pro-
vide assistance in the securing of health manpower. 
"(g) The Secretary shall conduct, or enter into contracts for the 
conduct of, studies of the methods of assignments of Corps members 
42 u s e 300m. 
Contracts; 
studies. 
90 STAT. 2274 
PUBLIC LAW 94-484-OCT. 12, 1976 
to health manpower shortage areas. Such studies shall include studies 
of— 
" Q) the characteristics of physicians, dentists, and other health 
proiessionals who are more likely to remain in practice in health 
manpower shortage areas; 
"(2) the characteristics, including utilization and reimburse-
ment patterns, of areas which have been able to retain health 
manpower personnel; and 
"(3) the appropriate conditions for the assignment and use of 
nurse practitioners, physician assistants, and expanded function 
dental auxiliaries in health manpower shortage areas. 
"(h) Notwithstanding any other law, any member of the Corps 
licensed to practice medicine, osteopathy, or dentistry in any State 
shall, while serving in the Corps, be allowed to practice such profes-
sion in any State. 
"COST SHARING 
42 use 254g. 
"SEC. 334. (a) The Secretary shall require, as a condition to the 
approval of an application under section 333, that the entity which 
submitted the application enter into an agreement for a specific assign-
ment period (not to exceed 4 years) with the Secretary under which— 
"(1) the entity shall be responsible for charging, in accordance 
with subsection (d), for health services provided by Corps mem-
bers assigned to the entity; 
"(2) the entity shall take such action as may be reasonable for 
the collection or payments for such health services, including, if 
a Federal agency, an agency of a State or local government, or 
other third party would be responsible for all or part of the cost 
of such health services if it had not been provided oy Corps mem-
bers under this subpart, the collection, on a fee-for-service or other 
basis, from such agency or third party, the portion of such cost 
for which it would be so responsible (and in determining the 
amount of such cost which such agency or third party would be 
responsible, the health services provided by Corps members shall 
be considered as being provided by private practitioners) ; 
" ^ ) the entity shall pay to the United States, as prescribed by 
the Secretary in each calendar quarter (or other period as may be 
specified in the agreement) during which any Corps member is 
assigned to such entity, the sum of— 
"(A) the portion of the salary (including amounts paid 
in accordance with section 331(d)) and allowances of any 
Corps member received by such member during such calendar 
quarter (or other period) while such member was assigned to 
such entity; 
"(B) for any Corps member assigned to such entity, an 
amount which bears the same ratio to the amount paid under 
the Scholarship Program to or on the behalf of such Corps 
member as the number of days of obligated service provided 
by such member during such quarter (or other period) bears 
to the number of days in his period of obligated service under 
such Program; and 
"(C) it such entity received a loan under section 335(c), 
an amount which bears the same ratio to the amount of such 
loan as the number of days in such quarter (or other period) 
during which any Corps members were assigned to the entity 
bears to the number of days in the assignment period after 
such entity received such loan; and 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2275 
"(4) the entity shall prepare and submit to the Secretary an 
annual report, in such form and manner, as the Secretary may 
require. 
"(b) (1) The Secretary may waive in whole or in part the applica-
tion of the requirement of subsection (a) (3) for an entity if he 
determines that the entity is financially unable to meet such require-
ment or if he determines that compliance with such requirement would 
unreasonably limit the ability of the entity to provide for the adequate 
support of the provision of health services by Corps members. 
"(2) The Secretary may waive in whole or in part the application 
of the requirement of subsection (a)(3) for any entity which is located 
in a health manpower shortage area in which a significant percentage 
of the individuals are elderly, living in poverty, or have other char-
acteristics which indicate an inability to repay, in whole or in part, 
the amounts required in subsection (a) (3). 
"(3) In the event that the Secretary grants a waiver under para-
graph (1) or (2), the entity shall be required to use the total amount 
of funds collected by such entity in accordance with subsection (a) (2) 
for the improvement of the capability of such entity to deliver health 
services to the individuals in, or served by, the health manpower 
shortage area. 
"(c) The excess (if any) of the amount of funds collected by an 
entity in accordance with subsection (a) (2) over the amount paid to 
the United States in accordance with subsection (a) (3) shall be used 
by the entity to expand and improve the provision of health services 
to the individuals in the health manpower shortage area for which the 
entity submitted an application or to recruit and retain health man-
power to provide health services for such individuals. 
"(d) Any person who receives health services provided by a Corps 
member under this subpart shall be charged for such services on a fee-
for-service or other basis, at a rate approved by the Secretary, pur-
suant to regulations. Such rate shall be computed in such a way as to 
permit the recovery of the value of such services, except that if such 
person is determined under regulations of the Secretary to be unable 
to pay such charge, the Secretary shall provide for the furnishing of 
such services at a reduced rate or without charge. 
"(e) Funds received by the Secretary under an agreement entered 
into under this section shall be deposited in the Treasury as miscel-
laneous receipts and shall be disregarded in determining the amounts 
of appropriations to be requested and the amounts to be made avail-
able from appropriations made under section 338 to carry out this 
subpart. 
Waiver. 
Waiver. 
u 
PROVISION OF HEALTH SERVICES BY CORPS MEMBERS 
"SEO. 335. (a) In providing health services in a health manpower 42 USC 254h. 
shortage area. Corps members shall utilize the techniques, facilities, 
and organizational forms most appropriate for the area, population 
group, medical facility, or other public facility, and shall, to the maxi-
mum extent feasible, provide such services (1) to all individuals in, 
or served by, such health manpower shortage area regardless of their 
ability to pay for the services, and (2) in connection with (A) direct 
health services programs carried out by the Service, (B) any other 
direct health services program carried out in whole or in part with 
Federal financial assistance, or (C) any other health services activity 
which is in furtherance of the purposes of this subpart. 
90 STAT. 2276 
PUBLIC LAW 94-484—OCT. 12, 1976 
Loan. 
Equipment sales. 
Fair market 
value. 
Notice and 
hearing. 
42 use 1395, 
1396. 
"Hospital." 
"(b) (1) Notwithstanding any other provision of law, the Secretary 
may (A) to the maximum extent feasible make such arrangements 
as he determines necessary to enable Corps members to utilize the 
health facilities in or serving the health manpower shortage area 
in providing health services; (B) make such arrangements as he 
determines are necessary for the use of equipment and supplies of the 
Service and for the lease or acquisition of other equipment and sup-
plies; and (C) secure the permanent or temporary services of physi-
cians, dentists, nurses, administrators, and other health personnel. If 
there are no health facilities in or serving such area, the Secretary may 
arrange to have Corps members provide health services in the nearest 
health facilities of the Service or may lease or otherwise provide facil-
ities in or serving such area for the provision of health services. 
"(2) If the individuals in or served by a health manpower shortage 
area are being served (as determined under regulations of the Secre-
tary) by a hospital or other health care delivery facility of the Service, 
the Secretary may, in addition to such other arrangements as he may 
make under paragraph (1), arrange for the utilization of such hospital 
or facility by Corps members in providing health services, but only 
to the extent that such utilization will not impair the delivery of health 
services and treatment through such hospital or facility to individuals 
who are entitled to health services and treatment through such hos-
pital or facility. 
"(c) The Secretary may make one loan to any entity with an 
approved application under section 333 to assist such entity in meet-
ing the costs of (1) establishing medical, dental, or other health pro-
fession practices, including the development of medical practice 
management systems; (2) acquiring equipment for use in providing 
health services; (3) renovating buildings to establish health facilities; 
and (4) establishing appropriate continuing education programs. No 
loan may be made under this subsection unless an application therefor 
is submitted to, and approved by, the Secretary. The amount of any 
such loan shall be determined by the Secretary, except that no such 
loan may exceed $50,000. 
"(d) Upon the expiration of the assignment of all Corps members 
to a health manpower shortage area, the Secretary may (notwithstand-
ing any other provision of law) sell, to any appropriate local entity, 
equipment and other property of the United States utilized by such 
members in providing Jiealth services. Sales made under this subsec-
tion shall be made at the fair market value (as determined by the 
Secretary) of the equipment or such other property; except that the 
Secretary may make such sales for a lesser value to an appropriate 
local entity, if he determines that the entity is financially unable to 
pay the full market value. 
"(e) (1) (A) It shall be unlawful for any hospital to deny an author-
ized physician or dentist member of the Corps admitting privileges 
when such Corps member otherwise meets the professional qualifica-
tions established by the hospital for granting such privileges and 
agrees to abide by the published bylaws of the hospital and the pub-
lished bylaws, rules, and regulations of its medical staff. 
"(B) Any hospital which is found by the Secretary, after notice 
and an opportunity for a hearing on the record, to have violated this 
subsection shall upon such finding cease, for a period to be determined 
by the Secretary, to receive and to be eligible to receive any Federal 
funds under this Act or under titles XVIII or XIX of the Social 
Security Act. 
"(2) For purposes of this subsection, the term 'hospital' includes a 
State or local pul^lic hospital, a private profit hospital, a private non-
/ 
. 
• 
. 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2277 
profit hospital, a general or special hospital, and any other type of 
hospital (excluding a hospital owned or operated by an agency of the 
Federal Government), and any related facilities. 
"ANNUAL REPORTS 
"SEC. 336. The Secretary shall submit an annual report to Congress 
on May 1 of each year, and shall include in such report with respect 
to the previous calendar year— 
"(1) the number, identity, and priority of all health manpower 
shortage areas designated m such year and the number of health 
manpower shortage areas which the Secretary estimates will be 
designated in the subsequent year; 
" (2) the number of applications filed under section 333 in such 
year for assignment of Corps members and the action taken on 
each such application; 
"(3) the number and types of Corps members assigned in such 
year to health manpower shortage areas, the number and types 
of additional Corps members which the Secretary estimates will 
be assigned to such areas in the subsequent year, and the need for 
additional members for the Corps; 
"(4) the recruitment efforts engaged in for the Corps in such 
year and the number of qualified individuals who applied for 
service in the Corps in such year; 
"(5) the number of patients seen and the number of patient 
visits recorded during such year with respect to each health man-
power shortage area to which a Corps member was assigned dur-
ing such year; 
{&) the number of Corps members who elected, and the num-
ber 01 Corps members who did not elect, to continue to provide 
health services in health manpower shortage areas after termina-
tion of their service in the Corps and the reasons (as reported to 
the Secretary) of members who did not elect for not making 
such election; 
"(7) the results of evaluations and determinations made under 
section 333 (a) (1) (D) during such year; and 
"(8) the amount charged during such year for health services 
proviaed by Corps members, the amount which was collected 
m such year by entities in accordance with agreements under sec-
tion 334, and the amount which was paid to me Secretary in such 
year under such agreements. 
"NATIONAL ADVISORY COUNCIL 
"SEC. 337. (a) There is established a council to be known as the 
National Advisory Council on the National Health Service Corps 
(hereinafter in this section referred to as the 'Council'). The Council 
shall be composed of fifteen members appointed by the Secretary as 
follows: 
"(1) Four members shall be appointed from the general public 
to represent the consumers of health care, at least two of whom 
shall be individuals who are residents of, members of, or served by 
Corps members assigned to, a health manpower shortage area. 
"(2) Three members shall be appointed from medical, dental, 
and other health professions. 
"(3) One member shall be appointed from a State health plan-
ning and development agency (designated under section 1521), 
Report to 
Congress. 
42 use 254i. 
National 
Advisory Council 
on the National 
Health Service 
Corps. 
Establishment, 
members. 
42 use 254j. 
42 use 300m. 
90 STAT. 2278 
PUBLIC LAW 94-484^0CT. 12, 1976 
42 use 300m-3. 
42 use 300/-4. 
42 
use 
300k-3. 
42 
use 
300n. 
Term. 
Travel expenses. 
5 use app. I, 
42 use 254k. 
42 use 254d 
note. 
one member shall be appointed from a Statewide Health Coordi-
nating Council (designated under section 1524), and one 
member shall be appointed from a health systems agency (desig-
nated under section 1515). 
"(4) Three members shall be appointed from the Service, at 
least two of whom shall be members of the Corps directly engaged 
in the provision of health services in a health manpower shortage 
area. 
"(5) Two members shall be appointed from the National Coun-
cil on Health Planning and Development (established under sec-
tion 1503). 
No individual who is a provider of health care (as defined in section 
1531(3)) may be appointed as a member of the Council under para-
graph (1), (3), or (5). The Council shall consult with, advise, and 
make recommendations to, the Secretary with respect to his responsi-
bilities in carrying out this subpart, and shall review and comment 
upon regulations promulgated by the Secretary under this subpart. 
"(b) (1) Members of the Council shall be appointed for a term of 
three years, except that any member appointed to fill a vacancy occur-
ring prior to the expiration of the term for which the member's 
predecessor was appointed shall be appointed for the remainder of 
such term. No member shall be removed, except for cause. Members 
may be reappointed to the Council. 
"(2) Members of the Council (other than members who are officers 
or employees of the United States), while attending meetings or con-
ferences thereof or otherwise serving on the business of the Council, 
shall be entitled to receive for each day (including traveltime) in 
which they are so serving the daily equivalent of the annual rate of 
basic pay in effect for grade GS-18 of the General Schedule; and while 
so serving away from their homes or regular places of business all 
members may be allowed travel expenses, including per diem in 
lieu of subsistence, as authorized by section 5703(b) of title 5 of the 
United States Code for persons in the Government Service employed 
intermittently. 
"(c) Section 14 of the Federal Advisory Committee Act shall not 
apply with respect to the Council. 
"AUTHORIZATION or APPROPRIATION 
"SEC. 338. (a) To carry out the purposes of this subpart, there are 
authorized to be appropriated $47,000,000 for the fiscal year 
ending September 30, 1978; $57,000,000 for the fiscal year ending 
September 30,1979; and $70,000,000 for the fiscal year ending Septem-
ber 30,1980. 
"(b) An appropriation under an authorization under subsection (a) 
for any fiscal year may be made at any time before that fiscal year and 
may be included in an Act making an appropriation under an authori-
zation under subsection (a) for another fiscal year; but no funds may 
be made available from any appropriation under such authorization 
for obligation under this subpart before the fiscal year for which such 
appropriation is authorized.". 
(c)(1) The amendment made by subsections (a) and (b) shall apply 
only with respect to fiscal years beginning after September 30, 1977, 
except that the Secretary of Health, Education, and Welfare shall 
carry out the activities described in section 332 of the Public Health 
Service Act (as added by such amendment) after the date of enact-
ment of this Act. 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2279 
(2) (A^ Any area for which a designation under section 329(b) of 
the Public Health Service Act (as in effect on September 30, 1977) 
was in effect on such date and in which National Health Service Corps 
personnel were, on such date, providing, under an assignment made 
under such section (as so in effect), health care and services for persons 
residing in such area shall, effective October 1, 1977, be considered 
under subpart II of part C of title III of such Act (as added by sub-
section (b) of this section) to (i) be designated a health manpower 
shortage area (as defined by section 332 of such Act (as so added)), and 
(ii) have had an application approved under section 333 of such Act 
(as so added) for the assignment of Corps personnel unless, as 
determined under subparagraph (B) of this paragraph, the assign-
ment period applicable to such area (within the meaning of section 334 
(as so added)) has expired. 
(B) The assignment period (within the meaning of such section 
334) applicable to an area described in subparagraph (A) of this 
paragraph shall be considered to have begun on the date Corps per-
sonnel were first assigned to such area under section 329 of such Act 
(as in effect on September 30,1977). 
(C) In the case of any physician or dentist member of the Corps 
who was providing health care and services on September 30, 1977, 
under an assignment made under section 329(b) of such Act (as in 
effect on September 30,1977), the number of the months during which 
such member provided such care and services before October 1, 1977, 
shall be counted in determining the application of the additional pay 
provisions of section 331(d) of such Act (as added by subsection (b) 
of this section) to such number. 
(3) The amendment made by subsection (b) which established an 
Advisory Council previously established under section 329 of the 
Public Health Service Act shall not be construed as requiring the 
establishment of a new Advisory Council under such section 337; and 
the amendment made by such subsection with respect to the composi-
tion of such Advisory Council shall apply with respect to appoint-
ments made to the Advisory Council after October 1, 1977, and the 
Secretary of Health, Education, and Welfare shall make appoint-
ments to the Advisory Council after such date in a manner which will 
brin^ about, at the earliest feasible time, the Advisory Council com-
position prescribed by the amendment. 
fd) (1) Section 741(f) (1) (C) is amended by striking out all that 42 U
S
C 294a, 
follows after "in a State" and inserting in lieu thereof "in a health ^^'*°-
manpower shortage area designated under section 332:". 
(2) The amendment made by paragraph (1) shall apply with 42 USC 294n 
respect to agreements entered into under section 741(f) of the Public °°*®-
Health Service Act after September 30,1977. 
SCHOLARSHIPS AND PUBLIC HEALTH 
TRAINEESHIPS 
SEC. 408. (a) Effective October 1, 1977, part C of title VII is Effective date, 
amended by adding at the end thereof the following new subpart: 
"Subpart III—Traineeships for Students in Schools of Public Health 
and Other Graduate Programs 
(
(
< 
TRAINEESHIPS FOR STUDENTS IN SCHOOLS OF PUBLIC HEALTH 
"SEC. 748. (a) The Secretary may make grants to accredited Grants, 
schools of public health for traineeships to train students enrolled in 42 USC 294r. 
such schools. 
90 STAT. 2280 
PUBLIC LAW 94-484—OCT. 12, 1976 
Application. 
Appropriation 
authorization. 
"(b) (1) No grant for traineeships may be made under subsection 
(a) unless an application therefor has been submitted to, and approved 
by, the Secretary. Such application shall be in such form, be submitted 
in such manner, and contain such information, as the Secretary by 
regulation may prescribe. Traineeships under such a grant shall be 
awarded in accordance with such regulations as the Secretary shall 
prescribe. The amount of any such grant shall be determined by the 
Secretary. 
"(2) Traineeships awarded under grants made under subsection (a) 
shall provide for such stipends and allowances (including travel and 
subsistence expenses and dependency allowances) for the trainees as 
the Secretary may deem necessary. 
"(3) In awarding traineeships under this section, each applicant 
shall assure to the satisfaction of the Secretary that at least the per-
cent specified in paragraph (4) of the funds received under this sec-
tion shall go to individuals who— 
"(A) (i) have previously received a postbaccalaureate degree, 
or 
"(ii) have three years of work experience in health services; 
and 
"(B) are pursuing a course of study in— 
"(i) biostatistics or epidemiology, 
"(ii) health administration, health planning, or health 
policy analysis and planning, 
"(iii) environmental or occupational health, or 
"(iv) dietetics or nutrition. 
"(4) The percent referred to in paragraph (3) is— 
"(A) 45 percent for grants made for the fiscal year ending 
September 30,1978, 
"(B) 55 percent for grants made for the fiscal year ending 
September 30,1979, and 
"(C) 65 percent for grants made for the fiscal year ending 
September 30, 1980, and in succeeding fiscal years. 
"(c) For payments under grants under subsection (a), there 
are authorized to be appropriated $7,500,000 for the fiscal year ending 
September 30, 1978: $8,000,000 for the fiscal year ending September 
30,1979; and $9,000,000 for the fiscal year ending September 30,1980. 
Grants. 
42 u s e 2948. 
Application. 
Regulation. 
"TRAINEESHIPS FOR STUDENTS IN OTHER GRADUATE PROGRAMS 
"SEC. 749. (a) The Secretary may make grants to public or nonprofit 
private educational entities, including graduate schools of social work 
but excluding accredited schools of puljlic healthy which offer a pro-
gram in hesQth administration, hospital administration, or health 
policy analysis and planning, which program is accredited by a body 
or bodies approved for such purpose by the Commissioner of Educa-
tion and which meets such other quality standards as the Secretary by 
regulation may prescribe, for traineeships to train students enrolled 
in such a program. 
"(b) (1) No grant for traineeships may be made under subsection 
(a) unless an application therefor has been submitted to, and approved 
hy^ the Secretary. Such application shall be in such form, be sub-
mitted in such manner, and contain such information, as the Secretary 
by regulation may prescribe. Traineeships under such a grant shall be 
awarded in accordance with such regulations as the Secretary shall 
prescribe. The amount of any such grant shall be determined by the 
Secretary. 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2281 
"(2) Traineeships awarded under grants made under subsection (a) 
shall provide for such stipends and allowances (including travel and 
subsistence expenses and dependency allowances) for the trainees as 
the Secretary may deem necessary. 
"(3) In awarding traineeships under this section, each applicant 
shall assure to the satisfaction of the Secretary that at least 80 per-
cent of the funds received under this section shall go to individuals 
who (A) have previously received a postbaccalaureate degree, or (B) 
have three years of work experience in health services. 
"(c) For payments under grants under subsection (a), there are 
authorized to be appropriated $2,500,000 for the fiscal year ending 
September 30, 1978; $2,500,000 for the fiscal year ending September 
30,1979; and $2,500,000 for the fiscal year ending September 30,1980.". 
(b) (1) Effective October 1,1977, section 225 is repealed and part C 
of title VII (as amended by subsection (a)) is amended by adding 
after subpart III the following new subpart: 
"Subpart IV—National Health Service Corps Scholarships 
Appropriation 
authorization. 
Repeal. 
42 use 234. 
(C 
NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP PROGRAM 
Establishment. 
42 use 294t. 
"SEC. 751. (a) The Secretary shall establish the National Health 
Service Corps Scholarship Program (hereinafter in this subpart 
referred to as the 'Scholarship Program') to assure an adequate sup-
ply of trained physicians, dentists, and nurses for the National Health 
Service Corps (hereinafter in this subpart referred to as the 'Corps') 
and, if needed by the Corps, podiatrists, optometrists, pharmacists, 
graduates of schools of veterinary medicine, graduates of schools of 
public health, graduates of programs in health administration, grad-
uates of programs for the training of physician assistants, expanded 
function dental auxiliaries, and nurse practitioners (as defined in sec-
tion 822), and other health professionals. 
"(b) To be eligible to participate in the Scholarship Program, an Eligibility 
individual must— 
"(1) be accepted for enrollment, or be enrolled, as a full-time 
student (A) in an accredited (as determined by the Secretary) 
educational institution in a State and (B) in a course of study or 
program, offered by such institution and approved by the Secre-
tary, leading to a degree in medicine, osteopathy, dentistry, or 
other health profession; 
"(2) be eligible for, or hold, an appointment as a commissioned 
officer in the Regular or Reserve Corps of the Service or be eli-
gible for selection for civilian service in the Corps; 
"(3) submit an application to participate m the Scholarship 
Program; and 
"(4) sign and submit to the Secretary, at the time of submittal 
of such application, a written contract (described in subsection 
(f)) to accept payment of a scholarship and to serve (in accord-
ance with this subpart) for the applicable period of obligated 
service in a health manpower shortage area. 
"(c) In disseminating application forms and contract forms to 
individuals desiring to participate in the Scholarship Program, the 
Secretary shall include with such forms— 
" ( 1 ) a fair summary of the rights and liabilities of an indi-
vidual whose application is approved (and whose contract is 
accepted^ by the Secretary, including in the summary a clear 
explanation of the damages to which the United States is entitled 
90 STAT. 2282 
PUBLIC LAW 94-484—OCT. 12, 1976 
under section 754 in the case of the individual's breach of the 
contract; and 
" (2) such other information as may be necessary for the indi-
vidual to understand the individual's prospective participation in 
the Scholarship Program and service in the Corps. 
The application form, contract form, and all other information fur-
nished by the Secretary under this subpart shall be written in a manner 
calculated to be understood by the average individual applying to 
Review and 
participate in the Scholarship Program. The Secretary shall make 
evaluation. 
such application forms, contract forms, and other information avail-
able to individuals desiring to participate in the Scholarship Program 
on a date sufficiently early to insure that such individuals have ade-
quate time to carefully review and evaluate such forms and 
information. 
"(d) In determining which applications under the Scholarship Pro-
gram to approve (and which contracts to accept), the Secretary shall 
give priority— 
"(1) first, to applications made (and contracts submitted) by 
individuals who have previously received scholarships under the 
Scholarship Program or under section 758; and 
"(2) second, to applications made (and contracts submitted)— 
" (A) in the school year ending in the fiscal year beginning 
October 1, 1977, by individuals who are entering their first 
or second year of study in a course of study or program 
described in subsection (b)(1)(B) in such school year; and 
"(B) in each school year thereafter, by individuals who 
are entering their first year of study in a course of study or 
program described in subsection (b) (1) (B) in such school 
year. 
"(e)(1) An individual becomes a participant in the Scholarship 
Program only upon the Secretary's approval of the individual's appli-
cation submitted under subsection (b) (3) and the Secretary's accept-
ance of the contract submitted by the individual under subsection 
(b)(4). 
"(2) The Secretary shall provide written notice to an individual 
promptly upon the Secretary's approving, under paragraph (1), of 
the individual's participation in the Scholarship Program. 
"(f) The written contract (referred to in this subpart) between the 
Secretary and an indiAddual shall contain— 
"(1) an agreement that— 
"(A) subject to paragraph (2), the Secretary agrees (i) 
to provide the individual with a scholarship (described in 
subsection (g)) in each such school year or years for a period 
of years (not to exceed four school years) determined by the 
individual, during which period the individual is pursuing a 
course of study described in subsection (b) (1) (B), and (li) 
to accept (subject to the availability of appropriated funds 
Ante, p. 2268. 
for carrying out subpart II of part C of title III) the indi-
vidual into the Corps (or for equivalent service as otherwise 
provided in this subpart); and 
"(B) subject to paragraph (2), the individual agrees— 
"(i) to accept provision of such a scholarship to the 
individual; 
"(ii) to maintain enrollment in a course of study 
described in subsection (b)(1)(B) until the individual 
completes the course of study; 
"(iii) while enrolled in such course of study, to main-
tain an acceptable level of academic standing (as deter-
Notice. 
Written contract. 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2283 
mined under regulations of the Secretary by the 
educational institution offering such course of study); 
and 
"(iv) to serve for a time period (hereinafter in the 
subpart referred to as the 'period of obligated service') 
equal to— 
"(I) one year for each school year for which the 
individual was provided a scholarship under the 
Scholarship Program, or 
"(II) two years, 
whichever is greater, in a health manpower shortage area 
(designated under section 332) to which he is assigned ^nte, p. 2270. 
by the Secretary as a member of the Corps, or as other-
wise j)rovided in this subpart; 
"(2) a provision that any financial obligation of the United 
States arising out of a contract entered into under this subpart 
and any obligation of the individual which is conditioned thereon, 
is contingent upon funds being appropriated for scholarships 
under this subpart and to carry out the purposes of subpart II 
of part C of title I I I ; 
Ante, p. 2268. 
"(3) a statement of the damages to which the United States is 
entitled, under section 754, for the individual's breach of the con-
tract; and 
"(4) such other statements of the rights and liabilities of the 
Secretary and of the individual, not inconsistent with the provi-
sions of this subpart. 
"(g)(1) A. scholarship provided to a student for a school year 
^ = •* 
under a written contract under the Scholarship Program or under 
section 758 (relating to scholarships for first-year students of excep-
tional financial need), shall consist o
f
—
• 
"(A) payment to, or (in accordance with paragraph (2)) on 
behalf of, the student of the amount (except as provided in sec-
tion 711) of— 
*'(i) the tuition of the student in such school year; and 
"(ii) all other reasonable educational expenses, including 
fees, books, and laboratory expenses, incurred by the student 
in such school year; and 
"(B) payment to the student of a stipend of $400 per month 
(adjusted in accordance with paragraph (3)) for each of the 12 
consecutive months beginning with the first month of such school 
year. 
"(2) The Secretary may contract with an educational institution. Contract, 
in which a participant in the Scholarship Program is enrolled, for the 
payment to the educational institution of the amounts of tuition and 
other reasonable educational expenses described in paragraph (1) (A). 
Payment to such an educational institution may be made without 
regard to section 3648 of the Eevised Statutes (31 U.S.C. 529). 
"(3) The amount of the monthly stipend, specified in paragraph 
(1) (B) and as previously adjusted (if at all) in accordance with 
this paragraph, shall be increased by the Secretary for each school 
year ending m a fiscal year beginning after September 30, 1978, by 
an amount (rounded to the next highest multiple of $1) equal to 
the amount of such stipend multiplied by the overall percentage 
(as set forth in the report transmitted to the Congress under sec-
tion 5303 of title 5, United States Code) of the adjustment (if 
such adjustment is an increase) in the rates of pay under the Gen-
eral Schedule made effective in the fiscal year in which such school 
year ends. 
90 STAT. 2284 
PUBLIC LAW 94-464—OCT. 12, 1976 
"(h) Notwithstanding any other provision of law, individuals 
who have entered into written contracts with the Secretary under 
this section, while undergoing academic training, shall not be counted 
against any employment ceiling affecting the Department. 
Report to 
"(t) The Secretary shall report to Congress on December 1 of 
Congress. 
each year— 
"(1) the number, and type of health profession training, of 
students receiving scholarships under the Scholarship Program; 
"(2) the educational institutions at which such students are 
receiving their training; 
"(3) the number of applications filed under this section in the 
school year beginning in such year and in prior school years; 
and 
"(4) the amount of tuition paid in the aggregate and at each 
educational institution for the school year beginning in such 
year and for prior school years. 
"(j) The administrative unit which administers section 770 shall— 
"(1) participate in the development of regulations, funding 
priorities, and application forms, and 
"(2) be consulted by, and may make recommendations to, the 
Secretary in the review of applications for scholarships and 
grants, 
with respect to the Scholarship Program. 
OBLIGATED SERVICE 
42 use 294u. 
Notification. 
"SEC. 752. (a) Except as provided in section 763, each individual 
who has entered into a written contract with the Secretary under sec-
tion 751 shall provide service in the full-time clinical practice of 
such individuars profession as a member of the Corps for the period 
of obligated service provided in such contract. 
"(b)(1) The Secretary shall notify each individual required to 
provide service under the Scholarship Program, not later than 60 
days before the date described in paragraph (5), of the opportunity of 
such individual to serve in the full-time clinical practice of his pro-
fession either as a commissioned officer in the Regular or Reserve 
Corps of the Service or as a civilian member of the Corps. The Sec-
retary shall include in such notice sufficient information regarding the 
advantages and disadvantages to each alternative to enable an indi-
vidual to make a decision on an informed basis. 
"(2) To be eligible to provide obligated service as a commissioned 
officer in the Service, an individual shall notify the Secretary, not 
later than 30 days before the date described in paragraph (5), of the 
individual's desire to provide such service as such an officer. 
"(3) If an individual who has notified the Secretary under para-
graph (2) qualifies for an appointment as such an officer, the Secretary 
shall, as soon as possible after the date described in paragraph (5), 
appoint the individual as a commissioned officer of the Regular or 
Reserve Corps and of the Service and shall designate the individual 
as a member of the Corps. If an individual who has notified the Sec-
retary under paragraph (2) does not so qualify, the Secretary shall, 
as soon as possible after the date described in paragraph (5), appoint 
such individual in accordance with paragraph (4). 
"(4) Except as provided in paragraph (3) and in section 753, the 
Secretary shall appoint each individual, as soon as possible after the 
date described in paragraph (5), to serve in the full-time clinical prac-
tice of his profession as a civilian member of the Corps. 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2285 
"(5) (A) With respect to an individual receiving a degree from a 
school of medicine, osteopathy, or dentistry, the date referred to in 
paragraphs (1) through (4) shall be the date upon which the indi-
vidual completes the training required for such degree, except that the 
Secretary shall, at the request of such individual, defer such date until 
the end of the period of time (not to exceed three years) required for 
the individual to complete an internship, residency, or other advanced 
clinical training. No such period of internship, residency, or other 
advanced clinical training shall be counted toward satisfying a period 
of obligated service under this subpart. 
"(B) With respect to an individual receiving a degree from an 
institution other than a school of medicine, osteopathy, or dentistry, 
the date referred to in paragraphs (1) through (4) shall be the date 
upon which the individual completes his academic training leading to 
such degree. 
"(c) An individual shall be considered to have begun serving a 
period of obligated service— 
"(1) on the date such individual is appointed as an officer in 
a Regular or Reserve Corps of the Service or as a member of the 
Corps, or 
"(2) in the case of an individual who has entered into an agree-
ment with the Secretary under section 753, on the date specified Infra. 
in such agreement, 
whichever is earlier. 
"(d) The Secretary shall assign individuals performing obligated 
service in accordance with a written contract under the Scholarship 
Program to health manpower shortage areas in accordance with sub-
part II of part C of title III. If the Secretary determines that there Ante, p. 2268. 
IS no need in a health manpower shortage area (designated under sec-
tion 332) for a member of the profession in which an individual 
Ante, p. 2270,, 
is obligated to provide service under a written contract, the Secretary 
may detail such individual to serve his period of obligated service as 
a full-time member of such profession in such unit of Sie Department 
as the Secretary may determine. 
" (e) Notwithstanding any other provision of this title, if the Sec-
retary determines that an individual who is or has been a participant 
in the Scholarship Program demonstrates exceptional promise for 
medical research, the Secretary may permit such individual to per-
form his service obligation under the National Research Service 
Award program established under section 472. 
42 U
S
C 289/-1. 
(( 
PRIVATE PRACTICE 
"SEC. 753. (a) The Secretary shall release an individual from all or Written 
part of his service obligation under section 752 (a) if the individual agreement, 
applies for such a release under this section and enters into a written ^^ USC 294v. 
agreement with the Secretary under which the individual agrees to 
engage for a period equal to the remaining period of his service obli-
gation in the full-time private clinical practice (including service as 
a salaried employee in an entity directly providing health services) 
of his health profession— 
"(1) in the case of an individual who is performing obligated 
service as a member of the Corps in a health manpower short-
age area on the date of his application for such a release, in the 
health manpower shortage area in which such individual is serv-
ing on such date; or 
90 STAT. 2286 
PUBLIC LAW 94-484—OCT. 12, 1976 
"(2) in the case of any other individual, in a health manpower 
Ante, p. 2270. 
shortage area (designated under section 332) which (A) has a 
priority for the assignment of Corps members under section 
Ante, p. 2272. 
333(c), and (B) has a sufficient financial base to sustain such 
private practice and to provide the individual with income of not 
less than the income of members of the Corps. 
In the case of an individual described in paragraph (1), the Secre-
tary shall release the individual from his service obligation under this 
subsection only if the Secretary determines that the area in which the 
individual is serving meets the requirement of clause (B) of para-
graph (2). 
"(b) The written agreement described in subsection (a) shall— 
"(1) provide that during the period of private practice by an 
individual pursuant to the agreement— 
"(A) any person who receives health services provided by 
the individual in connection with such practice will be charged 
for such services at the usual and customary rate prevailing 
in the area in which such services are provided, except that 
if such person is unable to pay such charge, such person shall 
be charged at a reduced rate or not charged any fee; and 
"(B) the individual in providing health services in con-
nection with such practice shall not discriminate against any 
person on the basis of such person's ability to pay for such 
services or because payment for the health services provided 
to such person will be made under the insurance program 
established under part A or B of title XVIII of the Social 
Security Act or under a State plan for medical assistance 
approved under title XIX of such Act; and 
"(2) contain such additional provisions as the Secretary may 
require to carry out the purposes of this section. 
For purposes of paragraph (1)(A), the Secretary shall by regula-
tion prescribe the method for determining a person's ability to pay a 
charge for health services and the method of determining the amount 
(if any) to be charged such person based on such ability. 
"BREACH OF SCHOLARSHIP CONTRACT 
42 use 294w. 
"SEC. 754. (a) An individual (other than an individual described 
in subsection (b)) who has entei-ed into a written contract with the 
Secretary under section 751 and who fails to accept payment, or 
instructs the educational institution in which he is enrolled not to 
accept payment, in whole or in part, of a scholarship under such 
contract, shall, in addition to any service or other obligation or 
liability under the contract, be liable to the United States for the 
amount of $1,500 as liquidated damages. 
"(b) An individual who has entered into a written contract with 
the Secretary under section 751 and who— 
"(1) fails to maintain an acceptable level of academic stand-
ing in the educational institution in which he is enrolled (such 
level determined by the educational institution under regulations 
of the Secretary), 
"(2) is dismissed from such educational institution for disci-
plinary reasons, or 
"(3) voluntarily terminates the training in such an educa-
tional institution for which he is provided a scholarship under 
such contract, before the completion of such training, 
in lieu of any service obligation arising under such contract, shall be 
42 use 1395c, 
1395J. 
42 use 1396. 
Regulation. 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2287 
liable to the United States for the amount which has been paid to him, 
OT^bn his behalf, under the contract. 
^ 
"(c) If an individual breaches his written contract by failing (for 
any reason) either to begin such individual's service obligation in 
accordance with section 752 or 753 or to complete such service obliga-
tion, the United States shall be entitled to recover from the individual 
an amount determined in accordance with the formula 
-3*(^0 
in which 'A' is the amount the United States is entitled to recover. 
'0' is the sum of the amount paid under this subpart to or on behali 
of the individual and the interest on such amount which would be pay-
able if at the time it was paid it was a loan bearing interest at the 
maximum legal prevuiling rate, as determined by the Treasurer of the 
United States; 't' is the total number of months in the individual's 
period of obligated service; and 's' is the number of months of such 
period served by him in accordance with section 752 or a written 
agreement under section 753. Any amount of damages which the 
United States is entitled to recover under this subsection shall, within 
the one year period beginning on the date of the breach of the writ-
ten contract, be paid to the United States. 
"(d)(1) Any obligation of an individual under the Scholarship 
Program (or a contract thereunder) for service or payment of dam-
ages shall be canceled upon the death of the individual. 
"(2) The Secretary shall by regulation provide for the waiver or 
suspension of any obligation of service or payment by an individual 
under the Scholarship Pro-am (or a contract thereunder) when-
ever compliance by tne individual is impossible or would involve 
extreme hardship to the individual and if enforcement of such obli-
gation with respect to any individual would be unconscionable. 
"(3) Any obligation of an individual under the Scholarship Pro-
gram (or a contract thereunder) for payment of damages may be 
released by a discharge in bankruptcy under title 11 of the United 
States Code only if such discharge is granted after the expiration of 11 USC 1 et seq. 
the five-year period beginning on the first date that payment of such 
damages is required. 
"SPECIAL GRANTS FOR FORMER CORPS MEMBERS TO ENTER PRIVATE 
PRACTICE 
"SEC. 755. (a) The Secretary may make one grant to an individual 42 USC 294x. 
(other than an individual who has entered into an agreement under 
section 763)— 
"(1) who has completed his period of obligated service in the 
Corps, and 
"(2) who has agreed in writing— 
Agreement. 
"(A) to engage in the private full-time clinical practice of 
his profession in a health manpower shortage area (desig-
nated under section 332 and described in paragraphs (1) Ante, p. 2270. 
and (2) of section 753(a)) for a period (beginning not later 
than one year after the date he completed his period of obli-
gated service in the Corps) of not less than one year; 
"(B) to conduct such practice in accordance with the pro-
visions of section 753 (b) (1); and 
' 
"(C) to such additional conditions as the Secretary may 
require to carry out the purposes of this section; 
90 STAT. 2288 
PUBLIC LAW 94-484—OCT. 12. 1976 
to assist such individual in meeting the costs of beginning the prac-
tice of such individual's profession in accordance with such agree-
ment, including the costs of acquiring equipment and renovating 
facilities for use in providing health services, and of hiring nurses 
and other personnel to assist in providing health services. Such grant 
may not be used for the purchase or construction of any building. 
"(b) The amount of the grant under subsection (a) to an individual 
shall be— 
"(1) $12,500, if the individual agrees to practice his profession 
in accordance with the agreement for a period of at least one year, 
but less than two years; or 
"(2) $25,000 if the individual agrees to practice his profession 
in accordance with the agreement for a period of at least two 
years. 
"(c) The Secretary may not make a grant under this section unless 
an application therefor has been submitted to, and approved by, the 
Secretary. 
Breach of 
"(d) If the Secretary determines that an individual has breached a 
agreement, 
written agreement entered into under subsection (a), he shall, as soon 
notification. 
j^g practicable after making such determination, notify the individual 
of such determination. If within 120 days after the date of giving such 
notice, such individual is not practicing his profession in accordance 
with the agreement under such subsection and has not provided assur-
ances satisfactory to the Secretary that he will not knowingly violate 
such agreement again, the United States shall be entitled to recover 
from such individual an amount determined under section 754 (c), 
except that in applying the formula contained in such section, '0' snail 
be the sum of the amount of the grant made under subsection (a) to 
such individual and the interest on such amount which would be pay-
able if at the time it was paid it was a loan bearing interest at the max-
imum legal prevailing rate, 't' shall be the number of months that such 
individual agreed to practice his profession under such agreement, and 
's' shall be the number of months that such individual practices his 
profession in accordance with such agreement. 
(( 
AUTHORIZATION OF APPROPRIATIONS 
42 use 294y. 
"SEC. 756. (a) There are authorized to be appropriated for scholar-
ships under this subpart $75,000,000 for the fiscal year ending Sep-
tember 30,1978, $140,000,000 for the fiscal year ending September 30, 
1979, and $200,000,000 for the fiscal year ending September 30,1980. 
For the fiscal year ending September 30,1981, and for each of the two 
succeeding fiscal years, there are authorized to be appropriated such 
sums as may be necessary to continue to make scholarship awards to 
students wlio have entered into written contracts under the Scholar-
ship Program before October 1,1980. 
"(b) Of the sums appropriated under this section (1) 90 percent 
shall be obligated for sdiolarships for medical, osteopathic, and den-
tal students, and (2) 10 percent of such 90 percent shall be obligated 
for scholarships for dental students,". 
42 use 294t 
(2) (A) Except as provided in subparagraph ( B ) , the amendment 
°°*®' 
made by paragraph (1) of this subsection shall applj^ with respect to 
scholarships awarded under the National Health Service Corps Schol-
arship Program from appropriations for such Program for fiscal years 
beginning after September 30,1977. 
^Bte, p. 415. 
(B) The provisions of section 225(f)(1) of the Public Health 
Service Act (as in effect on September 30, 1977) prescribing the 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2289 
financial obligation of a participant in the Public Health and National 
Health Service Corps Scholarship Program who fails to complete an 
active duty service obligation incurred under that Program shall 
apply to any individual who received a scholarship under such Pro-
gram for any school year ending before September 30, 1977, irrespec-
tive of whether such individual received such a scholarship after 
that date. 
(C) Periods of internship or residency served before September 30, 
1976, in a facility of the National Health Service Corps or other facil-
ity of the Public Health Service in accordance with an agreement 
entered into under section 225(b) of the Public Health Service Act 42 USC 234. 
(as in effect before that date) shall be creditable in satisfying a service 
obligation incurred under the Public Health and National Health 
Service Corps Scholarship Program as revised by this subsection. 
(c) Effective October 1, 1977, part C of title VII (as amended by 
subsections (a) and (b)) is amended by adding after subpart IV the 
following new subpart: 
"Subpart V—Other Scholarships 
" S C H O L A R S H I P S FOR FIRST-TEAR STUDENTS o r EXCEPTIONAL FINANCIAIj 
NEED 
42 USC 294z 
note. 
"SEC. 758. (a) The Secretary shall make grants to a public or non-
profit school of medicine, osteopathy, dentistry, optometry, pharmacy, 
podiatry, or veterinary medicine which is accredited as provided in 
section 721(b) (1) (B), for scholarships to be awarded by the school 
to full-time students thereof who are of exceptional financial need 
and who are in their first year of study at such school in the school 
year ending in the fiscal year in which such grant is made. 
"(b)(1) Scholarships may be awarded by a school from a grant 
under subsection (a) only to individuals who have been accepted by it 
for enrollment as full-time students in their first year of study at such 
school. 
"(2) A scholarship awarded to a student for a school year under 
a grant made under subsection (a) shall be the scholarship described 
in section 751(g). 
"(3) For purposes of this section, the term 'first year of study* 
means, with respect to a student of a school other than a school ol 
pharmacy, the student's first year of postbaccalaureate study at such 
school. 
"(c) The Secretary shall distribute grants under this section among 
all schools of the health professions, but shall give priority in dis-
tributing such grants to schools of medicine, osteopathy, and dentistry. 
"(d) For the purpose of making grants under this section, there is 
authorized to be appropriated $16,000,000 for the fiscal year ending 
September 30, 1978, $17,000,000 for the fiscal year ending September 
30,1979, and $18,000,000 for the fiscal year ending September 30,1980. 
Grants. 
42 USC 294z. 
"First year of 
study." 
Appropriation 
autnorization. 
"LISTER HILL SCHOLARSHIP PROGRAM 
"SEC. 759. (a) The Secretary annually shall make grants to at least 
10 individuals (to be known as Lister Hill scholars) for scholarships 
of up to $8,000 per year for up to four years of medical school if such 
individuals agree to enter into the family practice of medicine in a 
health manpower shortage area in accordance with this section. Grants 
made under this section shall be made only from funds appropriated 
under subsection (b). 
Grants. 
42 USC 294aa. 
90 STAT. 2290 
PUBLIC LAW 94-4«4—OCT. 12, 1976 
Appropriation 
authorization. 
"(b) There are authorized to be appropriated to carry out the pur-
poses of this section $80,000 for the fiscal year ending September 30, 
1977, $160,000 for the fiscal year ending September 30,1978, $240,000 
for the fiscal year ending September 30, 1979, and $320,000 for the 
fiscal year ending September 30,1980. For the fiscal year ending Sep-
tember 30,1981 and for each succeeding fiscal year, there are authorized 
to be appropriated such sums as may be necessary to continue to make 
such grants to students who (prior to October 1,1980) have received 
such a grant under this section during such succeeding fiscal year.". 
Repeal. 
42 use 295g, 
295g-l, 
295g-ll, 
295g-21-
295g-23. 
Grants. 
42 use 295g 
note. 
42 use 295g. 
42 use 
295g-21. 
SCHOLARSHIPS 
SEC. 409. (a) Effective October 1, 1976, subparts I, II, and I I I of 
part F of title VII are repealed. 
(b) The Secretary of Health, Education, and Welfare during the 
period beginning October 1, 1976, and ending September 30, 1979, 
may (1) make grants under section 780 of the Public Health Service 
Act (as in effect before October 1,1976) to public and nonprofit private 
schools of medicine, osteopathy, dentistry, veterinary medicine, 
optometry, podiatry, and pharmacy to enable such schools to continue 
making payments under scholarship awards to individuals enrolled 
and in good standing as full-time students who initially received such 
awards out of grants made to the schools under such section 780 for 
fiscal years ending before October 1, 1976, and (2) make scholarship 
grants under section 784 of such Act (as in effect before October 1, 
1976) to individuals enrolled and in good standing as medical students 
who initially received such grants before October 1, 1976. 
TITLE V—GKANTS FOR HEALTH PROFESSIONS 
SCHOOLS 
GRANT AMOUNTS; AUTHORIZATIONS 
42 use 295f. 
SEC. 501. (a) Section 770 (a) is amended to read as follows: 
" (a) GRANT COMPUTATION.—The Secretary shall make annual grants 
to schools of medicine, osteopathy, dentistry, public health, veterinary 
medicine, optometry, pharmacy, and podiatry for the support of the 
education programs of such schools. The amount of the annual grant 
to each such school with an approved application shall be computed 
for each fiscal year as follows: 
"(1) Each school of medicine, osteopathy, and dentistry shall 
receive— 
"(A) for the fiscal year ending September 30,1978, $2,000 
for each full-time student enrolled in such school in the school 
year beginning in such fiscal year, 
"(B) for the fiscal year ending September 30,1979, $2,050 
for each full-time student enrolled in such school in the school 
year beginning in such fiscal year, and 
"(C) for the fiscal year ending September 30, 1980, $2,100 
for each full-time student enrolled in such school in the school 
year beginning in such fiscal year. 
" (2) (A) Each school of public health shall receive for the fiscal 
year ending September 30,1978, and for each of the next two fiscal 
years an amount equal to the product of— 
"(i) $1,400, and 
"(ii) the sum of (I) the number of full-time students 
enrolled in such school in the school year beginning in such 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2291 
fiscal year, and (II) the number of full-time equivalents of 
part-time students, determined pursuant to subparagraph 
(B), for such school for such school year. 
"(B) For purposes of subparagraph (A) the number of full-
time equivalents of part-time students for a school of public health 
for any school year is a number equal to— 
" (i) the total number of credit hours of instruction in such 
year lor which part-time students of such school, who are 
pursuing a course of study leading to a graduate degree in 
public health or an equivalent degree, have enrolled, divided 
by 
"(ii) the greater of (I) the number of credit hours of 
instruction which a full-time student of such school was 
required to take in such year, or (II) 9, 
rounded to the next highest whole number. 
"(3) For the fiscal year ending September 30, 1978, and for 
each of the next two fiscal years, each school of veterinary medi-
cine shall receive $1,450 for each full-time student enrolled in such 
school in the school year beginning in such fiscal year. 
"(4) For the fiscal year ending Septeimber 30, 1978, and for 
each of the next two fiscal years, each school of optometry shall 
receive $765 for each full-time student enrolled in such school in 
the school year beginning in such fiscal year. 
"(5) For the fiscal year ending September 30, 1978, and for 
each of the next two fiscal years, each school of pharmacy (other 
than a school of pharmacy with a course of study of more than 
four years) shall receive $695 for each full-time student enrolled 
in such school in the school year beginning in such fiscal year. 
Each school of pharmacy with a course of study of more than four 
years shall receive $695 for each full-time student enrolled in the 
last four years of such school. For purposes of section 771, a Post, p. 2293. 
student enrolled in the first year of the last four years of such 
school shall be considered a first-year student. 
"(6) For the fiscal year endmg September 30, 1978, and for 
each of the next two fiscal years, each school of podiatry shall 
receive $965 for each full-time student enrolled in such school in 
the school year beginning in such fiscal year.", 
(b) Subsection (b) of section 770 is amended to read as follows: 
'*2 U
S
C 295f. 
"(b) APPORTIONMENT OF APPROPRIATIONS.—Notwithstanding subsec-
tion (a), if the aggregate of the amounts of the grants to be made in 
accordance with such subsection for any fiscal year to schools of either 
medicine, osteopathy, dentistry, public health, veterinary medicine, 
optometry, pharmacy, or podiatry with approved applications exceeds 
the total of the amounts appropriated for such category of schools 
under the appropriate paragraph of subsection (e) for such grants, 
the amount of a school's grant with respect to which such excess exists 
shall for such fiscal year be an amount which bears the same ratio to 
the amount determined for the school under subsection (a) as the 
total of the amounts appropriated for that year under the appropriate 
paragraph of subsection (e) for grants to schools of the same category 
as such school bears to the amount required to make grants in accord-
ance with subsection (a) to each of the schools of that category with 
approved applications.". 
(c)(1) Subsections (c), (d), (e), (f), and (g) of section 770 are Repeal, 
repealed. 
(2) Subsection (h) of section 770 is (A) redesignated as subsec-
tion (c), and (B) is amended to read as follows: 
90 STAT. 2292 
PUBLIC LAW 94-484—OCT. 12, 1976 
"(c) 
ENROLLMENT DETERMINATIONS.— 
" (1) For purposes of this section, regulations of the Secretary 
shall include provisions relating to the determination of the num-
ber of students enrolled in a school or in a particular year-class in 
a school on the basis of estimates, on the basis of the number of 
students who in an earlier year were enrolled in a school or in a 
particular year-class, or on such other basis as he deems appropri-
ate for making such determination, and shall include methods of 
making such determination when a school or a year-class was not 
in existence in an earlier year at a school. 
"Full time 
"(2) For purposes of this section, the term 'full-time students' 
students." 
(whether such term is used by itself or in connection with a par-
ticular year-class) means students pursuing a full-time course of 
study leading to a degree of doctor of medicine, doctor of dentistry 
or an equivalent degree, doctor of osteopathy, bachelor or master 
of science in pharmacy or an equivalent degree, doctor of optom-
etry or an equivalent degree, doctor of veterinary medicine or an 
equivalent degree, or doctor of podiatry or an equivalent degree 
or to a graduate degree in public health or equivalent degree. In 
the case of a training program of a school designed to permit the 
students enrolled in such program to complete, within six years 
after completing secondary school, the requirements for degree of 
doctor of medicine, doctor of dentistry or an equivalent degree, or 
doctor of osteopathy, the term 'full-time students' shall only 
include students enrolled on a full-time basis in the last four years 
of such program and for purposes of section 771, students enrolled 
in the first of the last four years of such program shall be 
considered as first-year students.". 
42 use 295f. 
(3) Subsection (i) of section 770 is amended (A) by inserting 
", public health" after "dentistry", (B) by striking out "and (b)", and 
(C) by redesignating it as subsection (d). 
(4) Subsection (j) of section 770 is redesignated as subsection (e) 
and is amended to read as follows: 
"(e) AUTHORIZATIONS or APPROPRIATIONS.— 
"(1) There are authorized to be appropriated $124,182,000 for 
the fiscal year ending September 30,1978, $131,683,800 for the fis-
cal year ending September 30,1979, and $139,400,100 for the fiscal 
year ending September 30,1980, for payments under grants under 
this section to schools of medicine. 
"(2) There are authorized to be appropriated $8,680,000 for 
the fiscal year ending September 30, 1978, $9,337,750 for the 
fiscal year ending September 30, 1979, and $10,159,800 for the 
fiscal year ending September 30,1980, for payments under grants 
under this section for schools of osteopathy. 
"(3) There are authorized to be appropriated $43,798,000 for 
the fiscal year ending September 30,1978, $45,409,550 for the fiscal 
year ending September 30,1979, and $46,909,800 for the fiscal year 
ending September 30,1980, for payments under grants under this 
section for schools of dentistry. 
"(4) There are authorized to be appropriated $9,739,800 for the 
fiscal year ending September 30, 1978, $10,462,200 for the fiscal 
year ending September 30,1979, and $11,060,000 for the fiscal year 
ending September 30,1980, for payments under grants under this 
section to schools of public health. 
"(5) There are authorized to be appropriated $10,219,000 for 
the fiscal year ending September 30,1978, $10,548,750 for t ho fiscal 
year ending September 30, 1979, and $10,705,350 for the fiscal 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2293 
year ending September 30,1980, for payments under grants under 
this section to schools of veterinary medicine. 
"(6) There are authorized to he appropriated $3,204,585 for 
the fiscal year ending September 30,1978, $3,272,670 for the fiscal 
year ending September 30, 1979, and $3,366,000 for the fiscal 
year ending September 30,1980, for payments under grants under 
this section to schools of optometry. 
"(7) There are authorized to be appropriated $16,989,970 for 
the fiscal year ending September 30, 1978, $17,110,205 for 
the fiscal year ending September 30, 1979, and $17,368,050 
for the fiscal year ending September 30,1980, for payments under 
grants under this section to schools of pharmacy. 
"(8) There are authorized to be appropriated $2,267,750 for 
the fiscal year ending September 30, 1978, $2,270,645 for the fiscal 
year ending September 30, 1979, and $2,285,120 for the fiscal 
year ending September 30,1980, for payments under grants under 
this section to schools of podiatry.". 
(d) For the fiscal year ending September 30, 1978, and for each of 42 USC 295f 
the next two fiscal years, there are authorized to be appropriated "
o
*
®
-
such sums as may be necessary to continue to make annual grants to 
schools of medicine, osteopathy, dentistry, veterinary medicine, optom-
etry, pharmacy, and podiatry under section 770(a) of the Public 
Health Service Act (as in effect on September 30, 1977) based on the 42 USC 295f. 
number of enrollment bonus students (determined in accordance with 
subsections (d) and (e) of section 770 of such Act (as so in effect)) 
enrolled in such schools who were first-year students in sucli schools 
for school years ending before September 30, 1977, except that the 
amount of any grant made to such a school from sums appropriated 
under this subsection may not exceed the amount of the grant the 
school received in the fiscal year ending September 30, 1977, based on 
the number of such students enrolled in it. 
(e) Effective October 1, 1977, the heading for part E of title VII 
is amended to read as follows: 
"PART E—GRANTS To IMPROVE THE QUALITY or SCHOOLS OF MEDI-
CINE, OSTEOPATHY, DENTISTRY, PUBLIC HEALTH, VETERINARY MED-
ICINE, OPTOMETRY, PHARMACY, AND PODIATRY". 
(f) The amendments made by subsections (a), (b), and (c) shall Effective date, 
apply with respect to appropriations under section 770 of the Public 42 USC 295f 
Health Service Act, and grants under that section, for fiscal years note, 
beginning after September 30,1977. 
GRANT REQUIREMENTS 
SEC. 502. Effective with respect to fiscal years beginning after Sep-
tember 30, 1977, part E of title VII is amended (1) by striking out 
sections 771, 772, 773, and 774, and (2) by adding after section 770 42 USC 
the following new section: 
295f-l-
295f-4. 
'ELIGIBILITY FOR CAPITATION GRANTS 
"SEC. 771. (a) I N GENERAL.—The Secretary shall not make a grant 42 USC 295f-l. 
under section 770 to any school in a fiscal year beginning after Septem-
ber 30, 1977, unless the application for the grant contains, or is sup-
ported by, assurances satisfactory to the Secretary that— 
"(1)_ the first-year enrollment of full-time students in the 
school in the school year beginning in the fiscal year in which the 
90 STAT. 2294 
PUBLIC LAW 94-484—OCT. 12, 1976 
grant applied for is to be made will not be less than the first-year 
enrollment of such students in the school in the preceding scnool 
year or in the school year beginning in the fiscal year ending Sep-
tember 30,1976, whichever is greater; and 
"(2) the applicant will expend in carrying out its functions as 
a school of medicine, osteopathy, dentistry, public health, veteri-
nary medicine, optometry, pharmacy, or podiatry, as the case 
may be, during the fiscal year for which such grant is sought, an 
amount of funds (other than funds for construction as determined 
by the Secretary) from non-Federal sources which is at least as 
great as the amount of funds expended by such applicant for 
such purpose (excluding expenditures of a nonrecurring nature) 
in the fiscal year preceding the fiscal year for which such grant 
is sought. 
"(b) (1) Mia)iCAL SCHOOLS.—To be eligible for a grant under sec-
Ante, p. 2290. 
tion 770 each school of medicine shall, in addition to the requirements 
of subsection (a), meet the applicable requirements of paragraphs (2) 
and (3). 
"(2)(A)(i) Unless, as determined under subparagraph (B), the 
number of filled first year positions on July 15,1977, in direct or affl-
iated medical residency training programs in primary care is at least 
35 percent of the number of filled first year positions on that date in 
all direct or affiliated medical residency training programs, to be eli-
gible for a grant under section 770 for the fiscal year ending Septem-
ber 30,1978, a school of medicine shall have on July 15, 1978, at least 
35 percent of its filled first year positions, as determined under sub-
paragraphs (C) and (D), in its direct or affiliated medical residency 
training programs in nrst year positions in such programs in primary 
care. 
"(ii) Unless, as determined under subparagraph (B), the number 
of filled first year positions on July 15, 1978, in direct or affiliated 
medical residency training programs in primary care is at least 40 
percent of the number of filled first year positions on that date in all 
direct or affiliated medical residency trainmg programs, to be eligible 
for a grant under section 770 for the fiscal year ending September 30, 
1979, a school of medicine shall have on July 15, 1979, at least 40 
percent of its filled first year positions, as determined under subpara-
graphs (C) and (D), in its direct or affiliated medical residency train-
ing programs in nrst year positions in such programs in primary care, 
"(iii) Unless, as determined under subparagraph (B), the number 
of filled first year positions on July 15 of any year (beginning with 
1979) in direct or affiliated medical residency training programs in 
primary care is at least 50 percent of the number of filled first year 
positions on that date in all direct or affiliated medical residency train-
ing programs, to be eligible for a grant under section 770 for the fiscal 
year ending on September 30 of the following year, a school of medi-
cine shall have on July 15 of such following year at least 50 percent 
of its filled first year positions, as determined under subparagraphs 
(C) and (D), in its direct or affiliated medical residency training 
programs in first year positions in such programs in primary care. 
"(B) The Secretary shall determine what percent of all the posi-
tions filled, as of July 15,1977, and July 15 of each subsequent year, in 
all direct or affiliated medical residency training programs are filled 
positions in such programs in primary care. In determining the num-
ber of such positions in primary care on July 15,1977, or on July 15 of 
a subsequent year, the Secretary shall deduct from such number a 
number equal to the number of individuals who were in a first year 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2295 
Publication in 
Federal Register; 
report to medical 
schools and 
congressional 
committees. 
Determination; 
report to medical 
school and 
congressional 
committees. 
position in any direct or affiliated medical residency training program 
m primary care as of July 15 of the previous year and who on the date 
for which the determination is to be made were not in any direct or 
affiliated medical residency training program in primary care. Each 
determination under this subparagraph shall, not later than 45 days 
after the date for which the determination is made, be published in the 
Federal Register and reported in writing to each school of medicine in 
the States and to the Committee on Interstate and Foreign Commerce 
of the House of Representatives and to the Committee on Labor and 
Public Welfare of the Senate. 
"(C) In determining if a school of medicine meets an applicable 
requirement of clause (i), (ii), or (iii) of subparagraph (A) for a 
fiscal year, the number of filled first year positions in direct or affili-
ated medical residency training programs of such school in primary 
care on July 15 in such fiscal year shall be reduced by the number 
of individuals who were in a first year position in a direct or affiliated 
medical residency training program of such school in primary care 
on July 15 in the previous fiscal year and who on July 15 in the fiscal 
year to which the requirement applies were not in a direct or affiliated 
medical residency training program of such school in primary care. 
Each determination, with respect to a school, under this subparagraph 
shall, not later than 45 days after the date on which the determination 
is made, be reported in writing to siich school and to the Committee 
on Interstate and Foreign Commerce bf the House of Representatives 
and to the Committee on Labor and Public Welfare of the Senate. 
"(D) The requirement under subparagraph (A) that a school of 
medicine have a particular percent of its filled first-year positions in 
its direct or affiliated medical residency training programs in primary 
care on a date in order to be eligible for a grant under section 770 shall •^'»'«» P- 2290. 
be waived by the Secretary if he determines that (i) such school has 
made a good faith effort to comply with such requirement, and (ii) 
such school has at least 98 percent of such percent of such positions in 
primary care on such date. 
"(E) The Secretary shall not make any grant under section 770 
to a school of medicine for any fiscal year if the Secretary, after pro-
viding notice and opportunity for a hearing, determines that in the 
fiscal year such school— 
"(i) terminated or failed to renew an affiliation with a medical 
resiaency training program for the purpose of meeting the 
requirements of this paragraph, and 
"(ii) after such a termination or failure to renew, provided 
support for such medical residency training program (includ-
ing any interchange of medical residents, students, or faculty 
between the school and such program, the offering of amr faculty 
position at such school to any individual on the staff of such 
entity who has any responsibility for such program, or the provi-
sion or receipt by such school of any funds for such program). 
"(F) For purposes of this paragraph: 
"(i^ The term 'direct or affiliated medical residency training pro-
gram means a medical residency training program with which a 
school of medicine is affiliated or has a similar arrangement (including 
any arrangement which provides for any interchange of medical resi-
dents, students, or faculty between the school and such program, the 
offering of any faculty position at such school to any individual on 
the staff of such entity who has any responsibility for such program, 
or the provision or receipt by such school of any funds for such 
program), as determined under regulations of the Secretary, or which 
is primarily conducted in facilities owned by a school ot medicine. 
Notice and 
hearing. 
Definitions. 
90 STAT. 2296 
PUBLIC LAW 94-484—OCT. 12, 1976 
"(ii) The term 'primary care' means general internal medicine, 
family medicine, or general pediatrics. 
"(iii) The term 'medical residency training program' means a pro-
gram which trains graduates of schools of medicine and schools of 
osteopathy in a medical specialty and which provides the graduate 
education required by the appropriate specialty board for certifica-
tion in such specialty. Such term does not include a residency training 
program in an osteopathic hospital. 
Ante, p. 2290. 
"(3) (A) To be eligible for a grant under section 770 a school 
of medicine shall, in its application for such grant, give assurances 
satisfactory to the Secretary that, except as provided in subpara-
graphs (C) and (D), the school will reserve positions, in the school 
year beginning immediately before the fiscal year for which such grant 
is applied for, for students described in subparagraph (B). 
"(B) No later than August 15, 1977, and August 15 of each of the 
next two years, the Secretary shall identify the citizens of the United 
States who, before the date of enactment of the Health Professions 
Ante, p. 2243. 
Educational Assistance Act of 1976, were students in a school of medi-
cine not in a State and who by the date of the identification made 
under this subparagraph— 
"(i) successfully completed at least two years in such school 
of medicine, and 
"(ii) successfully completed part I of the National Board of 
Medical Examiners' examination (or any successor to such 
examination). 
The Secretary shall equitably apportion a number of positions ade-
quate to fill the needs of students described in subparagraph (B) 
among the schools of medicine in the States. 
"(C) A school of medicine shall not be required to enroll a student 
described in subparagraph (B) if— 
"(i) the individual does not meet, as determined under guide-
lines established by the Secretary by regulation, the entrance 
requirements of the school (other than requirements related to 
academic qualifications or to place of residence), or 
"(ii) enrollment of such individual will, as determined by 
the Secretary after consultation with the appropriate accredita-
tion body, result in the school's not meeting the accreditation 
standards of such body. 
Waiver. 
"(D) The Secretary may waive the requirements of this paragraph 
upon a finding that, because of the inadequate size of the population 
served by the hospital or clinical facility in which such school con-
ducts its clinical training, compliance by such school with such 
assurances will prevent such school from providing high quality 
clinical training for the students added by the application of this 
paragraph to such school. 
"(c) SCHOOLS OF OSTEOPATHY.—(1) To be eligible for a grant under 
section 770 for a fiscal year beginning after September 30, 1977, a 
school of osteopathy shall, in addition to the requirements of subsection 
(a), submit to the Secretary and have approved by him before the 
grant applied for is made, a plan to train full-time students in ambu-
latory care settings, in the school year beginning in the fiscal year for 
which the grant is made and in each school year thereafter beginning 
in a fiscal year for which such a grant is made, either in areas geo-
graphically remote from the main site of the teaching facilities of 
the applicant (or any other school of osteopathy which has joined with 
the applicant in the submission of the plan) or in areas in which medi-
cally underserved populations reside. 
PUBLIC LAW 94-464—OCT. 12, 1976 
90 STAT. 2297 
"(2^ More than one applicant may join in the submission of a plan 
described in paragraph (1). No plan may be approved by the Sec-
retary unless— 
"(A) the application for a grant under section 770 of each Ante, f. 2290. 
school which has joined in the submission of the plan contains 
or is supported by assurances satisfactory to the Secretary that 
all of the full-time students who will graduate from such school 
will upon graduation have received at least 6 weeks (at least 3 of 
which shall be consecutive) of clinical training in an area vvliich 
is geographically remote from the main site of the training facili-
ties of such school or in which medically underserved popuhi-
tions reside; 
"(B) the plan contains a list of the areas where the training 
under such plan is to be conducted, a detailed description of the 
type and amount of training to be given in such areas, and pro-
vision for periodic review by experts in osteopathic education of 
the desirability of providing training in such areas and of the 
quality of training rendered in such areas; 
"(C) the plan contains a specific program for the appointing, 
as members of the faculty of the school or schools submitting the 
plan, of practicing physicians to serve as instructors in the train-
ing program in such areas; and 
"(D) the plan contains a plan for frequent counseling and con-
sultation between the faculty of the school or schools at the main 
site of their training facilities and the instructors in the training 
program in such areas, 
"(d) SCHOOLS or DENTISTRY.— (1) To be eligible for a grant under 
section 770 for a fiscal year beginning after September 30, 1977, a 
school of dentistry shall, in addition to the requirements of sub-
jection (a), meet the requirements of paragraph (2) and of paragraph 
(3) or (4). 
"(2) In the school year beginning in the fiscal year ending Septem-
ber 30, 1978, and in each school year thereafter beginning m a fiscal 
year for which a grant under section 770 is applied for, at least 70 
percent of a school of dentistry's filled positions in dental specialty 
programs which are in excess of the number of filled positions in its 
programs in the school year beginning in the fiscal year ending Sep-
tember 30, 1977, shall be positions in dental specialty programs m 
general dentistry or pedodontics. 
"(3) A school of dentistry shall maintain an enrollment of full-
time first-year students, for the school year beginning in the fiscal 
year ending September 30, 1978, and for each school year thereafter 
beginning in a fiscal year for which a grant under section 770 is 
applied for, which exceeds the number of full-time, first-year students 
enrolled in such school in the school year beginning in the fiscal year 
ending September 30,1976— 
"(A) by 10 percent of such number if such number was not 
more than 100, or 
"(B) by 5 percent of such number, or 10 students, whichever 
is greater, if such number was more than 100. 
"(4) (A) A school of dentistry shall submit to the Secretary and 
have approved by him before the grant applied for is made, a plan 
to train full-time students in ambulatory care settings, in the school 
year beginning in the fiscal year for which the grant is made and in 
each school year thereafter beginning in a fiscal year for which such a 
grant is made, either in areas geographically remote from the main 
site of the teaching facilities of the applicant (or any other school of 
90 STAT. 2298 
PUBLIC LAW 94-4«4—OCT. 12, 1976 
dentistry which has joined with the applicant in the submission of the 
plan) or in areas in which medically underserved populations reside. 
"(JB) More than one applicant may join in the submission of a plan 
described in subparagraph (A). No plan may be approved by the 
Secretarjr unless— 
Ante, p. 2290. 
"(i) the application for a grant under section 770 of each school 
which has joined in the submission of the plan contains or is 
supported by assurances satisfactory to the Secretary that all 
of the full-time students who will graduate from such school will 
upon graduation have received at least 6 weeks (in the aggregate) 
of clinical training in an area which is geographically remote 
from the main site of the training facilities of such school or in 
which medically underserved populations reside; 
"(ii) the plan contains a list of the areas where the train-
ing under such plan is to be conducted, a detailed description 
of the type and amount of training to be given in such areas, and 
provision for periodic review by experts in dental education of 
the desirability of providing training in such areas and of the 
quality of training rendered in such areas; 
"(iii) the plan contains a specific program for the appointing, 
as members of the faculty of the school or schools submitting the 
plan, of practicing dentists to serve as instructors in the train-
ing program in such areas; and 
"(iv) the plan contains a plan for frequent counseling and 
consultation between the faculty of the school or schools at the 
main site of their training facilities and the instructors in the 
training program in such areas. 
"(e) SCHOOLS OF PUBLIC HEALTH.—(1) To be eligible for a grant 
under section 770 for a fiscal year beginning after September 30,1977, 
a school of public health shall, in addition to the requirements of sub-
section (a), maintain an enrollment of full-time, first-year students, 
for the school year beginning in the fiscal year ending September 30, 
1978, and for each school year thereafter beginning in a fiscal year for 
which a grant under section 770 is applied for, which exceeds the num-
ber of full-time, first-year students enrolled in such school in the school 
year beginning in the fiscal year ending September 30, 1976— 
" (A) by 5 percent of such number if such number was not more 
than 100, or 
"(B) by 2.5 percent of such number, or 5 students, whichever 
is greater, if such number was more than 100. 
"(2) The Secretary may waive (in whole or in part) application 
to a school of public health of the rec[uirement of paragraph (1) if the 
Secretary determines, after receiving the written recommendation 
of the appropriate accreditation body or bodies (approved for such 
purpose oy the Commissioner of Education) that compliance by such 
school with such requirement will prevent it from maintaining its 
accreditation. 
"(f) 
SCHOOLS OF VETERINARY MEDICINE.—(1) To be eligible for a 
grant under section 770 for a fiscal year beginning after September 30, 
1977, a school of veterinary medicine shall, in addition to the require-
ments of subsection (a), meet the requirements of paragraph (2) and 
paragraph (3) or (4). 
"(2) An application of a school of veterinary medicine for a grant 
under section 770 shall contain or be supported oy assurances satisfac-
tory to the Secretary that the clinical training of the school shall 
emphasize predominantly care to food-producing animals or to fibre-
producing animals, or to both types of animals. 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2299 
"(3) A school of veterinary medicine shall maintain an enrollment 
of full-time, first-year students, for the school year beginning in the 
fiscal year ending September 30, 1978, and for each school year there-
after beginning in a fiscal year for which a grant under section 770 is Ante, p. 2290. 
applied for, which exceeds the number of full-time, first-year students 
enrolled in such school in the school year beginning in the fiscal year 
ending September 30,1976— 
" (A) by 5 percent of such number if such number was not more 
than 100, or 
"(B) by 2.5 percent of such number, or 5 students, whichever 
is greater, if such number was more than 100. 
" (4) An application of a school of veterinary medicine shall con-
tain or be supported by assurances satisfactory to the Secretary that 
for the school year beginning in the fiscal year for which a grant is 
made under section 770 at least 30 percent of the enrollment of full-
time, first-year students in such school will be comprised of students 
who are residents of States in which there are no accredited schools of 
veterinary medicine. 
"(g) SCHOOLS or OPTOMETRY,— (1) To be eligible for a grant under 
section 770 for a fiscal year beginning after September 30, 1977, a 
school of optometry shall, in addition to the requirements of subsec-
tion (a), meet the requirement of paragraph (2) or (3). 
"(2) A school of optometry shall maintain an enrollment of full-
time, first-year students, for the school year beginning in the fiscal year 
ending September 30, 1978, and for each school year thereafter begin-
ning in a fiscal year for which a grant under section 770 is applied for, 
which exceeds the number of full-time, first-year students enrolled in 
such school in the school year beginning in the fiscal year ending 
September 30,1976— 
" (A) by 5 percent of such number if such number was not more 
than 100, or 
"(B) by 2.5 percent of such number, or 5 students, whichever 
is greater, if such number was more than 100. 
"(3) An application of a school of optometry shall contain or be 
supported by assurances satisfactory to the Secretary that for the 
school year beginning in the fiscal year for which a grant is made 
under section 770 at least 25 percent (or 50 percent if the applicant is 
a nonprofit private school of optometry) of the first-year enrollment 
of full-time students in such school will be comprised of students who 
are residents of States in which there are no accredited schools of 
optometry. 
"(h) SCHOOLS or PODL4.TRT.—(1) To be eligible for a grant under 
section 770 for a fiscal year beginning after September 30, 1977, a 
school of podiatry shall, in addition to the requirements of subsection 
(a), meet the requirements of paragraph (2) or (3). 
"(2) A school of podiatry shall maintain an enrollment of full-time, 
first-year students, for the school year beginning in the fiscal year 
ending September 30, 1978, and for each school year thereafter begin-
ning in a fiscal year for which a grant under section 770 is applied for, 
which exceeds the number of full-time, first-year students enrolled in 
such school in the school year beginning in the fiscal year ending 
September 30,1976— 
" (A) by 5 percent of such number if such number was not more 
than 100, or 
"(B) by 2.5 percent of such number, or 5 students, whichever 
is greater, if such number was more than 100. 
90 STAT. 2300 
PUBLIC LAW 94-484—OCT. 12, 1976 
"(3) An application of a school of podiatry shall contain or be-
supported by assurances satisfactory to the Secretary that, for the 
school year beginning in the fiscal year for which a grant is made 
Ante, p. 2290. 
under section 770, at least 40 percent of the enrollment of full-time, 
first-year students in such school will be comprised of students who 
are residents of States in which there are no accredited schools of 
podiatry. 
"(i) SCHOOLS or PHARMACY.—To be eligible for a grant under sec-
tion 770 for a fiscal year beginning after September 30, 1977, a 
school of pharmacy's application for such a grant shall, in addition 
to the assurances required by subsection (a), contain or be supported 
by assurances that each student who is enrolled in the school will 
before graduation undergo a training program in clinical pharmacy, 
which shall include (1) an inpatient and outpatient clerkship experi-
ence in a hospital, extended care facility, or other clinical setting; 
(2) interaction with physicians and other health professionals; (3) 
training in the counseling of patients with regard to the appropriate 
use of and reactions to drugs; and (4) training in drug information 
retrieval and analysis in the context of actual patient problems.". 
TECHNICAL AND CONFORMING AMENDMENTS 
42 use 295f-5, 
SEC 503. (a) Section 775 is redesignated section 772 and is 
295f-2. 
amended— 
(1) by striking out "section 770, 771, 772, or 773'^ each place it 
occurs and inserting in lieu thereof "section 770" in subsections 
(a) and (d) and "section 770 or subsection (a) or (b) of section 
778" in subsection (b^, 
(2) by inserting ", public health" after "dentistry" in subsec-
tion (b), 
(3) by striking out "this part" in subsection (c) and inserting 
in lieu thereof "section 770", 
(4) by striking out "section 770, 771, or 773" in subsection (d) 
(1) and inserting in lieu thereof "section 771", and 
(5) by amending subsection (d) (3) to read as follows: 
"(3) provides for such fiscal control and accounting 
procedures and reports, including the use of such standard 
procedures for the recording and reporting of financial infor-
mation, as the Secretary may prescribe, and access to the rec-
ords of the applicant, as the Secretary may require to enable 
him to determine the costs to the applicant of its program 
for the education or training of students.". 
Repeal. 
^b) Sections 312 and 313 are repealed. 
42 use 244-1, 
(c) The amendments made by this section shall take effect Octo-
245a. 
ber 1,1977. 
Effective date. 
42^USC 295f-2 
TITLE VI—FOREIGN MEDICAL GRADUATES 
LIMITATION ON IMMIGRATION OF FOREIGN MEDICAL GRADUATES 
SEC. 601. (a) Section 212(a) of the Immigration and Nationality 
Act (8 U.S.C. 1182(a)) is amended by (1) striking out the period at 
the end thereof and inserting a semicolon in lieu thereof, and (2) by 
adding at the end thereof the following new paragraph: 
"(32) Aliens who are graduates of a medical school and are coming 
to the United States principally to perform services as members oi 
the medical profession, except such aliens who have passed parts I and 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2301 
II of the National Board of Medical Examiners Examination (or an 
equivalent examination as determined by the Secretary of Health, 
Education, and Welfare) and who are competent in oral and written 
English. The exclusion of aliens under this paragraph shall apply to 
special immigrants defined in section 101(a) (27) (A) (other than 8 USC 1101. 
the parents, spouses, or children of United States citizens or of aliens 
lawfully admitted for permanent residence), to nonpreference immi-
grant aliens described in section 203(a)(8), and to preference 8 USC 1153. 
immigrant aliens described in section 203(a) (3) and (6).". 
(b) Section 101(a) (15) of the Immigration and Nationality Act 
(8U.S.C. 1101(a) (15)) isamendedasfollows: 
(1) Subparagraph (H) (i) is amended by inserting before the 
semicolon ", and who, in the case of a graduate of a medical school 
coming to the United States to perform services as a member of 
the medical profession, is coming pursuant to an invitation from 
a public or nonprofit private educational or research institution 
or agency in the United States to teach or conduct research, or 
both, at or for such institution or agency". 
(2) Subparagraph (H) (ii) is amended by inserting before the 
semicolon ", but this clause shall not apply to graduates of medical 
schools coming to the United States to perform services as mem-
bers of the medical profession". 
(3) Subparagraph (H) (iii) is amended by inserting before the 
semicolon ", other than to receive graduate medical education or 
training". 
(4) Subparagraph (J) is amended by inserting "and who, if 
he is coming to the United States to participate in a program 
under which he will receive graduate medical education or train-
ing, also meets the requirements of section 212(j)" before ", and 
the alien spouse". 
(c) Section 212(e) of such Act (8 U.S.C. 1182(e)) is amended— 
(1) by striking out "whose (i)" and inserting in lieu thereof 
"(i) whose"; 
(2) by striking out "or" immediately before "(ii)"; 
(3) by inserting immediately before "shall be eligible" in the 
first sentence the following: "or (iii) who came to the United 
States or acquired such status in order to receive graduate medical 
education or training,"; and 
(4) by inserting ", except in the case of an alien described in 
clause (iii)." immediately after '"''Provided further^ That". 
(d) Section 212 of such Act (8 U.S.C. 1182) is amended by insert-
ing at the end thereof the following new subsection: 
"(j) (1) The additional requirements referred to in section 101(a) 
(15) (J) for an alien who is coming to the United States under a Supra. 
program under which he will receive graduate medical education or 
training are: 
"(A) A school of medicine or of one of the other health pro-
fessions, which is accredited by a body or bodies approved for the 
purpose by the Commissioner of Education, has agreed in writing 
to provide the graduate medical education or training under the 
program for which the alien is coming to the United States or 
to assume responsibility for arranging for the provision thereof 
by an appropriate public or nonprofit private institution or 
agency, except that, in the case of such an agreement by a school 
of medicine, any one or more of its affiliated hospitals which are 
to participate in the provision of the graduate medical education 
or training must join in the agreement; 
89-194 O—78—pt. 2 
53 
90 STAT. 2302 
PUBLIC LAW 94-484—OCT. 12, 1976 
"(B) Before making such agreement, the accredited school has 
been satisfied that the alien has passed parts I and II of the 
National Board of Medical Examiners Examination (or an equiv-
alent examination as determined by the Secretary of Health, 
Education, and Welfare), has competency in oral and written 
English, will be able to adapt to the educational and cultural 
environment in which he will be receiving his education or train-
ing, and has adequate prior education and training to participate 
satisfactorily in the program for which he is coming to the 
United States; 
"(C) The alien has made a commitment to return to the coun-
try of his nationality or last residence upon completion of the 
education or training for which he is coming to the United States 
(including any extension of the duration thereof imder subpara-
graph (D)), and the government of the country of his nationality 
or last residence has provided a written assurance, satisfactory 
to the Secretary of Health, Education, and Welfare, that upon 
such completion and return, he will be appointed to a position in 
which he will fully utilize the skills acquired in such education or 
training in the government of that country or in an educational or 
other appropriate institution or agency in that country; and 
"(D) The duration of the alien's participation in the program 
for which he is coming to the United States is limited to not more 
than 2 years, except that such duration may be extended for one 
year at the request of the government of his nationality or last 
residence, if (i) such government provides a written assurance, 
satisfactory to the Secretary of Health, Education, and Welfare, 
that the alien will, at the end of such extension, be appointed to a 
position in which he will fully utilize the skills acquired in such 
education or training in the government of that country or in an 
educational or other appropriate institution or agency in that 
country, (ii) the accredited school providing or arranging for 
the provision of his education or training agrees in writing to such 
extension, and (iii) such extension is for the purpose of continu-
ing the alien's education or training under the program for which 
he came to the United States. 
"(2) (A) Except as provided in subparagraph (B), the require-
ments of subparagraphs (A) through (D) of paragraph (1) shall not 
apply between the effective date of this subsection and December 31, 
1980, to any alien who seeks to come to the United States to participate 
in an accredited program of graduate medical education or training 
if there would be a substantial disruption in the health services pro-
vided in such program because such alien was not permitted, because 
of his failure to meet such requirements, to enter the United States 
to participate in such program. 
"(B) In the administration of this subsection, the Attorney Gen-
eral shall take such action as may be necessary to ensure that the 
total number of aliens participating (at any time) in programs 
described in subparagraph (A) does not, because of the exemption 
provided by such subparagraph, exceed the total number of aliens 
participating in such programs on the effective date of this 
subsection.". 
(e) Section 101(a) of the Immigration and Nationality Act (8 
U.S.C. 1101(a)) is amended by adding the following at the end 
thereof: 
"Graduates of 
" (41) The term 'graduates of medical school' means aliens who have 
medical school." 
graduated from a medical school or who have qualified to practice 
medicine in a foreign state.". 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2303 
(f) The amendments made by this section shall take effect ninety Effective date, 
days after the date of enactment of this section. 
8 USC1182 note. 
TITLE VII—PUBLIC AND ALLIED HEALTH PERSONNEL 
PUBLIC AND ALLIED HEALTH PERSONNEL 
SEC. 701. (a) Effective October 1, 1977, part G of title VII is 
amended to read as follows: 
"PART G—PROGRAMS FOR PERSONNEL IN HEALTH ADMINISTRATION AND 
IN ALLIED HEALTH 
-J * 
"SUBPART I—PUBLIC HEALTH PERSONNEL 
"GRANTS FOR GRADUATE PROGRAMS IN HEALTH ADMINISTRATION 
"SEC. 791. (a) From funds appropriated under subsection (d), the 42 USC 295h. 
Secretary shall make annual grants to public or nonprofit private 
educational entities (including schools of social work and excluding 
accredited schools of public health) to support the graduate educa-
tional programs of such entities in health administration, hospital 
administration, and health planning. 
"(b) The amount of the grant for any fiscal year under subsection 
(a) to an educational entity with an application approved under sub-
section (c) shall be equal to the amount appropriated under subsection 
(d) for such fiscal year divided by the number of educational entities 
which have applications for grants for such fiscal year approved under 
subsection (c). 
"(c)(1) No grant may be made under subsection (a) unless an Application, 
application therefor has been submitted to the Secretary before such 
time as he shall by regulation prescribe and has been approved by the 
Secretary. Such application shall be in such form, and submitted in 
such manner, as the Secretary shall by regulation, prescribe. 
" (2) The Secretary may not approve an application submitted under 
paragraph (1) unless— 
"(A) such application— 
"(i) contains assurances satisfactory to the Secretary that 
in the school year (as defined in regulations of the Secretary) 
beginning in the fiscal year for which the applicant receives 
a grant under subsection (a) that— 
"(I) at least 25 individuals will complete the graduate 
educational programs of the entity for which such appli-
cation is submitted; and 
"(II) such entity shall expend or obligate at least 
$100,000 in funds from non-Federal sources to conduct 
such programs; 
"(ii) contains assurances satisfactory to the Secretair that 
such entity shall maintain a first-year enrollment of full-
time students in the programs, for the school year beginning 
in the fiscal year ending September 30, 1978, and for each 
school year thereafter beginning in a fiscal year for which a 
grant under this section is applied for, which exceeds the 
number of full-time, first-year students enrolled in such pro-
grams in the school year beginning in the fiscal year ending 
September 30,1976— 
"(I) by 5 percent of such number if such number was 
not more than 100, or 
90 STAT. 2304 
PUBLIC LAW 94-484—OCT. 12, 1976 
Waiver. 
Appropriation 
autnorization. 
"(II) by 2.5 percent of such number, or 5 students, 
whichever is greater, if such number was more than 100; 
and 
"(iii) contains such other information as the Secretary 
may by regulation prescribe; and 
"(B) the program lor which such application was submitted 
has been accredited for the training of individuals for health 
administration, hospital administration, or health planning by a 
recognized body or bodies approved for such purpose by the Com-
missioner of Education and meets such other quality standards 
as the Secretary shall by regulation prescribe. 
"(3) The Secretary may waive (in whole or in part) the require-
ments of clause (ii) of paragraph (2) (A) with respect to any school 
upon written notification by the appropriate accreditation body or 
bodies that compliance with the assurances required by such para-
graph will prevent such school from meeting the accreditation stand-
ards of such body or bodies. 
"(4) The Secretary may not approve or disapprove an application 
submitted under paragraph (1) except after consultation with the 
National Advisory Council on Health Professions Education. 
"(d) There are authorized to be appropriated for payments under 
grants under this section $8,250,000 for the fiscal year ending Septem-
ber 30, 1978, $3,500,000 for the fiscal year ending September 30,1979, 
and $3,750,000 for the fiscal year ending September 30,1980. 
SPECIAL PROJECTS FOR ACCREDITED SCHOOLS OE PUBLIC HEALTH AND 
GRADUATE PROGRAMS I N HEALTH 
ADMINISTRATION 
Grants. 
"SEC. 792. (a) The Secretary may make grants to assist accredited 
42 use 295h-l. schools of public health in meeting the costs of special projects to 
develop new programs or to expand existing programs in— 
" (1) biostatistics or epidemiology, 
"(2) health administration, health planning, or health policy 
analysis and planning, 
" (3) environmental or occupational health, or 
"(4) dietetics and nutrition. 
"(b) (1) The Secretary may make grants to assist those public or 
non-profit educational entities (including graduate schools of social 
work) which have accredited programs described in paragraph 
(2) in meeting the costs of special projects to develop new programs 
or to expand existing programs in— 
" (A) biostatistics or epidemiology, 
"(B) health administration, health planning or health policy 
analysis and planning, 
"(C) environmental or occupational health, or 
"(D) dietetics and nutrition. 
Accredited 
"(2) For purposes of this subsection, an accredited program is a 
program. 
graduate program which is accredited for the training of individuals 
in health administration, health planning, or health policy analysis 
and planning by a recognized body or bodies approved by the Com-
missioner of Education and which meets such other quality standards 
as the Secretary may by regulation prescribe. 
Appropriation 
"(c) There are authorized for the purpose of making payments 
authorization. 
under grants under this section $5,000,000 for the fiscal year ending 
September 30,1978; $5,500,000 for the fiscal year ending September 30, 
1979; and $6,000,000 for the fiscal year ending September 30,1980. 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2305 
'STATISTICS AND ANNUAL REPORT 
42 use 295h-2. 
Personal data. 
"SEC. 793. (a) The Secretary shall, in coordination with the National 
Center for Health Statistics (established under section 306), con-
tinuously develop, publish, and disseminate on a nationwide basis 
statistics and other information respecting public and community 
health personnel, including— 
"(1) detailed descriptions of the various types of activities in 
which public and community health personnel are engaged, 
"(2) the current and anticipated needs for the various types 
of public and community health personnel, and 
"(3) the number, employment, geographic locations, salaries, 
and surpluses and shortages of public and community health per-
sonnel, the educational and licensure requirements for the various 
types of such personnel, and the cost of training such personnel. 
"(b) (1) The Secretary and each program entity shall in securing 
and maintaining any record of individually identifiable personal data 
(hereinafter in this subsection referred to as 'personal data') for 
purposes of this section— 
"(A) inform any individual who is asked to supply personal 
data whether he is legally required, or may refuse, to supply 
such data and inform him of any specific consequences, known 
to the Secretary or program entity as the case may be, of pro-
viding or not providing such data; 
"(B) upon request, inform any individual if he is the sub-
ject of personal data secured or maintained by the Secretary 
or program entity, as the case may be, and make the data avail-
able to him in a form comprehensible to him; 
"(C) assure that no use is made of personal data which is not 
within the purposes of this section unless an informed consent 
has been obtained from the individual who is the subject of such 
data; and 
"(D) upon request, inform any individual of the use being 
made of personal data respecting such individual and of the iden-
tity of the individuals and entities which will use the data and 
their relationship to the activities conducted under this section. 
"(2) Any entity which maintains a record of personal data and 
which receives a request from the Secretary or a program entity to 
use such data for purposes of this section shall not transfer any such 
data to the Secretary or to a program entity unless the individual 
whose personal data is to be so transferred gives an informed consent 
for such transfer. 
" ( 3 ) (A) Notwithstanding any other provision of law, personal Disclosure 
data collected bv the Secretary or any program entity for purposes of 
this section may not be made available or disclosed by the Secretary or 
any program entity to any person other than the individual who is the 
subject of such data unless (i) such person requires such data for 
purposes of this section, or fii) in response to a demand for such 
data made by means of compulsory legal process. Any individual who 
is the subject of personal data made available or disclosed under clause 
(ii) shall be notified of the demand for such data. 
"(B) Subject to all applicable laws regarding confidentiality, only 
the data collected by the Secretary under this section which is not 
personal data shall be made available to bona fide researchers and 
policy analysts (including the Congress) for the purposes of assist-
ing in the conduct of studies respecting health professions personnel 
"{4.\ For purposes of this subsection, the term 'program entity 
Consent for 
transfer of data. 
^(4) 
"Program 
entity." 
90 STAT. 2306 
PUBLIC LAW 9 4 - 4 8 4 ^ 0 C T . 12, 1976 
Report to 
congressional 
committees. 
Legislative 
recommendations. 
"Public and 
community 
health 
personnel." 
means any public or private entity which collects, compiles, or analyzes 
health professions data under an arrangement with the Secretary for 
purposes of this section. 
"(c) The Secretary shall submit annually to the Committee on Inter-
state and Foreign Commerce of the House of Representatives and to 
the Committee on Labor and Public Welfare of the Senate a report 
on— 
"(1) the statistics and other information developed pursuant 
to subsection (a), and 
"(2) the activities conducted under this subpart, including an 
evaluation of such activities. 
Such report shall contain such recommendations for legislation as the 
Secretary determines are needed to improve the programs authorized 
under this subpart. The Office of Management and Budget may review 
such report before its submission to such Committees, but the Office 
may not revise the report or delay its submission beyond the date pre-
scribed for its submission and may submit to such Committees its 
comments respecting such report. The first report under this subsec-
tion shall be submitted not later than December 1, 1978. 
"(d) For purposes of this section, the term 'public and community 
health personnel' means individuals who are engaged in— 
"(1) the planning, development, monitoring, or management of 
health care or health care institutions, organizations, or systems, 
" (2) research on health care development and the collection and 
analysis of health statistics, data on the health of population 
groups, and any other health data, 
"(3) the development and improvement of individual and 
community knowledge of health (including environmental health 
and preventive medicine) and the health care system, or 
"(4) the planning and development of a healthful environ-
ment and control of environmental health hazards. 
"SUBPART I I — A I J J E D HEALTH PERSONNEL 
"DEFINITIONS 
42 use 295h-4. 
"SEC. 795. For purposes of this subpart: 
" (1) The term 'allied health personnel' means individuals with 
training and responsibilities for (A) supporting, complementing, 
or supplementing the professional functions of physicians, den-
tists, and other health professionals in the delivery of health care 
to patients, or (B) assisting environmental engineers and other 
personnel in environmental health control and preventive medi-
cine activities. 
"(2) The term 'training center for allied health professions' 
means a junior college, college, or university— 
"(A) which provides, or can provide, programs of educa-
tion leading to a baccalaureate or associate degree (or to the 
equivalent of either) or to a higher degree in medical tech-
nology, optometric technology, dental hygiene, or in any of 
such other of the allied health professions curricula as are 
specified by regulation, or which, if in a junior college, pro-
vides a program (i) leading to an associate or an equivalent 
degree, (ii) of education in optometric technology, dental 
hygiene, or such other curricula as are specified by regulation, 
and (iii) acceptable for full credit toward a baccalaureate or 
equivalent degree in the allied health professions or designed 
PUBLIC LAW 94-4S4—OCT. 12, 1976 
90 STAT. 2307 
to prepare the student to work as a technician in a health 
occupation specified by regulations of the Secretary, 
"(B) which provides training for not less than a total of 
twenty persons in such curricula, 
"(C) which, if in a college or university which does not 
include a teaching hospital or in a junior college, is affiliated 
(to the extent and in the manner determined in accordance 
with regulations) with such a hospital, and 
"(D) which is (or is in a college or university which is) 
accredited by a recognized body or bodies approved for such 
purpose by the Commissioner of Education, or which is in a 
junior college which is accredited by the regional accrediting 
agency for the region in which it is located or there is satis-
factory assurance afforded by such accrediting agency to the 
Secretary that resasonable progress is being made toward 
accreditation by such junior college, 
except that an applicant for a grant under this subpart which does 
not at the time of application meet the requirement of subpara-
graph (B) shall be deemed to meet such requirement if the Sec-
retary finds there is reasonable assurance that the unit will meet 
the requirement of subparagraph (B) prior to the beginning of 
the academic year following the normal graduation date of the 
first entering class in such unit. 
"(3) The term 'nonprofit' as applied to any training center 
for allied health professions means such a training center which 
is an entity, or is owned and operated by an entity, no part of the 
net earnings of which inures or may lawfully inure, to the benefit 
of any private shareholder or individual; and as applied to any 
entity means an entity no part of the net earnings of which inures 
or may lawfully inure to the benefit of any private shareholder or 
individual. 
a 
PROJECT GRANTS AND CONTRACTS 
"SEC. 796. (a) The Secretary shall make grants to and enter into 42 U
S
C 295h-5. 
contracts with eligible entities to assist them in meeting the costs of 
planning, developing, demonstrating, operating, and evaluating 
projects relating to: 
" (1) Establishment of regional or State systems for the coordi-
nation and management of education and training at various 
levels for allied health personnel and nurses within and among 
educational institutions and their clinical affiliates for the pur-
pose of assuring that the needs of such region or State for allied 
' 
>a;; 
health personnel and nurses are substantially met. 
"(2) Establishment of new roles and functions for allied health 
personnel and methods for increasing the efficiency of health 
manpower through more effective utilization of allied health j)er-
sonnel in various practice settings. 
"(3) Establishment of new or improved methods of creden-
tialing allied health personnel, including techniques for appro-
priate recognition (through equivalency and proficiency testing 
or otherwise) of previously acquired training or experience, devel-
oped in coordination with the Secretary's program under section 
1123 of the Social Security Act. 
42 USC 
"(4) Establishment of methods of recruitment, training, and 1320a-2. 
retraining of allied health personnel. 
90 STAT. 2308 
PUBLIC LAW 94-484—OCT. 12, 1976 
Application. 
"Eligible 
entities." 
Appropriation 
authorization. 
"(5) Establishment of meaningful career ladders and programs 
of advancement for practicing allied health personnel. 
" (6) Establishment of continuing education programs for prac-
ticing allied health personnel. 
"(b) (1) No grant may be made or contract entered into under sub-
section (a) unless an application therefor has been submitted to, and 
approved by, the Secretary. Such application shall be in such form, 
submitted in such manner, and contain such information, as the Sec-
retary shall by regulation prescribe. 
"(2) The amount of any grant under subsection (a) shall be deter-
mined by the Secretary. 
"(c) For purposes of subsection (a), the term 'eligible entities' 
means entities which are— 
"(1) schools, universities, or other educational entities which 
proviae for allied health personnel education and training and 
which meet such standards as the Secretary may by regulation 
prescribe; 
"(2) States, political subdivisions of States, or regional and 
other public bodies representing States or political subdivisions of 
States or both; or 
" (3) entities which have a working arrangement (meeting such 
requirements as the Secretary may by regulation prescribe) with 
an entity described in paragraph (1). 
"(d)(1) For the purpose of making payments under grants and 
contracts under subsection (a), there are authorized to be appropriated 
$22,000,000 for the fiscal year ending September 30, 1978; $24,000,000 
for the fiscal year ending September 30, 1979; and $26,000,000 for the 
fiscal year ending September 30,1980. 
" (2) In each fiscal year for which funds are authorized to be appro-
priated under this subsection, not less than 50 percent of the funds 
appropriated shall be reserved for award to training centers for allied 
health professions. 
a, 
Grants. 
42 use 295h-6. 
Application. 
Appropriation 
authorization. 
TRAINEESHIPS FOR ADVANCED TRAINING OF ALLIED HEALTH PERSONNEL 
"SEC. 797. (a) The Secretary may make grants to public and non-
profit private entities for traineeships provided by such entities for 
the advanced training of allied health personnel to teach in training 
programs for such personnel or to serve in administrative or super-
visory positions. 
"(b)(1) No grant may be made under subsection (a) unless an 
application therefor has been submitted to and approved by the Secre-
tary. Such application shall be in such form, submitted in such man-
ner, and contain such information as the Secretary shall by regulation 
prescribe. 
"(2) Payments under such grants shall be limited to such amounts 
as the Secretary finds necessary to cover the cost of tuition and fees of, 
and stipends and allowances (including travel and subsistence expenses 
and dependency allowances) for, the trainees. 
"(c) For the purposes of making payments under grants under sub-
section (a), there are authorized to be appropriated $4,500,000 for the 
fiscal year ending September 30, 1978; $5,000,000 for the fiscal year 
ending September 30, 1979; and $5,500,000 for the fiscal year ending 
September 30, 1980. 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2309 
'EDUCATIONAL ASSISTANCE TO DISADVANTAGED INDIVIDUALS I N ALTiTKD 
HEALTH TRAINING 
Grants. 
42 use 295h-7. 
"SEC. 798. (a)(1) For the purpose of assisting individuals who, due 
to socioeconomic factors, are financially or otherwise disadvantaged 
(including individuals who are veterans of the Armed Forces with 
military training or experience in the health field) to undertake educa-
tion to enter the allied health professions, the Secretary may make 
grants to and enter into contracts with schools of allied health, State 
and local educational agencies, and other public or private nonprofit 
entities to assist in meeting the costs described in paragraph (2). 
"(2) A grant or contract under paragraph (1) may be used by the 
school, agency, or entity to meet the costs of— 
" (A) identifying, recruiting, and selecting such disadvantaged 
individuals who have a potential for education or training in the 
allied health professions; 
"(B) facilitating the entry of such individuals into such a 
school, agency, or entity; 
"(C) providing counseling or other services designed to assist 
such individuals to complete successfully their education at such 
school, agency, or entity; 
"(D) providing, for a period prior to the entry of such indi-
viduals into the regular course of education of such a school, 
agency, or entity, preliminary education designed to assist them 
to complete successfully such regular course of education at such 
a school, agency, or entity, or referring such individuals to insti-
tutions providini^ such preliminary education; and 
"(E) publicizing existing sources of financial aid available to 
persons enrolled in the education program of such a school, 
agency, or entity or who are undertaking training necessary to 
qualify them to enroll in such a program, 
"(b) (1) No grant may be made or contract entered into under sub- Application 
section (a) unless an application therefor has been submitted to, and 
approved by, the Secretary. Such application shall be in such form, 
submitted in such manner, and contain such information, as the Secre-
tary shall by regulation prescribe. 
"(2) The amount of any grant under subsection (a) shall be deter-
mined by the Secretary. 
"(c) For payments under grants and contracts under subsection 
(a) there are authorized to be appropriated $1,000,000 for fiscal year 
ending September 30, 1978, $1,000,000 for fiscal year ending Septem-
ber 30,1979, and $1,000,000 for fiscal year ending September 30,1980.". 
Appropriation 
authorization. 
STUDIES AND STATISTICAL REPORT ON ALLIED HEALTH PERSONNEL 
SEC. 702. (a) The Secretary of Health, Education, and Welfare 
shall conduct and complete, not later than two years after the date of 
enactment of this Act, studies— 
(1) to identify the various types of allied health personnel and 
the activities in which such personnel are engaged and the vari-
ous training programs currently offered for allied health 
personnel; 
(2) to establish classifications of allied health personnel on the 
basis of their activities, responsibilities, and training; 
(3) using appropriate methodologies, to determine the cost of 
educating and training allied health personnel in each such clas-
sification : and 
42 use 295h-^t 
note. 
90 STAT. 2310 
PUBLIC LAW 94-484—OCT. 12, 1976 
Report. 
42 use 242k. 
Personal data. 
Consent for 
transfer of data. 
Disclosure. 
"Program 
entity." 
(4) to identify the classifications in which there are a critical 
shortage of such personnel and the training programs which 
should be assisted to meet that shortage, 
(b) In addition, the Secretary shall, in coordination with the 
National Center for Health Statistics (established under section 306 of 
the Public Health Service Act), develop, publish, and disseminate 
on a nationwide basis a report containing statistics and other informa-
tion respecting allied health personnel, including— 
(1) detailed descriptions of the various types of such personnel 
and the activities in which such personnel are engaged, 
(2) the current and anticipated needs for the various types of 
such health personnel, and 
(3) the number, employment, geographic locations, salaries, 
and surpluses and shortages of such personnel. 
(c)(1) The Secretary and each program entity shall in securing 
and maintaining any record of individually identifiable personal data 
(hereinafter in this subsection referred to as 'personal data') for pur-
poses of this section— 
(A) inform any individual who is asked to supply personal 
data whether he is legally required, or may refuse, to supply 
such data and inform him of any specific consequences known 
to the Secretary or program entity, as the case may be, of pro-
viding or not providing such data; 
(B) upon request, inform any individual if he is the sub-
ject of personal data secured or maintained by the Secretary 
or program entity, as the case may be, and make the data avail-
able to him in a form comprehensible to him ; 
(C) assure that no use is made of personal data which is not 
within the purposes of this section unless an informed consent 
has been obtained from the individual who is the subject of such 
data; and 
(D) upon request, inform any individual of the use being made 
of personal data respecting such individual and of the identity 
of the individuals and entities which will use the data and their 
relationship to the studies made or information collected under 
this section. 
(2) Any entity which maintains a record of personal data and which 
receives a request from the Secretary or a program entity for data 
for purposes of this section shall not transfer any such data to the 
Secretary or to a program entity unless the individual whose personal 
data is to be so transferred gives an informed consent for such transfer. 
(3) (A) Notwithstanding any other provision of law, personal data 
collected by the Secretary or any program entity for purposes of this 
section may not be made available or disclosed by the Secretary or any 
program entity to any person other than the individual who is the 
subject of such data unless (i) such person requires such data for pur-
poses of this section, or (ii) in response to a demand for such data made 
by means of compulsory legal process. Any individual who is the sub-
ject of personal data made available or disclosed under clause (ii) shall 
be notified of the demand for such data. 
(B) Subject to all applicable laws regarding confidentiality, only 
the data collected by the Secretary under this section which is not 
personal data shall be made available to bona fide researchers and 
policy analysts (including the Congress) for the purposes of assist-
ing in the conduct of studies respecting health professions personnel. 
(4) For purposes of this subsection, the term "program entity" means 
any public or private entity which collects, compiles, or analyzes health 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2311 
professions data under an arrangement with the Secretary for pur-
poses of this section. 
(d) The Secretary shall submit, not later than two years after the 
date of enactment of this Act, to the Committee on Interstate and 
Foreign Commerce of the House of Representatives and to the Com-
mittee on Labor and Public Welfare of the Senate— 
(1) a report on the results of the studies conducted under sub-
section (a) ; 
(2) the report developed under subsection ( b ) ; and 
(3) a report on, including an evaluation of, activities conducted 
under subpart I I of part G of title V I I of the Public Health 
Service Act (relating to allied health personnel). 
The report described in paragraph (3) shall contain such recom-
mendations for legislation as the Secretary determines are needed 
to improve the programs authorized under such subpart. The Office 
of Management and Budget may review such report before its sub-
mission to such Committees, but the Office may not revise the report 
or delay its submission beyond the date prescribed for its submission 
and may submit to such Committees its comments respecting such 
report. 
(e) For the purposes of this section, the term "allied health per-
sonnel" means individuals with training and responsibilities for (1) 
supporting, complementing, or supplementing the professional func-
tions of physicians, dentists, and other health professionals in the 
delivery of health care to patients, or (2) assisting environmental engi-
neers and other personnel in environmental health control and pre-
ventive medicine activities. 
Reports to 
congressional 
committees. 
Ante, p. 2306. 
Legislative 
recommendations. 
"Allied health 
personnel." 
T I T L E V I I I — S P E C I A L P R O J E C T S 
GRANTS AND CONTRACTS 
SEC. 801. (a) Effective October 
amended to read as follows: 
1, 1976, part F of title V I I is 
"PART F — G R A N T S AND CONTRACTS FOR PROGRAMS AND PROJECTS 
"PROJECT G R A N T S FOR ESTABLISHMENT OF DEPARTMENTS OF 
FAMILY MEDICINE 
"SEC. 780. (a) The Secretary may make grants to schools of medi- 42 USC 295g. 
cine and osteopathy to meet the costs of projects to establish and 
maintain academic administrative units (which may be departments, 
divisions, or other units) to provide clinical instruction in family 
medicine. 
"(b) The Secretary may not approve an application for a grunt Application, 
under subsection (a) unless such application contains— 
"(1) assurance satisfactory to the Secretary that the academic 
administrative unit with respect to which the application is 
made will (A) be comparable to academic administrative units 
for other major clinical specialties offered by the applicant, (B) 
be responsible for directing an amount of the curriculum for each 
member of the student body engaged in an education program 
leading to the awarding of the degree of doctor of medicine or 
doctor of osteopathy which amount is determined by the Secre-
tary to be comparable to the amount of curriculum required for 
other major clinical specialties in the school, (C) have a number 
90 STAT. 2312 
PUBLIC LAW 94-484—OCT. 12, 1976 
Appropriation 
authorization. 
Contracts. 
42 use 295g-l. 
Ante, p. 2247. 
42 use 296m. 
of full-time faculty which is determined by the Secretary to be 
sufficient to conduct the instruction required by clause (B) and 
to be comparable to the number of faculty assigned to other major 
clinical specialties in the school, and (D) have control over a 
three-year approved or provisionally approved residency training 
program in family practice or its equivalent as determined by the 
Secretary which shall have the capacity to enroll a total of no less 
than twelve interns or residents per year; and 
"(2) such other information as the Secretary shall by regula-
tion prescribe. 
"(c) There are authorized to be appropriated $10,000,000 for the 
fiscal year ending September 30, 1978, $15,000,000 for the fiscal year 
ending September 30, 1979, and $20,000,000 for the fiscal year ending 
September 30, 1980, for payments under grants under subsection (a). 
a 
AREA HEALTH EDUCATION CENTERS 
"SEC. 781. (a) For the purpose of improving the distribution, sup-
ply, quality, utilization, and efficiency of health personnel in the 
health services delivery system and for the purpose of encouraging 
the regionalization of educational responsibilities of health pro-
fessions schools, the Secretary may enter into contracts for projects to 
assist in the planning, development, and operation of area health 
education center programs. 
"(b) An area health education center program shall be a coopera-
tive program of one or more medical or osteopathic schools and one or 
more nonprofit private or public area health education centers. 
"(c) Each medical or osteopathic school participating in an area 
health education center program shall— 
"(1) provide for the active participation in such program by 
individuals who are associated with the administration of the 
school and each of the departments (or specialties if the school 
has no such departments) 
of internal medicine, pediatrics, 
obstetrics and gynecology, surgery, psychiatry, and 
family 
medicine; 
"(2) provide that no less than 10 percent of all undergraduate 
medical or osteopathic clinical education of the school will be 
conducted in an area health education center and at locations 
under the sponsorship of such center; 
"(3) be responsible for, or conduct, a program for the training 
of physician assistants (as defined in section 701(7)) or nurse 
practitioners (as defined in section 822) which gives special con-
sideration to the enrollment of individuals from, or intending 
to practice in, the area served by the area health education center 
of the program; and 
"(4) provide for the active participation of at least 2 schools 
or programs of other health professions (including a school of 
dentistry if there is one affiliated with the university with which 
the school of medicine or osteopathy is affiliated) in the educa-
tional program conducted in the area served by the area health 
education center. 
"(d) (1) Each area health education center shall specifically desig-
nate a geographic area in which it will serve, or shall specifically 
designate a medically underserved population it will serve (such 
area or population with respect to such center in tliis section I'oferred 
to as 'the area served by the center'), which area or population is in a 
location remote from the main site of the teaching facilities of the 
school or schools which participate in the program with such center. 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2313 
" (2) Each area health education center shall— 
"(A) provide for or conduct training in health education serv-
ices, including education in nutrition evaluation and counseling, 
in the area served by the center; 
"(B) assess the health manpower needs of the area served by 
the center and assist in the planning and development of training 
programs to meet such needs; 
"(C) provide for or conduct a medical residency training pro-
gram in family medicine or general internal medicine in which 
no fewer than six individuals are enrolled in first-year positions 
in such program; 
"(D) provide opportunities for continuing medical education 
(including education in disease prevention) to all physicians and 
other health professionals (including allied health personnel) 
practicing within the area served by the center; 
"(E) provide continuing medical education and other support 
services to the National Health Service Corps members serving 
within the area served by the center; 
"(F) encourage the utilization of nurse practitioners and phy-
sician assistants within the area served by the center and the 
recruitment of individuals for training in such professions at the 
participating medical or osteopathic schools; 
"(G) arrange and support educational opportunities for medi-
cal and other students at health facilities, ambulatory care centers, 
and health agencies throughout the area served by the center; and 
" (K) have an advisory board of which at least 75 percent of the 
members shall be individuals, including both health service pro-
viders and consumers, from the area served by the center. 
Any area health education center which is participating in an area 
health education center program in which another center has a medical 
residency training program described in subparagraph (C) need not 
provide for or conduct such a medical residency training program. 
"(e) The Secretary is authorized to enter into contracts with medical 
and osteopathic schools, which have cooperative arrangements with 
area health education centers, for the planning, development, and 
operation of area health education center programs. In entering into 
contracts under this section the Secretary shall assure that— 
"(1) at least 75 percent of the total funds provided to any 
school shall be expended by an area health education center pro-
gram in the area health education centers; 
"(2) not more than 75 percent of the total operating funds of 
a program in any year shall be provided by the Secretary; and 
" (3) no contract shall provide funds solely for the planning or 
development of such a program for a period of longer than two 
years. 
"(f) For the purpose of this section the term 'area health educa-
tion center program' means a program which is organized and oper-
ated in a manner described in subsection (b) and which is capable, as 
determined by the Secretary, of performing each of the functions 
described in subsection (d)(2). The Secretary shall, by regulation, 
establish standards and criteria for the requirements of this section. 
"(g) There are authorized to be appropriated to carry out the pro-
visions of this section $20,000,000 for the fiscal year ending Septem-
ber 30,1978, $30,000,000 for the fiscal year ending September 30,1979, 
and $40,000,000 for the fiscal year ending September 30, 1980. 
Contracts. 
"Area health 
education center 
program." 
Appropriation 
authorization. 
90 STAT. 2314 
PUBLIC LAW 94-484—OCT. 12, 1976 
Grants. 
42 use 295g-2. 
Ante, p. 2243. 
Report. 
Appropriation 
authorization. 
Grants. 
42 use 295g-3. 
Ante, p. 2247. 
EDUCATION o r RETURNING UNITED STATES STUDENTS FROM FOREIGN 
MEDICAL SCHOOLS 
"SEC. 782. (a) The Secretary may make grants to schools of medi-
cine and osteopathy in the States to plan, develop, and operate 
programs— 
"(1) to train United States citizens who were students in 
medical schools in foreign countries before the date of enactment 
of the Health Professions Educational Assistance Act of 1976 to 
enable them to meet the requirements for enrolling in schools of 
medicine or osteopathy in the States as full-time students with 
advanced standing; or 
" (2) to train United States citizens who have transferred from 
medical schools in foreign countries in which they were enrolled 
before the date of enactment of the Health Professions Educa-
tional Assistance Act of 1976, and who have enrolled in schools of 
medicine or osteopathy in the States as full-time students with 
advanced standing. 
The costs for which a grant under this subsection may be made may 
include the costs of identifying deficiencies in the medical school edu-
cation of the United States citizens who were students in foreign 
medical schools, the development of materials and methodology for 
correcting such deficiencies, and specialized training designed to pre-
pare such United States citizens for enrollment in schools of medicine 
or osteopathy in the States as full-time students with advanced 
standing. 
"(b) More than one school of medicine or osteopathy may join in the 
submission of an application for a grant under subsection (a). 
"(c) Any school of medicine or osteopathy which receives a grant 
under this subsection in the fiscal year ending September 30,1978, shall 
submit to the Secretary before June 30, 1979, a report on the deficien-
cies (if any) identified by the school in the foreign medical education 
of the students trained by such school under the program for which 
such grant was made. The Secretary shall compile the reports sub-
mitted under the preceding sentence, and before September 30, 1979 
submit to the Congress his analysis and evaluation of the information 
contained in such reports. 
"(d) There are authorized to be appropriated for the purposes of 
this section $2,000,000 for the fiscal year ending September 30, 1977, 
$2,000,000 for the fiscal year ending September 30,1978, $3,000,000 for 
the fiscal year ending September 30,1979, and $4,000,000 for the fiscal 
year ending September 30,1980. 
" P R O G R A M S F O R PHYSICIAN ASSISTANTS, EXPANDED FUNCTION DENTAL 
AUXILIARIES AND DENTAL TEAM PRACTICE 
"SEC. 783. (a) The Secretary may make grants to and enter into 
contracts with public or nonprofit private schools of medicine, osteop-
athy, and dentistry and other public or nonprofit private entities to 
meet the costs of projects to— 
"(1) plan, develop, and operate or maintain programs for the 
training of physician assistants (as defined in section 701(7)); 
"(2) plan, develop, and operate or maintain programs for the 
training of expanded function dental auxiliaries (as defined in 
section 701 (8)) ; and 
" (3) plan, develop, and operate or maintain a program to train 
dental students in the organization and management of multiple 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2315 
auxiliary dental team practice in accordance with regulations of 
the Secretary. 
"(b) No grant or contract may be made under subsection (a) Application 
unless the application therefor contains or is supported by assurances 
satisfactory to the Secretary that the school or entity receiving the 
grant or contract has appropriate mechanisms for placing graduates 
of the training program with respect to which the application is sub-
mitted, in positions for which they have been trained. 
"(c) The Secretary shall ensure that the making of grants and 
entering into contracts under this section shall be integrated with the 
making of grants and entering into contracts under section 830. 
"(d) The costs for which a grant or contract under this section may 
be made include costs of preparing faculty members to teach in 
programs for the training of physician assistants and expanded func-
tion dental auxiliaries. 
"(e) For payments under grants and contracts under this section, 
there is authorized to be appropriated $25,000,000 for the fiscal year 
ending September 30,1978, $30,000,000 for the fiscal year ending Sep-
tember 30, 1979, and $35,000,000 for the fiscal year ending Septem-
ber 30,1980. 
42 use 297. 
Appropriation 
authorization. 
"GRANTS FOR T R A I N I N G , T R A I N E E S H I P S , A N D F E L L O W S H I P S I N GENERAL 
I N T E R N A L M E D I C I N E AND GENERAL PEDIATRICS 
"SEC. 784. (a) The Secretary may make grants to and enter into 42 U
S
C 295g~4. 
contracts with schools of medicine and osteopathy to meet the costs of 
projects— 
"(1) to plan, develop, and operate approved residency training 
programs in internal medicine or pediatrics, which emphasize the 
training of residents for the practice of general internal medicine 
or general pediatrics (as defined by the Secretary in regulations) ; 
and 
"(2) which provide financial assistance (in the form of train-
eeships and fellowships) to residents who are participants in any 
such program, and who plan to specialize or work in the practice 
of general internal medicine or general pediatrics. 
"(b) There are authorized to be appropriated to carry out the pro- Appropriation 
visions of this section $10,000,000 for the fiscal year ending Septem- authorization, 
ber 30,1977, $15,000,000 for the fiscal year ending September 30, 1978, 
$20,000,000 for the fiscal year ending September 30, 1979, and 
$25,000,000 for the fiscal year ending September 30, 1980. 
((. 
OCCUPATIONAL HEALTH TRAINING AND EDUCATION CENTERS 
"SEC. 785. (a)(1) The Secretary shall, by grants, assist public or 
private nonprofit colleges or universities to establish, operate, and 
administer occupational health training and education centers through 
cooperative arrangements between schools of medicine and schools of 
public health (or other qualified departments or schools within such 
colleges or universities which are qualified to participate in carrying 
out activities set forth in this section). 
"(2) To be eligible for a grant under this section, the applicant 
must demonstrate to the Secretary that it has or will have available 
full-time faculty members with training and experience in the field 
of occupational health and support from other faculty members 
Grants. 
42 USC 295g-5. 
90 STAT. 2316 
PUBLIC LAW 94^4S4—OCT. 12, 1976 
Appropriation 
authorization. 
Grants. 
42 use 295g-6. 
trained in the occupational health sciences and other relevant disci-
plines and medical and public health specialties and that it will sub-
stantially carrj^ out occupational health training and education 
activities including, but not limited to— 
"(A) the establishment and operation of a new graduate train-
ing pro-am or, where appropriate, the substantial expansion of 
an existing graduate training program in the field of occupational 
health; 
"(B) the development of curricula and operation of continu-
ing education for physicians, nurses, industrial hygienists, and 
other professionals who practice full- or part-time in the field 
of occupational health in order to upgrade their proficiency in 
delivering such services; 
"(C) the establishment and operation of projects designed to 
increase admissions to and enrollment in occupational health pro-
grams of individuals who by virtue of their background and inter-
ests are likely to engage in the delivery of occupational health 
services; 
"(D) the establishment of traineeships for industrial hygiene 
students; 
"(E) the establishment and operation of medical residencies 
in the field of occupational health at a level of financial support 
comparable to that provided to individuals undergoing training 
in medical residencies in other medical specialties; 
"(F) the establishment and operation of traineeships in the 
field oi occupational health for medical students, residents, nurs-
ing students, nurses, physicians, sanitarians, and students and 
professionals in related fields; 
"(G) the establishment and operation of short-term trainee-
ships for continuing education in the field of occupational health 
for health professionals dealing with problems of occupational 
health; and 
"(H) the appointment of full-time staff for the center, who 
have training, experience and demonstrated capacity for leader-
ship in the field of occupational health. 
"(b) To the extent feasible, the Secretary shall approve, at least 10 
such centers and at least one of which shall be located in each region 
of the Department. 
"(c) For the purpose of making grants to carry out this section, 
there are authorized to be appropriated $5,000,000 for the fiscal year 
ending September 30, 1977, $5,000,000 for the fiscal year ending Sep-
tember 30, 1978, $8,000,000 for the fiscal year ending September 30, 
1979, and $10,000,000 for the fiscal year ending September 30,1980. 
u 
FAMILY MEDICINE AND GENERAL PRACTICE OF DENTISTRY 
"SEC. 786. (a) The Secretary may make grants to, or enter into con-
tracts with, any public or nonprofit private hospital, school of medi-
cine or osteopathy, or to or with a public or private nonprofit entity 
(which the Secretary has determined is capable of carrying out such 
grant or contract) — 
"(1) to plan, develop, and operate, or participate in, an 
approved professional training program (including a continuing 
education program or an approved residency or internship pro-
gram) in the field of family medicine for medical and osteopathic 
students, interns (including interns in internships in osteopathic 
medicine), residents, or practicing physicians; 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2317 
" (2) to provide financial assistance (in the form of traineeships 
and fellowships) to medical and osteopathic students, interns 
(including interns in internships in osteopathic medicine), resi-
dents, practicing physicians, or other medical personnel, who are 
in need thereof, who are participants in any such program, and 
who plan to specialize or work in the practice of family medicine; 
"(3) to plan, develop, and operate a program for the train-
ing of physicians who plan to teach in family medicine training 
programs; and 
"(4) to provide financial assistance (in the form of traineeships 
and fellowships) to physicians who are participants in any such 
program and who plan to teach in a family medicine training 
program. 
"(b) The Secretarj^ may make grants to any public or nonprofit Grants, 
private school of dentistry or accredited postgraduate dental training 
institution— 
"(1) to plan, develop, and operate an approved residency pro-
gram in the general practice of dentistry; and 
" (2) to provide financial assistance (in the form of traineeships 
and fellowships) to residents in such a program who are in need 
of financial assistance and who plan to specialize in the practice 
of general dentistry. 
"(c) Not less than 10 percent of the amount appropriated in each 
fiscal year to make /rrants under this section shall be made available 
for grants under subsection (b). 
"(d) There are authorized to be appropriated to make grants Appropriation 
under this section $i5,0O3,0()0 for the fiscal year ending September 30, authorization. 
1978, $45,000,000 for the fiscal year ending September 30, 1979, and 
$50,000,000 for the fiscal year ending September 30,1980. 
"EDUCATIONAL ASSISTANCE TO INDIVIDUALS FROM DISADVANTAGED 
BACKGROUNDS 
"SEC. 787. (a) (1) For the purpose of assisting individuals from 
disadvantaged backgrounds, as determined in accordance with criteria 
prescribed by the Secretary, to undertake education to enter a health 
profession, the Secretary may make grants to and enter into contracts 
with schools of medicine, osteopathy, public health, dentistry, veteri-
nary medicine, optometry, pharmacy, and podiatry and other public 
or private nonprofit health or educational entities to assist in meeting 
the costs described in paragraph (2). 
"(2) A grant or contract under paragraph (1) may be used by the 
health or educational entity to meet the cost of— 
"(A) identifying, recruiting, and selecting individuals from 
disadvantaged backgrounds, as so determined, for education and 
training in a health profession, 
"(B) facilitating the entry of such individuals into such a 
school, 
"(C) providing counseling or other services designed to assist 
such individuals to complete successfully their education at such 
a school, 
" (D) providing, for a period prior to the entry of such individ-
uals into the regular course of education of such a school, 
preliminary education designed to assist them to complete suc-
cessfully such regular course of education at such a school, or 
referring such individuals to institutions providing such prelimi-
nary education, and 
Grants and 
contracts. 
42 use 295g-7. 
89-194 O-78-pt. 2 
54 
90 STAT. 2318 
PUBLIC LAW 94-484—OCT. 12, 1976 
Appropriation 
authorization. 
42 use 295g-8. 
Application. 
"(E) publicizing existing sources, of financial aid available to 
students in the education program of such a school or who are 
undertaking training necessary to qualify them to enroll in such 
a program. 
"(b) There are authorized to be appropriated $20,000,000 for the 
fiscal year ending September 30, 1978, $20,000,000 for the fiscal year 
ending September 30, 1979, and $20,000,000 for the fiscal year ending 
September 30, 1980, for payments under grants and contracts under 
subsection (a). 
(( 
PROJECT GRANT AUTHORITY FOR START-TJP ASSISTANCE, FINANCIAL DIS-
TRESS INTERDISCIPLINARY TRAINING, AND CURRICULUM DEVELOPMENT 
"SEC. 788. (a) (1) In the case of any new school of medicine, oste-
opathy, dentistry, public health, veterinary medicine, optometry, 
pharmacy, or podiatry which begins instruction after July 1, 1974, 
the Secretary may, after taking into account— 
" (A) the ability of such school to use a grant under this sub-
section to (i) accelerate the date it will begin instruction, or (ii) 
increase the number of students in its entering class, and 
"(B) the other resources available to such school, 
make a grant to such school for each year such school is a new school 
(as determined under paragraph (5)). No school may receive a grant 
under this subsection unless the Secretaiy estimates that the number 
of full-time students enrolled in its first school year of operation will 
exceed twenty-three. 
"(2) The Secretary shall determine the amount of any grant under 
this subsection; but no such grant to any school may exceed— 
"(A) in the case of the year preceding the first year in which 
such school has students enrolled, an amount equal to the product 
of $10,000 and the number of full-time students which the Secre-
tary estimates will enroll in such school in such first year; 
"(B) in the case of the first year in which such school has stu-
dents enrolled, an amount equal to the product of $7,500 and the 
number of full-time students enrolled in such school in such year; 
"(C) in the case of the second year in which such school has 
students enrolled, an amount equal to the product of $5,000 and 
the number of full-time students enrolled in such school in such 
year; and 
"(D) in the case of the third year in which such school has stu-
dents enrolled, an amount equal to the product of $2,500 and the 
number of full-time students enrolled in such school in such year. 
Estimates by the Secretary under this subsection of the number of 
full-time students enrolled in a school may be made on the basis of 
assurances provided by the school. 
"(3) A grant may not be made under this subsection unless an 
application for such grant is submitted to, and approved by, the Sec-
retary. The Secretary shall give priority to applications which provide 
for projects which— 
"(A) assist in the planning, development, or initial operation 
of a new school of medicine, osteopathy, or dentistry (i) which 
will conduct exceptionally innovative programs for training 
students in ambulatory primary care in cooperation with accred-
ited psychiatric practitioners or programs, as appropriate, or 
(ii) which will have as a major objective the provision of 
training opportunities for individuals from 
disadvantaged 
backgrounds; 
c„.rt-t»ej.efi 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2319 
"(B) assist in the planning, development, expansion, or initial 
operation of a regional health profession school granting a degree 
in one or more of the following professions: medicine, osteopathy, 
dentistry, veterinary medicine, optometry, podiatry, or public 
health; or 
"(C) the Secretary determines will meet a national or regional 
need for members of the profession to be trained in the new school 
for which the application is submitted. 
"(4) The Secretary shall give special consideration to each applica-
tion of a school for a grant under this subsection— 
"(A) which application contains or is reasonably supported 
by assurances that, because of the use that the school will make 
of existing facilities (including Federal medical or dental facili-
ties), such school will be able to accelerate the date on which it 
will begin its teaching program; 
"(B) which school will be located in a health manpower short-
age area (designated under section 332) ; or 
^'^^«' P- 2270. 
"(C) which school is a school of medicine or osteopathy which 
will be located in a State which has no other such school. 
" (5) For purposes of this subsection, any school of medicine, osteop-
athy, dentistry, public health, veterinary medicine, optometry, phar-
macy, or podiatry shall be considered a new school for any year if 
such year is the year preceding the first year in which such school has 
students enrolled, such first year, and the next two years. 
" (b) (1) The Secretary may make grants to, and enter into contracts Grants and 
with, schools of medicine, osteopathy, dentistry, veterinary medicine, contracts, 
optometry, pharmacy, podiatry, or public health for the purposes of 
assisting in— 
"(A) (i) meeting the costs of operation of any school of medi-
cine, osteopathy, dentistry, veterinary medicine, optometry, phar-
macy, podiatry, and public health if they are in serious financial 
distress, or 
" (ii) meeting accreditation requirements, if they have a special 
need to be assisted in meeting such requirements, and 
"(B) carrying out appropriate operational, managerial, and 
financial reforms on the basis of information obtained in a com-
prehensive cost analysis study or on the basis of other relevant 
information. 
" (2) Any grant under this subsection may be made upon such terms 
and conditions as the Secretary determines to be reasonable and neces-
sary, including requirements that the school agree— 
"(A) to disclose any financial information or data deemed by 
the Secretary to be necessary to determine the sources or causes 
of that school's financial distress, 
"(B) to conduct a comprehensive cost analysis study in coopera-
tion with the Secretary, and 
"(C) to carry out appropriate operational, managerial, and 
financial reforms (as the Secretary may require), including the 
securing of increased financial support from State or local govern-
mental units or the increasing of tuition on the basis of informa-
tion obtained in the course of a comprehensive cost analysis study 
or on the basis of other relevant information. 
"(3) An application for a grant under this subsection must contain Application, 
or be supported by assurances satisfactory to the Secretary that the 
applicant will expend in carrying out its function as a school of medi-
cine, osteopathy, dentistry, veterinary medicine, optometry, pharmacy, 
podiatry, or public health, as the case may be, during the fiscal year for 
90 STAT. 2320 
PUBLIC LAW 94-484—OCT. 12, 1976 
Report. 
Grants. 
Grants and 
contracts. 
which such grant is sought an amount of funds (other than funds for 
construction, as determined by the Secretary) from non-Federal 
sources which is at least as great as the average amount of funds 
expended by such applicant for such training in the preceding two 
years. 
"(4) In the case of a school which has received a grant under this 
subsection in the immediately preceding fiscal year, the amount granted 
to that school under this subsection in any fiscal year may not exceed 
75 percent of the amount granted to that school under this subsection 
in that immediately preceding fiscal year. 
"(5) The Secretary may provide to any school eligible for a grant 
under this subsection technical assistance to enable the school to con-
duct a comprehensive cost analysis study of its operations, to identify 
operational inefficiencies, and to develop or carry out appropriate 
operational, managerial, and financial reforms. 
"(6) The Secretary shall prepare and submit on or before Septem-
ber 30, 1978, a report on the administration of this subsection. Such 
report shall give special emphasis to a description of the results of any 
comprehensive cost analysis study carried out under paragraph (2) 
(B) and any operational, managerial, and financial reforms instituted 
under paragraph (2) (C). 
"(c) The Secretary may make grants to any health profession, 
allied health profession, or nurse training institution, or to any other 
public or nonprofit private entity for the development of programs for 
cooperative interdisciplinary training among schools of medicine, 
osteopathy, dentistry, veterinary medicine, optometry, pharmacy, 
podiatry, nursing, public health, and allied health, which emphasize— 
"(1) the use of the team approach to the delivery of health 
services, 
"(2) the training of ph^'sician assistants and nurse practi-
tioners with physicians and expanded function dental auxiliaries 
with dentists, and 
"(3) the training of physicians, dentists, nurses, and other 
health professionals in the organization, management, and effec-
tive utilization of such assistants, practitioners, and auxiliaries, 
"(d) The Secretary may make grants to and enter into contracts 
Avith any health profession, allied health profession, or nurse training 
institution, or any other public or nonprofit private entity for health 
manpower projects and programs such as— 
"(1) speech pathology, audiology, bioanalysis, and medical 
technology; 
"(2) establishing humanism in health care centers; 
" (3) biomedical combined educational programs; 
"(4) cooperative human behavior and psychiatry in medical 
and dental education and practice; 
" (5) bilingual health clinical training centers; 
"(6) curriculum development in schools of optometry, phar-
macy and podiatry; 
" (7) social work in health care; 
" (8) health manpower development; 
"(9) environmental health education and preventive medicine; 
"(10) the special medical problems related to women; 
"(11) the development or expansion of regional health profes-
sions schools; 
"(12) training of citizens of the United States from foreign 
health professions schools to enable them to enroll in residency 
programs in the States; 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2321 
" (13) psychology training programs; 
"(14) ethical implications of biomedical research; 
"(15) establishment of dietetic residencies; 
"(16) regional systems of continuing education; 
" (17) computer technology; 
"(18) training of professional standards review organization 
staff; 
"(19) training of health professionals in human nutrition and 
its application to health; 
"(20) health manpower development for the Trust Territories 
and incorporated Trust Territories of the United States; and 
"(21) training in the diagnosis, treatment, and prevention of 
the diseases and related medical and behavioral problems of the 
aged. 
"(e) (1) There are authorized to be appropriated to carry out the Appropriation 
provisions of this section (other than the provisions of subsections authorization, 
(f) and (g)) $25,000,000 for the fiscal year ending September 30,1978, 
$25,000,000 for the fiscal year ending September 30, 1979, and 
$25,000,000 for the fiscal year ending September 30,1980. 
" (2) From the sums authorized to be appropriated under paragraph 
(1) not more than— 
" (A) $5,000,000 may be obligated or expended for the purposes 
of subsection (a), and 
"(B) $5,000,000 may be obligated or expended for the purposes 
of subsection (b). 
"(f) (1) The Secretary may make grants to any school of medicine Grants, 
to meet the planning costs for projects for the training of students, 
enrolled in the last two years of such school, in facilities— 
"(A) which are other than the principal teaching facilities of 
such school and which are existing Federal heaHh care facilities 
or are other public or private health care facilities; and 
"(B) which are located in a health manpower shortage area 
(designated under section 332). 
Ante, p. 2270. 
No grant may be made under this paragraph with respect to any proj-
ect unless before the fiscal year for which the grant is to be made the 
project has received at least $100,000 from non-Federal sources and 
has been approved by the legislature of the State in which it is located. 
"(2) For payments under grants under paragraph (1), there are 
authorized to be appropriated $400,000 for the fiscal year ending Sep-
tember 30,1977. 
"(g)(1) The Secretary may make grants to public and nonprofit Grants, 
private institutions of higher education and hospitals and other health 
care delivery facilities which are engaged in the development of new 
schools of medicine to assist such institutions and facilities in meeting 
the costs of employing faculty, acquiring equipment, and taking such 
other action related to the initial operation of a school of medicine as 
may be necessary for the proposed schools to meet the eligibility 
requirements for a grant under subsection (a) of this section. 
"(2) No application for a grant under paragraph (1) may be Application, 
approved by the Secretary unless the application contains or is sup-
ported by assurances satisfactory to the Secretary that— 
"(A) with the assistance provided under the grant applied for 
the applicant will be able to accelerate the date on which the school 
of medicine being developed by the applicant will be able to begin 
its teaching program, 
"(B) there is a reasonable indication of non-Federal financial 
resources for development and operation of such school, and 
90 STAT. 2322 
PUBLIC LAW 94-484—OCT. 12, 1976 
"(C) the school of medicine will emphasize training programs 
in family medicine and will improve access to health care for resi-
dents of the geographical regions in which such training pro-
grams are located. 
The Secretary may not approve or disapprove an application sub-
mitted under this subsection unless he has consulted with the body 
recognized by the Commissioner of Education as the accrediting body 
for schools of medicine respecting approval of the application. 
"(3) No institution or facility may receive more than one grant 
Appropriation 
under this subsection. For payment under grants under this subsection, 
authorization. 
there is authorized to be appropriated $1,500,000 for the fiscal year 
ending September 30, 1977 and $1,500,000 for the fiscal year ending 
September 30,1978. 
" (4) Upon graduation of the second class from each school of medi-
cine for which a grant was made under this subsection, the Secretary 
sliall report to the Congress on the ability of the school of medicine to 
improve access to health care for residents of the geographical regions 
in which the clinical training programs of the school are located.". 
42 use 295f-6, 
(b) Effective November 1, 1976. section 776 of the Public Health 
295g-9. 
Service Act is redesignated as section 789 of such Act, and all refer-
ences to such section in title XII of such Act are redesignated 
accordingly. 
(c) Effective October 1, 1976, part F of title VII is amended by 
adding after section 789 (redesignated by subsection (b)) the follow-
inii'uew section: 
u, 
GENERAL PROVISIONS 
42 use 
"SEC. 790. Except as otherwise provided in this part: 
295g-10. 
" (1) Isfo grant may be made or contract entered into under this part 
unless an application therefor has been submitted to, and approved 
by, the Secretary. Such application shall be in such form, submitted 
in such manner, and contain such information, as the Secretary shall 
by regulation prescribe. The Secretary may not approve or disap-
prove any application for a grant or contract under this part except 
after consultation with the National Advisory Council on Health 
Professions Education. 
"(2) Payments by recipients of grants or contracts under this part 
for (A) traineeships shall be limited to such amounts as the Secre-
tary finds necessary to cover the cost of tuition and fees of, and 
stipends and allowances (including travel and subsistence expenses 
and dependency allowances) for the trainees; and (B) fellowships 
shall be limited to such amounts as the Secretary finds necessary to 
cover the cost of advanced study by, and stipends and allowances 
(including travel and subsistence expenses and dependency allowances) 
for, the fellows. 
"(3) The amount of any grant or contract under this part shall be 
determined by the Secretary. Contracts may be entered into under 
this part without regard to sections 3648 and 3709 of the Eevised 
Statutes (31 U.S.C. 529; 41 U.S.C. 5).". 
TRANSITIONAL PROVISIONS AND REPORT ON AREA HEALTH EDUCATION 
CENTERS 
42 use 295g-l 
SEC. 802. (a) For the fiscal year ending September 30,1978, and for 
^^^^- 
the next fiscal year there are authorized to be appropriated such 
sums as may be necessary to continue payments to entities under con-
tracts entered into under section 774 of the Public Health Service 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2323 
Act (as in effect on September 30, 1977) for projects for area health 42 U
S
C 295f-4. 
education centers, except that no payment shall be made to an entity 
under such a contract in the fiscal year ending September 30, 1979, 
unless the entity provides assurances satisfactory to the Secretary 
that not later than September 30, 1979, the project for which the 
payment is to be made will be a project described in subsection (a) 
of section 781 of such Act (as added by this Act) and the entity and -4««e, p. 2312. 
its application will meet the requirements of subsections (b), (c), 
and (d) of such section. Such payments may only be made from such 
sums for the periods and amounts specified in such contracts. 
(b) After October 1, 1978, the Secretary of Health, Education, 
^
^ 
and Welfare shall assess the program of contracts under section 781 
of the Public Health Service Act (as so added) to determine the 
effect of the projects funded under such contracts on the distribution 
of health manpower and on the access to and the quality of health 
care in the areas in which such projects are located. Not later than Report to 
September 30, 1979, the Secretary shall submit to the Congress a Congress, 
report on the assessment conducted under this subsection. 
TITLE IX—MISCELLANEOUS 
NURSE TRAINEESHIPS 
Sec. 901. Section 830 is amended— 
(1) by striking out in subsection (a) "There are authorized" 
and all that follows through "1978," and inserting in lieu thereof 
"(1) The Secretary may make grants to public or private non-
profit institutions"; 
(2) by redesignating paragraphs (1), (2), (3), and (4) of sub-
section (a) as subparagraphs (A), (B), (C), and (D); 
(3) by striking out subsection (b) and inserting in lieu thereof 
the following: 
" (2) In making grants for traineeships under this subsection, the 
Secretary shall give special consideration to applications for trainee-
ship programs (A) for the training of nurse practitioners who will 
practice in health manpower shortage areas (designated under section 
332), and (B) for traineeship programs which conform to guidelines 
established by the Secretary under section 822(a) (2) (B)."; 
(4) by striking out "section" in subsection (c) and inserting in 
lieu thereof "subsection"; 
(5) by redesignating subsection (c) as paragraph (3); and 
(6) by adding at the end thereof the following: 
"(b) (1) The Secretary may make grants to and enter into contracts 
with schools of nursing, medicine, and public health, public or non-
profit private hospitals, and other nonprofit entities to establish and 
operate traineeship programs to train nurse practitioners who are 
residents of a health manpower shortage area (designated under sec-
tion 332). 
"(2) Traineeships funded under.this subsection shall include 100 
percent of the costs of tuition, reasonable living and moving expenses 
(including stipends), books, fees, and necessary transportation. 
"(3) A traineeship funded under this subsection shall not be 
awarded unless the recipient enters into a. commitment with the Sec-
retary to practice as a nurse practitioner in a health manpower short-
age area (designated under section 332). 
"(c) There are authorized to be appropriated for the purposes of 
this section $15,000,000 for the fiscal year ending June 30, 1976, 
$20,000,000 for the fiscal year ending September 30, 1977, and 
$25,000,000 for the fiscal year ending September 30, 1978.". 
42 USC 297. 
Ante, p. 2270. 
42 USC 296m. 
Grants and 
contracts. 
Appropriation 
authorization. 
90 STAT. 2324 
PUBLIC LAW 94-484—OCT. 12, 1976 
42 u s e 300/-1. 
42 u s e 300n. 
Effective date. 
42 u s e 300/-1 
note. 
42 u s e 292h 
note. 
Report to 
Secretary and 
congressional 
committees. 
Effective date. 
HEALTH PLANNING 
SEC. 902. (a) Section 1512(b) (3) (c) (ii) (I) is amended by inserting 
"optometrists," after "nurses,". 
(b) Section 1531(3) (A) is amended by inserting "optometrist," 
after "podiatrist,". 
(c) The amendments made by subsections (a) and (b) shall take 
effect on the date of enactment of this Act. 
STUDY RELATING TO CHIROPRACTIC HEALTH PROFESSIONS 
SEC. 903. (a) (1) The Secretary of Health, Education, and Welfare 
shall arrange for the conduct of a study to determine the national 
average annual per student educational cost of providing education 
programs which lead to a degree of doctor of chiropractics. 
(2) Such study shall be completed and an interim report thereon 
submitted not later than March 30, 1978, and a final report not later 
than January 1, 1979, to the Secretary, the Committee on Labor and 
Public Welfare of the Senate, and the Committee on Interstate and 
Foreign Commerce of the House of Representatives. 
(3) Such study shall develop methodologies for ascertaining the 
average annual cost of chiropractic education, and the factors that 
affect any variation among schools with respect to their average 
annual per student educational costs. The study shall employ the 
most recent data available from the chiropractic schools in the United 
States at the time of the study. 
(4) The study shall also determine the current demand for chiro-
practic services throughout the United States and shall develop 
methodologies for determining if current supply of chiropractors is 
sufficient to meet this demand. 
(5) The study shall include an analysis of the current costs of chiro-
practic services by type of service and shall include an analysis of 
such costs over the past five years. 
(b) The Secretary shall enter into an agreement with an appro-
priate nonprofit group or association to conduct such a study under 
iili arran^>cmcnt in which the Secretary reimburses such group or asso-
ciation for actual expenses incurred by such group or association in 
conducting such a study. 
(c) The provisions of this section shall take effect on the date of 
enactment of this Act. 
42 use 292h 
note. 
STUDIES OF TRAINING I N BILINGUAL AND BICULTURAL AWARENESS AND OF 
ADMISSIONS EXAMINATIONS OF PERSONS FROM POPULATION GROUPS OF 
LIMITED 
ENGLISH-SPEAKING ABILITY 
SEC. 904. (a) The Secretary of Health, Education, and Welfare 
shall conduct, or arrange for the conduct of, a study of the adequacy 
of the efforts of health professions schools which provide training in 
clinical facilities which serve populations of limited English-speaking 
ability (1) in recruiting and training individuals who are competent 
in the predominant language (other than English) spoken by such 
populations, and (2) in conducting programs to increase the aware-
ness of such individuals of the cultural sensitivities of such 
populations. 
(b) The Secretary of Health, Education, and Welfare shall conduct, 
or arrange for the conduct of, a study or studies to determine the 
effectiveness of health training institution admissions examinations in 
PUBLIC LAW 94-484—OCT. 12, 1976 
90 STAT. 2325 
evaluating accurately the potential and ability of the student appli-
cant from a population group of limited English-speaking ability to 
participate in and successfully complete the educational program. 
Such study or studies shall particularly consider the extent of any cul-
tural bias in admissions examinations utilized by such institutions. 
(c) Within one year of the date of enactment of this Act the Secre- Report to 
tary shall report to the Congress the findings made in the studies Congress; 
conducted pursuant to subsections (a) and (b), recommendations for legisative 
administrative action and legislation, and the steps taken to carry out 
such action. 
DEFINITION OF STATE 
SEC. 905. (a) Section 2(f) is amended to read as follows: 
^^ U
S
C 201. 
"(f) Except as provided in sections 314(g)(4)(B), 318(c)(1), 
331(h)(3), 355(5), 361(d), 701(9), 1002(c), 1201(2), 1401(13), 
1531(1), and 1633(1), the term 'State' includes, in addition to the 
several States, only the District of Columbia, Guam, the Common-
wealth of Puerto Rico, the Northern Mariana Islands, and the Virgin 
(b)(i) Sections 314(g)(4)(B), 355(5), 1002(c), 1201(2), 1401 
(13), and 1633(1) are amended by inserting "the Northern Mariana 42 USC 246, 
Islands," immediately after "Puerto Rico," in each such section. 
263c, 300a, 
(2) Section 318(c)(1) is amended by inserting "the Northern foo^:|^^^' 
Mariana Islands," immediately after "American Samoa,". 
42 U
S
C 247 
LABOR CERTIFICATION 
SEC. 906. (a) The Secretary of Health, Education, and Welfare shall 8 U
S
C 1182 note, 
(not later than one year after the date of the enactment of this Act) 
develop sufficient data to enable the Secretary of Labor to make equi-
table determinations with regard to applications for labor certification 
by graduates of foreign medical schools. 
(b) The data required under subsection (a) shall include the num-
ber of physicians (by specialty and by percent of population) in a geo-
graphic area necessary to provide adequate medical care, including 
such care in hospitals, nursing homes, and other health care institu-
tions, in such area. 
(c) The Secretary of Health, Education, and Welfare shall develop 
such data after consultation with such medical or other associations as 
may be necessary. 
Approved October 12, 1976. 
LEGISLATIVE HISTORY: 
HOUSE REPORTS: No. 94-266 (Comm. on Interstate and Foreign Commerce) and No. 
94-1612 (Comm. of Conference). 
SENATE REPORTS: No. 94-886 (Comm. on Labor and Public Welfare) and No. 
94-887 accompanying S. 3239 (Comm. on Labor and Public 
Welfare). 
CONGRESSIONAL RECORD: 
Vol. 121 (1975): July 11, considered and passed House. 
Vol. 122 (l976): July 1, considered and passed Senate, amended. 
Sept. 20, Senate agreed to conference report. 
Sept. 27, House receded and concurred in Senate amendment 
with amendment. 
Sept. 30, Senate agreed to House amendment.