An Act to amend the conditions for schools receiving capitation grants under section 770 of such Act, and for other purposes.
PL 95-215 (H.R.9418), enacted 12/19/1977

PUBLIC LAW 95-215—DEC. 19, 1977 
91 STAT. 1503 
Public Law 95-215 
95th Congress 
An Act 
To amend the conditions for scliools receiving capitation grants under section 770 
of such Act, and for other purposes. 
Be it enacted hy the Senate UTid House of Representatives of the 
United States of America in Congress assenfibled, That (a) section 
771 (b) (3) of the Public Health Service Act is amended to read as 
follows: 
"(3] (A) Except as provided under subparagraph (D), a school of 
medicine may not receive a grant under section 770 to be made in the 
fiscal year ending September 30, 1978, unless its application for such 
grant contains or is supported by assurances satisfactory to the Secre-
tary that such school will increase its enrollment of full-time, third-
year students as prescribed by subparagraph (B). 
"(B) The enrollment increase referred to in subparagraph (A) is 
an enrollment increase in a school of medicine— 
" (i) which is to occur in school year 1978-1979, 
"(ii) in the number of full-time, third-year students over the 
number of full-time, second-year students who successfully com-
pleted the second-year program of such school in the preceding 
school year and enrolled in the third-year class of such school, and 
"(iii) which is not less than 5 per centum of the number of— 
"(I) full-time, first-year students enrolled in such school 
in school year 1977-1978, or 
" (II) full-time, third-year students enrolled in such school 
in school year 1977-1978, 
whichever is less. 
"(C) In determining the number of full-time, third-year students 
enrolled in a school in a school year in which an increase is required 
by subparagraph (B) (i) — 
"(i) full-time, third-year students of such school who were not 
second-year students in such school and— 
: 
"(I) who are not citizens of the United States, 
" (II) who were previously enrolled in a school of medicine 
to which the requirement of subparagraph (A) applies, 
: 
"(III) who were previously enrolled in a school of medi-
cine to which the requirement of subparagraph (A) does not 
apply because of subparagraph (D) and for whom a position 
in the third-year class of such school was available in such 
school year, 
" (IV) who first enrolled after October 12,1976, in a school 
» ! 
of medicine not in a State, 
" (V) who were previously enrolled in a school of dentistry 
. > 
or a school of osteopathy, or 
"(VI) who were previously enrolled in a school of medi-
cine which is in a State and which is not accredited by the 
body or bodies approved for such purpose by the Commis-
sioner of Education, 
shall not be counted; and 
Dec. 19, 1977 
[H.R. 9418] 
Public Health 
Service Act, 
amendment. 
Medical schooli! 
grant eligibility, 
Hscal year 1978. 
Enrollment 
requirements. 
42 u s e 295f-l. 
42 u s e 295f. 
Enrollment 
increase, criteria. 
2 9 - 1 9 4 
0 - 8 0 
91 STAT. 1504 
PUBLIC LAW 95-215—DEC. 19, 1977 
Waiver. 
42 use 295f. 
First time 
enrollees. 
42 use 295f-2. 
Ante, p. 1503; 
Infra. 
Dental specialty 
programs. 
42 use 295f-l. 
Public health 
schools, trainee-
ship grants. 
42 use 294r. 
"(ii) full-time, second-year students enrolled in such year who 
are citizens of the United States and who were first enrolled 
before October 12, 1976, in a school of medicine not in a State 
shall be counted as third-year students. 
"(D) The Secretary may waive (in whole or in part) the require-
ment of subparagraph (A) for a school of medicine— 
"(i) if the Secretary determines, after receiving the written 
recommendation of the appropriate accreditation body or bodies 
(approved for such purpose by the Commissioner of Education) 
that compliance by such school with such requirement will pre-
vent it from maintaining its accreditation; 
" (ii) upon a finding that, because of the inadequate size of the 
population served by the hospital or clinical facility in which such 
school conducts its clinical training, an increase in its enrollment 
of third-year students to meet such requirement will prevent it 
from providing high quality clinical training for each of its third-
year students; or 
"(iii) if the Secretary determines that such school has made a 
good faith effort to meet the requirement of subparagraph (A) 
but has been unable to meet such requirement solelj^ because there 
is an insufficient number of students who, under this paragraph, 
are eligible to be counted in determining if the school has met 
such requirement. 
The requirement of subparagraph (A) does not apply to the applica-
tion of a school of medicine for a grant under section 770 if in school 
year 1977-1978 such school had an enrollment of full-time, first-year 
students which exceeded its enrollment in such school year of full-time, 
third-year students by at least 25 per centum. 
"(E) A school of medicine which did not receive a grant under 
section 770 because it did not comply with the applicable require-
ments of this paragraph shall not be eligible to receive a grant under 
such section to be made in the fiscal year ending September 30, 1979, 
or in the next fiscal year.". 
(b) Section 772 of the Public Health Service Act is amended by 
adding at the end thereof the following new subsection: 
" (e) For purposes of administering the requirements of section 771, 
a reference to a year class of students is a reference to students enrolled 
in that class for the first time.". 
SEC. 2. Section 771(d) (2) of the Public Health Service Act is 
amended (1) by striking out "In" and inserting in lieu thereof "In 
the case of a school of dentistry which in school year 1976-1977 had 
at least six filled, first-year positions in dental specialty programs, 
in", (2) by striking out "a school of dentistry's" and inserting in lieu 
thereof "such a school's", (3) by striking out "filled positions" each 
place it occurs and inserting in lieu thereof "filled, first-year positions", 
and (4) by striking out "shall be positions" and inserting in lieu 
thereof "shall be first-year positions". 
SEC. 3. (a) Subsection (a) of section 748 of the Public Health Serv-
ice Act is amended to read as follows: 
"(a) The Secretary may make grants to— 
"(1) accredited schools of public health, and 
"(2) other public or nonprofit institutions which provide 
graduate or specialized training in public health and which are 
not eligible to receive a grant under section 749, 
to provide traineeships.". 
PUBLIC LAW 95-215—DEC. 19, 1977 
91 STAT. 1505 
(b) Section 748(b) (3) (B) of such Act is amended (1) by striking 42 USC 294r, 
out "or" at the end of clause (iii), (2) by striking out the period at 
the end of clause (iv) and inserting in lieu thereof ", or" and (3) 
by adding after such clause the following :
^ 
"(v) preventive medicine or dentistry.". 
(c) Section 748(c) of such Act is amended (1) by striking out 
"$8,000,000" and inserting in lieu thereof "$9,000,000", and (2) by 
striking out "$9,000,000" and inserting in lieu thereof "$10,000,000". 
(d) The heading for section 748 of such Act is amended to read as 
follows: 
Appropriation 
authorization. 
(( 
PUBLIC HEALTH TRAINEESHIPS . 
SEC. 4. (a) Subsection (a) (1) of section 731 of the Public Health 
Service Act (relating to eligibility of student borrowers and terms of 42 USC 294d. 
federally insured student loans) is amended to read as follows: 
"(1) made to— 
: 
, 
"(A) a student who— 
" (i) (I) has been accepted for enrollment at an eligible 
institution, or (II) in the case of a student attending 
an eligible institution, is in good standing at that institu-
tion, as determined by the institution; 
"(ii) is or will be a full-time student (as defined in 
section 770(c) (2)) at the eligible institution; 
_ 
42 USC 295f. 
"(iii) in the case of a student in a school of medicine, 
osteopathy, or dentistry, has been authorized by the 
institution in accordance with section 739(b)(2) to 42 USC 294/. 
receive a loan under this subpart; 
"(iv) has agreed that all funds received under such 
loan shall be used solely for tuition and other reasonable 
educational expenses, including fees, books, and labora-
tory expenses, incurred by such students; 
"(v) 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 
partBof title IV of the Higher Education Act of 1965; 20 U
S
C 1071. 
and 
"(vi) in the case of a pharmacy student, has satisfac-
torily completed three years of training; or 
"(B) an individual who— 
"(i) has previously had a loan insured under this sub-
part when the individual was a full-time student at an 
eligible institution; 
"(ii) is in a period during which, pursuant to para-
graph (2), the principal amount of such previous loan 
--' 
need not be paid; and 
"(iii) has agreed that all funds received under the 
proposed loan shall be used solely for repayment of inter-
est due on previous loans made under this subpart; and", 
(b) Subsection (a) (2) of such section is amended— 
Deferred interest. 
(1) by inserting before the semicolon at the end of subpara-
graph (D) the following: ", except that the note or other written 
agreement may provide that payment of any interest otherwise 
payable (i) before the beginninsf of the repayment period, (ii) 
during any period described in subparagraph (C), or (iii) during 
: 
any other period of forbearance of payment of principal, may be 
deferred until not later than the date upon which repayment of 
91 STAT. 1506 
PUBLIC LAW 95-215—DEC. 19, 1977 
42 use 294d. 
42 use 294. 
42 use 294a. 
Supra. 
Ante, p. 1505. 
42 use 294a. 
42 use 294b. 
42 use 294d. 
42 use 294e. 
42 use 294f. 
42 use 294k. 
42 use 294/. 
42 use 294j. 
Ante, p. 1503. 
Effective date. 
42 use 294d 
note. 
National Health 
Service eorps 
Scholarship 
program, 
application 
approval. 
42 use 294t. 
the first installment of principal falls due or the date repayment 
of principal is required to resume (whichever is applicable) and 
may further provide that, on such date, the amount of the interest 
which has so accrued may be added to the principal"; and 
(2) by striking out "student" in subparagraph ( E ) . 
(c) Subsection (b) of such section (relating to maximum interest 
rates) is amended by striking out "10 percent per annum" and insert-
ing in lieu thereof "12 percent per annum". 
(d) Such section is further amended by adding after subsection 
(c) the following new subsection: 
"(d) No provision of any law of the United States (other than sub-
sections ( a ) ( 2 ) ( D ) and (b) of this section) or of any State that limits 
the rate or amount of interest payable on loans shall apply to a loan 
insured under this subpart.". 
(e) Subpart I of part C of title V I I of the Public Health Service 
Act is amended as follows: 
(1) In section 727(a), insert" (and certain former students of)" 
after "students in". 
(2) In the first sentence of section 728(a), strike out "students" 
and insert in lieu thereof "borrowers". 
(3) In the second sentence of section 728 (a), insert "or to obtain 
a loan under section 731(a) (1) (B) to pay interest on such prior 
loans" after "to continue or complete their educational program". 
(4) I n section 728 (c), strike out "student". 
(5) In the second sentence of section 729 (a)— 
(A) strike out "student" the first time it appears and insert 
in lieu thereof "borrower"; and 
(B) insert "borrower who is or was a" before "student" the 
second and third time it appears. 
(6) I n section 731(a) (2) (B), strike out "student" and insert 
in lieu thereof "borrower". 
(7) In the heading to section 731, strike out "STUDENT". 
(8) In subsections (a) and (b) (2) of section 732, strike out 
"student" and insert in lieu thereof "borrower" each time it 
appears. 
(9) In subsections (b) (1) and (e) of section 732, strike out 
"student". 
(10) In section 733, strike out "student" each time it appears. 
(11) In the heading to section 733, strike out "STUDENT" and 
insert in lieu thereof "BORROWER". 
(12) In section 738, strike out "student". 
(13) I n section 739(a)(1), strike out "student" and insert in 
lieu thereof "borrower". 
(f) Section 737(1) of the Public Health Service Act is amended (1) 
by striking out "and public health" and inserting in lieu thereof "or 
public health", and (2) by inserting " ( A ) " after "that" and by insert-
ing before the period the following: ", or (B) was not eligible to 
receive such a grant for such fiscal year solely because it did not meet 
the applicable requirements of section 771(b) (3)". 
(g) The amendments made by this section shall take effect on 
October 1, 1977. 
SEC. 5. Effective October 1, 1977, section 751(d) (2) of the Public 
Health Service Act is amended to read as follows: 
"(2) second, to applications made (and contracts submitted) — 
"(A) for the school year beginning in calendar year 1978, 
by individuals who are entering their first, second, or third 
PUBLIC LAW 95-215—DEC. 19, 1977 
91 STAT. 1507 
year of study in a course of study or program described in 
subsection (b)(1)(B) in such school year; 
"(B) for the school year beginning in calendar year 1979, 
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 
"(C) for 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.". 
SEC. 6. (a)(1) Section 1515(b) (2) of the Public Health Service 
Act is amended (1) by striking out "which may not" and inserting in 
lieu thereof "which, except as otherwise provided in this paragraph, 
may not", and (2) by adding after the first sentence the following: 
"The Secretary may, upon application of a conditionally designated 
entity, extend for an additional period of not to exceed 12 months the 
period of such entity's conditional designation if the Secretary deter-
mines that (A) unusual circumstances exist or existed which prevent 
such entity from qualifying for designation under subsection (c) 
within 24 months of such entity's conditional designation under this 
subsection, (B) such extension should enable such entity to qualify 
for designation under subsection (c), and (C) such extension is neces-
sary to carry out the purposes of this title. Each such determination 
shall be in writing: and shall include a summary of the reasons for it.". 
(2) The second sentence of section 1516(a) of such Act is amended 
by inserting before the period at the end a comma and the following: 
"except that in the case of a grant made to a conditionally designated 
entity with which the Secretary will not enter into a designation agree-
ment under section 1515(c), such grant shall be available for obliga-
tion for such additional period as the Secretary determines such entity 
will require to satisfactorily terminate its activities under the agree-
ment for its conditional designation". 
(b) Section 1521(b)(2)(B) of the Public Health Service Act is 
amended by striking out "twenty-four months" and inserting in lieu 
thereof "thirty-six months". 
SEC. 7. The Secretary of Health, Education, and Welfare shall con-
duct a study to determine whether schools of medicine, nursing, or 
osteopathy deny admission or otherwise discriminate against any 
applicant to such schools because of the applicant's reluctance, or 
willingness, to counsel, suggest, recommend, assist, or in any way 
participate in the performance of abortions or sterilizations contrary 
to his or her religious beliefs or moral convictions. Not later than Feb-
ruary 1, 1978, the Secretary shall complete such study and report his 
findings and recommendations to the Committee on Interstate and 
Foreign Commerce of the House of Eepresentatives and the Commit-
tee on Human Resources of the Senate. 
SEC. 8. (a) Section 1121(b)(5) of the Public Health Service Act 
is amended by inserting "fiscal year" before "ending September 30, 
1977". 
(b) Section 206(b) (6) of the Public Health Service Act is amended 
by striking out "senior" and inserting in lieu thereof "junior". 
(c) Section 772(b) of the Public Health Service Act is amended by 
striking out "section 778" and inserting in lieu thereof "section 788''. 
Health systems 
agencies, 
conditional 
;nation. 
42 use 300/-4. 
Planning grants, 
availability. 
42 use 300/-5. 
42 use 300/-4. 
42 use 300m. 
Study. 
42 use 300 note. 
Report to 
congressional 
committees. 
42USe300c-ll,. 
42 use 207. 
42 use 295f-2. 
91 STAT. 1508 
PUBLIC LAW 95-215—DEC. 19, 1977 
Saint Elizabeths 
SEC. 9. Section 4839 of the Revised Statutes (24 U.S.C. 165) is 
Hospital, excess 
amended by inserting after the fourth sentence the following: "With 
nv sunent 
*^® approval of the Secretary of the Treasury, the disbursing agent 
may invest funds of the account in excess of current needs in interest-
bearing obligations of the United States with maturities suitable for 
the needs of the account, and any interest on such investment shall 
be credited to and form a part of the account.". 
Approved December 19, 1977. 
_ -
LEGISLATIVE HISTORY: 
HOUSE REPORTS: No. 95-707 (Comm. on Interstate and Foreign Commerce) and No. 
95-828 (Comm. of Conference). 
SENATE REPORTS: No. 95-545 accompanying S. 2159 (Comm. on Human Resources) 
and No. 95-608 (Comm. of Conference). 
CONGRESSIONAL RECORD, Vol. 123 (1977): 
Oct. 17, considered and passed House. 
Nov. 4, considered and passed Senate, amended, in lieu of S. 2159. 
Dec. 1, Senate agreed to conference report. 
Dec. 7, House agreed to conference report.