Health Services Research, Health Statistics, and Medical Libraries Act
PL 93-353 (H.R.11385), enacted 07/23/1974

362 
PUBLIC LAW 93-353-JULY 23, 1974 
[88 STAT. 
Public Law 93-353 
July 23,1974 
[H. R.11385] 
Health Serv-
ices Research, 
Health Statis-
tics, and Medi-
cal Libraries 
Act of 1974. 
42 u s e 242b 
note. 
42 use 201 
note. 
Health Serv-
ices Research 
and Evaluation 
and Health Sta-
tistics Act of 
1974. 
42 use 242b 
note. 
Repeals. 
42 use 242e, 
244, 244a, 245, 
247. 
42 use 242d. 
42 u s e 244-1. 
42 use 242g. 
42 u s e 245a. 
42 u s e 247d. 
42 u s e 235. 
42 u s e 242j. 
42 u s e 236. 
42 u s e 242b. 
AN ACT 
To amend the Public Health Service Act to revise the programs of health services 
research and to extend the program of assistance for medical libraries. 
Be it enacted hy the Senate and House of Representatives 
of the 
United States of America in Congress 
assembled, 
SECTION 1. (a) This Act may be cited as the "Health Services 
Research, Health Statistics, and Medical Libraries Act of 1974". 
(b) Unless the context otherwise requires, 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. 
TITLE I—HEALTH SERVICES RESEARCH AND EVALUA-
TION; HEALTH STATISTICS 
SEC. 101. This title may be cited as the "Health Services Research 
and Evaluation and Health Statistics Act of 1974". 
SEC. 102. (a) Sections 307, 312, 312a, 313, and 315 are repealed. 
(b) (1) Section 306 is amended (A) by striking out "Surgeon Gen-
eral" each place it appears and inserting in lieu thereof "Secretary", 
(B) by striking out "309" each place it occurs in subsection (d) and 
inserting in lieu thereof "313", and (C) by striking out subsection (e) 
and redesignating subsection (f) as subsection (e). 
(2) Section 306 as amended by paragraph (1) is transferred to 
part B of title III, is redesignated section 312, and is inserted after 
section 311. 
(c) (1^ Section 309 is amended (A) by striking out "Surgeon Gen-
eral" each place it occurs and inserting in lieu thereof "Secretary", and 
(B) by striking out "306(d)" and inserting in lieu thereof "312(d)". 
(2) Section 309, as amended by paragraph (1), is transferred to 
part B of title III, is redesignated section 313, and is inserted immedi-
ately before section 314. 
(d) Section 310 is transferred to part B of title III, is redesignated 
section 319, and is inserted after section 318. 
(e) Section 310A is transferred to title II, is redesignated section 
226, and is inserted after section 225. 
(f) (1) Section 310B is amended by striking out "304, 305,". 
^2) Section 310B, as amended by'paragraph (1) is transferred to 
title II, is redesignated section 227, and is inserted after section 226 
(inserted by subsection (e) of this section). 
SEC. 103. Section 304 is amended to read as follows: 
" G E N E R A L A U T H O R I T Y R E S P E C T I N G HEAI/ril STATISTICS AND HEALTH SERV-
ICES RESEARCH, EVALUATIONS, AND DEMONSTRATIONS 
"SEC. 304. (a)(1) The Secretary shall— 
"(A) undertake through the National Center for Health Serv-
ices Research, the National Center for Health Statistics, and such 
other units of the Department of Health, Education, and Welfare 
as he may select, and 
"(B) support, 
health statistical activities and health services research, evaluation, 
and demonstrations. 
"(2) In carrying out paragraph (1), the Secretary shall give 
appropriate emphasis to research and statistical activities respecting— 
" (A) the determinants of an individual's health, 
88 STAT. ] 
PUBLIC LAW 93-353-JULY 23, 1974 
363 
"(B) the impact of the environment on individual health and 
on health care, 
"(C) the accessibility, acceptability, planning, organization, 
technology, distribution, utilization, quality, and 
financing 
of systems for the delivery of health care, including systems for 
the delivery of preventive, personal, and mental health care, and 
"(D) individual and community knowledge of individual 
health and the systems for the delivery of health care. 
"(b) To implement subsection (a), the Secretary may, in addition 
to any other authority which under other provisions of this Act or any 
other law may be used by him to implement such subsection, do the 
following: 
"(1.) Utilize personnel and equipment, facilities, and other 
physical resources of the Department of Health, Education, and 
Welfare, permit appropriate (as determined by the Secretary) 
entities and individuals to utilize the physical resources of such 
Department, provide technical assistance and advice, make grants 
to public and nonprofit private entities and individuals, and enter 
into contracts with public and private entities and individuals, 
for (A) health services research, evaluation, and demonstrations, 
and (B) health services research and health statistics training, 
and (C) health statistical activities. 
,
» 
"(2) Admit and treat at hospitals and other facilities of the 
Service persons not otherwise eligible for admission and treat-
ment at such facilities. 
"(3) Secure, from time to time and for such periods as the 
Secretary deems advisable, the assistance and advice of experts 
and consultants from the United States or abroad. 
"(4) Acquire, construct, improve, repair, operate, and main-
tain laboratory, research, and other necessary facilities and equip-
ment, and such other real or personal property (including patents) 
as the Secretary deems necessary; and acquire, without regard 
to the Act of March 3,1877 (40 U.S.C. 34), by lease or otherwise, 
through the Administrator of General Services, buildings or 
parts of buildings in the District of Columbia or communities 
located adjacent to the District of Columbia. 
"(c) The Secretary shall coordinate all health services research, 
evaluation, demonstration, and health statistical activities undertaken 
and supported through units of the Department of Health, Education, 
and Welfare. To the maximum extent feasible, such coordination shall 
be carried out through the National Center for Health Services 
Research and the National Center for Health Statistics." 
SEC. 104. Section 305 is amended to read as follows: 
Additional 
authority. 
Experts and 
consultants. 
Health services 
and statistical 
activities, co-
ordination. 
42 use 242c. 
"NATIONAL CENTER FOR HEALTH SERVICES RESEARCH 
"SEC. 305. (a) There is established in the Department of Health, 
Education, and Welfare the National Center for Health Services 
Research (hereinafter in this section referred to as the 'Center') which 
shall be under the direction of a Director who shall be appointed by the 
Secretary and supervised by the Assistant Secretary for Health (or 
such other officer of the Department as may be designated by the Secre-
tary as the principal adviser to him for health programs). 
"(b) In carrying out section 304(a), the Secretary, acting through 
the Center, may undertake and support research, evaluation, and dem-
onstration projects (which may include and shall be appropriately 
coordinated with experiments and demonstration activities authorized 
by the Social Security Act and the Social Security Amendments of 
1967) respecting— 
E stablishmenti 
Ante, p. 362. 
42 use 1305. 
42 use 302 
note. 
364 
PUBLIC LAW 93-353-JULY 23, 1974 
[88 STAT. 
New centers, 
grants to non-
profit entities. 
Post, p. 368. 
Health Care 
Technology 
Center. 
Health Care 
Management 
Center. 
R e quire me nt s 
for aid. 
"(1) the accessibility, acceptability, planning, organization, 
distribution, technology, utilization, quality, and financing of 
health services and systems; 
"(2) the supply and distribution, education and training, qual-
ity, utilization, organization, and costs of health manpower; and 
"(3) the design, construction, utilization, organization, and 
cost of facilities and equipment. 
"(c) The Secretary shall afford appropriate consideration to 
requests of— 
"(1) State, regional, and local health planning and health 
agencies, 
"(2) public and private entities and individuals engaged in the 
delivery of health care, and 
" (3) other persons concerned with health services, 
to have the Center or other units of the Department of Health, Edu-
cation, and Welfare undertake research, evaluations, and demonstra-
tions respecting specific aspects of the matters referred to in subsection 
(b). 
"(d) (1) The Secretary shall, by grants or contracts, or both, assist 
public or private nonprofit entities in meeting the costs of planning 
and establishing new centers, and operating existing and new centers, 
for multidisciplinary health services, research, evaluations, and dem-
onstrations respecting the matters referred to in subsection (b). To 
the extent practicable, the Secretary shall approve, in accordance with 
the requirements of this subsection and section 308, a number of appli-
cations for grants and contracts under this subsection which will 
result in at least six of such centers (including two national special 
emphasis centers, one of which (to be designated as the Health Care 
Technology Center) shall focus on all forms of technology, including 
computers and electronic devices, and its applications in health care 
delivery; and one of which (to be designated as the Health Care Man-
agement Center) shall focus on the improvement of management and 
organization in the health field, the training and retraining of admin-
istrators of health care enterprises, and the development of leaders, 
planners, and policy analysts in the health field) being operational in 
each fiscal year. 
"(2) (A) No grant or contract may be made under this subsection 
for planning and establishing a center unless the Secretary determines 
that when it is operational it will meet the requirements listed in sub-
paragraph (B) and no payment shall be made under a grant or 
contract for operation of a center unless the center meets such 
requirements. 
"(B) The requirements referred to in subparagraph (A) are as 
follows: 
"(i) There shall be a full-time director of the center who 
possesses a demonsti''ated capacity for sustained productivity 
and leadership in health services research, demonstrations, and 
evaluations, and there shall be such additional full-time profes-
sional staff as may be appropriate. 
"(ii) The staff of the center shall represent all relevant 
disciplines. 
"(iii) The center shall (I) be located within an established 
academic or research institution with departments and resources 
appropriate to the programs of the center, and (II) have working 
relationships with health service delivery systems where experi-
ments in health services may be initiated and evaluated. 
"(iv) The center shall select problems in health services for 
research, demonstrations, and evaluations on the basis of (I) 
their regional or national importance, (II) the unique potential 
88 STAT. ] 
PUBLIC LAW 93-353-JULY 23, 1974 
365 
for definitive research on the problem, and (III) opportunities 
for local application of the research findings. 
"(v) Such additional requirements as the Secretary may by 
regulation prescribe. 
"(e) The authority of the Secretary under section 304(b) shall be 
available to him with respect to the undertaking and support of proj-
ects under subsections (b), (c),and (d) of this section." 
SEC. 105. The following new section is inserted in part A of title 
I I I after section 305: 
Ante, p. 362. 
Ante, p. 363. 
'NATIONAL CENTER FOR HEALTH STATISTICS 
Establishment. 
42 use 242k. 
Duties. 
"SEC. 306. (a) There is established in the Department of Health, 
Education, and Welfare the National Center for Health Statistics 
(hereinafter in this section referred to as the 'Center') which shall be 
under the direction of a Director who shall be appointed by the Secre-
tary and supervised by the Assistant Secretary for Health (or such 
other officer of the Department as may be designated by the Secretary 
as the principal adviser to him for health programs). 
"(b) In carrying out section 304(a), the Secretary, acting through 
the Center, may— 
"(1) collect statistics on— 
"(A) the extent and nature of illness and disability of the 
population of the United States (or of any groupings of the 
people included in the population), including life expectancy, 
the incidence of various acute and chronic illnesses, and infant 
and maternal morbidity and mortality, 
"(B) the impact of illness and disability of the population 
on the economy of the United States and on other aspects of 
the well-being of its population (or of such groupings), 
"(C) environmental, social, and other health hazards, 
"(D) determinants of health, 
"(E) 
health resources, including physicians, dentists, 
nurses, and other health professionals by specialty and type 
of practice and the supply of services by hospitals, extended 
care facilities, home health agencies, and other health 
institutions, 
" ( F ) utilization of health care, including utilization of 
(i) ambulatory health services by specialties and types of 
practice of the health professionals providing such services, 
and (ii) services of hospitals, extended care facilities, home 
health agencies, and other institutions, 
"(G) health care costs and financing, including the trends 
in health care prices and cost, the sources of payments for 
health care services, and Federal, State, and local govern-
mental expenditures for health care services, and 
"(H) family formation, growth, and dissolution; and 
"(2) undertake and support (by grant or contract) research, 
demonstrations, and evaluations respecting new or improved 
methods for obtaining current data on the matters referred to in 
paragraph (1). 
"(c) The Center shall furnish such special statistical compilations 
and surveys as the Committee on Labor and Public Welfare and the 
Committee on Appropriations of the Senate and the Committee on gressionai com 
Interstate and Foreign Commerce and the Committee on Appropria-
tions of the House of Representatives may request. Such statistical 
compilations and surveys shall not be made subject to the payment of 
the actual or estimated cost of the preparation of such compilations 
and surveys. 
"(d) To insure comparability and reliability of health statistics. 
Statistical 
compilations and 
urveys to con-
mittees. 
Technical aid 
the Secretary shall, through the Center, provide adequate technical '° ^*^*^^ ^"'^ 
localities. 
366 
PUBLIC LAW 93-353-JULY 23, 1974 
[88 STAT. 
Federal-state 
cooperation. 
Data collection 
forms. 
Registration 
area records. 
United States 
National Com-
mittee on Vital 
and Health Sta-
tistics. 
Establishment; 
membership. 
assistance to assist State and local jurisdictions in the development of 
model laws dealing with issues of confidentiality and comparability 
of data. 
"(e) The Secretary shall (1) assist State and local health agencies, 
and Federal agencies involved in matters relating to health, in the 
design and implementation of a cooperative system for producing 
comparable and uniform health information and statistics at the Fed-
eral, State, and local levels; (2) coordinate the activities of such Fed-
eral agencies respecting the design and implementation of such 
cooperative system; (3) undertake and support (by grant or contract) 
research, development, demonstrations, and evaluations respecting 
such cooperative system; (4) provide the Federal share of the data 
collection costs under such system; and (5) review statistical activities 
of the Department of Health, Education, and Welfare to assure that 
they are consistent with such cooperative system. 
"(f) To assist, in carrying out this section, the Secretary shall 
cooperate and consult with the Departments of Commerce and 
Labor and any other interested Federal departments or agencies 
and with State and local health departments and agencies. For such 
purpose he shall utilize insofar as possible the services or facilities of 
any agency of the Federal Government and, without regard to section 
3709 of the Revised Statutes (41 U.S.C. 5), of any appropriate State 
or other public agency, and may, without regard to such section, uti-
lize the services or facilities of any private agency, organization, group, 
or individual, in accordance with written agreements between the 
head of such agency, organization, or group and the Secretary or 
between such individual and the Secretary. Payment, if any, for such 
services or facilities shall be made in such amounts as may be provided 
in such agreement. 
"(g) To secure uniformity in the registration and collection of 
mortality, morbidity, and other health data, the Secretary shall pre-
pare and distribute suitable and necessary forms for the collection 
and compilation of such data which shall be published as a part of 
the health reports published by the Secretary. 
"(h) There shall be an annual collection of data from the records 
of births, deaths, marriages, and divorces in registration areas. The 
data shall be obtained only from and restricted to such records of the 
States and municipalities which the Secretary, in his discretion, 
determines possess records affording satisfactory data in necessary 
detail and form. Each State or registration area shall be paid by the 
Secretary the Federal share of its reasonable costs (as determined 
by the Secretary) for collecting and transcribing (at the request of 
the Secretary and by whatever method authorized by him) its records 
for such data. 
"(i) (1) There is established in the Office of the Secretary a com-
mittee to be known as the United States National Committee on Vital 
and Health Statistics (hereinafter in this subsection referred to as 
the 'Committee') which shall consist of fifteen members. 
"(2) (A) The members of the Committee shall be appointed by the 
Secretary from among persons who have distinguished themselves in 
the fields of health statistics, epidemiology, and the provision of health 
services. Except as provided in subparagraph (B), members of the 
Committee shall be appointed for terms of three years. 
"(B) Of the members first appointed— 
" (i) five shall be appointed for terms of one year, 
" (ii) five shall be appointed for terijis of two years, and 
" (iii) five shall be appointed for terms of three years, 
as designated by the Secretary at the time of appointment. Any 
member appointed to fill a vacancy occurring prior to the expiration 
88 
STAT.] 
PUBLIC LAW 93-353-JULY 23, 1974 
367 
of the term for which his predecessor was appointed shall be appointed 
only for the remainder of such term. A member may serve after the 
expiration of his term until his successor has taken office. 
"(3) Members of the Committee shall be compensated in accordance 
with section 208 (c). 
"(4) It shall be the function of the Committee to assist and 
adv^e the Secretary— 
"(A) to delineate statistical problems bearing on health and 
health services which are of national or international interest; 
"(B) to stimulate studies of such problems by other organiza-
tions and agencies whenever possible or to make investigations of 
such problems through subcommittees; 
"(C) to determine, approve, and revise the terms, definitions, 
classifications, and guidelines for assessing health status and 
health services, their distribution and costs, for use (i) within 
the Department of Health, Education, and Welfare, (ii) by all 
programs administered or funded by the Secretary, including the 
Federal-State-local cooperative health statistics system referred 
to in subsection (e), and (iii) to the extent possible as determined 
by the head of the agency involved, by the Veterans' Administra-
tion, the Department oi Defense, and other Federal agencies 
concerned with health and, health services; 
"(D) with respect to the design of and approval of health 
statistical and health information systems concerned with the 
collection, processing, and tribulation of health statistics within the 
Department of Health, Education, and Welfare; 
"(E) to review and comment on findings and proposals devel-
oped by other organizations and agencies and to make recom^ 
mendations for their adoption or implementation by local, State, 
national, or international agencies; 
"(F) to cooperate with national committees of other countries 
and with the World Health Organization and other national 
agencies in the studies of problems of mutual interest; and 
"(G) to issue an annual report on the state of the Natioh's 
health, its health services, their costs and distributions, and to 
make proposals for improvement of the Nation's health Statistics 
and health information systems. 
" (5) In carrying out health statistical activities under this part, the 
Secretary shall consult with, and seek the advice of, the Committee and 
other appropriate professional advisory groups." 
SEC. 106. Section 308 is redesignated as section 307 and is amended 
to read as follows: 
"INTERNATIONAL COOPERATION 
"SEC. 307. (a) For the purpose of advancing the status of the health 
sciences in the United States (^nd thereby the health of the American 
people), the Secretary may participate with other countries in cooper-
ative endeavors in biomedical research and the health services research 
and statistical activities authorized by sections 304, 305, and 306. 
"(b) In connection with the cooperative endeavors authorized by 
subsection (a), the Secretary may— 
" (1) make such use of resources offered by participating foreign 
countries as he may find necessary and appropriate; 
"(2) establish and irtaintain fellowships m the United States 
and in participating foreign countrieis; 
"(3) make grants to public institutions or agencies and to nMi-
profit private institutions or agencies in the United States and 
in participating foreign countries for the purpose of establishing 
and maintaining the fellowships authorized by paragraph (2); 
Compensation. 
Post, p. 369. 
Functions. 
42 use 242f,. 
42 use 242/,, 
Ante, pp. 
363, 365. 
362. 
368 
PUBLIC LAW 93-353-JULY 23, 1974 
[88 STAT. 
Interchange of 
scientists and 
experts. 
Ante, 
p . 367. 
42 u s e 242m. 
Report to 
Congress. 
Ante, 
pp. 362, 
363, 365,367. 
Reports to 
President and 
Congress. 
Ante, 
p. 365.. 
OMB review. 
Application 
submittal. 
" (4) make grants or loans of equipment and materials, for use 
by public or nonprofit private institutions or agencies, or by indi-
viduals, in participating foreign countries; 
"(5) participate and otherwise cooperate in any international 
meetings, conferences, or other activities concerned with biomedi-
cal research, health services research, or health statistics; 
"(6) facilitate the interchange between the United States and 
participating foreign countries, and among participating foreign 
countries, of research scientists and experts who are engaged in 
experiments and programs of biomedical research, health services 
research, and health statistical activities, and in carrying out such 
purpose may pay per diem compensation, subsistence, and travel 
for such scientists and experts when away from their places of 
residence at rates not to exceed those provided in section 5703(b) 
of title 5, United States Code, for persons in the Government 
service employed intermittently; and 
"(7) procure, in accordance with section 3109 of title 5, United 
States Code, the temporary or intermittent services of experts or 
consultants. 
The Secretary may not, in the exercise of his authority under this 
section, provide financial assistance for the construction of any facility 
in any foreign country.". 
SEC. 107. (a) Part A of title I I I is amended by inserting after sec-
tion 307 (as so redesignated) the following new sections: 
" G E N E R A L 
PROVISIONS 
R E S P E C T I N G 
S E C T I O N S 
304, 
305, 
306, 
AND 
307 
"SEC. 308. (a) (1) Not later than September 1 of each year, the Sec-
retary shall make a report to Congress respecting (A) the administra-
tion of sections 304 through 307 during the preceding fiscal year, and 
(B) the current state and progress of health services research and 
health statistics. 
"(2) The Secretary, acting through the National Center for Health 
Services Research and the National Center for Health Statistics, shall 
assemble and submit to the President and the Congress not later than 
September 1 of each year the following reports: 
"(A) A report on health care costs and financing. Such report 
shall include a description and analysis of the statistics collected 
under section 306(b) (1) (G). 
"(B) A report on health resources. Such report shall include 
a description and analysis, by geographic area, of the statistics col-
lected under section 306 (b) (1) (E). 
"(C) A report on the utilization of health resources. Such 
report shall include a description and analysis, by age, sex, in-
come, and geographic area, of the statistics collected under section 
306(b)(1)(F). 
"(D) A report on the health of the Nation's people. Such report 
shall include a description and analysis, by age, sex, income, and 
geographic area, of the statistics collected under section 306(b) 
(1)(A). 
"(S) The Office of Management and Budget may review any report 
required by paragraph (1) or (2) of this subsection before its sub-
mission to Congress, but the Office may not revise any such report or 
delay its submission beyond the date prescribed for its submission, 
and may submit to Congress its comments respecting any such report. 
"(b) (1) No grant or contract may be made under section 304, 305, 
306, or 307 unless an application therefor has been submitted to the 
Secretary in such form and manner, and containing such information, 
as the Secretary may by regulation prescribe. 
Ante, p. 365,, 
88 STAT. ] 
PUBLIC LAW 93-3'53-JULY 23, 1974 
369 
" (2) Each application submitted for a grant or contract under sec- revu^w'paneT 
tion 304 or 305, in an amount exceeding $35,000 of direct costs and for 
Ante, pp. 3
*
6
2
, 
a health services research, evaluation, or demonstration project, shall ^^^• 
be submitted by the Secretary for review for scientific merit to a panel 
of experts appointed by him,from persons who are not officers or 
employees of the United States and who possess qualifications relevant 
to the project for which the application was made. A panel to which 
an application is submitted under this paragraph shall report its find-
ings and recommendations respecting the application to the Secretary 
in such form and manner as the Secretary shall by regulation prescribe. 
"(3) If an application is submitted under section 304, 305, or 306 
for a grant or contract for a project for which a grant or contract 
may be made or entered into under another provision of this Act, such 
application may not be approved under section 304, 305, or 306 and 
funds appropriated under this section may not be obligated for such 
grant or contract. The applicant who submitted such application shall 
be notified of the other provision (or provisions) of this Act under 
which such application may be submitted. 
" (c) The aggregate number of grants and contracts made or entered 
Limited grants. 
into under sections 304 and 305 for any fiscal year respecting a par-
ticular means of delivery of health services or another particular aspect 
of health services may not exceed twenty; and the aggregate amount 
of funds obligated under grants and contracts under such sections for 
any fiscal year respecting a particular means of delivery of health 
services or another particular aspect of health services may not exceed 
$5,000,000. 
j ^ ^ ^ ^ ^ ^ .^^ 
"(d) No information obtained in the course of activities undertaken pubiica'tion"^^-
or supported under section 304, 305, 306, or 307 may be used for any strictions. 
purpose other than the purpose for which it was supplied unless '*"'^' P- 367. 
authorized under regulations of the Secretary; and (1) in the case of 
information obtained in the course of health statistical activities mider 
section 304 or 306, such information may not be published or released 
in other form if the particular establishment or person supplying the 
information or described in it is identifiable unless such establishment 
or person has consented (as determined under regulations of the Secre-
tary) to its publication or release in other form, and (2) in the case 
of information obtained in the course of health services research, 
evaluations, or demonstrations under section 304 or 305, such informa-
tion may not be published or released in other form if the person who 
supplied the information or who is described in it is identifiable unless 
such person has consented (as determined under regulations of the 
Secretary) to its publication or release in other form. 
" (e) (1) Payments of any grant or under any contract under section ^ Payment proce-
304, 305, 306, or 307 may be made in advance or by way of reimburse- '' "° 
ment, and in such installments and on such conditions, as the Secretary 
deems necessary to carry out the purposes of such section. 
" (2) The amounts otherwise payable to any person under a grant or 
contract made under section 304, 305, 306, or 307 shall be reduced by— 
" (A) amounts equal to the fair market value of any equipment 
or supplies furnished to such person by the Secretary for the pur-
pose of carrying out the project with respect to which such grant 
or contract is made, and 
" (B) amounts equal to the pay, allowances, traveling expenses, 
and related personnel expenses attributable to the performance of 
services by an officer or employee of the Government in connection 
with sucli project, if such officer or employee was assigned or 
detailed by the Secretary to perform such services, 
but only if such person requested the Secretary to furnish such equip-
ment or supplies, or such services, as the case may be. 
dures. 
370 
PUBLIC LAW 93-353-JULY 23, 1974 
[88 STAT. 
Ante, pp. 362, 
363, 365. 
Research re-
sults, publication. 
Indexing, ab-
stracting, and 
other services. 
Statistics, 
publication. 
Laborers and 
mechanics, wage 
rate. 
40 u s e 276a 
note. 
5 u s e app. 11. 
Regulations. 
Appropriations. 
"(f) Contracts may be entered into under section 304, 305, or 306 
without regard to sections 3648 and 3709 of the Revised Statutes (31 
U.S.C.529;41U.S.C.5). 
"(g) (1) The Secretary shall— 
"(A) publish, make available and disseminate, promptly in 
understandable form and on as broad a basis as practicable, the 
results of health services research, demonstrations, and evaluations 
undertaken and supported under sections 304 and 305; 
"(B) make available to the public data developed in such 
research, demonstrations, and evaluations; and 
"(C) provide indexing, abstracting, translating, publishing, 
and other services leading to a more effective and timely dissemi-
nation of information on health services research, demonstrations, 
and evaluations in health care delivery to public and private 
entities and individuals engaged in the improvement of health 
care delivery and the general public; and undertake programs to 
develop new or improved methods for making such information 
available. 
Except as provided in subsection (d), the Secretary may not restrict 
the publication and dissemination of data from, and results of projects 
undertaken by, centers supported under section 305 (d). 
"(2) The Secretary shall (A) take such action as may be necessary 
to assure that statistics developed under sections 304,305, and 306 are of 
high quality, timely, comprehensive as well as specific, standardized, 
and adequately analyzed and indexed, and (B) publish, make avail-
able, and disseminate such statistics on as wide a basis as is practicable. 
"(h) (1) Except where the Secretary determines that unusual cir-
cumstances make a larger percentage necessary in order to effectuate 
the purposes of section 304, 305, or 306, a grant or contract under sec-
tion 304, 305, or 306 with respect to any project for construction of a 
facility or for acquisition of equipment may not provide for payment 
of more than 50 per centum of so much of the cost of the facility or 
equipment as the Secretary determines is reasonably attributable to 
research, evaluation, or demonstration purposes. 
"(2) Laborers and mechanics employed by contractors and subcon-
tractors in the construction of such a facility shall be paid wages at 
rates not less than those prevailing on similar work in the locality, 
as determined by the Secretary of Labor in accordance with the Act of 
March 3, 1931 (40 U.S.C. 267a—267a-5, known as the Davis-Bacon 
Act) ; and the Secretary of Labor shall have with respect to any labor 
standards specified in this paragraph the authority and functions set 
forth in Reorganization Plan Numbered 14 of 1950 (5 U.S.C. 
Appendix) and section 2 of the Act of June 13,1934 (40 U.S.C. 276c). 
"(3) Such grants and contracts shall be subject to such additional 
requirements as the Secretary may by regulation prescribe. 
"(i) (1) For health service research, evaluation, and demonstration 
activities undertaken or supported under section 304 or 305, there are 
authorized to be appropriated $65,200,000 for the fiscal year ending 
June 30,1975, and $80,000,000 for the fiscal year ending June 30,1976. 
Of the funds appropriated under this paragraph for any fiscal year, 
not less than 25 per centum of such funds shall be made available only 
for health services research, evaluation, and demonstration activities 
directly undertaken by the Secretary under such section. 
" (2) For health statistical activities undertaken or supported under 
section 304 or 306, there are authorized to be appropriated $30,000,000 
for the fiscal year ending June 30, 1975, and $30,000,000 for the fiscal 
year ending June 30,1976. 
88 STAT. ] 
PUBLIC LAW 93-353-JULY 23, 1974 
371 
"HEALTH CONFERENCES 
"SEC. 309. A conference of the health authorities in and among the 
several States shall be called annually by the Secretary. Whenever in 
his opinion the interests of the public health would be promoted by a 
conference, the Secretary may invite as many of such health author-
ities and officials of other State or local public or private agencies, 
institutions, or organizations to confer as he deems necessary or 
groper. Upon the application of health authorities of five or more 
tates it shall be the duty of the Secretary to call a conference of all 
State health authorities joining in the request. Each State repre-
sented at any conference shall be entitled to a single vote. Whenever 
at any such conf 
ei*ence matters relating to mental health are to be dis-
cussed, the mental health authorities of the respective States shall 
be invited to attend. 
42 u s e 242n. 
ii HEALTH EDUCATION AND INFORMATION 
"SEC. 310. From time to time the Secretary shall issue information 
related to public health, in the form of publications or otherwise, for 
the use of the public, and shall publish weekly reports of health condi-
tions in the United States and other countries and other pertinent 
health information for the use of persons and institutions concerned 
with health services." 
(b) The authorizations of appropriations provided by section 308 (i) 
of the Public Health Service Act is extended for the fiscal year ending 
June 30, 1977, in the amounts authorized for the preceding fiscal year 
unless before June 30, 1976, Congress has passed legislation repealing 
this subsection. 
SEC. 108. (a) Subject to regulations of the President, lightkeepers, 
assistant lightkeepers, and officers and crews of vessels of the former 
Lighthouse Service, including any such persons who subsequent to 
June 30, 1939, were involuntarily assigned to other civilian duty in 
the Coast Guard, who were entitled to medical relief at hospitals and 
other stations of the Public Health Service prior to July 1, 1944, and 
who retired under the provisions of section 6 of the Act of June 20, 
1918 (40 U.S.C. 763), shall be entitled to medical, surgical, and dental 
treatment and hospitalization at hospitals and other stations of the 
Public Health Service. 
(b) Subsection (a) shall be effective from December 28, 1973. 
TITLE II—REVISION AND EXTENSION 
OF 
MEDICAL 
LIBRARY ASSISTANCE PROGRAMS 
SEC. 201. (a) Effective July 1, 1974, section 390 is amended by add-
ing after subsection (b) the following new subsection: 
"(c) For the purpose of grants and contracts under sections 393, 
394, 395, 396, and 397, there are authorized to be appropriated 
$17^500,000 for the fiscal year ending June 30, 1975, and $20,000,000 
for the fiscal year ending June 30,1976." 
(b) The section heading for such section is amended to read as 
follows: 
4? u s e 2420. 
Appropriation 
extension. 
42 u s e 242m 
note. 
Ante, p. 368. 
Former Light-
house Service 
employees, medi-
cal service eli-
gibility. 
42 u s e 253b,. 
33 use 763. 
Effective date. 
42 use 280b. 
Appropria tion. 
42 u s e 280b-3 
to 280b-8. 
" D E C L A R A T I O N O F POLICY, STATEMENT OF PURPOSE, AND AUTHORIZATION 
^ OF APPROPRIATIONS". 
(c) The authorization of appropriations provided by section 390(c) 
42'usc'28'ob 
of the Public Health Service Act is extended for the fiscal year ending note. 
June 30, 1977, in the amount authorized for the preceding fiscal year 
S"P'-°-
372 
PUBLIC LAW 93-353-JULY 23, 1974 
[88 STAT. 
42 u s e 280b. 
42 use 280b-l. 
42 u s e 280b-2. 
Repeal. 
42 u s e 280b-3. 
42 use 280b-8. 
Repeal. 
Repeals. 
42 use 280b-4. 
Supra. 
42 use 280b-5. 
Supra. 
42 u s e 280b-7. 
42 u s e 2 80b-8. 
42 u s e 280b-9. 
unless before June 30, 1976, Congress has passed legislation repealing 
this subsection. 
SEC. 202. (a) Subsection (b) of section 390 is amended by striking 
out paragraph (1) and by redesignating paragraphs (2) through (7) 
as paragraphs (1) through (6), respectively. 
(b) Section 391 is amended— 
(1) by inserting "and" at the end of paragraph (2), 
(2) by striking out paragraph (3), and 
(3) by redesignating clause (4) as paragraph (3). 
(c) Section 392(b) is amended to read as follows: 
" (b) The Board shall advise and assist the Secretary in the prepara-
tion of general regulations and with respect to policy matters arising 
in the administration of this part." 
(d) Section 393 is repealed. 
(e) Section 397(b) is amended— 
(1) by inserting "and" at the end of paragraph (4), 
(2) by striking out "; and" at the end of paragraph (5) and 
inserting in lieu thereof a period, and 
(3) by striking out paragraph (6). 
(f) The first sentence ot section 397(d) is repealed. 
SEC. 203. (a) The first sentence of section 394(a) is repealed; and 
the second sentence of such section is amended by striking out "Sums 
made available under this section shall be utilized by the Secretary 
in making" and inserting in lieu thereof "To carry out the purposes of 
section 390 (b) (1), the Secretary shall make". 
(b) (1) The first and second sentences of section 395 (a) are repealed; 
and the third sentence of such section is amended by striking out 
"Sums made available under this subsection shall be utilized by the 
Secretary to" and inserting in lieu thereof "To carry out the purposes 
of section 390 (b) (2), the Secretary shall". 
(2) The first and second sentences of section 395(b) are repealed; 
and the third sentence of such section is amended (A) by striking out 
"Sums made available under this subsection shall be utilized by the 
Secretary in making" and inserting in lieu thereof "To carry out the 
purposes of section 390(b) (3), the Secretary shall make", and (B) by 
striking out "entering into contracts" and inserting in lieu thereof 
"enter into contracts". 
(c) (1) The first sentence of section 396(b) is amended by striking 
out "Sums made available under this section shall be utilized by the 
Secretary for making" and inserting in lieu thereof "To carry out 
the purposes of section 390 (b) (4), the Secretary shall make". 
(2) Clauses (A), (B), (C), and (D) of section 396(b) are redes-
ignated as clauses (1), (2), (3),and (4),respectively. 
(3) Subsection (a) of section 396 is repealed and subsections (b) 
and (c) of such section are redesignated as subsections (a) and (b), 
respectively. 
(d)(1) The first sentence of section 397(a) is repealed; and the 
second sentence of such section is amended by striking out "Sums 
made available under this section shall be utilized by the Secretary, 
with the advice of the Board, to make" and inserting in lieu thereof 
"To carry out the purposes of section 390(b) (5), the Secretary, with 
the advice of the Board, shall make". 
(2) The section heading for section 397 is amended by inserting 
"AND CONTRACTS" after "GRANTS". 
(e) The first and second sentences of section 398(a) are repealed; 
and the third sentence of such section is amended by striking out 
"Sums made available under this section shall be utilized by the Sec-
retary, with the advice of the Board, in making grants to, and enter-
88 STAT. ] 
PUBLIC LAW 93-354-JULY 23, 1974 
373 
42 use 280b. 
ing into appropriate contracts'' and inserting in lieu thereof "To 
carrj out the purposes of section 390(b) (6), the Secretary, with the 
advice of the Board, shall make grants to, and enter into appropriate 
contracts". 
SEC. 204. Section 399b is repealed; and sections 394 through 399a Js^^'gc 280b-i2. 
are redesignated as sections 393 through 399, respectively. 
SEC. 205. The amendments made by sections 202, 203, and 204 shall J^l^^^'^ ^*°^ 
apply with respect to appropriations under part J of the Public 
42 use 280b. 
Health Service Act for fiscal years beginning after June 30, 1974. 
Approved July 23, 1974. 
Public Law 93-354 
AN A C T 
July 23, 1974 
rs 28301 
To amend the Public Health Service Act to provide for greater and more effective 
'. 
efforts in research and public education with regard to diabetes mellitus. 
Be it enacted hy the Senate and House of Representatives 
of the 
United States of America in Congress assembled, 
. '^^*'°"1|.P'^" 
•' 
i' 
' 
betes MelUtus 
Research and 
SHORT TITLE 
Education Act. 
SECTION 1. This Act may be cited as the "National Diabetes Mellitus „o{e.^^^ 289c-2 
Research and Education Act". 
FINDINGS AND DECLARATION OF PURPOSE 
SEC. 2. (a) The Congress makes the following 
findings: 
^'^ use 289c-2 
(1) Diabetes mellitus is a major health problem in the United 
States which directly affects perhaps as many as ten million Amer-
icans and indirectly affects perhaps as many as fifty million 
Americans who will pass the tendency to develop diabetes mellitus 
to their children or grandchildren or to both. 
(2) Diabetes mellitus is a family of diseases that has an impact 
on virtually all biological systems of the human body. 
(3) Diabetes mellitus is the fifth leading cause of death from 
disease, and it is the second leading cause of new cases of blindness. 
(4) The severity of diabetes mellitus in children and most 
adolescents is greater than in adults, which in most cases involves 
greater problems in the management of the disease. 
(5) The complications of diabetes mellitus, particularly cardio-
vascular degeneration, lead to many other serious health problems. 
(6) Uncontrolled diabetes mellitus significantly decreases life 
expectancy. 
(7) There is convincing evidence that the known prevalence of 
diabetes mellitus has increased dramatically in the past decade. 
(8) The citizens of the United States should have a full under-
standing of the nature of the impact of diabetes mellitus. 
(9) The attainment of better methods of diagnosis and treat-
ment of diabetes mellitus deserves the highest priority. 
(10) The establishment of regional diabetes research and train-
ing centers throughout the country is essential for the development 
of scientific information and appropriate therapies to deal with 
diabetes mellitus. 
(11) In order to provide for the most effective program against 
diabetes mellitus it is important to mobilize the resources of the 
National Institutes of Health as well as the public and private 
organizations capable of the necessary research and public educa-
tion in the disease. 
38-1S4 n - 76 - 27 Pt. 1
374 
PUBLIC LAW 93-354-JULY 23, 1974 
[88 STAT. 
(b) It is the purpose of this Act to— 
(1) expand the authority of the National Institutes of Health 
to advance the national attack on diabetes mellitus; and 
(2) as part of that attack, to establish a long-range plan to— 
(A) expand and coordinate the national research effort 
against diabetes mellitus; 
(B) advance activities of patient education, professional 
education, and public education which will alert the citizens 
of the United States to the early indications of diabetes 
mellitus; and 
(C) to emphasize the significance of early detection, proper 
control, and complications which may evolve from the disease. 
DIABETES PLAN 
mi^slon^on m^-' 
SEC 3. (a) The Director of the National Institutes of Health shall, 
betes. 
within sixty days of the date of the enactment of this section, establish 
4
2
^ usc^2'89c"2" ^' ^^^ional Commission on Diabetes (hereinafter in this section referred 
note. 
to as the "Commission"). 
Membership. 
(b) The Commlssiou shall be composed of seventeen members as 
follows: 
(1) The Directors of the seven Institutes referred to in subsec-
tion (e). 
(2) Six members appointed by the Secretary of Health, Educa-
tion, and Welfare from scientists or physicians who are not in the 
employment of the Federal Government and who represent the 
various specialties and disciplines involving diabetes mellitus and 
related endocrine and metabolic diseases. 
(3) Four members appointed by the Secretary of Health, Edu-
cation, and Welfare from the general public. At least two of the 
members appointed pursuant to this paragraph sl;iall be diabetics 
or parents of diabetics. 
The members of the Commission shall select a chairman from among 
their own number. 
(c) The Commission may appoint an executive director and such 
additional personnel as it determines are necessary for the perform-
ance of the Commission's functions. 
Compensation. 
((j^ Mcmbcrs of the Commission who are officers or employees of the 
Federal Government shall serve as members of the Commission with-
out compensation in addition to that received in their regular public 
employment. Members of the Commission who are not officers or 
employees of the Federal Government shall each receive the daily 
5 use 5332 
equivalent of the rate in effect for grade GS-18 of the General Schedule 
for each day (including traveltime) they are engaged in the perform-
Travei 
aucB of their duties as members of the Commission. All members of 
the Commission shall be entitled to reimbursement for travel, sub-
sistence, and other necessary expenses incurred by them in the perform-
ance of their duties as members of the Commission. 
(e) The Commission shall formulate a long-range plan to combat 
diabetes mellitus with specific recommendations for the utilization and 
organization of national resources for that purpose. Such a plan shall 
be based on a comprehensive survey investigating the magnitude of 
diabetes mellitus, its epidemiology, and its economic and social conse-
quences and on an evaluation of available scientific information and 
the national resources capable of dealing with the problem. The plan 
shall include a plan for a coordinated research program encompassing 
programs of the National Institute of Arthritis, Metabolism, and 
Digestive Diseases, the National Eye Institute, the National Institute 
of Neurological Diseases, the National Heart and Lung Institute, the 
Director and 
personnel. 
note. 
expenses. 
88 STAT. ] 
PUBLIC LAW 93-354-JULY 23, 1974 
375 
National Institute of General Medical Sciences, the National Institute 
of Child Health and Human Development, and the National Institute 
of Dental Eesearch, and other Federal and non-Federal programs. The 
coordinated research program shall provide for— 
(1) investigation in the epidemiology, etiology, prevention, 
and control of diabetes mellitus, including investigation into the grams 
social, environmental, behavioral, nutritional, biological, and 
genetic determinants and influences involved in the epidemiology, 
etiology, prevention, and control of diabetes mellitus; 
(2) studies and research into the basic biological processes and 
mechanisms involved in the underlying normal and abnormal 
phenomena associated with diabetes mellitus, including abnor-
malities of the skin, cardiovascular system, kidneys, eyes, and 
nervous system, and evaluation of influences of other endocrine 
hormones on the etiology, treatment, and complications of dia-
betes mellitus; 
(3) research into the development, trial, and evaluation of 
techniques and drugs used in, and approaches to, the diagnosis, 
treatment, and prevention of diabetes mellitus; 
(4) establishment of programs that will focus and apply scien-
tific and technological efforts involving biological, physical, and 
engineering science to all facets of diabetes mellitus; 
(5) establishment of programs for the conduct and direction 
of field studies, large-scale testing and evaluation, and demonstra-
tion of preventive diagnostic, therapeutic, rehabilitative, and con-
trol approaches to diabetes mellitus; 
(6) the education and training of scientists, clinicians, edu-
cators, and allied health personnel in the fields and specialties 
requisite to the conduct of programs respecting diabetes mellitus; 
(7) a system for the collection, analysis, and dissemination of 
all data useful in the prevention, diagnosis, and treatment of 
diabetes mellitus; 
(8^ appropriate distribution of resources between basic and 
applied research. 
The long-range plan formulated under this subsection shall also 
include within its scope related endocrine and metabolic diseases and 
basic biological processes and mechanisms, the better understanding of 
which is essential to the solution of the problem of diabetes mellitus. 
(f) In the development of the long-range plan under subsection (e), 
attention shall be given to means to assure continued development of 
knowledge, and dissemination of such knowledge to the public, which 
would form the basis of future advances in the understanding, treat-
ment, and control of diabetes mellitus. 
(g) The Commission may hold such hearings, take such testimony, 
and sit and act at such time and places as the Commission deems advis-
able to develop the long-range plan required by subsection (e). 
(h)(1) The Commission shall prepare for each of the Institutes 
whose programs are to be encompassed by the plan for a coordinated 
diabetes research program described in subsection (e) budget estimates 
for each Institute's part of such program. The budget estimates shall 
be prepared for the fiscal year ending June 30, 1976, and for each of 
the next two fiscal years. 
(2) Within five days after the Budget for the fiscal year ending 
June 30, 1976, and the Budget for each of the next two fiscal years is 
transmitted by the President to the Congress the Secretary shall trans-
mit to the Committees on Appropriations of the House of Representa-
tives and the Senate, the Committee on Labor and Public Welfare 
Investigation, 
studies and 
research pro-
Hearings. 
Budget esti-
mates. 
Budget esti-
mates from HEW, 
transmittal to 
congressional 
committees. 
376 
PUBLIC LAW 93-354^JULY 23, 1974 
[88 STAT. 
Final report to 
Congress. 
Termination. 
Appropriation. 
of the Senate, and the Committee on Interstate and Foreign Commerce 
of the House of Representatives an estimate of the amounts recjuested 
for each of the Institutes for diabetes research, and a comparison of 
such amounts with the budget estimates prepared by the Commission 
under paragraph (1). 
(i) (1) The Commission shall publish and transmit directly to the 
Congress (without prior administrative approval) a final report 
within nine months after the date funds are first appropriated for 
the implementation of this section. Such report shall contain the long-
range plan required by subsection (e), the budget estimates required 
by subsection (h), and any recommendations of the Commission for 
legislation. 
(2) The Commission shall cease to exist on the thirtieth day follow-
ing the date of the submission of its final report pursuant to paragraph 
(1) of this subsection. 
(j) There are authorized to be appropriated to carry out the pur-
poses of this section $1,000,000. 
42 u s e 247b. 
DIABETES MELLTTUS PREVENTION AND CONTROL PROGRAMS 
SEC. 4. Section 317 of the Public Health Service Act is amended— 
(1) by striking out "communicable disease control" each place 
it occurs and inserting in lieu thereof "communicable and other 
disease control"; 
(2) by striking out "communicable diseases" in subsection (a) 
and inserting in lieu thereof "communicable or other diseases"; 
(3) by striking out "communicable disease program" in sub-
section (a) and inserting in lieu thereof "communicable or other 
disease control program"; 
(4) by striking out "communicable disease" in subsection (b) 
(2) (C) (i) and inserting in lieu thereof "communicable or other 
disease"; 
(5) by striking out "Rh disease," in subsection (h) (1) and by 
inserting "diabetes mellitus and Rh disease and" before "tubercu-
losis" in that subsection; and 
(6) by striking out "COMMUNICABLE" in the section hea^pig. 
RESEARCH AND TRAINING CENTERS; DIABETES COORDINATING COMMITTEE 
AND GENERAL AUTHORITY 
SEC 5. (a) Part D of title IV of the Public Health Service Act is 
amended by adding at the end thereof the following new sections: 
42 u s e 289c-2. 
" D I A B E T E S RESEARCH AND TRAINING CENTERS 
"SEC. 435. (a) Consistent with applicable recommendations of the 
National Commission on Diabetes, the Secretary shall provide for the 
development, or substantial expansion, of centers for research and 
training in diabetes mellitus and related endocrine and metabolic dis-
orders. Each center developed or expanded under this section shall (1) 
utilize the facilities of a single institution, or be formed from a consor-
tium of cooperating institutions, meeting such research and training 
qualifications as may be prescribed by the Secretary; and (2) conduct 
(A) research in the diagnosis and treatment of diabetes mellitus and 
related endocrine and metabolic disorders and the complications result-
ing from such disease or disorders, (B) training programs for physi-
cians and allied health personnel in current methods of diagnosis and 
treatment of such disease, disorders, and complications, and (C) infor-
mation programs for physicians and allied health personnel who 
provide primary care for patients with such disease, disorders, or com-