Home Health Care and Alzheimer's Disease Amendments of 1990
PL 101-557 (H.R.5112), enacted 11/15/1990

104 STAT. 2766 
PUBLIC LAW 101-557—NOV. 15, 1990 
Public Law 101-557 
101st Congress 
An Act 
To amend the Public Health Service Act regcu-ding certain programs for health care 
services in the home and certain programs relating to Alzheimer's disease, and for 
[H.R. 5112] 
otj^er purposes. 
Nov. 15, 1990 
Home Health 
Care and 
Alzheimer's 
Disease 
Amendments of 
1990. 
42 u s e 201 note. 
Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the "Home Health Care and Alzheimer's 
Disease Amendments of 1990". 
TITLE 
I—DEMONSTRATION 
PROJECTS 
FOR HEALTH CARE SERVICES IN THE 
HOME 
SEC. 101. REVISION AND EXTENSION OF GENERAL PROGRAM. 
(a) NUMBER OF GRANTS.—Section 395(a) of the Public Health 
Service Act (42 U.S.C. 280c(a)) is amended in the matter preceding 
paragraph (1) by striking "shall make" and all that follows through 
"grants" and inserting the following: "shall make not less than 5, 
and not more than 20, grants". 
(b) SERVICES PROVIDED.—Section 395(aXl) of the Public Health 
Service Act (42 U.S.C. 280c(aXl)) is amended by striking "skilled" 
and all that follows and inserting the following: "skilled nursing 
care services, homemaker or home health aide services, or personal 
care services are provided in the homes of the individuals;". 
(c) AGE OF RECIPIENTS OF SERVICES.—Section 395(b) of the Public 
Health Service Act (42 U.S.C. 280c(b)) is amended by striking "to 
ensure" and all that follows and inserting the following: "to ensure 
that— 
"(1) not less than 25 percent of the grant is expended to 
provide services under such subsection to individuals who are 
not less than 65 years of age; and 
"(2) of the portion of the grant reserved by the State for 
purposes of compljdng with paragraph (1), not less than 10 
percent is expended to provide such services to individuals who 
are not less than 85 years of age.". 
(d) AUTHORIZATION OF APPROPRIATIONS.—Section 397(e) of the 
Public Health Service Act (42 U.S.C. 280c-2(e)) is amended— 
(1) by striking "there is" and inserting "there are"; and 
(2) by inserting before the period the following: ", $7,500,000 
for fiscal year 1991, and such sums as may be necessary for each 
of the fiscal years 1992 and 1^93". 
PUBLIC LAW 101-557—NOV. 15, 1990 
104 STAT. 2767 
SEC. 102. REVISION AND EXTENSION OF PROGRAM REGARDING ALZ-
HEIMER'S DISEASE. 
(a) NUMBER OF GRANTS.—Section 398(a) of the Public Health 
Service Act (42 U.S.C. 280c-3(a)) is amended in the matter preceding 
paragraph (1) by striking "shall make" and all that follows through 
"grants and inserting the following: "shall make not less than 5, 
and not more than 15, grants". 
(b) COORDINATION OF SERVICES.—Section 398(aXl) of the Public 
Health Service Act (42 U.S.C. 280c-3(aXl)) is amended by striking 
"by public and private organizations" and inserting "with public 
and private organizations". 
(c) AUTHORIZATION OF APPROPRIATIONS.—Section 399A(e) of the 
Public Health Service Act (42 U.S.C. 280c-5(e)) is amended— 
(1) by striking "there is" and inserting "there are"; and 
(2) by inserting before the period the following: ", $7,5()0,000 
for fiscal year 1991, and such sums as may be necessary for each 
of the fiscal years 1992 and 1993". 
TITLE II—REVISION OF PROGRAMS FOR 
RESEARCH ON ALZHEIMER'S DISEASE 
SEC. 201. ALZHEIMER'S DISEASE CENTERS. 
Section 445 of the Public Health Service Act (42 U.S.C. 285e-2) is 
amended— 
(1) in subsection (aXl)— 
(A) by inserting "(including university medical centers)" 
after "nonprofit entities"; 
(B) by inserting "(including staffing)" after "operating 
support"; 
(C) by inserting "(including multidisciplinary research)" 
after "clinical research"; and 
(D) by striking "Alzheimer's Disease" and inserting "Alz-
heimer's disease"; and 
(2) in subsection (b), by amending such subsection to read as 
follows: 
"(bXD Federal payments made under a cooperative agreement or 
grant under subsection (a) may, with respect to Alzheimer's disease, 
be used for— 
"(A) diagnostic examinations, patient assessments, patient 
care costs, and other costs necessary for conducting research; 
"(B) 
training, 
including 
training 
for 
allied 
health 
professionals; 
"(C) diagnostic and treatment clinics designed to meet the 
special needs of minority and rural populations and other 
underserved populations; 
"(D) activities to educate the public; and 
"(E) the dissemination of information. 
"(2) For purposes of paragraph (1), the term 'training' does not 
include research training for which National Research Service 
Awards may be provided under section 487.". 
SEC. 202. CENTERS OF GERIATRIC RESEARCH AND TRAINING. 
(a) REDESIGNATION AS CLAUDE D. PEPPER OLDER AMERICANS 
INDEPENDENCE CENTERS.—Section 445A of the Public Health Service 
Act (42 U.S.C. 285e-3) is amended— 
104 STAT. 2768 
PUBLIC LAW 101-557—NOV. 15, 1990 
(1) in the heading for such section, by amending the heading 
to read as follows: 
"CLAUDE D. PEPPER OLDER AMERICANS INDEPENDENCE CENTERS"; 
and 
(2) in subsection (a), by adding at the end the following new 
sentence: "Each such center shall be known as a Claude D. 
Pepper Older Americans Independence Center.". 
(b) REVISIONS IN PROGRAM.— 
(1) IN GENERAL.—Section 445A of the Public Health Service 
Act (42 U.S.C. 285e-3) is amended— 
(A) in subsection (a), by inserting "not less than 10" 
before "centers of excellence"; and 
(B) in subsection (bX2XA), by inserting before the semi-
colon at the end the following: ", including menopause, 
which research includes research on such treatments, and 
on medical devices and other medical interventions regard-
ing such diseases, disorders, and complications, that can 
assist individuals in avoiding institutionalization and pro-
^ 
longed hospitalization and in otherwise increasing the 
independence of the individuals". 
(2) CONFORMING AMENDMENT.—Section 445Afl3X2XB) of the 
Public Health Service Act (42 U.S.C. 285e-3(bX2XB)) is amended 
by striking "research concerning" and all that follows and 
inserting "research described in subparagraph (A).". 
(c) DEFINITION.—Section 445A of the Public Health Service Act (42 
U.S.C. 285e-3) is amended by adding at the end the following new 
subsection: 
"(d) For purposes of this section, the term 'independence', with 
respect to diseases, disorders, and complications of aging, means the 
functional ability of individuals to perform activities of daily living 
or instrumental activities of daily living without assistance or 
supervision.". 
TITLE III—TASK FORCE ON AGING 
RESEARCH 
42 use 242q. 
SEC. 301. ESTABLISHMENT AND DUTIES. 
(a) ESTABUSHMENT.—The Secretary of Hesdth and Human Serv-
ices shall establish a Task Force on Aging Research. 
(b) DUTIES.—With respect to aging research (as defined in section 
306), the Task Force each fiscal year shall— 
(1) make recommendations to the Secretary specifying the 
particular projects of research, or the particular categories of 
research, that should be conducted or supported by the Sec-
retary; 
(2) of the projects specified under paragraph (1), make rec-
ommendations to the Secretary of the projects that should be 
given priority in the provision of funds; and 
(3) make recommendations to the Secretary of the amount of 
funds that should be appropriated for such research. 
(c) PROVISION OF INFORMATION TO THE PUBUC.—The Task Force 
may make available to health professionals, and to other members 
PUBLIC LAW 101-557—NOV. 15, 1990 
104 STAT. 2769 
of the public, information regarding the research described in 
subsection (b)-
SEC. 302. MEMBERSHIP. 
42 USC 242q-l. 
(a) COMPOSITION.—The Task Force shall be composed of— 
(1) the Assistant Secretary for Health; 
(2) the Surgeon General of the Public Health Service; 
(3) the Assistant Secretary for Planning and Evaluation; 
(4) the Director of the National Institute on Aging, and the 
Directors of such other agencies of the National Institutes of 
Health as the Secretary determines to be appropriate; 
(5) the Commissioner of the Administration on Aging; 
(6) the Commissioner of Food and Drugs; 
(7) the Chief Medical Director of the Department of Veterans 
Affairs; 
(8) the Administrator of the the Alcohol, Drug Abuse, and 
Mental Health Administration; 
(9) the Administrator 
of the 
Health 
Care 
Financing 
Administration; 
(10) the Commissioner of Social Security; 
(11) the Administrator for Health Care Policy and Research; 
(12) two Members of the House of Representatives appointed 
by the Speaker of the House in consultation with the Minority 
Leader, and two members of the Senate appointed by the Major-
ity Leader in consultation with the Minority Leader, not more 
than one of whom from each body shall be members of the same 
political party; and 
(13) three members of the general public, to be appointed by 
the Secretary, that shall include one representative each from— 
(A) a nonprofit group representing older Americans; 
(B) a private voluntary health organization concerned 
with the health problems affecting older Americans; and 
(C) a nonprofit organization concerned with research re-
lated to the health and independence of older Americans. 
(b) CHAIR.—The Secretary, acting through either the Assistant 
Secretary for Health or the Director of the National Institute on 
Aging, shall serve as the Chair of the Task Force. 
(c) QUORUM.—A majority of the members of the Task Force shall 
constitute a quorum, and a lesser number may hold hearings. 
(d) MEETINGS.—The Task Force shall meet periodically at the call 
of the Chair, but in no event less than twice each year. 
(e) COMPENSATION AND EXPENSES.— 
(1) COMPENSATION.—Members of the Task Force who are not 
regular full-time employees of the United States Government 
shall, while attending meetings and conferences of the Task 
Force or otherwise engaged in the business of the Task Force 
(including traveltime), be entitled to receive compensation at a 
rate fixed by the Secretary, but not exceeding the rate specified 
at the time of such service under GS-18 of the General Sched-
ules established under section 5332 of title 5, United States 
Code. 
(2) EXPENSES.—While away from their homes or regular 
places of business on the business of the Task Force, members of 
such Task Force may be allowed travel expenses, including per 
diem in lieu of subsistence, as is authorized under section 5703 
of title 5, United States Code, for persons employed intermit-
tently in the Government service. 
104 STAT. 2770 
PUBLIC LAW 101-557—NOV. 15, 1990 
42 use 242q-2. 
SEC. 303. ADMINISTRATIVE STAFF AND SUPPORT. 
The Secretary, acting through either the Assistant Secretary for 
Health or the Director of the National Institute on Aging, shall 
appoint an Executive Secretary for the Task Force and shall provide 
the Task Force with such administrative staff and support as may 
be necessary to enable the Task Force to carry out subsections (b) 
and (c) of section 301. 
42 use 242q-3. 
SEC. 304. REPORTS. 
(a) IN GENERAL.—Not later than 1 year after the date of the 
enactment of this Act, and annually thereafter, the Task Force shall 
prepare and submit to the Secretary, and to the Committee on 
Energy and Commerce of the House of Representatives and the 
Committee on Labor and Human Resources of the Senate, a report 
providing the recommendations required in section 301(b). 
0?) AvAiLABiUTY TO PuBUC.—The Task Force may make available 
to the public copies of the reports required in subsection (a). 
42 use 242q-4. 
SEC. 305. DEFINITIONS. 
For purposes of this title: 
(1) AGING RESEARCH.— 
(A) The term "aging research" means research on the 
aging process and on the diagnosis and treatment of dis-
eases, disorders, and complications related to aging, in-
cluding menopause. Such research includes research on 
such treatments, and on medical devices and other medical 
interventions regarding such diseases, disorders, and 
complications, that can assist individuals in avoiding 
institutionalization and prolonged hospitalization and in 
otherwise increasing the independence of the individuals. 
(B) For 
purposes of subparagraph 
(A), the 
term 
"independence", with respect to diseases, disorders, and 
complications of aging, means the functional ability of 
individuals to perform 
activities of daily living or 
instrumental activities of daily living without assistance or 
supervision. 
(2) SECRETARY.—The term "Secretary" means the Secretary of 
Health and Human Services. 
(3) TASK FORCE.—The term "Task Force" means the Task 
Force on Aging Research established under section 301(a). 
42 use 242q-5. 
SEC. 306. AUTHORIZATION OF APPROPRIATIONS. 
For the purpose of carrying out this title, there are authorized to 
be appropriated such sums as may be necessary for each of the fiscal 
years 1991 through 1993. 
TITLE IV—MISCELLANEOUS PROVISIONS 
SEC. 401. MISCEIXANEOUS AMENDMENTS. 
(a) MINORITY HEALTH.— 
(1) IN GENERAL.—Section 1707(b) of the Pubic Health Service 
Act, as added by section 2 of the Disadvantaged Minority Health 
Ante, p. 2312. 
Improvement Act of 1990, is amended— 
(A) in paragraph (6), by striking "and" after the semi-
colon at the end; 
PUBLIC LAW 101-557—NOV. 15, 1990 
104 STAT. 2771 
(B) in paragraph (7), by striking the period at the end and 
inserting "; and"; and 
(C) by adding at the end the following new paragraph: 
"(8) support expansion and enhancement of tertiary perinatal 
facilities in rural States with infant mortality rates among 
individuals from disadvantaged backgrounds, including minori-
ties, that are significantly above the national average for such 
rates.". 
(2) EFFECTIVE DATE.—The amendments made by paragraph (1) 
42 USC 300u-6 
shall take effect on the date of the enactment of the Disadvan- 
note, 
taged Minority Health Improvement Act of 1990. 
(b) 
SERVICES REGARDING ACQUIRED IMMUNE DEFICIENCY SYN-
DROME.—Title XXVI of the Public Health Service Act, as added by 
Public Law 101-381, is amended— 
(1) in section 2607(1), by striking "2601(aXl)" and inserting 
Ante, p. 585. 
"2601(a)"; 
(2) in section 2651, by striking "section 2652(a)(1)" and insert- 
Ante, p. 606. 
mg "section 2652(a)"; and 
(3) in section 2652(a)— 
Ante, p. 607. 
(A) by striking "referred to in subsection (b)" and insert-
ing "referred to in section 2651(a)"; 
(B) by redesignating subparagraphs (A) through (F) as 
paragraphs (1) through (6), respectively; and 
(C) in paragraph (6) (as so redesignated), by striking "a 
nonprofit private entity that provides" and inserting "non-
profit private entities that provide". 
TITLE V—FELLOWSHIPS 
SEC. 501. JAMES MADISON MEMORIAL FELLOWSHIPS. 
Section 813(aX4) of the James Madison Memorial Fellowship Act 
(20 U.S.C. 4512(aX4)) is amended by striking the second sentence. 
Approved November 15, 1990. 
LEGISLATIVE HISTORY—H.R. 5112: 
HOUSE REPORTS: No. 101-612 (Comm. on Energy and (Commerce). 
CONGRESSIONAL RECORD, Vol. 136 (1990): 
July 23, considered and passed House. 
Oct. 22, considered and passed Senate, amended. 
Oct. 23, 25, House concurred in Senate amendments. 
o