National Arthritis Act
PL 93-640 (S.2854), enacted 01/04/1975

88 STAT. ] 
PUBLIC LAW 93-640-JAN. 4, 1975 
2217 
school. The Secretary shall transmit annually to the Committees on 
Interior and Insular Affairs of the United States Senate and House 
of Representatives a report on the educational assistance program 
conducted pursuant to this section. 
SEC. 209. The assistance provided in this Act for the education of 
Indians in the public schools of any State is in addition and supple-
mental to assistance provided under title IV of the Act of June 23,1972 
(86 Stat. 235). 
Approved January 4, 1975. 
Report to con-
gressional com-
mittees. 
25 u s e 458e. 
20 u s e 241aa 
note. 
Public Law 93-639 
AN ACT 
To amend certain provisions of Federal law relating to explosives. 
January 4, 197! 
[S.1083] 
Explosives. 
18 u s e 845 
note. 
Be it enacted by the Senate and House of Representatives 
of the 
United States of America in Congress assembled^ That this Act may 
Amendments o
f 
be cited as "Amendments of 1973 to Federal Law Kelating to Law Reiaun"^to 
Explosives". 
SEC. 101. Section 845(a) of title 18 of the United States Code 
(relating to exemptions from certain provisions of Federal law relat-
ing to explosives) is amended by striking out paragraph (5) and 
inserting in lieu thereof the following new paragraph: 
"(5) commercially manufactured black powder in quantities 
not to exceed fifty pounds, percussion caps, safety and pyrotechnic 
fuses, quills, quick and slow matches, and friction primers, 
intended to be used solely for sporting, recreational, or cultural 
purposes in antique firearms as defined in section 921(a) (16) of 
title 18 of the United States Code, or in antique devices as 
exempted from the term 'destructive device' in section 921(a) (4) 
of title 18 of the United States Code; and". 
SEC. 102. Section 921(a) (4) of title 18 of the United States Code 
is amended by inserting after the word "sporting" in the last sentence 
the following:", recreational or cultural". 
Approved January 4, 1975. 
Public Law 93-640 
AN A C T 
January 4, 1975 
To amend the Public Health Service Act to expand the authority of the National 
^^' '^^^^'^ 
Institute of Arthritis, Metabolism, and Digestive Diseases in order to advance 
a national att ick on arthritis. 
Be it enacted by the Senate amd House of Representatives 
of the 
United States of America in Congress assemhled^ 
National Arthri-
tis Act of 1974. 
SHORT TITLE 
SECTION 1. This Act may be cited as the "National Arthritis Act of 
'
*
2 use 289c-1 
1974". 
FINDINGS AND DECLARATION OF PURPOSE 
SEC. 2, The Congress makes the following findings— 
42 use 289c-i 
(1) Arthritis and related musculoskeletal diseases constitute "°'^' 
major health problems in the United States in that they afilict 
more than twenty million Americans and are the greatest single 
cause of chronic pain and disability. 
(2) The complications of arthritis lead to many other serious 
2218 
PUBLIC LAW 93-640-JAN. 4, 1975 
[88 STAT. 
health problems and other severe physical disabilities in persons 
of all ages with the disease, .particularly children and adolescents. 
(3) The annual cost of arthritis to the national economy in 1970, 
from medical care expenses and lost wages, was $9,200,000,000, 
and number of workdays lost in that year totaled over 14,500,000. 
(4) Uncontrolled arthritis significantly decreases the quality 
of life and has a major negative economic, social, and psycho-
logical impact on the families of its victims and society generally. 
(5) Athletic and other types of joint injuries involving trauma 
can lead to arthritis. 
(6) The development of advanced methods of diagnosis and 
treatment of arthritis and quality trained health professionals in 
arthritis deserves the highest national priority. 
(7) There is a critical shortage of medical facilities and prop-
erly trained health professionals and allied health professionals 
in the United States for arthritis research, prevention, treatment, 
care, and rehabilitation programs. 
(8) The citizens of the United States should have a full under-
standing of the nature of the human, social, and economic impact 
of arthritis and should be encouraged to seek early diagnosis and 
treatment to prevent or mitigate physical disability resulting from 
arthritis. 
(9) There is great potential for making major advances against 
arthritis in the National Institute of Arthritis, Metabolism, and 
Digestive Diseases, in concert with other institutes of the National 
Institutes of Health. 
NATIONAL COMMISSION ON ARTHRITIS; ARTHRITIS PLAN 
42^usc^28Tc"i' 
^^^' ^.' ^^\ "^'^^ Secretary of Health, Education, and Welfare (here-
note. 
" 
inafter in this section referred to as the "Secretary"), after consulting 
with the Director of the National Institutes of Health, shall, within 
sixty days of the date of the enactment of this section, establish a 
National Commission on Arthritis and Kelated Musculoskeletal Dis-
eases (hereinafter in this section referred to as the ''(Commission"'). 
Membership. 
^|^^ rpj^g Commissiou sliall be composed of eighteen members as 
follows: 
(1) Six members appointed by the Secretary who are scientists, 
physicians, or other health professionals not in the employment 
of the Federal Government, who represent the various specialties 
and disciplines involving arthritis and related musculoskeletal 
diseases (hereinafter in this section collectively referred to as 
; 
"arthritis"), and of whom at least two are practicing clinical 
rheumatologists, at least one is an orthopedic sur-geon, and at least 
one is an allied health professional. 
(2) Four members appointed by the Secretary from the general 
public, of whom at least two suffer from arthritis. 
(3) One member appointed by the Secretary, from members 
of the National Arthritis, Metabolism, Digestive Disease Advisory 
Council, whose primary interest is in the field of rheumatology. 
(4) The Director of the National Institutes of Health or his 
designee, the Director of the National Institute of Arthritis, 
Metabolism, and Digestive Diseases oi' his designee, the Directors, 
or their designees, of the National Institute of Allergy and 
Infectious Diseases and the National Institute of General Medical 
Science, the Associate Director for Arthritis and Related Muscu-
loskeletal Diseases of such Institute, and the chief medical 
officer of the Veterans' Administration and the Secretary of 
Defense or their designees, each of whom shall serve as ex officio, 
nonvoting members. 
88 STAT. ] 
PUBLIC LAW 93-640-JAN. 4, 1975 
2219 
(c) The members of the Commission shall select a chairman from 
among their own number. The Commission shall first meet on a date 
specified by the Secretary, not later than 30 days after the Commission 
is established, and thereafter shall meet at the call of the Chairman 
of the Commission (but not less often than three times). 
(d) The Director of the National Institute of Ai-thritis. Metab-
olism, and Digestive Diseases shall— 
(1) designate a member of the staff of such Institute to act as 
Executive Secretary of the Commission, and 
(2) provide the Commission with such full-time professional 
and clerical staff, such information, and the services of such con-
sultants as may be necessary to assist it in carrying out effectively 
its function under this section. 
(e) Members of the Commission who are officers or employees of 
the Federal Government shall serve as members of the Commission 
without 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 
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-
ance of their duties as members of the Commission. All members, 
while so serving away from their homes or regular places of business, 
may be allowed travel expenses, including per diem in lieu of subsist-
ence, in the same manner as such expenses are authorized by section 
6703, title 5, United States Code, for persons in the Government serv-
ice employed intermittently. 
(f) The Commission shall survey Federal, State, and local health 
programs and activities relating to arthritis and assess the adequacy, 
technical soundness, and coordination of such programs and activities. 
All Federal departments and agencies administering health programs 
and activities relating to arthritis shall provide such cooperation and 
assistance relating to such progra]:ns and activities as is reasonably 
necessary for the Commission to make such survey and assessment. 
(g) The Commission shall formulate a long-range plan (herein-
after in this section referred to as the "Arthritis Plan") with specific 
recommendations for the use and organization of national resources 
to combat arthritis. The Arthritis Plan shall be based on a survey 
investigating the incidence and prevalence of arthritis and its eco-
nomic and social consequences, and on an evaluation of scientific infor-
mation respecting, and the national resources capable of dealing with 
arthritis. The Arthritis Plan shall include a comprehensive program 
for the National Institute of Arthritis, Metabolism, and Digestive 
Diseases (hereinafter in this section referred to as the "Institute") 
and plans for Federal, State, and local programs, which program and 
programs shall, as appropriate, provide for— 
(1) investigation into the epidemiology, etiology, and preven-
tion and control of arthritis, including the social, environmental, 
behavioral, nutritional, and biological control of arthritis; 
(2) studies and research into the basic biological processes and 
mechanisms involved with arthritis, including abnormalities of 
the immune, musculoskeletal, cardiovascular, gastrointestinal, 
urogenital, pulmonary, and nervous systems, the skin, and the 
eyes; 
(3) research into the development, trial, and evaluation of tech-
niques, orthopedic and other surgical procedures, and drugs 
(including drugs intended for use by children) used in the diag-
nosis, early detection, treatment, prevention, and control of 
arthritis; 
(4) programs that will apply scientific and technological meth-
odologies and processes involving biological, physical, and engi-
Chairman. 
Director, Na-
tional Institute of 
Arthritis, Metab-
olism, and Diges-
tive Diseases, 
duties. 
Compensation. 
5 u s e 5332 
note. 
Federal, State, 
and local health 
programs, survey. 
Arthritis Plan. 
2220 
PUBLIC LAW 93-640-JAN. 4, 1975 
[88 STAT. 
neering sciences to deal with all facets of arthritis, including 
traumatic arthritis; 
(5) programs for the conduct and direction of field studies large-
scale testing, evaluation, and demonstration of preventive, diag-
nostic, therapeutic, rehabilitative, and control approaches to 
arthritis, including studies of the effectiveness and use of home 
care programs, mobile care units, community rehabilitation facili-
ties, and other appropriate community public health and social 
services; 
(6) studies of the feasibility of, and possible benefits accruing 
from, the organization and training of teams of health and allied 
health professionals in the treatment and rehabilitation of individ-
uals who suffer from arthritis; 
(7) programs to evaluate available resources for the rehabilita-
tion of individuals who suffer from arthritis; 
(8) programs to develop new and improved methods of screen-
ing and referral for arthritis, and particularly for the early detec-
tion of arthritis; 
(9) programs to establish standards and criteria for measure-
ment of the severity and rehabilitative potential of disabilities 
resulting from arthritis; 
(10) programs to develop a uniform descriptive vocabulary for 
use in basic and clinical research and a standardized clinical 
patient data set for arthritis to standardize collection, storage, and 
retrieval of research and treatment data in order to facilitate col-
laborative and comparative studies of large patient populations; 
(11) programs to establish a system for the collection, analysis, 
and dissemination of data useful in the screening, prevention, 
diagnosis, and treatment of arthritis, including the establishment 
of a national data storage bank to collect, catalog, and store, and 
facilitate retrieval and dissemination of information as to the 
practical application of research and other activities pertaining 
to arthritis; 
(12) programs for the education (including continuing educa-
tion programs and development of new techniques and curricula) 
of scientists, bioengineers, physicians engaged m general practice, 
the practice of family medicine, or other primary care specialties, 
surgeons, including orthopedic surgeons, and other health and 
allied health professionals and educators in the fields and special-
ties requisite to screening, early detection, diagnosis, treatment, 
and prevention of arthritis and rehabilitation of individuals who 
suffer from arthritis; 
(13) programs for public education and counseling relating to 
arthritis, including public information campaigns on current 
developments in diagnostic and treatment procedures and pro-
grams to discourage the promotion and use of unapproved and 
ineffective diagnostic, preventive, treatment, and control methods 
and unapproved and ineffective drugs and devices; 
(14) a program for the acceleration of international coopera-
tion in and exchange of knowledge on research, screening, early 
detection, diagnosis, treatment, prevention, and control of arthri-
tis; and 
Research pro- 
(15) coordiuatiou of the research programs relevant to arthri-
na^i^n.'^""'^ ' 
tis of othcr Institutes of the National Institutes of Health, the 
Department of Health, Education, and Welfare, and other Federal 
and non-Federal entities. 
Hearings. 
^}j^ q^j^g Commission may hold such hearings, take such testimony, 
and sit at such time and places as it deems advisable. 
timaTe^s"''''"" ''" 
(i) (1) Tl^e CommissioM shall prepare for each of the Institutes of 
the National Iiistitutcs of Health whose activities are to be affected by 
88 STAT.] 
PUBLIC LAW 93-640-JAN. 4, 1975 
2221 
the Arthritis Plan estimates of necessary expenditures to carry out 
each such Institute's part of the comprehensive program included in 
the Plan. The 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 is transmitted by the Presi-
dent to Congress for the fiscal year ending June 30,1976, and for each 
of the next two fiscal years, the Secretary shall transmit to the Com-
mittees on Appropriations of the House of Representatives and the 
Senate, the Committee on Labor and Public Welfare of the Senate, 
{ind the Committee on Commerce and Health of the United States 
House of Representatives an estimate of the amounts requested for 
arthritis research by each of the Institutes for which estimates were 
prepared under paragraph (1) and a comparison of such amounts 
with such estimates. 
(j) (1) The Commission shall publish and transmit directly to the 
Congress (without prior administrative approval or review by the 
Office of Management and Budget or any other Federal department 
or agency) the Arthritis Plan within two hundred and ten days after 
the date on which funds are first appropriated for the Commission. 
(2) The Commission shall cease to exist on the thirtieth day follow-
ing the date of the submission of the Arthritis Plan pursuant to para-
graph (1) of this subsection. 
(k) There are authorized to be appropriated, without fiscal year 
limitation, to carry out the purposes of this section $2,000,000. 
Transmittal to 
congressional 
committees. 
Arthritis Plan, 
publication; trans-
mittal to Congress. 
Termination 
date. 
Appropriation. 
ARTHRITIS 
COORDINATING 
CXDMMITTEE, DEMONSTRATION 
PROJECTS, 
AND 
COMPREHENSIVE ARTHRITIS CENTERS 
SEC. 4. Part D of title IV of the Public Health Service Act is 
amended by adding at the end thereof the following new sections: 
"ARTHRITIS COORDINATING 
COMMITTEE 
"SEC. 437. (a) In order to improve coordination of all activities in 
the National Institutes of Health, in the Department of Health, Edu-
cation, and Welfare, and in other departments and agencies of the 
Federal Government relating to Federal health programs and activi-
ties relating to arthritis, the Secretary shall establish an Arthritis 
Coordinating Committee to be composed of representatives of the 
Department of Health, Education, and Welfare (including the Food 
and Drug Administration) and of the Veterans' Administration, the 
Department of Defense, and other Federal departments and agencies 
iuA'olved in research, health services, or rehabilitation programs affect-
ing arthritis. This committee shall include the Directors (or their 
designated representatives) of each of the Institutes of the National 
Institutes of Health involved in arthritis related research. The Com-
mittee shall be chaired by the Associate Director established pursuant 
to section 434(e) and shall prepare a report not later than sixty days 
after the end of each fiscal year as possible, for the Secretary detailing 
the woi'k of the committee in seeking to improve coordination of 
departmental and interdepartmental activities relating to arthritis 
during the preceding fiscal year. Such report shall include— 
"(1) a description of the work of the committee in coordinating 
the research activities of the National Institutes of Health relating 
to arthritis during the preceding year, and 
"(2) a description of the work of the committee in promoting 
the coordination of Federal health programs and activities relat-
ing to arthritis to assure the adequacy of such programs and to 
provide for the adequate coordination of such programs and 
activities. 
Establishment. 
42 u s e 289C-4. 
Membership. 
Post, 
p. 
Report. 
Contents. 
2222 
PUBLIC LAW 93-640-JAN. 4, 1975 
[88 
STAT. 
Meetings. 
42 u s e 289C-5. 
Coordination 
with Federal, 
State, and other 
agencies. 
Intra. 
Arthritis Screen-
ing and Detection 
Data Bank. 
Establishment. 
Patient data 
and recordkeep-
ing, standardiza-
tion. 
Appropriations. 
"(b) The Committee shall meet at the call of the chairman, but not 
less often than four times a year. 
"ARTHRITIS SCREENING, DETECTION, PREVENTION, AND REFERRAL 
DEMONSTRATION PROJECTS; AND DATA BANK 
"SEC. 438. (a) The Secretary, acting through the Assistant Secretary 
for Health, may make grants to public and nonprofit entities to estab-
lish and support projects for the development and demonstration of 
methods for arthritis, screening, detection, prevention, and referral, 
and for the dissemination of these methods to health and allied 
health professions. Activities under such projects shall be coordinated 
with (1) Federal, State, local, and regional health agencies, (2) centers 
assisted under section 439, and (3) the data bank under subsection (c). 
"(b) Projects under this section shall include programs which— 
"(1) emphasize the development and demonstration of new and 
improved methods of screening and early detection, referral, and 
diagnosis of individuals with a risk of developing arthritis, asymp-
tomatic arthritis, or symptomatic arthritis; 
"(2) emphasize the development and demonstration of new 
and improved methods for patient referral from local hospitals 
and physicians to appropriate centers for early diagnosis and 
treatment; 
"(3) emphasize the development and demonstration of new and 
improved means of standardizing patient data and recordkeeping; 
and 
" (4) emphasize the development and demonstration of new and 
improved methods of dissemination of knowledge about the proj-
ects and methods referred to in the preceding paragraphs of this 
subsection to health and allied health professionals. 
"(c) (1) As soon as practicable after the date of enactment of this 
section the Secretary, through the Assistant Secretary for Health, 
shall establish the Arthritis Screening and Detection Data Bank for 
the collection, storage, analysis, retrieval, and dissemination of data 
useful in screening, prevention, and early detection involving patient 
populations with asymptomatic and symptomatic types of arthritis, 
including where possible, data involving general populations for the 
purpose of detection of individuals with a risk of developing arthritis. 
"(2) The Secretary shall provide for standardization of patient 
data and recordkeeping for the collection, storage, analysis, retrieval, 
and dissemination of such data in cooperation with projects under this 
section and centers assisted under section 439, and other persons 
engaged in arthritis programs, 
"(d) There are authorized to be appropriated to carry out this 
section $2,000,000 for fiscal year ending June 30, 1975, $3,000,000 for 
fiscal year ending June 30, 1976, and $4,000,000 for fiscal vear ending 
June 30, 1977. 
u 
COMPREHENSIVE ARTHRITIS CENTERS 
42 u s e 289C-6. 
"SE(^;. 439. (a) The Secretary, acting through the Assistant Secre-
tary for Health may, after consultation with the National Advisory 
42 use 289C-1. Council established under section 434(a) and consistent with the 
Arthritis Plan developed pursuant to the National Arthritis Act of 
Ante, p. 2217. 
1974, providc for the development, modernization, and operation 
(including staffing and other operating costs such as the costs of 
patient care required for research) of centers for arthritis research, 
screening, detection, diagnosis, prevention, control, and treatment, for 
education related to arthritis, and for rehabilitation of individuals 
"Modemiza- 
who suffer from arthritis. For purposes of this section, the term 
'°"*" 
'modernization' means the alteration, remodeling, improvement. 
88 STAT. ] 
PUBLIC LAW 93-640-JAN. 4, 1975 
2223 
expansion, and repair of existing buildings and the provision of 
equipment for such buildings to the extent necessary to make them 
suitable for use as centers described in the preceding sentence. 
"(b) Each center assisted under this section shall— 
" (1) (A) use the facilities of a single institution or a consortium 
of cooperating institutions, and (B) meet such qualifications as 
may be prescribed by the Secretary; and 
"(2) conduct— 
"(A) basic and clinical research into the cause, diagnosis, 
early detection, prevention, control, and treatment of, arthritis 
and complications resulting from arthritis, including research 
into implantable biomaterials and biomechanical and other 
orthopedic procedures and in the development of other diag-
nostic and treatment methods; 
"(B) training programs for physicians and other health 
and allied professionals in current methods of diagnosis, 
screening and early detection, prevention, control, and 
treatment of arthritis; 
"(C) information and continuing education programs for 
physicians and other health and allied health professionals 
who provide care for patients with arthritis; and 
"(D) programs for the dissemination to the general public 
of information— 
"(i) on the importance of early detection of arthritis, 
of seeking prompt treatment, and of following an 
appropriate regimen; and 
"(ii) to discourage the promotion and use of unap-
proved and ineffective diagnostic, preventive, treatment, 
and control methods and unapproved and ineffective 
drugs and devices. 
"(c) Each center assisted under this section may conduct programs 
to— 
"(1) develop new and improved methods of screening and early 
detection, referral, and diagnosis of individuals with a risk of 
developing arthritis, asymptomatic arthritis, or symptomatic 
arthritis, 
"(2) disseminate the results of research, screening, and other 
activities, and develop means of standardizing patient data and 
recordkeeping, and 
"(3) develop community consultative services to facilitate the 
referral of patients to centers for treatment. 
"(e) The Secretary shall, insofar as practicable, provide for an graphicaflris^tr°." 
equitable geographical distribution of centers assisted under this sec- bution o
f centers. 
tion. The Secretary shall give appropriate consideration to the need 
for centers especially suited to meeting the needs of children affected 
by arthritis. 
"(f) The Secretary shall evaluate on an annual basis the activities 
of centers receiving support under this section and shall report to the 
appropriate committees of Congress the results of his evaluations not 
later than four months after the end of each fiscal year. 
"(g) No center may receive more than three grants under this 
section. 
"(h) For purposes of this section, there are authorized to be appro- 
Appropriations. 
priated $11,000,000 for fiscal year ending June 30, 1975, $13,000,000 
Report to con-
gressional com-
mittees. 
Grants, limita-
tion. 
2224 
PUBLIC LAW 93-640-JAN. 4, 1975 
[88 STAT. 
for fiscal year ending June 30, 1976, and $15,000,000 for fiscal year 
ending June 30,1977. Not less than 20 per centum of the funds appro-
priated for each fiscal year under this subsection shall be used for the 
purposes of establishing new centers." 
ASSOCIATE DIRECTOR, ANNUAL REPORT, RESEARCH FUNDING, 
ADVISORY 
COUNCIL 
42 use 289C-1. 
gj,^. 5 (^j Scctlon 434 of the Public Health Service Act is amended 
by adding at the end the following new subsections: 
"(e) There is established within the Institute the position of Asso-
ciate Director for Arthritis and Related Musculoskeletal Disease 
(hereinafter in this part referred to as the 'Associate Director'), who 
shall report directly to the Director of such Institute and who, under 
the supervision of the Director of such Institute, shall be responsible 
for programs regarding arthritis and related musculoskeletal diseases 
hereinafter in this part collectively referred to as 'arthritis') within 
such Institute. 
Report to Presi- 
ii/^\ 
rpj^^ Director of the Institute shall, as soon as practicable, but 
dent and Congress. 
\ 
/ 
. 
f 
^ 
i
(
>
i
/
-
»
-
i 
not later than sixty days, after the end ot each fiscal year, prepare, 
in consultation with the National Advisory Council, and submit to 
the President and to the Congress a report. Such report shall include 
(1) a proposal for the Institute's activities under the Arthritis Plan 
formulated under the National Arthritis Act of 1974 and activities 
under other provisions of law during the next five years, with an esti-
mate for such additional staff positions and appropriations as may 
be required to pursue such activities, and (2) a program evaluation 
section, wherein the activities and accomplishments of the Institute 
during the preceding fiscal year shall be measured against the Direc-
tor's proposal for that year for activities under the Arthritis Plan.". 
42 use 289a. 
(^j^^ Scctiou 431 of such Act is amended by adding at the end thereof 
the following new subsection: 
"(c) Of the sums appropriated for any fiscal year under this Act 
for the National Institutes of Health, not less than $500,000 shall be 
obligated for basic and clinical orthopedic research conducted within 
the National Institute of Arthritis, Metabolism, and Digestive Diseases 
which relates to the methods of preventing, controlling and treating 
arthritis and related musculoskeletal diseases, including research in 
implantable biomaterials and biomechanical and other orthopedic 
procedures and research in the development of new and improved 
orthopedic treatment methods." 
Researchproj- 
(c) Scctiou 434(b) of such Act is amended by adding at the end 
ects, grant appii- thercof thc followiug! "The Advisory Council shall review applica-
cations, review. 
. 
^ 
T~.. 
n 
» 
i 
• 
i 
i 
42 use 289c-1. tious made to the Director for grants tor research projects related to 
arthritis and related musculoskeletal diseases and shall recommend to 
the Director for approval those applications and contracts w;l^ch the 
Council determines will best carry out the purposes of this part. The 
Advisory Council shall also review and evaluate the arthritis programs 
under this part and shall recommend to the Director such changes in 
the administration of such programs as it determines are necessary." 
Approved January 4, 1975.