Preventive Health Amendments of 1993
PL 103-183 (H.R.2202), enacted 12/14/1993

107 STAT. 2226 
PUBLIC LAW 103-183—DEC. 14, 1993 
Public Law 103-183 
103d Congress 
An Act 
Dec. 14, 1993 
[H.R. 2202] 
Preventive 
Health 
Amendments 
of 1993. 
Inter-
governmental 
relations. 
42 u s e 201 note. 
To amend the Public Health Service Act to revise and extend the program of 
grants relating to preventive health measures with respect to breast and cervical 
cancer. 
Be it enacted by the Senate and House of Representatives of 
the United States of 
America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—^This Act may be cited as the "Preventive 
Health Amendments of 1993". 
(b) TABLE OF CONTENTS.—The table of contents for this Act 
is as follows: 
Sec. 1. Short title; table of contents. 
TITLE I—BREAST AND CERVICAL CANCER 
Sec. 101. Revisions in program of State grants regarding breast and cervical can-
cer. 
Sec. 102. Establishment of demonstration program of grants for additional preven-
tive health services for women. 
Sec. 103. Funding for general program. 
Sec. 104. Breast and cervical cancer information. 
TITLE II—INJURY PREVENTION AND CONTROL 
Sec. 201. Establishment of requirements with respect to interpersonal violence 
within families and among acquaintances. 
Sec. 202. Advisory committee; reports. 
Sec. 203. Technical corrections. 
Sec. 204. Authorization of appropriations. 
TITLE III—TUBERCULOSIS 
Sec. 301. Preventive health services regarding tuberculosis. 
Sec. 302. Research through National Institute of Allergy and Infectious Diseases. 
Sec. 303. Research through the Food and Drug Administration. 
TITLE IV—SEXUALLY TRANSMITTED DISEASES 
Sec. 401. Extension of program of grants regarding prevention and control of sexu-
ally transmitted diseases. 
Sec. 402. Extension of program regarding preventable cases of infertility arising as 
result of sexually transmitted cuseases. 
TITLE V—NATIONAL CENTER FOR HEALTH STATISTICS 
Sec. 501. Revision and extension of programs. 
TITLE VI—TRAUMA CARE SYSTEMS 
Sec. 601. Revisions in pnu^rams relating to trauma care. 
Sec. 602. Authorization ofiappropriations. 
TITLE VII—MISCELLANEOUS PROVISIONS 
Sec. 701. Evaluations. 
Sec. 702. Federal benefits for overseas assignees. 
Sec. 703. Loan repayment program. 
PUBLIC LAW 103-183—DEC. 14, 1993 
107 STAT. 2227 
Sec. 704. Establishment of requirement of biennial report on nutrition and health. 
Sec. 705. Alignment of current Centers for Disease Control and Prevention reau-
thorization schedule. 
Sec. 706. Miscellaneous payment provisions. 
Sec. 707. Interim final regulations. 
Sec. 708. Simplification of vaccine information materiab. 
TITLE I—BREAST AND CERVICAL 
CANCER 
SEC. 101. REVISIONS IN PROGRAM OF STATE GRANTS REGARDING 
BREAST AND CERVICAL CANCER 
(a) LIMITED AUTHORITY REGARDING FOR-PROFIT ENTITIES.—Sec-
tion 1501(b) of the Public Health Service Act (42 U.S.C. 300k(b)), 
as amended by section 2008(cXl) of Public Law 103-43 (107 Stat. 
211), is amended— 
(1) in paragraph (1), by striking "paragraph (2)" and insert-
ing "paragraphs (2) and (3)"; and 
(2) bv striking paragraph (2) and inserting the following 
paragraphs: 
^(2) LIMITED AUTHORITY REGARDING OTHER ENTITIES.—In 
addition to the authority established in paragraph (1) for a 
State with respect to grants and contracts, the State may 
provide for screenings imder subsection (aXl) through entering 
into contracts with private entities that are not nonprofit 
entities. 
"(3) PAYMENTS FOR SCREENINGS.—The amount paid by a 
State to an entity under this subsection for a screenmg proce-
dure under subsection (aXD may not exceed the amount that 
would be paid under part B of title XVIII of the Social Security 
Act if payment were made under such part for furnishing 
the procedure to a woman enrolled under such part.". 
(b) SPECIAL CONSIDERATION.—Section 1501 of the Public Health 
Service Act (42 U.S.C. 300k) is amended by adding at the end 
the following subsection: 
"(c) SPECIAL CONSIDERATION FOR CERTAIN STATES.—In making 
grants under subsection (a) to States whose initial grants under 
such subsection are made for fiscal year 1995 or any subsequent 
fiscal year, the Secretary shall give special consideration to any 
State whose proposal for carrying out programs imder such 
subsection— 
"(1) has been approved through a process of peer review; 
and 
"(2) is made mth respect to geographic areas in which 
there is— 
"(A) a substantial rate of mortality from breast or 
cervical cancer; or 
"(B) a substantial incidence of either of such cancers.". 
(c) QUALITY ASSURANCE REGARDING SCREENING PROCEDURES.— 
(1) IN GENERAI..—Section 1503 of the PubUc Health Service 
Act (42 U.S.C. 300m) is amended by striking subsections (c) 
through (e) and inserting the following: 
"(c) 
QUALITY ASSURANCE REGARDING SCREENING PROCE-
DURES.—^The Secretary) may not make a grant under section 1501 
unless the State involved agrees that the State will, in accordance 
with applicable law, assure the quality of screening procedures 
conducted pursuant to such section. . 
69-194 O - 94 - 10 : QL 3 Part 3 
107 STAT. 2228 
PUBLIC LAW 103-183—DEC. 14, 1993 
42 use 300m 
(2) TRANSITION RULE REGARDING lifAMMOGRAPHIES.—With 
"°^' 
respect to the screening procedure for breast cancer known 
as a mammography, the requirements in effect on the day 
before the date of the enactment of this Act under section 
1503(c) of the Public Health Service Act remain in effect (for 
an individual or facility conducting such procedures pursuant 
to a grant to a State under section 1501 of such Act) until 
there is in effect for the facility a certificate (or provisional 
certificate) issued under section 354 of such Act. 
(d) STATEWIDE PROVISION OF SERVICES.—Section 1504(c) of the 
Public Health Service Act (42 U.S.C. 300n(c)) is amended by adding 
at the end the following p€uragraph: 
"(3) GRANTS TO TRIBES AND TRIBAL ORGANIZATIONS.— 
"(A) The Secretary, acting through the Director of the 
Centers for Disease Control and Prevention, may make 
grants to tribes and tribal organizations (as such terms 
are used in paragraph (1)) for the purpose of carrying 
out programs described in section 1501(a). This title applies 
to such a grant (in relation to the jurisdiction of the tribe 
or organization) to the same extent and in the same manner 
as such title applies to a grant to a State under section 
1501 (in relation to the jurisdiction of the State). 
"(B) If a tribe or tribal organization is receiving a 
grant imder subparagraph (A) and the State in which 
the tribe or organization is located is receiving a grant 
under section 1501, the requirement established in para-
graph (1) for the State regarding the tribe or organization 
is deemed to have been waived under paragraph (2).". 
(e) EVALUATIONS AND REPORTS.—Section 1508 of the Public 
Health Service Act (42 U.S;C. 300n-4) is amended— 
(1) in subsection (a), by adding at the end the following 
sentence: "Such evaluations shall include evaluations of the 
extent to which States carrying out such programs are in 
compliance with section 1501(aX2) and with section 1504(c).''; 
and 
(2) in subsection (b), by inserting before the period the 
following: ", including recommendations regarding compliance 
by the States wiUi section 1501(aX2) and with section 1504(c)''. 
(t) ESTABUSHMENT OF COORDINATING COMMITTEE.—Section 
1501 of the Public Health Service Act (42 U.S.C. 300k) is amended 
by adding at the end the following subsection: 
"(c) COORDINATING COMMITTEE REGARDING YEAR 2000 HEALTH 
OBJECTIVES.—^The Secretary, acting through the Director of the 
Centers for Disease Control and Prevention, shall establish a 
committee to coordinate the activities of the agencies of the Public 
Health Service (and other appropriate Federal a^fencies) that are 
carried out toward achieving the objectives established by the Sec-
retary for reductions in the rate of mortality from breast and 
cervical cancer in the United States ^ the year 2000. Such commit-
tee shall be comprised of Federal ofincers or employees designated 
by the heads of the agencies involved to serve on the committee 
as representatives of me agencies, and such representatives fix)m 
other public or private entities as the Secretary determines to 
be appropriate.". 
(g) TECHNICAL CORRECTIONS.—Title XV of the Public Health 
Service Act (42 U.S.C. 300k et seq.) is amended— 
PUBLIC LAW 103-183—DEC. 14, 1993 
107 STAT. 2229 
(1) in section 1501(a), in the matter preceding paragraph 42 use 300k. 
(1), by striking "Control," and inserting "XlJontrol and Preven-
tion,"; and 
(2) m section 1505— 
42 use 300n-i. 
(A) in paragraph (3) (as amended bv section 2008(cX2) 
of Public Law 103-43 (107 Stat. 211)), by striking "public" 
and all that follows and inserting 'public and nonprofit 
private entities; and"; and 
(B) in paragraph (4), by inserting "will" before "be 
used". 
SEC. 102. ESTABUSHMENT 
OF 
DEMONSTRATION 
PROGRAM 
OF 
GRANTS FOR ADDITIONAL PREVENTIVE HEALTH SERV-
ICES FOR WOMEN. 
(a) IN GENERAL.—Title XV of the Public Health Service Act 
(42 U.S.C. 300k et seq.) is amended— 
(1) by redesignating section 1509 as section 1510; and 42USe300n-5. 
(2) by inserting after section 1508 the following section: 
'9EC. 1508. SUPPLEMENTAL GRANTS FOR ADDITIONAL PREVENTIVE 42 USe 300n-4a. 
HEALTH SERVICEa 
"(a) DEMONSTRATION PROJECTS.—In the case of States receiving 
grants under section 1501, the Secretary, acting through the Direc-
tor of the Centers for Disease Control and Prevention, may make 
grants to not more than 3 such States to carry out demonstration 
projects for the pmrpose of— 
"(1) provioing preventive hetdth services in addition to 
the services authorized in such section, including screenings 
regarding blood pressure and cholesterol, and including health 
education; 
"(2) providing appropriate referrals for medical treatment 
of women receivmg services pursuant to p€u:agraph (1) and 
ensuring, to the extent practicable, the provision of appropriate 
follow-up services; and 
"(3) evaluating activities conducted under paragraphs (1) 
and (2) through appropriate surveillance or program-monitoring 
activities. 
"(b) STATUS AS PARTICIPANT IN PROGRAM REGARDING BREAST 
A
N
D CERVICAL CANCER.—^The Secretary may not make a grant 
under subsection (a) unless the Stote involved agrees that services 
under the grant will be provided only through entities that are 
screening women for breast or cervical cancer pursuant to a grant 
under section 1501. 
"(c) APPUCABIUTY O
F PROVISIONS OF GENERAL PROGRAM.—This 
title applies to a grant under subsection (a) to the same extent 
and in the same manner as such title applies to a grant under 
section 1501. 
"(d) FUNDING.— 
"(1) IN GENERAI..—Subject to paragraph (2), for the purpose Appropriation 
of carrving out this section, there are authorized to be appro- authorization. 
priated $3,000,000 for fiscal year 1994, and such sums as 
may be necessary for each of the fiscal years 1995 through 
1998. 
"(2) LIMITATION REGARDING FUNDING WITH RESPECT TO 
BREAST AND CERVICAL CANCER.—^The authorization of appropria-
tions esteblished in paragraph (1) is not effective for a nscal 
year unless the amount appropriated under section 1510(a) 
for the fiscal year is equal to or greater than $100,000,000.". 
107 STAT. 2230 
PUBLIC LAW 103-183—DEC. 14, 1993 
(b) CONFORMING AMENDMENT.—Section 1510(a) of the Public 
Health Service Act, as redesignated by subsection (aXl) of this 
42 use 300n-5. 
section, is amended in the heading for the section by striking 
"FUNDING." and inserting "FUNDING FOR GENERAL PROGRAM.". 
SEC. 103. FUNDING FOR GENERAL PROGRAM. 
Section 1510(a) of the Public Health Service Act, as redesig-
nated by section 102(aXl) of this Act, is amended— 
(1) by striking "and" after "1991,"; and 
(2) by inserting before the period the following: ", 
$150,000,000 for fiscal year 1994, and such sums as may be 
necessary for each of the fiscal years 1995 through 1998". 
SEC 104. BREAST AND CERVICAL CANCER INFORMATION. 
Part D of title III of the Public Health Service Act (42 U.S.C. 
254b et seq.), as amended by section 2008(iX2XA) of Public Law 
103-43 (107 Stat. 213), is amended by adding at the end the 
following new section: 
"BREAST AND CERVICAL CANCER INFORMATION 
42USC256d. 
"SEC. 340D. (a) IN GENERAL.—AS a condition of receiving 
grants, cooperative agreements, or contracts imder this Act, each 
of the entities specified in subsection (c) shall, to the extent deter-
mined to be appropriate by the Secretary, make available informa-
tion concerning breast and cervical cancer. 
"(b) CERTAIN AUTHORITIES.—^In canying out subsection (a), an 
entity specified in subsection (c)— 
"(1) may make the information involved available to such 
individuals as the entity determines appropriate; 
"(2) may, as appropriate, provide information under sub-
section (a) on the need for self-examination of the breasts 
and on the skills for such self-examinations; 
"(3) shall provide information under subsection (a) in the 
language and cultural context most appropriate to the individ-
uals to whom the information is provided; and 
"(4) shall refer such clients as the entities determine appro-
priate for breast and cervical cancer screening, treatment, or 
other appropriate services. 
"(c) RELEVANT ENTITIES.—^The entities specified in this sub-
section are the following: 
"(1) Entities receiving assistance under section 317E (relat-
ing to tuberculosis). 
"(2) Entities receiving assist€uice under section 318 (relat-
ing to sexually transmitted diseases). 
"(3) Migrant health centers receiving assistance under sec-
tion 329. 
"(4) Commimity health centers receiving assistance under 
section 330. 
"(5) Entities receiving assistance under section 340 (relat-
ing to homeless individuals). 
"(6) Entities receiving assistance under section 340A (relat-
ing to health services for residents of public housing). 
"(7) Entities providing services with assistance under title 
V or title XIX. 
"(8) Entities receiving assistance imder section 1001 (relat-
ing to family planning). 
PUBLIC LAW 103-183—DEC. 14, 1993 
107 STAT. 2231 
"(9) Entities receiving assistance under title XXVI (relating 
to services with respect to acquired immune deficiency syn-
drome). 
"(10) Non-Federal entities authorized under the Indian 
Self-Determination i\ct.''. 
TITLE n—IN.JURY PREVENTION AND 
CONTROL 
SEC. aOl. ESTABUSHMENT OF REQUIREMENTS WITH RESPECT TO 
INTERPERSONAL 
VIOLENCE 
WITHIN 
FAMILIES 
AND 
AMONG ACQUAINTANCE& 
Part J of title III of the Public Health Service Act (42 U.S.C. 
280b et seq.), as redesignated by section 2008(iX2XBXi) of Public 
Law 103-43 (107 Stat. 213), is amended— 
(1) by redesignating sections 393 and 394 as sections 394 
and 394A, respectively; and 
42 use 280b-2, 
(2) by inserting after section 392 the following section: 280b-3. 
"INTERPERSONAL VIOLENCE WITHIN FAMIUES AND AMONG 
ACQUAINTANCES 
"SEC. 393. (a) With respect to activities that are authorized 42 use 280b-ia. 
in sections 391 and 392, the Secretary, acting through the Director 
of the Centers for Disease Control and Prevention, shall carry 
out such activities with respect to interpersonal violence within 
families and among acquaintances. Activities authorized in the 
preceding sentence include the following: 
(1) Collecting data relating to the incidence of such 
violence. 
"(2) Making grtmts to pubUc and nonprofit private entities 
for the evaluation of programs whose purpose is to prevent 
such violence, including the evaluation of demonstration 
projects under paragraph (6). 
"(3) Making grtmts to public and nonprofit private entities 
for the conduct of research on identifying effective strategies 
for preventing such violence. 
"(4) Providing to the public information and education on Public . 
such violence, including information and education to increase "^formation. 
awareness of the pubUc health consequences of such violence. 
"(5) Training hcsalth care providers as follows: 
"(A) To idcintifyr individuals whose medical conditions 
or statements indicate that the individuals are victims 
of such violence. 
"(B) To routinely determine, in examining patients, 
whether the medical conditions or statements of the 
patients so indicate. 
"(C) To refer individuals so identified to entities that 
provide services regarding such violence, including referr^s 
for counseling, housing, legal services, and services of 
community organizations. 
"(6) Making grants to public and nonprofit private entities 
for demonstration projects with respect to such violence, includ-
ing with respect to prevention. 
"(b) For purposes of this part, the term interpersonal violence 
within families and aniong acquaintances' includes behavior com-
107 STAT. 2232 
PUBLIC LAW 103-183—DEC. 14, 1993 
monly referred to as domestic violence, sexual assault, spousal 
abuse, woman battering, partner abuse, elder abuse, and acquaint-
ance rape.". 
SEC. 202. ADVISORY COMMITTEE: REPORTS. 
: ^ 
Section 394 of the Public Health Service Act, as redesignated 
42USC280b-2. 
by section 201(1) of this Act, is amended to read as follows: 
"GENERAL PROVISIONS 
Establishment. 
"SEC. 394. (a) The Secretary, acting through the Director of 
the Centers for Disease Control and IVevention, shall establish 
an advisory committee to advise the Secretary and such Director 
with respect to the prevention and control of injuries. 
"(b) The Secretary, acting through the Director of the Centers 
for Disease Control and Prevention, may i)rovide technical assist-
ance to public and nonprofit private entities with respect to the 
planning, development, and operation of any program or service 
carried out pursuant to this part. The Secretary may provide such 
technical assistance directly or through grants or contracts. 
**(c) Not later than February 1 of 1995 and of every second 
year thereafter, the Secretaiy, acting through the Director of the 
Centers for Disease Control and Prevention, shall submit to the 
Committee on Energy and Commerce of the House of Representa-
tives, and to the Committee on Labor and Human Resources of 
the Senate, a report describing the activities carried out under 
this part during the preceding 2 fiscal years. Such report shall 
include a description of such activities that were carriea out with 
respect to interpersonal violence within families and among 
acquaintances and with respect to rural areas.". 
SEC. 203. TECHNICAL CORRECTIONS. 
(a) TERMINOLOGY.—Part J of title III of the Public Health 
Service Act (42 U.S.C. 280b et seq.), as redesignated by section 
2008(iX2XBXi) of Public Law 103-43 (107 Stat. 213), is amended— 
(1) in the heading for such part, by striking "INJURY CON-
TROL" and inserting 'TREVENTION AND CONTROL OF INJURIES"; 
and 
42 use 280b-i. 
(2) in section 392— 
(A) in the heading for such section, by inserting 
"PREVENTION AND" before "
C
O
N
T
R
O
L ACTIVITIES"; 
(B) in subsection (aXD, by inserting "and control" afi^er 
"prevention"; and 
(C) in subsection (bXl), by striking "ii^uries and imury 
control" and inserting Hhe prevention and control of 
injuries". 
(b) PROVISIONS RELATING TO PUBUG LAW 102-531.—Part J 
of title III of the PubUc Health Service Act (42 U.S.C. 280b et 
seq.), as amended by section 301 of Public Law 102-531 (106 
Stat. 3482) and as redesignated by section 2008(iX2XBXi) of Public 
Law 103-43 (107 Stat. 213), is amended— 
(1) in section 392(bX2), by striking "to promote ii\jury con-
trol" and all that follows and inserting "to promote activities 
regarding the prevention and control of ii^juries; and"; and 
42 use 280b. 
(2) in section 391(b), by adding at the end the following 
sentence: "In carrying out the preceding sentence, the Secretary 
shall disseminate such information to the public, including 
through elementary and secondary schools.". 
PUBLIC LAW 103-183—DEC. 14, 1993 
107 STAT. 2233 
SEC. 204. AUTHOBIZATION OF APPBOPRIATIONa 
Section 394A of the Public Health Service Act, as redesignated 
by section 201(1) of this Act, is amended by striking To carry 42 use 280b-3. 
out" and all that follows and inserting the following: Tor the 
purpose of carrying out this part, there are authorized to be appro-
priated $50,000,0(X) for fiscal year 1994, and such sums as may 
be necessary for each of the fiscal years 1995 through 1998. . 
TITLE in—TUBERCULOSIS 
SEC. 301. PREVENTIVE 
HEALTH 
SERVICES 
REGARDING 
TUBEIU 
CULOSia 
(a) IN GENERAL.—Part B of title III of the Public Health Service 
Act (42 U.S.C. 242 et iseq.), as amended by section 308 of Public 
Law 102-531 (106 Stat. 3495), is amended by inserting after section 
317D the following section: 
''PREVENTIVE HEALTH SERVICES REGARDING TUBERCULOSIS 
"SEC 317E. (a) IN GENERAL.—The Secretary, acting through 42 use 247b-6. 
the Director of the Centers for Disease Control and Prevention, 
may mcdce grants to States, political subdivisions, and other public 
entities for preventive health service programs for the prevention, 
control, and elimination of tuberculosis. 
"(b) RESEARCH, DEMONSTRATION PROJECTS, EDUCATION, AND 
TRAINING.—^With respe<:t to the prevention, control, and elimination 
of tuberculosis, the Secretary may, directly or through grants to 
public or nonprofit private entities, carry out the following: 
"(1) Research, with priority given to research concerning 
strains of tuberculosis resistant to drugs and research concern-
ing cases of tuberculosis that affect certain populations. 
"(2) Demonstration projects. 
"(3) Public information and education programs. 
"(4) Education, training, and clinical skills improvement 
activities for health professionals, including allied health 
personnel and emergency response employees. 
"(5) Support of centers to carry out activities under para-
graphs (1) through (4). 
"(6) (Collaboration with international organizations and for-
eign countries in carryingout such activities. 
"(c) COOPERATION WITH PROVIDERS OF PRIMARY HEALTH SERV-
ICES.—^The Secretory may make a grant imder subsection (a) or 
(b) only if the applicant for the grant agrees that, in carrying 
out activities under the grant, the applicant will cooperate with 
public and nonprofit private providers of primary health services 
or substance abuse services, including entities receiving assistonce 
under section 329, 330, 340, or 340A or under title V or XIX. 
"(d) APPUCATION FOR GRANT.— 
"(1) IN GENERAL.—^The Secretary may make a grant under 
subsection (a) or ('b) only if an application for the grant is 
submitted to the S<H:retery and the application, subject to para-
graph (2), is in such form, is made in such manner, and contoins 
such agreemente, assurances, and information as the Secretaiy 
determines to be necessary to carry out the subsection involved. 
"(2) PLAN FOR PREVENTION, CONTROL, AND ELIMINATION.— 
The Secretary may make a grant imder subsection (a) only 
107 STAT. 2234 
PUBLIC LAW 103-183—DEC. 14, 1993 
Establishment. 
Appropriation 
authorizations. 
if the application under paragraph (1) contains a plan regarding 
the prevention, control, and elimination of tuberculosis in the 
geographic area with respect to which the grant is sought, 
"(e) SUPPLIES AND SERVICES IN LIEU OF GRANT FUNDS.— 
"(1) IN GENERAL.—^Upon the request of a grantee under 
subsection (a) or (b), the Secretary may, subject to paragraph 
(2), provide supplies, eiquipment, and services for the purpose 
of aiding the grantee in carrying out the subsection involved 
and, for such purpose, may detail to the State any officer 
or employee of the Department of Hecdth and Human Services. 
"(2) CORRESPONDING REDUCTION IN PAYMENTS.—With 
respect to a request described in paragraph (1), the Secretary 
shall reduce the amount of payments under the grant involved 
by an amount equal to the costs of detailing personnel and 
the fair market value of any supplies, equipment, or services 
provided by the Secretary. The Secretanr snail, for the pajrment 
of expenses incurred in complying with such request, expend 
the amounts withheld. 
"(0 ADVISORY COUNCIL.— 
"(1) IN GENERAL.—^The Secretary shall establish an advisory 
council to be known as the Advisory Council for the Elimination 
of Tuberculosis (in this subsection referred to as the "Council"). 
"(2) GENERAL DUTIES.—^The Council shall provide advice 
and recommendations regarding the elimination of tuberculosis 
to the Secretary, the Assistant Secretary for Health, and the 
Director of the Centers for Disease Control and Prevention. 
"(3) CERTAIN ACTIVITIES.—With respect to the elimination 
of tuberculosis, the Council shall— 
"(A) in making recommendations under paragraph (2), 
make recommendations regarding policies, strategies, objec-
tives, and priorities; 
"(B) address the development and application of new 
technologies; and 
"(C) review the extent to which progress has been 
made toward eliminating tuberculosis. 
"(4) COMPOSITION.—^The Searetary shall determine the size 
and composition of the Council, and the frequency and scope 
of official meetings of the Council. 
"(5) STAFF, INFORMATION, AND OTHER ASSISTANCE.—The 
Secretary shall provide to the Council such staff, information, 
and other assistance as may be necessary to carry out the 
duties of the Council. 
"(g) FUNDING.— 
"(1) IN GENERAL; ALLOCATION FOR EMERGENCY GRANTS.— 
"(A) For the purpose of making grants under subsection 
(a), there are authorized to be appropriated $200,000,000 
for fiscal year 1994, and such sums as may be necessary 
for each of the 
fiscal 
years 1995 through 1998. 
"(B) Of the amounts appropriated under subparagraph 
(A) for a fiscal year, the Secretary may reserve not more 
than $50,000,0(J0 for emergency grants under subsection 
(a) for any geographic area in which there is, relative 
to other areas, a substantial number of cases of tuberculosis 
or a substantial rate of increase in such cases. 
"(2) RESEARCH, DEMONSTRATION PROJECTS, EDUCATION, AND 
TRAINING.—For the purpose of making grants imder subsection 
(b), there are authorized to be appropriated such sums as 
PUBLIC LAW 103-183—DEC. 14, 1993 
107 STAT. 2235 
may be necessary for each of the fiscal years 1994 through 
1998.". 
(b) CONFORMING AMENDMENTS.—Section 317 of the Public 
Health Service Act (42 U.S.C. 247b) is amended— 
(1) in subsection (j)— 
(A) by striking paragraph (2); 
(B) by striking "(jXlXA)" and inserting "XiXir; 
(C) by strikmg "(B) For grants" and inserting "(2) For 
grants"; and 
(D) in paragraph (1) (as so redesignated), by striking 
"established ini subparagraph (B)" and inserting "estab-
lished in parag]raph (2)"; 
(2) in subsection (k)— 
(A) by striking paragraph (2); 
(B) by redesignating paragraphs (3) through (5) as 
paragraphs (2) through (4), respectively; and 
(C) in paragraph (4) (as so redesignated), by striking 
"of section 317" each place such term appears; and 
(3) by striking subsection (1). 
SEC. 302. RESEARCH TEIROUGH NATIONAL INSTITUTE OF ALLERGY 
AND INFECTIOUS DISEASES. 
(a) CERTAIN DUTIES.—Subpart 6 of part C of title IV of the 
Public Health Service Act (42 U.S.C. 285f) is amended by inserting 
after section 446 the following section: 
"RESEARCH AND RESEARCH TRAINING REGARDING TUBERCULOSIS 
"SEC. 447. (a) In carrying out section 446, the Director of 42USC285f-2. 
the Institute shall conduct or support research and research train-
ing regarding the cause, diagnosis, early detection, prevention and 
treatment of tuberculosis. 
"(b) For the purpose of carrying out subsection (a), there are Appropriation 
authorized to be appropriated |50,000,000 for fiscal year 1994, 
and such sums as may be necessary for each of the fiscal years 
1995 through 1998. Such authorization is in addition to any other 
authorization of appropriations that is available for such purpose.". 
SEC. 303. RESEARCH THROUGH THE FOOD AND DRUG ADMINISTRA- 42 USC 285f-2 
TION. 
^°^-
The Secretary of Health and Human Services, acting through 
the Commissioner of Food and Drugs, shall implement a tuber-
culosis drug and device research program imder which the Commis-
sioner may— 
(1) provide assistance to other Federal agencies for the 
development of tuberculosis protocols; 
(2) review and evaluate medical devices designed for the 
diagnosis and control of airborne tuberculosis; and 
(3) conduct research concerning drugs or devices to be 
used in diagnosing, controlling and preventing tuberculosis. 
authorization. 
107 STAT. 2236 
PUBLIC LAW 103-183—DEC. 14, 1993 
TITLE IV—SEXUALLY TRANSMITTED 
DISEASES 
SEC. 401. EXTENSION OF PROGRAM OF GRANTS REGARDING PREVEN-
TION AND CONTROL OF SEXUALLY TRANSMITTED DIS-
EASES. 
(a) INNOVATIVE, INTERDISCIPLINARY APPROACHES.—Section 318 
of the Public Health Service Act (42 U.S.C. 247c(dXl)) is amended— 
(1) by redesignating subsection (d) as subsection (e); and 
(2) by inserting after subsection (c) the following subsection: 
"(d) The Secretary may make grants to States and political 
subdivisions of States for the development, implementation, and 
evaluation of innovative, interdisciplinary approaches to the preven-
tion and control of sexually transmitted (Useases.". 
(b) AUTHORIZATION OF APPROPRIATIONS.—Section 318(e) of the 
Public Health Service Act, as redesignated by subsection (aXD 
of this section, is amended by amending paragraph (1) to read 
as follows: "(1) For the purpose of making grants under subsections 
(b) through (d), there are authorized to be appropriated $85,000,000 
for fiscal year 1994, and such sums as may be necessary for each 
of the fiscal years 1995 through 1998.". 
(c) TECHNICAL CORRECTIONS.—Section 318 of the Public Health 
Service Act, as amended by subsection (a) of this section, is 
amended— 
(1) in subsection (bX3), by striking ", and" and inserting 
*
•
; and"; 
(2) in subsection (cX3), by striking ", and" and inserting 
"; and"; and 
(3) in subsection (dX5)— 
(A) in subparagraph (A), by striking Torm, or" and 
i 
inserting Torm; or"; and 
^ • • 
(B) in subparagraph (B), by striking "purposes," and 
inserting "purposes; . 
SEC. 402. EXTENSION OF PROGRAM REGARDING 
PREVENTABLE 
CASES OF INFERTILITY ARISING AS RESULT OF SEXUALLY 
TRANSMITTED DISEASES. 
(a) TECHNICAL CORRECTIONS.—Section 318A of the Public 
Health Service Act (42 U.S.C. 247c-l), as added by section 304 
of Public Law 102-531 (106 Stat. 3490), is amended in subsection 
(oX2) by striking "subsection (s)" and inserting "subsection (q)". 
(b) AUTHORIZATION OF APPROPRIATIONS.—Section 318A of the 
Public Health Service Act (42 U.S.C. 247c-l), as added by section 
304 of Public Law 102-531 (106 Stat. 3490), is amended— 
(1) in subsection (q), by striking "and 1995" and inserting 
"through 1998"; and 
(2) in subsection (rX2), by striking "through 1995" and 
inserting "through 1998". 
PUBLIC LAW 103-183—DEC. 14, 1993 
107 STAT. 2237 
TITLE V—NATIONAL CENTER FOR 
HEALTH STATISTICS 
SEC. 501. REVISION AND EXTENSION OF PROGRAMS. 
(a) IN GENERAL.~-Section 306 of the Public Health Service 
Act (42 U.S.C. 242k) is amended— 
(1) in subsection (c), by striking "Committee on Human 
Resources" and inserting "Committ^ on Labor and Human 
Resources"; 
(2) in subsection (g), by striking "data which shall be pub-
lished" and all that follows and inserting "data."; 
(3) in subsection (i), by striking "engaged in health planning 
activities"; 
(4) in subsection (kX2)— 
(A) in subparagraph (A), in the last sentence, by strik-
ing 'Except" and c
Q
l that follows through "members" and 
inserting Members"; 
(B) by striking subparagraph (B); and 
(C) by striking the remaining subparagraph designa-
tion; and 
(5XA) by striking subsection (1); 
(B) by redesignating subsections (m) through (o) as sub-
sections (1) through (n), respectively; 
(C) in subsection (1) (as so redesignated), in the last sen-
tence, b^ striking "(n)" and inserting "(m)"; and 
(D) in subsection (n) (as so redesignated)— 
(i) in paragraph (1), by striking "(m)" and inserting 
"(1)"; and 
(ii) in paragraph (2)— 
(I) by striking "(n)" and inserting "(m)"; and 
(II) by striking "(nX2)" and inserting "(mX2)". 
(b) GENERAL AUTHORITY RESPECTING RESEARCH, EVALUATIONS, 
A
N
D DEMONSTRATIONS.—Section 304 of the Public Health Service 
Act (42 U.S.C. 242b) is amended by striking subsection (d). 
(c) GENERAL PROMSIONS RESPECTING EFFECTIVENESS, EFFI-
CIENCY, A
N
D QUALITY OF HEALTH SERVICES.—Section 308 of the 
Public Health Service Act (42 U.S.C. 242m) is amended— 
(1) in subsection (a)— 
(A) in paragraph (1)— 
(i) by striking subparagraph (A); and 
(ii) by redesignating subparagraphs (B) through 
(E) as subpcuragraphs (A) through (D), respectively; 
and 
(B) in paragraph (2), by striking "reports required by 
subparagraphs" and all that follows through "Center" and 
inserting the following: "reports required in paragraph (1) 
shall be prepared through the National Center*; 
(2XA) by striking subsection (c); 
(B) by transferring paragraph (2) of subsection (g) from 
the current location of the paragraph; 
(C) by redesignating such paragraph as subsection (c); 
(D) by inserting subsection (c) (as so redesignated) after 
subsection (b); and 
(E) by striking the remainder of subsection (g); 
(3) in subsection (c) (as so redesignated)— 
107 STAT. 2238 
PUBLIC LAW 103-183—DEC. 14, 1993 
(A) by striking "shall (A) take" and inserting "shall 
take"; and 
(B) by striking "and (B) publish" and inscribing "and 
shall publish"; 
(4) in subsection (f), by striking "sections 3648" and all 
that follows and inseri;ing the following: "section 3324 of title 
31, United States Code, and section 3709 of the Revised Stat-
utes (41 U.S.C. 5)."; and 
(5) by striking subsection (h). 
(d) AUTHORIZATION OF APPROPRIATIONS.—Section 306(ri) of the 
42 use 242k. 
Public Health Service Act, as redesignated by subsection (aX5XB), 
is amended— 
(1) in paragraph (1), by striking "through 1993" and insert-
ing "through 1998**; and 
(2) in paragraph (2), in the first sentence— 
(A) by striking "and" after "1992,"; and 
(B) by inserting before the period the following: ", 
and $10,000,000 for each of the fiscal years 1994 through 
1998". 
TITLE VI—TRAUMA CARE SYSTEMS 
SEC. 601. REVISIONS IN PROGRAMS RELATING TO TRAUMA CARE. 
(a) GENERAL AUTHORITY.—Section 1201 of the Public Health 
Service Act (42 U.S.C. 300d) is amended— 
(1) in subsection (a), in the matter preceding paragraph 
(1), by inserting after "Secretarjr" the following: ", acting 
through the Administrator of the Health Resources and Services 
Administration,"; and 
(2) by adding at the end the following subsection: 
"(c) ADMINISTRATION.—The Administrator 
of the 
Health 
Resources and Services Administration shall ensure that this title 
is administered by the Division of Trauma and Emergency Medical 
Systems within such Administration. Such Division shall be headed 
by a director appointed by the Secretary from among individuals 
who are knowledgeable by training or experience in the development 
and operation of trauma and emergency medical systems.". 
(b) ADVISORY COUNCIL.—Section 1201 of the Public Health Serv-
ice Act (42 U.S.C. 300d) is amended— 
42 use 300d-l. 
(1) by striking section 1202; and 
(2) by redesignating sections 1203 and 1204 as sections 
42 use 300d-2, 
1202 and 1203, respective^; 
^^^•^ 
(c) REPORTS BY STATES; EVALUATIONS BY COMPTROLLER GEN-
ERAL.—Section 1216(c) of the PubUc Health Service Act (42 U.S.C. 
300d-16) is amended by striking "1993" and inserting "1994". 
(d) REPORT BY SECRETARY.—Section 1222 of the Public Health 
Service Act (42 U.S.C. 300d-22) is amended— 
(1) in the first sentence, by striking "1992" and inserting 
"1995"; and 
(2) by inserting afl^r the first sentence the following sen-
tence: "Such report shall include an assessment of the extent 
to which Federal and State efforts to develop systems of trauma 
care and to designate trauma centers have reduced the 
incidence of mortality, and the incidence of permanent disabil-
ity, resulting 
firom 
trauma.". 
PUBLIC LAW 103-183—DEC. 14, 1993 
107 STAT. 2239 
(e) WAIVER REGARDING PURPOSE OF GRANTS.—Section 1233 
of the Public Health Service Act (42 U.S.C. 300d-33) is repealed. 
(f) TECHNICAL CORRECTIONS.—Title XII of the Public Health 
Service Act (42 U.S.C. 300d et seq.) is amended— 
(1) in section 1204(c), by inserting before the period the 42 USC 300d-3. 
following: "determines to be necessary to carry out this section"; 
(2) in section 1212(aX2XA), by striking "1211(cr and insert- 42 USC 300d-12. 
ing"1211(br; 
(3) in section 1213(a)— 
42 USC 300d-l3. 
(A) in paragraph (4), by striking "Act" and inserting 
"Act)"; 
(B) in paragraphs (8) and (9), by striking "to provide" 
each place such term appears and inserting "provides for"; 
and 
(C) in paragraph (10), by striking "to conduct" and 
inserting "conducts"; and 
(4) in section 1231(3), by striking "Rico;" and insertmg 42 use 300d-3l. 
"Rico,". 
SEC. 602. AUTHORIZATION OF APPROPRIATIONS. 
Section 1232(a) of the PubUc Health Service Act (42 U.S.C. 
300d-32(a)) is amended by striking "for the purpose" and all that 
follows and inserting tlie following: "For the purpose of carrying 
out parts A and B, there are authorized to be appropriated 
$6,000,000 for fiscal year 1994, and such sums as may be necessary 
for each of the fiscal yeara 1995 and 1996.". 
TITLE VII—MISCELLANEOUS 
PROVISIONS 
SEC. 701. EVALUATIONS. 
Effective October 1, 1994, section 241 of the Public Health Effective date. 
Service Act (42 U.S.C. 238j), as transferred and redesignated by 
section 2010(a) of Public Law 103-43 (107 Stat. 213), is amended 
to read as follows: 
"EV.\LUATION OF PROGRAMS 
"SEC. 241. (a) IN GENERAL.—Such portion as the Secretary 
shall determine, but not less than 0.2 percent nor more than 1 
percent, of any amounts appropriated for programs authorized 
under this Act shall be made available for the evaluation (directly, 
or by grants of contracts) of the implementation and effectiveness 
of such programs. 
"(b) REPORT ON EVALUATIONS.—Not later than February 1 of 
each year, the Secretary' shall prepare and submit to the Committee 
on Labor and Human llesources of the Senate and the Committee 
on Energy and Commerce of the House of Representatives a report 
summarizing the findings of the evaluations conducted imder sub-
section (a).". 
SEC 702. FEDERAL BENEFITS FOR OVERSEAS ASSIGNEES. 
Section 307 of the Public Health Service Act (42 U.S.C. 2421) 
is amended by adding at the end thereof the following new sub-
section: 
"(c) The Secretary may provide to personnel appointed or 
assigned by the Secretary to serve abroad, allowances and benefits 
107 STAT. 2240 
PUBLIC LAW 103-183—DEC. 14, 1993 
similar to those provided under chapter 9 of title I of the Foreign 
Service Act of 1990 (22 U.S.C. 4081 et seq.). Leaves of absence 
for personnel under this subsection shall be on the same basis 
as that provided under subchapter I of chapter 63 of title 5, United 
States Code, to individuals serving in the Foreign Service.". 
SEC. 
7
0
3
. 
LOAN 
REPAYMENT 
PROGRAM. 
Part B of title III of the Public Health Service Act, as amended 
! 
by section 301 of this Act, is amended by inserting after section 
317E the following section: 
"LOAN REPAYMENT PROGRAM 
42 use 247b-7. 
«SEC. 317F. (a) IN GENERAL.— 
"(1) AUTHORITY.—Subject to paragraph (2), the Secretary 
may carry out a program of entering into contracts with appro-
I 
priately qualified health professionals under which such health 
professionals agree to conduct prevention activities, as employ-
ees of the Centers for Disease Control and Prevention and 
the Agency for Toxic Substances and Disease Registry, in 
consideration of the Federal Government agreeing to repay, 
for each year of such service, not more than $20,000 of the 
principal and interest of the educational loans of such health 
professionals. 
"(2) LIMITATION.—^The Secretary may not enter into an 
agreement with a health professional pursuant to paragraph 
(1) imless such professional— 
"(A) has a substantial amoimt of educational loans 
relative to income; and 
"(B) agrees to serve as an employee of the Centers 
" ' f o r Disease Control and Prevention or tne Agency for Toxic 
Substances and Disease Registry for purposes of paragraph 
(1) for a period of not less than 3 years. 
"(b) APPLICABILITY OF CERTAIN PROVISIONS.—With respect to 
the National Health Service Corps Loan Repa3nnent Program estab-
lished in subpart III of part D of title III of this Act, the provisions 
of such subpart shall, except as inconsistent with subsection (a), 
apply to the program established in this section in the same manner 
and to the same extent as such provisions apply to the National 
Health Service Corps Loan Repayment Program. 
"(c) AUTHORIZATION OF APPROPRIATIONS.—For the piupose of 
canying out this section, there are authorized to be appropriated 
$500,000 for fiscal year 1994, and such sums as may be necessary 
for each of the fiscal years 1995 through 1998.". 
SEC. 704. ESTABUSHMENT OF REQUIREMENT OF BIENNIAL REPORT 
ON NUTRITION AND HEALTH. 
Title XVII of the Public Health Service Act (42 U.S.C. 300u 
et seq.), as amended by section 302 of Public Law 102-531 (106 
Stat. 3483), is amended by adding at the end the following section: 
"BIENNIAL R
E
P
O
R
T REGARDING NUTRITION AND HEALTH 
42 use 300U-8. 
"SEC. 1709. (a) BIENNIAL REPORT.—The Secretary shall require 
the Surgeon (jeneral of the Public Health Service to prepare 
biennial reports on the relationship between nutrition and health. 
Such reports may, with respect to such relationship, include any 
recommendations of the Secretary and the Surgeon (jeneral. 
PUBLIC LAW 103-183—DEC. 14, 1993 
107 STAT. 2241 
"(b) SUBMISSION TO CONGRESS.—The Secretary shall ensure 
that, not later than February 1 of 1995 and of every second year 
thereafter, a report under subsection (a) is submitted to the Commit-
tee on Energy and Commerce of the House of Representatives 
and the Committee on Labor and Human Resources of the Senate.". 
SEC. 706. AUGNMENT OF CURRENT CENTERS FOR DISEASE CONTROL 
AND PREVENTION REAUTHORIZATION SCHEDULE. 
(a) SCREENINGS, EDUCATION, AND REFERRALS REGARDING LEAD 
POISONING.—Section 317A(1X1) of the Public Health Service Act 
(42 U.S.C. 247b-l(lXl)) is amended by striking "through 1997" 
and inserting 'through 1998". 
(b) PROSTATE CANCER PREVENTION.—Section 317D((1X1) of the 
Public Health Service Act (42 U.S.C. 247b-5(lXl)) is amended by 
striking "through 1996" and inserting "through 1998". 
(c) CANCER REGISTRIES.—Section 399L(a) of the Public Health 
Service Act (42 U.S.C. 280e-4(a)) (as amended by section 2003(1) 
of Public Law 103-43) is amended by striking "through 1996" 
and inserting "through 1998". 
(d) HEALTH PROMOTION AND DISEASE PREVENTION RESEARCH 
A
N
D DEMONSTRATION CENTERS.—Section 1706(e) of the Public 
Health Service Act (42 U.S.C. 300u-5(e)) is amended by striking 
"through 1996" and insijrting "through 1998". 
(e) TITLE XIX PRO<3RAM.—Section 1901(a) of the Public Health 
Service Act (42 U.S.C. 300w(a)) is amended by striking "through 
1997" and inserting "through 1998". 
(f) SENSE OF CONGRESS REGARDING SCHEDULE FOR LEGISLA-
TION.—^It is the sense of the Congress that, during the fiscal years 
1994 through 1997, authorizations of appropriations for the pro-
grams of the Centers for Disecise Control and Prevention should 
be provided only through fiscal year 1998, and that for fiscal year 
1999 and subsequent fiscal years such programs, when considered 
by the Con^ss through legislation providing 
fiirther 
authorizations 
of appropriations, should be so considered during a single year. 
SEC. 706. MISCELLANEOUS PAYMENT PROVISIONS 
(a) PAYMENT OF CERTAIN JUDGMENTS.—Section 224(kX2) of the 
Public Health Service Act (42 U.S.C. 233(kX2)), as added by section 
4 of the Federally Supported Health (Centers Assistance Act of 
1992, is amended by adding at the end thereof the following new 
sentence: "Appropriations for purposes of Uiis paragraph shall be 
made separate from appropriations made for purposes of sections 
329, 330, 340 and 340A.'*. 
(b) COMPENSATION REGARDING CERTAIN ADVISORY COUNCIL.— 
Section 337(bX2) of the Public Health Service Act (42 U.S.C. 
254j(bX2) is amended— 
(1) by inserting before "the daily equivalent" the following: 
"compensation at a rate fixed by the Secretary (but not to 
exceed"; and 
(2) by striking "Schedule;" and inserting "Schedule);". 
SEC. 707. INTERIM FINAI. REGULATIONS. 
42 USC 263b 
The Secretary of Health and Human Services is authorized 
to issue interim final regulations— 
(1) under which the Secretary may approve accreditation 
bodies under section 354(e) of the Public Health Service Act 
(42 U.S.C. 263b(e)); and 
107 STAT. 2242 
PUBLIC LAW 103-183—DEC. 14, 1993 
(2) establishing quality standards under section 354(f) of 
the Public Healtii Service Act (42 U.S.C. 263b(f)). 
SEC. 708. SIMPLIFICATION OF VACCINE INFORMATION MATERIALS. 
(a) INFORMATION.—Section 21260>) of the Public Health Service 
Act (42 U.S.C. 300aa-26(b)) is amended— 
(1) by striking 'i)y rule" in the matter preceding paragraph 
(1); and 
(2) by striking, in paragraph (1), ", opportunity for a public 
hearing, and 90" and inserting "and 60". 
(b) REQUIREMENTS.—Section 2126(c) of the Public Health Serv-
ice Act (42 U.S.C. 300aa-26(c)) is amended— 
(1) by inserting "shall be based on available data and 
information," after such materials" in the matter preceding 
paragraph (1); and 
(2) b}r striking paragraphs (1) through (10) and inserting 
the following: 
"(1) a concise description of the benefits of the vaccine, 
"(2) a concise description of the risks associated with the 
vaccine, 
"(3) a statement of the availability of the National Vaccine 
Ii\jury Compensation Program, and 
"(4) such other relevant information as may be determined 
by the Secretary.". 
(c) OTHER INDIVIDUALS.—Subsections (a) and (d) of section 2126 
of the Public Health Service Act (42 U.S.C. 300aa-26) are each 
amended by inserting "or to any other individual" after "to the 
legal representatives of any child". 
(d) PROVIDERS DUTIES.—Subsection (d) of section 2126 of the 
Public Health Service Act (42 U.S.C. 300aa-26) is amended— 
(1) by striking all after "subsection (a)," the second place 
it appears in the first sentence and inserting "supplemented 
with visual presentations or oral explanations, in appropriate 
cases."; and 
(2) by striking "or other information" in the last sentence. 
Approved December 14, 1993. 
LEGISLATIVE HISTORY—H.R. 2202 (S. 1002) (S. 1318): 
HOUSE REPORTS: Nos. 103-120 (Comm. on Energy and Commerce) and 103-397 
(Comm. of Conference). 
S E N A T E REPORTS: No. 103-135 accompanying S. 1318 (Comm. on Labor and Human 
RGsourcGs) 
CONGRESSIONAL RECORD, Vol. 139 (1993): 
June 14, considered and passed House. 
Nov. 2, considered and passed Senate, amended. 
Nov. 21, House agreed to conference report. 
Nov. 22, Senate agreed tp conference report. 
WEEKLY COMPILATION OF PRESIDENTIAL DOCUMENTS, Vol. 29 (1993): 
Dec. 16, Presidential statement.