An Act to amend title 1X of the Public Health Service Act so as to extend and improve the existing program relating to education, research, training, and demonstrations in the fields of heart disease, cancer, stroke, and other major diseases and conditions, and for other purposes
PL 91-515 (H.R.17570), enacted 10/30/1970

84 STAT. ] 
PUBLIC LAW 91-515-OCT. 30, 1970 
1297 
SEC. 2. The first sentence of section 3(a) of such Act of May 20, 
1964 (16 U.S.C. 1083), is amended to read as follows: "Enforcement 
of the provisions of this Act is the joint responsibility of the Secre-
tary of the Interior, the Secretary of the Treasury, and the Secretary 
of the Department in which the Coast Guard is operating, and each 
such Secretary may, by agreement with any other Federal department 
or agency, utilize the equipment (including aircraft and vessels) of 
that department or agency to carry out such enforcement." 
SEC. 3. Such Act of May 20, 1964 (16 U.S.C. 1081-1085), is further 
amended by adding at the end thereof the following new subsection: 
"SEC. 6. The Secretary of the Treasury may pay to any person, other 
than an officer of the United States or a person authorized to function 
as a Federal law enforcement agent under this Act, compensation of 
not more than $5,000 if such person submits to any such officer or 
authorized person original information concerning any violation, per-
petrated or contemplated, of this Act and such information leads to any 
penalty or forfeiture incurred for violation of this Act." 
Approved October 27, 1970. 
Enforcement 
responsibility. 
78 Stat. 195. 
Informers, reward. 
Public Law 91-515 
AN ACT 
October 30, 1970 
To amend titles III and IX of the Public Health Service Act so as to revise, 
[H. R. 17570.1 
extend, and improve the programs of research, investigation, education, 
training, and demonstrations authorized thereunder, and for other purposes. 
Be it enacted hy the Senate and House of Representatives 
of the 
United States of America in Congress assembled, 
TITLE I—AMENDMENTS TO TITLE I X OF T H E PUBLIC 
HEALTH SERVICE ACT 
Public Health 
Service Act, 
amendments. 
SEC. 101. This title may be cited as the "Heart Disease, Cancer, 4^^^^*^"°" °^ 
Stroke, and Kidney Disease Amendments of 1970". 
SEC. 102. Section 900 of the Public Health Service Act is amended 
79 stat. 926. 
to read as follows: 
42 use 299. 
"PURPOSES 
"SEC. 900. The purposes of this title are— 
"(a) through grants and contracts, to encourage and assist in 
the establishment of regional cooperative arrangements among 
medical schools, research institutions, and hospitals for research 
and training (including continuing education), for medical data 
exchange, and for demonstrations of patient care in the fields of 
heart disease, cancer, stroke, and kidney disease, and other 
related diseases; 
1298 
PUBLIC LAW 91-515-OCT. 30, 1970 
[84 STAT. 
Appropriations. 
79 Stat. 926; 
82 Stat» 1005. 
42 u s e 299a. 
Funds, limita-
tion. 
"(b) to afford to the medical profession and the medical insti-
tutions of the Nation, through such cooperative arrangements, 
the opportunity of making available to their patients the latest 
advances in the prevention, diagnosis, and treatment and reha-
bilitation of persons suffering from these diseases; 
"(c) to promote and foster regional linkages among health 
care institutions and providers so as to strengthen and improve 
primary care and the relationship between specialized and pri-
mary care; and 
"(d) by these means, to improve generally the qualitj^ and 
enhance the capacity of the health manpower and facilities 
available to the Nation and to improve health services for 
persons residing in areas with limited health services, and to 
accomplish these ends without interfering with the patterns, 
or the methods of financing, of patient care or professional 
practice, or with the administration of hospitals, and in cooper-
ation with practicing physicians, medical center officials, hospi-
tal 
administrators, 
and 
representatives 
from 
appropriate 
voluntary health agencies." 
SEC. 103. (a)(1) The jfirst sentence of section 901(a) of such 
Act is amended by striking out "and" immediately after "June 30, 
1969,", and 
by 
inserting 
immediately 
before 
", for 
grants" 
the following: ", $125,000,000 for the fiscal year ending June 30, 1971, 
$150,000,000 for the fiscal year ending June 30,1972, and $250,000,000 
for the fiscal year ending June 30,1973". 
(2) Such first sentence is further amended by striking out the period 
after "title" and inserting in lieu thereof "and for contracts to carry 
out the purposes of this title." 
(3) Such section 901(a) is amended by striking out the second 
sentence and inserting in lieu thereof the following: "Of the sums 
appropriated under this section for the fiscal year endmg June 30,1971, 
not more than $15,000,000 shall be available for activities in the field 
of kidney disease. Of the sums appropriated under this section for any 
fiscal year ending after June 80, 1970, not more than $5,000,000 may 
be made available in any such fiscal year for grants for new 
construction." 
(b) Section 901 of such Act is further amended by adding at the 
end thereof the following new subsection: 
"(e) At the request of any recipient of a grant under this title, the 
payments to such recipient may be reduced by the fair market value of 
any equipment, supplies, or services furnished by the Secretary to such 
recipient and by the amount of the pay, allowance, traveling expenses, 
and any other costs in connection with the detail of an officer or em-
ployee of the Government to the recipient when such furnishing or 
such detail, as the case may be, is for the convenience of and at the 
request of such recipient and for the purpose of carrying out the 
regional medical program to which the grant under this title is made." 
84 STAT.] 
PUBLIC LAW 91-515-OCT. 30, 1970 
1299 
SEC. 104. Section 902(a) of such Act is amended by striking out 
"training, diagnosis, and treatment relating to heart disease, cancer, 
or stroke, and, at the option of the applicant, related disease or 
diseases'' and inserting in lieu thereof "training, prevention, diagnosis, 
treatment, and rehabilitation relating to heart disease, cancer, stroke, 
or kidney disease and, at the option of tlie applicant, other related 
diseases'*. 
(b) Section 902(f) is amended by striking out "includes" and 
inserting in lieu thereof "means new construction of facilities for 
demonstrations, research, and training when necessary to cari-y out 
regional medical programs''. 
SEC. 105. Section 903(b) (4) of such Act is amended— 
(1) by striking out "voluntary health agencies, and" and insert-
ing in lieu thereof "voluntary or official health agencies, health 
planning agencies, and"; 
(2) by insei+ing immediately after "under the program", where 
it first appears therein, the following: "(including as an ex officio 
member, if there is located in such region one or more hospitals or 
other health facilities of the Veterans' Administration, the indi-
vidual whom the Administrator of Veterans' Affairs shall have 
designated to serve on such advisory group as the representative 
of the hospitals or other health care facilities of such Admin-
istration which are located in such region)"; and 
(3) by striking out "need for the services provided under the 
program" and inserting in lieu thereof "need for and financing of 
the services provided under the program, and which advisory 
group shall be sufficient in number to insure adequate community 
orientation (as determined by the Secretary)". 
SEC. 106. That part of the second sentence of section 904(b) of such 
Act preceding paragraph (1) is amended by striking out "section 
903(b) (4) and" and inserting in lieu thereof the following: "section 
903(b)(4), if opportunity has been provided, prior to such recom-
mendation, for consideration of the application by each public or non-
profit private agency or organization which has developed a compre-
hensive regional, metropolitan area, or other local area plan referred 
to in section 314(b) covering any area in which the regional medical 
program for which the application is made will be located, and if the 
application". 
SEC. 107. (a) Section 905(a) of such Act is amended to read as 
follows: 
"SEC. 905. (a) The Secretary may appoint, without regard to the 
civil service laws, a National Advisory Council on Regional Medical 
Programs. The Council shall consist of the Assistant Secretary of 
Health, Education, and Welfare for Health and Scientific Affairs, who 
79 Stat. 927; 
82 Stat. 1005. 
42 use 299b. 
42 use 299c. 
42 u s e 299d. 
National Ad-
visory eoiincil on 
Regional Medical 
Programs. 
42 use 299e. 
1300 
PUBLIC LAW 91-515-OCT. 30, 1970 
[84 STAT. 
shall be the Chairman, the Chief Medical Director of the Veterans' 
Administration who shall be an ex officio member, and twenty mem-
bers, not otherwise in the regular full-time employ of the United 
States, who are leaders in the fields of the fundamental sciences, the 
medical sciences, health care administration, or public affairs. At least 
two of the appointed members shall be practicing physicians, one shall 
be outstanding in the study or health care of persons suffering from 
heart disease, one shall be outstanding in the study or health care of 
persons suffering from cancer, one shall be outstanding in the study 
or health care of persons suffering from stroke, one shall be outstand-
ing in the study or health care of persons suffering from kidney 
disease, two shall be outstanding in the field of prevention of heart 
disease, cancer, stroke, or kidney disease, and four shall be members 
of the public." 
Term of office. 
^j^j Q-f ^j^g jpersous first appointed under section 905(a) of the 
Ante, p. 1299. 
Publlc Health Service Act to serve as the four additional members of 
the National Advisory Council on Regional Medical Programs author-
ized by t]\e amendment made by subsection (a) of this section— 
(1) one shall serve for a term of one year, 
(2) one shall serve for a term of two years, 
(3) one shall serve for a term of three years, and 
(4) one shall serve for a term of four years, 
as designated by the Secretary of Health, Education, and Welfare at 
the time of appointment. 
(c) Members of the National Advisory Council on Regional Medical 
Programs (other than the Surgeon General) in office on the date of 
enactment of this Act shall continue in office in accordance with the 
term of office for which they were last appointed to the Council. 
SEC. 108. Section 907 of such Act is amended by striking out "or 
stroke," and inserting in lieu thereof "stroke, or kidney disease,". 
42 use 2991. 
^^^^ -
j
^
Q
g
^ Section 909(a) of such Act is amended by inserting "or 
contract" aft«r "grant" each place it appears therein. 
42 us°c 299?.' 
^^'^' ^^^- (^) Section 910 of such Act is amended to read as follows: 
"MUL'FIPRCMiRAM SKRVTCES 
"SEC. 910. (a) To facilitate interregional cooperation, and develop 
improved national capability for delivery of health services, the Secre-
tary is authorized to utilize funds appropriated under this title to make 
grants to public or nonprofit private agencies or institutions or com-
binations thereof and to contract for— 
"(1) programs, services, and activities of substantial use to 
two or more regional medical programs ; 
"(2) development, trial, or demonstration of methods for con-
trol of heart disease, cancer, stroke, kidney disease, or other related 
diseases; 
"(8) the collection and study of epidemiologic data related to 
any of the diseases referred to in paragraph (2) ; 
"(4) development of training specifically related to the pre-
vention, diagnosis, or treatment of any of the diseases referred 
to in paragraph (2), or to the rehabilitation of persons suffering 
from any of such diseases; and for continuing programs of such 
training where shortage of trained personnel would otherwise 
limit application of knowledge and skills important to the control 
of any of such diseases; and 
"(5) the conduct of cooperative clinical field trials. 
"(b) The Secretary is authorized to assist in meeting the costs of 
special projects for improving or developing new means for the deliv-
ery of health services concerned with the diseases with which this title 
is concerned. 
79 Stat. 930. 
42 u s e 299g. 
84 STAT. ] 
PUBLIC LAW 91-515-OCT. 30, 1970 
1301 
"(c) The Secretary is authorized to support research, studies, 
investigations, training, and demonstrations designed to maximize 
the utilization of manpower in the delivery of health services," 
SEC. 111. (a) The heading to title I X of such Act is amended by 
striking out "STROKE, AND RELATED DISEASES" and insert-
ing in lieu thereof "STROKE, KIDNEY DISEASE, AND OTHER 
RELATED DISEASES". 
(b) Sections 902(a), 903(a), 903(b), 904(a), 904(b), 905(b), 
42 use 299b. 
905 (d), 906, 907, and 909 (a) of such Act (as amended by the preceding ^^^^* ^^^'' 
provisions of this Act) are each further amended by striking out 
"Surgeon General", each place it appears therein and inserting in lieu 
thereof "Secretary". 
TITLE II—AMENDMENTS TO TITLE I I I OF T H E PUBLIC 
HEALTH SERVICE ACT 
PART A—RESEARCH AND DEMONSTRATIONS RELATING TO HEALTH 
FACILITIES AND SERVICES 
SEC. 201. (a) (1) Section 304(a) of the Public Health Service Act 
si stat. 534. 
jj'^^'^ 
^ •' 
42 use 242b. 
IS amended— 
(A) by inserting "(1)" immediately after "SEC. 304. (a)"; 
(B) by redesignating clauses (1) and (2) as clauses (A) and 
(B), respectively; and 
(C) by redesignating clauses (A), (B), and (C) as clauses 
(i), (ii),and (iii), respectively. 
(2) Section 304(b) of such Act is amended— 
(A) by striking out "(b)" and inserting in lieu thereof "(2)"; 
and 
(B) by striking out "this section" each place it appears therein 
and inserting in lieu thereof "this subsection". 
(3) Section 304 (c) of such Act is amended— 
(A) by striking out " (c)" and inserting in lieu thereof "(3)"; 
and 
(B) by striking out "this section" each place it appears therein 
and inserting in lieu thereof "this subsection". 
(b) Section 304 of such Act is further amended by adding after the 
provision thereof redesignated as paragraph (3) by subsection 
(a)(3)(A) of this section the following new subsection: 
"Systems Analysis of National Health Care Plans 
"(b)(1)(A) The Secretary shall develop, through utilization of 
the systems analysis method, plans for health care systems designed 
adequately to meet the health needs of the American people. For 
purposes of the preceding sentence, the systems analysis method 
means the analytical method by which various means of obtaining a 
desired result or goal is associated with the costs and benefits involved. 
"(B) The Secretary shall complete the development of the plans 
referred to in subparagraph (A), within such period as may be neces-
sary to enable him to submit to the Congress not later than Septem- ^,^^f°*'* *° ^°''" 
ber 30, 1971, a report thereon which shall describe each plan so 
developed in terms of— 
"(i) the number of people who would be covered under the 
plan; 
"(ii) the kind and type of health care which would be covered 
under the plan; 
"(iii) the cost involved in carrying out the plan and how such 
costs would be financed; 
gress. 
1302 
PUBLIC LAW 91-515-OCT. 30, 1970 
[84 STAT. 
National health 
insurance plan 
legislation, study. 
Report to Con-
gress. 
Appropriation. 
81 Stat. 534; 
Ante, p. 352. 
42 u s e 242b. 
"(iv) the number of additional physicians and other health 
care personnel and the number and type of health care facilities 
needed to enable the plan to become fully effective; 
"(v) the new and improved methods, if any, of delivery of 
health care services which would be developed in order to effec-
tuate the plan; 
"(vi) the accessibility of the benefits of such plan to various 
socioeconomic classes of persons; 
"(vii) the relative effectiveness and efficiency of such plan as 
compared to existing means of financing and delivering health 
care; and 
"(viii) the legislative, administrative, and other actions which 
would be necessary to implement the plan. 
"(C) In order to assure that the advice and service of experts in 
the various fields concerned will be obtained in the plans authorized 
by this paragraph and that the purposes of this paragraph will fully 
be carried out— 
"(i) the Secretary shall utilize, whenever appropriate, per-
sonnel from the various agencies, bureaus, and other depart-
mental subdivisions of the Department of Health, Education, 
and Welfare; 
"(ii) the Secretary is authorized, with the consent of the head 
of the department or agency involved, to utilize (on a reim-
bursable basis) the personnel and other resources of other de-
partments and agencies of the Federal Government; and 
"(iii) the Secretary is authorized to consult with appropri-
ate State or local public agencies, private organizations, and 
individuals. 
"Cost and Coverage Report on Existing Legislative Proposals 
"(2) (A) The Secretary shall, in accordance with this paragraph, 
conduct a study of each legislative proposal which is introduced in 
the Senate or the House of Representatives during the Ninety-first 
Congress, and which undertakes to establish a national health in-
surance plan or similar plan designed to meet the needs of health 
insurance or for health services of all or the overwhelming majority 
of the people of the United States. 
"(B) In conducting such study with respect to each such legislative 
proposal, the Secretary shall evaluate and analyze such proposal with 
a view to determining— 
" (i) the costs of carrying out the proposal; and 
"(ii) the adequacy of the proposal in terms of (I) the portion 
of the population covered by the proposal, (II) the type health 
care provided, paid for, or insured against under the proposal, 
(III) whether, and if so, to what extent, the proposal provides 
for the development of new and improved methods for the de-
livery of health care and services. 
"(C) Not later than March 31, 1971, the Secretary shall submit to 
the Congress a report on each legislative proposal which he has been 
directed to study under this paragraph, together with an analysis and 
evaluation of such proposal." 
(c) Subsection (d) of section 304 of such Act is hereby redesignated 
as subsection (c) and is amended to read as follows: 
"(c) (1) There are authorized to be appropriated for payment of 
grants or under contracts under subsection (a), and for purposes of 
carrying out the provisions of subsection (b), $71,000,000 for the fiscal 
year ending June 30, 1971 (of which not less than $2,000,000 shall be 
available only for purposes of carrying out the provisions of subsection 
84 STAT. ] 
PUBLIC LAW 91-515-OCT. 30, 1970 
1303 
(b)), $82,000,000 for the fiscal year ending June 30, 1972, and 
$94,000,000 for the fiscal year ending June 30,1973. 
"(2) In addition to the funds authorized to be appropriated under 
paragraph (1) to carry out the provisions of subsection (b) there are 
hereby authorized to be appropriated to carry out such provisions for 
,each fiscal year such sums as may be necessary." 
(d) The amendments made by subsection (c) of this section shall be 
Effective date. 
effective only with respect to fiscal years ending after June 30, 1970. 
SEC. 202. That provision of section 304 of the Public Health Service 
Act redesignated by section 201(a) of this Act as paragraph (3) of 
-An'©, p. 1301. 
subsection (a) is further amended— 
(1) by inserting " (A)" immediately after " (3)''; and 
(2) by adding after and below such provision the following 
new subparagraph: 
"(B) The amounts otherwise payable to any person under a grant 
or contract made under this subsection shall be reduced by— 
"(i) 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 
"(ii) 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 such 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." 
SEC. 203. That provision of section 304 of the Public Health Service 
Act redesignated by section 201(a) of this Act as paragraph (1) of 
subsection (a) is further amended by— 
(1) striking out the period at the end thereof and inserting in 
lieu thereof ", and"; and 
(2) adding after and below the clause thereof redesignated by 
such section 201(a) as clause (iii) the following new clauses: 
"(iv) projects for research, experiments, and demonstrations 
dealing with the effective combination or coordination of public, 
private, or combined public-private methods or systems for the 
delivery of health services at regional. State, or local levels, and 
"(v) projects for research and demonstrations in the provision 
of home health services." 
PART B—NATIONAL HEALTH SURVEYS AND STUDIES 
SEC. 210. (a)(1) Clause (1) of subsection (a) of section 305 of the 
Public Health Service Act is amended by striking out "and" before 
42usc'242°c 
"(E)", and by inserting after the semicolon at the end of such clause 
the following: "(F) health care resources; (G) environmental and 
social health hazards; and (H) family formation, growth, and 
dissolution;". 
(2) Such subsection is further amended by adding at the end thereof 
the following new sentence: "No information obtained in accordance 
Avith this paragraph may be used for any purpose other than the 
statistical purposes for which it was supplied except pursuant to regu-
hitions of the Secretary; nor may any such information be published 
if the particular establishment or person supplying it is identifiable 
except with the consent of such establishment or person." 
(b) Section 305 is further amended by redesignating subsections 
(b), (c"), and (d) as subsections (c), (d), and (e), respectively, and 
by adding after subsection (a) the following new subsection: 
<17-S48 O - 72 - 86 (Pt. 1) 
1304 
PUBLIC LAW 91-515-OCT. 30, 1970 
[84 STAT. 
" (b) The Secretary is authorized, directly or by contract, to under-
take research, development, demonstration, and evaluation, relating to 
the design and implementation of a cooperative system for producing 
comparable and uniform health information and statistics at the 
Federal, State, and local levels." 
Appropriation. 
^Q"^ ^he subscctiou of such scctiou 305 redesignated (by subsection 
(b) of this section) as subsection (d) is amended to read as follows: 
"(d) There are authorized to be appropriated to carry out this sec-
tion $15,000,000 for the fiscal year ending June 30, 1971, $20,000,000 
for the fiscal year ending June 30, 1972, and $25,000,000 for the fiscal 
year ending June 30,1973." 
PART C—GRANTS TO STATES FOR COMPREHENSIVE STATE HEALTH 
PLANNING 
SEC. 220. (a)(1) The first sentence of section 314(a)(1) of the 
si^stat^saV^^' 
Public Health Service Act is amended by striking out "June 30,1970" 
42 use 24*6. 
a^nd inserting in lieu thereof "June 30,1973". 
(2) The second sentence of such section 314(a) (1) is amended by 
striking out "and $15,000,000 for the fiscal year ending June 30,1970" 
and inserting in lieu thereof the following: "$15,000,000 for the fiscal 
year ending June 30, 1970, $15,000,000 for the fiscal year ending 
June 30,1971, $17,000,000 for the fiscal year ending June 30,1972, and 
$20,000,000 for the fiscal year ending June 30,1973". 
(b) Section 314(a) (2) (B) of such Act is amended by striking out 
"State and local agencies" and inserting in lieu thereof "Federal, State, 
and local agencies (including as an ex officio member, if there is located 
in such State one or more hospitals or other health care facilities of the 
Veterans' Administration, the individual whom the Administrator of 
Veterans' Affairs shall have designated to serve on such council as the 
representative of the hospitals or other health care facilities of such 
Administration which are located in such State)". 
(c) Section 314(a)(2)(B) of such Act (as amended by subsection 
(b) of this section) is further amended by inserting "(including 
representation of the regional medical program or programs included 
in whole or in part within the State)" immediately after "concerned 
with health". 
(d) Section 314(a) (2) (C) of such Act is amended (1) by inserting 
"and including home health care" immediately after "private", and 
(2) by inserting immediately before the semicolon at the end thereof 
the follow^ing: "and including environmental considerations as they 
relate to public health". 
PART I)—PROJECT GRANTS FOR AREAWIDE HEALTH PLANNING 
Anfe,p. 340. 
g^,^ 230. Sectlou 314(b) of the Public Health Service Act is 
amended— 
(1) by striking out, in the first sentence thereof, "June 30, 
1970'' and inserting in lieu thereof "June 30,1973"; 
(2) by inserting after the word "services" the second place it 
appears therein, the phrase "and including the provision of such 
services through home health care"; 
(3) by striking out, in the second sentence thereof, "and 
$15,000,000 for the fiscal year ending June 30,1970" and inserting 
in lieu thereof the following: "$15,000,000 for the fiscal year ending 
June 30,1970, $20,000,000 for the fiscal year ending June 30,1971, 
$30,000,000 for the fiscal year ending June 30, 1972, and 
$40,000,000 for the fiscal year ending June 30,1973"; 
(4) by inserting "(1) (A)" immediately after "(b)''; and 
84 STAT. ] 
PUBLIC LAW 91-515-OCT. 30, 1970 
1305 
(5) by adding after and below the existing language contained 
therein the following: 
"(B) Project grants may be made by the Secretary under subpara-
graph (A) to the State agency administering or supervising the 
administration of the State plan approved under subsection (a) with 
respect to a particular region or area, but only if (i) no application 
for such a grant with respect to such region or area has been filed by 
any other agency or organization qualified to receive such a grant, and 
(ii) such State agency certifies, and the Secretary finds, that ample 
opportunity has been afforded to qualified agencies and organizations 
to file application for such a grant with respect to such region or area 
and that it is improbable that, in the foreseeable future, any agency 
or organization which is qualified for such a grant will file application 
therefor. 
"(2) (A) In order to be approved under this subsection, an applica-
tion for a grant under this subsection must contain or be supported by 
reasonable assurances that there has been or will be established, in or 
for the area with respect to which such grant is sought, an areawide 
health planning council. The membership of such council shall include 
representatives of public, voluntary, and nonprofit private agencies, 
institutions, and organizations concerned with health (including rep-
resentatives of the interests of local government, of the regional med-
ical program for such area, and of consumers of health services). A 
majority of the members of such council shall consist of representatives 
of consumers of health services. 
"(B) In addition, an application for a grant under this subsection 
must contain or be supported by reasonable assurances that the area-
wide health planning agency has made provision for assisting health 
care facilities in its area to develop a program for capital expenditures 
for replacement, modernization, and expansion which is consistent 
with an overall State plan which will meet the needs of the State and 
the area for health care facilities, equipment, and services without 
duplication and otherwise in the most efficient and economical manner." 
PART E—PROJECT GRANTS FOR TRAININCX, STUDIES AND 
DEMONSTRATIONS 
81 Stat. 533. 
42 u s e 246. 
SEC. 240. Section 314(c) of the Public Health Service Act is „,8°,i*^';,V^^' 
amended— 
(1) by striking out, in the first sentence thereof, "June 30,1970" 
and inserting in lieu thereof "June 30, 1973"; and 
(2) by striking out, in the second sentence thereof, "and 
$7,500,000 for the fiscal jrear ending June 30, 1970" and inserting 
in lieu thereof the following: "$7,500,000 for the fiscal year ending 
June 30, 1970, $8,000,000 for the fiscal year ending June 30, 1971, 
$10,000,000 for the fiscal year ending June 30,1972, and $12,000,000 
for the fiscal year ending June 30, 1973". 
PART F—GRANTS FOR COMPREHENSIVE PUBLIC HEALTH SERVICES 
SEC. 250. (a) Section 314(d) (1) of the Public Health Service Act is 
amended by striking out "and $100,000,000 for the fiscal year ending 
June 30,1970" and inserting in lieu thereof "$100,000,000 for the fiscal 
vear ending June 30, 1970, $130,000,000 for the fiscal year ending 
June 30, 1971, $145,000,000 for the fiscal year ending June 30, 1972, 
and $165,000,000 for the fiscal year ending June 30, 1973". 
(b) Section 314(d) (2) (C) of such Act is amended (1) by striking 
out "and (iii)" and inserting in lieu thereof "(iii)" and (2) by insert-
ing before the semicolon at the end thereof the following: "; and (iv) 
the plan is compatible with the total health program of the State". 
1306 
PUBLIC LAW 91-515-OCT. 30, 1970 
[84 STAT. 
PART G—PROJECT GRANTS FOR HEALTH SERVICES DEVELOPMENT 
80 Stat. 1186; 
QEC. 260. (a) Section 314(e) of the Public Health Service Act is 
42 use 24*6. 
amended by striking out "and" immediately after "June 30,1969," and 
by inserting after ^June 30, 1970," the following: "$109,500,000 for 
the fiscal year ending June 30, 1971, $135,000,000 for the fiscal year 
ending June 30, 1972, and $157,000,000 for the fiscal year ending 
June 30,1973,". 
(b) The first sentence of 314(e) is further amended by inserting 
immediately after "cost" the following: "(including equity require-
ments and amortization of loans on facilities acquired from the Office 
of Economic Opportunity or construction in connection with any 
program or project transferred 
from the Office of 
Economic 
Opportunity)". 
(c) (1) The second sentence of such section is amended to read as 
follows: "Any grant made under this subsection may be made only 
if the application for such grant has been referred for review and 
comment to the appropriate areawide health planning agency or agen-
cies (or, if there is no such agency in the area, then to such other public 
or nonprofit private agency or organization (if any) which performs 
similar functions) and only if the services assisted under such grant 
will be provided in accordance with such plans as have been developed 
pursuant to subsection (a)." 
Effective date. 
^g) The amendment made by paragraph (1) shall be effective with 
respect to grants under section 314(e) of the Public Health Service 
Act which are made after the date of enactment of this Act. 
PART 
H—ADMINISTRATION 
OF GRANTS IN 
CERTAIN 
MULTIGRANT 
PROJECTS 
./^^!^'c*o^o^^• 
SEC. 270. Part A of title I I I of the Public Health Service Act is 
7o St&t S92* 
• 
• 
42 use 241- 
amended by adding at the end thereof the following new section: 
242h. 
"Administration of Grants in Certain Multigrant Projects 
"SEC. 310A. For the purpose of facilitating the administration of, 
and expediting the carrying out of the purposes of, the programs 
established by title IX, and sections 304, 314(a), 314(b), 314(c), 
Ante, pp. 1297, 3l4.(d), aud 314(e) of this Act in situations in which grants are sought 
or made under two or more of such programs with respect to a single 
project, the Secretary is authorized to promulgate regulations— 
"(1) under which the administrative functions under such 
programs with respect to such project will be performed by a 
single administrative unit which is the administrative unit 
charged with the administration of any of such programs or is 
the administrative unit charged with the supervision of two or 
more of such programs; 
"(2) designed to reduce the number of applications, reports, 
and other materials required under such programs to be sub-
mitted with respect to such project, and otherwise to simplify, 
consolidate, and make uniform (to the extent feasible), the data 
and information required to be contained in such applications, 
reports, and other materials; and 
"(3) under which inconsistent or duplicative requirements im-
posed by such programs will be revised and made uniform with 
respect to such project; 
except that nothing in this section shall be construed to authorize the 
Secretary to waive or suspend, with respect to any such project, any 
requirement with respect to any of such programs if such requirement 
is imposed by law or by any regulation required by law." 
84 STAT. ] 
PUBLIC LAW 91-515-OCT. 30, 1970 
1307 
PART I—ANNUAL KEPORT, NATIONAL AD^1S0R'r COUNCIL, ETC. 
SEC. 280. Part A of title I I I of the Public Health Service Act is 
further amended by adding after section 310A thereof (as added by 
section 270 of this Act) the following new section: 
"Annual Eeport 
"310B. On or before January 1 of each year, the Secretary shall 
transmit to the Congress a report of the activities carried on under 
the provisions of title I X of this Act and sections 304, 305, 314(a), 
314(b),_314(c), 314(d), and 314(e) of this title together with (1) an 
evaluation of the effectiveness of such activities in improving the effi-
ciency and effectiveness of the research, planning, and delivery of 
health services in carrying out the purposes for which such provisions 
were enacted, (2) a statement of the relationship between Federal 
financing and financing from other sources of the activities under-
taken pursuant to such provisions (including the possibilities for more 
efficient support of such activities through use of alternate sources 
of financing after an initial period of support under such provi-
sions), and (3) such recommendations with respect to such provisions 
as he deems appropriate." 
SEC. 281. Title I I I of the Public Health Service Act is amended 
by adding after section 315 thereof the following new section: 
Ante, pp. 1297, 
1301, 1304. 
58 Stat. 691. 
42 u s e 241. 
"NATIONAL ADVISORY COUNCIL ON COMPREHENSIVE 
HEALTH 
PLANNING 
PROGRAMS 
"SEC. 316. (a) The Secretary shall appoint, without regard to the 
civil service laws, a National Advisory Council on Comprehensive 
Health Planning Programs. The Council shall consist of the Secretary 
or his designee, who shall be the chainnan, and sixteen members, not 
otherwise in the regular full-time employ of the United States, who 
are (1) leaders in the fields of the fundamental sciences, the medical 
sciences, or the organization, delivery, and financing of health care, 
(2) officials in State and areawide health planning agencies, (3) 
leaders in health care administration, or State or community or other 
public affairs, who are State or local officials, or (4) representa,tives 
of consumers of health care. At least six of the appointed members 
shall be individuals representing the consumers of health care, one 
shall be an official of a State health planning agency, one shall be an 
official of an areawide health planning agency, and one shall be a 
member of the National Advisory Council on Regional Medical 
Programs. 
"(b) Each appointed member of the Council shall hold office for a 
term of four years, except that any member appointed to fill a vacancy 
prior to the expiration of the term for which his predecessor was 
appointed shall be appointed for the remainder of such term, and 
except that the terms of office of the members first taking office shall 
expire, as designated by the Secretary at the time of appointment, 
four at the end of the first year, four at the end of the second year, 
four at the end of the third year, and four at the end of the fourth 
year after the date of appointment. An appointed member shall not 
be eligible to serve continuously for more than two terms. 
"(c) Appointed members of the Council, while attending meetings 
or conferences thereof or otherwise serving on the business of the 
Council, shall be entitled to receive compensation at rates fixed by the 
Secretary, but at rates not exceeding the daily equivalent of the rate 
specified at the time of service for GS-18 of the general schedule, 
Appointment, 
Members. 
Term. 
Ante, p . 198-1., 
1308 
PUBLIC LAW 91-515-OCT. 30, 1970 
[84 STAT. 
80 Stat. 499; 
53 Stat. 190. 
Ante, p. 1304. 
58 Stat. 693. 
42 u s e 243. 
58 Stat. 702. 
42 u s e 262. 
79 Stat. 448; 
(1 Stat. 540. 
42 u s e 241. 
Ante, 
p . 56. 
79 Stat. 428. 
42 u s e 2688. 
Ante, 
p. 57. 
including traveltime, and while so serving away from their homes 
or regular places of business they may be allowed travel expenses, 
including per diem in lieu of subsistence, as authorized by section 
5703(b) of title 5 of the Ignited States Code for persons in the 
Government service employed intermittently. 
"(d) The Council shall advise and assist the Secretary in the prep-
aration of general regulations for, and as to policy matters arising 
with respect to, the administration of section 314 of this title, with 
increased emphasis on cooperation in the coordination of programs 
thereunder with the National Advisory Council on Regional Medical 
Programs, with particular attention to the relationship between the 
improved organization and delivery of health services and the financ-
ing of such services; and shall, in carrying out such functions, review, 
not less often than annually, the grants made under section 314 to 
determine their effectiveness in carrying out its purposes." 
SEC. 282. Part B of title I I I of the Public Health Service Act is 
amended by striking out "Surgeon General" each place it appears and 
inserting in lieu thereof "Secretary". 
PART J—REGULATION or VACCINES, BLOOD, BLOOD COMPONENTS, AND 
ALLERGENIC PRODUCTS 
SEC. 291. Section 351 of the Public Health Service Act is amended 
by inserting, after "antitoxin", each time such word appears, the 
following: "vaccine, blood, blood component or derivative, allergenic 
product,". 
PART K—EXTENSION OF RESEARCH CONTRACT AUTHORITY 
SEC. 292. Paragraph (h) of section 301 of the Public Health Service 
Act is amended by striking out "five succeeding fiscal years" and 
inserting in lieu thereof "eight succeeding fiscal years". 
TITLE III—COMMUNITY MENTAL HEALTH CENTERS 
SEC. 301. Section 201 of the Community Mental Health Centers 
Amendments of 1970 is amended by adding at the end thereof the 
following new subsection: 
"(c) In the case of any community mental health center— 
"(1) for which a staffing grant was made under Part B of the 
Community Mental Health Centers Act for any period which 
began on or before June 30, 1970; and 
"(2) (A) with respect to which the portion of the costs (as 
described in section 220(a) of such Act) which may be met from 
funds under a grant under such part B is increased (by reason 
of the enactment of the preceding subsections of this section) for 
any period after June 30, 1970; or 
"(B) with respect to which the period during which a grant 
under such part B may be made is extended by reason of the 
enactment of subsection (a) of this section; 
the provisions of section 221(a) (4) of such Act shall be deemed to 
have been complied with for any period after June 30, 1970, if the 
Secretary determines that there is satisfactory assurance that the 
amount of total costs, Federal and non-Federal (as described in 
section 220(a) of such Act), which will be incurred by such center 
for staffing purposes for any period after June 30, 1970, will not be 
less than the amount of such total costs for the period which last 
commenced on or before June 30, 1970, except that the grantee shall 
not be required to increase the amount contributed as the non-Federal 
share in the event the amount of the Federal participation is reduced." 
84 STAT. ] 
PUBLIC LAW 91-515-OCT. 30, 1970 
1309 
TITLE IV—AUTHORITY FOR GROUP PRACTICE 
SEC. 401. (a) The Secretary of Health, Education, and Welfare may, 
m accordance with the provisions of this section, authorize any carrier, 
which is a party to a contract entered into under chapter 89 of title 5, 
United States Code (relating to health benefits for Federal employees), 
or under the Retired Federal Employees Health Benefits Act, or which 
participates in the carrying out of any such contract, to issue in any 
State contracts entitling any person as a beneficiary to receive compre-
hensive medical services (as defined in subsection (b)) from a group 
practice unit or organization (as defined in subsection (c)) with which 
such carrier has contracted or otherwise arranged for the provision 
of such services. 
(b) As used in this section, the term "comprehensive medical serv-
ices" means comprehensive preventive, diagnostic, and therapeutic 
medical services (as defined in regulations of the Secretary), furnished 
on a prepaid basis; and may include, at the option of a carrier, such 
other health services including mental health services, and equipment 
and supplies, furnished on such terms and conditions with respect to 
copayment and other matters, as may be authorized in regulations of 
the Secretary. 
(c) As used in this section: 
(1) The term "group practice unit or organization" means a non-
profit agency, co-operative, or other organization undertaking to pro-
vide, through direct employment of, or other arrangements with the 
members of a medical group, comprehensive medical services (or such 
services and other health services) to members, subscribers, or other 
persons protected under contracts of carriers. 
(2) The term "medical group" means a partnership or other associ-
ation or group of persons who are licensed to practice medicine in a 
State (or of such persons and persons licensed to practice dentistry or 
optometry) w^ho (A) as their principal professional activity and as a 
group responsibility, engage in the coordinated practice of their pro-
fession primarily in one or more group practice facilities, (B) pool 
their income from practice as members of the group and distribute it 
among themselves according to a prearranged plan, or enter into an 
employment arrangement with a group practice unit or organization 
for the provision of their services, (C) share common overhead 
expenses (if and to the extent such expenses are paid by members of 
the group), medical and other records, and substantial portions of the 
equipment and professional, technical, and administrative staff, and 
(D) include within the group at least such professional personnel, 
and make available at least such health services, as may be specified 
in regulations of the Secretary. 
(d) Nothing in this section shall preclude any State or State agency 
from regulating the amounts charged for contracts issued pursuant 
to subsection (a) or the manner of soliciting and issuing such contracts, 
or from regulating any carrier issuing such contracts in any manner 
not inconsistent with the provisions of this section. 
Ante, p. 869. 
Definitions. 
Contract charges. 
State regulation. 
TITLE V—STUDY RELATING TO ENVIRONMENTAL 
POLLUTION 
SEC. 501. (a) The Congress finds that there is general agreement 
that air, water, and other common environmental pollution may be 
hazardous to the health of individuals resident in the United States, 
but that despite the existence of various research papers and other 
technical reports on the health hazards of such pollution, there is no 
authoritative source of information about (1) the nature and gravity 
1310 
PUBLIC LAW 91-515-OCT. 30, 1970 
[84 STAT. 
Presidential 
study. 
Report to Con-
gress. 
Report supple-
ments. 
Appropriation. 
of these hazards, (2) the availability of medical and other assistance 
to persons affected by such pollution, especially when such pollution 
reaches emergency levels, and (3) the measures, other than those relat-
ing solely to abatement of the pollution, that may be taken to avoid or 
reduce the effects of such pollution on the health of individuals. 
(b) The President shall immediately commence (1) a study of the 
nature and gravity of the hazards to human health and safety created 
by air, water, and other common environmental pollution, (2) a survey 
of the medical and other assistance available to persons affected by 
such pollution, especially when such pollution reaches emergency 
levels, and (3) a survey of the measures, other than those relating 
solely to abatement of the pollution, that may be taken to avoid or 
reduce the effects of such pollution on the health of individuals. 
(c) The President shall, within nine months of the enactment of 
this Act, transmit to the Congress a report of the study and surveys 
required by subsection (b) of this section, including (1) his conclusions 
regarding the nature and gravity of the hazards to human health and 
safety created by environmental pollution, (2) his evaluation of the 
medical and other assistance available to persons affected by such 
pollution, especially when such pollution reaches emergency levels, 
(3) his assessment of the measures, other than those relating solely to 
abatement of the pollution, that may be taken to avoid or reduce the 
effects of such pollution on the health of individuals, and (4) such 
legislative or other recommendations as he may deem appropriate. 
(d) The President shall, within one year of his transmittal to the 
Congress of the report required by subsection (c) of this section, and 
annually thereafter, supplement that report with such new data, 
evaluations, or recommendations as he may deem appropriate. 
(e) There are authorized to be appropriated such sums as may be 
necessary to carry out the provisions of this section. 
TITLE VI—MISCELLANEOUS 
42 u s e 218, 
289b, 289f, 292b. 
42 u s e 289a-
289c, 289j. 
76 Stat. 1073. 
42 u s e 217a. 
eompensation. 
64 Stat. 447. 
42 u s e 210. 
Ante, p. 198-1. 
NATIONAL ADVISORY COUNCIL 
SEC. 601. (a)(1) Sections 217(b), 432(a), 443(b), and 703(c) of 
the Public Health Service Act are amended by inserting "or com-
mittees" after "councils" wherever it appears therein. 
(2) Sections 431, 432 (b), 433,443, and 452 of such Act are amended 
by inserting "or committee" after "council" wherever it appears 
therein. 
(3) Subsections (b) and (c) of section 222 of such Act are amended 
by inserting "council or" before "committee" wherever it appears 
therein. 
(4) Such section is further amended by inserting in the heading 
thereof "COUNCILS OR" before "COMMITTEES". 
(b) (1) Subsection (c) of section 208 of the Public Health Service 
Act is amended to read: 
"(c) Members of the National Advisory Health Council and mem-
bers of other national advisory or review councils or committees estab-
lished under this Act, including members of the Technical Electronic 
Product Radiation Safety Standards Committee and the Board of 
Regents of the National Library of Medicine, but excluding ex officio 
members, while attending conferences or meetings of their respective 
councils or committees or while otherwise serving at the request of 
the Secretary, shall be entitled to receive compensation at rates to be 
fixed by the Secretary, but at rates not exceeding the daily equivalent 
of the rate specified at the time of such service for grade GS-18 of the 
General Schedule, including traveltime; and while away from their 
homes or regular places of business they may be allowed travel ex-
84 STAT. ] 
PUBLIC LAW 91-515-OCT. 30, 1970 
1311 
penses, including per diem in lieu of subsistence, as authorized by sec-
tion 5703(b) of title 5 of the United States Code for persons in the ga^staJ^Vgo^^' 
Government service employed intermittently." 
(2) The second sentence of subsection (d) of section 306, the second 
^^ "^^ 242d. 
sentence of subsection (d) of section 307, the first sentence of para- 
^2 use 242e. 
graph (2) of subsection (f) of section 358, subsection (d) of section 
^^ use 263f. 
373, subsection (e) of section 641, subsection (d) of section 703, sub- 
^"'e, pp. ee, 
section (d) of section 725, subsection (d) of section 774, subsection (c) ^^2* use 292b. 
of section 841, and subsection (c) of section 905 of such Act are 
42 use 293ei 
deleted. 
^QSM. 293. 29c»e. 
(3) Paragraph (2) of subsection (f) of section 358 is further 
^^ ^'^'' "^9-
amended by striking out "under this subsection" in the second sentence 
thereof and by inserting in lieu thereof "to members of the Committee 
who are not officers or employees of the United States pursuant to 
subsection (c) of section 208 of this Act". 
(4) Subsection (d) of section 905 of such Act is redesignated as 
^^ ^
*
^
*
^
* ^^9. 
subsection (c). 
(c)(1) Subsection (a) of section 222 of such Act is amended to 
J|^ ^*sc*2^°^a* 
read: 
" (a) The Secretary may, without regard to the provisions of title 5, 
United States Code, governing appointments in the competitive serv-
ice, and without regard to the provisions of chapter 51 and subchapter 
I I I of chapter 53 of such title relating to classification and General 
Schedule pay rates, from time to time, appoint such advisory councils ^g^° ^
*
^
*
* ^'*^' 
or committees (in addition to those authorized to be established under 
s use 5101, 
other provisions of law), for such periods of time, as he deems desirable 5331. 
with such period commencing on a date specified by the Secretary for 
"*"'*' ^' ^^^"^• 
the purpose of advising him m connection with any of his functions." 
(2) Subsection (c) of such section is amended by inserting "or 
programs" after "projects". 
(d) (1) Subsection (g) of section 408 of the Food, Drug, and Cos-
metic Act is amended by striking out "as compensation for their 
esstat. 511. 
services a reasonable per diem, for time actually spent in the work of 
"^^ ^'^^^' 
the committee, and shall in addition be reimbursed for their necessary 
traveling and subsistence expenses while so serving away from their 
places of residence." after "shall receive" and by inserting in lieu 
thereof "compensation and travel expenses in accordance with sub-
section (b) (5) (D) of section 706." 
(2) Subparagraph (D) of paragraph (5) of subsection (b) of sec-
tion 706 of such Act is amended by striking out the third sentence 
^J u^icsje' 
thereof and by inserting in lieu thereof the following new sentence: 
"Members of any advisory committee established under this Act, while 
attending conferences or meetings of their committees or otherwise 
serving at the request of the Secretary, shall be entitled to receive 
compensation at rates to be fixed by the Secretary but at rates not 
exceeding the daily equivalent of the rate specified at the time of such 
service for grade GS-18 of the General Schedule, including traveltime; 
and while away from their homes or regular places of business they 
may be allowed travel expenses, including per diem in lieu of sub-
sistence, as authorized by section 5703(b) of title 5 of the United 
States Code for persons in the Government service employed 
intermittently." 
TRAINING AUTHORITY OF INSTITUTE OF GENERAL MEDICAL SCIENCES 
SEC. 602. Section 442 of the Public Health Service Act is amended 
H us^c'289e.* 
by striking out "research" before "training". 
Approved October 30, 1970.