[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2202 Enrolled Bill (ENR)]

        H.R.2202
                       One Hundred Third Congress

                                 of the

                        United States of America


                          AT THE FIRST SESSION

          Begun and held at the City of Washington on Tuesday,
  the fifth day of January, one thousand nine hundred and ninety-three


                                 An Act

  
 
  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 cancer.
Sec. 102. Establishment of demonstration program of grants for 
additional preventive 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 sexually transmitted diseases.
Sec. 402. Extension of program regarding preventable cases of 
infertility arising as result of sexually transmitted diseases.

             TITLE V--NATIONAL CENTER FOR HEALTH STATISTICS

Sec. 501. Revision and extension of programs.

                      TITLE VI--TRAUMA CARE SYSTEMS

Sec. 601. Revisions in programs relating to trauma care.
Sec. 602. Authorization of appropriations.

                   TITLE VII--MISCELLANEOUS PROVISIONS

Sec. 701. Evaluations.
Sec. 702. Federal benefits for overseas assignees.
Sec. 703. Loan repayment program.
Sec. 704. Establishment of requirement of biennial report on nutrition 
and health.
Sec. 705. Alignment of current Centers for Disease Control and 
Prevention reauthorization schedule.
Sec. 706. Miscellaneous payment provisions.
Sec. 707. Interim final regulations.
Sec. 708. Simplification of vaccine information materials.
                   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.--Section 
1501(b) of the Public Health Service Act (42 U.S.C. 300k(b)), as amended 
by section 2008(c)(1) of Public Law 103-43 (107 Stat. 211), is amended--
        (1) in paragraph (1), by striking ``paragraph (2)'' and 
    inserting ``paragraphs (2) and (3)''; and
        (2) by 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 under subsection (a)(1) 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 screening procedure under 
    subsection (a)(1) 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 under such subsection--
        ``(1) has been approved through a process of peer review; and
        ``(2) is made with 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 general.--Section 1503 of the Public 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 Procedures.--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.''.
        (2) Transition rule regarding mammographies.--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 paragraph:
        ``(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 
        under subparagraph (A) and the State in which the tribe or 
        organization is located is receiving a grant under section 1501, 
        the requirement established in paragraph (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(a)(2) and with section 1504(c).''; and
        (2) in subsection (b), by inserting before the period the 
    following: ``, including recommendations regarding compliance by the 
    States with section 1501(a)(2) and with section 1504(c)''.
    (f) Establishment 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 agencies) that are carried out toward 
achieving the objectives established by the Secretary for reductions in 
the rate of mortality from breast and cervical cancer in the United 
States by the year 2000. Such committee shall be comprised of Federal 
officers or employees designated by the heads of the agencies involved 
to serve on the committee as representatives of the agencies, and such 
representatives from 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--
        (1) in section 1501(a), in the matter preceding paragraph (1), 
    by striking ``Control,'' and inserting ``Control and Prevention,''; 
    and
        (2) in section 1505--
            (A) in paragraph (3) (as amended by section 2008(c)(2) 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. ESTABLISHMENT OF DEMONSTRATION PROGRAM OF GRANTS FOR 
      ADDITIONAL PREVENTIVE HEALTH SERVICES 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
        (2) by inserting after section 1508 the following section:
``SEC. 1509. SUPPLEMENTAL GRANTS FOR ADDITIONAL PREVENTIVE HEALTH 
SERVICES.
    ``(a) Demonstration Projects.--In the case of States receiving 
grants under section 1501, the Secretary, acting through the Director 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 
purpose of--
        ``(1) providing preventive health 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 receiving services pursuant to paragraph (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 and Cervical 
Cancer.--The Secretary may not make a grant under subsection (a) unless 
the State 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) Applicability of 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 general.--Subject to paragraph (2), for the purpose of 
    carrying out this section, there are authorized to be appropriated 
    $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 appropriations established in 
    paragraph (1) is not effective for a fiscal year unless the amount 
    appropriated under section 1510(a) for the fiscal year is equal to 
    or greater than $100,000,000.''.
    (b) Conforming Amendment.--Section 1510(a) of the Public Health 
Service Act, as redesignated by subsection (a)(1) of this 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 redesignated by 
section 102(a)(1) 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(i)(2)(A) of Public Law 103-43 (107 
Stat. 213), is amended by adding at the end the following new section:


                 ``breast and cervical cancer information

    ``Sec. 340D. (a) In General.--As a condition of receiving grants, 
cooperative agreements, or contracts under this Act, each of the 
entities specified in subsection (c) shall, to the extent determined to 
be appropriate by the Secretary, make available information concerning 
breast and cervical cancer.
    ``(b) Certain Authorities.--In carrying 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 subsection 
    (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 individuals to 
    whom the information is provided; and
        ``(4) shall refer such clients as the entities determine 
    appropriate for breast and cervical cancer screening, treatment, or 
    other appropriate services.
    ``(c) Relevant Entities.--The entities specified in this subsection 
are the following:
        ``(1) Entities receiving assistance under section 317E (relating 
    to tuberculosis).
        ``(2) Entities receiving assistance under section 318 (relating 
    to sexually transmitted diseases).
        ``(3) Migrant health centers receiving assistance under section 
    329.
        ``(4) Community health centers receiving assistance under 
    section 330.
        ``(5) Entities receiving assistance under section 340 (relating 
    to homeless individuals).
        ``(6) Entities receiving assistance under section 340A (relating 
    to health services for residents of public housing).
        ``(7) Entities providing services with assistance under title V 
    or title XIX.
        ``(8) Entities receiving assistance under section 1001 (relating 
    to family planning).
        ``(9) Entities receiving assistance under title XXVI (relating 
    to services with respect to acquired immune deficiency syndrome).
        ``(10) Non-Federal entities authorized under the Indian Self-
    Determination Act.''.
                 TITLE II--INJURY PREVENTION AND CONTROL
    SEC. 201. ESTABLISHMENT OF REQUIREMENTS WITH RESPECT TO 
      INTERPERSONAL VIOLENCE WITHIN FAMILIES AND AMONG ACQUAINTANCES.
    Part J of title III of the Public Health Service Act (42 U.S.C. 280b 
et seq.), as redesignated by section 2008(i)(2)(B)(i) of Public Law 103-
43 (107 Stat. 213), is amended--
        (1) by redesignating sections 393 and 394 as sections 394 and 
    394A, respectively; and
        (2) by inserting after section 392 the following section:


     ``interpersonal violence within families and among acquaintances

    ``Sec. 393. (a) With respect to activities that are authorized 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 grants to public 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 grants 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 such 
    violence, including information and education to increase awareness 
    of the public health consequences of such violence.
        ``(5) Training health care providers as follows:
            ``(A) To identify 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 referrals 
        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, including with 
    respect to prevention.
    ``(b) For purposes of this part, the term `interpersonal violence 
within families and among acquaintances' includes behavior commonly 
referred to as domestic violence, sexual assault, spousal abuse, woman 
battering, partner abuse, elder abuse, and acquaintance rape.''.

SEC. 202. ADVISORY COMMITTEE; REPORTS.

    Section 394 of the Public Health Service Act, as redesignated by 
section 201(1) of this Act, is amended to read as follows:


                           ``general provisions

    ``Sec. 394. (a) The Secretary, acting through the Director of the 
Centers for Disease Control and Prevention, 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 provide technical assistance 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 Secretary, 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 Representatives, 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 carried 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(i)(2)(B)(i) of Public Law 103-43 (107 Stat. 213), is amended--
        (1) in the heading for such part, by striking ``Injury Control'' 
    and inserting ``Prevention and Control of Injuries''; and
        (2) in section 392--
            (A) in the heading for such section, by inserting 
        ``prevention and'' before ``control activities'';
            (B) in subsection (a)(1), by inserting ``and control'' after 
        ``prevention''; and
            (C) in subsection (b)(1), by striking ``injuries and injury 
        control'' and inserting ``the prevention and control of 
        injuries''.
    (b) Provisions Relating to Public Law 102-531.--Part J of title III 
of the Public 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(i)(2)(B)(i) of Public Law 103-43 (107 Stat. 213), is 
amended--
        (1) in section 392(b)(2), by striking ``to promote injury 
    control'' and all that follows and inserting ``to promote activities 
    regarding the prevention and control of injuries; and''; and
        (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.''.

SEC. 204. AUTHORIZATION OF APPROPRIATIONS.

    Section 394A of the Public Health Service Act, as redesignated by 
section 201(1) of this Act, is amended by striking ``To carry out'' and 
all that follows and inserting the following: ``For the purpose of 
carrying out this part, there are 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.''.
                         TITLE III--TUBERCULOSIS
    SEC. 301. PREVENTIVE HEALTH SERVICES REGARDING TUBERCULOSIS.
    (a) In General.--Part B of title III of the Public Health Service 
Act (42 U.S.C. 242 et seq.), 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 the 
Director of the Centers for Disease Control and Prevention, may make 
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 respect 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 concerning 
    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 
    paragraphs (1) through (4).
        ``(6) Collaboration with international organizations and foreign 
    countries in carrying out such activities.
    ``(c) Cooperation With Providers of Primary Health Services.--The 
Secretary may make a grant under 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 assistance under section 329, 
330, 340, or 340A or under title V or XIX.
    ``(d) Application 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 Secretary and the application, subject to paragraph 
    (2), is in such form, is made in such manner, and contains such 
    agreements, assurances, and information as the Secretary determines 
    to be necessary to carry out the subsection involved.
        ``(2) Plan for prevention, control, and elimination.--The 
    Secretary may make a grant under subsection (a) only 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, equipment, 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 Health 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 
    Secretary shall, for the payment of expenses incurred in complying 
    with such request, expend the amounts withheld.
    ``(f) 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, objectives, 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 Secretary 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 
        $50,000,000 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 under subsection (b), 
    there are authorized to be appropriated such sums as 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 ``(j)(1)(A)'' and inserting ``(j)(1)'';
            (C) by striking ``(B) For grants'' and inserting ``(2) For 
        grants''; and
            (D) in paragraph (1) (as so redesignated), by striking 
        ``established in subparagraph (B)'' and inserting ``established 
        in paragraph (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 (l).
    SEC. 302. RESEARCH THROUGH 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 the 
Institute shall conduct or support research and research training 
regarding the cause, diagnosis, early detection, prevention and 
treatment of tuberculosis.
    ``(b) For the purpose of carrying out subsection (a), there are 
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 ADMINISTRATION.
  The Secretary of Health and Human Services, acting through the 
Commissioner of Food and Drugs, shall implement a tuberculosis drug and 
device research program under which the Commissioner 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.
                 TITLE IV--SEXUALLY TRANSMITTED DISEASES
    SEC. 401. EXTENSION OF PROGRAM OF GRANTS REGARDING PREVENTION AND 
      CONTROL OF SEXUALLY TRANSMITTED DISEASES.
    (a) Innovative, Interdisciplinary Approaches.--Section 318 of the 
Public Health Service Act (42 U.S.C. 247c(d)(1)) 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 prevention 
and control of sexually transmitted diseases.''.
    (b) Authorization of Appropriations.--Section 318(e) of the Public 
Health Service Act, as redesignated by subsection (a)(1) 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 (b)(3), by striking ``, and'' and inserting 
    ``; and'';
        (2) in subsection (c)(3), by striking ``, and'' and inserting 
    ``; and''; and
        (3) in subsection (d)(5)--
            (A) in subparagraph (A), by striking ``form, or'' and 
        inserting ``form; 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-1), as added by section 304 of Public Law 
102-531 (106 Stat. 3490), is amended in subsection (o)(2) 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-1), 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 (r)(2), by striking ``through 1995'' and 
    inserting ``through 1998''.
             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 ``Committee on Labor and Human 
    Resources'';
        (2) in subsection (g), by striking ``data which shall be 
    published'' and all that follows and inserting ``data.'';
        (3) in subsection (i), by striking ``engaged in health planning 
    activities'';
        (4) in subsection (k)(2)--
            (A) in subparagraph (A), in the last sentence, by striking 
        ``Except'' and all that follows through ``members'' and 
        inserting ``Members'';
            (B) by striking subparagraph (B); and
            (C) by striking the remaining subparagraph designation; and
        (5)(A) by striking subsection (l);
        (B) by redesignating subsections (m) through (o) as subsections 
    (l) through (n), respectively;
        (C) in subsection (l) (as so redesignated), in the last 
    sentence, by striking ``(n)'' and inserting ``(m)''; and
        (D) in subsection (n) (as so redesignated)--
            (i) in paragraph (1), by striking ``(m)'' and inserting 
        ``(l)''; and
            (ii) in paragraph (2)--
                (I) by striking ``(n)'' and inserting ``(m)''; and
                (II) by striking ``(n)(2)'' and inserting ``(m)(2)''.
    (b) General Authority Respecting Research, Evaluations, and 
Demonstrations.--Section 304 of the Public Health Service Act (42 U.S.C. 
242b) is amended by striking subsection (d).
    (c) General Provisions Respecting Effectiveness, Efficiency, and 
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 
            subparagraphs (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'';
        (2)(A) 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)--
            (A) by striking ``shall (A) take'' and inserting ``shall 
        take''; and
            (B) by striking ``and (B) publish'' and inserting ``and 
        shall publish'';
        (4) in subsection (f), by striking ``sections 3648'' and all 
    that follows and inserting the following: ``section 3324 of title 
    31, United States Code, and section 3709 of the Revised Statutes (41 
    U.S.C. 5).''; and
        (5) by striking subsection (h).
    (d) Authorization of Appropriations.--Section 306(n) of the Public 
Health Service Act, as redesignated by subsection (a)(5)(B), is 
amended--
        (1) in paragraph (1), by striking ``through 1993'' and inserting 
    ``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 ``Secretary'' 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 Service Act 
(42 U.S.C. 300d) is amended--
        (1) by striking section 1202; and
        (2) by redesignating sections 1203 and 1204 as sections 1202 and 
    1203, respectively;
    (c) Reports by States; Evaluations by Comptroller General.--Section 
1216(c) of the Public 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 after the first sentence the following 
    sentence: ``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 disability, resulting from 
    trauma.''.
    (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 
    following: ``determines to be necessary to carry out this section'';
        (2) in section 1212(a)(2)(A), by striking ``1211(c)'' and 
    inserting ``1211(b)'';
        (3) in section 1213(a)--
            (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 inserting 
    ``Rico,''.

SEC. 602. AUTHORIZATION OF APPROPRIATIONS.

    Section 1232(a) of the Public Health Service Act (42 U.S.C. 300d-
32(a)) is amended by striking ``for the purpose'' and all that follows 
and inserting the 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 
years 1995 and 1996.''.
                   TITLE VII--MISCELLANEOUS PROVISIONS

SEC. 701. EVALUATIONS.

    Effective October 1, 1994, section 241 of the Public Health 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:

                        ``evaluation 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 Resources of the Senate and the Committee on Energy and 
Commerce of the House of Representatives a report summarizing the 
findings of the evaluations conducted under subsection (a).''.

SEC. 702. FEDERAL BENEFITS FOR OVERSEAS ASSIGNEES.

    Section 307 of the Public Health Service Act (42 U.S.C. 242l) is 
amended by adding at the end thereof the following new subsection:
    ``(c) The Secretary may provide to personnel appointed or assigned 
by the Secretary to serve abroad, allowances and benefits 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. 703. 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

    ``Sec. 317F. (a) In General.--
        ``(1) Authority.--Subject to paragraph (2), the Secretary may 
    carry out a program of entering into contracts with appropriately 
    qualified health professionals under which such health professionals 
    agree to conduct prevention activities, as employees 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) unless such 
    professional--
            ``(A) has a substantial amount of educational loans relative 
        to income; and
            ``(B) agrees to serve as an employee of the Centers for 
        Disease Control and Prevention or the 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 Repayment Program established 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 purpose of carrying 
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. ESTABLISHMENT 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 report regarding nutrition and health

    ``Sec. 1709. (a) Biennial Report.--The Secretary shall require the 
Surgeon General 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 General.
    ``(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 Committee on Energy and 
Commerce of the House of Representatives and the Committee on Labor and 
Human Resources of the Senate.''.
    SEC. 705. ALIGNMENT OF CURRENT CENTERS FOR DISEASE CONTROL AND 
      PREVENTION REAUTHORIZATION SCHEDULE.
    (a) Screenings, Education, and Referrals Regarding Lead Poisoning.--
Section 317A(l)(1) of the Public Health Service Act (42 U.S.C. 247b-
1(l)(1)) is amended by striking ``through 1997'' and inserting ``through 
1998''.
    (b) Prostate Cancer Prevention.--Section 317D((l)(1) of the Public 
Health Service Act (42 U.S.C. 247b-5(l)(1)) 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 and 
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 
inserting ``through 1998''.
    (e) Title XIX Program.--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 Legislation.--It is the 
sense of the Congress that, during the fiscal years 1994 through 1997, 
authorizations of appropriations for the programs of the Centers for 
Disease 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 Congress through legislation 
providing further authorizations of appropriations, should be so 
considered during a single year.

SEC. 706. MISCELLANEOUS PAYMENT PROVISIONS

    (a) Payment of Certain Judgments.--Section 224(k)(2) of the Public 
Health Service Act (42 U.S.C. 233(k)(2)), 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 this 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(b)(2) of the Public Health Service Act (42 U.S.C. 254j(b)(2) 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 FINAL REGULATIONS.

    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
        (2) establishing quality standards under section 354(f) of the 
    Public Health Service Act (42 U.S.C. 263b(f)).

SEC. 708. SIMPLIFICATION OF VACCINE INFORMATION MATERIALS.

    (a) Information.--Section 2126(b) of the Public Health Service Act 
(42 U.S.C. 300aa-26(b)) is amended--
        (1) by striking ``by 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 Service 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) by 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 
    Injury 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.







                                Speaker of the House of Representatives.







                             Vice President of the United States and    
                                                President of the Senate.