[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3230 Introduced in House (IH)]
103d CONGRESS
1st Session
H. R. 3230
To amend the Public Health Service Act with respect to the health of
individuals who are members of racial or ethnic minority groups.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
October 6, 1993
Mr. Serrano (for himself, Mr. Richardson, Mr. Gutierrez, Ms. Roybal-
Allard, Mr. Pastor, Mr. Torres, Mr. Becerra, Ms. Velazquez, Mr. Romero-
Barcelo, Mr. de Lugo, Mr. Ortiz, Mr. Menendez, Mr. Diaz-Balart, and Mr.
Underwood) introduced the following bill; which was referred to the
Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act with respect to the health of
individuals who are members of racial or ethnic minority groups.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Minority Health Opportunity
Enhancement Act of 1993''.
SEC. 2. MODIFICATIONS REGARDING SECRETARY'S OFFICE OF MINORITY HEALTH.
(a) Duties.--Section 1707(b) of the Public Health Service Act (42
U.S.C. 300u-6(b)) is amended--
(1) in paragraph (1), by striking ``that relate'' and all
that follows and inserting the following: ``that relate to
programs regarding the prevention of diseases; the promotion of
health; the delivery of health services; research; the health
professions; and training and technical assistance regarding
such programs;''; and
(2)(A) in paragraph (7), by striking ``and'' after the
semicolon at the end;
(B) in paragraph (8), by striking the period at the end and
inserting ``; and''; and
(C) by adding at the end the following paragraph:
``(9)(A) establish by contract a center for the purpose of
carrying out programs to improve access to health care services
for individuals who have the limitation of lacking proficiency
in speaking the English language, which programs carry out such
purpose by facilitating the removal of barriers to the receipt
of health care that result from such limitation; and
``(B) in carrying out subparagraph (A), ensure that the
center under such subparagraph conducts research, develops and
evaluates model projects, and provides technical assistance to
health care providers.''.
(b) Definitions.--Section 1707 of the Public Health Service Act (42
U.S.C. 300u-6) is amended--
(1) by redesignating subsection (f) as subsection (h); and
(2) by inserting before subsection (h) (as so redesignated)
the following subsection:
``(g) Definition of Racial or Ethnic Minority Group.--The term
`racial or ethnic minority group' means Hispanics, African Americans,
Asian Americans, Pacific Islanders, Native Americans, Eskimos, and
Aleuts. For purposes of the preceding sentence, the term `Hispanic'
means individuals whose origin is Mexican, Puerto Rican, Cuban, Central
or South American, or any other Spanish-speaking country, including
Spain or the Caribbean Islands; and individuals indentifying themselves
as Hispanic, Latino, Spanish, or Spanish-American.''.
(c) Reports.--Section 1707(e) of the Public Health Service Act (42
U.S.C. 300u-6(e)) is amended by striking ``to the Congress'' and
inserting the following: ``to the Committee on Energy and Commerce and
the Committee on Appropriations of the House of Representatives, and to
the Committee on Labor and Human Resources and the Committee on
Appropriations of the Senate,''.
(d) Conforming Amendment.--Section 1707(b) of the Public Health
Service Act (42 U.S.C. 300u-6(b)) is amended in the matter preceding
paragraph (1) by striking ``racial and ethnic minorities'' and
inserting ``racial and ethnic minority groups''.
SEC. 3. ESTABLISHMENT OF INDIVIDUAL OFFICES OF MINORITY HEALTH WITHIN
AGENCIES OF PUBLIC HEALTH SERVICE.
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 inserting after section 1707 the following
section:
``individual offices of minority health within public health service
``Sec. 1707A. (a) In General.--The head of each agency specified in
subsection (b)(1) shall establish within the agency an office to be
known as the Office of Minority Health. Each such Office shall be
headed by a director, who shall be appointed by the head of the agency
within which the Office is established and who shall report directly to
the head of the agency. The head of such agency shall carry out this
section (as this section relates to the agency) acting through such
Director.
``(b) Specified Agencies.--
``(1) In general.--The agencies referred to in subsection
(a) are the following:
``(A) The Centers for Disease Control and
Prevention.
``(B) The Agency for Health Care Policy and
Research.
``(C) The Health Resources and Services
Administration.
``(D) The Substance Abuse and Mental Health
Services Administration.
``(2) National institutes of health.--For purposes of
subsection (c) and the subsequent provisions of this section,
the term `minority health office'' includes the Office of
Research on Minority Health established within the National
Institutes of Health. The Director of the National Institutes
of Health shall carry out this section (as this section relates
to the agency) acting through the Director of such Office.
``(c) Composition.--The head of each specified agency shall ensure
that the officers and employees of the minority health office of the
agency are, collectively, experienced in carrying out community-based
health programs for each of the various racial and ethnic minority
groups and subgroups that are present in significant numbers in the
United States. The head of such agency shall ensure that, of such
officers and employees who are members of racial and ethnic minority
groups, no such group is disproportionately represented.
``(d) Collaboration With Secretary's Office of Minority Health.--In
carrying out section 1707 regarding a specified agency, the Secretary
shall collaborate with the Director of the minority health office of
the agency. With respect to the health concerns of individuals who are
members of racial or ethnic minority groups, the activities with
respect to which such Director collaborates under the preceding
sentence shall be--
``(1) establishing short-range and long-range goals and
objectives;
``(2) coordinating all other activities within the agency
that relate to programs regarding the prevention of diseases;
the promotion of health; the delivery of health services;
research; the health professions; and training and technical
assistance regarding such programs; and
``(3) all other activities carried out under section 1707.
``(e) Monitoring of Agency Programs.--Each Director of a minority
health office shall monitor the programs of the specified agency of
such office in order to--
``(1) determine the extent to which the purposes of the
programs are being carried out with respect to racial and
ethnic minority groups;
``(2) determine the extent to which members of such groups
are represented among the Federal officers and employees who
administer the programs; and
``(3) make recommendations to the head of such agency on
carrying out the programs with respect to such groups.
``(f) Reports.--The head of each specified agency shall submit to
the Secretary a biennial report describing--
``(1) the extent to which the minority health office of the
agency employs individuals who are members of racial and ethnic
minority groups, including a specification by racial and ethnic
minority group of the number of such individuals employed by
such office; and
``(2) the extent to which the agency has complied with
Public Law 94-311 (relating to data on Americans of Spanish
origin or descent).
``(g) Definitions.--For purposes of this section:
``(1) The term ``minority health office'' means an office
established under subsection (a), subject to subsection (b)(2).
``(2) The term `racial or ethnic minority group' has the
meaning given such term in section 1707(g).
``(3) The term `specified agency' means--
``(A) an agency specified in subsection (b)(1); and
``(B) the National Institutes of Health.
``(h) Authorizations of Appropriations.--
``(1) Individual authorizations.--For the purpose of
carrying out activities under this section through the minority
health offices of the specified agencies, there is authorized
to be appropriated for each such office for each of the fiscal
years 1994 through 1996 an amount equal to 5 percent of the
amount appropriated for the preceding fiscal year for the
specified agency of such office, or $3,000,000, whichever is
greater.
``(2) Availability of funds for staffing.--The purposes for
which amounts appropriated under paragraph (1) may be expended
by a minority health office include the costs of employing
staff for such office.''.
SEC. 4. EQUITABLE ALLOCATIONS REGARDING CERTAIN PROGRAMS.
(a) Generally Applicable Provisions.--
(1) Increase in authorizations of appropriations.--
(A) For the purpose of carrying out the programs
specified in subparagraph (B), there is authorized to
be appropriated for each such program for each of the
fiscal years 1994 through 1996 an amount to 10 percent
of the amount appropriated for the program for fiscal
year 1993. The authorization established in the
preceding sentence for such a program for a fiscal year
is in addition to any other authorization of
appropriations that is available for such purpose.
(B) The programs referred to in subparagraph (A)
are the following sections of the Public Health Service
Act: Section 340A, section 724, section 737, section
738(a), 738(b), and 740.
(2) Peer review.--
(A) In carrying out the designated programs, the
Secretary shall ensure that each application for any
grant, cooperative agreement, or contract authorized
for the program is submitted to a peer review group for
an evaluation of the merits of the proposals made in
the application. The Secretary may not approve such an
application unless a peer review group has recommended
the application for approval.
(B) Each peer review group under subparagraph (A)
shall be composed principally of individuals who are
not officers or employees of the Federal Government.
Each such group shall be composed of individuals who
are experienced in carrying out community-based health
programs for each of the various racial and ethnic
minority groups and subgroups that are present in
significant numbers in the United States. The Secretary
shall ensure that, of individuals comprising the peer
review groups who are members of racial and ethnic
minority groups, no racial or ethnic minority group is
disproportionately represented.
(3) Outreach.--With respect to awards of grants and
contracts that are available under the designated programs, the
Secretary shall carry out a program--
(A) to inform entities, as appropriate, that the
entities may be eligible for the awards;
(B) to provide technical assistance to such
entities in the process of preparing and submitting
applications for the awards in accordance with the
policies of the Secretary regarding such applications;
and
(C) to inform populations, as appropriate, that
members of the populations may be eligible to receive
services or otherwise participate in the activities
carried out with such awards.
(4) Definitions.--For purposes of this subsection:
(A) The term `racial or ethnic minority group' has
the meaning given such term in section 1707(g) of the
Public Health Service Act.
(B) The term ``designated program'' means a program
specified in paragraph (1)(B).
(C) The term ``Secretary'' means the Secretary of
Health and Human Services.
(b) Equitable Allocations Regarding Racial and Ethnic Groups.--
Section 1707 of the Public Health Service Act, as amended by section 2
of this Act, is amended--
(1) by redesignating subsections (c) through (e) as
subsections (d) through (f), respectively;
(2) in subsection (d) (as so redesignated)--
(A) by striking paragraph (1); and
(B) by redesignating paragraphs (2) and (3) as
paragraphs (1) and (2), respectively; and
(3) by inserting after subsection (b) the following
subsection:
``(c) Equitable Allocations.--
``(1) Applicability to designated programs.--
``(A) This subsection applies--
``(i) to activities carried out under any
program established under this section; and
``(ii) to activities carried out under any
program of this Act that specifies that this
subsection is applicable to the program
(subject to such limitations as may be
established for the program involved).
``(B) With respect to a designated program, this
subsection shall be carried out by the Secretary,
acting through the head of the agency that carries out
the program.
``(2) Equitable allocations.--In carrying out activities
under a designated program on behalf of members of racial or
ethnic minority groups, the Secretary shall ensure that the
activities are equitably allocated among the various groups. In
carrying out the preceding sentence, the Secretary shall, in
the case of such a group, consider the following factors:
``(A) The extent to which the group has a
disproportionate incidence or prevalence of any health
condition relative to the incidence and prevalence of
the condition in the general population.
``(B) The extent to which there is evidence that
there has been discrimination against the group on the
basis of race or national origin.
``(C) The percentage constituted by the ratio of
the number of individuals who are members of the group
to the number of individuals in the general population.
``(3) Reports.--
``(A) Subject to subparagraph (C), not later than
February 1 of fiscal year 1995 and of each subsequent
fiscal year, the Secretary shall submit to the
Committee on Energy and Commerce and the Committee on
Appropriations of the House of Representatives, and to
the Committee on Labor and Human Resources and the
Committee on Appropriations of the Senate, a report
describing the allocations that, under paragraph (2),
were made for the preceding fiscal year under each
designated program.
``(B) A report under subparagraph (A) shall specify
the methodology that was used to make the allocations
involved, the total amount that was expended on behalf
of each of the racial and ethnic minority groups
involved, and the total amount that was expended to
employ staff to make the allocations.
``(C) With respect to reports under subparagraph
(A), in any case in which a designated program is
otherwise subject to a requirement that annual reports
concerning the program be submitted to the Committees
specified in such subparagraph, the reports under such
subparagraph may be incorporated into such other
reports.
``(4) Definitions.--For purposes of this subsection:
``(A) The term `designated program' means a program
to which this subsection applies, as indicated pursuant
to paragraph (1).
``(B) The term `racial or ethnic minority group'
has the meaning given such term in subsection (g).''.
(c) Designated Programs.--
(1) Health care for residents of public housing.--Section
340A of the Public Health Service Act (42 U.S.C. 256a), as
amended by section 309(d) of Public Law 102-531 (106 Stat.
3502), is amended--
(A) by redesignating subsections (o) through (q) as
subsections (p) through (r), respectively; and
(B) by inserting after subsection (n) the following
subsection:
``(o) Equitable Allocations.--The awarding of grants under
subsection (a) is subject to section 1707(c).''.
(2) Federally-supported loan funds regarding health
professions schools.--
(1) In general.--Section 724(f) of the Public Health
Service Act (42 U.S.C. 292t(f)), as added by section 102 of
Public Law 102-408 (106 Stat. 1994), is amended by adding at
the end the following paragraph:
``(3) Equitable allocations.--The awarding of Federal
capital contributions for purposes of subsection (a) is subject
to section 1707(c).''.
(d) Grants for Scholarships and Other Purposes Regarding Health
Professions Schools.--
(1) In general.--Section 737 of the Public Health Service
Act (42 U.S.C. 293a), as added by section 102 of Public Law
102-408 (106 Stat. 1994), is amended--
(A) by redesignating subsections (g) and (h) as
subsections (h) and (i), respectively; and
(B) by inserting after subsection (f) the following
subsection:
``(g) Equitable Allocations.--The awarding of grants under
subsection (a) is subject to section 1707(c).''.
(e) Loan Repayments and Fellowships Regarding Faculty Positions at
Health Professions Schools.--Section 738 of the Public Health Service
Act (42 U.S.C. 293b), as added by section 102 of Public Law 102-408
(106 Stat. 1994), is amended by adding at the end the following
subsection:
``(c) Equitable Allocations.--The awarding of contracts under
subsection (a), and the awarding of grants under subsection (b), are
subject to section 1707(c).''.
(f) Educational Assistance Regarding Undergraduates.--
(1) In general.--Section 740(c) of the Public Health
Service Act (42 U.S.C. 293d(c)), as added by section 102 of
Public Law 102-408 (106 Stat. 1994), is amended to read as
follows:
``(c) Equitable Allocations.--The awarding of grants and contracts
under subsection (a) is subject to section 1707(c).''.
SEC. 5. MEDICALLY UNDERSERVED POPULATIONS; HEALTH PROFESSIONAL SHORTAGE
AREAS.
(a) Medically Underserved Populations.--
(1) Factors in designating populations.--Section
330(b)(4)(B) of the Public Health Service Act (42 U.S.C.
245c(b)(4)(B)) is amended to read as follows:
``(B) include the following factors regarding the
population involved:
``(i) Factors indicating the health status of the
population, including the following (which the
Secretary shall consider to be of equal importance):
The rate of infant mortality and morbidity; and the
extent to which there is a substantial rate of
morbidity resulting from complications in infectious,
communicable, or chronic diseases that have progressed
to a critical condition (as indicated by data provided
pursuant to discharging patients from hospitals and
pursuant to admissions to the emergency facilities of
hospitals).
``(ii) The ability to pay for health services,
including the rate of poverty and including the
percentage of the population constituted by individuals
and families that do not have health insurance.
``(iii) The percentage of the population
constituted by members of racial or ethnic minority
groups.
``(iv) With respect to community-based physicians
who provide primary health services and who are
accepting additional patients whose means of payment is
through the program established in title XVIII or XIX
of the Social Security Act, the following: The ratio of
the number of such physicians to the number of
individuals in the population.
``(v) The extent to which the individuals lack
access to primary health services, taking into
consideration barriers resulting from a lack of
proficiency in speaking the English language or from
other cultural factors; the distance to sites providing
primary health services and the lack of transportation
to such sites; and any other barriers encountered by
the population.''.
(2) Certain definitions.--Section 330(b) of the Public
Health Service Act (42 U.S.C. 245c(b)) is amended by adding at
the end the following paragraph:
``(7) For purposes of paragraph (4), the terms `population' and
`population group' include Hispanics, African Americans, Native
Americans, Asian Americans; Pacific Islanders, and subgroups of such
racial or ethnic minority groups; individuals who lack proficiency in
speaking the English language; tribes and tribal organizations;
seasonal or migrant agricultural workers; homeless individuals; elderly
individuals; and individuals with a disability.''.
(3) Use of factors in making grants.--Section 330(b) of the
Public Health Service Act, as amended by paragraph (2) of this
subsection, is amended by adding at the end the following
paragraph:
``(8) In considering applications for grants under subsections (c)
and (d), the Secretary shall consider the extent to which the
population involved has a shortage of personal health services, as
indicated by the factors specified in paragraph (1) of this
subsection.''.
(4) Definition.--Section 330(b) of the Public Health
Service Act, as amended by paragraph (3) of this subsection, is
amended by adding at the end the following paragraph:
``(9) The term `racial or ethnic minority group' has the meaning
given such term in section 1707(g).''.
(b) Health Professional Shortage Areas.--
(1) Factors in designating shortage areas.--
(A) Section 332(b) of the Public Health Service Act
(42 U.S.C. 254e(b)) is amended--
(i) by redesignating paragraph (3) as
paragraph (6); and
(ii) by striking paragraphs (1) and (2) and
inserting the following:
``(1) Factors indicating the health status of the
population, including the following (which the Secretary shall
consider to be of equal importance): The rate of infant
mortality and morbidity; and the extent to which there is a
substantial rate of morbidity resulting from complications in
infectious, communicable, or chronic diseases that have
progressed to a critical condition (as indicated by data
provided pursuant to discharging patients from hospitals and
pursuant to admissions to the emergency facilities of
hospitals).
``(2) The ability to pay for health services, including the
rate of poverty and including the percentage of the population
constituted by individuals and families that do not have health
insurance.
``(3) The percentage of the population constituted by
members of racial or ethnic minority groups.
``(4) With respect to community-based physicians who
provide primary health services and who are accepting
additional patients whose means of payment is through the
program established in title XVIII or XIX, the following: The
ratio of the number of such physicians to the number of
individuals in the population.
``(5) The extent to which the individuals lack access to
primary health services, taking into consideration barriers
resulting from a lack of proficiency in speaking the English
language or from other cultural factors; the distance to sites
providing primary health services and the lack of
transportation to such sites; and any other barriers
encountered by the population.''.
(B) Section 332(a)(3) of the Public Health Service
Act (42 U.S.C. 254e(a)(3)) is amended to read as
follows:
``(3) With respect to the consideration by the Secretary under
paragraph (1) of the population of an area, the population served by a
facility, or a population group, the terms `population' and `population
group' include Hispanics, African Americans, Native Americans, Asian
Americans; Pacific Islanders, and subgroups of such racial or ethnic
minority groups; individuals who lack proficiency in speaking the
English language; tribes and tribal organizations; seasonal or migrant
agricultural workers; homeless individuals; elderly individuals; and
individuals with a disability.''.
(2) Priorities in assignment of corps personnel.--Section
333A(b) of the Public Health Service Act (42 U.S.C. 254f-1(b))
is amended by striking paragraphs (1) and (2) and inserting the
following:
``(1) Factors indicating the health status of the
population, including the following (which the Secretary shall
consider to be of equal importance): The rate of infant
mortality and morbidity; and the extent to which there is a
substantial rate of morbidity resulting from complications in
infectious, communicable, or chronic diseases that have
progressed to a critical condition (as indicated by data
provided pursuant to discharging patients from hospitals and
pursuant to admissions to the emergency facilities of
hospitals).
``(2) The ability to pay for health services, including the
rate of poverty and including the percentage of the population
constituted by individuals and families that do not have health
insurance.
``(3) The percentage of the population constituted by
members of racial or ethnic minority groups.
``(4) With respect to community-based physicians who
provide primary health services and who are accepting
additional patients whose means of payment is through the
program established in title XVIII or XIX, the following: The
ratio of the number of such physicians to the number of
individuals in the population.
``(5) The extent to which the individuals lack access to
primary health services, taking into consideration barriers
resulting from a lack of proficiency in speaking the English
language or from other cultural factors; the distance to sites
providing primary health services and the lack of
transportation to such sites; and any other barriers
encountered by the population.''.
(4) Definition.--Section 331(a)(3) of the Public Health
Service Act (42 U.S.C. 254d(a)(3)) is amended by adding at the
end the following subparagraph:
``(E) The term `racial or ethnic minority group' has the
meaning given such term in section 1707(g).''.
SEC. 6. LACK OF ENGLISH PROFICIENCY AS BARRIER TO OBTAINING HEALTH
CARE.
(a) Continuation of Certain Initiatives for Removal of Barriers.--
(1) Migrant health centers.--Section 329(h) of the Public
Health Service Act (42 U.S.C. 254b(h)) is amended by adding at
the end the following paragraph:
``(4)(A) For the purpose of carrying out subparagraph (B), there
are authorized to be appropriated $3,000,000 for each of the fiscal
years 1994 through 1996.
``(B) The Secretary may make grants to migrant health centers for
programs to reduce the extent to which a lack of proficiency in
speaking the English language (or other cultural factors) constitute a
significant barrier to obtaining health services.''.
(2) Community health centers.--Section 330(g) of the Public
Health Service Act (42 U.S.C. 254c(g)) is amended by adding at
the end the following paragraph:
``(4)(A) For the purpose of carrying out subparagraph (B), there
are authorized to be appropriated $3,000,000 for each of the fiscal
years 1994 through 1996.
``(B) The Secretary may make grants to community health centers for
programs to reduce the extent to which a lack of proficiency in
speaking the English language (or other cultural factors) constitute a
significant barrier to obtaining health services.''.
(b) Issuance of Regulations.--
(1) Proposed rule.--Not later than the expiration of the
90-day period beginning on the date of the enactment of this
Act, the Secretary of Health and Human Services (in this
section referred to as the ``Secretary'') shall issue a
proposed rule to establish regulations for policies to reduce
the extent to which a lack of proficiency in speaking the
English language constitutes a significant barrier to
individuals in establishing the eligibility of the individuals
for participation in health programs under the Public Health
Service Act or title XIX of the Social Security Act, or in
receiving services under such programs.
(2) Final rule.--
(A) In general.--Not later than the expiration of
the 1-year period beginning the date of the enactment
of this Act, the Secretary shall issue a final rule to
establish the regulations described in paragraph (1).
(B) Failure to issue by date certain.--If the
Secretary fails to issue a final rule under
subparagraph (A) before the expiration of the period
specified in such subparagraph, the proposed rule
issued under paragraph (1) is upon such expiration
deemed to be the final rule under subparagraph (A) (and
shall remain in effect until the Secretary issues a
final rule under such subparagraph).
SEC. 7. CENTERS OF EXCELLENCE IN HEALTH PROFESSIONS EDUCATION.
(a) Use of Funds.--Section 739(b) of the Public Health Service Act
(42 U.S.C. 293c(b)), as added by section 102 of Public Law 102-408 (106
Stat. 1994), is amended to read as follows:
``(b) Use of Funds.--
``(1) Required uses.--The Secretary may not make a grant
under subsection (a) unless the health professions school
involved agrees to expend the grant for each of the following
purposes:
``(A) To colloborate with public and nonprofit
private entities to carry out community-based programs
to recruit minority students of secondary schools and
institutions of higher education and to prepare the
students academically for attendance at the health
professions school.
``(B) To improve the capacity of such school to
train, recruit, and retain minority faculty.
``(C) With respect to minority health issues, to
carry out activities to improve the information
resources and curricula of the school and clinical
education at the school.
``(D) To facilitate faculty and student research on
health issues particularly affecting minority groups.
``(2) Relationship with other entities.--In expending a
grant under subsection (a), a health professions school may
permit public and nonprofit private entities to participate in
the programs and activities that the school carries out under
such subsection. The preceding sentence applies without regard
to whether such entities have been designated under subsection
(d) as centers of excellence.''.
(b) Definition.--Section 739(h) of the Public Health Service Act
(42 U.S.C. 293c(h)) is amended by adding at the end the following
paragraph:
``(4) The term `minority'', with respect to an individual,
means an individual who is a member of a racial or ethnic
minority group, as defined in section 1707(g).''.
(c) Funding.--Section 739(i) of the Public Health Service Act (42
U.S.C. 293c(i)), as added by section 102 of Public Law 102-408 (106
Stat. 1994), is amended--
(1) in paragraph (1), by inserting before the period the
following: ``, and $27,000,000 for each of the fiscal years
1994 through 1996''; and
(2) in paragraph (2)--
(A) in subparagraph (B), by striking ``60 percent''
and inserting ``80 percent''; and
(B) in subparagraph (C), by striking ``40 percent''
and inserting ``20 percent''.
SEC. 8. FUNDING FOR ACTIVITIES OF AGENCY FOR HEALTH CARE POLICY AND
RESEARCH.
Section 926(a) of the Public Health Service Act (42 U.S.C. 299c-
5(a)) is amended by adding at the end the following sentences: ``Of the
amounts appropriated under the preceding sentence for a fiscal year,
the Administrator shall reserve not less than 8 percent for carrying
out section 902(b)(2). The activities carried out by the Secretary with
the amounts so reserved shall include activities regarding Hispanic
individuals (as defined in section 1707(g)).''.
SEC. 9. FUNDING FOR CERTAIN ACTIVITIES OF NATIONAL CENTER FOR HEALTH
STATISTICS.
Section 306(o) of the Public Health Service Act (42 U.S.C. 242k(o))
is amended--
(1) in paragraph (1)--
(A) by striking ``subsections (a) through (m)'' and
inserting ``this section''; and
(B) by striking ``1993.'' and inserting ``1993,
$65,000,000 for fiscal year 1994, and such sums as may
be necessary for each of the fiscal years 1995 and
1996.''; and
(2) by amending paragraph (2) to read as follows:
``(2) Of the amounts appropriated under paragraph (1) for a fiscal
year, the Secretary shall obligate not less than an aggregate
$10,000,000 for carrying out subsections (h), (m), and (n), except that
not more than $100,000 may be expended in the aggregate for the
administration of activities under subsection (n) and for activities
described in paragraph (2) of such subsection.''.
SEC. 10. DEMONSTRATION PROJECTS REGARDING DIABETES-RELATED EYE
DISORDERS.
(a) In General.--The Secretary may make grants to public and
nonprofit private entities for the purpose of carrying out
demonstration projects that, for Hispanics, African Americans, and any
other populations that are at significant risk of contracting diabetes
mellitus--
(1) provide screenings for eye disorders for which diabetes
mellitus is a significant causal factor;
(2) provide appropriate referrals for services for
individuals who are screened pursuant to paragraph (1) and
ensure, to the extent practicable, the provision of appropriate
follow-up services;
(3) develop and disseminate public information and
education programs for the detection and control of such eye
disorders; and
(4) improve the education, training, and skills of health
professionals (including allied health professionals) in the
detection and control of such eye disorders.
(b) Priority Regarding Diabetic Retinopathy.--The Secretary may
make a grant under subsection (a) only if the applicant involved agrees
to give priority to carrying out paragraphs (1) through (4) of such
subsection with respect to the eye disorder known as diabetic
retinopathy.
(c) Application for Grant.--The Secretary may make a grant under
subsection (a) only if an application for the grant is submitted to the
Secretary and the application 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 this section.
(d) Definitions.--For purposes of this section, the term
``Secretary'' means the Secretary of Health and Human Services.
(e) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $100,000 for
fiscal year 1994, and such sums as may be necessary for each of the
fiscal years 1995 and 1996.
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