[Congressional Bills 103th Congress]
[From the U.S. Government Printing 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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