[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1895 Introduced in House (IH)]







105th CONGRESS
  1st Session
                                H. R. 1895

 To amend the Public Health Service Act to revise and extend programs 
   relating to the health of individuals who are from disadvantaged 
backgrounds, including individuals who are members of racial or ethnic 
                            minority groups.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 12, 1997

Mr. Stokes (for himself, Mr. Wynn, Ms. Christian-Green, Mr. Hastings of 
 Florida, Mr. Cummings, Mr. Rush, Ms. Waters, Mrs. Clayton, Mr. Payne, 
Mr. Flake, Ms. Kilpatrick, Mrs. Meek of Florida, Ms. Brown of Florida, 
Mr. Jackson of Illinois, Ms. Eddie Bernice Johnson of Texas, Mr. Towns, 
Mr. Conyers, Mr. Dellums, Mr. Clay, Mr. Clyburn, Mr. Lewis of Georgia, 
  Mr. Hilliard, Mr. Scott, Mr. Davis of Illinois, Ms. Jackson-Lee of 
 Texas, Mr. Thompson, Mr. Dixon, Mr. Fattah, Mr. Ford, Ms. Norton, Ms. 
 Millender-McDonald, Ms. McKinney, Mr. Owens, Mr. Bishop, Mr. Watt of 
 North Carolina, Mr. Jefferson, Mr. Rangel, and Ms. Carson) introduced 
  the following bill; which was referred to the Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
 To amend the Public Health Service Act to revise and extend programs 
   relating to the health of individuals who are from disadvantaged 
backgrounds, including 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 ``Disadvantaged Minority Health 
Improvement Amendments Act of 1997''.

SEC. 2. REVISION AND EXTENSION OF PROGRAM FOR OFFICE OF MINORITY 
              HEALTH.

    (a) In General.--Section 1707 of the Public Health Service Act (42 
U.S.C. 300u-6) is amended by striking subsection (c) and all that 
follows and inserting the following:
    ``(c) Advisory Committee.--
            ``(1) In general.--The Secretary shall establish an 
        advisory committee to be known as the Advisory Committee on 
        Minority Health (in this subsection referred to as the 
        `Committee'). The Deputy Assistant Secretary shall consult with 
        the Committee in carrying out this section.
            ``(2) Duties.--The Committee shall provide advice to the 
        Deputy Assistant Secretary carrying out this section, including 
        advice on the development of goals and specific program 
        activities under paragraphs (1) and (2) of subsection (b) for 
        each racial and ethnic minority group.
            ``(3) Chair.--The Deputy Assistant Secretary shall serve as 
        the chair of the Committee.
            ``(4) Composition.--
                    ``(A) The Committee shall be composed of not fewer 
                than 12 voting members appointed in accordance with 
                subparagraph (B), and nonvoting, ex officio members 
                designated in subparagraph (C).
                    ``(B)(i) The voting members of the Committee shall 
                be appointed from among individuals who are not 
                officers or employees of the Federal Government and who 
                have expertise regarding issues of minority health. The 
                racial and ethnic minority groups shall be equally 
                represented among such members.
                    ``(ii) Except as provided in clause (iii), the 
                voting members of the Committee shall be appointed by 
                the Secretary.
                    ``(iii) One voting member of the Committee shall be 
                appointed from among the voting members of the Advisory 
                Committee on Research on Minority Health established 
                under section 404(e). The appointment under the 
                preceding sentence shall be made by the Chair of the 
                Advisory Committee under such section, in consultation 
                with the other members of such Advisory Committee.
                    ``(C) The nonvoting, ex officio members of the 
                Committee shall be the Deputy Assistant Secretary and 
                the directors of each of the minority health offices, 
                and such additional officials of the Department of 
                Health and Human Services as the Secretary determines 
                to be appropriate.
            ``(5) Terms.--Each member of the Committee shall serve for 
        a term of 4 years, except that the Secretary shall initially 
        appoint a portion of the members to terms of 1 year, 2 years, 
        and 3 years.
            ``(6) Vacancies.--If a vacancy occurs on the Committee, a 
        new member shall be appointed by the Secretary within 90 days 
        from the date that the vacancy occurs, and serve for the 
        remainder of the term for which the predecessor of such member 
        was appointed. The vacancy shall not affect the power of the 
        remaining members to execute the duties of the Committee.
            ``(7) Compensation.--Members of the Committee who are 
        officers or employees of the United States shall serve without 
        compensation. Members of the Committee who are not officers or 
        employees of the United States shall receive compensation, for 
        each day (including travel time) they are engaged in the 
performance of the functions of the Committee. Such compensation may 
not be in an amount in excess of the daily equivalent of the annual 
maximum rate of basic pay payable under the General Schedule (under 
title 5, United States Code) for positions above GS-15.
    ``(d) Certain Requirements Regarding Duties.--
            ``(1) Bilingual assistance regarding health care.--In 
        carrying out subsection (b)(7), the Secretary shall give 
        special consideration to the unique linguistic needs of health 
        care providers serving Asians, and American Samoans and other 
        Pacific Islanders, including such needs regarding particular 
        subpopulations of such groups.
            ``(2) Equitable allocation regarding activities.--
                    ``(A) In making awards of grants, cooperative 
                agreements, or contracts under this section or section 
                330(i), 338A, 338B, 404, or 724, or part B of title 
                VII, the Secretary, acting as appropriate through the 
                Deputy Assistant Secretary or the Administrator of the 
                Health Resources and Services Administration, shall 
                ensure that such awards are equitably allocated with 
                respect to the various racial and minority populations.
                    ``(B) With respect to grants, cooperative 
                agreements, and contracts that are available under the 
                sections specified in subparagraph (A), the Secretary 
                shall--
                            ``(i) carry out activities to inform 
                        entities, as appropriate, that the entities may 
                        be eligible for awards of such assistance;
                            ``(ii) 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 application; and
                            ``(iii) 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.
            ``(3) Cultural competency of services.--The Secretary shall 
        ensure that information and services provided pursuant to 
        subsection (b) are provided in the language, educational, and 
        cultural context that is most appropriate for the individuals 
        for whom the information and services are intended.
    ``(e) Grants and Contracts Regarding Duties.--
            ``(1) In general.--In carrying out subsection (b), the 
        Deputy Assistant Secretary may make awards of grants, 
        cooperative agreements, and contracts to public and nonprofit 
        private entities.
            ``(2) Process for making awards.--The Deputy Assistant 
        Secretary shall ensure that grant awards under paragraph (1) 
        are made only on a competitive basis, and that a grant is 
        awarded for a proposal only if the proposal has been 
        recommended for such an award through a process of peer review.
            ``(3) Evaluation and dissemination.--The Deputy Assistant 
        Secretary, directly or through contracts with public and 
        private entities, shall provide for evaluations of projects 
        carried out with awards made under paragraph (1) during the 
        preceding 2 fiscal years. The report shall be included in the 
        report required under subsection (f) for the fiscal year 
        involved.
    ``(f) Reports.--
            ``(1) Biennial report.--Not later than February 1 of fiscal 
        year 1999 and of each second year thereafter, the Deputy 
        Assistant Secretary shall submit to the Committee on 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 section during the preceding 
        2 fiscal years and evaluating the extent to which such 
        activities have been effective in improving the health of 
        racial and ethnic minority groups. Each such report shall 
        include the reports submitted to the Deputy Assistant Secretary 
        under paragraph (2).
            ``(2) Reports of certain agencies.--Each fiscal year, the 
        heads of the agencies of the Department of Health and Human 
        Services shall submit to the Deputy Assistant Secretary a 
        report summarizing the minority health activities of each of 
        the respective agencies. The report for a fiscal year shall be 
        submitted not later than the date specified by the Deputy 
        Assistant Secretary.
    ``(g) Definition.--For purposes of this section:
            ``(1) The term `racial and ethnic minority group' means 
        American Indians (including Alaska Natives, Eskimos, and 
        Aleuts); Asian Americans and Pacific Islanders; Blacks; and 
        Hispanics.
            ``(2) The term `Hispanic' means individuals whose origin is 
        Mexican, Puerto Rican, Cuban, Central or South American, or any 
other Spanish-speaking country.
    ``(h) Funding.--For the purpose of carrying out this section, there 
are authorized to be appropriated such sums as may be necessary for 
each of the fiscal years 1998 through 2002.''.
    (b) Miscellaneous Amendment.--Section 1707 of the Public Health 
Service Act (42 U.S.C. 300u-6) is amended in the heading for the 
section by striking ``establishment of''.

SEC. 3. REVISION AND EXTENSION OF PROGRAM FOR OFFICE OF RESEARCH ON 
              MINORITY HEALTH.

    Section 404 of the Public Health Service Act (42 U.S.C. 283b) is 
amended by striking subsection (b) and adding after subsection (a) the 
following subsections:
    ``(b) Duties.--
            ``(1) Interagency coordination regarding minority health 
        conditions.--With respect to minority health conditions, the 
        Director of the Office shall plan, coordinate, and evaluate 
        research and other activities conducted or supported by the 
        agencies of the National Institutes of Health, and shall assist 
        in the administration of section 492B with respect to the 
        inclusion of members of minority groups as subjects in clinical 
        research. In carrying out the preceding sentence, the Director 
        of the Office shall evaluate the activities of each of such 
        agencies and shall provide for the periodic reevaluation of 
        such activities.
            ``(2) Consultations.--The Director of the Office shall 
        carry out this section (including developing and revising the 
        plan required in subsection (c)) in consultation with the heads 
        of the agencies of the National Institutes of Health, with the 
        advisory councils of the agencies, and with the advisory 
        council established under subsection (e).
            ``(3) Coordination.--The Director of the Office shall act 
        as the primary Federal official with responsibility for 
        overseeing all research on minority health conditions that is 
        conducted or supported by the National Institutes of Health, 
        and--
                    ``(A) shall serve to represent minority health 
                programs of the National Institutes of Health at all 
                relevant Executive branch task forces and committees; 
                and
                    ``(B) shall maintain communications with all 
                relevant Public Health Service agencies, and with 
                various other departments of the Federal Government, to 
                ensure the timely transmission between the agencies of 
                information concerning advances in research on minority 
                health conditions and the clinical treatment of such 
                conditions, and to ensure dissemination of such 
                information to affected communities and health care 
                providers.
    ``(c) Comprehensive Plan for Expenditure of Appropriations.--
            ``(1) In general.--Subject to the provisions of this 
        subsection and other applicable law, the Director of the 
        Office, in carrying out subsection (b), shall--
                    ``(A) establish a comprehensive plan for the 
                conduct and support by the National Institutes of 
                Health of activities with respect to minority health 
                conditions, including research on such conditions and 
                the training of individuals to conduct such research 
                (which plan shall be first established under this 
                subparagraph not later than 12 months after the date of 
                the enactment of the Disadvantaged Minority Health 
                Improvement Amendments Act of 1997);
                    ``(B) ensure that the Plan establishes priorities 
                among the activities with respect to minority health 
                that such agencies are authorized to carry out;
                    ``(C) ensure that the Plan establishes objectives 
                regarding such activities, describes the means for 
                achieving the objectives, and designates the date by 
                which the objectives are expected to be achieved;
                    ``(D) ensure that all amounts appropriated for such 
                activities are expended in accordance with the Plan;
                    ``(E) review the Plan not less than annually, and 
                revise the Plan as appropriate; and
                    ``(F) ensure that the Plan serves as a broad, 
                binding statement of policies regarding such activities 
                of the agencies, but does not remove the responsibility 
                of the heads of the agencies for the approval of 
                specific programs or projects, or for other details of 
                the daily administration of such activities, in 
                accordance with the Plan.
            ``(2) Certain components of plan.--With respect to 
        activities of the agencies of the National Institutes of Health 
        that relate to minority health conditions, the Director of the 
        Office shall ensure that the Plan--
                    ``(A) provides for basic research;
                    ``(B) provides for applied research;
                    ``(C) provides for research that is conducted by 
                the agencies;
                    ``(D) provides for research that is supported by 
                the agencies;
                    ``(E) provides for proposals developed pursuant to 
                solicitations by the agencies and for proposals 
                developed independently of such solicitations; and
                    ``(F) provides for behavioral research and social 
                sciences research.
    ``(d) Equity Regarding Various Groups.--The Director of the Office 
shall ensure that activities under subsection (b) equitably address all 
racial and ethnic minority groups.
    ``(e) Advisory Committee.--
            ``(1) Establishment.--In carrying out subsection (b), the 
        Secretary shall establish an advisory committee to be known as 
        the Advisory Committee on Research on Minority Health (in this 
        subsection referred to as the `Advisory Committee').
            ``(2) Composition.--
                    ``(A) Voting and nonvoting members.--The Advisory 
                Committee shall be composed of voting members appointed 
                in accordance with subparagraph (B) and the ex officio 
                nonvoting members described in subparagraph (C).
                    ``(B) Voting members.--
                            ``(i) In general.--The Advisory Committee 
                        shall include not fewer than 12 voting members 
                        who are not officers or employees of the 
                        Federal Government. Such members shall be 
                        appointed from among physicians, practitioners, 
                        scientists, consumers and other health 
                        professionals, whose clinical practices, 
                        research specialization, or professional 
                        expertise includes a significant focus on 
                        research on minority health or on the barriers 
                        that minorities must overcome to participate in 
                        clinical trials. The racial and ethnic minority 
                        groups shall be equally representative of the 
                        minority groups served by the Office.
                            ``(ii) Appointing official.--Except as 
                        provided in clause (iii), the voting members of 
                        the Advisory Committee shall be appointed by 
                        the Director of the Office.
                            ``(iii) Additional appointment.--One voting 
                        member of the Advisory Committee shall be 
                        appointed from among the voting members of the 
                        Advisory Committee on Minority Health 
                        established under section 1707(c). The 
                        appointment under the preceding sentence shall 
                        be made by the Chair of the Advisory Committee 
                        under such section, in consultation with the 
                        other members of such Advisory Committee.
                    ``(C) Ex officio nonvoting members.--The Deputy 
                Assistant Secretary for Minority Health, the Director 
                of the Office, and the directors of each of the 
                national research institutes shall serve as ex officio 
                nonvoting members of the Advisory Committee (except 
                that any of such directors may designate an official of 
                the institute involved to serve as such member of the 
                Committee in lieu of the director).
            ``(3) Chair.--The Director of the Office shall serve as the 
        chair of the Advisory Committee.
            ``(4) Duties.--The Advisory Committee shall--
                    ``(A) advise the Director of the Office on 
                appropriate research and training activities to be 
                undertaken by the national research institutes with 
                respect to--
                            ``(i) research and training on minority 
                        health;
                            ``(ii) research and training on racial and 
                        ethnic differences in clinical drug trials, 
                        including responses to pharmacological drugs;
                            ``(iii) research and training on racial and 
                        ethnic differences in disease etiology, course, 
                        and treatment; and
                            ``(iv) research and training on minority 
                        health conditions which require a 
                        multidisciplinary approach;
                    ``(B) report to the Director of the Office on such 
                research and training;
                    ``(C) provide recommendations to such Director 
                regarding activities of the Office (including 
                recommendations on priorities in carrying out research 
                described in subparagraph (A)); and
                    ``(D) assist in monitoring compliance with section 
                492B regarding the inclusion of minorities in clinical 
                research.
            ``(5) Biennial report.--
                    ``(A) Preparation.--The Advisory Committee shall 
                prepare a biennial report describing the activities of 
the Committee, including findings made by the Committee regarding--
                            ``(i) compliance with section 492B;
                            ``(ii) the extent of expenditures made for 
                        research and training on minority health by the 
                        agencies of the National Institutes of Health; 
                        and
                            ``(iii) the level of funding needed for 
                        such research and training.
                    ``(B) Submission.--The report required in 
                subparagraph (A) shall be submitted to the Director of 
                NIH for inclusion in the report required in section 
                403.
    ``(f) Representatives of Minorities Among Researchers.--The 
Secretary, acting through the Assistant Secretary for Personnel 
Administration and in collaboration with the Director of the Office, 
shall determine the extent to which minorities are represented among 
senior physicians and scientists of the national research institutes 
and among physicians and scientists conducting research with funds 
provided by such institutes, and as appropriate, carry out activities 
to increase the extent of such representation.
    ``(g) Requirement Regarding Grants and Contracts.--Any award of a 
grant, cooperative agreement, or contract that the Director of the 
Office is authorized to make shall be made only on a competitive basis.
    ``(h) Minority Health Initiative.--With respect to the program that 
was being conducted through the Office as of May 1997 and was known as 
the Minority Health Initiative, the Director of NIH, in collaboration 
with the Director of the Office, shall--
            ``(1) provide for the continuation of the program;
            ``(2) provide for expanding the scope of the program by 
        establishing timetables with benchmarks pertaining to the dual 
        goals of research and training; and
            ``(3) prepare biennial reports on the program and submit 
        the reports to the Director of NIH for inclusion in the 
        biennial reports required in section 403.
    ``(i) Definitions.--For purposes of this part:
            ``(1) The term `minority health conditions', with respect 
        to individuals who are members of racial and ethnic minority 
        groups, means all diseases, disorders, and conditions 
        (including with respect to mental health)--
                    ``(A) unique to, more serious, or more prevalent in 
                such individuals;
                    ``(B) for which the factors of medical risk or 
                types of medical intervention are different for such 
                individuals, or for which it is unknown whether such 
                factors or types are different for such individuals; or
                    ``(C) with respect to which there has been 
                insufficient research involving such individuals as 
                subjects or insufficient data on such individuals.
            ``(2) The term `research on minority health' means research 
        on minority health conditions, including research on preventing 
        such conditions.
            ``(3) The term `racial and ethnic minority group' has the 
        meaning given such term in section 1707(g).
    ``(j) Funding.--
            ``(1) In general.--For the purpose of carrying out this 
        section, there are authorized to be appropriated such sums as 
        may be necessary for each of the fiscal years 1998 through 
        2002.
            ``(2) Minority health initiative.--For the purpose of 
        carrying out subsection (h), there are authorized to be 
        appropriated such sums as may be necessary for each of the 
        fiscal years 1998 through 2002. Such authorization is in 
        addition to the authorization of appropriations established in 
        paragraph (1) with respect to such purpose.''.

SEC. 4. OTHER PROGRAMS REGARDING MINORITY HEALTH.

    (a) Collection of Health Data.--Section 306(n) of the Public Health 
Service Act (42 U.S.C. 242k(n)) is amended--
            (1) in paragraph (1), by striking ``1998'' and inserting 
        ``2002''; and
            (2) in paragraph (2), in the first sentence--
                    (A) by striking ``and'' after ``1993,''; and
                    (B) by striking ``for each of the fiscal years 1994 
                through 1998'' and inserting the following: ``for 
                fiscal year 1997, and such sums as may be necessary for 
                each of the fiscal years 1998 through 2002''.
    (b) Grants to States for Loan Repayment Programs.--Section 
338L(l)(1) of the Public Health Service Act (42 U.S.C. 254t(l)(1)) is 
amended--
            (1) by striking ``is authorized'' and inserting ``are 
        authorized''; and
            (2) by inserting before the period the following: ``, and 
        such sums as may be necessary for each of the fiscal years 1998 
        through 2002''.
    (c) Student Loan Funds.--Section 724(f)(1) of the Public Health 
Service Act (42 U.S.C. 292t(f)(1)) is amended--
            (1) by striking ``is authorized'' and inserting ``are 
        authorized''; and
            (2) by inserting before the period the following: ``, and 
        such sums as may be necessary for each of the fiscal years 1998 
        through 2002''.
    (d) Students of Exceptional Financial Need.--Section 736(c) of the 
Public Health Service Act (42 U.S.C. 293(c)) is amended--
            (1) by striking ``is authorized'' and inserting ``are 
        authorized''; and
            (2) by inserting before the period the following: ``, and 
        such sums as may be necessary for each of the fiscal years 1998 
        through 2002''.
    (e) Scholarships Generally; Other Purposes.--Section 737(h)(1) of 
the Public Health Service Act (42 U.S.C. 293a(h)(1)) is amended by 
inserting before the period the following: ``and for each of the fiscal 
years 1998 through 2002''.
    (f) Loan Repayments and Fellowships Regarding Faculty Positions.--
Section 738(c) of the Public Health Service Act (42 U.S.C. 293b(c)) is 
amended--
            (1) by striking ``is authorized'' and inserting ``are 
        authorized''; and
            (2) by inserting before the period the following: ``, and 
        such sums as may be necessary for each of the fiscal years 1998 
        through 2002''.
    (g) Centers of Excellence.--Section 739(i)(1) of the Public Health 
Service Act (42 U.S.C. 293c(i)(1)) is amended by inserting before the 
period the following: ``and for each of the fiscal years 1998 through 
2002''.
    (h) Educational Assistance Regarding Undergraduates.--Section 
740(d)(1) of the Public Health Service Act (42 U.S.C. 293d(d)(1)) is 
amended--
            (1) by striking ``is authorized'' and inserting ``are 
        authorized''; and
            (2) by inserting before the period the following: ``, and 
        such sums as may be necessary for each of the fiscal years 1998 
        through 2002''.
    (i) Research on Certain Health Professions Issues.--Section 781(e) 
of the Public Health Service Act (42 U.S.C. 295(e)) is amended--
            (1) by striking ``is authorized'' and inserting ``are 
        authorized''; and
            (2) by inserting before the period the following: ``, and 
        such sums as may be necessary for each of the fiscal years 1998 
        through 2002''.
    (j) Technical Correction.--Section 487E(a)(3) of the Public Health 
Service Act (42 U.S.C. 288-5(a)(3)) is amended by striking ``Except'' 
and all that follows and inserting the following: ``With respect to the 
National Health Service Corps Loan Repayment Program established in 
subpart III of part D of title III, the provisions of such subpart 
shall, except as inconsistent with this section, apply to the program 
established in paragraph (1) of this subsection in the same manner and 
to the same extent as such provisions apply to the National Health 
Service Corps Loan Repayment Program established in such subpart.''.

SEC. 5. NATIONAL CONFERENCE ON DISADVANTAGED AND MINORITY HEALTH.

    The President, in collaboration with the Secretary of Health and 
Human Services, shall during fiscal year 1998 hold a conference on 
matters relating to the health of individuals from disadvantaged 
backgrounds, including racial and ethnic minorities. Of the amounts 
appropriated under the Public Health Service Act for fiscal year 1998, 
such Secretary shall, for purposes of holding the conference, make 
available such sums as may be necessary.
                                 <all>