[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[S. 1754 Introduced in Senate (IS)]







105th CONGRESS
  2d Session
                                S. 1754

 To amend the Public Health Service Act to consolidate and reauthorize 
  health professions and minority and disadvantaged health education 
                   programs, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 12, 1998

 Mr. Frist (for himself, Mr. Kennedy, Mr. Jeffords, Mr. Bingaman, Mr. 
Cochran, and Mr. Inouye) introduced the following bill; which was read 
    twice and referred to the Committee on Labor and Human Resources

_______________________________________________________________________

                                 A BILL


 
 To amend the Public Health Service Act to consolidate and reauthorize 
  health professions and minority and disadvantaged health education 
                   programs, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Health Professions 
Education Partnerships Act of 1998''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
TITLE I--HEALTH PROFESSIONS EDUCATION AND FINANCIAL ASSISTANCE PROGRAMS

           Subtitle A--Health Professions Education Programs

Sec. 101. Under-represented minority health professions grant program.
Sec. 102. Training in primary care medicine and dentistry.
Sec. 103. Interdisciplinary, community-based linkages.
Sec. 104. Health professions workforce information and analysis.
Sec. 105. Public health workforce development.
Sec. 106. General provisions.
Sec. 107. Preference in certain programs.
Sec. 108. Definitions.
Sec. 109. Technical amendment on National Health Service Corps.
Sec. 110. Savings provision.
               Subtitle B--Nursing Workforce Development

Sec. 121. Short title.
Sec. 122. Purpose.
Sec. 123. Amendments to Public Health Service Act.
Sec. 124. Savings provision.
                    Subtitle C--Financial Assistance

              Chapter 1--School-Based Revolving Loan Funds

Sec. 131. Primary care loan program.
Sec. 132. Loans for disadvantaged students.
Sec. 133. Student loans regarding schools of nursing.
Sec. 134. General provisions.
   Chapter 2--Insured Health Education Assistance Loans to Graduate 
                                Students

Sec. 141. Health Education Assistance Loan Program.
Sec. 142. Heal lender and holder performance standards.
Sec. 143. Reauthorization.
Sec. 144. HEAL bankruptcy.
Sec. 145. HEAL refinancing.
                  TITLE II--OFFICE OF MINORITY HEALTH

Sec. 201. Revision and extension of programs of Office of Minority 
                            Health.
                    TITLE III--SELECTED INITIATIVES

Sec. 301. State offices of rural health.
Sec. 302. Demonstration projects regarding Alzheimer's Disease.
Sec. 303. Project grants for immunization services.
                   TITLE IV--MISCELLANEOUS PROVISIONS

Sec. 401. Technical corrections regarding Public Law 103-183.
Sec. 402. Miscellaneous amendments regarding PHS commissioned officers.
Sec. 403. Clinical traineeships.
Sec. 404. Project grants for screenings, referrals, and education 
                            regarding lead poisoning.
Sec. 405. Project grants for preventive health services regarding 
                            tuberculosis.
Sec. 406. Certain authorities of Centers for Disease Control and 
                            Prevention.
Sec. 407. Community programs on domestic violence.
Sec. 408. State loan repayment program.
Sec. 409. Construction of regional centers for research on primates.
Sec. 410. Peer review.
Sec. 411. Funding for trauma care.
Sec. 412. Health information and health promotion.
Sec. 413. Emergency medical services for children.
Sec. 414. Administration of certain requirements.
Sec. 415. Aids drug assistance program.

TITLE I--HEALTH PROFESSIONS EDUCATION AND FINANCIAL ASSISTANCE PROGRAMS

           Subtitle A--Health Professions Education Programs

SEC. 101. UNDER-REPRESENTED MINORITY HEALTH PROFESSIONS GRANT PROGRAM.

    (a) In General.--Part B of title VII of the Public Health Service 
Act (42 U.S.C. 293 et seq.) is amended to read as follows:

          ``PART B--HEALTH PROFESSIONS TRAINING FOR DIVERSITY

``SEC. 736. CENTERS OF EXCELLENCE.

    ``(a) In General.--The Secretary shall make grants to designated 
health professions schools described in subsection (c) for the purpose 
of assisting the schools in supporting programs of excellence in health 
professions education for under-represented minority individuals.
    ``(b) Required Use of Funds.--The Secretary may not make a grant 
under subsection (a) unless the designated health professions school 
involved agrees, subject to subsection (c)(1)(C), to expend the grant--
            ``(1) to develop a large competitive applicant pool through 
        linkages with institutions of higher education, local school 
        districts, and other community-based entities and establish an 
        education pipeline for health professions careers;
            ``(2) to establish, strengthen, or expand programs to 
        enhance the academic performance of under-represented minority 
        students attending the school;
            ``(3) to improve the capacity of such school to train, 
        recruit, and retain under-represented minority faculty 
        including the payment of such stipends and fellowships as the 
        Secretary may determine appropriate;
            ``(4) to carry out activities to improve the information 
        resources, clinical education, curricula and cultural 
        competence of the graduates of the school, as it relates to 
        minority health issues;
            ``(5) to facilitate faculty and student research on health 
        issues particularly affecting under-represented minority 
        groups, including research on issues relating to the delivery 
        of health care; and
            ``(6) to carry out a program to train students of the 
        school in providing health services to a significant number of 
        under-represented minority individuals through training 
        provided to such students at community-based health facilities 
        that--
                    ``(A) provide such health services; and
                    ``(B) are located at a site remote from the main 
                site of the teaching facilities of the school.
    ``(c) Centers of Excellence.--
            ``(1) Designated schools.--
                    ``(A) In general.--The designated health 
                professions schools referred to in subsection (a) are 
                such schools that meet each of the conditions specified 
                in subparagraphs (B) and (C), and that--
                            ``(i) meet each of the conditions specified 
                        in paragraph (2)(A);
                            ``(ii) meet each of the conditions 
                        specified in paragraph (3);
                            ``(iii) meet each of the conditions 
                        specified in paragraph (4); or
                            ``(iv) meet each of the conditions 
                        specified in paragraph (5).
                    ``(B) General conditions.--The conditions specified 
                in this subparagraph are that a designated health 
                professions school--
                            ``(i) has a significant number of under-
                        represented minority individuals enrolled in 
                        the school, including individuals accepted for 
                        enrollment in the school;
                            ``(ii) has been effective in assisting 
                        under-represented minority students of the 
                        school to complete the program of education and 
                        receive the degree involved;
                            ``(iii) has been effective in recruiting 
                        under-represented minority individuals to 
                        enroll in and graduate from the school, 
                        including providing scholarships and other 
                        financial assistance to such individuals and 
                        encouraging under-represented minority students 
                        from all levels of the educational pipeline to 
                        pursue health professions careers; and
                            ``(iv) has made significant recruitment 
                        efforts to increase the number of under-
                        represented minority individuals serving in 
                        faculty or administrative positions at the 
                        school.
                    ``(C) Consortium.--The condition specified in this 
                subparagraph is that, in accordance with subsection 
                (e)(1), the designated health profession school 
                involved has with other health profession schools 
                (designated or otherwise) formed a consortium to carry 
                out the purposes described in subsection (b) at the 
                schools of the consortium.
                    ``(D) Application of criteria to other programs.--
                In the case of any criteria established by the 
                Secretary for purposes of determining whether schools 
                meet the conditions described in subparagraph (B), this 
                section may not, with respect to racial and ethnic 
                minorities, be construed to authorize, require, or 
                prohibit the use of such criteria in any program other 
                than the program established in this section.
            ``(2) Centers of excellence at certain historically black 
        colleges and universities.--
                    ``(A) Conditions.--The conditions specified in this 
                subparagraph are that a designated health professions 
                school--
                            ``(i) is a school described in section 
                        799B(1); and
                            ``(ii) received a contract under section 
                        788B for fiscal year 1987, as such section was 
                        in effect for such fiscal year.
                    ``(B) Use of grant.--In addition to the purposes 
                described in subsection (b), a grant under subsection 
                (a) to a designated health professions school meeting 
                the conditions described in subparagraph (A) may be 
                expended--
                            ``(i) to develop a plan to achieve 
                        institutional improvements, including financial 
                        independence, to enable the school to support 
                        programs of excellence in health professions 
                        education for under-represented minority 
                        individuals; and
                            ``(ii) to provide improved access to the 
                        library and informational resources of the 
                        school.
                    ``(C) Exception.--The requirements of paragraph 
                (1)(C) shall not apply to a historically black college 
                or university that receives funding under paragraphs 
                (2) or (5).
            ``(3) Hispanic centers of excellence.--The conditions 
        specified in this paragraph are that--
                    ``(A) with respect to Hispanic individuals, each of 
                clauses (i) through (iv) of paragraph (1)(B) applies to 
                the designated health professions school involved;
                    ``(B) the school agrees, as a condition of 
                receiving a grant under subsection (a), that the school 
                will, in carrying out the duties described in 
                subsection (b), give priority to carrying out the 
                duties with respect to Hispanic individuals; and
                    ``(C) the school agrees, as a condition of 
                receiving a grant under subsection (a), that--
                            ``(i) the school will establish an 
                        arrangement with 1 or more public or nonprofit 
                        community based Hispanic serving organizations, 
                        or public or nonprofit private institutions of 
                        higher education, including schools of nursing, 
                        whose enrollment of students has traditionally 
                        included a significant number of Hispanic 
                        individuals, the purposes of which will be to 
                        carry out a program--
                                    ``(I) to identify Hispanic students 
                                who are interested in a career in the 
                                health profession involved; and
                                    ``(II) to facilitate the 
                                educational preparation of such 
                                students to enter the health 
                                professions school; and
                            ``(ii) the school will make efforts to 
                        recruit Hispanic students, including students 
                        who have participated in the undergraduate or 
                        other matriculation program carried out under 
                        arrangements established by the school pursuant 
                        to clause (i)(II) and will assist Hispanic 
                        students regarding the completion of the 
                        educational requirements for a degree from the 
                        school.
            ``(4) Native american centers of excellence.--Subject to 
        subsection (e), the conditions specified in this paragraph are 
        that--
                    ``(A) with respect to Native Americans, each of 
                clauses (i) through (iv) of paragraph (1)(B) applies to 
                the designated health professions school involved;
                    ``(B) the school agrees, as a condition of 
                receiving a grant under subsection (a), that the school 
                will, in carrying out the duties described in 
                subsection (b), give priority to carrying out the 
                duties with respect to Native Americans; and
                    ``(C) the school agrees, as a condition of 
                receiving a grant under subsection (a), that--
                            ``(i) the school will establish an 
                        arrangement with 1 or more public or nonprofit 
                        private institutions of higher education, 
                        including schools of nursing, whose enrollment 
                        of students has traditionally included a 
                        significant number of Native Americans, the 
                        purpose of which arrangement will be to carry 
                        out a program--
                                    ``(I) to identify Native American 
                                students, from the institutions of 
                                higher education referred to in clause 
                                (i), who are interested in health 
                                professions careers; and
                                    ``(II) to facilitate the 
                                educational preparation of such 
                                students to enter the designated health 
                                professions school; and
                            ``(ii) the designated health professions 
                        school will make efforts to recruit Native 
                        American students, including students who have 
                        participated in the undergraduate program 
                        carried out under arrangements established by 
                        the school pursuant to clause (i) and will 
                        assist Native American students regarding the 
                        completion of the educational requirements for 
                        a degree from the designated health professions 
                        school.
            ``(5) Other centers of excellence.--The conditions 
        specified in this paragraph are--
                    ``(A) with respect to other centers of excellence, 
                the conditions described in clauses (i) through (iv) of 
                paragraph (1)(B); and
                    ``(B) that the health professions school involved 
                has an enrollment of under-represented minorities above 
                the national average for such enrollments of health 
                professions schools.
    ``(d) Designation as Center of Excellence.--
            ``(1) In general.--Any designated health professions school 
        receiving a grant under subsection (a) and meeting the 
        conditions described in paragraph (2) or (5) of subsection (c) 
        shall, for purposes of this section, be designated by the 
        Secretary as a Center of Excellence in Under-Represented 
        Minority Health Professions Education.
            ``(2) Hispanic centers of excellence.--Any designated 
        health professions school receiving a grant under subsection 
        (a) and meeting the conditions described in subsection (c)(3) 
        shall, for purposes of this section, be designated by the 
Secretary as a Hispanic Center of Excellence in Health Professions 
Education.
            ``(3) Native american centers of excellence.--Any 
        designated health professions school receiving a grant under 
        subsection (a) and meeting the conditions described in 
        subsection (c)(4) shall, for purposes of this section, be 
        designated by the Secretary as a Native American Center of 
        Excellence in Health Professions Education. Any consortium 
        receiving such a grant pursuant to subsection (e) shall, for 
        purposes of this section, be so designated.
    ``(e) Authority Regarding Native American Centers of Excellence.--
With respect to meeting the conditions specified in subsection (c)(4), 
the Secretary may make a grant under subsection (a) to a designated 
health professions school that does not meet such conditions if--
            ``(1) the school has formed a consortium in accordance with 
        subsection (d)(1); and
            ``(2) the schools of the consortium collectively meet such 
        conditions, without regard to whether the schools individually 
        meet such conditions.
    ``(f) Duration of Grant.--The period during which payments are made 
under a grant under subsection (a) may not exceed 5 years. Such 
payments shall be subject to annual approval by the Secretary and to 
the availability of appropriations for the fiscal year involved to make 
the payments.
    ``(g) Definitions.--In this section:
            ``(1) Designated health professions school.--
                    ``(A) In general.--The term `health professions 
                school' means, except as provided in subparagraph (B), 
                a school of medicine, a school of osteopathic medicine, 
                a school of dentistry, a school of pharmacy, or a 
                graduate program in behavioral or mental health.
                    ``(B) Exception.--The definition established in 
                subparagraph (A) shall not apply to the use of the term 
                `designated health professions school' for purposes of 
                subsection (c)(2).
            ``(2) Program of excellence.--The term `program of 
        excellence' means any program carried out by a designated 
        health professions school with a grant made under subsection 
        (a), if the program is for purposes for which the school 
        involved is authorized in subsection (b) or (c) to expend the 
        grant.
            ``(3) Native americans.--The term `Native Americans' means 
        American Indians, Alaskan Natives, Aleuts, and Native 
        Hawaiians.
    ``(h) Funding.--
            ``(1) Authorization of appropriations.--For the purpose of 
        making grants under subsection (a), there authorized to be 
        appropriated $26,000,000 for fiscal year 1998, and such sums as 
        may be necessary for each of the fiscal years 1999 through 
        2002.
            ``(2) Allocations.--Based on the amount appropriated under 
        paragraph (1) for a fiscal year, one of the following 
        subparagraphs shall apply:
                    ``(A) In general.--If the amounts appropriated 
                under paragraph (1) for a fiscal year are less than 
                $24,000,000--
                            ``(i) the Secretary shall make available 
                        $12,000,000 for grants under subsection (a) to 
health professions schools that meet the conditions described in 
subsection (c)(2)(A); and
                            ``(ii) and available after grants are made 
                        with funds under clause (i), the Secretary 
                        shall make available--
                                    ``(I) 60 percent of such amount for 
                                grants under subsection (a) to health 
                                professions schools that meet the 
                                conditions described in paragraph (3) 
                                or (4) of subsection (c) (including 
                                meeting the conditions under subsection 
                                (e)); and
                                    ``(II) 40 percent of such amount 
                                for grants under subsection (a) to 
                                health professions schools that meet 
                                the conditions described in subsection 
                                (c)(5).
                    ``(B) Funding in excess of $24,000,000.--If amounts 
                appropriated under paragraph (1) for a fiscal year 
                exceed $24,000,000 but are less than $30,000,000--
                            ``(i) 80 percent of such excess amounts 
                        shall be made available for grants under 
                        subsection (a) to health professions schools 
                        that meet the requirements described in 
                        paragraph (3) or (4) of subsection (c) 
                        (including meeting conditions pursuant to 
                        subsection (e)); and
                            ``(ii) 20 percent of such excess amount 
                        shall be made available for grants under 
                        subsection (a) to health professions schools 
                        that meet the conditions described in 
                        subsection (c)(5).
                    ``(C) Funding in excess of $30,000,000.--If amounts 
                appropriated under paragraph (1) for a fiscal year 
                exceed $30,000,000, the Secretary shall make 
                available--
                            ``(i) not less than $12,000,000 for grants 
                        under subsection (a) to health professions 
                        schools that meet the conditions described in 
                        subsection (c)(2)(A);
                            ``(ii) not less than $12,000,000 for grants 
                        under subsection (a) to health professions 
                        schools that meet the conditions described in 
                        paragraph (3) or (4) of subsection (c) 
                        (including meeting conditions pursuant to 
                        subsection (e));
                            ``(iii) not less than $6,000,000 for grants 
                        under subsection (a) to health professions 
                        schools that meet the conditions described in 
                        subsection (c)(5); and
                            ``(iv) after grants are made with funds 
                        under clauses (i) through (iii), any remaining 
                        funds for grants under subsection (a) to health 
                        professions schools that meet the conditions 
                        described in paragraph (2)(A), (3), (4), or (5) 
                        of subsection (c).
            ``(3) No limitation.--Nothing in this subsection shall be 
        construed as limiting the centers of excellence referred to in 
        this section to the designated amount, or to preclude such 
        entities from competing for other grants under this section.
            ``(4) Maintenance of effort.--
                    ``(A) In general.--With respect to activities for 
                which a grant made under this part are authorized to be 
                expended, the Secretary may not make such a grant to a 
                center of excellence for any fiscal year unless the 
                center agrees to maintain expenditures of non-Federal 
                amounts for such activities at a level that is not less 
                than the level of such expenditures maintained by the 
                center for the fiscal year preceding the fiscal year 
                for which the school receives such a grant.
                    ``(B) Use of federal funds.--With respect to any 
                Federal amounts received by a center of excellence and 
                available for carrying out activities for which a grant 
                under this part is authorized to be expended, the 
                Secretary may not make such a grant to the center for 
                any fiscal year unless the center agrees that the 
                center will, before expending the grant, expend the 
                Federal amounts obtained from sources other than the 
                grant.

``SEC. 737. SCHOLARSHIPS FOR DISADVANTAGED STUDENTS.

    ``(a) In General.--The Secretary may make a grant to an eligible 
entity (as defined in subsection (d)(1)) under this section for the 
awarding of scholarships by schools to any full-time student who is an 
eligible individual as defined in subsection (d). Such scholarships may 
be expended only for tuition expenses, other reasonable educational 
expenses, and reasonable living expenses incurred in the attendance of 
such school.
    ``(b) Preference in Providing Scholarships.--The Secretary may not 
make a grant to an entity under subsection (a) unless the health 
professions and nursing schools involved agree that, in providing 
scholarships pursuant to the grant, the schools will give preference to 
students for whom the costs of attending the schools would constitute a 
severe financial hardship and, notwithstanding other provisions of this 
section, to former recipients of scholarships under sections 736 and 
740(d)(2)(B) (as such sections existed on the day before the date of 
enactment of this section).
    ``(c) Amount of Award.--In awarding grants to eligible entities 
that are health professions and nursing schools, the Secretary shall 
give priority to eligible entities based on the proportion of 
graduating students going into primary care, the proportion of 
underrepresented minority students, and the proportion of graduates 
working in medically underserved communities.
    ``(d) Definitions.--In this section:
            ``(1) Eligible entities.--The term `eligible entities' 
        means an entity that--
                    ``(A) is a school of medicine, osteopathic 
                medicine, dentistry, nursing (as defined in section 
                801), pharmacy, podiatric medicine, optometry, 
                veterinary medicine, public health, or allied health, a 
                school offering a graduate program in behavioral and 
                mental health practice, or an entity providing programs 
                for the training of physician assistants; and
                    ``(B) is carrying out a program for recruiting and 
                retaining students from disadvantaged backgrounds, 
                including students who are members of racial and ethnic 
                minority groups.
            ``(2) Eligible individual.--The term `eligible individual' 
        means an individual who--
                    ``(A) is from a disadvantaged background;
                    ``(B) has a financial need for a scholarship; and
                    ``(C) is enrolled (or accepted for enrollment) at 
                an eligible health professions or nursing school as a 
                full-time student in a program leading to a degree in a 
                health profession or nursing.

``SEC. 738. LOAN REPAYMENTS AND FELLOWSHIPS REGARDING FACULTY 
              POSITIONS.

    ``(a) Loan Repayments.--
            ``(1) Establishment of program.--The Secretary shall 
        establish a program of entering into contracts with individuals 
        described in paragraph (2) under which the individuals agree to 
        serve as members of the faculties of schools described in 
        paragraph (3) in consideration of the Federal Government 
        agreeing to pay, for each year of such service, not more than 
        $20,000 of the principal and interest of the educational loans 
        of such individuals.
            ``(2) Eligible individuals.--The individuals referred to in 
        paragraph (1) are individuals from disadvantaged backgrounds 
        who--
                    ``(A) have a degree in medicine, osteopathic 
                medicine, dentistry, nursing, or another health 
                profession;
                    ``(B) are enrolled in an approved graduate training 
                program in medicine, osteopathic medicine, dentistry, 
                nursing, or other health profession; or
                    ``(C) are enrolled as full-time students--
                            ``(i) in an accredited (as determined by 
                        the Secretary) school described in paragraph 
                        (3); and
                            ``(ii) in the final year of a course of a 
                        study or program, offered by such institution 
                        and approved by the Secretary, leading to a 
                        degree from such a school.
            ``(3) Eligible health professions schools.--The schools 
        described in this paragraph are schools of medicine, nursing 
        (as schools of nursing are defined in section 801), osteopathic 
        medicine, dentistry, pharmacy, allied health, podiatric 
        medicine, optometry, veterinary medicine, or public health, or 
        schools offering graduate programs in behavioral and mental 
        health.
            ``(4) Requirements regarding faculty positions.--The 
        Secretary may not enter into a contract under paragraph (1) 
        unless--
                    ``(A) the individual involved has entered into a 
                contract with a school described in paragraph (3) to 
                serve as a member of the faculty of the school for not 
                less than 2 years; and
                    ``(B) the contract referred to in subparagraph (A) 
                provides that--
                            ``(i) the school will, for each year for 
                        which the individual will serve as a member of 
                        the faculty under the contract with the school, 
                        make payments of the principal and interest due 
                        on the educational loans of the individual for 
                        such year in an amount equal to the amount of 
                        such payments made by the Secretary for the 
                        year;
                            ``(ii) the payments made by the school 
                        pursuant to clause (i) on behalf of the 
                        individual will be in addition to the pay that 
                        the individual would otherwise receive for 
                        serving as a member of such faculty; and
                            ``(iii) the school, in making a 
                        determination of the amount of compensation to 
                        be provided by the school to the individual for 
                        serving as a member of the faculty, will make 
                        the determination without regard to the amount 
                        of payments made (or to be made) to the 
                        individual by the Federal Government under 
                        paragraph (1).
            ``(5) Applicability of certain provisions.--The provisions 
        of sections 338C, 338G, and 338I shall apply to the program 
        established in paragraph (1) to the same extent and in the same 
        manner as such provisions apply to the National Health Service 
        Corps Loan Repayment Program established in subpart III of part 
        D of title III, including the applicability of provisions 
        regarding reimbursements for increased tax liability and 
        regarding bankruptcy.
            ``(6) Waiver regarding school contributions.--The Secretary 
        may waive the requirement established in paragraph (4)(B) if 
        the Secretary determines that the requirement will impose an 
        undue financial hardship on the school involved.
    ``(b) Fellowships.--
            ``(1) In general.--The Secretary may make grants to and 
        enter into contracts with eligible entities to assist such 
        entities in increasing the number of underrepresented minority 
        individuals who are members of the faculty of such schools.
            ``(2) Applications.--To be eligible to receive a grant or 
        contract under this subsection, an entity shall provide an 
        assurance, in the application submitted by the entity, that--
                    ``(A) amounts received under such a grant or 
                contract will be used to award a fellowship to an 
                individual only if the individual meets the 
                requirements of paragraphs (3) and (4); and
                    ``(B) each fellowship awarded pursuant to the grant 
                or contract will include--
                            ``(i) a stipend in an amount not exceeding 
                        50 percent of the regular salary of a similar 
                        faculty member for not to exceed 3 years of 
                        training; and
                            ``(ii) an allowance for other expenses, 
                        such as travel to professional meetings and 
                        costs related to specialized training.
            ``(3) Eligibility.--To be eligible to receive a grant or 
        contract under paragraph (1), an applicant shall demonstrate to 
        the Secretary that such applicant has or will have the ability 
        to--
                    ``(A) identify, recruit and select underrepresented 
                minority individuals who have the potential for 
                teaching, administration, or conducting research at a 
                health professions institution;
                    ``(B) provide such individuals with the skills 
                necessary to enable them to secure a tenured faculty 
                position at such institution, which may include 
                training with respect to pedagogical skills, program 
                administration, the design and conduct of research, 
                grants writing, and the preparation of articles 
                suitable for publication in peer reviewed journals;
                    ``(C) provide services designed to assist such 
                individuals in their preparation for an academic 
                career, including the provision of counselors; and
                    ``(D) provide health services to rural or medically 
                underserved populations.
            ``(4) Requirements.--To be eligible to receive a grant or 
        contract under paragraph (1) an applicant shall--
                    ``(A) provide an assurance that such applicant will 
                make available (directly through cash donations) $1 for 
                every $1 of Federal funds received under this section 
                for the fellowship;
                    ``(B) provide an assurance that institutional 
                support will be provided for the individual for the 
                second and third years at a level that is equal to the 
                total amount of institutional funds provided in the 
                year in which the grant or contract was awarded;
                    ``(C) provide an assurance that the individual that 
                will receive the fellowship will be a member of the 
                faculty of the applicant school; and
                    ``(D) provide an assurance that the individual that 
                will receive the fellowship will have, at a minimum, 
                appropriate advanced preparation (such as a master's or 
                doctoral degree) and special skills necessary to enable 
                such individual to teach and practice.
            ``(5) Definition.--For purposes of this subsection, the 
        term `underrepresented minority individuals' means individuals 
        who are members of racial or ethnic minority groups that are 
        underrepresented in the health professions including nursing.

``SEC. 739. EDUCATIONAL ASSISTANCE IN THE HEALTH PROFESSIONS REGARDING 
              INDIVIDUALS FROM DISADVANTAGED BACKGROUNDS.

    ``(a) In General.--
            ``(1) Authority for grants.--For the purpose of assisting 
        individuals from disadvantaged backgrounds, as determined in 
        accordance with criteria prescribed by the Secretary, to 
        undertake education to enter a health profession, the Secretary 
        may make grants to and enter into contracts with schools of 
        medicine, osteopathic medicine, public health, dentistry, 
        veterinary medicine, optometry, pharmacy, allied health, 
        chiropractic, and podiatric medicine, public and nonprofit 
        private schools that offer graduate programs in behavioral and 
        mental health, programs for the training of physician 
        assistants, and other public or private nonprofit health or 
        educational entities to assist in meeting the costs described 
        in paragraph (2).
            ``(2) Authorized expenditures.--A grant or contract under 
        paragraph (1) may be used by the entity to meet the cost of--
                    ``(A) identifying, recruiting, and selecting 
                individuals from disadvantaged backgrounds, as so 
                determined, for education and training in a health 
                profession;
                    ``(B) facilitating the entry of such individuals 
                into such a school;
                    ``(C) providing counseling, mentoring, or other 
                services designed to assist such individuals to 
                complete successfully their education at such a school;
                    ``(D) providing, for a period prior to the entry of 
                such individuals into the regular course of education 
                of such a school, preliminary education and health 
                research training designed to assist them to complete 
                successfully such regular course of education at such a 
                school, or referring such individuals to institutions 
                providing such preliminary education;
                    ``(E) publicizing existing sources of financial aid 
                available to students in the education program of such 
                a school or who are undertaking training necessary to 
                qualify them to enroll in such a program;
                    ``(F) paying such scholarships as the Secretary may 
                determine for such individuals for any period of health 
                professions education at a health professions school;
                    ``(G) paying such stipends as the Secretary may 
                approve for such individuals for any period of 
                education in student-enhancement programs (other than 
                regular courses) at any health professions school, 
                except that such a stipend may not be provided to an 
                individual for more than 12 months, and such a stipend 
                shall be in an amount determined appropriate by the 
                Secretary (notwithstanding any other provision of law 
                regarding the amount of stipends);
                    ``(H) carrying out programs under which such 
                individuals gain experience regarding a career in a 
                field of primary health care through working at 
                facilities of public or private nonprofit community-
                based providers of primary health services; and
                    ``(I) conducting activities to develop a larger and 
                more competitive applicant pool through partnerships 
                with institutions of higher education, school 
                districts, and other community-based entities.
            ``(3) Definition.--In this section, the term `regular 
        course of education of such a school' as used in subparagraph 
        (D) includes a graduate program in behavioral or mental health.
    ``(b) Requirements for Awards.--In making awards to eligible 
entities under subsection (a)(1), the Secretary shall give preference 
to approved applications for programs that involve a comprehensive 
approach by several public or nonprofit private health or educational 
entities to establish, enhance and expand educational programs that 
will result in the development of a competitive applicant pool of 
individuals from disadvantaged backgrounds who desire to pursue health 
professions careers. In considering awards for such a comprehensive 
partnership approach, the following shall apply with respect to the 
entity involved:
            ``(1) The entity shall have a demonstrated commitment to 
        such approach through formal agreements that have common 
        objectives with institutions of higher education, school 
        districts, and other community-based entities.
            ``(2) Such formal agreements shall reflect the coordination 
        of educational activities and support services, increased 
        linkages, and the consolidation of resources within a specific 
        geographic area.
            ``(3) The design of the educational activities involved 
        shall provide for the establishment of a competitive health 
        professions applicant pool of individuals from disadvantaged 
        backgrounds by enhancing the total preparation (academic and 
        social) of such individuals to pursue a health professions 
        career.
            ``(4) The programs or activities under the award shall 
        focus on developing a culturally competent health care 
        workforce that will serve the unserved and underserved 
        populations within the geographic area.
    ``(c) Equitable Allocation of Financial Assistance.--The Secretary, 
to the extent practicable, shall ensure that services and activities 
under subsection (a) are adequately allocated among the various racial 
and ethnic populations who are from disadvantaged backgrounds.
    ``(d) Matching Requirements.--The Secretary may require that an 
entity that applies for a grant or contract under subsection (a), 
provide non-Federal matching funds, as appropriate, to ensure the 
institutional commitment of the entity to the projects funded under the 
grant or contract. As determined by the Secretary, such non-Federal 
matching funds may be provided directly or through donations from 
public or private entities and may be in cash or in-kind, fairly 
evaluated, including plant, equipment, or services.

``SEC. 740. AUTHORIZATION OF APPROPRIATION.

    ``(a) Scholarships.--There are authorized to be appropriated to 
carry out section 737, $37,000,000 for fiscal year 1998, and such sums 
as may be necessary for each of the fiscal years 1999 through 2002. Of 
the amount appropriated in any fiscal year, the Secretary shall ensure 
that not less than 16 percent shall be distributed to schools of 
nursing.
    ``(b) Loan Repayments and Fellowships.--For the purpose of carrying 
out section 738, there is authorized to be appropriated $1,100,000 for 
fiscal year 1998, and such sums as may be necessary for each of the 
fiscal years 1999 through 2002.
    ``(c) Undergraduate Assistance.--For the purpose of grants and 
contracts under section 739(a)(1), there is authorized to be 
appropriated $29,400,000 for fiscal year 1998, and such sums as may be 
necessary for each of the fiscal years 1999 through 2002. The Secretary 
may use not to exceed 20 percent of the amount appropriated for a 
fiscal year under this subsection to provide scholarships under section 
739(a)(2)(F).
    ``(d) Report.--Not later than 6 months after the date of enactment 
of this part, the Secretary shall prepare and submit to the appropriate 
committees of Congress a report concerning the efforts of the Secretary 
to address the need for a representative mix of individuals from 
historically minority health professions schools, or from institutions 
or other entities that historically or by geographic location have a 
demonstrated record of training or educating underrepresented 
minorities, within various health professions disciplines, on peer 
review councils.''.
    (b) Repeal.--
            (1) In general.--Section 795 of the Public Health Service 
        Act (42 U.S.C. 295n) is repealed.
            (2) Nontermination of authority.--The amendments made by 
        this section shall not be construed to terminate agreements 
        that, on the day before the date of enactment of this Act, are 
        in effect pursuant to section 795 of the Public Health Service 
        Act (42 U.S.C. 795) as such section existed on such date. Such 
        agreements shall continue in effect in accordance with the 
        terms of the agreements. With respect to compliance with such 
        agreements, any period of practice as a provider of primary 
        health services shall be counted towards the satisfaction of 
        the requirement of practice pursuant to such section 795.
    (c) Conforming Amendments.--Section 481A(c)(3)(D)(i) of the Public 
Health Service Act (42 U.S.C. 287a-2(c)(3)(D)(i)) is amended by 
striking ``section 739'' and inserting ``part B of title VII''.

SEC. 102. TRAINING IN PRIMARY CARE MEDICINE AND DENTISTRY.

    Part C of title VII of the Public Health Service Act (42 U.S.C. 293 
et seq.) is amended--
            (1) in the part heading by striking ``PRIMARY HEALTH CARE'' 
        and inserting ``FAMILY MEDICINE, GENERAL INTERNAL MEDICINE, 
        GENERAL PEDIATRICS, PHYSICIAN ASSISTANTS, GENERAL DENTISTRY, 
        AND PEDIATRIC DENTISTRY'';
            (2) by repealing section 746 (42 U.S.C. 293j);
            (3) in section 747 (42 U.S.C. 293k)--
                    (A) by striking the section heading and inserting 
                the following:

``SEC. 747. FAMILY MEDICINE, GENERAL INTERNAL MEDICINE, GENERAL 
              PEDIATRICS, GENERAL DENTISTRY, PEDIATRIC DENTISTRY, AND 
              PHYSICIAN ASSISTANTS.'';

                    (B) in subsection (a)--
                            (i) in paragraph (1)--
                                    (I) by inserting ``, internal 
                                medicine, or pediatrics'' after 
                                ``family medicine''; and
                                    (II) by inserting before the 
                                semicolon the following: ``that 
                                emphasizes training for the practice of 
                                family medicine, general internal 
                                medicine, or general pediatrics (as 
                                defined by the Secretary)'';
                            (ii) in paragraph (2), by inserting ``, 
                        general internal medicine, or general 
                        pediatrics'' before the semicolon;
                            (iii) in paragraphs (3) and (4), by 
                        inserting ``, general internal medicine or 
                        general pediatrics'' after ``family medicine'';
                            (iv) in paragraphs (3) and (4), by 
                        inserting ``(including geriatrics) after 
                        ``family medicine'';
                            (v) in paragraph (3), by striking ``and'' 
                        at the end thereof;
                            (vi) in paragraph (4), by striking the 
                        period and inserting a semicolon; and
                            (vii) by adding at the end thereof the 
                        following new paragraphs:
            ``(5) to meet the costs of projects to plan, develop, and 
        operate or maintain programs for the training of physician 
        assistants (as defined in section 799B), and for the training 
        of individuals who will teach in programs to provide such 
        training; and
            ``(6) to meet the costs of planning, developing, or 
        operating programs, and to provide financial assistance to 
        residents in such programs, of general dentistry or pediatric 
        dentistry.
For purposes of paragraph (6), entities eligible for such grants or 
contracts shall include entities that have programs in dental schools, 
approved residency programs in the general or pediatric practice of 
dentistry, approved advanced education programs in the general or 
pediatric practice of dentistry, or approved residency programs in 
pediatric dentistry.'';
                    (C) in subsection (b)--
                            (i) in paragraphs (1) and (2)(A), by 
                        inserting ``, general internal medicine, or 
                        general pediatrics'' after ``family medicine'';
                            (ii) in paragraph (2)--
                                    (I) in subparagraph (A), by 
                                striking ``or'' at the end; and
                                    (II) in subparagraph (B), by 
                                striking the period and inserting ``; 
                                or''; and
                            (iii) by adding at the end the following:
            ``(3) Priority in making awards.--In making awards of 
        grants and contracts under paragraph (1), the Secretary shall 
        give priority to any qualified applicant for such an award that 
        proposes a collaborative project between departments of primary 
        care.'';
                    (D) by redesignating subsections (c) and (d) as 
                subsections (d) and (e), respectively;
                    (E) by inserting after subsection (b), the 
                following new subsection:
    ``(c) Priority.--
            ``(1) In general.--With respect to programs for the 
        training of interns or residents, the Secretary shall give 
        priority in awarding grants under this section to qualified 
        applicants that have a record of training the greatest 
        percentage of providers, or that have demonstrated significant 
        improvements in the percentage of providers, which enter and 
        remain in primary care practice or general or pediatric 
        dentistry.
            ``(2) Disadvantaged individuals.--With respect to programs 
        for the training of interns, residents, or physician 
        assistants, the Secretary shall give priority in awarding 
        grants under this section to qualified applicants that have a 
        record of training individuals who are from disadvantaged 
        backgrounds (including racial and ethnic minorities 
        underrepresented among primary care practice or general or 
        pediatric dentistry).
            ``(3) Special consideration.--In awarding grants under this 
        section the Secretary shall give special consideration to 
        projects which prepare practitioners to care for underserved 
        populations and other high risk groups such as the elderly, 
        individuals with HIV-AIDS, substance abusers, homeless, and 
        victims of domestic violence.''; and
                    (F) in subsection (e) (as so redesignated by 
                subparagraph (D))--
                            (i) in paragraph (1), by striking 
                        ``$54,000,000'' and all that follows and 
                        inserting ``$78,300,000 for fiscal year 1998, 
                        and such sums as may be necessary for each of 
                        the fiscal years 1999 through 2002.''; and
                            (ii) by striking paragraph (2) and 
                        inserting the following:
            ``(2) Allocation.--
                    ``(A) In general.--Of the amounts appropriated 
                under paragraph (1) for a fiscal year, the Secretary 
                shall make available--
                            ``(i) not less than $49,300,000 for awards 
                        of grants and contracts under subsection (a) to 
                        programs of family medicine, of which not less 
                        than $8,600,000 shall be made available for 
                        awards of grants and contracts under subsection 
                        (b) for family medicine academic administrative 
                        units;
                            ``(ii) not less than $17,700,000 for awards 
                        of grants and contracts under subsection (a) to 
                        programs of general internal medicine and 
                        general pediatrics;
                            ``(iii) not less than $6,800,000 for awards 
                        of grants and contracts under subsection (a) to 
                        programs relating to physician assistants; and
                            ``(iv) not less than $4,500,000 for awards 
                        of grants and contracts under subsection (a) to 
                        programs of general or pediatric dentistry.
                    ``(B) Ratable reduction.--If amounts appropriated 
                under paragraph (1) for any fiscal year are less than 
                the amount required to comply with subparagraph (A), 
                the Secretary shall ratably reduce the amount to be 
                made available under each of clauses (i) through (iv) 
                of such subparagraph accordingly.''; and
            (4) by repealing sections 748 through 752 (42 U.S.C. 293l 
        through 293p) and inserting the following:

``SEC. 748. ADVISORY COMMITTEE ON TRAINING IN PRIMARY CARE MEDICINE AND 
              DENTISTRY.

    ``(a) Establishment.--The Secretary shall establish an advisory 
committee to be known as the Advisory Committee on Training in Primary 
Care Medicine and Dentistry (in this section referred to as the 
`Advisory Committee').
    ``(b) Composition.--
            ``(1) In general.--The Secretary shall determine the 
        appropriate number of individuals to serve on the Advisory 
        Committee. Such individuals shall not be officers or employees 
        of the Federal Government.
            ``(2) Appointment.--Not later than 90 days after the date 
        of enactment of this Act, the Secretary shall appoint the 
        members of the Advisory Committee from among individuals who 
        are health professionals. In making such appointments, the 
        Secretary shall ensure a fair balance between the health 
        professions, that at least 75 percent of the members of the 
        Advisory Committee are health professionals, a broad geographic 
        representation of members and a balance between urban and rural 
        members. Members shall be appointed based on their competence, 
        interest, and knowledge of the mission of the profession 
        involved.
            ``(3) Minority representation.--In appointing the members 
        of the Advisory Committee under paragraph (2), the Secretary 
        shall ensure the adequate representation of women and 
        minorities.
    ``(c) Terms.--
            ``(1) In general.--A member of the Advisory Committee shall 
        be appointed for a term of 3 years, except that of the members 
        first appointed--
                    ``(A) \1/3\ of such members shall serve for a term 
                of 1 year;
                    ``(B) \1/3\ of such members shall serve for a term 
                of 2 years; and
                    ``(C) \1/3\ of such members shall serve for a term 
                of 3 years.
            ``(2) Vacancies.--
                    ``(A) In general.--A vacancy on the Advisory 
                Committee shall be filled in the manner in which the 
                original appointment was made and shall be subject to 
                any conditions which applied with respect to the 
                original appointment.
                    ``(B) Filling unexpired term.--An individual chosen 
                to fill a vacancy shall be appointed for the unexpired 
                term of the member replaced.
    ``(d) Duties.--The Advisory Committee shall--
            ``(1) provide advice and recommendations to the Secretary 
        concerning policy and program development and other matters of 
        significance concerning the activities under section 747; and
            ``(2) not later than 3 years after the date of enactment of 
        this section, and annually thereafter, prepare and submit to 
        the Secretary, and the Committee on Labor and Human Resources 
        of the Senate, and the Committee on Commerce of the House of 
        Representatives, a report describing the activities of the 
        Committee, including findings and recommendations made by the 
        Committee concerning the activities under section 747.
    ``(e) Meetings and Documents.--
            ``(1) Meetings.--The Advisory Committee shall meet not less 
        than 2 times each year. Such meetings shall be held jointly 
        with other related entities established under this title where 
        appropriate.
            ``(2) Documents.--Not later than 14 days prior to the 
        convening of a meeting under paragraph (1), the Advisory 
        Committee shall prepare and make available an agenda of the 
        matters to be considered by the Advisory Committee at such 
        meeting. At any such meeting, the Advisory Council shall 
        distribute materials with respect to the issues to be addressed 
        at the meeting. Not later than 30 days after the adjourning of 
        such a meeting, the Advisory Committee shall prepare and make 
        available a summary of the meeting and any actions taken by the 
        Committee based upon the meeting.
    ``(f) Compensation and Expenses.--
            ``(1) Compensation.--Each member of the Advisory Committee 
        shall be compensated at a rate equal to the daily equivalent of 
        the annual rate of basic pay prescribed for level IV of the 
        Executive Schedule under section 5315 of title 5, United States 
        Code, for each day (including travel time) during which such 
        member is engaged in the performance of the duties of the 
        Committee.
            ``(2) Expenses.--The members of the Advisory Committee 
        shall be allowed travel expenses, including per diem in lieu of 
        subsistence, at rates authorized for employees of agencies 
        under subchapter I of chapter 57 of title 5, United States 
        Code, while away from their homes or regular places of business 
        in the performance of services for the Committee.
    ``(g) FACA.--The Federal Advisory Committee Act shall apply to the 
Advisory Committee under this section only to the extent that the 
provisions of such Act do not conflict with the requirements of this 
section.''.

SEC. 103. INTERDISCIPLINARY, COMMUNITY-BASED LINKAGES.

    Part D of title VII of the Public Health Service Act (42 U.S.C. 294 
et seq.) is amended to read as follows:

         ``PART D--INTERDISCIPLINARY, COMMUNITY-BASED LINKAGES

``SEC. 750. GENERAL PROVISIONS.

    ``(a) Collaboration.--To be eligible to receive assistance under 
this part, an academic institution shall use such assistance in 
collaboration with 2 or more disciplines.
    ``(b) Activities.--An entity shall use assistance under this part 
to carry out innovative demonstration projects for strategic workforce 
supplementation activities as needed to meet national goals for 
interdisciplinary, community-based linkages. Such assistance may be 
used consistent with this part--
            ``(1) to develop and support training programs;
            ``(2) for faculty development;
            ``(3) for model demonstration programs;
            ``(4) for the provision of stipends for fellowship 
        trainees;
            ``(5) to provide technical assistance; and
            ``(6) for other activities that will produce outcomes 
        consistent with the purposes of this part.

``SEC. 751. AREA HEALTH EDUCATION CENTERS.

    ``(a) Authority for Provision of Financial Assistance.--
            ``(1) Assistance for planning, development, and operation 
        of programs.--
                    ``(A) In general.--The Secretary shall award grants 
                to and enter into contracts with schools of medicine 
                and osteopathic medicine, and incorporated consortia 
                made up of such schools, or the parent institutions of 
                such schools, for projects for the planning, 
                development and operation of area health education 
                center programs that--
                            ``(i) improve the recruitment, 
                        distribution, supply, quality and efficiency of 
                        personnel providing health services in 
                        underserved rural and urban areas and personnel 
                        providing health services to populations having 
                        demonstrated serious unmet health care needs;
                            ``(ii) increase the number of primary care 
                        physicians and other primary care providers who 
                        provide services in underserved areas through 
                        the offering of an educational continuum of 
                        health career recruitment through clinical 
                        education concerning underserved areas in a 
                        comprehensive health workforce strategy;
                            ``(iii) carry out recruitment and health 
                        career awareness programs to recruit 
                        individuals from underserved areas and under-
                        represented populations, including minority and 
                        other elementary or secondary students, into 
                        the health professions;
                            ``(iv) prepare individuals to more 
                        effectively provide health services to 
                        underserved areas or underserved populations 
                        through field placements, preceptorships, the 
                        conduct of or support of community-based 
                        primary care residency programs, and agreements 
                        with community-based organizations such as 
                        community health centers, migrant health 
                        centers, Indian health centers, public health 
                        departments and others;
                            ``(v) conduct health professions education 
                        and training activities for students of health 
                        professions schools and medical residents;
                            ``(vi) conduct at least 10 percent of 
                        medical student required clinical education at 
                        sites remote to the primary teaching facility 
                        of the contracting institution; and
                            ``(vii) provide information dissemination 
                        and educational support to reduce professional 
                        isolation, increase retention, enhance the 
                        practice environment, and improve health care 
                        through the timely dissemination of research 
                        findings using relevant resources.
                    ``(B) Other eligible entities.--With respect to a 
                State in which no area health education center program 
                is in operation, the Secretary may award a grant or 
                contract under subparagraph (A) to a school of nursing.
                    ``(C) Project terms.--
                            ``(i) In general.--Except as provided in 
                        clause (ii), the period during which payments 
                        may be made under an award under subparagraph 
                        (A) may not exceed--
                                    ``(I) in the case of a project, 12 
                                years or
                                    ``(II) in the case of a center 
                                within a project, 6 years.
                            ``(ii) Exception.--The periods described in 
                        clause (i) shall not apply to projects that 
                        have completed the initial period of Federal 
                        funding under this section and that desire to 
                        compete for model awards under paragraph 
                        (2)(A).
            ``(2) Assistance for operation of model programs.--
                    ``(A) In general.--In the case of any entity 
                described in paragraph (1)(A) that--
                            ``(i) has previously received funds under 
                        this section;
                            ``(ii) is operating an area health 
                        education center program; and
                            ``(iii) is no longer receiving financial 
                        assistance under paragraph (1);
                the Secretary may provide financial assistance to such 
                entity to pay the costs of operating and carrying out 
                the requirements of the program as described in 
                paragraph (1).
                    ``(B) Matching requirement.--With respect to the 
                costs of operating a model program under subparagraph 
                (A), an entity, to be eligible for financial assistance 
                under subparagraph (A), shall make available (directly 
                or through contributions from State, county or 
                municipal governments, or the private sector) recurring 
                non-Federal contributions in cash toward such costs in 
                an amount that is equal to not less than 50 percent of 
                such costs.
                    ``(C) Limitation.--The aggregate amount of awards 
                provided under subparagraph (A) to entities in a State 
                for a fiscal year may not exceed the lesser of--
                            ``(i) $2,000,000; or
                            ``(ii) an amount equal to the product of 
                        $250,000 and the aggregate number of area 
                        health education centers operated in the State 
                        by such entities.
    ``(b) Requirements for Centers.--
            ``(1) General requirement.--Each area health education 
        center that receives funds under this section shall encourage 
        the regionalization of health professions schools through the 
        establishment of partnerships with community-based 
        organizations.
            ``(2) Service area.--Each area health education center that 
        receives funds under this section shall specifically designate 
        a geographic area or medically underserved population to be 
        served by the center. Such area or population shall be in a 
        location removed from the main location of the teaching 
        facilities of the schools participating in the program with 
        such center.
            ``(3) Other requirements.--Each area health education 
        center that receives funds under this section shall--
                    ``(A) assess the health personnel needs of the area 
                to be served by the center and assist in the planning 
                and development of training programs to meet such 
                needs;
                    ``(B) arrange and support rotations for students 
                and residents in family medicine, general internal 
                medicine or general pediatrics, with at least one 
                center in each program being affiliated with or 
                conducting a rotating osteopathic internship or medical 
                residency training program in family medicine 
                (including geriatrics), general internal medicine 
                (including geriatrics), or general pediatrics in which 
                no fewer than 4 individuals are enrolled in first-year 
                positions;
                    ``(C) conduct and participate in interdisciplinary 
                training that involves physicians and other health 
                personnel including, where practicable, public health 
                professionals, physician assistants, nurse 
                practitioners, nurse midwives, and behavioral and 
                mental health providers; and
                    ``(D) have an advisory board, at least 75 percent 
                of the members of which shall be individuals, including 
                both health service providers and consumers, from the 
                area served by the center.
    ``(c) Certain Provisions Regarding Funding.--
            ``(1) Allocation to center.--Not less than 75 percent of 
        the total amount of Federal funds provided to an entity under 
        this section shall be allocated by an area health education 
        center program to the area health education center. Such entity 
        shall enter into an agreement with each center for purposes of 
        specifying the allocation of such 75 percent of funds.
            ``(2) Operating costs.--With respect to the operating costs 
        of the area health education center program of an entity 
        receiving funds under this section, the entity shall make 
        available (directly or through contributions from State, county 
        or municipal governments, or the private sector) non-Federal 
        contributions in cash toward such costs in an amount that is 
        equal to not less than 50 percent of such costs, except that 
the Secretary may grant a waiver for up to 75 percent of the amount of 
the required non-Federal match in the first 3 years in which an entity 
receives funds under this section.

``SEC. 752. HEALTH EDUCATION AND TRAINING CENTERS.

    ``(a) In General.--To be eligible for funds under this section, an 
health education training center shall be an entity otherwise eligible 
for funds under section 751 that--
            ``(1) addresses the persistent and severe unmet health care 
        needs in States along the border between the United States and 
        Mexico and in the State of Florida, and in other urban and 
        rural areas with populations with serious unmet health care 
        needs;
            ``(2) establishes an advisory board comprised of health 
        service providers, educators and consumers from the service 
        area;
            ``(3) conducts training and education programs for health 
        professions students in these areas;
            ``(4) conducts training in health education services, 
        including training to prepare community health workers; and
            ``(5) supports health professionals (including nursing) 
        practicing in the area through educational and other services.
    ``(b) Allocation of Funds.--The Secretary shall make available 50 
percent of the amounts appropriated for each fiscal year under section 
752 for the establishment or operation of health education training 
centers through projects in States along the border between the United 
States and Mexico and in the State of Florida.

``SEC. 753. EDUCATION AND TRAINING RELATING TO GERIATRICS.

    ``(a) Geriatric Education Centers.--
            ``(1) In general.--The Secretary shall award grants or 
        contracts under this section to entities described in 
        paragraphs (1), (3), or (4) of section 799B, and section 
        853(2), for the establishment or operation of geriatric 
        education centers.
            ``(2) Requirements.--A geriatric education center is a 
        program that--
                    ``(A) improves the training of health professionals 
                in geriatrics, including geriatric residencies, 
                traineeships, or fellowships;
                    ``(B) develops and disseminates curricula relating 
                to the treatment of the health problems of elderly 
                individuals;
                    ``(C) supports the training and retraining of 
                faculty to provide instruction in geriatrics;
                    ``(D) supports continuing education of health 
                professionals who provide geriatric care; and
                    ``(E) provides students with clinical training in 
                geriatrics in nursing homes, chronic and acute disease 
                hospitals, ambulatory care centers, and senior centers.
    ``(b) Geriatric Training Regarding Physicians and Dentists.--
            ``(1) In general.--The Secretary may make grants to, and 
        enter into contracts with, schools of medicine, schools of 
        osteopathic medicine, teaching hospitals, and graduate medical 
        education programs, for the purpose of providing support 
        (including residencies, traineeships, and fellowships) for 
        geriatric training projects to train physicians, dentists and 
        behavioral and mental health professionals who plan to teach 
        geriatric medicine, geriatric behavioral or mental health, or 
        geriatric dentistry.
            ``(2) Requirements.--Each project for which a grant or 
        contract is made under this subsection shall--
                    ``(A) be staffed by full-time teaching physicians 
                who have experience or training in geriatric medicine 
                or geriatric behavioral or mental health;
                    ``(B) be staffed, or enter into an agreement with 
                an institution staffed by full-time or part-time 
                teaching dentists who have experience or training in 
                geriatric dentistry;
                    ``(C) be staffed, or enter into an agreement with 
                an institution staffed by full-time or part-time 
                teaching behavioral mental health professionals who 
                have experience or training in geriatric behavioral or 
                mental health;
                    ``(D) be based in a graduate medical education 
                program in internal medicine or family medicine or in a 
                department of geriatrics or behavioral or mental 
                health;
                    ``(E) provide training in geriatrics and exposure 
                to the physical and mental disabilities of elderly 
                individuals through a variety of service rotations, 
                such as geriatric consultation services, acute care 
                services, dental services, geriatric behavioral or 
                mental health units, day and home care programs, 
                rehabilitation services, extended care facilities, 
                geriatric ambulatory care and comprehensive evaluation 
                units, and community care programs for elderly mentally 
retarded individuals; and
                    ``(F) provide training in geriatrics through one or 
                both of the training options described in subparagraphs 
                (A) and (B) of paragraph (3).
            ``(3) Training options.--The training options referred to 
        in subparagraph (F) of paragraph (2) shall be as follows:
                    ``(A) A 1-year retraining program in geriatrics 
                for--
                            ``(i) physicians who are faculty members in 
                        departments of internal medicine, family 
                        medicine, gynecology, geriatrics, and 
                        behavioral or mental health at schools of 
                        medicine and osteopathic medicine;
                            ``(ii) dentists who are faculty members at 
                        schools of dentistry or at hospital departments 
                        of dentistry; and
                            ``(iii) behavioral or mental health 
                        professionals who are faculty members in 
                        departments of behavioral or mental health; and
                    ``(B) A 2-year internal medicine or family medicine 
                fellowship program providing emphasis in geriatrics, 
                which shall be designed to provide training in clinical 
                geriatrics and geriatrics research for--
                            ``(i) physicians who have completed 
                        graduate medical education programs in internal 
                        medicine, family medicine, behavioral or mental 
                        health, neurology, gynecology, or 
                        rehabilitation medicine;
                            ``(ii) dentists who have demonstrated a 
                        commitment to an academic career and who have 
                        completed postdoctoral dental training, 
                        including postdoctoral dental education 
                        programs or who have relevant advanced training 
                        or experience; and
                            ``(iii) behavioral or mental health 
                        professionals who have completed graduate 
                        medical education programs in behavioral or 
                        mental health.
            ``(4) Definitions.--For purposes of this subsection:
                    ``(A) The term `graduate medical education program' 
                means a program sponsored by a school of medicine, a 
                school of osteopathic medicine, a hospital, or a public 
                or private institution that--
                            ``(i) offers postgraduate medical training 
                        in the specialties and subspecialties of 
                        medicine; and
                            ``(ii) has been accredited by the 
                        Accreditation Council for Graduate Medical 
                        Education or the American Osteopathic 
                        Association through its Committee on 
                        Postdoctoral Training.
                    ``(B) The term `post-doctoral dental education 
                program' means a program sponsored by a school of 
                dentistry, a hospital, or a public or private 
                institution that--
                            ``(i) offers post-doctoral training in the 
                        specialties of dentistry, advanced education in 
                        general dentistry, or a dental general practice 
                        residency; and
                            ``(ii) has been accredited by the 
                        Commission on Dental Accreditation.
    ``(c) Geriatric Faculty Fellowships.--
            ``(1) Establishment of program.--The Secretary shall 
        establish a program to provide Geriatric Academic Career Awards 
        to eligible individuals to promote the career development of 
        such individuals as academic geriatricians.
            ``(2) Eligible individuals.--To be eligible to receive an 
        Award under paragraph (1), an individual shall--
                    ``(A) have a degree in internal medicine, family 
                practice, or behavioral or mental health science;
                    ``(B) have completed an approved fellowship program 
                in geriatrics; and
                    ``(C) have a junior faculty appointment at an 
                accredited (as determined by the Secretary) school of 
                medicine or osteopathic medicine.
            ``(3) Limitations.--No Award under paragraph (1) may be 
        made to an eligible individual unless the individual--
                    ``(A) has submitted to the Secretary an 
                application, at such time, in such manner, and 
                containing such information as the Secretary may 
                require, and the Secretary has approved such 
                application; and
                    ``(B) provides, in such form and manner as the 
                Secretary may require, assurances that the individual 
                will meet the service requirement described in 
                subsection (e).
            ``(4) Amount and term.--
                    ``(A) Amount.--The amount of an Award under this 
                section shall equal $50,000 for fiscal year 1998, 
                adjusted for subsequent fiscal years to reflect the 
                increase in the Consumer Price Index.
                    ``(B) Term.--The term of any Award made under this 
                subsection shall not exceed 5 years.
            ``(5) Service requirement.--An individual who receives an 
        Award under this subsection shall provide training in clinical 
        geriatrics, including the training of interdisciplinary teams 
        of health care professionals. The provision of such training 
        shall constitute at least 75 percent of the obligations of such 
        individual under the Award.

``SEC. 754. RURAL INTERDISCIPLINARY TRAINING GRANTS.

    ``(a) Grants.--The Secretary may make grants or contracts under 
this section to help entities fund authorized activities under an 
application approved under subsection (c).
    ``(b) Use of Amounts.--
            ``(1) In general.--Amounts provided under subsection (a) 
        shall be used by the recipients to fund interdisciplinary 
        training projects designed to--
                    ``(A) use new and innovative methods to train 
                health care practitioners to provide services in rural 
                areas;
                    ``(B) demonstrate and evaluate innovative 
                interdisciplinary methods and models designed to 
                provide access to cost-effective comprehensive health 
                care;
                    ``(C) deliver health care services to individuals 
                residing in rural areas;
                    ``(D) enhance the amount of relevant research 
                conducted concerning health care issues in rural areas; 
                and
                    ``(E) increase the recruitment and retention of 
                health care practitioners from rural areas and make 
                rural practice a more attractive career choice for 
                health care practitioners.
            ``(2) Methods.--A recipient of funds under subsection (a) 
        may use various methods in carrying out the projects described 
        in paragraph (1), including--
                    ``(A) the distribution of stipends to students of 
                eligible applicants;
                    ``(B) the establishment of a post-doctoral 
                fellowship program;
                    ``(C) the training of faculty in the economic and 
                logistical problems confronting rural health care 
                delivery systems; or
                    ``(D) the purchase or rental of transportation and 
                telecommunication equipment where the need for such 
                equipment due to unique characteristics of the rural 
                area is demonstrated by the recipient.
            ``(3) Administration.--
                    ``(A) In general.--An applicant shall not use more 
                than 10 percent of the funds made available to such 
                applicant under subsection (a) for administrative 
                expenses.
                    ``(B) Training.--Not more than 10 percent of the 
                individuals receiving training with funds made 
                available to an applicant under subsection (a) shall be 
                trained as doctors of medicine or doctors of 
                osteopathy.
                    ``(C) Limitation.--An institution that receives a 
                grant under this section shall use amounts received 
                under such grant to supplement, not supplant, amounts 
                made available by such institution for activities of 
                the type described in subsection (b)(1) in the fiscal 
                year preceding the year for which the grant is 
                received.
    ``(c) Applications.--Applications submitted for assistance under 
this section shall--
            ``(1) be jointly submitted by at least two eligible 
        applicants with the express purpose of assisting individuals in 
        academic institutions in establishing long-term collaborative 
        relationships with health care providers in rural areas; and
            ``(2) designate a rural health care agency or agencies for 
        clinical treatment or training, including hospitals, community 
        health centers, migrant health centers, rural health clinics, 
        community behavioral and mental health centers, long-term care 
        facilities, Native Hawaiian health centers, or facilities 
        operated by the Indian Health Service or an Indian tribe or 
        tribal organization or Indian organization under a contract 
        with the Indian Health Service under the Indian Self-
        Determination Act.
    ``(d) Definitions.--For the purposes of this section, the term 
`rural' means geographic areas that are located outside of standard 
metropolitan statistical areas.

``SEC. 755. ALLIED HEALTH AND OTHER DISCIPLINES.

    ``(a) In General.--The Secretary may make grants or contracts under 
this section to help entities fund activities of the type described in 
subsection (b).
    ``(b) Activities.--Activities of the type described in this 
subsection include the following:
            ``(1) Assisting entities in meeting the costs associated 
        with expanding or establishing programs that will increase the 
        number of individuals trained in allied health professions. 
        Programs and activities funded under this paragraph may 
        include--
                    ``(A) those that expand enrollments in allied 
                health professions with the greatest shortages or whose 
                services are most needed by the elderly;
                    ``(B) those that provide rapid transition training 
                programs in allied health fields to individuals who 
                have baccalaureate degrees in health-related sciences;
                    ``(C) those that establish community-based allied 
                health training programs that link academic centers to 
                rural clinical settings;
                    ``(D) those that provide career advancement 
                training for practicing allied health professionals;
                    ``(E) those that expand or establish clinical 
                training sites for allied health professionals in 
                medically underserved or rural communities in order to 
                increase the number of individuals trained;
                    ``(F) those that develop curriculum that will 
                emphasize knowledge and practice in the areas of 
                prevention and health promotion, geriatrics, long-term 
                care, home health and hospice care, and ethics;
                    ``(G) those that expand or establish 
                interdisciplinary training programs that promote the 
                effectiveness of allied health practitioners in 
                geriatric assessment and the rehabilitation of the 
                elderly;
                    ``(H) those that expand or establish demonstration 
                centers to emphasize innovative models to link allied 
                health clinical practice, education, and research;
                    ``(I) those that provide financial assistance (in 
                the form of traineeships) to students who are 
                participants in any such program; and
                            ``(i) who plan to pursue a career in an 
                        allied health field that has a demonstrated 
                        personnel shortage; and
                            ``(ii) who agree upon completion of the 
                        training program to practice in a medically 
                        underserved community;
                that shall be utilized to assist in the payment of all 
                or part of the costs associated with tuition, fees and 
                such other stipends as the Secretary may consider 
                necessary; and
                    ``(J) those to meet the costs of projects to plan, 
                develop, and operate or maintain graduate programs in 
                behavioral and mental health practice.
            ``(2) Planning and implementing projects in preventive and 
        primary care training for podiatric physicians in approved or 
        provisionally approved residency programs that shall provide 
        financial assistance in the form of traineeships to residents 
        who participate in such projects and who plan to specialize in 
        primary care.
            ``(3) Carrying out demonstration projects in which 
        chiropractors and physicians collaborate to identify and 
        provide effective treatment for spinal and lower-back 
        conditions.

``SEC. 756. ADVISORY COMMITTEE ON INTERDISCIPLINARY, COMMUNITY-BASED 
              LINKAGES.

    ``(a) Establishment.--The Secretary shall establish an advisory 
committee to be known as the Advisory Committee on Interdisciplinary, 
Community-Based Linkages (in this section referred to as the `Advisory 
Committee').
    ``(b) Composition.--
            ``(1) In general.--The Secretary shall determine the 
        appropriate number of individuals to serve on the Advisory 
        Committee. Such individuals shall not be officers or employees 
        of the Federal Government.
            ``(2) Appointment.--Not later than 90 days after the date 
        of enactment of this Act, the Secretary shall appoint the 
        members of the Advisory Committee from among individuals who 
        are health professionals from schools of the types described in 
        sections 751(a)(1)(A), 751(a)(1)(B), 753(b), 754(3)(A), and 
        755(b). In making such appointments, the Secretary shall ensure 
        a fair balance between the health professions, that at least 75 
        percent of the members of the Advisory Committee are health 
        professionals, a broad geographic representation of members and 
        a balance between urban and rural members. Members shall be 
        appointed based on their competence, interest, and knowledge of 
the mission of the profession involved.
            ``(3) Minority representation.--In appointing the members 
        of the Advisory Committee under paragraph (2), the Secretary 
        shall ensure the adequate representation of women and 
        minorities.
    ``(c) Terms.--
            ``(1) In general.--A member of the Advisory Committee shall 
        be appointed for a term of 3 years, except that of the members 
        first appointed--
                    ``(A) \1/3\ of the members shall serve for a term 
                of 1 year;
                    ``(B) \1/3\ of the members shall serve for a term 
                of 2 years; and
                    ``(C) \1/3\ of the members shall serve for a term 
                of 3 years.
            ``(2) Vacancies.--
                    ``(A) In general.--A vacancy on the Advisory 
                Committee shall be filled in the manner in which the 
                original appointment was made and shall be subject to 
                any conditions which applied with respect to the 
                original appointment.
                    ``(B) Filling unexpired term.--An individual chosen 
                to fill a vacancy shall be appointed for the unexpired 
                term of the member replaced.
    ``(d) Duties.--The Advisory Committee shall--
            ``(1) provide advice and recommendations to the Secretary 
        concerning policy and program development and other matters of 
        significance concerning the activities under this part; and
            ``(2) not later than 3 years after the date of enactment of 
        this section, and annually thereafter, prepare and submit to 
        the Secretary, and the Committee on Labor and Human Resources 
        of the Senate, and the Committee on Commerce of the House of 
        Representatives, a report describing the activities of the 
        Committee, including findings and recommendations made by the 
        Committee concerning the activities under this part.
    ``(e) Meetings and Documents.--
            ``(1) Meetings.--The Advisory Committee shall meet not less 
        than 3 times each year. Such meetings shall be held jointly 
        with other related entities established under this title where 
        appropriate.
            ``(2) Documents.--Not later than 14 days prior to the 
        convening of a meeting under paragraph (1), the Advisory 
        Committee shall prepare and make available an agenda of the 
        matters to be considered by the Advisory Committee at such 
        meeting. At any such meeting, the Advisory Council shall 
        distribute materials with respect to the issues to be addressed 
        at the meeting. Not later than 30 days after the adjourning of 
        such a meeting, the Advisory Committee shall prepare and make 
        available a summary of the meeting and any actions taken by the 
        Committee based upon the meeting.
    ``(f) Compensation and Expenses.--
            ``(1) Compensation.--Each member of the Advisory Committee 
        shall be compensated at a rate equal to the daily equivalent of 
        the annual rate of basic pay prescribed for level IV of the 
        Executive Schedule under section 5315 of title 5, United States 
        Code, for each day (including travel time) during which such 
        member is engaged in the performance of the duties of the 
        Committee.
            ``(2) Expenses.--The members of the Advisory Committee 
        shall be allowed travel expenses, including per diem in lieu of 
        subsistence, at rates authorized for employees of agencies 
        under subchapter I of chapter 57 of title 5, United States 
        Code, while away from their homes or regular places of business 
        in the performance of services for the Committee.
    ``(g) FACA.--The Federal Advisory Committee Act shall apply to the 
Advisory Committee under this section only to the extent that the 
provisions of such Act do not conflict with the requirements of this 
section.

``SEC. 757. AUTHORIZATION OF APPROPRIATIONS.

    ``(a) In General.--There are authorized to be appropriated to carry 
out this part, $55,600,000 for fiscal year 1998, and such sums as may 
be necessary for each of the fiscal years 1999 through 2002.
    ``(b) Allocation.--
            ``(1) In general.--Of the amounts appropriated under 
        subsection (a) for a fiscal year, the Secretary shall make 
        available--
                    ``(A) not less than $28,587,000 for awards of 
                grants and contracts under section 751;
                    ``(B) not less than $3,765,000 for awards of grants 
                and contracts under section 752, of which not less than 
                50 percent of such amount shall be made available for 
                centers described in subsection (a)(1) of such section; 
                and
                    ``(C) not less than $22,631,000 for awards of 
                grants and contracts under sections 753, 754, and 755.
            ``(2) Ratable reduction.--If amounts appropriated under 
        subsection (a) for any fiscal year are less than the amount 
required to comply with paragraph (1), the Secretary shall ratably 
reduce the amount to be made available under each of subparagraphs (A) 
through (C) of such paragraph accordingly.
    ``(c) Obligation of Certain Amounts.--
            ``(1) Area health education center programs.--Of the 
        amounts made available under subsection (b)(1)(A) for each 
        fiscal year, the Secretary may obligate for awards under 
        section 751(a)(2)--
                    ``(A) not less than 23 percent of such amounts in 
                fiscal year 1998;
                    ``(B) not less than 30 percent of such amounts in 
                fiscal year 1999;
                    ``(C) not less than 35 percent of such amounts in 
                fiscal year 2000;
                    ``(D) not less than 40 percent of such amounts in 
                fiscal year 2001; and
                    ``(E) not less than 45 percent of such amounts in 
                fiscal year 2002.
            ``(2) Sense of congress.--It is the sense of the Congress 
        that--
                    ``(A) every State have an area health education 
                center program in effect under this section; and
                    ``(B) the ratio of Federal funding for the model 
                program under section 751(a)(2) should increase over 
                time and that Federal funding for other awards under 
                this section shall decrease so that the national 
                program will become entirely comprised of programs that 
                are funded at least 50 percent by State and local 
                partners.''.

SEC. 104. HEALTH PROFESSIONS WORKFORCE INFORMATION AND ANALYSIS.

    (a) In General.--Part E of title VII of the Public Health Service 
Act (42 U.S.C. 294n et seq.) is amended to read as follows:

        ``PART E--HEALTH PROFESSIONS AND PUBLIC HEALTH WORKFORCE

   ``Subpart 1--Health Professions Workforce Information and Analysis

``SEC. 761. HEALTH PROFESSIONS WORKFORCE INFORMATION AND ANALYSIS.

    ``(a) Purpose.--It is the purpose of this section to--
            ``(1) provide for the development of information describing 
        the health professions workforce and the analysis of workforce 
        related issues; and
            ``(2) provide necessary information for decision-making 
        regarding future directions in health professions and nursing 
        programs in response to societal and professional needs.
    ``(b) Grants or Contracts.--The Secretary may award grants or 
contracts to State or local governments, health professions schools, 
schools of nursing, academic health centers, community-based health 
facilities, and other appropriate public or private nonprofit entities 
to provide for--
            ``(1) targeted information collection and analysis 
        activities related to the purposes described in subsection (a);
            ``(2) research on high priority workforce questions;
            ``(3) the development of a non-Federal analytic and 
        research infrastructure related to the purposes described in 
        subsection (a); and
            ``(4) the conduct of program evaluation and assessment.
    ``(c) Authorization of Appropriations.--
            ``(1) In general.--There are authorized to be appropriated 
        to carry out this section, $750,000 for fiscal year 1998, and 
        such sums as may be necessary for each of the fiscal years 1999 
        through 2002.
            ``(2) Reservation.--Of the amounts appropriated under 
        subsection (a) for a fiscal year, the Secretary shall reserve 
        not less than $600,000 for conducting health professions 
        research and for carrying out data collection and analysis in 
        accordance with section 792.
            ``(3) Availability of additional funds.--Amounts otherwise 
        appropriated for programs or activities under this title may be 
        used for activities under subsection (b) with respect to the 
        programs or activities from which such amounts were made 
        available.''.
    (b) Council on Graduate Medical Education.--Section 301 of the 
Health Professions Education Extension Amendments of 1992 (Public Law 
102-408) is amended--
            (1) in subsection (j), by striking ``1995'' and inserting 
        ``2002'';
            (2) in subsection (k), by striking ``1995'' and inserting 
        ``2002'';
            (3) by adding at the end thereof the following new 
        subsection:
    ``(l) Funding.--Amounts otherwise appropriated under this title may 
be utilized by the Secretary to support the activities of the 
Council.'';
            (4) by transferring such section to part E of title VII of 
        the Public Health Service Act (as amended by subsection (a));
            (5) by redesignating such section as section 763; and
            (6) by inserting such section after section 762.

SEC. 105. PUBLIC HEALTH WORKFORCE DEVELOPMENT.

    Part E of title VII of the Public Health Service Act (as amended by 
section 104) is further amended by adding at the end the following:

                  ``Subpart 2--Public Health Workforce

``SEC. 765. GENERAL PROVISIONS.

    ``(a) In General.--The Secretary may award grants or contracts to 
eligible entities to increase the number of individuals in the public 
health workforce, to enhance the quality of such workforce, and to 
enhance the ability of the workforce to meet national, State, and local 
health care needs.
    ``(b) Eligibility.--To be eligible to receive a grant or contract 
under subsection (a) an entity shall--
            ``(1) be--
                    ``(A) a health professions school, including an 
                accredited school or program of public health, health 
                administration, preventive medicine, or dental public 
                health or a school providing health management 
                programs;
                    ``(B) an academic health center;
                    ``(C) a State or local government; or
                    ``(D) any other appropriate public or private 
                nonprofit entity; and
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require.
    ``(c) Preference.--In awarding grants or contracts under this 
section the Secretary may grant a preference to entities--
            ``(1) serving individuals who are from disadvantaged 
        backgrounds (including underrepresented racial and ethnic 
        minorities); and
            ``(2) graduating large proportions of individuals who serve 
        in underserved communities.
    ``(d) Activities.--Amounts provided under a grant or contract 
awarded under this section may be used for--
            ``(1) the costs of planning, developing, or operating 
        demonstration training programs;
            ``(2) faculty development;
            ``(3) trainee support;
            ``(4) technical assistance;
            ``(5) to meet the costs of projects--
                    ``(A) to plan and develop new residency training 
                programs and to maintain or improve existing residency 
                training programs in preventive medicine and dental 
                public health, that have available full-time faculty 
                members with training and experience in the fields of 
                preventive medicine and dental public health; and
                    ``(B) to provide financial assistance to residency 
                trainees enrolled in such programs;
            ``(6) the retraining of existing public health workers as 
        well as for increasing the supply of new practitioners to 
        address priority public health, preventive medicine, public 
        health dentistry, and health administration needs;
            ``(7) preparing public health professionals for employment 
        at the State and community levels; or
            ``(8) other activities that may produce outcomes that are 
        consistent with the purposes of this section
    ``(e) Traineeships.--
            ``(1) In general.--With respect to amounts used under this 
        section for the training of health professionals, such training 
        programs shall be designed to--
                    ``(A) make public health education more accessible 
                to the public and private health workforce;
                    ``(B) increase the relevance of public health 
                academic preparation to public health practice in the 
                future;
                    ``(C) provide education or training for students 
                from traditional on-campus programs in practice-based 
                sites; or
                    ``(D) develop educational methods and distance-
                based approaches or technology that address adult 
                learning requirements and increase knowledge and skills 
                related to community-based cultural diversity in public 
                health education.
            ``(2) Severe shortage disciplines.--Amounts provided under 
        grants or contracts under this section may be used for the 
        operation of programs designed to award traineeships to 
        students in accredited schools of public health who enter 
        educational programs in fields where there is a severe shortage 
        of public health professionals, including epidemiology, 
        biostatistics, environmental health, toxicology, public health 
        nursing, nutrition, preventive medicine, maternal and child 
health, and behavioral and mental health professions.

``SEC. 766. PUBLIC HEALTH TRAINING CENTERS.

    ``(a) In General.--The Secretary may make grants or contracts for 
the operation of public health training centers.
    ``(b) Eligible Entities.--
            ``(1) In general.--A public health training center shall be 
        an accredited school of public health, or another public or 
        nonprofit private institution accredited for the provision of 
        graduate or specialized training in public health, that plans, 
        develops, operates, and evaluates projects that are in 
        furtherance of the goals established by the Secretary for the 
        year 2000 in the areas of preventive medicine, health promotion 
        and disease prevention, or improving access to and quality of 
        health services in medically underserved communities.
            ``(2) Preference.--In awarding grants or contracts under 
        this section the Secretary shall give preference to accredited 
        schools of public health.
    ``(c) Certain Requirements.--With respect to a public health 
training center, an award may not be made under subsection (a) unless 
the program agrees that it--
            ``(1) will establish or strengthen field placements for 
        students in public or nonprofit private health agencies or 
        organizations;
            ``(2) will involve faculty members and students in 
        collaborative projects to enhance public health services to 
        medically underserved communities;
            ``(3) will specifically designate a geographic area or 
        medically underserved population to be served by the center 
        that shall be in a location removed from the main location of 
        the teaching facility of the school that is participating in 
        the program with such center; and
            ``(4) will assess the health personnel needs of the area to 
        be served by the center and assist in the planning and 
        development of training programs to meet such needs.

``SEC. 767. PUBLIC HEALTH TRAINEESHIPS.

    ``(a) In General.--The Secretary may make grants to accredited 
schools of public health, and to other public or nonprofit private 
institutions accredited for the provision of graduate or specialized 
training in public health, for the purpose of assisting such schools 
and institutions in providing traineeships to individuals described in 
subsection (b)(3).
    ``(b) Certain Requirements.--
            ``(1) Amount.--The amount of any grant under this section 
        shall be determined by the Secretary.
            ``(2) Use of grant.--Traineeships awarded under grants made 
        under subsection (a) shall provide for tuition and fees and 
        such stipends and allowances (including travel and subsistence 
        expenses and dependency allowances) for the trainees as the 
        Secretary may deem necessary.
            ``(3) Eligible individuals.--The individuals referred to in 
        subsection (a) are individuals who are pursuing a course of 
        study in a health professions field in which there is a severe 
        shortage of health professionals (which fields include the 
        fields of epidemiology, environmental health, biostatistics, 
        toxicology, nutrition, and maternal and child health).

``SEC. 768. PREVENTIVE MEDICINE; DENTAL PUBLIC HEALTH.

    ``(a) In General.--The Secretary may make grants to and enter into 
contracts with schools of medicine, osteopathic medicine, public 
health, and dentistry to meet the costs of projects--
            ``(1) to plan and develop new residency training programs 
        and to maintain or improve existing residency training programs 
        in preventive medicine and dental public health; and
            ``(2) to provide financial assistance to residency trainees 
        enrolled in such programs.
    ``(b) Administration.--
            ``(1) Amount.--The amount of any grant under subsection (a) 
        shall be determined by the Secretary.
            ``(2) Eligibility.--To be eligible for a grant under 
        subsection (a), the applicant must demonstrate to the Secretary 
        that it has or will have available full-time faculty members 
        with training and experience in the fields of preventive 
        medicine or dental public health and support from other faculty 
        members trained in public health and other relevant specialties 
        and disciplines.
            ``(3) Other funds.--Schools of medicine, osteopathic 
        medicine, dentistry, and public health may use funds committed 
        by State, local, or county public health officers as matching 
        amounts for Federal grant funds for residency training programs 
        in preventive medicine.

``SEC. 769. HEALTH ADMINISTRATION TRAINEESHIPS AND SPECIAL PROJECTS.

    ``(a) In General.--The Secretary may make grants to State or local 
governments (that have in effect preventive medical and dental public 
health residency programs) or public or nonprofit private educational 
entities (including graduate schools of social work and business 
schools that have health management programs) that offer a program 
described in subsection (b)--
            ``(1) to provide traineeships for students enrolled in such 
        a program; and
            ``(2) to assist accredited programs health administration 
        in the development or improvement of programs to prepare 
        students for employment with public or nonprofit private 
        entities.
    ``(b) Relevant Programs.--The program referred to in subsection (a) 
is an accredited program in health administration, hospital 
administration, or health policy analysis and planning, which program 
is accredited by a body or bodies approved for such purpose by the 
Secretary of Education and which meets such other quality standards as 
the Secretary of Health and Human Services by regulation may prescribe.
    ``(c) Preference in Making Grants.--In making grants under 
subsection (a), the Secretary shall give preference to qualified 
applicants that meet the following conditions:
            ``(1) Not less than 25 percent of the graduates of the 
        applicant are engaged in full-time practice settings in 
        medically underserved communities.
            ``(2) The applicant recruits and admits students from 
        medically underserved communities.
            ``(3) For the purpose of training students, the applicant 
        has established relationships with public and nonprofit 
        providers of health care in the community involved.
            ``(4) In training students, the applicant emphasizes 
        employment with public or nonprofit private entities.
    ``(d) Certain Provisions Regarding Traineeships.--
            ``(1) Use of grant.--Traineeships awarded under grants made 
        under subsection (a) shall provide for tuition and fees and 
        such stipends and allowances (including travel and subsistence 
        expenses and dependency allowances) for the trainees as the 
        Secretary may deem necessary.
            ``(2) Preference for certain students.--Each entity 
        applying for a grant under subsection (a) for traineeships 
        shall assure to the satisfaction of the Secretary that the 
        entity will give priority to awarding the traineeships to 
        students who demonstrate a commitment to employment with public 
        or nonprofit private entities in the fields with respect to 
        which the traineeships are awarded.

``SEC. 770. AUTHORIZATION OF APPROPRIATIONS.

    ``(a) In General.--For the purpose of carrying out this subpart, 
there is authorized to be appropriated $9,100,000 for fiscal year 1998, 
and such sums as may be necessary for each of the fiscal years 1999 
through 2002.
    ``(b) Limitation Regarding Certain Program.--In obligating amounts 
appropriated under subsection (a), the Secretary may not obligate more 
than 30 percent for carrying out section 767.''.

SEC. 106. GENERAL PROVISIONS.

    (a) In General.--
            (1) Part F of title VII of the Public Health Service Act 
        (42 U.S.C. 295 et seq.) is repealed.
            (2) Part G of title VII of the Public Health Service Act 
        (42 U.S.C. 295j et seq.) is amended--
                    (A) by redesignating such part as part F;
                    (B) in section 791 (42 U.S.C. 295j)--
                            (i) by striking subsection (b); and
                            (ii) redesignating subsection (c) as 
                        subsection (b);
                    (C) by repealing section 793 (42 U.S.C. 295l);
                    (D) by repealing section 798;
                    (E) by redesignating section 799 as section 799B; 
                and
                    (F) by inserting after section 794, the following 
                new sections:

``SEC. 796. APPLICATION.

    ``(a) In General.--To be eligible to receive a grant or contract 
under this title, an eligible entity shall prepare and submit to the 
Secretary an application that meets the requirements of this section, 
at such time, in such manner, and containing such information as the 
Secretary may require.
    ``(b) Plan.--An application submitted under this section shall 
contain the plan of the applicant for carrying out a project with 
amounts received under this title. Such plan shall be consistent with 
relevant Federal, State, or regional health professions program plans.
    ``(c) Performance Outcome Standards.--An application submitted 
under this section shall contain a specification by the applicant 
entity of performance outcome standards that the project to be funded 
under the grant or contract will be measured against. Such standards 
shall address relevant health workforce needs that the project will 
meet. The recipient of a grant or contract under this section shall 
meet the standards set forth in the grant or contract application.
    ``(d) Linkages.--An application submitted under this section shall 
contain a description of the linkages with relevant educational and 
health care entities, including training programs for other health 
professionals as appropriate, that the project to be funded under the 
grant or contract will establish. To the extent practicable, grantees 
under this section shall establish linkages with health care providers 
who provide care for underserved communities and populations.

``SEC. 797. USE OF FUNDS.

    ``(a) In General.--Amounts provided under a grant or contract 
awarded under this title may be used for training program development 
and support, faculty development, model demonstrations, trainee support 
including tuition, books, program fees and reasonable living expenses 
during the period of training, technical assistance, workforce 
analysis, dissemination of information, and exploring new policy 
directions, as appropriate to meet recognized health workforce 
objectives, in accordance with this title.
    ``(b) Maintenance of Effort.--With respect to activities for which 
a grant awarded under this title is to be expended, the entity shall 
agree to maintain expenditures of non-Federal amounts for such 
activities at a level that is not less than the level of such 
expenditures maintained by the entity for the fiscal year preceding the 
fiscal year for which the entity receives such a grant.

``SEC. 798. MATCHING REQUIREMENT.

    ``The Secretary may require that an entity that applies for a grant 
or contract under this title provide non-Federal matching funds, as 
appropriate, to ensure the institutional commitment of the entity to 
the projects funded under the grant. As determined by the Secretary, 
such non-Federal matching funds may be provided directly or through 
donations from public or private entities and may be in cash or in-
kind, fairly evaluated, including plant, equipment, or services.

``SEC. 799. GENERALLY APPLICABLE PROVISIONS.

    ``(a) Awarding of Grants and Contracts.--The Secretary shall ensure 
that grants and contracts under this title are awarded on a competitive 
basis, as appropriate, to carry out innovative demonstration projects 
or provide for strategic workforce supplementation activities as needed 
to meet health workforce goals and in accordance with this title. 
Contracts may be entered into under this title with public or private 
entities as may be necessary.
    ``(b) Eligible Entities.--Unless specifically required otherwise in 
this title, the Secretary shall accept applications for grants or 
contracts under this title from health professions schools, academic 
health centers, State or local governments, or other appropriate public 
or private nonprofit entities for funding and participation in health 
professions and nursing training activities. The Secretary may accept 
applications from for-profit private entities if determined appropriate 
by the Secretary.
    ``(c) Information Requirements.--
            ``(1) In general.--Recipients of grants and contracts under 
        this title shall meet information requirements as specified by 
        the Secretary.
            ``(2) Data collection.--The Secretary shall establish 
        procedures to ensure that, with respect to any data collection 
        required under this title, such data is collected in a manner 
        that takes into account age, gender, race, and ethnicity.
            ``(3) Use of funds.--The Secretary shall establish 
        procedures to permit the use of amounts appropriated under this 
        title to be used for data collection purposes.
            ``(4) Evaluations.--The Secretary shall establish 
        procedures to ensure the annual evaluation of programs and 
        projects operated by recipients of grants or contracts under 
        this title. Such procedures shall ensure that continued funding 
        for such programs and projects will be conditioned upon a 
        demonstration that satisfactory progress has been made by the 
        program or project in meeting the objectives of the program or 
        project.
    ``(d) Training Programs.--Training programs conducted with amounts 
received under this title shall meet applicable accreditation and 
quality standards.
    ``(e) Duration of Assistance.--
            ``(1) In general.--Subject to paragraph (2), in the case of 
        an award to an entity of a grant, cooperative agreement, or 
        contract under this title, the period during which payments are 
        made to the entity under the award may not exceed 5 years. The 
        provision of payments under the award shall be subject to 
        annual approval by the Secretary of the payments and subject to 
        the availability of appropriations for the fiscal year involved 
        to make the payments. This paragraph may not be construed as 
        limiting the number of awards under the program involved that 
        may be made to the entity.
            ``(2) Limitation.--In the case of an award to an entity of 
        a grant, cooperative agreement, or contract under this title, 
        paragraph (1) shall apply only to the extent not inconsistent 
        with any other provision of this title that relates to the 
        period during which payments may be made under the award.
    ``(f) Peer Review Regarding Certain Programs.--
            ``(1) In general.--Each application for a grant under this 
        title, except any scholarship or loan program, including those 
        under sections 701, 721, or 723, shall be 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.
            ``(2) Composition.--Each peer review group under this 
        subsection shall be composed principally of individuals who are 
        not officers or employees of the Federal Government. In 
        providing for the establishment of peer review groups and 
        procedures, the Secretary shall ensure gender, racial, ethnic, 
        and geographic balance among the membership of such groups.
            ``(3) Administration.--This subsection shall be carried out 
        by the Secretary acting through the Administrator of the Health 
        Resources and Services Administration.
    ``(g) Preference or Priority Considerations.--In considering a 
preference or priority for funding which is based on outcome measures 
for an eligible entity under this title, the Secretary may also 
consider the future ability of the eligible entity to meet the outcome 
preference or priority through improvements in the eligible entity's 
program design.
    ``(h) Analytic Activities.--The Secretary shall ensure that--
            ``(1) cross-cutting workforce analytical activities are 
        carried out as part of the workforce information and analysis 
        activities under section 761; and
            ``(2) discipline-specific workforce information and 
        analytical activities are carried out as part of--
                    ``(A) the community-based linkage program under 
                part D; and
                    ``(B) the health workforce development program 
                under subpart 2 of part E.
    ``(i) Osteopathic Schools.--For purposes of this title, any 
reference to--
            ``(1) medical schools shall include osteopathic medical 
        schools; and
            ``(2) medical students shall include osteopathic medical 
        students.

``SEC. 799A. TECHNICAL ASSISTANCE.

    ``Funds appropriated under this title may be used by the Secretary 
to provide technical assistance in relation to any of the authorities 
under this title.''.
    (b) Profession Counselors as Mental Health Professionals.--Section 
792(a) of the Public Health Service Act (42 U.S.C. 295k(a)) is amended 
by inserting ``professional counselors,'' after ``clinical 
psychologists,''.

SEC. 107. PREFERENCE IN CERTAIN PROGRAMS.

    (a) In General.--Section 791 of the Public Health Service Act (42 
U.S.C. 295j), as amended by section 105(a)(2)(B), is further amended by 
adding at the end thereof the following subsection:
    ``(c) Exceptions for New Programs.--
            ``(1) In general.--To permit new programs to compete 
        equitably for funding under this section, those new programs 
        that meet at least 4 of the criteria described in paragraph (3) 
        shall qualify for a funding preference under this section.
            ``(2) Definition.--As used in this subsection, the term 
        `new program' means any program that has graduated less than 
        three classes. Upon graduating at least three classes, a 
        program shall have the capability to provide the information 
        necessary to qualify the program for the general funding 
        preferences described in subsection (a).
            ``(3) Criteria.--The criteria referred to in paragraph (1) 
        are the following:
                    ``(A) The mission statement of the program 
                identifies a specific purpose of the program as being 
                the preparation of health professionals to serve 
                underserved populations.
                    ``(B) The curriculum of the program includes 
                content which will help to prepare practitioners to 
                serve underserved populations.
                    ``(C) Substantial clinical training experience is 
                required under the program in medically underserved 
                communities.
                    ``(D) A minimum of 20 percent of the clinical 
                faculty of the program spend at least 50 percent of 
                their time providing or supervising care in medically 
                underserved communities.
                    ``(E) The entire program or a substantial portion 
                of the program is physically located in a medically 
                underserved community.
                    ``(F) Student assistance, which is linked to 
                service in medically underserved communities following 
                graduation, is available to the students in the 
                program.
                    ``(G) The program provides a placement mechanism 
                for deploying graduates to medically underserved 
                communities.''.
    (b) Conforming Amendments.--Section 791(a) of the Public Health 
Service Act (42 U.S.C. 295j(a)) is amended--
            (1) in paragraph (1), by striking ``sections 747'' and all 
        that follows through ``767'' and inserting ``sections 747 and 
        750''; and
            (2) in paragraph (2), by striking ``under section 798(a)''.

SEC. 108. DEFINITIONS.

    (a) Graduate Program in Behavioral and Mental Health Practice.--
Section 799B(1)(D) of the Public Health Service Act (42 U.S.C. 
295p(1)(D)) (as so redesignated by section 106(a)(2)(E)) is amended--
            (1) by inserting ``behavioral health and'' before 
        ``mental''; and
            (2) by inserting ``behavioral health and mental health 
        practice,'' before ``clinical''.
    (b) Professional Counseling as a Behavioral and Mental Health 
Practice.--Section 799B of the Public Health Service Act (42 U.S.C. 
295p) (as so redesignated by section 106(a)(2)(E)) is amended--
            (1) in paragraph (1)--
                    (A) in subparagraph (C)--
                            (i) by inserting ``and `graduate program in 
                        professional counseling''' after ``graduate 
                        program in marriage and family therapy'''; and
                            (ii) by inserting before the period the 
                        following: ``and a concentration leading to a 
                        graduate degree in counseling'';
                    (B) in subparagraph (D), by inserting 
                ``professional counseling,'' after ``social work,''; 
                and
                    (C) in subparagraph (E), by inserting 
                ``professional counseling,'' after ``social work,''; 
                and
            (2) in paragraph (5)(C), by inserting before the period the 
        following: ``or a degree in counseling or an equivalent 
        degree''.
    (c) Medically Underserved Community.--Section 799B(6) of the Public 
Health Service Act (42 U.S.C. 295p(6)) (as so redesignated by section 
105(a)(2)(E)) is amended--
            (1) in subparagraph (B), by striking ``or'' at the end 
        thereof;
            (2) in subparagraph (C), by striking the period and 
        inserting ``; or''; and
            (3) by adding at the end the following:
                    ``(D) is designated by a State Governor (in 
                consultation with the medical community) as a shortage 
                area or medically underserved community.''.
    (d) Programs for the Training of Physician Assistants.--Paragraph 
(3) of section 799B of the Public Health Service Act (42 U.S.C. 295p) 
(as so redesignated by section 105(a)(2)(E)) is amended to read as 
follows:
            ``(3) The term `program for the training of physician 
        assistants' means an educational program that--
                    ``(A) has as its objective the education of 
                individuals who will, upon completion of their studies 
                in the program, be qualified to provide primary care 
                under the supervision of a physician;
                    ``(B) extends for at least one academic year and 
                consists of--
                            ``(i) supervised clinical practice; and
                            ``(ii) at least four months (in the 
                        aggregate) of classroom instruction, directed 
                        toward preparing students to deliver health 
                        care;
                    ``(C) has an enrollment of not less than eight 
                students; and
                    ``(D) trains students in primary care, disease 
                prevention, health promotion, geriatric medicine, and 
                home health care.''.

SEC. 109. TECHNICAL AMENDMENT ON NATIONAL HEALTH SERVICE CORPS.

    Section 338B(b)(1)(B) of the Public Health Service Act (42 U.S.C. 
254l-1(b)(1)(B)) is amended by striking ``or other health profession'' 
and inserting ``behavioral and mental health, or other health 
profession''.

SEC. 110. SAVINGS PROVISION.

    In the case of any authority for making awards of grants or 
contracts that is terminated by the amendments made by this subtitle, 
the Secretary of Health and Human Services may, notwithstanding the 
termination of the authority, continue in effect any grant or contract 
made under the authority that is in effect on the day before the date 
of the enactment of this Act, subject to the duration of any such grant 
or contract not exceeding the period determined by the Secretary in 
first approving such financial assistance, or in approving the most 
recent request made (before the date of such enactment) for 
continuation of such assistance, as the case may be.

               Subtitle B--Nursing Workforce Development

SEC. 121. SHORT TITLE.

    This title may be cited as the ``Nursing Education and Practice 
Improvement Act of 1998''.

SEC. 122. PURPOSE.

    It is the purpose of this title to restructure the nurse education 
authorities of title VIII of the Public Health Service Act to permit a 
comprehensive, flexible, and effective approach to Federal support for 
nursing workforce development.

SEC. 123. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.

    Title VIII of the Public Health Service Act (42 U.S.C. 296k et 
seq.) is amended--
            (1) by striking the title heading and all that follows 
        except for subpart II of part B and sections 846 and 855; and 
        inserting the following:

             ``TITLE VIII--NURSING WORKFORCE DEVELOPMENT'';

            (2) in subpart II of part B, by striking the subpart 
        heading and inserting the following:

                       ``PART E--STUDENT LOANS'';

            (3) by striking section 837;
            (4) by inserting after the title heading the following new 
        parts:

                      ``PART A--GENERAL PROVISIONS

``SEC. 801. DEFINITIONS.

    ``As used in this title:
            ``(1) Eligible entities.--The term `eligible entities' 
        means schools of nursing, nursing centers, academic health 
        centers, State or local governments, and other public or 
        private nonprofit entities determined appropriate by the 
        Secretary that submit to the Secretary an application in 
        accordance with section 802.
            ``(2) School of nursing.--The term `school of nursing' 
        means a collegiate, associate degree, or diploma school of 
        nursing in a State.
            ``(3) Collegiate school of nursing.--The term `collegiate 
        school of nursing' means a department, division, or other 
        administrative unit in a college or university which provides 
        primarily or exclusively a program of education in professional 
        nursing and related subjects leading to the degree of bachelor 
        of arts, bachelor of science, bachelor of nursing, or to an 
        equivalent degree, or to a graduate degree in nursing, or to an 
        equivalent degree, and including advanced training related to 
        such program of education provided by such school, but only if 
        such program, or such unit, college or university is 
        accredited.
            ``(4) Associate degree school of nursing.--The term 
        `associate degree school of nursing' means a department, 
        division, or other administrative unit in a junior college, 
        community college, college, or university which provides 
        primarily or exclusively a two-year program of education in 
        professional nursing and allied subjects leading to an 
        associate degree in nursing or to an equivalent degree, but 
        only if such program, or such unit, college, or university is 
        accredited.
            ``(5) Diploma school of nursing.--The term `diploma school 
        of nursing' means a school affiliated with a hospital or 
        university, or an independent school, which provides primarily 
        or exclusively a program of education in professional nursing 
        and allied subjects leading to a diploma or to equivalent 
        indicia that such program has been satisfactorily completed, 
        but only if such program, or such affiliated school or such 
        hospital or university or such independent school is 
        accredited.
            ``(6) Accredited.--
                    ``(A) In general.--Except as provided in 
                subparagraph (B), the term `accredited' when applied to 
                any program of nurse education means a program 
                accredited by a recognized body or bodies, or by a 
                State agency, approved for such purpose by the 
                Secretary of Education and when applied to a hospital, 
                school, college, or university (or a unit thereof) 
                means a hospital, school, college, or university (or a 
                unit thereof) which is accredited by a recognized body 
                or bodies, or by a State agency, approved for such 
                purpose by the Secretary of Education. For the purpose 
                of this paragraph, the Secretary of Education shall 
                publish a list of recognized accrediting bodies, and of 
                State agencies, which the Secretary of Education 
                determines to be reliable authority as to the quality 
                of education offered.
                    ``(B) New programs.--A new program of nursing that, 
                by reason of an insufficient period of operation, is 
not, at the time of the submission of an application for a grant or 
contract under this title, eligible for accreditation by such a 
recognized body or bodies or State agency, shall be deemed accredited 
for purposes of this title if the Secretary of Education finds, after 
consultation with the appropriate accreditation body or bodies, that 
there is reasonable assurance that the program will meet the 
accreditation standards of such body or bodies prior to the beginning 
of the academic year following the normal graduation date of students 
of the first entering class in such a program.
            ``(7) Nonprofit.--The term `nonprofit' as applied to any 
        school, agency, organization, or institution means one which is 
        a corporation or association, or is owned and operated by one 
        or more corporations or associations, no part of the net 
        earnings of which inures, or may lawfully inure, to the benefit 
        of any private shareholder or individual.
            ``(8) State.--The term `State' means a State, the 
        Commonwealth of Puerto Rico, the District of Columbia, the 
        Commonwealth of the Northern Mariana Islands, Guam, American 
        Samoa, the Virgin Islands, or the Trust Territory of the 
        Pacific Islands.

``SEC. 802. APPLICATION.

    ``(a) In General.--To be eligible to receive a grant or contract 
under this title, an eligible entity shall prepare and submit to the 
Secretary an application that meets the requirements of this section, 
at such time, in such manner, and containing such information as the 
Secretary may require.
    ``(b) Plan.--An application submitted under this section shall 
contain the plan of the applicant for carrying out a project with 
amounts received under this title. Such plan shall be consistent with 
relevant Federal, State, or regional program plans.
    ``(c) Performance Outcome Standards.--An application submitted 
under this section shall contain a specification by the applicant 
entity of performance outcome standards that the project to be funded 
under the grant or contract will be measured against. Such standards 
shall address relevant national nursing needs that the project will 
meet. The recipient of a grant or contract under this section shall 
meet the standards set forth in the grant or contract application.
    ``(d) Linkages.--An application submitted under this section shall 
contain a description of the linkages with relevant educational and 
health care entities, including training programs for other health 
professionals as appropriate, that the project to be funded under the 
grant or contract will establish.

``SEC. 803. USE OF FUNDS.

    ``(a) In General.--Amounts provided under a grant or contract 
awarded under this title may be used for training program development 
and support, faculty development, model demonstrations, trainee support 
including tuition, books, program fees and reasonable living expenses 
during the period of training, technical assistance, workforce 
analysis, and dissemination of information, as appropriate to meet 
recognized nursing objectives, in accordance with this title.
    ``(b) Maintenance of Effort.--With respect to activities for which 
a grant awarded under this title is to be expended, the entity shall 
agree to maintain expenditures of non-Federal amounts for such 
activities at a level that is not less than the level of such 
expenditures maintained by the entity for the fiscal year preceding the 
fiscal year for which the entity receives such a grant.

``SEC. 804. MATCHING REQUIREMENT.

    ``The Secretary may require that an entity that applies for a grant 
or contract under this title provide non-Federal matching funds, as 
appropriate, to ensure the institutional commitment of the entity to 
the projects funded under the grant. Such non-Federal matching funds 
may be provided directly or through donations from public or private 
entities and may be in cash or in-kind, fairly evaluated, including 
plant, equipment, or services.

``SEC. 805. PREFERENCE.

    ``In awarding grants or contracts under this title, the Secretary 
shall give preference to applicants with projects that will 
substantially benefit rural or underserved populations, or help meet 
public health nursing needs in State or local health departments.

``SEC. 806. GENERALLY APPLICABLE PROVISIONS.

    ``(a) Awarding of Grants and Contracts.--The Secretary shall ensure 
that grants and contracts under this title are awarded on a competitive 
basis, as appropriate, to carry out innovative demonstration projects 
or provide for strategic workforce supplementation activities as needed 
to meet national nursing service goals and in accordance with this 
title. Contracts may be entered into under this title with public or 
private entities as determined necessary by the Secretary.
    ``(b) Information Requirements.--
            ``(1) In general.--Recipients of grants and contracts under 
        this title shall meet information requirements as specified by 
        the Secretary.
            ``(2) Evaluations.--The Secretary shall establish 
        procedures to ensure the annual evaluation of programs and 
projects operated by recipients of grants under this title. Such 
procedures shall ensure that continued funding for such programs and 
projects will be conditioned upon a demonstration that satisfactory 
progress has been made by the program or project in meeting the 
objectives of the program or project.
    ``(c) Training Programs.--Training programs conducted with amounts 
received under this title shall meet applicable accreditation and 
quality standards.
    ``(d) Duration of Assistance.--
            ``(1) In general.--Subject to paragraph (2), in the case of 
        an award to an entity of a grant, cooperative agreement, or 
        contract under this title, the period during which payments are 
        made to the entity under the award may not exceed 5 years. The 
        provision of payments under the award shall be subject to 
        annual approval by the Secretary of the payments and subject to 
        the availability of appropriations for the fiscal year involved 
        to make the payments. This paragraph may not be construed as 
        limiting the number of awards under the program involved that 
        may be made to the entity.
            ``(2) Limitation.--In the case of an award to an entity of 
        a grant, cooperative agreement, or contract under this title, 
        paragraph (1) shall apply only to the extent not inconsistent 
        with any other provision of this title that relates to the 
        period during which payments may be made under the award.
    ``(e) Peer Review Regarding Certain Programs.--
            ``(1) In general.--Each application for a grant under this 
        title, except advanced nurse traineeship grants under section 
        811(a)(2), shall be 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.
            ``(2) Composition.--Each peer review group under this 
        subsection shall be composed principally of individuals who are 
        not officers or employees of the Federal Government. In 
        providing for the establishment of peer review groups and 
        procedures, the Secretary shall, except as otherwise provided, 
        ensure gender, racial, ethnic, and geographic balance among the 
        membership of such groups.
            ``(3) Administration.--This subsection shall be carried out 
        by the Secretary acting through the Administrator of the Health 
        Resources and Services Administration.
    ``(f) Analytic Activities.--The Secretary shall ensure that--
            ``(1) cross-cutting workforce analytical activities are 
        carried out as part of the workforce information and analysis 
        activities under this title; and
            ``(2) discipline-specific workforce information is 
        developed and analytical activities are carried out as part 
        of--
                    ``(A) the advanced practice nursing activities 
                under part B;
                    ``(B) the workforce diversity activities under part 
                C; and
                    ``(C) basic nursing education and practice 
                activities under part D.
    ``(g) State and Regional Priorities.--Activities under grants or 
contracts under this title shall, to extent practicable, be consistent 
with related Federal, State, or regional nursing professions program 
plans and priorities.
    ``(h) Filing of Applications.--
            ``(1) In general.--Applications for grants or contracts 
        under this title may be submitted by health professions 
        schools, schools of nursing, academic health centers, State or 
        local governments, or other appropriate public or private 
        nonprofit entities as determined appropriate by the Secretary 
        in accordance with this title.
            ``(2) For profit entities.--Notwithstanding paragraph (1), 
        a for-profit entity may be eligible for a grant or contract 
        under this title as determined appropriated by the Secretary.

``SEC. 807. TECHNICAL ASSISTANCE.

    ``Funds appropriated under this title may be used by the Secretary 
to provide technical assistance in relation to any of the authorities 
under this title.

``PART B--NURSE PRACTITIONERS, NURSE MIDWIVES, NURSE ANESTHETISTS, AND 
                     OTHER ADVANCED PRACTICE NURSES

``SEC. 811. ADVANCED PRACTICE NURSING GRANTS.

    ``(a) In General.--The Secretary may award grants to and enter into 
contracts with eligible entities to meet the costs of--
            ``(1) projects that support the enhancement of advanced 
        practice nursing education and practice; and
            ``(2) traineeships for individuals in advanced practice 
        nursing programs.
    ``(b) Definition of Advanced Practice Nurses.--For purposes of this 
section, the term `advanced practice nurses' means individuals trained 
in advanced degree programs including individuals in combined R.N./
Master's degree programs, post-nursing master's certificate programs, 
or, in the case of nurse midwives, in certificate programs in existence 
on the date that is one day prior to the date of enactment of this 
section, to serve as nurse practitioners, clinical nurse specialists, 
nurse midwives, nurse anesthetists, nurse educators, nurse 
administrators, or public health nurses, or in other nurse specialties 
determined by the Secretary to require advanced education.
    ``(c) Authorized Nurse Practitioner and Nurse-Midwifery Programs.--
Nurse practitioner and nurse midwifery programs eligible for support 
under this section are educational programs for registered nurses 
(irrespective of the type of school of nursing in which the nurses 
received their training) that--
            ``(1) meet guidelines prescribed by the Secretary; and
            ``(2) have as their objective the education of nurses who 
        will upon completion of their studies in such programs, be 
        qualified to effectively provide primary health care, including 
        primary health care in homes and in ambulatory care facilities, 
        long-term care facilities, acute care, and other health care 
        settings.
    ``(d) Authorized Nurse Anesthesia Programs.--Nurse anesthesia 
programs eligible for support under this section are education programs 
that--
            ``(1) provide registered nurses with full-time anesthetist 
        education; and
            ``(2) are accredited by the Council on Accreditation of 
        Nurse Anesthesia Educational Programs.
    ``(e) Other Authorized Educational Programs.--The Secretary shall 
prescribe guidelines as appropriate for other advanced practice nurse 
education programs eligible for support under this section.
    ``(f) Traineeships.--
            ``(1) In general.--The Secretary may not award a grant to 
        an applicant under subsection (a) unless the applicant involved 
        agrees that traineeships provided with the grant will only pay 
        all or part of the costs of--
                    ``(A) the tuition, books, and fees of the program 
                of advanced nursing practice with respect to which the 
                traineeship is provided; and
                    ``(B) the reasonable living expenses of the 
                individual during the period for which the traineeship 
                is provided.
            ``(2) Doctoral programs.--The Secretary may not obligate 
        more than 10 percent of the traineeships under subsection (a) 
        for individuals in doctorate degree programs.
            ``(3) Special consideration.--In making awards of grants 
        and contracts under subsection (a)(2), the Secretary shall give 
        special consideration to an eligible entity that agrees to 
        expend the award to train advanced practice nurses who will 
        practice in health professional shortage areas designated under 
        section 332.

            ``PART C--INCREASING NURSING WORKFORCE DIVERSITY

``SEC. 821. WORKFORCE DIVERSITY GRANTS.

    ``(a) In General.--The Secretary may award grants to and enter into 
contracts with eligible entities to meet the costs of special projects 
to increase nursing education opportunities for individuals who are 
from disadvantaged backgrounds (including racial and ethnic minorities 
underrepresented among registered nurses) by providing student 
scholarships or stipends, pre-entry preparation, and retention 
activities.
    ``(b) Guidance.--In carrying out subsection (a), the Secretary 
shall take into consideration the recommendations of the First, Second 
and Third Invitational Congresses for Minority Nurse Leaders on `Caring 
for the Emerging Majority,' in 1992, 1993 and 1997, and consult with 
nursing associations including the American Nurses Association, the 
National League for Nursing, the American Association of Colleges of 
Nursing, the National Black Nurses Association, the National 
Association of Hispanic Nurses, the Association of Asian American and 
Pacific Islander Nurses, the Native American Indian and Alaskan Nurses 
Association, and the National Council of State Boards of Nursing.
    ``(c) Required Information and Conditions for Award Recipients.--
            ``(1) In general.--Recipients of awards under this section 
        may be required, where requested, to report to the Secretary 
        concerning the annual admission, retention, and graduation 
        rates for individuals from disadvantaged backgrounds and ethnic 
        and racial minorities in the school or schools involved in the 
        projects.
            ``(2) Falling rates.--If any of the rates reported under 
        paragraph (1) fall below the average of the two previous years, 
        the grant or contract recipient shall provide the Secretary 
        with plans for immediately improving such rates.
            ``(3) Ineligibility.--A recipient described in paragraph 
        (2) shall be ineligible for continued funding under this 
        section if the plan of the recipient fails to improve the rates 
        within the 1-year period beginning on the date such plan is 
        implemented.

``PART D--STRENGTHENING CAPACITY FOR BASIC NURSE EDUCATION AND PRACTICE

``SEC. 831. BASIC NURSE EDUCATION AND PRACTICE GRANTS.

    ``(a) In General.--The Secretary may award grants to and enter into 
contracts with eligible entities for projects to strengthen capacity 
for basic nurse education and practice.
    ``(b) Priority Areas.--In awarding grants or contracts under this 
section the Secretary shall give priority to entities that will use 
amounts provided under such a grant or contract to enhance the 
educational mix and utilization of the basic nursing workforce by 
strengthening programs that provide basic nurse education, such as 
through--
            ``(1) establishing or expanding nursing practice 
        arrangements in noninstitutional settings to demonstrate 
        methods to improve access to primary health care in medically 
        underserved communities;
            ``(2) providing care for underserved populations and other 
        high-risk groups such as the elderly, individuals with HIV-
        AIDS, substance abusers, the homeless, and victims of domestic 
        violence;
            ``(3) providing managed care, quality improvement, and 
        other skills needed to practice in existing and emerging 
        organized health care systems;
            ``(4) developing cultural competencies among nurses;
            ``(5) expanding the enrollment in baccalaureate nursing 
        programs;
            ``(6) promoting career mobility for nursing personnel in a 
        variety of training settings and cross training or specialty 
        training among diverse population groups;
            ``(7) providing education in informatics, including 
        distance learning methodologies; or
            ``(8) other priority areas as determined by the 
        Secretary.'';
            (5) by adding at the end the following:

               ``PART F--AUTHORIZATION OF APPROPRIATIONS

``SEC. 841. AUTHORIZATION OF APPROPRIATIONS.

    ``There are authorized to be appropriated to carry out sections 
811, 821, and 831, $65,000,000 for fiscal year 1998, and such sums as 
may be necessary in each of the fiscal years 1999 through 2002.

  ``PART G--NATIONAL ADVISORY COUNCIL ON NURSE EDUCATION AND PRACTICE

``SEC. 845. NATIONAL ADVISORY COUNCIL ON NURSE EDUCATION AND PRACTICE.

    ``(a) Establishment.--The Secretary shall establish an advisory 
council to be known as the National Advisory Council on Nurse Education 
and Practice (in this section referred to as the `Advisory Council').
    ``(b) Composition.--
            ``(1) In general.--The Advisory Council shall be composed 
        of
                    ``(A) not less than 21, nor more than 23 
                individuals, who are not officers or employees of the 
                Federal Government, appointed by the Secretary without 
                regard to the Federal civil service laws, of which--
                            ``(i) 2 shall be selected from full-time 
                        students enrolled in schools of nursing;
                            ``(ii) 2 shall be selected from the general 
                        public;
                            ``(iii) 2 shall be selected from practicing 
                        professional nurses; and
                            ``(iv) 9 shall be selected from among the 
                        leading authorities in the various fields of 
                        nursing, higher, and secondary education, and 
                        from representatives of advanced practice 
                        nursing groups (such as nurse practitioners, 
                        nurse midwives, and nurse anesthetists), 
                        hospitals, and other institutions and 
                        organizations which provide nursing services; 
                        and
                    ``(B) the Secretary (or the delegate of the 
                Secretary (who shall be an ex officio member and shall 
                serve as the Chairperson)).
            ``(2) Appointment.--Not later than 90 days after the date 
        of enactment of this Act, the Secretary shall appoint the 
        members of the Advisory Council and each such member shall 
        serve a 4 year term. In making such appointments, the Secretary 
        shall ensure a fair balance between the nursing professions, a 
        broad geographic representation of members and a balance 
        between urban and rural members. Members shall be appointed 
        based on their competence, interest, and knowledge of the 
        mission of the profession involved. A majority of the members 
        shall be nurses.
            ``(3) Minority representation.--In appointing the members 
        of the Advisory Council under paragraph (1), the Secretary 
        shall ensure the adequate representation of minorities.
    ``(c) Vacancies.--
            ``(1) In general.--A vacancy on the Advisory Council shall 
        be filled in the manner in which the original appointment was 
        made and shall be subject to any conditions which applied with 
        respect to the original appointment.
            ``(2) Filling unexpired term.--An individual chosen to fill 
        a vacancy shall be appointed for the unexpired term of the 
        member replaced.
    ``(d) Duties.--The Advisory Council shall--
            ``(1) provide advice and recommendations to the Secretary 
        and Congress concerning policy matters arising in the 
        administration of this title, including the range of issues 
        relating to the nurse workforce, education, and practice 
        improvement;
            ``(2) provide advice to the Secretary and Congress in the 
        preparation of general regulations and with respect to policy 
        matters arising in the administration of this title, including 
        the range of issues relating to nurse supply, education and 
        practice improvement; and
            ``(3) not later than 3 years after the date of enactment of 
        this section, and annually thereafter, prepare and submit to 
        the Secretary, the Committee on Labor and Human Resources of 
        the Senate, and the Committee on Commerce of the House of 
        Representatives, a report describing the activities of the 
        Council, including findings and recommendations made by the 
        Council concerning the activities under this title.
    ``(e) Meetings and Documents.--
            ``(1) Meetings.--The Advisory Council shall meet not less 
        than 2 times each year. Such meetings shall be held jointly 
        with other related entities established under this title where 
        appropriate.
            ``(2) Documents.--Not later than 14 days prior to the 
        convening of a meeting under paragraph (1), the Advisory 
        Council shall prepare and make available an agenda of the 
        matters to be considered by the Advisory Council at such 
        meeting. At any such meeting, the Advisory Council shall 
        distribute materials with respect to the issues to be addressed 
        at the meeting. Not later than 30 days after the adjourning of 
        such a meeting, the Advisory Council shall prepare and make 
        available a summary of the meeting and any actions taken by the 
        Council based upon the meeting.
    ``(f) Compensation and Expenses.--
            ``(1) Compensation.--Each member of the Advisory Council 
        shall be compensated at a rate equal to the daily equivalent of 
        the annual rate of basic pay prescribed for level IV of the 
        Executive Schedule under section 5315 of title 5, United States 
        Code, for each day (including travel time) during which such 
        member is engaged in the performance of the duties of the 
        Council. All members of the Council who are officers or 
        employees of the United States shall serve without compensation 
        in addition to that received for their services as officers or 
        employees of the United States.
            ``(2) Expenses.--The members of the Advisory Council shall 
        be allowed travel expenses, including per diem in lieu of 
        subsistence, at rates authorized for employees of agencies 
        under subchapter I of chapter 57 of title 5, United States 
        Code, while away from their homes or regular places of business 
        in the performance of services for the Council.
    ``(g) Funding.--Amounts appropriated under this title may be 
utilized by the Secretary to support the nurse education and practice 
activities of the Council.
    ``(h) FACA.--The Federal Advisory Committee Act shall apply to the 
Advisory Committee under this section only to the extent that the 
provisions of such Act do not conflict with the requirements of this 
section.''; and
            (6) by redesignating section 855 as section 810, and 
        transferring such section so as to appear after section 809 (as 
        added by the amendment made by paragraph (5)).

SEC. 124. SAVINGS PROVISION.

    In the case of any authority for making awards of grants or 
contracts that is terminated by the amendment made by section 123, the 
Secretary of Health and Human Services may, notwithstanding the 
termination of the authority, continue in effect any grant or contract 
made under the authority that is in effect on the day before the date 
of the enactment of this Act, subject to the duration of any such grant 
or contract not exceeding the period determined by the Secretary in 
first approving such financial assistance, or in approving the most 
recent request made (before the date of such enactment) for 
continuation of such assistance, as the case may be.

                    Subtitle C--Financial Assistance

              CHAPTER 1--SCHOOL-BASED REVOLVING LOAN FUNDS

SEC. 131. PRIMARY CARE LOAN PROGRAM.

    (a) Requirement for Schools.--Section 723(b)(1) of the Public 
Health Service Act (42 U.S.C. 292s(b)(1)), as amended by section 
2014(c)(2)(A)(ii) of Public Law 103-43 (107 Stat. 216), is amended by 
striking ``3 years before'' and inserting ``4 years before''.
    (b) Noncompliance.--Section 723(a)(3) of the Public Health Service 
Act (42 U.S.C. 292s(a)(3)) is amended to read as follows:
            ``(3) Noncompliance by student.--Each agreement entered 
        into with a student pursuant to paragraph (1) shall provide 
        that, if the student fails to comply with such agreement, the 
        loan involved will begin to accrue interest at a rate of 18 
        percent per year beginning on the date of such 
        noncompliance.''.
    (c) Report Requirement.--Section 723 of the Public Health Service 
Act (42 U.S.C. 292s) is amended--
            (1) by striking subsection (c); and
            (2) by redesignating subsection (d) as subsection (c).

SEC. 132. LOANS FOR DISADVANTAGED STUDENTS.

    (a) Authorization of Appropriations.--Section 724(f)(1) of the 
Public Health Service Act (42 U.S.C. 292t(f)(1)) is amended by striking 
``$15,000,000 for fiscal year 1993'' and inserting ``$8,000,000 for 
each of the fiscal years 1998 through 2002''.
    (b) Repeal.--Effective October 1, 2002, paragraph (1) of section 
724(f) of the Public Health Service Act (42 U.S.C. 292t(f)(1)) is 
repealed.

SEC. 133. STUDENT LOANS REGARDING SCHOOLS OF NURSING.

    (a) In General.--Section 836(b) of the Public Health Service Act 
(42 U.S.C. 297b(b)) is amended--
            (1) in paragraph (1), by striking the period at the end and 
        inserting a semicolon;
            (2) in paragraph (2)--
                    (A) in subparagraph (A), by striking ``and'' at the 
                end; and
                    (B) by inserting before the semicolon at the end 
                the following: ``, and (C) such additional periods 
                under the terms of paragraph (8) of this subsection'';
            (3) in paragraph (7), by striking the period at the end and 
        inserting ``; and''; and
            (4) by adding at the end the following paragraph:
            ``(8) pursuant to uniform criteria established by the 
        Secretary, the repayment period established under paragraph (2) 
        for any student borrower who during the repayment period failed 
        to make consecutive payments and who, during the last 12 months 
        of the repayment period, has made at least 12 consecutive 
        payments may be extended for a period not to exceed 10 
        years.''.
    (b) Minimum Monthly Payments.--Section 836(g) of the Public Health 
Service Act (42 U.S.C. 297b(g)) is amended by striking ``$15'' and 
inserting ``$40''.
    (c) Elimination of Statute of Limitation for Loan Collections.--
            (1) In general.--Section 836 of the Public Health Service 
        Act (42 U.S.C. 297b) is amended by adding at the end the 
        following new subsection:
    ``(l) Elimination of Statute of Limitation for Loan Collections.--
            ``(1) Purpose.--It is the purpose of this subsection to 
        ensure that obligations to repay loans under this section are 
        enforced without regard to any Federal or State statutory, 
        regulatory, or administrative limitation on the period within 
        which debts may be enforced.
            ``(2) Prohibition.--Notwithstanding any other provision of 
        Federal or State law, no limitation shall terminate the period 
        within which suit may be filed, a judgment may be enforced, or 
        an offset, garnishment, or other action may be initiated or 
        taken by a school of nursing that has an agreement with the 
        Secretary pursuant to section 835 that is seeking the repayment 
        of the amount due from a borrower on a loan made under this 
        subpart after the default of the borrower on such loan.''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall be effective with respect to actions pending on or after 
        the date of enactment of this Act.
    (d) Breach of Agreements.--Section 338D of the Public Health 
Service Act is amended by adding at the end thereof the following new 
subsection:
    ``(g) Breach of Agreement.--
            ``(1) In general.--In the case of any program under this 
        section under which an individual makes an agreement to provide 
        health services for a period of time in accordance with such 
        program in consideration of receiving an award of Federal funds 
        regarding education as a nurse (including an award for the 
        repayment of loans), the following applies if the agreement 
        provides that this subsection is applicable:
                    ``(A) In the case of a program under this section 
                that makes an award of Federal funds for attending an 
                accredited program of nursing (in this section referred 
                to as a `nursing program'), the individual is liable to 
the Federal Government for the amount of such award (including amounts 
provided for expenses related to such attendance), and for interest on 
such amount at the maximum legal prevailing rate, if the individual--
                            ``(i) fails to maintain an acceptable level 
                        of academic standing in the nursing program (as 
                        indicated by the program in accordance with 
                        requirements established by the Secretary);
                            ``(ii) is dismissed from the nursing 
                        program for disciplinary reasons; or
                            ``(iii) voluntarily terminates the nursing 
                        program.
                    ``(B) The individual is liable to the Federal 
                Government for the amount of such award (including 
                amounts provided for expenses related to such 
                attendance), and for interest on such amount at the 
                maximum legal prevailing rate, if the individual fails 
                to provide health services in accordance with the 
                program under this section for the period of time 
                applicable under the program.
            ``(2) Waiver or suspension of liability.--In the case of an 
        individual or health facility making an agreement for purposes 
        of paragraph (1), the Secretary shall provide for the waiver or 
        suspension of liability under such subsection if compliance by 
        the individual or the health facility, as the case may be, with 
        the agreements involved is impossible, or would involve extreme 
        hardship to the individual or facility, and if enforcement of 
        the agreements with respect to the individual or facility would 
        be unconscionable.
            ``(3) Date certain for recovery.--Subject to paragraph (2), 
        any amount that the Federal Government is entitled to recover 
        under paragraph (1) shall be paid to the United States not 
        later than the expiration of the 3-year period beginning on the 
        date the United States becomes so entitled.
            ``(4) Availability.--Amounts recovered under paragraph (1) 
        with respect to a program under this section shall be available 
        for the purposes of such program, and shall remain available 
        for such purposes until expended.''.
    (e) Technical Amendments.--Section 839 of the Public Health Service 
Act (42 U.S.C. 297e) is amended--
            (1) in subsection (a)--
                    (A) by striking the matter preceding paragraph (1) 
                and inserting the following:
    ``(a) If a school terminates a loan fund established under an 
agreement pursuant to section 835(b), or if the Secretary for good 
cause terminates the agreement with the school, there shall be a 
capital distribution as follows:''; and
                    (B) in paragraph (1), by striking ``at the close of 
                September 30, 1999,'' and inserting ``on the date of 
                termination of the fund''; and
            (2) in subsection (b), to read as follows:
    ``(b) If a capital distribution is made under subsection (a), the 
school involved shall, after such capital distribution, pay to the 
Secretary, not less often than quarterly, the same proportionate share 
of amounts received by the school in payment of principal or interest 
on loans made from the loan fund established under section 835(b) as 
determined by the Secretary under subsection (a).''.

SEC. 134. GENERAL PROVISIONS.

    (a) Maximum Student Loan Provisions and Minimum Payments.--
            (1) In general.--Section 722(a)(1) of the Public Health 
        Service Act (42 U.S.C. 292r(a)(1)), as amended by section 
        2014(b)(1) of Public Law 103-43, is amended by striking ``the 
        sum of'' and all that follows through the end thereof and 
        inserting ``the cost of attendance (including tuition, other 
        reasonable educational expenses, and reasonable living costs) 
        for that year at the educational institution attended by the 
        student (as determined by such educational institution).''.
            (2) Third and fourth years.--Section 722(a)(2) of the 
        Public Health Service Act (42 U.S.C. 292r(a)(2)), as amended by 
        section 2014(b)(1) of Public Law 103-43, is amended by striking 
        ``the amount $2,500'' and all that follows through ``including 
        such $2,500'' and inserting ``the amount of the loan may, in 
        the case of the third or fourth year of a student at a school 
        of medicine or osteopathic medicine, be increased to the extent 
        necessary''.
            (3) Repayment period.--Section 722(c) of the Public Health 
        Service Act (42 U.S.C. 292r(c)), as amended by section 
        2014(b)(1) of Public Law 103-43, is amended--
                    (A) in the subsection heading by striking ``Ten-
                Year'' and inserting ``Repayment'';
                    (B) by striking ``ten-year period which begins'' 
                and inserting ``period of not less than 10 years nor 
more than 25 years, at the discretion of the institution, which 
begins''; and
                    (C) by striking ``such ten-year period'' and 
                inserting ``such period''.
            (4) Minimum payments.--Section 722(j) of the Public Health 
        Service Act (42 U.S.C. 292r(j)), as amended by section 
        2014(b)(1) of Public Law 103-43, is amended by striking ``$15'' 
        and inserting $40''.
    (b) Elimination of Statute of Limitation for Loan Collections.--
            (1) In general.--Section 722 of the Public Health Service 
        Act (42 U.S.C. 292r), as amended by section 2014(b)(1) of 
        Public Law 103-43, is amended by adding at the end the 
        following new subsection:
    ``(m) Elimination of Statute of Limitation for Loan Collections.--
            ``(1) Purpose.--It is the purpose of this subsection to 
        ensure that obligations to repay loans under this section are 
        enforced without regard to any Federal or State statutory, 
        regulatory, or administrative limitation on the period within 
        which debts may be enforced.
            ``(2) Prohibition.--Notwithstanding any other provision of 
        Federal or State law, no limitation shall terminate the period 
        within which suit may be filed, a judgment may be enforced, or 
        an offset, garnishment, or other action may be initiated or 
        taken by a school that has an agreement with the Secretary 
        pursuant to section 721 that is seeking the repayment of the 
        amount due from a borrower on a loan made under this subpart 
        after the default of the borrower on such loan.''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall be effective with respect to actions pending on or after 
        the date of enactment of this Act.
    (c) Date Certain for Contributions.--Paragraph (2) of section 
735(e) of the Public Health Service Act (42 U.S.C. 292y(e)(2)) is 
amended to read as follows:
            ``(2) Date certain for contributions.--Amounts described in 
        paragraph (1) that are returned to the Secretary shall be 
        obligated before the end of the succeeding fiscal year.''.

   CHAPTER 2--INSURED HEALTH EDUCATION ASSISTANCE LOANS TO GRADUATE 
                                STUDENTS

SEC. 141. HEALTH EDUCATION ASSISTANCE LOAN PROGRAM.

    (a) Health Education Assistance Loan Deferment for Borrowers 
Providing Health Services to Indians.--
            (1) In general.--Section 705(a)(2)(C) of the Public Health 
        Service Act (42 U.S.C. 292d(a)(2)(C)) is amended by striking 
        ``and (x)'' and inserting ``(x) not in excess of three years, 
        during which the borrower is providing health care services to 
        Indians through an Indian health program (as defined in section 
        108(a)(2)(A) of the Indian Health Care Improvement Act (25 
        U.S.C. 1616a(a)(2)(A)); and (xi)''.
            (2) Conforming amendments.--Section 705(a)(2)(C) of the 
        Public Health Service Act (42 U.S.C. 292d(a)(2)(C)) is further 
        amended--
                    (A) in clause (xi) (as so redesignated) by striking 
                ``(ix)'' and inserting ``(x)''; and
                    (B) in the matter following such clause (xi), by 
                striking ``(x)'' and inserting ``(xi)''.
            (3) Effective date.--The amendments made by this subsection 
        shall apply with respect to services provided on or after the 
        first day of the third month that begins after the date of the 
        enactment of this Act.
    (b) Report Requirement.--Section 709(b) of the Public Health 
Service Act (42 U.S.C. 292h(b)) is amended--
            (1) in paragraph (4)(B), by adding ``and'' after the 
        semicolon;
            (2) in paragraph (5), by striking ``; and'' and inserting a 
        period; and
            (3) by striking paragraph (6).
    (c) Collection From Estates.--Section 714 of the Public Health 
Service Act (42 U.S.C. 292m) is amended by adding at the end the 
following new sentence: ``Notwithstanding the first sentence, the 
Secretary may, in the case of a borrower who dies, collect any 
remaining unpaid balance owed to the lender, the holder of the loan, or 
the Federal Government from the borrower's estate.''.
    (d) Program Eligibility.--
            (1) Limitations on loans.--Section 703(a) of the Public 
        Health Service Act (42 U.S.C. 292b(a)) is amended by striking 
        ``or clinical psychology'' and inserting ``or behavioral and 
        mental health practice, including clinical psychology''.
            (2) Definition of eligible institution.--Section 719(1) of 
        the Public Health Service Act (42 U.S.C. 292o(1)) is amended by 
striking ``or clinical psychology'' and inserting ``or behavioral and 
mental health practice, including clinical psychology''.

SEC. 142. HEAL LENDER AND HOLDER PERFORMANCE STANDARDS.

    (a) General Amendments.--Section 707(a) of the Public Health 
Service Act (42 U.S.C. 292f) is amended--
            (1) by striking the last sentence;
            (2) by striking ``determined.'' and inserting ``determined, 
        except that, if the insurance beneficiary including any 
        servicer of the loan is not designated for `exceptional 
        performance', as set forth in paragraph (2), the Secretary 
        shall pay to the beneficiary a sum equal to 98 percent of the 
        amount of the loss sustained by the insured upon that loan.'';
            (3) by striking ``Upon'' and inserting:
            ``(1) In general.--Upon''; and
            (4) by adding at the end the following new paragraph:
            ``(2) Exceptional performance.--
                    ``(A) Authority.--Where the Secretary determines 
                that an eligible lender, holder, or servicer has a 
                compliance performance rating that equals or exceeds 97 
                percent, the Secretary shall designate that eligible 
                lender, holder, or servicer, as the case may be, for 
                exceptional performance.
                    ``(B) Compliance performance rating.--For purposes 
                of subparagraph (A), a compliance performance rating is 
                determined with respect to compliance with due 
                diligence in the disbursement, servicing, and 
                collection of loans under this subpart for each year 
                for which the determination is made. Such rating shall 
                be equal to the percentage of all due diligence 
                requirements applicable to each loan, on average, as 
                established by the Secretary, with respect to loans 
                serviced during the period by the eligible lender, 
                holder, or servicer.
                    ``(C) Annual audits for lenders, holders, and 
                servicers.--Each eligible lender, holder, or servicer 
                desiring a designation under subparagraph (A) shall 
                have an annual financial and compliance audit conducted 
                with respect to the loan portfolio of such eligible 
                lender, holder, or servicer, by a qualified independent 
                organization from a list of qualified organizations 
                identified by the Secretary and in accordance with 
                standards established by the Secretary. The standards 
                shall measure the lender's, holder's, or servicer's 
                compliance with due diligence standards and shall 
                include a defined statistical sampling technique 
                designed to measure the performance rating of the 
                eligible lender, holder, or servicer for the purpose of 
                this section. Each eligible lender, holder, or servicer 
                shall submit the audit required by this section to the 
                Secretary.
                    ``(D) Secretary's determinations.--The Secretary 
                shall make the determination under subparagraph (A) 
                based upon the audits submitted under this paragraph 
                and any information in the possession of the Secretary 
                or submitted by any other agency or office of the 
                Federal Government.
                    ``(E) Quarterly compliance audit.--To maintain its 
                status as an exceptional performer, the lender, holder, 
                or servicer shall undergo a quarterly compliance audit 
                at the end of each quarter (other than the quarter in 
                which status as an exceptional performer is established 
                through a financial and compliance audit, as described 
                in subparagraph (C)), and submit the results of such 
                audit to the Secretary. The compliance audit shall 
                review compliance with due diligence requirements for 
                the period beginning on the day after the ending date 
                of the previous audit, in accordance with standards 
                determined by the Secretary.
                    ``(F) Revocation authority.--The Secretary shall 
                revoke the designation of a lender, holder, or servicer 
                under subparagraph (A) if any quarterly audit required 
                under subparagraph (E) is not received by the Secretary 
                by the date established by the Secretary or if the 
                audit indicates the lender, holder, or servicer has 
                failed to meet the standards for designation as an 
                exceptional performer under subparagraph (A). A lender, 
                holder, or servicer receiving a compliance audit not 
                meeting the standard for designation as an exceptional 
                performer may reapply for designation under 
                subparagraph (A) at any time.
                    ``(G) Documentation.--Nothing in this section shall 
                restrict or limit the authority of the Secretary to 
                require the submission of claims documentation 
                evidencing servicing performed on loans, except that 
                the Secretary may not require exceptional performers to 
                submit greater documentation than that required 
for lenders, holders, and servicers not designated under subparagraph 
(A).
                    ``(H) Cost of audits.--Each eligible lender, 
                holder, or servicer shall pay for all the costs 
                associated with the audits required under this section.
                    ``(I) Additional revocation authority.--
                Notwithstanding any other provision of this section, a 
                designation under subparagraph (A) may be revoked at 
                any time by the Secretary if the Secretary determines 
                that the eligible lender, holder, or servicer has 
                failed to maintain an overall level of compliance 
                consistent with the audit submitted by the eligible 
                lender, holder, or servicer under this paragraph or if 
                the Secretary asserts that the lender, holder, or 
                servicer may have engaged in fraud in securing 
                designation under subparagraph (A) or is failing to 
                service loans in accordance with program requirements.
                    ``(J) Noncompliance.--A lender, holder, or servicer 
                designated under subparagraph (A) that fails to service 
                loans or otherwise comply with applicable program 
                regulations shall be considered in violation of the 
                Federal False Claims Act.''.
    (b) Definition.--Section 707(e) of the Public Health Service Act 
(42 U.S.C. 292f(e)) is amended by adding at the end the following new 
paragraph:
            ``(4) The term `servicer' means any agency acting on behalf 
        of the insurance beneficiary.''.
    (c) Effective Date.--The amendments made by subsections (a) and (b) 
shall apply with respect to loans submitted to the Secretary for 
payment on or after the first day of the sixth month that begins after 
the date of enactment of this Act.

SEC. 143. REAUTHORIZATION.

    (a) Loan Program.--Section 702(a) of the Public Health Service Act 
(42 U.S.C. 292a(a)) is amended--
            (1) by striking ``$350,000,000'' and all that follows 
        through ``1995'' and inserting ``$350,000,000 for fiscal year 
        1998, $375,000,000 for fiscal year 1999, and $425,000,000 for 
        each of the fiscal years 2000 through 2002'';
            (2) by striking ``obtained prior loans insured under this 
        subpart'' and inserting ``obtained loans insured under this 
        subpart in fiscal year 2002 or in prior fiscal years'';
            (3) by adding at the end thereof the following new 
        sentence: ``The Secretary may establish guidelines and 
        procedures that lenders must follow in distributing funds under 
        this subpart.''; and
            (4) by striking ``September 30, 1998'' and inserting 
        ``September 30, 2005''.
    (b) Insurance Program.--Section 710(a)(2)(B) of the Public Health 
Service Act (42 U.S.C. 292i(a)(2)(B)) is amended by striking ``any of 
the fiscal years 1993 through 1996'' and inserting ``fiscal year 1993 
and subsequent fiscal years''.

SEC. 144. HEAL BANKRUPTCY.

    (a) In General.--Section 707(g) of the Public Health Service Act 
(42 U.S.C. 292f(g)) is amended in the first sentence by striking ``A 
debt which is a loan insured'' and inserting ``Notwithstanding any 
other provision of Federal or State law, a debt that is a loan 
insured''.
    (b) Application.--The amendment made by subsection (a) shall apply 
to any loan insured under the authority of subpart I of part A of title 
VII of the Public Health Service Act (42 U.S.C. 292 et seq.) that is 
listed or scheduled by the debtor in a case under title XI, United 
States Code, filed--
            (1) on or after the date of enactment of this Act; or
            (2) prior to such date of enactment in which a discharge 
        has not been granted.

SEC. 145. HEAL REFINANCING.

    Section 706 of the Public Health Service Act (42 U.S.C. 292e) is 
amended--
            (1) in subsection (d)--
                    (A) in the subsection heading, by striking 
                ``Consolidation'' and inserting ``Refinancing or 
                Consolidation''; and
                    (B) in the first sentence, by striking 
                ``indebtedness'' and inserting ``indebtedness or the 
                refinancing of a single loan''; and
            (2) in subsection (e)--
                    (A) in the subsection heading, by striking 
                ``Debts'' and inserting ``Debts and Refinancing'';
                    (B) in the first sentence, by striking ``all of the 
                borrower's debts into a single instrument'' and 
                inserting ``all of the borrower's loans insured under 
                this subpart into a single instrument (or, if the 
                borrower obtained only 1 loan insured under this 
                subpart, refinancing the loan 1 time)''; and
                    (C) in the second sentence, by striking 
                ``consolidation'' and inserting ``consolidation or 
                refinancing''.

                  TITLE II--OFFICE OF MINORITY HEALTH

SEC. 201. REVISION AND EXTENSION OF PROGRAMS OF OFFICE OF MINORITY 
              HEALTH.

    (a) Duties and Requirements.--Section 1707 of the Public Health 
Service Act (42 U.S.C. 300u-6) is amended by striking subsection (b) 
and all that follows and inserting the following:
    ``(b) Duties.--With respect to improving the health of racial and 
ethnic minority groups, the Secretary, acting through the Deputy 
Assistant Secretary for Minority Health (in this section referred to as 
the `Deputy Assistant Secretary'), shall carry out the following:
            ``(1) Establish short-range and long-range goals and 
        objectives and coordinate all other activities within the 
        Public Health Service that relate to disease prevention, health 
        promotion, service delivery, and research concerning such 
        individuals. The heads of each of the agencies of the Service 
        shall consult with the Deputy Assistant Secretary to ensure the 
        coordination of such activities.
            ``(2) Enter into interagency agreements with other agencies 
        of the Public Health Service.
            ``(3) Support research, demonstrations and evaluations to 
        test new and innovative models.
            ``(4) Increase knowledge and understanding of health risk 
        factors.
            ``(5) Develop mechanisms that support better information 
        dissemination, education, prevention, and service delivery to 
        individuals from disadvantaged backgrounds, including 
        individuals who are members of racial or ethnic minority 
        groups.
            ``(6) Ensure that the National Center for Health Statistics 
        collects data on the health status of each minority group.
            ``(7) With respect to individuals who lack proficiency in 
        speaking the English language, enter into contracts with public 
        and nonprofit private providers of primary health services for 
        the purpose of increasing the access of the individuals to such 
        services by developing and carrying out programs to provide 
        bilingual or interpretive services.
            ``(8) Support a national minority health resource center to 
        carry out the following:
                    ``(A) Facilitate the exchange of information 
                regarding matters relating to health information and 
                health promotion, preventive health services, and 
                education in the appropriate use of health care.
                    ``(B) Facilitate access to such information.
                    ``(C) Assist in the analysis of issues and problems 
                relating to such matters.
                    ``(D) Provide technical assistance with respect to 
                the exchange of such information (including 
                facilitating the development of materials for such 
                technical assistance).
            ``(9) Carry out programs to improve access to health care 
        services for individuals with limited proficiency in speaking 
        the English language. Activities under the preceding sentence 
        shall include developing and evaluating model projects.
    ``(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').
            ``(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) through (9) of subsection (b) 
        for each racial and ethnic minority group.
            ``(3) Chair.--The chairperson of the Committee shall be 
        selected by the Secretary from among the members of the voting 
        members of the Committee. The term of office of the chairperson 
        shall be 2 years.
            ``(4) Composition.--
                    ``(A) The Committee shall be composed of 12 voting 
                members appointed in accordance with subparagraph (B), 
                and nonvoting, ex officio members designated in 
                subparagraph (C).
                    ``(B) The voting members of the Committee shall be 
                appointed by the Secretary 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.
                    ``(C) The nonvoting, ex officio members of the 
                Committee shall be such 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) Recommendations regarding language as impediment to 
        health care.--The Deputy Assistant Secretary for Minority 
        Health shall consult with the Director of the Office of Refugee 
        Health, the Director of the Office of Civil Rights, and the 
        Directors of other appropriate Departmental entities regarding 
        recommendations for carrying out activities under subsection 
        (b)(9).
            ``(2) Equitable allocation regarding activities.--
                    ``(A) In general.--In making awards of grants, 
                cooperative agreements, or contracts under this section 
                or section 338A, 338C, 340A, 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) Requirements.--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 
        Secretary acting through 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 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) In general.--Not later than February 1 of fiscal year 
        1999 and of each second year thereafter, the Secretary shall 
        submit to the Committee on Energy and Commerce of the House of 
        Representatives, and to the Committee on Labor and Human 
        Resources of the Senate, a report describing the activities 
        carried out under this 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 biennial reports submitted under 
sections 201(e)(3) and 201(f)(2) for such years by the heads of the 
Public Health Service agencies.
            ``(2) Agency reports.--Not later than February 1, 1999, and 
        biennially thereafter, the heads of the Public Health Service 
        agencies shall submit to the Deputy Assistant Secretary a 
        report summarizing the minority health activities of each of 
        the respective agencies.
    ``(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.--
            ``(1) Authorization of appropriations.--For the purpose of 
        carrying out this section, there are authorized to be 
        appropriated $30,000,000 for fiscal year 1998, such sums as may 
        be necessary for each of the fiscal years 1999 through 2002.
            ``(2) National center for health statistics.--For the 
        purpose of enabling the National Center for Health Statistics 
        to collect data on Hispanics and major Hispanic subpopulation 
        groups, American Indians, and to develop special area 
        population studies on major Asian American and Pacific Islander 
        populations, there are authorized to be appropriated $1,000,000 
        for fiscal year 1998, such sums as may be necessary for each of 
        the fiscal years 1999 through 2002.''.
    (b) Miscellaneous Amendments.--Section 1707 of the Public Health 
Service Act (42 U.S.C. 300u-6) is amended--
            (1) in the heading for the section by striking 
        ``establishment of''; and
            (2) in subsection (a), by striking ``Office of the 
        Assistant Secretary for Health'' and inserting ``Office of 
        Public Health and Science''.

                    TITLE III--SELECTED INITIATIVES

SEC. 301. STATE OFFICES OF RURAL HEALTH.

    (a) In General.--Section 338J of the Public Health Service Act (42 
U.S.C. 254r) is amended--
            (1) in subsection (b)(1), in the matter preceding 
        subparagraph (A), by striking ``in cash''; and
            (2) in subsection (j)(1)--
                    (A) by striking ``and'' after ``1992,''; and
                    (B) by inserting before the period the following: 
                ``, and such sums as may be necessary for each of the 
                fiscal years 1998 through 2002''; and
            (3) in subsection (k), by striking ``$10,000,000'' and 
        inserting ``$20,000,000''.
    (b) Repeal.--Effective on October 1, 2002, section 338J of the 
Public Health Service Act is repealed.

SEC. 302. DEMONSTRATION PROJECTS REGARDING ALZHEIMER'S DISEASE.

    (a) In General.--Section 398(a) of the Public Health Service Act 
(42 U.S.C. 280c-3(a)) is amended--
            (1) in the matter preceding paragraph (1), by striking 
        ``not less than 5, and not more than 15,'';
            (2) in paragraph (2)--
                    (A) by inserting after ``disorders'' the following: 
                ``who are living in single family homes or in 
                congregate settings''; and
                    (B) by striking ``and'' at the end;
            (3) by redesignating paragraph (3) as paragraph (4); and
            (4) by inserting after paragraph (2) the following:
            ``(3) to improve the access of such individuals to home-
        based or community-based long-term care services (subject to 
        the services being provided by entities that were providing 
        such services in the State involved as of October 1, 1995), 
        particularly such individuals who are members of racial or 
        ethnic minority groups, who have limited proficiency in 
        speaking the English language, or who live in rural areas; 
        and''.
    (b) Duration.--Section 398A of the Public Health Service Act (42 
U.S.C. 280c-4) is amended--
            (1) in the heading for the section, by striking 
        ``LIMITATION'' and all that follows and inserting ``REQUIREMENT 
        OF MATCHING FUNDS'';
            (2) by striking subsection (a);
            (3) by redesignating subsections (b) and (c) as subsections 
        (a) and (b), respectively;
            (4) in subsection (a) (as so redesignated), in each of 
        paragraphs (1)(C) and (2)(C), by striking ``third year'' and 
        inserting ``third or subsequent year''.
    (c) Authorization of Appropriations.--Section 398B(e) of the Public 
Health Service Act (42 U.S.C. 280c-5(e)) is amended--
            (1) by striking ``and such sums'' and inserting ``such 
        sums''; and
            (2) by inserting before the period the following: ``, 
        $8,000,000 for fiscal year 1998, and such sums as may be 
        necessary for each of the fiscal years 1999 through 2002''.

SEC. 303. PROJECT GRANTS FOR IMMUNIZATION SERVICES.

    Section 317(j) of the Public Health Service Act (42 U.S.C. 247b(j)) 
is amended--
            (1) in paragraph (1), by striking ``individuals against 
        vaccine-preventable diseases'' and all that follows through the 
        first period and inserting the following: ``children, 
        adolescents, and adults against vaccine-preventable diseases, 
        there are authorized to be appropriated such sums as may be 
        necessary for each of the fiscal years 1998 through 2002.''; 
        and
            (2) in paragraph (2), by striking ``1990'' and inserting 
        ``1997''.

                   TITLE IV--MISCELLANEOUS PROVISIONS

SEC. 401. TECHNICAL CORRECTIONS REGARDING PUBLIC LAW 103-183.

    (a) Amendatory Instructions.--Public Law 103-183 is amended--
            (1) in section 601--
                    (A) in subsection (b), in the matter preceding 
                paragraph (1), by striking ``Section 1201 of the Public 
                Health Service Act (42 U.S.C. 300d)'' and inserting 
                ``Title XII of the Public Health Service Act (42 U.S.C. 
                300d et seq.)''; and
                    (B) in subsection (f)(1), by striking ``in section 
                1204(c)'' and inserting ``in section 1203(c) (as 
                redesignated by subsection (b)(2) of this section)'';
            (2) in section 602, by striking ``for the purpose'' and 
        inserting ``For the purpose''; and
            (3) in section 705(b), by striking ``317D((l)(1)'' and 
        inserting ``317D(l)(1)''.
    (b) Public Health Service Act.--The Public Health Service Act, as 
amended by Public Law 103-183 and by subsection (a) of this section, is 
amended--
            (1) in section 317E(g)(2), by striking ``making grants 
        under subsection (b)'' and inserting ``carrying out subsection 
        (b)'';
            (2) in section 318, in subsection (e) as in effect on the 
        day before the date of the enactment of Public Law 103-183, by 
        redesignating the subsection as subsection (f);
            (3) in subpart 6 of part C of title IV--
                    (A) by transferring the first section 447 (added by 
                section 302 of Public Law 103-183) from the current 
                placement of the section;
                    (B) by redesignating the section as section 447A; 
                and
                    (C) by inserting the section after section 447;
            (4) in section 1213(a)(8), by striking ``provides for for'' 
        and inserting ``provides for'';
            (5) in section 1501, by redesignating the second subsection 
        (c) (added by section 101(f) of Public Law 103-183) as 
        subsection (d); and
            (6) in section 1505(3), by striking ``nonprivate'' and 
        inserting ``private''.
    (c) Miscellaneous Correction.--Section 401(c)(3) of Public Law 103-
183 is amended in the matter preceding subparagraph (A) by striking 
``(d)(5)'' and inserting ``(e)(5)''.
    (d) Effective Date.--This section is deemed to have taken effect 
immediately after the enactment of Public Law 103-183.

SEC. 402. MISCELLANEOUS AMENDMENTS REGARDING PHS COMMISSIONED OFFICERS.

    (a) Anti-Discrimination Laws.--Amend section 212 of the Public 
Health Service Act (42 U.S.C. 213) by adding the following new 
subsection at the end thereof:
    ``(f) Active service of commissioned officers of the Service shall 
be deemed to be active military service in the Armed Forces of the 
United States for purposes of all laws related to discrimination on the 
basis of race, color, gender, ethnicity, age, religion, and 
disability.''
    (b) Training in Leave Without Pay Status.--Section 218 of the 
Public Health Service Act (42 U.S.C. 218a) is amended by adding at the 
end the following:
    ``(c) A commissioned officer may be placed in leave without pay 
status while attending an educational institution or training program 
whenever the Secretary determines that such status is in the best 
interest of the Service. For purposes of computation of basic pay, 
promotion, retirement, compensation for injury or death, and the 
benefits provided by sections 212 and 224, an officer in such status 
pursuant to the preceding sentence shall be considered as performing 
service in the Service and shall have an active service obligation as 
set forth in subsection (b) of this section.''.
    (c) Utilization of Alcohol and Drug Abuse Records That Apply to the 
Armed Forces.--Section 543(e) of the Public Health Service Act (42 
U.S.C. 290dd-2(e)) is amended by striking ``Armed Forces'' each place 
that such term appears and inserting ``Uniformed Services''.

SEC. 403. CLINICAL TRAINEESHIPS.

    Section 303(d)(1) of the Public Health Service Act (42 U.S.C. 
242a(d)(1)) is amended by inserting ``counseling,'' after ``family 
therapy,''.

SEC. 404. PROJECT GRANTS FOR SCREENINGS, REFERRALS, AND EDUCATION 
              REGARDING LEAD POISONING.

    Section 317A(l)(1) of the Public Health Service Act (42 U.S.C. 
247b-1(l)(1)) is amended by striking ``1998'' and inserting ``2004''.

SEC. 405. PROJECT GRANTS FOR PREVENTIVE HEALTH SERVICES REGARDING 
              TUBERCULOSIS.

    Section 317E(g)(1) of the Public Health Service Act (42 U.S.C. 
247b-6(g)(1)) is amended--
            (1) in subparagraph (A), by striking ``1998'' and inserting 
        ``2004''; and
            (2) in subparagraph (B), by striking ``$50,000,000'' and 
        inserting ``25 percent''.

SEC. 406. CERTAIN AUTHORITIES OF CENTERS FOR DISEASE CONTROL AND 
              PREVENTION.

    (a) In General.--Part B of title III of the Public Health Service 
Act is amended by inserting after section 317H the following section:

 ``miscellaneous authorities regarding centers for disease control and 
                               prevention

    ``Sec. 317I. The Secretary, acting through the Director of the 
Centers for Disease Control and Prevention, may, without regard to the 
provisions of title 5, United States Code, governing appointments in 
the competitive service, and without regard to the provisions of 
chapter 51 and subchapter III of chapter 53 of such title relating to 
classification and General Schedule pay rates, establish such technical 
and scientific peer review groups and scientific program advisory 
committees as are needed to carry out the functions of such Centers and 
appoint and pay the members of such groups, except that officers and 
employees of the United States shall not receive additional 
compensation for service as members of such groups. The Federal 
Advisory Committee Act shall not apply to the duration of such peer 
review groups. Not more than one-fourth of the members of any such 
group shall be officers or employees of the United States.''.
    (b) Effective Date.--This section is deemed to have taken effect 
July 1, 1995.

SEC. 407. COMMUNITY PROGRAMS ON DOMESTIC VIOLENCE.

    (a) In General.--Section 318(h)(2) of the Family Violence 
Prevention and Services Act (42 U.S.C. 10418(h)(2)) is amended by 
striking ``fiscal year 1997'' and inserting ``for each of the fiscal 
years 1997 through 2002''.
    (b) Study.--The Secretary of Health and Human Services shall 
request that the Institute of Medicine conduct a study concerning the 
training needs of health professionals with respect to the detection 
and referral of victims of family or acquaintance violence. Not later 
than 2 years after the date of enactment of this Act, the Institute of 
Medicine shall prepare and submit to Congress a report concerning the 
study conducted under this subsection.

SEC. 408. STATE LOAN REPAYMENT PROGRAM.

    Section 338I(i)(1) of the Public Health Service Act (42 U.S.C. 
254q-1(i)(1)) is amended by inserting before the period ``, and such 
sums as may be necessary for each of the fiscal years 1998 through 
2002''.

SEC. 409. CONSTRUCTION OF REGIONAL CENTERS FOR RESEARCH ON PRIMATES.

    Section 481B(a) of the Public Health Service Act (42 U.S.C. 287a-
3(a)) is amended--
            (1) by striking ``shall'' and inserting ``may''; and
            (2) by striking ``$5,000,000'' and inserting ``up to 
        $2,500,000''.

SEC. 410. PEER REVIEW.

    Section 504(d)(2) of the Public Health Service Act (42 U.S.C. 
290aa-3(d)(2)) is amended by striking ``cooperative agreement, or 
contract'' each place that such appears and inserting ``or cooperative 
agreement''.

SEC. 411. FUNDING FOR TRAUMA CARE.

    Section 1232(a) of the Public Health Service Act (42 U.S.C. 300d-
32) is amended by striking ``and 1996'' and inserting ``through 2002''.

SEC. 412. HEALTH INFORMATION AND HEALTH PROMOTION.

    Section 1701(b) of the Public Health Service Act (42 U.S.C. 
300u(b)) is amended by striking ``through 1996'' and inserting 
``through 2002''.

SEC. 413. EMERGENCY MEDICAL SERVICES FOR CHILDREN.

    Section 1910 of the Public Health Service Act (42 U.S.C. 300w-9) is 
amended--
            (1) in subsection (a)--
                    (A) by striking ``two-year period'' and inserting 
                ``3-year period (with an optional 4th year based on 
                performance)''; and
                    (B) by striking ``one grant'' and inserting ``3 
                grants''; and
            (2) in subsection (d), by striking ``1997'' and inserting 
        ``2005''.

SEC. 414. ADMINISTRATION OF CERTAIN REQUIREMENTS.

    (a) In General.--Section 2004 of Public Law 103-43 (107 Stat. 209) 
is amended by striking subsection (a).
    (b) Conforming Amendments.--Section 2004 of Public Law 103-43, as 
amended by subsection (a) of this section, is amended--
            (1) by striking ``(b) Sense'' and all that follows through 
        ``In the case'' and inserting the following:
    ``(a) Sense of Congress Regarding Purchase of American-Made 
Equipment and Products.--In the case'';
            (2) by striking ``(2) Notice to recipients of assistance'' 
        and inserting the following:
    ``(b) Notice to Recipients of Assistance''; and
            (3) in subsection (b), as redesignated by paragraph (2) of 
        this subsection, by striking ``paragraph (1)'' and inserting 
        ``subsection (a)''.
    (c) Effective Date.--This section is deemed to have taken effect 
immediately after the enactment of Public Law 103-43.

SEC. 415. AIDS DRUG ASSISTANCE PROGRAM.

    Section 2618(b)(3) of the Public Health Service Act (42 U.S.C. 
300ff-28(b)(3)) is amended--
            (1) in paragraph (1), by striking ``and the Commonwealth of 
        Puerto Rico'' and inserting ``, the Commonwealth of Puerto 
        Rico, the Virgin Islands, and Guam''; and
            (2) in paragraph (2), by striking ``the Virgin Islands, 
        Guam''.
                                 <all>