[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3250 Reported in House (RH)]






                                                 Union Calendar No. 581
106th CONGRESS
  2d Session
                                H. R. 3250

                          [Report No. 106-986]

    To amend the Public Health Service Act to improve the health of 
                         minority individuals.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            November 8, 1999

  Mr. Thompson of Mississippi (for himself, Mr. Lewis of Georgia, Mr. 
  Norwood, Mr. Jackson of Illinois, Mr. Brown of Ohio, Mr. Towns, Ms. 
     Roybal-Allard, Mr. Rodriguez, Mr. Underwood, Mr. Filner, Mrs. 
  Christensen, Mr. Conyers, Mr. Wynn, Mr. Gonzalez, Mr. Hilliard, Ms. 
Carson, Ms. Eddie Bernice Johnson of Texas, Mr. Scott, Ms. Kilpatrick, 
 Mr. Clyburn, Mr. Rush, Mr. Cummings, Mr. Payne, Mr. Dixon, Mr. Ford, 
Ms. Millender-McDonald, Ms. Waters, Mr. Meeks of New York, Mr. Bishop, 
 Mrs. Meek of Florida, Mrs. Jones of Ohio, Mr. Davis of Illinois, Ms. 
  Lee, Ms. McKinney, Mrs. Napolitano, Ms. Jackson-Lee of Texas, Mrs. 
   Clayton, Mr. Watt of North Carolina, Mr. Fattah, Ms. Pelosi, Mr. 
   Abercrombie, and Mr. George Miller of California) introduced the 
    following bill; which was referred to the Committee on Commerce

                            October 18, 2000

 Additional sponsors: Mr. Waxman, Mr. Watts of Oklahoma, Mr. Green of 
 Texas, Mr. Jefferson, Ms. Brown of Florida, Mr. Owens, Mr. Frost, Mr. 
 Stark, Ms. Hooley of Oregon, Mr. Matsui, Mr. Hastings of Florida, Ms. 
   Norton, Mr. LaHood, Mr. Kennedy of Rhode Island, Mr. Kildee, Mr. 
Tierney, Mr. Brady of Pennsylvania, Mr. Sandlin, Mr. Bonior, Mr. Evans, 
Mrs. Thurman, Mr. Cardin, Mr. Berman, Mr. Meehan, Mr. Rangel, Mr. Clay, 
  Mr. Strickland, Mr. Baca, Ms. Eshoo, Mr. DeFazio, Mr. Deutsch, Mr. 
   Bentsen, Mr. Hayworth, Mr. Upton, Mr. Neal of Massachusetts, Mr. 
  Blagojevich, Mr. Rahall, Mr. Faleomavaega, Mr. Baird, Mr. Wamp, Mr. 
      Lantos, Mr. Dickey, Mr. Engel, Ms. DeGette, and Mr. Lampson
Deleted sponsor: Mr. Coburn (added May 25, 2000; deleted July 25, 2000)

                            October 18, 2000

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]
    [For text of introduced bill, see copy of bill as introduced on 
                           November 8, 1999]

_______________________________________________________________________

                                 A BILL


 
    To amend the Public Health Service Act to improve the health of 
                         minority individuals.

    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 Care 
Fairness Act of 2000''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.

 TITLE I--IMPROVING MINORITY HEALTH THROUGH THE NATIONAL INSTITUTES OF 
                HEALTH; ESTABLISHMENT OF NATIONAL CENTER

Sec. 101. Establishment of National Center for Research on Minority 
                            Health and Health Disparities.
Sec. 102. Centers of excellence for research education and training.
Sec. 103. Extramural loan repayment program for minority health 
                            research.
Sec. 104. General provisions regarding the Center.
Sec. 105. Report regarding resources of National Institutes of Health 
                            dedicated to research on minority health.

TITLE II--HEALTH DISPARITIES RESEARCH BY AGENCY FOR HEALTHCARE RESEARCH 
                              AND QUALITY

Sec. 201. Health disparities research by Agency for Healthcare Research 
                            and Quality.

        TITLE III--DATA COLLECTION RELATING TO RACE OR ETHNICITY

Sec. 301. Study and report by National Academy of Sciences.

   TITLE IV--MEDICAL EDUCATION AND OTHER HEALTH PROFESSIONS EDUCATION

Sec. 401. Grants for health care education curriculum development.
Sec. 402. National conference on continuing health professional 
                            education and disparities in health 
                            outcomes.
Sec. 403. Continuing medical education incentive program.
Sec. 404. Advisory committee.
Sec. 405. Cultural competency clearinghouse.

                   TITLE V--MISCELLANEOUS PROVISIONS

Sec. 501. Office for Civil Rights.
Sec. 502. Development of outcome measures; study to measure patient 
                            outcomes under the medicare and medicaid 
                            programs by race and ethnicity.
Sec. 503. Departmental definition regarding minority individuals.
Sec. 504. Conforming provision regarding definitions.

                        TITLE VI--EFFECTIVE DATE

Sec. 601. Effective date.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) Despite notable progress in the overall health of the 
        Nation, there are continuing disparities in the burden of 
        illness and death experienced by African Americans, Indians, 
        Alaska Natives, and Asian Pacific Islanders, compared to the 
        United States population as a whole.
            (2) Minority Americans lag behind on nearly every health 
        indicator, including health care coverage, access to care, life 
        expectancy, and disease rates. More detailed data on health 
        disparities is needed to evaluate the impact that race, 
        ethnicity, and socioeconomic status have on health status, 
        access to care, and the quality of care. More data is also 
        needed to enforce existing protections for equal access to 
        care.
            (3) Despite substantial overall improvements in Americans' 
        health, racial and ethnic disparities persist across age, sex, 
        and income categories. Some striking examples are as follows: 
        (A) The black infant mortality rate, which is twice that of all 
        U.S. infants. (B) A higher breast cancer mortality rate for 
        black women than white women (even though black women have a 
        lower incidence rate). (C) Nearly twice as many Hispanics 
        adults report they do not have a regular doctor compared to 
        white adults.
            (4) Minority adults are more likely to lack health 
        insurance than are white adults, a consistent trend over the 
        past decade. Nearly two of five (38 percent) Hispanic adults, 
        one of four (24 percent) black adults, and one of four (24 
        percent) Asian American adults are uninsured, compared with one 
        of seven (14 percent) white adults.
            (5) Differences in the socioeconomic status among U.S. 
        ethnic groups exist. When examined collectively, African 
        Americans and Hispanics are three times as likely as whites to 
        be poor. Low socioeconomic and ethnic minority status are not 
        synonymous, but many members of ethnic minority who also have 
        low income comprise an important proportion of underserved 
        populations in the United States.
            (6) The largest numbers of the medically underserved are 
        white, and many of them have the same health care access 
        problems as do members of minority groups. Nearly 20,000,000 
        white Americans live below the poverty line with many living in 
        non-metropolitan, rural areas. However, there is a higher 
        proportion of racial and ethnic minorities in the United States 
        represented among the medically underserved.
            (7) Despite suffering disproportionate rates of illness, 
        death and disability, minorities have not been proportionately 
        represented in many clinical trials, except in studies of 
        behavioral risk factors associated with negative stereotypes.
            (8) Many minority groups suffer disproportionately from 
        cancer. Mortality rates remain the most important measure of 
        the overall progress against cancer. Decreasing rates of death 
        from cancer reflect improvements in both prevention and 
        treatment. Among all ethnic groups in the United States, 
        African American males have the highest overall rate of 
        mortality from cancer. Some specific forms of cancer affect 
        other ethnic minority communities at rates up to several times 
        higher than the national averages (such as stomach and liver 
        cancers among Asian American populations, colon and rectal 
        cancer among Alaska natives, and cervical cancer among Hispanic 
        and Vietnamese-American women).
            (9) In Appalachian Kentucky, a region characterized by high 
        rates of poverty, the incidence of lung cancer among white 
        males was 127 per 100,000 in 1992, a rate higher than that for 
        any ethnic minority groups in the United States during the same 
        period.
            (10) Major disparities exist among population groups, with 
        a disproportionate burden of death and disability from 
        cardiovascular disease in minority and low-income populations. 
        Compared with rates for whites, coronary heart disease 
        mortality was 40 percent lower for Asian Americans but 40 
        percent higher for African-Americans.
            (11) While racial and ethnic groups account only for about 
        25 percent of the U.S. population, they account for more than 
        50 percent of all AIDS cases. While overall AIDS deaths are 
        down dramatically, AIDS remains the leading killer of African-
        Americans age 25-44. The death rate from HIV/AIDS for African 
        Americans is more than seven times that of whites.
            (12) The prevalence of diabetes in African-Americans is 
        approximately 70 percent higher than whites and the prevalence 
        in Hispanics is nearly double that of whites.
            (13) American Indians and Alaska Natives have an infant 
        mortality rate almost double that of whites. The rate of 
        diabetes for this population group is more than twice that for 
        whites. The Pima of Arizona have one of the highest rates of 
        diabetes in the world. American Indians living in North and 
        South Dakota have an average life expectancy that is 11 years 
        less than that for the rest of the U.S. population. Overall, 
        the life expectancy for American Indians and Alaska Native is 
        71 years of age--nearly five years less than the U.S. Races 
        populations.
            (14) Asian and Pacific Islanders, on average, have 
        indicators of being one of the healthiest population groups in 
        the United States. However, there is great diversity within 
        this population group, and health disparities for some specific 
        groups are quite marked. Vietnamese women suffer from cervical 
        cancer at nearly five times the rate of white women. New cases 
        of hepatitis and tuberculosis are also higher in Asian and 
        Pacific Islanders living in the United States than in whites.
            (15) Minority populations have a disproportionately higher 
        infection rate of hepatitis C virus than the general United 
        States Population. The prevalence rate of hepatitis C virus 
        among African Americans is more than twice that of the general 
        population (3.5 to 5 percent and 1.8 percent, respectively).
            (16) There is a national need for minority scientists in 
        the fields of biomedical, clinical, behavioral, and health 
        services research. Ninety percent of minority physicians 
        produced by Historically Black Medical Colleges live and serve 
        in minority communities.
            (17) The proportion of minorities in high academic ranks, 
        such as professors and associate professors, decreased from 
        1980 to 1990. Only 1 percent of full professors were minority 
        persons in 1990.
            (18) Demographic trends inspire concern about the Nation's 
        ability to meet its future scientific, technological and 
        engineering workforce needs. Historically, non-Hispanic white 
        males have made up the majority of the United States 
        scientific, technological, and engineering workers.
            (19) The Hispanic and Black population will increase 
        significantly in the next 50 years. The scientific, 
        technological, and engineering workforce may decrease if 
        participation by underepresented minorities remains the same.
            (20) Increasing rates of Black and Hispanic workers must 
        occur in order to ensure strong scientific, technological, and 
        engineering workforce.
            (21) Individuals such as underepresented minorities and 
        women in the scientific, technological, and engineering 
        workforce enable society to address its diverse needs.
            (22) If there had not been a substantial increase in the 
        number of science and engineering degrees awarded to women and 
        underepresented minorities over the past few decades, the 
        United States would be facing even greater shortages in 
        scientific, technological, and engineering workers.
            (23) In order to effectively promote a diverse and strong 
        21st Century scientific, technological, and engineering 
        workforce: agencies should expand or add programs that 
        effectively overcome barriers such as educational transition 
        from one level to the next and student requirements for 
        financial resources.
            (24) Federal agencies should work in concert with the 
        private sector to emphasize the recruitment and retention of 
        qualified individuals from ethnic and gender groups that are 
        currently underrepresented in the scientific, technological, 
        and engineering workforce.
            (25) Cultural competency training in medical schools and 
        residency training programs has the potential to reduce 
        disparities in health care and health outcomes.
            (26) Culturally sensitive approaches to research are needed 
        to encourage participation of minorities and the 
        socioeconomically disadvantages in research studies.
            (27) African Americans with identical complaints of chest 
        pain are less likely than white Americans to be referred by 
        physicians for sophisticated cardiac tests.
            (28) Behavioral and social sciences research has increased 
        awareness and understanding of factors associated with health 
        care utilization and access, patient attitudes toward health 
        services, and risk and protective behaviors that affect health 
        and illness. These factors have the potential to then be 
        modified to help close the health disparities gap among ethnic 
        minority populations. In addition, there is a shortage of 
        minority behavioral science researchers and behavioral health 
        care professionals. According to the National Science 
        Foundation, only 15.5 percent of behavioral research-oriented 
        psychology doctorate degrees were awarded to minority students 
        in 1997. In addition, only 17.9 percent of practice-oriented 
        psychology doctorate degrees were awarded to ethnic minorities.

   TITLE I--IMPROVING MINORITY HEALTH THROUGH NATIONAL INSTITUTES OF 
                HEALTH; ESTABLISHMENT OF NATIONAL CENTER

SEC. 101. ESTABLISHMENT OF NATIONAL CENTER FOR RESEARCH ON MINORITY 
              HEALTH AND HEALTH DISPARITIES.

    (a) In General.--Part E of title IV of the Public Health Service 
Act (42 U.S.C. 287 et seq.) is amended by adding at the end the 
following subpart:

``Subpart 6--National Center for Research on Minority Health and Health 
                              Disparities

``SEC. 485E. PURPOSE OF CENTER.

    ``(a) In General.--The general purpose of the National Center for 
Research on Minority Health and Health Disparities (in this subpart 
referred to as the `Center') is the conduct and support of basic and 
clinical research, training, the dissemination of health information, 
and other programs with respect to the health of racial and ethnic 
minority groups and other health disparity populations.
    ``(b) Priorities.--The Director of the Center shall in expending 
amounts appropriated under this section give priority to conducting and 
supporting minority health research.
    ``(c) Minority Health Research.--For purposes of this subpart:
            ``(1) The term `minority health research' means research on 
        minority health conditions (as defined in paragraph (2)), 
        including research on preventing such conditions; research on 
        access, outreach, treatment, and the quality of health care; 
        and research on cultural and linguistic services for decreasing 
        the extent of health problems associated with such conditions.
            ``(2) The term `minority health conditions', with respect 
        to individuals who are members of racial and ethnic minority 
        groups, means all diseases, disorders, and conditions 
        (including with respect to mental health and substance abuse)--
                    ``(A) unique to, more serious, or more prevalent in 
                such individuals;
                    ``(B) for which the factors of medical risk or 
                types of medical intervention are different for such 
                individuals, or for which it is unknown whether such 
                factors or types are different for such individuals; or
                    ``(C) with respect to which there has been 
                insufficient research involving such individuals as 
                subjects or insufficient data on such individuals.
            ``(3) The term `racial and ethnic minority group' has the 
        meaning given such term in section 1707.
            ``(4) The term `minorities' means individuals from a racial 
        or ethnic minority group.
    ``(d) Health Disparity Populations.--
            ``(1) In general.--For purposes of this subpart:
                    ``(A) A population is a health disparity population 
                if, as determined by the Director of the Center after 
                consultation with the Director of the Agency for 
                Healthcare Research and Quality, there is a significant 
                disparity in the overall rate of disease incidence, 
                morbidity, mortality, or survival rates in the 
                population as compared to the health status of the 
                general population.
                    ``(B) The term `health disparity populations' 
                includes racial and ethnic minority groups.
                    ``(C) The term `health disparities research' means 
                research on health disparity populations (and 
                individual members and communities of such populations) 
                that relates to the health disparities involved, 
                including basic and applied biomedical and behavioral 
                research on the nature of health disparities, the 
                causes of such disparities, and remedies for such 
                disparities. Such term includes minority health 
                research.
            ``(2) Priority.--With amounts available under this section 
        for a fiscal year after providing for minority health research 
        in accordance with subsection (b), the Secretary shall conduct 
        and support health disparities research on other health 
        disparity populations, with priority given to such research on 
        health disparity populations for which socioeconomic status is 
        one of the principal causal factors with respect to being a 
        health disparity population.
    ``(e) Coordination of Activities.--The Director of the Center shall 
act as the primary Federal official with responsibility for overseeing 
all minority health and other health disparities research conducted or 
supported by the National Institutes of Health, and--
            ``(1) shall represent the health disparities research 
        program of the National Institutes of Health, including the 
        minority health research program, at all relevant Executive 
branch task forces, committees and planning activities; and
            ``(2) shall maintain communications with all relevant 
        Public Health Service agencies and with various other 
        departments of the Federal Government, to ensure the timely 
        transmission of information concerning advances in minority 
        health and other health disparities research between these 
        various agencies for dissemination to affected communities and 
        health care providers.
    ``(f) Collaborative Comprehensive Plan and Budget.--
            ``(1) In general.--Subject to the provisions of this 
        section and other applicable law, the Director of NIH, the 
        Director of the Center, and the directors of the national 
        research institutes in collaboration (and in consultation with 
        the advisory council for the Center) shall--
                    ``(A) establish a comprehensive plan and budget for 
                the conduct and support of all minority health and 
                other health disparities research activities of the 
                agencies of the National Institutes of Health (which 
                plan and budget shall be first established under this 
                subsection not later than 12 months after the date of 
                the enactment of this subpart);
                    ``(B) ensure that the plan and budget demonstrate 
                how health disparities research activities address the 
                health needs of specific health disparity populations, 
                taking into account socioeconomic status; the areas in 
                which the population involved resides; attitudes toward 
                health; the language spoken, the extent of formal 
                education; and such other factors as the Director of 
                the Center determines to be appropriate;
                    ``(C) ensure that the plan and budget establish 
                priorities among the health disparities research 
                activities that such agencies are authorized to carry 
                out;
                    ``(D) ensure that the plan and budget establish 
                objectives regarding such activities, describes the 
                means for achieving the objectives, and designates the 
                date by which the objectives are expected to be 
                achieved;
                    ``(E) ensure that, with respect to amounts 
                appropriated for activities of the Center, the plan and 
                budget give priority in the expenditure of funds to 
                conducting and supporting minority health research;
                    ``(F) ensure that all amounts appropriated for such 
                activities are expended in accordance with the plan and 
                budget;
                    ``(G) review the plan and budget not less than 
                annually, and revise the plan and budget as 
                appropriate; and
                    ``(H) ensure that the plan and budget serve as a 
                broad, binding statement of policies regarding minority 
                health and other health disparities research activities 
                of the agencies, but do not remove the responsibility 
                of the heads of the agencies for the approval of 
                specific programs or projects, or for other details of 
                the daily administration of such activities, in 
                accordance with the plan and budget.
            ``(2) Certain components of plan and budget.--With respect 
        to health disparities research activities of the agencies of 
        the National Institutes of Health, the Director of the Center 
        shall ensure that the plan and budget under paragraph (1) 
        provide for--
                    ``(A) basic research and applied research, 
                including research and development with respect to 
                products;
                    ``(B) research that is conducted by the agencies;
                    ``(C) research that is supported by the agencies;
                    ``(D) proposals developed pursuant to solicitations 
                by the agencies and for proposals developed 
                independently of such solicitations; and
                    ``(E) behavioral research and social sciences 
                research, which may include cultural and linguistic 
                research in each of the agencies.
            ``(3) Minority health research.--The plan and budget under 
        paragraph (1) shall include a separate statement of the plan 
        and budget for minority health research.
    ``(g) Clinical Research Equity.--The Director of the Center shall 
assist in the administration of section 492B with respect to the 
inclusion of members of minority groups as subjects in clinical 
research.
    ``(h) Research Endowments.--The Director of the Center may carry 
out a program to facilitate minority health research by providing for 
research endowments at centers of excellence under section 736.
    ``(i) Certain Activities.--In carrying out subsection (a), the 
Director of the Center--
            ``(1) shall assist the Director of the National Center for 
        Research Resources in carrying out section 481(c)(3) and in 
        committing resources for construction at Institutions of 
        Emerging Excellence;
            ``(2) shall establish projects to promote cooperation among 
        Federal agencies, State, local, and regional public health 
        agencies, and private entities in health disparities research;
            ``(3) may conduct or support research on the use of service 
        delivery models (such as health centers under section 330) to 
        reduce health disparities; and
            ``(4) may utilize information from previous health 
        initiatives concerning minorities and other health disparity 
        populations.
    ``(j) Advisory Council.--
            ``(1) In general.--The Secretary shall, in accordance with 
        section 406, establish an advisory council to advise, assist, 
        consult with, and make recommendations to the Director of the 
        Center on matters relating to the activities described in 
        subsection (a), and with respect to such activities to carry 
        out any other functions described in section 406 for advisory 
        councils under such section. Functions under the preceding 
        sentence shall include making recommendations on budgetary 
        allocations made in the plan under subsection (f), and shall 
include reviewing reports under subjection (k) before the reports are 
submitted under such subsection.
            ``(2) Membership.--With respect to the membership of the 
        advisory council under paragraph (1), a majority of the members 
        shall be representatives of the various racial and ethnic 
        minority groups; representatives of other health disparity 
        populations shall be included; and a diversity of health 
        professionals shall be represented. The membership shall in 
        addition include a representative of the Office of Behavioral 
        and Social Sciences Research under section 404A.
    ``(k) Annual Report.--The Director of the Center shall prepare an 
annual report on the activities carried out or to be carried out by the 
Center, and shall submit each such report to the Congress, the 
Secretary, and the Director of NIH. With respect to the fiscal year 
involved, the report shall--
            ``(1) describe and evaluate the progress made in health 
        disparities research conducted or supported by the national 
        research institutes;
            ``(2) summarize and analyze expenditures made for 
        activities with respect to health disparities research 
        conducted or supported by the National Institutes of Health;
            ``(3) include a separate statement applying the 
        requirements of paragraphs (1) and (2) specifically to minority 
        health research; and
            ``(4) contain such recommendations as the Director 
        considers appropriate.
    ``(l) Authorization of Appropriations.--For the purpose of carrying 
out this subpart, there are authorized to be appropriated $100,000,000 
for fiscal year 2001, and such sums as may be necessary for each of the 
fiscal years 2002 through 2005. Such authorization of appropriations is 
in addition to other authorizations of appropriations that are 
available for the conduct and support of minority health or other 
health disparities research by the national research institutes and 
other agencies of the National Institutes of Health.''.
    (b) Conforming Amendment.--Part A of title IV of the Public Health 
Service Act (42 U.S.C. 281 et seq.) is amended--
            (1) in section 401(b)(2)--
                    (A) in subparagraph (F), by moving the subparagraph 
                two ems to the left; and
                    (B) by adding at the end the following 
                subparagraph:
            ``(G) The National Center for Research on Minority Health 
        and Health Disparities.''; and
            (2) by striking section 404.

SEC. 102. CENTERS OF EXCELLENCE FOR RESEARCH EDUCATION AND TRAINING.

    Subpart 6 of part E of title IV of the Public Health Service Act, 
as added by section 101 of this Act, is amended by adding at the end 
the following section:

``SEC. 485F. CENTERS OF EXCELLENCE FOR RESEARCH EDUCATION AND TRAINING.

    ``(a) In General.--The Director of the Center shall make awards of 
grants or contracts to designated biomedical and behavioral research 
institutions under paragraph (1) of subsection (c), or to consortia 
under paragraph (2) of such subsection, for the purpose of assisting 
the institutions in supporting programs of excellence in biomedical and 
behavioral research education for individuals who are members of health 
disparity populations, including minorities.
    ``(b) Required Use of Funds.--An award may be made under subsection 
(a) only if the applicant involved agrees that the grant will be 
expended--
            ``(1) to conduct minority health research, including 
        research on the use of service delivery models (such as health 
        centers under section 330) with respect to minority health 
        conditions;
            ``(2) to train minorities and other members of health 
        disparities populations as professionals in the area of 
        biomedical or behavioral research or both; or
            ``(3) to expand, remodel, renovate, or alter existing 
        research facilities or construct new research facilities for 
        the purpose of conducting minority health research.
    ``(c) Centers of Excellence.--
            ``(1) In general.--For purposes of this section, a 
        designated biomedical and behavioral research institution is a 
        biomedical and behavioral research institution that--
                    ``(A) has a significant number of health disparity 
                students, including minorities, enrolled in the 
                institution (including individuals accepted for 
                enrollment in the institution);
                    ``(B) has been effective in assisting such students 
                of the institution to complete the program of education 
                and receive the degree involved;
                    ``(C) has been effective in recruiting members of 
                health disparity populations, including minorities, to 
                enroll in and graduate from the institution, including 
                providing scholarships and other financial assistance 
                to such individuals and encouraging health disparity 
                students from all levels of the educational pipeline to 
                pursue biomedical research careers; and
                    ``(D) has made significant recruitment efforts to 
                increase the number of members of health disparities 
                populations, including minorities, serving in faculty 
                or administrative positions at the institution.
            ``(2) Consortium.--Any designated biomedical and behavioral 
        research institution involved may, with other biomedical and 
        behavioral institutions (designated or otherwise), form a 
        consortium to receive an award under subsection (a).
            ``(3) Application of criteria to other programs.--In the 
        case of any criteria established by the Director of the Center 
        for purposes of determining whether institutions meet the 
        conditions described in paragraph (1), this section may not, 
        with respect to minorities, be construed to authorize, require, 
        or prohibit the use of such criteria in any program other than 
        the program established in this section.
    ``(d) 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 Director of the 
Center and to the availability of appropriations for the fiscal year 
involved to make the payments.
    ``(e) Maintenance of Effort.--
            ``(1) In general.--With respect to activities for which an 
        award under subsection (a) is authorized to be expended, the 
        Director of the Center may not make such an award to a 
        designated research institution or consortium for any fiscal 
        year unless the institution, or institutions in the consortium, 
        as the case may be, 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 
        institutions involved for the fiscal year preceding the fiscal 
        year for which such institutions receive such an award.
            ``(2) Use of federal funds.--With respect to any Federal 
        amounts received by a designated research institution or 
        consortium and available for carrying out activities for which 
        an award under subsection (a) is authorized to be expended, the 
        Director of the Center may make such an award only if the 
        institutions involved agree that the institutions will, before 
        expending the award, expend the Federal amounts obtained from 
        sources other than the award.
    ``(f) Certain Expenditures.--The Director of the Center may 
authorize a designated biomedical and behavioral research institution 
to expend a portion of an award under subsection (a) for research 
endowments.
    ``(g) Definitions.--For purposes of this section:
            ``(1) The term `designated biomedical and behavioral 
        research institution' has the meaning indicated for such term 
        in subsection (c)(1). Such term includes any health professions 
        school receiving an award of a grant or contract under section 
        736.
            ``(2) The term `program of excellence' means any program 
        carried out by a designated biomedical and behavioral research 
        institution with an award under subsection (a), if the program 
        is for purposes for which the institution involved is 
        authorized in subsection (b) to expend the grant.
    ``(h) Authorization of Appropriations.--For the purpose of making 
grants under subsection (a), there are authorized to be appropriated 
such sums as may be necessary for each of the fiscal years 2001 through 
2005.''.

SEC. 103. EXTRAMURAL LOAN REPAYMENT PROGRAM FOR MINORITY HEALTH 
              RESEARCH.

    Subpart 6 of part E of title IV of the Public Health Service Act, 
as amended by section 102 of this Act, is amended by adding at the end 
the following section:

``SEC. 485G. LOAN REPAYMENT PROGRAM FOR MINORITY HEALTH RESEARCH.

    ``(a) In General.--The Director of the Center shall establish a 
program of entering into contracts with qualified health professionals 
under which such health professionals agree to engage in minority 
health research in consideration of the Federal Government agreeing to 
repay, for each year of engaging in such research, not more than 
$35,000 of the principal and interest of the educational loans of such 
health professionals.
    ``(b) Service Provisions.--The provisions of sections 338B, 338C, 
and 338E shall, except as inconsistent with subsection (a), apply to 
the program established in such subsection 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.
    ``(c) Requirement Regarding Health Disparity Populations.--The 
Director of the Center shall ensure that not fewer than 50 percent of 
the contracts entered into under subsection (a) are for appropriately 
qualified health professionals who are members of a health disparity 
population.
    ``(d) Priority.--With respect to minority health research under 
subsection (a), the Secretary shall ensure that priority is given to 
conducting projects of biomedical research.
    ``(e) Funding.--
            ``(1) Authorization of appropriations.--For the purpose of 
        carrying out this section, there are authorized to be 
        appropriated such sums as may be necessary for each of the 
        fiscal years 2001 through 2005.
            ``(2) Availability of appropriations.--Amounts available 
        for carrying out this section shall remain available until the 
        expiration of the second fiscal year beginning after the fiscal 
        year for which the amounts were made available.''.

SEC. 104. GENERAL PROVISIONS REGARDING THE CENTER.

    Subpart 6 of part E of title IV of the Public Health Service Act, 
as amended by section 103 of this Act, is amended by adding at the end 
the following section:

``SEC. 485H. GENERAL PROVISIONS REGARDING THE CENTER.

    ``(a) Administrative Support for Center.--The Secretary, acting 
through the Director of the National Institutes of Health, shall 
provide administrative support and support services to the Director of 
the Center and shall ensure that such support takes maximum advantage 
of existing administrative structures at the agencies of the National 
Institutes of Health.
    ``(b) Evaluation and Report.--
            ``(1) Evaluation.--Not later than 5 years after the date of 
        the enactment of this part, the Secretary shall conduct an 
        evaluation to--
                    ``(A) determine the effect of this section on the 
                planning and coordination of the health disparities 
                research programs at the institutes, centers and 
                divisions of the National Institutes of Health;
                    ``(B) evaluate the extent to which this part has 
                eliminated the duplication of administrative resources 
                among such Institutes, centers and divisions; and
                    ``(C) provide recommendations concerning future 
                legislative and administrative modifications with 
                respect to this part, for both minority health research 
                and research on other health disparity populations.
            ``(2) Minority health research.--The evaluation under 
        paragraph (1) shall include a separate statement that applies 
        subparagraphs (A) and (B) of such paragraph to minority health 
        research.
            ``(3) Report.--Not later than 1 year after the date on 
        which the evaluation is commenced under paragraph (1), the 
        Secretary shall prepare and submit to the Committee on Health, 
        Education, Labor, and Pensions of the Senate, and the Committee 
        on Commerce of the House of Representatives, a report 
        concerning the results of such evaluation.''.

SEC. 105. REPORT REGARDING RESOURCES OF NATIONAL INSTITUTES OF HEALTH 
              DEDICATED TO RESEARCH ON MINORITY HEALTH.

    Not later than December 1, 2003, the Director of the National 
Center for Research on Minority Health and Health Disparities 
(established by the amendment made by section 101(a)), after 
consultation with the advisory council for such Center, shall submit to 
the Congress, the Secretary of Health and Human Services, and the 
Director of the National Institutes of Health a report that provides 
the following:
            (1) Recommendations for the methodology that should be used 
        to determine the extent of the resources of the National 
        Institutes of Health that are dedicated to research on minority 
        health, including determining the amount of funds that are used 
        to conduct and support such research. With respect to such 
        methodology, the report shall address the discrepancies between 
        the methodology used by such Institutes as of the date of the 
        enactment of this Act and the methodology used by the Institute 
        of Medicine as of such date.
            (2) A determination of whether and to what extent, relative 
        to fiscal year 1999, there has been an increase in the level of 
        resources of the National Institutes of Health that are 
        dedicated to research on minority health, including the amount 
        of funds used to conduct and support such research. The report 
        shall include provisions describing whether and to what extent 
        there have been increases in the number and amount of awards to 
        minority serving institutions.

TITLE II--HEALTH DISPARITIES RESEARCH BY AGENCY FOR HEALTHCARE RESEARCH 
                              AND QUALITY

SEC. 201. HEALTH DISPARITIES RESEARCH BY AGENCY FOR HEALTHCARE RESEARCH 
              AND QUALITY.

    (a)  General.--Part A of title IX of the Public Health Service Act 
(42 U.S.C. 299 et seq.) is amended by adding at the end the following:

``SEC. 903. RESEARCH ON HEALTH DISPARITIES.

    ``(a) In General.--The Director shall--
            ``(1) conduct and support research to identify how to 
        improve the quality and outcomes of health care services for 
        health disparity populations and the causes of the health 
        disparities involved, including identifying barriers to health 
        care access and environmental factors leading to health 
        problems;
            ``(2) conduct and support research and support 
        demonstration projects to identify, test, and evaluate 
        strategies for eliminating health disparities and promoting 
        effective interventions;
            ``(3) develop measures for the assessment and improvement 
        of the quality and appropriateness of health care services 
        provided to health disparity populations; and
            ``(4) in carrying out 902(c), provide support to increase 
        the number of researchers who are members of health disparity 
        populations, and the health services research capacity of 
        institutions that train such researchers.
    ``(b) Research and Demonstration Projects.--
            ``(1) In general.--In carrying out subsection (a), the 
        Director shall conduct and support research to--
                    ``(A) identify the clinical, cultural, 
                socioeconomic, and organizational factors that 
                contribute to health disparities, including for 
                minority populations, which factors include examination 
                of patterns of clinical decisionmaking and of the 
                availability of support services;
                    ``(B) identify and evaluate clinical and 
                organizational strategies to improve the quality, 
                outcomes, and access to care for health disparity 
                populations, including minority populations;
                    ``(C) support demonstrations to test such 
                strategies; and
                    ``(D) widely disseminate strategies for which there 
                is scientific evidence of effectiveness.
            ``(2) Use of certain strategies.--In carrying out this 
        section, the Director shall implement research strategies and 
        mechanisms that will enhance the involvement of individuals who 
        are members of health disparity populations (including minority 
        populations), health services researchers who are such 
        individuals, institutions that train such individuals as 
        researchers, members of health disparity populations (including 
        minority populations) for whom the Agency is attempting to 
        improve the quality and outcomes of care, and representatives 
        of appropriate community-based organizations with respect to 
        health disparity populations. Such research strategies and 
        mechanisms may include the use of--
                    ``(A) centers of excellence that can demonstrate, 
                either individually or through consortia, a combination 
                of multi-disciplinary expertise in outcomes or quality 
                improvement research and a demonstrated capacity to 
                engage members and communities of health disparity 
                populations, including minority populations, in the 
                planning, conduct and translation of research, with 
                linkages to relevant sites of care;
                    ``(B) provider-based research networks, including 
                health plans, facilities, or delivery system sites of 
                care (especially primary care), that make extensive use 
                of health care providers who are members of health 
                disparity populations or who serve patients in such 
                populations and have the capacity to evaluate and 
                promote quality improvement;
                    ``(C) service delivery models (such as health 
                centers under section 330) to reduce health 
                disparities; and
                    ``(D) other innovative mechanisms or strategies 
                that will facilitate the translation of past research 
                investments into clinical practices that can reasonably 
                be expected to benefit these populations.
    ``(c) Quality Measurement Development.--
            ``(1) In general.--To ensure that health disparity 
        populations, including minority populations, benefit from the 
        progress made in the ability of individuals to measure the 
        quality of health care delivery, the Director shall support the 
        development of quality of health care measures that assess the 
        experience of such populations with health care systems, such 
        as measures that assess the access of such populations to 
        health care, the cultural competence of the care provided, the 
        quality of the care provided, the outcomes of care, or other 
        aspects of health care practice that the Director determines to 
        be important. In carrying out the preceding sentence, the 
        Director shall in consultation with the Administrator of the 
        Health Resources and Services Administration examine the 
        practices of providers (such as health centers under section 
        330) that have a record of reducing health disparities or have 
        experience in providing culturally competent health services to 
        minority or other health disparity populations.
            ``(2) Report.--Not later than 24 months after the date of 
        the enactment of this section, the Secretary, acting through 
        the Director, shall prepare and submit to the appropriate 
        committees of Congress a report describing the state-of-the-art 
        of quality measurement for minority and other health disparity 
        populations that will identify critical unmet needs, the 
        current activities of the Department to address those needs, 
        and a description of related activities in the private sector.
    ``(d) Definition.--For purposes of this section:
            ``(1) The term `health disparity population' has the 
        meaning given such term in section 485E.
            ``(2) The term `minority', with respect to populations, 
        refers to racial and ethnic minority groups as defined in 
        section 1707.''.
    (b) Funding.--Section 927 of the Public Health Service Act (42 
U.S.C. 299c-6) is amended by adding at the end the following:
    ``(d) Health Disparities Research.--For the purpose of carrying out 
the activities under section 903, there are authorized to be 
appropriated such sums as may be necessary for each of the fiscal years 
2001 through 2005.''.

        TITLE III--DATA COLLECTION RELATING TO RACE OR ETHNICITY

SEC. 301. STUDY AND REPORT BY NATIONAL ACADEMY OF SCIENCES.

    (a) Study.--The National Academy of Sciences shall conduct a 
comprehensive study of the Department of Health and Human Services' 
data collection systems and practices, and any data collection or 
reporting systems required under any of the programs or activities of 
the Department, relating to the collection of data on race or 
ethnicity, including other Federal data collection systems (such as the 
Social Security Administration) with which the Department interacts to 
collect relevant data on race and ethnicity.
    (b) Report.--Not later than 1 year after the date of enactment of 
this Act, the National Academy of Sciences shall prepare and submit to 
the Committee on Health, Education, Labor, and Pensions of the Senate 
and the Committee on Commerce of the House of Representatives, a report 
that--
            (1) identifies the data needed to support efforts to 
        evaluate the effects of race and ethnicity on access to health 
        care and other services and on disparity in health and other 
        social outcomes and the data needed to enforce existing 
        protections for equal access to health care;
            (2) examines the effectiveness of the systems and practices 
        of the Department of Health and Human Services described in 
        subsection (a), including pilot and demonstration projects of 
        the Department, and the effectiveness of selected systems and 
        practices of other Federal and State agencies and the private 
        sector, in collecting and analyzing such data;
            (3) contains recommendations for ensuring that the 
        Department of Health and Human Services, in administering its 
        entire array of programs and activities, collects, or causes to 
        be collected, reliable and complete information relating to 
        race and ethnicity; and
            (4) includes projections about the costs associated with 
        the implementation of the recommendations described in 
        paragraph (3), and the possible effects of the costs on program 
        operations.
    (c) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary for fiscal year 2001.

   TITLE IV--MEDICAL EDUCATION AND OTHER HEALTH PROFESSIONS EDUCATION

SEC. 401. GRANTS FOR HEALTH CARE EDUCATION CURRICULUM DEVELOPMENT.

    Part F of title VII of the Public Health Service Act (42 U.S.C. 
295j et seq.) is amended by inserting after section 791 the following:

``SEC. 791A. GRANTS FOR HEALTH PROFESSIONAL EDUCATION CURRICULUM 
              DEVELOPMENT.

    ``(a) Grants for Graduate Education Curriculum Development.--
            ``(1) In general.--The Secretary, acting through the 
        Administrator of the Health Resources and Services 
        Administration and in collaboration with the Director of the 
        Agency for Healthcare Research and Quality and the Deputy 
        Assistant Secretary for Minority Health, may make awards of 
        grants, contracts, or cooperative agreements to public and 
        nonprofit private entities for the purpose of carrying out 
        research projects and demonstration projects to develop 
        curricula to reduce disparities in health care outcomes, 
        including curricula for cultural competency in graduate health 
        professions education.
            ``(2) Eligibility.--To be eligible to receive an award 
        under paragraph (1), an entity shall--
                    ``(A) be a school of medicine, school of 
                osteopathic medicine, school of dentistry, school of 
                public health, school of nursing, graduate program in 
                behavioral health and mental health practice, or other 
                recognized health profession school; and
                    ``(B) prepare and submit to the Secretary an 
                application at such time, in such manner, and 
                containing such information as the Secretary may 
                require.
            ``(3) Use of funds.--An entity shall use amounts received 
        under an award under paragraph (1) to carry out research 
        projects and demonstration projects to develop curricula to 
        reduce disparity in health care outcomes, including curricula 
        for cultural competency in graduate health professions 
        education.
            ``(4) Number of grants and grant term.--The Secretary shall 
        award grants, contracts or cooperative agreements (or 
        combination thereof) under paragraph (1) in each of the first 
        and second fiscal years for which funds are available under 
        subsection (f). The term of each such grant, contract or 
        cooperative agreement shall be 3 years.
    ``(b) Grants for Continuing Health Professional Education 
Curriculum Development.--
            ``(1) In general.--The Secretary, acting through the Health 
        Resources and Services Administration and the Agency for 
        Healthcare Research Quality and in collaboration with the 
        Office of Minority Health, shall award grants to eligible 
        entities for the establishment of demonstration and pilot 
        projects to develop curricula to reduce disparity in health 
        care and health outcomes, including curricula for cultural 
        competency, in continuing health professions education.
            ``(2) Eligibility.--To be eligible to receive a grant under 
        paragraph (1) an entity shall--
                    ``(A) be a school of medicine, osteopathic 
                medicine, public health, dentistry, optometry, 
                pharmacy, allied health, chiropractic, podiatric 
                medicine, nursing, and public health and health 
                administration, public or nonprofit private school that 
                offers a graduate program in clinical social work or 
                other graduate programs in behavioral health and mental 
                health practice, program for the training of physician 
                assistants, health professional association, or other 
                public or nonprofit health educational entity, or any 
                consortium of entities described in this subparagraph; 
                and
                    ``(B) prepare and submit to the Secretary an 
                application at such time, in such manner, and 
                containing such information as the Secretary may 
                require.
            ``(3) Use of funds.--An entity shall use amounts received 
        under a grant under paragraph (1) to develop and evaluate the 
        effect of curricula for continuing health professions education 
        courses or programs to provide education concerning issues 
        relating to disparity in health care and health outcomes, 
        including cultural competency of health professionals. Such 
        curricula shall focus on the need to remove bias from health 
        care at a personal level as well as at a systemic level.
            ``(4) Number of grants and grant term.--The Secretary shall 
        award grants under paragraph (1) in each of the first and 
        second fiscal years for which funds are available under 
        subsection (f). The term of each such grant shall be 3 years.
    ``(c) Distribution of Projects.--The Secretary shall ensure that, 
to the extent practicable, projects under subsections (a) and (b) are 
carried out in each of the principal geographic regions of the United 
States and involve different health disparity populations (as defined 
in section 485E) and health professions.
    ``(d) Monitoring.--An entity that receives a grant, contract or 
cooperative agreement under subsection (a) or (b) shall ensure that 
procedures are in place to monitor activities undertaken using grant, 
contract or cooperative agreement funds. Such entity shall annually 
prepare and submit to the Secretary a report concerning the 
effectiveness of curricula developed under the grant contract or 
cooperative agreement.
    ``(e) Report to Congress.--Not later than January 1, 2002, the 
Secretary shall prepare and submit to the appropriate committees of 
Congress, a report concerning the effectiveness of programs funded 
under this section and a plan to encourage the implementation and 
utilization of curricula to reduce disparities in health care and 
health outcomes. A final report shall be submitted by the Secretary not 
later than January 1, 2004.
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $3,500,000 for fiscal year 
2001, $7,000,000 for fiscal year 2002, $7,000,000 for fiscal year 2003, 
and $3,500,000 for fiscal year 2004.''.

SEC. 402. NATIONAL CONFERENCE ON CONTINUING HEALTH PROFESSIONAL 
              EDUCATION AND DISPARITIES IN HEALTH OUTCOMES.

    (a) In General.--Not later than 1 year after the date of enactment 
of this Act, the Secretary of Health and Human Services shall convene a 
national conference on continuing medical education as a method for 
reducing disparities in health care and health outcomes, including 
continuing medical education on cultural competency. The conference 
shall include sessions to address measurements of outcomes to assess 
the effectiveness of curricula in reducing disparities.
    (b) Participants.--The Secretary of Health and Human Services shall 
invite minority and other health disparity populations advocacy groups, 
health education entities described in section 791A(b)(2)(A) of the 
Public Health Service Act (as added by section 401), health centers 
under section 330 of such Act, and other interested parties to attend 
the conference under subsection (a).
    (c) Issues.--The national conference convened under subsection (a) 
shall address issues relating to the role of continuing medical 
education in the effort to reduce disparities in health care and health 
outcomes, including the role of continuing medical education in 
improving the cultural competency of health professionals. The 
conference shall focus on methods to achieve reductions in the 
disparities in health care and health outcomes through continuing 
medical education courses or programs and on strategies for measuring 
the effectiveness of curricula to reduce disparities.
    (d) Publication of Findings.--Not later than 6 months after the 
convening of the national conference under subsection (a), the 
Secretary of Health and Human Services shall publish in the Federal 
Register a summary of the proceedings and the findings of the 
conference.
    (e) Authorization of Appropriations.--There is authorized to be 
appropriated such sums as may be necessary to carry out this section.

SEC. 403. CONTINUING MEDICAL EDUCATION INCENTIVE PROGRAM.

    (a) In General.--The Secretary of Health and Human Services shall 
develop and implement a program to provide incentives to health 
maintenance organizations, community health centers, rural health 
centers, and other entities providing services under title XVIII or XIX 
of the Social Security Act (42 U.S.C. 1395 et seq. or 1396 et seq.) to 
encourage health care professionals employed by, or under contract 
with, such entities to participate in continuing medical education 
programs designed to reduce health disparities.
    (b) Effective Programs.--In developing the program under subsection 
(a), the Secretary of Health and Human Services shall ensure that 
incentives are targeted at programs that address each of the following 
issues:
            (1) Implementing new curricula or strategies for continuing 
        medical education programs designed to reduce health 
        disparities, or continuing medical education curricula or 
        strategies that have been proven effective in reducing such 
        disparities.
            (2) Encouraging health professionals to participate in such 
        curricula.
            (3) Monitoring health care and health outcomes as a way to 
        evaluate the effectiveness of continuing medical education 
        programs in reducing health disparities.
    (c) Definition.--For purposes of this section, the term ``health 
disparities'' has the meaning given such term in section 485E of the 
Public Health Service Act.
    (d) Authorization of Appropriations.--There is authorized to be 
appropriated such sums as may be necessary to carry out this section.

SEC. 404. ADVISORY COMMITTEE.

    (a) Establishment.--The Secretary of Health and Human Services 
shall establish an advisory committee to provide advice to the 
Secretary on matters related to the development, implementation, and 
evaluation of graduate and continuing education curricula for health 
care professionals to decrease disparities in health care and health 
outcomes, including curricula on cultural competency as a method of 
eliminating health disparities.
    (b) Membership.--Not later than 3 months after the date on which 
amounts are appropriated to carry out this section, the Secretary of 
Health and Human Services shall appoint the members of the advisory 
committee. Such members shall be appointed from among individuals who--
            (1) are not officers or employees of the Federal 
        Government;
            (2) are experienced in issues relating to health 
        disparities;
            (3) are minorities or representatives of racial and ethnic 
        minority groups or other health disparity populations; and
            (4) meet such other requirements as the Secretary 
        determines appropriate;
Such committee shall include individuals who are experienced in 
providing health services to racial and ethnic minority groups or other 
health disparity populations, including representatives of health 
centers under section 330 of the Public Health Service Act. The 
committee shall in addition include a representative of the Office of 
Minority Health under section 1707 of such Act, a representative of the 
Health Resources and Services Administration, and such other 
representatives of offices and agencies of the Public Health Service as 
the Secretary determines to be appropriate. Such representatives shall 
include one or more individuals who serve on the advisory committee 
under section 1707(c) of such Act.
    (c) Collaboration.--The advisory committee shall carry out its 
duties under this section in collaboration with the Office of Minority 
Health of the Department of Health and Human Services, and other 
offices, centers, and institutes of the Department of Health and Human 
Services, and other Federal agencies.
    (d) Termination.--The advisory committee shall terminate on the 
date that is 4 years after the date on which the first member of the 
committee is appointed.
    (e) Existing Committee.--The Secretary may designate an existing 
advisory committee operating under the authority of the Office of 
Minority Health of the Department of Health and Human Services to serve 
as the advisory committee under this section.

SEC. 405. CULTURAL COMPETENCY CLEARINGHOUSE.

    (a) Establishment.--The Director of the Office of Minority Health 
of the Department of Health and Human Services shall establish within 
the Resource Center of the Office of Minority Health, or through the 
awarding of a grant provide for the establishment of, an information 
clearinghouse for curricula to reduce disparities in health care and 
health outcomes. The clearinghouse shall facilitate and enhance, 
through the effective dissemination of information, knowledge and 
understanding of practices that lead to reductions in health 
disparities (as defined in section 485E of the Public Health Service 
Act), including curricula for continuing medical education to develop 
cultural competency in health care professionals.
    (b) Availability of Information.--Information contained in the 
clearinghouse shall be made available to minority health advocacy 
groups and other organizations representing health disparity 
populations, health education entities described in section 
791A(b)(2)(A) of the Public Health Service Act (as added by section 
401), health maintenance organizations, and other interested parties.
    (c) Authorization of Appropriations.--There is authorized to be 
appropriated such sums as may be necessary to carry out this section.

                   TITLE V--MISCELLANEOUS PROVISIONS

SEC. 501. OFFICE FOR CIVIL RIGHTS.

    (a) Public Awareness Campaign.--
            (1) In general.--The Secretary of Health and Human Services 
        shall conduct a national media campaign for the purpose of 
        informing the public of the programs and activities of the 
        Office for Civil Rights, Department of Health and Human 
        Services. The campaign shall--
                    (A) have a specific focus on racial and ethnic 
                minority communities, as well as the general public; 
                and
                    (B) involve racial and ethnic minority media as 
                participants in the design and conduct of the campaign.
            (2) Authorization of Appropriations.--For the purpose of 
        carrying out paragraph (1), there are authorized to be 
        appropriated such sums as may be necessary for fiscal year 
        2001.
    (b) Ombudsman Demonstration Program.--
            (1) In general.--The Secretary of Health and Human Services 
        (in this subsection referred to as the ``Secretary'') shall 
        carry out a demonstration program under which the Secretary 
        makes grants to States for the purpose of establishing and 
        operating State offices to identify, investigate, and 
        facilitate the resolution of complaints relating to civil 
        rights, and to carry out functions authorized pursuant to 
        paragraph (3) (which office is referred to in this subsection 
        as the ``State Ombudsman Office'').
            (2) Ombudsman.--The Secretary shall require that each State 
        Ombudsman Office under paragraph (1) be headed by an individual 
        with expertise and experience in the field of civil rights and 
        advocacy.
            (3) Certain requirements and authorities.--In carrying out 
        paragraph (1), the Secretary shall consider the requirements 
        and authorities that apply to the operation of State offices 
        under chapter 2 of subtitle A of title VII of the Older 
        Americans Act of 1965 (relating to State Long-Term Care 
        Ombudsman Programs). In providing for State Ombudsman Offices 
        under paragraph (1), the Secretary may establish requirements 
        and authorities with respect to civil rights that are the same 
        as or similar to the requirements and authorities that apply 
        under such chapter 2 with respect to residents of long-term 
        care facilities.
    (c) Funding.--There are authorized to be appropriated for the 
Office for Civil Rights, Department of Health and Human Services, 
$36,000,000 for fiscal year 2001 and each subsequent fiscal year.

SEC. 502. DEVELOPMENT OF OUTCOME MEASURES; STUDY TO MEASURE PATIENT 
              OUTCOMES UNDER THE MEDICARE AND MEDICAID PROGRAMS BY RACE 
              AND ETHNICITY.

    (a) Development of Outcome Measures.--Not later than 1 year after 
the date of the enactment of this Act, the Secretary of Health and 
Human Services, acting through the Administrator of the Health Care 
Financing Administration, shall develop outcome measures to evaluate, 
by race and ethnicity, and on an age-specific and sex-specific basis, 
the performance of health care programs and projects that provide 
health care to individuals under the medicare and medicaid programs 
(under titles XVIII and XIX, respectively, of the Social Security Act 
(42 U.S.C. 1395 et seq. and 1396 et seq.).
    (b) Study.--After the Secretary develops the outcome measures under 
subsection (a), the Secretary shall conduct a study that evaluates, by 
race and ethnicity, and on an age-specific and sex-specific basis, the 
performance of health care programs and projects referred to in 
subsection (a) in relation to such outcome measures.
    (c) Report to Congress.--Not later than 2 years after the date of 
the enactment of this Act, the Secretary of Health and Human Services 
shall submit to Congress a report describing the outcome measures 
developed under subsection (a), and the results of the study conducted 
pursuant to subsection (b).

SEC. 503. DEPARTMENTAL DEFINITION REGARDING MINORITY INDIVIDUALS.

    Section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 
300u-6) is amended--
            (1) by striking ``Asian Americans and'' and inserting 
        ``Asian Americans;''; and
            (2) by inserting ``Native Hawaiians and other'' before 
        ``Pacific Islanders;''.

SEC. 504. CONFORMING PROVISION REGARDING DEFINITIONS.

    For purposes of this Act, the term ``racial and ethnic minority 
group'' has the meaning given such term in section 1707 of the Public 
Health Service Act.

                        TITLE VI--EFFECTIVE DATE

SEC. 601. EFFECTIVE DATE.

    This Act and the amendments made by this Act take effect October 1, 
2000, or upon the date of the enactment of this Act, whichever occurs 
later.
                                                 Union Calendar No. 581

106th CONGRESS

  2d Session

                               H. R. 3250

                          [Report No. 106-986]

_______________________________________________________________________

                                 A BILL

    To amend the Public Health Service Act to improve the health of 
                         minority individuals.

_______________________________________________________________________

                            October 18, 2000

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed