[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5595 Introduced in House (IH)]







106th CONGRESS
  2d Session
                                H. R. 5595

 To provide for programs regarding the health of Hispanic individuals, 
                        and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 27, 2000

 Mr. Rodriguez (for himself, Ms. Roybal-Allard, Mr. Pastor, Mr. Romero-
Barcelo, Mr. Underwood, Mr. Reyes, and Mrs. Napolitano) introduced the 
following bill; which was referred to the Committee on Commerce, and in 
    addition to the Committee on Ways and Means, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL


 
 To provide for programs regarding the health of Hispanic individuals, 
                        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 ``Hispanic Health 
Act of 2000''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.
  TITLE I--ANNUAL REPORT TO CONGRESS ON PROGRAMS FOR IMPROVING HEALTH 
                     STATUS OF HISPANIC INDIVIDUALS

Sec. 101. Annual report regarding diabetes, HIV/AIDS, substance abuse, 
                            and mental health.
               TITLE II--DIABETES CONTROL AND PREVENTION

Sec. 201. National Diabetes Education Program of Centers for Disease 
                            Control and Prevention; increased 
                            authorization of appropriations for 
                            activities regarding Hispanic individuals.
Sec. 202. National Institutes of Health; implementation of 
                            recommendations of Diabetes Research 
                            Working Group.
  TITLE III--HIV PREVENTION ACTIVITIES REGARDING HISPANIC INDIVIDUALS

Sec. 301. Programs of Centers for Disease Control and Prevention; 
                            representation of Hispanic individuals in 
                            membership of community planning groups.
Sec. 302. AIDS education and training centers funded by Health 
                            Resources and Services Administration; 
                            establishment of center directed toward 
                            minority populations with HIV.
           TITLE IV--PREVENTION OF LATINA ADOLESCENT SUICIDES

Sec. 401. Establishment of program for prevention of Latina adolescent 
                            suicides.
                TITLE V--BILINGUAL HEALTH PROFESSIONALS

Sec. 501. Training of bilingual health professionals with respect to 
                            minority health conditions.
                     TITLE VI--CULTURAL COMPETENCE

Sec. 601. Definition.
Sec. 602. Activities of Office of Minority Health; Center for 
                            Linguistic and Cultural Competence in 
                            Health Care.
Sec. 603. Cultural competence demonstration projects.
Sec. 604. Use of medicare and medicaid disproportionate share hospital 
                            funds to pay for translators.
         TITLE VII--HISPANIC-SERVING HEALTH PROFESSIONS SCHOOLS

Sec. 701. Hispanic-serving health professions schools.
             TITLE VIII--DATA REGARDING RACE AND ETHNICITY

Sec. 801. Collection of data.
Sec. 802. Development of standards; study to measure patient outcomes 
                            under medicare and medicaid programs.
                      TITLE IX--GENERAL PROVISIONS

Sec. 901. Definitions.
Sec. 902. Effective date.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) Type 2 diabetes accounts for 90 to 95 percent of 
        diabetes cases nationwide, and it is the most common form of 
        the disease in the Hispanic community. Among Hispanics, type 2 
        diabetes is twice as common as the disease is among non-
        Hispanic whites. Six percent of the Hispanic population has 
        been diagnosed with type 2 diabetes, and another six percent is 
        estimated to have undiagnosed diabetes.
            (2) Controlling the risk factors of diabetes can prevent 
        the development of diabetes in many genetically susceptible 
        individuals. Addressing environmental risk factors like diet, 
        weight and physical activity can significantly impact the 
        development of diabetes.
            (3) Hispanics account for 20 percent of new AIDS cases. Of 
        these new AIDS cases, Hispanic men account for 20 percent of 
        reported cases among males, Hispanic women account for 19 
        percent of reported cases among females, and Hispanic children 
        account for 22 percent of cases among all children.
            (4) The two primary modes of HIV transmission in the 
        Hispanic community are (A) individuals who have unprotected 
        sex, and (B) individuals who inject themselves with drugs.
            (5) Mexican-American women are more likely to report severe 
        depression than their non-Hispanic Anglo or African-American 
        peers.
            (6) Hispanic girls now lead girls nationwide in rates of 
        suicide attempts, alcohol and drug abuse, and self-reported gun 
        possession.
            (7) Federal agencies do not have adequate mechanisms to 
        collect health care data for Hispanic-Americans and other 
        minority groups.
            (8) The lack of understandable or culturally appropriate 
        information on health care options prevents many Hispanics from 
        receiving adequate care and from making educated decisions 
        about their well-being.

  TITLE I--ANNUAL REPORT TO CONGRESS ON PROGRAMS FOR IMPROVING HEALTH 
                     STATUS OF HISPANIC INDIVIDUALS

SEC. 101. ANNUAL REPORT REGARDING DIABETES, HIV/AIDS, SUBSTANCE ABUSE, 
              AND MENTAL HEALTH.

    (a) In General.--The Secretary of Health and Human Services (in 
this Act referred to as the ``Secretary'') shall annually submit to the 
Congress a report on programs carried out through the Public Health 
Service with respect to improving the health status of Hispanic 
individuals regarding diabetes, HIV infection, AIDS, substance abuse, 
and mental health, including--
            (1) prevention programs carried out through the Centers for 
        Disease Control and Prevention and the Substance Abuse and 
        Mental Health Services Administration;
            (2) treatment programs carried out through the Health 
        Resources and Services Administration and the Substance Abuse 
        and Mental Health Services Administration;
            (3) research programs carried out through the National 
        Institutes of Health; and
            (4) activities of the Office of Public Health and Science, 
        including activities of the Office of Minority Health.
    (b) Data Collection.--Each report under subsection (a) shall 
include information on programs carried out through the Public Health 
Service to collect data that relates to the health status of Hispanic 
individuals regarding diabetes, HIV infection, AIDS, substance abuse, 
and mental health.

               TITLE II--DIABETES CONTROL AND PREVENTION

SEC. 201. NATIONAL DIABETES EDUCATION PROGRAM OF CENTERS FOR DISEASE 
              CONTROL AND PREVENTION; INCREASED AUTHORIZATION OF 
              APPROPRIATIONS FOR ACTIVITIES REGARDING HISPANIC 
              INDIVIDUALS.

    (a) In General.--For the purpose of carrying out the activities 
described in subsection (b) through the National Diabetes Education 
Program of the Centers for Disease Control and Prevention, 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 such purpose.
    (b) Increase in Prevention Activities.--The activities referred to 
in subsection (a) are--
            (1) identifying geographic areas in which the incidence of 
        or mortality from diabetes in Hispanic individuals is 
        significantly above the national average for such individuals; 
        and
            (2) carrying out in such areas prevention activities 
        regarding diabetes that are directed toward Hispanic 
        individuals, including education programs and screening 
        programs.

SEC. 202. NATIONAL INSTITUTES OF HEALTH; IMPLEMENTATION OF 
              RECOMMENDATIONS OF DIABETES RESEARCH WORKING GROUP.

    For the purpose of carrying out the plan to implement the 
recommendations of the Diabetes Research Working Group of the National 
Institute on Diabetes and Digestive and Kidney Diseases (which plan was 
developed and submitted to the Congress pursuant to the Department of 
Health and Human Services Appropriations Act, 2000), there are 
authorized to be appropriated $1,000,000,000 for fiscal year 2001, and 
such sums as may be necessary for each of the fiscal years 2002 through 
2005.

  TITLE III--HIV PREVENTION ACTIVITIES REGARDING HISPANIC INDIVIDUALS

SEC. 301. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND PREVENTION; 
              REPRESENTATION OF HISPANIC INDIVIDUALS IN MEMBERSHIP OF 
              COMMUNITY PLANNING GROUPS.

    (a) In General.--With respect to community planning groups that the 
Centers for Disease Control and Prevention utilizes in carrying out 
programs for the prevention of HIV infection, the Secretary, acting 
through the Director of such Centers, shall carry out the following:
            (1) The Secretary shall identify community planning groups 
        for which Hispanic individuals are underrepresented as members 
        in relation to the number of Hispanic individuals with HIV who 
        reside in the communities involved.
            (2) The Secretary shall develop a plan to increase the 
        representation of Hispanic individuals in the membership of the 
        community planning groups identified under paragraph (1). Such 
        plan may provide for facilitating the participation of Hispanic 
        individuals as members in such groups by assisting the 
        individuals with the incidental costs incurred by the 
        individuals in being such members, such as the costs of 
        transportation and child-care services.
            (3) The plan shall include a strategy and detailed timeline 
        for implementing the plan.
    (b) Definition.--For purposes of this section, the term ``community 
planning group'' has the meaning that applies for purposes of programs 
established pursuant to the Ryan White Comprehensive AIDS Resources 
Emergency Act of 1990 (including title XXVI of the Public Health 
Service Act).

SEC. 302. AIDS EDUCATION AND TRAINING CENTERS FUNDED BY HEALTH 
              RESOURCES AND SERVICES ADMINISTRATION; ESTABLISHMENT OF 
              CENTER DIRECTED TOWARD MINORITY POPULATIONS WITH HIV.

    (a) In General.--In carrying out section 2692 of the Public Health 
Service Act, the Secretary, acting through the Administrator of the 
Health Resources and Services Administration, shall make grants to 
eligible Hispanic-serving institutions for the purpose of carrying out 
projects under such section with respect to HIV in racial and ethnic 
minority groups.
    (b) Cultural Competence.--A condition for grants under subsection 
(a) is that the applicants involved agree that the education and 
training provided through projects under such subsection will be 
provided in a culturally competent manner (as defined in section 601).
    (c) Eligible Institutions.--For purposes of this section:
            (1) The term `eligible Hispanic-serving institution' means 
        a Hispanic-serving institution that has a record of carrying 
        out HIV-related activities with respect to Hispanic 
        individuals.
            (2) The term `Hispanic-serving institution' has the meaning 
        given such term in section 502 of the Higher Education Act of 
        1965.

           TITLE IV--PREVENTION OF LATINA ADOLESCENT SUICIDES

SEC. 401. ESTABLISHMENT OF PROGRAM FOR PREVENTION OF LATINA ADOLESCENT 
              SUICIDES.

    Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) 
is amended by inserting after section 520B the following section:

``SEC. 520C. PREVENTION OF LATINA ADOLESCENT SUICIDES.

    ``(a) In General.--The Secretary shall make awards of grants, 
cooperative agreements, or contracts to public and nonprofit private 
entities for the purpose of reducing suicide attempts and deaths among 
Latina adolescents.
    ``(b) Collaboration.--The Secretary shall ensure that the program 
under this section is developed in collaboration with the relevant 
institutes at the National Institutes of Health, the Health Resources 
and Services Administration, the Centers for Disease Control and 
Prevention, and the Administration on Children and Families.
    ``(c) Preference.--In making awards under subsection (a), the 
Secretary shall give preference to applicants that--
            ``(1) demonstrate a strong linkage with schools and are 
        actually supported by and operated within a school facility or 
        associated setting; and
            ``(2) involve direct services to Latina adolescents.
    ``(d) Requirements.--A condition for the receipt of an award under 
subsection (a) is that the applicant involved demonstrate that the 
project to be carried out with the award will--
            ``(1) provide for the timely assessment and treatment of 
        Latina adolescents at risk for suicide;
            ``(2) use evidenced based strategies;
            ``(3) be based on exemplary practices that are adapted to 
        the unique characteristics and needs of the local community;
            ``(4) be integrated into the existing health care system in 
        the community including primary health care, mental health 
        services, and substance abuse services as appropriate;
            ``(5) be integrated into other systems in the community to 
        address the needs of Latina adolescents including the 
        educational system, juvenile justice, and recreation;
            ``(6) provide support services to the families and friends 
        of those who plan, attempt, or actually commit suicide;
            ``(7) provide culturally, linguistically and 
        developmentally appropriate services;
            ``(8) agree to outcomes evaluation to determine the success 
        of the program and the possibility of replication to other 
        adolescent girls at risk of suicide;
            ``(9) provide or ensure referral for mental health and 
        substance abuse services as needed; and
            ``(10) ensure that staff used in the program are trained in 
        suicide prevention, are capable of providing culturally and 
        linguistically appropriate services and that professionals 
        involved in the system of care are given training in 
        identifying persons at risk of suicide.
    ``(e) Coordination.--A condition for the receipt of an award under 
subsection (a) is that the applicant involved demonstrate that--
            ``(1) the application has the support of the local 
        communities and the approval of the political subdivision to be 
        served by the project; and
            ``(2) the applicant has discussed the application with 
        State mental health officials.
    ``(f) Matching Requirement.--With respect to the costs to be 
incurred by an applicant in carrying out a project under subsection 
(a), the Secretary may require as a condition of the receipt of the 
award that the applicant make available (directly or through donations 
from public or private entities) non-Federal contributions toward such 
costs in an amount that is not less than 25 percent of such costs ($1 
for each $3 of Federal funds provided in the award).
    ``(g) Evaluation.--The Secretary shall ensure that entities 
receiving awards under subsection (a) submit an evaluation of the 
project that includes an evaluation of--
            ``(1) the efficacy of project strategies; and
            ``(2) short, intermediate, and long-term outcomes, 
        including the overall impact of the project on the self-esteem 
        of Latina adolescents and their emotional development and 
        ability to deal in a positive and confident manner with their 
        families, social environment, and peers.
    ``(h) Dissemination and Education.--The Secretary shall ensure that 
the findings from the program under this section are disseminated to 
State and local governmental agencies and private providers of mental 
health and substance abuse services.
    ``(i) Duration of Projects.--With respect to an award under 
subsection (a), the period during which payments under such award are 
made may not exceed 5 years.
    ``(j) Definition.--For purposes of this section, the term 
`adolescent' means an individual between the ages of 11 and 17 
(inclusive).
    ``(k) Funding.--
            ``(1) Authorization of appropriations.--For the purpose of 
        carrying out this section, there are authorized to be 
        appropriated $10,000,000 for fiscal year 2001, and such sums as 
        may be necessary for each of the fiscal years 2002 and 2005.
            ``(2) Allocation for program management.--Of the amount 
        appropriated under paragraph (1) for a fiscal year, the 
        Secretary may reserve not more than 1 percent for administering 
        the program under this section.''.

                TITLE V--BILINGUAL HEALTH PROFESSIONALS

SEC. 501. TRAINING OF BILINGUAL HEALTH PROFESSIONALS WITH RESPECT TO 
              MINORITY HEALTH CONDITIONS.

    (a) In General.--The Secretary, acting through the Administrator of 
the Health Resources and Services Administration, shall (directly or 
through awards of grants or contracts to public or nonprofit private 
entities) carry out a program--
            (1) to identify health professionals who speak both English 
        and a language used by racial or ethnic minority groups in the 
        United States; and
            (2) to train such health professionals with respect to the 
        treatment of minority health conditions, such as diabetes, HIV 
        infection, substance abuse, and conditions regarding mental 
        health.
    (b) Authorization of Appropriations.--For the purpose of carrying 
out subsection (a), there are authorized to be appropriated such sums 
as may be necessary for each of the fiscal years 2001 through 2005.

                     TITLE VI--CULTURAL COMPETENCE

SEC. 601. DEFINITION.

    (a) In General.--For purposes of this Act, the term ``culturally 
competent'', with respect to the manner in which health-related 
services, education, and training are provided, means providing the 
services, education, and training in the language and cultural context 
that is most appropriate for the individuals for whom the services, 
education, and training are intended, including as necessary the 
provision of bilingual services.
    (b) Modification.--The definition established in subsection (a) may 
be modified as needed at the discretion of the Secretary after 
providing a 30-day notice to the Congress.

SEC. 602. ACTIVITIES OF OFFICE OF MINORITY HEALTH; CENTER FOR 
              LINGUISTIC AND CULTURAL COMPETENCE IN HEALTH CARE.

    (a) Educational Materials; Technical Assistance.--
            (1) In general.--The Secretary, through the Office of 
        Minority Health under section 1707 of the Public Health Service 
        Act, shall--
                    (A) provide for the development of educational 
                materials on providing health services in a culturally 
                competent manner;
                    (B) provide technical assistance in carrying out 
                programs that use such materials; and
                    (C) provide technical assistance on other matters 
                regarding the provision of health services in a 
                culturally competent manner.
            (2) Authorization of appropriations.--For the purpose of 
        carrying out paragraph (1), there are authorized to be 
        appropriated $1,000,000 for fiscal year 2001, and such sums as 
        may be necessary for each of the fiscal years 2002 through 
        2005.
    (b) Center for Linguistic and Cultural Competence in Health Care.--
            (1) In general.--The Secretary, through the Office of 
        Minority Health under section 1707 of the Public Health Service 
        Act, shall provide for a Center for Linguistic and Cultural 
        Competence in Health Care to carry out programs to promote and 
        facilitate the provision of health-related services, education, 
        and training in a culturally competent manner.
            (2) Authorization of appropriations.--For the purpose of 
        carrying out paragraph (1), there are authorized to be 
        appropriated $5,000,000 for fiscal year 2001, and such sums as 
        may be necessary for each of the fiscal years 2002 through 
        2005.

SEC. 603. CULTURAL COMPETENCE DEMONSTRATION PROJECTS.

    (a) In General.--The Secretary, acting through the Administrator of 
the Health Care Financing Administration, shall conduct a cultural 
competence demonstration project under which grants are made to two 
hospitals with a history in the medicare program to enable them to 
implement standards for the culturally competent provision of services 
to address the specific needs of any population that constitutes at 
least 5 percent of the population served by the hospital involved.
    (b) Number and Type.--Of the hospitals provided grants under this 
section, one shall be located in an urban and the other in a rural area 
(as defined in section 1886(d)(2)(D) of the Social Security Act). The 
urban hospital shall serve a significant limited English proficient 
population and be within 175 miles of the border with Mexico. In 
selecting such hospitals, the Secretary shall give preference to 
hospitals that serve large immigrant populations.
    (c) Amount and Duration of Grant.--A grant under this section for a 
hospital shall be in the amount of $5,000,000 and shall be for a period 
of 5 years.
    (d) Evaluation and Report.--
            (1) Evaluation.--The Secretary shall also provide for a 
        grant to an appropriate qualified entity in an amount not to 
        exceed $1,000,000 to evaluate the demonstration projects 
        conducted under this section.
            (2) Report.--The Secretary shall submit to Congress a 
        report on the projects conducted under this section. The 
        Secretary shall include in such report the results of the 
        evaluation conducted under paragraph (1) and recommendations on 
        whether on going medicare funding should be provided for 
        implementation of standards for cultural competency in 
        hospitals.
    (e) Authorization of Appropriations.--There are authorized to be 
appropriated from the Federal Hospital Insurance Trust Fund (under 
section 1817 of the Social Security Act) to carry out this section, 
$11,000,000, which shall remain available until expended.

SEC. 604. USE OF MEDICARE AND MEDICAID DISPROPORTIONATE SHARE HOSPITAL 
              FUNDS TO PAY FOR TRANSLATORS.

    Nothing in title XVIII or XIX of the Social Security Act shall be 
construed to prevent a disproportionate share hospital that receives 
funds under section 1886(d)(5)(F) or section 1923 of such Act from 
using such funds to pay for translators for a population that is 
limited English proficient and that constitutes 10 percent or more of 
the population that it serves.

         TITLE VII--HISPANIC-SERVING HEALTH PROFESSIONS SCHOOLS

SEC. 701. HISPANIC-SERVING HEALTH PROFESSIONS SCHOOLS.

    (a) In General.--The Secretary, acting through the Administrator of 
the Health Resources and Services Administration, shall make grants to 
Hispanic-serving health professions schools for the purpose of carrying 
out programs to recruit Hispanic individuals to enroll in and graduate 
from the schools, which may include providing scholarships and other 
financial assistance as appropriate.
    (b) Eligibility.--For purposes of subsection (a), an entity is a 
Hispanic-serving health professions school if the entity--
            (1) is a school or program under section 799B of the Public 
        Health Service Act;
            (2) has an enrollment of full-time equivalent students that 
        is at least 5 percent Hispanic students;
            (3) has been effective in carrying out programs to recruit 
        Hispanic individuals to enroll in and graduate from the school;
            (4) has been effective in recruiting and retaining Hispanic 
        faculty members; and
            (5) has a significant number of graduates who are providing 
        health services to medically underserved populations or to 
        individuals in health professional shortage areas.
    (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 each of the fiscal years 2001 through 2005.

             TITLE VIII--DATA REGARDING RACE AND ETHNICITY

SEC. 801. COLLECTION OF DATA.

    Part A of title III of the Public Health Service Act (42 U.S.C. 241 
et seq.) is amended by inserting after section 306 the following 
section:

                      ``data on race and ethnicity

    ``Sec. 306A. (a) In General.--The Secretary shall by regulation 
provide for the following:
            ``(1) Health data collected under programs carried out by 
        the Secretary (whether collected directly or pursuant to 
        grants, cooperative agreements, or contracts) shall include 
        data on race and ethnicity and shall, at a minimum, use the 
        categories for race and ethnicity described in OMB Directive 
        15.
            ``(2) Data collected by the Secretary pursuant to title VI 
        of the Civil Rights Act of 1964 shall include data on race and 
        ethnicity and shall, at a minimum, use such categories.
            ``(3) Data on race and ethnicity that is collected under 
        paragraph (1) or (2) shall use the procedures described in such 
        Directive for collecting data from an individual, and shall be 
        maintained and presented (including for reporting purposes) in 
        accordance with such Directive.
            ``(4) Such other data as the Secretary may designate 
        (including administrative records) shall be collected, 
        maintained, and presented in accordance with such Directive, to 
        the extent that such data are collected by the Secretary and 
        relate to health-related programs that are carried out by the 
        Secretary.
    ``(b) Exemptions.--The final rule promulgated by the Secretary 
under subsection (a) shall be in accordance with the following:
            ``(1) Such rule shall provide that, with respect to a 
        program referred to in subsection (a) or an activity under the 
        program, a requirement under the rule does not apply to the 
        extent that compliance with the requirement would exceed the 
        authority provided by law for the program, or would be 
        inconsistent with the purpose of the program or activity.
            ``(2) Such rule shall provide that the Secretary may 
        provide an exemption from the applicability of a requirement 
        under the rule to a program, or an activity under the program, 
        if the Secretary determines that there is a reasonable basis 
        for providing the exemption.
            ``(3) With respect to each program or activity that the 
        Secretary determines is exempt under paragraph (1) or (2), such 
        rule shall require the Secretary--
                    ``(A) to publish in the Federal Register a notice 
                of such fact;
                    ``(B) to include in the notice an explanation of 
                the reason or reasons underlying the determination by 
                the Secretary that the standard described in paragraph 
                (1) or (2) (as applicable) has been met; and
                    ``(C) to so publish the notice not later than 30 
                days after the date on which the determination involved 
                is made.
    ``(c) Definition.--For purposes of this section, the term `OMB 
Directive 15' means Statistical Policy Directive No. 15, Race and 
Ethnic Standards for Federal Statistics and Administrative Reporting, 
as established by the Director of the Office of Management and Budget 
through the notice issued October 30, 1997 (62 FR 58782). Such term 
includes any subsequent revisions to such Directive.''.

SEC. 802. DEVELOPMENT OF STANDARDS; STUDY TO MEASURE PATIENT OUTCOMES 
              UNDER MEDICARE AND MEDICAID PROGRAMS.

    (a) Development of Standards.--Not later than one year after the 
date of the enactment of this Act, the Secretary, through the 
Administrator of the Health Care Financing Administration, shall 
develop outcome measures to evaluate, by race and ethnicity, 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).
    (b) Study.--After the Secretary develops the outcome measures under 
subsection (a), the Secretary shall conduct a study that evaluates, by 
race and ethnicity, the performance of health care programs and 
projects referred to in subsection (a).
    (c) Report to Congress.--Not later that two years after the date of 
the enactment of this Act, the Secretary 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).

                      TITLE IX--GENERAL PROVISIONS

SEC. 901. DEFINITIONS.

    For purposes of this Act:
            (1) The term ``culturally competent'' has the meaning given 
        such term in section 601.
            (2) The term ``HIV'' means the human immunodeficiency 
        virus, the causative agent for acquired immune deficiency 
        syndrome (commonly known as AIDS).
            (3) The term ``Secretary'' has the meaning indicated for 
        such term in section 101(a).

SEC. 902. EFFECTIVE DATE.

    This Act and the amendments made by this Act take effect upon the 
date of the enactment of this Act.
                                 <all>