[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 2857 Introduced in Senate (IS)]







107th CONGRESS
  2d Session
                                S. 2857

To amend titles XVIII and XIX of the Social Security Act to improve the 
 requirements regarding advance directives in order to ensure that an 
  individual's health care decisions are complied with, and for other 
                               purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             August 1, 2002

 Mr. Rockefeller (for himself, Ms. Collins, and Mr. Wyden) introduced 
the following bill; which was read twice and referred to the Committee 
                               on Finance

_______________________________________________________________________

                                 A BILL


 
To amend titles XVIII and XIX of the Social Security Act to improve the 
 requirements regarding advance directives in order to ensure that an 
  individual's health care decisions are complied with, 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 ``Advance Planning 
and Compassionate Care Act of 2002''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Development of standards to assess end-of-life care.
Sec. 3. Study and report by the Secretary of Health and Human Services 
                            regarding the establishment and 
                            implementation of a national uniform policy 
                            on advance directives.
Sec. 4. Improvement of policies related to the use of advance 
                            directives.
Sec. 5. National information hotline for end-of-life decisionmaking and 
                            hospice care.
Sec. 6. Demonstration project for innovative and new approaches to end-
                            of-life care for medicare, medicaid, and 
                            SCHIP beneficiaries.
Sec. 7. Establishment of End-of-Life Care Advisory Board.

SEC. 2. DEVELOPMENT OF STANDARDS TO ASSESS END-OF-LIFE CARE.

    (a) In General.--The Secretary of Health and Human Services, in 
consultation with the Administrator of the Centers for Medicare & 
Medicaid Services, the Director of the National Institutes of Health, 
the Administrator of the Agency for Health Care Policy and Research, 
and the End-of-Life Care Advisory Board (established under section 7), 
shall develop outcome standards and measures to--
            (1) evaluate the performance of health care programs and 
        projects that provide end-of-life care to individuals, 
        including the quality of the care provided by such programs and 
        projects; and
            (2) assess the access to, and utilization of, such programs 
        and projects, including differences in such access and 
        utilization in rural and urban areas and for minority 
        populations.
    (b) Report to Congress.--Not later than 2 years after the date of 
enactment of this Act, the Secretary of Health and Human Services shall 
submit to Congress a report on the outcome standards and measures 
developed under subsection (a), together with recommendations for such 
legislation and administrative actions as the Secretary considers 
appropriate.

SEC. 3. STUDY AND REPORT BY THE SECRETARY OF HEALTH AND HUMAN SERVICES 
              REGARDING THE ESTABLISHMENT AND IMPLEMENTATION OF A 
              NATIONAL UNIFORM POLICY ON ADVANCE DIRECTIVES.

    (a) Study.--
            (1) In general.--The Secretary of Health and Human Services 
        shall conduct a thorough study of all matters relating to the 
        establishment and implementation of a national uniform policy 
        on advance directives for individuals receiving items and 
        services under titles XVIII and XIX of the Social Security Act 
        (42 U.S.C. 1395 et seq.; 1396 et seq.).
            (2) Matters studied.--The matters studied by the Secretary 
        of Health and Human Services under paragraph (1) shall include 
        issues concerning--
                    (A) family satisfaction that a patient's wishes, as 
                stated in the patient's advance directive, were carried 
                out;
                    (B) the portability of advance directives, 
                including cases involving the transfer of an individual 
                from 1 health care setting to another;
                    (C) immunity from civil liability and criminal 
                responsibility for health care providers that follow 
                the instructions in an individual's advance directive 
                that was validly executed in, and consistent with the 
                laws of, the State in which it was executed;
                    (D) conditions under which an advance directive is 
                operative;
                    (E) revocation of an advance directive by an 
                individual;
                    (F) the criteria used by States for determining 
                that an individual has a terminal condition;
                    (G) surrogate decisionmaking regarding end-of-life 
                care;
                    (H) the provision of adequate palliative care (as 
                defined in paragraph (3)), including pain management; 
                and
                    (I) adequate and timely referrals to hospice care 
                programs.
            (3) Palliative care.--For purposes of paragraph (2)(H), the 
        term ``palliative care'' means interdisciplinary care for 
        individuals with a life-threatening illness or injury relating 
        to pain and symptom management and psychological, social, and 
        spiritual needs and that seeks to improve the quality of life 
        for the individual and the individual's family.
    (b) Report to Congress.--Not later than 18 months after the date of 
enactment of this Act, the Secretary of Health and Human Services shall 
submit to Congress a report on the study conducted under subsection 
(a), together with recommendations for such legislation and 
administrative actions as the Secretary considers appropriate.
    (c) Consultation.--In conducting the study and developing the 
report under this section, the Secretary of Health and Human Services 
shall consult with the End-of-Life Care Advisory Board (established 
under section 7), the Uniform Law Commissioners, and other interested 
parties.

SEC. 4. IMPROVEMENT OF POLICIES RELATED TO THE USE OF ADVANCE 
              DIRECTIVES.

    (a) Medicare.--Section 1866(f) of the Social Security Act (42 
U.S.C. 1395cc(f)) is amended--
            (1) in paragraph (1)--
                    (A) in subparagraph (B), by inserting ``and if 
                presented by the individual, to include the content of 
such advance directive in a prominent part of such record'' before the 
semicolon at the end;
                    (B) in subparagraph (D), by striking ``and'' after 
                the semicolon at the end;
                    (C) in subparagraph (E), by striking the period at 
                the end and inserting ``; and''; and
                    (D) by inserting after subparagraph (E) the 
                following new subparagraph:
            ``(F) to provide each individual with the opportunity to 
        discuss issues relating to the information provided to that 
        individual pursuant to subparagraph (A) with an appropriately 
        trained professional.'';
            (2) in paragraph (3), by striking ``a written'' and 
        inserting ``an''; and
            (3) by adding at the end the following new paragraph:
    ``(5)(A) An advance directive validly executed outside of the State 
in which such advance directive is presented by an adult individual to 
a provider of services, a Medicare+Choice organization, or a prepaid or 
eligible organization shall be given the same effect by that provider 
or organization as an advance directive validly executed under the law 
of the State in which it is presented would be given effect.
    ``(B)(i) The definition of an advanced directive shall also include 
actual knowledge of instructions made while an individual was able to 
express the wishes of such individual with regard to health care.
    ``(ii) For purposes of clause (i), the term `actual knowledge' 
means the possession of information of an individual's wishes 
communicated to the health care provider orally or in writing by the 
individual, the individual's medical power of attorney representative, 
the individual's health care surrogate, or other individuals resulting 
in the health care provider's personal cognizance of these wishes. 
Other forms of imputed knowledge are not actual knowledge.
    ``(C) The provisions of this paragraph shall preempt any State law 
to the extent such law is inconsistent with such provisions. The 
provisions of this paragraph shall not preempt any State law that 
provides for greater portability, more deference to a patient's wishes, 
or more latitude in determining a patient's wishes.''.
    (b) Medicaid.--Section 1902(w) of the Social Security Act (42 
U.S.C. 1396a(w)) is amended--
            (1) in paragraph (1)--
                    (A) in subparagraph (B)--
                            (i) by striking ``in the individual's 
                        medical record'' and inserting ``in a prominent 
                        part of the individual's current medical 
                        record''; and
                            (ii) by inserting ``and if presented by the 
                        individual, to include the content of such 
                        advance directive in a prominent part of such 
                        record'' before the semicolon at the end;
                    (B) in subparagraph (D), by striking ``and'' after 
                the semicolon at the end;
                    (C) in subparagraph (E), by striking the period at 
                the end and inserting ``; and''; and
                    (D) by inserting after subparagraph (E) the 
                following new subparagraph:
            ``(F) to provide each individual with the opportunity to 
        discuss issues relating to the information provided to that 
        individual pursuant to subparagraph (A) with an appropriately 
        trained professional.'';
            (2) in paragraph (4), by striking ``a written'' and 
        inserting ``an''; and
            (3) by adding at the end the following paragraph:
    ``(6)(A) An advance directive validly executed outside of the State 
in which such advance directive is presented by an adult individual to 
a provider or organization shall be given the same effect by that 
provider or organization as an advance directive validly executed under 
the law of the State in which it is presented would be given effect.
    ``(B)(i) The definition of an advanced directive shall also include 
actual knowledge of instructions made while an individual was able to 
express the wishes of such individual with regard to health care.
    ``(ii) For purposes of clause (i), the term `actual knowledge' 
means the possession of information of an individual's wishes 
communicated to the health care provider orally or in writing by the 
individual, the individual's medical power of attorney representative, 
the individual's health care surrogate, or other individuals resulting 
in the health care provider's personal cognizance of these wishes. 
Other forms of imputed knowledge are not actual knowledge.
    ``(C) The provisions of this paragraph shall preempt any State law 
to the extent such law is inconsistent with such provisions. The 
provisions of this paragraph shall not preempt any State law that 
provides for greater portability, more deference to a patient's wishes, 
or more latitude in determining a patient's wishes.''.
    (c) Study and Report Regarding Implementation.--
            (1) Study.--The Secretary of Health and Human Services 
        shall conduct a study regarding the implementation of the 
        amendments made by subsections (a) and (b).
            (2) Report.--Not later than 18 months after the date of 
        enactment of this Act, the Secretary of Health and Human 
        Services shall submit to Congress a report on the study 
        conducted under paragraph (1), together with recommendations 
        for such legislation and administrative actions as the 
        Secretary considers appropriate.
    (d) Effective Dates.--
            (1) In general.--Subject to paragraph (2), the amendments 
        made by subsections (a) and (b) shall apply to provider 
        agreements and contracts entered into, renewed, or extended 
        under title XVIII of the Social Security Act (42 U.S.C. 1395 et 
        seq.), and to State plans under title XIX of such Act (42 
        U.S.C. 1396 et seq.), on or after such date as the Secretary of 
        Health and Human Services specifies, but in no case may such 
        date be later than 1 year after the date of enactment of this 
        Act.
            (2) Extension of effective date for state law amendment.--
        In the case of a State plan under title XIX of the Social 
        Security Act (42 U.S.C. 1396 et seq.) which the Secretary of 
        Health and Human Services determines requires State legislation 
        in order for the plan to meet the additional requirements 
        imposed by the amendments made by subsection (b), the State 
        plan shall not be regarded as failing to comply with the 
        requirements of such title solely on the basis of its failure 
        to meet these additional requirements before the first day of 
        the first calendar quarter beginning after the close of the 
        first regular session of the State legislature that begins 
        after the date of enactment of this Act. For purposes of the 
        previous sentence, in the case of a State that has a 2-year 
        legislative session, each year of the session is considered to 
        be a separate regular session of the State legislature.

SEC. 5. NATIONAL INFORMATION HOTLINE FOR END-OF-LIFE DECISIONMAKING AND 
              HOSPICE CARE.

    The Secretary of Health and Human Services, acting through the 
Administrator of the Centers for Medicare & Medicaid Services, shall 
operate directly, or by grant, contract, or interagency agreement, out 
of funds otherwise appropriated to the Secretary, a clearinghouse and a 
24-hour toll-free telephone hotline in order to provide consumer 
information about advance directives (as defined in section 1866(f)(3) 
of the Social Security Act (42 U.S.C. 1395cc(f)(3)), as amended by 
section 4(a)), end-of-life decisionmaking, and available end-of-life 
and hospice care services. In carrying out the preceding sentence, the 
Administrator may designate an existing clearinghouse and 24-hour toll-
free telephone hotline or, if no such entity is appropriate, may 
establish a new clearinghouse and a 24-hour toll-free telephone 
hotline.

SEC. 6. DEMONSTRATION PROJECT FOR INNOVATIVE AND NEW APPROACHES TO END-
              OF-LIFE CARE FOR MEDICARE, MEDICAID, AND SCHIP 
              BENEFICIARIES.

    (a) Establishment.--
            (1) In general.--The Secretary, acting through the 
        Administrator of the Centers for Medicare & Medicaid Services, 
        shall conduct a demonstration project under which the Secretary 
        contracts with entities operating programs in order to develop 
        new and innovative approaches to providing end-of-life care to 
        medicare beneficiaries, medicaid beneficiaries, and SCHIP 
        beneficiaries.
            (2) Application.--Any entity seeking to participate in the 
        demonstration project shall submit to the Secretary an 
        application in such form and manner as the Secretary may 
        require.
            (3) Duration.--The authority of the Secretary to conduct 
        the demonstration project shall terminate at the end of the 5-
        year period beginning on the date the Secretary implements the 
        demonstration project.
    (b) Selection Criteria.--
            (1) In general.--Subject to paragraphs (2) and (3), in 
        selecting entities to participate in the demonstration project, 
        the Secretary shall select entities that will allow for 
        programs to be conducted in a variety of States, in an array of 
        care settings, and that reflect--
                    (A) a balance between urban and rural settings;
                    (B) cultural diversity; and
                    (C) various modes of medical care and insurance, 
                such as fee-for-service, preferred provider 
                organizations, health maintenance organizations, 
                hospice care, home care services, long-term care, 
                pediatric care, and integrated delivery systems.
            (2) Preferences.--The Secretary shall give preference to 
        entities operating programs that--
                    (A) will serve medicare beneficiaries, medicaid 
                beneficiaries, or SCHIP beneficiaries who are dying of 
                illnesses that are most prevalent under the medicare 
                program, the medicaid program, or SCHIP, respectively; 
                and
                    (B) appear capable of sustained service and broad 
                replication at a reasonable cost within commonly 
                available organizational structures.
            (3) Selection of program that provides pediatric end-of-
        life care.--The Secretary shall ensure that at least 1 of the 
        entities selected to participate in the demonstration project 
        operates a program that provides pediatric end-of-life care.
    (c) Evaluation of Programs.--
            (1) In general.--Each program operated by an entity under 
        the demonstration project shall be evaluated at such regular 
        intervals as the Secretary determines are appropriate.
            (2) Use of private entities to conduct evaluations.--The 
        Secretary, in consultation with the End-of-Life Care Advisory 
        Board (established under section 7), shall contract with 1 or 
        more private entities to coordinate and conduct the evaluations 
        under paragraph (1). Such a contract may not be awarded to an 
        entity selected to participate in the demonstration project.
            (3) Requirements for evaluations.--
                    (A) Use of outcome measures and standards.--In 
                coordinating and conducting an evaluation of a program 
                conducted under the demonstration project, an entity 
                shall use the outcome standards and measures required 
                to be developed under section 2 as soon as those 
                standards and measures are available.
                    (B) Elements of evaluation.--In addition to the use 
                of the outcome standards and measures under 
                subparagraph (A), an evaluation of a program conducted 
                under the demonstration project shall include the 
                following:
                            (i) A comparison of the quality of care 
                        provided by, and of the outcomes for medicare 
                        beneficiaries, medicaid beneficiaries, and 
                        SCHIP beneficiaries, and the families of such 
                        beneficiaries enrolled in, the program being 
                        evaluated to the quality of care and outcomes 
                        for such individuals that would have resulted 
                        if care had been provided under existing 
                        delivery systems.
                            (ii) An analysis of how ongoing measures of 
                        quality and accountability for improvement and 
                        excellence could be incorporated into the 
                        program being evaluated.
                            (iii) A comparison of the costs of the care 
                        provided to medicare beneficiaries, medicaid 
                        beneficiaries, and SCHIP beneficiaries under 
                        the program being evaluated to the costs of 
                        such care that would have been incurred under 
                        the medicare program, the medicaid program, and 
                        SCHIP if such program had not been conducted.
                            (iv) An analysis of whether the program 
                        being evaluated implements practices or 
                        procedures that result in improved patient 
                        outcomes, resource utilization, or both.
                            (v) An analysis of--
                                    (I) the population served by the 
                                program being evaluated; and
                                    (II) how accurately that population 
                                reflects the total number of medicare 
                                beneficiaries, medicaid beneficiaries, 
                                and SCHIP beneficiaries residing in the 
                                area who are in need of services 
                                offered by such program.
                            (vi) An analysis of the eligibility 
                        requirements and enrollment procedures for the 
                        program being evaluated.
                            (vii) An analysis of the services provided 
                        to beneficiaries enrolled in the program being 
                        evaluated and the utilization rates for such 
                        services.
                            (viii) An analysis of the structure for the 
                        provision of specific services under the 
                        program being evaluated.
                            (ix) An analysis of the costs of providing 
                        specific services under the program being 
                        evaluated.
                            (x) An analysis of any procedures for 
                        offering medicare beneficiaries, medicaid 
                        beneficiaries, and SCHIP beneficiaries enrolled 
                        in the program being evaluated a choice of 
                        services and how the program responds to the 
                        preferences of such beneficiaries.
                            (xi) An analysis of the quality of care 
                        provided to, and of the outcomes for, medicare 
                        beneficiaries, medicaid beneficiaries, and 
                        SCHIP beneficiaries, and the families of such 
                        beneficiaries, that are enrolled in the program 
                        being evaluated.
                            (xii) An analysis of any ethical, cultural, 
                        or legal concerns--
                                    (I) regarding the program being 
                                evaluated; and
                                    (II) with the replication of such 
                                program in other settings.
                            (xiii) An analysis of any changes to 
                        regulations or of any additional funding that 
                        would result in more efficient procedures or 
                        improved outcomes under the program being 
                        evaluated.
    (d) Waiver Authority.--The Secretary may waive compliance with any 
of the requirements of titles XI, XVIII, XIX, and XXI of the Social 
Security Act (42 U.S.C. 1301 et seq.; 1395 et seq.; 1396 et seq.; 
1397aa et seq.) which, if applied, would prevent the demonstration 
project carried out under this section from effectively achieving the 
purpose of such project.
    (e) Reports to Congress.--
            (1) Annual reports by secretary.--
                    (A) In general.--Beginning 1 year after the date of 
                enactment of this Act, and annually thereafter, the 
                Secretary shall submit to Congress a report on the 
                demonstration project and on the quality of end-of-life 
                care under the medicare program, the medicaid program, 
                and SCHIP, together with recommendations for such 
                legislation and administrative actions as the Secretary 
                considers appropriate.
                    (B) Summary of recent studies.--A report submitted 
                under subparagraph (A) shall include a summary of any 
                recent studies and advice from experts in the health 
                care field regarding the ethical, cultural, and legal 
                issues that may arise when attempting to improve the 
                health care system to meet the needs of individuals 
                with serious and eventually terminal conditions.
                    (C) Continuation or replication of demonstration 
                projects.--The first report submitted under 
                subparagraph (A) after the 3-year anniversary of the 
                date the Secretary implements the demonstration project 
                shall include recommendations regarding whether such 
                demonstration project should be continued beyond the 
                period described in subsection (a)(3) and whether broad 
                replication of any of the programs conducted under the 
                demonstration project should be initiated.
            (2) Report by end-of-life care advisory board on 
        demonstration project.--
                    (A) In general.--Not later than 2 years after the 
                conclusion of the demonstration project, the End-of-
                Life Advisory Board shall submit a report to the 
                Secretary and Congress on such project.
                    (B) Contents.--The report submitted under 
                subparagraph (A) shall contain--
                            (i) an evaluation of the effectiveness of 
                        the demonstration project; and
                            (ii) recommendations for such legislation 
                        and administrative actions as the Board 
                        considers appropriate.
    (f) Funding.--There are appropriated such sums as are necessary for 
conducting the demonstration project and for preparing and submitting 
the reports required under subsection (e)(1).
    (g) Definitions.--In this section:
            (1) Demonstration project.--The term ``demonstration 
        project'' means the demonstration project conducted under this 
        section.
            (2) Medicaid beneficiaries.--The term ``medicaid 
        beneficiaries'' means individuals who are enrolled in the State 
        medicaid program.
            (3) Medicaid program.--The term ``medicaid program'' means 
        the health care program under title XIX of the Social Security 
        Act (42 U.S.C. 1395 et seq.).
            (4) Medicare beneficiaries.--The term ``medicare 
        beneficiaries'' means individuals who are entitled to benefits 
        under part A or enrolled for benefits under part B of the 
        medicare program.
            (5) Medicare program.--The term ``medicare program'' means 
        the health care program under title XVIII of the Social 
        Security Act (42 U.S.C. 1395 et seq.).
            (6) SCHIP beneficiary.--The term ``SCHIP beneficiary'' 
        means an individual who is enrolled in SCHIP.
            (7) SCHIP.--The term ``SCHIP'' means the State children's 
        health insurance program under title XXI of the Social Security 
        Act (42 U.S.C. 1397aa et seq.).
            (8) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.

SEC. 7. ESTABLISHMENT OF END-OF-LIFE CARE ADVISORY BOARD.

    (a) Establishment.--There is established within the Department of 
Health and Human Services an End-of-Life Care Advisory Board (in this 
section referred to as the ``Board'').
    (b) Structure and Membership.--
            (1) In general.--The Board shall be composed of 15 members 
        who shall be appointed by the Secretary of Health and Human 
        Services (in this section referred to as the ``Secretary'').
            (2) Required representation.--The Secretary shall ensure 
        that the following groups, organizations, and associations are 
        represented in the membership of the Board:
                    (A) An end-of-life consumer advocacy organization.
                    (B) A senior citizen advocacy organization.
                    (C) A physician-based hospice or palliative care 
                organization.
                    (D) A nurse-based hospice or palliative care 
                organization.
                    (E) A hospice or palliative care provider 
                organization.
                    (F) A hospice or palliative care representative 
                that serves the veterans population.
                    (G) A physician-based medical association.
                    (H) A physician-based pediatric medical 
                association.
                    (I) A home health-based nurses association.
                    (J) A hospital-based or health system-based 
                palliative care group.
                    (K) A children-based or family-based hospice 
                resource group.
                    (L) A cancer pain management resource group.
                    (M) A cancer research and policy advocacy group.
                    (N) An end-of-life care policy advocacy group.
                    (O) An interdisciplinary end-of-life care academic 
                institution.
            (3) Ethnic diversity requirement.--The Secretary shall 
        ensure that the members of the Board appointed under paragraph 
        (1) represent the ethnic diversity of the United States.
            (4) Prohibition.--No individual who is a Federal officer or 
        employee may serve as a member of the Board.
            (5) Terms of appointment.--Each member of the Board shall 
        serve for a term determined appropriate by the Secretary.
            (6) Chairperson.--The Secretary shall designate a member of 
        the Board as chairperson.
    (c) Meetings.--The Board shall meet at the call of the chairperson 
but not less often than every 3 months.
    (d) Duties.--
            (1) In general.--The Board shall advise the Secretary on 
        all matters related to the furnishing of end-of-life care to 
        individuals.
            (2) Specific duties.--The specific duties of the Board are 
        as follows:
                    (A) Consulting.--The Board shall consult with the 
                Secretary regarding--
                            (i) the development of the outcome 
                        standards and measures under section 2;
                            (ii) conducting the study and submitting 
                        the report under section 3; and
                            (iii) the selection of private entities to 
                        conduct evaluations pursuant to section 
                        6(c)(2).
                    (B) Report on demonstration project.--The Board 
                shall submit the report required under section 6(e)(2).
    (e) Members To Serve Without Compensation.--
            (1) In general.--All members of the Board shall serve on 
        the Board without compensation for such service.
            (2) Travel expenses.--The members of the Board shall be 
        allowed travel expenses, including per diem in lieu of 
        subsistence, at rates authorized for employees of agencies 
        under subchapter I of chapter 57 of title 5, United States 
        Code, while away from their homes or regular places of business 
        in the performance of services for the Board.
    (f) Staff.--
            (1) In general.--The chairperson of the Board may, without 
        regard to the civil service laws and regulations, appoint and 
        terminate an executive director and such other additional 
        personnel as may be necessary to enable the Board to perform 
        its duties. The employment of an executive director shall be 
        subject to confirmation by the Board.
            (2) Compensation.--The chairperson of the Board may fix the 
        compensation of the executive director and other personnel 
        without regard to chapter 51 and subchapter III of chapter 53 
        of title 5, United States Code, relating to classification of 
        positions and General Schedule pay rates, except that the rate 
        of pay for the executive director and other personnel may not 
        exceed the rate payable for level V of the Executive Schedule 
        under section 5316 of such title.
            (3) Personnel as federal employees.--
                    (A) In general.--The executive director and any 
                personnel of the Board who are employees shall be 
                employees under section 2105 of title 5, United States 
                Code, for purposes of chapters 63, 81, 83, 84, 85, 87, 
                89, and 90 of that title.
                    (B) Members of board.--Subparagraph (A) shall not 
                be construed to apply to members of the Board.
    (g) Detail of Government Employees.--Any Federal Government 
employee may be detailed to the Board without additional reimbursement 
(other than the employee' regular compensation), and such detail shall 
be without interruption or loss of civil service status or privilege.
    (h) Procurement of Temporary and Intermittent Services.--The 
chairperson of the Board may procure temporary and intermittent 
services under section 3109(b) of title 5, United States Code, at rates 
for individuals which do not exceed the daily equivalent of the annual 
rate of basic pay prescribed for level V of the Executive Schedule 
under section 5316 of such title.
    (i) Federal Advisory Committee Act.--Section 14 of the Federal 
Advisory Committee Act (5 U.S.C. App.) shall not apply to the Board.
    (j) Termination.--The Board shall terminate 90 days after the date 
on which the Board submits the report under section 6(e)(2).
    (k) Funding.--Funding for the operation of the Board shall be from 
amounts otherwise appropriated to the Department of Health and Human 
Services.
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