[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6275 Introduced in House (IH)]








109th CONGRESS
  2d Session
                                H. R. 6275

             To improve the health of minority individuals.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 29, 2006

 Mrs. Christensen (for herself, Mr. Davis of Alabama, and Ms. Norton) 
 introduced the following bill; which was referred to the Committee on 
Energy and Commerce, and in addition to the Committees on Education and 
  the Workforce, the Judiciary, Ways and Means, and Resources, 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 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.

    This Act may be cited as the ``Health Equity and Justice Act of 
2006''.

SEC. 2. TABLE OF CONTENTS.

    The table of contents of this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.
     TITLE I--CULTURALLY AND LINGUISTICALLY APPROPRIATE HEALTH CARE

Sec. 101. Amendment to the Public Health Service Act.
Sec. 102. Standards for language access services.
Sec. 103. Federal reimbursement for culturally and linguistically 
                            appropriate services under the Medicare, 
                            Medicaid and State Children's Health 
                            Insurance Program.
Sec. 104. Increasing understanding of health literacy.
Sec. 105. Report on Federal efforts to provide culturally and 
                            linguistically appropriate healthcare 
                            services.
Sec. 106. General Accounting Office report on impact of language access 
                            services.
Sec. 107. Definitions.
Sec. 108. Treatment of the Medicare part B program under title VI of 
                            the Civil Rights Act of 1964.
                  TITLE II--HEALTH WORKFORCE DIVERSITY

Sec. 201. Amendment to the Public Health Service Act.
Sec. 202. Health Careers Opportunity Program.
Sec. 203. Program of Excellence in Health Professions Education for 
                            Underrepresented Minorities.
Sec. 204. Hispanic-serving health professions schools.
Sec. 205. Health Professions Student Loan fund; authorizations of 
                            appropriations regarding students from 
                            disadvantaged backgrounds.
Sec. 206. National Health Service Corps; recruitment and fellowships 
                            for individuals from disadvantaged 
                            backgrounds.
Sec. 207. Loan Repayment Program of the Centers for Disease Control and 
                            Prevention.
Sec. 208. Cooperative agreements for online degree programs at schools 
                            of public health and schools of allied 
                            health.
Sec. 209. Mid-career health professions scholarship program.
Sec. 210. Strengthening and expanding rural health provider networks.
Sec. 211. National report on the preparedness of health professionals 
                            to care for diverse populations.
Sec. 212. Scholarship and fellowship programs.
Sec. 213. Advisory Committee on Health Professions Training for 
                            Diversity.
Sec. 214. McNair Postbaccalaureate Achievement program.
                TITLE III--DATA COLLECTION AND REPORTING

Sec. 301. Amendment to the Public Health Service Act.
Sec. 302. Collection of race and ethnicity data by the Social Security 
                            Administration.
Sec. 303. Revision of HIPAA claims standards.
Sec. 304. National Center for Health Statistics.
Sec. 305. Geo-access study.
Sec. 306. Racial, ethnic, and linguistic data collected by the Federal 
                            Government.
                TITLE IV--ACCOUNTABILITY AND EVALUATION

                     Subtitle A--General Provisions

Sec. 401. Report on workforce diversity.
Sec. 402. Federal agency plan to eliminate disparities and improve the 
                            health of minority populations.
Sec. 403. Accountability within the Department of Health and Human 
                            Services.
Sec. 404. Office of Minority Health Disparity Elimination.
Sec. 405. Establishment of the Indian Health Service as an agency of 
                            the Public Health Service.
Sec. 406. Establishment of individual offices of minority health within 
                            agencies of the Public Health Service.
Sec. 407. Office of Minority Health at the Centers for Medicare and 
                            Medicaid Services.
Sec. 408. Office of Minority Affairs at the Food and Drug 
                            Administration.
Sec. 409. Safety and effectiveness of drugs with respect to racial and 
                            ethnic background.
Sec. 410. United States Commission on Civil Rights.
Sec. 411. Sense of Congress concerning full funding of activities to 
                            eliminate racial and ethnic health 
                            disparities.
Sec. 412. Guidelines for disease screening for minority patients.
              Subtitle B--Improving Environmental Justice

Sec. 421. Definitions.
Sec. 422. Environmental justice responsibilities of Federal agencies.
Sec. 423. Interagency environmental justice working group.
Sec. 424. Federal agency strategies.
Sec. 425. Federal Environmental Justice Advisory Committee.
Sec. 426. Human health and environmental research, data collection and 
                            analysis.
                   TITLE V--HEALTH EMPOWERMENT ZONES

Sec. 501. Health empowerment zones.

     TITLE I--CULTURALLY AND LINGUISTICALLY APPROPRIATE HEALTH CARE

SEC. 101. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.

    The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by 
adding at the end the following:

   ``TITLE XXIX--CULTURALLY AND LINGUISTICALLY APPROPRIATE HEALTHCARE

``SEC. 2900. DEFINITIONS.

    ``In this title:
            ``(1) Appropriate healthcare services.--The term 
        `appropriate healthcare services' includes services or 
        treatments to address physical, mental, and behavioral 
        disorders or syndromes.
            ``(2) Indian tribe.--The term `Indian tribe' means any 
        Indian tribe, band, nation, or other organized group or 
        community, including any Alaska Native village or group or 
        regional or village corporation as defined in or established 
        pursuant to the Alaska Native Claims Settlement Act (85 Stat. 
        688) (43 U.S.C. 1601 et seq.), which is recognized as eligible 
        for the special programs and services provided by the United 
        States to Indians because of their status as Indians.
            ``(3) Limited english proficient.--The term `limited 
        English proficient' with respect to an individual means an 
        individual who cannot speak, read, write, or understand the 
        English language at a level that permits them to interact 
        effectively with clinical or nonclinical staff at a healthcare 
        organization.
            ``(4) Minority.--
                    ``(A) In general.--The terms `minority' and 
                `minorities' refer to individuals from a minority 
                group.
                    ``(B) Populations.--The term `minority', with 
                respect to populations, refers to racial and ethnic 
                minority groups.
            ``(5) Minority group.--The term `minority group' has the 
        meaning given the term `racial and ethnic minority group'.
            ``(6) Racial and ethnic minority group.--The term `racial 
        and ethnic minority group' means American Indians and Alaska 
        Natives, African Americans (including Caribbean Blacks and 
        Africans), Asian Americans, Hispanics (including Latinos), and 
        Native Hawaiians and other Pacific Islanders.
            ``(7) State.--The term `State' means each of the several 
        states, the District of Columbia, the Commonwealth of Puerto 
        Rico, the Indian tribes, the Virgin Islands, Guam, American 
        Samoa, and the Commonwealth of the Northern Mariana Islands.

``SEC. 2901. IMPROVING ACCESS TO SERVICES FOR INDIVIDUALS WITH LIMITED 
              ENGLISH PROFICIENCY.

    ``(a) Purpose.--As provided in Executive Order 13166, it is the 
purpose of this section--
            ``(1) to improve access to federally conducted and 
        federally assisted programs and activities for individuals who 
        are limited in their English proficiency;
            ``(2) to require each Federal agency to examine the 
        services it provides and develop and implement a system by 
        which limited English proficient individuals can enjoy 
        meaningful access to those services consistent with, and 
        without substantially burdening, the fundamental mission of the 
        agency;
            ``(3) to require each Federal agency to ensure that 
        recipients of Federal financial assistance provide meaningful 
        access to their limited English proficient applicants and 
        beneficiaries;
            ``(4) to ensure that recipients of Federal financial 
        assistance take reasonable steps, consistent with the 
        guidelines set forth in the Limited English Proficient Guidance 
        of the Department of Justice (as issued on June 12, 2002), to 
        ensure meaningful access to their programs and activities by 
        limited English proficient individuals; and
            ``(5) to ensure compliance with title VI of the Civil 
        Rights Act of 1964 and that healthcare providers and 
        organizations do not discriminate in the provision of services.
    ``(b) Federally Conducted Programs and Activities.--
            ``(1) In general.--Not later than 120 days after the date 
        of enactment of this Act, each Federal agency that carries out 
        health care-related activities shall prepare a plan to improve 
        access to the federally conducted health care-related programs 
        and activities of the agency by limited English proficient 
        individuals.
            ``(2) Plan requirement.--Each plan under paragraph (1) 
        shall be consistent with the standards set forth in section 102 
        of the Healthcare Equality and Accountability Act, and shall 
        include the steps the agency will take to ensure that limited 
        English proficient individuals have access to the agency's 
        health care-related programs and activities. Each agency shall 
        send a copy of such plan to the Department of Justice, which 
        shall serve as the central repository of the agencies' plans.
    ``(c) Federally Assisted Programs and Activities.--
            ``(1) In general.--Not later than 120 days after the date 
        of enactment of this Act, each Federal agency providing health 
        care-related Federal financial assistance shall ensure that the 
        guidance for recipients of Federal financial assistance 
        developed by the agency to ensure compliance with title VI of 
        the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.) is 
        specifically tailored to the recipients of such assistance and 
        is consistent with the standards described in section 102 of 
        the Healthcare Equality and Accountability Act. Each agency 
        shall send a copy of such guidance to the Department of Justice 
        which shall serve as the central repository of the agencies' 
        plans. After approval by the Department of Justice, each agency 
        shall publish its guidance document in the Federal Register for 
        public comment.
            ``(2) Requirements.--The agency-specific guidance developed 
        under paragraph (1) shall--
                    ``(A) detail how the general standards established 
                under section 102 of the Healthcare Equality and 
                Accountability Act will be applied to the agency's 
                recipients; and
                    ``(B) take into account the types of health care 
                services provided by the recipients, the individuals 
                served by the recipients, and other factors set out in 
                such standards.
            ``(3) Existing guidances.--A Federal agency that has 
        developed a guidance for purposes of title VI of the Civil 
        Rights Act of 1964 that the Department of Justice determines is 
        consistent with the standards described in section 102 of the 
        Healthcare Equality and Accountability Act shall examine such 
        existing guidance, as well as the programs and activities to 
        which such guidance applies, to determine if modification of 
        such guidance is necessary to comply with this subsection.
            ``(4) Consultation.--Each Federal agency shall consult with 
        the Department of Justice in establishing the guidances under 
        this subsection.
    ``(d) Consultations.--
            ``(1) In general.--In carrying out this section, each 
        Federal agency that carriers out health care-related activities 
        shall ensure that stakeholders, such as limited English 
        proficient individuals and their representative organizations, 
        recipients of Federal assistance, and other appropriate 
        individuals or entities, have an adequate and comparable 
        opportunity to provide input with respect to the actions of the 
        agency.
            ``(2) Evaluation.--Each Federal agency described in 
        paragraph (1) shall evaluate the--
                    ``(A) particular needs of the limited English 
                proficient individuals served by the agency, and by a 
                recipient of assistance provided by the agency;
                    ``(B) burdens of compliance with the agency 
                guidance and its recipients of the requirements of this 
                section; and
                    ``(C) outcomes or effectiveness of services.

``SEC. 2902. NATIONAL STANDARDS FOR CULTURALLY AND LINGUISTICALLY 
              APPROPRIATE SERVICES IN HEALTHCARE.

    ``Recipients of Federal financial assistance from the Secretary 
shall, to the extent reasonable and practicable after applying the 4-
factor analysis described in title V of the Guidance to Federal 
Financial Assistance Recipients Regarding Title VI Prohibition Against 
National Origin Discrimination Affecting Limited-English Proficient 
Persons (June 12, 2002)--
            ``(1) implement strategies to recruit, retain, and promote 
        individuals at all levels of the organization to maintain a 
        diverse staff and leadership that can provide culturally and 
        linguistically appropriate healthcare to patient populations of 
        the service area of the organization;
            ``(2) ensure that staff at all levels and across all 
        disciplines of the organization receive ongoing education and 
        training in culturally and linguistically appropriate service 
        delivery;
            ``(3) offer and provide language assistance services, 
        including bilingual staff and interpreter services, at no cost 
        to each patient with limited English proficiency at all points 
        of contact, in a timely manner during all hours of operation;
            ``(4) notify patients of their right to receive language 
        assistance services in their primary language;
            ``(5) ensure the competence of language assistance provided 
        to limited English proficient patients by interpreters and 
        bilingual staff, and ensure that family, particularly minor 
        children, and friends are not used to provide interpretation 
        services--
                    ``(A) except in case of emergency; or
                    ``(B) except on request of the patient, who has 
                been informed in his or her preferred language of the 
                availability of free interpretation services;
            ``(6) make available easily understood patient-related 
        materials, if such materials exist for non-limited English 
        proficient patients, including information or notices about 
        termination of benefits and post signage in the languages of 
        the commonly encountered groups or groups represented in the 
        service area of the organization;
            ``(7) develop and implement clear goals, policies, 
        operational plans, and management accountability and oversight 
        mechanisms to provide culturally and linguistically appropriate 
        services;
            ``(8) conduct initial and ongoing organizational 
        assessments of culturally and linguistically appropriate 
        services-related activities and integrate valid linguistic 
        competence-related measures into the internal audits, 
        performance improvement programs, patient satisfaction 
        assessments, and outcomes-based evaluations of the 
        organization;
            ``(9) ensure that, consistent with the privacy protections 
        provided for under the regulations promulgated under section 
        264(c) of the Health Insurance Portability and Accountability 
        Act of 1996 (42 U.S.C. 1320d-2 note)--
                    ``(A) data on the individual patient's race, 
                ethnicity, and primary language are collected in health 
                records, integrated into the organization's management 
                information systems, and periodically updated; and
                    ``(B) if the patient is a minor or is 
                incapacitated, the primary language of the parent or 
                legal guardian is collected;
            ``(10) maintain a current demographic, cultural, and 
        epidemiological profile of the community as well as a needs 
        assessment to accurately plan for and implement services that 
        respond to the cultural and linguistic characteristics of the 
        service area of the organization;
            ``(11) develop participatory, collaborative partnerships 
        with communities and utilize a variety of formal and informal 
        mechanisms to facilitate community and patient involvement in 
        designing and implementing culturally and linguistically 
        appropriate services-related activities;
            ``(12) ensure that conflict and grievance resolution 
        processes are culturally and linguistically sensitive and 
        capable of identifying, preventing, and resolving cross-
        cultural conflicts or complaints by patients;
            ``(13) regularly make available to the public information 
        about their progress and successful innovations in implementing 
        the standards under this section and provide public notice in 
        their communities about the availability of this information; 
        and
            ``(14) if requested, regularly make available to the head 
        of each Federal entity from which Federal funds are received, 
        information about their progress and successful innovations in 
        implementing the standards under this section as required by 
        the head of such entity.

``SEC. 2903. ROBERT T. MATSUI CENTER FOR CULTURAL AND LINGUISTIC 
              COMPETENCE IN HEALTHCARE.

    ``(a) Establishment.--The Secretary, acting through the Director of 
the Office of Minority Health Disparity Elimination, shall establish 
and support a center to be known as the `Robert T. Matsui Center for 
Cultural and Linguistic Competence in Healthcare' (referred to in this 
section as the `Center') to carry out the following activities:
            ``(1) Remote medical interpreting.--The Center shall 
        provide remote medical interpreting, directly or through 
        contracts, to healthcare providers who otherwise would be 
        unable to provide language interpreting services, at reasonable 
        or no cost as determined appropriate by the Director of the 
        Center. Methods of interpretation may include remote, 
        simultaneous or consecutive interpreting through telephonic 
        systems, video conferencing, and other methods determined 
        appropriate by the Secretary for patients with limited English 
        proficiency. The quality of such interpreting shall be 
        monitored and reported publicly. Nothing in this paragraph 
        shall be construed to limit the ability of healthcare providers 
        or organizations to provide medical interpreting services 
        directly and obtain reimbursement for such services as provided 
        for under the medicare, medicaid or SCHIP programs under titles 
        XVIII, XIX, or XXI of the Social Security Act.
            ``(2) Model language assistance programs.--The Center shall 
        provide for the collection and dissemination of information on 
        current model language assistance programs and strategies to 
        improve language access to healthcare for individuals with 
        limited English proficiency, including case studies using de-
        identified patient information, program summaries, and program 
        evaluations.
            ``(3) Medical interpreting guidelines.--
                    ``(A) In general.--The Center shall convene a 
                national working group to develop medical interpreting 
                and translation guidelines and standards for--
                            ``(i) the provision of services;
                            ``(ii) the actual practice of interpreting;
                            ``(iii) the training of medical 
                        interpreters and translators, developed by 
                        interpreters and translators.
                    ``(B) Publication.--Not later than 18 months after 
                the date of enactment of this Act, the Center shall 
                publish guidelines and standards developed under this 
                paragraph in the Federal Register.
            ``(4) Internet health clearinghouse.--The Center shall 
        develop and maintain an Internet clearinghouse to reduce 
        medical errors and improve medical outcomes and reduce 
        healthcare costs caused by communication with individuals with 
        limited English proficiency or low functional health literacy 
        and reduce or eliminate the duplication of effort to translate 
        materials by--
                    ``(A) developing and making available templates for 
                standard documents that are necessary for patients and 
                consumers to access and make educated decisions about 
                their healthcare, including--
                            ``(i) administrative and legal documents 
                        such as informed consent, advanced directives, 
                        and waivers of rights;
                            ``(ii) clinical information such as how to 
                        take medications, how to prevent transmission 
                        of a contagious disease, and other prevention 
                        and treatment instructions;
                            ``(iii) patient education and outreach 
                        materials such as immunization notices, health 
                        warnings, or screening notices; and
                            ``(iv) additional health or healthcare-
                        related materials as determined appropriate by 
                        the Director of the Center;
                    ``(B) ensuring that the documents the posted in 
                English and non-English languages and are culturally 
                appropriate;
                    ``(C) allowing public review of the documents 
                before dissemination in order to ensure that the 
                documents are understandable and culturally appropriate 
                for the target populations;
                    ``(D) allowing healthcare providers to customize 
                the documents for their use;
                    ``(E) facilitating access to these documents;
                    ``(F) providing technical assistance with respect 
                to the access and use of such information; and
                    ``(G) carrying out any other activities the 
                Secretary determines to be useful to fulfill the 
                purposes of the Clearinghouse.
            ``(5) Provision of information.--The Center shall provide 
        information relating to culturally and linguistically competent 
        healthcare for minority populations residing in the United 
        States to all healthcare providers and healthcare organizations 
        at no cost. Such information shall include--
                    ``(A) tenets of culturally and linguistically 
                competent care;
                    ``(B) cultural and linguistic competence self-
                assessment tools;
                    ``(C) cultural and linguistic competence training 
                tools;
                    ``(D) strategic plans to increase cultural and 
                linguistic competence in different types of healthcare 
                organizations; and
                    ``(E) resources for cultural competence information 
                for educators, practitioners and researchers.
    ``(b) Director.--The Center shall be headed by a Director who shall 
be appointed by, and who shall report to, the Deputy Assistant 
Secretary for Minority Health Disparity Elimination.
    ``(c) Availability of Language Access.--The Director shall 
collaborate with the Administrator of the Centers for Medicare and 
Medicaid Services and the Administrator of the Health Resources and 
Services Administration, to notify healthcare providers and healthcare 
organizations about the availability of language access services by the 
Center.
    ``(d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2006 through 2011.

``SEC. 2904. INNOVATIONS IN LANGUAGE ACCESS GRANTS.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Centers for Medicare and Medicaid Services, the Administrator of 
the Health Resources and Services Administration, the Secretary of 
Education, and the Deputy Assistant Secretary for Minority Health 
Disparity Elimination, shall award grants to eligible entities to 
enable such entities to design, implement, and evaluate innovative, 
cost-effective programs to improve language access to healthcare for 
individuals with limited English proficiency.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a) an entity shall--
            ``(1) be a city, county, Indian tribe, State, territory, 
        community-based and other nonprofit organization, health center 
        or community clinic, university, college, or other entity 
        designated by the Secretary; and
            ``(2) prepare and submit to the Secretary an application, 
        at such time, in such manner, and accompanied by such 
        additional information as the Secretary may require.
    ``(c) Use of Funds.--An entity shall use funds received under a 
grant under this section to--
            ``(1) develop, implement, and evaluate models of providing 
        real-time interpretation services through in-person 
        interpretation, communications, and computer technology, 
        including the Internet, teleconferencing, or video 
        conferencing;
            ``(2) develop short-term medical interpretation training 
        courses and incentives for bilingual healthcare staff who are 
        asked to interpret in the workplace;
            ``(3) develop formal training programs for individuals 
        interested in becoming dedicated healthcare interpreters;
            ``(4) provide staff language training instruction which 
        shall include information on the practical limitations of such 
        instruction for non-native speakers;
            ``(5) provide basic healthcare-related English language 
        instruction for limited English proficient individuals; and
            ``(6) develop other language assistance services as 
        determined appropriate by the Secretary.
    ``(d) Priority.--In awarding grants under this section, the 
Secretary shall give priority to entities that have developed 
partnerships with organizations or agencies with experience in language 
access services.
    ``(e) Evaluation.--An entity that receives a grant under this 
section shall submit to the Secretary an evaluation that describes the 
activities carried out with funds received under the grant, and how 
such activities improved access to healthcare services and the quality 
of healthcare for individuals with limited English proficiency. Such 
evaluation shall be collected and disseminated through the Center for 
Linguistic and Cultural Competence in Healthcare established under 
section 2903.
    ``(f) Grantee Convention.--The Secretary, acting through the 
Director of the Center for Linguistic and Cultural Competence in 
Healthcare, shall at the end of the grant cycle convene grantees under 
this section to share findings and develop and disseminate model 
programs and practices.
    ``(g) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2006 through 2011.

``SEC. 2905. RESEARCH ON LANGUAGE ACCESS.

    ``(a) In General.--The Director of the Agency for Healthcare 
Research and Quality, in collaboration with the Deputy Assistant 
Secretary for Minority Health Disparity Elimination, shall expand 
research concerning--
            ``(1) the barriers to healthcare services including mental 
        and behavioral services that are faced by limited English 
        proficient individuals;
            ``(2) the impact of language barriers on the quality of 
        healthcare and the health status of limited English proficient 
        individuals and populations;
            ``(3) healthcare provider attitudes, knowledge, and 
        awareness of the barriers described in paragraphs (1) and (2);
            ``(4) the means by which language access services are 
        provided to limited English proficient individuals and how such 
        services are effective in improving the quality of care;
            ``(5) the cost-effectiveness of providing language access; 
        and
            ``(6) optimal approaches for delivering language access.
    ``(b) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2006 through 2011.

``SEC. 2906. INFORMATION ABOUT FEDERAL HEALTH PROGRAMS FOR LIMITED 
              ENGLISH PROFICIENT POPULATIONS.

    ``The Secretary shall provide for a means by which limited English 
proficient individuals who are seeking information about, or assistance 
with, Federal healthcare programs may obtain such information or 
assistance.''.

SEC. 102. STANDARDS FOR LANGUAGE ACCESS SERVICES.

    Not later than 120 days after the date of enactment of this Act, 
the head of each Federal agency that carries out health care-related 
activities shall develop and adopt a guidance on language services for 
those with limited English proficiency who attempt to have access to or 
participate in such activities that provides at the minimum the factors 
and principles set forth in the Department of Justice guidance 
published on June 12, 2002.

SEC. 103. FEDERAL REIMBURSEMENT FOR CULTURALLY AND LINGUISTICALLY 
              APPROPRIATE SERVICES UNDER THE MEDICARE, MEDICAID AND 
              STATE CHILDREN'S HEALTH INSURANCE PROGRAM.

    (a) Demonstration Project Promoting Access for Medicare 
Beneficiaries With Limited English Proficiency.--
            (1) In general.--The Secretary shall conduct a 
        demonstration project (in this section referred to as the 
        ``project'') to demonstrate the impact on costs and health 
        outcomes of providing reimbursement for interpreter services to 
        certain medicare beneficiaries who are limited English 
        proficient in urban and rural areas.
            (2) Scope.--The Secretary shall carry out the project in 
        not less than 30 States through contracts with--
                    (A) health plans (under part C of title XVIII of 
                the Social Security Act);
                    (B) small providers;
                    (C) hospitals; and
                    (D) community-based clinics.
            (3) Duration.--Each contract entered into under the project 
        shall extend over a period of not longer than 2 years.
            (4) Report.--Upon completion of the project, the Secretary 
        shall submit a report to Congress on the project which shall 
        include recommendations regarding the extension of such project 
        to the entire medicare program.
            (5) Evaluation.--The Director of the Agency for Healthcare 
        Research and Quality shall award grants to public and private 
        nonprofit entities for the evaluation of the project. Such 
        evaluations shall focus on access, utilization, efficiency, 
        cost-effectiveness, patient satisfaction, and select health 
        outcomes.
    (b) Medicaid.--Section 1903(a)(3) of the Social Security Act (42 
U.S.C. 1396b(a)(3)) is amended--
            (1) in subparagraph (E), by striking ``plus'' at the end 
        and inserting ``and''; and
            (2) by adding at the end the following:
                    ``(F) 90 percent of the sums expended with respect 
                to costs incurred during such quarter as are 
                attributable to the provision of culturally and 
                linguistically appropriate services, including oral 
                interpretation, translations of written materials, and 
                other cultural and linguistic services for individuals 
                with limited English proficiency and disabilities who 
                apply for, or receive, medical assistance under the 
                State plan (including any waiver granted to the State 
                plan); plus''.
    (c) SCHIP.--Section 2105(a)(1) of the Social Security Act (42 
U.S.C. 1397ee(a)) is amended--
            (1) in the matter preceding subparagraph (A), by inserting 
        ``or, in the case of expenditures described in subparagraph 
        (D)(iv), 90 percent'' after ``enhanced FMAP''; and
            (2) in subparagraph (D)--
                    (A) in clause (iii), by striking ``and'' at the 
                end;
                    (B) by redesignating clause (iv) as clause (v); and
                    (C) by inserting after clause (iii) the following:
                            ``(iv) for expenditures attributable to the 
                        provision of culturally and linguistically 
                        appropriate services, including oral 
                        interpretation, translations of written 
                        materials, and other language services for 
                        individuals with limited English proficiency 
                        and disabilities who apply for, or receive, 
                        child health assistance under the plan; and''.
    (d) Effective Date.--The amendments made by this section take 
effect on October 1, 2006.

SEC. 104. INCREASING UNDERSTANDING OF HEALTH LITERACY.

    (a) In General.--The Secretary, acting through the Director of the 
Agency for Healthcare Research and Quality and the Administrator of the 
Health Resources and Services Administration, shall award grants to 
eligible entities to improve healthcare for patient populations that 
have low functional health literacy.
    (b) Eligibility.--To be eligible to receive a grant under 
subsection (a), an entity shall--
            (1) be a hospital, health center or clinic, health plan, or 
        other health entity; and
            (2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require.
    (c) Use of Funds.--
            (1) Agency for healthcare research and quality.--Grants 
        awarded under subsection (a) through the Agency for Healthcare 
        Research and Quality shall be used--
                    (A) to define and increase the understanding of 
                health literacy;
                    (B) to investigate the correlation between low 
                health literacy and health and healthcare;
                    (C) to clarify which aspects of health literacy 
                have an effect on health outcomes; and
                    (D) for any other activity determined appropriate 
                by the Director of the Agency.
            (2) Health resources and services administration.--Grants 
        awarded under subsection (a) through the Health Resources and 
        Services Administration shall be used to conduct demonstration 
        projects for interventions for patients with low health 
        literacy that may include--
                    (A) the development of new disease management 
                programs for patients with low health literacy;
                    (B) the tailoring of existing disease management 
                programs addressing mental and physical health 
                conditions for patients with low health literacy;
                    (C) the translation of written health materials for 
                patients with low health literacy;
                    (D) the identification, implementation, and testing 
                of low health literacy screening tools;
                    (E) the conduct of educational campaigns for 
                patients and providers about low health literacy; and
                    (F) other activities determined appropriate by the 
                Administrator of the Health Resources and Services 
                Administration.
    (d) Definitions.--In this section, the term ``low health literacy'' 
means the inability of an individual to obtain, process, and understand 
basic health information and services needed to make appropriate health 
decisions.
    (e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2006 through 2011.

SEC. 105. REPORT ON FEDERAL EFFORTS TO PROVIDE CULTURALLY AND 
              LINGUISTICALLY APPROPRIATE HEALTHCARE SERVICES.

    Not later than 1 year after the date of enactment of this Act and 
annually thereafter, the Secretary of Health and Human Services shall 
enter into a contract with the Institute of Medicine for the 
preparation and publication of a report that describes Federal efforts 
to ensure that all individuals have meaningful access to culturally and 
linguistically appropriate healthcare services. Such report shall 
include--
            (1) a description and evaluation of the activities carried 
        out under this Act; and
            (2) a description of best practices, model programs, 
        guidelines, and other effective strategies for providing access 
        to culturally and linguistically appropriate healthcare 
        services.

SEC. 106. GENERAL ACCOUNTING OFFICE REPORT ON IMPACT OF LANGUAGE ACCESS 
              SERVICES.

    Not later than 3 years after the date of enactment of this Act, the 
Comptroller General of the United States shall examine, and prepare and 
publish a report on, the impact of language access services on the 
health and healthcare of limited English proficient populations. Such 
report shall include--
            (1) recommendations on the development and implementation 
        of policies and practices by healthcare organizations and 
        providers for limited English proficient patient populations;
            (2) a description of the effect of providing language 
        access services on quality of healthcare and access to care and 
        reduced medical error; and
            (3) a description of the costs associated with or savings 
        related to provision of language access services.

SEC. 107. DEFINITIONS.

    In this title:
            (1) Incorporated definitions.--The definitions contained in 
        section 2900 of the Public Health Service Act, as added by 
        section 101, shall apply.
            (2) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.

SEC. 108. TREATMENT OF THE MEDICARE PART B PROGRAM UNDER TITLE VI OF 
              THE CIVIL RIGHTS ACT OF 1964.

    A payment provider of services or physician or other supplier under 
part B of title XVIII of the Social Security Act shall be deemed a 
grant, and not a contract of insurance or guaranty, for the purposes of 
title VI of the Civil Rights Act of 1964.

                  TITLE II--HEALTH WORKFORCE DIVERSITY

SEC. 201. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.

    Title XXIX of the Public Health Service Act, as added by section 
101, is amended by adding at the end the following:

          ``Subtitle A--Diversifying the Healthcare Workplace

``SEC. 2911. REPORT ON WORKFORCE DIVERSITY.

    ``(a) In General.--Not later than July 1, 2006, and biannually 
thereafter, the Secretary, acting through the director of each entity 
within the Department of Health and Human Services, shall prepare and 
submit to the Committee on Health, Education, Labor, and Pensions of 
the Senate and the Committee on Energy and Commerce of the House of 
Representatives a report on health workforce diversity.
    ``(b) Requirement.--The report under subsection (a) shall contain 
the following information:
            ``(1) A description of any grant support that is provided 
        by each entity for workforce diversity initiatives with the 
        following information--
                    ``(A) the number of grants made;
                    ``(B) the purpose of the grants;
                    ``(C) the populations served through the grants;
                    ``(D) the organizations and institutions receiving 
                the grants; and
                    ``(E) the tracking efforts that were used to follow 
                the progress of participants.
            ``(2) A description of the entity's plan to achieve 
        workforce diversity goals that includes, to the extent relevant 
        to such entity--
                    ``(A) the number of underrepresented minority 
                health professionals that will be needed in various 
                disciplines over the next 10 years to achieve 
                population parity;
                    ``(B) the level of funding needed to fully expand 
                and adequately support health professions pipeline 
                programs;
                    ``(C) the impact such programs have had on the 
                admissions practices and policies of health professions 
                schools;
                    ``(D) the management strategy necessary to 
                effectively administer and institutionalize health 
                profession pipeline programs; and
                    ``(E) the impact that the Government Performance 
                and Results Act (GPRA) has had on evaluating the 
                performance of grantees and whether the GPRA is the 
                best assessment tool for programs under titles VII and 
                VIII.
            ``(3) A description of measurable objectives of each entity 
        relating to workforce diversity initiatives.
    ``(c) Public Availability.--The report under subsection (a) shall 
be made available for public review and comment.

``SEC. 2912. NATIONAL WORKING GROUP ON WORKFORCE DIVERSITY.

    ``(a) In General.--The Secretary, acting through the Bureau of 
Health Professions within the Health Resources and Services 
Administration, shall award a grant to an entity determined appropriate 
by the Secretary for the establishment of a national working group on 
workforce diversity.
    ``(b) Representation.--In establishing the national working group 
under subsection (a), the grantee shall ensure that the group has 
representation from the following entities:
            ``(1) The Health Resources and Services Administration.
            ``(2) The Department of Health and Human Services Data 
        Council.
            ``(3) The Office of Minority Health Disparity Elimination.
            ``(4) The Bureau of Labor Statistics of the Department of 
        Labor.
            ``(5) The Public Health Practice Program Office--Office of 
        Workforce Policy and Planning.
            ``(6) The National Center on Minority Health and Health 
        Disparities.
            ``(7) The Agency for Healthcare Research and Quality.
            ``(8) The Institute of Medicine Study Committee for the 
        2004 workforce diversity report.
            ``(9) The Indian Health Service.
            ``(10) Academic institutions.
            ``(11) Consumer organizations.
            ``(12) Health professional associations, including those 
        that represent underrepresented minority populations.
            ``(13) Researchers in the area of health workforce.
            ``(14) Health workforce accreditation entities.
            ``(15) Private foundations that have sponsored workforce 
        diversity initiatives.
            ``(16) Not less than 5 health professions students 
        representing various health profession fields and levels of 
        training.
    ``(c) Activities.--The working group established under subsection 
(a) shall convene at least twice each year to complete the following 
activities:
            ``(1) Review current public and private health workforce 
        diversity initiatives.
            ``(2) Identify successful health workforce diversity 
        programs and practices.
            ``(3) Examine challenges relating to the development and 
        implementation of health workforce diversity initiatives.
            ``(4) Draft a national strategic work plan for health 
        workforce diversity, including recommendations for public and 
        private sector initiatives.
            ``(5) Develop a framework and methods for the evaluation of 
        current and future health workforce diversity initiatives.
            ``(6) Develop recommended standards for workforce diversity 
        that could be applicable to all health professions programs and 
        programs funded under this Act.
            ``(7) Develop curriculum guidelines for diversity training.
            ``(8) Develop a strategy for the inclusion of community 
        members on admissions committees for health profession schools.
            ``(9) Other activities determined appropriate by the 
        Secretary.
    ``(d) Annual Report.--Not later than 1 year after the establishment 
of the working group under subsection (a), and annually thereafter, the 
working group shall prepare and make available to the general public 
for comment, an annual report on the activities of the working group. 
Such report shall include the recommendations of the working group for 
improving health workforce diversity.
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.

``SEC. 2913. TECHNICAL CLEARINGHOUSE FOR HEALTH WORKFORCE DIVERSITY.

    ``(a) In General.--The Secretary, acting through the Office of 
Minority Health Disparity Elimination, and in collaboration with the 
Bureau of Health Professions within the Health Resources and Services 
Administration, shall establish a technical clearinghouse on health 
workforce diversity within the Office of Minority Health Disparity 
Elimination and coordinate current and future clearinghouses.
    ``(b) Information and Services.--The clearinghouse established 
under subsection (a) shall offer the following information and 
services:
            ``(1) Information on the importance of health workforce 
        diversity.
            ``(2) Statistical information relating to underrepresented 
        minority representation in health and allied health professions 
        and occupations.
            ``(3) Model health workforce diversity practices and 
        programs.
            ``(4) Admissions policies that promote health workforce 
        diversity and are in compliance with Federal and State laws.
            ``(5) Lists of scholarship, loan repayment, and loan 
        cancellation grants as well as fellowship information for 
        underserved populations for health professions schools.
            ``(6) Foundation and other large organizational initiatives 
        relating to health workforce diversity.
    ``(c) Consultation.--In carrying out this section, the Secretary 
shall consult with non-Federal entities which may include minority 
health professional associations to ensure the adequacy and accuracy of 
information.
    ``(d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.

``SEC. 2914. EVALUATION OF WORKFORCE DIVERSITY INITIATIVES.

    ``(a) In General.--The Secretary, acting through the Bureau of 
Health Professions within the Health Resources and Services 
Administration, shall award grants to eligible entities for the conduct 
of an evaluation of current health workforce diversity initiatives 
funded by the Department of Health and Human Services.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a) an entity shall--
            ``(1) be a city, county, Indian tribe, State, territory, 
        community-based nonprofit organization, health center, 
        university, college, or other entity determined appropriate by 
        the Secretary;
            ``(2) with respect to an entity that is not an academic 
        medical center, university, or private research institution, 
        carry out activities under the grant in partnership with an 
        academic medical center, university, or private research 
        institution; and
            ``(3) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require.
    ``(c) Use of Funds.--Amounts awarded under a grant under subsection 
(a) shall be used to support the following evaluation activities:
            ``(1) Determinations of measures of health workforce 
        diversity success.
            ``(2) The short- and long-term tracking of participants in 
        health workforce diversity pipeline programs funded by the 
        Department of Health and Human Services.
            ``(3) Assessments of partnerships formed through activities 
        to increase health workforce diversity.
            ``(4) Assessments of barriers to health workforce 
        diversity.
            ``(5) Assessments of policy changes at the Federal, State, 
        and local levels.
            ``(6) Assessments of coordination within and between 
        Federal agencies and other institutions.
            ``(7) Other activities determined appropriate by the 
        Secretary and the Working Group established under section 2912.
    ``(d) Report.--Not later than 1 year after the date of enactment of 
this title, the Bureau of Health Professions within the Health 
Resources and Services Administration shall prepare and make available 
for public comment a report that summarizes the findings made by 
entities under grants under this section.
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.

``SEC. 2915. DATA COLLECTION AND REPORTING BY HEALTH PROFESSIONAL 
              SCHOOLS.

    ``(a) In General.--The Secretary, acting through the Bureau of 
Health Professions of the Health Resources and Services Administration 
and the Office of Minority Health Disparity Elimination, shall 
establish an aggregated database on health professional students.
    ``(b) Requirement to Collect Data.--Each health professional school 
(including medical, dental, and nursing schools) and allied health 
profession school and program that receives Federal funds shall collect 
race, ethnicity, and language proficiency data concerning those 
students enrolled at such schools or in such programs. In collecting 
such data, a school or program shall--
            ``(1) at a minimum, use the categories for race and 
        ethnicity described in the 1997 Office of Management and Budget 
        Standards for Maintaining, Collecting, and Presenting Federal 
        Data on Race and Ethnicity and available language standards; 
        and
            ``(2) if practicable, collect data on additional population 
        groups if such data can be aggregated into the minimum race and 
        ethnicity data categories.
    ``(c) Use of Data.--Data on race, ethnicity, and primary language 
collected under this section shall be reported to the database 
established under subsection (a) on an annual basis. Such data shall be 
available for public use.
    ``(d) Privacy.--The Secretary shall ensure that all data collected 
under this section is protected from inappropriate internal and 
external use by any entity that collects, stores, or receives the data 
and that such data is collected without personally identifiable 
information.
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.

``SEC. 2916. SUPPORT FOR INSTITUTIONS COMMITTED TO WORKFORCE DIVERSITY.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Health Resources and Services Administration, shall award grants 
to eligible entities that demonstrate a commitment to health workforce 
diversity.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a), an entity shall--
            ``(1) be an educational institution or entity that 
        historically produces or trains meaningful numbers of 
        underrepresented minority health professionals, including--
                    ``(A) Historically Black Colleges and Universities;
                    ``(B) Hispanic-Serving Health Professions Schools;
                    ``(C) Hispanic-Serving Institutions;
                    ``(D) Tribal Colleges and Universities;
                    ``(E) Asian American and Pacific Islander-serving 
                institutions;
                    ``(F) institutions that have programs to recruit 
                and retain underrepresented minority health 
                professionals, in which a significant number of the 
                enrolled participants are underrepresented minorities;
                    ``(G) health professional associations, which may 
                include underrepresented minority health professional 
                associations; and
                    ``(H) institutions--
                            ``(i) located in communities with 
                        predominantly underrepresented minority 
                        populations;
                            ``(ii) with whom partnerships have been 
                        formed for the purpose of increasing workforce 
                        diversity; and
                            ``(iii) in which at least 20 percent of the 
                        enrolled participants are underrepresented 
                        minorities; and
            ``(2) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require.
    ``(c) Use of Funds.--Amounts received under a grant under 
subsection (a) shall be used to expand existing workforce diversity 
programs, implement new workforce diversity programs, or evaluate 
existing or new workforce diversity programs, including with respect to 
mental health care professions. Such programs shall enhance diversity 
by considering minority status as part of an individualized 
consideration of qualifications. Possible activities may include--
            ``(1) educational outreach programs relating to 
        opportunities in the health professions;
            ``(2) scholarship, fellowship, grant, loan repayment, and 
        loan cancellation programs;
            ``(3) post-baccalaureate programs;
            ``(4) academic enrichment programs, particularly targeting 
        those who would not be competitive for health professions 
        schools;
            ``(5) kindergarten through 12th grade and other health 
        pipeline programs;
            ``(6) mentoring programs;
            ``(7) internship or rotation programs involving hospitals, 
        health systems, health plans and other health entities;
            ``(8) community partnership development for purposes 
        relating to workforce diversity; or
            ``(9) leadership training.
    ``(d) Reports.--Not later than 1 year after receiving a grant under 
this section, and annually for the term of the grant, a grantee shall 
submit to the Secretary a report that summarizes and evaluates all 
activities conducted under the grant.
    ``(e) Definition.--In this section, the term `Asian American and 
Pacific Islander-serving institutions' means institutions--
            ``(1) that are eligible institutions under section 312(b) 
        of the Higher Education Act of 1965; and
            ``(2) that, at the time of their application, have an 
        enrollment of undergraduate students that is made up of at 
        least 10 percent Asian American and Pacific Islander students.
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.

``SEC. 2917. CAREER DEVELOPMENT FOR SCIENTISTS AND RESEARCHERS.

    ``(a) In General.--The Secretary, acting through the Director of 
the National Institutes of Health, the Director of the Centers for 
Disease Control and Prevention, the Commissioner of Food and Drugs, and 
the Director of the Agency for Healthcare Research and Quality, shall 
award grants that expand existing opportunities for scientists and 
researchers and promote the inclusion of underrepresented minorities in 
the health professions.
    ``(b) Research Funding.--The head of each entity within the 
Department of Health and Human Services shall establish or expand 
existing programs to provide research funding to scientists and 
researchers in-training. Under such programs, the head of each such 
entity shall give priority in allocating research funding to support 
health research in traditionally underserved communities, including 
underrepresented minority communities, and research classified as 
community or participatory.
    ``(c) Data Collection.--The head of each entity within the 
Department of Health and Human Services shall collect data on the 
number (expressed as an absolute number and a percentage) of 
underrepresented minority and nonminority applicants who receive and 
are denied agency funding at every stage of review. Such data shall be 
reported annually to the Secretary and the appropriate committees of 
Congress.
    ``(d) Student Loan Reimbursement.--The Secretary shall establish a 
student loan reimbursement program to provide student loan 
reimbursement assistance to researchers who focus on racial and ethnic 
disparities in health. The Secretary shall promulgate regulations to 
define the scope and procedures for the program under this subsection.
    ``(e) Student Loan Cancellation.--The Secretary shall establish a 
student loan cancellation program to provide student loan cancellation 
assistance to researchers who focus on racial and ethnic disparities in 
health. Students participating in the program shall make a minimum 5-
year commitment to work at an accredited health profession school. The 
Secretary shall promulgate additional regulations to define the scope 
and procedures for the program under this subsection.
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.

``SEC. 2918. CAREER SUPPORT FOR NON-RESEARCH HEALTH PROFESSIONALS.

    ``(a) In General.--The Secretary, acting through the Director of 
the Centers for Disease Control and Prevention, the Administrator of 
the Substance Abuse and Mental Health Services Administration, the 
Administrator of the Health Resources and Services Administration, and 
the Administrator of the Centers for Medicare and Medicaid Services 
shall establish a program to award grants to eligible individuals for 
career support in non-research-related healthcare.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a) an individual shall--
            ``(1) be a student in a health professions school, a 
        graduate of such a school who is working in a health 
        profession, or a faculty member of such a school; and
            ``(2) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require.
    ``(c) Use of Funds.--An individual shall use amounts received under 
a grant under this section to--
            ``(1) support the individual's health activities or 
        projects that involve underserved communities, including racial 
        and ethnic minority communities;
            ``(2) support health-related career advancement activities; 
        and
            ``(3) to pay, or as reimbursement for payments of, student 
        loans for individuals who are health professionals and are 
        focused on health issues affecting underserved communities, 
        including racial and ethnic minority communities.
    ``(d) Definition.--In this section, the term `career in non-
research-related healthcare' means employment or intended employment in 
the field of public health, health policy, health management, health 
administration, medicine, nursing, pharmacy, allied health, community 
health, or other fields determined appropriate by the Secretary, other 
than in a position that involves research.
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.

``SEC. 2919. RESEARCH ON THE EFFECT OF WORKFORCE DIVERSITY ON QUALITY.

    ``(a) In General.--The Director of the Agency for Healthcare 
Research and Quality, in collaboration with the Deputy Assistant 
Secretary for Minority Health Disparity Elimination and the Director of 
the National Center on Minority Health and Health Disparities, shall 
award grants to eligible entities to expand research on the link 
between health workforce diversity and quality healthcare.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a) an entity shall--
            ``(1) be a clinical, public health, or health services 
        research entity or other entity determined appropriate by the 
        Director; and
            ``(2) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require.
    ``(c) Use of Funds.--Amounts received under a grant awarded under 
subsection (a) shall be used to support research that investigates the 
effect of health workforce diversity on--
            ``(1) language access;
            ``(2) cultural competence;
            ``(3) patient satisfaction;
            ``(4) timeliness of care;
            ``(5) safety of care;
            ``(6) effectiveness of care;
            ``(7) efficiency of care;
            ``(8) patient outcomes;
            ``(9) community engagement;
            ``(10) resource allocation;
            ``(11) organizational structure; or
            ``(12) other topics determined appropriate by the Director.
    ``(d) Priority.--In awarding grants under subsection (a), the 
Director shall give individualized consideration to all relevant 
aspects of the applicant's background. Consideration of prior research 
experience involving the health of underserved communities shall be 
such a factor.
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.

``SEC. 2920. HEALTH DISPARITIES EDUCATION PROGRAM.

    ``(a) Establishment.--The Secretary, acting through the National 
Center on Minority Health and Health Disparities and in collaboration 
with the Office of Minority Health Disparity Elimination, the Office 
for Civil Rights, the Centers for Disease Control and Prevention, the 
Centers for Medicare and Medicaid Services, the Health Resources and 
Services Administration, and other appropriate public and private 
entities, shall establish and coordinate a health and healthcare 
disparities education program to support, develop, and implement 
educational initiatives and outreach strategies that inform healthcare 
professionals and the public about the existence of and methods to 
reduce racial and ethnic disparities in health and healthcare.
    ``(b) Activities.--The Secretary, through the education program 
established under subsection (a) shall, through the use of public 
awareness and outreach campaigns targeting the general public and the 
medical community at large--
            ``(1) disseminate scientific evidence for the existence and 
        extent of racial and ethnic disparities in healthcare, 
        including disparities that are not otherwise attributable to 
        known factors such as access to care, patient preferences, or 
        appropriateness of intervention, as described in the 2002 
        Institute of Medicine Report, Unequal Treatment;
            ``(2) disseminate new research findings to healthcare 
        providers and patients to assist them in understanding, 
        reducing, and eliminating health and healthcare disparities;
            ``(3) disseminate information about the impact of 
        linguistic and cultural barriers on healthcare quality and the 
        obligation of health providers who receive Federal financial 
        assistance to ensure that people with limited English 
        proficiency have access to language access services;
            ``(4) disseminate information about the importance and 
        legality of racial, ethnic, and primary language data 
        collection, analysis, and reporting;
            ``(5) design and implement specific educational initiatives 
        to health care providers relating to health and health care 
        disparities;
            ``(6) assess the impact of the programs established under 
        this section in raising awareness of health and healthcare 
        disparities and providing information on available resources.
    ``(c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.

``SEC. 2920A. CULTURAL COMPETENCE TRAINING FOR HEALTHCARE 
              PROFESSIONALS.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Health Resources and Services Administration, the Deputy 
Assistant Secretary for Minority Health Disparity Elimination, and the 
Director of the National Center for Minority Health and Health 
Disparities, shall award grants to eligible entities to test, 
implement, and evaluate models of cultural competence training, 
including continuing education, for healthcare providers in 
coordination with the initiative under section 2920(a).
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a), an entity shall--
            ``(1) be an academic medical center, a health center or 
        clinic, a hospital, a health plan, a health system, or a health 
        care professional guild (including a mental health care 
        professional guild);
            ``(2) partner with a minority serving institution, minority 
        professional association, or community-based organization 
        representing minority populations, in addition to a research 
        institution to carry out activities under this grant; and
            ``(3) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require.
    ``(c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.''.

SEC. 202. HEALTH CAREERS OPPORTUNITY PROGRAM.

    (a) Purpose.--It is the purpose of this section to diversify the 
healthcare workforce by increasing the number of individuals from 
disadvantaged backgrounds in the health and allied health professions 
by enhancing the academic skills of students from disadvantaged 
backgrounds and supporting them in successfully competing, entering, 
and graduating from health professions training programs.
    (b) Authorization of Appropriations.--Section 740(c) of the Public 
Health Service Act (42 U.S.C. 293d(c)) is amended by striking 
``$29,400,000'' and all that follows through ``2002'' and inserting 
``$50,000,000 for fiscal year 2007, and such sums as may be necessary 
for each of fiscal years 2008 through 2012''.

SEC. 203. PROGRAM OF EXCELLENCE IN HEALTH PROFESSIONS EDUCATION FOR 
              UNDERREPRESENTED MINORITIES.

    (a) Purpose.--It is the purpose of this section to diversify the 
healthcare workforce by supporting programs of excellence in designated 
health professions schools that demonstrate a commitment to 
underrepresented minority populations with a focus on minority health 
issues, cultural and linguistic competence, and eliminating health 
disparities.
    (b) Authorization of Appropriation.--Section 737(h)(1) of the 
Public Health Service Act (42 U.S.C. 293(h)(1)) is amended to read as 
follows:
            ``(1) Authorization of appropriations.--For the purpose of 
        making grants under subsection (a), there are authorized to be 
        appropriated $50,000,000 for fiscal year 2007, and such sums as 
        may be necessary for each of the fiscal years 2008 through 
        2012.''.

SEC. 204. HISPANIC-SERVING HEALTH PROFESSIONS SCHOOLS.

    Part B of title VII of the Public Health Service Act (42 U.S.C. 293 
et seq.) is amended by adding at the end the following:

``SEC. 742. HISPANIC-SERVING HEALTH PROFESSIONS SCHOOLS.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Health Resources and Services Administration, shall award grants 
to Hispanic-serving health professions schools for the purpose of 
carrying out programs to recruit Hispanic individuals to enroll in and 
graduate from such schools, which may include providing scholarships 
and other financial assistance as appropriate.
    ``(b) Eligibility.--In subsection (a), the term `Hispanic-serving 
health professions school' means an entity that--
            ``(1) is a school or program under section 799B;
            ``(2) has an enrollment of full-time equivalent students 
        that is made up of at least 9 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.''.

SEC. 205. HEALTH PROFESSIONS STUDENT LOAN FUND; AUTHORIZATIONS OF 
              APPROPRIATIONS REGARDING STUDENTS FROM DISADVANTAGED 
              BACKGROUNDS.

    Section 724(f)(1) of the Public Health Service Act (42 U.S.C. 
292t(f)(1)) is amended by striking ``$8,000,000'' and all that follows 
and inserting ``$35,000,000 for fiscal year 2007, and such sums as may 
be necessary for each of the fiscal years 2008 through 2012.''.

SEC. 206. NATIONAL HEALTH SERVICE CORPS; RECRUITMENT AND FELLOWSHIPS 
              FOR INDIVIDUALS FROM DISADVANTAGED BACKGROUNDS.

    (a) In General.--Section 331(b) of the Public Health Service Act 
(42 U.S.C. 254d(b)) is amended by adding at the end the following:
    ``(3) The Secretary shall ensure that the individuals with respect 
to whom activities under paragraphs (1) and (2) are carried out include 
individuals from disadvantaged backgrounds, including activities 
carried out to provide health professions students with information on 
the Scholarship and Repayment Programs.''.
    (b) Assignment of Corps Personnel.--Section 333(a) of the Public 
Health Service Act (42 U.S.C. 254f(a)) is amended by adding at the end 
the following:
    ``(4) In assigning Corps personnel under this section, the 
Secretary shall give preference to applicants who request assignment to 
a federally qualified health center (as defined in section 
1905(l)(2)(B) of the Social Security Act) or to a provider organization 
that has a majority of patients who are minorities or individuals from 
low-income families (families with a family income that is less than 
200 percent of the Official Poverty Line).''.

SEC. 207. LOAN REPAYMENT PROGRAM OF THE CENTERS FOR DISEASE CONTROL AND 
              PREVENTION.

    Section 317F(c) of the Public Health Service Act (42 U.S.C. 247b-
7(c)) is amended--
            (1) by striking ``and'' after ``1994,''; and
            (2) by inserting before the period the following: 
        ``$750,000 for fiscal year 2007, and such sums as may be 
        necessary for each of the fiscal years 2008 through 2012.''.

SEC. 208. COOPERATIVE AGREEMENTS FOR ONLINE DEGREE PROGRAMS AT SCHOOLS 
              OF PUBLIC HEALTH AND SCHOOLS OF ALLIED HEALTH.

    Part B of title VII of the Public Health Service Act (42 U.S.C. 293 
et seq.), as amended by section 204, is further amended by adding at 
the end the following:

``SEC. 743. COOPERATIVE AGREEMENTS FOR ONLINE DEGREE PROGRAMS.

    ``(a) Cooperative Agreements.--The Secretary, acting through the 
Administrator of the Health Resources and Services Administration, in 
consultation with the Director of the Centers for Disease Control and 
Prevention, the Director of the Agency for Healthcare Research and 
Quality, and the Deputy Assistant Secretary for Minority Health 
Disparity Elimination, shall award cooperative agreements to schools of 
public health and schools of allied health to design and implement 
online degree programs.
    ``(b) Priority.--In awarding cooperative agreements under this 
section, the Secretary shall give priority to any school of public 
health or school of allied health that has an established track record 
of serving medically underserved communities.
    ``(c) Requirements.--Awardees must design and implement an online 
degree program, that meet the following restrictions:
            ``(1) Enrollment of individuals who have obtained a 
        secondary school diploma or its recognized equivalent.
            ``(2) Maintaining a significant enrollment of 
        underrepresented minority or disadvantaged students.
    ``(d) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.''.

SEC. 209. MID-CAREER HEALTH PROFESSIONS SCHOLARSHIP PROGRAM.

    Part B of title VII of the Public Health Service Act (as amended by 
section 208) is further amended by adding at the end the following:

``SEC. 744. MID-CAREER HEALTH PROFESSIONS SCHOLARSHIP PROGRAM.

    ``(a) In General.--The Secretary may make grants to eligible 
schools for awarding scholarships to eligible individuals to attend the 
school involved, for the purpose of enabling the individuals to make a 
career change from a non-health profession to a health profession.
    ``(b) Expenses.--Amounts awarded as a scholarship under this 
section--
            ``(1) subject to paragraph (2), may be expended only for 
        tuition expenses, other reasonable educational expenses, and 
        reasonable living expenses incurred in the attendance of the 
        school involved; and
            ``(2) may be expended for stipends to eligible individuals 
        for the enrolled period at eligible schools, except that such a 
        stipend may not be provided to an individual for more than 4 
        years, and such a stipend may not exceed $35,000 per year 
        (notwithstanding any other provision of law regarding the 
        amount of stipends).
    ``(c) Definitions.--In this section:
            ``(1) Eligible school.--The term `eligible school' means a 
        school of medicine, osteopathic medicine, dentistry, nursing 
        (as defined in section 801), pharmacy, podiatric medicine, 
        optometry, veterinary medicine, public health, chiropractic, or 
        allied health, a school offering a graduate program in mental 
        and behavioral health practice, or an entity providing programs 
        for the training of physician assistants.
            ``(2) Eligible individual.--The term `eligible individual' 
        means an individual who has obtained a secondary school diploma 
        or its recognized equivalent.
    ``(d) Priority.--In providing scholarships to eligible individuals, 
eligible schools shall give to individuals from disadvantaged 
backgrounds.
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.''.

SEC. 210. STRENGTHENING AND EXPANDING RURAL HEALTH PROVIDER NETWORKS.

    Section 330A of the Public Health Service Act (42 U.S.C. 254c) is 
amended--
            (1) in subsection (h), by adding at the end the following:
            ``(4) Rural minority, border, and indian populations.--In 
        making grants under this section, the Director of the Office of 
        Rural Health Policy of the Health Resources and Services 
        Administration, in coordination with the Director of the Indian 
        Health Service and the Deputy Assistant Secretary for Minority 
        Health Disparity Elimination, shall make grants to entities 
        that serve rural minority, border, and Indian populations.
            ``(5) Diversity health training programs.--The Director of 
        the Office of Rural Health Policy of the Health Resources and 
        Services Administration, in coordination with the Director of 
        the Indian Health Service and the Deputy Assistant Secretary 
        for Minority Health Disparity Elimination, shall coordinate the 
        awarding of grants under this section with the awarding of 
        grants and contracts under section 765 to connect and integrate 
        diversity health training programs.''; and
            (2) in subsection (k), as redesignated by this section, by 
        striking ``and such sums as may be necessary for each of fiscal 
        years 2003 through 2006'' and inserting ``, such sums as may be 
        necessary for each of fiscal years 2003 through 2005, and 
        $60,000,000 for each of fiscal years 2006 through 2010''.

SEC. 211. NATIONAL REPORT ON THE PREPAREDNESS OF HEALTH PROFESSIONALS 
              TO CARE FOR DIVERSE POPULATIONS.

    The Secretary of Health and Human Services shall include in the 
report prepared under section 1707(c) of the Public Health Service Act 
(as added by section 404 of this Act), information relating to the 
preparedness of health professionals to care for racially and 
ethnically diverse populations. Such information, which shall be 
collected by the Bureau of Health Professions, shall include--
            (1) with respect to health professions education, the 
        number and percentage of hours of classroom discussion relating 
        to minority health issues, including cultural competence;
            (2) a description of the coursework involved in such 
        education;
            (3) a description of the results of an evaluation of the 
        preparedness of students in such education;
            (4) a description of the types of exposure that students 
        have during their education to minority patient populations; 
        and
            (5) a description of model programs and practices.

SEC. 212. SCHOLARSHIP AND FELLOWSHIP PROGRAMS.

    Subtitle A of title XXIX of the Public Health Service Act, as 
amended by section 201, is further amended by adding at the end the 
following:

``SEC. 2920B. DAVID SATCHER PUBLIC HEALTH AND HEALTH SERVICES CORPS.

    ``(a) In General.--The Administrator of the Health Resources and 
Services Administration and Director of the Centers for Disease Control 
and Prevention, in collaboration with the Deputy Assistant Secretary 
for Minority Health Disparity Elimination, shall award grants to 
eligible entities to increase awareness among post-primary and post-
secondary students of career opportunities in the health professions.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a) an entity shall--
            ``(1) be a clinical, public health or health services 
        organization, community-based or non-profit entity, or other 
        entity determined appropriate by the Director of the Centers 
        for Disease Control and Prevention;
            ``(2) serve a health professional shortage area, as 
        determined by the Secretary;
            ``(3) work with students, including those from racial and 
        ethnic minority backgrounds, that have expressed an interest in 
        the health professions; and
            ``(4) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require.
    ``(c) Use of Funds.--Grant awards under subsection (a) shall be 
used to support internships that will increase awareness among students 
of non-research based and career opportunities in the following health 
professions:
            ``(1) Medicine.
            ``(2) Nursing.
            ``(3) Public Health.
            ``(4) Pharmacy.
            ``(5) Health Administration and Management.
            ``(6) Health Policy.
            ``(7) Psychology.
            ``(8) Dentistry.
            ``(9) International Health.
            ``(10) Social Work.
            ``(11) Allied Health.
            ``(12) Hospice.
            ``(13) Other professions deemed appropriate by the Director 
        of the Centers for Disease Control and Prevention.
    ``(d) Priority.--In awarding grants under subsection (a), the 
Director of the Centers for Disease Control and Prevention shall give 
priority to those entities that--
            ``(1) serve a high proportion of individuals from 
        disadvantaged backgrounds;
            ``(2) have experience in health disparity elimination 
        programs;
            ``(3) facilitate the entry of disadvantaged individuals 
        into institutions of higher education; and
            ``(4) provide counseling or other services designed to 
        assist disadvantaged individuals in successfully completing 
        their education at the post-secondary level.
    ``(e) Stipends.--The Secretary may approve stipends under this 
section for individuals for any period of education in student-
enhancement programs (other than regular courses) at health professions 
schools, programs, or entities, except that such a stipend may not be 
provided to an individual for more than 6 months, and such a stipend 
may not exceed $20 per day (notwithstanding any other provision of law 
regarding the amount of stipends).
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.

``SEC. 2920C. LOUIS STOKES PUBLIC HEALTH SCHOLARS PROGRAM.

    ``(a) In General.--The Director of the Centers for Disease Control 
and Prevention, in collaboration with the Deputy Assistant Secretary 
for Minority Health Disparity Elimination, shall award scholarships to 
postsecondary students who seek a career in public health.
    ``(b) Eligibility.--To be eligible to receive a scholarship under 
subsection (a) an individual shall--
            ``(1) have experience in public health research or public 
        health practice, or other health professions as determined 
        appropriate by the Director of the Centers for Disease Control 
        and Prevention;
            ``(2) reside in a health professional shortage area as 
        determined by the Secretary;
            ``(3) have expressed an interest in public health;
            ``(4) demonstrate promise for becoming a leader in public 
        health;
            ``(5) secure admission to a 4-year institution of higher 
        education;
            ``(6) comply with subsection (f); and
            ``(7) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require.
    ``(c) Use of Funds.--Amounts received under an award under 
subsection (a) shall be used to support opportunities for students to 
become public health professionals.
    ``(d) Priority.--In awarding grants under subsection (a), the 
Director shall give priority to those students that--
            ``(1) are from disadvantaged backgrounds;
            ``(2) have secured admissions to a minority serving 
        institution; and
            ``(3) have identified a health professional as a mentor at 
        their school or institution and an academic advisor to assist 
        in the completion of their baccalaureate degree.
    ``(e) Scholarships.--The Secretary may approve payment of 
scholarships under this section for such individuals for any period of 
education in student undergraduate tenure, except that such a 
scholarship may not be provided to an individual for more than 4 years, 
and such scholarships may not exceed $10,000 per academic year 
(notwithstanding any other provision of law regarding the amount of 
scholarship).
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.

``SEC. 2920D. PATSY MINK HEALTH AND GENDER RESEARCH FELLOWSHIP PROGRAM.

    ``(a) In General.--The Director of the Centers for Disease Control 
and Prevention, in collaboration with the Deputy Assistant Secretary 
for Minority Health Disparity Elimination, the Administrator of the 
Substance Abuse and Mental Health Services Administration, and the 
Director of the Indian Health Services, shall award research 
fellowships to post-baccalaureate students to conduct research that 
will examine gender and health disparities and to pursue a career in 
the health professions.
    ``(b) Eligibility.--To be eligible to receive a fellowship under 
subsection (a) an individual shall--
            ``(1) have experience in health research or public health 
        practice;
            ``(2) reside in a health professional shortage area as 
        determined by the Secretary;
            ``(3) have expressed an interest in the health professions;
            ``(4) demonstrate promise for becoming a leader in the 
        field of women's health;
            ``(5) secure admission to a health professions school or 
        graduate program with an emphasis in gender studies;
            ``(6) comply with subsection (f); and
            ``(7) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require.
    ``(c) Use of Funds.--Amounts received under an award under 
subsection (a) shall be used to support opportunities for students to 
become researchers and advance the research base on the intersection 
between gender and health.
    ``(d) Priority.--In awarding grants under subsection (a), the 
Director of the Centers for Disease Control and Prevention shall give 
priority to those applicants that--
            ``(1) are from disadvantaged backgrounds; and
            ``(2) have identified a mentor and academic advisor who 
        will assist in the completion of their graduate or professional 
        degree and have secured a research assistant position with a 
        researcher working in the area of gender and health.
    ``(e) Fellowships.--The Director of the Centers for Disease Control 
and Prevention may approve fellowships for individuals under this 
section for any period of education in the student's graduate or health 
profession tenure, except that such a fellowship may not be provided to 
an individual for more than 3 years, and such a fellowship may not 
exceed $18,000 per academic year (notwithstanding any other provision 
of law regarding the amount of fellowship).
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.

``SEC. 2920E. PAUL DAVID WELLSTONE INTERNATIONAL HEALTH FELLOWSHIP 
              PROGRAM.

    ``(a) In General.--The Director of the Agency for Healthcare 
Research and Quality, in collaboration with the Deputy Assistant 
Secretary for Minority Health Disparity Elimination, shall award 
research fellowships to college students or recent graduates to advance 
their understanding of international health.
    ``(b) Eligibility.--To be eligible to receive a fellowship under 
subsection (a) an individual shall--
            ``(1) have educational experience in the field of 
        international health;
            ``(2) reside in a health professional shortage area as 
        determined by the Secretary;
            ``(3) demonstrate promise for becoming a leader in the 
        field of international health;
            ``(4) be a college senior or recent graduate of a four year 
        higher education institution;
            ``(5) comply with subsection (f); and
            ``(6) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require.
    ``(c) Use of Funds.--Amounts received under an award under 
subsection (a) shall be used to support opportunities for students to 
become health professionals and to advance their knowledge about 
international issues relating to healthcare access and quality.
    ``(d) Priority.--In awarding grants under subsection (a), the 
Director shall give priority to those applicants that--
            ``(1) are from a disadvantaged background; and
            ``(2) have identified a mentor at a health professions 
        school or institution, an academic advisor to assist in the 
        completion of their graduate or professional degree, and an 
        advisor from an international health Non-Governmental 
        Organization, Private Volunteer Organization, or other 
        international institution or program that focuses on increasing 
        healthcare access and quality for residents in developing 
        countries.
    ``(e) Fellowships.--The Secretary shall approve fellowships for 
college seniors or recent graduates, except that such a fellowship may 
not be provided to an individual for more than 6 months, may not be 
awarded to a graduate that has not been enrolled in school for more 
than 1 year, and may not exceed $4,000 per academic year 
(notwithstanding any other provision of law regarding the amount of 
fellowship).
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.

``SEC. 2920F. EDWARD R. ROYBAL HEALTHCARE SCHOLAR PROGRAM.

    ``(a) In General.--The Director of the Agency for Healthcare 
Research and Quality, the Director of the Centers for Medicaid and 
Medicare, and the Administrator for Health Resources and Services 
Administration, in collaboration with the Deputy Assistant Secretary 
for Minority Health Disparity Elimination, shall award grants to 
eligible entities to expose entering graduate students to the health 
professions.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a) an entity shall--
            ``(1) be a clinical, public health or health services 
        organization, community-based or non-profit entity, or other 
        entity determined appropriate by the Director of the Agency for 
        Healthcare Research and Quality;
            ``(2) serve in a health professional shortage area as 
        determined by the Secretary;
            ``(3) work with students obtaining a degree in the health 
        professions; and
            ``(4) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require.
    ``(c) Use of Funds.--Amounts received under a grant awarded under 
subsection (a) shall be used to support opportunities that expose 
students to non-research based health professions, including--
            ``(1) public health policy;
            ``(2) healthcare and pharmaceutical policy;
            ``(3) healthcare administration and management;
            ``(4) health economics; and
            ``(5) other professions determined appropriate by the 
        Director of the Agency for Healthcare Research and Quality.
    ``(d) Priority.--In awarding grants under subsection (a), the 
Director of the Agency for Healthcare Research and Quality shall give 
priority to those entities that--
            ``(1) have experience with health disparity elimination 
        programs;
            ``(2) facilitate training in the fields described in 
        subsection (c); and
            ``(3) provide counseling or other services designed to 
        assist such individuals in successfully completing their 
        education at the post-secondary level.
    ``(e) Stipends.--The Secretary may approve the payment of stipends 
for individuals under this section for any period of education in 
student-enhancement programs (other than regular courses) at health 
professions schools or entities, except that such a stipend may not be 
provided to an individual for more than 2 months, and such a stipend 
may not exceed $100 per day (notwithstanding any other provision of law 
regarding the amount of stipends).
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2007 through 2012.''.

SEC. 213. ADVISORY COMMITTEE ON HEALTH PROFESSIONS TRAINING FOR 
              DIVERSITY.

    (a) Establishment.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary'') shall establish an 
advisory committee to be known as the Advisory Committee on Health 
Professions Training for Diversity (in this section referred to as the 
``Advisory Committee'').
    (b) Composition.--
            (1) In general.--The Secretary shall determine the 
        appropriate number of individuals to serve on the Advisory 
        Committee. Such individuals shall not be officers or employees 
        of the Federal Government.
            (2) Appointment.--Not later than 60 days after the date of 
        enactment of this section, the Secretary shall appoint the 
        members of the Advisory Committee from among individuals who 
        are health professionals. In making such appointments, the 
        Secretary shall ensure a fair balance between the health 
        professions, that at least 75 percent of the members of the 
        Advisory Committee are health professionals, a broad geographic 
        representation of members and a balance between urban and rural 
        members. Members shall be appointed based on their competence, 
        interest, and knowledge of the mission of the profession 
        involved.
            (3) Minority representation.--In appointing the members of 
        the Advisory Committee under paragraph (2), the Secretary shall 
        ensure the adequate representation of women and minorities.
    (c) Terms.--
            (1) In general.--A member of the Advisory Committee shall 
        be appointed for a term of 3 years, except that of the members 
        first appointed--
                    (A) \1/3\ of such members shall serve for a term of 
                1 year;
                    (B) \1/3\ of such members shall serve for a term of 
                2 years; and
                    (C) \1/3\ of such members shall serve for a term of 
                3 years.
            (2) Vacancies.--
                    (A) In general.--A vacancy on the Advisory 
                Committee shall be filled in the manner in which the 
                original appointment was made and shall be subject to 
                any conditions which applied with respect to the 
                original appointment.
                    (B) Filling unexpired term.--An individual chosen 
                to fill a vacancy shall be appointed for the unexpired 
                term of the member replaced.
    (d) Duties.--
            (1) In general.--The Advisory Committee shall--
                    (A) provide advice and recommendations to the 
                Secretary concerning policy and program development and 
                other matters of significance concerning activities 
                under this part; and
                    (B) not later than 2 years after the date of 
                enactment of this section, and annually thereafter, 
                prepare and submit to the Secretary, and the Committee 
                on Health, Education, Labor and Pensions of the Senate, 
                and the Committee on Energy and Commerce of the House 
                of Representatives, a report describing the activities 
                of the Committee.
            (2) Consultation with students.--In carrying out duties 
        under paragraph (1), the Advisory Committee shall consult with 
        individuals who are attending health professions schools with 
        which this part is concerned.
    (e) Meetings and Documents.--
            (1) Meetings.--The Advisory Committee shall meet not less 
        than 2 times each year. Such meetings shall be held jointly 
        with other related entities established under this title where 
        appropriate.
            (2) Documents.--Not later than 14 days prior to the 
        convening of a meeting under paragraph (1), the Advisory 
        Committee shall prepare and make available an agenda of the 
        matters to be considered by the Advisory Committee at such 
        meeting. At any such meeting, the Advisory Committee shall 
        distribute materials with respect to the issues to be addressed 
        at the meeting. Not later than 30 days after the adjourning of 
        such a meeting, the Advisory Committee shall prepare and make 
        available a summary of the meeting and any actions taken by the 
        Committee based upon the meeting.
    (f) Compensation and Expenses.--
            (1) Compensation.--Each member of the Advisory Committee 
        shall be compensated at a rate equal to the daily equivalent of 
        the annual rate of basic pay prescribed for level IV of the 
        Executive Schedule under section 5315 of title 5, United States 
        Code, for each day (including travel time) during which such 
        member is engaged in the performance of the duties of the 
        Committee.
            (2) Expenses.--The members of the Advisory Committee shall 
        be allowed travel expenses, including per diem in lieu of 
        subsistence, at rates authorized for employees of agencies 
        under subchapter I of chapter 57 of title 5, United States 
        Code, while away from their homes or regular places of business 
        in the performance of services for the Committee.
    (g) FACA.--The Federal Advisory Committee Act shall apply to the 
Advisory Committee under this section only to the extent that the 
provisions of such Act do not conflict with the requirements of this 
section.

SEC. 214. MCNAIR POSTBACCALAUREATE ACHIEVEMENT PROGRAM.

    Section 402E of the Higher Education Act of 1965 (20 U.S.C. 1070a-
15) is amended by striking subsection (f) and inserting the following:
    ``(f) Collaboration in Health Profession Diversity Training 
Programs.--The Secretary of Education shall coordinate with the 
Secretary of Health and Human Services to ensure that there is 
collaboration between the goals of the program under this section and 
programs of the Health Resources and Services Administration that 
promote health workforce diversity. The Secretary of Education shall 
take such measures as may be necessary to encourage participants in 
programs under this section to consider health profession careers.
    ``(g) Funding.--From amounts appropriated pursuant to the authority 
of section 402A(f), the Secretary shall, to the extent practicable, 
allocate funds for projects authorized by this section in an amount 
which is not less than $31,000,000 for each of the fiscal years 2006 
through 2012.''.

                TITLE III--DATA COLLECTION AND REPORTING

SEC. 301. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.

    (a) Purpose.--It is the purpose of this section to promote data 
collection, analysis, and reporting by race, ethnicity, and primary 
language among federally supported health programs.
    (b) Amendment.--Title XXIX of the Public Health Service Act, as 
amended by title II of this Act, is further amended by adding at the 
end the following:

 ``Subtitle B--Strengthening Data Collection, Improving Data Analysis, 
                      and Expanding Data Reporting

``SEC. 2931. DATA ON RACE, ETHNICITY, AND PRIMARY LANGUAGE.

    ``(a) Requirements.--
            ``(1) In general.--Each health-related program operated by 
        or that receives funding or reimbursement, in whole or in part, 
        either directly or indirectly from the Department of Health and 
        Human Services shall--
                    ``(A) require the collection, by the agency or 
                program involved, of data on the race, ethnicity, and 
                primary language of each applicant for and recipient of 
                health-related assistance under such program--
                            ``(i) using, at a minimum, the categories 
                        for race and ethnicity described in the 1997 
                        Office of Management and Budget Standards for 
                        Maintaining, Collecting, and Presenting Federal 
                        Data on Race and Ethnicity;
                            ``(ii) using the standards developed under 
                        subsection (e) for the collection of language 
                        data;
                            ``(iii) where practicable, collecting data 
                        for additional population groups if such groups 
                        can be aggregated into the minimum race and 
                        ethnicity categories; and
                            ``(iv) where practicable, through self-
                        report;
                    ``(B) with respect to the collection of the data 
                described in subparagraph (A) for applicants and 
                recipients who are minors or otherwise legally 
                incapacitated, require that--
                            ``(i) such data be collected from the 
                        parent or legal guardian of such an applicant 
                        or recipient; and
                            ``(ii) the preferred language of the parent 
                        or legal guardian of such an applicant or 
                        recipient be collected;
                    ``(C) systematically analyze such data using the 
                smallest appropriate units of analysis feasible to 
                detect racial and ethnic disparities in health and 
                healthcare and when appropriate, for men and women 
                separately, and report the results of such analysis to 
                the Secretary, the Director of the Office for Civil 
                Rights, the Committee on Health, Education, Labor, and 
                Pensions and the Committee on Finance of the Senate, 
                and the Committee on Energy and Commerce and the 
                Committee on Ways and Means of the House of 
                Representatives;
                    ``(D) provide such data to the Secretary on at 
                least an annual basis; and
                    ``(E) ensure that the provision of assistance to an 
                applicant or recipient of assistance is not denied or 
                otherwise adversely affected because of the failure of 
                the applicant or recipient to provide race, ethnicity, 
                and primary language data.
            ``(2) Rules of construction.--Nothing in this subsection 
        shall be construed to--
                    ``(A) permit the use of information collected under 
                this subsection in a manner that would adversely affect 
                any individual providing any such information; and
                    ``(B) require health care providers to collect 
                data.
    ``(b) Protection of Data.--The Secretary shall ensure (through the 
promulgation of regulations or otherwise) that all data collected 
pursuant to subsection (a) is protected--
            ``(1) under the same privacy protections as the Secretary 
        applies to other health data under the regulations promulgated 
        under section 264(c) of the Health Insurance Portability and 
        Accountability Act of 1996 (Public Law 104-191; 110 Stat. 2033) 
        relating to the privacy of individually identifiable health 
        information and other protections; and
            ``(2) from all inappropriate internal use by any entity 
        that collects, stores, or receives the data, including use of 
        such data in determinations of eligibility (or continued 
        eligibility) in health plans, and from other inappropriate 
        uses, as defined by the Secretary.
    ``(c) National Plan of the Data Council.--The Secretary shall 
develop and implement a national plan to improve the collection, 
analysis, and reporting of racial, ethnic, and primary language data at 
the Federal, State, territorial, Tribal, and local levels, including 
data to be collected under subsection (a). The Data Council of the 
Department of Health and Human Services, in consultation with the 
National Committee on Vital Health Statistics, the Office of Minority 
Health Disparity Elimination, and other appropriate public and private 
entities, shall make recommendations to the Secretary concerning the 
development, implementation, and revision of the national plan. Such 
plan shall include recommendations on how to--
            ``(1) implement subsection (a) while minimizing the cost 
        and administrative burdens of data collection and reporting;
            ``(2) expand awareness among Federal agencies, States, 
        territories, Indian tribes, health providers, health plans, 
        health insurance issuers, and the general public that data 
        collection, analysis, and reporting by race, ethnicity, and 
        primary language is legal and necessary to assure equity and 
        non-discrimination in the quality of healthcare services;
            ``(3) ensure that future patient record systems have data 
        code sets for racial, ethnic, and primary language identifiers 
        and that such identifiers can be retrieved from clinical 
        records, including records transmitted electronically;
            ``(4) improve health and healthcare data collection and 
        analysis for more population groups if such groups can be 
        aggregated into the minimum race and ethnicity categories, 
        including exploring the feasibility of enhancing collection 
        efforts in States for racial and ethnic groups that comprise a 
        significant proportion of the population of the State;
            ``(5) provide researchers with greater access to racial, 
        ethnic, and primary language data, subject to privacy and 
        confidentiality regulations; and
            ``(6) safeguard and prevent the misuse of data collected 
        under subsection (a).
    ``(d) Compliance With Standards.--Data collected under subsection 
(a) shall be obtained, maintained, and presented (including for 
reporting purposes) in accordance with the 1997 Office of Management 
and Budget Standards for Maintaining, Collecting, and Presenting 
Federal Data on Race and Ethnicity (at a minimum).
    ``(e) Language Collection Standards.--Not later than 1 year after 
the date of enactment of this title, the Deputy Assistant Secretary for 
Minority Health Disparity Elimination, in consultation with the Office 
for Civil Rights of the Department of Health and Human Services, shall 
develop and disseminate Standards for the Classification of Federal 
Data on Preferred Written and Spoken Language.
    ``(f) Technical Assistance for the Collection and Reporting of 
Data.--
            ``(1) In general.--The Secretary may, either directly or 
        through grant or contract, provide technical assistance to 
        enable a healthcare program or an entity operating under such 
        program to comply with the requirements of this section.
            ``(2) Types of assistance.--Assistance provided under this 
        subsection may include assistance to--
                    ``(A) enhance or upgrade computer technology that 
                will facilitate racial, ethnic, and primary language 
                data collection and analysis;
                    ``(B) improve methods for health data collection 
                and analysis including additional population groups 
                beyond the Office of Management and Budget categories 
                if such groups can be aggregated into the minimum race 
                and ethnicity categories;
                    ``(C) develop mechanisms for submitting collected 
                data subject to existing privacy and confidentiality 
                regulations; and
                    ``(D) develop educational programs to inform health 
                insurance issuers, health plans, health providers, 
                health-related agencies, and the general public that 
                data collection and reporting by race, ethnicity, and 
                preferred language are legal and essential for 
                eliminating health and healthcare disparities.
    ``(g) Analysis of Racial and Ethnic Data.--The Secretary, acting 
through the Director of the Agency for Healthcare Research and Quality 
and in coordination with the Administrator of the Centers for Medicare 
and Medicaid Services, shall provide technical assistance to agencies 
of the Department of Health and Human Services in meeting Federal 
standards for race, ethnicity, and primary language data collection and 
analysis of racial and ethnic disparities in health and healthcare in 
public programs by--
            ``(1) identifying appropriate quality assurance mechanisms 
        to monitor for health disparities;
            ``(2) specifying the clinical, diagnostic, or therapeutic 
        measures which should be monitored;
            ``(3) developing new quality measures relating to racial 
        and ethnic disparities in health and healthcare;
            ``(4) identifying the level at which data analysis should 
        be conducted; and
            ``(5) sharing data with external organizations for research 
        and quality improvement purposes.
    ``(h) National Conference.--
            ``(1) In general.--The Secretary shall sponsor a biennial 
        national conference on racial, ethnic, and primary language 
        data collection to enhance coordination, build partnerships, 
        and share best practices in racial, ethnic, and primary 
        language data collection, analysis, and reporting.
            ``(2) Reports.--Not later than 6 months after the date on 
        which a national conference has convened under paragraph (1), 
        the Secretary shall publish in the Federal Register and submit 
        to the Committee on Health, Education, Labor, and Pensions and 
        the Committee on Finance of the Senate and the Committee on 
        Energy and Commerce and the Committee on Ways and Means of the 
        House of Representatives a report concerning the proceedings 
        and findings of the conference.
    ``(i) Report.--Not later than 2 years after the date of enactment 
of this title, and biennially thereafter, the Secretary shall submit to 
the appropriate committees of Congress a report on the effectiveness of 
data collection, analysis, and reporting on race, ethnicity, and 
primary language under the programs and activities of the Department of 
Health and Human Services and under other Federal data collection 
systems with which the Department interacts to collect relevant data on 
race and ethnicity. The report shall evaluate the progress made in the 
Department with respect to the national plan under subsection (c) or 
subsequent revisions thereto.
    ``(j) Definition.--In this section, the term `health-related 
program' mean a program--
            ``(1) under the Social Security Act (42 U.S.C. 301 et seq.) 
        that pay for healthcare and services; and
            ``(2) under this Act that provide Federal financial 
        assistance for healthcare, biomedical research, health services 
        research, and programs designed to improve the public's health.
    ``(k) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.

``SEC. 2932. PROVISIONS RELATING TO NATIVE AMERICANS.

    ``(a) Epidemiology Centers.--
            ``(1) Establishment.--
                    ``(A) In general.--In addition to those centers 
                operating 1 day prior to the date of enactment of this 
                title, (including those centers for which funding is 
                currently being provided through funding agreements 
                under the Indian Self-Determination and Education 
                Assistance Act), the Secretary shall, not later than 
                180 days after such date of enactment, establish and 
                fund an epidemiology center in each service area which 
                does not have such a center to carry out the functions 
                described in subparagraph (B). Any centers established 
                under the preceding sentence may be operated by Indian 
                tribes or tribal organizations pursuant to funding 
                agreements under the Indian Self-Determination and 
                Education Assistance Act, but funding under such 
                agreements may not be divisible.
                    ``(B) Functions.--In consultation with and upon the 
                request of Indian tribes, tribal organizations and 
                urban Indian organizations, each area epidemiology 
                center established under this subsection shall, with 
                respect to such area shall--
                            ``(i) collect data related to the health 
                        status objective described in section 3(b) of 
                        the Indian Health Care Improvement Act, and 
                        monitor the progress that the Service, Indian 
                        tribes, tribal organizations, and urban Indian 
                        organizations have made in meeting such health 
                        status objective;
                            ``(ii) evaluate existing delivery systems, 
                        data systems, and other systems that impact the 
                        improvement of Indian health;
                            ``(iii) assist Indian tribes, tribal 
                        organizations, and urban Indian organizations 
                        in identifying their highest priority health 
                        status objectives and the services needed to 
                        achieve such objectives, based on 
                        epidemiological data;
                            ``(iv) make recommendations for the 
                        targeting of services needed by tribal, urban, 
                        and other Indian communities;
                            ``(v) make recommendations to improve 
                        healthcare delivery systems for Indians and 
                        urban Indians;
                            ``(vi) provide requested technical 
                        assistance to Indian tribes and urban Indian 
                        organizations in the development of local 
                        health service priorities and incidence and 
                        prevalence rates of disease and other illness 
                        in the community; and
                            ``(vii) provide disease surveillance and 
                        assist Indian tribes, tribal organizations, and 
                        urban Indian organizations to promote public 
                        health.
                    ``(C) Technical assistance.--The director of the 
                Centers for Disease Control and Prevention shall 
                provide technical assistance to the centers in carrying 
                out the requirements of this subsection.
            ``(2) Funding.--The Secretary may make funding available to 
        Indian tribes, tribal organizations, and eligible intertribal 
        consortia or urban Indian organizations to conduct 
        epidemiological studies of Indian communities.
    ``(b) Definitions.--For purposes of this section, the definitions 
contained in section 4 of the Indian Health Care Improvement Act shall 
apply.''.

SEC. 302. COLLECTION OF RACE AND ETHNICITY DATA BY THE SOCIAL SECURITY 
              ADMINISTRATION.

    Part A of title XI of the Social Security Act (42 U.S.C. 1301 et 
seq.) is amended by adding at the end the following:

``SEC. 1150A. COLLECTION OF RACE AND ETHNICITY DATA BY THE SOCIAL 
              SECURITY ADMINISTRATION.

    ``(a) Requirement.--The Commissioner of the Social Security 
Administration in consultation with the Administrator of the Centers 
for Medicare and Medicaid Services shall--
            ``(1) require the collection of data on the race, 
        ethnicity, and primary language of all applicants for social 
        security numbers, social security income, social security 
        disability, and medicare--
                    ``(A) using, at a minimum, the categories for race 
                and ethnicity described in the 1997 Office of 
                Management and Budget Standards for Maintaining, 
                Collecting, and Presenting Federal Data on Race and 
                Ethnicity and available language standards; and
                    ``(B) where practicable, collecting data for 
                additional population groups if such groups can be 
                aggregated into the minimum race and ethnicity 
                categories;
            ``(2) with respect to the collection of the data described 
        in paragraph (1) for applicants who are under 18 years of age 
        or otherwise legally incapacitated, require that--
                    ``(A) such data be collected from the parent or 
                legal guardian of such an applicant; and
                    ``(B) the primary language of the parent or legal 
                guardian of such an applicant or recipient be used;
            ``(3) require that such data be uniformly analyzed and 
        reported at least annually to the Commissioner of Social 
        Security;
            ``(4) be responsible for storing the data reported under 
        paragraph (3);
            ``(5) ensure transmission to the Centers for Medicare and 
        Medicaid Services and other Federal health agencies;
            ``(6) provide such data to the Secretary on at least an 
        annual basis; and
            ``(7) ensure that the provision of assistance to an 
        applicant is not denied or otherwise adversely affected because 
        of the failure of the applicant to provide race, ethnicity, and 
        primary language data.
    ``(b) Protection of Data.--The Commissioner of Social Security 
shall ensure (through the promulgation of regulations or otherwise) 
that all data collected pursuant subsection (a) is protected--
            ``(1) under the same privacy protections as the Secretary 
        applies to other health data under the regulations promulgated 
        under section 264(c) of the Health Insurance Portability and 
        Accountability Act of 1996 (Public Law 104-191; 110 Stat. 2033) 
        relating to the privacy of individually identifiable health 
        information and other protections; and
            ``(2) from all inappropriate internal use by any entity 
        that collects, stores, or receives the data, including use of 
        such data in determinations of eligibility (or continued 
        eligibility) in health plans, and from other inappropriate 
        uses, as defined by the Secretary.
    ``(c) National Education Program.--Not later than 18 months after 
the date of enactment of this section, the Secretary, acting through 
the Deputy Assistant Secretary for Minority Health Disparity 
Elimination and in collaboration with the Commissioner of the Social 
Security Administration, shall develop and implement a program to 
educate all populations about the purpose and uses of racial, ethnic, 
and primary language health data collection.
    ``(d) Rule of Construction.--Nothing in this section shall be 
construed to permit the use of information collected under this section 
in a manner that would adversely affect any individual providing any 
such information.
    ``(e) Technical Assistance.--The Secretary may, either directly or 
by grant or contract, provide technical assistance to enable any health 
entity to comply with the requirements of this section.
    ``(f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.''.

SEC. 303. REVISION OF HIPAA CLAIMS STANDARDS.

    (a) In General.--Not later than 1 year after the date of enactment 
of this Act, the Secretary of Health and Human Services shall revise 
the regulations promulgated under part C of title XI of the Social 
Security Act (42 U.S.C. 1320d et seq.), as added by the Health 
Insurance Portability and Accountability Act of 1996 (Public Law 104-
191), relating to the collection of data on race, ethnicity, and 
primary language in a health-related transaction to require--
            (1) the use, at a minimum, of the categories for race and 
        ethnicity described in the 1997 Office of Management and Budget 
        Standards for Maintaining, Collecting, and Presenting Federal 
        Data on Race and Ethnicity;
            (2) the establishment of a new data code set for primary 
        language; and
            (3) the designation of the racial, ethnic, and primary 
        language code sets as ``required'' for claims and enrollment 
        data.
    (b) Dissemination.--The Secretary of Health and Human Services 
shall disseminate the new standards developed under subsection (a) to 
all health entities that are subject to the regulations described in 
such subsection and provide technical assistance with respect to the 
collection of the data involved.
    (c) Compliance.--The Secretary of Health and Human Services shall 
require that health entities comply with the new standards developed 
under subsection (a) not later than 2 years after the final 
promulgation of such standards.

SEC. 304. NATIONAL CENTER FOR HEALTH STATISTICS.

    Section 306(n) of the Public Health Service Act (42 U.S.C. 242k(n)) 
is amended--
            (1) in paragraph (1), by striking ``2005'' and inserting 
        ``2012'';
            (2) in paragraph (2), in the first sentence, by striking 
        ``2005'' and inserting ``2012''; and
            (3) in paragraph (3), by striking ``2002'' and inserting 
        ``2012''.

SEC. 305. GEO-ACCESS STUDY.

    The Administrator of the Substance Abuse and Mental Health Services 
Administration shall--
            (1) conduct a study to--
                    (A) determine which geographic areas of the United 
                States have shortages of specialty mental health 
                providers; and
                    (B) assess the preparedness of speciality mental 
                health providers to deliver culturally and 
                linguistically appropriate services; and
            (2) submit a report to the Congress on the results of such 
        study.

SEC. 306. RACIAL, ETHNIC, AND LINGUISTIC DATA COLLECTED BY THE FEDERAL 
              GOVERNMENT.

    (a) Collection; Submission.--Not later than 90 days after the date 
of the enactment of this Act, and January 31st of each year thereafter, 
each department, agency, and office of the Federal Government that has 
collected racial, ethnic, or linguistic data during the preceding 
calendar year shall submit such data to the Secretary of Health and 
Human Services.
    (b) Analysis; Public Availability; Reporting.--Not later than April 
30, 2007, and each April 30th thereafter, the Secretary of Health and 
Human Services, acting through the Director of the National Center on 
Minority Health and Health Disparities and the Deputy Assistant 
Secretary for Minority Health Disparity Elimination, shall--
            (1) collect and analyze the racial, ethnic, and linguistic 
        data submitted under subsection (a) for the preceding calendar 
        year;
            (2) make publicly available such data and the results of 
        such analysis; and
            (3) submit a report to the Congress on such data and 
        analysis.

                TITLE IV--ACCOUNTABILITY AND EVALUATION

                     Subtitle A--General Provisions

SEC. 401. REPORT ON WORKFORCE DIVERSITY.

    (a) In General.--Not later than July 1, 2007, and annually 
thereafter, the Secretary, acting through the director of each entity 
within the Department of Health and Human Services, shall prepare and 
submit to the Committee on Health, Education, Labor, and Pensions of 
the Senate and the Committee on Energy and Commerce of the House of 
Representatives a report on healthcare workforce diversity.
    (b) Requirement.--The report under subsection (a) shall contain the 
following information:
            (1) The response of the entity involved to the 2004 
        Institute of Medicine report entitled ``In the Nation's 
        Compelling Interest: Ensuring Diversity in the Health Care 
        Workforce'', the 2002 Institute of Medicine report entitled 
        ``The Future of the Public Health in the 21st Century'', and 
        the Healthy People 2010 initiative.
            (2) A description of the personnel in each such entity who 
        are responsible for overseeing workforce diversity initiatives.
            (3) The level of workforce diversity achieved within each 
        such entity, including absolute numbers and percentages of 
        minority employees as well as the rank of such employees.
            (4) A description of any grant support that is provided by 
        each entity for workforce diversity initiatives, including the 
        amount of the grants and the percentage of grant funds as 
        compared to overall entity funding.
    (c) Public Availability.--The report under subsection (a) shall be 
made available for public review and comment.

SEC. 402. FEDERAL AGENCY PLAN TO ELIMINATE DISPARITIES AND IMPROVE THE 
              HEALTH OF MINORITY POPULATIONS.

    (a) In General.--Not later than September 1, 2007, each Federal 
health agency shall develop and implement a national strategic action 
plan to eliminate disparities on the basis of race, ethnicity, and 
primary language and improve the health and healthcare of minority 
populations, through programs relevant to the mission of the agency.
    (b) Publication.--Each action plan described in paragraph (1) 
shall--
            (1) be publicly reported in draft form for public review 
        and comment;
            (2) include a response to the review and comment described 
        in paragraph (1) in the final plan;
            (3) include the agency response to the 2002 Institute of 
        Medicine report, Unequal Treatment--Confronting Racial and 
        Ethnic Disparities in Healthcare;
            (4) demonstrate progress in meeting the Healthy People 2010 
        objectives; and
            (5) be updated, including progress reports, for inclusion 
        in an annual report to Congress.

SEC. 403. ACCOUNTABILITY WITHIN THE DEPARTMENT OF HEALTH AND HUMAN 
              SERVICES.

    Title XXIX of the Public Health Service Act, as amended by titles 
II and III of this Act, is further amended by adding at the end the 
following:

               ``Subtitle C--Strengthening Accountability

``SEC. 2941. ELEVATION OF THE OFFICE OF CIVIL RIGHTS.

    ``(a) In General.--The Secretary shall establish within the Office 
for Civil Rights an Office of Health Disparities, which shall be headed 
by a director to be appointed by the Secretary.
    ``(b) Purpose.--The Office of Health Disparities shall ensure that 
the health programs, activities, and operations of health entities 
which receive Federal financial assistance are in compliance with title 
VI of the Civil Rights Act, which prohibits discrimination on the basis 
of race, color, or national origin. The activities of the Office shall 
include the following:
            ``(1) The development and implementation of an action plan 
        to address racial and ethnic healthcare disparities, which 
        shall address concerns relating to the Office for Civil Rights 
        as released by the United States Commission on Civil Rights in 
        the report entitled `Health Care Challenge: Acknowledging 
        Disparity, Confronting Discrimination, and Ensuring Equity' 
        (September, 1999). This plan shall be publicly disclosed for 
        review and comment and the final plan shall address any 
        comments or concerns that are received by the Office.
            ``(2) Investigative and enforcement actions against 
        intentional discrimination and policies and practices that have 
        a disparate impact on minorities.
            ``(3) The review of racial, ethnic, and primary language 
        health data collected by Federal health agencies to assess 
        healthcare disparities related to intentional discrimination 
        and policies and practices that have a disparate impact on 
        minorities.
            ``(4) Outreach and education activities relating to 
        compliance with title VI of the Civil Rights Act.
            ``(5) The provision of technical assistance for health 
        entities to facilitate compliance with title VI of the Civil 
        Rights Act.
            ``(6) Coordination and oversight of activities of the civil 
        rights compliance offices established under section 2942.
            ``(7) Ensuring compliance with the 1997 Office of 
        Management and Budget Standards for Maintaining, Collecting, 
        and Presenting Federal Data on Race, Ethnicity and the 
        available language standards.
    ``(c) Funding and Staff.--The Secretary shall ensure the 
effectiveness of the Office of Health Disparities by ensuring that the 
Office is provided with--
            ``(1) adequate funding to enable the Office to carry out 
        its duties under this section; and
            ``(2) staff with expertise in--
                    ``(A) epidemiology;
                    ``(B) statistics;
                    ``(C) health quality assurance;
                    ``(D) minority health and health disparities; and
                    ``(E) civil rights.
    ``(d) Report.--Not later than December 31, 2007, and annually 
thereafter, the Secretary, in collaboration with the Director of the 
Office for Civil Rights, shall submit a report to the Committee on 
Health, Education, Labor, and Pensions of the Senate and the Committee 
on Energy and Commerce of the House of Representatives that includes--
            ``(1) the number of cases filed, broken down by category;
            ``(2) the number of cases investigated and closed by the 
        office;
            ``(3) the outcomes of cases investigated; and
            ``(4) the staffing levels of the office including staff 
        credentials.
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.

``SEC. 2942. ESTABLISHMENT OF HEALTH PROGRAM OFFICES FOR CIVIL RIGHTS 
              WITHIN FEDERAL HEALTH AND HUMAN SERVICES AGENCIES.

    ``(a) In General.--The Secretary shall establish civil rights 
compliance offices in each agency within the Department of Health and 
Human Services that administers health programs.
    ``(b) Purpose of Offices.--Each office established under subsection 
(a) shall ensure that recipients of Federal financial assistance under 
Federal health programs administer their programs, services, and 
activities in a manner that--
            ``(1) does not discriminate, either intentionally or in 
        effect, on the basis of race, national origin, language, 
        ethnicity, sex, age, or disability; and
            ``(2) promotes the reduction and elimination of disparities 
        in health and healthcare based on race, national origin, 
        language, ethnicity, sex, age, and disability.
    ``(c) Powers and Duties.--The offices established in subsection (a) 
shall have the following powers and duties:
            ``(1) The establishment of compliance and program 
        participation standards for recipients of Federal financial 
        assistance under each program administered by an agency within 
        the Department of Health and Human Services including the 
        establishment of disparity reduction standards to encompass 
        disparities in health and healthcare related to race, national 
        origin, language, ethnicity, sex, age, and disability.
            ``(2) The development and implementation of program-
        specific guidelines that interpret and apply Department of 
        Health and Human Services guidance under title VI of the Civil 
        Rights Act of 1964 to each Federal health program administered 
        by the agency.
            ``(3) The development of a disparity-reduction impact 
        analysis methodology that shall be applied to every rule issued 
        by the agency and published as part of the formal rulemaking 
        process under sections 555, 556, and 557 of title 5, United 
        States Code.
            ``(4) Oversight of data collection, analysis, and 
        publication requirements for all recipients of Federal 
        financial assistance under each Federal health program 
        administered by the agency, and compliance with the 1997 Office 
        of Management and Budget Standards for Maintaining, Collecting, 
        and Presenting Federal Data on Race and Ethnicity and the 
        available language standards.
            ``(5) The conduct of publicly available studies regarding 
        discrimination within Federal health programs administered by 
        the agency as well as disparity reduction initiatives by 
        recipients of Federal financial assistance under Federal health 
        programs.
            ``(6) Annual reports to the Committee on Health, Education, 
        Labor, and Pensions and the Committee on Finance of the Senate 
        and the Committee on Energy and Commerce and the Committee on 
        Ways and Means of the House of Representatives on the progress 
        in reducing disparities in health and healthcare through the 
        Federal programs administered by the agency.
    ``(d) Relationship to Office for Civil Rights in the Department of 
Justice.--
            ``(1) Department of health and human services.--The Office 
        for Civil Rights in the Department of Health and Human Services 
        shall provide standard-setting and compliance review 
        investigation support services to the Civil Rights Compliance 
        Office for each agency.
            ``(2) Department of justice.--The Office for Civil Rights 
        in the Department of Justice shall continue to maintain the 
        power to institute formal proceedings when an agency Office for 
        Civil Rights determines that a recipient of Federal financial 
        assistance is not in compliance with the disparity reduction 
        standards of the agency.
    ``(e) Definition.--In this section, the term `Federal health 
programs' mean programs--
            ``(1) under the Social Security Act (42 U.S.C. 301 et seq.) 
        that pay for healthcare and services; and
            ``(2) under this Act that provide Federal financial 
        assistance for healthcare, biomedical research, health services 
        research, and programs designed to improve the public's 
        health.''.

SEC. 404. OFFICE OF MINORITY HEALTH DISPARITY ELIMINATION.

    Section 1707 of the Public Health Service Act (42 U.S.C. 300u-6) is 
amended--
            (1) by striking the section heading and inserting the 
        following: ``office of minority health disparity elimination'';
            (2) by striking ``Office of Minority Health'' each place 
        such term appears and inserting ``Office of Minority Health 
        Disparity Elimination'';
            (3) by striking subsection (b) and inserting the following:
    ``(b) Duties.--With respect to improving the health of racial and 
ethnic minority groups, the Secretary, acting through the Deputy 
Assistant Secretary for Minority Health Disparity Elimination (in this 
section referred to as the `Deputy Assistant Secretary'), shall carry 
out the following:
            ``(1) Establish, implement, monitor, and evaluate short-
        range and long-range goals and objectives and oversee all other 
        activities within the Public Health Service that relate to 
        disease prevention, health promotion, service delivery, and 
        research concerning minority groups. The heads of each of the 
        agencies of the Service shall consult with the Deputy Assistant 
        Secretary to ensure the coordination of such activities.
            ``(2) Oversee all activities within the Department of 
        Health and Human Services that relate to reducing or 
        eliminating disparities in health and healthcare in racial and 
        ethnic minority populations, including coordinating--
                    ``(A) the design of programs, support for programs, 
                and the evaluation of programs;
                    ``(B) the monitoring of trends in health and 
                healthcare;
                    ``(C) research efforts;
                    ``(D) the training of health providers; and
                    ``(E) information and education programs and 
                campaigns.
            ``(3) Enter into interagency and intra-agency agreements 
        with other agencies of the Public Health Service.
            ``(4) Ensure that the Federal health agencies and the 
        National Center for Health Statistics collect data on the 
        health status and healthcare of each minority group, using at a 
        minimum the categories specified in the 1997 OMB Standards for 
        Maintaining, Collecting, and Presenting Federal Data on Race 
        and Ethnicity as required under subtitle B and available 
        language standards.
            ``(5) Provide technical assistance to States, local 
        agencies, territories, Indian tribes, and entities for 
        activities relating to the elimination of racial and ethnic 
        disparities in health and healthcare.
            ``(6) Support a national minority health resource center to 
        carry out the following:
                    ``(A) Facilitate the exchange of information 
                regarding matters relating to health information, 
                health promotion and wellness, preventive health 
                services, and education in the appropriate use of 
                health services.
                    ``(B) Facilitate timely access to culturally and 
                linguistically appropriate information.
                    ``(C) Assist in the analysis of such information.
                    ``(D) Provide technical assistance with respect to 
                the exchange of such information (including 
                facilitating the development of materials for such 
                technical assistance).
            ``(7) Carry out programs to improve access to healthcare 
        services for individuals with limited English proficiency, 
        including developing and carrying out programs to provide 
        bilingual or interpretive services through the development and 
        support of the Robert T. Matsui Center for Cultural and 
        Linguistic Competence in Healthcare as provided for in section 
        2903.
            ``(8) Carry out programs to improve access to healthcare 
        services and to improve the quality of healthcare services for 
        individuals with low functional health literacy. As used in the 
        preceding sentence, the term `functional health literacy' means 
        the ability to obtain, process, and understand basic health 
        information and services needed to make appropriate health 
        decisions.
            ``(9) Advise in matters related to the development, 
        implementation, and evaluation of health professions education 
        on decreasing disparities in healthcare outcomes, with focus on 
        cultural competency as a method of eliminating disparities in 
        health and healthcare in racial and ethnic minority 
        populations.
            ``(10) Assist healthcare professionals, community and 
        advocacy organizations, academic centers and public health 
        departments in the design and implementation of programs that 
        will improve the quality of health outcomes by strengthening 
        the provider-patient relationship.''.
            (4) by redesignating subsections (c) through (f) and 
        subsections (g) and (h) as subsections (d) through (g) and 
        subsections (j) and (k), respectively;
            (5) by inserting after subsection (b), the following:
    ``(c) National Plan to Eliminate Racial and Ethnic Health and 
Healthcare Disparities.--
            ``(1) In general.--The Secretary, acting through the Deputy 
        Assistant Secretary, shall--
                    ``(A) not later than 1 year after the date of 
                enactment of the Healthcare Equality and Accountability 
                Act, establish and implement a comprehensive plan to 
                achieve the goal of Healthy People 2010 to eliminate 
                health disparities in the United States;
                    ``(B) establish the plan referred to in 
                subparagraph (A) in consultation with--
                            ``(i) the Director of the Centers for 
                        Disease Control and Prevention;
                            ``(ii) the Director of the National 
                        Institutes of Health;
                            ``(iii) the Director of the National Center 
                        on Minority Health and Health Disparities;
                            ``(iv) the Director of the Agency for 
                        Healthcare Research and Quality;
                            ``(v) the Administrator of the Health 
                        Resources and Services Administration;
                            ``(vi) the Administrator of the Centers for 
                        Medicare and Medicaid Services;
                            ``(vii) the Director of the Office for 
                        Civil Rights;
                            ``(viii) the Administrator of the Substance 
                        Abuse and Mental Health Services 
                        Administration;
                            ``(ix) the Commissioner of Food and Drugs; 
                        and
                            ``(x) the heads of other appropriate public 
                        and private entities;
                    ``(C) ensure that the plan includes measurable 
                objectives, describes the means for achieving such 
                objectives, and designates a date by which such 
                objectives are expected to be achieved;
                    ``(D) ensure that all amounts appropriated for such 
                activities are expended in accordance with the plan;
                    ``(E) review the plan on at least an annual basis 
                and revise the plan as appropriate;
                    ``(F) ensure that the plan will serve as a binding 
                statement of policy with respect to the agencies' 
                activities related to disparities in health and 
                healthcare; and
                    ``(G) not later than March 1 of each year, submit 
                the plan (or any revisions to the plan), to the 
                Committee on Health, Education, Labor, and Pensions of 
                the Senate and the Committee on Energy and Commerce of 
                the House of Representatives.
            ``(2) Components of the plan.--The Deputy Assistant 
        Secretary shall ensure that the comprehensive plan established 
        under paragraph (1) addresses--
                    ``(A) the recommendations of the 2002 Institute of 
                Medicine report (Unequal Treatment) with respect to 
                racial and ethnic disparities in healthcare;
                    ``(B) health and disease prevention education for 
                racial, ethnic, and primary language health disparity 
                populations;
                    ``(C) research to identify sources of health and 
                healthcare disparities in minority groups;
                    ``(D) the implementation and assessment of 
                promising intervention strategies;
                    ``(E) data collection and the monitoring of the 
                healthcare and health status of health disparity 
                populations;
                    ``(F) care of individuals who lack proficiency with 
                the English language;
                    ``(G) care of individuals with low functional 
                health literacy;
                    ``(H) the training, recruitment, and retention of 
                minority health professionals;
                    ``(I) programs to expand and facilitate access to 
                healthcare services, including the use of telemedicine, 
                National Health Service Scholars, community health 
                workers, and case managers;
                    ``(J) public and health provider awareness of 
                racial and ethnic disparities in healthcare;
                    ``(K) methods to evaluate and measure progress 
                toward the goal of eliminating disparities in health 
                and healthcare in racial and ethnic minority 
                populations;
                    ``(L) the promotion of interagency and intra-agency 
                coordination and collaboration and public-private and 
                community partnerships; and
                    ``(M) the preparedness of health professionals to 
                care for racially, ethnically, and linguistically 
                diverse populations and low functional health literacy 
                populations including evaluations.'';
            (6) in subsection (d) (as so redesignated)--
                    (A) in paragraph (1), by inserting ``and Racial, 
                Ethnic, and Primary Language Health Disparities 
                Elimination'' after ``Minority Health''; and
                    (B) in paragraph (2)--
                            (i) by striking ``Deputy Assistant''; and
                            (ii) by striking ``(10) of subsection (b)'' 
                        and inserting ``(9) of subsection (c)'';
            (7) in subsection (e)(1) (as so redesignated)--
                    (A) in subparagraph (A), by striking ``subsection 
                (b)(9)'' and inserting ``subsection (b)(7)''; and
                    (B) in subparagraph (B), by striking ``subsection 
                (b)(10)'' and inserting ``subsection (b)(8)'';
            (8) in subsection (f)(3) (as so redesignated), by striking 
        ``subsection (f)'' and inserting ``subsection (g)'';
            (9) in subsection (g)(1) (as so redesignated)--
                    (A) by striking ``1999 and each second'' and 
                inserting ``2006 and each'';
                    (B) by striking ``Labor and Human Resources'' and 
                inserting ``Health, Education, Labor, and Pensions'';
                    (C) by striking ``2 fiscal years'' and inserting 
                ``fiscal year''; and
                    (D) by inserting after ``improving the health of 
                racial and ethnic minority groups'' the following: 
                ``reducing and eliminating disparities in health and 
                healthcare in racial and ethnic minority populations, 
                in accordance with the national plan specified under 
                subsection (c) and the goals of Healthy People 2010'';
            (10) by inserting after subsection (g) (as so redesignated) 
        the following:
    ``(h) Federal Partnership With Accreditation Entities.--
            ``(1) In general.--Not later than 1 year after the date of 
        enactment of the Healthcare Equality and Accountability Act, 
        the Secretary, in collaboration with the Director of the Agency 
        for Healthcare Research and Quality, the Administrator of the 
        Centers for Medicare and Medicaid Services, the Director of the 
        Office for Minority Health, and the heads of appropriate State 
        agencies, shall convene a working group with members of 
        accreditation organizations and other quality standard setting 
        organizations to develop guidelines to evaluate and report on 
        the health and healthcare of minority populations served by 
        health centers, health plans, hospitals, and other federally 
        funded health entities.
            ``(2) Report.--Not later than 6 months after the convening 
        of the working group under paragraph (1), the working group 
        shall submit a report to the Secretary at such time, in such 
        manner, and containing such information as the Secretary may 
        require, including guidelines and recommendations on how each 
        accreditation body will work with constituent members to ensure 
        the adoption of such guidelines.
            ``(3) Demonstration projects.--The Secretary, acting 
        through the Administrator of the Centers for Medicare and 
        Medicaid Services, shall award grants for the establishment of 
        demonstration projects to assess the impact of providing 
        financial incentives for the reporting and analysis of the 
        quality of minority healthcare by hospitals, health plans, 
        health centers, and other healthcare entities.
            ``(4) Authorization of appropriations.--There are 
        authorized to be appropriated to carry out this subsection, 
        such sums as may be necessary for each of fiscal years 2007 
        through 2012.
    ``(i) Preparation of Health Professionals To Provide Healthcare to 
Minority Populations.--The Secretary, in collaboration with the 
Director of the Bureau of Health Professions and the Deputy Assistant 
Secretary for Minority Health Disparity Elimination, shall require that 
health professional schools that receive Federal funds train future 
health professionals to provide culturally and linguistically 
appropriate healthcare to diverse populations.''; and
            (11) by striking subsection (k) (as so redesignated) and 
        inserting the following:
    ``(k) Authorization of Appropriations.--For the purpose of carrying 
out this section (other than subsection (h)), there is authorized to be 
appropriated $100,000,000 for fiscal year 2006, and such sums as may be 
necessary for each of fiscal years 2007 through 2012.''.

SEC. 405. ESTABLISHMENT OF THE INDIAN HEALTH SERVICE AS AN AGENCY OF 
              THE PUBLIC HEALTH SERVICE.

    (a) Establishment.--
            (1) In general.--In order to more effectively and 
        efficiently carry out the responsibilities, authorities, and 
        functions of the United States to provide healthcare services 
        to Indians and Indian tribes, as are or may be hereafter 
        provided by Federal statute or treaties, there is established 
        within the Public Health Service of the Department of Health 
        and Human Services the Indian Health Service.
            (2) Assistant secretary of indian health.--The Service 
        shall be administered by an Assistant Secretary of Indian 
        Health, who shall be appointed by the President, by and with 
        the advice and consent of the Senate. The Assistant Secretary 
        shall report to the Secretary. Effective with respect to an 
        individual appointed by the President, by and with the advice 
        and consent of the Senate the term of service of the Assistant 
        Secretary shall be 4 years. An Assistant Secretary may serve 
        more than 1 term.
    (b) Agency.--The Service shall be an agency within the Public 
Health Service of the Department, and shall not be an office, 
component, or unit of any other agency of the Department.
    (c) Functions and Duties.--The Secretary shall carry out through 
the Assistant Secretary of the Service--
            (1) all functions which were, on the day before the date of 
        enactment of the Indian Health Care Amendments of 1988, carried 
        out by or under the direction of the individual serving as 
        Director of the Service on such day;
            (2) all functions of the Secretary relating to the 
        maintenance and operation of hospital and health facilities for 
        Indians and the planning for, and provision and utilization of, 
        health services for Indians;
            (3) all health programs under which healthcare is provided 
        to Indians based upon their status as Indians which are 
        administered by the Secretary, including programs under--
                    (A) the Indian Health Care Improvement Act;
                    (B) the Act of November 2, 1921 (25 U.S.C. 13);
                    (C) the Act of August 5, 1954 (42 U.S.C. 2001, et 
                seq.);
                    (D) the Act of August 16, 1957 (42 U.S.C. 2005 et 
                seq.);
                    (E) the Indian Self-Determination Act (25 U.S.C. 
                450f, et seq.); and
                    (F) title XXIX of the Public Health Service Act; 
                and
            (4) all scholarship and loan functions carried out under 
        title I of the Indian Health Care Improvement Act.
    (d) Authority.--
            (1) In general.--The Secretary, acting through the 
        Assistant Secretary, shall have the authority--
                    (A) except to the extent provided for in paragraph 
                (2), to appoint and compensate employees for the 
                Service in accordance with title 5, United States Code;
                    (B) to enter into contracts for the procurement of 
                goods and services to carry out the functions of the 
                Service; and
                    (C) to manage, expend, and obligate all funds 
                appropriated for the Service.
            (2) Personnel actions.--Notwithstanding any other provision 
        of law, the provisions of section 12 of the Act of June 18, 
        1934 (48 Stat. 986; 25 U.S.C. 472), shall apply to all 
        personnel actions taken with respect to new positions created 
        within the Service as a result of its establishment under 
        subsection (a).
    (e) Rate of Pay.--
            (1) Positions at level iv.--Section 5315 of title 5, United 
        States Code, is amended by striking the following: ``Assistant 
        Secretaries of Health and Human Services (6).'' and inserting 
        ``Assistant Secretaries of Health and Human Services (7).''.
            (2) Positions at level v.--Section 5316 of such title is 
        amended by striking the following: ``Director, Indian Health 
        Service, Department of Health and Human Services.''.
    (f) Duties of Assistant Secretary for Indian Health.--Section 601 
of the Indian Health Care Improvement Act (25 U.S.C. 1661) is amended 
in subsection (a)--
            (1) by inserting ``(1)'' after ``(a)'';
            (2) in the second sentence of paragraph (1), as so 
        designated, by striking ``a Director,'' and inserting ``the 
        Assistant Secretary for Indian Health,'';
            (3) by striking the third sentence of paragraph (1), as so 
        designated, and all that follows through the end of the 
        subsection (a) of such section and inserting the following: 
        ``The Assistant Secretary for Indian Health shall carry out the 
        duties specified in paragraph (2).''; and
            (4) by adding after paragraph (1) the following:
            ``(2) The Assistant Secretary for Indian Health shall--
                    ``(A) report directly to the secretary concerning 
                all policy and budget-related matters affecting Indian 
                health;
                    ``(B) collaborate with the Assistant Secretary for 
                Health concerning appropriate matters of Indian health 
                that affect the agencies of the Public Health Service;
                    ``(C) advise each Assistant Secretary of the 
                Department of Health and Human Services concerning 
                matters of Indian health with respect to which that 
                Assistant Secretary has authority and responsibility;
                    ``(D) advise the heads of other agencies and 
                programs of the Department of Health and Human Services 
                concerning matters of Indian health with respect to 
                which those heads have authority and responsibility; 
                and
                    ``(E) coordinate the activities of the Department 
                of Health and Human Services concerning matters of 
                Indian health.''.
    (g) Continued Service by Incumbent.--The individual serving in the 
position of Director of the Indian Health Service on the date preceding 
the date of enactment of this Act may serve as Assistant Secretary for 
Indian Health, at the pleasure of the President after the date of 
enactment of this Act.
    (h) Conforming Amendments.--
            (1) Amendments to indian health care improvement act.--The 
        Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.) is 
        amended--
                    (A) in section 601--
                            (i) in subsection (c), by striking 
                        ``Director of the Indian Health Service'' both 
                        places it appears and inserting ``Assistant 
                        Secretary for Indian Health''; and
                            (ii) in subsection (d), by striking 
                        ``Director of the Indian Health Service'' and 
                        inserting ``Assistant Secretary for Indian 
                        Health''; and
                    (B) in section 816(c)(1), by striking ``Director of 
                the Indian Health Service'' and inserting ``Assistant 
                Secretary for Indian Health''.
            (2) Amendments to other provisions of law.--The following 
        provisions are each amended by striking ``Director of the 
        Indian Health Service'' each place it appears and inserting 
        ``Assistant Secretary for Indian Health'':
                    (A) Section 203(a)(1) of the Rehabilitation Act of 
                1973 (29 U.S.C. 761b(a)(1)).
                    (B) Subsections (b) and (e) of section 518 of the 
                Federal Water Pollution Control Act (33 U.S.C. 1377 (b) 
                and (e)).
                    (C) Section 803B(d)(1) of the Native American 
                Programs Act of 1974 (42 U.S.C. 2991b-2(d)(1)).
    (i) References.--Reference in any other Federal law, Executive 
order, rule, regulation, or delegation of authority, or any document of 
or relating to the Director of the Indian Health Service shall be 
deemed to refer to the Assistant Secretary for Indian Health.
    (j) Definitions.--For purposes of this section, the definitions 
contained in section 4 of the Indian Health Care Improvement Act shall 
apply.

SEC. 406. ESTABLISHMENT OF INDIVIDUAL OFFICES OF MINORITY HEALTH WITHIN 
              AGENCIES OF THE PUBLIC HEALTH SERVICE.

    Title XVII of the Public Health Service Act (42 U.S.C. 300u et 
seq.) is amended by inserting after section 1707 the following section:

  ``individual offices of minority health within public health service

    ``Sec. 1707A.  (a) In General.--The head of each agency specified 
in subsection (b)(1) shall establish within the agency an office to be 
known as the Office of Minority Health and Racial, Ethnic, and Primary 
Language Health Disparities Elimination. Each such Office shall be 
headed by a director, who shall be appointed by the head of the agency 
within which the Office is established, and who shall report directly 
to the head of the agency. The head of such agency shall carry out this 
section (as this section relates to the agency) acting through such 
Director.
    ``(b) Specified Agencies.--
            ``(1) In general.--The agencies referred to in subsection 
        (a) are the following:
                    ``(A) The Centers for Disease Control and 
                Prevention.
                    ``(B) The Health Resources and Services 
                Administration.
                    ``(C) The Substance Abuse and Mental Health 
                Services Administration; and
                    ``(D) The Administration on Aging.
    ``(c) Composition.--The head of each specified agency shall ensure 
that the officers and employees of the minority health office of the 
agency are, collectively, experienced in carrying out community-based 
health programs for each of the various racial and ethnic minority 
groups that are present in significant numbers in the United States.
    ``(d) Duties.--Each Director of a minority health office shall 
establish and monitor the programs of the specified agency of such 
office in order to carry out the following:
            ``(1) Determine the extent to which the purposes of the 
        programs are being carried out with respect to racial and 
        ethnic minority groups;
            ``(2) Determine the extent to which members of such groups 
        are represented among the Federal officers and employees who 
        administer the programs; and
            ``(3) Make recommendations to the head of such agency on 
        carrying out the programs with respect to such groups. In the 
        case of programs that provide services, such recommendations 
        shall include recommendations toward ensuring that--
                    ``(A) the services are equitably delivered with 
                respect to racial and ethnic minority groups;
                    ``(B) the programs provide the services in the 
                language and cultural context that is most appropriate 
                for the individuals for whom the services are intended; 
                and
                    ``(C) the programs utilize racial and ethnic 
                minority community-based organizations to deliver 
                services.
    ``(e) Biennial Reports to Secretary.--The head of each specified 
agency shall submit to the Secretary for inclusion in each biennial 
report describing--
            ``(1) the extent to which the minority health office of the 
        agency employs individuals who are members of racial and ethnic 
        minority groups, including a specification by minority group of 
        the number of such individuals employed by such office.
    ``(f) Funding.--
            ``(1) Allocations.--Of the amounts appropriated for a 
        specified agency for a fiscal year, the Secretary must 
        designate an appropriate amount of funds for the purpose of 
        carrying out activities under this section through the minority 
        health office of the agency. In reserving an amount under the 
        preceding sentence for a minority health office for a fiscal 
        year, the Secretary shall reduce, by substantially the same 
        percentage, the amount that otherwise would be available for 
        each of the programs of the designated agency involved.
            ``(2) Availability of funds for staffing.--The purposes for 
        which amounts made available under paragraph may be expended by 
        a minority health office include the costs of employing staff 
        for such office.''.

SEC. 407. OFFICE OF MINORITY HEALTH AT THE CENTERS FOR MEDICARE AND 
              MEDICAID SERVICES.

    (a) In General.--Not later than 60 days after the date of enactment 
of this Act, the Secretary of Health and Human Services shall establish 
within the Centers for Medicare and Medicaid Services an Office of 
Minority Health (referred to in this section as the ``Office'').
    (b) Duties.--The Office shall be responsible for the coordination 
and facilitation of activities of the Centers for Medicare and Medicaid 
Services to improve minority health and healthcare and to reduce racial 
and ethnic disparities in health and healthcare, which shall include--
            (1) creating a strategic plan, which shall be made 
        available for public review, to improve the health and 
        healthcare of Medicare, Medicaid, and SCHIP beneficiaries;
            (2) promoting agency-wide policies relating to healthcare 
        delivery and financing that could have a beneficial impact on 
        the health and healthcare of minority populations;
            (3) assisting health plans, hospitals, and other health 
        entities in providing culturally and linguistically appropriate 
        healthcare services;
            (4) increasing awareness and outreach activities for 
        minority healthcare consumers and providers about the causes 
        and remedies for health and healthcare disparities;
            (5) developing grant programs and demonstration projects to 
        identify, implement and evaluate innovative approaches to 
        improving the health and healthcare of minority beneficiaries 
        in the Medicare, Medicaid, and SCHIP programs;
            (6) considering incentive programs relating to 
        reimbursement that would reward health entities for providing 
        quality healthcare for minority populations using established 
        benchmarks for quality of care;
            (7) collaborating with the compliance office to ensure 
        compliance with the anti-discrimination provisions under title 
        VI of the Civil Rights Act of 1964;
            (8) identifying barriers to enrollment in public programs 
        under the jurisdiction of the Centers for Medicare and Medicaid 
        Services;
            (9) monitoring and evaluating on a regular basis the 
        success of minority health programs and initiatives;
            (10) publishing an annual report about the activities of 
        the Centers for Medicare and Medicaid Services relating to 
        minority health improvement; and
            (11) other activities determined appropriate by the 
        Secretary of Health and Human Services.
    (c) Staff.--The staff at the Office shall include--
            (1) one or more individuals with expertise in minority 
        health and racial and ethnic health disparities; and
            (2) one or more individuals with expertise in healthcare 
        financing and delivery in underserved communities.
    (d) Coordination.--In carrying out its duties under this section, 
the Office shall coordinate with--
            (1) the Office of Minority Health in the Office of the 
        Secretary of Health and Human Services;
            (2) the National Centers for Minority Health and Health 
        Disparities in the National Institutes of Health; and
            (3) the Office of Minority Health in the Centers for 
        Disease Control and Prevention.
    (e) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated $10,000,000 
for fiscal year 2006, and such sums may be necessary for each of fiscal 
years 2007 through 2012.

SEC. 408. OFFICE OF MINORITY AFFAIRS AT THE FOOD AND DRUG 
              ADMINISTRATION.

    Chapter IX of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
391 et seq.) is amended by adding at the end the following:

``SEC. 908. OFFICE OF MINORITY AFFAIRS.

    ``(a) In General.--Not later than 60 days after the date of 
enactment of this section, the Secretary shall establish within the 
Office of the Commissioner of Food and Drugs an Office of Minority 
Affairs (referred to in this section as the `Office').
    ``(b) Duties.--The Office shall be responsible for the coordination 
and facilitation of activities of the Food and Drug Administration to 
improve minority health and healthcare and to reduce racial and ethnic 
disparities in health and healthcare, which shall include--
            ``(1) promoting policies in the development and review of 
        medical products that reduce racial and ethnic disparities in 
        health and healthcare;
            ``(2) encouraging appropriate data collection, analysis, 
        and dissemination of racial and ethnic differences using, at a 
        minimum, the categories described in the 1997 Office of 
        Management and Budget standards, in response to different 
        therapies in both adult and pediatric populations;
            ``(3) providing, in coordination with other appropriate 
        government agencies, education, training, and support to 
        increase participation of minority patients and physicians in 
        clinical trials;
            ``(4) collecting and analyzing data using, at a minimum, 
        the categories described in the 1997 Office of Management and 
        Budget standards, on the number of participants from minority 
        racial and ethnic backgrounds in clinical trials used to 
        support medical product approvals;
            ``(5) the identification of methods to reduce language and 
        literacy barriers; and
            ``(6) publishing an annual report about the activities of 
        the Food and Drug Administration pertaining to minority health.
    ``(c) Staff.--The staff of the Office shall include--
            ``(1) one or more individuals with expertise in the design 
        and conduct of clinical trials of drugs, biological products, 
        and medical devices; and
            ``(2) one or more individuals with expertise in therapeutic 
        classes or disease states for which medical evidence suggests a 
        difference based on race or ethnicity.
    ``(d) Coordination.--In carrying out its duties under this section, 
the Office shall coordinate with--
            ``(1) the Office of Minority Health in the Office of the 
        Secretary of Health and Human Services;
            ``(2) the National Center for Minority Health and Health 
        Disparities in the National Institutes of Health; and
            ``(3) the Office of Minority Health in the Centers for 
        Disease Control and Prevention.
    ``(e) 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 2007 through 2012.''.

SEC. 409. SAFETY AND EFFECTIVENESS OF DRUGS WITH RESPECT TO RACIAL AND 
              ETHNIC BACKGROUND.

    (a) In General.--Chapter V of the Federal Food, Drug, and Cosmetic 
Act (21 U.S.C. 351 et seq.) is amended by adding after section 505B the 
following:

``SEC. 505C. SAFETY AND EFFECTIVENESS OF DRUGS WITH RESPECT TO RACIAL 
              AND ETHNIC BACKGROUND.

    ``(a) Pre-Approval Studies.--If there is evidence that there may be 
a disparity on the basis of racial or ethnic background as to the 
safety or effectiveness of a drug, then--
            ``(1)(A) the investigations required under section 
        505(b)(1)(A) shall include adequate and well-controlled 
        investigations of the disparity; or
            ``(B) the evidence required under section 351(a) of the 
        Public Health Service Act for approval of a biologics license 
        application for the drug shall include adequate and well-
        controlled investigations of the disparity; and
            ``(2) if the investigations confirm that there is a 
        disparity, the labeling of the drug shall include appropriate 
        information about the disparity.
    ``(b) Post-Market Studies.--
            ``(1) In general.--If there is evidence that there may be a 
        disparity on the basis of racial or ethnic background as to the 
        safety or effectiveness of a drug for which there is an 
        approved application under section 505 or a license under 
        section 351 of the Public Health Service Act, the Secretary may 
        by order require the holder of the approved application or 
        license to conduct, by a date specified by the Secretary, post-
        marketing studies to investigate the disparity.
            ``(2) Labeling.--If the Secretary determines that the post-
        market studies confirm that there is a disparity described in 
        paragraph (1), the labeling of the drug shall include 
        appropriate information about the disparity.
            ``(3) Study design.--The Secretary may specify all aspects 
        of study design, including the number of studies and study 
        participants, in the order requiring post-market studies of the 
        drug.
            ``(4) Modifications of study design.--The Secretary may by 
        order modify any aspect of the study design as necessary after 
        issuing an order under paragraph (1).
            ``(5) Study results.--The results from studies required 
        under paragraph (1) shall be submitted to the Secretary as 
        supplements to the drug application or biological license 
        application.
    ``(c) Disparity.--The term `evidence that there may be a disparity 
on the basis of racial or ethnic background for adult and pediatric 
populations as to the safety or effectiveness of a drug' includes--
            ``(1) evidence that there is a disparity on the basis of 
        racial or ethnic background as to safety or effectiveness of a 
        drug in the same chemical class as the drug;
            ``(2) evidence that there is a disparity on the basis of 
        racial or ethnic background in the way the drug is metabolized; 
        and
            ``(3) other evidence as the Secretary may determine.
    ``(d) Applications Under Section 505(b)(2) and 505(j).--
            ``(1) In general.--A drug for which an application has been 
        submitted or approved under section 505(j) shall not be 
        considered ineligible for approval under that section or 
        misbranded under section 502 on the basis that the labeling of 
        the drug omits information relating to a disparity on the basis 
        of racial or ethnic background as to the safety or 
        effectiveness of the drug, whether derived from investigations 
        or studies required under this section or derived from other 
        sources, when the omitted information is protected by patent or 
        by exclusivity under clause (iii) or (iv) of section 
        505(j)(5)(D).
            ``(2) Labeling.--Notwithstanding clauses (iii) and (iv) of 
        section 505(j)(5)(D), the Secretary may require that the 
        labeling of a drug approved under section 505(j) that omits 
        information relating to a disparity on the basis of racial or 
        ethnic background as to the safety or effectiveness of the drug 
        include a statement of any appropriate contraindications, 
        warnings, or precautions related to the disparity that the 
        Secretary considers necessary.''.
    (b) Enforcement.--Section 502 of the Federal Food, Drug, and 
Cosmetic Act (21 U.S.C. 352) is amended by adding at the end the 
following:
    ``(w)(1) If it is a drug and the holder of the approved application 
under section 505 or license under section 351 of the Public Health 
Service Act for the drug has failed to complete the investigations or 
studies, or comply with any other requirement, of section 505C.''.
    (c) Drug Fees.--Section 736(a)(1)(A)(ii) of the Federal Food, Drug, 
and Cosmetic Act (21 U.S.C. 379h) is amended by adding after 
``required'' the following: ``, including supplements required under 
section 505C of the Act''.

SEC. 410. UNITED STATES COMMISSION ON CIVIL RIGHTS.

    (a) Coordination Within Department of Justice of Activities 
Regarding Health Disparities.--Section 3 of the Civil Rights Commission 
Act of 1983 (42 U.S.C. 1975a) is amended--
            (1) in paragraph (1)(B), by striking ``and'' at the end;
            (2) in paragraph (2), in the matter after and below 
        subparagraph (D), by striking the period and inserting ``; 
        and''; and
            (3) by adding at the end the following:
            ``(3) shall, with respect to activities carried out in 
        healthcare and correctional facilities toward the goal of 
        eliminating health disparities between the general population 
        and members of racial or ethnic minority groups, coordinate 
        such activities of--
                    ``(A) the Office for Civil Rights within the 
                Department of Justice;
                    ``(B) the Office of Justice Programs within the 
                Department of Justice;
                    ``(C) the Office for Civil Rights within the 
                Department of Health and Human Services; and
                    ``(D) the Office of Minority Health within the 
                Department of Health and Human Services (headed by the 
                Deputy Assistant Secretary for Minority Health 
                Disparity Elimination).''.
    (b) Authorization of Appropriations.--Section 5 of the Civil Rights 
Commission Act of 1983 (42 U.S.C. 1975c) is amended by striking the 
first sentence and inserting the following: ``For the purpose of 
carrying out this Act, there are authorized to be appropriated 
$30,000,000 for fiscal year 2007, and such sums as may be necessary for 
each of the fiscal years 2008 through 2012.''.

SEC. 411. SENSE OF CONGRESS CONCERNING FULL FUNDING OF ACTIVITIES TO 
              ELIMINATE RACIAL AND ETHNIC HEALTH DISPARITIES.

    (a) Findings.--Congress makes the following findings:
            (1) The health status of the American populace is declining 
        and the United States currently ranks below most industrialized 
        nations in health status measured by longevity, sickness, and 
        mortality.
            (2) Racial and ethnic minority populations tend have the 
        poorest health status and face substantial cultural, social, 
        and economic barriers to obtaining quality healthcare.
            (3) Efforts to improve minority health have been limited by 
        inadequate resources (funding, staffing, and stewardship) and 
        accountability.
    (b) Sense of Congress.--It is the sense of Congress that--
            (1) funding should be doubled by fiscal year 2007 for the 
        National Center for Minority Health Disparities, the Office of 
        Civil Rights in the Department of Health and Human Services, 
        the National Institute of Nursing Research, and the Office of 
        Minority Health;
            (2) adequate funding by fiscal year 2007, and subsequent 
        funding increases, should be provided for health professions 
        training programs, the Racial and Ethnic Approaches to 
        Community Health (REACH) at the Center for Disease Control and 
        Prevention, the Minority HIV/AIDS Initiative, and the 
        Excellence Centers to Eliminate Ethnic/Racial Disparities 
        (EXCEED) Program at the Agency for Healthcare Research and 
        Quality;
            (3) current and newly-created health disparity elimination 
        incentives, programs, agencies, and departments under this Act 
        (and the amendments made by this Act) should receive adequate 
        staffing and funding by fiscal year 2007; and
            (4) stewardship and accountability should be provided by 
        Congress and the President for health disparity elimination.

SEC. 412. GUIDELINES FOR DISEASE SCREENING FOR MINORITY PATIENTS.

    (a) In General.--The Secretary, acting through the Director of the 
Agency for Healthcare Research and Quality, shall convene a series of 
meetings to develop guidelines for disease screening for minority 
patient populations which have a higher than average risk for many 
chronic diseases and cancers.
    (b) Participants.--In convening meetings under subsection (a), the 
Secretary shall ensure that meeting participants include 
representatives of--
            (1) professional societies and associations;
            (2) minority health organizations;
            (3) healthcare researchers and providers, including those 
        with expertise in minority health;
            (4) Federal health agencies, including the Office of 
        Minority Health and the National Institutes of Health; and
            (5) other experts determined appropriate by the Secretary.
    (c) Diseases.--Screening guidelines for minority populations shall 
be developed under subsection (a) for--
            (1) hypertension;
            (2) hypercholesterolemia;
            (3) diabetes;
            (4) cardiovascular disease;
            (5) prostate cancer;
            (6) breast cancer;
            (7) colon cancer;
            (8) kidney disease;
            (9) glaucoma; and
            (10) other diseases determined appropriate by the 
        Secretary.
    (d) Dissemination.--Not later than 24 months after the date of 
enactment of this title, the Secretary shall publish and disseminate to 
healthcare provider organizations the guidelines developed under 
subsection (a).
    (e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, sums as may be necessary for 
each of fiscal years 2007 through 2012.

              Subtitle B--Improving Environmental Justice

SEC. 421. DEFINITIONS.

    For purposes of this subtitle:
            (1) Environmental justice.--
                    (A) In general.--The term ``environmental justice'' 
                means the fair treatment of people of all races, 
                cultures, and socioeconomic groups with respect to the 
                development, adoption, implementation, and enforcement 
                of laws, regulations, and policies affecting the 
                environment.
                    (B) Fair treatment.--The term ``fair treatment'' 
                means policies and practices that will minimize the 
                likelihood that a minority, low-income, or Native 
                American community will bear a disproportionate share 
                of the adverse environmental consequences, or be denied 
                reasonable access to the environmental benefits, 
                resulting from implementation of a Federal program or 
                policy.
            (2) Federal agency.--The term ``Federal agency'' means--
                    (A) each Federal entity represented on the Working 
                Group;
                    (B) any other entity that conducts any Federal 
                program or activity that substantially affects human 
                health or the environment; and
                    (C) each Federal agency that implements any 
                program, policy, or activity applicable to Native 
                Americans.
            (3) Working group.--The term ``Working Group'' means the 
        interagency working group established by section 423.
            (4) Advisory committee.--The term ``the Advisory 
        Committee'' means the advisory committee established by section 
        425.

SEC. 422. ENVIRONMENTAL JUSTICE RESPONSIBILITIES OF FEDERAL AGENCIES.

    (a) Environmental Justice Mission.--To the greatest extent 
practicable, the head of each Federal agency shall make achieving 
environmental justice part of its mission by identifying and 
addressing, as appropriate, disproportionately high and adverse human 
health or environmental effects of its programs, policies, and 
activities on minority and low-income populations in the United States 
and its territories and possessions, including the District of 
Columbia, the Commonwealth of Puerto Rico, Virgin Islands, Guam, and 
the Commonwealth of the Mariana Islands.
    (b) Nondiscrimination.--Each Federal agency shall conduct its 
programs, policies, and activities in a manner that ensures that such 
programs, policies, and activities do not have the effect of excluding 
any person or group from participation in, denying any person or group 
the benefits of, or subjecting any person or group to discrimination 
under, such programs, policies, and activities, because of race, color, 
national origin, or income.

SEC. 423. INTERAGENCY ENVIRONMENTAL JUSTICE WORKING GROUP.

    (a) Creation and Composition.--There is hereby established the 
Interagency Working Group on Environmental Justice, comprising the 
heads of the following executive agencies and offices, or their 
designees:
            (1) The Department of Defense.
            (2) The Department of Health and Human Services.
            (3) The Department of Housing and Urban Development.
            (4) The Department of Homeland Security.
            (5) The Department of Labor.
            (6) The Department of Agriculture.
            (7) The Department of Transportation.
            (8) The Department of Justice;
            (9) The Department of the Interior.
            (10) The Department of Commerce.
            (11) The Department of Energy.
            (12) The Environmental Protection Agency.
            (13) The Office of Management and Budget.
            (14) Any other official of the United States that the 
        President may designate.
    (b) Functions.--The Working Group shall--
            (1) provide guidance to Federal agencies on criteria for 
        identifying disproportionately high and adverse human health or 
        environmental effects on minority, low-income, and Native 
        American populations;
            (2) coordinate with, provide guidance to, and serve as a 
        clearinghouse for, each Federal agency as it develops or 
        revises an environmental justice strategy as required by this 
        subtitle, in order to ensure that the administration, 
        interpretation and enforcement of programs, activities, and 
        policies are undertaken in a consistent manner;
            (3) assist in coordinating research by, and stimulating 
        cooperation among, the Environmental Protection Agency, the 
        Department of Health and Human Services, the Department of 
        Housing and Urban Development, and other Federal agencies 
        conducting research or other activities in accordance with 
        section 424;
            (4) assist in coordinating data collection, maintenance, 
        and analysis required by this subtitle;
            (5) examine existing data and studies on environmental 
        justice;
            (6) hold public meetings and otherwise solicit public 
        participation and consider complaints as required under 
        subsection (c);
            (7) develop interagency model projects on environmental 
        justice that evidence cooperation among Federal agencies; and
            (8) in coordination with the Department of the Interior and 
        after consultation with tribal leaders, coordinate steps to be 
        taken pursuant to this subtitle that affect or involve 
        federally-recognized Indian Tribes.
    (c) Public Participation.--The Working Group shall--
            (1) hold public meetings and otherwise solicit public 
        participation, as appropriate, for the purpose of fact-finding 
        with regard to implementation of this subtitle, and prepare for 
        public review a summary of the comments and recommendations 
        provided; and
            (2) receive, consider, and in appropriate instances conduct 
        inquiries concerning complaints regarding environmental justice 
        and the implementation of this subtitle by Federal agencies.
    (d) Annual Reports.--
            (1) In general.--Each fiscal year following enactment of 
        this Act, the Working Group shall submit to the President, 
        through the Office of the Deputy Assistant to the President for 
        Environmental Policy and the Office of the Assistant to the 
        President for Domestic Policy, a report that describes the 
        implementation of this subtitle, including, but not limited to, 
        a report of the final environmental justice strategies 
        described in section 424 of this subtitle and annual progress 
        made in implementing those strategies.
            (2) Copy of report.--The President shall transmit to the 
        Speaker of the House of Representatives and the President of 
        the Senate a copy of each report submitted to the President 
        pursuant to paragraph (1).
    (e) Conforming Change.--The Interagency Working Group on 
Environmental Justice established under Executive Order No. 12898, 
dated February 11, 1994, is abolished.

SEC. 424. FEDERAL AGENCY STRATEGIES.

    (a) Agency-Wide Strategies.--Each Federal agency shall develop an 
agency-wide environmental justice strategy that identifies and 
addresses disproportionally high and adverse human health or 
environmental effects or disproportionally low benefits of its 
programs, policies, and activities with respect to minority, low-
income, and Native American populations.
    (b) Revisions.--Each strategy developed pursuant to subsection (a) 
shall identify programs, policies, planning, and public participation 
processes, rulemaking, and enforcement activities related to human 
health or the environment that should be revised to--
            (1) promote enforcement of all health and environmental 
        statutes in areas with minority, low-income, or Native American 
        populations;
            (2) ensure greater public participation;
            (3) improve research and data collection relating to the 
        health of and environment of minority, low-income, and Native 
        American populations; and
            (4) identify differential patterns of use of natural 
        resources among minority, low-income, and Native American 
        populations.
    (c) Timetables.--Each strategy developed pursuant to subsection (a) 
shall include, where appropriate, a timetable for undertaking revisions 
identified pursuant to subsection (b).

SEC. 425. FEDERAL ENVIRONMENTAL JUSTICE ADVISORY COMMITTEE.

    (a) Establishment.--There is established a committee to be known as 
the ``Federal Environmental Justice Advisory Committee''.
    (b) Duties.--The Advisory Committee shall provide independent 
advice and recommendations to the Environmental Protection Agency and 
the Working Group on areas relating to environmental justice, which may 
include any of the following:
            (1) Advice on Federal agencies' framework development for 
        integrating socioeconomic programs into strategic planning, 
        annual planning, and management accountability for achieving 
        environmental justice results agency-wide.
            (2) Advice on measuring and evaluating agencies' progress, 
        quality, and adequacy in planning, developing, and implementing 
        environmental justice strategies, projects, and programs.
            (3) Advice on agencies' existing and future information 
        management systems, technologies, and data collection, and the 
        conduct of analyses that support and strengthen environmental 
        justice programs in administrative and scientific areas.
            (4) Advice to help develop, facilitate, and conduct reviews 
        of the direction, criteria, scope, and adequacy of the Federal 
        agencies' scientific research and demonstration projects 
        relating to environmental justice.
            (5) Advice for improving how the Environmental Protection 
        Agency and others participate, cooperate, and communicate 
        within that agency and between other Federal agencies, State or 
        local governments, federally recognized Tribes, environmental 
        justice leaders, interest groups, and the public.
            (6) Advice regarding the Environmental Protection Agency's 
        administration of grant programs relating to environmental 
        justice assistance (not to include the review or 
        recommendations of individual grant proposals or awards).
            (7) Advice regarding agencies' awareness, education, 
        training, and other outreach activities involving environmental 
        justice.
    (c) Advisory Committee.--The Advisory Committee shall be considered 
an advisory committee within the meaning of the Federal Advisory 
Committee Act (5 U.S.C. App.).
    (d) Membership.--
            (1) In general.--The Advisory Committee shall be composed 
        of 21 members to be appointed in accordance with paragraph (2). 
        Members shall include representatives of--
                    (A) community-based groups;
                    (B) industry and business;
                    (C) academic and educational institutions;
                    (D) minority health organizations;
                    (E) State and local governments, federally 
                recognized tribes, and indigenous groups; and
                    (F) nongovernmental and environmental groups.
            (2) Appointments.--Of the members of the Advisory 
        Committee--
                    (A) five members shall be appointed by the majority 
                leader of the Senate;
                    (B) five members shall be appointed by the minority 
                leader of the Senate;
                    (C) five members shall be appointed by the Speaker 
                of the House of Representatives;
                    (D) five members shall be appointed by the minority 
                leader of the House of Representatives; and
                    (E) one member to be appointed by the President.
    (e) Meetings.--The Advisory Committee shall meet at least twice 
annually. Meetings shall occur as needed and approved by the Director 
of the Office of Environmental Justice of the Environmental Protection 
Agency, who shall serve as the officer required to be appointed under 
section 10(e) of the Federal Advisory Committee Act (5 U.S.C. App.) 
with respect to the Committee (in this subsection referred to as the 
``Designated Federal Officer''). The Administrator of the Environmental 
Protection Agency may pay travel and per diem expenses of members of 
the Advisory Committee when determined necessary and appropriate. The 
Designated Federal Officer or a designee of such Officer shall be 
present at all meetings, and each meeting will be conducted in 
accordance with an agenda approved in advance by such Officer. The 
Designated Federal Officer may adjourn any meeting when the Designated 
Federal Officer determines it is in the public interest to do so. As 
required by the Federal Advisory Committee Act, meetings of the 
Advisory Committee shall be open to the public unless the President 
determines that a meeting or a portion of a meeting may be closed to 
the public in accordance with subsection (c) of section 552b of title 
5, United States Code. Unless a meeting or portion thereof is closed to 
the public, the Designated Federal Officer shall provide an opportunity 
for interested persons to file comments before or after such meeting or 
to make statements to the extent that time permits.
    (f) Duration.--The Advisory Committee shall remain in existence 
until otherwise provided by law.

SEC. 426. HUMAN HEALTH AND ENVIRONMENTAL RESEARCH, DATA COLLECTION AND 
              ANALYSIS.

    (a) Disproportionate Impact.--To the extent permitted by other 
applicable law, including section 552a of title 5, United States Code, 
popularly known as the Privacy Act of 1974, the Administrator of the 
Environmental Protection Agency, or the head of such other Federal 
agency as the President may direct, shall collect, maintain, and 
analyze information assessing and comparing environmental and human 
health risks borne by populations identified by race, national origin, 
or income. To the extent practical and appropriate, Federal agencies 
shall use this information to determine whether their programs, 
policies, and activities have disproportionally high and adverse human 
health or environmental effects on, or disproportionally low benefits 
for, minority, low-income, and Native American populations.
    (b) Information Related to Non-Federal Facilities.--In connection 
with the development and implementation of agency strategies in section 
424, the Administrator of the Environmental Protection Agency, or the 
head of such other Federal agency as the President may direct, shall 
collect, maintain, and analyze information on the race, national 
origin, and income level, and other readily accessible and appropriate 
information, for areas surrounding facilities or sites expected to have 
a substantial environmental, human health, or economic effect on the 
surrounding populations, if such facilities or sites become the subject 
of a substantial Federal environmental administrative or judicial 
action.
    (c) Impact From Federal Facilities.--The Administrator of the 
Environmental Protection Agency, or the head of such other Federal 
agency as the President may direct, shall collect, maintain, and 
analyze information on the race, national origin, and income level, and 
other readily accessible and appropriate information, for areas 
surrounding Federal facilities that are--
            (1) subject to the reporting requirements under the 
        Emergency Planning and Community Right-to-Know Act (42 U.S.C. 
        11001 et seq.) as mandated in Executive Order No. 12856; and
            (2) expected to have a substantial environmental, human 
        health, or economic effect on surrounding populations.
    (d) Information Sharing.--
            (1) In general.--In carrying out the responsibilities in 
        this section, each Federal agency, to the extent practicable 
        and appropriate, shall share information and eliminate 
        unnecessary duplication of efforts through the use of existing 
        data systems and cooperative agreements among Federal agencies 
        and with State, local, and tribal governments.
            (2) Public availability.--Except as prohibited by other 
        applicable law, information collected or maintained pursuant to 
        this section shall be made available to the public.
    (e) Public Comment.--Federal agencies shall provide minority, low-
income, and Native American populations the opportunity to participate 
in the development, design, and conduct of activities undertaken 
pursuant to this section.

                   TITLE V--HEALTH EMPOWERMENT ZONES

SEC. 501. HEALTH EMPOWERMENT ZONES.

    (a) Health Empowerment Zone Programs.--
            (1) Grants.--The Secretary, acting through the 
        Administrator of the Health Resources and Services 
        Administration and the Deputy Assistant Secretary for Minority 
        Health Disparity Elimination, and in cooperation with the 
        Director of the Office of Community Services and the Director 
        of the National Center for Minority Health and Health 
        Disparities, shall make grants to partnerships of private and 
        public entities to establish health empowerment zone programs 
        in communities that disproportionately experience disparities 
        in health status and healthcare for the purpose described in 
        paragraph (2).
            (2) Use of funds.--
                    (A) In general.--Subject to subparagraph (B), the 
                purpose of a health empowerment zone program under this 
                section shall be to assist individuals, businesses, 
                schools, minority health associations, non-profit 
                organizations, community-based organizations, 
                hospitals, healthcare clinics, foundations, and other 
                entities in communities that disproportionately 
                experience disparities in health status and healthcare 
                which are seeking--
                            (i) to improve the health or environment of 
                        minority individuals in the community and to 
                        reduce disparities in health status and 
                        healthcare by assisting individuals in 
                        accessing Federal programs; and
                            (ii) to coordinate the efforts of 
                        governmental and private entities regarding the 
                        elimination of racial and ethnic disparities in 
                        health status and healthcare.
                    (B) Medicare and medicaid.--A health empowerment 
                zone program under this section shall not provide any 
                assistance (other than referral and follow-up services) 
                that is duplicative of programs under title XVIII or 
                XIX of the Social Security Act (42 U.S.C. 1395 and 1396 
                et seq.).
            (3) Distribution.--The Secretary shall make at least 1 
        grant under this section to a partnership for a health 
        empowerment zone program in communities that disproportionately 
        experience disparities in health status and healthcare that is 
        located in a territory or possession of the United States.
            (4) Application.--To obtain a grant under this section, a 
        partnership shall submit to the Secretary an application in 
        such form and in such manner as the Secretary may require. An 
        application under this paragraph shall--
                    (A) demonstrate that the communities to be served 
                by the health empowerment zone program are those that 
                disproportionately experience disparities in health 
                status and healthcare;
                    (B) set forth a strategic plan for accomplishing 
                the purpose described in paragraph (2), by--
                            (i) describing the coordinated health, 
                        economic, human, community, and physical 
                        development plan and related activities 
                        proposed for the community;
                            (ii) describing the extent to which local 
                        institutions and organizations have contributed 
                        and will contribute to the planning process and 
                        implementation;
                            (iii) identifying the projected amount of 
                        Federal, State, local, and private resources 
                        that will be available in the area and the 
                        private and public partnerships to be used 
                        (including any participation by or cooperation 
                        with universities, colleges, foundations, non-
                        profit organizations, medical centers, 
                        hospitals, health clinics, school districts, or 
                        other private and public entities);
                            (iv) identifying the funding requested 
                        under any Federal program in support of the 
                        proposed activities;
                            (v) identifying benchmarks for measuring 
                        the success of carrying out the strategic plan;
                            (vi) demonstrating the ability to reach and 
                        service the targeted underserved minority 
                        community populations in a culturally 
                        appropriate and linguistically responsive 
                        manner; and
                            (vii) demonstrating a capacity and 
                        infrastructure to provide long-term community 
                        response that is culturally appropriate and 
                        linguistically responsive to communities that 
                        disproportionately experience disparities in 
                        health and healthcare; and
                    (C) include such other information as the Secretary 
                may require.
            (5) Preference.--In awarding grants under this subsection, 
        the Secretary shall give preference to proposals from 
        indigenous community entities that have an expertise in 
        providing culturally appropriate and linguistically responsive 
        services to communities that disproportionately experience 
        disparities in health and health care.
    (b) Federal Assistance for Health Empowerment Zone Grant 
Programs.--The Secretary, the Administrator of the Small Business 
Administration, the Secretary of Agriculture, the Secretary of 
Education, the Secretary of Labor, and the Secretary of Housing and 
Urban Development shall each--
            (1) where appropriate, provide entity-specific technical 
        assistance and evidence-based strategies to communities that 
        disproportionately experience disparities in health status and 
        healthcare to further the purposes served by a health 
        empowerment zone program established with a grant under 
        subsection (a);
            (2) identify all programs administered by the Department of 
        Health and Human Services, Small Business Administration, 
        Department of Agriculture, Department of Education, Department 
        of Labor, and the Department of Housing and Urban Development, 
        respectively, that may be used to further the purpose of a 
        health empowerment zone program established with a grant under 
        subsection (a); and
            (3) in administering any program identified under paragraph 
        (2), consider the appropriateness of giving priority to any 
        individual or entity located in communities that 
        disproportionately experience disparities in health status and 
        healthcare served by a health empowerment zone program 
        established with a grant under subsection (a), if such priority 
        would further the purpose of the health empowerment zone 
        program.
    (c) Health Empowerment Zone Coordinating Committee.--
            (1) Establishment.--For each health empowerment zone 
        program established with a grant under subsection (a), the 
        Secretary acting through the Director of Office of Minority 
        Health and the Administrator of the Health Resources and 
        Services Administration shall establish a health empowerment 
        zone coordinating committee.
            (2) Duties.--Each coordinating committee established, in 
        coordination with the Deputy Assistant Secretary for Minority 
        Health Disparity Elimination and the Administrator of the 
        Health Resources and Services Administration, shall provide 
        technical assistance and evidence-based strategies to the grant 
        recipient involved, including providing guidance on research, 
        strategies, health outcomes, program goals, management, 
        implementation, monitoring, assessment, and evaluation 
        processes.
            (3) Membership.--
                    (A) Appointment.--The Deputy Assistant Secretary 
                for Minority Health Disparity Elimination and the 
                Administrator of the Health Resources and Services 
                Administration, in consultation with the respective 
                grant recipient shall appoint the members of each 
                coordinating committee.
                    (B) Composition.--The Deputy Assistant Secretary 
                for Minority Health Disparity Elimination, and the 
                Administrator of the Health Resources and Services 
                Administration shall ensure that each coordinating 
                committee established--
                            (i) has not more than 20 members;
                            (ii) includes individuals from communities 
                        that disproportionately experience disparities 
                        in health status and healthcare;
                            (iii) includes community leaders and 
                        leaders of community-based organizations;
                            (iv) includes representatives of academia 
                        and lay and professional organizations and 
                        associations including those having expertise 
                        in medicine, technical, social and behavioral 
                        science, health policy, advocacy, cultural and 
                        linguistic competency, research management, and 
                        organization; and
                            (v) represents a reasonable cross-section 
                        of knowledge, views, and application of 
                        expertise on societal, ethical, behavioral, 
                        educational, policy, legal, cultural, 
                        linguistic, and workforce issues related to 
                        eliminating disparities in health and 
                        healthcare.
                    (C) Individual qualifications.--The Deputy 
                Assistant Secretary for Minority Health Disparity 
                Elimination and the Administrator of the Health 
                Resources and Services Administration may not appoint 
                an individual to serve on a coordinating committee 
                unless the individual meets the following 
                qualifications:
                            (i) The individual is not employed by the 
                        Federal Government.
                            (ii) The individual has appropriate 
                        experience, including experience in the areas 
                        of community development, cultural and 
                        linguistic competency, reducing and eliminating 
                        racial and ethnic disparities in health and 
                        health care, or minority health.
                    (D) Selection.--In selecting individuals to serve 
                on a coordinating committee, the Deputy Assistant 
                Secretary for Minority Health Disparity Elimination and 
                the Administrator Health Resources and Services 
                Administration shall give due consideration to the 
                recommendations of the Congress, industry leaders, the 
                scientific community (including the Institute of 
                Medicine), academia, community based non-profit 
                organizations, minority health and related 
                organizations, the education community, State and local 
                governments, and other appropriate organizations.
                    (E) Chairperson.--The Deputy Assistant Secretary 
                for Minority Health Disparity Elimination and the 
                Administrator of the Health Resources and Services 
                Administration, in consultation with the members of the 
                coordinating committee involved, shall designate a 
                chairperson of the coordinating committee, who shall 
                serve for a term of 3 years and who may be reappointed 
                at the expiration of each such term.
                    (F) Terms.--Each member of a coordinating committee 
                shall be appointed for a term of 1 to 3 years in 
                overlapping staggered terms, as determined by the 
                Deputy Assistant Secretary for Minority Health 
                Disparity Elimination and the Administrator of the 
                Health Resources and Services Administration at the 
                time of appointment, and may be reappointed at the 
                expiration of each such term.
                    (G) Vacancies.--A vacancy on a coordinating 
                committee shall be filled in the same manner in which 
                the original appointment was made.
                    (H) Compensation.--Each member of a coordinating 
                committee shall be compensated at a rate equal to the 
                daily equivalent of the annual rate of basic pay for 
                level IV of the Executive Schedule for each day 
                (including travel time) during which such member is 
                engaged in the performance of the duties of the 
                coordinating committee.
                    (I) Travel expenses.--Each member of a coordinating 
                committee shall receive travel expenses, including per 
                diem in lieu of subsistence, in accordance with 
                applicable provisions under subchapter I of chapter 57 
                of title 5, United States Code.
            (4) Meetings.--A coordinating committee shall meet 3 to 5 
        times each year, at the call of the coordinating committee's 
        chairperson and in consultation with the Deputy Assistant 
        Secretary for Minority Health Disparity Elimination and the 
        Administrator Health Resources and Services Administration.
            (5) Report.--Each coordinating committee shall transmit to 
        the Congress an annual report that, with respect to the health 
        empowerment zone program involved, includes the following:
                    (A) A review of the program's effectiveness in 
                achieving stated goals and outcomes.
                    (B) A review of the program's management and the 
                coordination of the entities involved.
                    (C) A review of the activities in the program's 
                portfolio and components.
                    (D) An identification of policy issues raised by 
                the program.
                    (E) An assessment of the program's capacity, 
                infrastructure, and number of underserved minority 
                communities reached.
                    (F) Recommendations for new program goals, research 
                areas, enhanced approaches, partnerships, coordination 
                and management mechanisms, and projects to be 
                established to achieve the program's stated goals, to 
                improve outcomes, monitoring, and evaluation.
                    (G) A review of the degree of minority entity 
                participation in the program, and an identification of 
                a strategy to increase such participation.
                    (H) Any other reviews or recommendations determined 
                to be appropriate by the coordinating committee.
    (d) Report.--The Deputy Assistant Secretary for Minority Health 
Disparity Elimination and the Administrator of the Health Resources and 
Services Administration shall submit a joint annual report to the 
appropriate committees of Congress on the results of the implementation 
of programs under this section.
    (e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of fiscal years 2007 through 2012.
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