110 HR 3014 IH: Health Equity and Accountability Act
U.S. House of Representatives
2007-07-12
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.This Act may be cited as the
Health Equity and Accountability Act
of 2007
.
2.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 and improving health
literacy.
Sec. 105. Report on Federal efforts to provide culturally and
linguistically appropriate health care services.
Sec. 106. Definitions.
Sec. 107. 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. Minority-Serving Institutions and Hispanic-serving
health professions schools.
Sec. 205. Health Professions Student Loan fund; authorizations
of appropriations regarding students from underrepresented minority
communities.
Sec. 206. National Health Service Corps; training
programs.
Sec. 207. Loan Repayment Program of the Centers for Disease
Control and Prevention.
Sec. 208. Strengthening and expanding rural health provider
networks.
Sec. 209. McNair Postbaccalaureate Achievement
program.
Sec. 210. Ensuring proportional representation of interests of
rural areas on MedPAC.
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.
Sec. 307. Health information technology grants.
Sec. 308. Study of health information technology in medically
underserved communities.
Sec. 309. Health information technology in medically
underserved communities.
Sec. 310. Data collection and analysis grants to
minority-serving institutions.
Sec. 311. Health information technology grants for rural health
care providers.
Title IV—Accountability and Evaluation
Subtitle A—General provisions
Sec. 401. Federal agency plan to eliminate disparities and
improve the health of minority populations.
Sec. 402. Accountability within the Department of Health and
Human Services.
Sec. 403. Office of Minority Health.
Sec. 404. Establishment of the Indian Health Service as an
agency of the Public Health Service.
Sec. 405. Establishment of individual offices of minority
health within agencies of the Public Health Service.
Sec. 406. Office of Minority Health at the Centers for Medicare
& Medicaid Services.
Sec. 407. Office of Minority Affairs at the Food and Drug
Administration.
Sec. 408. Safety and effectiveness of drugs with respect to
racial and ethnic background.
Sec. 409. United States Commission on Civil Rights.
Sec. 410. Sense of Congress concerning full funding of
activities to eliminate racial and ethnic health disparities.
Sec. 411. Guidelines for disease screening for minority
patients.
Sec. 412. National center for minority health and health
disparities reauthorization.
Subtitle B—Improving environmental justice
Sec. 421. Codification of executive order 12898.
Sec. 422. Implementation of recommendations by environmental
protection agency.
Sec. 423. Grant program.
Sec. 424. Additional research on the relationship between the
built environment and the health of community residents.
Title V—Improvement of Health Care Services
Sec. 501. Health empowerment zones.
Sec. 502. Amendment to the Public Health Service Act.
Sec. 503. Optional coverage of legal immigrants under the
Medicaid program and SCHIP.
Sec. 504. Border health grants.
Sec. 505. Cancer prevention and treatment demonstration for
ethnic and racial minorities.
Sec. 506. Grants to promote positive health behaviors in women
and children.
Sec. 507. Exception for citizens of freely associated
States.
Sec. 508. Medicare graduate medical education.
Sec. 509. HIV/AIDS reduction in racial and ethnic minority
communities.
Sec. 510. Grants for racial and ethnic approaches to community
health.
Sec. 511. Critical access hospital improvements.
Sec. 512. Coverage of marriage and family therapist services
and mental health counselor services under part
B of the Medicare program.
Sec. 513. Establishment of rural community hospital (RCH)
program.
Sec. 514. Medicare remote monitoring pilot
projects.
Sec. 515. Rural health quality advisory commission and
demonstration projects.
Sec. 516. Rural health care services.
Sec. 517. Community health center collaborative access
expansion.
Sec. 518. Facilitating the provision of telehealth services
across State lines.
<enum>I</enum><header>Culturally and
linguistically appropriate health care</header>
<section id="H42F086C652D3467BB9F2973344357003"><enum>101.</enum><header>Amendment to
the <act-name parsable-cite="PHSA">Public Health Service
Act</act-name></header><text display-inline="no-display-inline">The
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
201 et seq.) is amended by adding at the end the following:</text>
<quoted-block act-name="Public Health Service Act" id="H1F059008053D4CCD83E92FB1FA9994E7">
<title id="H0F27294913BF4E2100F378858518999F"><enum>XXX</enum><header>Culturally and
linguistically appropriate health care</header>
<section id="HD01C93A0662A4B6BA8AA11C2C8EE6B3E"><enum>3000.</enum><header>Definitions</header><text display-inline="no-display-inline">In this title:</text>
<paragraph id="HD05AB06658544224A953C886EB24F7BC"><enum>(1)</enum><header>Appropriate
health care services</header><text>The term <term>appropriate health care
services</term> includes services or treatments to address prevention and care
of physical, mental, oral, and behavioral disorders or syndromes.</text>
</paragraph><paragraph id="HC9EA400F7BB14E838C2E1D00C39701B0"><enum>(2)</enum><header>Indian
tribe</header><text>The term <term>Indian tribe</term> 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)
(<external-xref legal-doc="usc" parsable-cite="usc/43/1601">43 U.S.C. 1601 et seq.</external-xref>), which is recognized as eligible for the special
programs and services provided by the United States to Indians because of their
status as Indians.</text>
</paragraph><paragraph id="H91C40745719D48179B6F57028EE9EE33"><enum>(3)</enum><header>Limited English
proficient</header><text>The term <term>limited English proficient</term> with
respect to an individual means an individual who speaks a primary language
other than English and cannot speak, read, write, or understand the English
language at a level that permits them to effectively communicate with clinical
or nonclinical staff at a health care organization.</text>
</paragraph><paragraph id="H2DA2BE6B0BEC4492AF9BE18CB93FD100"><enum>(4)</enum><header>Minority</header>
<subparagraph id="H32171DB27FAB4EDB974FE1CE2B00ECED"><enum>(A)</enum><header>In
general</header><text>The terms <term>minority</term> and
<term>minorities</term> refer to individuals from a minority group.</text>
</subparagraph><subparagraph id="HDF28D4EC9F6845E8B1596447E400CFD1"><enum>(B)</enum><header>Populations</header><text>The
term <term>minority</term>, with respect to populations, refers to racial and
ethnic minority groups.</text>
</subparagraph></paragraph><paragraph id="H79A5430C344449CBAEFF83D13126699C"><enum>(5)</enum><header>Minority
Group</header><text>The term <term>minority group</term> has the meaning given
the term <term>racial and ethnic minority group</term>.</text>
</paragraph><paragraph id="HDA23B004CF0640CAADE5D65CBFF1C914"><enum>(6)</enum><header>Racial and
ethnic minority Group</header><text>The term <term>racial and ethnic minority
group</term> means American Indians and Alaska Natives, African Americans
(including Caribbean Blacks, Africans and other Blacks), Asian Americans,
Hispanics (including Latinos), and Native Hawaiians and other Pacific
Islanders.</text>
</paragraph><paragraph id="H08737AF4C3D3466AA94FDB6F64BF6705"><enum>(7)</enum><header>State</header><text>The
term <term>State</term> 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.</text>
</paragraph></section><section id="H76F463F994F24432AD8F6B6B00261DE9"><enum>3001.</enum><header>Improving
access to services for individuals with Limited English proficiency</header>
<subsection id="H30013330A24244B691BF257297002605"><enum>(a)</enum><header>Purpose</header><text>As
provided in Executive Order 13166, it is the purpose of this section—</text>
<paragraph id="H8FBAE11AE30E4C70B237A700BA63B1D8"><enum>(1)</enum><text>to improve access
to federally conducted and federally assisted programs and activities for
individuals who are limited in their English proficiency;</text>
</paragraph><paragraph id="H6F795FB6E3DB47349EC0F4002972F7A6"><enum>(2)</enum><text>to require each
Federal agency to examine the services it provides and develop and implement a
system by which limited English proficient individuals can obtain meaningful
access to those services consistent with, and without substantially burdening,
the fundamental mission of the agency;</text>
</paragraph><paragraph id="HDA6645C702CE43FBB5F78E06289C9069"><enum>(3)</enum><text>to require each
Federal agency to ensure that recipients of Federal financial assistance
provide meaningful access to their limited English proficient applicants and
beneficiaries;</text>
</paragraph><paragraph id="HAE810D71A8094FF8A32749D9C13CC5B0"><enum>(4)</enum><text>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</text>
</paragraph><paragraph id="H85C7301FF34D4988903DA3E4B19EED6"><enum>(5)</enum><text>to ensure
compliance with title VI of the <act-name parsable-cite="CRA64">Civil Rights
Act of 1964</act-name> and that health care providers and organizations do not
discriminate in the provision of services.</text>
</paragraph></subsection><subsection id="H94D4AC2414EB41C6B56904C6899CF441"><enum>(b)</enum><header>Federally
conducted programs and activities</header>
<paragraph id="H51DE1A2618B446DF8F509500F89F8318"><enum>(1)</enum><header>In
general</header><text>Not later than 120 days after the date of enactment of
this title, 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.</text>
</paragraph><paragraph id="H21237C6A5C5F4DA6998309A55ED13453"><enum>(2)</enum><header>Plan
requirement</header><text>Each plan under paragraph (1) shall be consistent
with the standards set forth in section 102 of the Health Equity and
Accountability Act of 2007, 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.</text>
</paragraph></subsection><subsection id="HF9FEEC0B5D7D4DEC933F40A3E0A1042C"><enum>(c)</enum><header>Federally
assisted programs and activities</header>
<paragraph id="H4C3372F9CBC447408EC2349571B2CF19"><enum>(1)</enum><header>In
general</header><text>Not later than 120 days after the date of enactment of
this title, 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
<act-name parsable-cite="CRA64">Civil Rights Act of 1964</act-name> (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 Health
Equity and Accountability Act of 2007. 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.</text>
</paragraph><paragraph id="HECCDF8C096AE4F4B824B5C5D63BA1BED"><enum>(2)</enum><header>Requirements</header><text>The
agency-specific guidance developed under paragraph (1) shall—</text>
<subparagraph id="H2CA3ADCCE1384CE0AA1B4E41844D23E5"><enum>(A)</enum><text>detail how the
general standards established under section 102 of the Health Equity and
Accountability Act of 2007 will be applied to the agency’s recipients;
and</text>
</subparagraph><subparagraph id="H660E6FCB1EED4A04BCEA4FACC6C0621"><enum>(B)</enum><text>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.</text>
</subparagraph></paragraph><paragraph id="H4E3982685AA34BF7972F892E1F60B6D"><enum>(3)</enum><header>Existing
guidances</header><text>A Federal agency that has developed a guidance for
purposes of title VI of the <act-name parsable-cite="CRA64">Civil Rights Act of
1964</act-name> that the Department of Justice determines is consistent with
the standards described in section 102 of the Health Equity and Accountability
Act of 2007 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.</text>
</paragraph><paragraph id="H1DFBC5A639A643129E9E605D817E6B83"><enum>(4)</enum><header>Consultation</header><text>Each
Federal agency shall consult with the Department of Justice in establishing the
guidances under this subsection.</text>
</paragraph></subsection><subsection id="H239D4E5F2A7B4E2BB1FC773CF9AA5382"><enum>(d)</enum><header>Consultations</header>
<paragraph id="HFA6B16F19F964D0FA1CC2FC0DBCF345D"><enum>(1)</enum><header>In
general</header><text>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.</text>
</paragraph><paragraph id="H82B72DF85B1649E1863E9625FF8000AA"><enum>(2)</enum><header>Evaluation</header><text>Each
Federal agency described in paragraph (1) shall evaluate the—</text>
<subparagraph id="HB375D133405849BE80ADB862ED46E100"><enum>(A)</enum><text>particular needs
of the limited English proficient individuals served by the agency, and by a
recipient of assistance provided by the agency;</text>
</subparagraph><subparagraph id="HD8B5B8EE682C4EE9A3804187C6002F00"><enum>(B)</enum><text>burdens of
compliance with the agency guidance and its recipients of the requirements of
this section; and</text>
</subparagraph><subparagraph id="HD1C080C71FC5485985203541005703A0"><enum>(C)</enum><text>outcomes or
effectiveness of services.</text>
</subparagraph></paragraph></subsection></section><section id="HF0D3A006410F45BBACCD0818EBEC78CE"><enum>3002.</enum><header>National
Standards for culturally and linguistically appropriate services in health
care</header><text display-inline="no-display-inline">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)—</text>
<paragraph id="H2AB58C0EC9014325B77D34B2681718A2"><enum>(1)</enum><text>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 health care to patient populations of
the service area of the organization;</text>
</paragraph><paragraph id="HFAEB15A4AB2A49F48F46B8B8C9E4A437"><enum>(2)</enum><text>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;</text>
</paragraph><paragraph id="HCE089385A3D2407AB66F6220BA8DDE45"><enum>(3)</enum><text>offer and provide
language assistance services, including trained 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;</text>
</paragraph><paragraph id="H0A89DDAC4A1841399FD04EC45104E400"><enum>(4)</enum><text>notify patients of
their right to receive language assistance services in their primary
language;</text>
</paragraph><paragraph id="HFA644AA3DA594CC2A19300B92B4367FD"><enum>(5)</enum><text>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—</text>
<subparagraph id="H98D9C0578F644634BCE3DF3FF53245B"><enum>(A)</enum><text>except in case of
emergency; or</text>
</subparagraph><subparagraph id="H91AEC7E918D74C9D9897BBA6D934D0CD"><enum>(B)</enum><text>except on request
of the patient, who has been informed in his or her preferred language of the
availability of free interpretation services;</text>
</subparagraph></paragraph><paragraph id="HADA662AD24BD4B6B87B9A73123B26032"><enum>(6)</enum><text>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;</text>
</paragraph><paragraph id="HEB028C7F1076431990140010CD3E830"><enum>(7)</enum><text>develop and
implement clear goals, policies, operational plans, and management
accountability and oversight mechanisms to provide culturally and
linguistically appropriate services;</text>
</paragraph><paragraph id="HFF625556E0C342D6B8DCE527C2837C57"><enum>(8)</enum><text>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;</text>
</paragraph><paragraph id="H7061AC914D034CFA980214777FF70083"><enum>(9)</enum><text>ensure that,
consistent with the privacy protections provided for under the regulations
promulgated under section 264(c) of the <act-name parsable-cite="HIPAA">Health
Insurance Portability and Accountability Act of 1996</act-name> (42 U.S.C.
1320d–2 note)—</text>
<subparagraph id="HBA3F28BA976645DCB63FA5CDD3499FD1"><enum>(A)</enum><text>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</text>
</subparagraph><subparagraph id="H61703D5EABEE4D918306D0CEEF1F00"><enum>(B)</enum><text>if the patient is a
minor or is incapacitated, the primary language of the parent or legal guardian
is collected;</text>
</subparagraph></paragraph><paragraph id="HC8C0A074AABF4D29A2EE69D700A4FB01"><enum>(10)</enum><text>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;</text>
</paragraph><paragraph id="H38BF3358E4BA4C329377D12CD2B1E962"><enum>(11)</enum><text>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;</text>
</paragraph><paragraph id="HA681D2FA4D654DC89E2E482E741DCF8C"><enum>(12)</enum><text>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;</text>
</paragraph><paragraph id="HF0F6954F5D444C30AB3382BFB4007516"><enum>(13)</enum><text>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</text>
</paragraph><paragraph id="H17DFF354E0DB4DA38723D660BE910029"><enum>(14)</enum><text>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.</text>
</paragraph></section><section id="H13C0026B83EF4CA983E96BDB9053DAC5"><enum>3003.</enum><header>Robert T.
Matsui Center for Cultural and Linguistic Competence in Health Care</header>
<subsection id="H3211CA397525438F888456AF29A1B8C"><enum>(a)</enum><header>Establishment</header><text>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
<quote>Robert T. Matsui Center for Cultural and Linguistic Competence in Health
Care</quote> (referred to in this section as the <quote>Center</quote>) to
carry out the following activities:</text>
<paragraph id="HD3933A766C9E4C0E00772DB2D2D56E04"><enum>(1)</enum><header>Remote medical
interpreting</header><text>The Center shall provide remote medical
interpreting, directly or through contracts, to health care 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
health care 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
<act-name parsable-cite="SSA">Social Security Act</act-name>.</text>
</paragraph><paragraph id="H924133DE94DD42E39D964F69AE46715C"><enum>(2)</enum><header>Model language
assistance programs</header><text>The Center shall provide for the collection
and dissemination of information on current model language assistance programs
and strategies to improve language access to health care for individuals with
limited English proficiency, including case studies using de-identified patient
information, program summaries, and program evaluations.</text>
</paragraph><paragraph id="HF874F1D8B9794F0F9D65BB514CA89C2"><enum>(3)</enum><header>Internet Health
Clearinghouse</header><text>The Center shall develop and maintain an Internet
clearinghouse to reduce medical errors and improve medical outcomes and reduce
health care costs caused by miscommunication with individuals with limited
English proficiency or low functional health literacy and reduce or eliminate
the duplication of effort to translate materials by—</text>
<subparagraph id="H4E2F8B7E6D594C85829D8E2E7BE42793"><enum>(A)</enum><text>developing and
making available templates for standard documents that are necessary for
patients and consumers to access and make educated decisions about their health
care, including—</text>
<clause id="H4F67291C450C4C8984F2D2520871845B"><enum>(i)</enum><text>administrative and
legal documents such as informed consent, advanced directives, and waivers of
rights;</text>
</clause><clause id="H7ED207AA74664D6E9B8B27FB875059E0"><enum>(ii)</enum><text>clinical
information such as how to take medications, how to prevent transmission of a
contagious disease, and other prevention and treatment instructions;</text>
</clause><clause id="HA7A6DF380CA4466D8800E42B47FEB8B4"><enum>(iii)</enum><text>patient
education and outreach materials such as immunization notices, health warnings,
or screening notices; and</text>
</clause><clause id="HE767BEA229B94C799D3C07DBBD2B329B"><enum>(iv)</enum><text>additional health
or health care-related materials as determined appropriate by the Director of
the Center;</text>
</clause></subparagraph><subparagraph id="HC1B317D73BAE4BE3B5A10083AC79DC1C"><enum>(B)</enum><text>ensuring that the
documents posted in English and non-English languages are culturally
appropriate;</text>
</subparagraph><subparagraph id="H3A53F20AA29244EF90F6F6D2399903C"><enum>(C)</enum><text>allowing public
review of the documents before dissemination in order to ensure that the
documents are understandable and culturally appropriate for the target
populations;</text>
</subparagraph><subparagraph id="H688DB2AF22754FFFB01EB882787EF831"><enum>(D)</enum><text>allowing health
care providers to customize the documents for their use;</text>
</subparagraph><subparagraph id="H36420622FA4046C1B57873CDF57FD10"><enum>(E)</enum><text>facilitating access
to these documents;</text>
</subparagraph><subparagraph id="HC869896E205045FBB939E4741C3EF7B9"><enum>(F)</enum><text>providing
technical assistance with respect to the access and use of such information;
and</text>
</subparagraph><subparagraph id="H3190AFC50D2E490D81C1A155141D6D2C"><enum>(G)</enum><text>carrying out any
other activities the Secretary determines to be useful to fulfill the purposes
of the Clearinghouse.</text>
</subparagraph></paragraph><paragraph id="H71EB7A5670584829A42DD900E77015CB"><enum>(4)</enum><header>Provision of
information</header><text>The Center shall provide information relating to
culturally and linguistically competent health care for minority populations
residing in the United States to all health care providers and health care
organizations at no cost. Such information shall include—</text>
<subparagraph id="H8E41444D3F454655A255DEF7C226F49"><enum>(A)</enum><text>tenets of
culturally and linguistically competent care;</text>
</subparagraph><subparagraph id="H7191E98593D344DAB0440050C8C04EE0"><enum>(B)</enum><text>cultural and
linguistic competence self-assessment tools;</text>
</subparagraph><subparagraph id="H7301554E4F224CE1B8F2071100E66200"><enum>(C)</enum><text>cultural and
linguistic competence training tools;</text>
</subparagraph><subparagraph id="H5B0FE8F6961541709400DE974F162435"><enum>(D)</enum><text>strategic plans to
increase cultural and linguistic competence in different types of health care
organizations, including regional collaborations among health care
organizations; and</text>
</subparagraph><subparagraph id="H5B258D12441C4547A13C40BE0340D638"><enum>(E)</enum><text>resources for
cultural and linguistic competence information for educators, practitioners and
researchers.</text>
</subparagraph></paragraph></subsection><subsection id="H7CB75500F5B64613A270F000C605D214"><enum>(b)</enum><header>Director</header><text display-inline="yes-display-inline">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.</text>
</subsection><subsection id="H71D353A5B889401C8E42FD68A380717B"><enum>(c)</enum><header>Availability of
language access</header><text>The Director shall collaborate with all agencies
within the Department of Health and Human Services to notify health care
providers and health care organizations about the availability of language
access services by the Center.</text>
</subsection><subsection id="H2543BC1E48894C10A3ECC72492F04BC"><enum>(d)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section such sums as may be necessary for each of fiscal years 2008
through 2012.</text>
</subsection></section><section id="H3995CC5032D74AA587FBE659EAD16645"><enum>3004.</enum><header>Innovations in
cultural and linguistic competence grants</header>
<subsection id="H2BDFB9D6F7D7436A8710A3D014CACDDB"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Administrator of the
Centers for Medicare & Medicaid Services, the Administrator of the Health
Resources and Services Administration, the Secretary of Education, and the
Deputy Assistant Secretary for Minority Health, shall award grants to eligible
entities to enable such entities to design, implement, and evaluate innovative,
cost-effective programs to improve cultural and linguistic competence in health
care for individuals with limited English proficiency.</text>
</subsection><subsection id="HB3E04CFD96414F59A0F501DE182D433"><enum>(b)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under subsection (a) an entity shall—</text>
<paragraph id="H28A8652FFEF14A9A8C56A29BB612BD85"><enum>(1)</enum><text>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</text>
</paragraph><paragraph id="HC0FA10793A5A44ED9D6E22746B857D00"><enum>(2)</enum><text>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.</text>
</paragraph></subsection><subsection id="H74CAACD672C74E07AA03ABB79DB2B23E"><enum>(c)</enum><header>Use of
funds</header><text>An entity shall use funds received under a grant under this
section to—</text>
<paragraph id="H406B71E5A2FD4A1CABBF342DFD37C006"><enum>(1)</enum><text>develop,
implement, and evaluate models of providing real-time cultural competence and
interpretation services through in-person interpretation, communications, and
computer technology, including the Internet, teleconferencing, or video
conferencing;</text>
</paragraph><paragraph id="HE4902B41E50D4B238215389332C0AB46"><enum>(2)</enum><text>develop short-term
medical interpretation training courses and incentives for bilingual health
care staff who are asked to interpret in the workplace;</text>
</paragraph><paragraph id="H10BDDD708D9044E981B6DF18AF2460C9"><enum>(3)</enum><text>develop formal
training programs for individuals interested in becoming dedicated health care
interpreters and culturally competent providers;</text>
</paragraph><paragraph id="H7EF98BE70A4449178F8FF72D60CE937E"><enum>(4)</enum><text>provide staff
language training instruction which shall include information on the practical
limitations of such instruction for non-native speakers; and</text>
</paragraph><paragraph id="H993A12E0477746D7B3A94C7004C67F27"><enum>(5)</enum><text>develop other
language assistance services as determined appropriate by the Secretary.</text>
</paragraph></subsection><subsection id="H65004AFA4C3045C5A66F51DE15398049"><enum>(d)</enum><header>Priority</header><text>In
awarding grants under this section, the Secretary shall give priority to
entities that have developed partnerships with organizations or agencies with
experience in culturally competent and language access services.</text>
</subsection><subsection id="H5FFBBCAB421743DD8C30D232FEC56332"><enum>(e)</enum><header>Evaluation</header><text>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 health care
services and the quality of health care for individuals with limited English
proficiency. Such evaluation shall be collected and disseminated through the
Robert T. Matsui Center for Cultural and Linguistic Competence in Health Care
established under section 3003.</text>
</subsection><subsection id="HCAD739CB7720478FB08B32872E2D96A6"><enum>(f)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, $5,000,000 for each of fiscal years 2008 through 2012.</text>
</subsection></section><section id="H12FB070AF64A4DF8A0EE26CD65F41B5C"><enum>3005.</enum><header>Research on
cultural and language competence</header>
<subsection id="HDA8E28C32A024B03AA00DE4620939854"><enum>(a)</enum><header>In
general</header><text>The Director of the Agency for Healthcare Research and
Quality, in collaboration with the Deputy Assistant Secretary for Minority
Health, shall expand research concerning—</text>
<paragraph id="H36D985C075164F24B8079C042E056518"><enum>(1)</enum><text>the barriers to
health care services including mental and behavioral services that are faced by
limited English proficient individuals;</text>
</paragraph><paragraph id="HBCA5B72C2FD943AB98A80026349BC851"><enum>(2)</enum><text>the impact of
cultural and language barriers on the quality of health care and the health
status of limited English proficient individuals and populations;</text>
</paragraph><paragraph id="HBBC5E8B9EE274787B34000961B8E94E2"><enum>(3)</enum><text>health care
providers’ and health administrators’ attitudes, knowledge, and awareness of
the barriers described in paragraphs (1) and (2);</text>
</paragraph><paragraph id="HB1140C9C909C42F7AA66136ECE8E09AA"><enum>(4)</enum><text>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;</text>
</paragraph><paragraph id="HD0CDF7F2D9CF49CE90F8CF9BA32B6BAF"><enum>(5)</enum><text>the
cost-effectiveness of providing language access; and</text>
</paragraph><paragraph id="H49802271AA7045D28B1926BB767B2260"><enum>(6)</enum><text>optimal approaches
for delivering language access.</text>
</paragraph></subsection><subsection id="HCFF3300ADE9643619678E31700D744D1"><enum>(b)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2008
through 2012.</text>
</subsection></section><section id="H8B843D0CFF8B46AE8DEC45078EB4DC44"><enum>3006.</enum><header>Information
about Federal Health programs for Limited English proficient
populations</header><text display-inline="no-display-inline">The Secretary
shall provide for a means by which limited English proficient individuals who
are seeking information about, or assistance with, Federal health care programs
may obtain such information or
assistance.</text>
</section>.
102.Standards for
language access servicesNot
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.
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)The Secretary shall conduct a demonstration project (in
this subsection 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)The
Secretary shall carry out the project in not less than 30 States or territories
through contracts with—
(A)MA plans (under
part C of title XVIII of the Social Security
Act);
(B)small
providers;
(C)hospitals;
and
(D)community-based
clinics.
(3)Each
contract entered into under the project shall extend over a period of not
longer than 2 years.
(4)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)The Director of the Agency for Healthcare
Research and Quality, in consultation with the Office of Minority Health and
the National Center on Minority Health and Health Disparities, shall award
grants to public and private nonprofit entities that demonstrate experience and
capability with respect to cultural and linguistic competence, including
Historically Black Colleges and Universities, Hispanic-serving institutions,
and other entities directed by and serving representatives of racial and ethnic
minority groups, for the evaluation of the project. Such evaluations shall
focus on access, utilization, efficiency, cost-effectiveness, patient
satisfaction, and select health outcomes.
(b)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)100 percent of the
sums expended with respect to costs incurred during such quarter as are
attributable to the provision of language services on behalf of individuals
with limited English proficiency who apply for or receive medical assistance
under the State plan under this title (including any provisions of the plan
implemented pursuant to any waiver authority of the Secretary) or child health
assistance under a State child health plan under title XXI;
plus
.
(c)Section
2105(c)(2)(A) of the Social Security Act (42 U.S.C. 1397ee(c)(2)(A)) is amended
by inserting before the period at the end the following: except that
expenditures described in, and reimbursable under, section 1903(a)(3)(F) shall
not count towards this total
.
(d)The amendments made by this section take effect on October
1, 2007.
104.Increasing
understanding of and improving health literacy
(a)The Secretary, acting through the Director of the Agency
for Healthcare Research and Quality and the Administrator of the Health
Resources and Services Administration, in consultation with the Office of
Minority Health, shall award grants to eligible entities to improve health care
for patient populations that have low functional health literacy.
(b)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 (including a
nonprofit minority health organization or association); 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)
(1)Agency for
Healthcare Research and QualityGrants 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 health care;
(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 AdministrationGrants 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, physical, oral, and
behavioral 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)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
appropriationsThere is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2008
through 2012.
105.Report on
Federal efforts to provide culturally and linguistically appropriate health
care servicesNot 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 health care services. Such report
shall include—
(1)a
description and evaluation of the activities carried out under this Act;
(2)a
description of best practices, model programs, guidelines, and other effective
strategies for providing access to culturally and linguistically appropriate
health care services; and
(3)an assessment of
the implementation of the Department of Health and Human Services National
Standards on Culturally and Linguistically Appropriate Services (CLAS) in
Health Care, in particular the implementation of CLAS mandates by recipients of
Federal funds.
106.In this title:
(1)The definitions contained in section 3000 of the
Public Health Service Act, as added
by section 101, shall apply.
(2)The
term Secretary means the Secretary of Health and Human
Services.
107.Treatment of the
Medicare part B program under title VI of the Civil Rights Act of
1964A 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.
<enum>II</enum><header>Health Workforce
Diversity</header>
<section id="H6047630B7B184C8B9EE3CDC06D14318B"><enum>201.</enum><header>Amendment to
the <act-name parsable-cite="PHSA">Public Health Service
Act</act-name></header><text display-inline="no-display-inline">Title XXX of
the <act-name parsable-cite="PHSA">Public Health Service Act</act-name>, as
added by section 101, is amended by adding at the end the following:</text>
<quoted-block act-name="Public Health Service Act" id="HA11501B2CBCF4DF587961D6006D366E">
<subtitle id="HF5F8AA303FAD4BC68E957812F24009B6"><enum>A</enum><header>Diversifying the
health care workplace</header>
<section id="HDCD79A2FA98641A7939006607535A56D"><enum>3011.</enum><header>Report on
workforce Diversity</header>
<subsection id="H13C2D4F7C45E454F80A1EE4405C17F5"><enum>(a)</enum><header>In
general</header><text>Not later than July 1, 2008, 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.</text>
</subsection><subsection id="H16EE1124DF894F0992D7B712D8FE9558"><enum>(b)</enum><header>Requirement</header><text>The
report under subsection (a) shall contain the following information:</text>
<paragraph id="H5D2AAF135F424587B20974DADBA1D2FB"><enum>(1)</enum><text>A description of
any grant support that is provided by each entity for workforce diversity
initiatives with the following information—</text>
<subparagraph id="H2E14845E23FE4055BA47B1D07EE53F04"><enum>(A)</enum><text>the number of
grants made;</text>
</subparagraph><subparagraph id="HEC991895260E44C3805DED25003B27B7"><enum>(B)</enum><text>the purpose of the
grants;</text>
</subparagraph><subparagraph id="H6DACC6C2F12A49D9AEA1C3C174C91DA"><enum>(C)</enum><text>the populations
served through the grants;</text>
</subparagraph><subparagraph id="H7E5492DBDF69439993762CA9FF8EBB98"><enum>(D)</enum><text>the organizations
and institutions receiving the grants, including specification of the number of
Hispanic health professions schools and minority-serving institutions;
and</text>
</subparagraph><subparagraph id="H7069C78B690948248BC876A43363452D"><enum>(E)</enum><text>the tracking
efforts that were used to follow the progress of participants.</text>
</subparagraph></paragraph><paragraph id="H34DEA4762A45426D85F644D000724D70"><enum>(2)</enum><text>A description of
the entity’s plan to achieve workforce diversity goals that includes, to the
extent relevant to such entity—</text>
<subparagraph id="H4B2B1671267749248BF3A757B9393C78"><enum>(A)</enum><text>the number of
underrepresented minority health professionals that will be needed in various
disciplines over the next 10 years to achieve population parity;</text>
</subparagraph><subparagraph id="H4ADC900F2F5D4CD6A0D85F71317648E2"><enum>(B)</enum><text>the level of
funding needed to fully expand and adequately support health professions
pipeline programs;</text>
</subparagraph><subparagraph id="H3C3A6E1564C74177963851BD8614EAB0"><enum>(C)</enum><text>the impact such
programs have had on the admissions practices and policies of health
professions schools;</text>
</subparagraph><subparagraph id="HF17220ADD6664C40A1BA87433DFB1736"><enum>(D)</enum><text>the management
strategy necessary to effectively administer and institutionalize health
profession pipeline programs;</text>
</subparagraph><subparagraph id="H7705980680754192A3B21DA48709C0B3"><enum>(E)</enum><text>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; and</text>
</subparagraph><subparagraph id="H6FCC5AB8691F4C7B97DA3270AA2F95D4"><enum>(F)</enum><text>an examination of
the role and support for minority-serving institutions and Hispanic health
professions schools in training minority health professionals and in increasing
their representation at all levels in the Department of Health and Human
Services.</text>
</subparagraph></paragraph><paragraph id="H8151A04150484AEB00E669F1AF3892F1"><enum>(3)</enum><text>A description of
measurable objectives of each entity relating to workforce diversity
initiatives.</text>
</paragraph></subsection><subsection id="HF236E0400DDB4820A877B733C2A8C936"><enum>(c)</enum><header>Public
availability</header><text>The report under subsection (a) shall be made
available for public review and comment.</text>
</subsection></section><section id="HF6BD700C29A44C8CAB4DFB3F23DB8C94"><enum>3012.</enum><header>Technical
Clearinghouse for Health workforce Diversity</header>
<subsection id="HC312DE61CF304395B26166F82C653A7"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Office of Minority
Health, 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 and coordinate current and future clearinghouses.</text>
</subsection><subsection id="HF083C2C8175C4959BF61983738E950C5"><enum>(b)</enum><header>Information and
services</header><text>The clearinghouse established under subsection (a) shall
offer the following information and services:</text>
<paragraph id="H9C7B726CA1144EF8B97BE741431F9EAE"><enum>(1)</enum><text>Information on the
importance of health workforce diversity.</text>
</paragraph><paragraph id="HD72A70B423934AA781ED4BFF0AB1EDD"><enum>(2)</enum><text>Statistical
information relating to underrepresented minority representation in health and
allied health professions and occupations.</text>
</paragraph><paragraph id="H5E922D3670D040F194FC393072C3146B"><enum>(3)</enum><text>Model health
workforce diversity practices and programs.</text>
</paragraph><paragraph id="H1235E685632B4EC9929FE80092572508"><enum>(4)</enum><text>Admissions
policies that promote health workforce diversity and are in compliance with
Federal and State laws.</text>
</paragraph><paragraph id="HCA3D42E47081415E943EE7E135E7C52D"><enum>(5)</enum><text>Lists of
scholarship, loan repayment, and loan cancellation grants as well as fellowship
information for underserved populations for health professions schools.</text>
</paragraph><paragraph id="H83599FD07F0F489B8008E75C003F7799"><enum>(6)</enum><text>Foundation and
other large organizational initiatives relating to health workforce
diversity.</text>
</paragraph></subsection><subsection id="HB46D810FEDD94A11B76354E95B366D2B"><enum>(c)</enum><header>Consultation</header><text>In
carrying out this section, the Secretary shall consult with non-Federal
entities, which shall include minority health professional associations to help
ensure thoroughness and accuracy of information.</text>
</subsection><subsection id="H99BAAB8C3258493B9C4BFE684A8EB4"><enum>(d)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2008
through 2013.</text>
</subsection></section><section id="H5F7297DC494A4CD6B4D320148F1167B"><enum>3013.</enum><header>Evaluation of
workforce Diversity initiatives</header>
<subsection id="HFC90580131CD45F187EFB02A6B05B7D"><enum>(a)</enum><header>In
general</header><text>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.</text>
</subsection><subsection id="HA6371CA06C1C414284ECC5F9C2F83800"><enum>(b)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under subsection (a) an entity shall—</text>
<paragraph id="HB723916F94684980B8C6008488E34798"><enum>(1)</enum><text>be a city, county,
Indian tribe, State, territory, community-based nonprofit organization, health
center, university, college, or other entity determined appropriate by the
Secretary;</text>
</paragraph><paragraph id="HDE2B03D83A604A25B41B11C24873CAAF"><enum>(2)</enum><text>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</text>
</paragraph><paragraph id="H32002A41DEE641B9BAC776E157007194"><enum>(3)</enum><text>submit to the
Secretary an application at such time, in such manner, and containing such
information as the Secretary may require.</text>
</paragraph></subsection><subsection id="HEA70550554354842873F734F0575CE6D"><enum>(c)</enum><header>Use of
funds</header><text>Amounts awarded under a grant under subsection (a) shall be
used to support the following evaluation activities:</text>
<paragraph id="H383C1E1E608846879D94ED978501E44"><enum>(1)</enum><text>Determinations of
measures of health workforce diversity success.</text>
</paragraph><paragraph commented="no" id="HB705C66BDFC14EF2A990372C0500FFE"><enum>(2)</enum><text>Assessments of the
effects of health workforce diversity on quality, including—</text>
<subparagraph commented="no" id="H2511EB5D51FD4022B21E28502512F251"><enum>(A)</enum><text>language
access;</text>
</subparagraph><subparagraph commented="no" id="HD2270FB10F6242858921981D96780008"><enum>(B)</enum><text>cultural
competence;</text>
</subparagraph><subparagraph commented="no" id="HE69FED0499784919AEDCCFE800FA873"><enum>(C)</enum><text>patient
satisfaction;</text>
</subparagraph><subparagraph commented="no" id="H65AF312E931147F99E00C2912F3DB1F5"><enum>(D)</enum><text>timeliness of
care;</text>
</subparagraph><subparagraph commented="no" id="H223A169F774D4B1C8C2CC93B2D22375C"><enum>(E)</enum><text>safety of
care;</text>
</subparagraph><subparagraph commented="no" id="HC1C99A0A22A94BBDA8934EC216931385"><enum>(F)</enum><text>effectiveness of
care;</text>
</subparagraph><subparagraph commented="no" id="H171987433B424D67B842E8AA1006ECB"><enum>(G)</enum><text>efficiency of
care;</text>
</subparagraph><subparagraph commented="no" id="H88AACCFD970844CFBBD959976FA3FF7B"><enum>(H)</enum><text>patient
outcomes;</text>
</subparagraph><subparagraph commented="no" id="HCC6C28F99B5B4FD4AF00B94E3CE490A4"><enum>(I)</enum><text>community
engagement;</text>
</subparagraph><subparagraph commented="no" id="H777F966843D544E48C7427415F6099FA"><enum>(J)</enum><text>resource
allocation;</text>
</subparagraph><subparagraph commented="no" id="H1FF982A7AC3E473DBAE9F2031959F015"><enum>(K)</enum><text>organizational
structure; and</text>
</subparagraph><subparagraph commented="no" id="HD83841A19AEE429DBBA09113D77BF8B"><enum>(L)</enum><text>other topics
determined appropriate by the Secretary.</text>
</subparagraph></paragraph><paragraph id="H9DDF34F1E69B4EF38FF2C15C4916D932"><enum>(3)</enum><text>The short- and
long-term tracking of participants in health workforce diversity pipeline
programs funded by the Department of Health and Human Services.</text>
</paragraph><paragraph id="H464B1D03BDB74A64BA6CC4598727AD65"><enum>(4)</enum><text>Assessments of
partnerships formed through activities to increase health workforce
diversity.</text>
</paragraph><paragraph id="H060C625906914AB3AF71E952C52ECE7C"><enum>(5)</enum><text>Assessments of
barriers to health workforce diversity.</text>
</paragraph><paragraph id="H8CA7A30EB23145668462BD7C80D7B2F2"><enum>(6)</enum><text>Assessments of
policy changes at the Federal, State, and local levels.</text>
</paragraph><paragraph id="H41A17D3B982B4E84BAB3A801EA3F81B7"><enum>(7)</enum><text>Assessments of
coordination within and between Federal agencies and other institutions.</text>
</paragraph><paragraph id="H1A8EA42C2A3F41FF92C51CBEF359006C"><enum>(8)</enum><text>Other activities
determined appropriate by the Secretary.</text>
</paragraph></subsection><subsection id="H04512081314D4BBEBDDA51555DFF975"><enum>(d)</enum><header>Report</header><text>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.</text>
</subsection><subsection id="H0592170FB984444E82E017B5CC661E7F"><enum>(e)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2008
through 2013.</text>
</subsection></section><section id="H351D1247F41D410ABC044FF56486B4E1"><enum>3014.</enum><header>Data
collection and reporting by Health professional schools</header>
<subsection id="HD07EAFC01E3D4895AC09B9161CDA8B15"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Bureau of Health
Professions of the Health Resources and Services Administration and the Office
of Minority Health, shall establish an aggregated database on health
professional students.</text>
</subsection><subsection id="H77FCC1755B6E4EB982004F12EF24D109"><enum>(b)</enum><header>Requirement To
collect data</header><text>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—</text>
<paragraph id="H21E7C7D13BBF4C898B9579025B45CD75"><enum>(1)</enum><text>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</text>
</paragraph><paragraph id="H4F50662308C441B49472314D384FCD03"><enum>(2)</enum><text>if practicable,
collect data on additional population groups if such data can be aggregated
into the minimum race and ethnicity data categories.</text>
</paragraph></subsection><subsection id="H578F1DF4E5CD4DB3B9DBA37B0140CD78"><enum>(c)</enum><header>Use of
data</header><text>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.</text>
</subsection><subsection id="HFDD00DBA0BE5467DA747ECE4EDE8CB42"><enum>(d)</enum><header>Privacy</header><text>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.</text>
</subsection><subsection id="HE52783E7DA6D435FBC125F3421F1D317"><enum>(e)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2008
through 2013.</text>
</subsection></section><section id="HE30E648E0AB64A52A5AE73BA850029ED"><enum>3015.</enum><header>Support for
Institutions committed to workforce Diversity</header>
<subsection id="H777B472FCCC04B69B228B996318751C1"><enum>(a)</enum><header>In
general</header><text>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.</text>
</subsection><subsection id="H0ADB650BCE3745B2853479FD00CFB590"><enum>(b)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under subsection (a), an entity shall—</text>
<paragraph id="HDE53B0633F424D7B98FCED7E1FA1914D"><enum>(1)</enum><text>be an educational
institution or entity that historically produces or trains meaningful numbers
of underrepresented minority health professionals, including—</text>
<subparagraph id="H87B16EADCB784AD39501515FCBAA149D"><enum>(A)</enum><text>Historically Black
Colleges and Universities;</text>
</subparagraph><subparagraph id="HF8E7738EC4B64E5980B2F0A7E28D9FA"><enum>(B)</enum><text>Hispanic-serving
health professions schools;</text>
</subparagraph><subparagraph id="HD497B5154C7949F1B100F4B2D35B201"><enum>(C)</enum><text>Hispanic-serving
institutions;</text>
</subparagraph><subparagraph id="H5A33DEE49F2640A2BFC3F0DFFB02E7DD"><enum>(D)</enum><text>Tribal Colleges
and Universities;</text>
</subparagraph><subparagraph id="H7FBC80B4BA9E49AA82FE60ED15A3E0A9"><enum>(E)</enum><text>Asian American and
Pacific Islander-serving institutions;</text>
</subparagraph><subparagraph id="H2FFB90F020BE4104A202ED72D5EC4216"><enum>(F)</enum><text>institutions that
have programs to recruit and retain underrepresented minority health
professionals, in which a significant number of the enrolled participants are
underrepresented minorities;</text>
</subparagraph><subparagraph id="HAC0A7090741A4FD2BF871837FAEE1900"><enum>(G)</enum><text>health
professional associations, which may include underrepresented minority health
professional associations; and</text>
</subparagraph><subparagraph id="HE3388D8B28E84E0F97D6CAA9CA7ADAC"><enum>(H)</enum><text>institutions—</text>
<clause id="HB46795A7C5D44DFCB4933D5BCC7BCDFC"><enum>(i)</enum><text>located in
communities with predominantly underrepresented minority populations;</text>
</clause><clause id="H199574883E184B1FAA3800B2832D3616"><enum>(ii)</enum><text>with whom
partnerships have been formed for the purpose of increasing workforce
diversity; and</text>
</clause><clause id="H649D65E4B99A48E28D7DB062F45E24D1"><enum>(iii)</enum><text>in which at
least 20 percent of the enrolled participants are underrepresented minorities;
and</text>
</clause></subparagraph></paragraph><paragraph id="H9BD949549C554286848F5B9007D171C"><enum>(2)</enum><text>submit to the
Secretary an application at such time, in such manner, and containing such
information as the Secretary may require.</text>
</paragraph></subsection><subsection id="HD2DDCDACF97643D0B445047CE7727E49"><enum>(c)</enum><header>Use of
funds</header><text>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 as well as oral health care
professions. Such programs shall enhance diversity by considering minority
status as part of an individualized consideration of qualifications. Possible
activities may include—</text>
<paragraph id="H08EB4CACB26F4E80947C91F4A6470439"><enum>(1)</enum><text>educational
outreach programs relating to opportunities in the health professions;</text>
</paragraph><paragraph id="H46868F682A2D4BB3A7DB7155A0009DE5"><enum>(2)</enum><text>scholarship,
fellowship, grant, and loan repayment programs;</text>
</paragraph><paragraph id="H135000DA0979466C8D83B1E7C43B86B8"><enum>(3)</enum><text>post-baccalaureate
programs;</text>
</paragraph><paragraph id="HB80D318BC76A4755A2CEF8D78678C4EC"><enum>(4)</enum><text>academic
enrichment programs, particularly targeting those who would not be competitive
for health professions schools;</text>
</paragraph><paragraph id="H92C55B59779C43F9B9A100E5C4C18D00"><enum>(5)</enum><text>kindergarten
through 12th grade and other health pipeline programs;</text>
</paragraph><paragraph id="H5C499AD798DE4E02AE5B6C3236A493FC"><enum>(6)</enum><text>mentoring
programs;</text>
</paragraph><paragraph id="H5C6F787A4A58401F005F8E73842B74CD"><enum>(7)</enum><text>internship or
rotation programs involving hospitals, health systems, health plans and other
health entities;</text>
</paragraph><paragraph id="HF18EB6998ABB4248B56F2B00A87B082E"><enum>(8)</enum><text>community
partnership development for purposes relating to workforce diversity; or</text>
</paragraph><paragraph id="H04EB22AAEF994E729D237FF26FB3763C"><enum>(9)</enum><text>leadership
training.</text>
</paragraph></subsection><subsection id="H7C6FDD7B9D34484AA644CB11289786B0"><enum>(d)</enum><header>Reports</header><text>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.</text>
</subsection><subsection id="H1B7063527302414593DBAB159200C4DF"><enum>(e)</enum><header>Definition</header><text>In
this section, the term <term>Asian American and Pacific Islander-serving
institutions</term> means institutions—</text>
<paragraph id="H40F87518F6EA4088A32148A072CB1446"><enum>(1)</enum><text>that are eligible
institutions under section 312(b) of the <act-name parsable-cite="HEA65">Higher
Education Act of 1965</act-name>; and</text>
</paragraph><paragraph id="H41B273E2F93648EAB513FDBB25E4B4B"><enum>(2)</enum><text>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.</text>
</paragraph></subsection><subsection id="HED52AEAA95A74E6C85FA2DF7B5D14278"><enum>(f)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section $100,000,000 for each of fiscal years 2008 through
2013.</text>
</subsection></section><section id="H21AC610A1319468683A845AFB94EF7F"><enum>3016.</enum><header>Career
development for scientists and researchers</header>
<subsection id="H8676899DAE98465BA1E104C802726752"><enum>(a)</enum><header>In
general</header><text>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.</text>
</subsection><subsection id="H6049DEC1BCD34DF7B8D5DEEFD513CF41"><enum>(b)</enum><header>Research
funding</header><text>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.</text>
</subsection><subsection id="H516FDF67335248F0BAF56EAFE39899E0"><enum>(c)</enum><header>Data
collection</header><text>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.</text>
</subsection><subsection id="HAA446EBF3E904BFF98F09C43D7C62095"><enum>(d)</enum><header>Student loan
reimbursement</header><text>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.</text>
</subsection></section><section id="H2FEAB71ABCF2430A9726290859B61C5B"><enum>3017.</enum><header>Career support
for non-research Health professionals</header>
<subsection id="H3ECC492ED7164F338F78489CDB5657E1"><enum>(a)</enum><header>In
general</header><text>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 & Medicaid Services shall establish a program to award grants to
eligible individuals for career support, including leadership training, in
non-research-related health care.</text>
</subsection><subsection id="H88D686739C004FC4B55FC046A6F1665"><enum>(b)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under subsection (a) an individual shall—</text>
<paragraph id="H82135E00EEA8471DAE6E6BAC98800000"><enum>(1)</enum><text>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</text>
</paragraph><paragraph id="HBC7EBD4AA61D483DA7030288A0CE5B3D"><enum>(2)</enum><text>submit to the
Secretary an application at such time, in such manner, and containing such
information as the Secretary may require.</text>
</paragraph></subsection><subsection id="HED0A2E8B3FF5474B89FE569B598FF97B"><enum>(c)</enum><header>Use of
funds</header><text>An individual shall use amounts received under a grant
under this section to—</text>
<paragraph id="H26551249A5FD489482F95C62008984D4"><enum>(1)</enum><text>support the
individual’s health activities or projects that involve underserved
communities, including rural communities and racial and ethnic minority
communities;</text>
</paragraph><paragraph id="H2A90A54E08664096B83DD631F5A0003C"><enum>(2)</enum><text>support
health-related career advancement activities; and</text>
</paragraph><paragraph id="HB605AA18B9FE4F3D8B944E0346DD07C3"><enum>(3)</enum><text>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 rural communities and racial and ethnic minority
communities.</text>
</paragraph></subsection><subsection id="H4D316003FEEA48108613E068E4DDE633"><enum>(d)</enum><header>Definition</header><text>In
this section, the term <term>career in non-research-related health care</term>
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.</text>
</subsection><subsection id="H899DC4C1C56A44C9863E18D62F1AC33"><enum>(e)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2008
through 2013.</text>
</subsection></section><section id="H121153F15C0F4BE39DFC312600F6AF8C"><enum>3018.</enum><header>Cultural
competence training for health care professionals</header>
<subsection id="HDDA35F0F2CC94009A968EAE2009C2123"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Administrator of the
Health Resources and Services Administration, the Deputy Assistant Secretary
for Minority Health, 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 health care providers.</text>
</subsection><subsection id="HB481F864E5A14833B2E81D68473D9726"><enum>(b)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under subsection (a), an entity shall—</text>
<paragraph id="H330FC6D5A1094106A6ABC881C7983CCA"><enum>(1)</enum><text>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);</text>
</paragraph><paragraph id="H2B1A59ECD01941A982E5C4F5FF4D1F68"><enum>(2)</enum><text>partner with a
minority-serving institution, minority health professional association, or
community-based organization representing minority populations, in addition to
a research institution to carry out activities under this grant; and</text>
</paragraph><paragraph id="H72E35EAFD9DC4D03AB4CCB1F964E357"><enum>(3)</enum><text>prepare and submit
to the Secretary an application at such time, in such manner, and containing
such information as the Secretary may require.</text>
</paragraph></subsection><subsection id="HF844AAD53EF44B1A8638F61F7618F8C5"><enum>(c)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2008
through 2013.</text>
</subsection></section><section id="H38BE5BD5D3CF4ED2895F00DC1166A3B2"><enum>3019.</enum><header>Regional
Minority Centers of Excellence Programs</header>
<subsection commented="no" id="HA4C98FCAB8F74C01B7032C8D6CD14C4D"><enum>(a)</enum><header>Establishment</header><text display-inline="yes-display-inline">The Office of Minority Health, in
collaboration with the Health Resources and Services Administration and the
National Center on Minority Health and Health Disparities, shall establish and
jointly fund Regional Minority Centers of Excellence Programs in medically
underserved regions through the award of major funded, long-term cooperative
agreements to eligible minority community-based organizations, school
districts, and health professions organizations.</text>
</subsection><subsection commented="no" id="H2899BD1196BB491B9856EFBF648DCB12"><enum>(b)</enum><header>Use of
funds</header><text>The Office of Minority Health shall not award a cooperative
agreement to an entity for a Regional Minority Centers of Excellence Program
under subsection (a) unless the entity agrees that its program will
include—</text>
<paragraph id="H57F1871FEA3548089BC89D8DE99227FF"><enum>(1)</enum><text>recruitment of
minority students and faculty; and</text>
</paragraph><paragraph id="H3CEB169E8D1347E4A13400C4119E7DD6"><enum>(2)</enum><text>development of
curriculum on minority health for health professions students, allied health
students, and other health professionals.</text>
</paragraph></subsection><subsection id="H3088142421FA459192F63B5811007750"><enum>(c)</enum><header>Eligibility</header><text>To
be eligible to receive a cooperative agreement under subsection (a), a minority
community-based organization, school district, or profession organization must
be recognized for its demonstrated ability to engage minority community
involvement in health care programs.</text>
</subsection><subsection commented="no" id="HA85569D52FD249DC867DC8CD02001FFA"><enum>(d)</enum><header>Priority</header><text>In
awarding cooperative agreements under subsection (a), the Office of Minority
Health shall give priority to entities that—</text>
<paragraph id="HB8F0C59519D8445DB48C22FB2C9E227D"><enum>(1)</enum><text>will use the
agreement in a geographic area that has a large medically underserved minority
population; and</text>
</paragraph><paragraph id="H5057F73699BC47BE8952EC61B58F2175"><enum>(2)</enum><text>will use a
regional approach through partnerships with other health professions schools,
private sector entities, school districts, and community-based organizations
that serve the
area.</text>
</paragraph></subsection></section></subtitle><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HDD1B9D2A6334428AB7007466599612ED"><enum>202.</enum><header>Health Careers
Opportunity Program</header>
<subsection id="H40392E0F8F884853A7E8962F886F6BB7"><enum>(a)</enum><header>Purpose</header><text>It
is the purpose of this section to diversify the health care 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.</text>
</subsection><subsection id="H6655C12C7E63488E964BECE621E55705"><enum>(b)</enum><header>Authorization of
appropriations</header><text>Section 740(c) of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
293d(c)) is amended by striking <quote>$29,400,000</quote> and all that follows
through <quote>2002</quote> and inserting <quote>$50,000,000 for fiscal year
2008, and such sums as may be necessary for each of fiscal years 2009 through
2013</quote>.</text>
</subsection></section><section id="H15E75FBAB957488CA5EC6CA2B0D72BE2"><enum>203.</enum><header>Program of
Excellence in Health Professions Education for Underrepresented
Minorities</header>
<subsection id="HA9367DDDBA224DDBBBBDCB0E2868ED4"><enum>(a)</enum><header>Purpose</header><text>It
is the purpose of this section to diversify the health care workforce by
supporting programs of excellence in designated health professions schools with
a demonstrated set of effective policies, criteria, programs, performance
standards, and measures that document commitment and capacity to
underrepresented minority populations with a focus on minority health issues,
cultural and linguistic competence, and eliminating racial and ethnic
disparities in health and health care.</text>
</subsection><subsection id="HA3EF6CCC33B54DADBEE7EF16C134B00"><enum>(b)</enum><header>Authorization of
appropriation</header><text>Section 736(h)(1) of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
293(h)(1)) is amended to read as follows:</text>
<quoted-block act-name="Public Health Service Act" id="H45E45836189C4CE5AA34C78DE4FF4F3">
<paragraph id="H0EAE2AD6D52E43DD87000955271C9E3D"><enum>(1)</enum><header>Authorization of
appropriations</header><text>For the purpose of making grants under subsection
(a), there are authorized to be appropriated $50,000,000 for fiscal year 2008,
and such sums as may be necessary for each of the fiscal years 2009 through
2013.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section id="HB3F920EAF18E4447B6B272F76CE60036"><enum>204.</enum><header>Minority-Serving
Institutions and Hispanic-serving health professions schools</header><text display-inline="no-display-inline">Part B of title VII of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
293 et seq.) is amended by adding at the end the following:</text>
<quoted-block act-name="Public Health Service Act" id="H13270E5C11D045D4A300EC025800882F">
<section id="H5BF52BDB377B4E9EB29BE0F7B364A7A3"><enum>742.</enum><header>Minority-Serving
Institutions and Hispanic-serving health professions schools</header>
<subsection id="H235127C8CC9E46BB80B052583F270161"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary, acting
through the Administrator of the Health Resources and Services Administration,
shall award grants to minority-serving institutions and Hispanic-serving health
professions schools for the purpose of carrying out programs to recruit
underrepresented individuals to enroll in and graduate from such schools, which
may include providing scholarships and other financial assistance as
appropriate.</text>
</subsection><subsection commented="no" id="H05E9EC9AA3BB4B02A7C0DFD4AAFC63B"><enum>(b)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="HBF188B174B174024A99DA7C3B0F6B3EF"><enum>(1)</enum><text>The term
<term>Hispanic-serving health professions school</term> means an entity
that—</text>
<subparagraph id="H729C88B1287C406E927EB80722757FFC"><enum>(A)</enum><text>is a school or
program under section 799B;</text>
</subparagraph><subparagraph id="HBF6ECCA7A64B4863AACFBF1863206F1B"><enum>(B)</enum><text>has an enrollment
of full-time equivalent students that is made up of at least 9 percent Hispanic
students;</text>
</subparagraph><subparagraph id="H46BED2F07EAB44D0B2E04D701512071F"><enum>(C)</enum><text>has been effective
in carrying out programs to recruit Hispanic individuals to enroll in and
graduate from the school;</text>
</subparagraph><subparagraph id="HA54852F2D0584306A137D96668B50017"><enum>(D)</enum><text>has been effective
in recruiting and retaining Hispanic faculty members; and</text>
</subparagraph><subparagraph id="H47173B40AA7949E9B4D3FC6CDB8E19C3"><enum>(E)</enum><text>has a significant
number of graduates who are providing health services to medically underserved
populations or to individuals in health professional shortage areas.</text>
</subparagraph></paragraph><paragraph id="H70A0FFDC4E42462BABEE2F449810C964"><enum>(2)</enum><text display-inline="yes-display-inline">The term <term>historically Black college
or university</term> means a part B institution (as defined in section 322(2)
of the Higher Education Act of 1965).</text>
</paragraph><paragraph commented="no" id="HDE476251A6734815AE93A3EE1FC2A467"><enum>(3)</enum><text>The term
<term>minority-serving institution</term> means an entity that is—</text>
<subparagraph commented="no" id="HA19D8B71D4DD4CC3AA359B783BBB667D"><enum>(A)</enum><text>an historically
Black college or university;</text>
</subparagraph><subparagraph commented="no" id="H8BEB27C2627B449FB4B9F9E089689D8B"><enum>(B)</enum><text>an
Hispanic-serving institution (as defined in section 502(a)(5) of the Higher
Education Act of 1965);</text>
</subparagraph><subparagraph commented="no" id="HDD17FD8F4ECF466491BC9698A179CE88"><enum>(C)</enum><text>a tribally
controlled college or university (as defined in section 2(a)(4) of the Tribally
Controlled College or University Assistance Act of 1978);</text>
</subparagraph><subparagraph commented="no" id="H72F0AD69AEF84CD0B6815F83BE096EAD"><enum>(D)</enum><text>an Alaska
Native-serving institution (as defined in section 317(b)(2) of the Higher
Education Act of 1965); or</text>
</subparagraph><subparagraph commented="no" id="H6B3692018D5142BDA486B5F37236F996"><enum>(E)</enum><text>a Native
Hawaiian-serving institution (as defined in section 317(b)(4) of the Higher
Education Act of
1965).</text>
</subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H6F00395772A84A83A6F2A13FBC2BD7D4"><enum>205.</enum><header>Health
Professions Student Loan fund; authorizations of appropriations regarding
students from underrepresented minority communities</header><text display-inline="no-display-inline">Section 724(f) of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
292t(f)) is amended by inserting before paragraph (2) the following:</text>
<quoted-block display-inline="no-display-inline" id="H3EE86C3269CB47B188EEC6BE94C30092" style="OLC">
<paragraph id="H61881F46C1924B208C38B3B1EAAC4F"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">With respect to
making Federal capital contributions to student loan funds for purposes of
subsection (a), there is authorized to be appropriated $50,000,000 for fiscal
year 2008, and such sums as may be necessary for each of the fiscal years 2009
through
2013.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H05283536DFB54AF9006C12B06D5BF1ED"><enum>206.</enum><header>National Health
Service Corps; training programs</header>
<subsection id="HA76EA737563543CB97FE00C6D42C3D1C"><enum>(a)</enum><header>In
general</header><text>Section 331(b) of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/254d">42 U.S.C. 254d(b)</external-xref>)
is amended by adding at the end the following:</text>
<quoted-block act-name="Public Health Service Act" id="H18AF874864BC4EE30082A32D96D0D600">
<paragraph id="HFE35ADF779034C20BF16BF04DCF334CD" indent="up1"><enum>(3)</enum><text>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.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HA5CACE11899240BFA5E72BC6707E6318"><enum>(b)</enum><header>Assignment of
Corps personnel</header>
<paragraph id="H8FD7DA88F0CA48EBAA01B50636AD9BDC"><enum>(1)</enum><header>In
general</header><text>Section 333(a)(3) of the Public Health Service Corps (42
U.S.C. 254f(a)(3)) is amended to read as follows:</text>
<quoted-block id="HF1FBD951DAF54A7988F4F905296E287C" style="OLC">
<paragraph id="H8C1FD274F90E466B9289A44382EE10C3"><enum>(3)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="H4167226620A9457283D68200CD7371B8"><enum>(A)</enum><text>In approving
applications for assignment of members of the Corps the Secretary shall not
discriminate against application from entities which are not receiving Federal
financial assistance under this Act.</text>
</subparagraph><subparagraph id="H50BE02B0054341E489A914A34985964" indent="up1"><enum>(B)</enum><text>In approving such applications, the
Secretary shall—</text>
<clause id="H75CE6D94183A436EB4C2B000ADDDF951"><enum>(i)</enum><text>give preference to applications in
which a nonprofit entity or public entity shall provide a site to which Corps
members may be assigned; and</text>
</clause><clause id="HCAEF8E074CAC4F4DB553929388C2F2ED"><enum>(ii)</enum><text>give highest preference to
applications—</text>
<subclause id="H39A021AFF9C84024B80014212BFC7F04"><enum>(I)</enum><text>from entities described in clause (i)
that are federally qualified health centers as defined in section 1905(l)(2)(B)
of the Social Security Act; and</text>
</subclause><subclause id="HED13A1092CDD4FF4A8749DC1339A0A6"><enum>(II)</enum><text>from entities described in clause (i)
that primarily serve rural communities, racial and ethnic minorities, and other
health disparity populations with annual incomes at or below twice those set
forth in the most recent poverty guidelines issued by the Secretary pursuant to
section 673(2) of the Community Services Block Grant Act (42 U.S.C.
9902(2)).</text>
</subclause></clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="HBA6CD9F601A944CBB71FF5D7647563BE"><enum>(2)</enum><header>Priorities in
assignment of corps personnel</header><text>Section 333A of the Public Health
Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254f-1">42 U.S.C. 254f-1</external-xref>) is amended—</text>
<subparagraph id="H83C44EB57C364847873C4BA13100A22B"><enum>(A)</enum><text>in subsection
(a)—</text>
<clause id="H6424876980774F37A7808616D2F5E3E4"><enum>(i)</enum><text>by
redesignating paragraphs (1), (2), and (3) as paragraphs (2), (3), and (4),
respectively; and</text>
</clause><clause id="H3D454A291F33437F89226235BB5CC31"><enum>(ii)</enum><text>by
striking <quote>shall—</quote> and
inserting</text>
<quoted-block display-inline="yes-display-inline" id="H29CE2F9EF6D74CB5AF1E8FB4E3A75E82" style="OLC">
<text>shall—</text><paragraph id="H479A3927FC81433A8B2474C408D06866"><enum>(1)</enum><text>give preference to
applications as set forth in subsection (a)(3) of section
333;</text>
</paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="H9B23EA7B128941AABF1221981D8B298B"><enum>(B)</enum><text>in subsection
(b)(1), by striking <quote>subsection (a)(1)(A)</quote> and inserting
<quote>subsection (a)(2)(A)</quote>; and</text>
</subparagraph><subparagraph id="H18F33E959ADA4B97BF27FCC1831E975C"><enum>(C)</enum><text>by striking
<quote>subsection (a)(1)</quote> each place it appears and inserting
<quote>subsection (a)(2)</quote>.</text>
</subparagraph></paragraph><paragraph id="HD9FEEBD9A65643549051507434D2BF6"><enum>(3)</enum><header>Conforming
amendment</header><text>Section 338I(c)(3)(B)(ii) of the Public Health Service
Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254q-1">42 U.S.C. 254q-1(c)(3)(B)(ii)</external-xref>) is amended by striking <quote>section
333A(a)(1)</quote> and inserting <quote>section 333A(a)(2)</quote>.</text>
</paragraph></subsection><subsection id="H8910C4986B6E482400EEB00B1FE61DB"><enum>(c)</enum><header>Reauthorization
of National Health Service Corps Scholarship Program and Loan Repayment
Program</header>
<paragraph id="HC8237F5A158D4F8FB6C48E5EF70112CA"><enum>(1)</enum><header>Reauthorization
of appropriations</header><text>Section 338H(a) of the Public Health Service
Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254q">42 U.S.C. 254q(a)</external-xref>) is amended by striking <quote>$146,250,000</quote> and
all that follows through the period and inserting <quote>$300,000,000 for each
of fiscal years 2008 through 2012.</quote>.</text>
</paragraph><paragraph id="H394AE2D544BB4A76A9F70657BDD26CC1"><enum>(2)</enum><header>Scholarships for
medical students</header><text>Section 338H of such Act is further amended by
adding at the end the following:</text>
<quoted-block id="HD84FC76F2F014640AC052D694F3F6DE" style="OLC">
<subsection id="HE80EB20D9BEE4F03AFAF1FC46F14D329"><enum>(d)</enum><header>Scholarships for
Medical Students</header><text>For contracts for scholarships under this
subpart to individuals who are accepted for enrollment, or enrolled, in a
course of study or program described in section 338A(b)(1)(B) that leads to a
degree in medicine, osteopathic medicine, dentistry, or mental health services,
the Secretary shall, of the amounts appropriated under subsection (a) for a
fiscal year, obligate the greater of 10 percent or such amount as necessary to
fund ongoing activities related to such
contracts.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="HB6934919C1E54F5BABBC33B1F7958F6"><enum>(d)</enum><header>Reauthorization
of Certain Programs Providing Grants for Health Professions Training for
Diversity</header>
<paragraph id="H930CE77268A44DD592E75CAF7687356"><enum>(1)</enum><header>Grants for
centers of excellence</header><text>Section 736(h)(1) of the Public Health
Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/293">42 U.S.C. 293(h)(1)</external-xref>) is amended by striking
<quote>$26,000,000</quote> and all that follows through <quote>2002</quote> and
inserting <quote>$50,000,000 for each of fiscal years 2008 through
2012</quote>.</text>
</paragraph><paragraph id="H9EF19E3BAAAA461E9D75007912E2A75"><enum>(2)</enum><header>Educational
assistance for individuals from disadvantaged backgrounds</header><text>Section
740(c) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/293d">42 U.S.C. 293d(c)</external-xref>) is amended by striking
<quote>$29,400,000</quote> and all that follows through <quote>1999 through
2002.</quote> and inserting <quote>$50,000,000 for each of fiscal years 2008
through 2012.</quote>.</text>
</paragraph></subsection><subsection id="H8FC11DA7B53A4A1DBE531657EB24963C"><enum>(e)</enum><header>Expansion of
Residency Training Programs and Primary Care Services Offered by Community
Health Centers</header><text>Part C of title VII of the Public Health Service
Act (<external-xref legal-doc="usc" parsable-cite="usc/42/293k">42 U.S.C. 293k et seq.</external-xref>) is amended—</text>
<paragraph id="H24F54982C5C944CC871D692200C400F3"><enum>(1)</enum><text>by adding before
section 747 the following:</text>
<quoted-block display-inline="no-display-inline" id="H3043E914A122434787B0630291522275" style="OLC">
<subpart id="H5E4637ED298446FD00153FEE36EDD7D5"><enum>I</enum><header>In
General</header>
</subpart><after-quoted-block>;
and</after-quoted-block></quoted-block>
</paragraph><paragraph id="HC70896B604D7408BA7795727CA423426"><enum>(2)</enum><text>by adding after
section 748 the following:</text>
<quoted-block display-inline="no-display-inline" id="HAB9B40529910494E88B60539CD6E712F" style="OLC">
<subpart id="HA72F7C67858842D4B84E8C15691501C0"><enum>II</enum><header>Additional
Programs</header>
<section id="H3C2E5767C9F740C5A2538518971E3002"><enum>749.</enum><header>Grants to
expand medical residency training programs at community health centers</header>
<subsection id="H8B441854A3494B5BB100A1975DDDD273"><enum>(a)</enum><header>Program
Authorized</header><text>The Secretary may make grants to community health
centers—</text>
<paragraph id="H2BDACDFA1FFF494995E0D100A64E944C"><enum>(1)</enum><text>to establish, at
the centers, new or alternative-campus accredited medical residency training
programs affiliated with a hospital or other health care facility; or</text>
</paragraph><paragraph id="H74C1AF7FEC3E4E10BD218B9707440772"><enum>(2)</enum><text>to fund new
residency positions within existing accredited medical residency training
programs at the centers and their affiliated partners.</text>
</paragraph></subsection><subsection id="HCD1AE005610C4046BE57CA7311CD2202"><enum>(b)</enum><header>Use of
Funds</header><text>Amounts from a grant under this section shall be used to
cover the costs of establishing or expanding a medical residency training
program described in subsection (a), including costs associated with—</text>
<paragraph id="HD6CDFDDFD8034B5DAAB199B7CFBA0020"><enum>(1)</enum><text>curriculum
development;</text>
</paragraph><paragraph id="H229110A25671413AA29FC1142FD5FABD"><enum>(2)</enum><text>equipment
acquisition;</text>
</paragraph><paragraph id="HF482AC674084454D0034CBDD905FAF4E"><enum>(3)</enum><text>recruitment,
training, and retention of residents and faculty; and</text>
</paragraph><paragraph id="H18E760F00A3645399B74005C3C973DB2"><enum>(4)</enum><text>residency
stipends.</text>
</paragraph></subsection><subsection id="H2C0765AE482D4E798BD0FA515B1C7408"><enum>(c)</enum><header>Applications</header><text>A
community health center seeking a grant under this section shall submit an
application to the Secretary at such time, in such manner, and containing such
information as the Secretary may require.</text>
</subsection><subsection id="HF10B57BF6E974DF78939FE347478A0CC"><enum>(d)</enum><header>Preference</header><text>In
selecting recipients for a grant under this section, the Secretary shall give
preference to funding medical residency training programs focusing on primary
health care.</text>
</subsection><subsection id="HF4506F1651364117A3C88BE900F9F91"><enum>(e)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="H1B81D00EDAC841FC8BDB2C35E2511623"><enum>(1)</enum><text>The term
<term>accredited</term>, as applied to a new or alternative-campus medical
residency training program, means a program that is accredited by a recognized
body or bodies approved for such purpose by the Accreditation Council for
Graduate Medical Education, except that a new medical residency training
program that, by reason of an insufficient period of operation, is not eligible
for accreditation on or before the date of submission of an application under
subsection (c) shall be deemed accredited if the Accreditation Council for
Graduate Medical Education finds, after consultation with the appropriate
accreditation body or bodies, that there is reasonable assurance that the
program will meet the accreditation standards of such body or bodies prior to
the date of graduation of the first entering class in that program.</text>
</paragraph><paragraph id="HC0BC85B3F13745CDA78531E2035B7F8F"><enum>(2)</enum><text>The term
<term>community health center</term> means a health center as defined in
section 330.</text>
</paragraph></subsection></section><section id="H7D3D21F01CA94AE39DBB7B1EADC1398"><enum>749A.</enum><header>Grants to
improve delivery of primary care services in community health centers</header>
<subsection id="HFBF6AB5CF5BB4EA1BBF21BC0614C3990"><enum>(a)</enum><header>Primary Care
Access Grants</header>
<paragraph id="H8DD36AB4EACF4C4BBFFB57711B28218C"><enum>(1)</enum><header>Program
authorized</header><text>The Secretary, acting through the Administrator of the
Health Resources and Services Administration, may make grants to community
health centers for the purpose of increasing the number of medical service
providers associated with such centers.</text>
</paragraph><paragraph id="H6F54FD94BF2D4DE6A82B437D73B502B6"><enum>(2)</enum><header>Grants</header><text>A
recipient of a grant under this subsection shall be eligible to receive such
grants for a total of 5 fiscal years.</text>
</paragraph><paragraph id="HDB24BC0104E64D05B35D472773E539E7"><enum>(3)</enum><header>Use of
funds</header><text>A recipient of a grant under this subsection shall use
amounts from the grant for one or more of the following activities:</text>
<subparagraph id="HEE5B47CEBC2B41FABDB082B3ECC10620"><enum>(A)</enum><text>To recruit
residents for medical residency training programs at the community health
center.</text>
</subparagraph><subparagraph id="H0F7076DC3A4745449CF0E17212CD0006"><enum>(B)</enum><text>To establish a
multi-community physician mentoring program to encourage upper level residents
to remain in the State or Territory in which the community health center and
medical residency training program are located.</text>
</subparagraph><subparagraph id="HE026FC509CBC4A2E801400008FEB11AB"><enum>(C)</enum><text>To enter into
contracts for technical assistance for the purpose of recruiting or retaining
primary health care staff.</text>
</subparagraph><subparagraph id="HD82EBB5341A54AB7AFF95B4644871D60"><enum>(D)</enum><text>To enter into
contracts for technical assistance in preparing contracts with local providers
of primary health care to provide services for medically underserved
communities.</text>
</subparagraph><subparagraph id="HBACD4AC081DD4E20856329F8C27E982"><enum>(E)</enum><text>To enter into
contracts for the development and implementation of strategies to identify and
retain health care professionals and specialists, including oral and mental
health providers, who are willing and able to provide direct actual service to
the community health center on a referral basis.</text>
</subparagraph></paragraph><paragraph id="HD90F69541FD2469185388F183FA2F1F"><enum>(4)</enum><header>Application</header><text>A
community health center seeking a grant under this subsection shall submit an
application to the Secretary at such time, in such manner, and containing such
information as the Secretary may require.</text>
</paragraph></subsection><subsection id="H5E96CF5B17044D7381641D0068B4BFEE"><enum>(b)</enum><header>Grants for
Primary Care Facility Capital Expenditures</header>
<paragraph id="H4BD48341FCD244299DE5ACD639615D9C"><enum>(1)</enum><header>Program
authorized</header><text>The Secretary, acting through the Administrator of the
Health Resources and Services Administration, may make grants to community
health centers for the purpose of increasing primary health care capabilities
through the construction, expansion, or renovation of facilities.</text>
</paragraph><paragraph id="HDCCA8E043D3D45EFB79DC8204BA2163"><enum>(2)</enum><header>Grants</header><text>A
recipient of a grant under this subsection shall be eligible to receive such
grants for a total of 5 fiscal years.</text>
</paragraph><paragraph id="H1FA67BC950DA457482112B076684EA6B"><enum>(3)</enum><header>Use of
funds</header><text>A recipient of a grant under this subsection shall use
amounts from the grant for one or more of the following activities:</text>
<subparagraph id="H39D4689271AB4916ABBFAC9585492C2"><enum>(A)</enum><text>To acquire or lease
facilities.</text>
</subparagraph><subparagraph id="HB9A698BD41D742DAB6F8102ECBFA4882"><enum>(B)</enum><text>To construct new
facilities.</text>
</subparagraph><subparagraph id="HE58A9362E64A4E14A1A56951ABBDBAAC"><enum>(C)</enum><text>To repair or
modernize existing facilities.</text>
</subparagraph><subparagraph id="HD60A02728ECE4A9381FF17369CF33E8E"><enum>(D)</enum><text>To purchase or
lease medical equipment.</text>
</subparagraph></paragraph></subsection><subsection id="H8F19CAD4EAF84DEF9F2267BFAE3CD2E9"><enum>(c)</enum><header>Definition</header><text>The
term <term>community health center</term> means a health center as defined in
section 330.</text>
</subsection></section><section id="H40F74A4BDE994CF0AFDDB88600EDCD15"><enum>749B.</enum><header>Authorization
of appropriations</header><text display-inline="no-display-inline">There is
authorized to be appropriated $200,000,000 for fiscal year 2008 and such sums
as may be necessary for each fiscal year thereafter to carry out this
subpart.</text>
</section></subpart><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H245FCED5537D442F00279BAF8CB3D5D"><enum>(f)</enum><header>Interdisciplinary,
Community-Based Programs</header>
<paragraph id="HC115FE0148954BD68CFEA09E11F1D87E"><enum>(1)</enum><header>Area health
education centers</header><text>Section 751(a) of the Public Health Service Act
(<external-xref legal-doc="usc" parsable-cite="usc/42/294a">42 U.S.C. 294a(a)</external-xref>) is amended—</text>
<subparagraph id="H11DDE1A6CA40432BB0C52681B01B7A4"><enum>(A)</enum><text>in paragraph
(1)(A)—</text>
<clause id="HA9D7C7E198F3437B8F5CC3202108E172"><enum>(i)</enum><text>in
clause (i), by inserting at the end before the semicolon the following:
<quote>, with an emphasis on such personnel who focus on primary
care</quote>;</text>
</clause><clause id="H6AC42456FA8B4B0283C67F934EE3BCB"><enum>(ii)</enum><text>by
redesignating clauses (ii) through (vii) as clauses (iii) through (viii),
respectively; and</text>
</clause><clause id="H6D6A01FCD8384688B79EB7E604CC272B"><enum>(iii)</enum><text>by
inserting after clause (i) the following:</text>
<quoted-block id="HF651C6F549F74E1A884FA477C39F3D3F" style="OLC">
<clause id="H3A0788C805714A97885F87CD00D2745D"><enum>(ii)</enum><text>foster and
provide community-based training and education for health professions students
in underserved communities and among underserved populations, including but not
limited to the National Health Service Corps, community and migrant health
centers, rural health clinics, critical access hospitals, tribal health
clinics, and public health departments;</text>
</clause><after-quoted-block>;
and</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="HE2948F7146C54D789B788265CFAFEEFB"><enum>(B)</enum><text>by adding at the
end the following:</text>
<quoted-block id="H27E61679FD3549049F57040063C570FC" style="OLC">
<paragraph id="H09062B0709E84799B157391D331533CE"><enum>(3)</enum><header>Point of service
enhancement grants</header>
<subparagraph id="HB0897131B54B4F448235D96E1C3FA65C"><enum>(A)</enum><header>In
general</header><text>The Secretary may award grants to entities receiving an
award under paragraph (1) or (2) to improve the effectiveness of the programs
operated by such entities or to enable the entities to respond to changes
affecting such entities arising since the date of the receipt of the award
under paragraph (1) or (2).</text>
</subparagraph><subparagraph id="H92C580A5E2D54C14A6003500452716B1"><enum>(B)</enum><header>Application</header><text>To
receive an award under this paragraph, an entity described under subparagraph
(A) shall submit to the Secretary an application at such time, in such manner,
and containing such information as the Secretary may require, including an
explanation of the changes affecting such entity arising since the date of the
receipt by the entity of the award under paragraph (1) or (2), such as changes
in the demographics of the area served, the needs of the population served, and
the situations encountered by such population and such
entity.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H699AAA9227EC48ADB1442EBAAF0054ED"><enum>(2)</enum><header>Authorization of
appropriations</header><text>Section 757 of the Public Health Service Act (42
U.S.C. 294g) is amended—</text>
<subparagraph id="H8F1D11DA32A0416D88786242DAABDE23"><enum>(A)</enum><text>in subsection (a),
by striking <quote>$55,600,000</quote> and all that follows through
<quote>2002</quote> and inserting <quote>$125,000,000 for fiscal year 2008 and
such sums as may be necessary for each of fiscal years 2009 through
2012</quote>;</text>
</subparagraph><subparagraph id="H7A3025370AD345CF939856700044A700"><enum>(B)</enum><text>by striking
subsection (b) and inserting the following:</text>
<quoted-block id="H561071E7AA8E4E7C9F96C3F5D63D51DF" style="OLC">
<subsection id="H9F1D4EDE90114682B1C291DB7F7D955C"><enum>(b)</enum><header>Allocation</header>
<paragraph id="HD470358E448D4882A22F921729C9F63"><enum>(1)</enum><header>In
general</header><text>Of the amounts appropriated under subsection (a) that the
Secretary makes available for each fiscal year to carry out section 751, the
Secretary shall obligate—</text>
<subparagraph id="HE1FEBDA350DA4428ACC654E45B098EC3"><enum>(A)</enum><text>for awards under
paragraph (1) of section 751(a), not more than 25 percent of such amounts in
each fiscal year; and</text>
</subparagraph><subparagraph id="H22C8924888904477BB29A2B31C6BABC6"><enum>(B)</enum><text>for awards under
paragraphs (2) and (3) of section 751(a), not less than 60 percent of such
amounts in each fiscal year.</text>
</subparagraph></paragraph></subsection><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="H54640AB105E54DBE878711AB399851D2"><enum>(C)</enum><text>in subsection (c),
by—</text>
<clause id="H481C6B4FE99645EAAA2365B7F5F59862"><enum>(i)</enum><text>striking the
subsection designation and heading and inserting the following:</text>
<quoted-block id="H52E6BC61A2D947B78CF556D1CC042EE4" style="OLC">
<subsection id="H38A54C75AB23476399A1FA007CC9F3FB"><enum>(c)</enum><header>Sense of the
Congress</header><text>It is the sense of the Congress
that—</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</clause><clause id="HEE1058B5E4D1494684F01440B8B320E8"><enum>(ii)</enum><text>striking
paragraph (1); and</text>
</clause><clause id="H03ADE35BC325417BB9350070AD3F7D68"><enum>(iii)</enum><text>in
paragraph (2), by—</text>
<subclause id="H9AB07CEA01D7418696EA0949A2E7CFC"><enum>(I)</enum><text>striking the
paragraph designation and all that follows through <quote>Congress
that—</quote>; and</text>
</subclause><subclause id="H35CF2765352F4D8094DBA88532B09C96"><enum>(II)</enum><text>redesignating
subparagraphs (A) and (B) as paragraphs (1) and (2) and indenting
appropriately.</text>
</subclause></clause></subparagraph></paragraph></subsection></section><section id="H5F0123ECA4394A69A7BDCEAE4633C5CD"><enum>207.</enum><header>Loan Repayment
Program of the Centers for Disease Control and Prevention</header><text display-inline="no-display-inline">Section 317F(c) of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
247b–7(c)) is amended—</text>
<paragraph id="HE51F9000C3374B00986F1988ACE195F"><enum>(1)</enum><text>by
striking <quote>and</quote> after <quote>1994,</quote>; and</text>
</paragraph><paragraph id="H02173DEFA8854E8BB49F6E9C6ED3258F"><enum>(2)</enum><text>by inserting
before the period the following: <quote>$750,000 for fiscal year 2008, and such
sums as may be necessary for each of the fiscal years 2009 through
2013.</quote>.</text>
</paragraph></section><section id="H2FF4D95565274157A65879EFF14300A0"><enum>208.</enum><header>Strengthening
and expanding rural health provider networks</header><text display-inline="no-display-inline">Section 330A of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
254c) is amended—</text>
<paragraph id="H10B3714CFC834215A4C1A800A8BFB621"><enum>(1)</enum><text>in subsection (h),
by adding at the end the following:</text>
<quoted-block id="H4F489FDDF2BB4FD89E00FB967671B2EF">
<paragraph id="H787E40A2F9014AA580E41625B6229FFE"><enum>(4)</enum><header>Rural minority,
border, and Indian populations</header><text>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,
shall make grants to entities that serve rural minority, border, and Indian
populations.</text>
</paragraph><paragraph id="H5E3B5A28A1CB474786D6BCA995A07288"><enum>(5)</enum><header>Diversity Health
training programs</header><text>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, 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.</text>
</paragraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</paragraph><paragraph id="H863FE2A3E1AC4912BD568331005B879C"><enum>(2)</enum><text>in subsection (j),
by striking <quote>and such sums as may be necessary for each of fiscal years
2003 through 2006</quote> and inserting <quote>, such sums as may be necessary
for each of fiscal years 2008 through 2010, and $60,000,000 for each of fiscal
years 2011 through 2015</quote>.</text>
</paragraph></section><section id="HD0172BC567C24B13B1C05578E4A3EA80"><enum>209.</enum><header>McNair
Postbaccalaureate Achievement program</header><text display-inline="no-display-inline">Section 402E of the
<act-name parsable-cite="HEA65">Higher Education Act of 1965</act-name> (20
U.S.C. 1070a–15) is amended by striking subsection (f) and inserting the
following:</text>
<quoted-block act-name="Higher Education Act of 1965" id="H0994FC7BC07C4C77893312009E394878">
<subsection id="HFC06EF8C50B74C2B965D2E66B4D6B72"><enum>(f)</enum><header>Collaboration in
Health profession Diversity training programs</header><text>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.</text>
</subsection><subsection id="HB6992546C07F466A92261E2B364C4BDE"><enum>(g)</enum><header>Funding</header><text>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 2008 through
2014.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section display-inline="no-display-inline" id="H39131F30C6B84B5EBC086EA7B47D2400" section-type="subsequent-section"><enum>210.</enum><header>Ensuring
proportional representation of interests of rural areas on MedPAC</header>
<subsection id="H5E594C50D56E47D0937DA373746167AE"><enum>(a)</enum><header>In
general</header><text>Section 1805(c)(2) of the Social Security Act (42 U.S.C.
1395b–6(c)(2)) is amended—</text>
<paragraph id="H5E5C9C69FB6A4D6DAF78008CFB268164"><enum>(1)</enum><text>in subparagraph
(A), by inserting <quote>consistent with subparagraph (E)</quote> after
<quote>rural representatives</quote>; and</text>
</paragraph><paragraph id="H59001035F928436EACCD94A0B8C62CC8"><enum>(2)</enum><text>by adding at the
end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H4D77C7ED490B43618317C53E39B7C668" style="OLC">
<subparagraph id="HDF0675725A6E44128110BE3E63299C56"><enum>(E)</enum><header>Proportional
representation of interests of rural areas</header><text display-inline="yes-display-inline">In order to provide a balance between urban
and rural representatives under subparagraph (A), the proportion of members who
represent the interests of health care providers and Medicare beneficiaries
located in rural areas shall be no less than the proportion, of the total
number of Medicare beneficiaries, who reside in rural
areas.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H272877A3A5974F009E1EFD9683F59982"><enum>(b)</enum><header>Effective
date</header><text>The amendments made by subsection (a) shall apply with
respect to appointments made to the Medicare Payment Advisory Commission after
the date of the enactment of this Act.</text>
</subsection></section><enum>III</enum><header>Data collection
and reporting</header>
<section id="HA4A66F2422FC4519B77D4C35FE9C03B8"><enum>301.</enum><header>Amendment to
the <act-name parsable-cite="PHSA">Public Health Service
Act</act-name></header>
<subsection id="H76CC856C02254F89BCCBC4626F57F4F8"><enum>(a)</enum><header>Purpose</header><text>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.</text>
</subsection><subsection id="H1259758D89794D1F97512CECF8376BE"><enum>(b)</enum><header>Amendment</header><text>Title
XXX of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name>,
as amended by title II of this Act, is further amended by adding at the end the
following:</text>
<quoted-block act-name="Public Health Service Act" id="HDBE18CE878E74C5199DD32833B913EBB">
<subtitle id="HAD3F5744424B42B1A7FD603DF6B71D6B"><enum>B</enum><header>Strengthening data
collection, improving data analysis, and expanding data reporting</header>
<section id="HD71D708445C94782B8005C44109FDAF"><enum>3031.</enum><header>Data on race,
ethnicity, and primary language</header>
<subsection id="H2C0DDD23D49C4000B286E0401C5EE6E5"><enum>(a)</enum><header>Requirements</header>
<paragraph id="H04C81D011F4D405BBF1CC28537A8EE9F"><enum>(1)</enum><header>In
general</header><text>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—</text>
<subparagraph id="H0AD637C1ECB946818E68BCC6A81B3FF2"><enum>(A)</enum><text>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—</text>
<clause id="HF649D273F5FD40888BB684645FF261A6"><enum>(i)</enum><text>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;</text>
</clause><clause id="H6F4B0AA79F074F4C92B5D040202964F"><enum>(ii)</enum><text>using the
standards developed under subsection (e) for the collection of language
data;</text>
</clause><clause id="HBA58415B9437480294D07310F5FE00D6"><enum>(iii)</enum><text>collecting data
for additional population groups if such groups can be aggregated into the
minimum race and ethnicity categories; and</text>
</clause><clause id="HAE97F917E065453F92117087B223369F"><enum>(iv)</enum><text>where
practicable, through self-report;</text>
</clause></subparagraph><subparagraph id="H1C8017FDF2434E9D9D13C8A4D2820000"><enum>(B)</enum><text>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—</text>
<clause id="H22BA1CB55C9D4A2AAED1567898C32E66"><enum>(i)</enum><text>such data be
collected from the parent or legal guardian of such an applicant or recipient;
and</text>
</clause><clause id="HDB114899C0BC451EBA9F00F03DFACA1"><enum>(ii)</enum><text>the preferred
language of the parent or legal guardian of such an applicant or recipient be
collected;</text>
</clause></subparagraph><subparagraph id="H49C6C1929107477B9ED73F352E3F9B32"><enum>(C)</enum><text>systematically
analyze such data using the smallest appropriate units of analysis feasible to
detect racial and ethnic disparities in health and health care 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;</text>
</subparagraph><subparagraph id="H188B1BAD90924BEAA8DA5B00D427D556"><enum>(D)</enum><text>provide such data
to the Secretary on at least an annual basis; and</text>
</subparagraph><subparagraph id="H90E59F8B339441419B53006EDE10B52"><enum>(E)</enum><text>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.</text>
</subparagraph></paragraph><paragraph id="HF30AA0024B4B4BE0B67CA135F3858D31"><enum>(2)</enum><header>Rules of
construction</header><text>Nothing in this subsection shall be construed
to—</text>
<subparagraph id="H6B4D86FBC6F0483E94AB76B98FE1A6C0"><enum>(A)</enum><text>permit the use of
information collected under this subsection in a manner that would adversely
affect any individual providing any such information; and</text>
</subparagraph><subparagraph id="H5BCD100C38014439BEABAB936270ED50"><enum>(B)</enum><text>require health
care providers to collect data.</text>
</subparagraph></paragraph></subsection><subsection id="HF40F649BE8E04ACF92FACF010081476E"><enum>(b)</enum><header>Protection of
data</header><text>The Secretary shall ensure (through the promulgation of
regulations or otherwise) that all data collected pursuant to subsection (a) is
protected—</text>
<paragraph id="H9C84A4905D08444CB7D9E8006896A72D"><enum>(1)</enum><text>under the same
privacy protections as the Secretary applies to other health data under the
regulations promulgated under section 264(c) of the
<act-name parsable-cite="HIPAA">Health Insurance Portability and Accountability
Act of 1996</act-name> (<external-xref legal-doc="public-law" parsable-cite="pl/104/191">Public Law 104–191</external-xref>; 110 Stat. 2033) relating to the
privacy of individually identifiable health information and other protections;
and</text>
</paragraph><paragraph id="H279D954050084E0A8E4D003941E373EE"><enum>(2)</enum><text>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.</text>
</paragraph></subsection><subsection id="H58F30F70BA884D018D76BE2F80E5118"><enum>(c)</enum><header>National plan of
the data Council</header><text>The Secretary shall develop and implement a
national plan to ensure the collection of data in a culturally appropriate and
competent manner, and 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, 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—</text>
<paragraph id="HFE24645E46394BA98009998793B700AF"><enum>(1)</enum><text>implement
subsection (a) while minimizing the cost and administrative burdens of data
collection and reporting;</text>
</paragraph><paragraph id="HAD607BF34FA6413B84D12B93E4E0A272"><enum>(2)</enum><text>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
health care services;</text>
</paragraph><paragraph id="HE3D3288A432E4DC8A5D0DC565F68FF00"><enum>(3)</enum><text>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;</text>
</paragraph><paragraph id="HCF9CB5FF136E4BF4A78871834665B833"><enum>(4)</enum><text>improve health and
health care 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;</text>
</paragraph><paragraph id="H8B240CE617934987BD1F81DADC83AE26"><enum>(5)</enum><text>provide
researchers with greater access to racial, ethnic, and primary language data,
subject to privacy and confidentiality regulations; and</text>
</paragraph><paragraph id="H8171DF4C773F4EB991F400ADAA006ECB"><enum>(6)</enum><text>safeguard and
prevent the misuse of data collected under subsection (a).</text>
</paragraph></subsection><subsection id="H9957637DF4384E1A9FBA3B197F8F5CD1"><enum>(d)</enum><header>Compliance with
Standards</header><text>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).</text>
</subsection><subsection id="HE0C98CF95C8C4940A07E00FE050539F7"><enum>(e)</enum><header>Language
collection Standards</header><text>Not later than 1 year after the date of
enactment of this title, the Deputy Assistant Secretary for Minority Health, 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.</text>
</subsection><subsection id="H86B9494C5977474DBBF25288C0426556"><enum>(f)</enum><header>Technical
assistance for the collection and reporting of data</header>
<paragraph id="H22283ECD835E4B71B5FF9F8074DFD75D"><enum>(1)</enum><header>In
general</header><text>The Secretary may, either directly or through grant or
contract, provide technical assistance to enable a health care program or an
entity operating under such program to comply with the requirements of this
section.</text>
</paragraph><paragraph id="H2374F8C921CD4F998B172383B0DDDDB"><enum>(2)</enum><header>Types of
assistance</header><text>Assistance provided under this subsection may include
assistance to—</text>
<subparagraph id="H4598D16D382C45B5B56C003917A7F33"><enum>(A)</enum><text>enhance or upgrade
computer technology that will facilitate racial, ethnic, and primary language
data collection and analysis;</text>
</subparagraph><subparagraph id="H0713DEFD461F45D9A03918D01D83D003"><enum>(B)</enum><text>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;</text>
</subparagraph><subparagraph id="H4946D34F7C314A80BA96608842C0E02"><enum>(C)</enum><text>develop mechanisms
for submitting collected data subject to existing privacy and confidentiality
regulations; and</text>
</subparagraph><subparagraph id="HBBCE2498E39F493BA7CF92C1564844B0"><enum>(D)</enum><text>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 health care disparities.</text>
</subparagraph></paragraph></subsection><subsection id="H170B813E8ADC4D03A61443467248A87F"><enum>(g)</enum><header>Analysis of
racial and ethnic data</header><text>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 & 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
health care in public programs by—</text>
<paragraph id="HB9C4717402A244D6B8096390C829152E"><enum>(1)</enum><text>identifying
appropriate quality assurance mechanisms to monitor for health
disparities;</text>
</paragraph><paragraph id="H228CA22EEBAD4A05B28CE77F2983969F"><enum>(2)</enum><text>specifying the
clinical, diagnostic, or therapeutic measures which should be monitored;</text>
</paragraph><paragraph id="HEA6C1A3B31024233AC000091A729EC66"><enum>(3)</enum><text>developing new
quality measures relating to racial and ethnic disparities in health and health
care;</text>
</paragraph><paragraph id="H4D240FC7974D46839D928621F5700419"><enum>(4)</enum><text>identifying the
level at which data analysis should be conducted; and</text>
</paragraph><paragraph id="HB413B5D2E3DF40E7B99C3D6F98304700"><enum>(5)</enum><text>sharing data with
external organizations for research and quality improvement purposes.</text>
</paragraph></subsection><subsection id="HF4565A0C6392469CB263EEAB12B7646B"><enum>(h)</enum><header>Report</header><text>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.</text>
</subsection><subsection id="H8DE89A226F674EC8926FFEDCABCAEC81"><enum>(i)</enum><header>Definition</header><text>In
this section, the term <term>health-related program</term> mean a
program—</text>
<paragraph id="H01678F84298840D096B387CB01F55B20"><enum>(1)</enum><text>under the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C. 301 et
seq.) that pay for health care and services; and</text>
</paragraph><paragraph id="H91F720918CB44C1E984EB5222E41644C"><enum>(2)</enum><text>under this Act
that provide Federal financial assistance for health care, biomedical research,
health services research, and programs designed to improve the public’s
health.</text>
</paragraph></subsection><subsection id="HCD92C2C1E1BD410A00AB3400FB919286"><enum>(j)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2008
through 2013.</text>
</subsection></section><section commented="no" id="H621F878E271D46929CAC161792D4CBE"><enum>3032.</enum><header>Provisions
relating to Native Americans</header>
<subsection commented="no" display-inline="no-display-inline" id="HD4ACEFD6D70D47BAA5C8F37D3847FCF5"><enum>(a)</enum><header>Establishment of
epidemiology centers</header><text>The Secretary shall establish an
epidemiology center in each service area to carry out the functions described
in subsection (b). Any new center established after the date of the enactment
of the Health Equity and Accountability Act of 2007 may be operated under a
grant authorized by subsection (d), but funding under such a grant shall not be
divisible.</text>
</subsection><subsection commented="no" id="H2F8675F17A2340380038C8C3F8E85264"><enum>(b)</enum><header>Functions of
centers</header><text>In consultation with and upon the request of Indian
Tribes, Tribal Organizations, and Urban Indian Organizations, each service area
epidemiology center established under this subsection shall, with respect to
such service area—</text>
<paragraph commented="no" id="H7E5D089C9E0340BB9E90F88C279BEE35"><enum>(1)</enum><text>collect data
relating to, and monitor progress made toward meeting, each of the health
status objectives of the Service, the Indian Tribes, Tribal Organizations, and
Urban Indian Organizations in the service area;</text>
</paragraph><paragraph commented="no" id="H36CAA1CF98AA4410812BE8F13085C31B"><enum>(2)</enum><text>evaluate existing
delivery systems, data systems, and other systems that impact the improvement
of Indian health;</text>
</paragraph><paragraph commented="no" id="H30B1BA93504948658B7B941C98497442"><enum>(3)</enum><text>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;</text>
</paragraph><paragraph commented="no" id="H486FC8A7CFC34A9CAC4F81AC3520E5F"><enum>(4)</enum><text>make
recommendations for the targeting of services needed by the populations
served;</text>
</paragraph><paragraph commented="no" id="HB036AA1514B6453186BDA31144491EC4"><enum>(5)</enum><text>make
recommendations to improve health care delivery systems for Indians and Urban
Indians;</text>
</paragraph><paragraph commented="no" id="H6B571CD78B1C446D83B6CD5D5678CFF"><enum>(6)</enum><text>provide requested
technical assistance to Indian Tribes, Tribal Organizations, 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</text>
</paragraph><paragraph commented="no" id="HCC46CDB72BD54218B7B835888FEB6086"><enum>(7)</enum><text>provide disease
surveillance and assist Indian Tribes, Tribal Organizations, and Urban Indian
Organizations to promote public health.</text>
</paragraph></subsection><subsection commented="no" id="H530C28F9F76E4501BEA1BCBB37F9C7E0"><enum>(c)</enum><header>Technical
assistance</header><text>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.</text>
</subsection><subsection commented="no" id="H8FE6AA341F3E4C018FC5112369CC014"><enum>(d)</enum><header>Grants for
studies</header>
<paragraph commented="no" id="H6990B7989770497A90ABC966C74C4783"><enum>(1)</enum><header>In
general</header><text>The Secretary may make grants to Indian Tribes, Tribal
Organizations, Urban Indian Organizations, and eligible intertribal consortia
to conduct epidemiological studies of Indian communities.</text>
</paragraph><paragraph commented="no" id="H44E490E22A754CC595823944E9C0800"><enum>(2)</enum><header>Eligible
intertribal consortia</header><text>An intertribal consortium is eligible to
receive a grant under this subsection if—</text>
<subparagraph commented="no" id="H9BFBE49D4E994B1D904EFD5906F782E0"><enum>(A)</enum><text>the intertribal
consortium is incorporated for the primary purpose of improving Indian health;
and</text>
</subparagraph><subparagraph commented="no" id="HF888E6FC813A4B0A86383C8816760065"><enum>(B)</enum><text>the intertribal
consortium is representative of the Indian Tribes or urban Indian communities
in which the intertribal consortium is located.</text>
</subparagraph></paragraph><paragraph commented="no" id="HDD29AD4E3B134E4880F942198867923"><enum>(3)</enum><header>Applications</header><text>An
application for a grant under this subsection shall be submitted in such manner
and at such time as the Secretary shall prescribe.</text>
</paragraph><paragraph commented="no" id="H4BBF85A4D3894BDA92C114C8E21B9A9"><enum>(4)</enum><header>Requirements</header><text>An
applicant for a grant under this subsection shall—</text>
<subparagraph commented="no" id="H9076AA3E9C6C4A468552E2D1F70108C"><enum>(A)</enum><text>demonstrate the
technical, administrative, and financial expertise necessary to carry out the
functions described in paragraph (5);</text>
</subparagraph><subparagraph commented="no" id="HBFAB13DB5E3F4DFEA7D355696BD01317"><enum>(B)</enum><text>consult and
cooperate with providers of related health and social services in order to
avoid duplication of existing services; and</text>
</subparagraph><subparagraph commented="no" id="H928F2BE4AE804B76AB01CC99F963A937"><enum>(C)</enum><text>demonstrate
cooperation from Indian tribes or Urban Indian Organizations in the area to be
served.</text>
</subparagraph></paragraph><paragraph commented="no" id="H81F0C73B9ADC4F6397DAC8ABDBA70778"><enum>(5)</enum><header>Use of
funds</header><text>A grant awarded under paragraph (1) may be used—</text>
<subparagraph commented="no" id="HAAD70DFD57364BD69454B89226473CD5"><enum>(A)</enum><text>to carry out the
functions described in subsection (b);</text>
</subparagraph><subparagraph commented="no" id="H4412B856038F45CFA916A72D070DB4F"><enum>(B)</enum><text>to provide
information to and consult with tribal leaders, urban Indian community leaders,
and related health staff on health care and health service management issues;
and</text>
</subparagraph><subparagraph commented="no" id="HA98798255FAF4BF98B54A535165301B"><enum>(C)</enum><text>in collaboration
with Indian Tribes, Tribal Organizations, and urban Indian communities, to
provide the Service with information regarding ways to improve the health
status of Indians.</text>
</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HCCAFFB9AD01B4992ADBD52B45B65A31B"><enum>(e)</enum><header>Access to
information</header><text>An epidemiology center operated by a grantee pursuant
to a grant awarded under subsection (d) shall be treated as a public health
authority for purposes of the Health Insurance Portability and Accountability
Act of 1996 (<external-xref legal-doc="public-law" parsable-cite="pl/104/191">Public Law 104–191</external-xref>; 110 Stat. 2033), as such entities are defined
in part 164.501 of title 45, Code of Federal Regulations (or a successor
regulation). The Secretary shall grant such grantees access to and use of data,
data sets, monitoring systems, delivery systems, and other protected health
information in the possession of the
Secretary.</text>
</subsection></section></subtitle><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section id="HE18CE46327234386810064B67250ED39"><enum>302.</enum><header>Collection of
race and ethnicity data by the Social Security Administration</header><text display-inline="no-display-inline">Part A of title XI of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C. 1301 et
seq.) is amended by adding at the end the following:</text>
<quoted-block act-name="Social Security Act" id="H2421FECEF62B4D6B87E59AC7942D251">
<section id="H9FD714EDFD414D999C4C21AAEA4B5118"><enum>1150A.</enum><header>Collection of
race and ethnicity data by the Social Security Administration</header>
<subsection id="H1132C14880084E94AD3FF82066D49F4"><enum>(a)</enum><header>Requirement</header><text>The
Commissioner of Social Security, in consultation with the Administrator of the
Centers for Medicare & Medicaid Services, shall—</text>
<paragraph id="HEAA824899E2046FBA58C51501E379DEE"><enum>(1)</enum><text>require the
collection of data on the race, ethnicity, and primary language of all
applicants for social security account numbers or benefits under title II or
part A of title XVIII and all individuals with respect to whom the Commissioner
maintains records of wages and self-employment income in accordance with
reports received by the Commissioner or the Secretary of the Treasury—</text>
<subparagraph id="HEDC36B8430154FDA829C009C47086438"><enum>(A)</enum><text>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</text>
</subparagraph><subparagraph id="H385BAF3EE449467AA442934100FB9729"><enum>(B)</enum><text>where practicable,
collecting data for additional population groups if such groups can be
aggregated into the minimum race and ethnicity categories;</text>
</subparagraph></paragraph><paragraph id="HAD896549C03D4795911D7201F1ED00CD"><enum>(2)</enum><text>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—</text>
<subparagraph id="H0DF6D13B224A4FCFB1D3EB43C46B1F14"><enum>(A)</enum><text>such data be
collected from the parent or legal guardian of such an applicant; and</text>
</subparagraph><subparagraph id="H28216BE8C1F74AC4AAB81D2CB9454ED0"><enum>(B)</enum><text>the primary
language of the parent or legal guardian of such an applicant or recipient be
used;</text>
</subparagraph></paragraph><paragraph id="HA55D0A4D39EC42DBB6A00302C9EB8769"><enum>(3)</enum><text>require that such
data be uniformly analyzed and reported at least annually to the Commissioner
of Social Security;</text>
</paragraph><paragraph id="HD20B683EC2D648ADB65D9046C61D5715"><enum>(4)</enum><text>be responsible for
storing the data reported under paragraph (3);</text>
</paragraph><paragraph id="H1DCD76D820BB4A8EB8FCDF83A3448EC7"><enum>(5)</enum><text>ensure
transmission to the Centers for Medicare & Medicaid Services and other
Federal health agencies;</text>
</paragraph><paragraph id="HC7C7C67C2C964BAE8BCB29AF5B7DF46F"><enum>(6)</enum><text>provide such data
to the Secretary on at least an annual basis; and</text>
</paragraph><paragraph id="H0D2E211C1DBD4681801BA5AD5FC6F0CC"><enum>(7)</enum><text>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.</text>
</paragraph></subsection><subsection id="HF35D0E1B6EFC4FB599E540090E2BBAD"><enum>(b)</enum><header>Protection of
data</header><text>The Commissioner of Social Security shall ensure (through
the promulgation of regulations or otherwise) that all data collected pursuant
subsection (a) is protected—</text>
<paragraph id="H0E3702526CD14A08AB3B69AA0049A2D7"><enum>(1)</enum><text>under the same
privacy protections as the Secretary applies to health data under the
regulations promulgated under section 264(c) of the
<act-name parsable-cite="HIPAA">Health Insurance Portability and Accountability
Act of 1996</act-name> (<external-xref legal-doc="public-law" parsable-cite="pl/104/191">Public Law 104–191</external-xref>; 110 Stat. 2033) relating to the
privacy of individually identifiable health information and other protections;
and</text>
</paragraph><paragraph id="H794ED1E70FB0497CA503D55B82142E39"><enum>(2)</enum><text>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.</text>
</paragraph></subsection><subsection id="H1BE09E01F26C497DAF398B4E751500E7"><enum>(c)</enum><header>Rule of
construction</header><text>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.</text>
</subsection><subsection id="H610AB8CE681B4B6086A6002781CFC651"><enum>(d)</enum><header>Technical
assistance</header><text>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.</text>
</subsection><subsection id="HD0B7FB68879947E4A800A84BC621E4D6"><enum>(e)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2008
through
2013.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H3BAAD627CAA744629CD766ACD583DE40"><enum>303.</enum><header>Revision of
HIPAA claims standards</header>
<subsection id="HC36BEDC88F41424A85B8C0F3F9A4DCC5"><enum>(a)</enum><header>In
general</header><text>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 <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1320d">42 U.S.C. 1320d et seq.</external-xref>),
as added by the <act-name parsable-cite="HIPAA">Health Insurance Portability
and Accountability Act of 1996</act-name> (<external-xref legal-doc="public-law" parsable-cite="pl/104/191">Public Law 104–191</external-xref>), relating to the
collection of data on race, ethnicity, and primary language in a health-related
transaction to require—</text>
<paragraph id="HCF5FE2C274DF475DA2AE39451C290000"><enum>(1)</enum><text>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;</text>
</paragraph><paragraph id="HFAD5F5F5BAD2410E8F85005EE8469999"><enum>(2)</enum><text>the establishment
of a new data code set for primary language; and</text>
</paragraph><paragraph id="H5F36830508694B6FB664CE7DEA8CB5EF"><enum>(3)</enum><text>the designation of
the racial, ethnic, and primary language code sets as <quote>required</quote>
for claims and enrollment data.</text>
</paragraph></subsection><subsection id="HD755FAD2E36749089690CBC478545043"><enum>(b)</enum><header>Dissemination</header><text>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.</text>
</subsection><subsection id="H4A43C0D6BF3645FFAB91438FEE672487"><enum>(c)</enum><header>Compliance</header><text>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.</text>
</subsection></section><section id="H097068FEB3D741469F5F76E7BB4518DF"><enum>304.</enum><header>National Center
for Health Statistics</header><text display-inline="no-display-inline">Section
306(n) of the <act-name parsable-cite="PHSA">Public Health Service
Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/242k">42 U.S.C. 242k(n)</external-xref>) is amended—</text>
<paragraph id="H4A7952D4B47B4D45AAC872BAF18E8202"><enum>(1)</enum><text>in paragraph (1),
by striking <quote>2003</quote> and inserting <quote>2012</quote>;</text>
</paragraph><paragraph id="H687EA1F8881543B2A5BA1BD23B89F31"><enum>(2)</enum><text>in
paragraph (2), in the first sentence, by striking <quote>2003</quote> and
inserting <quote>2012</quote>; and</text>
</paragraph><paragraph id="HB27AA6B952D04BE2A710F5E78FE74F5D"><enum>(3)</enum><text>in paragraph (3),
by striking <quote>2002</quote> and inserting <quote>2012</quote>.</text>
</paragraph></section><section id="HFF52A7AEC73B44DE8BF747C894CF67F"><enum>305.</enum><header>Geo-access
study</header><text display-inline="no-display-inline">The Administrator of the
Substance Abuse and Mental Health Services Administration shall—</text>
<paragraph id="H5A53B4F7535B49B4B3594CCA2EC59900"><enum>(1)</enum><text>conduct a study
to—</text>
<subparagraph id="H01B314FA08444FB2B400D1BEE4485F44"><enum>(A)</enum><text>determine which
geographic areas of the United States have shortages of specialty mental health
providers; and</text>
</subparagraph><subparagraph id="HD554175045FB44148329F4E5D0FF532B"><enum>(B)</enum><text>assess the
preparedness of speciality mental health providers to deliver culturally and
linguistically appropriate services; and</text>
</subparagraph></paragraph><paragraph id="H6C73F7DC46F44C0A8E61E35176762759"><enum>(2)</enum><text>submit a report to
the Congress on the results of such study.</text>
</paragraph></section><section id="H979F7FC1B99C446BBBB86C5015C0BE95"><enum>306.</enum><header>Racial, ethnic,
and linguistic data collected by the Federal Government</header>
<subsection id="HF7E296F84C6449FC944E691554BAF439"><enum>(a)</enum><header>Collection;
submission</header><text>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.</text>
</subsection><subsection id="HA11EF5E6FD1846369400BFE3CC9043B"><enum>(b)</enum><header>Analysis; public
availability; reporting</header><text>Not later than April 30, 2008, 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,
shall—</text>
<paragraph id="HEB0BE47E122C49D29F8068BA148D58F"><enum>(1)</enum><text>collect and analyze
the racial, ethnic, and linguistic data submitted under subsection (a) for the
preceding calendar year;</text>
</paragraph><paragraph id="H265806F41B5D40E0AF5344CC22007814"><enum>(2)</enum><text>make publicly
available such data and the results of such analysis; and</text>
</paragraph><paragraph id="H5A38A1F7A0C8496CB7C7D86317C0076E"><enum>(3)</enum><text>submit a report to
the Congress on such data and analysis.</text>
</paragraph></subsection></section><section commented="no" id="H01F174F405CD424BAC9177A3E2805657"><enum>307.</enum><header>Health
information technology grants</header>
<subsection commented="no" id="H1905B27EA8FE4EC8B9F8A830D287513"><enum>(a)</enum><header>Authority</header><text>The
Deputy Assistant Secretary for Minority Health, in coordination with the Office
of the National Coordinator for Health Information Technology, the Health
Resources and Services Administration, the Substance Abuse and Mental Health
Services Administration, and the National Center on Minority Health and Health
Disparities, may award grants to appropriate entities for the purpose of
ensuring appropriate and best practices to collect appropriate data and
documents on the reduction of health disparities.</text>
</subsection><subsection commented="no" id="HE28A70AAC4274C1AAB69224CDB68AC03"><enum>(b)</enum><header>Use of
funds</header><text>A grant received under subsection (a) shall be used to
achieve the purpose described in such subsection through one or more of the
following:</text>
<paragraph commented="no" id="HE6C7DB249F2F47C3806D197098CEA76"><enum>(1)</enum><text>Purchasing new, or
enhancing existing, health information technology.</text>
</paragraph><paragraph commented="no" id="HA6624E7A7A30460AA7D066D301339CA3"><enum>(2)</enum><text>Providing support
and training to providers concerning such technology.</text>
</paragraph><paragraph commented="no" id="H0EACBE28E17349739BE02EF681151BA"><enum>(3)</enum><text>Conducting outreach
and education on health information technology and its benefits to patients,
physicians, allied health professionals, and advocacy groups in medically
underserved communities (as defined in section 799B of the Public Health
Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/295p">42 U.S.C. 295p</external-xref>)).</text>
</paragraph></subsection><subsection commented="no" id="HCEB0E1E2D15849938FE2CC150074067D"><enum>(c)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated $20,000,000 for each of fiscal years 2008 through 2013.</text>
</subsection></section><section commented="no" id="H9C2880C781824ED381AD00BAE37D07C6"><enum>308.</enum><header>Study of health
information technology in medically underserved communities</header>
<subsection commented="no" id="HBC19CE5CD801447084CCA221B3343586"><enum>(a)</enum><header>Study</header><text display-inline="yes-display-inline">The National Coordinator for Health
Information Technology shall conduct a study on the development and
implementation of health information technology in medically underserved
communities. The study shall—</text>
<paragraph commented="no" id="H05D633EF84BF45D497E61EAC497FBE60"><enum>(1)</enum><text>identify barriers
to successful implementation of health information technology in these
communities;</text>
</paragraph><paragraph commented="no" id="HFE7E058C677F4E5BA400EDC727EF60A4"><enum>(2)</enum><text>examine the impact
of health information technology on providing quality care and reducing the
cost of care to these communities;</text>
</paragraph><paragraph commented="no" id="H96DCB5A2BA2D4820B5314E938E2D2D15"><enum>(3)</enum><text display-inline="yes-display-inline">examine urban and rural community health
systems and determine the impact that health information technology may have on
the capacity of primary health providers; and</text>
</paragraph><paragraph commented="no" id="HBF0EEA768F174684A3770100418078B9"><enum>(4)</enum><text>assess the
feasibility and the costs of associated with the use of health information
technology in these communities.</text>
</paragraph></subsection><subsection commented="no" id="H3C8DF21BE352412981FD6809B10B214"><enum>(b)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 18 months after the date of
the enactment of this Act, the National Coordinator for Health Information
Technology shall submit to the Congress a report on the study conducted under
subsection (a) and shall include in such report such recommendations for
legislation or administrative action as the Coordinator determines
appropriate.</text>
</subsection></section><section id="H79CDA1C248764042A7DC5B1F5612E445"><enum>309.</enum><header>Health
information technology in medically underserved communities</header><text display-inline="no-display-inline">The National Coordinator for Health
Information Technology shall—</text>
<paragraph id="H13FAF3F430534476AF9B25133000A44"><enum>(1)</enum><text display-inline="yes-display-inline">identify sources of funds that will be made
available to promote and support the planning and adoption of health
information technology in medically underserved communities (as defined in
section 799B of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/295p">42 U.S.C. 295p</external-xref>)), including in
urban and rural areas, either through grants or technical assistance;</text>
</paragraph><paragraph id="HAF92B382112A472D8456759E2023BC18"><enum>(2)</enum><text>coordinate with
the funding sources to help such communities connect to identified funding;
and</text>
</paragraph><paragraph id="H6E116A894E154AE392A2383F62F9C4D8"><enum>(3)</enum><text>collaborate with
the Agency for Healthcare Research and Quality, the Health Resources and
Services Administration, and other Federal agencies to support technical
assistance, knowledge dissemination, and resource development, to such
communities seeking to plan for and adopt technology and establish electronic
health information networks across providers.</text>
</paragraph></section><section commented="no" id="H4A25389E900441289B28B3BE618D7781"><enum>310.</enum><header>Data collection
and analysis grants to minority-serving institutions</header>
<subsection id="H16F9A557D5404D27AC75EEC4C264832F"><enum>(a)</enum><header>Authority</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services,
acting through the Center on Minority Health and Health Disparities and the
Office of Minority Health, may award grants to access and analyze racial and
ethnic, and where possible, primary language data to monitor and report on
progress to reduce and eliminate racial and ethnic disparities in health and
health care.</text>
</subsection><subsection id="HE87CE1D71E304CFFAC1BC700097182B4"><enum>(b)</enum><header>Eligible
entity</header><text>In this section, the term <term>eligible entity</term>
means a historically Black college or university, an Hispanic-serving
institution, a tribal college or university, or an Asian American and Pacific
Islander-serving institution with an accredited public health, health policy,
or health services research program.</text>
</subsection></section><section display-inline="no-display-inline" id="HC51BFE32EBFD4225AC8800F1EFAC6344" section-type="subsequent-section"><enum>311.</enum><header>Health information
technology grants for rural health care providers</header><text display-inline="no-display-inline">Title II of the Public Health Service Act is
amended by adding at the end the following new part:</text>
<quoted-block display-inline="no-display-inline" id="H66710BE232694A12899697E800BC692E" style="OLC">
<part id="H11A51C8DA87347D6A4F1C97CB5E23093"><enum>D</enum><header>Health Information
Technology Grants</header>
<section id="HA07C2BE5CDDA445F9F289472C9262000"><enum>271.</enum><header>Grants to
facilitate the widespread adoption of interoperable health information
technology in rural areas</header>
<subsection id="HB9D7C65B4D6A400D8877A41B36941C69"><enum>(a)</enum><header>Competitive
grants to eligible entities in rural areas</header>
<paragraph id="HA28E32D409DC4AD197DEEFE3DEE1D21"><enum>(1)</enum><header>In
general</header><text>The Secretary may award competitive grants to eligible
entities in rural areas to facilitate the purchase and enhance the utilization
of qualified health information technology systems to improve the quality and
efficiency of health care.</text>
</paragraph><paragraph id="H35408313E408471AB5D1D96D30451BD8"><enum>(2)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under paragraph (1) an entity shall—</text>
<subparagraph id="H56A42412655A49C38CA21F2875E4D492"><enum>(A)</enum><text>submit to the
Secretary an application at such time, in such manner, and containing such
information as the Secretary may require;</text>
</subparagraph><subparagraph id="H3AF85DD8F6134BD29689B166A65F5B0"><enum>(B)</enum><text>submit to the
Secretary a strategic plan for the implementation of data sharing and
interoperability measures;</text>
</subparagraph><subparagraph id="HECC75AA047E24A95917E3DF41253A3F1"><enum>(C)</enum><text>be a rural health
care provider;</text>
</subparagraph><subparagraph id="H2EC18D454FF24046A105B473F146C2F5"><enum>(D)</enum><text display-inline="yes-display-inline">adopt any applicable core interoperability
guidelines (endorsed under other provisions of law);</text>
</subparagraph><subparagraph id="H9D0F13A1772245DCBC58DF97792DE373"><enum>(E)</enum><text>agree to notify
patients if their individually identifiable health information is wrongfully
disclosed;</text>
</subparagraph><subparagraph id="H6ABCA9E82A114199A997C513198ED612"><enum>(F)</enum><text>demonstrate
significant financial need; and</text>
</subparagraph><subparagraph id="H92A5CF0713EA44F0934297E21FE2C82D"><enum>(G)</enum><text>provide matching
funds in accordance with paragraph (4).</text>
</subparagraph></paragraph><paragraph id="H27B9F0B394F84866B31654209259125B"><enum>(3)</enum><header>Use of
funds</header><text>Amounts received under a grant under this subsection shall
be used to facilitate the purchase and enhance the utilization of qualified
health information technology systems and training personnel in the use of such
technology.</text>
</paragraph><paragraph id="H7C824A309DED4380A33FEEA1D0F20071"><enum>(4)</enum><header>Matching
requirement</header><text>To be eligible for a grant under this subsection an
entity shall contribute non-Federal contributions to the costs of carrying out
the activities for which the grant is awarded in an amount equal to $1 for each
$3 of Federal funds provided under the grant.</text>
</paragraph><paragraph id="HAA2A8CF04C0A4FA49CFB583E5E9DD1D4"><enum>(5)</enum><header>Limit on grant
amount</header><text display-inline="yes-display-inline">In no case shall the
payment amount under this subsection with respect to the purchase or enhanced
utilization of qualified health information technology for a rural health care
provider, in addition to the amount of any loan made to the provider from a
grant to a State under subsection (b) for such purpose, exceed 100 percent of
the provider’s costs for such purchase or enhanced utilization (taking into
account costs for training, implementation, and maintenance).</text>
</paragraph><paragraph id="HB17E0393EA584675BCE2E500EFEA9CB"><enum>(6)</enum><header>Preference in
awarding grants</header><text>In awarding grants to eligible entities under
this subsection, the Secretary shall give preference to each of the following
types of applicants:</text>
<subparagraph id="HE4EF8B701293497BA879E0B74F909567"><enum>(A)</enum><text>An entity that is
located in a frontier or other rural underserved area as determined by the
Secretary.</text>
</subparagraph><subparagraph id="H882C98A9E26A4C849BB1EE3FD61E5991"><enum>(B)</enum><text>An entity that
will link, to the extent practicable, the qualified health information system
to a local or regional health information plan or plans.</text>
</subparagraph><subparagraph id="HFAAB92D80A0D4723AA34D46846CD515"><enum>(C)</enum><text display-inline="yes-display-inline">A rural health care provider that is a
nonprofit hospital or a Federally qualified health center.</text>
</subparagraph><subparagraph id="H2187DB3F72C047D5B900CBF1C900BD6D"><enum>(D)</enum><text display-inline="yes-display-inline">A rural health care provider that is an
individual practice or group practice.</text>
</subparagraph></paragraph></subsection><subsection display-inline="no-display-inline" id="HF9E563F1720C42439845DE278D83E1E3"><enum>(b)</enum><header>Authorization of
appropriations</header>
<paragraph id="H97F8D3FC46EA4B4B9D47628CB57DF244"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">For the purpose of
carrying out this section, there is authorized to be appropriated $20,000,000
for fiscal year 2008, $30,000,000 for fiscal year 2009, and such sums as may be
necessary, but not to exceed $30,000,000 for each of fiscal years 2010 through
2012.</text>
</paragraph><paragraph id="H12B83CCB4636490483CAF908C2F6A800"><enum>(2)</enum><header>Availability</header><text display-inline="yes-display-inline">Amounts appropriated under paragraph (1)
shall remain available through fiscal year 2011.</text>
</paragraph></subsection><subsection id="H2A2096B0E5734459923DE000C103D41"><enum>(c)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="H820CF97C9E8A4FC0B9E8A36449D6B13F"><enum>(1)</enum><header>Federally
qualified health center</header><text display-inline="yes-display-inline">The
term <term>Federally qualified health center</term> has the meaning given that
term in section 1861(aa)(4) of the Social Security Act (42 U.S.C.
1395x(aa)(4)).</text>
</paragraph><paragraph id="HDE305A6544F14D8C001B5B83AFECB3AE"><enum>(2)</enum><header>Group
practice</header><text>The term <term>group practice</term> has the meaning
given that term in section 1877(h)(4) of the Social Security Act (42 U.S.C.
1395nn(h)(4)).</text>
</paragraph><paragraph id="HED6882CC0E8C4AB795BD9DD500C843CF"><enum>(3)</enum><header>Health care
provider</header><text display-inline="yes-display-inline">The term
<term>health care provider</term> means a hospital, skilled nursing facility,
home health agency (as defined in subsection (o) of section 1861 of the Social
Security Act, <external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x</external-xref>), health care clinic, rural health clinic,
Federally qualified health center, group practice, a pharmacist, a pharmacy, a
laboratory, a physician (as defined in subsection (r) of such section), a
practitioner (as defined in section 1842(b)(18)(CC) of such Act, 42 U.S.C.
1395u(b)(18)(CC)), a health facility operated by or pursuant to a contract with
the Indian Health Service, and any other category of facility or clinician
determined appropriate by the Secretary.</text>
</paragraph><paragraph id="H84768B3165474D7A857DAFB2C82DC0F"><enum>(4)</enum><header>Health
information; individually identifiable health information</header><text>The
terms <term>health information</term> and <term>individually identifiable
health information</term> have the meanings given those terms in paragraphs (4)
and (6), respectively, of section 1171 of the Social Security Act (42 U.S.C.
1320d).</text>
</paragraph><paragraph id="HD1323A4C1BDC451893DA114C0FF621B"><enum>(5)</enum><header>Laboratory</header><text>The
term <term>laboratory</term> has the meaning given that term in section
353.</text>
</paragraph><paragraph id="HE46ED0421C2746EBA68EEFD6F10863D8"><enum>(6)</enum><header>Pharmacist</header><text display-inline="yes-display-inline">The term <term>pharmacist</term> has the
meaning given that term in section 804(a)(2) of the Federal Food, Drug, and
Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/384">21 U.S.C. 384(a)(2)</external-xref>).</text>
</paragraph><paragraph id="H37AE9ED97CF44F639128F4EBC5C035D"><enum>(7)</enum><header>Qualified health
information technology</header><text display-inline="yes-display-inline">The
term <term>qualified health information technology</term> means a system or
components of health information technology that meet any applicable core
interoperability guidelines (endorsed under applicable provisions of law) when
in use or that use interface software that allows for interoperability in
accordance with such guidelines.</text>
</paragraph><paragraph id="H59BC9CADE67A4726B3DC00DD1060755"><enum>(8)</enum><header>Rural
area</header><text display-inline="yes-display-inline">The term <term>rural
area</term> has the meaning given such term for purposes of section
1886(d)(2)(D) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395ww">42 U.S.C. 1395ww(d)(2)(D)</external-xref>).</text>
</paragraph><paragraph id="H0FE367BC8BAA455296D68B4E3D78BFC5"><enum>(9)</enum><header>Rural health
care provider</header><text>The term <term>rural health care provider</term>
means a health care provider that is located in a rural
area.</text>
</paragraph></subsection></section></part><after-quoted-block>.</after-quoted-block></quoted-block>
</section><enum>IV</enum><header>Accountability
and Evaluation</header>
<subtitle id="H9C1BFB4CD63F4690B917424D54B25CFD"><enum>A</enum><header>General
provisions</header>
<section id="H5455AB97D30D41A2844C8202FC2E75C"><enum>401.</enum><header>Federal agency
plan to eliminate disparities and improve the health of minority
populations</header>
<subsection id="H88A23E22C128411A902C5BE46F5DC4A4"><enum>(a)</enum><header>In
general</header><text>Not later than September 1, 2008, 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 health care of minority populations, through programs
relevant to the mission of the agency.</text>
</subsection><subsection id="H2EAA9601993946D4A51DB9ED1C13D11B"><enum>(b)</enum><header>Publication</header><text>Each
action plan described in paragraph (1) shall—</text>
<paragraph id="H60DB66A4E9644DFAB5097F86E8047A8"><enum>(1)</enum><text>be
publicly reported in draft form for public review and comment;</text>
</paragraph><paragraph id="H07F4AB7359684D5D9CFEE988EB94DEF0"><enum>(2)</enum><text>include a response
to the review and comment described in paragraph (1) in the final plan;</text>
</paragraph><paragraph id="H4B86632C1BD64E800065E805ADE59D6E"><enum>(3)</enum><text>include the agency
response to the 2002 Institute of Medicine report, Unequal
Treatment—Confronting Racial and Ethnic Disparities in Healthcare;</text>
</paragraph><paragraph id="H77C33C0203BC4F10A6E800EFEA2FE0E3"><enum>(4)</enum><text>respond to data
and analyses presented in the National Healthcare Disparities Report and the
National Healthcare Quality Report published annually by the Agency for
Healthcare Research and Quality;</text>
</paragraph><paragraph id="H258D68FA932E409A9DD6C2E56B1D9284"><enum>(5)</enum><text>demonstrate
progress in meeting the Healthy People 2010 objectives; and</text>
</paragraph><paragraph id="H1AD8FD4ACEFC4B12AE7720B7B7840339"><enum>(6)</enum><text>be updated,
including progress reports, for inclusion in an annual report to
Congress.</text>
</paragraph></subsection></section><section id="H109F05B4FB264CB39E8E7FC15929A9A2"><enum>402.</enum><header>Accountability
within the Department of Health and Human Services</header><text display-inline="no-display-inline">Title
XXX of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name>,
as amended by titles II and III of this Act, is further amended by adding at
the end the following:</text>
<quoted-block act-name="Public Health Service Act" id="HD9E84782AEA44FE79E61BDAA53C1AF8E">
<subtitle id="H48639201C4C04427A231BA05BFD3EEE6"><enum>C</enum><header>Strengthening
accountability</header>
<section id="H65A649806E5A4C49A3E9C3AF6D71C977"><enum>3041.</enum><header>Elevation of
the Office of Civil Rights</header>
<subsection id="HF435858DDA9D4CBABAF4E02CC40924A9"><enum>(a)</enum><header>In
general</header><text>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.</text>
</subsection><subsection id="H913BEDAE759248AD9BDF46389BA04396"><enum>(b)</enum><header>Purpose</header><text>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:</text>
<paragraph id="H6517ED31236241818D48EF0854EAC956"><enum>(1)</enum><text display-inline="yes-display-inline">The development and implementation of an
action plan to address racial and ethnic health care 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 <quote>Health
Care Challenge: Acknowledging Disparity, Confronting Discrimination, and
Ensuring Equity</quote> (September, 1999) in conjunction with the reports by
the Institute of Medicine entitled <quote>Unequal Treatment: Confronting Racial
and Ethnic Disparities in Health Care</quote>, <quote>Crossing the Quality
Chasm: A New Health System for the 21st Century</quote>, and <quote>In the
Nation's Compelling Interest: Ensuring Diversity in the Health Care
Workforce</quote> and other related reports by the Institute of Medicine. 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.</text>
</paragraph><paragraph id="HF3BE514B300C4DA3B22CA9FF39FADEA7"><enum>(2)</enum><text>Investigative and
enforcement actions against intentional discrimination and policies and
practices that have a disparate impact on minorities.</text>
</paragraph><paragraph id="HEFC2E4B23D50489FA58D1000AE1BC1AC"><enum>(3)</enum><text>The review of
racial, ethnic, and primary language health data collected by Federal health
agencies to assess health care disparities related to intentional
discrimination and policies and practices that have a disparate impact on
minorities.</text>
</paragraph><paragraph id="HB727CAE75B5C49C4008C30DE72B468BE"><enum>(4)</enum><text>Outreach and
education activities relating to compliance with title VI of the Civil Rights
Act.</text>
</paragraph><paragraph id="HE56104B2A7FE4C90AFEDAA1778273EB6"><enum>(5)</enum><text>The provision of
technical assistance for health entities to facilitate compliance with title VI
of the Civil Rights Act.</text>
</paragraph><paragraph id="H3F99D86D4D324E92B6EA0084F1FD42F"><enum>(6)</enum><text>Coordination and
oversight of activities of the civil rights compliance offices established
under section 3042.</text>
</paragraph><paragraph id="HC302E0301F1647CDA004843D8B69B885"><enum>(7)</enum><text>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.</text>
</paragraph></subsection><subsection id="H293BE0129DF2456C937844CED4055C4D"><enum>(c)</enum><header>Funding and
staff</header><text>The Secretary shall ensure the effectiveness of the Office
of Health Disparities by ensuring that the Office is provided with—</text>
<paragraph id="HD4A67BA7D6C24237BB00CF9DD28E8F8B"><enum>(1)</enum><text>adequate funding
to enable the Office to carry out its duties under this section; and</text>
</paragraph><paragraph id="H813C91179ACF425B8BFF16EF41D8F4ED"><enum>(2)</enum><text>staff with
expertise in—</text>
<subparagraph id="H7E418E8E5CCD44AE96F0D8AE05DC5CD"><enum>(A)</enum><text>epidemiology;</text>
</subparagraph><subparagraph id="HE1E74EB77D284CAD85FB4704F2FCFA8"><enum>(B)</enum><text>statistics;</text>
</subparagraph><subparagraph id="HA31BA84456624B5EB300ED8741FE9F89"><enum>(C)</enum><text>health quality
assurance;</text>
</subparagraph><subparagraph id="HDCB8D4C63BC647B2B86B7D9740DDA43"><enum>(D)</enum><text>minority health and
health disparities;</text>
</subparagraph><subparagraph id="HFF77CEC18E4C4DC7BB3133939706919D"><enum>(E)</enum><text>cultural and
linguistic competency; and</text>
</subparagraph><subparagraph id="HEC297F3C4E874D658D0000E972D00566"><enum>(F)</enum><text>civil
rights.</text>
</subparagraph></paragraph></subsection><subsection id="HBB2632592EAC4985B128DB2005576EF5"><enum>(d)</enum><header>Report</header><text>Not
later than December 31, 2008, and annually thereafter, the Secretary, in
collaboration with the Director of the Office for Civil Rights and the Director
of the Office of Minority Health, 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—</text>
<paragraph id="HCD887716B2EB45AE9042AFF82BF8B87B"><enum>(1)</enum><text>the number of
cases filed, broken down by category;</text>
</paragraph><paragraph id="HD7E751D6DF4149FB99E17E1076240024"><enum>(2)</enum><text>the number of
cases investigated and closed by the office;</text>
</paragraph><paragraph id="HC061B2EE4FBC4001B52463D32F92F1B"><enum>(3)</enum><text>the outcomes of
cases investigated;</text>
</paragraph><paragraph id="H9A6C3320DFBA4979A55CBCAA67995CC2"><enum>(4)</enum><text>the staffing
levels of the office including staff credentials;</text>
</paragraph><paragraph id="H213D0809B5644070887F5F4BCB23C5BF"><enum>(5)</enum><text>the number of
other lingering and emerging cases in which civil rights inequities can be
demonstrated; and</text>
</paragraph><paragraph id="HDA7325AD790C4062A300B37037ABAE40"><enum>(6)</enum><text>the number of
cases remaining open and an explanation for their open status.</text>
</paragraph></subsection><subsection id="H219009822FAF42B4B4A0524C77CE29C"><enum>(e)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2008
through 2013.</text>
</subsection></section><section id="H9AED33FB806F4569A98E7BEF4F25C355"><enum>3042.</enum><header>Establishment
of Health Program offices for Civil Rights within Federal Health and human
services agencies</header>
<subsection id="H7BBD6A956FB74CCAACE437D9923A0D4"><enum>(a)</enum><header>In
general</header><text>The Secretary shall establish civil rights compliance
offices in each agency within the Department of Health and Human Services that
administers health programs.</text>
</subsection><subsection id="H334A3FD1DBC243E987027BD35DE7F240"><enum>(b)</enum><header>Purpose of
offices</header><text>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—</text>
<paragraph id="HDEDC1F9474A04D8EAD24D68BD03C852F"><enum>(1)</enum><text>does not
discriminate, either intentionally or in effect, on the basis of race, national
origin, language, ethnicity, sex, age, or disability; and</text>
</paragraph><paragraph id="H44EF89B17A364E46B0E51F27D5C4BDD8"><enum>(2)</enum><text>promotes the
reduction and elimination of disparities in health and health care based on
race, national origin, language, ethnicity, sex, age, and disability.</text>
</paragraph></subsection><subsection id="HD860F6DD44C54708915960514B5F6F00"><enum>(c)</enum><header>Powers and
duties</header><text>The offices established in subsection (a) shall have the
following powers and duties:</text>
<paragraph id="H6BDDC25970E9487A8F3446C29C387F00"><enum>(1)</enum><text>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 health
care related to race, national origin, language, ethnicity, sex, age, and
disability.</text>
</paragraph><paragraph id="HD3D2FAB440734613B7A4C07F7C2D47"><enum>(2)</enum><text>The development and
implementation of program-specific guidelines that interpret and apply
Department of Health and Human Services guidance under title VI of the
<act-name parsable-cite="CRA64">Civil Rights Act of 1964</act-name> to each
Federal health program administered by the agency.</text>
</paragraph><paragraph id="H30908B4274A449D1B04071C9B5A4A588"><enum>(3)</enum><text>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.</text>
</paragraph><paragraph id="HD75E76AED5BA40E1BAA401735E9DDB43"><enum>(4)</enum><text>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.</text>
</paragraph><paragraph id="H36DD80B8663F45D7A7844837855C992E"><enum>(5)</enum><text>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.</text>
</paragraph><paragraph id="HAE3AC72FD3874764007960B9E597EFE3"><enum>(6)</enum><text>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 health care through the Federal programs
administered by the agency.</text>
</paragraph></subsection><subsection id="H5389C0BACDD24E00B677E6477F00DCB"><enum>(d)</enum><header>Relationship to
Office for Civil Rights in the Department of Justice</header>
<paragraph id="HCB5B56B6C1C44EE7A79419E3CE3E26DC"><enum>(1)</enum><header>Department of
Health and Human Services</header><text>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.</text>
</paragraph><paragraph id="H4096C98D5D2A41AE9994D6D2A4EC0758"><enum>(2)</enum><header>Department of
Justice</header><text>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.</text>
</paragraph></subsection><subsection id="HC677D8884C594FF2BD3C7686653000AC"><enum>(e)</enum><header>Definition</header><text>In
this section, the term <term>Federal health programs</term> mean
programs—</text>
<paragraph id="H0EBCBC0478EE486085A765DFA773F008"><enum>(1)</enum><text>under the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C. 301 et
seq.) that pay for health care and services; and</text>
</paragraph><paragraph id="HBC08D5878949408DB222E17477B16196"><enum>(2)</enum><text>under this Act
that provide Federal financial assistance for health care, biomedical research,
health services research, and programs designed to improve the public’s
health.</text>
</paragraph></subsection></section></subtitle><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HB601B0D6776744E88F76403045E459E0"><enum>403.</enum><header>Office of
Minority Health</header><text display-inline="no-display-inline">Section 1707
of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42
U.S.C. 300u–6) is amended—</text>
<paragraph id="H726A7732A38044F48663EB5618EC0006"><enum>(1)</enum><text>by striking
subsection (b) and inserting the following:</text>
<quoted-block id="HB0DE9C22377B4780A757FF00454E6B8C">
<subsection id="H136EA8AC673B4472AFF92CB22977ED5E"><enum>(b)</enum><header>Duties</header><text>With
respect to improving the health of racial and ethnic minority groups, the
Secretary, acting through the Deputy Assistant Secretary for Minority Health
(in this section referred to as the <quote>Deputy Assistant Secretary</quote>),
shall carry out the following:</text>
<paragraph id="H088644E630094A268C48252785F1F7C3"><enum>(1)</enum><text>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.</text>
</paragraph><paragraph id="H98C0CAA70DA241948EF98DAC4C73A200"><enum>(2)</enum><text>Oversee all
activities within the Department of Health and Human Services that relate to
reducing or eliminating disparities in health and health care in racial and
ethnic minority populations and in rural and underserved communities, including
coordinating—</text>
<subparagraph id="H070A406B63F64FB48D2600721DE4FFC5"><enum>(A)</enum><text>the design of
programs, support for programs, and the evaluation of programs;</text>
</subparagraph><subparagraph id="H38833979C34E4F46A9BAFA77BB2218EA"><enum>(B)</enum><text>the monitoring of
trends in health and health care;</text>
</subparagraph><subparagraph id="H7016A0913972457E8CA2665B68E59287"><enum>(C)</enum><text>research
efforts;</text>
</subparagraph><subparagraph id="HE25E82F05CEB48E585E27F84E84E6B2F"><enum>(D)</enum><text>the training of
health providers; and</text>
</subparagraph><subparagraph id="HE8842183E26249D68D33133D25A82DDC"><enum>(E)</enum><text>information and
education programs and campaigns.</text>
</subparagraph></paragraph><paragraph id="H442367B4B7FB4781B29B27B4258D00C5"><enum>(3)</enum><text>Enter into
interagency and intra-agency agreements with other agencies of the Public
Health Service.</text>
</paragraph><paragraph id="H45F271AD9843421FBDD711D546823D7"><enum>(4)</enum><text>Ensure that the
Federal health agencies and the National Center for Health Statistics collect
data on the health status and health care 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.</text>
</paragraph><paragraph id="HD9E5C39B291C4721B9635524A8C07634"><enum>(5)</enum><text>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 health care.</text>
</paragraph><paragraph id="HD92BAE4C462E46AF850085F31D5C7329"><enum>(6)</enum><text>Support a national
minority health resource center to carry out the following:</text>
<subparagraph id="HF3B7033006684A74B19370B749A143A1"><enum>(A)</enum><text>Facilitate the
exchange of information regarding matters relating to health information,
health promotion and wellness, preventive health services, clinical trials,
health information technology, and education in the appropriate use of health
services.</text>
</subparagraph><subparagraph id="HF8E2188C14D6408F97A1D7BBB76F086"><enum>(B)</enum><text>Facilitate timely
access to culturally and linguistically appropriate information.</text>
</subparagraph><subparagraph id="H7B96930BAE424466BA94C040CAA60DB"><enum>(C)</enum><text>Assist in the
analysis of such information.</text>
</subparagraph><subparagraph id="H45B05483943C4C25B7D156884FDE79C6"><enum>(D)</enum><text>Provide technical
assistance with respect to the exchange of such information (including
facilitating the development of materials for such technical
assistance).</text>
</subparagraph></paragraph><paragraph id="HE8AA3CEB5F18428186A87D88D31CBD48"><enum>(7)</enum><text>Carry out programs
to improve access to health care 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 Health Care
as provided for in section 3003.</text>
</paragraph><paragraph id="H1B9479482924419E8B1069F9F3D464F"><enum>(8)</enum><text>Carry out programs
to improve access to health care services and to improve the quality of health
care services for individuals with low functional health literacy. As used in
the preceding sentence, the term <term>functional health literacy</term> means
the ability to obtain, process, and understand basic health information and
services needed to make appropriate health decisions.</text>
</paragraph><paragraph id="H91FD4591145840D996BAC27FABAE9611"><enum>(9)</enum><text>Advise in matters
related to the development, implementation, and evaluation of health
professions education on decreasing disparities in health care outcomes, with
focus on cultural competency as a method of eliminating disparities in health
and health care in racial and ethnic minority populations.</text>
</paragraph><paragraph id="H53871DDBA4E24ECEBB1C52360000BC3B"><enum>(10)</enum><text>Assist health
care 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.</text>
</paragraph></subsection><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph id="HEB212DC0D3684148B39E4B1939E61DC"><enum>(2)</enum><text>by
redesignating subsections (f) through (h) as subsections (g) through (i) ,
respectively;</text>
</paragraph><paragraph id="H3C14FA52233446D499D77FBF594F52AB"><enum>(3)</enum><text>by inserting after
subsection (d) the following:</text>
<quoted-block display-inline="no-display-inline" id="HBE496F7F980E4659B95651534FECD435" style="OLC">
<subsection id="HACD91C487AEE459782C54D1B291D85BD"><enum>(f)</enum><header>Preparation of
health professionals to provide health care to minority
populations</header><text>The Secretary, in collaboration with the Director of
the Bureau of Health Professions and the Deputy Assistant Secretary for
Minority Health, shall require that health professional schools that receive
Federal funds train future health professionals to provide culturally and
linguistically appropriate health care to diverse
populations.</text>
</subsection><after-quoted-block>;
and</after-quoted-block></quoted-block>
</paragraph><paragraph id="H17F7DB3BE7C54EB6A48E74F632999031"><enum>(4)</enum><text>by striking
subsection (i) (as so redesignated) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="HDEA6793E6BC341B18445AF2254DBE195" style="OLC">
<subsection id="H1EE4B8000F444751A009003D5B1DDFBB"><enum>(i)</enum><header>Authorization of
Appropriations</header><text>For the purpose of carrying out this section,
there are authorized to be appropriated $100,000,000 for fiscal year 2008, and
such sums as may be necessary for each of fiscal years 2009 through
2013.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section id="HBCDAF8F3F0AE499800C9A3008862FF9B"><enum>404.</enum><header>Establishment
of the Indian Health Service as an agency of the Public Health Service</header>
<subsection id="HFB3736C085B74321834280FDC9946640"><enum>(a)</enum><header>Establishment</header>
<paragraph id="HFA42075A3C4C4FD29C4CAA4310D545BF"><enum>(1)</enum><header>In
general</header><text>In order to more effectively and efficiently carry out
the responsibilities, authorities, and functions of the United States to
provide health care 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.</text>
</paragraph><paragraph id="HAF3C170184C145969600499F45DEB1D0"><enum>(2)</enum><header>Assistant
Secretary of Indian Health</header><text>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.</text>
</paragraph></subsection><subsection id="H2D111D30A485446A8C5CD175F0D06310"><enum>(b)</enum><header>Agency</header><text>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.</text>
</subsection><subsection id="HF737F7AEC064467AAD4EB4EC054711F"><enum>(c)</enum><header>Functions and
duties</header><text>The Secretary shall carry out through the Assistant
Secretary of the Service—</text>
<paragraph id="H6681E4A60E944DBAAF751548A8010631"><enum>(1)</enum><text>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;</text>
</paragraph><paragraph id="H20F5B2FEA8E7472700A94951ACB3F241"><enum>(2)</enum><text>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;</text>
</paragraph><paragraph id="H3FF848C78BCC4D9496A94700AE91703B"><enum>(3)</enum><text>all health
programs under which health care is provided to Indians based upon their status
as Indians which are administered by the Secretary, including programs
under—</text>
<subparagraph id="H3F4CAD58427A4F86BD18097900834BF4"><enum>(A)</enum><text>the
<act-name parsable-cite="IHCIA">Indian Health Care Improvement
Act</act-name>;</text>
</subparagraph><subparagraph id="H1E29BAF553D147348754AC68A49097E4"><enum>(B)</enum><text>the Act of
November 2, 1921 (<external-xref legal-doc="usc" parsable-cite="usc/25/13">25 U.S.C. 13</external-xref>);</text>
</subparagraph><subparagraph id="HB0BDAC63A9904D7182E861D0FB2426A2"><enum>(C)</enum><text>the Act of August
5, 1954 (<external-xref legal-doc="usc" parsable-cite="usc/42/2001">42 U.S.C. 2001</external-xref>, et seq.);</text>
</subparagraph><subparagraph id="HDE8CB614D2EC45068056F7403143A049"><enum>(D)</enum><text>the Act of August
16, 1957 (<external-xref legal-doc="usc" parsable-cite="usc/42/2005">42 U.S.C. 2005 et seq.</external-xref>);</text>
</subparagraph><subparagraph id="H24044D879216423285DF41F022888C17"><enum>(E)</enum><text>the
<act-name parsable-cite="ISDEAA">Indian Self-Determination Act</act-name> (25
U.S.C. 450f, et seq.); and</text>
</subparagraph><subparagraph id="H3433083B94AE44168D9F63CF4E3EACE"><enum>(F)</enum><text>title XXX of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name>, as added
by this Act; and</text>
</subparagraph></paragraph><paragraph id="H51FA0B7697324E5B9D7B00FB10C1F478"><enum>(4)</enum><text>all scholarship
and loan functions carried out under title I of the
<act-name parsable-cite="IHCIA">Indian Health Care Improvement
Act</act-name>.</text>
</paragraph></subsection><subsection id="H0B9147527906474FB0229F1F65692500"><enum>(d)</enum><header>Authority</header>
<paragraph id="HDC00C13838A64342A9CD0412617CA99F"><enum>(1)</enum><header>In
general</header><text>The Secretary, acting through the Assistant Secretary,
shall have the authority—</text>
<subparagraph id="H12CE9FBB4CCA4C43AFD4E76512C068F1"><enum>(A)</enum><text>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;</text>
</subparagraph><subparagraph id="HEB913697FC3A4C5696F006E2E14F9F72"><enum>(B)</enum><text>to enter into
contracts for the procurement of goods and services to carry out the functions
of the Service; and</text>
</subparagraph><subparagraph id="H81B774A7A8264C84A0C9D945F55EE24"><enum>(C)</enum><text>to manage, expend,
and obligate all funds appropriated for the Service.</text>
</subparagraph></paragraph><paragraph id="HCDC5A4839C8E434597BB9C2C505056C6"><enum>(2)</enum><header>Personnel
actions</header><text>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).</text>
</paragraph></subsection><subsection id="H83DE288725624955A242B68D47D78EF"><enum>(e)</enum><header>Rate of
pay</header>
<paragraph id="H959B12A96C154B6A94A1A528EC6EBB00"><enum>(1)</enum><header>Positions at
level IV</header><text><external-xref legal-doc="usc" parsable-cite="usc/5/5315">Section 5315</external-xref> of title 5, United States Code, is amended
by striking the following: <quote>Assistant Secretaries of Health and Human
Services (6).</quote> and inserting <quote>Assistant Secretaries of Health and
Human Services (7).</quote>.</text>
</paragraph><paragraph id="HAAF7C4C676654C1DA23C90A02E234949"><enum>(2)</enum><header>Positions at
level v</header><text>Section 5316 of such title is amended by striking the
following: <quote>Director, Indian Health Service, Department of Health and
Human Services.</quote>.</text>
</paragraph></subsection><subsection id="H7610C8C1F68B4B00A465DC92CCA47099"><enum>(f)</enum><header>Duties of
Assistant Secretary for Indian Health</header><text>Section 601 of the
<act-name parsable-cite="IHCIA">Indian Health Care Improvement Act</act-name>
(<external-xref legal-doc="usc" parsable-cite="usc/25/1661">25 U.S.C. 1661</external-xref>) is amended in subsection (a)—</text>
<paragraph id="HF5C024831AA746029F711C597D0872F2"><enum>(1)</enum><text>by inserting
<quote>(1)</quote> after <quote>(a)</quote>;</text>
</paragraph><paragraph id="H8380AB1F069641D098D48E5924EBE878"><enum>(2)</enum><text>in the second
sentence of paragraph (1), as so designated, by striking <quote>a
Director,</quote> and inserting <quote>the Assistant Secretary for Indian
Health,</quote>;</text>
</paragraph><paragraph id="HF5F1A7C18CA846C99D40BB9BD0F8ABD0"><enum>(3)</enum><text>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:
<quote>The Assistant Secretary for Indian Health shall carry out the duties
specified in paragraph (2).</quote>; and</text>
</paragraph><paragraph id="H04D7A429269B44249E36145D2E0543B2"><enum>(4)</enum><text>by adding after
paragraph (1) the following:</text>
<quoted-block id="HF7C5192561B94FCCBDCFC1009526BEA">
<paragraph id="HFE7EDA24C0854505BB55044CFAF169F4"><enum>(2)</enum><text>The Assistant
Secretary for Indian Health shall—</text>
<subparagraph id="H6C2EAFDE076A4417A727E6252FFC79A4"><enum>(A)</enum><text>report directly to
the secretary concerning all policy and budget-related matters affecting Indian
health;</text>
</subparagraph><subparagraph id="HE9AC6594E1B24AFE952FE04F806C77EC"><enum>(B)</enum><text>collaborate with
the Assistant Secretary for Health concerning appropriate matters of Indian
health that affect the agencies of the Public Health Service;</text>
</subparagraph><subparagraph id="HC02B0502BA8F439793F02DA9CF5FEB34"><enum>(C)</enum><text>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;</text>
</subparagraph><subparagraph id="HA5FA32AAD20146FC8DB3C7A521147B00"><enum>(D)</enum><text>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</text>
</subparagraph><subparagraph id="HBCFD02E7D88A4F5A9CAB01A9220022C9"><enum>(E)</enum><text>coordinate the
activities of the Department of Health and Human Services concerning matters of
Indian
health.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H5791517FB41742A9BA1CF23658ECF840"><enum>(g)</enum><header>Continued
Service by incumbent</header><text>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.</text>
</subsection><subsection id="H3F63179D90B74C4294B5C9AF19318DE9"><enum>(h)</enum><header>Conforming
amendments</header>
<paragraph id="H10281FC2D4C747249127B5412E002F00"><enum>(1)</enum><header>Amendments to
<act-name parsable-cite="IHCIA">Indian Health Care Improvement
Act</act-name></header><text>The <act-name parsable-cite="IHCIA">Indian Health
Care Improvement Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/25/1601">25 U.S.C. 1601 et seq.</external-xref>) is amended—</text>
<subparagraph id="HCA5E98DBE94E4C2E85E00533A8EA2F7F"><enum>(A)</enum><text>in section
601—</text>
<clause id="HFF0D8C752171414EB72C5E55DCBAEA1"><enum>(i)</enum><text>in
subsection (c), by striking <quote>Director of the Indian Health
Service</quote> both places it appears and inserting <quote>Assistant Secretary
for Indian Health</quote>; and</text>
</clause><clause id="H132B5F1265E74313A046BE2B1869B976"><enum>(ii)</enum><text>in
subsection (d), by striking <quote>Director of the Indian Health
Service</quote> and inserting <quote>Assistant Secretary for Indian
Health</quote>; and</text>
</clause></subparagraph><subparagraph id="H18F1A51778BD4AF79ECA7BC4D1810007"><enum>(B)</enum><text>in section
816(c)(1), by striking <quote>Director of the Indian Health Service</quote> and
inserting <quote>Assistant Secretary for Indian Health</quote>.</text>
</subparagraph></paragraph><paragraph id="HF208FCD45AAE404CAD00CBA25CAF6B"><enum>(2)</enum><header>Amendments to
other provisions of law</header><text>The following provisions are each amended
by striking <quote>Director of the Indian Health Service</quote> each place it
appears and inserting <quote>Assistant Secretary for Indian
Health</quote>:</text>
<subparagraph id="H01D8E45B5B6E4F8E92DA51656E004D10"><enum>(A)</enum><text>Section 203(a)(1)
of the <act-name parsable-cite="REH">Rehabilitation Act of 1973</act-name> (29
U.S.C. 763(a)(1)).</text>
</subparagraph><subparagraph id="H0A438EE539394A7BA8ABEE5CFBBE3B00"><enum>(B)</enum><text>Subsections (b)
and (e) of section 518 of the <act-name parsable-cite="FWPCA">Federal Water
Pollution Control Act</act-name> (33 U.S.C. 1377 (b) and (e)).</text>
</subparagraph><subparagraph id="H96B6AEB300364566B2228C9DB42752F2"><enum>(C)</enum><text>Section 803B(d)(1)
of the Native American Programs Act of 1974 (<external-xref legal-doc="usc" parsable-cite="usc/42/2991b-2">42 U.S.C. 2991b–2(d)(1)</external-xref>).</text>
</subparagraph></paragraph></subsection><subsection id="HC8ECD09EFA204A8EBB1D0006DDD9A4A8"><enum>(i)</enum><header>References</header><text>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.</text>
</subsection><subsection id="H0905524743254B2000EBE83884CE2CA"><enum>(j)</enum><header>Definitions</header><text>For
purposes of this section, the definitions contained in section 4 of the
<act-name parsable-cite="IHCIA">Indian Health Care Improvement Act</act-name>
shall apply.</text>
</subsection></section><section id="H6B047C9FE2214C2F921BF659EDAC793D"><enum>405.</enum><header>Establishment
of individual offices of minority health within agencies of the Public Health
Service</header><text display-inline="no-display-inline">Title XVII of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
300u et seq.) is amended by inserting after section 1707 the following
section:</text>
<quoted-block act-name="Public Health Service Act" id="H4E0628E09A8F446989DC59001C9B154D" style="traditional">
<section id="HB32BA60368D6476781B1B2F991FD9B5"><enum>1707A.</enum>
<header>Individual offices of Minority Health within public Health
Service</header>
<subsection commented="no" display-inline="no-display-inline" id="H8B59C88AE82240E2A88EEFAEBC7B8E78"><enum>(a)</enum><header>In
general</header><text>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. 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.</text>
</subsection><subsection id="H1ECB9FE678D24AE3BEDC026875199D69"><enum>(b)</enum><header>Specified
agencies</header>
<paragraph id="H10F0018017F745C2952FC359A762F8FD"><enum>(1)</enum><header>In
general</header><text>The agencies referred to in subsection (a) are the
following:</text>
<subparagraph id="HC45098B4BC814757B8CED864E5D05BD3"><enum>(A)</enum><text>The Centers for
Disease Control and Prevention.</text>
</subparagraph><subparagraph id="H6326A074422044FFAC08A239F68BF005"><enum>(B)</enum><text>The Health
Resources and Services Administration.</text>
</subparagraph><subparagraph id="HBEDF875DC80E4C1293E200073D167262"><enum>(C)</enum><text>The Substance
Abuse and Mental Health Services Administration; and</text>
</subparagraph><subparagraph id="H505FFDB67CF8426D80DE955B46706963"><enum>(D)</enum><text>The Administration
on Aging.</text>
</subparagraph></paragraph></subsection><subsection id="H8D52CD81C74541249333C637DC00F6FE"><enum>(c)</enum><header>Composition</header><text>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.</text>
</subsection><subsection id="H65B74CF2B92349D698A41BE904B6FE6C"><enum>(d)</enum><header>Duties</header><text>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:</text>
<paragraph id="HB6C681B0D4EA4BCABBA41D3DDCB8D7FF"><enum>(1)</enum><text>Determine the
extent to which the purposes of the programs are being carried out with respect
to racial and ethnic minority groups;</text>
</paragraph><paragraph id="HED6531E2DB7D427DB9AE5058504E00BD"><enum>(2)</enum><text>Determine the
extent to which members of such groups are represented among the Federal
officers and employees who administer the programs; and</text>
</paragraph><paragraph id="H7B3DB8EC2E4744BBB8CF25232253E9BD"><enum>(3)</enum><text>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—</text>
<subparagraph id="H6AADF15B6A97415500553C743501D233"><enum>(A)</enum><text>the services are
equitably delivered with respect to racial and ethnic minority groups;</text>
</subparagraph><subparagraph id="H3FC8B75E91A94B4DAEC4FAD32C53E9C"><enum>(B)</enum><text>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</text>
</subparagraph><subparagraph id="H2397A74A314642AA99F0855754E6AA5E"><enum>(C)</enum><text>the programs
utilize racial and ethnic minority community-based organizations to deliver
services.</text>
</subparagraph></paragraph></subsection><subsection id="HED986E776559438FA80003A4FADECAE8"><enum>(e)</enum><header>Biennial reports
to Secretary</header><text>The head of each specified agency shall submit to
the Secretary for inclusion in each biennial report describing—</text>
<paragraph id="H3685D0B98F01415D9605A6EDFF91C4E"><enum>(1)</enum><text>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.</text>
</paragraph></subsection><subsection id="HB9BB1304086E462095EA50FA25876412"><enum>(f)</enum><header>Funding</header>
<paragraph id="HB6F710A760A346F78CA4131E49F1AFF"><enum>(1)</enum><header>Allocations</header><text>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.</text>
</paragraph><paragraph id="HC27CB2323DA94E38AF1808C362C747C"><enum>(2)</enum><header>Availability of
funds for staffing</header><text>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.</text>
</paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HFD496592E4EE43F2AE21063CE77970E9"><enum>406.</enum><header>Office of
Minority Health at the Centers for Medicare & Medicaid Services</header>
<subsection id="H33B3D972569C46328BC98F227EB679A4"><enum>(a)</enum><header>In
general</header><text>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 & Medicaid Services an Office of Minority Health
(referred to in this section as the <quote>Office</quote>).</text>
</subsection><subsection id="H702A564AA6B24C569D2FE2DAF5D576AD"><enum>(b)</enum><header>Duties</header><text>The
Office shall be responsible for the coordination and facilitation of activities
of the Centers for Medicare & Medicaid Services to improve minority health
and health care and to reduce racial and ethnic disparities in health and
health care, which shall include—</text>
<paragraph id="HB2BCA16CBAAB427DB9BEEC800002414"><enum>(1)</enum><text>creating a
strategic plan, which shall be made available for public review, to improve the
health and health care of Medicare, Medicaid, and SCHIP beneficiaries;</text>
</paragraph><paragraph id="HA2681F435C9A48A78936BB36E3647E1"><enum>(2)</enum><text>promoting
agency-wide policies relating to health care delivery and financing that could
have a beneficial impact on the health and health care of minority
populations;</text>
</paragraph><paragraph id="H1E8BDEEC8CDE42968ED5E2556F4E571F"><enum>(3)</enum><text>assisting health
plans, hospitals, and other health entities in providing culturally and
linguistically appropriate health care services;</text>
</paragraph><paragraph id="HDF74AF8C0133467B83A4E506BE31999E"><enum>(4)</enum><text>increasing
awareness and outreach activities for minority health care consumers and
providers about the causes and remedies for health and health care
disparities;</text>
</paragraph><paragraph id="H3C3FC551A1F746C9813DD7498100892F"><enum>(5)</enum><text>developing grant
programs and demonstration projects to identify, implement and evaluate
innovative approaches to improving the health and health care of minority
beneficiaries in the Medicare, Medicaid, and SCHIP programs;</text>
</paragraph><paragraph id="H9BC749500802476EA5DF57452B7491F9"><enum>(6)</enum><text>considering
incentive programs relating to reimbursement that would reward health entities
for providing quality health care for minority populations using established
benchmarks for quality of care;</text>
</paragraph><paragraph id="H8967C2C47F3747AD86D3F67E8186D1FF"><enum>(7)</enum><text>collaborating with
the compliance office to ensure compliance with the anti-discrimination
provisions under title VI of the <act-name parsable-cite="CRA64">Civil Rights
Act of 1964</act-name>;</text>
</paragraph><paragraph id="HD71E6CAA058641C18CCD764530949490"><enum>(8)</enum><text>identifying
barriers to enrollment in public programs under the jurisdiction of the Centers
for Medicare & Medicaid Services;</text>
</paragraph><paragraph id="H8F64AD1500C04063B7290079A765B37F"><enum>(9)</enum><text>monitoring and
evaluating on a regular basis the success of minority health programs and
initiatives;</text>
</paragraph><paragraph id="HE6CA823DFA6C461FAADC961395E0BC6F"><enum>(10)</enum><text>publishing an
annual report about the activities of the Centers for Medicare & Medicaid
Services relating to minority health improvement; and</text>
</paragraph><paragraph id="HCF65976ACDC044C1A249FB49F64B21B3"><enum>(11)</enum><text>other activities
determined appropriate by the Secretary of Health and Human Services.</text>
</paragraph></subsection><subsection id="H2C4C61EE7ECB44D4A70890B2F8009100"><enum>(c)</enum><header>Staff</header><text>The
staff at the Office shall include—</text>
<paragraph id="H6BD039487EE14B9EA6C117B31B78C5A7"><enum>(1)</enum><text>one or more
individuals with expertise in minority health and racial and ethnic health
disparities; and</text>
</paragraph><paragraph id="HDC29B86260124D90A9AA635B52FBF8B4"><enum>(2)</enum><text>one or more
individuals with expertise in health care financing and delivery in underserved
communities.</text>
</paragraph></subsection><subsection id="HED0A011D59504BE3920907E29B3DA5C4"><enum>(d)</enum><header>Coordination</header><text>In
carrying out its duties under this section, the Office shall coordinate
with—</text>
<paragraph id="HF841F15360434FA39FF255AD1364F02F"><enum>(1)</enum><text>the Office of
Minority Health in the Office of the Secretary of Health and Human
Services;</text>
</paragraph><paragraph id="H1F25D7DE2EDA49909F6938766BB7CEF"><enum>(2)</enum><text>the National
Centers for Minority Health and Health Disparities in the National Institutes
of Health; and</text>
</paragraph><paragraph id="H8C094CE1761543A5A428F4D694712F9"><enum>(3)</enum><text>the Office of
Minority Health in the Centers for Disease Control and Prevention.</text>
</paragraph></subsection><subsection id="H5D35FCAF10D84938B17DDE9037874FE9"><enum>(e)</enum><header>Authorization of
appropriations</header><text>For the purpose of carrying out this section,
there are authorized to be appropriated $10,000,000 for fiscal year 2008, and
such sums may be necessary for each of fiscal years 2009 through 2014.</text>
</subsection></section><section id="HDBDCF7C7E32047DA984D54951500A34E"><enum>407.</enum><header>Office of
Minority Affairs at the Food and Drug Administration</header><text display-inline="no-display-inline">Chapter IX of the
<act-name parsable-cite="FFDCA">Federal Food, Drug, and Cosmetic Act</act-name>
(<external-xref legal-doc="usc" parsable-cite="usc/21/391">21 U.S.C. 391 et seq.</external-xref>) is amended by adding at the end the following:</text>
<quoted-block act-name="Federal Food, Drug, and Cosmetic Act" id="H5AFCAAD7A92F4A910005AE690156ABDB">
<section id="H8D6634AFDAC84ED7AB06A6A0B0BFAB00"><enum>910.</enum><header>Office of
Minority Affairs</header>
<subsection id="H587F331D80284E0FA7A3FB2442431798"><enum>(a)</enum><header>In
general</header><text>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 <quote>Office</quote>).</text>
</subsection><subsection id="HC4F9038646CB475FBF72C4DD9F8C3B60"><enum>(b)</enum><header>Duties</header><text>The
Office shall be responsible for the coordination and facilitation of activities
of the Food and Drug Administration to improve minority health and health care
and to reduce racial and ethnic disparities in health and health care, which
shall include—</text>
<paragraph id="HCE37830B14CD43E784CE9BCE9114D72"><enum>(1)</enum><text>promoting policies
in the development and review of medical products that reduce racial and ethnic
disparities in health and health care;</text>
</paragraph><paragraph id="H091B77341869468CB2A5903BB7BD6BFB"><enum>(2)</enum><text>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;</text>
</paragraph><paragraph id="H8E4B9D6F63594F93A8A40070E5BF02F"><enum>(3)</enum><text>providing, in
coordination with other appropriate government agencies, education, training,
and support to increase participation of minority patients and physicians in
clinical trials;</text>
</paragraph><paragraph id="H06EE24F09BC7444C8275BD40038FB4F6"><enum>(4)</enum><text>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;</text>
</paragraph><paragraph id="H057A50519A164217B9C1577F762000A"><enum>(5)</enum><text>the identification
of methods to reduce language and literacy barriers; and</text>
</paragraph><paragraph id="HBF3414F0CA6A4025B4FA240052904B27"><enum>(6)</enum><text>publishing an
annual report about the activities of the Food and Drug Administration
pertaining to minority health.</text>
</paragraph></subsection><subsection id="H633524D2049F44149883B8751516F73"><enum>(c)</enum><header>Staff</header><text>The
staff of the Office shall include—</text>
<paragraph id="H53C9BF7060074451A866C9263F91427E"><enum>(1)</enum><text>one or more
individuals with expertise in the design and conduct of clinical trials of
drugs, biological products, and medical devices; and</text>
</paragraph><paragraph id="H71C590BA1831411F00C1F155E74804F6"><enum>(2)</enum><text>one or more
individuals with expertise in therapeutic classes or disease states for which
medical evidence suggests a difference based on race or ethnicity.</text>
</paragraph></subsection><subsection id="H56E35347EF6B48C494700075AF468423"><enum>(d)</enum><header>Coordination</header><text>In
carrying out its duties under this section, the Office shall coordinate
with—</text>
<paragraph id="HE78B7C7E9B0F411B934518B12692B17D"><enum>(1)</enum><text>the Office of
Minority Health in the Office of the Secretary of Health and Human
Services;</text>
</paragraph><paragraph id="H357F23463A514F6BBD00D7D5607D5CAE"><enum>(2)</enum><text>the National
Center for Minority Health and Health Disparities in the National Institutes of
Health; and</text>
</paragraph><paragraph id="H49BF734EF2104BCA9BB800A41C3F174F"><enum>(3)</enum><text>the Office of
Minority Health in the Centers for Disease Control and Prevention.</text>
</paragraph></subsection><subsection id="H92387458793E41238EAE6DFA00B931A1"><enum>(e)</enum><header>Authorization of
appropriations</header><text>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 2008 through
2013.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H0F72AEDE60694ED1B1202BFAEB14F75C"><enum>408.</enum><header>Safety and
effectiveness of drugs with respect to racial and ethnic background</header>
<subsection id="H23C72B5A0AC546E0A160F9E9FE0052F7"><enum>(a)</enum><header>In
general</header><text>Chapter V of the <act-name parsable-cite="FFDCA">Federal
Food, Drug, and Cosmetic Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/21/351">21 U.S.C. 351 et seq.</external-xref>) is amended by
adding after section 505B the following:</text>
<quoted-block act-name="Federal Food, Drug, and Cosmetic Act" id="H6E80DFB12AE7489294A49521E759CFF9">
<section id="H2F4C8624CB4245B9B28E3FD41F343EAF"><enum>505C.</enum><header>Safety and
effectiveness of drugs with respect to racial and ethnic background</header>
<subsection id="H4A4634ACCBCA4CB589C1A195F875F678"><enum>(a)</enum><header>Pre-Approval
studies</header><text>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—</text>
<paragraph id="H4E039EEA3041401BA93CC5B8319C98C1"><enum>(1)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="HCA1D84BDBC824B22AA00D407CD3DE5C2"><enum>(A)</enum><text>the investigations
required under section 505(b)(1)(A) shall include adequate and well-controlled
investigations of the disparity; or</text>
</subparagraph><subparagraph id="H8915F2F5D7524445AA00C8FCA31D99D4" indent="up1"><enum>(B)</enum><text>the evidence required under section
351(a) of the <act-name parsable-cite="PHSA">Public Health Service
Act</act-name> for approval of a biologics license application for the drug
shall include adequate and well-controlled investigations of the disparity;
and</text>
</subparagraph></paragraph><paragraph id="H6B872DD33D2A428BB386112BD773B68F"><enum>(2)</enum><text>if the
investigations confirm that there is a disparity, the labeling of the drug
shall include appropriate information about the disparity.</text>
</paragraph></subsection><subsection id="H297FB91B2D1E475D938494CEF62078BC"><enum>(b)</enum><header>Post-Market
studies</header>
<paragraph id="H92CB9091C73B4FFD9699FF2F597216E5"><enum>(1)</enum><header>In
general</header><text>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 <act-name parsable-cite="PHSA">Public Health Service
Act</act-name>, 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.</text>
</paragraph><paragraph id="H3E56917D39AE459785AC6E53F7DE9BF"><enum>(2)</enum><header>Labeling</header><text>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.</text>
</paragraph><paragraph id="HE472D0730BF14456A167062EC79BECEA"><enum>(3)</enum><header>Study
design</header><text>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.</text>
</paragraph><paragraph id="H96EF3561BFB340BCA5AF5E68663CB2D"><enum>(4)</enum><header>Modifications of
study design</header><text>The Secretary may by order modify any aspect of the
study design as necessary after issuing an order under paragraph (1).</text>
</paragraph><paragraph id="H22646D1C99A448E48DC7818DA84F0685"><enum>(5)</enum><header>Study
results</header><text>The results from studies required under paragraph (1)
shall be submitted to the Secretary as supplements to the drug application or
biological license application.</text>
</paragraph></subsection><subsection id="HB2F0B211D05345C09CC1023640827221"><enum>(c)</enum><header>Disparity</header><text>The
term <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</term> includes—</text>
<paragraph id="H8F3924E649F5419DB03BF3A8E5FA004B"><enum>(1)</enum><text>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;</text>
</paragraph><paragraph id="H29DB6D99C1F14C9FAA34998949FC749D"><enum>(2)</enum><text>evidence that
there is a disparity on the basis of racial or ethnic background in the way the
drug is metabolized; and</text>
</paragraph><paragraph id="H26AECB7205E34FE895644F6DC07F79B6"><enum>(3)</enum><text>other evidence as
the Secretary may determine.</text>
</paragraph></subsection><subsection id="H30CED91EB4E84913A4A6A7C658E6281"><enum>(d)</enum><header>Applications
under Section <enum-in-header>505(b)(2)</enum-in-header> and
<enum-in-header>505(j)</enum-in-header></header>
<paragraph id="HD6CADA52768F4FB7A7E5BFC7F3EEBE6"><enum>(1)</enum><header>In
general</header><text>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)(B).</text>
</paragraph><paragraph id="HAD07794BB7A042D198E520F1FA3B29C6"><enum>(2)</enum><header>Labeling</header><text>Notwithstanding
clauses (iii) and (iv) of section 505(j)(5)(B), 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.</text>
</paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H845E2BD4549C45778DD300D820008240"><enum>(b)</enum><header>Enforcement</header><text>Section
502 of the <act-name parsable-cite="FFDCA">Federal Food, Drug, and Cosmetic
Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/21/352">21 U.S.C. 352</external-xref>) is amended by adding at the end the
following:</text>
<quoted-block act-name="Federal Food, Drug, and Cosmetic Act" id="HDF8F4B226D8F4C0A84B377AC4C791C9">
<subsection id="H28D62CC04B3A4BCD949C66A4ACB423A5"><enum>(y)</enum><text display-inline="yes-display-inline">If it is a drug and the holder of the
approved application under section 505 or license under section 351 of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> for the
drug has failed to complete the investigations or studies, or comply with any
other requirement, of section
505C.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H26FD0482399B4439B75894EB466B641E"><enum>(c)</enum><header>Drug
fees</header><text>Section 736(a)(1)(A)(ii) of the
<act-name parsable-cite="FFDCA">Federal Food, Drug, and Cosmetic Act</act-name>
(<external-xref legal-doc="usc" parsable-cite="usc/21/379h">21 U.S.C. 379h</external-xref>) is amended by adding after <quote>are required</quote> the
following: <quote>, including supplements required under section
505C</quote>.</text>
</subsection></section><section id="HB131343BBAC04A769C8DD8DA8D1E0046"><enum>409.</enum><header>United States
Commission on Civil Rights</header>
<subsection id="HC1F140D7D11647258C14EF61721FB26"><enum>(a)</enum><header>Coordination
within Department of Justice of activities regarding Health
disparities</header><text>Section 3 of the Civil Rights Commission Act of 1983
(<external-xref legal-doc="usc" parsable-cite="usc/42/1975a">42 U.S.C. 1975a</external-xref>) is amended—</text>
<paragraph id="HCCFA0DCD74584FC39ED7A9DE87BFB0D0"><enum>(1)</enum><text>in paragraph
(1)(B), by striking <quote>and</quote> at the end;</text>
</paragraph><paragraph id="H71B77D064F444594BEEC080042BE4D6D"><enum>(2)</enum><text>in paragraph (2),
in the matter after and below subparagraph (D), by striking the period and
inserting <quote>; and</quote>; and</text>
</paragraph><paragraph id="HA6829E52C71D4DA600C05830BCEF0457"><enum>(3)</enum><text>by adding at the
end the following:</text>
<quoted-block id="HDE217765780B4F22005E60D9E5D43094">
<paragraph id="HE9F789EF158C4E4FA6E782EF3F22176D"><enum>(3)</enum><text>shall, with
respect to activities carried out in health care 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—</text>
<subparagraph id="HFB57227DA89840BCB0CD2BA99BD19300"><enum>(A)</enum><text>the Office for
Civil Rights within the Department of Justice;</text>
</subparagraph><subparagraph id="HCCD251EC200F426ABAAA055752AD7F40"><enum>(B)</enum><text>the Office of
Justice Programs within the Department of Justice;</text>
</subparagraph><subparagraph id="HD71180120CC742829D00F45F8E1EAC28"><enum>(C)</enum><text>the Office for
Civil Rights within the Department of Health and Human Services; and</text>
</subparagraph><subparagraph id="HAF869612653B4CC3BF47FAE9B380978D"><enum>(D)</enum><text>the Office of
Minority Health within the Department of Health and Human Services (headed by
the Deputy Assistant Secretary for Minority
Health).</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="HB28B9F09DB044A91A6E4B800928384CC"><enum>(b)</enum><header>Authorization of
appropriations</header><text>Section 5 of the Civil Rights Commission Act of
1983 (<external-xref legal-doc="usc" parsable-cite="usc/42/1975c">42 U.S.C. 1975c</external-xref>) is amended by striking the first sentence and inserting
the following: <quote>For the purpose of carrying out this Act, there are
authorized to be appropriated $30,000,000 for fiscal year 2008, and such sums
as may be necessary for each of the fiscal years 2009 through
2013.</quote>.</text>
</subsection></section><section id="HB946B250D53F4E2EBAF09300B671E1AB"><enum>410.</enum><header>Sense of
Congress concerning full funding of activities to eliminate racial and ethnic
health disparities</header>
<subsection id="H30061286E4DF467EBE2BB9C87DCA73D"><enum>(a)</enum><header>Findings</header><text>Congress
makes the following findings:</text>
<paragraph id="HE4619645C2F24C6AA0CDEB253B8D61B2"><enum>(1)</enum><text>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.</text>
</paragraph><paragraph id="HCE451E210FB24E2FA039539B55FC9C84"><enum>(2)</enum><text>Racial and ethnic
minority populations tend have the poorest health status and face substantial
cultural, social, and economic barriers to obtaining quality health
care.</text>
</paragraph><paragraph id="HF1CB89E3281F4147938EC8D71C49DE59"><enum>(3)</enum><text>Efforts to improve
minority health have been limited by inadequate resources (funding, staffing,
and stewardship) and accountability.</text>
</paragraph></subsection><subsection id="H0A343B2DD5F1418CB7486190A93B504E"><enum>(b)</enum><header>Sense of
Congress</header><text>It is the sense of Congress that—</text>
<paragraph id="H0D5E180E9CC84922814C76C62C14D4B"><enum>(1)</enum><text>funding should be
doubled by fiscal year 2008 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;</text>
</paragraph><paragraph id="H605BF0F6417144149F83A560C800BDDA"><enum>(2)</enum><text>adequate funding
by fiscal year 2008, 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;</text>
</paragraph><paragraph id="H6BC1ACCA17D8477E9FEB865ED6B2D2DA"><enum>(3)</enum><text>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 2008; and</text>
</paragraph><paragraph id="HE2A8450408BE40789F5D6ED75EE7E0B4"><enum>(4)</enum><text>stewardship and
accountability should be provided to Congress and the President for measurable
and sustainable progress toward health disparity elimination.</text>
</paragraph></subsection></section><section display-inline="no-display-inline" id="H2DF715A872EA499892A5E226D2935384" section-type="subsequent-section"><enum>411.</enum><header>Guidelines for
disease screening for minority patients</header>
<subsection id="HD7709806F8AB44C49E5CB5E20330D81"><enum>(a)</enum><header>In
general</header><text>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.</text>
</subsection><subsection id="H5865DD088943412E8629E928625875AD"><enum>(b)</enum><header>Participants</header><text>In
convening meetings under subsection (a), the Secretary shall ensure that
meeting participants include representatives of—</text>
<paragraph id="HF4572D19E4F5439B8FC4163957B0ECFF"><enum>(1)</enum><text>professional
societies and associations;</text>
</paragraph><paragraph id="HF0E36AB1402B49298165BEFEC7537C5"><enum>(2)</enum><text>minority health
organizations;</text>
</paragraph><paragraph id="HE928ABF8FD8C4B11BB51B5671F78CC03"><enum>(3)</enum><text>health care
researchers and providers, including those with expertise in minority
health;</text>
</paragraph><paragraph id="HFA663AFFD71346B48E9E00EFE6D88D32"><enum>(4)</enum><text>Federal health
agencies, including the Office of Minority Health and the National Institutes
of Health; and</text>
</paragraph><paragraph id="H9DB5261FF2E846099439D6340095001D"><enum>(5)</enum><text>other experts
determined appropriate by the Secretary.</text>
</paragraph></subsection><subsection id="H83655E5421EB47F28B91009DAD5C1238"><enum>(c)</enum><header>Diseases</header><text>Screening
guidelines for minority populations shall be developed under subsection (a)
for—</text>
<paragraph id="HD739A9734AB04037A36EB6851393A8DD"><enum>(1)</enum><text>hypertension;</text>
</paragraph><paragraph id="HAD2B9830EAC542A2BA0084F7D74B56E7"><enum>(2)</enum><text>hypercholesterolemia;</text>
</paragraph><paragraph id="H84EF2F4E486842E884A90068A1BF8718"><enum>(3)</enum><text>diabetes;</text>
</paragraph><paragraph id="HDE0CD2FE19AA4A6B8D579532A6684159"><enum>(4)</enum><text>cardiovascular
disease;</text>
</paragraph><paragraph id="HA1A2E2E887FC46FCA6B64BBBB1B9EB03"><enum>(5)</enum><text>cancers, including
breast, prostate, colon, cervical, and lung cancer;</text>
</paragraph><paragraph id="H77644ED719974BD19CDCD77BBE4801C9"><enum>(6)</enum><text>asthma;</text>
</paragraph><paragraph id="HEB0D60D2C65F48EDB9AB7B75113EC0BD"><enum>(7)</enum><text>diabetes;</text>
</paragraph><paragraph id="H6FCBBDED1FA74AE9953BAACB1602C181"><enum>(8)</enum><text>kidney
diseases;</text>
</paragraph><paragraph id="H58F08064FE1D4FE2A4D6B6C176B52C62"><enum>(9)</enum><text>eye diseases and
disorders, including glaucoma;</text>
</paragraph><paragraph id="H6CE1BBCD57B04FC2A9139E3ECDF759B4"><enum>(10)</enum><text>HIV/AIDS and
sexually transmitted diseases;</text>
</paragraph><paragraph id="H2EF68CF944954D2586187DA3E5BF3265"><enum>(11)</enum><text>uterine
fibroids;</text>
</paragraph><paragraph id="HF98ED82714EE4C9BB754A9A9C68EEBD7"><enum>(12)</enum><text>autoimmune
disease;</text>
</paragraph><paragraph id="H5D4C3C09DAB545D293A95606567B9B00"><enum>(13)</enum><text>mental health
conditions;</text>
</paragraph><paragraph id="H27E8709EDFA04588A42BA6E3D996035"><enum>(14)</enum><text>dental health
conditions and oral diseases;</text>
</paragraph><paragraph id="H942E6611A6284CF6913FD8F55674AF81"><enum>(15)</enum><text>environmental and
related health illnesses and conditions;</text>
</paragraph><paragraph id="H6B2C264815674AB1BF2B043E39D69EEF"><enum>(16)</enum><text>Sickle cell
disease;</text>
</paragraph><paragraph id="H2D68C541600B4430B46F73EDE2441027"><enum>(17)</enum><text>violence and
injury prevention and control;</text>
</paragraph><paragraph id="HE36253A97E3D40988F2136D5CD72736E"><enum>(18)</enum><text>genetic and
related conditions;</text>
</paragraph><paragraph id="HDC4407DD22AD4F6585A88E4428626F78"><enum>(19)</enum><text>heart disease and
stroke;</text>
</paragraph><paragraph id="HBF8DE40835FA464B9083211C32A6BB09"><enum>(20)</enum><text>tuberculosis;</text>
</paragraph><paragraph id="H6386C5E852BF488EB5CF14B1F6B0DD4E"><enum>(21)</enum><text>chronic
obstructive pulmonary disease; and</text>
</paragraph><paragraph id="HAF0259E1D6D94509BE31B28EA64D50CB"><enum>(22)</enum><text>other diseases
determined appropriate by the Secretary.</text>
</paragraph></subsection><subsection id="HAAA206C5A2EE4CEAADBD8B8C86B63597"><enum>(d)</enum><header>Dissemination</header><text>Not
later than 24 months after the date of enactment of this title, the Secretary
shall publish and disseminate to health care provider organizations the
guidelines developed under subsection (a).</text>
</subsection><subsection id="HAF7112DBFD894DAABCAD2DDB2110935C"><enum>(e)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, sums as may be necessary for each of fiscal years 2008
through 2013.</text>
</subsection></section><section commented="no" id="HBE3AF27752154DDAA51CE1B3640088EF"><enum>412.</enum><header>National center
for minority health and health disparities reauthorization</header>
<subsection id="HC7299E80F03041908E1EAF2089E9BAC0"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 485E of the
Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/287c-31">42 U.S.C. 287c-31</external-xref>) is amended—</text>
<paragraph commented="no" id="HA7B7A3FA570246F4A2DDDC2E9880FC76"><enum>(1)</enum><text>by striking
subsection (e) and inserting the following:</text>
<quoted-block id="H18172DD1DC5E4A2E8F11FEB7B2A5ACC2" style="OLC">
<subsection commented="no" id="H159823F0C6084166A18476B9004BF3C"><enum>(e)</enum><header>Duties of the
Director</header>
<paragraph commented="no" id="H3CC05DDAD338455CAAA2126FFEF2E3F7"><enum>(1)</enum><header>Interagency
coordination of minority health and health disparities
activities</header><text>With respect to minority health and health
disparities, the Director of the Center shall plan, coordinate, and evaluate
research and other activities conducted or supported by the agencies of the
National Institutes of Health. In carrying out the preceding sentence, the
Director of the Center shall evaluate the minority health and health disparity
activities of each of such agencies and shall provide for the timely periodic
re-evaluation of such activities.</text>
</paragraph><paragraph commented="no" id="HF5A513117EC04BEE93DBC6229D75E219"><enum>(2)</enum><header>Consultations</header><text>The
Director of the Center shall carry out this subpart (including developing and
revising the plan and budget required in subsection (f)) in consultation with
the Directors of the agencies (or a designee of the Directors) of the National
Institutes of Health, with the advisory councils of the agencies, and with the
advisory council established under section (j).</text>
</paragraph><paragraph commented="no" id="HC59C8408762E4A5A80BF798CE4162B82"><enum>(3)</enum><header>Coordination of
activities</header><text>The Director of the Center shall act as the primary
Federal official with responsibility for coordinating all minority health
disparities research and other health disparities research conducted or
supported by the National Institutes of Health and shall—</text>
<subparagraph commented="no" id="HD46001C6F07C4BD283EE5DE4BF74DD23"><enum>(A)</enum><text>represent the
health disparities research program of the National Institutes of Health
including the minority health disparities research program at all relevant
executive branch task forces, committees, and planning activities;</text>
</subparagraph><subparagraph commented="no" id="HE6E931C6A5264915BFE93C250000C8AD"><enum>(B)</enum><text>maintain
communications with all relevant Public Health Service agencies, including the
Indian Health Service and various other departments of the Federal Government,
to ensure the timely transmission of information concerning advances in
minority health disparities research and other health disparities research
between these various agencies for dissemination to affected communities and
health care providers;</text>
</subparagraph><subparagraph commented="no" id="H4211A88EAFF547CDA3C1B5A042A95C07"><enum>(C)</enum><text>undertake research
to further refine and develop the conceptual, definitional, and methodological
issues involved in health disparities research and to further the understanding
of the cause of disparities; and</text>
</subparagraph><subparagraph commented="no" id="H7DD55A31DDC1481C9BCDD3E4D5D4B36"><enum>(D)</enum><text>engage with
national and community-based organizations and health provider groups, led by
and serving racial and ethnic minorities, to—</text>
<clause commented="no" id="H115B71D1CF964EFC9D84019D4995AB7B"><enum>(i)</enum><text>increase
education, awareness, and participation with respect to the Center’s activities
and areas of research focus; and</text>
</clause><clause commented="no" id="H859C369960E34C36B220D4CBD5B6F75D"><enum>(ii)</enum><text>accelerate the
translation of research findings into programs including those carried out by
community-based
organizations.</text>
</clause></subparagraph></paragraph></subsection><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph commented="no" id="HB047DD4D740D40F8A3474706F1CF500"><enum>(2)</enum><text>in subsection
(f)—</text>
<subparagraph commented="no" id="H719219322B974DA29345EA9DF4D06B39"><enum>(A)</enum><text>by striking the
subsection heading and inserting the following: <quote><header-in-text level="subsection" style="OLC">Comprehensive Plan for Research; Budget
Estimate; Allocation of Appropriations</header-in-text>.—</quote>;</text>
</subparagraph><subparagraph commented="no" id="H55BD71E22187462700CDE29B9CA63D"><enum>(B)</enum><text>in paragraph
(1)—</text>
<clause commented="no" id="H8C1EB5AD02E34400895D00B78B847F57"><enum>(i)</enum><text>by striking the
paragraph designation, the paragraph heading, the matter preceding subparagraph
(A), and subparagraph (A) and inserting the following:</text>
<quoted-block id="HAAA2FD8CC1894EE89FF0EAA4476C5424" style="OLC">
<paragraph commented="no" id="H0F97341E632D4FFFAA1FCFE9CA005B57"><enum>(1)</enum><header>In
general</header><text>Subject to the provisions of this section and other
applicable law, the Director of the Center, in consultation with the Director
of NIH, the Directors of the other agencies of the National Institutes of
Health, and the advisory council established under subsection (j) shall—</text>
<subparagraph commented="no" id="H12005C0C7C2645BCAE8206E843F3E5A"><enum>(A)</enum><text>annually review and
revise a comprehensive plan (referred to in this section as <quote>the
plan</quote>) and budget for the conduct and support of all minority health and
health disparities research and other health disparities research activities of
the agencies of the National Institutes of Health that includes time-based
targeted objectives with measurable outcomes and assure that the annual review
and revision of the plan uses an established trans-NIH process subject to
timely review, approval, and
dissemination;</text>
</subparagraph></paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</clause><clause commented="no" id="HDBB2F4F1D04C4E7CAEAF1725930F246"><enum>(ii)</enum><text>in subparagraph
(D), by striking <quote>, with respect to amounts appropriated for activities
of the Center,</quote>;</text>
</clause><clause commented="no" id="H2580DBDBFF924EB29600FF22DB3CCEE4"><enum>(iii)</enum><text>by striking
subparagraph (F) and inserting the following:</text>
<quoted-block id="HFC66417EE8CE4B99A249EDE2F278B9C" style="OLC">
<subparagraph commented="no" id="H6A32AED9C203490DA7A426B7D9AE667E"><enum>(F)</enum><text>ensure that the
plan and budget are presented to and considered by the Director in a clear and
timely process during the formulation of the overall annual budget for the
National Institutes of
Health;</text>
</subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</clause><clause commented="no" id="H3EE6EB4B05EA4EB783E64F91028DD6B"><enum>(iv)</enum><text>by redesignating
subparagraphs (G) and (H) as subparagraphs (I) and (J), respectively;
and</text>
</clause><clause commented="no" id="H15F505D5CA3740788194C656D26B5F00"><enum>(v)</enum><text>by inserting after
subparagraph (F), the following:</text>
<quoted-block id="H51768B7FE5504318892304D8DCFAAC5" style="OLC">
<subparagraph commented="no" id="H47C0835D16FA45E08FAA5ECDCCBFDA9F"><enum>(G)</enum><text>annually submit to
the Congress a report on the progress made with respect to the plan;</text>
</subparagraph><subparagraph commented="no" id="H2E78A360F6BC4321A4BD8E4F1D3CBBFD"><enum>(H)</enum><text>create and
implement a plan for the systematic review of research activities supported by
the National Institutes of Health that are within the mission of both the
Center and other agencies of the National Institutes of Health, by establishing
mechanisms for—</text>
<clause commented="no" id="H872B82971CAF464700BE366B80CB7C25"><enum>(i)</enum><text>tracking minority
health and health disparity research conducted within the agencies and
assessing the appropriateness of this research with regard to the overall goals
and objectives of the plan;</text>
</clause><clause commented="no" id="HC7C3A1CB61F34984BD65853FC1971D47"><enum>(ii)</enum><text>the early
identification of applications and proposals for grants, contracts, and
cooperative agreements supporting extramural training, research, and
development, that are submitted to the agencies and that are within the mission
of the Center;</text>
</clause><clause commented="no" id="HE79AA8D27B894279A79CE0E4ADD734C"><enum>(iii)</enum><text>providing the
Center with the written descriptions and scientific peer review results of such
applications and proposals;</text>
</clause><clause commented="no" id="H8257E1E320BC402F9D5689852DF95F85"><enum>(iv)</enum><text>enabling the
agencies to consult with the Director of the Center prior to final approval of
such applications and proposals; and</text>
</clause><clause commented="no" id="H6EC8275AE5FE4289830022CAB4F3CBFE"><enum>(v)</enum><text>reporting to the
Director of the Center all such applications and proposals that are approved
for funding by the agencies;</text>
</clause></subparagraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph commented="no" id="H4EE59C4C6C164D19961037ED0191FFA1"><enum>(C)</enum><text>in paragraph
(2)—</text>
<clause commented="no" id="H4BBD5529CAEA4009AED0692B299B0629"><enum>(i)</enum><text>in subparagraph
(D), by striking <quote>and</quote> at the end;</text>
</clause><clause commented="no" id="HDBBF37B5F82A4A6FB842B0E8E6B2D00"><enum>(ii)</enum><text>in subparagraph
(E), by striking the period and inserting <quote>; and</quote>; and</text>
</clause><clause commented="no" id="H94EF521257584F3EB63D4E276FA9682D"><enum>(iii)</enum><text>by adding at the
end the following:</text>
<quoted-block id="HA6DC4069193E4627B4C79C056E410817" style="OLC">
<subparagraph commented="no" id="H2AE5EA3CA4F248E1BA452D4EE5FD207"><enum>(F)</enum><text>the number and type
of personnel needs of the
Center.</text>
</subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</clause></subparagraph></paragraph><paragraph commented="no" id="H96A96A0F6453493998DCAF6BEF579B9B"><enum>(3)</enum><text>in subsection
(h)—</text>
<subparagraph commented="no" id="HFE921A4701AB43EA8BB7B49E7F2EE45F"><enum>(A)</enum><text>in paragraph (1),
by striking <quote>endowments at centers of excellence under section
736.</quote> and inserting the
following:</text>
<quoted-block display-inline="yes-display-inline" id="H280BBA17FF8E4EBFAA07391C29E8CED4" style="OLC">
<text>endowments
at—</text><subparagraph commented="no" id="HA55ED4448FB54DDA95B520F4CB53DF4B"><enum>(A)</enum><text>centers of
excellence under section 736; and</text>
</subparagraph><subparagraph commented="no" id="HC17D256743314847B613641303BC9C01"><enum>(B)</enum><text>centers of
excellence under section 485F.</text>
</subparagraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph><subparagraph commented="no" id="HDD5BBB2CA21848ABAE3ECF98F82F416F"><enum>(B)</enum><text>in paragraph
(2)(A), by striking <quote>average</quote> and inserting <quote>median</quote>;
and</text>
</subparagraph></paragraph><paragraph commented="no" id="HD1301BBAFF414C97B424ED75882729CF"><enum>(4)</enum><text>by inserting after
subsection (j), the following:</text>
<quoted-block id="HAAC37C2F4DDE49558311EA00A5076AB" style="OLC">
<subsection commented="no" id="HC16558CA33114926BC79A171DFE9E6E9"><enum>(k)</enum><header>Representation
of Minorities Among Researchers</header><text>The Secretary, in collaboration
with the Director of the Center, shall determine, by means of the collection
and reporting of aggregated and disaggregated data, the extent to which racial
and ethnic minority groups are represented among senior physicians and
scientists of the national research institutes and among physicians and
scientists conducting research with funds provided by such institutes, and as
appropriate, carry out activities to increase the extent of such
representation, including developing a pipeline of minority researchers
interested in the study of health and health disparities, as well as attracting
minority scientists in social and behavioral science fields who can bring their
expertise to the study of health disparities.</text>
</subsection><subsection commented="no" id="H887B965EEDA94339B42305A753C17D62"><enum>(l)</enum><header>Cancer
Research</header><text>The Secretary, in collaboration with the Director of the
Center, shall designate and support a cancer prevention, control, and
population science center to address the significantly elevated rate of
morbidity and mortality from cancer in racial and ethnic minority populations.
Such designated center shall be housed within an existing, stand-alone cancer
center at a minority-serving institution that has a demonstrable commitment to
and expertise in cancer research in the basic, clinical, and population
sciences.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H3B13E816BE6D433A00EE0000D6542FC4"><enum>(b)</enum><header>Authorization of
appropriations</header>
<paragraph commented="no" id="H9853B90AC24D4A32886E85CE005E6D00"><enum>(1)</enum><header>In
general</header><text>To carry out section 485E of the Public Health Service
Act (42 U.S.C.287c–31), as amended by subsection (a), there are authorized to
be appropriated $240,000,000 for fiscal year 2008 and such sums as may be
necessary for each of fiscal years 2009 through 2012.</text>
</paragraph><paragraph commented="no" id="H9071ADFE62144F5FAE1B64C324B9BD02"><enum>(2)</enum><header>Expenditure</header><text>The
Director of the National Center on Minority Health and Health Disparities shall
expend amounts appropriated for activities under such section 485E in
accordance with such section and other applicable law and in collaboration with
the Director of National Institutes of Health and the directors of other
institutes and centers of the National Institutes of Health.</text>
</paragraph><paragraph commented="no" id="H4A664D81BE944421A334099D3C44E600"><enum>(3)</enum><header>Management</header><text>All
amounts expended for minority health and health disparities research activities
under this subsection shall be reported programmatically to and approved by the
Director of the National Center on Minority Health and Health Disparities under
such section 485E, in accordance with the plan described under subsection
(f)(1)(A) of such section 485E.</text>
</paragraph></subsection></section></subtitle><subtitle id="HEC04DF39404F432CBE7B0021ACE32DB"><enum>B</enum><header>Improving
environmental justice</header>
<section id="H232C131C59DD4F21B1009734BA1200AA"><enum>421.</enum><header>Codification of
executive order 12898</header>
<subsection id="HDA421B4070C845FA8EC332971FF9008"><enum>(a)</enum><header>In
general</header><text>The President of the United States is authorized and
directed to execute, administer, and enforce as a matter of Federal law the
provisions of Executive Order 12898, dated February 11, 1994, (<quote>Federal
Actions To Address Environmental Justice In Minority Populations and Low-Income
Populations</quote>) with such modifications as are provided in this
section.</text>
</subsection><subsection id="HF275F51888064E16AF42E2AB530909E1"><enum>(b)</enum><header>Definition of
environmental justice</header><text>For purposes of carrying out the provisions
of Executive Order 12898, the following definitions shall apply:</text>
<paragraph id="H5582C1FE9C2C403DA7D011C6897A544"><enum>(1)</enum><text>The term
<term>environmental justice</term> means the fair treatment and meaningful
involvement of all people regardless of race, color, national origin,
educational level, or income with respect to the development, implementation,
and enforcement of environmental laws and regulations in order to ensure
that—</text>
<subparagraph id="HC0D89856E1824139BC6300DC12A6FAAC"><enum>(A)</enum><text>minority and
low-income communities have access to public information relating to human
health and environmental planning, regulations, and enforcement; and</text>
</subparagraph><subparagraph id="H230C056989354026A8C1B461937136ED"><enum>(B)</enum><text>no minority or
low-income population is forced to shoulder a disproportionate burden of the
negative human health and environmental impacts of pollution or other
environmental hazard.</text>
</subparagraph></paragraph><paragraph id="HF471CBCD3D1849CAB8CE0078E3E0B864"><enum>(2)</enum><text>The term
<term>fair treatment</term> means policies and practices that ensure that no
group of people, including racial, ethnic, or socioeconomic groups bear
disproportionately high and adverse human health or environmental effects
resulting from Federal agency programs, policies, and activities.</text>
</paragraph></subsection><subsection id="H60B3E3EE803045D885E73988FB3C00B3"><enum>(c)</enum><header>Judicial review
and rights of action</header><text>The provisions of section 6–609 of Executive
Order 12898 shall not apply for purposes of this Act.</text>
</subsection></section><section id="H160C4152F12148F8A29804971D53F45C"><enum>422.</enum><header>Implementation
of recommendations by environmental protection agency</header>
<subsection id="H9EF743B951694A8BA802B879E6040009"><enum>(a)</enum><header>Inspector
general recommendations</header><text>The Administrator of the Environmental
Protection Agency shall, as promptly as practicable, carry out each of the
following recommendations of the Inspector General of the agency as set forth
in Report No. 2006–P-00034 entitled <quote>EPA needs to conduct environmental
justice reviews of its programs, policies and activities</quote>:</text>
<paragraph id="HC6AFC08AB7444288B7232881D8A9D067"><enum>(1)</enum><text>The recommendation
that the Agency’s program and regional offices identify which programs,
policies, and activities need environmental justice reviews and require these
offices to establish a plan to complete the necessary reviews.</text>
</paragraph><paragraph id="HE3EE40969D72450CBE079FBA4545C888"><enum>(2)</enum><text>The recommendation
that the Administrator of the Agency ensure that these reviews determine
whether the programs, policies, and activities may have a disproportionately
high and adverse health or environmental impact on minority and low-income
populations.</text>
</paragraph><paragraph id="HC089FBE5B80C4ED5991B48F2E6D1D259"><enum>(3)</enum><text>The recommendation
that each program and regional office develop specific environmental justice
review guidance for conducting environmental justice reviews.</text>
</paragraph><paragraph id="HEA50979342FA411FBF45036930D850FB"><enum>(4)</enum><text>The recommendation
that the Administrator designate a responsible office to compile results of
environmental justice reviews and recommend appropriate actions.</text>
</paragraph></subsection><subsection id="HB6E8E85EFF08441AB762F7C5D1664DC"><enum>(b)</enum><header>Gao
recommendations</header><text>In developing rules under laws administered by
the Environmental Protection Agency, the Administrator of the Agency shall, as
promptly as practicable, carry out each of the following recommendations of the
Comptroller General of the United States as set forth in GAO Report numbered
GAO–05-289 entitled <quote>EPA Should Devote More Attention to Environmental
Justice when Developing Clean Air Rules</quote>:</text>
<paragraph id="H69BAAD00A7F64D2EA4E42CAE89429D09"><enum>(1)</enum><text>The recommendation
that the Administrator ensure that workgroups involved in developing a rule
devote attention to environmental justice while drafting and finalizing the
rule.</text>
</paragraph><paragraph id="H7043BF226C3E4AA590649622F150F07F"><enum>(2)</enum><text>The recommendation
that the Administrator enhance the ability of such workgroups to identify
potential environmental justice issues through such steps as providing
workgroup members with guidance and training to helping them identify potential
environmental justice problems and involving environmental justice coordinators
in the workgroups when appropriate.</text>
</paragraph><paragraph id="H0C395431C91A45E1BF5371EDB4B305A3"><enum>(3)</enum><text>The recommendation
that the Administrator improve assessments of potential environmental justice
impacts in economic reviews by identifying the data and developing the modeling
techniques needed to assess such impacts.</text>
</paragraph><paragraph id="H72932F7B178F4BEB87D55415047F5559"><enum>(4)</enum><text>The recommendation
that the Administrator direct appropriate Agency officers and employees to
respond fully when feasible to public comments on environmental justice,
including improving the Agency’s explanation of the basis for its conclusions,
together with supporting data.</text>
</paragraph></subsection><subsection id="HCAC16FCA6F3F461EA7F149B47D1EE5A1"><enum>(c)</enum><header>2004 inspector
general report</header><text>The Administrator of the Environmental Protection
Agency shall, as promptly as practicable, carry out each of the following
recommendations of the Inspector General of the Agency as set forth in the
report entitled <quote>EPA Needs to Consistently Implement the Intent of the
Executive Order on Environmental Justice</quote> (Report No.
2004–P–00007):</text>
<paragraph id="H99AE46AC331F47C9A0949782C7522C3"><enum>(1)</enum><text>The recommendation
that the Agency clearly define the mission of the Office of Environmental
Justice (OEJ) and provide Agency staff with an understanding of the roles and
responsibilities of the Office.</text>
</paragraph><paragraph id="H1563C344D19944EE86587682FE8392C0"><enum>(2)</enum><text>The recommendation
that the Agency establish (through issuing guidance or a policy statement from
the Administrator) specific time frames for the development of definitions,
goals, and measurements regarding environmental justice and provide the regions
and program offices a standard and consistent definition for a minority and
low-income community, with instructions on how the Agency will implement and
operationalize environmental justice into the Agency’s daily activities.</text>
</paragraph><paragraph id="H136120E773604C25A0E17E6C7CEB4306"><enum>(3)</enum><text>The recommendation
that the Agency ensure the comprehensive training program currently under
development includes standard and consistent definitions of the key
environmental justice concepts (such as <quote>low-income</quote>,
<quote>minority</quote>, and <quote>disproportionately impacted</quote>) and
instructions for implementation of those concepts.</text>
</paragraph></subsection><subsection id="H223E9654D4314E8FB8AD00646C06F856"><enum>(d)</enum><header>Report</header><text>The
Administrator shall submit an initial report to Congress within 6 months after
the enactment of this Act regarding the Administrator’s strategy for
implementing the recommendations referred to in subsections (a), (b), and (c).
Thereafter, the Administrator shall provide semi-annual reports to Congress
regarding the Administrator’s progress in implementing such recommendations and
modifying the Administrator’s emergency management procedures to incorporate
environmental justice in the Agency’s Incident Command Structure (in accordance
with the December 18, 2006, letter from the Deputy Administrator to the Acting
Inspector General of the agency).</text>
</subsection></section><section id="H10B30AABC98941328D85A237F2D71582"><enum>423.</enum><header>Grant
program</header>
<subsection id="H749E02EA8D8745D584B8FC02BFE6C00"><enum>(a)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="HC9B014A820E34FD6A954E26743F4D5B5"><enum>(1)</enum><header>Director</header><text>The
term <term>Director</term> means the Director of the Centers for Disease
Control and Prevention, acting in collaboration with the Administrator of the
Environmental Protection Agency and the Director of the National Institute of
Environmental Health Sciences.</text>
</paragraph><paragraph id="H39F3C61606894B5CA4A4FCC266270C9"><enum>(2)</enum><header>Eligible
entity</header><text>The term <term>eligible entity</term> means a State or
local community that—</text>
<subparagraph id="H9F20B86BADCA48449D349F78BFD5832E"><enum>(A)</enum><text>bears a
disproportionate burden of exposure to environmental health hazards;</text>
</subparagraph><subparagraph id="H06A161BF09D54DE69D767C529DFE0097"><enum>(B)</enum><text>has established a
coalition—</text>
<clause id="H7112DF0ADE09461C9D9F4B65ACD45649"><enum>(i)</enum><text>with
not less than 1 community-based organization; and</text>
</clause><clause id="H93B350C08F31432CA601EF805459BD26"><enum>(ii)</enum><text>with not less
than 1—</text>
<subclause id="H20142BA2FD3C43829FAEF9D9FDCDE738"><enum>(I)</enum><text>public health
entity;</text>
</subclause><subclause id="H235F8D280A1A4B68AAE92E8B92602496"><enum>(II)</enum><text>health care
provider organization; or</text>
</subclause><subclause id="H54A5C9C977984CA781A7D14CFB9CB7E"><enum>(III)</enum><text>academic
institution, including any minority-serving institution (including an
Hispanic-serving institution, a historically Black college or university, and a
tribal college or university);</text>
</subclause></clause></subparagraph><subparagraph id="H8B265858188040A7A9AB399C32AA18C8"><enum>(C)</enum><text>ensures planned
activities and funding streams are coordinated to improve community health;
and</text>
</subparagraph><subparagraph id="H4B969506EE844D72A711BD3D1B9BD200"><enum>(D)</enum><text>submits an
application in accordance with subsection (c).</text>
</subparagraph></paragraph></subsection><subsection id="H20733E1C553A4B288966F36B8332446F"><enum>(b)</enum><header>Establishment</header><text>The
Director shall establish a grant program under which eligible entities shall
receive grants to conduct environmental health improvement activities.</text>
</subsection><subsection id="H2BEF311751EC40020069F971877E76D4"><enum>(c)</enum><header>Application</header><text>To
receive a grant under this section, an eligible entity shall submit an
application to the Director at such time, in such manner, and accompanied by
such information as the Director may require.</text>
</subsection><subsection id="H424D20A5889441E5A7B41C116F003CDD"><enum>(d)</enum><header>Cooperative
agreements</header><text>An eligible entity may use a grant under this
section—</text>
<paragraph id="H205E63BDCC6642D98DFA6C8DF25D8F6C"><enum>(1)</enum><text>to promote
environmental health; and</text>
</paragraph><paragraph id="H9F250FD4F55D4E3B00266650905825D0"><enum>(2)</enum><text>to address
environmental health disparities.</text>
</paragraph></subsection><subsection id="HEDFAEF52B9584AE4B69090EED001450"><enum>(e)</enum><header>Amount of
cooperative agreement</header>
<paragraph id="HA82C3642E8DB4B42933BC565A490EC96"><enum>(1)</enum><header>In
general</header><text>The Director shall award grants to eligible entities at
the 2 different funding levels described in this subsection.</text>
</paragraph><paragraph id="H826248E3DD064A3CAA359E2C2F75CBB6"><enum>(2)</enum><header>Level 1
cooperative agreements</header>
<subparagraph id="HB8F6C41BD74B4A269061957CB1E1090"><enum>(A)</enum><header>In
general</header><text>An eligible entity awarded a grant under this paragraph
shall use the funds to identify environmental health problems and solutions
by—</text>
<clause id="H3DA39A7C40F841C6B1EAB210535E77D4"><enum>(i)</enum><text>establishing a
planning and prioritizing council in accordance with subparagraph (B);
and</text>
</clause><clause id="H421D4E4229F1429EB6D6E7D0DDED3F45"><enum>(ii)</enum><text>conducting an
environmental health assessment in accordance with subparagraph (C).</text>
</clause></subparagraph><subparagraph id="H83256B8D13B74BFCB1C6FCECEB072C79"><enum>(B)</enum><header>Planning and
prioritizing council</header>
<clause id="HA5CC7E1D60BF4847B3D4C5C42050689"><enum>(i)</enum><header>In
general</header><text>A prioritizing and planning council established under
subparagraph (A)(i) (referred to in this paragraph as a <quote>PPC</quote>)
shall assist the environmental health assessment process and environmental
health promotion activities of the eligible entity.</text>
</clause><clause id="H881E1C31CE724DC1B400A153514D4E53"><enum>(ii)</enum><header>Membership</header><text>Membership
of a PPC shall consist of representatives from various organizations within
public health, planning, development, and environmental services and shall
include stakeholders from vulnerable groups such as children, the elderly,
disabled, and minority ethnic groups that are often not actively involved in
democratic or decision-making processes.</text>
</clause><clause id="HE360B4C0D2954BE39FC697F155E88CA2"><enum>(iii)</enum><header>Duties</header><text>A
PPC shall—</text>
<subclause id="HDCD3C8C2C81A4DEE809E2EDABC71E6EB"><enum>(I)</enum><text>identify key
stakeholders and engage and coordinate potential partners in the planning
process;</text>
</subclause><subclause id="HB4704AD5667B408E9D20F6E9FCA86B60"><enum>(II)</enum><text>establish a
formal advisory group to plan for the establishment of services;</text>
</subclause><subclause id="H04053FCED551496BBC64ACFDE4B9B4FD"><enum>(III)</enum><text>conduct an
in-depth review of the nature and extent of the need for an environmental
health assessment, including a local epidemiological profile, an evaluation of
the service provider capacity of the community, and a profile of any target
populations; and</text>
</subclause><subclause id="HF39FB49AEA344C7DA4B8A4FCE3D095AB"><enum>(IV)</enum><text>define the
components of care and form essential programmatic linkages with related
providers in the community.</text>
</subclause></clause></subparagraph><subparagraph id="H34FCCF29AC5E4D35BA8760862200001C"><enum>(C)</enum><header>Environmental
health assessment</header>
<clause id="H1C2855DF21AD40A79DF5B4CFD9DC6CAB"><enum>(i)</enum><header>In
general</header><text>A PPC shall carry out an environmental health assessment
to identify environmental health concerns.</text>
</clause><clause id="HE826A7E79A6748C3906F699898AAD763"><enum>(ii)</enum><header>Assessment
process</header><text>The PPC shall—</text>
<subclause id="H25F85B95E46549B8A8ABD047FA756F8E"><enum>(I)</enum><text>define the goals
of the assessment;</text>
</subclause><subclause id="H7E27F589C45D401BA384EC98ABD63900"><enum>(II)</enum><text>generate the
environmental health issue list;</text>
</subclause><subclause id="HB073C94CA7F64265B2508C9D63E37B3E"><enum>(III)</enum><text>analyze issues
with a systems framework;</text>
</subclause><subclause id="H424B39898066497B8340F7CFC7AB1B55"><enum>(IV)</enum><text>develop
appropriate community environmental health indicators;</text>
</subclause><subclause id="H3BF2D93AE8C044E2916BC14970016E6E"><enum>(V)</enum><text>rank the
environmental health issues;</text>
</subclause><subclause id="H53B27262BC924E9A0091D166D59B078"><enum>(VI)</enum><text>set priorities for
action;</text>
</subclause><subclause id="HD427DC33F6D34ECC977EFA244500D5A0"><enum>(VII)</enum><text>develop an
action plan;</text>
</subclause><subclause id="H5F9F3D97567A4CF4B3E79BB0CED2E100"><enum>(VIII)</enum><text>implement the
plan; and</text>
</subclause><subclause id="HCBF19BC6ED274C4DA98600C7B53EE6B8"><enum>(IX)</enum><text>evaluate progress
and planning for the future.</text>
</subclause></clause></subparagraph><subparagraph id="HC73B6740E29B460DB0E65BF8138839C4"><enum>(D)</enum><header>Evaluation</header><text>Each
eligible entity that receives a grant under this paragraph shall evaluate,
report, and disseminate program findings and outcomes.</text>
</subparagraph><subparagraph id="HD1AB2D510E2B4F149485A5E86DA415D2"><enum>(E)</enum><header>Technical
assistance</header><text>The Director may provide such technical and other
non-financial assistance to eligible entities as the Director determines to be
necessary.</text>
</subparagraph></paragraph><paragraph id="H8D2B404553494434BFC2CA744ED8A257"><enum>(3)</enum><header>Level 2
cooperative agreements</header>
<subparagraph id="HF923C197317A43EDA6555BA6ED6F551C"><enum>(A)</enum><header>Eligibility</header>
<clause id="H025E289B450C4D4BB1B313D3F280404"><enum>(i)</enum><header>In
general</header><text>The Director shall award grants under this paragraph to
eligible entities that have already—</text>
<subclause id="H3D5584EA867C4FF08DB544BF3EDA427"><enum>(I)</enum><text>established
broad-based collaborative partnerships; and</text>
</subclause><subclause id="HD3A4473B19C5424F9B6C41A76D74B96"><enum>(II)</enum><text>completed
environmental assessments.</text>
</subclause></clause><clause id="HF2E353E78E734D7BA828EA39360901B"><enum>(ii)</enum><header>No
level 1 requirement</header><text>To be eligible to receive a grant under this
paragraph, an eligible entity is not required to have successfully completed a
Level 1 Cooperative Agreement (as described in paragraph (2).</text>
</clause></subparagraph><subparagraph id="H3BF0D41891DF436B8D06957118D37745"><enum>(B)</enum><header>Use of grant
funds</header><text>An eligible entity awarded a grant under this paragraph
shall use the funds to further activities to carry out environmental health
improvement activities, including—</text>
<clause id="H66B646E4F2174B909DF4EB388083ED3"><enum>(i)</enum><text>addressing
community environmental health priorities in accordance with paragraph
(2)(C)(ii), including—</text>
<subclause id="H06E1C5E90CE448848CF66FBF46A39B32"><enum>(I)</enum><text>air
quality;</text>
</subclause><subclause id="H1A36609134754DF3AD725FC4467DBB3D"><enum>(II)</enum><text>water
quality;</text>
</subclause><subclause id="HBFFCF2BD655048DAA08E8EF200AA21FE"><enum>(III)</enum><text>solid
waste;</text>
</subclause><subclause id="HAFE6E74796EF43BE96B62520A8A096E"><enum>(IV)</enum><text>land use;</text>
</subclause><subclause id="HBDE60E7F666A4BBF8721BAF471FC54AC"><enum>(V)</enum><text>housing;</text>
</subclause><subclause id="H7DC31A52D1C74A66A2A15260107E7E76"><enum>(VI)</enum><text>food
safety;</text>
</subclause><subclause id="H702C6B74581B473FAED96DFE3F8EA5AD"><enum>(VII)</enum><text>crime;</text>
</subclause><subclause id="H25865897AFFA47CA9E5DEA53161CFBA6"><enum>(VIII)</enum><text>injuries;
and</text>
</subclause><subclause id="H9BE2597C07EA402D906750B569AB657B"><enum>(IX)</enum><text>healthcare
services;</text>
</subclause></clause><clause id="H89CE2853E2CB425D91F33C36222FFC5C"><enum>(ii)</enum><text>building
partnerships between planning, public health, and other sectors, to address how
the built environment impacts food availability and access and physical
activity to promote healthy behaviors and lifestyles and reduce overweight and
obesity, asthma, respiratory conditions, dental, oral and mental health
conditions, and related co-morbidities;</text>
</clause><clause id="H91FD2C03F37E4AB68F856E9EACE29E44"><enum>(iii)</enum><text>establishing
programs to address—</text>
<subclause id="H00D61B4F16CB4B0A8ED2005F3C4868C1"><enum>(I)</enum><text>how environmental
and social conditions of work and living choices influence physical activity
and dietary intake; or</text>
</subclause><subclause id="HD09957FF32144F3B803973F386E2BDCF"><enum>(II)</enum><text>how those
conditions influence the concerns and needs of people who have impaired
mobility and use assistance devices, including wheelchairs and lower limb
prostheses; and</text>
</subclause></clause><clause id="HC4049E987532408C94BEECD33FD15DC"><enum>(iv)</enum><text>convening
intervention programs that examine the role of the social environment in
connection with the physical and chemical environment in—</text>
<subclause id="H98506C38D79645748FC389BFEC828445"><enum>(I)</enum><text>determining access
to nutritional food; and</text>
</subclause><subclause id="H34521E1BCD874640A036E08B52178311"><enum>(II)</enum><text>improving
physical activity to reduce morbidity and increase quality of life.</text>
</subclause></clause></subparagraph></paragraph></subsection><subsection id="H026A9CE740CC4993B35381BC91A00098"><enum>(f)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this section—</text>
<paragraph id="HB8A9648E9134452594D05F94814E6043"><enum>(1)</enum><text>$25,000,000 for
fiscal year 2008; and</text>
</paragraph><paragraph id="HFA0878E69BD74C15AA765CBECD6531B2"><enum>(2)</enum><text>such sums as may
be necessary for fiscal years 2009 through 2012.</text>
</paragraph></subsection></section><section id="HA225A17022894BBEA4CBB74C477F6DC"><enum>424.</enum><header>Additional
research on the relationship between the built environment and the health of
community residents</header>
<subsection id="HF751DE5E41464936B69F514E2211A042"><enum>(a)</enum><header>Definition of
eligible institution</header><text>In this section, the term <term>eligible
institution</term> means a public or private nonprofit institution that submits
to the Secretary of Health and Human Services (in this section referred to as
the <quote>Secretary</quote>) and the Administrator of the Environmental
Protection Agency (in this section referred to as the
<quote>Administrator</quote>) an application for a grant under the grant
program authorized under subsection (b)(2) at such time, in such manner, and
containing such agreements, assurances, and information as the Secretary and
Administrator may require.</text>
</subsection><subsection id="H503C655D9BAA44C7AB9361E7CF418CB0"><enum>(b)</enum><header>Research grant
program</header>
<paragraph id="HE95C926D90574983A96835EE7D98DFA7"><enum>(1)</enum><header>Definition of
health</header><text>In this section, the term <term>health</term>
includes—</text>
<subparagraph id="H1141911F84CB4673B0331497639829B"><enum>(A)</enum><text>levels of physical
activity;</text>
</subparagraph><subparagraph id="H43DBFB8FFCD248A797AE9DF5A4D05C75"><enum>(B)</enum><text>consumption of
nutritional foods;</text>
</subparagraph><subparagraph id="HC5584434F47941C0A5A46221FFC4E569"><enum>(C)</enum><text>rates of
crime;</text>
</subparagraph><subparagraph id="HF2E4AE5C40334C5EBA5576DE7C30749F"><enum>(D)</enum><text>air, water, and
soil quality;</text>
</subparagraph><subparagraph id="H4ECBADD713D9462EA8B03766035149B0"><enum>(E)</enum><text>risk of
injury;</text>
</subparagraph><subparagraph id="HBEA5ED0BEE3B4A17908B1CE506C2DD35"><enum>(F)</enum><text>accessibility to
healthcare services; and</text>
</subparagraph><subparagraph id="HC11196ECC3234184A103AF63112188B9"><enum>(G)</enum><text>other indicators
as determined appropriate by the Secretary.</text>
</subparagraph></paragraph><paragraph id="H5BF30122D9AD455EAB7536FACDEF7B8F"><enum>(2)</enum><header>Grants</header><text>The
Secretary, in collaboration with the Administrator, shall provide grants to
eligible institutions to conduct and coordinate research on the built
environment and its influence on individual and population-based health.</text>
</paragraph><paragraph id="H458D47EE975E4FDDA837402C853786DE"><enum>(3)</enum><header>Research</header><text>The
Secretary shall support research that—</text>
<subparagraph id="H712666A7E8204AD7A4824BA544EBAD97"><enum>(A)</enum><text>investigates and
defines the causal links between all aspects of the built environment and the
health of residents;</text>
</subparagraph><subparagraph id="H0A930821854346689EA1C41B7BE68D4F"><enum>(B)</enum><text>examines—</text>
<clause id="H895BD0047BFE478CBC2102AD1318DA3B"><enum>(i)</enum><text>the
extent of the impact of the built environment (including the various
characteristics of the built environment) on the health of residents;</text>
</clause><clause id="HAF409821A3E44A6E996B7D53DAB8ECAB"><enum>(ii)</enum><text>the
variance in the health of residents by—</text>
<subclause id="H2D553BC5B4CC4E1700C2BFA5F4BCDCFE"><enum>(I)</enum><text>location (such as
inner cities, inner suburbs, and outer suburbs); and</text>
</subclause><subclause id="H203E23887DF74268A4C05445B3A20F7"><enum>(II)</enum><text>population
subgroup (such as children, the elderly, the disadvantaged); or</text>
</subclause></clause><clause id="HA1111C293DE64A7C9380F814F584591"><enum>(iii)</enum><text>the
importance of the built environment to the total health of residents, which is
the primary variable of interest from a public health perspective;</text>
</clause></subparagraph><subparagraph id="H4F7A27FA8CC2497D8448CC00F9D5905"><enum>(C)</enum><text>is used to
develop—</text>
<clause id="H5F48A51CA04F473AA047185C74F478B7"><enum>(i)</enum><text>measures to
address health and the connection of health to the built environment;
and</text>
</clause><clause id="H3462DF8CF23D44CBA41E8DB501ED50C4"><enum>(ii)</enum><text>efforts to link
the measures to travel and health databases; and</text>
</clause></subparagraph><subparagraph id="HF62E76ADC11344EC8D2414858F65C5C3"><enum>(D)</enum><text>distinguishes
carefully between personal attitudes and choices and external influences on
observed behavior to determine how much an observed association between the
built environment and the health of residents, versus the lifestyle preferences
of the people that choose to live in the neighborhood, reflects the physical
characteristics of the neighborhood; and</text>
</subparagraph><subparagraph id="H9317FBC6E5874754BB125CAB3177CA2C"><enum>(E)</enum><clause commented="no" display-inline="yes-display-inline" id="H4CEBF556A8CD4165A9D913BD3BA009D"><enum>(i)</enum><text>identifies or develops
effective intervention strategies to promote better health among residents with
a focus on behavioral interventions and enhancements of the built environment
that promote increased use by residents; and</text>
</clause><clause id="H2B906154E40E4FE58800CF115E89DFCA" indent="up1"><enum>(ii)</enum><text>in developing the intervention
strategies under clause (i), ensures that the intervention strategies will
reach out to high-risk populations, including racial and ethnic minorities and
low-income urban and rural communities.</text>
</clause></subparagraph></paragraph><paragraph id="HF14F5BA9202E460EA55FEEE05ED188F1"><enum>(4)</enum><header>Priority</header><text>In
providing assistance under the grant program authorized under paragraph (2),
the Secretary and the Administrator shall give priority to research that
incorporates—</text>
<subparagraph id="HB52F11947E18487F89356482F81300A9"><enum>(A)</enum><text>Minority-serving
institutions as grantees;</text>
</subparagraph><subparagraph id="HED11FA6EB547452EA35B2CA8477EA8A3"><enum>(B)</enum><text>interdisciplinary
approaches; or</text>
</subparagraph><subparagraph id="H95BFE20EA22B4B7282B0AFA09CC50868"><enum>(C)</enum><text>the expertise of
the public health, physical activity, urban planning, and transportation
research communities in the United States and abroad.</text>
</subparagraph></paragraph></subsection></section></subtitle><enum>V</enum><header>Improvement of
Health Care Services</header>
<section id="H0DA91E3A7AF44B35009089405E57B9F1"><enum>501.</enum><header>Health
empowerment zones</header>
<subsection id="HC5AD8D3F68A34CD89B87CB2B7EB0095"><enum>(a)</enum><header>Health
empowerment zone programs</header>
<paragraph id="H0FE73AC6859D40D6BD50EA73332F1913"><enum>(1)</enum><header>Grants</header><text>The
Secretary, acting through the Administrator of the Health Resources and
Services Administration and the Deputy Assistant Secretary for Minority Health,
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 health care for the purpose
described in paragraph (2).</text>
</paragraph><paragraph id="HE29C8698CD564634A6E0A67459C0969E"><enum>(2)</enum><header>Use of
funds</header>
<subparagraph id="H7EDE082BC0BC4F6E955BC0F69F8E00EE"><enum>(A)</enum><header>In
general</header><text>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, health care clinics, foundations, and
other entities in communities that disproportionately experience disparities in
health status and health care which are seeking—</text>
<clause id="HDA061E8F6FB3421183913EBE261EF5C"><enum>(i)</enum><text>to
improve the health or environment of minority individuals in the community and
to reduce disparities in health status and health care by assisting individuals
in accessing Federal programs;</text>
</clause><clause id="HE30956534B234EED956DB9EE66E7CEB5"><enum>(ii)</enum><text>to
coordinate the efforts of governmental and private entities regarding the
elimination of racial and ethnic disparities in health status and health care;
and</text>
</clause><clause commented="no" id="H6AA50CC60C2C416100386234F2F05EDC"><enum>(iii)</enum><text>to increase the
adoption and use of health information technology by providers in racial and
ethnic minority and rural communities to improve quality of care; enhance
minority and rural consumer awareness; understand, adopt, and use health
information technology to improve health literacy and health self-management;
and foster improved coordination of health services and care quality.</text>
</clause></subparagraph><subparagraph id="H85AEF5E6C78B4265A18B73FF604FB1BF"><enum>(B)</enum><header>Medicare and
Medicaid</header><text>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
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C. 1395
and 1396 et seq.).</text>
</subparagraph></paragraph><paragraph id="H3A70B2AE01E041E28EC174DCEA350042"><enum>(3)</enum><header>Distribution</header><text>The
Secretary shall make at least 1 grant per Health and Human Services region
under this section to a partnership for a health empowerment zone program in
communities that disproportionately experience disparities in health status and
health care that is located in a territory or possession of the United
States.</text>
</paragraph><paragraph id="H56899A72AEB2451DBD2938BBEB301CCB"><enum>(4)</enum><header>Application</header><text>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—</text>
<subparagraph id="H0503A0D48AFA487E85DFACDEFCB4159F"><enum>(A)</enum><text>demonstrate that
the communities to be served by the health empowerment zone program are those
that disproportionately experience disparities in health status and health
care;</text>
</subparagraph><subparagraph id="H37C2B2D72EEC44519302C0C7942DF0B7"><enum>(B)</enum><text>set forth a
strategic plan for accomplishing the purpose described in paragraph (2),
by—</text>
<clause id="HCBB939CBD06B4215A1812C81D9ABE420"><enum>(i)</enum><text>describing the
coordinated health, economic, human, community, and physical development plan
and related activities proposed for the community;</text>
</clause><clause id="HACC4441A04024F9BA4C87673EE3116B2"><enum>(ii)</enum><text>describing the
extent to which local institutions and organizations have contributed and will
contribute to the planning process and implementation;</text>
</clause><clause id="HB52C261A56E64EA3B600BDDFF3F3EDA"><enum>(iii)</enum><text>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);</text>
</clause><clause id="H9D092AC27BE243B389B4772D5908FA85"><enum>(iv)</enum><text>identifying the
funding requested under any Federal program in support of the proposed
activities;</text>
</clause><clause id="HACA0104078B24C29A2118D5326648E10"><enum>(v)</enum><text>identifying
benchmarks for measuring the success of carrying out the strategic plan;</text>
</clause><clause id="HB330879795CC42B094514BF532A7EEE1"><enum>(vi)</enum><text>demonstrating the
ability to reach and service the targeted underserved minority community
populations in a culturally appropriate and linguistically responsive manner;
and</text>
</clause><clause id="HCAA3971C415F477492C4F13361F2A13C"><enum>(vii)</enum><text>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 health care; and</text>
</clause></subparagraph><subparagraph id="HF771EDB606AD4D7F0022B01EE90078E"><enum>(C)</enum><text>include such other
information as the Secretary may require.</text>
</subparagraph></paragraph><paragraph id="H71965068923A4AF79F26549EF4E8F3A8"><enum>(5)</enum><header>Preference</header><text>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.</text>
</paragraph></subsection><subsection id="H32D6549A8DE444F2B4024DE8A148AC00"><enum>(b)</enum><header>Federal
assistance for Health empowerment zone grant programs</header><text>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—</text>
<paragraph id="H285422EDBB1D4233B2C500807C76D614"><enum>(1)</enum><text>where appropriate,
provide entity-specific technical assistance and evidence-based strategies to
communities that disproportionately experience disparities in health status and
health care to further the purposes served by a health empowerment zone program
established with a grant under subsection (a);</text>
</paragraph><paragraph id="H05E75BDE58BA460AAB3823B887A7C55B"><enum>(2)</enum><text>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</text>
</paragraph><paragraph id="H0E47B609F3954D3888D5DDE49EC8D3BB"><enum>(3)</enum><text>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 health care
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.</text>
</paragraph></subsection><subsection id="H627DA45A6F2C4C068CB1D47FBA659F32"><enum>(c)</enum><header>Health
empowerment zone Coordinating Committee</header>
<paragraph id="HB54B59C2D0E04BBF85A0E83C77375FFD"><enum>(1)</enum><header>Establishment</header><text>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.</text>
</paragraph><paragraph id="H906886B98CB0440A9DB496F9C7E8CD49"><enum>(2)</enum><header>Duties</header><text>Each
coordinating committee established, in coordination with the Deputy Assistant
Secretary for Minority Health 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.</text>
</paragraph><paragraph id="H81CC12165B024FA0A1E600C8B033E76E"><enum>(3)</enum><header>Membership</header>
<subparagraph id="HF8D115767E6C4EA48B000089CD265FBC"><enum>(A)</enum><header>Appointment</header><text>The
Deputy Assistant Secretary for Minority Health 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.</text>
</subparagraph><subparagraph id="H86493CE84CD647C18D9E5DF074CD198C"><enum>(B)</enum><header>Composition</header><text>The
Deputy Assistant Secretary for Minority Health, and the Administrator of the
Health Resources and Services Administration shall ensure that each
coordinating committee established—</text>
<clause id="HF7913129D5D4463D959E9542CD93C1D"><enum>(i)</enum><text>has
not more than 20 members;</text>
</clause><clause id="H9C8956D8447447FCB8D0ED926747883"><enum>(ii)</enum><text>includes
individuals from communities that disproportionately experience disparities in
health status and health care;</text>
</clause><clause id="H17C0A2A62037418BA1F51479E5E461F8"><enum>(iii)</enum><text>includes
community leaders and leaders of community-based organizations;</text>
</clause><clause id="H95D5DC9DA05743CEBD6625F08B004FEB"><enum>(iv)</enum><text>includes
representatives of academia and lay and professional organizations and
associations including those having expertise in medicine (including dental and
oral medicine), technical, social, and behavioral science, health policy,
health information technology, advocacy, cultural and linguistic competency,
research management, and organization; and</text>
</clause><clause id="HFB73E69642D34F6586B9C6E41793C252"><enum>(v)</enum><text>represents a
reasonable cross-section of knowledge, views, and application of expertise on
societal, ethical, behavioral, educational, policy, legal, cultural,
linguistic, and technological workforce issues related to eliminating
disparities in health and health care.</text>
</clause></subparagraph><subparagraph id="H4B54E7470A6D474EAAB314133D33C3F1"><enum>(C)</enum><header>Individual
qualifications</header><text>The Deputy Assistant Secretary for Minority Health
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:</text>
<clause id="H32EF24C34A5A48A69E2C85FE69F76069"><enum>(i)</enum><text>The
individual is not employed by the Federal Government.</text>
</clause><clause id="HBFB8C1F7966B42D992318D00939782A4"><enum>(ii)</enum><text>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.</text>
</clause></subparagraph><subparagraph id="HC7EDB8032D9C4326AD21F0F8B9C2752"><enum>(D)</enum><header>Selection</header><text>In
selecting individuals to serve on a coordinating committee, the Deputy
Assistant Secretary for Minority Health 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.</text>
</subparagraph><subparagraph id="H06C836B613D548CAB68C38707655DAA7"><enum>(E)</enum><header>Chairperson</header><text>The
Deputy Assistant Secretary for Minority Health 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.</text>
</subparagraph><subparagraph id="H1C770923E3444FD7A0503985E1D10700"><enum>(F)</enum><header>Terms</header><text>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 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.</text>
</subparagraph><subparagraph id="HAD66CB36034B420F8DC9ECC8D1C3103"><enum>(G)</enum><header>Vacancies</header><text>A
vacancy on a coordinating committee shall be filled in the same manner in which
the original appointment was made.</text>
</subparagraph></paragraph><paragraph id="H341E0A43E954462A99C39CD8D900CC5E"><enum>(4)</enum><header>Meetings</header><text>A
coordinating committee shall meet at least twice each year, at the call of the
coordinating committee’s chairperson and in consultation with the Deputy
Assistant Secretary for Minority Health and the Administrator Health Resources
and Services Administration.</text>
</paragraph><paragraph id="HA20631E3053F4E0C9B6861C1823712D"><enum>(5)</enum><header>Report</header><text>Each
coordinating committee shall transmit to the Congress an annual report that,
with respect to the health empowerment zone program involved, includes the
following:</text>
<subparagraph id="H8B3115620B3F46699071A3B1F5622314"><enum>(A)</enum><text>A review of the
program’s effectiveness in achieving stated goals and outcomes.</text>
</subparagraph><subparagraph id="H5B05873C40A14285826731AC7DB5814D"><enum>(B)</enum><text>A review of the
program’s management and the coordination of the entities involved, including
the representation and involvement of communities experiencing health
disparities.</text>
</subparagraph><subparagraph id="H83D6C39A22E541AE0036084412FC170"><enum>(C)</enum><text>A review of the
activities in the program’s portfolio and components.</text>
</subparagraph><subparagraph id="H3779D607885B411A92851F59C28FE439"><enum>(D)</enum><text>An identification
of policy issues raised by the program.</text>
</subparagraph><subparagraph id="H682F54929142443EAB1D9723A21961EC"><enum>(E)</enum><text>An assessment of
the program’s capacity, infrastructure, and number of underserved minority
communities engaged.</text>
</subparagraph><subparagraph id="HAA4E1907B5174F98825E1FE920EA58F0"><enum>(F)</enum><text>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.</text>
</subparagraph><subparagraph id="HFA49029A9CF14D0698BD13825300DE5F"><enum>(G)</enum><text>A review of the
degree of minority entity participation in the program, and an identification
of a strategy to increase such participation.</text>
</subparagraph><subparagraph id="H0F5951817F524BB59E2F31E1EA1BBFE4"><enum>(H)</enum><text>Any other reviews
or recommendations determined to be appropriate by the coordinating
committee.</text>
</subparagraph></paragraph></subsection><subsection id="H75FF86486CD742BF93F951396B953C2B"><enum>(d)</enum><header>Report</header><text>The
Deputy Assistant Secretary for Minority Health 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.</text>
</subsection><subsection id="H6D57DC2CEBC746140046780061BCD66B"><enum>(e)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2008
through 2013.</text>
</subsection></section><section display-inline="no-display-inline" id="H3C9B46502C054BB4A2945DE45DE8D6C1" section-type="subsequent-section"><enum>502.</enum><header>Amendment to the
<act-name parsable-cite="PHSA">Public Health Service
Act</act-name></header><text display-inline="no-display-inline">Title XXX of
the <act-name parsable-cite="PHSA">Public Health Service Act</act-name>, as
amended by titles II, III, and IV of this Act, is further amended by adding at
the end the following:</text>
<quoted-block act-name="Public" id="H090502CF0C5E4625A3C9FFBB245B8EA8">
<subtitle id="H0D6BFCC097754054AEEC1A6008EB468"><enum>D</enum><header>Reconstruction and
improvement grants for public health care facilities serving Pacific Islanders
and the insular areas</header>
<section id="H099F87293E714C788546379666201BDC"><enum>3051.</enum><header>Grant support
for quality improvement initiatives</header>
<subsection id="HB307C32E2BB149C58DC5E4003CE2FD9D"><enum>(a)</enum><header>In
general</header><text>The Secretary, in collaboration with the Administrator of
the Health Resources and Services Administration, the Director of the Agency
for Healthcare Research and Quality, and the Administrator of the Centers for
Medicare & Medicaid Services, shall award grants to eligible entities for
the conduct of demonstration projects to improve the quality of and access to
health care.</text>
</subsection><subsection id="HBBDC9CB04AFC410D002E00A1C749D42C"><enum>(b)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under subsection (a), an entity shall—</text>
<paragraph id="H14DF966DA34E422F996FA95D96B4F5C2"><enum>(1)</enum><text>be a health
center, hospital, health plan, health system, community clinic. or other health
entity determined appropriate by the Secretary—</text>
<subparagraph id="H7A421CD4363A4413928CE3E462F7D2D4"><enum>(A)</enum><text>that, by legal
mandate or explicitly adopted mission, provides patients with access to
services regardless of their ability to pay;</text>
</subparagraph><subparagraph id="H8156D8BD39944DE08F3E528D6CA6D700"><enum>(B)</enum><text>that provides care
or treatment for a substantial number of patients who are uninsured, are
receiving assistance under a State program under title XIX of the
<act-name parsable-cite="SSA">Social Security Act</act-name>, or are members of
vulnerable populations, as determined by the Secretary; and</text>
</subparagraph><subparagraph id="HC0674A9408094DA8863063588443EDAC"><enum>(C)</enum><clause commented="no" display-inline="yes-display-inline" id="H5B53A18416F84BADB26280E54F7EA429"><enum>(i)</enum><text>with respect to which,
not less than 50 percent of the entity’s patient population is made up of
racial and ethnic minorities; or</text>
</clause><clause id="H716652BEC0694EFC90B35427D472200" indent="up1"><enum>(ii)</enum><text>that—</text>
<subclause id="HA2D34EC49C3F497CA74731BF4389998F"><enum>(I)</enum><text>serves a disproportionate percentage of
local, minority racial and ethnic patients, or that has a patient population,
at least 50 percent of which is limited English proficient; and</text>
</subclause><subclause id="HD57C5580B9834546962575D42BBD1B23"><enum>(II)</enum><text>provides an assurance that amounts
received under the grant will be used only to support quality improvement
activities in the racial and ethnic population served; and</text>
</subclause></clause></subparagraph></paragraph><paragraph id="HBF0644F67CAE45A79830F859CF1B3BB5"><enum>(2)</enum><text>prepare and submit
to the Secretary an application at such time, in such manner, and containing
such information as the Secretary may require.</text>
</paragraph></subsection><subsection id="HE686CBA3AC67428CB600E629BC4D86EA"><enum>(c)</enum><header>Priority</header><text>In
awarding grants under subsection (a), the Secretary shall give priority to
applicants under subsection (b)(2) that—</text>
<paragraph id="H1911E109AD5F429E9CEB3E4BD9EB8900"><enum>(1)</enum><text>demonstrate an
intent to operate as part of a health care partnership, network, collaborative,
coalition, or alliance where each member entity contributes to the design,
implementation, and evaluation of the proposed intervention; or</text>
</paragraph><paragraph id="H42CA407707AB44E9B158ADC2FC60DFED"><enum>(2)</enum><text>intend to use
funds to carry out systemwide changes with respect to health care quality
improvement, including—</text>
<subparagraph id="H3887ACA5A8A043759B88288FE8A13C50"><enum>(A)</enum><text>improved systems
for data collection and reporting;</text>
</subparagraph><subparagraph id="H55C7140413EB4414B600347DF22205C5"><enum>(B)</enum><text>innovative
collaborative or similar processes;</text>
</subparagraph><subparagraph id="H0F46DBB7813F4953BCF651D4D56D3700"><enum>(C)</enum><text>group programs
with behavioral or self-management interventions;</text>
</subparagraph><subparagraph id="H93E67CD7B93B45939C936016F58C28F5"><enum>(D)</enum><text>case management
services;</text>
</subparagraph><subparagraph id="HDEB2435BB3D64960914E000266222B27"><enum>(E)</enum><text>physician or
patient reminder systems;</text>
</subparagraph><subparagraph id="HEE8F42E01FEC48E78B87F1199023AA3F"><enum>(F)</enum><text>educational
interventions; or</text>
</subparagraph><subparagraph id="H4BE3E020DA384C60BB57D1CA0057839B"><enum>(G)</enum><text>other activities
determined appropriate by the Secretary.</text>
</subparagraph></paragraph></subsection><subsection id="HE499CAFCE8B744C08197E208D1C8226F"><enum>(d)</enum><header>Use of
funds</header><text>An entity shall use amounts received under a grant under
subsection (a) to support the implementation and evaluation of health care
quality improvement activities or minority health and health care disparity
reduction activities that include—</text>
<paragraph id="H8430D48C71E64971B5DF4EB42300C1D2"><enum>(1)</enum><text>with respect to
health care systems, activities relating to improving—</text>
<subparagraph id="HE957D4D6E5844B08825C02307FE7E21"><enum>(A)</enum><text>patient
safety;</text>
</subparagraph><subparagraph id="H4C3808130DD04E14B5413016D946DA15"><enum>(B)</enum><text>timeliness of
care;</text>
</subparagraph><subparagraph id="HE5FD87478F684B898F24C5CD1C2FF912"><enum>(C)</enum><text>effectiveness of
care;</text>
</subparagraph><subparagraph id="H0BF092A709774373A83CE862E6009E28"><enum>(D)</enum><text>efficiency of
care;</text>
</subparagraph><subparagraph id="H4D13C3925E3846EBA68937469F96A7B"><enum>(E)</enum><text>patient
centeredness; and</text>
</subparagraph><subparagraph id="H241BA20FDBDC4BE8BFD1EF895034BF64"><enum>(F)</enum><text>health information
technology; and</text>
</subparagraph></paragraph><paragraph id="H0AE69C263550409793D836DA9879539"><enum>(2)</enum><text>with respect to
patients, activities relating to—</text>
<subparagraph id="H73655B6021D74B3AB65077610034A681"><enum>(A)</enum><text>staying
healthy;</text>
</subparagraph><subparagraph id="H09E53176D9A447BD8BF1B600F8EDED39"><enum>(B)</enum><text>getting
well;</text>
</subparagraph><subparagraph id="H0DBD7E4982BE4BBDBC00AD7B8C202B19"><enum>(C)</enum><text>living with
illness or disability; and</text>
</subparagraph><subparagraph id="HAC2BC4CDC3FC4E2BBF29FCC87B5CBDCF"><enum>(D)</enum><text>coping with end of
life issues.</text>
</subparagraph></paragraph></subsection><subsection id="H37E1397A8746436D85F2223B7C68FFB9"><enum>(e)</enum><header>Common data
systems</header><text>The Secretary shall provide financial and other technical
assistance to grantees under this section for the development of common data
systems.</text>
</subsection><subsection id="HDF42734F03614A17918EB97FF815AB9"><enum>(f)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2008
through 2013.</text>
</subsection></section><section id="H8FF48D6EA4434AB5007D1F54DF4F42CD"><enum>3052.</enum><header>Centers of
excellence</header>
<subsection id="H496B44B6B1E54662818115BD07C5E9A8"><enum>(a)</enum><header>In
general</header><text>The Secretary, acting through the Administrator of the
Health Resources and Services Administration, shall designate centers of
excellence at public hospitals, and other health systems serving large numbers
of minority patients, that—</text>
<paragraph id="HA847F9D8A49740E79793D4068DD5EE4"><enum>(1)</enum><text>meet the
requirements of section 3051(b)(1);</text>
</paragraph><paragraph id="H177636CB7B13463EBD150542BD4326CF"><enum>(2)</enum><text>demonstrate
excellence in providing care to minority populations; and</text>
</paragraph><paragraph id="HB31CC89F5EF545B29F08F7AC06538FCC"><enum>(3)</enum><text>demonstrate
excellence in reducing disparities in health and health care.</text>
</paragraph></subsection><subsection id="H1245116F610B47568F25E35DB291CBBC"><enum>(b)</enum><header>Requirements</header><text>A
hospital or health system that serves as a Center of Excellence under
subsection (a) shall—</text>
<paragraph id="H6ACFE1D3BEC2430600E0D0A0EE2B5789"><enum>(1)</enum><text>design, implement,
and evaluate programs and policies relating to the delivery of care in
racially, ethnically, and linguistically diverse populations;</text>
</paragraph><paragraph id="HF84A2A64C71F4021801C71372DF644E0"><enum>(2)</enum><text>provide training
and technical assistance to other hospitals and health systems relating to the
provision of quality health care to minority populations; and</text>
</paragraph><paragraph id="H5AE49E28D434403A8728E53CBA17A891"><enum>(3)</enum><text>develop activities
for graduate or continuing medical education that institutionalize a focus on
cultural competence training for health care providers.</text>
</paragraph></subsection><subsection id="HDA4B164E9B3E4E9DACC2E1979970093"><enum>(c)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, such sums as may be necessary for each of fiscal years 2008
through 2013.</text>
</subsection></section><section id="HE853299A0034422A8119936299F6ED8E"><enum>3053.</enum><header>Reconstruction
and improvement grants for Public Health care facilities serving Pacific
Islanders and the insular areas</header>
<subsection id="H9B00B84EDAF742ECB3EFF830ED44073E"><enum>(a)</enum><header>In
general</header><text>The Secretary shall provide direct financial assistance
to designated health care providers and community health centers in American
Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the United
States Virgin Islands, Puerto Rico, and Hawaii for the purposes of
reconstructing and improving health care facilities and services.</text>
</subsection><subsection id="HB42244D64A304ED793C7604F0022D3B6"><enum>(b)</enum><header>Eligibility</header><text>To
be eligible to receive direct financial assistance under subsection (a), an
entity shall be a public health facility or community health center located in
American Samoa, Guam, or the Commonwealth of the Northern Mariana Islands, the
United States Virgin Islands, Puerto Rico, and Hawaii that—</text>
<paragraph id="HE274277014DD4878AD655D06474165D"><enum>(1)</enum><text>is owned or
operated by—</text>
<subparagraph id="H633F61F33B294B838D23A5D4A27F95D8"><enum>(A)</enum><text>the government of
American Samoa, Guam, or the Commonwealth of the Northern Mariana Islands, the
United States Virgin Islands, Puerto Rico, and Hawaii or a unit of local
government; or</text>
</subparagraph><subparagraph id="H83D962D826714C73AEB6FF38F6280000"><enum>(B)</enum><text>a nonprofit
organization; and</text>
</subparagraph></paragraph><paragraph id="HED9053F2EB4840C892A9D68504A6F78E"><enum>(2)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="H029B1CF8051E48A800FB7E3025AFFD3E"><enum>(A)</enum><text>provides care or
treatment for a substantial number of patients who are uninsured, receiving
assistance under a State program under a title XVIII of the
<act-name parsable-cite="SSA">Social Security Act</act-name>, or a State
program under title XIX of such Act, or who are members of a vulnerable
population, as determined by the Secretary; or</text>
</subparagraph><subparagraph id="HD8FC962C17934A7189AF5348398EC737" indent="up1"><enum>(B)</enum><text>serves a disproportionate percentage
of local, minority racial and ethnic patients.</text>
</subparagraph></paragraph></subsection><subsection id="H8F7A73D1C59445BDBFA66C69F13868C9"><enum>(c)</enum><header>Report</header><text>Not
later than 180 days after the date of enactment of this title and annually
thereafter, the Secretary shall submit to the Congress and the President a
report that includes an assessment of health resources and facilities serving
populations in American Samoa, Guam, and the Commonwealth of the Northern
Mariana Islands, the United States Virgin Islands, Puerto Rico, and Hawaii. In
preparing such report, the Secretary shall—</text>
<paragraph id="H979D4015E8A34216A5E90CDCCBCD2DD"><enum>(1)</enum><text>consult with and
obtain information on all health care facilities needs from the entities
described in subsection (b); and</text>
</paragraph><paragraph id="H501EA91866D146EDAD74B677B7F242AE"><enum>(2)</enum><text>include all
amounts of Federal assistance received by each entity in the preceding fiscal
year;</text>
</paragraph><paragraph id="HF93AF1C8834F422D9705229CC83CAE22"><enum>(3)</enum><text>review the total
unmet needs of each jurisdiction for health care facilities, including needs
for renovation and expansion of existing facilities; and</text>
</paragraph><paragraph id="H78948FFD2BA5444BB4C2F296EA7E06F3"><enum>(4)</enum><text>include a
strategic plan for addressing the needs of each jurisdiction identified in the
report.</text>
</paragraph></subsection><subsection id="H80E72227D77D48DA9B6049EEB9B3E946"><enum>(d)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated such sums
as necessary to carry out this
section.</text>
</subsection></section></subtitle><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HC36A0C8D3D3449E385243E7BD10005A7"><enum>503.</enum><header>Optional
coverage of legal immigrants under the Medicaid program and SCHIP</header>
<subsection id="H7856CA40609940759FAF932CB1A7273F"><enum>(a)</enum><header>Medicaid
program</header><text>Section 1903(v) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1396b">42 U.S.C. 1396b(v)</external-xref>) is
amended—</text>
<paragraph id="H60E82166CB6F4E39B241C62F06E1A1C5"><enum>(1)</enum><text>in paragraph (1),
by striking <quote>paragraph (2)</quote> and inserting <quote>paragraphs (2)
and (4)</quote>; and</text>
</paragraph><paragraph id="H03364B22AC25464500F36D16ED83C3F"><enum>(2)</enum><text>by
adding at the end the following new paragraph:</text>
<quoted-block id="HE479848E4B674E45BF8315FA756F6EB7">
<paragraph id="H9E8462BA755E4D18A7E2C8E04EFF9150" indent="up1"><enum>(4)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="H19C7909625114DC8993B55958F77A700"><enum>(A)</enum><text>A State may elect (in a
plan amendment under this title) to provide medical assistance under this
title, notwithstanding sections 401(a), 402(b), 403, and 421 of the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996, for
undocumented residents who are lawfully residing in the United States
(including battered undocumented residents described in section 431(c) of such
Act) and who are otherwise eligible for such assistance, within either or both
of the following eligibility categories:</text>
<clause id="H6728A016A8E04B30945DB61BEED31B7" indent="up1"><enum>(i)</enum><header>Pregnant women</header><text>Women
during pregnancy (and during the 60-day period beginning on the last day of the
pregnancy).</text>
</clause><clause id="H30EB7E723EAD4A059FB18141B0EFEF51" indent="up1"><enum>(ii)</enum><header>Children</header><text display-inline="yes-display-inline">Individuals under 21 years of age,
including optional targeted low-income children described in section
1905(u)(2)(B).</text>
</clause></subparagraph><subparagraph id="H8BB399871CBE43D5BB5E41BBC5C77515" indent="up1"><enum>(B)</enum><text>In the case of a State that has
elected to provide medical assistance to a category of undocumented residents
under subparagraph (A), no debt shall accrue under an affidavit of support
against any sponsor of such an undocumented resident on the basis of provision
of assistance to such category and the cost of such assistance shall not be
considered as an unreimbursed
cost.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H33B6F4F1C12045B4B278CAFEAE7E5200"><enum>(b)</enum><header>SCHIP</header><text>Section
2107(e)(1) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1397gg">42 U.S.C. 1397gg(e)(1)</external-xref>) is amended by redesignating
subparagraphs (C) and (D) as subparagraph (D) and (E), respectively, and by
inserting after subparagraph (B) the following new subparagraph:</text>
<quoted-block id="H9C203605CD6747FCB0966C884F412DE2">
<subparagraph id="H17EC3647BE414625962D4EFCA5FE5B85"><enum>(C)</enum><text>Section 1903(v)(4)
(relating to optional coverage of categories of lawfully residing immigrant
children), but only if the State has elected to apply such section to the
category of children under title
XIX.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H1B9FD3DD03E4486FB5E18B1C2F0330E7"><enum>(c)</enum><header>Effective
date</header><text>The amendments made by this section take effect on October
1, 2007, and apply to medical assistance and child health assistance furnished
on or after such date.</text>
</subsection></section><section display-inline="no-display-inline" id="HF52244146CA34389A572DC13CDEBE6F" section-type="subsequent-section"><enum>504.</enum><header>Border health
grants</header>
<subsection id="H58B316D26A06460E9751A6CE916E3BB3"><enum>(a)</enum><header>Eligible entity
defined</header><text>In this section, the term <term>eligible entity</term>
means a State, public institution of higher education, local government, tribal
government, nonprofit health organization, community health center, or
community clinic receiving assistance under section 330 of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
254b), that is located in the border area.</text>
</subsection><subsection id="H402DDDC7C28741968850BCC5FE83F633"><enum>(b)</enum><header>Authorization</header><text>From
funds appropriated under subsection (f), the Secretary of Health and Human
Services (in this section referred to as the <quote>Secretary</quote>), acting
through the United States members of the United States-Mexico Border Health
Commission, shall award grants to eligible entities to address priorities and
recommendations to improve the health of border area residents that are
established by—</text>
<paragraph id="H6341D3CD119140BA8F53ED040010CF15"><enum>(1)</enum><text>the United States
members of the United States-Mexico Border Health Commission;</text>
</paragraph><paragraph id="HEFF7F1CA12334CE1BC224EDA00A2F46"><enum>(2)</enum><text>the State border
health offices; and</text>
</paragraph><paragraph id="H4509AEFA94054D9B8300B0E18C581005"><enum>(3)</enum><text>the
Secretary.</text>
</paragraph></subsection><subsection id="HB6C784B474EA406CAFABBE4000001925"><enum>(c)</enum><header>Application</header><text>An
eligible entity that desires a grant under subsection (b) shall submit an
application to the Secretary at such time, in such manner, and containing such
information as the Secretary may require.</text>
</subsection><subsection id="HFEA7FD4285D24C8C9E85C18DFE8BBA07"><enum>(d)</enum><header>Use of
funds</header><text>An eligible entity that receives a grant under subsection
(b) shall use the grant funds for—</text>
<paragraph id="H2F84D425D5BF4C2B9E6F021711DAC97C"><enum>(1)</enum><text>programs relating
to—</text>
<subparagraph id="H3D56D04AE8334B19A517E1F63C450072"><enum>(A)</enum><text>maternal and child
health;</text>
</subparagraph><subparagraph id="HAE55E3A5FE2341E9BC2EA1D073900A9"><enum>(B)</enum><text>primary care and
preventative health;</text>
</subparagraph><subparagraph id="H09F185654D5D43598F8F00FACD858D6"><enum>(C)</enum><text>public health and
public health infrastructure;</text>
</subparagraph><subparagraph id="HD2C61048FAAE43D28FB45E8D41DF77FE"><enum>(D)</enum><text>health education
and promotion;</text>
</subparagraph><subparagraph id="H72236456237448C7925B639E2DCC4B9F"><enum>(E)</enum><text>oral
health;</text>
</subparagraph><subparagraph id="H9ACCD91FCF624DBD93C14EDE53008903"><enum>(F)</enum><text>mental and
behavioral health;</text>
</subparagraph><subparagraph id="H2F385EE458DF47BB83BBB7DC4DA63C9"><enum>(G)</enum><text>substance
abuse;</text>
</subparagraph><subparagraph id="H6D4A1AB3AB0446689D4DF7F4A3D51B25"><enum>(H)</enum><text>health conditions
that have a high prevalence in the border area;</text>
</subparagraph><subparagraph id="H24612A4AB2E9423A82C6405DCA6B2758"><enum>(I)</enum><text>medical and health
services research;</text>
</subparagraph><subparagraph id="H272EBB46873F45A6AB525352DE54041B"><enum>(J)</enum><text>workforce training
and development;</text>
</subparagraph><subparagraph id="H684F3441E750445C84CA2DCB17C400FD"><enum>(K)</enum><text>community health
workers or promotoras;</text>
</subparagraph><subparagraph id="H216F3BFBC5C9476F8BB1CE379D4CC1CA"><enum>(L)</enum><text>health care
infrastructure problems in the border area (including planning and construction
grants);</text>
</subparagraph><subparagraph id="H4991CD62028D4FE5985D515560B15139"><enum>(M)</enum><text>health disparities
in the border area;</text>
</subparagraph><subparagraph id="HFDEBB3996B404BE200D1E52B29AE9289"><enum>(N)</enum><text>environmental
health; and</text>
</subparagraph><subparagraph id="HD2C5E18A7A5F4627BB19C1B300167E35"><enum>(O)</enum><text>outreach and
enrollment services with respect to Federal programs (including programs
authorized under titles XIX and XXI of the <act-name parsable-cite="SSA">Social
Security Act</act-name> (42 U.S.C. 1396 and 1397aa)); and</text>
</subparagraph></paragraph><paragraph id="H5C1F3C9980BB45F39DCED0E381B74B7E"><enum>(2)</enum><text>other programs
determined appropriate by the Secretary.</text>
</paragraph></subsection><subsection id="H836310A80C3F4D210020217817DC0B5"><enum>(e)</enum><header>Supplement, not
supplant</header><text>Amounts provided to an eligible entity awarded a grant
under subsection (b) shall be used to supplement and not supplant other funds
available to the eligible entity to carry out the activities described in
subsection (d).</text>
</subsection><subsection id="HA0F6112DCD1E4910A83BCC5FDC6E7380"><enum>(f)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this section, $200,000,000 for fiscal year 2008, and such sums as may be
necessary for each succeeding fiscal year.</text>
</subsection></section><section id="HC37AC6ED14924FE19205D1AED485004F"><enum>505.</enum><header>Cancer
prevention and treatment demonstration for ethnic and racial
minorities</header>
<subsection id="H66BD463A4A6541A3A77DEAA96F1E7832"><enum>(a)</enum><header>Demonstration</header>
<paragraph id="HE93E892E7F48448A889147AAD1F8CE44"><enum>(1)</enum><header>In
general</header><text>The Secretary of Health and Human Services (in this
section referred to as the <quote>Secretary</quote>) shall conduct
demonstration projects (in this section referred to as <quote>demonstration
projects</quote>) for the purpose of developing models and evaluating methods
that—</text>
<subparagraph id="H24216F6E7BC6425882FEAEF5CA5DA36"><enum>(A)</enum><text>improve the quality
of items and services provided to target individuals in order to facilitate
reduced disparities in early detection and treatment of cancer;</text>
</subparagraph><subparagraph id="H88CF0F0606A34015005E33E82E49C1FE"><enum>(B)</enum><text>improve clinical
outcomes, satisfaction, quality of life, and appropriate use of
Medicare-covered services and referral patterns among those target individuals
with cancer;</text>
</subparagraph><subparagraph id="H732E682404214C0ABF22B8FFD1B02C2C"><enum>(C)</enum><text>eliminate
disparities in the rate of preventive cancer screening measures, such as pap
smears, prostate cancer screenings, and CT scans for lung cancer among target
individuals; and</text>
</subparagraph><subparagraph id="H49815950FD9946EEBFFE68CEEEA5E618"><enum>(D)</enum><text>promote
collaboration with community-based organizations to ensure cultural competency
of health care professionals and linguistic access for persons with limited
English proficiency.</text>
</subparagraph></paragraph><paragraph id="H799EC7A1E2DF47B5A1956180A7709665"><enum>(2)</enum><header>Target
individual defined</header><text>In this section, the term <term>target
individual</term> means an individual of a racial and ethnic minority group, as
defined by section 1707 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300u-6">42 U.S.C. 300u–6</external-xref>) who
is entitled to benefits under part A, and enrolled under part B, of title XVIII
of the Social Security Act.</text>
</paragraph></subsection><subsection id="HCD0CC14121904470BD2DEC138E033346"><enum>(b)</enum><header>Program
design</header>
<paragraph id="H10239527F385488BA7B592CD000090AE"><enum>(1)</enum><header>Initial
design</header><text>Not later than 1 year after the date of the enactment of
this Act, the Secretary shall evaluate best practices in the private sector,
community programs, and academic research of methods that reduce disparities
among individuals of racial and ethnic minority groups in the prevention and
treatment of cancer and shall design the demonstration projects based on such
evaluation.</text>
</paragraph><paragraph id="H7AFB71DFCB21432FA8F48DE3A7E3C4C"><enum>(2)</enum><header>Number and
project areas</header><text>Not later than 2 years after the date of the
enactment of this Act, the Secretary shall implement at least nine
demonstration projects, including the following:</text>
<subparagraph id="HFB46E11660BF4150B5B450305B32ECC"><enum>(A)</enum><text>Two projects for
each of the four following major racial and ethnic minority groups:</text>
<clause id="H3B286A9B49F54EF5001874712BD4BA47"><enum>(i)</enum><text>American Indians
and Alaska Natives, Eskimos and Aleuts.</text>
</clause><clause id="H724F39AF74E74579B608552CF4D2003F"><enum>(ii)</enum><text>Asian
Americans.</text>
</clause><clause id="HDFEDC575F5FE407AB7FDC2FF27DA9D7"><enum>(iii)</enum><text>Blacks/African
Americans.</text>
</clause><clause id="HFA353184FEA645BEBF4C0034BFA81FB2"><enum>(iv)</enum><text>Hispanic/Latino
Americans.</text>
</clause><clause id="HF7C1F6F73BF64A4A8E2F12E34706963E"><enum>(v)</enum><text>Native Hawaiians
and other Pacific Islanders.</text>
</clause><continuation-text continuation-text-level="subparagraph">The two
projects must target different ethnic subpopulations.</continuation-text></subparagraph><subparagraph id="H6BB64F321E7142FB9F36F100295B99E4"><enum>(B)</enum><text>One project within
the Pacific Islands or United States insular areas.</text>
</subparagraph><subparagraph id="HC1F1AEC843854DAEACF51B8D77B0BBB4"><enum>(C)</enum><text>At least one
project each in a rural area and inner-city area.</text>
</subparagraph></paragraph><paragraph id="H2F5F1386481B47CDB2DABBF002B41F28"><enum>(3)</enum><header>Expansion of
projects; implementation of demonstration project results</header><text>If the
initial report under subsection (c) contains an evaluation that demonstration
projects—</text>
<subparagraph id="H2EC57682B7E3410EA58B24B01D00E9FB"><enum>(A)</enum><text>reduce
expenditures under the Medicare program under title XVIII of the Social
Security Act; or</text>
</subparagraph><subparagraph id="H396AE285C76A457EB0911FD00F51015"><enum>(B)</enum><text>do not increase
expenditures under the Medicare program and reduce racial and ethnic health
disparities in the quality of health care services provided to target
individuals and increase satisfaction of beneficiaries and health care
providers;</text>
</subparagraph><continuation-text continuation-text-level="paragraph">the
Secretary shall continue the existing demonstration projects and may expand the
number of demonstration projects.</continuation-text></paragraph></subsection><subsection id="H5D3F764B2C9D456A005FBA42BC17B59"><enum>(c)</enum><header>Report to
congress</header>
<paragraph id="H6BF1760789714A2F978D229F1BF211EC"><enum>(1)</enum><header>In
general</header><text>Not later than 2 years after the date the Secretary
implements the initial demonstration projects, and biannually thereafter, the
Secretary shall submit to Congress a report regarding the demonstration
projects.</text>
</paragraph><paragraph id="HC065FE8FE33B413AB41375ED75907BD3"><enum>(2)</enum><header>Contents of
report</header><text>Each report under paragraph (1) shall include the
following:</text>
<subparagraph id="HE232E9D4BFC54AF6BA38A43400A4EF37"><enum>(A)</enum><text>A description of
the demonstration projects.</text>
</subparagraph><subparagraph id="H45CE85453D90425CBAB37540F3008CAD"><enum>(B)</enum><text>An evaluation
of—</text>
<clause id="HD2E28BC74AB342729CC1E1B9E646840"><enum>(i)</enum><text>the
cost-effectiveness of the demonstration projects;</text>
</clause><clause id="HFE55E7E0C64D47A18224DF20DC00E196"><enum>(ii)</enum><text>the
quality of the health care services provided to target individuals under the
demonstration projects; and</text>
</clause><clause id="H13327D7F54464570BA711522876608A7"><enum>(iii)</enum><text>beneficiary and
health care provider satisfaction under the demonstration projects.</text>
</clause></subparagraph><subparagraph id="H42698A4C63114C5D812B12B74B36DD98"><enum>(C)</enum><text>Any other
information regarding the demonstration projects that the Secretary determines
to be appropriate.</text>
</subparagraph></paragraph></subsection><subsection id="H2650389586364FCA90451DD9345B219C"><enum>(d)</enum><header>Waiver
authority</header><text>The Secretary shall waive compliance with the
requirements of title XVIII of the Social Security Act to such extent and for
such period as the Secretary determines is necessary to conduct demonstration
projects.</text>
</subsection></section><section display-inline="no-display-inline" id="HAC3B79740A4E4C689E5617BAB57FDC62"><enum>506.</enum><header>Grants to
promote positive health behaviors in women and children</header><text display-inline="no-display-inline">Part P of title III of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
280g et seq.) is amended by adding at the end the following:</text>
<quoted-block act-name="Public" id="H29D657EF49274C91ACBA03EDB3FE61D5" style="OLC">
<section id="H565DF1DC5581445CB9B1EA801690181B"><enum>399R.</enum><header>Grants to
promote positive health behaviors in women and children</header>
<subsection id="H88E676E571D3481F9BB1C38FDC7EE837"><enum>(a)</enum><header>Grants
Authorized</header><text>The Secretary, in collaboration with the Director of
the Centers for Disease Control and Prevention and other Federal officials
determined appropriate by the Secretary, is authorized to award grants to
eligible entities to promote positive health behaviors for women and children
in target populations, especially racial and ethnic minority women and children
in medically underserved communities.</text>
</subsection><subsection id="HE43CC769C6DF4877ADB62736CCE69668"><enum>(b)</enum><header>Use of
Funds</header><text>Grants awarded pursuant to subsection (a) may be used to
support community health workers—</text>
<paragraph id="H70CB7BBCF58F442D9B1089003E56E1DD"><enum>(1)</enum><text>to educate and
provide outreach regarding enrollment in health insurance including the State
Children’s Health Insurance Program under title XXI of the
<act-name parsable-cite="SSA">Social Security Act</act-name>, Medicare under
title XVIII of such Act, and Medicaid under title XIX of such Act;</text>
</paragraph><paragraph id="H5CE8A11FFF2E45F083B8AAA1EF949102"><enum>(2)</enum><text>to educate, guide,
and provide outreach in a community setting regarding health problems prevalent
among women and children and especially among racial and ethnic minority women
and children;</text>
</paragraph><paragraph id="HEE45C3D21DA347A0BE1E62671500CA18"><enum>(3)</enum><text>to educate, guide,
and provide experiential learning opportunities that target behavioral risk
factors including—</text>
<subparagraph id="H877A835AAD9B42AAB6A50975008DFC90"><enum>(A)</enum><text>poor
nutrition;</text>
</subparagraph><subparagraph id="H75AB2D119C9B4924A22FE28DBCDF5260"><enum>(B)</enum><text>physical
inactivity;</text>
</subparagraph><subparagraph id="H85A56A186364456090540000DDD146EA"><enum>(C)</enum><text>being overweight
or obese;</text>
</subparagraph><subparagraph id="H347431B14FEF4DD6BBC68147CD79758E"><enum>(D)</enum><text>tobacco
use;</text>
</subparagraph><subparagraph id="H76A971305F5449CBAF31E589AEF1AE6D"><enum>(E)</enum><text>alcohol and
substance use;</text>
</subparagraph><subparagraph id="HE251035F28D048FCB8D2E3D0EFFA54AD"><enum>(F)</enum><text>injury and
violence;</text>
</subparagraph><subparagraph id="H64CD2154C17E49FE96827E72A9A93259"><enum>(G)</enum><text>risky sexual
behavior;</text>
</subparagraph><subparagraph id="HBEC036E563DE4C68B85D5598506178D3"><enum>(H)</enum><text>mental health
problems;</text>
</subparagraph><subparagraph id="HAA311FFE68564EADBC41B7C7E163242B"><enum>(I)</enum><text>dental and oral
health problems; and</text>
</subparagraph><subparagraph id="HB0E4EB4B750047FAAC005EC04FD833B2"><enum>(J)</enum><text>understanding
informed consent;</text>
</subparagraph></paragraph><paragraph id="H9E05A1D9C7B241F1A4AA01FDC6BB206"><enum>(4)</enum><text>to educate and
guide regarding effective strategies to promote positive health behaviors
within the family;</text>
</paragraph><paragraph id="H941B1A453FD04584A474B0BF24B980AD"><enum>(5)</enum><text>to promote
community wellness and awareness; and</text>
</paragraph><paragraph id="H96048E72F8764C24BEB350AEF74C8233"><enum>(6)</enum><text>to educate and
refer target populations to appropriate health care agencies and
community-based programs and organizations in order to increase access to
quality health care services, including preventive health services.</text>
</paragraph></subsection><subsection id="H46521D4E4AC2465F8F97EDA1F2711101"><enum>(c)</enum><header>Application</header>
<paragraph id="H7CB9EFEF5C7C473398FD665011278538"><enum>(1)</enum><header>In
general</header><text>Each eligible entity that desires to receive a grant
under subsection (a) shall submit an application to the Secretary, at such
time, in such manner, and accompanied by such additional information as the
Secretary may require.</text>
</paragraph><paragraph id="HB72D65C4C5304E759BE0EC67ED87B94"><enum>(2)</enum><header>Contents</header><text>Each
application submitted pursuant to paragraph (1) shall—</text>
<subparagraph id="H2D50D2CE3795497CAA8CFB23CC9FBF98"><enum>(A)</enum><text>describe the
activities for which assistance under this section is sought;</text>
</subparagraph><subparagraph id="H25952A98AC094B689D8D35B298BEFD1B"><enum>(B)</enum><text>contain an
assurance that with respect to each community health worker program receiving
funds under the grant awarded, such program provides training and supervision
to community health workers to enable such workers to provide authorized
program services;</text>
</subparagraph><subparagraph id="H80EF8AD22EBE4658B9AA3BC8BE296CB8"><enum>(C)</enum><text>contain an
assurance that the applicant will evaluate the effectiveness of community
health worker programs receiving funds under the grant;</text>
</subparagraph><subparagraph id="H19B5532E33F84EFB876673A2D58774F0"><enum>(D)</enum><text>contain an
assurance that each community health worker program receiving funds under the
grant will provide services in the cultural context most appropriate for the
individuals served by the program;</text>
</subparagraph><subparagraph id="H700090A83A264B80B7C74F24D200746C"><enum>(E)</enum><text>contain a plan to
document and disseminate project description and results to other States and
organizations as identified by the Secretary; and</text>
</subparagraph><subparagraph id="H013369A46FDA4B6B88FA4ED6067078F7"><enum>(F)</enum><text>describe plans to
enhance the capacity of individuals to utilize health services and
health-related social services under Federal, State, and local programs
by—</text>
<clause id="H0146D8D29A1F4F0CA1BBF763537FAD45"><enum>(i)</enum><text>assisting
individuals in establishing eligibility under the programs and in receiving the
services or other benefits of the programs; and</text>
</clause><clause id="H502B8BEDFDA34B7491BD4283805329A1"><enum>(ii)</enum><text>providing other
services as the Secretary determines to be appropriate, that may include
transportation and translation services.</text>
</clause></subparagraph></paragraph></subsection><subsection id="HE6A98BEC9B8F453DA105A61B4F964C09"><enum>(d)</enum><header>Priority</header><text>In
awarding grants under subsection (a), the Secretary shall give priority to
those applicants—</text>
<paragraph id="H0ACB079C538A43FB8D17B77FF1AF2BC7"><enum>(1)</enum><text>who propose to
target geographic areas—</text>
<subparagraph id="H5BD34D2F805942AC00A3656B4898A7AB"><enum>(A)</enum><text>with a high
percentage of residents who are eligible for health insurance but are uninsured
or underinsured; and</text>
</subparagraph><subparagraph id="H8B55BC6D30804BADA26B9593D0821DC8"><enum>(B)</enum><text>with a high
percentage of families for whom English is not their primary language.</text>
</subparagraph></paragraph><paragraph id="HF659331852494A139DAC817C77080940"><enum>(2)</enum><text>with experience in
providing health or health-related social services to individuals who are
underserved with respect to such services; and</text>
</paragraph><paragraph id="HF4FF173A1B8647C68189AF299FA8E797"><enum>(3)</enum><text>with documented
community activity and experience with community health workers.</text>
</paragraph></subsection><subsection id="HD292A4C0F3FF4458BFC9ED186273D3A8"><enum>(e)</enum><header>Collaboration
With Academic Institutions</header><text display-inline="yes-display-inline">The Secretary shall encourage community
health worker programs receiving funds under this section to collaborate with
academic institutions, including minority-serving institutions. Nothing in this
section shall be construed to require such collaboration.</text>
</subsection><subsection id="HB1F06B46E2FC4863A8020065C7F4EC6"><enum>(f)</enum><header>Quality Assurance
and Cost-Effectiveness</header><text>The Secretary shall establish guidelines
for assuring the quality of the training and supervision of community health
workers under the programs funded under this section and for assuring the
cost-effectiveness of such programs.</text>
</subsection><subsection id="HC7538399EEF14B988BFE5BA1F0005030"><enum>(g)</enum><header>Monitoring</header><text>The
Secretary shall monitor community health worker programs identified in approved
applications and shall determine whether such programs are in compliance with
the guidelines established under subsection (f).</text>
</subsection><subsection id="H1FD0F5597B4C4ED58EACDCE005144B63"><enum>(h)</enum><header>Technical
Assistance</header><text>The Secretary may provide technical assistance to
community health worker programs identified in approved applications with
respect to planning, developing, and operating programs under the grant.</text>
</subsection><subsection id="HB77D9D9B0E734CE49CF0C8BF6CABFBAA"><enum>(i)</enum><header>Report to
Congress</header>
<paragraph id="H9A6E142DADBB4A2DB95419257DF6A0BC"><enum>(1)</enum><header>In
general</header><text>Not later than 4 years after the date on which the
Secretary first awards grants under subsection (a), the Secretary shall submit
to Congress a report regarding the grant project.</text>
</paragraph><paragraph id="H001E40278F644E4485589E05FDA88EED"><enum>(2)</enum><header>Contents</header><text>The
report required under paragraph (1) shall include the following:</text>
<subparagraph id="HD94925E0AC9D46A296160600419F5FD3"><enum>(A)</enum><text>A description of
the programs for which grant funds were used.</text>
</subparagraph><subparagraph id="HCFB50CB2DD904051A0C36D195B798B3C"><enum>(B)</enum><text>The number of
individuals served.</text>
</subparagraph><subparagraph id="HDAC9F62E9FA0449A9DEB36064288B3BB"><enum>(C)</enum><text>An evaluation
of—</text>
<clause id="H8B360D8FBDF5414997881916D6BC1CC4"><enum>(i)</enum><text>the effectiveness
of these programs;</text>
</clause><clause id="HDA11B8C73E8841B39977550669C4CCE"><enum>(ii)</enum><text>the cost of these
programs; and</text>
</clause><clause id="HF2E84E12C5624F488388F20080DB2E86"><enum>(iii)</enum><text>the impact of
the project on the health outcomes of the community residents.</text>
</clause></subparagraph><subparagraph id="HF5BC37702D0345FE96E824E587E718E1"><enum>(D)</enum><text>Recommendations
for sustaining the community health worker programs developed or assisted under
this section.</text>
</subparagraph><subparagraph id="H842864C731314C40A100782B4F95F8A5"><enum>(E)</enum><text>Recommendations
regarding training to enhance career opportunities for community health
workers.</text>
</subparagraph></paragraph></subsection><subsection id="H79D787ED8D3941B0B9F131AA0001436C"><enum>(j)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="HC5371A1B9874485791BD00BF3C51C7D0"><enum>(1)</enum><header>Community health
worker</header><text>The term <term>community health worker</term> means an
individual who promotes health or nutrition within the community in which the
individual resides—</text>
<subparagraph id="H1E60876512BD4F2291C77CFFC2489BB"><enum>(A)</enum><text>by serving as a
liaison between communities and health care agencies;</text>
</subparagraph><subparagraph id="HC7C5AF7C6D0F42A79E80AE40C706E4F1"><enum>(B)</enum><text>by providing
guidance and social assistance to community residents;</text>
</subparagraph><subparagraph id="H3A01D8D8A2534EC800EF50A90844ADE3"><enum>(C)</enum><text>by enhancing
community residents’ ability to effectively communicate with health care
providers;</text>
</subparagraph><subparagraph id="HA3DD8AB5708344CD8896C389501F36FF"><enum>(D)</enum><text>by providing
culturally and linguistically appropriate health or nutrition education;</text>
</subparagraph><subparagraph id="H078A302C45EC412EB2A5FE0B4842E00"><enum>(E)</enum><text>by advocating for
individual and community health, including dental, oral, mental, and
environmental health, or nutrition needs; and</text>
</subparagraph><subparagraph id="H9A94E5F6D75E4A36BACBFF9B568388D6"><enum>(F)</enum><text>by providing
referral and followup services.</text>
</subparagraph></paragraph><paragraph id="HEC08CDF48B324B1CA022E8CBD1759DE5"><enum>(2)</enum><header>Community
setting</header><text>The term <term>community setting</term> means a home or a
community organization located in the neighborhood in which a participant
resides.</text>
</paragraph><paragraph id="H6B1DF78BB32B46F6A49437D5CE8BEFC1"><enum>(3)</enum><header>Eligible
entity</header><text>The term <term>eligible entity</term> means—</text>
<subparagraph id="H4F97C82F6D7C416A8721E87C96BD9426"><enum>(A)</enum><text display-inline="yes-display-inline">a unit of State, territorial, local, or
tribal government (including a federally recognized tribe or Alaska native
villages); or</text>
</subparagraph><subparagraph id="HBAD763211A964440B9F4A2DCFF81C8C1"><enum>(B)</enum><text>a community-based
organization.</text>
</subparagraph></paragraph><paragraph id="HEE3D95712A2D4771B245E508E4A75914"><enum>(4)</enum><header>Medically
underserved community</header><text>The term <term>medically underserved
community</term> means a community—</text>
<subparagraph id="H5605324F193E44579E0004ED361E97A7"><enum>(A)</enum><text>that has a
substantial number of individuals who are members of a medically underserved
population, as defined by section 330(b)(3); and</text>
</subparagraph><subparagraph id="H0C39B64C40314D9EAD81DEF2C540832E"><enum>(B)</enum><text>a significant
portion of which is a health professional shortage area as designated under
section 332.</text>
</subparagraph></paragraph><paragraph id="HB56E7BA6EFE949468BD5CB6320C2349D"><enum>(5)</enum><header>Support</header><text>The
term <term>support</term> means the provision of training, supervision, and
materials needed to effectively deliver the services described in subsection
(b), reimbursement for services, and other benefits.</text>
</paragraph><paragraph id="H4934759F2DE74BC7B3A4AF5D538B447F"><enum>(6)</enum><header>Target
population</header><text>The term <term>target population</term> means women of
reproductive age, regardless of their current childbearing status and children
under 21 years of age.</text>
</paragraph></subsection><subsection id="HBAEDC68961CB4E02A582A9B92447DD2F"><enum>(k)</enum><header>Authorization of
Appropriations</header><text>There are authorized to be appropriated to carry
out this section $15,000,000 for each of fiscal years 2008, 2009, 2010, 2011,
and
2012.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H287594D17EF741D8AA038F5D139FB071"><enum>507.</enum><header>Exception for
citizens of freely associated States</header>
<subsection id="HC63B868024DE42F88E5B74C5FEF9068B"><enum>(a)</enum><header>In
General</header><text>Section 402(a)(2) of the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996 (<external-xref legal-doc="usc" parsable-cite="usc/8/1612">8 U.S.C. 1612(a)(2)</external-xref>) is amended by
adding at the end the following:</text>
<quoted-block id="HFB3DABF18B6F46C1A468944F38D98396" style="OLC">
<subparagraph id="H709F4CCEAD354168834123D8EA167F83"><enum>(M)</enum><header>Exception for
citizens of freely associated states</header><text>With respect to eligibility
for benefits for the specified Federal programs described in paragraph (3),
paragraph (1) shall not apply to any individual who lawfully resides in the
United States (including territories and possessions of the United States) in
accordance with—</text>
<clause id="H0A3EEAA1E582499B9ED6CC7188225CE"><enum>(i)</enum><text>section 141 of the
Compact of Free Association between the Government of the United States and the
Government of the Federated States of Micronesia, approved by Congress in the
Compact of Free Association Amendments Act of 2003;</text>
</clause><clause id="H81059CC6A92C4FC7AF8E753447706B33"><enum>(ii)</enum><text>section 141 of
the Compact of Free Association between the Government of the United States and
the Government of the Republic of the Marshall Islands, approved by Congress in
the Compact of Free Association Amendments Act of 2003; or</text>
</clause><clause id="H7D763E5020054021B27E4C44F690D9DF"><enum>(iii)</enum><text>section 141 of
the Compact of Free Association between the Government of the United States and
the Government of Palau, approved by Congress in <external-xref legal-doc="public-law" parsable-cite="pl/99/658">Public Law 99–658</external-xref> (100 Stat.
3672).</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H8AA663815DE24A8FB154EB63724BB690"><enum>(b)</enum><header>Medicaid
Exception</header><text>Section 402(b)(2) of the Personal Responsibility and
Work Opportunity Reconciliation Act of 1996 (<external-xref legal-doc="usc" parsable-cite="usc/8/1612">8 U.S.C. 1612(b)(2)</external-xref>) is amended by
adding at the end the following:</text>
<quoted-block id="HCF350ECA2C474FBFB7BF38EAB54319E7" style="OLC">
<subparagraph id="H0B9D79832E3B495DB2E3ABBE93EEFF07"><enum>(G)</enum><header>Medicaid
exceptions for citizens of freely associated states</header><text>With respect
to eligibility for benefits for the programs defined in subparagraphs (A) and
(C) of paragraph (3) (relating to Medicaid), paragraph (1) shall not apply to
any individual who lawfully resides in the United States (including territories
and possessions of the United States) in accordance with a Compact of Free
Association referred to in subsection
(a)(2)(M).</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H31EBD01DA4A044588E12746BFBE4D8C1"><enum>(c)</enum><header>Qualified
Alien</header><text>Section 431(b) of the Personal Responsibility and Work
Opportunity Reconciliation Act of 1996 (<external-xref legal-doc="usc" parsable-cite="usc/8/1641">8 U.S.C. 1641(b)</external-xref>) is amended—</text>
<paragraph id="H6F298866E4F0428FBE35F286431E1EF3"><enum>(1)</enum><text>in paragraph (6),
by striking <quote>or</quote> at the end;</text>
</paragraph><paragraph id="H0BF0F1E5350F4E3D827B9940EC2780CF"><enum>(2)</enum><text>in paragraph (7),
by striking the period at the end and inserting <quote>; or</quote>; and</text>
</paragraph><paragraph id="H086543959AE148578D00F0ED55433483"><enum>(3)</enum><text>by adding at the
end the following:</text>
<quoted-block id="H416B466D8B834BB58CA223723DAEFBE0" style="OLC">
<paragraph id="HE45486021D914E7DB7E85C4EB1CB00A"><enum>(8)</enum><text>an individual who
lawfully resides in the United States (including territories and possessions of
the United States) in accordance with a Compact of Free Association referred to
in section
402(a)(2)(M).</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="HCB253CDCCCE442B396F2660007D8E0C4"><enum>(d)</enum><header>Financial
Treatment Under Medicaid</header><text>Section 1108 of the Social Security Act
(<external-xref legal-doc="usc" parsable-cite="usc/42/1308">42 U.S.C. 1308</external-xref>) is amended—</text>
<paragraph id="H1DC77A31AED04DBDB8EC4D13A7C0CD94"><enum>(1)</enum><text>in subsection (f),
by striking <quote>subsection (g)</quote> and inserting <quote>subsections (g)
and (h)</quote>; and</text>
</paragraph><paragraph id="HC9DF80A03B6F48F9A971606089DCD12"><enum>(2)</enum><text>by
adding at the end the following new subsection:</text>
<quoted-block id="H4F1108516670463700B1D0E3810078BA" style="OLC">
<subsection id="H317F0B08CFD6498300B4E6A407395E77"><enum>(h)</enum><text>The limitations of
subsections (f) and (g) shall not apply with respect to medical assistance
provided to an individual described in section 431(b)(8) of the Personal
Responsibility and Work Opportunity Reconciliation Act of
1996.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H0E3318511B2B4555A3B7A0335A372B76"><enum>(e)</enum><header>Increased
FMAP</header><text>The third sentence of section 1905(b) of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
1396d(b)) is amended by inserting before the period at the end the following:
<quote>and for services furnished to individuals described in section 431(b)(8)
of the Personal Responsibility and Work Opportunity Reconciliation Act of
1996</quote>.</text>
</subsection></section><section id="H1FC8A669CB984ECFBE01397185ABE4C1"><enum>508.</enum><header>Medicare
graduate medical education</header>
<subsection id="HA5746C70FEDD430BB6374F29C255D7D9"><enum>(a)</enum><header>Clarification of
Congressional Intent Regarding the Counting of Residents in a Nonhospital
Setting</header>
<paragraph id="HEDBBBE37D86F42FEAC5B41BB64A5D8F5"><enum>(1)</enum><header>D-GME</header><text>Section
1886(h)(4)(E) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395ww">42 U.S.C. 1395ww(h)(4)(E)</external-xref>) is amended
by adding at the end the following new sentences: <quote>For purposes of the
preceding sentence, the term <term>all, or substantially all, of the costs for
the training program</term> means the stipends and benefits provided to the
resident and other amounts, if any, as determined by the hospital and the
entity operating the nonhospital setting. The hospital is not required to pay
the entity any amounts other than those determined by the hospital and the
entity in order for the hospital to be considered to have incurred all, or
substantially all, of the costs for the training program in that
setting.</quote>.</text>
</paragraph><paragraph display-inline="no-display-inline" id="H8E3753E070824FDA9EBA01FD72698585"><enum>(2)</enum><header>IME</header><text>Section
1886(d)(5)(B)(iv) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395ww">42 U.S.C. 1395ww(d)(5)(B)(iv)</external-xref>) is
amended by adding at the end the following new sentences: <quote>For purposes
of the preceding sentence, the term <term>all, or substantially all, of the
costs for the training program</term> means the stipends and benefits provided
to the resident and other amounts, if any, as determined by the hospital and
the entity operating the nonhospital setting. The hospital is not required to
pay the entity any amounts other than those determined by the hospital and the
entity in order for the hospital to be considered to have incurred all, or
substantially all, of the costs for the training program in that
setting.</quote>.</text>
</paragraph><paragraph id="HFF0FCAD5CEB54D85BF3623D330AEBC35"><enum>(3)</enum><header>Effective
date</header><text>The amendments made by this subsection shall take effect on
January 1, 2008.</text>
</paragraph></subsection><subsection id="HEC44DFB2D40041FA8900334E00D1B8C"><enum>(b)</enum><header>Clarification of
eligibility of a nonrural hospital that has a training program with an
integrated rural track</header>
<paragraph id="HC7CEE8A55DDE43F58172F6F5692987E4"><enum>(1)</enum><header>In
general</header><text>Section 1886(h)(4)(H) of the Social Security Act (42
U.S.C. 1395ww(h)(4)(H)) is amended—</text>
<subparagraph id="H2CE92CC4D8B044E4A222CD3F99F0A13D"><enum>(A)</enum><text>in clause (iv), by
inserting <quote>(as defined in clause (v))</quote> after <quote>an integrated
rural track</quote>; and</text>
</subparagraph><subparagraph id="H14A754B60AFE4F69AC50153086828D00"><enum>(B)</enum><text>by adding at the
end the following new clause:</text>
<quoted-block id="H01F4BB596800490A8405FB6076EEFC6" style="OLC">
<clause id="HAE620C970A2840E492466F00F5009B06"><enum>(v)</enum><header>Definition of
accredited training program with an integrated rural track</header><text>For
purposes of clause (iv), the term <term>accredited training program with an
integrated rural track</term> means an accredited medical residency training
program located in an urban area which offers a curriculum for all residents in
the program that includes the following characteristics:</text>
<subclause id="HAF78FE950B9948B1B3D8F8C511DDE089"><enum>(I)</enum><text>A minimum of 3
block months of rural rotations. During such 3 block months, the resident is in
a rural area for 4 weeks or a month.</text>
</subclause><subclause id="HBE26407FB8DC44429569C15435223B4F"><enum>(II)</enum><text>A stated mission
for training rural physicians.</text>
</subclause><subclause id="H4A0FA4CDE6534BF1BE7031E0C8BD56BF"><enum>(III)</enum><text>A minimum of 3
months of obstetrical training, or an equivalent longitudinal
experience.</text>
</subclause><subclause id="HE6DB6679FD6E41098503576B43FE28A6"><enum>(IV)</enum><text>A minimum of 4
months of pediatric training that includes neonatal, ambulatory, inpatient, and
emergency experiences through rotations, or an equivalent longitudinal
experience.</text>
</subclause><subclause id="HBDA32DFA87684B10B52D221506944BB1"><enum>(V)</enum><text>A minimum of 2
months of emergency medicine rotations, or an equivalent longitudinal
experience.</text>
</subclause></clause><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H2C518B93F1674F07A97BF751E762F99F"><enum>(2)</enum><header>Effective
date</header><text>The amendments made by this subsection apply with respect
to—</text>
<subparagraph id="H0FC70461FBBF45D988ED5C94A684C0F3"><enum>(A)</enum><text>payments to
hospitals under section 1886(h) of the Social Security Act (42 U.S.C.
1395ww(h)) for cost reporting periods beginning on or after January 1, 2008;
and</text>
</subparagraph><subparagraph id="HA0D1F595B79D468CB626E177008C5000"><enum>(B)</enum><text>payments to
hospitals under section 1886(d)(5)(B)(v) of such Act (42 U.S.C.
1395ww(d)(5)(B)(v)) for discharges occurring on or after January 1,
2008.</text>
</subparagraph></paragraph></subsection></section><section commented="no" id="HFC3071CE463D451D9E47568F70C278E5"><enum>509.</enum><header>HIV/AIDS
reduction in racial and ethnic minority communities</header>
<subsection commented="no" id="HD6D6F2DF8B5A4609B89D3489FF84F52"><enum>(a)</enum><header>Expanded
funding</header><text>The Secretary, in collaboration with the Director of the
Office of Minority Health, the Director of the Centers for Disease Control and
Prevention, the Administrator of the Health Resources and Services
Administration, and the Administrator of the Substance Abuse and Mental Health
Services Administration, shall provide funds and carry out activities to expand
the Minority HIV/AIDS Initiative.</text>
</subsection><subsection commented="no" id="HCB7A12E704C84A939D587C9F01852C4B"><enum>(b)</enum><header>Use of
funds</header><text>The additional funds made available under this section may
be used, through the Minority AIDS Initiative, to support the following
activities:</text>
<paragraph commented="no" id="HF6A39157133A411291C39DEC2F6E7FBC"><enum>(1)</enum><text>Providing
technical assistance and infrastructure support to reduce HIV/AIDS in minority
populations.</text>
</paragraph><paragraph commented="no" id="H6A21FA869ED2474A9471C72DE138E9BA"><enum>(2)</enum><text>Increasing
minority populations’ access to HIV/AIDS prevention and care services.</text>
</paragraph><paragraph commented="no" id="H7D2ACACC9A12411FA3C3B1ABDD310003"><enum>(3)</enum><text>Building strong
community programs and partnerships to address HIV prevention and the health
care needs of specific racial and ethnic minority populations.</text>
</paragraph></subsection><subsection commented="no" id="H09CF73951DA044CCA4ECE4F0FF292D38"><enum>(c)</enum><header>Priority
interventions</header><text>Within the racial and ethnic minority populations
referred to in subsection (b), priority in conducting intervention services
shall be given to—</text>
<paragraph commented="no" id="H2825DBB32EA3489F91E9007B777141D4"><enum>(1)</enum><text>women;</text>
</paragraph><paragraph commented="no" id="HD71692F89B084F628DD9E20062A0099E"><enum>(2)</enum><text>youth;</text>
</paragraph><paragraph commented="no" id="HBA00306E52A04BC0B6B73DAF8E64DFD3"><enum>(3)</enum><text>men who engage in
homosexual activity;</text>
</paragraph><paragraph commented="no" id="H54806C4ED95A439CB34D183481CB0029"><enum>(4)</enum><text>persons who engage
in intravenous drug abuse;</text>
</paragraph><paragraph commented="no" id="H130FF3B022864B8D891186C9D3ABEB64"><enum>(5)</enum><text>homeless
individuals; and</text>
</paragraph><paragraph commented="no" id="HE053C2B84367460DAA029DD166ABC500"><enum>(6)</enum><text>individuals
incarcerated or in the penal system.</text>
</paragraph></subsection><subsection commented="no" id="H290C37D8F7544BA696B4E4537E7FFFDE"><enum>(d)</enum><header>Authorization of
appropriations</header><text>For carrying out this section, there are
authorized to be appropriated $610,000,0000 for fiscal year 2008 and such sums
as may be necessary for each of fiscal years 2009 through 2012.</text>
</subsection></section><section commented="no" id="H8817BD0530A24375B37E8C2D5C9D9EA7"><enum>510.</enum><header>Grants for
racial and ethnic approaches to community health</header>
<subsection commented="no" id="H8096B069BF9945A28C9F0096B9BD00D4"><enum>(a)</enum><header>Purpose</header><text>It
is the purpose of this section to provide for the awarding of grants to assist
communities in mobilizing and organizing resources in support of effective and
sustainable programs that will reduce or eliminate disparities in health and
health care experienced by racial and ethnic minority individuals.</text>
</subsection><subsection commented="no" id="H32BDC413F4C94F2EBEB9CF70D7217362"><enum>(b)</enum><header>Authority</header><text>The
Secretary, acting through the Director of the Centers for Disease Control and
Prevention, in consultation with the Office of Minority Health, shall award
grants to eligible entities to assist in designing, implementing, and
evaluating culturally and linguistically appropriate, evidence-based, and
community-driven sustainable strategies to eliminate racial and ethnic health
and health care disparities.</text>
</subsection><subsection commented="no" id="H7E43F393005146B58DEB50BB4B2C602D"><enum>(c)</enum><header>Eligible
Entities</header><text>To be eligible to receive a grant under this section, an
entity shall—</text>
<paragraph commented="no" id="HEDF7C35BB1EF487BAAA858D968C1A48"><enum>(1)</enum><text>represent a
coalition—</text>
<subparagraph commented="no" id="HCAE1D49AC51449C7B14B7756AD026033"><enum>(A)</enum><text>whose principal
purpose is to develop and implement interventions to reduce or eliminate a
health or health care disparity in a targeted racial or ethnic minority group
in the community served by the coalition; and</text>
</subparagraph><subparagraph commented="no" id="HCA8C3255357C45C8A1F235A8CA20A30"><enum>(B)</enum><text>that
includes—</text>
<clause commented="no" id="H28A22E8F63154A26B1453C77053872BA"><enum>(i)</enum><text>at least 3 members
selected from among—</text>
<subclause commented="no" id="HA60CD2D92EB84D878B81171869D534E6"><enum>(I)</enum><text>public health
departments;</text>
</subclause><subclause commented="no" id="H1D3FFA41FBD044029B85D456D1622CDE"><enum>(II)</enum><text>community-based
organizations;</text>
</subclause><subclause commented="no" id="H88776FAA84214E17B221D42D1900C5BB"><enum>(III)</enum><text>university and
research organizations;</text>
</subclause><subclause commented="no" id="H0AF0232EC2464F6AAEDE00C9F7F9A4A3"><enum>(IV)</enum><text>Indian tribes,
tribal organizations, urban Indian organizations, national or regional Indian
organizations, or the Indian Health Service;</text>
</subclause><subclause commented="no" id="HFAF677470F2642008790FBC52BE7DAC4"><enum>(V)</enum><text>organizations
serving Native Hawaiians;</text>
</subclause><subclause commented="no" id="H5CB42943923C4572B91C521E3B2495C5"><enum>(VI)</enum><text>organizations
serving Pacific Islanders; and</text>
</subclause><subclause commented="no" id="H600DB7266DC74037993712FC84D7363B"><enum>(VII)</enum><text>interested
public or private health care providers or organizations as deemed appropriate
by the Secretary; and</text>
</subclause></clause><clause commented="no" id="HFD842B9229414AB3A3ACC02F699758DB"><enum>(ii)</enum><text>at least 1 member
from a community-based organization that represents the targeted racial or
ethnic minority group; and</text>
</clause></subparagraph></paragraph><paragraph commented="no" id="H3543F429EA764168BCC453E5817587AB"><enum>(2)</enum><text>submit to the
Secretary an application at such time, in such manner, and containing such
information as the Secretary may require, which shall include—</text>
<subparagraph commented="no" id="HB60CB0A24B574142BBBEE5B3018CB4B2"><enum>(A)</enum><text>a description of
the targeted racial or ethnic populations in the community to be served under
the grant;</text>
</subparagraph><subparagraph commented="no" id="H17B97F14DBBB4785AB7FDADCD0CE408D"><enum>(B)</enum><text>a description of
at least 1 health disparity that exists in the racial or ethnic targeted
populations, including infant mortality, breast and cervical cancer screening
and management, cardiovascular disease, diabetes, child and adult immunization
levels, HIV/AIDS, hepatitis B, tuberculosis, or asthma, or other health
priority areas as designated by the Secretary; and</text>
</subparagraph><subparagraph commented="no" id="H6A0D8CDD9EBD4E61BDE7E9F661B683ED"><enum>(C)</enum><text>a demonstration of
a proven record of accomplishment of the coalition members in serving and
working with the targeted community.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="H867E5D9B20FC457FA6B4B7E9A960FC87"><enum>(d)</enum><header>Sustainability</header><text>The
Secretary shall give priority to an eligible entity under this section if the
entity agrees that, with respect to the costs to be incurred by the entity in
carrying out the activities for which the grant was awarded, the entity (and
each of the participating partners in the coalition represented by the entity)
will maintain its expenditures of non-Federal funds for such activities at a
level that is not less than the level of such expenditures during the fiscal
year immediately preceding the first fiscal year for which the grant is
awarded.</text>
</subsection><subsection commented="no" id="HCD295615315B4A9E9B37C79E8FE3A99F"><enum>(e)</enum><header>Nonduplication</header><text>Funds
provided through this grant program should supplement, not supplant, existing
Federal funding, and the funds should not be used to duplicate the activities
of the other health disparity grant programs in this Act.</text>
</subsection><subsection commented="no" id="H6273E65A15174A05BAA7F8CCA4151586"><enum>(f)</enum><header>Technical
Assistance</header><text>The Secretary may, either directly or by grant or
contract, provide any entity that receives a grant under this section with
technical and other non-financial assistance necessary to meet the requirements
of this section.</text>
</subsection><subsection commented="no" id="HFF311A1AEA33470C91B99072BE98F87C"><enum>(g)</enum><header>Dissemination</header><text>The
Secretary shall encourage and enable grantees to share best practices,
evaluation results, and reports using the Internet, conferences, and other
pertinent information regarding the projects funded by this section, including
the outreach efforts of the Office of Minority Health and the Centers for
Disease Control and Prevention. Such information shall be publicly available,
and posted on the Internet website of relevant Government agencies.</text>
</subsection><subsection commented="no" id="H206BBE641AE94975B534EDEF011164C8"><enum>(h)</enum><header>Administrative
Burdens</header><text>The Secretary shall make every effort to minimize
duplicative or unnecessary administrative burdens on grantees.</text>
</subsection></section><section display-inline="no-display-inline" id="HD6ADB363BB774684AB592F1871009400" section-type="subsequent-section"><enum>511.</enum><header>Critical access
hospital improvements</header>
<subsection id="HE99B317B6E02442084D5DD1C98B4657B"><enum>(a)</enum><header>Clarification of
payment for clinical laboratory tests furnished by critical access
hospitals</header>
<paragraph id="H80434F776A984063A1686381C8CA19CA"><enum>(1)</enum><header>In
general</header><text>Section 1834(g)(4) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395m">42 U.S.C. 1395m(g)(4)</external-xref>) is
amended—</text>
<subparagraph id="H9FA7D7BDE5024C6EB3DCEBDB64EFF208"><enum>(A)</enum><text>in the heading, by
striking <quote><header-in-text level="paragraph" style="OLC">no beneficiary
cost-sharing</header-in-text></quote> and inserting <quote><header-in-text level="paragraph" style="OLC">treatment of</header-in-text></quote>; and</text>
</subparagraph><subparagraph id="H67F3DF5036C640BC82F8F200E4BC6389"><enum>(B)</enum><text>by adding at the
end the following new sentence: “For purposes of the preceding sentence and
section 1861(mm)(3), clinical diagnostic laboratory services furnished by a
critical access hospital shall be treated as being furnished as part of
outpatient critical access services without regard to whether—</text>
<quoted-block id="H5FC0E9C53FF64DB38405274619CA3E04">
<subparagraph id="HF7660EB0319D4833B44F938FDB099272"><enum>(A)</enum><text>the individual
with respect to whom such services are furnished is physically present in the
critical access hospital at the time the specimen is collected;</text>
</subparagraph><subparagraph id="H59A58219613F4EF9BECEE25E9DFB2271"><enum>(B)</enum><text>such individual is
registered as an outpatient on the records of, and receives such services
directly from, the critical access hospital; or</text>
</subparagraph><subparagraph id="HE25C33827177473281FB09B97CC1F2D5"><enum>(C)</enum><text>payment is (or,
but for this subsection, would be) available for such services under the fee
schedule established under section
1833(h).</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H87D76E59A2E6478790439291E0F5B45F"><enum>(2)</enum><header>Effective
date</header><text>The amendments made by paragraph (1) shall apply to cost
reporting periods beginning on or after October 1, 2008.</text>
</paragraph></subsection><subsection id="HE3C0CE472EBD45158E4DD6AE1B1382D8"><enum>(b)</enum><header>Elimination of
isolation Test for cost-based ambulance reimbursement</header>
<paragraph id="H86301DE364D64F68A055912C8ED39166"><enum>(1)</enum><header>In
general</header><text>Section 1834(l)(8) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395m">42 U.S.C. 1395m(l)(8)</external-xref>) is
amended—</text>
<subparagraph id="H1915BEA69F2142C1972F8607F5D5736D"><enum>(A)</enum><text>in subparagraph
(B)—</text>
<clause id="HC5644F2999E744E4B363BE3BC7D20524"><enum>(i)</enum><text>by
striking <quote>owned and</quote>; and</text>
</clause><clause id="HD9F1428642F54715981E2521048E6819"><enum>(ii)</enum><text>by
inserting <quote>(including when such services are provided by the entity under
an arrangement with the hospital)</quote> after <quote>hospital</quote>;
and</text>
</clause></subparagraph><subparagraph id="H0F7C1578EB674D5CA9E333D39F19CEC"><enum>(B)</enum><text>by striking the
comma at the end of subparagraph (B) and all that follows and inserting a
period.</text>
</subparagraph></paragraph><paragraph id="H0874EC86E63044A299C29C00B099D21"><enum>(2)</enum><header>Effective
date</header><text>The amendments made by this subsection shall apply to
services furnished on or after January 1, 2008.</text>
</paragraph></subsection><subsection display-inline="no-display-inline" id="HAE88E389CCEB4408810361AB5B003979"><enum>(c)</enum><header>Provision of a
more flexible alternative to the CAH designation 25 inpatient bed limit
requirement</header>
<paragraph id="H285DD556917445CA86C17C92502BD53C"><enum>(1)</enum><header>In
general</header><text>Section 1820(c)(2) of the Social Security Act (42 U.S.C.
1395i–4(c)(2)) is amended—</text>
<subparagraph id="H7B42F67023014553AD2F5FF8A0F532E"><enum>(A)</enum><text>in subparagraph
(B)(iii), by striking <quote>provides not more than</quote> and inserting
<quote>subject to subparagraph (F), provides not more than</quote>; and</text>
</subparagraph><subparagraph id="HAF0765029297438C927FF522CFFC33B"><enum>(B)</enum><text>by adding at the
end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H55C7300B6EC845FEB56F0025AA6206D4" style="OLC">
<subparagraph id="HD0CEC7DA5FA44F5FA414B397BAD2CE7"><enum>(F)</enum><header>Alternative to 25
inpatient bed limit requirement</header>
<clause id="HC3CE9E4B98C34796A2898BC009E96B21"><enum>(i)</enum><header>In
general</header><text display-inline="yes-display-inline">A State may elect to
treat a facility, with respect to the designation of the facility for a cost
reporting period, as satisfying the requirement of subparagraph (B)(iii)
relating to a maximum number of acute care inpatient beds if the facility
elects, in accordance with a method specified by the Secretary and before the
beginning of the cost reporting period, to meet the requirement under clause
(ii).</text>
</clause><clause id="HFBD5BCF8BD8B40EF9CE114CAFB0500B"><enum>(ii)</enum><header>Alternate
requirement</header><text>The requirement under this clause, with respect to a
facility and a cost reporting period, is that the total number of inpatient bed
days described in subparagraph (B)(iii) during such period will not exceed
7,300. For purposes of this subparagraph, an individual who is an inpatient in
a bed in the facility for a single day shall be counted as one inpatient bed
day.</text>
</clause><clause id="HE154C3A107304DD7BB83B97DFECCB381"><enum>(iii)</enum><header>Withdrawal of
election</header><text>The option described in clause (i) shall not apply to a
facility for a cost reporting period if the facility (for any two consecutive
cost reporting periods during the previous 5 cost reporting periods) was
treated under such option and had a total number of inpatient bed days for each
of such two cost reporting periods that exceeded the number specified in such
clause.</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H482B337066E64728A5DA582900FE4C09"><enum>(2)</enum><header>Effective
date</header><text>The amendments made by paragraph (1) shall apply to cost
reporting periods beginning on or after the date of the enactment of this
Act.</text>
</paragraph></subsection></section><section display-inline="no-display-inline" id="HC9305D0637A64587BB79A30078B2F62E" section-type="subsequent-section"><enum>512.</enum><header>Coverage of marriage
and family therapist services and mental health counselor services under part
<enum-in-header>B</enum-in-header> of the Medicare program</header>
<subsection id="H42E77AF17807471AB0546C4F9CDA86E3"><enum>(a)</enum><header>Coverage of
Services</header>
<paragraph id="H4F9B8E1CFF244D88866184D3C42062FF"><enum>(1)</enum><header>In
general</header><text>Section 1861(s)(2) of the <act-name parsable-cite="SSA">Social Security Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(s)(2)</external-xref>) is
amended—</text>
<subparagraph id="HBC650F7436494ED79152881B720940E8"><enum>(A)</enum><text>in subparagraph
(Z), by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="H67454FD6255E426489A5B3BA6AE54DD"><enum>(B)</enum><text>in subparagraph
(AA), by inserting <quote>and</quote> at the end; and</text>
</subparagraph><subparagraph id="HAAEE408106C748B99DECDD63CE0647E0"><enum>(C)</enum><text>by adding at the
end the following new subparagraph:</text>
<quoted-block id="HD61ED68504C84723AF7E3C5E3987CF66" style="OLC">
<subitem id="H918BB65FECE7437ABCCE84023316C9FF" indent="up5"><enum>(BB)</enum><text>marriage and family therapist
services (as defined in subsection (ccc)(1)) and mental health counselor
services (as defined in subsection
(ccc)(3));</text>
</subitem><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H44BF5D9FBA344521BADE2DAE81A5072F"><enum>(2)</enum><header>Definitions</header><text>Section
1861 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x</external-xref>) is amended by adding at the end the
following new subsection:</text>
<quoted-block act-name="Social" id="HAE530A99A52D4A3B91CEAC8152009630" other-style="archaic" style="other"><subsection id="H7508AD1DB6D24BBEACA2419FCF0E4FD"><enum>(ccc)</enum><header>Marriage and Family
Therapist Services; Marriage and Family Therapist; Mental Health Counselor
Services; Mental Health Counselor</header><paragraph commented="no" display-inline="yes-display-inline" id="H4C1237574DAC4EB8BB892D6E21EB2021"><enum>(1)</enum><text>The term <term>marriage
and family therapist services</term> means services performed by a marriage and
family therapist (as defined in paragraph (2)) for the diagnosis and treatment
of mental illnesses, which the marriage and family therapist is legally
authorized to perform under State law (or the State regulatory mechanism
provided by State law) of the State in which such services are performed, as
would otherwise be covered if furnished by a physician or as an incident to a
physician’s professional service, but only if no facility or other provider
charges or is paid any amounts with respect to the furnishing of such
services.</text>
</paragraph><paragraph id="H59713D9846D44986BB24032DAB027455" indent="up1"><enum>(2)</enum><text>The term <term>marriage and family
therapist</term> means an individual who—</text>
<subparagraph id="HA2A4B06FB24F40ADAAD9105F00DA1991"><enum>(A)</enum><text>possesses a master’s or doctoral
degree which qualifies for licensure or certification as a marriage and family
therapist pursuant to State law;</text>
</subparagraph><subparagraph id="HBDB83416B7314D8F9EE4A5906E44F40"><enum>(B)</enum><text>after obtaining such degree has
performed at least 2 years of clinical supervised experience in marriage and
family therapy; and</text>
</subparagraph><subparagraph id="HB49AF1A9F18F4BBBB94235054DB4C567"><enum>(C)</enum><text>in the case of an individual
performing services in a State that provides for licensure or certification of
marriage and family therapists, is licensed or certified as a marriage and
family therapist in such State.</text>
</subparagraph></paragraph><paragraph id="H17E126B9BE7040089B00FDEE5063922C" indent="up1"><enum>(3)</enum><text>The term <term>mental health
counselor services</term> means services performed by a mental health counselor
(as defined in paragraph (4)) for the diagnosis and treatment of mental
illnesses which the mental health counselor is legally authorized to perform
under State law (or the State regulatory mechanism provided by the State law)
of the State in which such services are performed, as would otherwise be
covered if furnished by a physician or as incident to a physician’s
professional service, but only if no facility or other provider charges or is
paid any amounts with respect to the furnishing of such services.</text>
</paragraph><paragraph id="H7F2C0820960B482DAB941E1BB0F6B5B4" indent="up1"><enum>(4)</enum><text>The term <term>mental health
counselor</term> means an individual who—</text>
<subparagraph id="HE9A48847B9EC494C8279C407E43EB223"><enum>(A)</enum><text>possesses a master’s or doctor’s
degree in mental health counseling or a related field;</text>
</subparagraph><subparagraph id="HA60A9492441144ABB76C688D46D9A701"><enum>(B)</enum><text>after obtaining such a degree has
performed at least 2 years of supervised mental health counselor practice;
and</text>
</subparagraph><subparagraph id="HDC462146B9154FD1A06B28CD1EA42C22"><enum>(C)</enum><text>in the case of an individual
performing services in a State that provides for licensure or certification of
mental health counselors or professional counselors, is licensed or certified
as a mental health counselor or professional counselor in such
State.</text>
</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H75B4F7F615534B028BFD8CDF9FC63413"><enum>(3)</enum><header>Provision for
payment under part B</header><text>Section 1832(a)(2)(B) of such Act (42 U.S.C.
1395k(a)(2)(B)) is amended by adding at the end the following new
clause:</text>
<quoted-block act-name="Social" id="HCCA321C3BC3A4533ABA251A1EE6F005B" style="OLC">
<clause id="H0796871EBF264520873E058BD2FCFA7E"><enum>(v)</enum><text>marriage and
family therapist services and mental health counselor
services;</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H938A9A2EC9D04541859B94077EE0B454"><enum>(4)</enum><header>Amount of
payment</header><text>Section 1833(a)(1) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(a)(1)</external-xref>) is
amended—</text>
<subparagraph id="HFBBCF7A6D3E64F07BDF35963CD36142C"><enum>(A)</enum><text>by striking
<quote>and (V)</quote> and inserting <quote>(V)</quote>; and</text>
</subparagraph><subparagraph id="H5F442280B9F749A98B7275B3AD17E1A1"><enum>(B)</enum><text>by inserting
before the semicolon at the end the following: <quote>, and (W) with respect to
marriage and family therapist services and mental health counselor services
under section 1861(s)(2)(BB), the amounts paid shall be 80 percent of the
lesser of the actual charge for the services or 75 percent of the amount
determined for payment of a psychologist under subparagraph (L)</quote>.</text>
</subparagraph></paragraph><paragraph id="H8FA6AF0ECD20450F988792D785695BAE"><enum>(5)</enum><header>Exclusion of
marriage and family therapist services and mental health counselor services
from skilled nursing facility prospective payment system</header><text>Section
1888(e)(2)(A)(ii) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395yy">42 U.S.C. 1395yy(e)(2)(A)(ii)</external-xref>) is amended by
inserting <quote>marriage and family therapist services (as defined in section
1861(ccc)(1)), mental health counselor services (as defined in section
1861(ccc)(3)),</quote> after <quote>qualified psychologist
services,</quote>.</text>
</paragraph><paragraph id="H609DFB94238E4F4EA1785E389DB28B2D"><enum>(6)</enum><header>Inclusion of
marriage and family therapists and mental health counselors as practitioners
for assignment of claims</header><text>Section 1842(b)(18)(C) of such Act (42
U.S.C. 1395u(b)(18)(C)) is amended by adding at the end the following new
clauses:</text>
<quoted-block act-name="Social" id="HEBEFF9604542412A8851B8E1B31D9DD8" style="OLC">
<clause id="H30CEE3794B9F4B77A8689EF0B3B4D7A2" indent="up2"><enum>(vii)</enum><text>A marriage and family therapist (as
defined in section 1861(ccc)(2)).</text>
</clause><clause id="H99CD2CD717F847DCA4514491EEB74CF" indent="up2"><enum>(viii)</enum><text>A mental health counselor (as
defined in section
1861(ccc)(4)).</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H2594E551F16B450F93B1C29E9EB94C44"><enum>(b)</enum><header>Coverage of
Certain Mental Health Services Provided in Certain Settings</header>
<paragraph id="HCC77BB0035B24BA3A743AE246C1E892"><enum>(1)</enum><header>Rural health
clinics and federally qualified health centers</header><text>Section
1861(aa)(1)(B) of the <act-name parsable-cite="SSA">Social Security
Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(aa)(1)(B)</external-xref>) is amended by striking <quote>or by
a clinical social worker (as defined in subsection (hh)(1)),</quote> and
inserting <quote>, by a clinical social worker (as defined in subsection
(hh)(1)), by a marriage and family therapist (as defined in subsection
(ccc)(2)), or by a mental health counselor (as defined in subsection
(ccc)(4)),</quote>.</text>
</paragraph><paragraph id="HE41F5F3360AE48A589F81BEBED298D1"><enum>(2)</enum><header>Hospice
programs</header><text>Section 1861(dd)(2)(B)(i)(III) of such Act (42 U.S.C.
1395x(dd)(2)(B)(i)(III)) is amended by inserting <quote>or one marriage and
family therapist (as defined in subsection (ccc)(2))</quote> after
<quote>social worker</quote>.</text>
</paragraph></subsection><subsection id="H4D62A4928FE047B6B6BDEBF69409C819"><enum>(c)</enum><header>Authorization of
Marriage and Family Therapists To Develop Discharge Plans for Post-Hospital
Services</header><text>Section 1861(ee)(2)(G) of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
1395x(ee)(2)(G)) is amended by inserting <quote>marriage and family therapist
(as defined in subsection (ccc)(2)),</quote> after <quote>social
worker,</quote>.</text>
</subsection><subsection id="HA6CF99863AD34A4FBA5DE2B90000FAE3"><enum>(d)</enum><header>Effective
Date</header><text>The amendments made by this section shall apply with respect
to services furnished on or after January 1, 2008.</text>
</subsection></section><section display-inline="no-display-inline" id="H220BB889FAE34B7FB691632415C32C40" section-type="subsequent-section"><enum>513.</enum><header>Establishment of
rural community hospital (RCH) program</header>
<subsection id="HAD64E040C975437A93C060FE225B6B73"><enum>(a)</enum><header>In
general</header><text>Section 1861 of the Social Security Act (42 U.S.C.
1395x), as amended by section 512, is amended by adding at the end of the
following new subsection:</text>
<quoted-block act-name="" display-inline="no-display-inline" id="H5C52C55DE3D74A349FB774F83FC1D605" other-style="archaic" style="other">
<subsection id="H2F46D7C1A031419FAEAA4303A447E40"><enum>(ddd)</enum><header>Rural community Hospital; Rural Community Hospital
Services</header><paragraph commented="no" display-inline="yes-display-inline" id="HCB92518B82F04ED2BF4800CEBA00AD01"><enum>(1)</enum><text>The term <term>rural
community hospital</term> means a hospital (as defined in subsection (e))
that—</text>
<subparagraph id="HEBD5075B8C9A44A8BC87BC39CDF84E00" indent="up1"><enum>(A)</enum><text>is located in a rural area (as defined
in section 1886(d)(2)(D)) or treated as being so located pursuant to section
1886(d)(8)(E);</text>
</subparagraph><subparagraph id="H7F044E6AA21443BAB200049F8C6F3F5D" indent="up1"><enum>(B)</enum><text>subject to paragraph (2), has less
than 51 acute care inpatient beds, as reported in its most recent cost
report;</text>
</subparagraph><subparagraph id="H0F3D3B2AB47A4A9280D8CB5902B126A6" indent="up1"><enum>(C)</enum><text>makes available 24-hour emergency care
services;</text>
</subparagraph><subparagraph id="H674D0909D183425F8467D342F7A233A4" indent="up1"><enum>(D)</enum><text>subject to paragraph (3), has a
provider agreement in effect with the Secretary and is open to the public as of
January 1, 2008; and</text>
</subparagraph><subparagraph id="HE0DF89BAA63C46DA9737F280539B4285" indent="up1"><enum>(E)</enum><text>applies to the Secretary for such
designation.</text>
</subparagraph></paragraph><paragraph id="HC348FD46F03147479E843300EC872E8" indent="up1"><enum>(2)</enum><text>For purposes of paragraph (1)(B),
beds in a psychiatric or rehabilitation unit of the hospital which is a
distinct part of the hospital shall not be counted.</text>
</paragraph><paragraph id="H721EB29AF0F04120B99117B583E32BF4" indent="up1"><enum>(3)</enum><text>Subparagraph (1)(D) shall not be
construed to prohibit any of the following from qualifying as a rural community
hospital:</text>
<subparagraph id="HF7F17D462137435095AB138CF0023700"><enum>(A)</enum><text>A replacement facility (as defined by
the Secretary in regulations in effect on January 1, 2008) with the same
service area (as defined by the Secretary in regulations in effect on such
date).</text>
</subparagraph><subparagraph id="H08F82F5FCB9C46E9BCCB8407B14562BD"><enum>(B)</enum><text>A facility obtaining a new provider
number pursuant to a change of ownership.</text>
</subparagraph><subparagraph id="H98D8F3EEC49641319C11988D266687DA"><enum>(C)</enum><text>A facility which has a binding written
agreement with an outside, unrelated party for the construction,
reconstruction, lease, rental, or financing of a building as of January 1,
2008.</text>
</subparagraph></paragraph><paragraph id="H4E999414D4904496B9E5E8108C45F0A8" indent="up1"><enum>(4)</enum><text>Nothing in this subsection shall be
construed as prohibiting a critical access hospital from qualifying as a rural
community hospital if the critical access hospital meets the conditions
otherwise applicable to hospitals under subsection (e) and section 1866.</text>
</paragraph><paragraph id="HBA8C05A5D651432E82999B38EA0008" indent="up1"><enum>(5)</enum><text>Nothing in this subsection shall be
construed as prohibiting a rural community hospital participating in the
demonstration program under Section 410A of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (<external-xref legal-doc="public-law" parsable-cite="pl/108/173">Public Law 108–173</external-xref>; 117 Stat. 2313)
from qualifying as a rural community hospital if the rural community hospital
meets the conditions otherwise applicable to hospitals under subsection (e) and
section
1866.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H73E865A9A2C44A8690ECB4E4E39F81C0"><enum>(b)</enum><header>Payment</header>
<paragraph id="H400210CD5F2649A5AA268D844F54F738"><enum>(1)</enum><header>Inpatient
hospital services</header><text>Section 1814 of the Social Security Act (42
U.S.C. 1395f) is amended by adding at the end the following new
subsection:</text>
<quoted-block act-name="" display-inline="no-display-inline" id="HCD202D38A4274AA3A0EDC80096CE4808" other-style="archaic" style="other">
<subsection id="HF1A3DA64BB3E43D4A780CA865299FC75"><enum>(m)</enum><header>Payment for Inpatient Services Furnished in Rural Community
Hospitals</header><text>The amount of
payment under this part for inpatient hospital services furnished in a rural
community hospital, other than such services furnished in a psychiatric or
rehabilitation unit of the hospital which is a distinct part, is, at the
election of the hospital in the application referred to in section
1861(ddd)(1)(E)—</text>
<paragraph id="H7B0796E512A646B1AE2C7DB495B61CE2"><enum>(1)</enum><text>101 percent of the
reasonable costs of providing such services, without regard to the amount of
the customary or other charge, or</text>
</paragraph><paragraph id="H725EBAD5A00C455DAC828615AB27DCE8"><enum>(2)</enum><text>the amount of
payment provided for under the prospective payment system for inpatient
hospital services under section
1886(d).</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H1148DFCF9A9146E0948F8964C050CA2C"><enum>(2)</enum><header>Outpatient
services</header><text>Section 1834 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395m">42 U.S.C. 1395m</external-xref>) is amended by
adding at the end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="H880A819035124EA884FED26D207005E" style="OLC">
<subsection id="HB9ABF871054948C7884C4877B6004CC"><enum>(n)</enum><header>Payment for
outpatient services furnished in rural community hospitals</header><text>The
amount of payment under this part for outpatient services furnished in a rural
community hospital is, at the election of the hospital in the application
referred to in section 1861(ddd)(1)(E)—</text>
<paragraph id="H940C6BBD2E054A46B19997AB76E675C8"><enum>(1)</enum><text>101 percent of the
reasonable costs of providing such services, without regard to the amount of
the customary or other charge and any limitation under section 1861(v)(1)(U),
or</text>
</paragraph><paragraph id="H328C7FE4101446F38E16AE4203D1B1DE"><enum>(2)</enum><text>the amount of
payment provided for under the prospective payment system for covered OPD
services under section
1833(t).</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H6A139F805C544CBBAC67A9670091836F"><enum>(3)</enum><header>Exemption from
30-percent reduction in reimbursement for bad debt</header><text>Section
1861(v)(1)(T) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(v)(1)(T)</external-xref>) is amended by inserting
<quote>(other than for a rural community hospital)</quote> after <quote>In
determining such reasonable costs for hospitals</quote>.</text>
</paragraph></subsection><subsection id="H19065B0F286041D08225EA4CB8104614"><enum>(c)</enum><header>Beneficiary
cost-sharing for outpatient services</header><text>Section 1834(n) of such Act
(as added by subsection (b)(2)) is amended—</text>
<paragraph id="H3FE616EE68544A69B905F484FD7B58D"><enum>(1)</enum><text>by
redesignating paragraphs (1) and (2) as subparagraphs (A) and (B),
respectively;</text>
</paragraph><paragraph id="H8F4B864DC9B74E958F245E76C1E75D1"><enum>(2)</enum><text>by
inserting <quote>(1)</quote> after <quote>(n)</quote>; and</text>
</paragraph><paragraph id="H53ED1F3CFA524E6B8C256D86DB1BB460"><enum>(3)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="H5E0CFD336F064427962EB10003CD4BB6" style="OLC">
<paragraph id="HE20BBD2028FC45FB9EFB07F571460464" indent="up1"><enum>(2)</enum><text>The amounts of beneficiary
cost-sharing for outpatient services furnished in a rural community hospital
under this part shall be as follows:</text>
<subparagraph id="H6EE8D7B765B844689DDBB74E69B62EFF"><enum>(A)</enum><text>For items and services that would have
been paid under section 1833(t) if provided by a hospital, the amount of
cost-sharing determined under paragraph (8) of such section.</text>
</subparagraph><subparagraph id="HDB7CCB37574343D183078C4BB5DC075"><enum>(B)</enum><text>For items and services that would have
been paid under section 1833(h) if furnished by a provider or supplier, no
cost-sharing shall apply.</text>
</subparagraph><subparagraph id="H4A76361F8686409D96C7256F33A24293"><enum>(C)</enum><text>For all other items and services, the
amount of cost-sharing that would apply to the item or service under the
methodology that would be used to determine payment for such item or service if
provided by a physician, provider, or supplier, as the case may
be.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H5254A17DF31B4C39B6A8C99EA664EAFD"><enum>(d)</enum><header>Conforming
amendments</header>
<paragraph id="H6D3D92B014A14DA2A84F549B987DB4FC"><enum>(1)</enum><header>Part a
payment</header><text>Section 1814(b) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395f">42 U.S.C. 1395f(b)</external-xref>) is
amended in the matter preceding paragraph (1) by inserting <quote>other than
inpatient hospital services furnished by a rural community hospital,</quote>
after <quote>critical access hospital services,</quote>.</text>
</paragraph><paragraph id="H1C0D2C9A23864F0FAFFB7E3CAFB8335"><enum>(2)</enum><header>Part B
payment</header><text>Section 1833(a) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l(a)</external-xref>) is
amended—</text>
<subparagraph id="H79D0AFDA96354BC68889A83020DE6FDE"><enum>(A)</enum><text>in paragraph (2),
in the matter before subparagraph (A), by striking <quote>and (I)</quote> and
inserting <quote>(I), and (K)</quote>;</text>
</subparagraph><subparagraph id="HCB406B1B4A4D4805B729F9064805EF7E"><enum>(B)</enum><text>by striking
<quote>and</quote> at the end of paragraph (8);</text>
</subparagraph><subparagraph id="H83E8CC98A8E5487090ED4C3210729675"><enum>(C)</enum><text>by striking the
period at the end of paragraph (9) and inserting <quote>; and</quote>;
and</text>
</subparagraph><subparagraph id="H6888A3B9178E4DF0AB50A2AAF43CC88"><enum>(D)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="HBC08CF7CC6624E9E98E76C2F46067EC" style="OLC">
<paragraph id="HDF41A9E3DB3642DD9D80ABCDEE23EB53"><enum>(10)</enum><text>in the case of
outpatient services furnished by a rural community hospital, the amounts
described in section
1834(n).</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H4EBE957E052D444CB8A8B0CDFDD1DC96"><enum>(3)</enum><header>Technical
amendments</header>
<subparagraph id="HEBFE66D8E979422C9CA32FEDB003D47"><enum>(A)</enum><header>Consultation with
state agencies</header><text>Section 1863 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395z">42 U.S.C. 1395z</external-xref>) is
amended by striking <quote>and (dd)(2)</quote> and inserting <quote>(dd)(2),
(mm)(1), and (ddd)(1)</quote>.</text>
</subparagraph><subparagraph id="H2A527C77888D4C758E3C50D623035079"><enum>(B)</enum><header>Provider
agreements</header><text>Section 1866(a)(2)(A) of such Act (42 U.S.C.
1395cc(a)(2)(A)) is amended by inserting <quote>section 1834(n)(2),</quote>
after <quote>section 1833(b),</quote>.</text>
</subparagraph></paragraph></subsection><subsection id="H657EB25F27904A2BBAC13C84C71B813"><enum>(e)</enum><header>Effective
date</header><text>The amendments made by this section shall apply to items and
services furnished on or after October 1, 2007.</text>
</subsection></section><section id="HFF41752D05324A3192CE3CFA22EC2015"><enum>514.</enum><header>Medicare remote
monitoring pilot projects</header>
<subsection id="H82A99B223A8F4102880044E8507E2F09"><enum>(a)</enum><header>Pilot
projects</header>
<paragraph id="HFF2C9E74B78C43B1A766153F147D00D0"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">Not later than 9
months after the date of enactment of this Act, the Secretary of Health and
Human Services (in this section referred to as the <quote>Secretary</quote>)
shall conduct pilot projects under title XVIII of the Social Security Act for
the purpose of providing incentives to home health agencies to utilize home
monitoring and communications technologies that—</text>
<subparagraph id="H7D8DF3A9FA554BBE8FFBA03962FEAB03"><enum>(A)</enum><text>enhance health
outcomes for Medicare beneficiaries; and</text>
</subparagraph><subparagraph id="H19C4E0CF6AFF4FDB80CD9B515BFC0174"><enum>(B)</enum><text>reduce
expenditures under such title.</text>
</subparagraph></paragraph><paragraph id="HCBAF90BF6B7E44C6BC00F5CD00B3BFE7"><enum>(2)</enum><header>Site
requirements</header>
<subparagraph id="H95B9AC27F21C4E44B3F7144441160079"><enum>(A)</enum><header>Urban and
Rural</header><text>The Secretary shall conduct the pilot projects under this
section in both urban and rural areas.</text>
</subparagraph><subparagraph id="HE5865D87C6FE4C79B1E965431619D946"><enum>(B)</enum><header>Site in a small
state</header><text>The Secretary shall conduct at least 3 of the pilot
projects in a State with a population of less than 1,000,000.</text>
</subparagraph></paragraph><paragraph id="H7A7898D9899E4DC3B6E2C56815ED576B"><enum>(3)</enum><header>Definition of
home health agency</header><text>In this section, the term <term>home health
agency</term> has the meaning given that term in section 1861(o) of the Social
Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(o)</external-xref>).</text>
</paragraph></subsection><subsection id="HF13418228AC74390BEDB669384094629"><enum>(b)</enum><header>Medicare
beneficiaries within the scope of projects</header><text>The Secretary shall
specify the criteria for identifying those Medicare beneficiaries who shall be
considered within the scope of the pilot projects under this section for
purposes of the application of subsection (c) and for the assessment of the
effectiveness of the home health agency in achieving the objectives of this
section. Such criteria may provide for the inclusion in the projects of
Medicare beneficiaries who begin receiving home health services under title
XVIII of the Social Security Act after the date of the implementation of the
projects.</text>
</subsection><subsection id="H9CA4B10E6D734486B5A900F8B9C8A953"><enum>(c)</enum><header>Incentives</header>
<paragraph id="H3A3ABB0EC1704BD4A7A6627C00D48712"><enum>(1)</enum><header>Performance
targets</header><text>The Secretary shall establish for each home health agency
participating in a pilot project under this section a performance target using
one of the following methodologies, as determined appropriate by the
Secretary:</text>
<subparagraph id="H783C61381B6B4C6EAAAEC3DB6B40B7ED"><enum>(A)</enum><header>Adjusted
historical performance target</header><text>The Secretary shall establish for
the agency—</text>
<clause id="HF3BFA2228F294FE4ACF9E5CF3B16C03E"><enum>(i)</enum><text>a
base expenditure amount equal to the average total payments made to the agency
under parts A and B of title XVIII of the Social Security Act for Medicare
beneficiaries determined to be within the scope of the pilot project in a base
period determined by the Secretary; and</text>
</clause><clause id="HB5016C86FAA34E17B25135AAA3C36F3"><enum>(ii)</enum><text>an
annual per capita expenditure target for such beneficiaries, reflecting the
base expenditure amount adjusted for risk and adjusted growth rates.</text>
</clause></subparagraph><subparagraph id="H2859BBD158E142DAA9327398DA586F98"><enum>(B)</enum><header>Comparative
performance target</header><text>The Secretary shall establish for the agency a
comparative performance target equal to the average total payments under such
parts A and B during the pilot project for comparable individuals in the same
geographic area that are not determined to be within the scope of the pilot
project.</text>
</subparagraph></paragraph><paragraph id="H79EF3A59AFE746CE89BC5DC82DD201BA"><enum>(2)</enum><header>Incentive</header><text>Subject
to paragraph (3), the Secretary shall pay to each participating home care
agency an incentive payment for each year under the pilot project equal to a
portion of the Medicare savings realized for such year relative to the
performance target under paragraph (1).</text>
</paragraph><paragraph id="HA0F43FBE08DF44BFB1AF0767578CD32"><enum>(3)</enum><header>Limitation on
expenditures</header><text>The Secretary shall limit incentive payments under
this section in order to ensure that the aggregate expenditures under title
XVIII of the Social Security Act (including incentive payments under this
subsection) do not exceed the amount that the Secretary estimates would have
been expended if the pilot projects under this section had not been
implemented.</text>
</paragraph></subsection><subsection id="HDD9181E878274C32B2F430A9546B2771"><enum>(d)</enum><header>Waiver
authority</header><text>The Secretary may waive such provisions of titles XI
and XVIII of the Social Security Act as the Secretary determines to be
appropriate for the conduct of the pilot projects under this section.</text>
</subsection><subsection id="H5CCEB77FFAD4473F8909B14C389BBF46"><enum>(e)</enum><header>Report to
Congress</header><text>Not later than 5 years after the date that the first
pilot project under this section is implemented, the Secretary shall submit to
Congress a report on the pilot projects. Such report shall contain a detailed
description of issues related to the expansion of the projects under subsection
(f) and recommendations for such legislation and administrative actions as the
Secretary considers appropriate.</text>
</subsection><subsection id="HF469A36686264246B0FD0363E69E2753"><enum>(f)</enum><header>Expansion</header><text>If
the Secretary determines that any of the pilot projects under this section
enhance health outcomes for Medicare beneficiaries and reduce expenditures
under title XVIII of the Social Security Act, the Secretary may initiate
comparable projects in additional areas.</text>
</subsection><subsection id="H702644821CF842B8B13D745D6CDC8182"><enum>(g)</enum><header>Incentive
payments have no effect on other Medicare payments to agencies</header><text>An
incentive payment under this section—</text>
<paragraph id="H851193BB90384B459192A8FD6B860568"><enum>(1)</enum><text>shall be in
addition to the payments that a home health agency would otherwise receive
under title XVIII of the Social Security Act for the provision of home health
services; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H6C2300C789CF4D8990892B06C5D387F"><enum>(2)</enum><text>shall have no
effect on the amount of such payments.</text>
</paragraph></subsection></section><section display-inline="no-display-inline" id="HBD046AFFC48A4EE7914FDA36552CB3AD" section-type="subsequent-section"><enum>515.</enum><header>Rural health quality
advisory commission and demonstration projects</header>
<subsection id="H60B2267ECF424D3D873EA53C96A2A332"><enum>(a)</enum><header>Rural Health
Quality Advisory Commission</header>
<paragraph id="H71C6D59BC9F741CDA33E27A51BC3F58F"><enum>(1)</enum><header>Establishment</header><text>Not
later than 6 months after the date of the enactment of this section, the
Secretary of Health and Human Services (in this section referred to as the
<quote>Secretary</quote>) shall establish a commission to be known as the Rural
Health Quality Advisory Commission (in this section referred to as the
<quote>Commission</quote>).</text>
</paragraph><paragraph id="HE3C89F08907546BF9FE267BF9C74B53C"><enum>(2)</enum><header>Duties of
commission</header>
<subparagraph id="H3110BAB246344CD78063C4C62973AF28"><enum>(A)</enum><header>National
plan</header><text>The Commission shall develop, coordinate, and facilitate
implementation of a national plan for rural health quality improvement. The
national plan shall—</text>
<clause id="HFA93B9E7FB79474AA695B98084FE003C"><enum>(i)</enum><text>identify
objectives for rural health quality improvement;</text>
</clause><clause id="H46BE9D29EAFA436F9ECE37486BBC21A9"><enum>(ii)</enum><text>identify
strategies to eliminate known gaps in rural health system capacity and improve
rural health quality; and</text>
</clause><clause id="H2AF977F76F544E1C95AEAF22EFD9E26"><enum>(iii)</enum><text>provide for
Federal programs to identify opportunities for strengthening and aligning
policies and programs to improve rural health quality.</text>
</clause></subparagraph><subparagraph id="H14020A6963EC47E688910485B869764D"><enum>(B)</enum><header>Demonstration
projects</header><text>The Commission shall design demonstration projects to
test alternative models for rural health quality improvement, including with
respect to both personal and population health.</text>
</subparagraph><subparagraph id="HA08948339A06401681FE52BC33D26DB"><enum>(C)</enum><header>Monitoring</header><text>The
Commission shall monitor progress toward the objectives identified pursuant to
paragraph (1)(A).</text>
</subparagraph></paragraph><paragraph id="H8FE8176ED4B843189C844136764907F"><enum>(3)</enum><header>Membership</header>
<subparagraph id="H8CDA5657D531489B8F887E00B17C33E7"><enum>(A)</enum><header>Number</header><text>The
Commission shall be composed of 11 members appointed by the Secretary.</text>
</subparagraph><subparagraph id="HFA14C5A092E2458E9E95E4EDF2C4D8C5"><enum>(B)</enum><header>Selection</header><text>The
Secretary shall select the members of the Commission from among individuals
with significant rural health care and health care quality expertise, including
expertise in clinical health care, health care quality research, population or
public health, or purchaser organizations.</text>
</subparagraph></paragraph><paragraph id="H11BF9500A735407283EA3B38C5367C51"><enum>(4)</enum><header>Contracting
authority</header><text>Subject to the availability of funds, the Commission
may enter into contracts and make other arrangements, as may be necessary to
carry out the duties described in paragraph (2).</text>
</paragraph><paragraph id="HE554C5CFA52441FDAF1D3CE703193632"><enum>(5)</enum><header>Staff</header><text>Upon
the request of the Commission, the Secretary may detail, on a reimbursable
basis, any of the personnel of the Office of Rural Health Policy of the Health
Resources and Services Administration, the Agency for Health Care Quality and
Research, or the Centers for Medicare & Medicaid Services to the
Commission to assist in carrying out this subsection.</text>
</paragraph><paragraph id="H6F24980E493944E1949D3822B9C04743"><enum>(6)</enum><header>Reports to
congress</header><text>Not later than 1 year after the establishment of the
Commission, and annually thereafter, the Commission shall submit a report to
the Congress on rural health quality. Each such report shall include the
following:</text>
<subparagraph id="H43C8CEB6FE074248A6E3556C413F3E6B"><enum>(A)</enum><text>An inventory of
relevant programs and recommendations for improved coordination and integration
of policy and programs.</text>
</subparagraph><subparagraph id="H6BB4C79FEBB342CEA93F4361ADDD1714"><enum>(B)</enum><text>An assessment of
achievement of the objectives identified in the national plan developed under
paragraph (2) and recommendations for realizing such objectives.</text>
</subparagraph><subparagraph id="H696EB98B3D964755A07110D6B630200"><enum>(C)</enum><text>Recommendations on
Federal legislation, regulations, or administrative policies to enhance rural
health quality and outcomes.</text>
</subparagraph></paragraph></subsection><subsection id="H0C99A9473A0B48DA99F94530C65E4206"><enum>(b)</enum><header>Rural Health
Quality Demonstration Projects</header>
<paragraph id="H526C38B9E7884ECE8E38CC4D0011B638"><enum>(1)</enum><header>In
general</header><text>Not later than 270 days after the date of the enactment
of this section, the Secretary, in consultation with the Rural Health Quality
Advisory Commission, the Office of Rural Health Policy of the Health Resources
and Services Administration, the Agency for Healthcare Research and Quality,
and the Centers for Medicare & Medicaid Services, shall make grants to
eligible entities for 5 demonstration projects to implement and evaluate
methods for improving the quality of health care in rural communities. Each
such demonstration project shall include—</text>
<subparagraph id="H6FB0B89E4BDC450EBDF1E8087682E0CF"><enum>(A)</enum><text>alternative
community models that—</text>
<clause id="H8A5BB7A1174F47F7A0ABE07E9758B4A0"><enum>(i)</enum><text>will
achieve greater integration of personal and population health services;
and</text>
</clause><clause id="H837CAEB4C4D548F39083754DAF1E89D1"><enum>(ii)</enum><text>address safety,
effectiveness, patient- or community-centeredness, timeliness, efficiency, and
equity (the six aims identified by the Institute of Medicine of the National
Academies in its report entitled <quote>Crossing the Quality Chasm: A New
Health System for the 21st Century</quote> released on March 1, 2001);</text>
</clause></subparagraph><subparagraph id="H4BAE64AE99E44B38B7E3DC9669CC877"><enum>(B)</enum><text>innovative
approaches to the financing and delivery of health services to achieve rural
health quality goals; and</text>
</subparagraph><subparagraph id="H1E7DA4F655454A15885239BBCD2ECF1"><enum>(C)</enum><text>development of
quality improvement support structures to assist rural health systems and
professionals (such as workforce support structures, quality monitoring and
reporting, clinical care protocols, and information technology
applications).</text>
</subparagraph></paragraph><paragraph id="HBE9BE70396B54625BD379C50C8262B93"><enum>(2)</enum><header>Eligible
entities</header><text>In this subsection, the term <term>eligible
entity</term> means a consortium that—</text>
<subparagraph id="HF50F4713DEAD4B9FB7D33578E18016A6"><enum>(A)</enum><text>shall
include—</text>
<clause id="H1FE5AB21D7144F38B8F09F02B677D8A0"><enum>(i)</enum><text>at
least one health care provider or health care delivery system located in a
rural area; and</text>
</clause><clause id="H9E94CF1C823A4038A4ADD6AB059C86AC"><enum>(ii)</enum><text>at
least one organization representing multiple community stakeholders; and</text>
</clause></subparagraph><subparagraph id="HE9B1C49939174300923858F9C005BB4"><enum>(B)</enum><text>may include other
partners such as rural research centers.</text>
</subparagraph></paragraph><paragraph id="H97C8A4E1412543E9AEFB6FEFBAA9D0F8"><enum>(3)</enum><header>Consultation</header><text>In
developing the program for awarding grants under this subsection, the Secretary
shall consult with the Administrator of the Agency for Healthcare Research and
Quality, rural health care providers, rural health care researchers, and
private and non-profit groups (including national associations) which are
undertaking similar efforts.</text>
</paragraph><paragraph id="H1A9C551018614398A680BF083C7D18FD"><enum>(4)</enum><header>Expedited
waivers</header><text>The Secretary shall expedite the processing of any waiver
that—</text>
<subparagraph id="H777152A5FBE34809B90050DFB3C78CF"><enum>(A)</enum><text>is authorized under
title XVIII or XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395 et seq.</external-xref>);
and</text>
</subparagraph><subparagraph id="H4702011271C04BFA85B4AF13793F5326"><enum>(B)</enum><text>is necessary to
carry out a demonstration project under this subsection.</text>
</subparagraph></paragraph><paragraph id="HA1AC36F28225423EB488BE5384E636E8"><enum>(5)</enum><header>Demonstration
project sites</header><text>The Secretary shall ensure that the 5 demonstration
projects funded under this subsection are conducted at a variety of sites
representing the diversity of rural communities in the Nation.</text>
</paragraph><paragraph id="HCAE928B23DB14EC8ADFC00BBF3AD68FD"><enum>(6)</enum><header>Duration</header><text>Each
demonstration project under this subsection shall be for a period of 4
years.</text>
</paragraph><paragraph id="H5CA8F62CEA0D4DCF91812207590054E2"><enum>(7)</enum><header>Independent
evaluation</header><text>The Secretary shall enter into an arrangement with an
entity that has experience working directly with rural health systems for the
conduct of an independent evaluation of the program carried out under this
subsection.</text>
</paragraph><paragraph id="HE1EA91C419C944159989B872C5903DC8"><enum>(8)</enum><header>Report</header><text>Not
later than one year after the conclusion of all of the demonstration projects
funded under this subsection, the Secretary shall submit a report to the
Congress on the results of such projects. The report shall include—</text>
<subparagraph id="H64BE89ADBA8542C8B08F1D20851300D1"><enum>(A)</enum><text>an evaluation of
patient access to care, patient outcomes, and an analysis of the cost
effectiveness of each such project; and</text>
</subparagraph><subparagraph id="H16509965EDB946E48E41D8D85911577"><enum>(B)</enum><text>recommendations on
Federal legislation, regulations, or administrative policies to enhance rural
health quality and outcomes.</text>
</subparagraph></paragraph></subsection><subsection id="HB2107BC93DE84E55A7DC008F084BA8B0"><enum>(c)</enum><header>Appropriation</header>
<paragraph id="HBC831942B42A4061A0ACDE3C8433ED30"><enum>(1)</enum><header>In
general</header><text>Out of funds in the Treasury not otherwise appropriated,
there are appropriated to the Secretary to carry out this section $30,000,000
for the period of fiscal years 2008 through 2012.</text>
</paragraph><paragraph id="HBCA587B8025144B5AB6FFC00FCD58883"><enum>(2)</enum><header>Availability</header>
<subparagraph id="H079E486C3CF646C08253393572D777A"><enum>(A)</enum><header>In
general</header><text>Funds appropriated under paragraph (1) shall remain
available for expenditure through fiscal year 2012.</text>
</subparagraph><subparagraph id="H59A899D9F06146868988F37180A940CF"><enum>(B)</enum><header>Report</header><text>For
purposes of carrying out subsection (b)(8), funds appropriated under paragraph
(1) shall remain available for expenditure through fiscal year 2013.</text>
</subparagraph></paragraph><paragraph id="HF33C3F1FA1784E5292F7CAACA39036B4"><enum>(3)</enum><header>Reservation</header><text>Of
the amount appropriated under paragraph (1), the Secretary shall
reserve—</text>
<subparagraph id="HCA7E85993EE84D5F8FD5EA7C27C9B246"><enum>(A)</enum><text>$5,000,000 to
carry out subsection (a); and</text>
</subparagraph><subparagraph id="H57B97DD54B474E1A84F5AB57C91FE368"><enum>(B)</enum><text>$25,000,000 to
carry out subsection (b), of which—</text>
<clause id="HD724BCD3033947E381D9A5A00648267"><enum>(i)</enum><text>2
percent shall be for the provision of technical assistance to grant recipients;
and</text>
</clause><clause id="HAE51021D5C2B46ABBB8D4814CEF8BE6"><enum>(ii)</enum><text>5
percent shall be for independent evaluation under subsection (b)(7).</text>
</clause></subparagraph></paragraph></subsection></section><section display-inline="no-display-inline" id="HF8B66E0B80F442BA9CD5E6438E59DF9C" section-type="subsequent-section"><enum>516.</enum><header>Rural health care
services</header><text display-inline="no-display-inline">Section 330A of the
Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254c">42 U.S.C. 254c</external-xref>) is amended to read as
follows:</text>
<quoted-block display-inline="no-display-inline" id="HC2ECB8874D6F41B98CA827D8D12DF87B" style="OLC">
<section id="H73B3E61FA2864191B6793254EF256C7D"><enum>330A.</enum><header>Rural health
care services outreach, rural health network development, Delta rural
disparities and health systems development, and small rural health care
provider quality improvement grant programs</header>
<subsection id="HBFB52CF8CF5142FC91DA1CD9BECAFAC"><enum>(a)</enum><header>Purpose</header><text>The
purpose of this section is to provide for grants—</text>
<paragraph id="HC7B217886C8441C0B914C798A0DFFA80"><enum>(1)</enum><text>under subsection
(b), to promote rural health care services outreach;</text>
</paragraph><paragraph id="H7EAE86D97F1145D8B106D5004C881D5E"><enum>(2)</enum><text display-inline="yes-display-inline">under subsection (c), to provide for the
planning and implementation of integrated health care networks in rural
areas;</text>
</paragraph><paragraph id="HABE47CE35BF4414A98853124C81DFE32"><enum>(3)</enum><text display-inline="yes-display-inline">under subsection (d), to assist rural
communities in the Delta Region to reduce health disparities and to promote and
enhance health system development; and</text>
</paragraph><paragraph id="H3ADF6AB088FB4319A98F9536BEE56C93"><enum>(4)</enum><text display-inline="yes-display-inline">under subsection (e), to provide for the
planning and implementation of small rural health care provider quality
improvement activities.</text>
</paragraph></subsection><subsection id="HFA2B5D29B3F748F797CB52EFD7F11B2"><enum>(b)</enum><header>Rural health care
services outreach grants</header>
<paragraph id="H9029ED7F74254857A48FB013BFE51336"><enum>(1)</enum><header>Grants</header><text display-inline="yes-display-inline">The Director of the Office of Rural Health
Policy of the Health Resources and Services Administration may award grants to
eligible entities to promote rural health care services outreach by expanding
the delivery of health care services to include new and enhanced services in
rural areas. The Director may award the grants for periods of not more than 3
years.</text>
</paragraph><paragraph id="H700502D989F74AF4834461FD8FF17573"><enum>(2)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under this subsection for a project, an
entity—</text>
<subparagraph id="H571AE377513648D18E9587EA053F8E67"><enum>(A)</enum><text display-inline="yes-display-inline">shall be a rural public or rural nonprofit
private entity, a facility that qualifies as a rural health clinic under title
XVIII of the Social Security Act, a public or nonprofit entity existing
exclusively to provide services to migrant and seasonal farm workers in rural
areas, or a tribal government whose grant-funded activities will be conducted
within federally recognized tribal areas;</text>
</subparagraph><subparagraph id="HDDFACC89D4B3490391CC920529653CDD"><enum>(B)</enum><text>shall represent a
consortium composed of members—</text>
<clause id="HB32D0E09CF1D4D30003C4F852468FD6B"><enum>(i)</enum><text>that include 3 or
more independently-owned health care entities; and</text>
</clause><clause id="H64480D01AB8743C891524E86CB3BA179"><enum>(ii)</enum><text>that may be
nonprofit or for-profit entities; and</text>
</clause></subparagraph><subparagraph id="HC6249F86F0214A438733B3DDA8CBB481"><enum>(C)</enum><text>shall not
previously have received a grant under this subsection for the same or a
similar project, unless the entity is proposing to expand the scope of the
project or the area that will be served through the project.</text>
</subparagraph></paragraph><paragraph id="H214B6B402E844F178CC22FCCCBF4100"><enum>(3)</enum><header>Applications</header><text>To
be eligible to receive a grant under this subsection, an eligible entity shall
prepare and submit to the Director an application at such time, in such manner,
and containing such information as the Director may require, including—</text>
<subparagraph id="H4416C374D7624E73A1DF93C519A666A5"><enum>(A)</enum><text>a description of
the project that the eligible entity will carry out using the funds provided
under the grant;</text>
</subparagraph><subparagraph id="HA517EB7600A9467A87F057006D7474AD"><enum>(B)</enum><text>a description of
the manner in which the project funded under the grant will meet the health
care needs of rural populations in the local community or region to be
served;</text>
</subparagraph><subparagraph id="HAF2C984A861B4F6087C6AAF245558E82"><enum>(C)</enum><text>a plan for
quantifying how health care needs will be met through identification of the
target population and benchmarks of service delivery or health status, such
as—</text>
<clause id="HB602842B0C124CFEA821585FDEB3A359"><enum>(i)</enum><text>quantifiable
measurements of health status improvement for projects focusing on health
promotion; or</text>
</clause><clause id="H75593F6DF70F4B10BC57BB518F44AF72"><enum>(ii)</enum><text>benchmarks of
increased access to primary care, including tracking factors such as the number
and type of primary care visits, identification of a medical home, or other
general measures of such access;</text>
</clause></subparagraph><subparagraph id="H7E333FAF7CFB40879E7D0083134D9DAE"><enum>(D)</enum><text>a description of
how the local community or region to be served will be involved in the
development and ongoing operations of the project;</text>
</subparagraph><subparagraph id="H0C3C740B135F41E395ED5EDE4D1D7FFA"><enum>(E)</enum><text>a plan for
sustaining the project after Federal support for the project has ended;</text>
</subparagraph><subparagraph id="H5DBAED015DF8499EA411985EDB717BA2"><enum>(F)</enum><text>a description of
how the project will be evaluated;</text>
</subparagraph><subparagraph id="H55C66AE8AF67422100FCA7F36F841036"><enum>(G)</enum><text>the administrative
capacity to submit annual performance data electronically as specified by the
Director; and</text>
</subparagraph><subparagraph id="H058B8EFB04FC45CFB202C2B9F5A97764"><enum>(H)</enum><text>other such
information as the Director determines to be appropriate.</text>
</subparagraph></paragraph></subsection><subsection id="H1E66A6EFAB65495C96BB76A5EBC5F985"><enum>(c)</enum><header>Rural health
network development grants</header>
<paragraph id="HE34E81847D354BE5B0BAB90797ECF32F"><enum>(1)</enum><header>Grants</header>
<subparagraph id="H4134193B8F964224A200CB23F3FAC4FC"><enum>(A)</enum><header>In
general</header><text>The Director may award rural health network development
grants to eligible entities to promote, through planning and implementation,
the development of integrated health care networks that have combined the
functions of the entities participating in the networks in order to—</text>
<clause id="H9F3C7D37D15C4A5CA85EF41CC0D7814"><enum>(i)</enum><text>achieve
efficiencies and economies of scale;</text>
</clause><clause id="H5AB979E2B24A47619295097C58C185EF"><enum>(ii)</enum><text>expand access to,
coordinate, and improve the quality of the health care delivery system through
development of organizational efficiencies;</text>
</clause><clause id="H1D867286B47E4C5600006071EB242E71"><enum>(iii)</enum><text>implement health
information technology to achieve efficiencies, reduce medical errors, and
improve quality;</text>
</clause><clause id="H6F2AD4A729A7432ABAE86E2946242784"><enum>(iv)</enum><text>coordinate care
and manage chronic illness; and</text>
</clause><clause id="H6959D9C53B684CAAA447BFBC435F19FA"><enum>(v)</enum><text>strengthen the
rural health care system as a whole in such a manner as to show a quantifiable
return on investment to the participants in the network.</text>
</clause></subparagraph><subparagraph id="HF98F248AC124486584A27392EB7FFF6E"><enum>(B)</enum><header>Grant
periods</header><text>The Director may award such a rural health network
development grant—</text>
<clause id="H885CB4262E6B4AC6AC1595426EF5CD2F"><enum>(i)</enum><text>for a period of 3
years for implementation activities; or</text>
</clause><clause id="H258504E6404C4AFCA09620B04430C0FF"><enum>(ii)</enum><text display-inline="yes-display-inline">for a period of 1 year for planning
activities to assist in the initial development of an integrated health care
network, if the proposed participants in the network do not have a history of
collaborative efforts and a 3-year grant would be inappropriate.</text>
</clause></subparagraph></paragraph><paragraph id="H934481BC34EB4A67BBC9C3B882C4CB79"><enum>(2)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under this subsection, an entity—</text>
<subparagraph id="H32F8CC1C8D3042CA8784C98D5679B0F3"><enum>(A)</enum><text display-inline="yes-display-inline">shall be a rural public or rural nonprofit
private entity, a facility that qualifies as a rural health clinic under title
XVIII of the Social Security Act, a public or nonprofit entity existing
exclusively to provide services to migrant and seasonal farm workers in rural
areas, or a tribal government whose grant-funded activities will be conducted
within federally recognized tribal areas;</text>
</subparagraph><subparagraph id="HB80E862BCAAE473C874DDCBCADD865E7"><enum>(B)</enum><text>shall represent a
network composed of participants—</text>
<clause id="HB43597B943B141489D99F017006F506D"><enum>(i)</enum><text>that include 3 or
more independently-owned health care entities; and</text>
</clause><clause id="H27E1678FF8DF4A1193E7AFC0F2EEE828"><enum>(ii)</enum><text>that may be
nonprofit or for-profit entities; and</text>
</clause></subparagraph><subparagraph id="H2C91EE58256240C0861946F25362B628"><enum>(C)</enum><text>shall not
previously have received a grant under this subsection (other than a 1-year
grant for planning activities) for the same or a similar project.</text>
</subparagraph></paragraph><paragraph id="H7BC9728836DA447387D7697C49471BD5"><enum>(3)</enum><header>Applications</header><text>To
be eligible to receive a grant under this subsection, an eligible entity, in
consultation with the appropriate State office of rural health or another
appropriate State entity, shall prepare and submit to the Director an
application at such time, in such manner, and containing such information as
the Director may require, including—</text>
<subparagraph id="H01A1BFB5CEF044D5859154FB44C87F2D"><enum>(A)</enum><text>a description of
the project that the eligible entity will carry out using the funds provided
under the grant;</text>
</subparagraph><subparagraph id="HDF4ED9649378457AB7F64D3EC13C73D9"><enum>(B)</enum><text>an explanation of
the reasons why Federal assistance is required to carry out the project;</text>
</subparagraph><subparagraph id="H35117AF352C64C9F8900AD2C4B951722"><enum>(C)</enum><text>a description
of—</text>
<clause id="H5B11F71DE5834D5F965400716E7D571D"><enum>(i)</enum><text>the history of
collaborative activities carried out by the participants in the network;</text>
</clause><clause id="H1049D00DD5DB45D78DB49CD874509E"><enum>(ii)</enum><text>the
degree to which the participants are ready to integrate their functions;
and</text>
</clause><clause id="H13236143BCDD48D797930024998FBC7"><enum>(iii)</enum><text>how the local
community or region to be served will benefit from and be involved in the
activities carried out by the network;</text>
</clause></subparagraph><subparagraph id="H4E23499DCB054B44AEE748DE408C0674"><enum>(D)</enum><text>a description of
how the local community or region to be served will experience increased access
to quality health care services across the continuum of care as a result of the
integration activities carried out by the network, including a description
of—</text>
<clause id="H50F6025FED6E45BC94B7427866ED8B3"><enum>(i)</enum><text>return on
investment for the community and the network members; and</text>
</clause><clause id="H430ABAACFDE247B900A1DA56304615F5"><enum>(ii)</enum><text>other
quantifiable performance measures that show the benefit of the network
activities;</text>
</clause></subparagraph><subparagraph id="H04440BC43A074ABC846E014958086356"><enum>(E)</enum><text>a plan for
sustaining the project after Federal support for the project has ended;</text>
</subparagraph><subparagraph id="H211F530FEADD4906846943B5C1346F4"><enum>(F)</enum><text>a description of
how the project will be evaluated;</text>
</subparagraph><subparagraph id="HB3383DEBA2254BBB9CE826CF54F155BC"><enum>(G)</enum><text>the administrative
capacity to submit annual performance data electronically as specified by the
Director; and</text>
</subparagraph><subparagraph id="H26B2E1A47C594529A73DF68057B02F64"><enum>(H)</enum><text>other such
information as the Director determines to be appropriate.</text>
</subparagraph></paragraph></subsection><subsection id="HD61E269903E54A9FA3214600E8AFBCD1"><enum>(d)</enum><header>Delta rural
disparities and health systems development grants</header>
<paragraph id="H85A9A78F985740999D55003CF030DCB8"><enum>(1)</enum><header>Grants</header><text>The
Director may award grants to eligible entities to support reduction of health
disparities, improve access to health care, and enhance rural health system
development in the Delta Region.</text>
</paragraph><paragraph id="HB88BD47F0FA54B64BC93322D00EAF297"><enum>(2)</enum><header>Eligibility</header><text display-inline="yes-display-inline">To be eligible to receive a grant under
this subsection, an entity shall be a rural public or rural nonprofit private
entity, a facility that qualifies as a rural health clinic under title XVIII of
the Social Security Act, a public or nonprofit entity existing exclusively to
provide services to migrant and seasonal farm workers in rural areas, or a
tribal government whose grant-funded activities will be conducted within
federally recognized tribal areas.</text>
</paragraph><paragraph id="HD8DB57C325C04F5CBD851ED4ECD325AC"><enum>(3)</enum><header>Applications</header><text>To
be eligible to receive a grant under this subsection, an eligible entity shall
prepare and submit to the Director an application at such time, in such manner,
and containing such information as the Director may require, including—</text>
<subparagraph id="H9518CD5D857E4F409F121F5BF502F7F9"><enum>(A)</enum><text>a description of
the project that the eligible entity will carry out using the funds provided
under the grant;</text>
</subparagraph><subparagraph id="H960F31D9EAEE46AFB448ADD441A6A47"><enum>(B)</enum><text>an explanation of
the reasons why Federal assistance is required to carry out the project;</text>
</subparagraph><subparagraph id="HCCEF5BE6D6264BB397E13ED2AD2CE6A0"><enum>(C)</enum><text>a description of
the manner in which the project funded under the grant will meet the health
care needs of the Delta Region;</text>
</subparagraph><subparagraph id="HCE7E668A865847FC958E8D5620C0A300"><enum>(D)</enum><text>a description of
how the local community or region to be served will experience increased access
to quality health care services as a result of the activities carried out by
the entity;</text>
</subparagraph><subparagraph id="HE92BC373AA0D46AA98C8CF3D52459300"><enum>(E)</enum><text>a description of
how health disparities will be reduced or the health system will be
improved;</text>
</subparagraph><subparagraph id="H5225B6F3AA71428B9288333D009DFC4"><enum>(F)</enum><text>a plan for
sustaining the project after Federal support for the project has ended;</text>
</subparagraph><subparagraph id="HC3C169E4DB0E4EF4B067AFE83FAE695C"><enum>(G)</enum><text>a description of
how the project will be evaluated including process and outcome measures
related to the quality of care provided or how the health care system improves
its performance;</text>
</subparagraph><subparagraph id="HD49C57D322CF476DB4F2A86F799EF29D"><enum>(H)</enum><text>a description of
how the grantee will develop an advisory group made up of representatives of
the communities to be served to provide guidance to the grantee to best meet
community need; and</text>
</subparagraph><subparagraph id="H3ACDE4F56E41402FAAE180B2E0E21BD6"><enum>(I)</enum><text>other such
information as the Director determines to be appropriate.</text>
</subparagraph></paragraph></subsection><subsection id="H125F3A59D065443B8989D8633DA9322C"><enum>(e)</enum><header>Small rural
health care provider quality improvement grants</header>
<paragraph id="HE2DFDB336C1248C8B58041D924AACFDA"><enum>(1)</enum><header>Grants</header><text>The
Director may award grants to provide for the planning and implementation of
small rural health care provider quality improvement activities. The Director
may award the grants for periods of 1 to 3 years.</text>
</paragraph><paragraph id="H491BE7F888454645009350254075E510"><enum>(2)</enum><header>Eligibility</header><text>To
be eligible for a grant under this subsection, an entity—</text>
<subparagraph id="HF12207BD8241452E837061C4564DDE42"><enum>(A)</enum><text>shall be—</text>
<clause id="HDCFEE4CCD30B44A4B15B001D2F366943"><enum>(i)</enum><text display-inline="yes-display-inline">a rural public or rural nonprofit private
health care provider or provider of health care services, such as a rural
health clinic; or</text>
</clause><clause id="H2EC088BAD92E43159C16D493FF3DDAB3"><enum>(ii)</enum><text display-inline="yes-display-inline">another rural provider or network of small
rural providers identified by the Director as a key source of local care;
and</text>
</clause></subparagraph><subparagraph id="HC9A6156415B14946A3AA6BAF2D8200DE"><enum>(B)</enum><text>shall not
previously have received a grant under this subsection for the same or a
similar project.</text>
</subparagraph></paragraph><paragraph id="HAC0E13D7D61441E59E998914C6FC81AC"><enum>(3)</enum><header>Preference</header><text display-inline="yes-display-inline">In awarding grants under this subsection,
the Director shall give preference to facilities that qualify as rural health
clinics under title XVIII of the Social Security Act.</text>
</paragraph><paragraph id="HD67B4B944FD646348140D909AD180335"><enum>(4)</enum><header>Applications</header><text>To
be eligible to receive a grant under this subsection, an eligible entity shall
prepare and submit to the Director an application at such time, in such manner,
and containing such information as the Director may require, including—</text>
<subparagraph id="H073923451E5A4E68A76BF6E9727306E6"><enum>(A)</enum><text>a description of
the project that the eligible entity will carry out using the funds provided
under the grant;</text>
</subparagraph><subparagraph id="H2F39E16F39F0429C8E555E4758ECE9DA"><enum>(B)</enum><text>an explanation of
the reasons why Federal assistance is required to carry out the project;</text>
</subparagraph><subparagraph id="HDC9E4909FBFF4BF496217E8B93F935EC"><enum>(C)</enum><text>a description of
the manner in which the project funded under the grant will assure continuous
quality improvement in the provision of services by the entity;</text>
</subparagraph><subparagraph id="HFBC108AAD91E4EF9A34C5E66BF6084ED"><enum>(D)</enum><text>a description of
how the local community or region to be served will experience increased access
to quality health care services as a result of the activities carried out by
the entity;</text>
</subparagraph><subparagraph id="H9092537B9EC745BFA5CC6D721EB31718"><enum>(E)</enum><text>a plan for
sustaining the project after Federal support for the project has ended;</text>
</subparagraph><subparagraph id="HF6BB922006494CE3A66FB31F6EE941AC"><enum>(F)</enum><text>a description of
how the project will be evaluated including process and outcome measures
related to the quality of care provided; and</text>
</subparagraph><subparagraph id="HF8B8231517B44A0AB8DBBFC69E53C040"><enum>(G)</enum><text>other such
information as the Director determines to be appropriate.</text>
</subparagraph></paragraph></subsection><subsection id="H1EAA2C16EF0E4214873F3DFF83F4C49F"><enum>(f)</enum><header>General
requirements</header>
<paragraph id="H48A6BB72A63641C082D3E0A1B600F032"><enum>(1)</enum><header>Prohibited uses
of funds</header><text>An entity that receives a grant under this section may
not use funds provided through the grant—</text>
<subparagraph id="H4E116A4EF92549988EA484074995296D"><enum>(A)</enum><text>to build or
acquire real property; or</text>
</subparagraph><subparagraph id="HA67BFE1BFAC94949AE63481FB07090E9"><enum>(B)</enum><text>for
construction.</text>
</subparagraph></paragraph><paragraph id="HE208B730CF8441669F7DC01100453141"><enum>(2)</enum><header>Coordination
with other agencies</header><text>The Director shall coordinate activities
carried out under grant programs described in this section, to the extent
practicable, with Federal and State agencies and nonprofit organizations that
are operating similar grant programs, to maximize the effect of public dollars
in funding meritorious proposals.</text>
</paragraph></subsection><subsection id="H1FF40B6B46D14006B1649ED6A2F0634E"><enum>(g)</enum><header>Report</header><text>Not
later than September 30, 2010, the Secretary shall prepare and submit to the
appropriate committees of Congress a report on the progress and accomplishments
of the grant programs described in subsections (b), (c), (d), and (e).</text>
</subsection><subsection id="H653AF45663564AB4003C11833EEF5BF4"><enum>(h)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="H22541CBBDF0E4634BC157E1CB2541C67"><enum>(1)</enum><text display-inline="yes-display-inline">The term <term>Delta Region</term> has the
meaning given to the term <term>region</term> in section 382A of the
Consolidated Farm and Rural Development Act (<external-xref legal-doc="usc" parsable-cite="usc/7/2009aa">7 U.S.C. 2009aa</external-xref>).</text>
</paragraph><paragraph id="H744A5293C7AB477DA3E830DA8313A5D0"><enum>(2)</enum><text>The term
<term>Director</term> means the Director of the Office of Rural Health Policy
of the Health Resources and Services Administration.</text>
</paragraph></subsection><subsection id="H614CD72D39BA426CBAA6D18721719959"><enum>(i)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out this section $40,000,000 for fiscal year 2008, and such sums as may be
necessary for each of fiscal years 2009 through
2012.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H95E04DD1FF8C46C48E1DEDE7B700F800"><enum>517.</enum><header>Community
health center collaborative access expansion</header><text display-inline="no-display-inline">Section 330 of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C.
254b) is amended by adding at the end the following:</text>
<quoted-block act-name="Public" display-inline="no-display-inline" id="HF6B19D516A17434FA1A0EF47D323EE63" style="OLC">
<subsection id="H8CF66FBD3E2A47B9B9B6D6D8745F7197"><enum>(s)</enum><header>Miscellaneous
Provisions</header>
<paragraph id="H1FA3D4D3ADC7430191C73B703C837C93"><enum>(1)</enum><header>Rule of
construction with respect to rural health clinics</header>
<subparagraph id="H9A2724EB4EF348E6A4CA140721F6EFF"><enum>(A)</enum><header>In
general</header><text>Nothing in this section shall be construed to prevent a
community health center from contracting with a federally certified rural
health clinic (as defined by section 1861(aa)(2) of the
<act-name parsable-cite="SSA">Social Security Act</act-name>) for the delivery
of primary health care services that are available at the rural health clinic
to individuals who would otherwise be eligible for free or reduced cost care if
that individual were able to obtain that care at the community health center.
Such services may be limited in scope to those primary health care services
available in that rural health clinic.</text>
</subparagraph><subparagraph id="H4985946D662A4ACFB833626403AF92F2"><enum>(B)</enum><header>Assurances</header><text>In
order for a rural health clinic to receive funds under this section through a
contract with a community health center under paragraph (1), such rural health
clinic shall establish policies to ensure—</text>
<clause id="H63EB72257B8948718EE76D411CE93C3D"><enum>(i)</enum><text>nondiscrimination
based upon the ability of a patient to pay; and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="H143224140E0B48EFA55091DDF3A9FC3D"><enum>(ii)</enum><text>the establishment
of a sliding fee scale for low-income
patients.</text>
</clause></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HEFF2CE38CB864E918E4B1526E7005EC4"><enum>518.</enum><header>Facilitating
the provision of telehealth services across State lines</header>
<subsection id="H3FD89CCA696A4B96A1A8568D537DF6B1"><enum>(a)</enum><header>In
general</header><text>For purposes of expediting the provision of telehealth
services, for which payment is made under the Medicare program, across State
lines, the Secretary of Health and Human Services shall, in consultation with
representatives of States, physicians, health care practitioners, and patient
advocates, encourage and facilitate the adoption of provisions allowing for
multistate practitioner practice across State lines.</text>
</subsection><subsection id="HC2E28AEB72D740049221794E55FB5E31"><enum>(b)</enum><header>Definitions</header><text>In
subsection (a):</text>
<paragraph id="H83338A703F4D40818BEBFC01BB5C89E"><enum>(1)</enum><header>Telehealth
service</header><text>The term <term>telehealth service</term> has the meaning
given that term in subparagraph (F) of section 1834(m)(4) of the
<act-name parsable-cite="SSA">Social Security Act</act-name> (42 U.S.C.
1395m(m)(4)).</text>
</paragraph><paragraph id="H47A5FB2E30F2478FB1E8E438FA97CD2"><enum>(2)</enum><header>Physician,
practitioner</header><text>The terms <term>physician</term> and
<term>practitioner</term> have the meaning given those terms in subparagraphs
(D) and (E), respectively, of such section.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H5D5E961D3CC749709E793E9579302373"><enum>(3)</enum><header>Medicare
program</header><text>The term <term>Medicare program</term> means the program
of health insurance administered by the Secretary of Health and Human Services
under title XVIII of the <act-name parsable-cite="SSA">Social Security
Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395 et seq.</external-xref>).</text>
</paragraph></subsection></section>