[Congressional Record Volume 142, Number 135 (Thursday, September 26, 1996)]
[Senate]
[Pages S11391-S11401]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




        NATIONAL INSTITUTES OF HEALTH REVITALIZATION ACT OF 1996

  Mr. LOTT. Mr. President, I ask unanimous consent that the Senate 
proceed to the consideration of Calendar No. 583, S. 1897.
  The PRESIDING OFFICER. The clerk will report.
  The legislative clerk read as follows:

       A bill (S. 1897) to amend the Public Health Service Act to 
     revise and extend certain programs relating to the National 
     Institutes of Health, and for other purposes.

  The PRESIDING OFFICER. Is there objection to the immediate 
consideration of the bill?
  There being no objection, the Senate proceeded to consider the 
bill which has been reported from the Committee on Labor and Human 
Resources, with amendments; as follows:

  (The parts of the bill intended to be stricken are shown in boldface 
brackets and the parts of the bill intended to be inserted are shown in 
italic.)

                                S. 1897

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE; REFERENCES; AND TABLE OF CONTENTS

       (a) Short Title.--This Act may be cited as the ``National 
     Institutes of Health Revitalization Act of 1996''.
       (b) References.--Whenever in this Act an amendment is 
     expressed in terms of an amendment to a section or other 
     provision, the reference shall be considered to be made to a 
     section or other provision of the Public Health Service Act 
     (42 U.S.C. 201 et seq.).
       (c) Table of Contents.--The table of contents for this Act 
     is as follows:

Sec. 1. Short title; references; and table of contents.

   TITLE I--PROVISIONS RELATING TO THE NATIONAL INSTITUTES OF HEALTH

Sec. 101. Director's discretionary fund.
Sec. 102. Children's vaccine initiative.

   TITLE II--PROVISIONS RELATING TO THE NATIONAL RESEARCH INSTITUTES

Sec. 201. Research on osteoporosis, Paget's disease, and related bone 
              disorders.
Sec. 202. National Human Genome Research Institute.
Sec. 203. Increased amount of grant and other awards.
Sec. 204. Meetings of advisory committees and councils.
Sec. 205. Elimination or modification of reports.

               TITLE III--SPECIFIC INSTITUTES AND CENTERS

                 Subtitle A--National Cancer Institute

Sec. 301. Authorization of appropriations.
Sec. 302. DES study.

          Subtitle B--National Heart Lung and Blood Institute

Sec. 311. Authorization of appropriations.

   Subtitle C--National Institute of Allergy and Infectious Diseases

Sec. 321. Research and research training regarding tuberculosis.

[[Page S11392]]

Sec. 322. Terry Beirn community-based aids research initiative.

  Subtitle D--National Institute of Child Health and Human Development

Sec. 331. Research centers for contraception and infertility.

                Subtitle E--National Institute on Aging

Sec. 341. Authorization of appropriations.

     Subtitle F--National Institute on Alcohol Abuse and Alcoholism

Sec. 351. Authorization of appropriations.
Sec. 352. National alcohol research center.

              Subtitle G--National Institute on Drug Abuse

Sec. 361. Authorization of appropriations.
Sec. 362. Medication development program.
Sec. 363. Drug abuse research centers.

            Subtitle H--National Institute of Mental Health

Sec. 371. Authorization of appropriations.

           Subtitle I--National Center for Research Resources

Sec. 381. Authorization of appropriations.
Sec. 382. General clinical research centers.
Sec. 383. Enhancement awards.
Sec. 384. Waiver of limitations.

                Subtitle J--National Library of Medicine

Sec. 391. Authorization of appropriations.
Sec. 392. Increasing the cap on grant amounts.

                     TITLE IV--AWARDS AND TRAINING

Sec. 401. Medical scientist training program.
Sec. 402. Raise in maximum level of loan repayments.
Sec. 403. General loan repayment program.
Sec. 404. Clinical research assistance.

                 TITLE V--RESEARCH WITH RESPECT TO AIDS

Sec. 501. Comprehensive plan for expenditure of AIDS appropriations.
Sec. 502. Emergency AIDS discretionary fund.

                      TITLE VI--GENERAL PROVISIONS

              Subtitle A--Authority of the Director of NIH

Sec. 601. Authority of the director of NIH.

              Subtitle B--Office of Rare Disease Research

Sec. 611. Establishment of office for rare disease research.

                  Subtitle C--Certain Reauthorizations

Sec. 621. National research service awards.
Sec. 622. National Foundation for Biomedical Research.

                  Subtitle D--Miscellaneous Provisions

Sec. 631. Establishment of national fund for health research.
Sec. 632. Definition of clinical research.
Sec. 633. Senior Biomedical Research Service.
Sec. 634. Establishment of a pediatric research initiative.
Sec. 635. Diabetes research.
Sec. 636. Parkinson's research.

             Subtitle E--Repeals and Conforming Amendments

Sec. 641. Repeals and conforming amendments.
   TITLE I--PROVISIONS RELATING TO THE NATIONAL INSTITUTES OF HEALTH

     SEC. 101. DIRECTOR'S DISCRETIONARY FUND.

       Section 402(i)(3) (42 U.S.C. 282(i)(3)) is amended by 
     striking ``$25,000,000'' and all that follows through the 
     period and inserting ``such sums as may be necessary for each 
     of the fiscal years 1997 through 1999.''.

     SEC. 102. CHILDREN'S VACCINE INITIATIVE.

       Section 404B(c) (42 U.S.C. 283d(c)) is amended by striking 
     ``$20,000,000'' and all that follows through the period and 
     inserting ``such sums as may be necessary for each of the 
     fiscal years 1997 through 1999.''.
   TITLE II--PROVISIONS RELATING TO THE NATIONAL RESEARCH INSTITUTES

     SEC. 201. RESEARCH ON OSTEOPOROSIS, PAGET'S DISEASE, AND 
                   RELATED BONE DISORDERS.

       Section 409A(d) (42 U.S.C. 284e(d)) is amended by striking 
     ``$40,000,000'' and all that follows through the period and 
     inserting ``such sums as may be necessary for each of the 
     fiscal years 1997 through 1999.''.

     SEC. 202. NATIONAL HUMAN GENOME RESEARCH INSTITUTE.

       (a) In General.--Part C of title IV (42 U.S.C. 285 et seq.) 
     is amended by adding at the end thereof the following new 
     subpart:

         ``Subpart 18--National Human Genome Research Institute

     ``SEC. 464Z. PURPOSE OF THE INSTITUTE.

       ``(a) In General.--The general purpose of the National 
     Human Genome Research Institute is to characterize the 
     structure and function of the human genome, including the 
     mapping and sequencing of individual genes. Such purpose 
     includes--
       ``(1) planning and coordinating the research goal of the 
     genome project;
       ``(2) reviewing and funding research proposals;
       ``(3) conducting and supporting research training;
       ``(4) coordinating international genome research;
       ``(5) communicating advances in genome science to the 
     public;
       ``(6) reviewing and funding proposals to address the 
     ethical, legal, and social issues associated with the genome 
     project (including legal issues regarding patents); and
       ``(7) planning and administering intramural, collaborative, 
     and field research to study human genetic disease.
       ``(b) Research.--The Director of the Institute may conduct 
     and support research training--
       ``(1) for which fellowship support is not provided under 
     section 487; and
       ``(2) that is not residency training of physicians or other 
     health professionals.
       ``(c) Ethical, Legal, and Social Issues.--
       ``(1) In general.--Except as provided in paragraph (2), of 
     the amounts appropriated to carry out subsection (a) for a 
     fiscal year, the Director of the Institute shall make 
     available not less than 5 percent of amounts made available 
     for extramural research for carrying out paragraph (6) of 
     such subsection.
       ``(2) Nonapplication.--With respect to providing funds 
     under subsection (a)(6) for proposals to address the ethical 
     issues associated with the genome project, paragraph (1) 
     shall not apply for a fiscal year if the Director of the 
     Institute certifies to the Committee on Commerce of the 
     House of Representatives, and to the Committee on Labor 
     and Human Resources of the Senate, that the Director has 
     determined that an insufficient number of such proposals 
     meet the applicable requirements of sections 491 and 492.
       ``(d) Transfer.--
       ``(1) In general.--There are transferred to the National 
     Human Genome Research Institute all functions which the 
     National Center for Human Genome Research exercised before 
     the date of enactment of this subpart, including all related 
     functions of any officer or employee of the National Center 
     for Human Genome Research. The personnel employed in 
     connection with, and the assets, liabilities, contracts, 
     property, records, and unexpended balances of appropriations, 
     authorizations, allocations, and other funds employed, used, 
     held, arising from, available to, or to be made available in 
     connection with the functions transferred under this 
     subsection shall be transferred to the National Human Genome 
     Research Institute.
       ``(2) Legal documents.--All orders, determinations, rules, 
     regulations, permits, agreements, grants, contracts, 
     certificates, licenses, regulations, privileges, and other 
     administrative actions which have been issued, made, granted, 
     or allowed to become effective in the performance of 
     functions which are transferred under this subsection shall 
     continue in effect according to their terms until 
     modified, terminated, superseded, set aside, or revoked in 
     accordance with law.
       ``(3) References.--References in any other Federal law, 
     Executive order, rule, regulation, or delegation of 
     authority, or any document of or relating to the National 
     Center for Human Genome Research shall be deemed to refer to 
     the National Human Genome Research Institute.
       ``(e) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section, such 
     sums as may be necessary for each of the fiscal years 1997 
     through 1999.''.
       (b) Conforming Amendments.--
       (1) Section 401(b) (42 U.S.C. 281(b)) is amended--
       (A) in paragraph (1), by adding at the end thereof the 
     following new subparagraph:
       ``(R) The National Human Genome Research Institute.''; and
       (B) in paragraph (2)--
       (i) by striking subparagraph (D); and
       (ii) by redesignating subparagraph (E) as subparagraph (D).
       (2) Subpart 3 of part E of title IV (42 U.S.C. 287c et 
     seq.) is repealed.

     SEC. 203. INCREASED AMOUNT OF GRANT AND OTHER AWARDS.

       Section 405(b)(2)(B) (42 U.S.C. 284(b)(2)(B) is amended--
       (1) in clause (i), by striking ``$50,000'' and inserting 
     ``$100,000''; and
       (2) in clause (ii), by striking ``$50,000'' and inserting 
     ``$100,000''.

     SEC. 204. MEETINGS OF ADVISORY COMMITTEES AND COUNCILS.

       (a) In General.--Section 406 (42 U.S.C. 284a) is amended--
       (1) in subsection (e), by striking ``, but at least three 
     times each fiscal year''; and
       (2) in subsection (h)(2)--
       (A) in subparagraph (A)--
       (i) in clause (iv), by adding ``and'' after the semicolon;
       (ii) in clause (v), by striking ``; and'' and inserting a 
     period; and
       (iii) by striking clause (vi); and
       (B) in subparagraph (B), by striking ``, except'' and all 
     that follows through ``year''.
       (b) President's Cancer Panel.--Section 415(a)(3) (42 U.S.C. 
     285a-4(a)(3)) is amended by striking ``, but not less often 
     than four times a year''.
       (c) Institute of Diabetes and Digestive and Kidney Diseases 
     Interagency Coordinating Committees.--Section 429(b) (42 
     U.S.C. 285c-3(b)) is amended by striking ``, but not less 
     often than four times a year''.
       (d) Institute of Arthritis and Musculoskeletal and Skin 
     Diseases Interagency Coordinating Committees.--Section 439(b) 
     (42 U.S.C. 285d-4(b)) is amended by striking ``, but not less 
     often than four times a year''.
       (e) Institute on Deafness and Other Communication Disorders 
     Interagency Coordinating Committees.--Section 464E(d) (42 
     U.S.C. 285m-5(d)) is amended by striking ``, but not less 
     often than four times a year''.
       (f) Institute of Nursing Research Advisory Council.--
     Section 464X(e) (42 U.S.C. 285q-2(e)) is amended by striking 
     ``, but at least three times each fiscal year''.
       (g) Center for Research Resources Advisory Council.--
     Section 480(e) (42 U.S.C. 287a(e)) is amended by striking ``, 
     but at least three times each fiscal year''.

[[Page S11393]]

       (h) Application of FACA.--Part B of title IV (42 U.S.C. 284 
     et seq.) is amended by adding at the end thereof the 
     following new section:

     ``SEC. 409B. APPLICATION OF FEDERAL ADVISORY COMMITTEE ACT.

       ``Notwithstanding any other provision of law, the 
     provisions of the Federal Advisory Committee Act (5 U.S.C. 
     Ap. 2) shall not apply to a scientific or technical peer 
     review group, established under this title.''.

     SEC. 205. ELIMINATION OR MODIFICATION OF REPORTS.

       (a) Public Health Service Act Reports.--The following 
     provisions of the Public Health Service Act are repealed:
       (1) Section 403 (42 U.S.C. 283) relating to the biennial 
     report of the Director of the National Institutes of Health 
     to Congress and the President.
       (2) Subsection (c) of section 439 (42 U.S.C. 285d-4(c)) 
     relating to the annual report of the Arthritis and 
     Musculoskeletal Diseases Interagency Coordinating Committee 
     and the annual report of the Skin Diseases Interagency 
     Coordinating Committee.
       (3) Subsection (j) of section 442 (42 U.S.C. 285d-7(j)) 
     relating to the annual report of the National Arthritis and 
     Musculoskeletal and Skin Diseases Advisory Board.
       (4) Subsection (b) of section 494A (42 U.S.C. 289c-1(b)) 
     relating to the annual report of the Secretary of Health and 
     Human Services on health services research relating to 
     alcohol abuse and alcoholism, drug abuse, and mental health.
       (5) Subsection (b) of section 503 (42 U.S.C. 290aa-2(b)) 
     relating to the triennial report of the Secretary of Health 
     and Human Services to Congress.
       (b) Report on Disease Prevention.--Section 402(f)(3) (42 
     U.S.C. 282(f)(3)) is amended by striking ``annually'' and 
     inserting ``biennially''.
       (c) Reports of the Coordinating Committees on Digestive 
     Diseases, Diabetes Mellitus, and Kidney, Urologic and 
     Hematologic Diseases.--Section 429 (42 U.S.C. 285c-3) is 
     amended by striking subsection (c).
       (d) Report of the Task Force on Aging Research.--Section 
     304 of the Home Health Care and Alzheimer's Disease 
     Amendments of 1990 (42 U.S.C. 242q-3) is repealed.
       (e) Sudden Infant Death Syndrome Research.--Section 1122 
     (42 U.S.C. 300c-12) is amended--
       (1) in subsection (a)--
       (A) by striking the subsection designation and heading; and
       (B) by striking ``of the type'' and all that follows 
     through ``adequate,'' and insert ``, such amounts each year 
     as will be adequate for research which relates generally to 
     sudden infant death syndrome, including high-risk pregnancy 
     and high-risk infancy research which directly relates to 
     sudden infant death syndrome, and to the relationship of the 
     high-risk pregnancy and high-risk infancy research to sudden 
     infant death syndrome,''; and
       (2) by striking subsections (b) and (c).
       (f) U.S.-Japan Cooperative Medical Science Program.--
     Subsection (h) of section 5 of the International Health 
     Research Act of 1960 is repealed.
       (g) Bioengineering Research.--Not later than 6 months after 
     the date of enactment of this Act, the Secretary of Health 
     and Human Services, acting through the Director of the 
     National Institutes of Health, shall prepare and submit to 
     the Committee on Labor and Human Resources of the Senate 
     and the Committee on Commerce of the House of 
     Representatives, a report containing specific plans and 
     timeframes on how the Director will implement the findings 
     and recommendations of the report to Congress entitled 
     ``Support for Bioengineering Research'' (submitted in 
     August of 1995 in accordance with section 1912 of the 
     National Institutes of Health Revitalization Act of 1993 
     (42 U.S.C. 282 note)).
       [g] (h) Conforming Amendments.--Title IV is amended--
       (1) in section 404C(c) (42 U.S.C. 283e(c)), by striking 
     ``included'' and all that follows through the period and 
     inserting ``made available to the committee established under 
     subsection (e) and included in the official minutes of the 
     committee'';
       (2) in section 404E(d)(3)(B) (42 U.S.C. 283g(d)(3)(B)), by 
     striking ``for inclusion in the biennial report under section 
     403'';
       (3) in section 406(g) (42 U.S.C. 284a(g))--
       (A) by striking ``for inclusion in the biennial report made 
     under section 407'' and inserting ``as it may determine 
     appropriate''; and
       (B) by striking the second sentence;
       (4) in section 407 (42 U.S.C. 284b)--
       (A) in the section heading, to read as follows:


                            ``reports''; and

       (B) by striking ``shall prepare for inclusion in the 
     biennial report made under section 403 a biennial'' and 
     inserting ``may prepare a'';
       (5) in section 416(b) (42 U.S.C. 285a-5(b)) by striking 
     ``407'' and inserting ``402(f)(3)'';
       (6) in section 417 (42 U.S.C. 285a-6), by striking 
     subsection (e);
       (7) in section 423(b) (42 U.S.C. 285b-6(b)), by striking 
     ``407'' and inserting ``402(f)(3)'';
       (8) by striking section 433 (42 U.S.C. 285c-7);
       (9) in section 451(b) (42 U.S.C. 285g-3(b)), by striking 
     ``407'' and inserting ``402(f)(3)'';
       (10) in section 452(d) (42 U.S.C. 285g-4(d))--
       (A) in paragraph (3)--
       (i) in subparagraph (A), by striking ``(A) Not'' and 
     inserting ``Not''; and
       (ii) by striking subparagraph (B); and
       (B) in the last sentence of paragraph (4), by striking 
     ``contained'' and all that follows through the period and 
     inserting ``transmitted to the Director of NIH.'';
       (11) in section 464I(b) (42 U.S.C. 285n-1(b)), by striking 
     ``407'' and inserting ``402(f)(3)'';
       (12) in section 464M(b) (42 U.S.C. 285o-1)(b)), by striking 
     ``407'' and inserting ``402(f)(3)'';
       (13) in section 464S(b) (42 U.S.C. 285p-1(b)), by striking 
     ``407'' and inserting ``402(f)(3)'';
       (14) in section 464X(g) (42 U.S.C. 285q-2(g)) is amended--
       (A) by striking ``for inclusion in the biennial report made 
     under section 464Y'' and inserting ``as it may determine 
     appropriate''; and
       (B) by striking the second sentence;
       (15) in section 464Y (42 U.S.C. 285q-3)--
       (A) in the section heading, to read as follows:


                            ``reports''; and

       (B) by striking ``shall prepare for inclusion in the 
     biennial report made under section 403 a biennial'' and 
     inserting ``may prepare a'';
       (16) in section 480(g) (42 U.S.C. 287a(g))--
       (A) by striking ``for inclusion in the biennial report made 
     under section 481'' and inserting ``as it may determine 
     appropriate''; and
       (B) by striking the second sentence;
       (17) in section 481 (42 U.S.C. 287a-1)--
       (A) in the section heading, to read as follows:


                            ``reports''; and

       (B) by striking ``shall prepare for inclusion in the 
     biennial report made under section 403 a biennial'' and 
     inserting ``may prepare a'';
       (18) in section 486(d)(5)(B) (42 U.S.C. 287d(d)(5)(B)), by 
     striking ``for inclusion in the report required in section 
     403'';
       (19) in section 486B (42 U.S.C. 287d-2) by striking 
     subsection (b) and inserting the following new subsection:
       ``(b) Submission.--The Director of the Office shall submit 
     each report prepared under subsection (a) to the Director of 
     NIH.''; and
       (20) in section 492B(f) (42 U.S.C. 289a-2(f)), by striking 
     ``for inclusion'' and all that follows through the period and 
     inserting ``and the Director of NIH.''.
               TITLE III--SPECIFIC INSTITUTES AND CENTERS
                 Subtitle A--National Cancer Institute

     SEC. 301. AUTHORIZATION OF APPROPRIATIONS.

       Section 417B (42 U.S.C. 286a-8) is amended--
       (1) in subsection (a), by striking ``$2,728,000,000'' and 
     all that follows through the period and inserting 
     ``$3,000,000,000 for fiscal year 1997, and such sums as may 
     be necessary for each of the fiscal years 1998 and 1999.'';
       (2) in subsection (b)--
       (A) in paragraph (1)--
       (i) in the first sentence of subparagraph (A), by striking 
     ``$225,000,000'' and all that follows through the first 
     period and inserting ``such sums as may be necessary for each 
     of the fiscal years 1997 through 1999.''; and
       (ii) in the first sentence of subparagraph (B), by striking 
     ``$100,000,000'' and all that follows through the first 
     period and inserting ``such sums as may be necessary for each 
     of the fiscal years 1997 through 1999.''; and
       (B) in the first sentence of paragraph (2), by striking 
     ``$75,000,000'' and all that follows through the first period 
     and inserting ``such sums as may be necessary for each of the 
     fiscal years 1997 through 1999.''; and
       (3) in the first sentence of subsection (c), by striking 
     ``$72,000,000'' and all that follows through the first period 
     and inserting ``such sums as may be necessary for each of the 
     fiscal years 1997 through 1999.''.

     SEC. 302. DES STUDY.

       Section 403A(e) (42 U.S.C. 283a(e)) is amended by striking 
     ``1996'' and inserting ``1999''.
          Subtitle B--National Heart Lung and Blood Institute

     SEC. 311. AUTHORIZATION OF APPROPRIATIONS.

       Section 425 (42 U.S.C. 285b-8) is amended by striking 
     ``$1,500,000,000'' and all that follows through the period 
     and inserting ``$1,600,000,000 for fiscal year 1997, and such 
     sums as may be necessary for each of the fiscal years 1998 
     and 1999.''.
   Subtitle C--National Institute of Allergy and Infectious Diseases

     SEC. 321. RESEARCH AND RESEARCH TRAINING REGARDING 
                   TUBERCULOSIS.

       Subpart 6 of part C of title IV is amended in the first 
     section 447(b) (42 U.S.C. 285f-2(b)) by striking 
     ``$50,000,000'' and all that follows through the first period 
     1998'' and inserting ``such sums as may be necessary for each 
     of the fiscal years 1997 through 1999.''.

     SEC. 322. TERRY BEIRN COMMUNITY-BASED AIDS RESEARCH 
                   INITIATIVE.

       Section 2313(e) (42 U.S.C. 300cc-13(e)) is amended--
       (1) in paragraph (1), by striking ``1996'' and inserting 
     ``1999''; and
       (2) in paragraph (2), by striking ``1996'' and inserting 
     ``1999''.
  Subtitle D--National Institute of Child Health and Human Development

     SEC. 331. RESEARCH CENTERS FOR CONTRACEPTION AND INFERTILITY.

       Section 452A(g) (42 U.S.C. 285g-5(g)) is amended by 
     striking ``$30,000,000'' and all that follows through the 
     period and inserting ``such sums as may be necessary for 
     each of the fiscal years 1997 through 1999.''.
                Subtitle E--National Institute on Aging

     SEC. 341. AUTHORIZATION OF APPROPRIATIONS.

       Section 445I (42 U.S.C. 285e-11) is amended by striking 
     ``$500,000,000'' and all that follows through the period and 
     inserting ``$550,000,000 for fiscal year 1997, and such sums 
     as may be necessary for each of the fiscal years 1998 and 
     1999.''.

[[Page S11394]]

     Subtitle F--National Institute on Alcohol Abuse and Alcoholism

     SEC. 351. AUTHORIZATION OF APPROPRIATIONS.

       Section 464H(d)(1) (42 U.S.C. 285n(d)(1)) is amended by 
     striking ``300,000,000'' and all that follows through the 
     period and inserting ``$330,000,000 for fiscal year 1997, and 
     such sums as may be necessary for each of the fiscal years 
     1998 and 1999.''.

     SEC. 352. NATIONAL ALCOHOL RESEARCH CENTER.

       Section 464J(b) (42 U.S.C. 285n-2(b)) is amended--
       (1) by striking ``(b) The'' and inserting ``(b)(1) The'';
       (2) by striking the third sentence; and
       (3) by adding at the end thereof the following new 
     paragraph:
       ``(2) As used in paragraph (1), the terms `construction' 
     and `cost of construction' include--
       ``(A) the construction of new buildings, the expansion of 
     existing buildings, and the acquisition, remodeling, 
     replacement, renovation, major repair (to the extent 
     permitted by regulations), or alteration of existing 
     buildings, including architects' fees, but not including the 
     cost of the acquisition of land or offsite improvements; and
       ``(B) the initial equipping of new buildings and of the 
     expanded, remodeled, repaired, renovated, or altered part of 
     existing buildings; except that

     such term shall not include the construction or cost of 
     construction of so much of any facility as is used or is to 
     be used for sectarian instruction or as a place for religious 
     worship.''.
              Subtitle G--National Institute on Drug Abuse

     SEC. 361. AUTHORIZATION OF APPROPRIATIONS.

       Section 464L(d)(1) (42 U.S.C. 285o(d)(1)) is amended by 
     striking ``$440,000,000'' and all that follows through the 
     period and inserting ``$480,000,000 for fiscal year 1997, and 
     such sums as may be necessary for each of the fiscal years 
     1998 and 1999.''.

     SEC. 362. MEDICATION DEVELOPMENT PROGRAM.

       Section 464P(e) (42 U.S.C. 285o-4(e)) is amended by 
     striking ``$85,000,000'' and all that follows through the 
     period and inserting ``such sums as may be necessary for each 
     of the fiscal years 1997 through 1999''.

     SEC. 363. DRUG ABUSE RESEARCH CENTERS.

       Section 464N(b) (42 U.S.C. 285o-2(b)) is amended--
       (1) by striking ``(b) The'' and inserting ``(b)(1) The'';
       (2) by striking the last sentence; and
       (3) by adding at the end thereof the following new 
     paragraph:
       ``(2) As used in paragraph (1), the terms `construction' 
     and `cost of construction' include--
       ``(A) the construction of new buildings, the expansion of 
     existing buildings, and the acquisition, remodeling, 
     replacement, renovation, major repair (to the extent 
     permitted by regulations), or alteration of existing 
     buildings, including architects' fees, but not including the 
     cost of the acquisition of land or offsite improvements; and
       ``(B) the initial equipping of new buildings and of the 
     expanded, remodeled, repaired, renovated, or altered part of 
     existing buildings; except that

     such term does not include the construction or cost of 
     construction of so much of any facility as is used or is to 
     be used for sectarian instruction or as a place for religious 
     worship.''.
            Subtitle H--National Institute of Mental Health

     SEC. 371. AUTHORIZATION OF APPROPRIATIONS.

       Section 464R(f)(1) (42 U.S.C. 285p(f)(1)) is amended by 
     striking ``$675,000,000'' and all that follows through the 
     period and inserting ``$750,000,000 for fiscal year 1997, and 
     such sums as may be necessary for each of the fiscal years 
     1998 and 1999.''.
           Subtitle I--National Center for Research Resources

     SEC. 381. AUTHORIZATION OF APPROPRIATIONS.

       (a) General Authorization.--Section 481A(h) (42 U.S.C. 
     287a-2(h)) is amended by striking ``$150,000,000'' and all 
     that follows through the period and inserting ``such sums as 
     may be necessary for each of the fiscal years 1997 through 
     1999.''.
       (b) Reservation for Construction of Regional Centers.--
     Section 481B(a) (42 U.S.C. 287a-3(a)) is amended--
       (1) by striking ``shall'' and inserting ``may'';
       (2) by striking ``1994 through 1996'' and inserting ``1997 
     through 1999''; and
       (3) by striking ``$5,000,000'' and inserting ``such sums as 
     may be necessary for each such fiscal year''.

     SEC. 382. GENERAL CLINICAL RESEARCH CENTERS.

       Part B of title IV (42 U.S.C. 284 et seq.), as amended by 
     section 205(h), is further amended by adding at the end 
     thereof the following new section:

     ``SEC. 409C. GENERAL CLINICAL RESEARCH CENTERS.

       ``(a) Grants.--The Director of the National Center for 
     Research Resources shall award grants for the establishment 
     of general clinical research centers to provide the 
     infrastructure for clinical research including clinical 
     research training and career enhancement. Such centers shall 
     support clinical studies and career development in all 
     settings of the hospital or academic medical center involved.
       ``(b) Activities.--In carrying out subsection (a), the 
     Director of NIH shall expand the activities of the general 
     clinical research centers through the increased use of 
     telecommunications and telemedicine initiatives.
       ``(c) Authorization of Appropriations.--There are 
     authorized to be appropriated to make grants under subsection 
     (a), such sums as may be necessary for each of the fiscal 
     years 1996 and 1999.''.

     SEC. 383. ENHANCEMENT AWARDS.

       Part B of title IV (42 U.S.C. 284 et seq.), as amended by 
     sections 205(h) and 382, is further amended by adding at the 
     end thereof the following new section:

     ``SEC. 409D. ENHANCEMENT AWARDS.

       ``(a) Clinical Research Career Enhancement Award.--
       ``(1) In general.--The Director of the National Center for 
     Research Resources shall make grants (to be referred to as 
     `clinical research career enhancement awards') to support 
     individual careers in clinical research.
       ``(2) Applications.--An application for a grant under this 
     subsection shall be submitted by an individual scientist at 
     such time as the Director may require.
       ``(3) Limitations.--The amount of a grant under this 
     subsection shall not exceed $130,000 per year per grant. 
     Grants shall be for terms of 5 years. The Director shall 
     award not more than 20 grants in the first fiscal year in 
     which grants are awarded under this subsection. The total 
     number of grants awarded under this subsection for the first 
     and second fiscal years in which grants such are awarded 
     shall not exceed 40 grants.
       ``(4) Authorization of appropriations.--There are 
     authorized to be appropriated to make grants under paragraph 
     (1), such sums as may be necessary for each of the fiscal 
     years 1997 through 1999.
       ``(b) Innovative Medical Science Award.--
       ``(1) In general.--The Director of the National Center for 
     Research Resources shall make grants (to be referred to as 
     `innovative medical science awards') to support individual 
     clinical research projects.
       ``(2) Applications.--An application for a grant under this 
     subsection shall be submitted by an individual scientist at 
     such time as the Director requires.
       ``(3) Limitations.--The amount of a grant under this 
     subsection shall not exceed $100,000 per year per grant.
       ``(4) Authorization of appropriations.--There are 
     authorized to be appropriated to make grants under paragraph 
     (1), such sums as may be necessary for each of the fiscal 
     years 1997 through 1999.
       ``(c) Peer Review.--The Director of NIH, in cooperation 
     with the Director of the National Center for Research 
     Resources, shall establish peer review mechanisms to evaluate 
     applications for clinical research fellowships, clinical 
     research career enhancement awards, and innovative medical 
     science award programs. Such review mechanisms shall include 
     individuals who are exceptionally qualified to appraise the 
     merits of potential clinical research trainees.''.

     SEC. 384. WAIVER OF LIMITATIONS.

       Section 481A (42 U.S.C. 287a-2) is amended--
       (1) in subsection (b)(3)(A), by striking ``9'' and 
     inserting ``12'';
       (2) in subsection (e)--
       (A) in paragraph (1)--
       (i) in subparagraph (A), by striking ``50'' and inserting 
     ``40''; and
       (ii) in subparagraph (B), by striking ``40'' and inserting 
     ``30''; and
       (B) in paragraph (4), by striking ``for applicants meeting 
     the conditions described in paragraphs (1) and (2) of 
     subsection (c)''; and
       (3) in subsection (h), by striking $150,000,000'' and all 
     that follows through ``1996'' and inserting ``such sums as 
     may be necessary for each of the fiscal years 1997 through 
     1999''.
                Subtitle J--National Library of Medicine

     SEC. 391. AUTHORIZATION OF APPROPRIATIONS.

       Section 468(a) (42 U.S.C. 286a-2(a)) is amended by striking 
     ``$150,000,000'' and all that follows through the period and 
     inserting ``$160,000,000 for fiscal year 1997, and such sums 
     as may be necessary for each of the fiscal years 1998 and 
     1999.''.

     SEC. 392. INCREASING THE CAP ON GRANT AMOUNTS.

       Section 474(b)(2) (42 U.S.C. 286b-5(b)(2)) is amended by 
     striking ``$1,000,000'' and inserting ``$1,250,000''.
                     TITLE IV--AWARDS AND TRAINING

     SEC. 401. MEDICAL SCIENTIST TRAINING PROGRAM.

       (a) Expansion of Program.--Notwithstanding any other 
     provision of law, the Secretary of Health and Human Services, 
     acting through the Director of the National Institutes of 
     Health, shall expand the Medical Scientist Training Program 
     to include fields that will contribute to training clinical 
     investigators in the skills of performing patient-oriented 
     clinical research.
       (b) Designation of Slots.--In carrying out subsection (a), 
     the Director of the National Institutes of Health shall 
     designate a specific percentage of positions under the 
     Medical Scientist Training Program for use with respect to 
     the pursuit of a Ph.D. degree in the disciplines of 
     economics, epidemiology, public health, bioengineering, 
     biostatistics and bioethics, and other fields determined 
     appropriate by the Director.

     SEC. 402. RAISE IN MAXIMUM LEVEL OF LOAN REPAYMENTS.

       (a) Repayment Programs With Respect to AIDS.--Section 487A 
     (42 U.S.C. 288-1) is amended--

[[Page S11395]]

       (1) in subsection (a), by striking ``$20,000'' and 
     inserting ``$35,000''; and
       (2) in subsection (c), by striking ``1996'' and inserting 
     ``1999''.
       (b) Repayment Programs With Respect to Contraception and 
     Infertility.--Section 487B(a) (42 U.S.C. 288-2(a)) is amended 
     by striking ``$20,000'' and inserting ``$35,000''.
       (c) Repayment Programs With Respect to Research 
     Generally.--Section 487C(a)(1) (42 U.S.C. 288-3(a)(1)) is 
     amended by striking ``$20,000'' and inserting ``$35,000''.
       (d) Repayment Programs With Respect to Clinical Researchers 
     From Disadvantaged Backgrounds.--Section 487E(a) (42 U.S.C. 
     288-5(a)) is amended--
       (1) in paragraph (1), by striking ``$20,000'' and inserting 
     ``$35,000''; and
       (2) in paragraph (3), by striking ``338C'' and inserting 
     ``338B, 338C''.

     SEC. 403. GENERAL LOAN REPAYMENT PROGRAM.

       Part G of title IV (42 U.S.C. 288 et seq.) is amended by 
     inserting after section 487E, the following new section:

     ``SEC. 487F. GENERAL LOAN REPAYMENT PROGRAM.

       ``(a) Establishment.--
       ``(1) In general.--The Secretary, acting through the 
     Director of NIH, shall carry out a program of entering into 
     agreements with appropriately qualified health professionals 
     under which such health professionals agree to conduct 
     research with respect to the areas identified under paragraph 
     (2) in consideration of the Federal Government agreeing to 
     repay, for each year of such service, not more than $35,000 
     of the principal and interest of the educational loans of 
     such health professionals.
       ``(2) Research areas.--In carrying out the program under 
     paragraph (1), the Director of NIH shall annually identify 
     areas of research for which loan repayments made be awarded 
     under paragraph (1).
       ``(3) Term of agreement.--A loan repayment agreement under 
     paragraph (1) shall be for a minimum of two years.
       ``(b) Applicability of Certain Provisions.--With respect to 
     the National Health Service Corps Loan Repayment Program 
     established in subpart III of part D of title III, the 
     provisions of such subpart shall, except as inconsistent with 
     subsection (a) of this section, apply to the program 
     established in such subsection (a) in the same manner and to 
     the same extent as such provisions apply to the National 
     Health Service Corps Loan Repayment Program established in 
     such subpart.
       ``(c) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated such sums as may be necessary for each of the 
     fiscal years 1997 through 1999.''.

     SEC. 404. CLINICAL RESEARCH ASSISTANCE.

       (a) National Research Service Awards.--Section 487(a)(1)(C) 
     (42 U.S.C. 288(a)(1)(C)) is amended--
       (1) by striking ``50 such'' and inserting ``100 such''; and
       (2) by striking ``1996'' and inserting ``1999''.
       (b) Loan Repayment Program.--Section 487E (42 U.S.C. 288-5) 
     is amended--
       (1) in the section heading, by striking ``from 
     disadvantaged backgrounds'';
       (2) in subsection (a)(1), by striking ``who are from 
     disadvantaged backgrounds'';
       (3) in subsection (b)--
       (A) by striking ``Amounts'' and inserting the following:
       ``(1) In general.--Amounts''; and
       (B) by adding at the end thereof the following new 
     paragraph:
       ``(2) Disadvantaged backgrounds set-aside.--In carrying out 
     this section, the Secretary shall ensure that not less than 
     50 percent of the amounts appropriated for a fiscal year are 
     used for contracts involving those appropriately qualified 
     health professionals who are from disadvantaged 
     backgrounds.''; and
       (4) by adding at the end thereof the following new 
     subsections:
       ``(c) Clinical Research Training Position.--A position 
     shall be considered a clinical research training position 
     under subsection (a)(1) if such position involves an 
     individual serving in a general clinical research center or 
     other organizations and institutions determined to be 
     appropriate by the Director of NIH, or a physician receiving 
     a clinical research career enhancement award or NIH 
     intramural research fellowship.
       ``(d) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section such 
     sums as may be necessary for each fiscal year.''.
                 TITLE V--RESEARCH WITH RESPECT TO AIDS

     SEC. 501. COMPREHENSIVE PLAN FOR EXPENDITURE OF AIDS 
                   APPROPRIATIONS.

       Section 2353(d)(1) (42 U.S.C. 300cc-40b(d)(1)) is amended 
     by striking ``through 1996'' and inserting ``through 1999''.

     SEC. 502. EMERGENCY AIDS DISCRETIONARY FUND.

       Section 2356(g)(1) (42 U.S.C. 300cc-43(g)(1)) is amended by 
     striking ``$100,000,000'' and all that follows through the 
     period and inserting ``such sums as may be necessary for each 
     of the fiscal years 1997 through 1999''.
                      TITLE VI--GENERAL PROVISIONS
              Subtitle A--Authority of the Director of NIH

     SEC. 601. AUTHORITY OF THE DIRECTOR OF NIH.

       Section 402(b) (42 U.S.C. 282(b)) is amended--
       (1) in paragraph (11), by striking ``and'' at the end 
     thereof;
       (2) in paragraph (12), by striking the period and inserting 
     a semicolon; and
       (3) by adding after paragraph (12), the following new 
     paragraphs:
       ``(13) may conduct and support research training--
       ``(A) for which fellowship support is not provided under 
     section 487; and
       ``(B) which does not consist of residency training of 
     physicians or other health professionals; and
       ``(14) may appoint physicians, dentists, and other health 
     care professionals, subject to the provisions of title 5, 
     United States Code, relating to appointments and 
     classifications in the competitive service, and may 
     compensate such professionals subject to the provisions of 
     chapter 74 of title 38, United States Code.''.
              Subtitle B--Office of Rare Disease Research

     SEC. 611. ESTABLISHMENT OF OFFICE FOR RARE DISEASE RESEARCH.

       Part A of title IV of the Public Health Service Act (42 
     U.S.C. 281 et seq.) is amended by adding at the end thereof 
     the following new section:

     ``SEC. 404F. OFFICE FOR RARE DISEASE RESEARCH.

       ``(a) Establishment.--There is established within the 
     Office of the Director of the National Institutes of Health 
     an office to be known as the Office for Rare Disease Research 
     (in this section referred to as the `Office'). The Office 
     shall be headed by a director, who shall be appointed by the 
     Director of the National Institutes of Health.
       ``(b) Purpose.--The purpose of the Office is to promote and 
     coordinate the conduct of research on rare diseases through a 
     strategic research plan and to establish and manage a rare 
     disease research clinical database.
       ``(c) Advisory Council.--The Secretary shall establish an 
     advisory council for the purpose of providing advice to the 
     director of the Office concerning carrying out the strategic 
     research plan and other duties under this section. Section 
     222 shall apply to such council to the same extent and in the 
     same manner as such section applies to committees or councils 
     established under such section.
       ``(d) Duties.--In carrying out subsection (b), the director 
     of the Office shall--
       ``(1) develop a comprehensive plan for the conduct and 
     support of research on rare diseases;
       ``(2) coordinate and disseminate information among the 
     institutes and the public on rare diseases;
       ``(3) support research training and encourage the 
     participation of a diversity of individuals in the conduct of 
     rare disease research;
       ``(4) identify projects or research on rare diseases that 
     should be conducted or supported by the National Institutes 
     of Health;
       ``(5) develop and maintain a central database on current 
     government sponsored clinical research projects for rare 
     diseases;
       ``(6) determine the need for registries of research 
     subjects and epidemiological studies of rare disease 
     populations; and
       ``(7) prepare biennial reports on the activities carried 
     out or to be carried out by the Office and submit such 
     reports to the Secretary and the Congress.''.
                  Subtitle C--Certain Reauthorizations

     SEC. 621. NATIONAL RESEARCH SERVICE AWARDS.

       Section 487(d) (42 U.S.C. 288(d)) is amended by striking 
     ``$400,000,000'' and all that follows through the first 
     period and inserting ``such sums as may be necessary for each 
     of the fiscal years 1997 through 1999.''.

     SEC. 622. NATIONAL FOUNDATION FOR BIOMEDICAL RESEARCH.

       Section 499(m)(1) (42 U.S.C. 290b(m)(1)) is amended by 
     striking ``an aggregate'' and all that follows through the 
     period and inserting ``such sums as may be necessary for each 
     of the fiscal years 1997 through 1999.''.
                  Subtitle D--Miscellaneous Provisions

     SEC. 631. ESTABLISHMENT OF NATIONAL FUND FOR HEALTH RESEARCH.

       Part A of title IV (42 U.S.C. 281 et seq.), as amended by 
     section 611, is further amended by adding at the end thereof 
     the following new section:

     ``SEC. 404G. ESTABLISHMENT OF NATIONAL FUND FOR HEALTH 
                   RESEARCH.

       ``(a) Establishment.--There is established in the Treasury 
     of the United States a fund, to be known as the `National 
     Fund for Health Research' (hereafter in this section referred 
     to as the `Fund'), consisting of such amounts as are 
     transferred to the Fund and any interest earned on investment 
     of amounts in the Fund.
       ``(b)  Obligations From Fund.--
       ``(1) In general.--Subject to the provisions of paragraph 
     (2), with respect to the amounts made available in the Fund 
     in a fiscal year, the Secretary shall distribute all of such 
     amounts during any fiscal year to research institutes and 
     centers of the National Institutes of Health in the same 
     proportion to the total amount received under this section, 
     as the amount of annual appropriations under appropriations 
     Acts for each member institute and centers for the fiscal 
     year bears to the total amount of appropriations under 
     appropriations Acts for all research institutes and centers 
     of the National Institutes of Health for the fiscal year.
       ``(2) Trigger and release of monies.--No expenditure shall 
     be made under paragraph (1) during any fiscal year in which 
     the annual amount appropriated for the National Institutes of 
     Health is less than the amount so appropriated for the prior 
     fiscal year.''.

[[Page S11396]]

     SEC. 632. DEFINITION OF CLINICAL RESEARCH.

       Part A of title [V] IV (42 U.S.C. 281 et seq.) as amended 
     by sections 611 and 631, is further amended by adding at the 
     end thereof the following new section:

     ``SEC. 404H. DEFINITION OF CLINICAL RESEARCH.

       ``As used in this title, the term `clinical research' means 
     patient oriented clinical research conducted with human 
     subjects, or research on the causes and consequences of 
     disease in human populations, or on material of human origin 
     (such as tissue specimens and cognitive phenomena) for which 
     an investigator or colleague directly interacts with human 
     subjects in an outpatient or inpatient setting to clarify a 
     problem in human physiology, pathophysiology, or disease, 
     epidemiologic or behavioral studies, outcomes research, or 
     health services research.''.

     SEC. 633. SENIOR BIOMEDICAL RESEARCH SERVICE.

       Section 228 (42 U.S.C. 237) is amended by adding at the end 
     thereof the following new subsection:
       ``(h) Notwithstanding any other provision of law, the 
     Secretary shall be treated as a non-profit entity for the 
     purposes of making contributions to the retirement systems of 
     appointees under this section in a manner that will permit 
     such appointees to continue to be fully covered under the 
     retirement systems that such appointees were members of 
     immediately prior to their appointment under this section.''.

     SEC. 634. ESTABLISHMENT OF A PEDIATRIC RESEARCH INITIATIVE.

       Part A of title IV (42 U.S.C. 281 et seq.), as amended by 
     sections 611, 631, and 632, is further amended by adding at 
     the end the following new section:

     ``SEC. 404I. PEDIATRIC RESEARCH INITIATIVE

       ``(a) Establishment.--The Secretary shall establish within 
     the Office of the Director of NIH a Pediatric Research 
     Initiative (hereafter in this section referred to as the 
     `Initiative'). The Initiative shall be headed by the Director 
     of NIH.
       ``(b) Purpose.--The purpose of the Initiative is to provide 
     funds to enable the Director of NIH to encourage--
       ``(1) increased support for pediatric biomedical research 
     within the National Institutes of Health to ensure that the 
     expanding opportunities for advancement in scientific 
     investigations and care for children are realized;
       ``(2) enhanced collaborative efforts among the Institutes 
     to support multidisciplinary research in the areas that the 
     Director deems most promising;
       ``(3) increased support for pediatric outcomes and medical 
     effectiveness research to demonstrate how to improve the 
     quality of children's health care while reducing cost;
       ``(4) the development of adequate pediatric clinical trials 
     and pediatric use information to promote the safer and more 
     effective use of prescription drugs in the pediatric 
     population; and
       ``(5) recognition of the special attention pediatric 
     research deserves.
       ``(c) Duties.--In carrying out subsection (b), the Director 
     of NIH shall--
       ``(1) consult with the Institutes and other advisors as the 
     Director determines appropriate when considering the role of 
     the Institute for Child Health and Human Development;
       ``(2) have broad discretion in the allocation of any 
     Initiative assistance among the Institutes, among types of 
     grants, and between basic and clinical research so long as 
     the--
       ``(A) assistance is directly related to the illnesses and 
     diseases of children; and
       ``(B) assistance is extramural in nature; and
       ``(3) be responsible for the oversight of any newly 
     appropriated Initiative funds and be accountable with respect 
     to such funds to Congress and to the public.
       ``(d) Authorization.--There is authorized to be 
     appropriated to carry out this section, $50,000,000 for 
     fiscal years 1997 through 1999.
       ``(e) Transfer of Funds.--The Director of NIH may transfer 
     amounts appropriated to any of the Institutes for a fiscal 
     year to the Initiative to carry out this section.''.

     SEC. 635. DIABETES RESEARCH.

       (a) Findings.--The Congress finds as follows:
       (1) Diabetes is a serious health problem in America.
       (2) More than 16,000,000 Americans suffer from diabetes.
       (3) Diabetes is the fourth leading cause of death in 
     America, taking the lives of more than 169,000 people 
     annually.
       (4) Diabetes disproportionately affects minority 
     populations, especially African-Americans, Hispanics, and 
     Native Americans.
       (5) Diabetes is the leading cause of new blindness in 
     adults over age 30.
       (6) Diabetes is the leading cause of kidney failure 
     requiring dialysis or transplantation, affecting more than 
     56,000 Americans each year.
       (7) Diabetes is the leading cause of nontraumatic 
     amputations, affecting 54,000 Americans each year.
       (8) The cost of treating diabetes and its complications are 
     staggering for our Nation.
       (9) Diabetes accounted for health expenditures of 
     $105,000,000,000 in 1992.
       (10) Diabetes accounts for over 14 percent of our Nation's 
     health care costs.
       (11) Federal funds invested in diabetes research over the 
     last two decades has led to significant advances and, 
     according to leading scientists and endocrinologists, has 
     brought the United States to the threshold of revolutionary 
     discoveries which hold the potential to dramatically reduce 
     the economic and social burden of this disease.
       (12) The National Institute of Diabetes and Digestive and 
     Kidney Diseases supports, in addition to many other areas of 
     research, genetic research, islet cell transplantation 
     research, and prevention and treatment clinical trials 
     focusing on diabetes. Other research institutes within the 
     National Institutes of Health conduct diabetes-related 
     research focusing on its numerous complications, such as 
     heart disease, eye and kidney problems, amputations, and 
     diabetic neuropathy.
       (b) Increased Funding Regarding Diabetes.--With respect to 
     the conduct and support of diabetes-related research by the 
     National Institutes of Health, there are authorized to be 
     appropriated for such purpose--
       (1) for each of the fiscal years 1997 through 1999, an 
     amount equal to the amount appropriated for such purpose for 
     fiscal year 1996; and
       (2) for the 3-fiscal year period beginning with fiscal year 
     1997, an additional amount equal to 25 percent of the amount 
     appropriated for such purpose for fiscal year 1996.

     SEC. 636. PARKINSON'S RESEARCH.

       Part B of title IV (42 U.S.C. 284 et seq.), as amended by 
     sections 204, 382 and 383, is further amended by adding at 
     the end the following section:


                         ``parkinson's disease

       ``Sec. 409E. (a) In General.--The Director of NIH shall 
     establish a program for the conduct and support of research 
     and training with respect to Parkinson's disease.
       ``(b) Inter-institute Coordination.--
       ``(1) In general.--The Director of NIH shall provide for 
     the coordination of the program established under subsection 
     (a) among all of the national research institutes conducting 
     Parkinson's research.
       ``(2) Conference.--Coordination under paragraph (1) shall 
     include the convening of a research planning conference not 
     less frequently than once every 2 years. Each such conference 
     shall prepare and submit to the Committee on Appropriations 
     and the Committee on Labor and Human Resources of the Senate 
     and the Committee on Appropriations and the Committee on 
     Commerce of the House of Representatives a report concerning 
     the conference.
       ``(c) Morris K. Udall Research Centers.--
       ``(1) In general.--The Director of NIH shall award Core 
     Center Grants to encourage the development of innovative 
     multidisciplinary research and provide training concerning 
     Parkinson's. The Director shall award not more than 10 Core 
     Center Grants and designate each center funded under such 
     grants as a Morris K. Udall Center for Research on 
     Parkinson's Disease.
       ``(2) Requirements.--
       ``(A) In general.--With respect to Parkinson's, each center 
     assisted under this subsection shall--
       ``(i) use the facilities of a single institution or a 
     consortium of cooperating institutions, and meet such 
     qualifications as may be prescribed by the Director of the 
     NIH; and
       ``(ii) conduct basic and clinical research.
       ``(B) Discretionary requirements.--With respect to 
     Parkinson's, each center assisted under this subsection may--
       ``(i) conduct training programs for scientists and health 
     professionals;
       ``(ii) conduct programs to provide information and 
     continuing education to health professionals;
       ``(iii) conduct programs for the dissemination of 
     information to the public;
       ``(iv) develop and maintain, where appropriate, a brain 
     bank to collect specimens related to the research and 
     treatment of Parkinson's;
       ``(v) separately or in collaboration with other centers, 
     establish a nationwide data system derived from patient 
     populations with Parkinson's, and where possible, comparing 
     relevant data involving general populations;
       ``(vi) separately or in collaboration with other centers, 
     establish a Parkinson's Disease Information Clearinghouse to 
     facilitate and enhance knowledge and understanding of 
     Parkinson's disease; and
       ``(vii) separately or in collaboration with other centers, 
     establish a national education program that fosters a 
     national focus on Parkinson's and the care of those with 
     Parkinson's.
       ``(3) Stipends regarding training programs.--A center may 
     use funds provided under paragraph (1) to provide stipends 
     for scientists and health professionals enrolled in training 
     programs under paragraph (2)(B).
       ``(4) Duration of support.--Support of a center under this 
     subsection may be for a period not exceeding five years. Such 
     period may be extended by the Director of NIH for one or more 
     additional periods of not more than five years if the 
     operations of such center have been reviewed by an 
     appropriate technical and scientific peer review group 
     established by the Director and if such group has recommended 
     to the Director that such period should be extended.
       ``(d) Morris K. Udall Awards for Innovation in Parkinson's 
     Disease Research.--The Director of NIH shall establish a 
     grant program to support innovative proposals leading to 
     significant breakthroughs in Parkinson's research. Grants 
     under this subsection shall be available to support 
     outstanding neuroscientists and clinicians who bring 
     innovative ideas to bear on the understanding of the 
     pathogenesis, diagnosis and treatment of Parkinson's disease.
       ``(e) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $80,000,000 for fiscal year 1997, and such sums 
     as may be necessary for each of the fiscal years 1998 and 
     1999.''.
             Subtitle E--Repeals and Conforming Amendments

     SEC. 641. REPEALS AND CONFORMING AMENDMENTS.

       (a) Renaming of Division of Research Resources.--Section 
     403(5) (42 U.S.C. 283(5)) is amended by striking ``Division 
     of Research Resources'' and inserting ``National Center for 
     Research Resources''.
       (b) Renaming of National Center for Nursing Research.--

[[Page S11397]]

       (1) Section 403(5) (42 U.S.C. 283(5)) is amended by 
     striking ``National Center for Nursing Research'' and 
     inserting ``National Institute of Nursing Research''.
       (2) Section 408(a)(2) (42 U.S.C. 284c(a)(2)) is amended by 
     striking ``National Center for Nursing Research'' and 
     inserting ``National Institute of Nursing Research''.
       (c) Renaming of Chief Medical Director for Veterans 
     Affairs.--
       (1) Section 406 (42 U.S.C. 284a) is amended--
       (A) in subsection (b)(2)(A), by striking ``Chief Medical 
     Director of the Department of Veterans Affairs or the Chief 
     Dental Director of the Department of Veterans Affairs'' and 
     inserting ``Under Secretary for Health of the Department of 
     Veterans Affairs''; and
       (B) in subsection (h)(2)(A)(v) by striking ``Chief Medical 
     Director of the Department of Veterans Affairs,'' and 
     inserting ``Under Secretary for Health of the Department of 
     Veterans Affairs''.
       (2) Section 424(c)(3)(B)(x) (42 U.S.C. 285b-7(c)(3)(B)(x)) 
     is amended by striking ``Chief Medical Director of the 
     Veterans' Administration'' and inserting ``Under Secretary 
     for Health of the Department of Veterans Affairs''.
       (3) Section 429(b) (42 U.S.C. 285c-3(b)) is amended by 
     striking ``Chief Medical Director of the Veterans' 
     Administration'' and inserting ``Under Secretary for Health 
     of the Department of Veterans Affairs''.
       (4) Section 430(b)(2)(A)(i) (42 U.S.C. 285c-4(b)(2)(A)(i)) 
     is amended by striking ``Chief Medical Director of the 
     Department of Veterans Affairs'' and inserting ``Under 
     Secretary for Health of the Department of Veterans Affairs''.
       (5) Section 439(b) (42 U.S.C. 285d-4(b)) is amended by 
     striking ``Chief Medical Director of the Department of 
     Veterans Affairs'' and inserting ``Under Secretary for Health 
     of the Department of Veterans Affairs''.
       (6) Section 452(f)(3)(B)[(ix)](xi) (42 U.S.C. 285g-
     4(f)(3)(B)[(ix)](xi)) is amended by striking ``Chief Medical 
     Director of the Department of Veterans Affairs'' and 
     inserting ``Under Secretary for Health of the Department of 
     Veterans Affairs''.
       (7) Section 466(a)(1)(B) (42 U.S.C. 286a(a)(1)(B)) is 
     amended by striking ``Chief Medical Director of the 
     Department of Veterans Affairs'' and inserting ``Under 
     Secretary for Health of the Department of Veterans Affairs''.
       (8) Section 480(b)(2)(A) (42 U.S.C. 287a(b)(2)(A)) is 
     amended by striking ``Chief Medical Director of the 
     Department of Veterans Affairs'' and inserting ``Under 
     Secretary for Health of the Department of Veterans Affairs''.
       (b) Advisory Councils.--Section 406(h) (42 U.S.C. 284a(h)) 
     is amended--
       (1) by striking paragraph (1); and
       (2) in paragraph (2)--
       (A) by striking ``(2)(A) The'' and inserting ``(1) The'';
       (B) by redesignating subparagraph (B) as paragraph (2); and
       (C) by redesignating clauses (i) through (vi) of paragraph 
     (1) (as so redesignated) as subparagraphs (A) through (F), 
     respectively.
       (c) Diabetes and Digestive and Kidney Disorders Advisory 
     Boards.--Section 430 (42 U.S.C. 285c-4) is repealed.
       (d) National Arthritis and Musculoskeletal and Skin 
     Diseases Advisory Board.--Section 442 (42 U.S.C. 285d-7) is 
     repealed.
       (e) Research Centers Regarding Chronic Fatigue Syndrome.--
     Subpart 6 of part C of title IV (42 U.S.C. 285f et seq.) is 
     amended by redesignating the second section 447 (42 U.S.C. 
     285f-1) as section 447A.
       (f) National Institute on Deafness Advisory Board.--Section 
     464D (42 U.S.C. 285m-4) is repealed.
       (g) Biomedical and Behavioral Research Personnel Study.--
     Section 489 (42 U.S.C. 288b) is amended--
       (1) by striking subsections (b); and
       (2) by redesignating subsection (c) as subsection (b).
       (h) National Commission on Alcoholism and Other Alcohol-
     Related Problems.--Section 18 of the Comprehensive Alcohol 
     Abuse and Alcoholism Prevention, Treatment, and 
     Rehabilitation Act Amendments of 1979 (42 U.S.C. 4541 note) 
     is repealed.
       (i) Advisory Council on Hazardous Substances Research and 
     Training.--Section 311(a) of the Comprehensive Environmental 
     Response, Compensation and Liability Act of 1980 (42 U.S.C. 
     9660(a)) is amended--
       (1) by striking paragraph (5); and
       (2) in the last sentence of paragraph (6), by striking 
     ``the relevant Federal agencies referred to in subparagraph 
     (A) of paragraph (5)'' and inserting ``relevant Federal 
     agencies''.

  Mr. LOTT. Mr. President, I ask unanimous consent that the committee 
amendments be agreed to en bloc.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The committee amendments were agreed to.


                           Amendment No. 5404

            (Purpose: To provide for a substitute amendment)

  Mr. LOTT. Senator Kassebaum has a substitute amendment at the desk. I 
ask for its consideration.
  The PRESIDING OFFICER. The clerk will report.
  The legislative clerk read as follows:

       The Senator from Mississippi [Mr. Lott], for Mrs. 
     Kassebaum, proposes an amendment numbered 5404.

  Mr. LOTT. I ask unanimous consent that the amendment be considered as 
read.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (The text of the amendment is printed in today's Record under 
``Amendments Submitted.'')
  Mrs. KASSEBAUM. Mr. President, I am extremely pleased that the Senate 
is considering the National Institutes of Health [NIH].
  All Americans can take great pride in the exceptional contributions 
that the NIH has made. It has compiled an astonishing record of 
biomedical research advances which have transformed all of our lives. 
Vaccines against conditions which once crippled and killed are now 
routine, and drugs hailed as miracles at their inception are as well 
known as aspirin.
  The NIH has spawned and nurtured a level of scientific creativity 
which truly seems to have no bounds. Past successes against seemingly 
insurmountable odds have inspired confidence and offered hope to those 
who have nowhere else to turn. The legislation we are considering today 
will help support and improve these critical efforts.
  In addition to reauthorizing the important work of the two largest 
institutes--the National Cancer Institute and the National Heart, Lung, 
and Blood Institute--this bill attempts to strengthen the ability of 
the NIH to respond to emerging issues in the biomedical research arena 
and in the larger health care environment in which it operates.
  Certainly, one of the biggest future frontiers is that of the human 
genetic code. Among the recent discoveries is the BRCA-1 gene, a 
genetic marker for a form of breast cancer. In recognition of the 
significance of this area of inquiry, the bill authorizes the creation 
of the National Human Genome Research Institute. The elevation of the 
National Center for Genome Research to institute status will serve to 
better focus NIH resources for this important work.
  The bill also recognizes a need to invest in the education and 
training of the next generation of clinical researchers--those 
biomedical scientists who perform research that directly involves 
patients. It provides for greater support for expert training of young 
biomedical scientists who have elected the difficult, and frequently 
less well-compensated, careers in scientific inquiry.
  In addition, the bill makes substantial efforts to reduce excess and 
often duplicative infrastructure that has grown up over time in the 
NIH. It streamlines operations through steps such as eliminating 
redundant committees and reports. Every dollar saved from unnecessary 
administrative burdens is another dollar freed up for support of 
biomedical research.
  By the very nature of ever-expanding new knowledge, it seems there is 
no end to the pressure on the limited resources for biomedical research 
support. Accordingly, the bill establishes a framework under which 
additional sources of funding could be tapped by creating a biomedical 
research trust fund within the Treasury. This trust fund is a small, 
but important, first step.
  Academic health centers in the 21st century will be posed with an 
unprecedented challenge: how to maintain their research mission in the 
face of a fundamentally changed health care system. These changes are 
the consequence of dramatic market shifts that are taking place in 
health care in this country. Cost-competition has made it particularly 
difficult for the continuation of many of these important institutions 
that frequently care for the sickest as well as the poorest citizens of 
our communities.
  Although additional action may be required as ongoing studies offer a 
better understanding of the ramifications of these changes, this bill 
offers support for the 75 general clinical research centers that exist 
in academic medical centers throughout the country.
  Finally, this measure includes a significant initiative in the area 
of Parkinson's disease research. Based on separate legislation with 
broad bipartisan support in both the Senate and House, this initiative 
is designed to expand and improve Parkinson's research efforts. It 
establishes up to 20 Morris K.

[[Page S11398]]

Udall Centers for Research on Parkinson's disease and provides for 
awards to neuroscientists and clinicians to support innovative 
research.
  This legislation offers hope to individuals with Parkinson's and 
their families, who have worked long and hard to assure that greater 
attention and emphasis is placed on pursuing promising research leads.
  In fact, Mr. President, reauthorization of the important work of the 
National Institutes of Health offers hope to us all. Moreover, it 
reaffirms our commitment to approach the future frontiers of science 
with the same enthusiasm and dedication which has characterized our 
past. I urge my colleagues to support the adoption of the National 
Institutes of Health Revitalization Act of 1996.
  Mr. GREGG. Mr. President, I am pleased to see that the Senate will 
pass a bill today, S. 1879, that reauthorizes funding for the National 
Institutes of Health [NIH]. The NIH is one of the few Federal 
Government agencies that truly receives bipartisan support as it works 
to respond to the challenges posed by the medical mysteries of our 
times. I share the overwhelming support for the work generally being 
done at, and funded by, the NIH with my constituents in New Hampshire 
who have contacted me about this legislation.
  The NIH is composed of 24 separate Institutes that conduct basic 
biomedical research; our investment in the NIH represents over one-
third of the total nondefense research and development funding in the 
Federal Government. Institutes like the National Center for Human 
Genome Research, which has recently received a tremendous amount of 
attention for its undertaking of mapping and sequencing human genes to 
find the genetic bases for disease, continue to change the way we look 
at science.
  I think that we have to be aware, however, that each time the science 
improves, a number of the factors come into play: How to update the 
standard of ethics; how to manage the flow of information; how to 
ensure that coordination is being optimized between Centers and 
Institutes internally at the NIH; how to encourage public/private 
partnership in the funding of these developments; and how to best 
prioritize the Federal funding in relation to the pursuit of such 
critical medical discoveries. Mr. President, I am not certain that, in 
our role as the overseers of this important Federal agency, we have 
been as attentive as we need to be to these issue in the 
reauthorization process; and that is why I am especially pleased that 
the decision was make to make this a 1-year reauthorization. I believe 
we need to revisit a number of important items on the NIH agenda next 
session, and I look forward to being involved in those efforts.
  For example, the last NIH reauthorization included authority for a 
foundation which NIH can use to raise funds. Its purposes was to 
increase coordination with universities and the private sector and make 
it possible to solicit funds for special projects. I remain uncertain 
that the foundation is being utilized. It is time to recognize that 
Federal dollars must function as a means to an end--the appropriations 
we are able to provide to the NIH will never be enough. But before we 
begin to craft new schemes to raise additional funds for the NIH, we 
need to be sure that the mechanisms we have already put in place are 
functioning as intended. Therefore, I believe the NIH must use their 
authority to appropriately levy additional funds, to maximize their 
available resources. In this way, a dedicated effort can be made to 
increase the awareness of, involvement in, and contributions to our 
premiere biomedical research facility, rather than continue to rely on 
the limited taxpayer funds were able to appropriate to the Institutes.
  In other areas, the NIH receives very high marks. Their support of 
both intramural clinical research and extramural research funded 
through grants and is conducted outside NIH, at such premiere 
facilities as Dartmouth College and the University of New Hampshire, 
demonstrates their understanding of the need to utilize every resource 
we have in fighting the diseases which face Americans. I applaud the 
NIH's efforts to ensure that funding is provided to scientists 
conducting research beyond the NIH campus. Too often we see Federal 
agencies adopt the attitude that they have a lock on the science they 
practice; I believe our Government science administrators need to adopt 
the attitude of openness and the spirit of cooperation demonstrated at 
NIH toward their colleagues in academia and the private sector.
  I am pleased to note that we have included a provision that has long 
been championed by Senator Hatfield, who has demonstrated a devoted 
dedication to supporting the research and vision of the NIH. It is a 
program designed to ensure that young people are encouraged to enter 
the field of basic clinical research by providing needed financial 
assistance. It is the students of science who represent our hope for 
the future, and I am hopeful that this program will provide them the 
necessary support to take on a career in this critical field.
  So I am pleased to offer my support for this legislation today, 
realizing that several outstanding issues remain before us in relation 
to this reauthorization. I am hopeful, Mr. President, that when we 
return in 1997, we will turn to this legislation early in the opening 
days of the 105th Congress, and make a bipartisan effort to further 
improve this agency that offers so much to so many.
  The PRESIDING OFFICER. The Senator from North Dakota.
  Mr. DORGAN. Mr. President, two mornings ago I spoke with a friend of 
mine in North Dakota named Olaf. He is 85 years old. He was to have 
open heart surgery that morning to repair a leaky heart valve.
  I mention this because I want to talk just for a moment today about 
the reauthorization of the National Institutes of Health, which the 
Senate has just unanimously approved, and I was thinking about Olaf. 
When he underwent open heart surgery not too many hours ago at age 85, 
I thought it was kind of an unusual thing, to have open heart surgery 
at age 85. I asked some doctors about it, and they said this is not so 
unusual anymore.
  This reminds me of the breathtaking advances that we have seen in 
medicine in recent years, many of which come as a result of the 
dedicated research of the National Institutes of Health and researchers 
from all around the country and the world who work on NIH-supported 
projects.
  There is a wonderful exhibit at the National Institutes of Health 
that I encourage all those who visit Washington, DC, to go see. It is 
an exhibit called, ``The Healing Garden.'' The healing garden is a 
little garden exhibit showing the plants that researchers are now 
discovering have remarkable uses in modern medicine.
  A lot of people think of medicine these days as doing some research 
to find some chemicals and compounds, putting these chemicals together 
in a pill, and giving somebody this pill that represents some sort of 
chemical response to an illness or disease. However, much of what we 
now are understanding about today's medicine begins with trees and 
shrubs and plants.
  I just want to talk for a moment about what the healing garden at the 
National Institutes of Health demonstrates. The reason I want to do 
that is because we talk so often about what is wrong in Government, or 
what this agency does that is inappropriate, or what these bureaucrats 
do that is somehow improper. Today, I want everyone to know that there 
are wonderful researchers down at the National Institutes of Health 
doing extraordinary work in the field of medicine.
  For instance, researchers at the National Institutes of Health, 
working with the Department of Agriculture, have collected more than 
60,000 plant samples from all over the world, and preserved and stored 
them at National Institutes of Health facilities in Frederick, MD. 
These samples are then distributed to researchers for testing. Let me 
describe some of the testing.
  Researchers have found that a tree that is commonly found in China, 
and often known there by the name of ``The Tree of Joy'' or ``The Tree 
of Love,'' is a source of a promising compound called CPT that works to 
kill cancer cells. Various derivatives of this compound from the Tree 
of Love in China are being tested in clinical trials right now at the 
National Institutes of Health, involving patients with lung cancer, 
ovarian cancer, breast cancer,

[[Page S11399]]

colon cancer, and leukemia. In the future, when these tests are 
complete, we may very well call the ``Tree of Joy'' the ``Tree of 
Life'' for cancer patients.
  A researcher from Brigham Young University has consulted with 
traditional healers in Samoa, and other regions of Polynesia, about the 
local uses of medicinal plants. During the testing of these plants from 
Polynesia here at the National Cancer Institute of the National 
Institutes of Health, researchers have found that an extract of wood, 
which the healers were using to treat Yellow Fever, has showed 
significant promise in fighting the AIDS virus. This potential anti-
AIDS drug is now in preclinical development at the National Cancer 
Institute at the NIH.
  A plant found in Australia known as the Salt Bush has shown 
significant promise in combating AIDS as well. A compound from the Salt 
Bush from Australia is now also being studied in preclinical 
development.
  A NIH researcher recently discovered that an alkaloid from the skin 
of an Ecuadorian poison frog may be a potent pain killer, 200 times 
more powerful than morphine, and potentially nonaddictive as well.
  I could go on and on, but finally, the last example I'll share today: 
There is another poison from a frog that they have tested at the NIH 
that is so incredibly powerful that the slightest contact with it by a 
human being will stop the heart instantly. Researchers wondered then if 
this incredibly powerful poison that can stop the human heart instantly 
might also have wonderful powers that could be harnessed positively, 
and they are now researching that.

  If you go to the National Institutes of Health and ask them to tell 
you about the healing garden, they will show you the exhibit that 
demonstrates that much of what we have now discovered about medicine 
involves the use of items living naturally all around us--plants, 
shrubs, trees--in ways that some might have known to use them long ago 
and that we are now learning how to use again to provide powerful 
treatment opportunities for those in our world who are sick.
  The reason, again, I wanted to mention this wonderful work being done 
at NIH is my friend Olaf, who, as I said when I started, had open heart 
surgery recently at age 85. Incidentally, Olaf had the ventilator tubes 
removed 2 hours after the surgery and had all of the other tubes 
removed by suppertime that evening, and at age 85, he is doing 
wonderfully, I am told. He is a part of a health care system that 
really does provide close to miracles for many, with divine help, I 
might add. But these miracles come with a great deal of help from 
researchers at the National Institutes of Health.
  When I was at the National Institutes of Health, I also talked to the 
researchers in cardiology. The research they are doing in the area of 
heart disease is quite remarkable. What they are doing in the areas of 
cancer treatment is extraordinary. What they are doing in the search 
for AIDS treatments is really quite amazing. Arthritis, diabetes, the 
list goes on.
  I assume there are some who would call using Government money to pay 
for the scientists and the researchers and the doctors, for the 
clinical trials and for all of the basic and applied research that goes 
on at the National Institutes of Health, spending. I think rather than 
call it ``spending'' we ought to call it ``investment.'' The NIH is one 
of the most remarkably productive investments our country has made.
  At the turn of this century, if you were an American, you were 
expected to live to perhaps age 47. The century is about to turn again, 
and 100 years later, you can likely expect to live to nearly age 77, a 
30-year increase in your lifespan in this century.
  There are a lot of reasons for that: people are healthier, they take 
better care of themselves, know more about nutrition. There are many 
reasons for this significant increase in life expectancy but included 
among those reasons are the breathtaking advances in health care.
  At the root of those breathtaking advances in medical care is an 
investment in something called the National Institutes of Health which 
seldom gets the due it deserves here in this Congress. I just wanted to 
stand up and say a kind word about some awfully dedicated public 
servants all across this country; the doctors and nurses in the private 
sector and so many others who participate in these clinical trials, but 
especially about the folks here and around the country working for the 
NIH who spend their days looking at an abstract plant garnered from a 
region in China that might be called the ``Tree of Life,'' discovering 
that this tree might contain the secret to curing a cancer. Or 
researching a bush called the ``Salt Bush'' from Australia that might 
have promise to cure AIDS.
  Someone might say in a magazine article some day, ``You know, we pay 
people to sit around and investigate ``Salt Bushes.'' Can you imagine 
anything more wasteful than that? We are paying people to sit around 
and cut up trees and ruminate about whether an obscure tree from China 
might be helpful to somebody, can you imagine anything more wasteful 
than that?"
  I say, this is not wasteful at all. This is a wonderful, remarkable 
investment, and I am pleased that the Congress will, once again, 
reauthorize the National Institutes of Health for three more years. My 
only wish is that it were a longer reauthorization.
  Let me also say, I would be willing to support a modest increase in 
the Federal tax on cigarettes, for example, if the money raised from 
that tax were to go exclusively to boost the funding for more research 
at the National Institutes of Health and for more investment in saving 
people's lives in this country.
  Mr. President, thank you for the opportunity to speak, and I yield 
the floor.
  Mr. HATCH. Mr. President, nurturing our biomedical research 
infrastructure is one of the most important roles Government can serve, 
and that is why S. 1897 is a significant piece of legislation.
  I rise to express my support for the bill, and, in particular, to 
thank the chairman, Senator Kassebaum, for her cooperation in 
addressing the concerns that Senator Faircloth, Senator Harkin, and I 
have expressed about the need to bolster the National Institutes of 
Health's research efforts on pain management.
  Pain is a condition that each of us experiences during our lifetime, 
with millions suffering--perhaps needlessly.
  After serious study of this issue, I have concluded there is 
insufficient knowledge about the causes and treatments of pain, despite 
its substantial impact on virtually every American. Inadequate 
resources are dedicated to the development and evaluation of pain 
treatment modalities, and there is an inadequate transfer of what 
knowledge and information we have to health care professionals.
  It may surprise many of my colleagues to know that despite the impact 
of pain on our society, according to estimates NIH supplied to my 
office, the agency spent less than $60 million of its $11 billion 
appropriation on pain research last year, a number which, in fact, at 
best equal to the previous year's level of $59.5 million. For acute 
back pain, a condition which is estimated to affect 85 percent of the 
population at one time or another, NIH reports it currently spends only 
$2.5 million on research. An additional problem is that pain research 
is spread across many of the Institutes, yet there is little 
coordination of these research activities to make certain the resources 
are used effectively.
  In fact, a December 1995 Workshop on Selected Chronic Pain 
Conditions: Clinical Spectrum, Frequency and Costs, held by the 
National Institutes of Health concluded:

       With respct to strategies for promoting research on chronic 
     pain, the participants noted that the NIH components 
     separately support pain research, but no organizational unit 
     integrates or coordinates this research.

  They strongly urged that the NIH establish a formal NIH Office of 
Pain Research, which would enable the NIH components to argue for pain 
research as a priority.
  As an aside, I note that this workshop was not initiated at NIH's own 
behest, but rather, was held to comply with the 1993 NIH 
reauthorization law.
  Indeed, there is a recent history of congressional support for 
enhancing the NIH's efforts on pain research. In the report accompany 
the fiscal year 1997 appropriations for the NIH, Senator Specter was 
very helpful by including the following language:

       The Committee is pleased that pain research is becoming an 
     increasing part of the

[[Page S11400]]

     NIH research agenda, and remains interested in the level of 
     its overall growth and the need for better coordination. Pain 
     is a major public health problem afflecting or disabling 
     nearly 50 million Americans. The Committee encourages the NIH 
     to quickly advance interdisciplanary coordination and support 
     of the complex issues involved in pain research, including 
     collaboration with chiropractic colleges and schools of 
     nursing. The Committee is aware of the 1995 NIH-sponsored 
     workshop on pain research, and requests the Director be 
     prepared to report on the implrementation of the workshop's 
     recommendations during the fiscal year 1998 budget hearing.

  Earlier this year, Senators Harkin, Faircloth, Bennett, Inouye, 
Thurmond, Pressler and I introduced S. 1955, to establish a pain center 
at NIH. That legislation forms the basis of the provision included in 
S. 1897. The provision that is included in S. 1897 today, however, 
differs from our original bill in that it requires NIH to establish a 
pain research consortium. The consortium, which will be comprised of 
experts in pain management from both the public and private sectors, 
will perform the advocacy and coordinating functions outlined in our 
original bill.
  Specifically, the pain research consortium will: provide a structure 
for coordinating pain research activities; facilitate communications 
among Federal and State governmental agencies and private sector 
organizations concerned with pain; share information concerning pain-
related research; encourage the recruitment and retention of 
individuals desiring to conduct pain research; avoid unnecessary 
duplication of pain research efforts; and achieve a more efficient use 
of Federal and private sector research funds.
  The consortium will be composed of representatives from the NIH 
Institutes, and practitioners of pain management, including 
representatives from each of the following professions: physicians who 
practice pain management, psychologists, physical medicine and 
rehabilitation service representatives--including physical therapists 
and occupational therapists, nurses, dentists, and chiropractors. 
Finally, of course, patient advocacy organization representatives will 
be an integral part of the consortium.
  Mr. President, the Congress needs to go on record in support of a 
stronger pain effort at the NIH. Today, we accomplish that goal. I urge 
adoption the bill, which now includes the Faircloth/Hatch amendment to 
establish a pain research consortium. I yield to my friend from North 
Carolina, Senator Faircloth.
  Mr. FAIRCLOTH. I thank the distinguished Senator from Utah for 
yielding. I commend Senator Hatch and Senator Harkin for their success 
in advancing the issue of pain research. I am absolutely convinced of 
the merits of S. 1955, and I am committed to moving ahead with the idea 
of establishing a formal entity at NIH to coordinate the current 
research effort and give greater priority within the overall NIH budget 
for research on back pain, cancer-related pain and the other focus 
areas addressed in S. 1955.
  I also thank Senator Kassebaum for working with us to take an 
important step toward reaching our goal of increased emphasis on pain 
research. During the mark-up of S. 1897, Senator Kassebaum pledged to 
work with me to develop a provision relating to pain research. I 
appreciate her efforts and those of her staff in accommodating our 
concerns.
  With regard to the consortium, I would like to clarify a point raised 
by Senator Hatch. It is our intention that the consortium established 
pursuant to S. 1897 shall include an equal number of representatives 
from each group of pain management practitioners defined under 
subparagraph (c)(4) of the section relating to the pain research 
consortium.
  Finally, it is my sincere hope and intention that during the 105th 
Congress we will work again in a bipartisan manner toward establishing 
a more permanent entity at NIH for pain research.
  Ms. MIKULSKI. Mr. President, I rise in strong support of the National 
Institutes of Health Revitalization Act. I support this bill for three 
reasons. It puts new emphasis on research into Parkinson's disease, a 
terribly debilitating and costly disease. It provides new incentives 
for physicians to do clinical research. It streamlines the NIH and 
makes it easier for NIH to do its job.
  I want to thank Senator Kassebaum and her staff for their hard work 
on this bill. NIH is a national treasure. I'm proud that it's located 
in Maryland. I'm proud of its dedicated employees. Let's give them the 
tools they need to perform their jobs effectively and efficiently. 
Let's give hope to the American people that cures to dreaded diseases 
and conditions are on the horizon.
  This bill honors our dear colleague, former Congressman Morris K. 
Udall. Mo was forced to retire from the House because of the disabling 
effects of Parkinson's disease. It includes language that has wide 
bipartisan support in both Chambers. The bill establishes up to 10 
Morris K. Udall Centers for Research on Parkinson's Disease. It also 
provides awards to outstanding scientists and clinicians who bring 
innovative ideas to bear on Parkinson's research.
  Great advances in brain research in the last few years create the 
potential for major treatments of this disease, possibly in this 
decade--the decade of the brain. Expanded focus on Parkinson's disease 
will bring hope to the 50,000 Americans diagnosed with this 
debilitating illness each year. And it will cut down on the estimated 
$25 billion a year in health-related costs and lost productivity due to 
Parkinson's.
  The number of physician's entering careers in research is dwindling. 
This trend concerns me. Physicians who practice in academic medical 
centers face more pressure to bring in clinical revenue. They have less 
time to conduct research. I don't like the discouraging picture this 
paints for young investigators. Fewer and fewer physicians enter 
careers in biomedical research. They simply can't afford it. And as a 
nation, we can't afford it. We must provide incentives to our young 
people to enter careers in biomedical research.
  Clinical research leads to interventions and cures for diseases. It 
improves the quality of life for many people. Obstacles to clinical 
research slow progress in medicine. Patients are kept waiting longer 
for the cure to their disease or condition. This bill helps turn this 
around.
  Seventy-five General Clinical Research Centers [GCRC's] are 
authorized by this bill. I'm proud that three of these are located at 
Johns Hopkins. The bill increases investment and incentives for the 
education and training of the next generation of clinical researchers. 
It establishes new awards programs for clinical investigators and also 
recognizes the importance of basic medical research. It helps both 
basic and clinical investigators pay for their training by raising the 
loan repayment level.
  The NIH has enjoyed significant support over the last few decades. 
But we all know that the days of unlimited Federal funding are gone. 
This bill recognizes that resources are dwindling. It reduces 
administrative excess. It repeals duplicative advisory boards and 
committees. Instead, it frees up money from these unecessary endeavors 
for important research.
  Finally, this bill reauthorizes institutes carrying out important 
work in so many areas that affect our lives--cancer, heart, and aging 
research to name just a few. Let's not miss this important opportunity 
to pass this bill today. I urge my colleagues to vote for it.
  Mr. LOTT. I ask unanimous consent that the amendment be agreed to, 
the bill be deemed read a third time and passed, the motion to 
reconsider be laid upon the table, and that any statements relating to 
the bill be placed at this point in the Record.
  The PRESIDING OFFICER. Is there objection?
  Mr. DORGAN. Reserving the right to object, and I shall not object, is 
this the reauthorization of the NIH?
  Mr. LOTT. This is the reauthorization of the National Institutes of 
Health.
  The PRESIDING OFFICER. Is there objection to the majority leader's 
request? The Chair hears none, and it is so ordered.
  The amendment (No. 5404) was agreed to.
  The bill (S. 1897), as amended, was deemed read for a third time and 
passed, as follows:
  [The bill was not available for printing. It will appear in a future 
issue of the Record.]

[[Page S11401]]

  Mr. LOTT. I do wish to thank all Senators who have been involved in 
making this agreement possible--Senator Kassebaum, Senator Hatch. There 
has been cooperation on the Democratic side of the aisle. We appreciate 
it. It is the right thing to do. I am glad it has been accomplished.
  I thank the Senator for yielding.

                          ____________________