[Congressional Record Volume 147, Number 178 (Thursday, December 20, 2001)]
[Senate]
[Pages S13966-S13969]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. HUTCHISON (for herself and Mr. Bingaman):
  S. 1878. A bill to establish programs to address the health care 
needs of residents of the United States-Mexico Border Area, and for 
other purposes; to the Committee on Health, Education, Labor, and 
Pensions.
  Mrs. HUTCHISON. Mr. President, I rise today to introduce the U.S./
Mexico Border Health Improvement Act. The issue of public health along 
the U.S./Mexico Border is as vast and varied as the 2000-mile Border 
itself. With the enactment of the NAFTA agreement, and the tremendous 
growth in population in the region, the Border represents, for both 
countries, the area of both greatest potential and enormous challenge. 
From San Yisidro to Brownsville, and from Tijuana to Matamoros, over 10 
million people call the Border region home. At the same time, the U.S. 
Border population is growing three times as fast as the rest of the 
Nation's, and the population of Mexico's border cities is expected to 
double over the next decade. For this reason, I am pleased to be joined 
by Senator Bingaman to offer legislation on the critical issue of 
improving U.S./Mexico Border Health.
  The Border region is like a ``top ten'' list of substandard living 
conditions: the highest poverty rate; the lowest education rate; 
highest unemployment; worst environmental degradation; and the worst 
record for all major public health indicators.
  The statistics are mind-numbing, but it is the sad reality of the 
human suffering and of the individuals, families, and communities 
behind those numbers that is so heart wrenching. Diabetes, HIV, 
hepatitis, tuberculosis, and birth defects all remain 
disproportionately and unacceptably high. Meanwhile, childhood 
immunizations, screenings, health education, and the ratio of health 
care providers to the general population all remain unacceptably low.
  This legislation that I offer today provides for a comprehensive 
border health program to address this woeful situation that includes 
the creation of an office of Border Health within Health and Human 
Services, authorizations for community health centers, and dental 
outreach programs. This bill also directs the Secretary of Health and 
Human Services to recruit and retain quality members of the National 
Health Service Corps for service

[[Page S13967]]

in the border region, while requesting authorization for the 
recruitment, training and retaining of bilingual health professionals, 
``promotor(a)s.''
  As a member of the United States Senate, I have worked very hard to 
improve the health of Border residents in the short term, but more 
important, to putting in place the infrastructure and institutions 
necessary to ensure a good, healthful life for our Nation's people well 
into the twenty-first century.
  I commend the Senator from New Mexico for his support on this issue, 
and I urge other Senators to join us in this effort.
  I ask unanimous consent the bill be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1878

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``United States/Mexico Border 
     Health Improvement Act of 2001''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) The United States-Mexico Border Area is the area 
     located in the United States within 100 kilometers of the 
     border between the United States and Mexico.
       (2) In the United States, the United States-Mexico Border 
     Area encompasses 46 counties in California, Arizona, New 
     Mexico, and Texas.
       (3) Presently, the United States-Mexico Border Area is 
     experiencing explosive population growth. In the United 
     States, this region currently has 11,500,000 residents. 
     However, this number is expected to exceed 22,000,000 by the 
     year 2025. The population of the region in Mexico is growing 
     at an ever faster rate. In total, the population of the 
     communities in both countries is expected to double between 
     the years 2020 and 2025.
       (4) With 11,500,000 residents and a 2,000-mile expanse, the 
     United States-Mexico Border Area has the population and size 
     of a State of the United States. If the region was such a 
     State, it would rank--
       (A) last in access to health care;
       (B) second in death rates (due to hepatitis);
       (C) third in deaths related to diabetes;
       (D) first in the number of tuberculosis cases;
       (E) first in schoolchildren living in poverty; and
       (F) last in per capita income.
       (5) In addition to the specific health problems listed in 
     paragraph (5), hundreds of thousands of Area residents also 
     each day face increased health risks due to being exposed to 
     the polluted water, soil, and air of the region.
       (6) Every county in the United States-Mexico Border Area in 
     the United States has at least a partial health professional 
     shortage area designation. Twenty-five percent of such 
     counties have severe shortages and lack adequate primary care 
     physicians. The shortage of dentists is also severe in many 
     Area localities.
       (7) According to GAO, the United States-Mexico Border Area 
     contains hundreds of colonias. Colonias are substandard 
     developments that typically lack running water, sewerage 
     systems, and electricity. Many of the residents of colonias 
     are migrant farmworker families.
       (8) Due to the poor living conditions in the colonias, the 
     United States-Mexico Border Area has a much higher rate of 
     waterborne infectious diseases. The occurrence of hepatitis 
     A, for example, is 3 times the national rate, and the 
     occurrence of salmonella and shigella dysentery occur is 2 to 
     4 times the national rate.

     SEC. 3. DEFINITIONS.

       In this Act:
       (1) United States-Mexico Border Area.--The term ``United 
     States-Mexico Border Area'' means the area located in the 
     United States within 100 kilometers of the border between the 
     United States and Mexico.
       (2) Secretary.--The term ``Secretary'' means the Secretary 
     of Health and Human Services.

     SEC. 4. OFFICE OF BORDER HEALTH.

       (a) In General.--There is established within the Department 
     of Health and Human Services an Office of Border Health 
     (referred to in this section as the ``Office'').
       (b) Director.--The Secretary shall appoint a Director of 
     the Office to administer and oversee the functions of such 
     Office.
       (c) Authority.--In overseeing the Office, the Secretary, 
     acting through the Director--
       (1) shall be responsible for the overall direction of the 
     Office and for the establishment and implementation of 
     general policies respecting the management and operation of 
     programs and activities of the Office;
       (2) shall establish programs and activities to study and 
     monitor border health service delivery in general, the 
     coordination of Federal and State and Federal and local 
     border health activities, the health education available for 
     border residents, existing outreach for residents and the 
     success of such outreach, health service activities, 
     particularly prevention, and early intervention activities, 
     and any other activity that the Secretary determines is 
     appropriate to improve the health of United States-Mexico 
     Border Area residents, including the health of Native 
     American tribes located within the primary Area;
       (3) shall review Federal public health programs and 
     identify opportunities for collaboration with other Federal, 
     State, and local efforts to address border health issues;
       (4) shall coordinate activities with the United States-
     Mexico Border Health Commission and State offices;
       (5) shall award grants to States, local governments, 
     nonprofit organizations, or other eligible entities as 
     determined by the Secretary, in the United States-Mexico 
     border area to address priorities and recommendations 
     established by--
       (A) the United States-Mexico Border Health Commission on a 
     binational basis, including the Healthy Border 2010 Program 
     Objectives; and
       (B) the Director, to improve the health of border region 
     residents;
       (6) shall award grants to programs that seek to improve the 
     health care of Area residents, with priority given to 
     applicants such as the Health Resources and Services 
     Administration and other applicants that seek to provide 
     telemedicine and telehealth services; and
       (7) shall collaborate with appropriate counterparts in 
     Mexico to coordinate actions and programs to improve health 
     for residents of the United States-Mexico border area.
       (d) Report.--Not later than 1 year after the date of 
     enactment of this section, the Secretary shall prepare and 
     submit to the appropriate committees of Congress a report 
     describing Federal health programs' limitations in addressing 
     United States-Mexico Border Area health concerns and 
     recommending solutions to better address such concerns.
       (e) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary.

     SEC. 5. UNITED STATES-MEXICO BORDER AREA ENVIRONMENTAL HEALTH 
                   PROGRAM.

       (a) In General.--The Secretary shall award grants to 
     eligible entities as determined by the Secretary to establish 
     environmental health hazard programs for the United States-
     Mexico Border Area.
       (b) Priority.--In awarding grants under this section, the 
     Secretary shall give priority to eligible entities that 
     propose to establish and carry out programs that address 
     environmental health hazards in the United States-Mexico 
     Border Area for pregnant women and children.
       (c) Duties.--An eligible entity that receives a grant under 
     this section, shall use funds received through such grant 
     to--
       (1) establish an environmental health program that 
     addresses health hazards along the United States-Mexico 
     Border Area;
       (2) identify and eliminate environmental health hazards;
       (3) coordinate its program with any environmental health 
     programs, if applicable, administered by the Environmental 
     Protection Agency, the National Institute of Environmental 
     Health Sciences, the International Consortium for the 
     Environment (ICE), other relevant Federal, State, and local 
     agencies, and nongovernmental organizations;
       (4) recruit and train health professionals and 
     environmental health specialists to identify and address 
     environmental health hazards in the United States-Mexico 
     Border Area; or
       (5) support State and local public health, food safety, and 
     building inspection agencies to reduce environmental health 
     hazards, including hazards existing in or around private 
     residences in the United States-Mexico Border Area.
       (d) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary.

     SEC. 6. COMMUNITY HEALTH CENTERS.

       Part D of the Public Health Service Act (42 U.S.C. 254b et 
     seq.) is amended by adding at the end the following:

     ``SEC. 330I. UNITED STATES-MEXICO BORDER AREA GRANTS.

       ``(a) In General.--The Secretary shall award grants to 
     eligible entities as determined by the Secretary to establish 
     community health centers in medically underserved areas of 
     the United States-Mexico Border Area.
       ``(b) Definitions.--The term ``United States-Mexico Border 
     Area'' means the area located in the United States within 100 
     kilometers of the border between the United States and 
     Mexico.
       ``(c) Duties.--An eligible entity that receives a grant 
     under this section shall establish and fund community health 
     centers in medically underserved areas of the United States-
     Mexico Border Area, and as designated by the Secretary.
       ``(d) Application.--An eligible entity desiring a grant 
     under this section shall submit an application at such time, 
     in such manner, and containing such information as the 
     Secretary may reasonably require.
       ``(e) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary.''.

     SEC. 7. NATIONAL HEALTH SERVICE CORPS.

       Subpart II of the Public Health Service Act (42 U.S.C. 254d 
     et seq.) is amended by adding at the end the following:

[[Page S13968]]

     ``SEC. 339. UNITED STATES-MEXICO BORDER HEALTH SERVICE CORPS.

       ``(a) In General.--The Secretary shall establish a loan 
     repayment program and recruit National Health Service Corps 
     members to provide health services for United States-Mexico 
     Border Area residents in exchange for participation in such 
     program.
       ``(b) Preference.--In selecting Corps members to 
     participate, the Secretary shall give preference to 
     pediatricians and pediatric specialists who are fluent in 
     English and Spanish, and to applicants who agree to serve 
     along the United States-Mexico Border Health Area for at 
     least 2 years.
       ``(c) Program.--
       ``(1) In general.--The Secretary shall establish a loan 
     repayment program described in subsection (a).
       ``(2) Contract.--Under such program, the Secretary shall 
     enter into written agreements with individuals selected by 
     the Secretary to provide the health services described in 
     subsection (a) in exchange for the Secretary providing 
     payment for the individual for the principal, interest, and 
     related expenses on government and commercial loans received 
     by the individual regarding the graduate or undergraduate 
     education of the individual (or both).
       ``(3) Payment for years served.--For every 2 years of 
     service that an individual contracts to serve under this 
     section the Secretary may pay for 1 year of educational 
     expenses, including tuition, living expenses, and any other 
     such reasonable educational expenses.
       ``(d) United States-Mexico Border Area.--The term ``United 
     States-Mexico Border Area'' means the area located in the 
     United States within 100 kilometers of the border between the 
     United States and Mexico.
       ``(e) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary.''.

     SEC. 8. PROMOTOR(A) GRANT PROGRAMS.

       (a) Program Authorized.--The Secretary shall award grants 
     to eligible entities to establish promotor(a) programs to 
     recruit, train, and retain bilingual lay health advisers to 
     provide culturally appropriate health education and other 
     services for medically underserved populations in the United 
     States-Mexico Border Area.
       (b) Definition.--The term ``eligible entity'' means a 
     school of public health, an academic health sciences center, 
     a Federally qualified health center, a public health agency, 
     a border health office, or a border health education training 
     center or any other entity determined by the Secretary that 
     is located in or that serves the United States-Mexico Border 
     Area.
       (c) Duties.--An eligible entity that receives a grant under 
     this section shall, in addition to the duties described in 
     subsection (a), develop bilingual promotor(a) and other 
     border-specific health training programs.
       (d) Application.--An eligible entity desiring a grant under 
     this section, shall submit an application to the Secretary at 
     such time, in such manner, and containing such information as 
     the Secretary may reasonably require.
       (e) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary.

     SEC. 9. GRANTS FOR DISTANCE LEARNING.

       (a) Program Authorized.--The Secretary shall award grants 
     to United States-Mexico Border Area State and local health 
     agencies, community health centers, and other appropriate 
     organizations to fully participate in the provider education 
     distance learning/information dissemination network of the 
     Health Services and Resources Administration.
       (b) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary.

     SEC. 10. PREVENTION AND TREATMENT OF HIV/AIDS.

       (a) Program Authorized.--The Secretary shall carry out a 
     study to review agency activities regarding reducing the 
     spread of HIV/Aids affecting the residents in the United 
     States-Mexico Border Area.
       (b) Coordinations.--In carrying out such study, the 
     Secretary shall coordinate activities with the appropriate 
     Federal and State agencies and with appropriate agencies in 
     Mexico to develop early intervention and treatment efforts to 
     curb the spread of HIV/AIDS.
       (c) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary.

     SEC. 11. PREVENTION AND TREATMENT OF TUBERCULOSIS.

       (a) Program Authorized.--The Secretary shall carry out a 
     study to review agency activities regarding reducing the 
     spread of tuberculosis, particularly multi-drug resistant 
     tuberculosis, affecting the residents in the United States-
     Mexico Border Area.
       (b) Coordination.--In carrying out such study, the 
     Secretary shall coordinate activities with the Immigration 
     and Naturalization Service and other appropriate Federal and 
     State agencies and with appropriate agencies in Mexico to 
     develop diagnosis, detection, and early intervention and 
     treatment efforts to curb the spread of tuberculosis, 
     particularly multi-drug resistant tuberculosis.
       (c) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary.

     SEC. 12. CHILDREN'S HEALTH INSURANCE PROGRAM.

       The Secretary shall establish a targeted campaign of public 
     education and awareness in the United States-Mexico Border 
     Area that is culturally relevant to the residents of that 
     Area.

     SEC. 13. INTERVENTION AND TREATMENT GRANTS.

       (a) Program Authorized.--The Secretary shall award grants 
     to eligible entities as determined by the Secretary to carry 
     out intervention and treatment programs for diabetes.
       (b) Use of Funds.--An entity that receives a grant under 
     this section shall use funds received through such grant to--
       (1) develop intervention programs oriented towards 
     increasing access to diabetes health care;
       (2) increase venues and opportunities for physical activity 
     and exercise in the border area;
       (3) address obesity as a risk factor for diabetes, 
     especially in juvenile populations;
       (4) improve health choices in school nutrition; and
       (5) develop diabetes networks and coalitions to encourage 
     communities to address diabetes risk factors.
       (c) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary.

     SEC. 14. CENTERS FOR DISEASE CONTROL AND PREVENTION.

       (a) Program Authorized.--The Centers for Disease Control 
     and Prevention shall establish a National Border Health 
     Databank (referred to in this section as the ``Databank'') to 
     gather and retain data and other information on the health of 
     United States-Mexico Border Area residents and on past, 
     present, and emerging health issues in such Area.
       (b) Content.--The Databank shall include an Epidemiological 
     Information System that shall be linked, where feasible, to 
     all relevant State and local health agencies and other 
     relevant national and international health organizations.
       (c) Availability of Data.--All information gathered and 
     retained by the Databank shall, where practicable, be made 
     available for the public via the Internet. The Centers for 
     Disease Control and Prevention shall publish no less than 
     quarterly a publication reporting on activities, studies, and 
     trends regarding United States-Mexico Border Area health 
     issues, including, the resources available from the Databank.
       (d) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary.

     SEC. 15. CENTER FOR DISEASE CONTROL PREVENTION.

       (a) Program Authorized.--There is established within the 
     Centers for Disease Control and Prevention a Border Health 
     Surveillance Network (referred to in this section as the 
     ``Network'').
       (b) Duties.--The Network shall--
       (1) carry out activities to develop and electronically link 
     the health surveillance, assessment, and response 
     capabilities of the Centers for Disease Control and 
     Prevention and all border State and local health agencies; 
     and
       (2) award grants to State and local public health agencies, 
     medical schools, schools of public health, Border Health 
     Education Training Centers, or other entities as determined 
     by the Secretary located in or serving the United States-
     Mexico Border Area for the development of border health 
     epidemiology training programs and to build upon the existing 
     Health Alert Network, the Information Network for Public 
     Health Officials, the Border Infectious Disease Surveillance 
     (``BIDS'') Project, and a Noncommunicable Disease 
     Surveillance System.
       (c) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary.

     SEC. 16. BORDER AREA BREAST AND CERVICAL CANCER SCREENING.

       Section 1501 of the Public Health Service Act (42 U.S.C. 
     300k) is amended by adding at the end the following:
       ``(e) Special Consideration for Border Area Residents.--In 
     making grants under subsection (a), the Secretary shall set-
     aside certain funds described in give special consideration 
     to any State that proposes to increase the number of United 
     States-Mexico Border Area residents who are screened for 
     breast and cervical cancer.''.

     SEC. 17. GRANTS FOR BORDER AREA HEALTH TESTING.

       (a) In General.--The Director of the Centers for Disease 
     Control and Prevention shall award grants to United States-
     Mexico Border Area State and local health agencies to upgrade 
     public health laboratories and conduct rapid tests for 
     disease organisms and toxic chemicals.
       (b) Coordination.--A State or local health agency that 
     receives a grant under this section shall, to the extent 
     possible, coordinate its activities carried out with funds 
     received under this section with activities carried out under 
     programs administered by the National Laboratory Training 
     Network.
       (c) Application.--A State or local health agency desiring a 
     grant under this section shall submit an application to the 
     Director

[[Page S13969]]

     at such time, in such manner, and containing such information 
     as the Director may reasonably require.
       (d) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary.

     SEC. 18. HEALTH PROMOTION ACTIVITIES.

       (a) In General.--The Secretary shall establish new, 
     comprehensive guidelines for community- and family-oriented 
     prevention and health promotion activities focused on 
     Guidelines under The Healthy Border 2010 Guidelines. The 
     Director shall disseminate these guidelines in both English 
     and Spanish to all United States-Mexico Border Area health 
     professionals, utilizing all available tools, including the 
     CDC Prevention Guidelines Database.
       (b) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary.

     SEC. 19. GENERAL ACCOUNTING OFFICE.

       (a) Program Authorized.--The General Accounting Office 
     shall conduct a comprehensive study of Federal and Federal 
     and State border health programs.
       (b) Content.--The study described in subsection (a) shall 
     review border health care programs to determine the manner in 
     which such programs may be improved. Such study shall also 
     review any problematic limitations of medicare and medicaid 
     programs in serving United States-Mexico Border Area 
     residents.
       (c) Report.--Not later than 1 year after the date of 
     enactment of this section, the General Accounting Office 
     shall prepare and submit to Congress a report describing the 
     findings of the study described in subsection (a) and 
     recommending certain courses of action to improve such border 
     health care programs, with particular emphasis on 
     recommendations for improving Federal and State and Federal 
     and local coordinations. Such report shall also make 
     recommendations for changes with regard to medicare and 
     medicaid payment laws and policies for telemedicine and 
     telehealth activities.
       (d) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary.

     SEC. 20. AGENCY FOR HEALTH CARE RESEARCH AND QUALITY.

       (a) In General.--The Agency for Health Care Research and 
     Quality shall conduct a comprehensive study of border health 
     needs, trends, and areas of needed improvement and shall 
     utilize border academic institutes to carry out such study 
     and share the results of such study with such institutes.
       (b) Content.--The study described in subsection (a) shall 
     study the health needs of United States-Mexico Border Area 
     residents and--
       (1) residents' access to health care services;
       (2) communicable disease control in the Area;
       (3) environmental problems in the Area that contribute to 
     health care problems;
       (4) health research being done on residents' health care 
     needs;
       (5) make recommendations regarding environmental 
     improvements that may be made to improve health conditions of 
     Area residents; and
       (6) make recommendations regarding long range plans to 
     improve the quality and availability of health care of Area 
     residents.
       (c) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary.

     SEC. 21. GRANTS TO INCREASE RESOURCES FOR COMMUNITY WATER 
                   FLUORIDATION.

       (a) In General.--The Secretary, acting through the Director 
     of the Division of Oral Health of the Centers for Disease 
     Control and Prevention, may make grants to Southwestern 
     border States or localities for the purpose of increasing the 
     resources available for community water fluoridation.
       (b) Use of Funds.--A State or locality shall use amounts 
     provided under a grant under subsection (a)--
       (1) to purchase fluoridation equipment;
       (2) to train fluoridation engineers; or
       (3) to develop educational materials on the advantages of 
     fluoridation.
       (c) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary.

     SEC. 22. COMMUNITY WATER FLUORIDATION.

       (a) In General.--The Secretary, acting through the Director 
     of the U.S. Mexico Border Health Commission and the Director 
     of the Centers for Disease Control and Prevention, shall 
     establish a demonstration project that is designed to assist 
     rural water systems in Texas, New Mexico, Arizona and 
     California in successfully implementing the Centers for 
     Disease Control and Prevention water fluoridation guidelines 
     entitled ``Engineering and Administrative Recommendations for 
     Water Fluoridation'' (referred to in this section as the 
     ``EARWF'').
       (b) Requirements.--
       (1) Collaboration.--The Director of the U.S. Mexico Border 
     Health Commission shall collaborate with the Director of the 
     Centers for Disease Control and Prevention in developing the 
     project under subsection (a). Through such collaboration the 
     Directors shall ensure that technical assistance and training 
     are provided to sites located in each of the 4 States 
     referred to in subsection (a). The Director of the U.S. 
     Mexico Border Health Commission shall provide coordination 
     and administrative support to tribes under this section.
       (2) General use of funds.--Amounts made available under 
     this section shall be used to assist small water systems in 
     improving the effectiveness of water fluoridation and to meet 
     the recommendations of the EARWF.
       (3) Fluoridation specialists.--
       (A) In general.--In carrying out this section, the 
     Secretary shall provide for the establishment of fluoridation 
     specialist engineering positions in each of the Dental 
     Clinical and Preventive Support Centers through which 
     technical assistance and training will be provided to tribal 
     water operators.
       (B) CDC.--The Director of the Centers for Disease Control 
     and Prevention shall appoint individuals to serve as the 
     fluoridation specialists.
       (4) Implementation.--The project established under this 
     section shall be planned, implemented and evaluated over the 
     5-year period beginning on the date on which funds are 
     appropriated under this section and shall be designed to 
     serve as a model for improving the effectiveness of water 
     fluoridation systems of small rural communities.
       (c) Evaluation.--In conducting the ongoing evaluation as 
     provided for in subsection (b)(4), the Secretary shall ensure 
     that such evaluation includes--
       (1) the measurement of changes in water fluoridation 
     compliance levels resulting from assistance provided under 
     this section;
       (2) the identification of the administrative, technical and 
     operational challenges that are unique to the fluoridation of 
     small water systems;
       (3) the development of a practical model that may be easily 
     utilized by other tribal, State, county or local governments 
     in improving the quality of water fluoridation with emphasis 
     on small water systems; and
       (4) the measurement of any increased percentage of 
     Southwestern border residents who receive the benefits of 
     optimally fluoridated water.
       (d) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary.

     SEC. 23. COMMUNITY-BASED DENTAL SEALANT PROGRAM.

       (a) In General.--The Secretary, acting through the Director 
     of the Maternal and Child Health Bureau of the Health 
     Resources and Services Administration, may award grants to 
     eligible entities determined by the Secretary to provide for 
     the development of innovative programs utilizing mobile van 
     units to carry out dental sealant activities to improve the 
     access of children to sealants as well as for prevention and 
     primary care.
       (b) Use of Funds.--An entity shall use amounts received 
     under a grant under subsection (a) to provide funds to 
     eligible community-based entities to make available a mobile 
     van unit to provide children in second or sixth grade with 
     access to dental care and dental sealant services. Such 
     services may be provided by dental hygienists so long as a 
     formalized plan for the referral of a child for treatment of 
     dental problems is established.
       (c) Eligibility.--To be eligible to receive funds under 
     this section an entity shall--
       (1) prepare and submit to the Secretary an application at 
     such time, in such manner and containing such information as 
     the Secretary may require; and
       (2) be a community-based entity that is determined by the 
     Secretary to provide an appropriate entry point for children 
     into the dental care system and be located within 100 
     kilometers of the United States Mexico Border.
       (d) Coordination with Other Programs.--An entity that 
     receives funds from a State under this section shall serve as 
     an enrollment site for purposes of enabling individuals to 
     enroll in the State plan under title XIX of the Social 
     Security Act (42 U.S.C. 1396 et seq.) or in the State 
     Children's Health Insurance Program under title XXI of such 
     Act (42 U.S.C. 1397aa et seq.).
       (e) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary.

     SEC. 24. UNITED STATES HISPANIC NUTRITION EDUCATION AND 
                   RESEARCH CENTER.

       (a) Establishment.--The Secretary shall establish a United 
     States Hispanic Nutrition Education and Research Center 
     (referred to in this section as the ``Center'') at a regional 
     academic health center.
       (b) Purpose.--The general purpose of the Center shall be to 
     undertake nutrition research and nutrition education 
     activities that sustain and promote the health of United 
     States Hispanics, particularly those United States Hispanics 
     in the United States-Mexico Border Area. The Center shall 
     serve as a national clearinghouse for research, and for data 
     collection and information dissemination on nutrition in the 
     United States Hispanic population. In addition, the Center 
     shall serve as an educational resource on United States 
     Hispanic nutrition for students, universities, and academic 
     and research institutions throughout the United States.
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