[Congressional Record Volume 152, Number 125 (Friday, September 29, 2006)]
[Senate]
[Pages S10696-S10711]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. FRIST (for himself, Mr. Kennedy, Mr. Obama, and Mr. 
        Bingaman):
  S. 4024. A bill to amend the Public Health Service Act to improve the 
health and healthcare of racial and ethnic minority and other health 
disparity populations; to the Committee on Health, Education, Labor, 
and Pensions.
  Mr. FRIST. Mr. President, I rise today to discuss a bill that has 
been very close to my heart for some time. And that is a bill that will 
help us better understand, and one day eliminate, the health 
disparities that plague this country.
  Many Americans don't realize that a problem exists. But traveling 
through rural Tennessee and spending 20 years in medicine, I know that 
it does.
  The fact of the matter is African-Americans have higher overall rates 
of death and are more likely to report poor health than white or other 
minorities. The death rate for all kinds of cancers is a third higher 
for African-Americans than it is for whites. And there are 8 times as 
many blacks as whites in the United States with HIV-AIDS.
  In Tennessee, African-Americans are 32 percent more likely to die 
from heart disease. The stroke rate for black Tennesseans is 43 percent 
higher than for whites. The infant mortality rate among African-
Americans in Tennessee is almost 3 times as high as it is for whites. 
In a State that ranks 3rd in the Nation for infant mortality--it's a 
hard statistic to swallow.
  Which is why we must change it.
  And that is the goal of the bill before us.
  The intent of this bi-partisan bill is two-fold: to understand the 
root causes of health disparities, and through better understanding 
them, wipe them away.
  To help foster that fuller comprehension of the challenge we face, 
this legislation will direct the Secretary of Health and Human Services 
to collect and report healthcare data by race and ethnicity, as well as 
geographic location, socioeconomic status and health literacy to 
identify and address health care disparities.
  The legislation outlines mechanisms to research the problem, to 
conduct educational outreach to minorities, to increase diversity among 
healthcare professionals, to enhance communication between patients and 
doctors, and to improve the delivery of health care to minorities.
  Through educational outreach we can work to change patient behavior.
  The top 3 causes of death among African-Americans are heart disease, 
cancer, and stroke. Thirteen percent of the adult African-American 
population has diabetes. And the risks of each of these can be 
minimized through healthier diet and tobacco cessation.
  The bill before us establishes grants for programs that will reach 
out to health disparity populations, and teach healthier habits. 
Emphasizing the importance of preventative care is a fundamental step 
in the road to reducing disparities.
  Fostering better communication between healthcare providers and 
health disparity populations can be achieved in part by encouraging 
more minorities to enter the healthcare profession. To that end, the 
bill before us reauthorizes several programs to support educational 
opportunities for minorities in healthcare.
  We have a long history in this country of working to eliminate the 
inequities driven by race, ethnicity, and socioeconomic status. I 
believe that the bill before us today will go a long way in helping us 
realize a day when we are truly a Nation of equals.

[[Page S10697]]

  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 4024

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

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Minority 
     Health Improvement and Health Disparity Elimination Act''.
       (b) Table of Contents.--
Sec. 1. Short title; table of contents.
Sec. 2. Definitions.

                    TITLE I--EDUCATION AND TRAINING

Sec. 101. Cultural competency and communication for providers.
Sec. 102. Healthcare workforce, education, and training.
Sec. 103. Workforce training to achieve diversity.
Sec. 104. Mid-career health professions scholarship program.
Sec. 105. Cultural competency training.
Sec. 106. Authorization of appropriations; reauthorizations.

                       TITLE II--CARE AND ACCESS

Sec. 201. Care and access.
Sec. 202. Authorization of appropriations.

                          TITLE III--RESEARCH

Sec. 301. Agency for healthcare research and quality.
Sec. 302. Genetic variation and health.
Sec. 303. Evaluations by the Institute of Medicine.
Sec. 304. National Center for Minority Health and Health Disparities 
              reauthorization.
Sec. 305. Authorization of appropriations.

            TITLE IV--DATA COLLECTION, ANALYSIS, AND QUALITY

Sec. 401. Data collection, analysis, and quality.

      TITLE V--LEADERSHIP, COLLABORATION, AND NATIONAL ACTION PLAN

Sec. 501. Office of Minority Health and Health Disparity Elimination.

     SEC. 2. DEFINITIONS.

       In this Act and the amendments made by this Act:
       (1) Cultural competency.--The term ``culturally 
     competent''--
       (A) when used to describe health-related services, means 
     providing healthcare tailored to meet the social, cultural, 
     and linguistic needs of patients from diverse backgrounds; 
     and
       (B) when used to describe education or training, means 
     education or training designed to prepare those receiving the 
     education or training to provide health-related services 
     tailored to meet the social, cultural, and linguistic needs 
     of patients from diverse backgrounds.
       (2) Health disparity population.--The term ``health 
     disparity population'' has the meaning given such term in 
     section 903(d)(1) of the Public Health Service Act (42 U.S.C. 
     299a-1(d)(1)).
       (3) Health literacy.--The term ``health literacy'' means 
     the degree to which an individual has the capacity to obtain, 
     communicate, process, and understand health information 
     (including the language in which the information is provided) 
     and services in order to make appropriate health decisions.
       (4) Minority group.--The term ``minority group'' has the 
     meaning given the term ``racial and ethnic minority group'' 
     in section 1707 of the Public Health Service Act (42 U.S.C. 
     300u-6) (as amended by section 501).
       (5) Practice-based research networks.--The term ``practice-
     based research network'' means a group of ambulatory 
     practices devoted principally to the primary care of 
     patients, and affiliated in their mission to investigate 
     questions related to community-based practice and to improve 
     the quality of primary care
       (6) Secretary.--The term ``Secretary'' means the Secretary 
     of Health and Human Services.

                    TITLE I--EDUCATION AND TRAINING

     SEC. 101. CULTURAL COMPETENCY AND COMMUNICATION FOR 
                   PROVIDERS.

       Title II of the Public Health Service Act (42 U.S.C. 202 et 
     seq.) is amended by adding at the end the following:

     ``SEC. 270. INTERNET CLEARINGHOUSE TO IMPROVE CULTURAL 
                   COMPETENCY AND COMMUNICATION BY HEALTHCARE 
                   PROVIDERS.

       ``(a) Establishment.--Not later than 1 year after the date 
     of enactment of the Minority Health Improvement and Health 
     Disparity Elimination Act, the Secretary, acting through the 
     Deputy Assistant Secretary for Minority Health and Health 
     Disparity Elimination, shall assist providers to improve the 
     health and healthcare of racial and ethnic minority and other 
     health disparity populations by developing and maintaining an 
     Internet Clearinghouse within the Office of Minority Health 
     and Health Disparity Elimination that--
       ``(1) increases cultural competency;
       ``(2) improves communication between healthcare providers, 
     staff, and their patients, including those patients with low 
     functional health literacy;
       ``(3) improves healthcare quality and patient satisfaction;
       ``(4) reduces medical errors and healthcare costs; and
       ``(5) reduces duplication of effort regarding translation 
     of materials.
       ``(b) Internet Clearinghouse.--Not later than 12 months 
     after the date of enactment of this section the Secretary, 
     acting through the Deputy Assistant Secretary for Minority 
     Health and Health Disparity Elimination, and in consultation 
     with the Director of the Office for Civil Rights, shall carry 
     out subsection (a) by--
       ``(1) developing and maintaining, through the Office of 
     Minority Health and Health Disparity Elimination, an 
     accessible library and database on the Internet with easily 
     searchable, clinically-relevant information regarding 
     culturally competent healthcare for racial and ethnic 
     minority and other health disparity populations, including 
     Internet links to additional resources that fulfill the 
     purpose of this section;
       ``(2) developing and making templates for visual aids and 
     standard documents with clear explanations that can help 
     patients and consumers access and make informed decisions 
     about healthcare, including--
       ``(A) administrative and legal documents, including 
     informed consent and advanced directives;
       ``(B) clinical information, including information 
     pertaining to treatment adherence, self-management training 
     for chronic conditions, preventing transmission of disease, 
     and discharge instructions;
       ``(C) patient education and outreach materials, including 
     immunization or screening notices and health warnings; and
       ``(D) Federal health forms and notices;
       ``(3) ensuring that documents described in paragraph (2) 
     are posted in English and non-English languages and are 
     culturally appropriate;
       ``(4) encouraging healthcare providers to customize such 
     documents for their use;
       ``(5) facilitating access to such documents, including 
     distribution in both paper and electronic formats;
       ``(6) providing technical assistance to healthcare 
     providers with respect to the access and use of information 
     described in paragraph (1) including information to help 
     healthcare providers--
       ``(A) understand the concept of cultural competence;
       ``(B) implement culturally competent practices;
       ``(C) care for patients with low functional health 
     literacy, including helping such patients understand and 
     participate in healthcare decisions;
       ``(D) understand and apply Federal guidance and directives 
     regarding healthcare for racial and ethnic minority and other 
     health disparity populations;
       ``(E) obtain reimbursement for provision of culturally 
     competent services;
       ``(F) understand and implement bioinformatics and health 
     information technology in order to improve healthcare for 
     racial and ethnic minority and other health disparity 
     populations; and
       ``(G) conduct other activities determined appropriate by 
     the Secretary;
       ``(7) providing educational materials to patients, 
     representatives of community-based organizations, and the 
     public with respect to the access and use of information 
     described in paragraph (1), including--
       ``(A) information to help such individuals--
       ``(i) understand the concept of cultural competence, and 
     the role of cultural competence in the delivery of 
     healthcare;
       ``(ii) work with healthcare providers to implement 
     culturally competent practices; and
       ``(iii) understand the concept of low functional health 
     literacy, and the barriers it presents to care; and
       ``(B) other material determined appropriate by the 
     Secretary; and
       ``(8) supporting initiatives that the Secretary determines 
     to be useful to fulfill the purposes of the Internet 
     Clearinghouse.
       ``(c) Definitions.--The definitions contained in section 2 
     of the Minority Health Improvement and Health Disparity 
     Elimination Act shall apply for purposes of this section.''.

     SEC. 102. HEALTHCARE WORKFORCE, EDUCATION, AND TRAINING.

       (a) In General.--Part F of title VII of the Public Health 
     Service Act (42 U.S.C. 295j et seq.) is amended by inserting 
     after section 792 the following:

     ``SEC. 793. HEALTHCARE WORKFORCE, EDUCATION, AND TRAINING.

       ``(a) In General.--The Secretary, acting through the 
     Administrator of the Health Resources and Services 
     Administration and the Deputy Assistant Secretary for 
     Minority Health and Health Disparity Elimination, shall 
     establish an aggregated and disaggregated database on health 
     professional students, including applicants, matriculates, 
     and graduates.
       ``(b) Requirement to Collect Data.--
       ``(1) In general.--Each health professions school described 
     in paragraph (2) that receives Federal funds, shall collect 
     race and ethnicity data, primary language data, and other 
     health disparity data, as feasible and pursuant to subsection 
     (d), concerning the students described in subsection (a), as 
     well as intended geographical site of practice and intended 
     discipline of practice for graduates. In collecting such 
     data, a school shall--
       ``(A) at a minimum, use the categories for race and 
     ethnicity established by the Director of the Office of 
     Management and Budget in effect on the date of enactment of 
     the Minority Health Improvement and Health Disparity 
     Elimination Act; and

[[Page S10698]]

       ``(B) if practicable, collect data on additional population 
     groups if such data can be aggregated into the minimum race 
     and ethnicity data categories.
       ``(2) Health professions school.--A health professions 
     school described under this paragraph is a school of medicine 
     or osteopathic medicine, public health, nursing, dentistry, 
     optometry, pharmacy, allied health, podiatric medicine, or 
     veterinary medicine, or a graduate program in mental health 
     practice.
       ``(c) Reporting.--Each school or program described under 
     subsection (b), shall, on an annual basis, report to the 
     Secretary data on race and ethnicity and primary language 
     collected under this section for inclusion in the database 
     established under subsection (a). The Secretary shall ensure 
     that such disparity data is reported to Congress and made 
     available to the public.
       ``(d) Health Disparity Measures.--The Secretary shall 
     develop, report, and disseminate measures of the other health 
     data referenced in section 793(b)(1), to ensure uniform and 
     consistent collection and reporting of these measures by 
     health professions schools. In developing such measures, the 
     Secretary shall take into consideration health disparity 
     indicators developed pursuant to section 2901(c).
       ``(e) Use of Data.--Data reported pursuant to subsection 
     (c) shall be used by the Secretary to conduct ongoing short- 
     and long-term analyses of diversity within health professions 
     schools and the health professions. The Secretary shall 
     ensure that such analyses are reported to Congress and made 
     available to the public.
       ``(f) Cultural Competency Training.--The Secretary shall 
     collect and report data from health professions schools 
     regarding the extent to which cultural competency training is 
     provided to health professions students, and conduct periodic 
     assessments regarding the preparedness of such students to 
     care for patients from racial and ethnic minority and other 
     health disparity populations.
       ``(g) Privacy.--The Secretary shall ensure that all data 
     collected under this section is protected from inappropriate 
     internal and external use by any entity that collects, 
     stores, or receives the data and that such data is collected 
     without personally identifiable information.
       ``(h) Partnership.--The Secretary may contract with 
     external entities to fulfill the requirements under this 
     section if such entities have demonstrated expertise and 
     experience collecting, analyzing, and reporting data required 
     under this section for health professional students.''.
       (b) National Health Service Corps Program.--
       (1) Assignment of corps personnel.--Section 333(a)(3) of 
     the Public Health Service Corps (42 U.S.C. 254f(a)(3)) is 
     amended to read as follows:
       ``(3)(A) In approving applications for assignment of 
     members of the Corps the Secretary shall not discriminate 
     against application from entities which are not receiving 
     Federal financial assistance under this Act.
       ``(B) In approving such applications, the Secretary shall--
       ``(i) give preference to applications in which a nonprofit 
     entity or public entity shall provide a site to which Corps 
     members may be assigned; and
       ``(ii) give highest preference to applications--
       ``(I) from entities described in clause (i) that are 
     federally qualified health centers as defined in section 
     1905(l)(2)(B) of the Social Security Act; and
       ``(II) from entities described in clause (i) that primarily 
     serve racial and ethnic minority and other health disparity 
     populations with annual incomes at or below twice those set 
     forth in the most recent poverty guidelines issued by the 
     Secretary pursuant to section 673(2) of the Community 
     Services Block Grant Act (42 U.S.C. 9902(2)).''.
       (2) Priorities in assignment of corps personnel.--Section 
     333A of the Public Health Service Act (42 U.S.C. 254f-1) is 
     amended--
       (A) in subsection (a)--
       (i) by redesignating paragraphs (1), (2), and (3) as 
     paragraphs (2), (3), and (4), respectively; and
       (ii) by striking ``shall--'' and inserting ``shall--
       ``(1) give preference to applications as set forth in 
     subsection (a)(3) of section 333;''; and
       (B) by striking ``subsection (a)(1)'' each place it appears 
     and inserting ``subsection (a)(2)''.
       (3) Conforming amendment.--Section 338I(c)(3)(B)(ii) of the 
     Public Health Service Act (42 U.S.C. 254q-1(c)(3)(B)(ii)) is 
     amended by striking ``section 333A(a)(1)'' and inserting 
     ``section 333A(a)(2)''.

     SEC. 103. WORKFORCE TRAINING TO ACHIEVE DIVERSITY.

       (a) Centers of Excellence.--Section 736 of the Public 
     Health Service Act (42 U.S.C. 293) is amended--
       (1) by striking subsection (a) and inserting the following:
       ``(a) In General.--The Secretary shall make grants to, and 
     enter into contracts with, public and nonprofit private 
     health or educational entities, including designated health 
     professions schools described in subsection (c), for the 
     purpose of assisting the entities in supporting programs of 
     excellence in health professions education for 
     underrepresented minorities in health professions.'';
       (2) by striking subsection (b) and inserting the following:
       ``(b) Required Use of Funds.--The Secretary may not make a 
     grant under subsection (a) unless the designated health 
     professions school involved agrees, subject to subsection 
     (c)(1)(C), to use the funds awarded under the grant to--
       ``(1) develop a large competitive applicant pool through 
     linkages with institutions of higher education, local school 
     districts, and other community-based entities and establish 
     an education pipeline for health professions careers;
       ``(2) establish, strengthen, or expand programs to enhance 
     the academic performance of underrepresented minority in 
     health professions students attending the school;
       ``(3) improve the capacity of such school to train, 
     recruit, and retain underrepresented minority faculty members 
     including the payment of such stipends and fellowships as the 
     Secretary may determine appropriate;
       ``(4) carry out activities to improve the information 
     resources, clinical education, curricula, and cultural and 
     linguistic competence of the graduates of the school, as it 
     relates to minority health and other health disparity issues;
       ``(5) facilitate faculty and student research on health 
     issues particularly affecting racial and ethnic minority and 
     other health disparity populations, including research on 
     issues relating to the delivery of culturally competent 
     healthcare (as defined in section 270);
       ``(6) carry out a program to train students of the school 
     in providing health services to racial and ethnic minority 
     and other health disparity populations (as defined in section 
     903(d)(1)) through training provided to such students at 
     community-based health facilities that--
       ``(A) provide such health services; and
       ``(B) are located at a site remote from the main site of 
     the teaching facilities of the school;
       ``(7) provide stipends as the Secretary determines 
     appropriate, in amounts as the Secretary determines 
     appropriate; and
       ``(8) conduct accountability and other reporting 
     activities, as required by the Secretary in subsection 
     (i).'';
       (3) in subsection (c)--
       (A) by amending paragraph (1) to read as follows:
       ``(1) Designated schools.--
       ``(A) In general.--The designated health professions 
     schools referred to in subsection (a) are such schools that 
     meet each of the conditions specified in subparagraphs (B) 
     and (C), and that--
       ``(i) meet each of the conditions specified in paragraph 
     (2)(A);
       ``(ii) meet each of the conditions specified in paragraph 
     (3);
       ``(iii) meet each of the conditions specified in paragraph 
     (4); or
       ``(iv) meet each of the conditions specified in paragraph 
     (5).
       ``(B) General conditions.--The conditions specified in this 
     subparagraph are that a designated health professions 
     school--
       ``(i) has a significant number of underrepresented minority 
     in health professions students enrolled in the school, 
     including individuals accepted for enrollment in the school;
       ``(ii) has been effective in assisting such students of the 
     school to complete the program of education and receive the 
     degree involved;
       ``(iii) has been effective in recruiting such students to 
     enroll in and graduate from the school, including providing 
     scholarships and other financial assistance to such students 
     and encouraging such students from all levels of the 
     educational pipeline to pursue health professions careers; 
     and
       ``(iv) has made significant recruitment efforts to increase 
     the number of underrepresented minority in health professions 
     individuals serving in faculty or administrative positions at 
     the school.
       ``(C) Consortium.--The condition specified in this 
     subparagraph is that, in accordance with subsection (e)(1), 
     the designated health profession school involved has with 
     other health profession schools (designated or otherwise) 
     formed a consortium to carry out the purposes described in 
     subsection (b) at the schools of the consortium.
       ``(D) Application of criteria to other programs.--In the 
     case of any criteria established by the Secretary for 
     purposes of determining whether schools meet the conditions 
     described in subparagraph (B), this section may not, with 
     respect to racial and ethnic minorities, be construed to 
     authorize, require, or prohibit the use of such criteria in 
     any program other than the program established in this 
     section.'';
       (B) by amending paragraph (2) to read as follows:
       ``(2) Centers of excellence at certain historically black 
     colleges and universities.--
       ``(A) Conditions.--The conditions specified in this 
     subparagraph are that a designated health professions school 
     is a school described in section 799B(1).
       ``(B) Use of grant.--In addition to the purposes described 
     in subsection (b), a grant under subsection (a) to a 
     designated health professions school meeting the conditions 
     described in subparagraph (A) may be expended--
       ``(i) to develop a plan to achieve institutional 
     improvements, including financial independence, to enable the 
     school to support programs of excellence in health 
     professions education for underrepresented minority 
     individuals; and

[[Page S10699]]

       ``(ii) to provide improved access to the library and 
     informational resources of the school.
       ``(C) Exception.--The requirements of paragraph (1)(C) 
     shall not apply to a historically black college or university 
     that receives funding under this paragraph or paragraph 
     (5).''; and
       (C) by amending paragraphs (3) through (5) to read as 
     follows:
       ``(3) Hispanic centers of excellence.--The conditions 
     specified in this paragraph are that--
       ``(A) with respect to Hispanic individuals, each of clauses 
     (i) through (iv) of paragraph (1)(B) applies to the 
     designated health professions school involved;
       ``(B) the school agrees, as a condition of receiving a 
     grant under subsection (a) of this section, that the school 
     will, in carrying out the duties described in subsection (b) 
     of this section, give priority to carrying out the duties 
     with respect to Hispanic individuals; and
       ``(C) the school agrees, as a condition of receiving a 
     grant under subsection (a) of this section, that--
       ``(i) the school will establish an arrangement with 1 or 
     more public or nonprofit community-based Hispanic serving 
     organizations, or public or nonprofit private institutions of 
     higher education, including schools of nursing, whose 
     enrollment of students has traditionally included a 
     significant number of Hispanic individuals, the purposes of 
     which will be to cary out a program--

       ``(I) to identify Hispanic students who are interested in a 
     career in the health profession involved; and
       ``(II) to facilitate the educational preparation of such 
     students to enter the health professions school; and

       ``(ii) the school will make efforts to recruit Hispanic 
     students, including students who have participated in the 
     undergraduate or other matriculation program carried out 
     under arrangements established by the school pursuant to 
     clause (i)(II) and will assist Hispanic students regarding 
     the completion of the educational requirements for a degree 
     from the school.
       ``(4) Native american centers of excellence.--Subject to 
     subsection (e), the conditions specified in this paragraph 
     are that--
       ``(A) with respect to Native Americans, each of clauses (i) 
     through (iv) of paragraph (1)(B) applies to the designated 
     health professions school involved;
       ``(B) the school agrees, as a condition of receiving a 
     grant under subsection (a) of this section, that the school 
     will, in carrying out the duties described in subsection (b) 
     of this section, give priority to carrying out the duties 
     with respect to Native Americans; and
       ``(C) the school agrees, as a condition of receiving a 
     grant under subsection (a) of this section, that--
       ``(i) the school will establish an arrangement with 1 or 
     more public or nonprofit private institutions of higher 
     education, including schools of nursing, whose enrollment of 
     students has traditionally included a significant number of 
     Native Americans, the purpose of which arrangement will be to 
     carry out a program--

       ``(I) to identify Native American students, from the 
     institutions of higher education referred to in clause (i), 
     who are interested in health professions careers; and
       ``(II) to facilitate the educational preparation of such 
     students to enter the designated health professions school; 
     and

       ``(ii) the designated health professions school will make 
     efforts to recruit Native American students, including 
     students who have participated in the undergraduate program 
     carried out under arrangements established by the school 
     pursuant to clause (i) and will assist Native American 
     students regarding the completion of the educational 
     requirements for a degree from the designated health 
     professions school.
       ``(5) Other centers of excellence.--The conditions 
     specified in this paragraph are--
       ``(A) with respect to other centers of excellence, the 
     conditions described in clauses (i) through (iv) of paragraph 
     (1)(B); and
       ``(B) that the health professions school involved has an 
     enrollment of underrepresented minorities in health 
     professions significantly above the national average for such 
     enrollments of health professions schools.''; and
       (4) by striking subsection (h) and inserting the following:
       ``(h) Formula for Allocations.--
       ``(1) Allocations.--Based on the amount appropriated under 
     section 106(a) of the Minority Health Improvement and Health 
     Disparity Elimination Act for a fiscal year, the following 
     subparagraphs shall apply as appropriate:
       ``(A) In general.--If the amounts appropriated under 
     section 106(a) of the Minority Health Improvement and Health 
     Disparity Elimination Act for a fiscal year are $24,000,000 
     or less--
       ``(i) the Secretary shall make available $12,000,000 for 
     grants under subsection (a) to health professions schools 
     that meet the conditions described in subsection (c)(2)(A); 
     and
       ``(ii) and available after grants are made with funds under 
     clause (i), the Secretary shall make available--

       ``(I) 60 percent of such amount for grants under subsection 
     (a) to health professions schools that meet the conditions 
     described in paragraph (3) or (4) of subsection (c) 
     (including meeting the conditions under subsection (e)); and
       ``(II) 40 percent of such amount for grants under 
     subsection (a) to health professions schools that meet the 
     conditions described in subsection (c)(5).

       ``(B) Funding in excess of $24,000,000.--If amounts 
     appropriated under section 106(a) of the Minority Health 
     Improvement and Health Disparity Elimination Act for a fiscal 
     year exceed $24,000,000 but are less than $30,000,000--
       ``(i) 80 percent of such excess amounts shall be made 
     available for grants under subsection (a) to health 
     professions schools that meet the requirements described in 
     paragraph (3) or (4) of subsection (c) (including meeting 
     conditions pursuant to subsection (e)); and
       ``(ii) 20 percent of such excess amount shall be made 
     available for grants under subsection (a) to health 
     professions schools that meet the conditions described in 
     subsection (c)(5).
       ``(C) Funding in excess of $30,000,000.--If amounts 
     appropriated under section 106(a) of the Minority Health 
     Improvement and Health Disparity Elimination Act for a fiscal 
     year exceed $30,000,000 but are less than $40,000,000, the 
     Secretary shall make available--
       ``(i) not less than $12,000,000 for grants under subsection 
     (a) to health professions schools that meet the conditions 
     described in subsection (c)(2)(A);
       ``(ii) not less than $12,000,000 for grants under 
     subsection (a) to health professions schools that meet the 
     conditions described in paragraph (3) or (4) of subsection 
     (c) (including meeting conditions pursuant to subsection 
     (e));
       ``(iii) not less than $6,000,000 for grants under 
     subsection (a) to health professions schools that meet the 
     conditions described in subsection (c)(5); and
       ``(iv) after grants are made with funds under clauses (i) 
     through (iii), any remaining excess amount for grants under 
     subsection (a) to health professions schools that meet the 
     conditions described in paragraph (2)(A), (3), (4), or (5) of 
     subsection (c).
       ``(D) Funding in excess of $40,000,000.--If amounts 
     appropriated under section 106(a) of the Minority Health 
     Improvement and Health Disparity Elimination Act for a fiscal 
     year are $40,000,000 or more, the Secretary shall make 
     available--
       ``(i) not less than $16,000,000 for grants under subsection 
     (a) to health professions schools that meet the conditions 
     described in subsection (c)(2)(A);
       ``(ii) not less than $16,000,000 for grants under 
     subsection (a) to health professions schools that meet the 
     conditions described in paragraph (3) or (4) of subsection 
     (c) (including meeting conditions pursuant to subsection 
     (e));
       ``(iii) not less than $8,000,000 for grants under 
     subsection (a) to health professions schools that meet the 
     conditions described in subsection (c)(5); and
       ``(iv) after grants are made with funds under clauses (i) 
     through (iii), any remaining funds for grants under 
     subsection (a) to health professions schools that meet the 
     conditions described in paragraph (2)(A), (3), (4), or (5) of 
     subsection (c).
       ``(2) No limitation.--Nothing in this subsection shall be 
     construed as limiting the centers of excellence referred to 
     in this section to the designated amount, or to preclude such 
     entities from competing for grants under this section.
       ``(3) Maintenance of effort.--
       ``(A) In general.--With respect to activities for which a 
     grant made under this part are authorized to be expended, the 
     Secretary may not make such a grant to a center of excellence 
     for any fiscal year unless the center agrees to maintain 
     expenditures of non-Federal amounts for such activities at a 
     level that is not less than the level of such expenditures 
     maintained by the center for the fiscal year preceding the 
     fiscal year for which the school receives such a grant.
       ``(B) Use of federal funds.--With respect to any Federal 
     amounts received by a center of excellence and available for 
     carrying out activities for which a grant under this part is 
     authorized to be expended, the center shall, before expending 
     the grant, expend the Federal amounts obtained from sources 
     other than the grant, unless given prior approval from the 
     Secretary.
       ``(i) Evaluations.--
       ``(1) Advisory committee.--
       ``(A) In general.--Not later than 90 days after the date of 
     enactment of the Minority Health Improvement and Health 
     Disparity Elimination Act, the Secretary shall establish and 
     appoint the members of an advisory committee composed of 
     representatives of government agencies, including the Health 
     Resources and Services Administration, the Office of Minority 
     Health and Health Disparity Elimination, and the Indian 
     Health Service, community stakeholders and experts in 
     identifying and addressing the health concerns of racial and 
     ethnic minority and other health disparity populations, and 
     designees from health professions schools described in 
     subsection (b).
       ``(B) Duties.--The advisory committee shall develop and 
     recommend performance measures with which to assess, based on 
     data to be compiled by recipients of grants or contracts 
     under this section or section 736, 737, 738, or 739, the 
     extent to which the program described in this section and 
     sections 736, 737, 738, and 739 has met the purpose of this 
     part. The advisory committee shall submit such 
     recommendations to the Administrator of the Health Resources 
     and Services Administration not later than 6 months after the 
     appointment of the advisory committee.

[[Page S10700]]

       ``(C) Notification.--Not later than 30 days after the 
     submission of the recommendations, the Administrator of the 
     Health Resources and Services Administration shall review the 
     recommendations and establish performance measures described 
     in subparagraph (B), and the Administrator shall notify 
     recipients of grants or contracts under this section or 
     section 736, 737, 738, or 739 of the new performance measures 
     and make requirements related to the performance measures 
     publicly available both on the website of the Administration 
     and as part of any notifications of awards released to 
     entities receiving the grants or contracts.
       ``(2) Data collection and annual evaluations.--
       ``(A) In general.--The Administrator of the Health 
     Resources and Services Administration shall collect annual 
     data from recipients of grants or contracts under this 
     section or section 736, 737, 738, or 739 on the performance 
     measures established under paragraph (1).
       ``(B) Biannual meeting.--The Administrator of the Health 
     Resources and Services Administration shall convene a meeting 
     of the advisory committee established under paragraph (1) not 
     less than twice per year. At the meeting, the advisory 
     committee shall recommend any necessary changes to such 
     performance measures to improve data collection and short-
     term evaluation with respect to the programs carried out 
     under this section or section 736, 737, 738, or 739, and 
     provide technical assistance as necessary.
       ``(3) Updates.--The Administrator of the Health Resources 
     and Services Administration shall determine whether to 
     incorporate the recommended changes as described in paragraph 
     (2)(B) and provide technical assistance as necessary. The 
     Administrator shall not penalize a current recipient of a 
     grant or contract under this section or section 736, 737, 
     738, or 739 for failing to comply with the revised data 
     collection or performance measure requirements if the 
     recipient demonstrates an inability to provide additional 
     data mandated under the requirements.
       ``(4) Accountability.--The Administrator shall review and 
     take into consideration performance measurement data 
     previously collected from recipients of grants or contracts 
     under this section or section 736, 737, 738, or 739 when 
     deciding to renew the grants or contracts of such 
     recipients.''.
       (b) Cooperative Agreements for Online Degree Programs at 
     Schools of Public Health and Schools of Allied Health.--Part 
     B of title VII of the Public Health Service Act (42 U.S.C. 
     293 et seq.) is amended by adding at the end the following:

     ``SEC. 742. COOPERATIVE AGREEMENTS FOR ONLINE DEGREE 
                   PROGRAMS.

       ``(a) Cooperative Agreements.--The Secretary shall award 
     cooperative agreements to accredited schools of public 
     health, schools of allied health, and public health programs 
     to design and implement a degree program over the Internet 
     (referred to in this section as an `online degree program').
       ``(b) Application.--To be eligible to receive a cooperative 
     agreement under subsection (a), an accredited school of 
     public health, school of allied health, or public health 
     program shall submit an application at such time, in such 
     manner, and containing such information as the Secretary may 
     require.
       ``(c) Priority.--In awarding cooperative agreements under 
     this section, the Secretary shall give priority to any 
     accredited school of public health, school of allied health, 
     or public health program that serves a disproportionate 
     number of individuals from racial and ethnic minority and 
     other health disparity populations.
       ``(d) Requirements.--Awardees shall use an award under 
     subsection (a) to design and implement an online degree 
     program that meets the following conditions:
       ``(1) Limiting enrollment to individuals who have obtained 
     a secondary school diploma or a recognized equivalent.
       ``(2) Maintaining significant enrollment and graduation of 
     underrepresented minorities in health professions.''.
       (c) Definition.--Part B of title VII of the Public Health 
     Service Act (42 U.S.C. 293 et seq.) is amended by inserting 
     after the part heading the following:

     ``SEC. 735A. APPLICATION OF DEFINITION.

       ``The definition contained in section 738(b)(5) shall apply 
     for purposes of this part, except that such definition shall 
     also apply in the case of references to `underrepresented 
     minority students', `underrepresented minority faculty 
     members', `underrepresented minority faculty administrators', 
     and `underrepresented minorities in health professions'.''.

     SEC. 104. MID-CAREER HEALTH PROFESSIONS SCHOLARSHIP PROGRAM.

       Subpart 2 of part E of title VII of the Public Health 
     Service Act (42 U.S.C. 295 et seq.) is amended--
       (1) in section 770, by inserting ``(other than section 
     771)'' after ``this subpart'';
       (2) by redesignating section 770 as section 771; and
       (3) by inserting after section 769 the following:

     ``SEC. 770. MID-CAREER HEALTH PROFESSIONS SCHOLARSHIP 
                   PROGRAM.

       ``(a) In General.--The Secretary may make grants to 
     eligible schools to award scholarships to eligible 
     individuals to attend the school involved, for the purpose of 
     enabling the individuals to make a career change from a non-
     health profession to a health profession.
       ``(b) Application.--To receive a grant under this section, 
     an eligible school shall submit to the Secretary an 
     application at such time, in such manner, and containing such 
     information as the Secretary may require.
       ``(c) Use of Funds.--Amounts awarded as a scholarship under 
     this section may be expended only for tuition expenses, other 
     reasonable educational expenses, and reasonable living 
     expenses incurred in the attendance of the school involved.
       ``(d) Definitions.--In this section:
       ``(1) Eligible school.--The term `eligible school' means an 
     accredited school of medicine, osteopathic medicine, 
     dentistry, nursing, pharmacy, podiatric medicine, optometry, 
     veterinary medicine, public health, chiropractic, allied 
     health, a school offering a graduate program in behavioral 
     and mental health practice, or an entity providing programs 
     for the training of physician assistants.
       ``(2) Eligible individual.--The term `eligible individual' 
     means an individual who is an underrepresented minority 
     individual who has obtained a secondary school diploma or its 
     recognized equivalent.''.

     SEC. 105. CULTURAL COMPETENCY TRAINING.

       Part B of title VII of the Public Health Service Act (42 
     U.S.C. 293 et seq.), as amended by section 104, is amended by 
     adding at the end the following:

     ``SEC. 743. CULTURAL COMPETENCY TRAINING.

       ``(a) In General.--The Secretary, acting through the 
     Administrator of the Health Resources and Services 
     Administration and in collaboration with the Office of 
     Minority Health and Health Disparity Elimination and Agency 
     for Healthcare Research and Quality, shall support the 
     development, evaluation, and dissemination of model curricula 
     for cultural competency training for use in health 
     professions schools and continuing education programs, and 
     other purposes determined appropriate by the Secretary.
       ``(b) Curricula.--In carrying out subsection (a), the 
     Secretary shall collaborate with health professional 
     societies, licensing and accreditation entities, health 
     professions schools, and experts in minority health and 
     cultural competency, and other organizations as determined 
     appropriate by the Secretary. Such curricula shall include a 
     focus on cultural competency measures and cultural competency 
     self-assessment methodology for health providers, systems and 
     institutions.
       ``(c) Dissemination.--
       ``(1) In general.--Such model curricula should be 
     disseminated through the Internet Clearinghouse under section 
     270 and other means as determined appropriate by the 
     Secretary.
       ``(2) Evaluation.--The Secretary shall evaluate adoption 
     and the implementation of cultural competency training 
     curricula, and facilitate inclusion of cultural competency 
     measures in quality measurement systems as appropriate.''.

     SEC. 106. AUTHORIZATION OF APPROPRIATIONS; REAUTHORIZATIONS.

       (a) Authorization of Appropriations.--There are authorized 
     to be appropriated--
       (1) such sums as may be necessary for each of fiscal years 
     2007 through 2011, to carry out the amendments made by 
     sections 101 and 102 of this title (adding sections 270 and 
     793 to the Public Health Service Act);
       (2) $45,000,000 for fiscal year 2007, and such sums as may 
     be necessary for each of fiscal years 2008 through 2011, to 
     carry out the amendments made by section 103(a) (relating to 
     centers of excellence in section 736 of the Public Health 
     Service Act);
       (3) such sums as may be necessary for each of fiscal years 
     2007 through 2011, to carry out the amendments made by 
     section 103(b) (adding section 742 to the Public Health 
     Service Act);
       (4) such sums as may be necessary for each of fiscal years 
     2007 through 2011, to carry out the amendments made by 
     section 104(b) (adding section 770 to the Public Health 
     Service Act); and
       (5) such sums as may be necessary for each of fiscal years 
     2007 through 2011, to carry out the amendment made by section 
     105 (adding section 743 to the Public Health Service Act).
       (b) Reauthorizations.--The following programs are 
     reauthorized as follows:
       (1) Educational assistance in the health professions 
     regarding individuals from disadvantaged background.--Section 
     740(c) of the Public Health Service Act (42 U.S.C. 293a(c)) 
     is amended by striking the first sentence and inserting the 
     following: ``For the purpose of grants and contracts under 
     section 739(a)(1), there is authorized to be appropriated 
     $60,000,000 for fiscal year 2007 and such sums as may be 
     necessary for each of fiscal years 2008 through 2011.''.
       (2) Scholarships for disadvantaged students.--Section 
     740(a) of the Public Health Service Act (42 U.S.C. 293a(a)) 
     is amended by striking ``$37,000,000'' and all that follows 
     through ``through 2002'' and inserting ``$51,000,000 for 
     fiscal year 2007, and such sums as may be necessary for each 
     of fiscal years 2008 through 2011''.
       (3) Loan repayments and fellowships.--Section 740(b) of the 
     Public Health Service Act (42 U.S.C. 293a(b)) is amended by 
     striking ``$1,100,000'' and all that follows through 
     ``through 2002'' and inserting ``$1,700,000 for fiscal year 
     2007, and such sums as may be necessary for each of fiscal 
     years 2008 through 2011''.
       (4) Grants for health professions education.--Section 741 
     of the Public Health Service Act (42 U.S.C. 293e) is amended 
     in

[[Page S10701]]

     subsection (b), by striking ``$3,500,000'' and all that 
     follows through the period and inserting ``such sums as may 
     be necessary for each of fiscal years 2007 through 2011.''.

                       TITLE II--CARE AND ACCESS

     SEC. 201. CARE AND ACCESS.

       Part P of title III of the Public Health Service Act (42 
     U.S.C. 280g et seq.) is amended by--
       (1) redesignating the second section 339O (as added by 
     section 504 of the Violence Against Women and Department of 
     Justice Reauthorization Act of 2005) as section 399P; and
       (2) adding at the end the following:

     ``SEC. 399Q. ACCESS, AWARENESS, AND OUTREACH ACTIVITIES.

       ``(a) Demonstration Projects.--The Secretary shall award 
     multiyear contracts or competitive grants to eligible 
     entities to support demonstration projects designed to 
     improve the health and healthcare of racial and ethnic 
     minority and other health disparity populations through 
     improved access to healthcare, patient navigators, and health 
     literacy education and services.
       ``(b) Eligibility.--In this section:
       ``(1) Eligible entity.--The term `eligible entity' means an 
     organization or a community-based consortium.
       ``(2) Organization.--The term `organization' means--
       ``(A) a hospital, health plan, or clinic;
       ``(B) an academic institution;
       ``(C) a State health agency;
       ``(D) an Indian Health Service hospital or clinic, Indian 
     tribal health facility, or urban Indian facility;
       ``(E) a nonprofit organization, including a faith-based 
     organization or consortium, to the extent that a contract or 
     grant awarded to such an entity is consistent with the 
     requirements of section 1955;
       ``(F) a primary care practice-based research network; and
       ``(G) any other similar entity determined to be appropriate 
     by the Secretary.
       ``(3) Community-based consortium.--The term `community-
     based consortium' means a partnership that--
       ``(A) includes--
       ``(i) individuals who are representatives of organizations 
     of racial and ethnic minority and other health disparity 
     populations;
       ``(ii) community leaders and leaders of community-based 
     organizations;
       ``(iii) healthcare providers, including providers who treat 
     racial and ethnic minority and other health disparity 
     populations; and
       ``(iv) experts in the area of social and behavioral 
     science, who have knowledge, training, or practical 
     experience in health policy, advocacy, cultural or linguistic 
     competency, or other relevant areas as determined by the 
     Secretary; and
       ``(B) is located within a federally- or State-designated 
     medically underserved area, a federally designated health 
     provider shortage area, or an area with a significant 
     population of racial and ethnic minorities.
       ``(c) Application.--An eligible entity seeking a contract 
     or grant under this section shall submit an application to 
     the Secretary at such time, in such manner, and containing 
     such information as the Secretary may require, including 
     assurances that the eligible entity will--
       ``(1) target populations that are members of racial and 
     ethnic minority groups and health disparity populations 
     through specific outreach activities;
       ``(2) collaborate with appropriate community organizations 
     and include meaningful community participation in planning, 
     implementation, and evaluation of activities;
       ``(3) demonstrate capacity to promote culturally competent 
     and appropriate care for target populations with 
     consideration for health literacy;
       ``(4) develop a plan for long-term sustainability;
       ``(5) evaluate the effectiveness of activities under this 
     section, within an appropriate timeframe, which shall include 
     a focus on quality and outcomes performance measures to 
     ensure that the activities are meeting the intended goals, 
     and that the entity is able to disseminate findings from such 
     evaluations;
       ``(6) provide ongoing outreach and education to the health 
     disparity populations served;
       ``(7) demonstrate coordination between public and private 
     entities; and
       ``(8) assist individuals and groups in accessing public and 
     private programs that will help eliminate disparities in 
     health and healthcare.
       ``(d) Priorities.--In awarding contracts and grants under 
     this section, the Secretary shall give priority to applicants 
     that are--
       ``(1) safety-net hospitals, defined as hospitals with a low 
     income utilization rate (as defined in Section 1923(b)(3) of 
     the Social Security Act (42 U.S.C 1396r-4(b)(3))) greater 
     than 25 percent;
       ``(2) community health centers, as defined in section 
     1905(l)(2)(B) of the Social Security Act (42 U.S.C. 
     1396d(l)(2)(B)); and
       ``(3) other health systems that--
       ``(A) by legal mandate or explicitly adopted mission, 
     provide patients with access to services regardless of their 
     ability to pay;
       ``(B) provide care or treatment for a substantial number of 
     patients who are uninsured, are receiving assistance under a 
     State program under title XIX of the Social Security Act, or 
     are members of vulnerable populations, as determined by the 
     Secretary;
       ``(C) serve a disproportionate percentage of patients from 
     racial and ethnic minority and other health disparity 
     populations;
       ``(D) provide an assurance that amounts received under the 
     grant or contract will be used to implement strategies that 
     address patients' linguistic needs, where necessary, and 
     recruit and maintain diverse staff and leadership; and
       ``(E) provide an assurance that amounts received under the 
     grant or contract will be used to support quality improvement 
     activities for patients from racial and ethnic minority and 
     other health disparity populations.
       ``(e) Use of Funds.--An eligible entity shall use such 
     amounts received under this section for demonstration 
     projects to--
       ``(1) address health disparities in the United States-
     Mexico Border Area, as defined in section 8 of the United 
     States-Mexico Border Health Commission Act (22 U.S.C. 290n-
     6), relating to health disparities in the areas of--
       ``(A) maternal and child health;
       ``(B) primary care and preventive health, including health 
     education and promotion;
       ``(C) public health and public infrastructure;
       ``(D) oral health;
       ``(E) behavioral and mental health and substance abuse;
       ``(F) health conditions that have a disproportionate impact 
     on racial and ethnic minorities and a high prevalence in the 
     Border Area;
       ``(G) health services research;
       ``(H) the health impacts of exposure to environmental 
     hazards;
       ``(I) workforce training and development; or
       ``(J) other areas determined appropriate by the Secretary;
       ``(2) implement the best practices in disease management, 
     including those that address co-occurring chronic conditions, 
     as defined by the public- private partnership established 
     under section 918(b), target patients with low functional 
     health literacy, and, as feasible, incorporate health 
     information technology;
       ``(3) evaluate methods for strengthening the health 
     coverage of, and continuity of coverage of, migratory 
     agricultural workers and seasonal agricultural workers, as 
     such terms are defined in section 330(g), and workers in 
     other industries with traditionally low rates of employer-
     sponsored health insurance;
       ``(4) train community health workers to educate, guide, and 
     provide outreach in a community setting regarding problems 
     prevalent among medically underserved populations (as defined 
     in section 330(b)); or
       ``(5) identify, educate, and enroll eligible patients from 
     racial and ethnic minorities and other health disparity 
     populations into clinical trials.
       ``(f) Report.--Not later than 3 years after the date an 
     entity receives a contract or grant under this section and 
     annually thereafter, the entity shall provide to the 
     Secretary a report containing the results of any evaluation 
     conducted pursuant to subsection (c)(5).
       ``(g) Dissemination of Findings.--The Secretary shall, as 
     appropriate, disseminate to public and private entities, 
     including Congress, the findings made in evaluations 
     described under subsection (f).

     ``SEC. 399R. GRANTS FOR RACIAL AND ETHNIC APPROACHES TO 
                   COMMUNITY HEALTH.

       ``(a) Purpose.--It is the purpose of this section to 
     provide for the awarding of grants to assist communities in 
     mobilizing and organizing resources in support of effective 
     and sustainable programs that will reduce or eliminate 
     disparities in health and healthcare experienced by racial 
     and ethnic minority individuals.
       ``(b) Authority to Award Grants.--The Secretary, acting 
     through the Centers for Disease Control and Prevention and 
     the Office of Minority Health and Health Disparity 
     Elimination, shall award planning, implementation, and 
     evaluation grants to eligible entities to assist in 
     designing, implementing, and evaluating culturally and 
     linguistically appropriate, science-based and community-
     driven sustainable strategies to eliminate racial and ethnic 
     health and healthcare disparities.
       ``(c) Eligible Entities.--To be eligible to receive a grant 
     under this section, an entity shall--
       ``(1) represent a coalition--
       ``(A) whose principal purpose is to develop and implement 
     interventions to reduce or eliminate a health or healthcare 
     disparity in a targeted racial or ethnic minority group in 
     the community served by the coalition; and
       ``(B) that includes--
       ``(i) at least 3 members selected from among--

       ``(I) public health departments;
       ``(II) community-based organizations;
       ``(III) university and research organizations;
       ``(IV) American Indian tribal organizations, national 
     American Indian organizations, Indian Health Service, or 
     organizations serving Alaska Natives;
       ``(V) organizations serving Native Hawaiians;
       ``(VI) organizations serving Pacific Islanders; and
       ``(VII) interested public or private healthcare providers 
     or organizations as deemed appropriate by the Secretary; and

       ``(ii) at least 1 member from a community-based 
     organization that represents the targeted racial or ethnic 
     minority group; and

[[Page S10702]]

       ``(2) submit to the Secretary an application at such time, 
     in such manner, and containing such information as the 
     Secretary may require, which shall include--
       ``(A) a description of the targeted racial or ethnic 
     population in the community to be served under the grant;
       ``(B) a description of at least 1 health disparity that 
     exists in the racial or ethnic targeted population, including 
     infant mortality, breast and cervical cancer screening and 
     management, cardiovascular disease, diabetes, child and adult 
     immunization levels, or HIV/AIDS; and
       ``(C) a demonstration of a proven record of accomplishment 
     of the coalition members in serving and working with the 
     targeted community.
       ``(d) Planning Grants.--
       ``(1) In general.--The Secretary shall award one-time 
     grants to eligible entities described in subsection (c) to 
     support the planning and development of culturally and 
     linguistically appropriate programs that utilize science-
     based and community-driven strategies to reduce or eliminate 
     a health or healthcare disparity in the targeted population. 
     Such grants may be used to--
       ``(A) expand the coalition that is represented by the 
     eligible entity through the identification of additional 
     partners, particularly among the targeted community, and 
     establish linkages with national, State, tribal, or local 
     public and private partners which may include community 
     health workers, advocacy, and policy organizations;
       ``(B) establish community working groups;
       ``(C) conduct a needs assessment of the community and 
     targeted population to determine a health disparity and the 
     factors contributing to that disparity, using input from the 
     targeted community;
       ``(D) participate in workshops sponsored by the Office of 
     Minority Health and Health Disparity Elimination or the 
     Centers for Disease Control and Prevention for technical 
     assistance, planning, evaluation, and other programmatic 
     issues;
       ``(E) identify promising intervention strategies; and
       ``(F) develop a plan with the input of the targeted 
     community that includes strategies for--
       ``(i) implementing intervention strategies that have the 
     greatest potential for reducing the health disparity in the 
     target population;
       ``(ii) identifying other sources of revenue and integrating 
     current and proposed funding sources to ensure long-term 
     sustainability of the program; and
       ``(iii) evaluating the program, including collecting data 
     and measuring progress toward reducing or eliminating the 
     health disparity in the targeted population that takes into 
     account the evaluation model developed by the Centers for 
     Disease Control and Prevention in collaboration with the 
     Office of Minority Health and Health Disparity Elimination.
       ``(2) Duration.--The period during which payments may be 
     made under a grant under paragraph (1) shall not exceed 1 
     year, except where the Secretary determines that 
     extraordinary circumstances exist as described in section 
     340(c)(3).
       ``(e) Implementation Grants.--
       ``(1) In general.--The Secretary shall award grants to 
     eligible entities that have received a planning grant under 
     subsection (d) to enable such entity to--
       ``(A) implement a plan to address the selected health 
     disparity for the target population, in an effective and 
     timely manner;
       ``(B) collect data appropriate for monitoring and 
     evaluating the program carried out under the grant;
       ``(C) analyze and interpret data, or collaborate with 
     academic or other appropriate institutions, for such analysis 
     and collection;
       ``(D) participate in conferences and workshops for the 
     purpose of informing and educating others regarding the 
     experiences and lessons learned from the project;
       ``(E) collaborate with appropriate partners to publish the 
     results of the project for the benefit of the public health 
     community;
       ``(F) establish mechanisms with other public or private 
     groups to maintain financial support for the program after 
     the grant terminates; and
       ``(G) maintain relationships with local partners and 
     continue to develop new relationships with national and State 
     partners.
       ``(2) Duration.--The period during which payments may be 
     made under a grant under paragraph (1) shall not exceed 4 
     years. Such payments shall be subject to annual approval by 
     the Secretary and to the availability of appropriations for 
     the fiscal year involved.
       ``(f) Evaluation Grants.--
       ``(1) In general.--The Secretary may award grants to 
     eligible entities that have received an implementation grant 
     under subsection (e) that require additional assistance for 
     the purpose of rigorous data analysis, program evaluation 
     (including process and outcome measures), or dissemination of 
     findings.
       ``(2) Priority.--In awarding grants under this subsection, 
     the Secretary shall give priority to--
       ``(A) entities that in previous funding cycles--
       ``(i) have received a planning grant under subsection (d); 
     or
       ``(ii) implemented activities of the type described in 
     subsection (e)(1); and
       ``(B) entities that incorporate best practices or build on 
     successful models in their action plan, including the use of 
     community health workers.
       ``(g) Sustainability.--The Secretary shall give priority to 
     an eligible entity under this section if the entity agrees 
     that, with respect to the costs to be incurred by the entity 
     in carrying out the activities for which the grant was 
     awarded, the entity (and each of the participating partners 
     in the coalition represented by the entity) will maintain its 
     expenditures of non-Federal funds for such activities at a 
     level that is not less than the level of such expenditures 
     during the fiscal year immediately preceding the first fiscal 
     year for which the grant is awarded.
       ``(h) Nonduplication.--Funds provided through this grant 
     program should supplement, not supplant, existing Federal 
     funding, and the funds should not be used to duplicate the 
     activities of the other health disparity grant programs in 
     this Act.
       ``(i) Technical Assistance.--The Secretary may, either 
     directly or by grant or contract, provide any entity that 
     receives a grant under this section with technical and other 
     nonfinancial assistance necessary to meet the requirements of 
     this section.
       ``(j) Dissemination.--The Secretary shall enable grantees 
     to share best practices, evaluation results, and reports 
     using the Internet, conferences, and other pertinent 
     information regarding the projects funded by this section, 
     including the outreach efforts of the Office of Minority 
     Health and Health Disparity Elimination.
       ``(k) Administrative Burdens.--The Secretary shall make 
     every effort to minimize duplicative or unnecessary 
     administrative burdens on grantees.

     ``SEC. 399S. GRANTS FOR HEALTH DISPARITY COLLABORATIVES.

       ``(a) Purpose.--The Secretary, acting through the 
     Administrator of the Health Resources and Services 
     Administration, shall award grants to eligible entities to 
     assist in implementing systems of primary care practices 
     through which to eliminate disparities in the delivery of 
     healthcare and improve the healthcare provided to all 
     patients.
       ``(b) Eligible Entities.--To be eligible to receive a grant 
     under this section, an entity shall--
       ``(1) be a federally qualified health center as defined in 
     section 1905(l)(2)(B) of the Social Security Act with the 
     ability to establish and lead a collaborative partnership; 
     and
       ``(2) submit to the Secretary an application, at such time, 
     in such manner, and containing such information as the 
     Secretary may require, which shall include plans to implement 
     collaboratives in one or more of the following areas:
       ``(A) Diabetes.
       ``(B) Asthma.
       ``(C) Depression.
       ``(D) Cardiovascular disease.
       ``(E) Cancer.
       ``(F) Preventive health, including screenings.
       ``(G) Perinatal health.
       ``(H) Patient safety.
       ``(I) Other areas as designated by the Secretary.
       ``(c) Nonduplication.--Funds provided through this grant 
     program should supplement, not supplant, existing Federal 
     funding, and the funds should not be used to duplicate the 
     activities of the other health disparity grant programs in 
     this Act.
       ``(d) Technical Assistance.--The Secretary may, either 
     directly or by grant or contract, provide any entity that 
     receives a grant under this section with technical and other 
     nonfinancial assistance necessary to meet the requirements of 
     this section.
       ``(e) Administrative Burdens.--The Secretary shall make 
     every effort to minimize duplicative or unnecessary 
     administrative burdens on grantees.

     ``SEC. 399T. COMMUNITY HEALTH INITIATIVES.

       ``(a) Purpose.--The Secretary shall establish the Community 
     Health Initiative demonstration program to support 
     comprehensive State, tribal, or local initiatives to improve 
     the health of racial and ethnic minority and other health 
     disparity populations.
       ``(b) Community Health Initiative Program.--
       ``(1) In general.--The Secretary shall award Community 
     Health Initiative Program grants to State and local public 
     health agencies of eligible communities. Each grant shall be 
     funded for 5 years.
       ``(2) Eligible communities.--
       ``(A) Identification.--The Secretary shall develop, after 
     opportunity for public review and comment, and implement a 
     metric for identifying and notifying eligible communities 
     pursuant to subparagraph (B), and report such findings to 
     Congress and the public.
       ``(B) Eligibility.--Eligible communities shall be 
     communities that are most at risk, or at greatest 
     disproportionate risk, for adverse health outcomes, as 
     measured by--
       ``(i) overall burden of disease and health conditions;
       ``(ii) accessibility to and availability of health and 
     economic resources;
       ``(iii) proportion of individuals from racial and ethnic 
     minority and other health disparity populations; and
       ``(iv) other factors as determined appropriate by the 
     Secretary.
       ``(3) Agency collaboration.--The Secretary, in 
     collaboration with the Deputy Assistant Secretary for 
     Minority Health and Health Disparity Elimination, the 
     Director of the Centers for Disease Control and Prevention, 
     the Administrator of the Health Resources and Services 
     Administration, the Director of the Indian Health Service, 
     and

[[Page S10703]]

     heads of other Federal agencies as appropriate, shall 
     determine, with respect to the Community Health Initiative 
     Program--
       ``(A) core goals, objectives and reasonable timelines for 
     implementing, evaluating and sustaining comprehensive and 
     effective health and healthcare improvement activities in 
     eligible communities;
       ``(B) current programmatic and research initiatives in 
     which eligible communities may participate;
       ``(C) existing agency resources that can be targeted to 
     eligible communities; and
       ``(D) mechanisms to facilitate joint application, or 
     establish a common application, to multiple grant programs, 
     as appropriate.
       ``(4) Applications.--
       ``(A) In general.--The State and local public health 
     agencies of eligible communities shall jointly submit an 
     application to the Secretary at such time, in such manner, 
     and accompanied by such information as the Secretary may 
     require, including a strategic plan that shall--
       ``(i) describe the proposed activities pursuant to 
     paragraph (5);
       ``(ii) report the extent to which local institutions and 
     organizations and community residents have participated in 
     the strategic plan development;
       ``(iii) identify established public-private partnerships, 
     and State, local, and private resources that will be 
     available;
       ``(iv) identify Federal funding needed to support the 
     proposed activities; and
       ``(v) report the baselines, methods, and benchmarks for 
     measuring the success of activities proposed in the strategic 
     plan.
       ``(B) Community advisory board.--
       ``(i) In general.--In order to receive a Community Health 
     Initiative Program grant under this section, an eligible 
     community shall have a community advisory board.
       ``(ii) Members.--

       ``(I) Community.--The majority of the members of a 
     community advisory board under clause (i) shall be 
     individuals that will benefit from the activities or services 
     provided by the grants under this section.
       ``(II) Representatives.--A community advisory board shall 
     include representatives from the State health department and 
     county or local health department, community-based 
     organizations, environmental and public health experts, 
     healthcare professionals and providers, nonprofit leaders, 
     community organizers, elected officials, private payers, 
     employers, and consumers.

       ``(iii) Duties.--A community advisory board shall--

       ``(I) oversee the functions and operations of Community 
     Health Initiative Program grant activities;
       ``(II) assist in the evaluation of such activities; and
       ``(III) prepare an annual report that describes the 
     progress made towards achieving stated goals and recommends 
     future courses of action.

       ``(5) Use of funds.--An eligible community that receives a 
     grant under this section shall use the funding to support 
     activities to achieve stated core goals and objectives, 
     pursuant to paragraph (3), which may include initiatives 
     that--
       ``(A) promote disease prevention and health promotion, 
     particularly for racial and ethnic minority and other health 
     disparity populations;
       ``(B) facilitate partnerships between healthcare providers, 
     public and health agencies, academic institutions, community 
     based or advocacy organizations, elected officials, 
     professional societies, and other stakeholder groups;
       ``(C) enhance the local capacity for aggregated and 
     disaggregated health data collection and reporting;
       ``(D) coordinate and integrate community-based activities 
     including education, city planning, transportation 
     initiatives, environmental changes, and other related 
     activities at the local level that help improve public health 
     and address health concerns;
       ``(E) mobilize financial and other resources from the 
     public and private sector to increase local capacity to 
     address health issues;
       ``(F) support the training of staff in communication and 
     outreach to the general public, particularly those at 
     disproportionate risk for health and healthcare disparities;
       ``(G) assist eligible communities in meeting Healthy People 
     2010 objectives; and
       ``(H) aid eligible communities in providing employment, and 
     cultural and recreational resources that enable healthy 
     lifestyles.
       ``(6) Evaluation.--The Secretary, directly or through 
     contract, shall conduct and report an evaluation of the 
     Community Health Initiative Program that shall be available 
     to the public.
       ``(7) Supplement not supplant.--Grant funds received under 
     this section shall be used to supplement, and not supplant, 
     funding that would otherwise be used for activities described 
     under this section.

     ``SEC. 399U. OUTREACH.

       ``(a) In General.--The Secretary, in collaboration with the 
     Office for Minority Health and Health Disparity Elimination, 
     the Centers for Medicare and Medicaid Services, and the 
     Health Resources and Services Administration, shall establish 
     a grant program to improve outreach, participation, and 
     enrollment by eligible entities with respect to available 
     healthcare programs.
       ``(b) Eligibility.--In this section, the term `eligible 
     entity' means any of the following:
       ``(1) A State or local government.
       ``(2) A Federal health safety net organization.
       ``(3) A national, local, or community-based public or 
     nonprofit private organization.
       ``(4) A faith-based organization or consortia, to the 
     extent that a grant awarded to such an entity is consistent 
     with the requirements of section 1955 relating to a grant 
     award to nongovernmental entities.
       ``(5) An elementary or secondary school.
       ``(c) Definition.--In this section:
       ``(1) Federal health safety net organization.--The term 
     `Federal health safety net organization' means--
       ``(A) an Indian tribe, tribal organization, or an urban 
     Indian organization receiving funds under title V of the 
     Indian Health Care Improvement Act (25 U.S.C. 1651 et seq.), 
     or an Indian Health Service provider;
       ``(B) a Federally-qualified health center (as defined in 
     section 330);
       ``(C) a hospital defined as a disproportionate share 
     hospital;
       ``(D) a covered entity described in section 340B(a)(4); and
       ``(E) any other entity or a consortium that serves children 
     under a federally funded program, including the special 
     supplemental nutrition program for women, infants, and 
     children (WIC) established under section 17 of the Child 
     Nutrition Act of 1966 (42 U.S.C. 1786), the head start and 
     early head start programs under the Head Start Act (42 U.S.C. 
     9831 et seq.), the school lunch program established under the 
     Richard B. Russell National School Lunch Act (42 U.S.C. 1751 
     et seq.), and an elementary or secondary school.
       ``(2) Indians; indian tribe; tribal organization; urban 
     indian organization.--The terms `Indian', `Indian tribe', 
     `tribal organization', and `urban Indian organization' have 
     the meanings given such terms in section 4 of the Indian 
     Health Care Improvement Act (25 U.S.C. 1603).
       ``(d) Priority for Award of Grants.--
       ``(1) In general.--In making grants under subsection (a), 
     the Secretary shall give priority to--
       ``(A) eligible entities that propose to target geographic 
     areas with high rates of--
       ``(i) eligible but unenrolled children, including such 
     children who reside in rural areas; or
       ``(ii) racial and ethnic minorities and health disparity 
     populations, including those proposals that address cultural 
     and linguistic barriers to enrollment; and
       ``(B) eligible entities that plan to engage in outreach 
     efforts with respect to individuals described in subparagraph 
     (A) and that are--
       ``(i) Federal health safety net organizations; or
       ``(ii) faith-based organizations or consortia.
       ``(2) Ten percent set aside for outreach to indian 
     children.--An amount equal to 10 percent of the funds 
     appropriated under section 202(3) of the Minority Health 
     Improvement and Health Disparity Elimination Act to carry out 
     this section for a fiscal year shall be used by the Secretary 
     to award grants to Indian Health Service providers and urban 
     Indian organizations receiving funds under title V of the 
     Indian Health Care Improvement Act (25 U.S.C. 1651 et seq.) 
     for outreach to, and enrollment of, children who are 
     Indians.''.

     SEC. 202. AUTHORIZATION OF APPROPRIATIONS.

       There are authorized to be appropriated--
       (1) such sums as may be necessary for each of fiscal years 
     2007 through 2011, to carry out section 399Q of the Public 
     Health Service Act (as added by section 201);
       (2) $52,000,000 for fiscal year 2007, and such sums as may 
     be necessary for each of fiscal years 2008 through 2011, to 
     carry out section 399R of the Public Health Service Act (as 
     added by section 201); and
       (3) such sums as necessary for each of fiscal years 2007 
     through 2011, to carry out sections 399S, 399T, and 399U of 
     the Public Health Service Act (as added by section 201).

                          TITLE III--RESEARCH

     SEC. 301. AGENCY FOR HEALTHCARE RESEARCH AND QUALITY.

       Part B of title IX of the Public Health Service Act (42 
     U.S.C. 299b et seq.) is amended by adding at the end the 
     following:

     ``SEC. 918. ENHANCED RESEARCH WITH RESPECT TO HEALTHCARE 
                   DISPARITIES.

       ``(a) Accelerating the Elimination of Disparities.--
       ``(1) Strategic plan.--The Secretary, acting through the 
     Director, and in collaboration with the Deputy Assistant 
     Secretary for Minority Health and Health Disparity 
     Elimination, shall develop a strategic plan regarding 
     research supported by the agency to improve healthcare and 
     eliminate healthcare disparities among racial and ethnic 
     minority and other health disparity populations. In 
     developing such plan, the Secretary shall--
       ``(A) determine which areas of research focus would have 
     the greatest impact on healthcare improvement and elimination 
     of disparities, taking into consideration the overall health 
     status of various populations, disproportionate burden of 
     diseases or health conditions, and types of interventions for 
     which data on effectiveness is limited;
       ``(B) establish measurable goals and objectives which will 
     allow assessment of progress;
       ``(C) solicit public review and comment from experts in 
     healthcare, minority health and health disparities, health 
     services research, and other areas as determined appropriate 
     by the Secretary;
       ``(D) incorporate recommendations from the Institute of 
     Medicine, pursuant to section 303 of the Minority Health 
     Improvement and Health Disparity Elimination Act, as 
     appropriate;

[[Page S10704]]

       ``(E) complete such plan within 12 months of enactment of 
     the Minority Health Improvement and Health Disparity 
     Elimination Act, and update such plan and report on progress 
     meeting established goals and objectives not less than every 
     2 years;
       ``(F) include progress meeting plan goals and objectives in 
     annual performance budget submissions;
       ``(G) ensure coordination and integration with the National 
     Plan to Improve Minority Health and Eliminate Health 
     Disparities, as described in section 1707(c) and other 
     Department-wide initiatives, as feasible; and
       ``(H) report the plan to the Congress and make available to 
     the public in print and electronic format.
       ``(2) Establishment of grants.--The Secretary, acting 
     through the Director, and in collaboration with the Deputy 
     Assistant Secretary for Minority Health and Health Disparity 
     Elimination, may award grants or contracts to eligible 
     entities for research to improve the health of racial and 
     ethnic minority and other health disparity populations (as 
     defined in section 903(d)).
       ``(3) Application; eligible entities.--
       ``(A) Application.--To receive a grant or contract under 
     this section, an eligible entity shall submit to the 
     Secretary an application at such time, in such manner, and 
     containing such information as the Secretary may require.
       ``(B) Eligible entities.--To be eligible to receive a grant 
     or contract under this section, an entity shall be a health 
     center, hospital, health plan, health system, community 
     clinic, or other health entity determined appropriate by the 
     Secretary, that--
       ``(i) by legal mandate or explicitly adopted mission, 
     provides patients with access to services regardless of their 
     ability to pay;
       ``(ii) provides care or treatment for a substantial number 
     of patients who are uninsured, are receiving assistance under 
     a State program under title XIX of the Social Security Act, 
     or are members of vulnerable populations, as determined by 
     the Secretary;
       ``(iii) serves a disproportionate percentage of patients 
     from racial and ethnic minority and other health disparity 
     populations;
       ``(iv) provides an assurance that amounts received under 
     the grant or contract will be used to implement strategies 
     that address patients' linguistic needs, where necessary, and 
     recruit and maintain diverse staff and leadership; and
       ``(v) provides an assurance that amounts received under the 
     grant or contract will be used to support quality improvement 
     activities for patients from racial and ethnic minority and 
     other health disparity populations.
       ``(C) Preference.--Consortia of 3 or more eligible entities 
     shall be given a preference for grant or contract funding.
       ``(4) Research.--The research funded under paragraph (2), 
     with respect to racial and ethnic minority and other health 
     disparity populations, shall--
       ``(A) prioritize the translation of existing research into 
     practical interventions for improving health and healthcare 
     and reducing disparities;
       ``(B) target areas of need as identified in the strategic 
     plan pursuant to subsection (a)(1), the National Healthcare 
     Disparities Report published by the Agency for Healthcare 
     Research and Quality, relevant reports by the Institute of 
     Medicine, and other reports issued by Federal health 
     agencies;
       ``(C) include a focus on community-based solutions and 
     partnerships as appropriate;
       ``(D) expand practice-based research networks (primary care 
     and larger delivery systems) to include networks of delivery 
     sites serving large numbers of minority and health disparity 
     populations including--
       ``(i) public hospitals and private non-profit hospitals;
       ``(ii) health centers;
       ``(iii) health plans; and
       ``(iv) other sites as determined appropriate by the 
     Director.
       ``(5) Dissemination of research findings.--To ensure that 
     findings from the research described in paragraph (4) are 
     disseminated and applied promptly, the Director shall--
       ``(A) develop outreach and training programs for healthcare 
     providers with respect to the practical and effective 
     interventions that result from research programs carried out 
     with grants or contracts awarded under this section; and
       ``(B) provide technical assistance for the implementation 
     of evidence-based practices that will improve health and 
     healthcare and reduce disparities.
       ``(b) Realizing the Potential of Disease Management.--
       ``(1) Public-private sector partnership to assess 
     effectiveness of existing disease management strategies.--
       ``(A) In general.--The Secretary shall establish a public-
     private partnership to identify, evaluate, and disseminate 
     effective disease management strategies, tailored to improve 
     healthcare and health outcomes for patients from racial and 
     ethnic minority and other health disparity populations. Such 
     strategies shall reflect established healthcare quality 
     standards and benchmarks and other evidence-based 
     recommendations.
       ``(B) Partnership composition.--The partnership's members 
     shall include the following:
       ``(i) Representatives from the following:

       ``(I) The Office of Minority Health and Health Disparity 
     Elimination.
       ``(II) The Centers for Disease Control and Prevention.
       ``(III) The Agency for Healthcare Research and Quality.
       ``(IV) The Centers for Medicare and Medicaid Services.
       ``(V) The Health Resources and Services Administration.
       ``(VI) The Indian Health Service.
       ``(VII) Other agencies as designated by the Secretary.

       ``(ii) Representatives of health plans, employers, or other 
     private entities that have implemented disease management 
     programs.
       ``(iii) Representatives of hospitals, community health 
     centers, large, small, or solo provider groups, or other 
     organizations that provide healthcare and have implemented 
     disease management programs.
       ``(iv) Community-based representatives who have been 
     involved with establishing, implementing, or evaluating 
     disease management programs.
       ``(v) Other individuals as designated by the Secretary.
       ``(C) Partnership duties.--
       ``(i) In general.--Not later than 18 months after the date 
     of enactment of the Minority Health Improvement and Health 
     Disparity Elimination Act, the partnership shall release a 
     best practices report, with a particular focus on the 
     following:

       ``(I) Self-management training.
       ``(II) Increasing patient participation in and satisfaction 
     with healthcare encounters.
       ``(III) Helping patients use quality performance and cost 
     information to choose appropriate healthcare providers for 
     their care.
       ``(IV) Interventions outside of a traditional healthcare 
     environment, including the workplace, school, community, or 
     home.
       ``(V) Interventions utilizing community health workers and 
     case managers.
       ``(VI) Interventions that implement integrated disease 
     management and treatment strategies to address multiple 
     chronic co-occurring conditions.
       ``(VII) Other interventions as identified by the Secretary.

       ``(2) Report.--
       ``(A) In general.--Not later than September 30, 2010, the 
     partnership shall submit to the Secretary and the relevant 
     committees of Congress a report that describes the extent to 
     which the activities and research funded under this section 
     have been successful in reducing and eliminating disparities 
     in health and healthcare in targeted populations.
       ``(B) Availability.--The Secretary shall ensure that the 
     report is made available on the Internet websites of the 
     Office of Minority Health and Health Disparity Elimination, 
     the Agency for Healthcare Research and Quality, and other 
     agencies as appropriate.''.

     SEC. 302. GENETIC VARIATION AND HEALTH.

       (a) In General.--The Secretary shall ensure that any 
     current, proposed, or future research and programmatic 
     activities regarding genomics include focus on genetic 
     variation within and between populations, with a focus on 
     racial and ethnic minority populations, that may affect risk 
     of disease or response to drug therapy and other treatments, 
     in order to ensure that all populations are able to derive 
     full benefit from genomic tests and treatments that may 
     improve their health and healthcare. The Secretary shall 
     encourage, with respect to racial and ethnic minority 
     populations, efforts to--
       (1) increase access, availability, and utilization of 
     genomic tests and treatments;
       (2) determine and monitor appropriateness of use of genomic 
     tests and treatments;
       (3) increase awareness of the importance of knowing one's 
     family history and the relationships between genes, the 
     social and physical environment, and health; and
       (4) expand genomics research that would help to--
       (A) improve tests to facilitate earlier and more accurate 
     diagnoses;
       (B) enhance the safety of drugs, particularly for drugs 
     that pose an elevated risk for adverse drug events in such 
     populations;
       (C) increase the effectiveness of drugs, particularly for 
     diseases and conditions that disproportionately affect such 
     populations; and
       (D) augment the current understanding of the interactions 
     between genomic, social and physical environmental factors 
     and their influence on the causality, prevention, and 
     treatment of diseases common in such populations.
       (b) Genetic Variation, Environment, and Health Summit.--
       (1) Summit.--Not later than 1 year after the date of 
     enactment of this Act, the Director of the National Human 
     Genome Research Institute, in collaboration with the Director 
     of the Office of Genomics and Disease Prevention at the 
     Centers for Disease Control and Prevention, the Director of 
     the Office of Behavioral and Social Science Research at the 
     National Institutes of Health, and the Deputy Assistant 
     Secretary of the Office of Minority Health and Health 
     Disparity Elimination, shall convene a Summit for the purpose 
     of providing leadership and guidance to Secretary, Congress, 
     and other public and private entities on current and future 
     areas of focus for genomics research, including 
     translation of findings from such research, relating to 
     improving the health of racial and ethnic minority 
     populations and reducing health disparities.
       (2) Participation.--The Summit shall include--

[[Page S10705]]

       (A) representatives from the Federal health agencies, 
     including the National Institutes of Health, the Centers for 
     Disease Control and Prevention, the Food and Drug 
     Administration, the Health Resources and Services 
     Administration, and additional agencies and departments as 
     determined appropriate by the Secretary;
       (B) independent experts and stakeholders from relevant 
     industry and academic institutions, particularly those that 
     have demonstrated expertise in both genomics and minority 
     health and serve a disproportionate number of racial and 
     ethnic minority patients; and
       (C) leaders of community organizations that work to reduce 
     and eliminate health disparities.
       (3) Report.--Not later than 90 days after the conclusion of 
     the Summit, the Director of the National Human Genome 
     Research Institute shall submit to Congress and make 
     available to the public a report detailing recommendations 
     on--
       (A) an appropriate description of human diversity, 
     incorporating available information on genetics, for use in 
     genomic research and programs operated or supported by the 
     Federal Government;
       (B) guiding ethics, principles, and protocols for the 
     inclusion and designation of racial and ethnic minority 
     populations in genomics research, particularly clinical 
     trials programs operated or supported by the Federal 
     Government;
       (C) ways to increase access to and utilization of effective 
     pharmacogenomic and other genetic screening and services for 
     racial and ethnic minority populations;
       (D) research opportunities and funding support in the area 
     of genomic variation that may improve the health and 
     healthcare of minority populations;
       (E) ways to enhance integration of Federal Government-wide 
     efforts and activities pertaining to race, genomics, and 
     health; and
       (F) need for additional privacy protections in preventing 
     stigmatization and inappropriate use of genetic information.
       (c) Pharmacogenomics and Emerging Issues Advisory 
     Committee.--
       (1) In general.--The Secretary, under section 222 of the 
     Public Health Service Act (42 U.S.C. 217a), shall convene and 
     consult an advisory committee on issues relating to 
     pharmacogenomics (referred to in this subsection as the 
     ``Advisory Committee'').
       (2) Duties.--
       (A) In general.--The Advisory Committee shall advise and 
     make recommendations to the Secretary, through the 
     Commissioner of Food and Drugs and in consultation with the 
     Director of the National Institutes of Health, on the 
     evolving science of pharmacogenomics and interindividual 
     variability in drug response, as it relates to the health of 
     racial and ethnic minorities.
       (B) Matters considered.--The recommendations under 
     subparagraph (A) shall include recommendations on--
       (i) the ethics, design, and analysis of clinical trials 
     involving racial and ethnic minorities conducted under 
     section 351, 409I, or 499 of the Public Health Service Act or 
     section 505(i), 505A, 505B, or 515(g) of the Federal Food, 
     Drug, and Cosmetic Act;
       (ii) general policy and guidance with respect to the 
     development, approval or clearance, and labeling of medical 
     products for racial and ethnic minorities;
       (iii) the role of pharmacogenomics during the development 
     of drugs, biological products, and diagnostics;
       (iv) the understanding of interindividual variability in 
     drug response;
       (v) diagnostics or treatments for diseases or conditions 
     common in racial and ethnic minorities; and
       (vi) the identification of other areas of unmet medical 
     need.
       (3) Composition.--The Advisory Committee shall include--
       (A) experts in the fields of--
       (i) minority health and health disparities;
       (ii) genomics;
       (iii) pharmaceutical and diagnostic research and 
     development;
       (iv) ethical, legal, and social issues relating to clinical 
     trials; and
       (v) bioinformatics and information technology;
       (B) representatives from minority health organizations and 
     relevant patient organizations; and
       (C) other experts as deemed appropriate by the Secretary.
       (4) Coordination with other advisory committees.--The 
     Advisory Committee may consult and coordinate with other 
     advisory committees of the Department of Health and Human 
     Services as determined appropriate by the Secretary.
       (5) Recommendations.--The Advisory Committee shall submit 
     recommendations to the Secretary with respect to each of the 
     matters described under paragraph (2)(B) prior to the 
     development by the Secretary of the report described under 
     paragraph (6).
       (6) Report.--Not later than 180 days after the date of 
     enactment of this Act, the Secretary--
       (A) shall, acting through the Commissioner of Food and 
     Drugs and in consultation with the Director of the National 
     Institutes of Health, and taking into consideration the 
     recommendations of the Advisory Committee submitted under 
     paragraph (5), submit to the Committee on Health, Education, 
     Labor, and Pensions of the Senate and the Committee on Energy 
     and Commerce of the House of Representatives, a report on the 
     evolving science of pharmacogenomics as it relates to racial 
     and ethnic minorities, including a review of the guidance of 
     the Food and Drug Administration on the participation of 
     racial and ethnic minorities in clinical trials; and
       (B) shall ensure that such report is made publicly 
     available.

     SEC. 303. EVALUATIONS BY THE INSTITUTE OF MEDICINE.

       (a) Health Disparities Summit.--
       (1) In general.--Not later than 270 days after the date of 
     enactment of this Act, the Institute of Medicine shall 
     convene a summit on health disparities (referred to this 
     section as the ``Summit'').
       (2) Purpose.--The purposes of the Summit include--
       (A) reviewing current activities of the Federal Government 
     in addressing health and healthcare disparities as 
     experienced by racial and ethnic minority populations, and 
     other health disparity populations as practicable; and
       (B) assessing progress made since the 2002 Institute of 
     Medicine National Healthcare Disparities Report.
       (3) Areas of focus.--The Summit shall examine the 
     activities of the Federal Government to reduce and eliminate 
     health disparities, with a focus on--
       (A) education and training, including health professions 
     programs that increase minority representation in medicine 
     and the health professions;
       (B) data collection and analysis;
       (C) coordination among agencies and departments in 
     addressing healthcare disparities;
       (D) research into the causes of and strategies to eliminate 
     health disparities; and
       (E) programs that increase access to care and improve 
     health outcomes for health disparity populations.
       (4) Participation.--Summit participants shall include--
       (A) representatives of the Federal Government;
       (B) experts with research experience in identifying and 
     addressing healthcare disparities among racial and ethnic 
     minority and other health disparity populations; and
       (C) representatives from community-based organizations and 
     nonprofit groups that address the issues of racial and ethnic 
     minority and other health disparity populations.
       (5) Summit proceedings.--Not later than 180 days after the 
     conclusion of the Summit, the Secretary shall offer to enter 
     into a contract with the Institute of Medicine to publish a 
     report summarizing the discussions of the Summit and review 
     of current Federal activities to address healthcare 
     disparities for racial and ethnic minority and other health 
     disparity populations.
       (b) National Plan to Eliminate Disparities.--
       (1) Plan.--Not later than 2 years after the date of 
     enactment of this Act, the Institute of Medicine shall 
     develop an evidence-based, strategic, national plan to 
     eliminate disparities which shall--
       (A) include goals, interventions, and resources needed to 
     eliminate disparities;
       (B) establish a reasonable timetable to reach selected 
     priorities;
       (C) inform and complement the National Plan to Improve 
     Minority Health and Eliminate Health Disparities, pursuant to 
     section 1707(c)(2) of the Public Health Service Act (as added 
     by section 501 of this Act); and
       (D) inform the development of criteria for evaluation of 
     the effectiveness of programs authorized under this Act (and 
     the amendments made by this Act), pursuant to subsection (c).
       (2) Report.--The Secretary shall offer to enter into a 
     contract with the Institute of Medicine to publish the 
     National Plan to Eliminate Disparities.
       (c) Institute of Medicine Evaluation.--
       (1) In general.--Not later than 3 years after the date of 
     enactment of this Act, the Secretary shall offer to enter 
     into a contract with the Institute of Medicine to evaluate 
     the effectiveness of the programs authorized under this Act 
     (and the amendments made by this Act) in addressing and 
     reducing health disparities experienced by racial and ethnic 
     minority and other health disparity populations. In making 
     such an evaluation, the Institute of Medicine shall consult--
       (A) representatives of the Federal Government;
       (B) experts with research and policy experience in 
     identifying and addressing healthcare disparities among 
     racial and ethnic minority and other health disparity 
     populations; and
       (C) representatives from community-based organizations and 
     nonprofit groups that address health disparity issues.
       (2) Report.--Not later than 2 years after the Secretary 
     enters into the contract under paragraph (1), the Institute 
     of Medicine shall submit to the Secretary and relevant 
     committees of Congress a report that contains the results of 
     the evaluation described under such subparagraph, and any 
     recommendations of such Institute.
       (3) Response.--Not later than 180 days after the date the 
     Institute of Medicine submits the report under this 
     subsection, the Secretary shall publish a response to such 
     recommendations, which shall be provided to the relevant 
     committees of Congress and made publicly available through 
     the Internet Clearinghouse under section 270 of the Public 
     Health Service Act (as added by section 101).
       (d) Health Information Technology.--
       (1) In general.--Not later than 180 days after the date of 
     enactment of this Act, the

[[Page S10706]]

     Secretary, acting through the Director of the National 
     Library of Medicine, shall offer to enter into a contract 
     with the Institute of Medicine to study and make 
     recommendations regarding the use of health information 
     technology and bioinformatics to improve the health and 
     healthcare of racial and ethnic minority and other health 
     disparity populations.
       (2) Study.--The study under paragraph (1), with respect to 
     increasing access and quality of healthcare for racial and 
     ethnic minority and other health disparity populations, shall 
     assess and make recommendations regarding--
       (A) effective applications of health information 
     technology, including telemedicine and telepsychiatry;
       (B) status of development of health information technology 
     standards that will permit healthcare information of the type 
     required to support patient care;
       (C) inclusion of organizations with expertise in minority 
     health and health disparities in the development of health 
     information technology standards and applications;
       (D) priority areas for research to improve the 
     dissemination, management, and use of biomedical knowledge 
     that address identified and unmet needs;
       (E) educational and training needs and opportunities to 
     assist health professionals understand and apply health 
     information technology; and
       (F) ways to increase recruitment and retention of racial 
     and ethnic minorities into the field of medical informatics.
       (3) Report.--Not later than 2 years after the Secretary 
     enters into the contract under paragraph (1), the Institute 
     of Medicine shall submit to the Secretary and relevant 
     committees of Congress a report that contains the findings 
     and recommendations of this study.

     SEC. 304. NATIONAL CENTER FOR MINORITY HEALTH AND HEALTH 
                   DISPARITIES REAUTHORIZATION.

       Section 485E of the Public Health Service Act (42 U.S.C. 
     287c-31) is amended--
       (1) by striking subsection (e) and inserting the following:
       ``(e) Duties of the Director.--
       ``(1) Interagency coordination of minority health and 
     health disparities activities.--With respect to minority 
     health and health disparities, the Director of the Center 
     shall plan, coordinate, and evaluate research and other 
     activities conducted or supported by the agencies of the 
     National Institutes of Health. In carrying out the preceding 
     sentence, the Director of the Center shall evaluate the 
     minority health and health disparity activities of each of 
     such agencies and shall provide for the periodic reevaluation 
     of such activities.
       ``(2) Consultations.--The Director of the Center shall 
     carry out this subpart (including developing and revising the 
     plan and budget required in subsection (f)) in consultation 
     with the Directors of the agencies (or a designee of the 
     Directors) of the National Institutes of Health, with the 
     advisory councils of the agencies, and with the advisory 
     council established under section (j).
       ``(3) Coordination of activities.--The Director of the 
     Center shall act as the primary Federal official with 
     responsibility for coordinating all minority health 
     disparities research and other health disparities research 
     conducted or supported by the National Institutes of Health 
     and shall--
       ``(A) represent the health disparities research program of 
     the National Institutes of Health including the minority 
     health disparities research program at all relevant executive 
     branch task forces, committees, and planning activities;
       ``(B) maintain communications with all relevant Public 
     Health Service agencies, including the Indian Health Service 
     and various other departments of the Federal Government, to 
     ensure the timely transmission of information concerning 
     advances in minority health disparities research and other 
     health disparities research between these various agencies 
     for dissemination to affected communities and healthcare 
     providers; and
       ``(C) engage with community-based organizations and health 
     provider groups to--
       ``(i) increase education and awareness about the Center's 
     activities and areas of research focus; and
       ``(ii) accelerate the translation of research findings into 
     programs including those carried out by community-based 
     organizations.'';
       (2) in subsection (f)--
       (A) by striking the subsection heading and inserting the 
     following:
       ``(f) Comprehensive Plan for Research; Budget Estimate; 
     Allocation of Appropriations.--'';
       (B) in paragraph (1)--
       (i) by striking the matter preceding subparagraph (A) and 
     subparagraph (A) and inserting the following:
       ``(1) In general.--Subject to the provisions of this 
     section and other applicable law, the Director of the Center, 
     in consultation with the Director of NIH, the Directors of 
     the other agencies of the National Institutes of Health, and 
     the advisory council established under subsection (j) shall--
       ``(A) annually review and revise a comprehensive plan 
     (referred to in this section as `the Plan') and budget for 
     the conduct and support of all minority health and health 
     disparities research and other health disparities research 
     activities of the agencies of the National Institutes of 
     Health;'';
       (ii) in subparagraph (D), by striking ``, with respect to 
     amounts appropriated for activities of the Center,'';
       (iii) by striking subparagraph (F) and inserting the 
     following:
       ``(F) ensure that the Plan and budget are presented to and 
     considered by the Director during the formulation of the 
     overall annual budget for the National Institutes of 
     Health;'';
       (iv) by redesignating subparagraphs (G) and (H) as 
     subparagraphs (I) and (J), respectively; and
       (v) by inserting after subparagraph (F), the following:
       ``(G) annually submit to Congress a report on the progress 
     made with respect to the Plan;
       ``(H) creating and implementing a plan for the systematic 
     review of research activities supported by the National 
     Institutes of Health that are within the mission of both the 
     Center and other agencies of the National Institutes of 
     Health, by establishing mechanisms for--
       ``(i) tracking minority health and health disparity 
     research conducted within the agencies;
       ``(ii) the early identification of applications and 
     proposals for grants, contracts, and cooperative agreements 
     supporting extramural training, research, and development, 
     that are submitted to the agencies and that are within the 
     mission of the Center;
       ``(iii) providing the Center with the written descriptions 
     and scientific peer review results of such applications and 
     proposals;
       ``(iv) enabling the agencies to consult with the Director 
     of the Center prior to final approval of such applications 
     and proposals; and
       ``(v) reporting to the Director of the Center all such 
     applications and proposals that are approved for funding by 
     the agencies;''; and
       (C) in paragraph (2)--
       (i) in subparagraph (D), by striking ``and'' at the end;
       (ii) in subparagraph (E), by striking the period and 
     inserting ``; and''; and
       (iii) by adding at the end the following:
       ``(F) the number and type of personnel needs of the 
     Center.'';
       (3) in subsection (h)--
       (A) in paragraph (1), by striking ``endowments at centers 
     of excellence under section 736.'' and inserting the 
     following: ``endowments at--
       ``(A) centers of excellence under section 736; and
       ``(B) centers of excellence under section 485F.''; and
       (B) in paragraph (2)(A), by striking ``average'' and 
     inserting ``median'';
       (4) by redesignating subsections (k) and (l) as subsections 
     (m) and (n), respectively;
       (5) by inserting after subsection (j), the following:
       ``(k) Representation of Minorities Among Researchers.--The 
     Secretary, in collaboration with the Director of the Center, 
     shall determine the extent to which racial and ethnic 
     minority and other health disparity populations are 
     represented among senior physicians and scientists of the 
     national research institutes and among physicians and 
     scientists conducting research with funds provided by such 
     institutes, and as appropriate, carry out activities to 
     increase the extent of such representation.
       ``(l) Cancer Research.--The Secretary, in collaboration 
     with the Director of the Center, shall designate and support 
     a cancer prevention, control, and population science center 
     to address the significantly elevated rate of morbidity and 
     mortality from cancer in racial and ethnic minority 
     populations. Such designated center shall be housed within an 
     existing, stand-alone cancer center at a historically black 
     college and university that has a demonstrable commitment to 
     and expertise in cancer research in the basic, clinical, and 
     population sciences.'';
       (6) in subsection (l)(1) (as so redesignated), by inserting 
     before the semicolon the following: ``, with a particular 
     focus on evaluation of progress made toward fulfillment of 
     the goals of the Plan''; and
       (7) by striking subsection (m) (as so redesignated).

     SEC. 305. AUTHORIZATION OF APPROPRIATIONS.

       (a) Sections 301, 302, and 303.--There are authorized to be 
     appropriated such sums as may be necessary for each of fiscal 
     years 2007 through 2011, to carry out sections 301, 302, and 
     303 (and the amendments made by such sections).
       (b) Section 304.--
       (1) In general.--There are authorized to be appropriated 
     $240,000,000 for fiscal year 2007, such sums as may be 
     necessary for each of fiscal years 2008 through 2011, to 
     carry out section 304.
       (2) Allocation of funds.--Subject to section 485E of the 
     Public Health Service Act (as amended by section 304) and 
     other applicable law, the Director of the Center under such 
     section 485E shall direct all amounts appropriated for 
     activities under such section and in collaboration with the 
     Director of National Institutes of Health and the directors 
     of other institutes and centers of the National Institutes of 
     Health.
       (3) Management of allocations.--All amounts allocated or 
     expended for minority health and health disparities research 
     activities under this subsection shall be reported 
     programmatically to and approved by the Director of the 
     Center under such section 485E, in accordance with the Plan 
     described under such section 485E.

[[Page S10707]]

            TITLE IV--DATA COLLECTION, ANALYSIS, AND QUALITY

     SEC. 401. DATA COLLECTION, ANALYSIS, AND QUALITY.

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

          ``TITLE XXIX--DATA COLLECTION, ANALYSIS, AND QUALITY

     ``SEC. 2901. DATA COLLECTION, ANALYSIS, AND QUALITY.

       ``(a) Data Collection and Reporting.--The Secretary shall 
     ensure that not later than 3 years after the date of 
     enactment of the Minority Health Improvement and Health 
     Disparity Elimination Act any ongoing or new federally 
     conducted or supported health programs (including surveys) 
     result in the--
       ``(1) collection and reporting of data by race and 
     ethnicity using, at a minimum, Office of Budget and 
     Management standards in effect on the date of enactment of 
     the Minority Health Improvement and Health Disparity 
     Elimination Act;
       ``(2) collection and reporting of data by geographic 
     location, socioeconomic position (such as employment, income, 
     and education), primary language, and, when determined 
     practicable by the Secretary, health literacy; and
       ``(3) if practicable, collection and reporting of data on 
     additional population groups if such data can be aggregated 
     into the minimum race and ethnicity data categories.
       ``(b) Data Analysis and Dissemination.--
       ``(1) Data analysis.--
       ``(A) In general.--The Secretary shall analyze data 
     collected under subsection (a) to detect and monitor trends 
     in disparities in health and healthcare for racial and ethnic 
     minority and other health disparity populations, and examine 
     the interaction between various disparity indicators.
       ``(B) Quality analysis.--The Secretary shall ensure that 
     the analyses under subparagraph (A) incorporate data reported 
     according to quality measurement systems.
       ``(2) Quality measures.--When the Secretary, by statutory 
     or regulatory authority, adopts and implements any quality 
     measures or any quality measurement system, the Secretary 
     shall ensure the quality measures or quality measurement 
     system comply with the following:
       ``(A) Measures.--Measures selected shall, to the extent 
     practicable--
       ``(i) assess the effectiveness, timeliness, patient self-
     management, patient centeredness, equity, and efficiency of 
     care received by patients, including patients from racial and 
     ethnic minority and other health disparity populations;
       ``(ii) are evidence based, reliable, and valid; and
       ``(iii) include measures of clinical processes and 
     outcomes, patient experience and efficiency.
       ``(B) Consultation.--In selecting quality measures or a 
     quality measurement system or systems for adoption and 
     implementation, the Secretary shall consult with--
       ``(i) individuals from racial and ethnic minority and other 
     health disparity populations; and
       ``(ii) experts in the identification and elimination of 
     disparities in health and healthcare among racial and ethnic 
     minority and other health disparity populations.
       ``(3) Dissemination.--
       ``(A) In general.--The Secretary shall make the measures, 
     data, and analyses described in paragraph (1) and (2) 
     available to--
       ``(i) the Office of Minority Health and Health Disparity 
     Elimination;
       ``(ii) the National Center on Minority Health and Health 
     Disparities;
       ``(iii) the Agency for Healthcare Research and Quality for 
     inclusion in the Agency's reports;
       ``(iv) the Centers for Disease Control and Prevention;
       ``(v) the Centers for Medicare and Medicaid Services;
       ``(vi) the Indian Health Service;
       ``(vii) other agencies within the Department of Health and 
     Human Services; and
       ``(viii) other entities as determined appropriate by the 
     Secretary.
       ``(B) Additional research.--The Secretary may, as the 
     Secretary determines appropriate, make the measures, data, 
     and analysis described in paragraphs (1) and (2) available 
     for additional research, analysis, and dissemination to 
     nongovernmental entities and the public.
       ``(c) Research.--
       ``(1) Disparity indicators.--
       ``(A) In general.--The Secretary shall award grants or 
     contracts for research to develop appropriate methods, 
     indicators, and measures that will enable the detection and 
     assessment of disparities in healthcare. Such research shall 
     prioritize research with respect to the following:
       ``(i) Race and ethnicity.
       ``(ii) Geographic location (such as geocoding).
       ``(iii) Socioeconomic position (such as income or education 
     level).
       ``(iv) Health literacy.
       ``(v) Cultural competency.
       ``(vi) Additional measures as determined appropriate by the 
     Secretary.
       ``(B) Applied research.--The Secretary shall use the 
     results of the research from grants awarded under 
     subparagraph (A) to improve the data collection described 
     under subsection (a).
       ``(2) Strategic partnerships to encourage and improve data 
     collection.--
       ``(A) In general.--The Secretary may award not more than 20 
     grants to eligible entities for the purposes of--
       ``(i) enhancing and improving methods for the collection, 
     reporting, analysis, and dissemination of data, as required 
     under the Minority Health Improvement and Health Disparity 
     Elimination Act; and
       ``(ii) encouraging the collection, reporting, analysis, and 
     dissemination of data to identify and address disparities in 
     health and healthcare.
       ``(B) Definition of eligible entity.--In this paragraph, 
     the term `eligible entity' means a health plan, federally 
     qualified health center, hospital, rural health clinic, 
     academic institution, policy research organization, or other 
     entity, including an Indian Health Service hospital or 
     clinic, Indian tribal health facility, or urban Indian 
     facility, that the Secretary determines to be appropriate.
       ``(C) Application.--An eligible entity desiring a grant 
     under this paragraph shall submit an application to the 
     Secretary at such time, in such manner, and containing such 
     information as the Secretary may require.
       ``(D) Priority in awarding grants.--In awarding grants 
     under this paragraph, the Secretary shall give priority to 
     eligible entities that represent collaboratives with--
       ``(i) hospitals, health plans, or health centers; and
       ``(ii) at least 1 community-based organization or patient 
     advocacy group.
       ``(E) Use of funds.--An eligible entity that receives a 
     grant under this paragraph shall use grant funds to--
       ``(i) collect, analyze, or report data by race, ethnicity, 
     geographic location, socioeconomic position, health literacy, 
     or other health disparity indicator;
       ``(ii) conduct and report analyses of quality of healthcare 
     and disparities in health and healthcare for racial and 
     ethnic minority and other health disparity populations, 
     including disparities in diagnosis, management and treatment, 
     and health outcomes for acute and chronic disease;
       ``(iii) improve health data collection, analysis, and 
     reporting for subpopulations and categories;
       ``(iv) modify, implement, and evaluate use of health 
     information technology systems that facilitate data 
     collection, analysis and reporting for racial and ethnic 
     minority and other health disparity populations, and support 
     healthcare interventions;
       ``(v) develop educational programs to inform patients, 
     providers, purchasers, and other individuals served about the 
     legality and importance of the collection, analysis, and 
     reporting of data by race, ethnicity, socioeconomic position, 
     geographic location, and health literacy, for eliminating 
     disparities in health; and
       ``(vi) evaluate the activities conducted under this 
     paragraph.
       ``(d) Technical Assistance.--The Secretary may provide 
     technical assistance to promote compliance with the data 
     collection and reporting requirements of the Minority Health 
     Improvement and Health Disparity Elimination Act.
       ``(e) Privacy and Security.--The Secretary shall ensure all 
     appropriate privacy and security protections for health data 
     collected, reported, analyzed, and disseminated pursuant to 
     the Minority Health Improvement and Health Disparity 
     Elimination Act.
       ``(f) 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 fiscal 
     years 2007 through 2011.''.

      TITLE V--LEADERSHIP, COLLABORATION, AND NATIONAL ACTION PLAN

     SEC. 501. OFFICE OF MINORITY HEALTH AND HEALTH DISPARITY 
                   ELIMINATION.

       (a) In General.--Section 1707 of the Public Health Service 
     Act (42 U.S.C. 300u-6) is amended to read as follows:

     ``SEC. 1707. OFFICE OF MINORITY HEALTH AND HEALTH DISPARITY 
                   ELIMINATION.

       ``(a) Establishment.--For the purpose of improving the 
     health of racial and ethnic minority populations and other 
     health disparity populations, as described in subsection (b), 
     there is established an Office of Minority Health and Health 
     Disparity Elimination within the Office of Public Health and 
     Science. There shall be in the Department of Health and Human 
     Services a Deputy Assistant Secretary for Minority Health and 
     Health Disparity Elimination, who shall be the head of the 
     Office of Minority Health and Health Disparity Elimination. 
     The Secretary, acting through such Deputy Assistant 
     Secretary, shall carry out this section.
       ``(b) Populations to Be Served.--The Secretary shall ensure 
     that services provided under this section are prioritized to 
     improve the health of racial and ethnic minority groups. To 
     the extent that services are provided to other health 
     disparity populations, such populations, as compared to the 
     general population, must experience a--
       ``(1) disproportionate burden of disease, particularly 
     chronic conditions such as hepatitis B, diabetes, heart 
     disease, stroke, high blood pressure, mental illness, asthma, 
     obesity, HIV/AIDS, and cancer;
       ``(2) significantly elevated risk for poor health outcomes, 
     including disability and premature mortality;
       ``(3) disproportionate lack of access to local health 
     resources, including hospitals, clinics, and health 
     professionals; and
       ``(4) lower socioeconomic position.

[[Page S10708]]

       ``(c) Duties.--With respect to racial and ethnic minority 
     groups, and other health disparity groups, the Secretary, 
     acting through the Deputy Assistant Secretary, shall carry 
     out the following:
       ``(1) Coordinate and provide input on activities within the 
     Public Health Service that relate to disease prevention, 
     health promotion, health service delivery, health workforce, 
     and research concerning racial and ethnic minority 
     populations, and other health disparity populations. The 
     Secretary shall ensure that the heads of each of the agencies 
     of the Service collaborate with the Deputy Assistant 
     Secretary on the development and conduct of such activities.
       ``(2) Not later than 1 year after the date of enactment of 
     the Minority Health Improvement and Health Disparity 
     Elimination Act, develop and implement a comprehensive 
     Department-wide plan to improve minority health and eliminate 
     health disparities in the United States, to be known as the 
     National Plan to Improve Minority Health and Eliminate Health 
     Disparities, (referred to in this section as the `National 
     Plan'). With respect to development and implementation of the 
     National Plan, the Secretary shall carry out the following:
       ``(A) Consult with the following:
       ``(i) The Director of the Centers for Disease Control and 
     Prevention.
       ``(ii) The Director of the National Institutes of Health.
       ``(iii) The Director of the National Center on Minority 
     Health and Health Disparities of the National Institutes of 
     Health.
       ``(iv) The Director of the Agency for Healthcare Research 
     and Quality.
       ``(v) The National Coordinator for Health Information 
     Technology.
       ``(vi) The Administrator of the Health Resources and 
     Services Administration.
       ``(vii) The Administrator of the Centers for Medicare & 
     Medicaid Services.
       ``(viii) The Director of the Office for Civil Rights.
       ``(ix) The Secretary of Veterans Affairs.
       ``(x) The Administrator of the Substance Abuse and Mental 
     Health Services Administration.
       ``(xi) The Secretary of Defense.
       ``(xii) The Commissioner of the Food and Drug 
     Administration.
       ``(xiii) The Director of the Indian Health Service.
       ``(xiv) The Secretary of Education.
       ``(xv) The Secretary of Labor.
       ``(xvi) The heads of other public and private entities, as 
     determined appropriate by the Secretary.
       ``(B) Review and integrate existing information and 
     recommendations as appropriate, such as Healthy People 2010, 
     Institute of Medicine studies, and Surgeon General Reports.
       ``(C) Ensure inclusion of measurable short-range and long-
     range goals and objectives, a description of the means for 
     achieving such goals and objectives, and a designated date by 
     which such goals and objectives are expected to be achieved.
       ``(D) Ensure that all amounts appropriated for such 
     activities are expended in accordance with the National Plan.
       ``(E) Review the National Plan on at least an annual basis, 
     and report to the public and appropriate committees of 
     Congress on progress.
       ``(F) Revise such Plan as appropriate.
       ``(G) Ensure that the National Plan will serve as a binding 
     statement of policy with respect to the agencies' activities 
     related to improving health and eliminating disparities in 
     health and healthcare.
       ``(3) Work with Federal agencies and departments outside of 
     the Department of Health and Human Services as appropriate to 
     maximize resources available to increase understanding about 
     why disparities exist, and effective ways to improve health 
     and eliminate health disparities.
       ``(4) In cooperation with the appropriate agencies, support 
     research, demonstrations, and evaluations to test new and 
     innovative models for--
       ``(A) expanding healthcare access;
       ``(B) improving healthcare quality; and
       ``(C) increasing healthcare educational opportunity.
       ``(5) Develop mechanisms that support better information 
     dissemination, education, prevention, and service delivery to 
     individuals from disadvantaged backgrounds, including 
     individuals who are members of racial or ethnic minority 
     groups or health disparity populations.
       ``(6) Increase awareness of disparities in healthcare, and 
     knowledge and understanding of health risk factors, among 
     healthcare providers, health plans, and the public.
       ``(7) Advise in matters related to the development, 
     implementation, and evaluation of health professions 
     education on improving healthcare outcomes and decreasing 
     disparities in healthcare outcomes, with focus on cultural 
     competence.
       ``(8) Assist healthcare professionals, community and 
     advocacy organizations, academic medical centers and other 
     health entities and public health departments in the design 
     and implementation of programs that will improve health 
     outcomes by strengthening the patient-provider relationship.
       ``(9) Carry out programs to improve access to healthcare 
     services and to improve the quality of healthcare services 
     for individuals with low functional health literacy.
       ``(10) Facilitate the classification and collection of 
     healthcare data to allow for ongoing analysis to identify and 
     determine the causes of disparities and monitoring of 
     progress toward improving health and eliminating health 
     disparities.
       ``(11) Ensure that the National Center for Health 
     Statistics collects data on the health status of each racial 
     or ethnic minority group or health disparity population 
     pursuant to section 2901.
       ``(12) Support a national minority health resource center 
     to carry out the following:
       ``(A) Facilitate the exchange of information regarding 
     matters relating to health information and health promotion, 
     preventive health services, and education in the appropriate 
     use of healthcare.
       ``(B) Facilitate access to such information.
       ``(C) Assist in the analysis of issues and problems 
     relating to such matters.
       ``(D) Provide technical assistance with respect to the 
     exchange of such information (including facilitating the 
     development of materials for such technical assistance).
       ``(13) Support a center for linguistic and cultural 
     competence to carry out the following:
       ``(A) With respect to individuals who lack proficiency in 
     speaking the English language, enter into contracts with 
     public and nonprofit private providers of primary health 
     services for the purpose of increasing the access of such 
     individuals to such services by developing and carrying out 
     programs to improve health literacy and cultural competency.
       ``(B) Carry out programs to improve access to healthcare 
     services for individuals with limited proficiency in speaking 
     the English language. Activities under this subparagraph 
     shall include developing and evaluating model projects.
       ``(14) Enter into interagency agreements with other 
     agencies of the Public Health Service, as appropriate.
       ``(15) Collaborate with the Office for Civil Rights to--
       ``(A) assist healthcare providers with application of 
     guidance and directives regarding healthcare for racial and 
     ethnic minority and other health disparity populations, 
     including--
       ``(i) reviewing cases with the Office of Inspector General 
     and the Office for Civil Rights which have been closed 
     without a finding of discrimination to determine if a pattern 
     or practice of activities that could lead to discrimination 
     exists, and if such a pattern or practice is identified, 
     provide technical assistance or education, as applicable, to 
     the relevant provider or to a group of providers located 
     within a particular geographic area;
       ``(ii) biannually publishing information on cases filed 
     with the Office for Civil Rights which have resulted in a 
     finding of discrimination, including the name and location of 
     the entity found to have discriminated, and any findings and 
     agreements entered into between the Office for Civil Rights 
     and the entity; and
       ``(iii) monitoring and analysis of trends in cases reported 
     to the Office for Civil Rights to ensure that the Office of 
     Minority Health and Health Disparity Elimination acts to 
     educate and assist healthcare providers as necessary; and
       ``(B) provide technical assistance or education, as 
     applicable, to the relevant provider or to a group of 
     providers located within a particular geographic area.
       ``(16) Promote and expand efforts to increase racial and 
     ethnic minority enrollment in clinical trials.
       ``(17) Establish working groups--
       ``(A) to examine and report recommendations to the 
     Secretary regarding--
       ``(i) emergency preparedness and response for underserved 
     populations;
       ``(ii) development and implementation of health information 
     technology that can assist providers to deliver culturally 
     competent healthcare;
       ``(iii) outreach and education of health disparity groups 
     about new Federal health programs, as appropriate, including 
     the programs under Part D of title XVIII of the Social 
     Security Act and chronic care management programs under the 
     Medicare Prescription Drug, Improvement, and Modernization 
     Act of 2003 (and the amendments made by such Act);
       ``(iv) leadership development in public health; and
       ``(v) other emerging health issues at the discretion of the 
     Secretary; and
       ``(B) that include representation from the relevant health 
     agencies, centers and offices, as well as public and private 
     entities as appropriate.
       ``(d) Advisory Committee.--
       ``(1) In general.--The Secretary shall establish an 
     advisory committee to be known as the Advisory Committee on 
     Minority Health and Health Disparities (in this subsection 
     referred to as the `Committee').
       ``(2) Duties.--The Committee shall provide advice to the 
     Deputy Assistant Secretary carrying out this section, 
     including advice on the development of goals and specific 
     program activities under subsection (c) for racial and ethnic 
     minority groups and health disparity population.
       ``(3) Chair.--The chairperson of the Committee shall be 
     selected by the Secretary from among the members of the 
     voting members of the Committee. The term of office of the 
     chairperson shall be 2 years.
       ``(4) Composition.--
       ``(A) The Committee shall be composed of 12 voting members 
     appointed in accordance with subparagraph (B), and nonvoting, 
     ex-

[[Page S10709]]

     officio members designated in subparagraph (C).
       ``(B) The voting members of the Committee shall be 
     appointed by the Secretary from among individuals who are not 
     officers or employees of the Federal Government and who have 
     expertise regarding issues of minority health and health 
     disparities. Racial and ethnic minority groups and health 
     disparity populations shall be appropriately represented 
     among such members.
       ``(C) The nonvoting, ex officio members of the Committee 
     shall be such officials of the Department of Health and Human 
     Services, including the Director of the Office of Minority 
     Health and Health Disparity Elimination and the Office for 
     Civil Rights, and other officials as the Secretary determines 
     to be appropriate.
       ``(D) The Secretary shall provide an opportunity for the 
     Chairman and Ranking Member of the Committee on Health, 
     Education, Labor, and Pensions of the Senate to submit to the 
     Secretary names of potential Committee members under this 
     section for consideration.
       ``(5) Terms.--Each member of the Committee shall serve for 
     a term of 4 years, except that the Secretary shall initially 
     appoint a portion of the members to terms of 1 year, 2 years, 
     and 3 years.
       ``(6) Vacancies.--If a vacancy occurs on the Committee, a 
     new member shall be appointed by the Secretary within 90 days 
     from the date that the vacancy occurs, and serve for the 
     remainder of the term for which the predecessor of such 
     member was appointed. The vacancy shall not affect the power 
     of the remaining members to execute the duties of the 
     Committee.
       ``(7) Compensation.--Members of the Committee who are 
     officers or employees of the United States shall serve 
     without additional compensation. Members of the Committee who 
     are not officers or employees of the United States shall 
     receive compensation, for each day (including travel time) 
     they are engaged in the performance of the functions of the 
     Committee. Such compensation may not be in an amount in 
     excess of the daily equivalent of the annual maximum rate of 
     basic pay payable under the General Schedule for positions 
     above GS-15 under title 5, United States Code.
       ``(e) Certain Requirements Regarding Duties.--
       ``(1) Recommendations regarding language.--
       ``(A) Proficiency in speaking english.--The Deputy 
     Assistant Secretary shall consult with the Director of the 
     Office of International and Refugee Health, the Director of 
     the Office for Civil Rights, and the Directors of other 
     appropriate departmental entities regarding recommendations 
     for carrying out activities under subsection (c)(9).
       ``(B) Health professions education regarding health 
     disparities.--The Deputy Assistant Secretary shall carry out 
     the duties under subsection (c)(7) in collaboration with 
     appropriate personnel of the Department of Health and Human 
     Services, other Federal agencies, and other offices, centers, 
     and institutions, as appropriate, that have responsibilities 
     under the Minority Health and Health Disparities Research and 
     Education Act of 2000.
       ``(2) Resource allocation.--
       ``(A) Funding.--In carrying out subsection (c), the 
     Secretary shall ensure that such funding and other resources 
     directed to health disparity populations that are not racial 
     and ethnic minority populations are used to supplement, not 
     supplant, funding and other resources currently or 
     historically allocated for services provided to such 
     populations.
       ``(B) Activities.--When carrying out activities for health 
     disparity populations that are not racial and ethnic minority 
     populations, the Secretary shall ensure that such activities 
     carried out by the Office of Minority Health and Health 
     Disparity Elimination supplement, not supplant, the 
     activities of other offices or agencies whose primary mission 
     by established mandate, or current or historical practice is 
     to serve such populations.
       ``(3) Cultural competency of services.--The Secretary shall 
     ensure that information and services provided pursuant to 
     subsection (c) consider the unique cultural or linguistic 
     issues facing such populations and are provided in the 
     language, educational, and cultural context that is most 
     appropriate for the individuals for whom the information and 
     services are intended.
       ``(4) Agency coordination.--In carrying out subsection (c), 
     the Secretary shall ensure that new or existing agency 
     offices of minority health, or other health disparity 
     offices, report current and proposed activities to the Deputy 
     Assistant Secretary, and provide, to the extent practicable, 
     an opportunity for input in the development of such 
     activities by the Deputy Assistant Secretary.
       ``(f) Grants and Contracts Regarding Duties.--
       ``(1) In general.--In carrying out subsection (c), the 
     Secretary acting through the Deputy Assistant Secretary, may 
     make awards of grants, cooperative agreements, and contracts 
     to public and nonprofit private entities.
       ``(2) Process for making awards.--The Deputy Assistant 
     Secretary shall ensure that awards under paragraph (1) are 
     made, to the extent practical, only on a competitive basis, 
     and that a grant is awarded for a proposal only if the 
     proposal has been recommended for such an award through a 
     process of peer review.
       ``(3) Evaluation and dissemination.--The Deputy Assistant 
     Secretary, directly or through contracts with public and 
     private entities, shall provide for evaluations of projects 
     carried out with awards made under paragraph (1) during the 
     preceding 2 fiscal years. The report shall be included in the 
     report required under subsection (g) for the fiscal year 
     involved.
       ``(g) State Offices of Minority Health.--The Deputy 
     Assistant Secretary shall assist the voluntary establishment 
     and functions of State offices of minority health in order to 
     expand and coordinate State efforts to improve the health of 
     minority and other health disparity populations.
       ``(1) Priorities.--The Deputy Assistant Secretary may 
     facilitate, with respect to minority and health disparity 
     populations--
       ``(A) integration and coordination of State and national 
     efforts, including those pertaining to the National Plan 
     pursuant to subsection (b);
       ``(B) strategic plan development within States to assess 
     and respond to local health concerns;
       ``(C) education and engagement of key stakeholders within 
     States, including representatives from public health 
     agencies, hospitals, clinics, provider groups, elected 
     officials, community-based organizations, advocacy groups, 
     media, and the private sector;
       ``(D) development and implementation of accepted standards, 
     core competencies, and minimum infrastructure requirements 
     for State offices;
       ``(E) access to State level health data for minority and 
     health disparity populations, which may include State data 
     collection and analysis;
       ``(F) development, implementation, and evaluation of State 
     programs and policies, as appropriate;
       ``(G) communication and networking among States to share 
     effective policies, programs and practices with respect to 
     increasing access and quality of care;
       ``(H) recognition and reporting of State successes and 
     challenges; and
       ``(I) identification of Federal grant programs and other 
     funding for which States could apply to carry out health 
     improvement activities.
       ``(2) Resources.--The Deputy Assistant Secretary may 
     provide grants and technical assistance for the voluntary 
     establishment or capacity development of State offices of 
     minority health.
       ``(3) Collaboration.--To the extent practicable, the Deputy 
     Assistant Secretary may encourage and facilitate 
     collaboration between State offices of minority health and 
     State offices addressing the needs of other health disparity 
     or disadvantaged populations, including offices of rural 
     health.
       ``(4) Definition.--For the purpose of this subsection, 
     `State offices of minority health' include offices, councils, 
     commissions, or advisory panels designated by States or 
     territories to address the health of minority populations.
       ``(h) Reports.--
       ``(1) In general.--Not later than 1 year after the date of 
     enactment of the Minority Health Improvement and Health 
     Disparity Elimination Act, the Secretary shall submit to the 
     appropriate committees of Congress, a report on the National 
     Plan developed under subsection (c).
       ``(2) Report on activities.--Not later than February 1 of 
     fiscal year 2008 and of each second year thereafter, the 
     Secretary shall submit to the appropriate committees of 
     Congress, a report describing the activities carried out 
     under this section during the preceding 2 fiscal years and 
     evaluating the extent to which such activities have been 
     effective in improving the health of racial and ethnic 
     minority groups and health disparity populations. Each such 
     report shall include the biennial reports submitted under 
     subsection (f)(3) for such years by the heads of the Public 
     Health Service agencies.
       ``(3) Agency reports.--Not later than February 1, 2007, and 
     on a biannual basis thereafter, the heads of the Public 
     Health Service shall submit to the Deputy Assistant Secretary 
     a report that summarizes the minority health and health 
     disparity activities of each of the respective agencies.
       ``(i) Definitions.--In this section:
       ``(1) The term `health disparity population' has the 
     meaning given the term in section 903(d)(1).
       ``(2) The term `racial and ethnic minority group' means 
     American Indians (including Alaska Natives, Eskimos, and 
     Aleuts), Asian Americans, Native Hawaiians and other Pacific 
     Islanders, Blacks, and Hispanics.
       ``(3) The term `Hispanic' means individuals whose origin is 
     Mexican, Puerto Rican, Cuban, Central or South American, or 
     of any other Spanish-speaking country.
       ``(j) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $110,000,000 for fiscal year 2007, such sums as 
     may be necessary for each of fiscal years 2008 through 
     2011.''.
       (b) Transfer of Functions; References.--
       (1) Transfer of functions.--
       (A) Office of minority health and health disparity 
     elimination.--The functions of the Office of Minority Health 
     under section 1707 of the Public Health Service Act (42 
     U.S.C. 300u-6) as in effect the day before the date of 
     enactment of this Act are transferred to the

[[Page S10710]]

     Office of Minority Health and Health Disparity Elimination 
     under such section 1707 (as amended by subsection (a)).
       (B) Deputy assistant secretary for minority health and 
     health disparity elimination.--The functions of the Deputy 
     Assistant Secretary for Minority Health of the Office of 
     Minority Health under section 1707 of the Public Health 
     Service Act (42 U.S.C. 300u-6) as in effect the day before 
     the date of enactment of this Act are transferred to the 
     Deputy Assistant Secretary for Minority Health and Health 
     Disparity Elimination of the Office of Minority Health and 
     Health Disparity Elimination under such section 1707 (as 
     amended by subsection (a)).
       (2) References.--
       (A) Office of minority health and health disparity 
     elimination.--Any reference in any Federal law, Executive 
     order, rule, regulation, or delegation of authority, or any 
     document of or pertaining to the Office of Minority Health 
     under section 1707 of the Public Health Service Act (42 
     U.S.C. 300u-6) as in effect the day before the enactment of 
     this Act is deemed to be a reference to the Office of 
     Minority Health and Health Disparity Elimination under such 
     section 1707 (as amended by subsection (a)).
       (B) Deputy assistant secretary for minority health and 
     health disparity elimination.--Any reference in any Federal 
     law, Executive order, rule, regulation, or delegation of 
     authority, or any document of or pertaining to the Deputy 
     Assistant Secretary for Minority Health of the Office of 
     Minority Health under section 1707 of the Public Health 
     Service Act (42 U.S.C. 300u-6) as in effect the day before 
     the enactment of this Act is deemed to be a reference to the 
     Deputy Assistant Secretary for Minority Health and Health 
     Disparity Elimination of the Office of Minority Health and 
     Health Disparity Elimination under such section 1707 (as 
     amended by subsection (a)).

  Mr. KENNEDY. Mr. President, unfortunately, serious and unjustified 
health disparities continue to exist in our Nation today. Over 45 
million Americans have no health insurance and often don't get the 
health care they need, or else they receive it too late. We know that 
persons who are uninsured are more likely to delay doctor visits and 
needed screenings like mammograms and other early detection tests, 
which can help prevent serious illness and death. The Institute of 
Medicine estimates that at least 18,000 Americans die prematurely each 
year solely because they lack health coverage.
  Some of the most shameful health disparities involve racial and 
ethnic minorities, and typically they are more likely to be uninsured. 
African Americans have a lower life expectancy than whites, and are 
much more likely to die from stroke, and their uninsurance rates are 
much higher than for their white counterparts.
  Many Americans--even physicians--want to believe such disparities 
don't exist, but ignoring them only contributes more to the widening 
gap between the haves and have-nots. It's a scandal that people of 
color have greater difficulty obtaining good health care than other 
Americans. Your health should not depend on the color of your skin, the 
size of your bank account, or where you live. In a Nation as advanced 
as ours and with its state-of-the-art medical technology for preventing 
illness and caring for the sick, it's appalling that so many health 
disparities continue to exist.
  That's the reason why I am introducing the Minority Health and Health 
Disparity Elimination Act as part of our effort to eliminate these 
unacceptable disparities.
  The bill provides grants to communities to increase public awareness 
about access to health care and disease prevention. It writes the 
Centers for Disease Control's Racial and Ethnic Approaches to Community 
Health program into law, so that this successful program can involve 
all communities in closing the health care gap.
  Greater diversity in the health care workforce is also a key part of 
ending these disparities. African Americans, Hispanic Americans, and 
other minorities account for only 6 percent of the nation's doctors and 
7 percent of nurses and dentists, even though they are almost one-third 
of the U.S. population. The disparity in the health workforce must be 
closed, not just to fulfill our commitment to equality of opportunity, 
but because of the impact it has on health care. Studies demonstrate 
that minority health professionals are more likely to care for minority 
patients, including those who are low-income and uninsured.
  The Minority Health and Health Disparity Elimination Act reauthorizes 
the Title VII healthcare workforce diversity programs, and supports the 
Centers of Excellence at Historically Black Colleges and Universities 
and institutions that educate Hispanic and Native American students.
  A diverse health care workforce is essential for a healthy country. 
Emphasizing workforce diversity does not mean that health care workers 
of all races should not be prepared to work with diverse patients. We 
must also make a more serious effort to train culturally competent 
health care professionals and work towards creating a health care 
system that is accessible for the more than 46 million Americans who 
speak a language other than English at home. The bill creates an 
Internet clearinghouse to help increase cultural competency and improve 
communication between health care providers and patients. It also 
supports the development of curricula on cultural competence in health 
professions schools.
  Language barriers in health care obviously contribute to reduced 
access and poorer care for those who have limited English proficiency 
or low health literacy. The legislation recognizes the importance of 
this issue for the quality of our health care system and provides funds 
for activities to improve and encourage services for such patients.
  The Minority Health and Health Disparities Research and Education Act 
enacted into law in 2000 created the National Center for Minority 
Health and Health Disparities. The legislation I am introducing today 
reauthorizes this important Center and strengthens its role in 
coordinating and planning research that focuses on minority health and 
health disparities. It further strengthens research in health care 
quality by establishing a grant program for healthcare delivery sites 
and public-private partnerships to evaluate and identify best practices 
in disease management strategies and interventions.
  In addition, the bill promotes the participation of racial and ethnic 
minorities and other health disparity populations in clinical trials 
and intensifies efforts throughout the Department of Health and Human 
Services to increase and apply knowledge about the interaction of 
racial, genetic, and environmental factors that affect people's health.
  Finally, the bill reinforces and clarifies the duties of the Office 
of Minority Health and Health Disparity Elimination and encourages 
greater cooperation among federal agencies and departments in meeting 
these serious challenges.
  I look forward to working with my colleagues to enact this needed 
legislation when we return to session after the election recess.
  Mr. OBAMA. Mr. President, for forty years the civil rights activist 
Fannie Lou Hamer rallied the Nation with her statement ``I am sick and 
tired, of being sick and tired.'' She would be disheartened to know the 
extent to which her words are still resonating with millions of 
Americans today. Whether we are talking about African Americans, 
Latinos, Asians or American Indians, the fact is that minorities 
continue to suffer a greater burden of disease and die prematurely. 
African Americans are one-third more likely than all other Americans to 
die from cancer, and have the highest rate of new HIV infection. One in 
3 Latinos has no insurance coverage. Fifty percent of Americans 
suffering from chronic hepatitis B are Asian. And among many American 
Indian tribes, the rate of diabetes has hit epidemic proportions, with 
rates near 50 percent in certain tribes. The state of minority health 
in this Nation is deplorable, and by many measures, is getting worse.
  Researchers have contributed a substantial body of work that has 
increased our understanding of the factors contributing to poor health. 
Higher rates of uninsurance are one such factor. Racial and ethnic 
minorities, particularly African Americans and Latinos, are 
significantly more likely to be uninsured. This lack of access to care 
leads to delayed or foregone care, and according to the Institute of 
Medicine, is the 6th leading cause of death in this Nation for adults 
aged 25-64. But equally disturbing, an overwhelming number of studies 
have shown that regardless of insurance status, minorities are more 
likely to receive low quality health care, and as a consequence, suffer 
worse health outcomes.

[[Page S10711]]

  The Institute of Medicine's 2002 historic report, Unequal Treatment: 
Confronting Racial and Ethnic Disparities in Healthcare, documented 
persistent and pervasive disparities in health care for minority 
groups, even after adjusting for differences in insurance status and 
socioeconomic factors. The American Journal of Public Health has 
reported that more than 886,000 deaths could have been prevented from 
1991 to 2000 if African Americans had received the same level of health 
care as whites. In contrast, the same study estimates that 
technological improvements in medicine--including better drugs, devices 
and procedures--prevented only 176,633 deaths during the same period.
  African Americans are not the only minorities getting worse care. 
Data has shown, for example, that compared to white Americans, Mexican 
Americans receive 38 percent fewer heart medications, and American 
Indians get recommended care for only 40 percent of quality measures. 
The bottom line is that although the level of health care quality is 
mediocre at best for all Americans, it is much worse for minority 
groups. And this is unacceptable.
  For these reasons, I am joining my colleagues Senator Frist and 
Senator Kennedy in introducing the Minority Health Improvement and 
Health Disparity Elimination Act. This critical legislation has a 
number of important provisions to help address the dismal health status 
of minority and other underserved populations. First, this bill 
strengthens education and training in cultural competence and 
communication, which is the cornerstone of quality health care for all 
patients. It also reauthorizes the pipeline programs in Title VII of 
the Public Health Service Act, which seek to increase diversity in the 
health professions. We all know that the door to opportunity is only 
half open for minority students in the health professions. The 
percentage of minority health professionals is shockingly low--African 
Americans, Hispanics and American Indians account for one-third of the 
Nation's population but less than 10 percent of the Nation's doctors, 
less than 5 percent of dentists and only 12 percent of nurses. We can 
do better, and we must.
  Lack of workforce diversity has serious implications for both access 
and quality of health care. Minority physicians are significantly more 
likely to treat low-income patients, and their patients are 
disproportionately minority. Studies have also shown that minority 
physicians provide higher quality of care to minority patients, who are 
more satisfied with their care and more likely to follow their doctor's 
recommendations.
  Second, this bill expands and supports a number of initiatives to 
increase access to quality care. Specifically, the legislation 
authorizes demonstration projects to help address health disparities in 
the U.S.-Mexico border region, increase health coverage and continuity 
of coverage, identify and implement effective disease management 
strategies, train community health workers, and increase enrollment of 
minorities in clinical trials. The REACH program at the Centers for 
Disease Control and Prevention, and the Health Disparity Collaboratives 
at the Bureau of Primary Health Care are authorized in statute. And I 
am pleased that the Community Health Initiative has also been 
authorized. This new environmental public health program is modeled 
after the Health Action Zones in the Healthy Communities Act, S. 2047, 
that I introduced a year ago, and guides and strengthens community 
efforts to improve health in comprehensive and sustained fashion.
  A third area of focus is expansion and acceleration of data 
collection and research across the agencies, including the Agency for 
Healthcare Research and Quality and the National Institutes of Health, 
with special emphasis on translational research. The tremendous 
advances in medical science and health technology, which have benefited 
millions of Americans, have remained out of reach for too many 
minorities, and translational research will help to remedy this 
problem. The National Center on Minority Health and Health Disparities, 
which has a leadership role in establishing the disparities research 
strategic plan at the National Institutes of Health, is reauthorized, 
and a new advisory committee has been established at the Food and Drug 
Administration, to focus on pharmacogenomics and its safe and 
appropriate application in minority populations.
  Last but not least, I want to highlight that the bill reauthorizes 
the Office of Minority Health and Health Disparity Elimination. This 
Office has been critical in providing the leadership, expertise and 
guidance for health improvement activities within the agencies of the 
Department of Health and Human Services, and has helped to ensure 
coordination, collaboration and integration of such efforts as well.
  In conclusion, I want to note that this is the first bipartisan 
effort on minority health and health disparities since 2000, when the 
Congress passed the last minority health bill. That bill accelerated 
the research that documented the full scope and magnitude of 
disparities in health and health care in this Nation, and more 
importantly, helped us understand why these disparities occur. But it 
is time for the next step. We've got to translate the knowledge we have 
gained into practical and effective interventions that will improve 
minority health and eliminate disparities, and this bill will help us 
do just that.
  I urge my colleagues to join me in cosponsoring and passing this 
critical legislation. Regardless of how you measure it--whether by 
needless suffering, lost productivity, financial costs, or lives lost--
disparities in health and health care are a tremendous problem and 
moral imperative for our Nation, and one that is within our power to 
address right now. On behalf of the millions of Americans who continue 
to be sick and tired of being sick and tired, I ask you to join me in 
voting yes to pass this bill.
                                 ______