[Congressional Record (Bound Edition), Volume 146 (2000), Part 17]
[Senate]
[Pages 24849-24868]
[From the U.S. Government Publishing Office, www.gpo.gov]



                          AMENDMENTS SUBMITTED

                                 ______
                                 

                   OLDER AMERICANS AMENDMENTS OF 1999

                                 ______
                                 

                        GREGG AMENDMENT NO. 4343

  Mr. GREGG proposed an amendment to the bill (H.R. 782) to amend the 
Older Americans Act of 1965 to authorize appropriations for fiscal 
years 2000 through 2003; as follows:

       Beginning on page 151, strike line 1 through line 23, page 
     153, and insert the following:
       ``(d) Responsibility Tests.--
       ``(1) In general.--Before final selection of a grantee, the 
     Secretary shall make an assessment of the applicant agency or 
     State's overall responsibility to administer Federal funds.
       ``(2) Review.--
       ``(A) In general.--As part of the assessment described in 
     paragraph (1), the Secretary shall conduct a review of the 
     available records to assess the applicant agency or State's 
     proven ability and history with regard to the management of 
     other grants, including Department of Labor grants, and may 
     consider any other information.
       ``(B) Existing grantees.--As part of the assessment 
     described in paragraph (1), any applicant agency or State who 
     in the prior year received funds under this title shall be 
     assessed in accordance with subparagraph (A), and particular 
     consideration shall be given to such agency or State's proven 
     ability to manage funds under this title.
       ``(C) Time for review.--The Secretary shall conduct the 
     review described in this paragraph in a timely manner to 
     ensure that, if such agency or State is determined to be not 
     responsible and ineligible as a grantee, any competition of 
     funds from such agency or State who in the prior year 
     received funds under this title will be accomplished without 
     disruption to any employment of older individuals provided 
     under this title. Such competition shall be performed in 
     accordance with paragraph (7).
       ``(3) Failure to satisfy test.--The failure to satisfy any 
     1 responsibility test that is listed in paragraph (4), except 
     for those listed in subparagraphs (A), (B), and (C) of such 
     paragraph, does not establish that the organization is not 
     responsible unless such failure is substantial or persistent 
     (for 2 or more consecutive years).
       ``(4) Test.--The responsibility test shall include the 
     following factors:
       ``(A) Efforts by the Secretary to recover debts, after 3 
     demand letters have been sent, that are established by final 
     agency action and have been unsuccessful, or that there has 
     been failure to comply with an approved repayment plan.
       ``(B) Established fraud or criminal activity of a 
     significant nature within the organization.
       ``(C) Established misuse of funds, including the use of 
     funds to lobby or litigate against any Federal entity or 
     official or to provide compensation for any lobbying or 
     litigation activity identified by the Secretary, independent 
     Inspector General audits, or other official inquiries or 
     investigations by the Federal Government.
       ``(D) Serious administrative deficiencies identified by the 
     Secretary, such as failure to maintain a financial management 
     system as required by Federal regulations.
       ``(E) Willful obstruction of the audit process.
       ``(F) Failure to provide services to applicants as agreed 
     to in a current or recent grant or to meet applicable 
     performance measures.
       ``(G) Failure to correct deficiencies brought to the 
     grantee's attention in writing as a result of monitoring 
     activities, reviews, assessments, or other activities.
       ``(H) Failure to return a grant closeout package or 
     outstanding advances within 90 days of the grant expiration 
     date or receipt of closeout package, whichever is later, 
     unless an extension has been requested and granted.
       ``(I) Failure to submit required reports.
       ``(J) Failure to properly report and dispose of government 
     property as instructed by the Secretary.
       ``(K) Failure to have maintained effective cash management 
     or cost controls resulting in excess cash on hand.
       ``(L) Failure to ensure that a subrecipient complies with 
     its Office of Management and Budget Circular A-133 audit 
     requirements specified at section 667.200(b) of title 20, 
     Code of Federal Regulations.
       ``(M) Failure to audit a subrecipient within the required 
     period.
       ``(N) Final disallowed costs in excess of 2 percent of the 
     grant or contract award if, in the judgment of the grant 
     officer, the disallowances are egregious findings.
       ``(O) Failure to establish a mechanism to resolve a 
     subrecipient's audit in a timely fashion.
       ``(5) Determination.--Applicants that are determined to be 
     not responsible under paragraph (4), shall not be selected as 
     a grantee, and shall not receive a grant, or be allowed to 
     enter into a contract, to provide goods, services, or 
     employment with funds made available under this title.
       ``(6) Authority to bar providers.--If, after notice and an 
     opportunity for a hearing, the Secretary determines that an 
     applicant agency or State who in the prior year received 
     funds under this title, is not responsible under paragraph 
     (4), and that funds expended under such title by a recipient 
     of a grant, directly or indirectly, by a grant to or contract 
     with a provider to provide employment for older individuals, 
     have not been expended in compliance with this title or a 
     regulation issued to carry out this title, then the Secretary 
     shall issue an order barring such provider, for a period not 
     to exceed 5 years as specified in such order, from receiving 
     a grant, or entering into a contract, to provide goods, 
     services, or employment with funds made available under this 
     title.
       ``(7) Competition for funds.--
       ``(A) In general.--In the case of an applicant agency or 
     State, who has in the prior year received funds under this 
     title, and who has been determined to be not responsible 
     under paragraph (4), the Secretary shall establish procedures 
     to conduct a competition for the funds to carry out such 
     project among any and all eligible entities that meet the 
     responsibility test under paragraph (4), except that any 
     existing grantee that is the subject of the corrective action 
     under subsection (e) shall not be eligible to compete for 
     such funds.
       ``(B) Use of funds.--The eligible applicant or State that 
     receives the grant through the competition shall continue 
     service to the geographic areas formerly served by the 
     grantee that previously received the grant.
       ``(8) Disallowed costs.--Interest on disallowed costs shall 
     accrue in accordance with the Debt Collection Improvement Act 
     of 1996.
       ``(9) Additional audits.--With respect to unspent funds 
     under this title that are returned to the Department of Labor 
     at the end of the program year, the Secretary may use such 
     funds (not to exceed $1,000,000 annually) to provide for 
     additional auditing and oversight activities of grantees 
     receiving funds under this title.
                                 ______
                                 

  TO AMEND PUBLIC HEALTH SERVICE ACT (CARDIAC ARREST SURVIVAL ACT OF 
                                 1999)

                                 ______
                                 

                 FRIST (AND OTHERS) AMENDMENT NO. 4344

  Mr. JEFFORDS (for Mr. Frist (for himself, Mr. Kennedy, Mr. Jeffords, 
Mr. Dodd, Mr. Enzi, Mr. Harkin, Mr. Hutchinson, Ms. Mikulski, Ms. 
Collins, Mr. Wellstone, Mrs. Murray, Mr. Gorton, and Mr. Graham)) 
proposed an amendment to the bill (H.R. 2498) to authorize the 
Smithsonian Institution to plan, design, construct, and equip 
laboratory, administrative, and support space to house base operations 
for the Smithsonian Astrophysical Observatory Submillimeter Array 
located on Mauna Kea at Hilo, Hawaii; as follows:

       Strike all after the enacting clause and insert the 
     following:

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Public 
     Health Improvement Act''.

[[Page 24850]]

       (b) Table of Contents.--The table of contents of this Act 
     is as follows:

Sec. 1. Short title; table of contents.

               TITLE I--EMERGING THREATS TO PUBLIC HEALTH

Sec. 101. Short title.
Sec. 102. Amendments to the Public Health Service Act.

                TITLE II--CLINICAL RESEARCH ENHANCEMENT

Sec. 201. Short title.
Sec. 202. Findings and purpose.
Sec. 203. Increasing the involvement of the National Institutes of 
              Health in clinical research.
Sec. 204. General clinical research centers.
Sec. 205. Loan repayment program regarding clinical researchers.
Sec. 206. Definition.
Sec. 207. Oversight by General Accounting Office.

             TITLE III--RESEARCH LABORATORY INFRASTRUCTURE

Sec. 301. Short title.
Sec. 302. Findings.
Sec. 303. Biomedical and behavioral research facilities.
Sec. 304. Construction program for National Primate Research Centers.
Sec. 305. Shared instrumentation grant program.

                   TITLE IV--CARDIAC ARREST SURVIVAL

           Subtitle A--Recommendations for Federal Buildings

Sec. 401. Short title.
Sec. 402. Findings.
Sec. 403. Recommendations and guidelines of Secretary of Health and 
              Human Services regarding automated external 
              defibrillators for Federal buildings.
Sec. 404. Good samaritan protections regarding emergency use of 
              automated external defibrillators.

             Subtitle B--Rural Access to Emergency Devices

Sec. 411. Short title.
Sec. 412. Findings.
Sec. 413. Grants.

                    TITLE V--LUPUS RESEARCH AND CARE

Sec. 501. Short title.
Sec. 502. Findings.

                     Subtitle A--Research on Lupus

Sec. 511. Expansion and intensification of activities.

            Subtitle B--Delivery of Services Regarding Lupus

Sec. 521. Establishment of program of grants.
Sec. 522. Certain requirements.
Sec. 523. Technical assistance.
Sec. 524. Definitions.
Sec. 525. Authorization of appropriations.

           TITLE VI--PROSTATE CANCER RESEARCH AND PREVENTION

Sec. 601. Short title.
Sec. 602. Amendments to the Public Health Service Act.

               TITLE VII--ORGAN PROCUREMENT AND DONATION

Sec. 701. Organ procurement organization certification.
Sec. 702. Designation of Give Thanks, Give Life Day.

         TITLE VIII--ALZHEIMER'S CLINICAL RESEARCH AND TRAINING

Sec. 801. Alzheimer's clinical research and training awards.

 TITLE IX--SEXUALLY TRANSMITTED DISEASE CLINICAL RESEARCH AND TRAINING

Sec. 901. Sexually transmitted disease clinical research and training 
              awards.

                    TITLE X--MISCELLENOUS PROVISIONS

Sec. 1001. Technical correction to the Children's Health Act of 2000.

               TITLE I--EMERGING THREATS TO PUBLIC HEALTH

     SEC. 101. SHORT TITLE.

       This title may be cited as the ``Public Health Threats and 
     Emergencies Act''.

     SEC. 102. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.

       Part B of title III of the Public Health Service Act (42 
     U.S.C. 243 et seq.) is amended by striking section 319 and 
     inserting the following:

     ``SEC. 319. PUBLIC HEALTH EMERGENCIES.

       ``(a) Emergencies.--If the Secretary determines, after 
     consultation with such public health officials as may be 
     necessary, that--
       ``(1) a disease or disorder presents a public health 
     emergency; or
       ``(2) a public health emergency, including significant 
     outbreaks of infectious diseases or bioterrorist attacks, 
     otherwise exists,

     the Secretary may take such action as may be appropriate to 
     respond to the public health emergency, including making 
     grants and entering into contracts and conducting and 
     supporting investigations into the cause, treatment, or 
     prevention of a disease or disorder as described in 
     paragraphs (1) and (2).
       ``(b) Public Health Emergency Fund.--
       ``(1) In general.--There is established in the Treasury a 
     fund to be designated as the `Public Health Emergency Fund' 
     to be made available to the Secretary without fiscal year 
     limitation to carry out subsection (a) only if a public 
     health emergency has been declared by the Secretary under 
     such subsection. There is authorized to be appropriated to 
     the Fund such sums as may be necessary.
       ``(2) Report.--Not later than 90 days after the end of each 
     fiscal year, the Secretary shall prepare and submit to the 
     Committee on Health, Education, Labor, and Pensions and the 
     Committee on Appropriations of the Senate and the Committee 
     on Commerce and the Committee on Appropriations of the House 
     of Representatives a report describing--
       ``(A) the expenditures made from the Public Health 
     Emergency Fund in such fiscal year; and
       ``(B) each public health emergency for which the 
     expenditures were made and the activities undertaken with 
     respect to each emergency which was conducted or supported by 
     expenditures from the Fund.
       ``(c) Supplement Not Supplant.--Funds appropriated under 
     this section shall be used to supplement and not supplant 
     other Federal, State, and local public funds provided for 
     activities under this section.

     ``SEC. 319A. NATIONAL NEEDS TO COMBAT THREATS TO PUBLIC 
                   HEALTH.

       ``(a) Capacities.--
       ``(1) In general.--Not later than 1 year after the date of 
     enactment of this section, the Secretary, and such 
     Administrators, Directors, or Commissioners, as may be 
     appropriate, and in collaboration with State and local health 
     officials, shall establish reasonable capacities that are 
     appropriate for national, State, and local public health 
     systems and the personnel or work forces of such systems. 
     Such capacities shall be revised every 10 years, or more 
     frequently as the Secretary determines to be necessary.
       ``(2) Basis.--The capacities established under paragraph 
     (1) shall improve, enhance or expand the capacity of 
     national, state and local public health agencies to detect 
     and respond effectively to significant public health threats, 
     including major outbreaks of infectious disease, pathogens 
     resistant to antimicrobial agents and acts of bioterrorism. 
     Such capacities may include the capacity to--
       ``(A) recognize the clinical signs and epidemiological 
     characteristic of significant outbreaks of infectious 
     disease;
       ``(B) identify disease-causing pathogens rapidly and 
     accurately;
       ``(C) develop and implement plans to provide medical care 
     for persons infected with disease-causing agents and to 
     provide preventive care as needed for individuals likely to 
     be exposed to disease-causing agents;
       ``(D) communicate information relevant to significant 
     public health threats rapidly to local, State and national 
     health agencies, and health care providers; or
       ``(E) develop or implement policies to prevent the spread 
     of infectious disease or antimicrobial resistance.
       ``(b) Supplement Not Supplant.--Funds appropriated under 
     this section shall be used to supplement and not supplant 
     other Federal, State, and local public funds provided for 
     activities under this section.
       ``(c) Technical Assistance.--The Secretary shall provide 
     technical assistance to the States to assist such States in 
     fulfilling the requirements of this section.
       ``(d) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section 
     $4,000,000 for fiscal year 2001, and such sums as may be 
     necessary for each subsequent fiscal year through 2006.

     ``SEC. 319B. ASSESSMENT OF PUBLIC HEALTH NEEDS.

       ``(a) Program Authorized.--Not later than 1 year after the 
     date of enactment of this section and every 10 years 
     thereafter, the Secretary shall award grants to States, or 
     consortia of 2 or more States or political subdivisions of 
     States, to perform, in collaboration with local public health 
     agencies, an evaluation to determine the extent to which the 
     States or local public health agencies can achieve the 
     capacities applicable to State and local public health 
     agencies described in subsection (a) of section 319A. The 
     Secretary shall provide technical assistance to States, or 
     consortia of 2 or more States or political subdivisions of 
     States, in addition to awarding such grants.
       ``(b) Procedure.--
       ``(1) In general.--A State, or a consortium of 2 or more 
     States or political subdivisions of States, may contract with 
     an outside entity to perform the evaluation described in 
     subsection (a).
       ``(2) Methods.--To the extent practicable, the evaluation 
     described in subsection (a) shall be completed by using 
     methods, to be developed by the Secretary in collaboration 
     with State and local health officials, that facilitate the 
     comparison of evaluations conducted by a State to those 
     conducted by other States receiving funds under this section.
       ``(c) Report.--Not later than 1 year after the date on 
     which a State, or a consortium of 2 or more States or 
     political subdivisions of States, receives a grant under this 
     subsection, such State, or a consortium of 2 or more States 
     or political subdivisions of States, shall prepare and submit 
     to the Secretary a report describing the results of the

[[Page 24851]]

     evaluation described in subsection (a) with respect to such 
     State, or consortia of 2 or more States or political 
     subdivisions of States.
       ``(d) Supplement Not Supplant.--Funds appropriated under 
     this section shall be used to supplement and not supplant 
     other Federal, State, and local public funds provided for 
     activities under this section.
       ``(e) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section 
     $45,000,000 for fiscal year 2001, and such sums as may be 
     necessary for each subsequent fiscal year through 2003.

     ``SEC. 319C. GRANTS TO IMPROVE STATE AND LOCAL PUBLIC HEALTH 
                   AGENCIES.

       ``(a) Program Authorized.--The Secretary shall award 
     competitive grants to eligible entities to address core 
     public health capacity needs using the capacities developed 
     under section 319A, with a particular focus on building 
     capacity to identify, detect, monitor, and respond to threats 
     to the public health.
       ``(b) Eligible Entities.--A State or political subdivision 
     of a State, or a consortium of 2 or more States or political 
     subdivisions of States, that has completed an evaluation 
     under section 319B(a), or an evaluation that is substantially 
     equivalent as determined by the Secretary under section 
     319B(a), shall be eligible for grants under subsection (a).
       ``(c) Use of Funds.--An eligible entity that receives a 
     grant under subsection (a), may use funds received under such 
     grant to--
       ``(1) train public health personnel;
       ``(2) develop, enhance, coordinate, or improve 
     participation in an electronic network by which disease 
     detection and public health related information can be 
     rapidly shared among national, regional, State, and local 
     public health agencies and health care providers;
       ``(3) develop a plan for responding to public health 
     emergencies, including significant outbreaks of infectious 
     diseases or bioterrorism attacks, which is coordinated with 
     the capacities of applicable national, State, and local 
     health agencies and health care providers; and
       ``(4) enhance laboratory capacity and facilities.
       ``(d) Report.--No later than January 1, 2005, the Secretary 
     shall prepare and submit to the Committee on Health, 
     Education, Labor, and Pensions and the Committee on 
     Appropriations of the Senate and the Committee on Commerce 
     and the Committee on Appropriations of the House of 
     Representatives a report that describes the activities 
     carried out under sections 319A, 319B, and 319C.
       ``(e) Supplement Not Supplant.--Funds appropriated under 
     this section shall be used to supplement and not supplant 
     other Federal, State, and local public funds provided for 
     activities under this section.
       ``(f) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section 
     $50,000,000 for fiscal year 2001, and such sums as may be 
     necessary for each subsequent fiscal year through 2006.

     ``SEC. 319D. REVITALIZING THE CENTERS FOR DISEASE CONTROL AND 
                   PREVENTION.

       ``(a) Findings.--Congress finds that the Centers for 
     Disease Control and Prevention have an essential role in 
     defending against and combatting public health threats of the 
     twenty-first century and requires secure and modern 
     facilities that are sufficient to enable such Centers to 
     conduct this important mission.
       ``(b) Authorization of Appropriations.--For the purposes of 
     achieving the mission of the Centers for Disease Control and 
     Prevention described in subsection (a), for constructing new 
     facilities and renovating existing facilities of such 
     Centers, including laboratories, laboratory support 
     buildings, health communication facilities, office buildings 
     and other facilities and infrastructure, for better 
     conducting the capacities described in section 319A, and for 
     supporting related public health activities, there are 
     authorized to be appropriated $180,000,000 for fiscal year 
     2001, and such sums as may be necessary for each subsequent 
     fiscal year through 2010.

     ``SEC. 319E. COMBATING ANTIMICROBIAL RESISTANCE.

       ``(a) Task Force.--
       ``(1) In general.--The Secretary shall establish an 
     Antimicrobial Resistance Task Force to provide advice and 
     recommendations to the Secretary and coordinate Federal 
     programs relating to antimicrobial resistance. The Secretary 
     may appoint or select a committee, or other organization in 
     existence as of the date of enactment of this section, to 
     serve as such a task force, if such committee, or other 
     organization meets the requirements of this section.
       ``(2) Members of task force.--The task force described in 
     paragraph (1) shall be composed of representatives from such 
     Federal agencies, and shall seek input from public health 
     constituencies, manufacturers, veterinary and medical 
     professional societies and others, as determined to be 
     necessary by the Secretary, to develop and implement a 
     comprehensive plan to address the public health threat of 
     antimicrobial resistance.
       ``(3) Agenda.--
       ``(A) In general.--The task force described in paragraph 
     (1) shall consider factors the Secretary considers 
     appropriate, including--
       ``(i) public health factors contributing to increasing 
     antimicrobial resistance;
       ``(ii) public health needs to detect and monitor 
     antimicrobial resistance;
       ``(iii) detection, prevention, and control strategies for 
     resistant pathogens;
       ``(iv) the need for improved information and data 
     collection;
       ``(v) the assessment of the risk imposed by pathogens 
     presenting a threat to the public health; and
       ``(vi) any other issues which the Secretary determines are 
     relevant to antimicrobial resistance.
       ``(B) Detection and control.--The Secretary, in 
     consultation with the task force described in paragraph (1) 
     and State and local public health officials, shall--
       ``(i) develop, improve, coordinate or enhance participation 
     in a surveillance plan to detect and monitor emerging 
     antimicrobial resistance; and
       ``(ii) develop, improve, coordinate or enhance 
     participation in an integrated information system to 
     assimilate, analyze, and exchange antimicrobial resistance 
     data between public health departments.
       ``(4) Meetings.--The task force described under paragraph 
     (1) shall convene not less than twice a year, or more 
     frequently as the Secretary determines to be appropriate.
       ``(b) Research and Development of New Antimicrobial Drugs 
     and Diagnostics.--The Secretary and the Director of 
     Agricultural Research Services, consistent with the 
     recommendations of the task force established under 
     subsection (a), shall conduct and support research, 
     investigations, experiments, demonstrations, and studies in 
     the health sciences that are related to--
       ``(1) the development of new therapeutics, including 
     vaccines and antimicrobials, against resistant pathogens;
       ``(2) the development or testing of medical diagnostics to 
     detect pathogens resistant to antimicrobials;
       ``(3) the epidemiology, mechanisms, and pathogenesis of 
     antimicrobial resistance;
       ``(4) the sequencing of the genomes of priority pathogens 
     as determined by the Director of the National Institutes of 
     Health in consultation with the task force established under 
     subsection (a); and
       ``(5) other relevant research areas.
       ``(c) Education of Medical and Public Health Personnel.--
     The Secretary, after consultation with the Assistant 
     Secretary for Health, the Surgeon General, the Director of 
     the Centers for Disease Control and Prevention, the 
     Administrator of the Health Resources and Services 
     Administration, the Director of the Agency for Healthcare 
     Research and Quality, members of the task force described in 
     subsection (a), professional organizations and societies, and 
     such other public health officials as may be necessary, 
     shall--
       ``(1) develop and implement educational programs to 
     increase the awareness of the general public with respect to 
     the public health threat of antimicrobial resistance and the 
     appropriate use of antibiotics;
       ``(2) develop and implement educational programs to 
     instruct health care professionals in the prudent use of 
     antibiotics; and
       ``(3) develop and implement programs to train laboratory 
     personnel in the recognition or identification of resistance 
     in pathogens.
       ``(d) Grants.--
       ``(1) In general.--The Secretary shall award competitive 
     grants to eligible entities to enable such entities to 
     increase the capacity to detect, monitor, and combat 
     antimicrobial resistance.
       ``(2) Eligible entities.--Eligible entities for grants 
     under paragraph (1) shall be State or local public health 
     agencies, Indian tribes or tribal organizations, or other 
     public or private nonprofit entities.
       ``(3) Use of funds.--An eligible entity receiving a grant 
     under paragraph (1) shall use funds from such grant for 
     activities that are consistent with the factors identified by 
     the task force under subsection (a)(3), which may include 
     activities that--
       ``(A) provide training to enable such entity to identify 
     patterns of resistance rapidly and accurately;
       ``(B) develop, improve, coordinate or enhance participation 
     in information systems by which data on resistant infections 
     can be shared rapidly among relevant national, State, and 
     local health agencies and health care providers; and
       ``(C) develop and implement policies to control the spread 
     of antimicrobial resistance.
       ``(e) Grants for Demonstration Programs.--
       ``(1) In general.--The Secretary shall award competitive 
     grants to eligible entities to establish demonstration 
     programs to promote judicious use of antimicrobial drugs or 
     control the spread of antimicrobial-resistant pathogens.
       ``(2) Eligible entities.--Eligible entities for grants 
     under paragraph (1) may include hospitals, clinics, 
     institutions of long-term care, professional medical 
     societies, or other public or private nonprofit entities.
       ``(3) Technical assistance.--The Secretary shall provide 
     appropriate technical assistance to eligible entities that 
     receive grants under paragraph (1).
       ``(f) Supplement Not Supplant.--Funds appropriated under 
     this section shall be used

[[Page 24852]]

     to supplement and not supplant other Federal, State, and 
     local public funds provided for activities under this 
     section.
       ``(g) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section, 
     $40,000,000 for fiscal year 2001, and such sums as may be 
     necessary for each subsequent fiscal year through 2006.

     ``SEC. 319F. PUBLIC HEALTH COUNTERMEASURES TO A BIOTERRORIST 
                   ATTACK.

       ``(a) Working Group on Preparedness for Acts of 
     Bioterrorism.--The Secretary, in coordination with the 
     Secretary of Defense, shall establish a joint 
     interdepartmental working group on preparedness and readiness 
     for the medical and public health effects of a bioterrorist 
     attack on the civilian population. Such joint working group 
     shall--
       ``(1) coordinate research on pathogens likely to be used in 
     a bioterrorist attack on the civilian population as well as 
     therapies to treat such pathogens;
       ``(2) coordinate research and development into equipment to 
     detect pathogens likely to be used in a bioterrorist attack 
     on the civilian population and protect against infection from 
     such pathogens;
       ``(3) develop shared standards for equipment to detect and 
     to protect against infection from pathogens likely to be used 
     in a bioterrorist attack on the civilian population; and
       ``(4) coordinate the development, maintenance, and 
     procedures for the release of, strategic reserves of 
     vaccines, drugs, and medical supplies which may be needed 
     rapidly after a bioterrorist attack upon the civilian 
     population.
       ``(b) Working Group on the Public Health and Medical 
     Consequences of Bioterrorism.--
       ``(1) In general.--The Secretary, in collaboration with the 
     Director of the Federal Emergency Management Agency, the 
     Attorney General, and the Secretary of Agriculture, shall 
     establish a joint interdepartmental working group to address 
     the public health and medical consequences of a bioterrorist 
     attack on the civilian population.
       ``(2) Functions.--Such working group shall--
       ``(A) assess the priorities for and enhance the 
     preparedness of public health institutions, providers of 
     medical care, and other emergency service personnel to 
     detect, diagnose, and respond to a bioterrorist attack; and
       ``(B) in the recognition that medical and public health 
     professionals are likely to provide much of the first 
     response to such an attack, develop, coordinate, enhance, and 
     assure the quality of joint planning and training programs 
     that address the public health and medical consequences of a 
     bioterrorist attack on the civilian population between--
       ``(i) local firefighters, ambulance personnel, police and 
     public security officers, or other emergency response 
     personnel; and
       ``(ii) hospitals, primary care facilities, and public 
     health agencies.
       ``(3) Working group membership.--In establishing such 
     working group, the Secretary shall act through the Assistant 
     Secretary for Health and the Director of the Centers for 
     Disease Control and Prevention.
       ``(4) Coordination.--The Secretary shall ensure 
     coordination and communication between the working groups 
     established in this subsection and subsection (a).
       ``(c) Grants.--
       ``(1) In general.--The Secretary, in coordination with the 
     working group established under subsection (b), shall, on a 
     competitive basis and following scientific or technical 
     review, award grants to or enter into cooperative agreements 
     with eligible entities to enable such entities to increase 
     their capacity to detect, diagnose, and respond to acts of 
     bioterrorism upon the civilian population.
       ``(2) Eligibility.--To be an eligible entity under this 
     subsection, such entity must be a State, political 
     subdivision of a State, a consortium of 2 or more States or 
     political subdivisions of States, or a hospital, clinic, or 
     primary care facility.
       ``(3) Use of funds.--An entity that receives a grant under 
     this subsection shall use such funds for activities that are 
     consistent with the priorities identified by the working 
     group under subsection (b), including--
       ``(A) training health care professionals and public health 
     personnel to enhance the ability of such personnel to 
     recognize the symptoms and epidemiological characteristics of 
     exposure to a potential bioweapon;
       ``(B) addressing rapid and accurate identification of 
     potential bioweapons;
       ``(C) coordinating medical care for individuals exposed to 
     bioweapons; and
       ``(D) facilitating and coordinating rapid communication of 
     data generated from a bioterrorist attack between national, 
     State, and local health agencies, and health care providers.
       ``(4) Coordination.--The Secretary, in awarding grants 
     under this subsection, shall--
       ``(A) notify the Director of the Office of Justice 
     Programs, and the Director of the National Domestic 
     Preparedness Office annually as to the amount and status of 
     grants awarded under this subsection; and
       ``(B) coordinate grants awarded under this subsection with 
     grants awarded by the Office of Emergency Preparedness and 
     the Centers for Disease Control and Prevention for the 
     purpose of improving the capacity of health care providers 
     and public health agencies to respond to bioterrorist attacks 
     on the civilian population.
       ``(5) Activities.--An entity that receives a grant under 
     this subsection shall, to the greatest extent practicable, 
     coordinate activities carried out with such funds with the 
     activities of a local Metropolitan Medical Response System.
       ``(d) Federal Assistance.--The Secretary shall ensure that 
     the Department of Health and Human Services is able to 
     provide such assistance as may be needed to State and local 
     health agencies to enable such agencies to respond 
     effectively to bioterrorist attacks.
       ``(e) Education.--The Secretary, in collaboration with 
     members of the working group described in subsection (b), and 
     professional organizations and societies, shall--
       ``(1) develop and implement educational programs to 
     instruct public health officials, medical professionals, and 
     other personnel working in health care facilities in the 
     recognition and care of victims of a bioterrorist attack; and
       ``(2) develop and implement programs to train laboratory 
     personnel in the recognition and identification of a 
     potential bioweapon.
       ``(f) Future Resource Development.--The Secretary shall 
     consult with the working group described in subsection (a), 
     to develop priorities for and conduct research, 
     investigations, experiments, demonstrations, and studies in 
     the health sciences related to--
       ``(1) the epidemiology and pathogenesis of potential 
     bioweapons;
       ``(2) the development of new vaccines or other therapeutics 
     against pathogens likely to be used in a bioterrorist attack;
       ``(3) the development of medical diagnostics to detect 
     potential bioweapons; and
       ``(4) other relevant research areas.
       ``(g) General Accounting Office Report.--Not later than 180 
     days after the date of enactment of this section, the 
     Comptroller General shall submit to the Committee on Health, 
     Education, Labor, and Pensions and the Committee on 
     Appropriations of the Senate and the Committee on Commerce 
     and the Committee on Appropriations of the House of 
     Representatives a report that describes--
       ``(1) Federal activities primarily related to research on, 
     preparedness for, and the management of the public health and 
     medical consequences of a bioterrorist attack against the 
     civilian population;
       ``(2) the coordination of the activities described in 
     paragraph (1);
       ``(3) the amount of Federal funds authorized or 
     appropriated for the activities described in paragraph (1); 
     and
       ``(4) the effectiveness of such efforts in preparing 
     national, State, and local authorities to address the public 
     health and medical consequences of a potential bioterrorist 
     attack against the civilian population.
       ``(h) Supplement Not Supplant.--Funds appropriated under 
     this section shall be used to supplement and not supplant 
     other Federal, State, and local public funds provided for 
     activities under this section.
       ``(i) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section 
     $215,000,000 for fiscal year 2001, and such sums as may be 
     necessary for each subsequent fiscal year through 2006.

     ``SEC. 319G. DEMONSTRATION PROGRAM TO ENHANCE BIOTERRORISM 
                   TRAINING, COORDINATION, AND READINESS.

       ``(a) In General.--The Secretary shall make grants to not 
     more than three eligible entities to carry out demonstration 
     programs to improve the detection of pathogens likely to be 
     used in a bioterrorist attack, the development of plans and 
     measures to respond to bioterrorist attacks, and the training 
     of personnel involved with the various responsibilities and 
     capabilities needed to respond to acts of bioterrorism upon 
     the civilian population. Such awards shall be made on a 
     competitive basis and pursuant to scientific and technical 
     review.
       ``(b) Eligible Entities.--Eligible entities for grants 
     under subsection (a) are States, political subdivisions of 
     States, and public or private non-profit organizations.
       ``(c) Specific Criteria.--In making grants under subsection 
     (a), the Secretary shall take into account the following 
     factors:
       ``(1) Whether the eligible entity involved is proximate to, 
     and collaborates with, a major research university with 
     expertise in scientific training, identification of 
     biological agents, medicine, and life sciences.
       ``(2) Whether the entity is proximate to, and collaborates 
     with, a laboratory that has expertise in the identification 
     of biological agents.
       ``(3) Whether the entity demonstrates, in the application 
     for the program, support and participation of State and local 
     governments and research institutions in the conduct of the 
     program.
       ``(4) Whether the entity is proximate to, and collaborates 
     with, or is, an academic medical center that has the capacity 
     to serve an uninsured or underserved population, and is 
     equipped to educate medical personnel.
       ``(5) Such other factors as the Secretary determines to be 
     appropriate.
       ``(d) Duration of Award.--The period during which payments 
     are made under a grant

[[Page 24853]]

     under subsection (a) may not exceed five years. The provision 
     of such payments shall be subject to annual approval by the 
     Secretary of the payments and subject to the availability of 
     appropriations for the fiscal year involved to make the 
     payments.
       `` (e) Supplement Not Supplant.--Grants under subsection 
     (a) shall be used to supplement, and not supplant, other 
     Federal, State, or local public funds provided for the 
     activities described in such subsection.
       ``(f) General Accounting Office Report.--Not later than 180 
     days after the conclusion of the demonstration programs 
     carried out under subsection (a), the Comptroller General of 
     the United States shall submit to the Committee on Health, 
     Education, Labor, and Pensions and the Committee on 
     Appropriations of the Senate, and the Committee on Commerce 
     and the Committee on Appropriations of the House of 
     Representatives, a report that describes the ability of 
     grantees under such subsection to detect pathogens likely to 
     be used in a bioterrorist attack, develop plans and measures 
     for dealing with such threats, and train personnel involved 
     with the various responsibilities and capabilities needed to 
     deal with bioterrorist threats.
       ``(g) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $6,000,000 for 
     fiscal year 2001, and such sums as may be necessary through 
     fiscal year 2006.''.

                TITLE II--CLINICAL RESEARCH ENHANCEMENT

     SEC. 201. SHORT TITLE.

       This title may be cited as the ``Clinical Research 
     Enhancement Act of 1999''.

     SEC. 202. FINDINGS AND PURPOSE.

       (a) Findings.--Congress makes the following findings:
       (1) Clinical research is critical to the advancement of 
     scientific knowledge and to the development of cures and 
     improved treatment for disease.
       (2) Tremendous advances in biology are opening doors to new 
     insights into human physiology, pathophysiology and disease, 
     creating extraordinary opportunities for clinical research.
       (3) Clinical research includes translational research which 
     is an integral part of the research process leading to 
     general human applications. It is the bridge between the 
     laboratory and new methods of diagnosis, treatment, and 
     prevention and is thus essential to progress against cancer 
     and other diseases.
       (4) The United States will spend more than 
     $1,200,000,000,000 on health care in 1999, but the Federal 
     budget for health research at the National Institutes of 
     Health was $15,600,000,000 only 1 percent of that total.
       (5) Studies at the Institute of Medicine, the National 
     Research Council, and the National Academy of Sciences have 
     all addressed the current problems in clinical research.
       (6) The Director of the National Institutes of Health has 
     recognized the current problems in clinical research and 
     appointed a special panel, which recommended expanded support 
     for existing National Institutes of Health clinical research 
     programs and the creation of new initiatives to recruit and 
     retain clinical investigators.
       (7) The current level of training and support for health 
     professionals in clinical research is fragmented, 
     undervalued, and underfunded.
       (8) Young investigators are not only apprentices for future 
     positions but a crucial source of energy, enthusiasm, and 
     ideas in the day-to-day research that constitutes the 
     scientific enterprise. Serious questions about the future of 
     life-science research are raised by the following:
       (A) The number of young investigators applying for grants 
     dropped by 54 percent between 1985 and 1993.
       (B) The number of physicians applying for first-time 
     National Institutes of Health research project grants fell 
     from 1226 in 1994 to 963 in 1998, a 21 percent reduction.
       (C) Newly independent life-scientists are expected to raise 
     funds to support their new research programs and a 
     substantial proportion of their own salaries.
       (9) The following have been cited as reasons for the 
     decline in the number of active clinical researchers, and 
     those choosing this career path:
       (A) A medical school graduate incurs an average debt of 
     $85,619, as reported in the Medical School Graduation 
     Questionnaire by the Association of American Medical Colleges 
     (AAMC).
       (B) The prolonged period of clinical training required 
     increases the accumulated debt burden.
       (C) The decreasing number of mentors and role models.
       (D) The perceived instability of funding from the National 
     Institutes of Health and other Federal agencies.
       (E) The almost complete absence of clinical research 
     training in the curriculum of training grant awardees.
       (F) Academic Medical Centers are experiencing difficulties 
     in maintaining a proper environment for research in a highly 
     competitive health care marketplace, which are compounded by 
     the decreased willingness of third party payers to cover 
     health care costs for patients engaged in research studies 
     and research procedures.
       (10) In 1960, general clinical research centers were 
     established under the Office of the Director of the National 
     Institutes of Health with an initial appropriation of 
     $3,000,000.
       (11) Appropriations for general clinical research centers 
     in fiscal year 1999 equaled $200,500,000.
       (12) Since the late 1960s, spending for general clinical 
     research centers has declined from approximately 3 percent to 
     1 percent of the National Institutes of Health budget.
       (13) In fiscal year 1999, there were 77 general clinical 
     research centers in operation, supplying patients in the 
     areas in which such centers operate with access to the most 
     modern clinical research and clinical research facilities and 
     technologies.
       (b) Purpose.--It is the purpose of this title to provide 
     additional support for and to expand clinical research 
     programs.

     SEC. 203. INCREASING THE INVOLVEMENT OF THE NATIONAL 
                   INSTITUTES OF HEALTH IN CLINICAL RESEARCH.

       Part B of title IV of the Public Health Service Act (42 
     U.S.C. 284 et seq.) is amended by adding at the end the 
     following:

     ``SEC. 409C. CLINICAL RESEARCH.

       ``(a) In General.--The Director of National Institutes of 
     Health shall undertake activities to support and expand the 
     involvement of the National Institutes of Health in clinical 
     research.
       ``(b) Requirements.--In carrying out subsection (a), the 
     Director of National Institutes of Health shall--
       ``(1) consider the recommendations of the Division of 
     Research Grants Clinical Research Study Group and other 
     recommendations for enhancing clinical research; and
       ``(2) establish intramural and extramural clinical research 
     fellowship programs directed specifically at medical and 
     dental students and a continuing education clinical research 
     training program at the National Institutes of Health.
       ``(c) Support for the Diverse Needs of Clinical Research.--
     The Director of National Institutes of Health, in cooperation 
     with the Directors of the Institutes, Centers, and Divisions 
     of the National Institutes of Health, shall support and 
     expand the resources available for the diverse needs of the 
     clinical research community, including inpatient, outpatient, 
     and critical care clinical research.
       ``(d) Peer Review.--The Director of National Institutes of 
     Health shall establish peer review mechanisms to evaluate 
     applications for the awards and fellowships provided for in 
     subsection (b)(2) and section 409D. Such review mechanisms 
     shall include individuals who are exceptionally qualified to 
     appraise the merits of potential clinical research training 
     and research grant proposals.''.

     SEC. 204. GENERAL CLINICAL RESEARCH CENTERS.

       (a) Grants.--Subpart 1 of part E of title IV of the Public 
     Health Service Act (42 U.S.C. 287 et seq.) is amended by 
     adding at the end the following:

     ``SEC. 481C. GENERAL CLINICAL RESEARCH CENTERS.

       ``(a) Grants.--The Director of the National Center for 
     Research Resources shall award grants for the establishment 
     of general clinical research centers to provide the 
     infrastructure for clinical research including clinical 
     research training and career enhancement. Such centers shall 
     support clinical studies and career development in all 
     settings of the hospital or academic medical center involved.
       ``(b) Activities.--In carrying out subsection (a), the 
     Director of National Institutes of Health shall expand the 
     activities of the general clinical research centers through 
     the increased use of telecommunications and telemedicine 
     initiatives.
       ``(c) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated such sums as may be necessary for each fiscal 
     year.''.
       (b) Enhancement Awards.--Part B of title IV of the Public 
     Health Service Act (42 U.S.C. 284 et seq.), as amended by 
     section 203, is further amended by adding at the end the 
     following:

     ``SEC. 409D. ENHANCEMENT AWARDS.

       ``(a) Mentored Patient-Oriented Research Career Development 
     Awards.--
       ``(1) Grants.--
       ``(A) In general.--The Director of the National Institutes 
     of Health shall make grants (to be referred to as `Mentored 
     Patient-Oriented Research Career Development Awards') to 
     support individual careers in clinical research at general 
     clinical research centers or at other institutions that have 
     the infrastructure and resources deemed appropriate for 
     conducting patient-oriented clinical research.
       ``(B) Use.--Grants under subparagraph (A) shall be used to 
     support clinical investigators in the early phases of their 
     independent careers by providing salary and such other 
     support for a period of supervised study.
       ``(2) Applications.--An application for a grant under this 
     subsection shall be submitted by an individual scientist at 
     such time as the Director may require.
       ``(3) Authorization of appropriations.--For the purpose of 
     carrying out this subsection, there are authorized to be 
     appropriated such sums as may be necessary for each fiscal 
     year.

[[Page 24854]]

       ``(b) Mid-Career Investigator Awards in Patient-Oriented 
     Research.--
       ``(1) Grants.--
       ``(A) In general.--The Director of the National Institutes 
     of Health shall make grants (to be referred to as `Mid-Career 
     Investigator Awards in Patient-Oriented Research') to support 
     individual clinical research projects at general clinical 
     research centers or at other institutions that have the 
     infrastructure and resources deemed appropriate for 
     conducting patient-oriented clinical research.
       ``(B) Use.--Grants under subparagraph (A) shall be used to 
     provide support for mid-career level clinicians to allow such 
     clinicians to devote time to clinical research and to act as 
     mentors for beginning clinical investigators.
       ``(2) Applications.--An application for a grant under this 
     subsection shall be submitted by an individual scientist at 
     such time as the Director requires.
       ``(3) Authorization of appropriations.--For the purpose of 
     carrying out this subsection, there are authorized to be 
     appropriated such sums as may be necessary for each fiscal 
     year.
       ``(c) Graduate Training in Clinical Investigation Award.--
       ``(1) In general.--The Director of the National Institutes 
     of Health shall make grants (to be referred to as `Graduate 
     Training in Clinical Investigation Awards') to support 
     individuals pursuing master's or doctoral degrees in clinical 
     investigation.
       ``(2) Applications.--An application for a grant under this 
     subsection shall be submitted by an individual scientist at 
     such time as the Director may require.
       ``(3) Limitations.--Grants under this subsection shall be 
     for terms of 2 years or more and shall provide stipend, 
     tuition, and institutional support for individual advanced 
     degree programs in clinical investigation.
       ``(4) Definition.--As used in this subsection, the term 
     `advanced degree programs in clinical investigation' means 
     programs that award a master's or Ph.D. degree in clinical 
     investigation after 2 or more years of training in areas such 
     as the following:
       ``(A) Analytical methods, biostatistics, and study design.
       ``(B) Principles of clinical pharmacology and 
     pharmacokinetics.
       ``(C) Clinical epidemiology.
       ``(D) Computer data management and medical informatics.
       ``(E) Ethical and regulatory issues.
       ``(F) Biomedical writing.
       ``(5) Authorization of appropriations.--For the purpose of 
     carrying out this subsection, there are authorized to be 
     appropriated such sums as may be necessary for each fiscal 
     year.
       ``(d) Clinical Research Curriculum Awards.--
       ``(1) In general.--The Director of the National Institutes 
     of Health shall make grants (to be referred to as `Clinical 
     Research Curriculum Awards') to institutions for the 
     development and support of programs of core curricula for 
     training clinical investigators, including medical students. 
     Such core curricula may include training in areas such as the 
     following:
       ``(A) Analytical methods, biostatistics, and study design.
       ``(B) Principles of clinical pharmacology and 
     pharmacokinetics.
       ``(C) Clinical epidemiology.
       ``(D) Computer data management and medical informatics.
       ``(E) Ethical and regulatory issues.
       ``(F) Biomedical writing.
       ``(2) Applications.--An application for a grant under this 
     subsection shall be submitted by an individual institution or 
     a consortium of institutions at such time as the Director may 
     require. An institution may submit only 1 such application.
       ``(3) Limitations.--Grants under this subsection shall be 
     for terms of up to 5 years and may be renewable.
       ``(4) Authorization of appropriations.--For the purpose of 
     carrying out this subsection, there are authorized to be 
     appropriated such sums as may be necessary for each fiscal 
     year.''.

     SEC. 205. LOAN REPAYMENT PROGRAM REGARDING CLINICAL 
                   RESEARCHERS.

       Part G of title IV of the Public Health Service Act is 
     amended by inserting after section 487E (42 U.S.C. 288-5) the 
     following:

     ``SEC. 487F. LOAN REPAYMENT PROGRAM REGARDING CLINICAL 
                   RESEARCHERS.

       ``(a) In General.--The Secretary, acting through the 
     Director of the National Institutes of Health, shall 
     establish a program to enter into contracts with qualified 
     health professionals under which such health professionals 
     agree to conduct clinical research, in consideration of the 
     Federal Government agreeing to repay, for each year of 
     service conducting such research, not more than $35,000 of 
     the principal and interest of the educational loans of such 
     health professionals.
       ``(b) Application of Provisions.--The provisions of 
     sections 338B, 338C, and 338E shall, except as inconsistent 
     with subsection (a) of this section, apply to the program 
     established under subsection (a) to the same extent and in 
     the same manner as such provisions apply to the National 
     Health Service Corps Loan Repayment Program established in 
     subpart III of part D of title III.
       ``(c) Funding.--
       ``(1) 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 fiscal 
     year.
       ``(2) Availability.--Amounts appropriated for carrying out 
     this section shall remain available until the expiration of 
     the second fiscal year beginning after the fiscal year for 
     which the amounts were made available.''.

     SEC. 206. DEFINITION.

       Section 409 of the Public Health Service Act (42 U.S.C. 
     284d) is amended--
       (1) by striking ``For purposes'' and inserting ``(a) Health 
     Service Research.--For purposes''; and
       (2) by adding at the end the following:
       ``(b) Clinical Research.--As used in this title, the term 
     `clinical research' means patient oriented clinical research 
     conducted with human subjects, or research on the causes and 
     consequences of disease in human populations involving 
     material of human origin (such as tissue specimens and 
     cognitive phenomena) for which an investigator or colleague 
     directly interacts with human subjects in an outpatient or 
     inpatient setting to clarify a problem in human physiology, 
     pathophysiology or disease, or epidemiologic or behavioral 
     studies, outcomes research or health services research, or 
     developing new technologies, therapeutic interventions, or 
     clinical trials.''.

     SEC. 207. OVERSIGHT BY GENERAL ACCOUNTING OFFICE.

       Not later than 18 months after the date of enactment of 
     this Act, the Comptroller General of the United States shall 
     submit to the Congress a reporting describing the extent to 
     which the National Institutes of Health has complied with the 
     amendments made by this title.

             TITLE III--RESEARCH LABORATORY INFRASTRUCTURE

     SEC. 301. SHORT TITLE.

       This title may be cited as the ``Twenty-First Century 
     Research Laboratories Act''.

     SEC. 302. FINDINGS.

       Congress finds that--
       (1) the National Institutes of Health is the principal 
     source of Federal funding for medical research at 
     universities and other research institutions in the United 
     States;
       (2) the National Institutes of Health has received a 
     substantial increase in research funding from Congress for 
     the purpose of expanding the national investment of the 
     United States in behavioral and biomedical research;
       (3) the infrastructure of our research institutions is 
     central to the continued leadership of the United States in 
     medical research;
       (4) as Congress increases the investment in cutting-edge 
     basic and clinical research, it is critical that Congress 
     also examine the current quality of the laboratories and 
     buildings where research is being conducted, as well as the 
     quality of laboratory equipment used in research;
       (5) many of the research facilities and laboratories in the 
     United States are outdated and inadequate;
       (6) the National Science Foundation found, in a 1998 report 
     on the status of biomedical research facilities, that over 60 
     percent of research-performing institutions indicated that 
     they had an inadequate amount of medical research space;
       (7) the National Science Foundation reports that academic 
     institutions have deferred nearly $11,000,000,000 in 
     renovation and construction projects because of a lack of 
     funds; and
       (8) future increases in Federal funding for the National 
     Institutes of Health must include increased support for the 
     renovation and construction of extramural research facilities 
     in the United States and the purchase of state-of-the-art 
     laboratory instrumentation.

     SEC. 303. BIOMEDICAL AND BEHAVIORAL RESEARCH FACILITIES.

       Section 481A of the Public Health Service Act (42 U.S.C. 
     287a-2 et seq.) is amended to read as follows:

     ``SEC. 481A. BIOMEDICAL AND BEHAVIORAL RESEARCH FACILITIES.

       ``(a) Modernization and Construction of Facilities.--
       ``(1) In general.--The Director of NIH, acting through the 
     Director of the Center, may make grants or contracts to 
     public and nonprofit private entities to expand, remodel, 
     renovate, or alter existing research facilities or construct 
     new research facilities, subject to the provisions of this 
     section.
       ``(2) Construction and cost of construction.--For purposes 
     of this section, the terms `construction' and `cost of 
     construction' include the construction of new buildings and 
     the expansion, renovation, remodeling, and alteration of 
     existing buildings, including architects' fees, but do not 
     include the cost of acquisition of land or off-site 
     improvements.
       ``(b) Scientific and Technical Review Boards for Merit-
     Based Review of Proposals.--
       ``(1) In general: approval as precondition to grants.--
       ``(A) Establishment.--There is established within the 
     Center a Scientific and Technical

[[Page 24855]]

     Review Board on Biomedical and Behavioral Research Facilities 
     (referred to in this section as the `Board').
       ``(B) Requirement.--The Director of the Center may approve 
     an application for a grant under subsection (a) only if the 
     Board has under paragraph (2) recommended the application for 
     approval.
       ``(2) Duties.--
       ``(A) Advice.--The Board shall provide advice to the 
     Director of the Center and the advisory council established 
     under section 480 (in this section referred to as the 
     `Advisory Council') in carrying out this section.
       ``(B) Determination of merit.--In carrying out subparagraph 
     (A), the Board shall make a determination of the merit of 
     each application submitted for a grant under subsection (a), 
     after consideration of the requirements established in 
     subsection (c), and shall report the results of the 
     determination to the Director of the Center and the Advisory 
     Council. Such determinations shall be conducted in a manner 
     consistent with procedures established under section 492.
       ``(C) Amount.--In carrying out subparagraph (A), the Board 
     shall, in the case of applications recommended for approval, 
     make recommendations to the Director and the Advisory Council 
     on the amount that should be provided under the grant.
       ``(D) Annual report.--In carrying out subparagraph (A), the 
     Board shall prepare an annual report for the Director of the 
     Center and the Advisory Council describing the activities of 
     the Board in the fiscal year for which the report is made. 
     Each such report shall be available to the public, and 
     shall--
       ``(i) summarize and analyze expenditures made under this 
     section;
       ``(ii) provide a summary of the types, numbers, and amounts 
     of applications that were recommended for grants under 
     subsection (a) but that were not approved by the Director of 
     the Center; and
       ``(iii) contain the recommendations of the Board for any 
     changes in the administration of this section.
       ``(3) Membership.--
       ``(A) In general.--Subject to subparagraph (B), the Board 
     shall be composed of 15 members to be appointed by the 
     Director of the Center, and such ad-hoc or temporary members 
     as the Director of the Center determines to be appropriate. 
     All members of the Board, including temporary and ad-hoc 
     members, shall be voting members.
       ``(B) Limitation.--Not more than 3 individuals who are 
     officers or employees of the Federal Government may serve as 
     members of the Board.
       ``(4) Certain requirements regarding membership.--In 
     selecting individuals for membership on the Board, the 
     Director of the Center shall ensure that the members are 
     individuals who, by virtue of their training or experience, 
     are eminently qualified to perform peer review functions. In 
     selecting such individuals for such membership, the Director 
     of the Center shall ensure that the members of the Board 
     collectively--
       ``(A) are experienced in the planning, construction, 
     financing, and administration of entities that conduct 
     biomedical or behavioral research sciences;
       ``(B) are knowledgeable in making determinations of the 
     need of entities for biomedical or behavioral research 
     facilities, including such facilities for the dentistry, 
     nursing, pharmacy, and allied health professions;
       ``(C) are knowledgeable in evaluating the relative 
     priorities for applications for grants under subsection (a) 
     in view of the overall research needs of the United States; 
     and
       ``(D) are experienced with emerging centers of excellence, 
     as described in subsection (c)(2).
       ``(5) Certain authorities.--
       ``(A) Workshops and conferences.--In carrying out paragraph 
     (2), the Board may convene workshops and conferences, and 
     collect data as the Board considers appropriate.
       ``(B) Subcommittees.--In carrying out paragraph (2), the 
     Board may establish subcommittees within the Board. Such 
     subcommittees may hold meetings as determined necessary to 
     enable the subcommittee to carry out its duties.
       ``(6) Terms.--
       ``(A) In general.--Except as provided in subparagraph (B), 
     each appointed member of the Board shall hold office for a 
     term of 4 years. Any member appointed to fill a vacancy 
     occurring prior to the expiration of the term for which such 
     member's predecessor was appointed shall be appointed for the 
     remainder of the term of the predecessor.
       ``(B) Staggered terms.--Members appointed to the Board 
     shall serve staggered terms as specified by the Director of 
     the Center when making the appointments.
       ``(C) Reappointment.--No member of the Board shall be 
     eligible for reappointment to the Board until 1 year has 
     elapsed after the end of the most recent term of the member.
       ``(7) Compensation.--Members of the Board who are not 
     officers or employees of the United States shall receive for 
     each day the members are engaged in the performance of the 
     functions of the Board compensation at the same rate received 
     by members of other national advisory councils established 
     under this title.
       ``(c) Requirements for Grants.--
       ``(1) In general.--The Director of the Center may make a 
     grant under subsection (a) only if the applicant for the 
     grant meets the following conditions:
       ``(A) The applicant is determined by such Director to be 
     competent to engage in the type of research for which the 
     proposed facility is to be constructed.
       ``(B) The applicant provides assurances satisfactory to the 
     Director that--
       ``(i) for not less than 20 years after completion of the 
     construction involved, the facility will be used for the 
     purposes of the research for which it is to be constructed;
       ``(ii) sufficient funds will be available to meet the non-
     Federal share of the cost of constructing the facility;
       ``(iii) sufficient funds will be available, when 
     construction is completed, for the effective use of the 
     facility for the research for which it is being constructed; 
     and
       ``(iv) the proposed construction will expand the 
     applicant's capacity for research, or is necessary to improve 
     or maintain the quality of the applicant's research.
       ``(C) The applicant meets reasonable qualifications 
     established by the Director with respect to--
       ``(i) the relative scientific and technical merit of the 
     applications, and the relative effectiveness of the proposed 
     facilities, in expanding the capacity for biomedical or 
     behavioral research and in improving the quality of such 
     research;
       ``(ii) the quality of the research or training, or both, to 
     be carried out in the facilities involved;
       ``(iii) the congruence of the research activities to be 
     carried out within the facility with the research and 
     investigator manpower needs of the United States; and
       ``(iv) the age and condition of existing research 
     facilities.
       ``(D) The applicant has demonstrated a commitment to 
     enhancing and expanding the research productivity of the 
     applicant.
       ``(2) Institutions of emerging excellence.--From the amount 
     appropriated under subsection (i) for a fiscal year up to 
     $50,000,000, the Director of the Center shall make available 
     25 percent of such amount, and from the amount appropriated 
     under such subsection for a fiscal year that is over 
     $50,000,000, the Director of the Center shall make available 
     up to 25 percent of such amount, for grants under subsection 
     (a) to applicants that in addition to meeting the 
     requirements established in paragraph (1), have demonstrated 
     emerging excellence in biomedical or behavioral research, as 
     follows:
       ``(A) The applicant has a plan for research or training 
     advancement and possesses the ability to carry out the plan.
       ``(B) The applicant carries out research and research 
     training programs that have a special relevance to a problem, 
     concern, or unmet health need of the United States.
       ``(C) The applicant has been productive in research or 
     research development and training.
       ``(D) The applicant--
       ``(i) has been designated as a center of excellence under 
     section 739;
       ``(ii) is located in a geographic area whose population 
     includes a significant number of individuals with health 
     status deficit, and the applicant provides health services to 
     such individuals; or
       ``(iii) is located in a geographic area in which a deficit 
     in health care technology, services, or research resources 
     may adversely affect the health status of the population of 
     the area in the future, and the applicant is carrying out 
     activities with respect to protecting the health status of 
     such population.
       ``(d) Requirement of Application.--The Director of the 
     Center may make a grant under subsection (a) only if an 
     application for the grant is submitted to the Director and 
     the application is in such form, is made in such manner, and 
     contains such agreements, assurances, and information as the 
     Director determines to be necessary to carry out this 
     section.
       ``(e) Amount of Grant; Payments.--
       ``(1) Amount.--The amount of any grant awarded under 
     subsection (a) shall be determined by the Director of the 
     Center, except that such amount shall not exceed--
       ``(A) 50 percent of the necessary cost of the construction 
     of a proposed facility as determined by the Director; or
       ``(B) in the case of a multipurpose facility, 40 percent of 
     that part of the necessary cost of construction that the 
     Director determines to be proportionate to the contemplated 
     use of the facility.
       ``(2) Reservation of amounts.--On the approval of any 
     application for a grant under subsection (a), the Director of 
     the Center shall reserve, from any appropriation available 
     for such grants, the amount of such grant, and shall pay such 
     amount, in advance or by way of reimbursement, and in such 
     installments consistent with the construction progress, as 
     the Director may determine appropriate. The reservation of 
     any amount by the Director under this paragraph may be 
     amended by the Director, either on the approval of an 
     amendment of the application or on the revision of the 
     estimated cost of construction of the facility.
       ``(3) Exclusion of certain costs.--In determining the 
     amount of any grant under subsection (a), there shall be 
     excluded from

[[Page 24856]]

     the cost of construction an amount equal to the sum of--
       ``(A) the amount of any other Federal grant that the 
     applicant has obtained, or is assured of obtaining, with 
     respect to construction that is to be financed in part by a 
     grant authorized under this section; and
       ``(B) the amount of any non-Federal funds required to be 
     expended as a condition of such other Federal grant.
       ``(4) Waiver of limitations.--The limitations imposed under 
     paragraph (1) may be waived at the discretion of the Director 
     for applicants meeting the conditions described in subsection 
     (c).
       ``(f) Recapture of Payments.--If, not later than 20 years 
     after the completion of construction for which a grant has 
     been awarded under subsection (a)--
       ``(1) the applicant or other owner of the facility shall 
     cease to be a public or non profit private entity; or
       ``(2) the facility shall cease to be used for the research 
     purposes for which it was constructed (unless the Director 
     determines, in accordance with regulations, that there is 
     good cause for releasing the applicant or other owner from 
     obligation to do so);
     the United States shall be entitled to recover from the 
     applicant or other owner of the facility the amount bearing 
     the same ratio to the current value (as determined by an 
     agreement between the parties or by action brought in the 
     United States District Court for the district in which such 
     facility is situated) of the facility as the amount of the 
     Federal participation bore to the cost of the construction of 
     such facility.
       ``(g) Guidelines.--Not later than 6 months after the date 
     of the enactment of this section, the Director of the Center, 
     after consultation with the Advisory Council, shall issue 
     guidelines with respect to grants under subsection (a).
       ``(h) Report to Congress.--The Director of the Center shall 
     prepare and submit to the appropriate committees of Congress 
     a biennial report concerning the status of the biomedical and 
     behavioral research facilities and the availability and 
     condition of technologically sophisticated laboratory 
     equipment in the United States. Such reports shall be 
     developed in concert with the report prepared by the National 
     Science Foundation on the needs of research facilities of 
     universities as required under section 108 of the National 
     Science Foundation Authorization Act for Fiscal Year 1986 (42 
     U.S.C. 1886).
       ``(i) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $250,000,000 for fiscal year 2001, and such sums 
     as may be necessary for each of the fiscal years 2002 and 
     2003.''.

     SEC. 304. CONSTRUCTION PROGRAM FOR NATIONAL PRIMATE RESEARCH 
                   CENTERS.

       Section 481B(a) of the Public Health Service Act (42 U.S.C. 
     287a-3(a)) is amended by striking ``1994'' and all that 
     follows through ``$5,000,000'' and inserting ``2000 through 
     2002, reserve from the amounts appropriated under section 
     481A(i) such sums as necessary''.

     SEC. 305. SHARED INSTRUMENTATION GRANT PROGRAM.

       (a) Authorization of Appropriations.--There is authorized 
     to be appropriated $100,000,000 for fiscal year 2000, and 
     such sums as may be necessary for each subsequent fiscal 
     year, to enable the Secretary of Health and Human Services, 
     acting through the Director of the National Center for 
     Research Resources, to provide for the continued operation of 
     the Shared Instrumentation Grant Program (initiated in fiscal 
     year 1992 under the authority of section 479 of the Public 
     Health Service Act (42 U.S.C. 287 et seq.)).
       (b) Requirements for Grants.--In determining whether to 
     award a grant to an applicant under the program described in 
     subsection (a), the Director of the National Center for 
     Research Resources shall consider--
       (1) the extent to which an award for the specific 
     instrument involved would meet the scientific needs and 
     enhance the planned research endeavors of the major users by 
     providing an instrument that is unavailable or to which 
     availability is highly limited;
       (2) with respect to the instrument involved, the 
     availability and commitment of the appropriate technical 
     expertise within the major user group or the applicant 
     institution for use of the instrumentation;
       (3) the adequacy of the organizational plan for the use of 
     the instrument involved and the internal advisory committee 
     for oversight of the applicant, including sharing 
     arrangements if any;
       (4) the applicant's commitment for continued support of the 
     utilization and maintenance of the instrument; and
       (5) the extent to which the specified instrument will be 
     shared and the benefit of the proposed instrument to the 
     overall research community to be served.
       (c) Peer Review.--In awarding grants under the program 
     described in subsection (a) Director of the National Center 
     for Research Resources shall comply with the peer review 
     requirements in section 492 of the Public Health Service Act 
     (42 U.S.C. 289a).

                   TITLE IV--CARDIAC ARREST SURVIVAL

           Subtitle A--Recommendations for Federal Buildings

     SEC. 401. SHORT TITLE.

       This subtitle may be cited as the ``Cardiac Arrest Survival 
     Act of 2000''.

     SEC. 402. FINDINGS.

       Congress makes the following findings:
       (1) Over 700 lives are lost every day to sudden cardiac 
     arrest in the United States alone.
       (2) Two out of every three sudden cardiac deaths occur 
     before a victim can reach a hospital.
       (3) More than 95 percent of these cardiac arrest victims 
     will die, many because of lack of readily available life 
     saving medical equipment.
       (4) With current medical technology, up to 30 percent of 
     cardiac arrest victims could be saved if victims had access 
     to immediate medical response, including defibrillation and 
     cardiopulmonary resuscitation.
       (5) Once a victim has suffered a cardiac arrest, every 
     minute that passes before returning the heart to a normal 
     rhythm decreases the chance of survival by 10 percent.
       (6) Most cardiac arrests are caused by abnormal heart 
     rhythms called ventricular fibrillation. Ventricular 
     fibrillation occurs when the heart's electrical system 
     malfunctions, causing a chaotic rhythm that prevents the 
     heart from pumping oxygen to the victim's brain and body.
       (7) Communities that have implemented programs ensuring 
     widespread public access to defibrillators, combined with 
     appropriate training, maintenance, and coordination with 
     local emergency medical systems, have dramatically improved 
     the survival rates from cardiac arrest.
       (8) Automated external defibrillator devices have been 
     demonstrated to be safe and effective, even when used by lay 
     people, since the devices are designed not to allow a user to 
     administer a shock until after the device has analyzed a 
     victim's heart rhythm and determined that an electric shock 
     is required.
       (9) Increasing public awareness regarding automated 
     external defibrillator devices and encouraging their use in 
     Federal buildings will greatly facilitate their adoption.
       (10) Limiting the liability of Good Samaritans and 
     acquirers of automated external defibrillator devices in 
     emergency situations may encourage the use of automated 
     external defibrillator devices, and result in saved lives.

     SEC. 403. RECOMMENDATIONS AND GUIDELINES OF SECRETARY OF 
                   HEALTH AND HUMAN SERVICES REGARDING AUTOMATED 
                   EXTERNAL DEFIBRILLATORS FOR FEDERAL BUILDINGS.

       Part B of title II of the Public Health Service Act (42 
     U.S.C. 238 et seq.) is amended by adding at the end the 
     following:


     ``recommendations and guidelines regarding automated external 
                  defibrillators for federal buildings

       ``Sec. 247. (a) Guidelines on Placement.--The Secretary 
     shall establish guidelines with respect to placing automated 
     external defibrillator devices in Federal buildings. Such 
     guidelines shall take into account the extent to which such 
     devices may be used by lay persons, the typical number of 
     employees and visitors in the buildings, the extent of the 
     need for security measures regarding the buildings, buildings 
     or portions of buildings in which there are special 
     circumstances such as high electrical voltage or extreme heat 
     or cold, and such other factors as the Secretary determines 
     to be appropriate.
       ``(b) Related Recommendations.--The Secretary shall publish 
     in the Federal Register the recommendations of the Secretary 
     on the appropriate implementation of the placement of 
     automated external defibrillator devices under subsection 
     (a), including procedures for the following:
       ``(1) Implementing appropriate training courses in the use 
     of such devices, including the role of cardiopulmonary 
     resuscitation.
       ``(2) Proper maintenance and testing of the devices.
       ``(3) Ensuring coordination with appropriate licensed 
     professionals in the oversight of training of the devices.
       ``(4) Ensuring coordination with local emergency medical 
     systems regarding the placement and incidents of use of the 
     devices.
       ``(c) Consultations; Consideration of Certain 
     Recommendations.--In carrying out this section, the Secretary 
     shall--
       ``(1) consult with appropriate public and private entities;
       ``(2) consider the recommendations of national and local 
     public-health organizations for improving the survival rates 
     of individuals who experience cardiac arrest in nonhospital 
     settings by minimizing the time elapsing between the onset of 
     cardiac arrest and the initial medical response, including 
     defibrillation as necessary; and
       ``(3) consult with and counsel other Federal agencies where 
     such devices are to be used.
       ``(d) Date Certain for Establishing Guidelines and 
     Recommendations.--The Secretary shall comply with this 
     section not later than 180 days after the date of the 
     enactment of the Cardiac Arrest Survival Act of 2000.
       ``(e) Definitions.--For purposes of this section:
       ``(1) The term `automated external defibrillator device' 
     has the meaning given such term in section 248.

[[Page 24857]]

       ``(2) The term `Federal building' includes a building or 
     portion of a building leased or rented by a Federal agency, 
     and includes buildings on military installations of the 
     United States.''.

     SEC. 404. GOOD SAMARITAN PROTECTIONS REGARDING EMERGENCY USE 
                   OF AUTOMATED EXTERNAL DEFIBRILLATORS.

       Part B of title II of the Public Health Service Act, as 
     amended by section 403, is amended by adding at the end the 
     following:


       ``liability regarding emergency use of automated external 
                             defibrillators

       ``Sec. 248. (a) Good Samaritan Protections Regarding 
     AEDs.--Except as provided in subsection (b), any person who 
     uses or attempts to use an automated external defibrillator 
     device on a victim of a perceived medical emergency is immune 
     from civil liability for any harm resulting from the use or 
     attempted use of such device; and in addition, any person who 
     acquired the device is immune from such liability, if the 
     harm was not due to the failure of such acquirer of the 
     device--
       ``(1) to notify local emergency response personnel or other 
     appropriate entities of the most recent placement of the 
     device within a reasonable period of time after the device 
     was placed;
       ``(2) to properly maintain and test the device; or
       ``(3) to provide appropriate training in the use of the 
     device to an employee or agent of the acquirer when the 
     employee or agent was the person who used the device on the 
     victim, except that such requirement of training does not 
     apply if--
       ``(A) the employee or agent was not an employee or agent 
     who would have been reasonably expected to use the device; or
       ``(B) the period of time elapsing between the engagement of 
     the person as an employee or agent and the occurrence of the 
     harm (or between the acquisition of the device and the 
     occurrence of the harm, in any case in which the device was 
     acquired after such engagement of the person) was not a 
     reasonably sufficient period in which to provide the 
     training.
       ``(b) Inapplicability of Immunity.--Immunity under 
     subsection (a) does not apply to a person if--
       ``(1) the harm involved was caused by willful or criminal 
     misconduct, gross negligence, reckless misconduct, or a 
     conscious, flagrant indifference to the rights or safety of 
     the victim who was harmed; or
       ``(2) the person is a licensed or certified health 
     professional who used the automated external defibrillator 
     device while acting within the scope of the license or 
     certification of the professional and within the scope of the 
     employment or agency of the professional; or
       ``(3) the person is a hospital, clinic, or other entity 
     whose purpose is providing health care directly to patients, 
     and the harm was caused by an employee or agent of the entity 
     who used the device while acting within the scope of the 
     employment or agency of the employee or agent; or
       ``(4) the person is an acquirer of the device who leased 
     the device to a health care entity (or who otherwise provided 
     the device to such entity for compensation without selling 
     the device to the entity), and the harm was caused by an 
     employee or agent of the entity who used the device while 
     acting within the scope of the employment or agency of the 
     employee or agent.
       ``(c) Rules of Construction.--
       ``(1) In general.--The following applies with respect to 
     this section:
       ``(A) This section does not establish any cause of action, 
     or require that an automated external defibrillator device be 
     placed at any building or other location.
       ``(B) With respect to a class of persons for which this 
     section provides immunity from civil liability, this section 
     supersedes the law of a State only to the extent that the 
     State has no statute or regulations that provide persons in 
     such class with immunity for civil liability arising from the 
     use by such persons of automated external defibrillator 
     devices in emergency situations (within the meaning of the 
     State law or regulation involved).
       ``(C) This section does not waive any protection from 
     liability for Federal officers or employees under--
       ``(i) section 224; or
       ``(ii) sections 1346(b), 2672, and 2679 of title 28, United 
     States Code, or under alternative benefits provided by the 
     United States where the availability of such benefits 
     precludes a remedy under section 1346(b) of title 28.
       ``(2) Civil actions under federal law.--
       ``(A) In general.--The applicability of subsections (a) and 
     (b) includes applicability to any action for civil liability 
     described in subsection (a) that arises under Federal law.
       ``(B) Federal areas adopting state law.--If a geographic 
     area is under Federal jurisdiction and is located within a 
     State but out of the jurisdiction of the State, and if, 
     pursuant to Federal law, the law of the State applies in such 
     area regarding matters for which there is no applicable 
     Federal law, then an action for civil liability described in 
     subsection (a) that in such area arises under the law of the 
     State is subject to subsections (a) through (c) in lieu of 
     any related State law that would apply in such area in the 
     absence of this subparagraph.
       ``(d) Federal Jurisdiction.--In any civil action arising 
     under State law, the courts of the State involved have 
     jurisdiction to apply the provisions of this section 
     exclusive of the jurisdiction of the courts of the United 
     States.
       ``(e) Definitions.--
       ``(1) Perceived medical emergency.--For purposes of this 
     section, the term `perceived medical emergency' means 
     circumstances in which the behavior of an individual leads a 
     reasonable person to believe that the individual is 
     experiencing a life-threatening medical condition that 
     requires an immediate medical response regarding the heart or 
     other cardiopulmonary functioning of the individual.
       ``(2) Other definitions.--For purposes of this section:
       ``(A) The term `automated external defibrillator device' 
     means a defibrillator device that--
       ``(i) is commercially distributed in accordance with the 
     Federal Food, Drug, and Cosmetic Act;
       ``(ii) is capable of recognizing the presence or absence of 
     ventricular fibrillation, and is capable of determining 
     without intervention by the user of the device whether 
     defibrillation should be performed;
       ``(iii) upon determining that defibrillation should be 
     performed, is able to deliver an electrical shock to an 
     individual; and
       ``(iv) in the case of a defibrillator device that may be 
     operated in either an automated or a manual mode, is set to 
     operate in the automated mode.
       ``(B)(i) The term `harm' includes physical, nonphysical, 
     economic, and noneconomic losses.
       ``(ii) The term `economic loss' means any pecuniary loss 
     resulting from harm (including the loss of earnings or other 
     benefits related to employment, medical expense loss, 
     replacement services loss, loss due to death, burial costs, 
     and loss of business or employment opportunities) to the 
     extent recovery for such loss is allowed under applicable 
     State law.
       ``(iii) The term `noneconomic losses' means losses for 
     physical and emotional pain, suffering, inconvenience, 
     physical impairment, mental anguish, disfigurement, loss of 
     enjoyment of life, loss of society and companionship, loss of 
     consortium (other than loss of domestic service), hedonic 
     damages, injury to reputation and all other nonpecuniary 
     losses of any kind or nature.''.

             Subtitle B--Rural Access to Emergency Devices

     SEC. 411. SHORT TITLE.

       This subtitle may be cited as the ``Rural Access to 
     Emergency Devices Act'' or the ``Rural AED Act''.

     SEC. 412. FINDINGS.

       Congress makes the following findings:
       (1) Heart disease is the leading cause of death in the 
     United States.
       (2) The American Heart Association estimates that 250,000 
     Americans die from sudden cardiac arrest each year.
       (3) A cardiac arrest victim's chance of survival drops 10 
     percent for every minute that passes before his or her heart 
     is returned to normal rhythm.
       (4) Because most cardiac arrest victims are initially in 
     ventricular fibrillation, and the only treatment for 
     ventricular fibrillation is defibrillation, prompt access to 
     defibrillation to return the heart to normal rhythm is 
     essential.
       (5) Lifesaving technology, the automated external 
     defibrillator, has been developed to allow trained lay 
     rescuers to respond to cardiac arrest by using this simple 
     device to shock the heart into normal rhythm.
       (6) Those people who are likely to be first on the scene of 
     a cardiac arrest situation in many communities, particularly 
     smaller and rural communities, lack sufficient numbers of 
     automated external defibrillators to respond to cardiac 
     arrest in a timely manner.
       (7) The American Heart Association estimates that more than 
     50,000 deaths could be prevented each year if defibrillators 
     were more widely available to designated responders.
       (8) Legislation should be enacted to encourage greater 
     public access to automated external defibrillators in 
     communities across the United States.

     SEC. 413. GRANTS.

       (a) In General.--The Secretary of Health and Human 
     Services, acting through the Rural Health Outreach Office of 
     the Health Resources and Services Administration, shall award 
     grants to community partnerships that meet the requirements 
     of subsection (b) to enable such partnerships to purchase 
     equipment and provide training as provided for in subsection 
     (c).
       (b) Community Partnerships.--A community partnership meets 
     the requirements of this subsection if such partnership--
       (1) is composed of local emergency response entities such 
     as community training facilities, local emergency responders, 
     fire and rescue departments, police, community hospitals, and 
     local non-profit entities and for-profit entities concerned 
     about cardiac arrest survival rates;
       (2) evaluates the local community emergency response times 
     to assess whether they meet the standards established by 
     national public health organizations such as the

[[Page 24858]]

     American Heart Association and the American Red Cross; and
       (3) submits to the Secretary of Health and Human Services 
     an application at such time, in such manner, and containing 
     such information as the Secretary may require.
       (c) Use of Funds.--Amounts provided under a grant under 
     this section shall be used--
       (1) to purchase automated external defibrillators that have 
     been approved, or cleared for marketing, by the Food and Drug 
     Administration; and
       (2) to provide defibrillator and basic life support 
     training in automated external defibrillator usage through 
     the American Heart Association, the American Red Cross, or 
     other nationally recognized training courses.
       (d) Report.--Not later than 4 years after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services shall prepare and submit to the appropriate 
     committees of Congress a report containing data relating to 
     whether the increased availability of defibrillators has 
     affected survival rates in the communities in which grantees 
     under this section operated. The procedures under which the 
     Secretary obtains data and prepares the report under this 
     subsection shall not impose an undue burden on program 
     participants under this section.
       (e) Authorization of Appropriations.--There is authorized 
     to be appropriated $25,000,000 for fiscal years 2001 through 
     2003 to carry out this section.

                    TITLE V--LUPUS RESEARCH AND CARE

     SEC. 501. SHORT TITLE.

       This title may be cited as the ``Lupus Research and Care 
     Amendments of 2000''.

     SEC. 502. FINDINGS.

       The Congress finds that--
       (1) lupus is a serious, complex, inflammatory, autoimmune 
     disease of particular concern to women;
       (2) lupus affects women nine times more often than men;
       (3) there are three main types of lupus: systemic lupus, a 
     serious form of the disease that affects many parts of the 
     body; discoid lupus, a form of the disease that affects 
     mainly the skin; and drug-induced lupus caused by certain 
     medications;
       (4) lupus can be fatal if not detected and treated early;
       (5) the disease can simultaneously affect various areas of 
     the body, such as the skin, joints, kidneys, and brain, and 
     can be difficult to diagnose because the symptoms of lupus 
     are similar to those of many other diseases;
       (6) lupus disproportionately affects African-American 
     women, as the prevalence of the disease among such women is 
     three times the prevalence among white women, and an 
     estimated 1 in 250 African-American women between the ages of 
     15 and 65 develops the disease;
       (7) it has been estimated that between 1,400,000 and 
     2,000,000 Americans have been diagnosed with the disease, and 
     that many more have undiagnosed cases;
       (8) current treatments for the disease can be effective, 
     but may lead to damaging side effects;
       (9) many victims of the disease suffer debilitating pain 
     and fatigue, making it difficult to maintain employment and 
     lead normal lives; and
       (10) in fiscal year 1996, the amount allocated by the 
     National Institutes of Health for research on lupus was 
     $33,000,000, which is less than one-half of 1 percent of the 
     budget for such Institutes.

                     Subtitle A--Research on Lupus

     SEC. 511. EXPANSION AND INTENSIFICATION OF ACTIVITIES.

       Subpart 4 of part C of title IV of the Public Health 
     Service Act (42 U.S.C. 285d et seq.) is amended by inserting 
     after section 441 the following:


                                ``lupus

       ``Sec. 441A. (a) In General.--The Director of the Institute 
     shall expand and intensify research and related activities of 
     the Institute with respect to lupus.
       ``(b) Coordination With Other Institutes.--The Director of 
     the Institute shall coordinate the activities of the Director 
     under subsection (a) with similar activities conducted by the 
     other national research institutes and agencies of the 
     National Institutes of Health to the extent that such 
     Institutes and agencies have responsibilities that are 
     related to lupus.
       ``(c) Programs for Lupus.--In carrying out subsection (a), 
     the Director of the Institute shall conduct or support 
     research to expand the understanding of the causes of, and to 
     find a cure for, lupus. Activities under such subsection 
     shall include conducting and supporting the following:
       ``(1) Research to determine the reasons underlying the 
     elevated prevalence of lupus in women, including African-
     American women.
       ``(2) Basic research concerning the etiology and causes of 
     the disease.
       ``(3) Epidemiological studies to address the frequency and 
     natural history of the disease and the differences among the 
     sexes and among racial and ethnic groups with respect to the 
     disease.
       ``(4) The development of improved diagnostic techniques.
       ``(5) Clinical research for the development and evaluation 
     of new treatments, including new biological agents.
       ``(6) Information and education programs for health care 
     professionals and the public.
       ``(d) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated such sums as may be necessary for each of the 
     fiscal years 2001 through 2003.''.

            Subtitle B--Delivery of Services Regarding Lupus

     SEC. 521. ESTABLISHMENT OF PROGRAM OF GRANTS.

       (a) In General.--The Secretary of Health and Human Services 
     shall in accordance with this subtitle make grants to provide 
     for projects for the establishment, operation, and 
     coordination of effective and cost-efficient systems for the 
     delivery of essential services to individuals with lupus and 
     their families.
       (b) Recipients of Grants.--A grant under subsection (a) may 
     be made to an entity only if the entity is a public or 
     nonprofit private entity, which may include a State or local 
     government; a public or nonprofit private hospital, 
     community-based organization, hospice, ambulatory care 
     facility, community health center, migrant health center, or 
     homeless health center; or other appropriate public or 
     nonprofit private entity.
       (c) Certain Activities.--To the extent practicable and 
     appropriate, the Secretary shall ensure that projects under 
     subsection (a) provide services for the diagnosis and disease 
     management of lupus. Activities that the Secretary may 
     authorize for such projects may also include the following:
       (1) Delivering or enhancing outpatient, ambulatory, and 
     home-based health and support services, including case 
     management and comprehensive treatment services, for 
     individuals with lupus; and delivering or enhancing support 
     services for their families.
       (2) Delivering or enhancing inpatient care management 
     services that prevent unnecessary hospitalization or that 
     expedite discharge, as medically appropriate, from inpatient 
     facilities of individuals with lupus.
       (3) Improving the quality, availability, and organization 
     of health care and support services (including transportation 
     services, attendant care, homemaker services, day or respite 
     care, and providing counseling on financial assistance and 
     insurance) for individuals with lupus and support services 
     for their families.
       (d) Integration With Other Programs.--To the extent 
     practicable and appropriate, the Secretary shall integrate 
     the program under this subtitle with other grant programs 
     carried out by the Secretary, including the program under 
     section 330 of the Public Health Service Act.

     SEC. 522. CERTAIN REQUIREMENTS.

       A grant may be made under section 521 only if the applicant 
     involved makes the following agreements:
       (1) Not more than 5 percent of the grant will be used for 
     administration, accounting, reporting, and program oversight 
     functions.
       (2) The grant will be used to supplement and not supplant 
     funds from other sources related to the treatment of lupus.
       (3) The applicant will abide by any limitations deemed 
     appropriate by the Secretary on any charges to individuals 
     receiving services pursuant to the grant. As deemed 
     appropriate by the Secretary, such limitations on charges may 
     vary based on the financial circumstances of the individual 
     receiving services.
       (4) The grant will not be expended to make payment for 
     services authorized under section 521(a) to the extent that 
     payment has been made, or can reasonably be expected to be 
     made, with respect to such services--
       (A) under any State compensation program, under an 
     insurance policy, or under any Federal or State health 
     benefits program; or
       (B) by an entity that provides health services on a prepaid 
     basis.
       (5) The applicant will, at each site at which the applicant 
     provides services under section 521(a), post a conspicuous 
     notice informing individuals who receive the services of any 
     Federal policies that apply to the applicant with respect to 
     the imposition of charges on such individuals.

     SEC. 523. TECHNICAL ASSISTANCE.

       The Secretary may provide technical assistance to assist 
     entities in complying with the requirements of this subtitle 
     in order to make such entities eligible to receive grants 
     under section 521.

     SEC. 524. DEFINITIONS.

       For purposes of this subtitle:
       (1) Official poverty line.--The term ``official poverty 
     line'' means the poverty line established by the Director of 
     the Office of Management and Budget and revised by the 
     Secretary in accordance with section 673(2) of the Omnibus 
     Budget Reconciliation Act of 1981.
       (2) Secretary.--The term ``Secretary'' means the Secretary 
     of Health and Human Services.

     SEC. 525. AUTHORIZATION OF APPROPRIATIONS.

       For the purpose of carrying out this subtitle, there are 
     authorized to be appropriated such sums as may be necessary 
     for each of the fiscal years 2001 through 2003.

[[Page 24859]]



           TITLE VI--PROSTATE CANCER RESEARCH AND PREVENTION

     SEC. 601. SHORT TITLE.

       This title may be cited as the ``Prostate Cancer Research 
     and Prevention Act''.

     SEC. 602. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.

       (a) Preventive Health Measures.--Section 317D of the Public 
     Health Service Act (42 U.S.C. 247b-5) is amended--
       (1) by striking subsection (a) and inserting the following:
       ``(a) In General.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     may make grants to States and local health departments for 
     the purpose of enabling such States and departments to carry 
     out programs that may include the following:
       ``(1) To identify factors that influence the attitudes or 
     levels of awareness of men and health care practitioners 
     regarding screening for prostate cancer.
       ``(2) To evaluate, in consultation with the Agency for 
     Health Care Policy and Research and the National Institutes 
     of Health, the effectiveness of screening strategies for 
     prostate cancer.
       ``(3) To identify, in consultation with the Agency for 
     Health Care Policy and Research, issues related to the 
     quality of life for men after prostrate cancer screening and 
     followup.
       ``(4) To develop and disseminate public information and 
     education programs for prostate cancer, including appropriate 
     messages about the risks and benefits of prostate cancer 
     screening for the general public, health care providers, 
     policy makers and other appropriate individuals.
       ``(5) To improve surveillance for prostate cancer.
       ``(6) To address the needs of underserved and minority 
     populations regarding prostate cancer.
       ``(7) Upon a determination by the Secretary, who shall take 
     into consideration recommendations by the United States 
     Preventive Services Task Force and shall seek input, where 
     appropriate, from professional societies and other private 
     and public entities, that there is sufficient consensus on 
     the effectiveness of prostate cancer screening--
       ``(A) to screen men for prostate cancer as a preventive 
     health measure;
       ``(B) to provide appropriate referrals for the medical 
     treatment of men who have been screened under subparagraph 
     (A) and to ensure, to the extent practicable, the provision 
     of appropriate followup services and support services such as 
     case management;
       ``(C) to establish mechanisms through which State and local 
     health departments can monitor the quality of screening 
     procedures for prostate cancer, including the interpretation 
     of such procedures; and
       ``(D) to improve, in consultation with the Health Resources 
     and Services Administration, the education, training, and 
     skills of health practitioners (including appropriate allied 
     health professionals) in the detection and control of 
     prostate cancer.
       ``(8) To evaluate activities conducted under paragraphs (1) 
     through (7) through appropriate surveillance or program 
     monitoring activities.''; and
       (2) in subsection (l)(1), by striking ``1998'' and 
     inserting ``2004''.
       (b) National Institutes of Health.--Section 417B(c) of the 
     Public Health Service Act (42 U.S.C. 286a-8(c)) is amended by 
     striking ``and 1996'' and inserting ``through 2004''.

               TITLE VII--ORGAN PROCUREMENT AND DONATION

     SEC. 701. ORGAN PROCUREMENT ORGANIZATION CERTIFICATION.

       (a) Short Title.--This section may be cited as the ``Organ 
     Procurement Organization Certification Act of 2000''.
       (b) Findings.--Congress makes the following findings:
       (1) Organ procurement organizations play an important role 
     in the effort to increase organ donation in the United 
     States.
       (2) The current process for the certification and 
     recertification of organ procurement organizations conducted 
     by the Department of Health and Human Services has created a 
     level of uncertainty that is interfering with the 
     effectiveness of organ procurement organizations in raising 
     the level of organ donation.
       (3) The General Accounting Office, the Institute of 
     Medicine, and the Harvard School of Public Health have 
     identified substantial limitations in the organ procurement 
     organization certification and recertification process and 
     have recommended changes in that process.
       (4) The limitations in the recertification process include:
       (A) An exclusive reliance on population-based measures of 
     performance that do not account for the potential in the 
     population for organ donation and do not permit consideration 
     of other outcome and process standards that would more 
     accurately reflect the relative capability and performance of 
     each organ procurement organization.
       (B) A lack of due process to appeal to the Secretary of 
     Health and Human Services for recertification on either 
     substantive or procedural grounds.
       (5) The Secretary of Health and Human Services has the 
     authority under section 1138(b)(1)(A)(i) of the Social 
     Security Act (42 U.S.C. 1320b-8(b)(1)(A)(i)) to extend the 
     period for recertification of an organ procurement 
     organization from 2 to 4 years on the basis of its past 
     practices in order to avoid the inappropriate disruption of 
     the nation's organ system.
       (6) The Secretary of Health and Human Services can use the 
     extended period described in paragraph (5) for 
     recertification of all organ procurement organizations to--
       (A) develop improved performance measures that would 
     reflect organ donor potential and interim outcomes, and to 
     test these measures to ensure that they accurately measure 
     performance differences among the organ procurement 
     organizations; and
       (B) improve the overall certification process by 
     incorporating process as well as outcome performance 
     measures, and developing equitable processes for appeals.
       (c) Certification and Recertification of Organ Procurement 
     Organizations.--Section 371(b)(1) of the Public Health 
     Service Act (42 U.S.C. 273(b)(1)) is amended--
       (1) by redesignating subparagraphs (D) through (G) as 
     subparagraphs (E) through (H), respectively;
       (2) by realigning the margin of subparagraph (F) (as so 
     redesignated) so as to align with subparagraph (E) (as so 
     redesignated); and
       (3) by inserting after subparagraph (C) the following:
       ``(D) notwithstanding any other provision of law, has met 
     the other requirements of this section and has been certified 
     or recertified by the Secretary within the previous 4-year 
     period as meeting the performance standards to be a qualified 
     organ procurement organization through a process that 
     either--
       ``(i) granted certification or recertification within such 
     4-year period with such certification or recertification in 
     effect as of January 1, 2000, and remaining in effect through 
     the earlier of--
       ``(I) January 1, 2002; or
       ``(II) the completion of recertification under the 
     requirements of clause (ii); or
       ``(ii) is defined through regulations that are promulgated 
     by the Secretary by not later than January 1, 2002, that--
       ``(I) require recertifications of qualified organ 
     procurement organizations not more frequently than once every 
     4 years;
       ``(II) rely on outcome and process performance measures 
     that are based on empirical evidence, obtained through 
     reasonable efforts, of organ donor potential and other 
     related factors in each service area of qualified organ 
     procurement organizations;
       ``(III) use multiple outcome measures as part of the 
     certification process; and
       ``(IV) provide for a qualified organ procurement 
     organization to appeal a decertification to the Secretary on 
     substantive and procedural grounds;''.

     SEC. 702. DESIGNATION OF GIVE THANKS, GIVE LIFE DAY.

       (a) Findings.--Congress finds that--
       (1) traditionally, Thanksgiving is a time for families to 
     take time out of their busy lives to come together and to 
     give thanks for the many blessings in their lives;
       (2) approximately 21,000 men, women, and children in the 
     United States are given the gift of life each year through 
     transplantation surgery, made possible by the generosity of 
     organ and tissue donations;
       (3) more than 66,000 Americans are awaiting their chance to 
     prolong their lives by finding a matching donor;
       (4) nearly 5,000 of these patients each year (or 13 
     patients each day) die while waiting for a donated heart, 
     liver, kidney, or other organ;
       (5) nationwide there are up to 15,000 potential donors 
     annually, but families' consent to donation is received for 
     less than 6,000;
       (6) the need for organ donations greatly exceeds the supply 
     available;
       (7) designation as an organ donor on a driver's license or 
     voter's registration is a valuable step, but does not ensure 
     donation when an occasion arises;
       (8) the demand for transplantation will likely increase in 
     the coming years due to the growing safety of transplantation 
     surgery due to improvements in technology and drug 
     developments, prolonged life expectancy, and increased 
     prevalence of diseases that may lead to organ damage and 
     failure, including hypertension, alcoholism, and hepatitis C 
     infection;
       (9) the need for a more diverse donor pool, including a 
     variety of racial and ethnic minorities, will continue to 
     grow in the coming years;
       (10) the final decision on whether a potential donor can 
     share the gift of life usually is made by surviving family 
     members regardless of the patient's initial intent;
       (11) many Americans have indicated a willingness to donate 
     their organs and tissues but have not discussed this critical 
     matter with the family members who are most likely to make 
     the decision, if the occasion arises, as to whether that 
     person will be an organ and tissue donor;
       (12) some family members may be reluctant to give consent 
     to donate their deceased loved one's organs and tissues at a 
     very difficult and emotional time if that person has not 
     clearly expressed a desire or willingness to do so;

[[Page 24860]]

       (13) the vast majority of Americans are likely to spend 
     part of Thanksgiving Day with some of those family members 
     who would be approached to make such a decision; and
       (14) it is fitting for families to spend a portion of that 
     day discussing how they might give life to others on a day 
     devoted to giving thanks for their own blessings.
       (b) Designation.--November 23, 2000, Thanksgiving Day, is 
     hereby designated as a day to ``Give Thanks, Give Life'' and 
     to discuss organ and tissue donation with other family 
     members so that informed decisions can be made if the 
     occasion to donate arises.

         TITLE VIII--ALZHEIMER'S CLINICAL RESEARCH AND TRAINING

     SEC. 801. ALZHEIMER'S CLINICAL RESEARCH AND TRAINING AWARDS.

       Subpart 5 of part C of title IV of the Public Health 
     Service Act (42 U.S.C. 285e et seq.) is amended--
       (1) by redesignating section 445I as section 445J; and
       (2) by inserting after section 445H the following:

     ``SEC. 445I. ALZHEIMER'S CLINICAL RESEARCH AND TRAINING 
                   AWARDS.

       ``(a) In General.--The Director of the Institute is 
     authorized to establish and maintain a program to enhance and 
     promote the translation of new scientific knowledge into 
     clinical practice related to the diagnosis, care and 
     treatment of individuals with Alzheimer's disease.
       ``(b) Support of Promising Clinicians.--In order to foster 
     the application of the most current developments in the 
     etiology, pathogenesis, diagnosis, prevention and treatment 
     of Alzheimer's disease, amounts made available under this 
     section shall be directed to the support of promising 
     clinicians through awards for research, study, and practice 
     at centers of excellence in Alzheimer's disease research and 
     treatment.
       ``(c) Excellence in Certain Fields.--Research shall be 
     carried out under awards made under subsection (b) in 
     environments of demonstrated excellence in neuroscience, 
     neurobiology, geriatric medicine, and psychiatry and shall 
     foster innovation and integration of such disciplines or 
     other environments determined suitable by the Director of the 
     Institute.
       ``(d) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $2,250,000 for fiscal year 2001, and such sums 
     as may be necessary for each of fiscal years 2002 through 
     2005.''.

 TITLE IX--SEXUALLY TRANSMITTED DISEASE CLINICAL RESEARCH AND TRAINING

     SEC. 901. SEXUALLY TRANSMITTED DISEASE CLINICAL RESEARCH AND 
                   TRAINING AWARDS.

       Subpart 6 of part C of title IV of the Public Health 
     Service Act (42 U.S.C. 285f et seq.) is amended by adding at 
     the end the following:

     ``SEC. 447B. SEXUALLY TRANSMITTED DISEASE CLINICAL RESEARCH 
                   AND TRAINING AWARDS.

       ``(a) In General.--The Director of the Institute is 
     authorized to establish and maintain a program to enhance and 
     promote the translation of new scientific knowledge into 
     clinical practice related to the diagnosis, care and 
     treatment of individuals with sexually transmitted diseases.
       ``(b) Support of Promising Clinicians.--In order to foster 
     the application of the most current developments in the 
     etiology, pathogenesis, diagnosis, prevention and treatment 
     of sexually transmitted diseases, amounts made available 
     under this section shall be directed to the support of 
     promising clinicians through awards for research, study, and 
     practice at centers of excellence in sexually transmitted 
     disease research and treatment.
       ``(c) Excellence in Certain Fields.--Research shall be 
     carried out under awards made under subsection (b) in 
     environments of demonstrated excellence in the etiology and 
     pathogenesis of sexually transmitted diseases and shall 
     foster innovation and integration of such disciplines or 
     other environments determined suitable by the Director of the 
     Institute.
       ``(d) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $2,250,000 for fiscal year 2001, and such sums 
     as may be necessary for each of fiscal years 2002 through 
     2005.''.

                    TITLE X--MISCELLENOUS PROVISIONS

     SEC. 1001. TECHNICAL CORRECTION TO THE CHILDREN'S HEALTH ACT 
                   OF 2000.

       (a) In General.--Section 2701 of the Children's Health Act 
     of 2000 is amended by striking ``part 45 of title 46'' and 
     inserting ``part 46 of title 45''.
       (b) Effective Date.--The amendment made by subsection (a) 
     takes effect on the date of enactment of the Children's 
     Health Act of 2000.
                                 ______
                                 

   PAUL COVERDELL NATIONAL FORENSIC SCIENCES IMPROVEMENT ACT OF 2000

                                 ______
                                 

                      SESSIONS AMENDMENT NO. 4345

  Mr. BROWNBACK (for Mr. Sessions) proposed an amendment to the bill 
(S. 3045) to improve the quality, timeliness, and credibility of 
forensic science services for criminal justice purposes; as follows:

       Strike all after the enacting clause and insert the 
     following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Paul Coverdell National 
     Forensic Sciences Improvement Act of 2000''.

     SEC. 2. IMPROVING THE QUALITY, TIMELINESS, AND CREDIBILITY OF 
                   FORENSIC SCIENCE SERVICES FOR CRIMINAL JUSTICE 
                   PURPOSES.

       (a) Description of Drug Control and System Improvement 
     Grant Program.--Section 501(b) of title I of the Omnibus 
     Crime Control and Safe Streets Act of 1968 (42 U.S.C. 375(b)) 
     is amended--
       (1) in paragraph (25), by striking ``and'' at the end;
       (2) in paragraph (26), by striking the period at the end 
     and inserting ``; and''; and
       (3) by adding at the end the following:
       ``(27) improving the quality, timeliness, and credibility 
     of forensic science services for criminal justice 
     purposes.''.
       (b) State Applications.--Section 503(a) of title I of the 
     Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C. 
     3753(a)) is amended by adding at the end the following:
       ``(13) If any part of the amount received from a grant 
     under this part is to be used to improve the quality, 
     timeliness, and credibility of forensic science services for 
     criminal justice purposes, a certification that, as of the 
     date of enactment of this paragraph, the State, or unit of 
     local government within the State, has an established--
       ``(A) forensic science laboratory or forensic science 
     laboratory system, that--
       ``(i) employs 1 or more full-time scientists--
       ``(I) whose principal duties are the examination of 
     physical evidence for law enforcement agencies in criminal 
     matters; and
       ``(II) who provide testimony with respect to such physical 
     evidence to the criminal justice system;
       ``(ii) employs generally accepted practices and procedures, 
     as established by appropriate accrediting organizations; and
       ``(iii) is accredited by the Laboratory Accreditation Board 
     of the American Society of Crime Laboratory Directors or the 
     National Association of Medical Examiners, or will use a 
     portion of the grant amount to prepare and apply for such 
     accreditation by not later than 2 years after the date on 
     which a grant is initially awarded under this paragraph; or
       ``(B) medical examiner's office (as defined by the National 
     Association of Medical Examiners) that--
       ``(i) employs generally accepted practices and procedures, 
     as established by appropriate accrediting organizations; and
       ``(ii) is accredited by the Laboratory Accreditation Board 
     of the American Society of Crime Laboratory Directors or the 
     National Association of Medical Examiners, or will use a 
     portion of the grant amount to prepare and apply for such 
     accreditation by not later than 2 years after the date on 
     which a grant is initially awarded under this paragraph.''.
       (c) Paul Coverdell Forensic Sciences Improvement Grants.--
       (1) In general.--Title I of the Omnibus Crime Control and 
     Safe Streets Act of 1968 (42 U.S.C. 3711 et seq.) is amended 
     by adding at the end the following:

     ``PART BB--PAUL COVERDELL FORENSIC SCIENCES IMPROVEMENT GRANTS

     ``SEC. 2801. GRANT AUTHORIZATION.

       ``The Attorney General shall award grants to States in 
     accordance with this part.

     ``SEC. 2802. APPLICATIONS.

       ``To request a grant under this part, a State shall submit 
     to the Attorney General--
       ``(1) a certification that the State has developed a 
     consolidated State plan for forensic science laboratories 
     operated by the State or by other units of local government 
     within the State under a program described in section 
     2804(a), and a specific description of the manner in which 
     the grant will be used to carry out that plan;
       ``(2) a certification that any forensic science laboratory 
     system, medical examiner's office, or coroner's office in the 
     State, including any laboratory operated by a unit of local 
     government within the State, that will receive any portion of 
     the grant amount uses generally accepted laboratory practices 
     and procedures, established by accrediting organizations; and
       ``(3) a specific description of any new facility to be 
     constructed as part of the program described in paragraph 
     (1), and the estimated costs of that facility, and a 
     certification that the amount of the grant used for the costs 
     of the facility will not exceed the limitations set forth in 
     section 2804(c).

     ``SEC. 2803. ALLOCATION.

       ``(a) In General.--
       ``(1) Population allocation.--Seventy-five percent of the 
     amount made available to carry out this part in each fiscal 
     year shall be allocated to each State that meets the 
     requirements of section 2802 so that each State shall receive 
     an amount that bears the same ratio to the 75 percent of the 
     total amount made available to carry out this part for that 
     fiscal year as the population of the State bears to the 
     population of all States.

[[Page 24861]]

       ``(2) Discretionary allocation.--Twenty-five percent of the 
     amount made available to carry out this part in each fiscal 
     year shall be allocated pursuant to the Attorney General's 
     discretion to States with above average rates of part 1 
     violent crimes based on the average annual number of part 1 
     violent crimes reported by such State to the Federal Bureau 
     of Investigation for the 3 most recent calendar years for 
     which such data is available.
       ``(3) Minimum requirement.--Each State shall receive not 
     less than 0.6 percent of the amount made available to carry 
     out this part in each fiscal year.
       ``(4) Proportional reduction.--If the amounts available to 
     carry out this part in each fiscal year are insufficient to 
     pay in full the total payment that any State is otherwise 
     eligible to receive under paragraph (3), then the Attorney 
     General shall reduce payments under paragraph (1) for such 
     payment period to the extent of such insufficiency. 
     Reductions under the preceding sentence shall be allocated 
     among the States (other than States whose payment is 
     determined under paragraph (3)) in the same proportions as 
     amounts would be allocated under paragraph (1) without regard 
     to paragraph (3).
       ``(b) State Defined.--In this section, the term `State' 
     means each of the several States, the District of Columbia, 
     the Commonwealth of Puerto Rico, the Virgin Islands, American 
     Samoa, Guam, and the Commonwealth of the Northern Mariana 
     Islands, except that--
       ``(1) for purposes of the allocation under this section, 
     American Samoa and the Commonwealth of the Northern Mariana 
     Islands shall be considered as 1 State; and
       ``(2) for purposes of paragraph (1), 67 percent of the 
     amount allocated shall be allocated to American Samoa, and 33 
     percent shall be allocated to the Commonwealth of the 
     Northern Mariana Islands.

     ``SEC. 2804. USE OF GRANTS.

       ``(a) In General.--A State that receives a grant under this 
     part shall use the grant to carry out all or a substantial 
     part of a program intended to improve the quality and 
     timeliness of forensic science or medical examiner services 
     in the State, including such services provided by the 
     laboratories operated by the State and those operated by 
     units of local government within the State.
       ``(b) Permitted Categories of Funding.--Subject to 
     subsections (c) and (d), a grant awarded under this part--
       ``(1) may only be used for program expenses relating to 
     facilities, personnel, computerization, equipment, supplies, 
     accreditation and certification, education, and training; and
       ``(2) may not be used for any general law enforcement or 
     nonforensic investigatory function.
       ``(c) Facilities Costs.--
       ``(1) States receiving minimum grant amount.--With respect 
     to a State that receives a grant under this part in an amount 
     that does not exceed 0.6 percent of the total amount made 
     available to carry out this part for a fiscal year, not more 
     than 80 percent of the total amount of the grant may be used 
     for the costs of any new facility constructed as part of a 
     program described in subsection (a).
       ``(2) Other states.--With respect to a State that receives 
     a grant under this part in an amount that exceeds 0.6 percent 
     of the total amount made available to carry out this part for 
     a fiscal year--
       ``(A) not more than 80 percent of the amount of the grant 
     up to that 0.6 percent may be used for the costs of any new 
     facility constructed as part of a program described in 
     subsection (a); and
       ``(B) not more than 40 percent of the amount of the grant 
     in excess of that 0.6 percent may be used for the costs of 
     any new facility constructed as part of a program described 
     in subsection (a).
       ``(d) Administrative Costs.--Not more than 10 percent of 
     the total amount of a grant awarded under this part may be 
     used for administrative expenses.

     ``SEC. 2805. ADMINISTRATIVE PROVISIONS.

       ``(a) Regulations.--The Attorney General may promulgate 
     such guidelines, regulations, and procedures as may be 
     necessary to carry out this part, including guidelines, 
     regulations, and procedures relating to the submission and 
     review of applications for grants under section 2802.
       ``(b) Expenditure Records.--
       ``(1) Records.--Each State, or unit of local government 
     within the State, that receives a grant under this part shall 
     maintain such records as the Attorney General may require to 
     facilitate an effective audit relating to the receipt of the 
     grant, or the use of the grant amount.
       ``(2) Access.--The Attorney General and the Comptroller 
     General of the United States, or a designee thereof, shall 
     have access, for the purpose of audit and examination, to any 
     book, document, or record of a State, or unit of local 
     government within the State, that receives a grant under this 
     part, if, in the determination of the Attorney General, 
     Comptroller General, or designee thereof, the book, document, 
     or record is related to the receipt of the grant, or the use 
     of the grant amount.

     ``SEC. 2806. REPORTS.

       ``(a) Reports to Attorney General.--For each fiscal year 
     for which a grant is awarded under this part, each State that 
     receives such a grant shall submit to the Attorney General a 
     report, at such time and in such manner as the Attorney 
     General may reasonably require, which report shall include--
       ``(1) a summary and assessment of the program carried out 
     with the grant;
       ``(2) the average number of days between submission of a 
     sample to a forensic science laboratory or forensic science 
     laboratory system in that State operated by the State or by a 
     unit of local government and the delivery of test results to 
     the requesting office or agency; and
       ``(3) such other information as the Attorney General may 
     require.
       ``(b) Reports to Congress.--Not later than 90 days after 
     the last day of each fiscal year for which 1 or more grants 
     are awarded under this part, the Attorney General shall 
     submit to the Speaker of the House of Representatives and the 
     President pro tempore of the Senate, a report, which shall 
     include--
       ``(1) the aggregate amount of grants awarded under this 
     part for that fiscal year; and
       ``(2) a summary of the information provided under 
     subsection (a).''.
       (2) Authorization of appropriations.--
       (A) In general.--Section 1001(a) of title I of the Omnibus 
     Crime Control and Safe Streets Act of 1968 (42 U.S.C. 
     3753(a)) is amended by adding at the end the following:
       ``(24) There are authorized to be appropriated to carry out 
     part BB, to remain available until expended--
       ``(A) $35,000,000 for fiscal year 2001;
       ``(B) $85,400,000 for fiscal year 2002;
       ``(C) $134,733,000 for fiscal year 2003;
       ``(D) $128,067,000 for fiscal year 2004;
       ``(E) $56,733,000 for fiscal year 2005; and
       ``(F) $42,067,000 for fiscal year 2006.''.
       (B) Backlog elimination.--There is authorized to be 
     appropriated $30,000,000 for fiscal year 2001 for the 
     elimination of DNA convicted offender database sample 
     backlogs and for other related purposes, as provided in the 
     Departments of Commerce, Justice, and State, the Judiciary, 
     and Related Agencies Appropriations Act, 2001.
       (3) Table of contents.--Title I of the Omnibus Crime 
     Control and Safe Streets Act of 1968 (42 U.S.C. 3711 et seq.) 
     is amended by striking the table of contents.
       (4) Repeal of 20 percent floor for cita crime lab grants.--
     Section 102(e)(2) of the Crime Identification Technology Act 
     of 1998 (42 U.S.C. 14601(e)(2)) is amended--
       (A) in subparagraph (B), by adding ``and'' at the end; and
       (B) by striking subparagraph (C) and redesignating 
     subparagraph (D) as subparagraph (C).

     SEC. 3. CLARIFICATION REGARDING CERTAIN CLAIMS.

       (a) In General.--Section 983(a)(2)(C)(ii) of title 18, 
     United States Code, is amended by striking ``(and provide 
     customary documentary evidence of such interest if available) 
     and state that the claim is not frivolous''.
       (b) Effective Date.--The amendment made by this section 
     shall take effect as if included in the amendment made by 
     section 2(a) of Public Law 106-185.

     SEC. 4. SENSE OF CONGRESS REGARDING THE OBLIGATION OF GRANTEE 
                   STATES TO ENSURE ACCESS TO POST-CONVICTION DNA 
                   TESTING AND COMPETENT COUNSEL IN CAPITAL CASES.

       (a) Findings.--Congress finds that--
       (1) over the past decade, deoxyribonucleic acid testing 
     (referred to in this section as ``DNA testing'') has emerged 
     as the most reliable forensic technique for identifying 
     criminals when biological material is left at a crime scene;
       (2) because of its scientific precision, DNA testing can, 
     in some cases, conclusively establish the guilt or innocence 
     of a criminal defendant;
       (3) in other cases, DNA testing may not conclusively 
     establish guilt or innocence, but may have significant 
     probative value to a finder of fact;
       (4) DNA testing was not widely available in cases tried 
     prior to 1994;
       (5) new forensic DNA testing procedures have made it 
     possible to get results from minute samples that could not 
     previously be tested, and to obtain more informative and 
     accurate results than earlier forms of forensic DNA testing 
     could produce, resulting in some cases of convicted inmates 
     being exonerated by new DNA tests after earlier tests had 
     failed to produce definitive results;
       (6) DNA testing can and has resulted in the post-conviction 
     exoneration of more than 75 innocent men and women, including 
     some under sentence of death;
       (7) in more than a dozen cases, post-conviction DNA testing 
     that has exonerated an innocent person has also enhanced 
     public safety by providing evidence that led to the 
     apprehension of the actual perpetrator;
       (8) experience has shown that it is not unduly burdensome 
     to make DNA testing available to inmates in appropriate 
     cases;
       (9) under current Federal and State law, it is difficult to 
     obtain post-conviction DNA testing because of time limits on 
     introducing newly discovered evidence;
       (10) the National Commission on the Future of DNA Evidence, 
     a Federal panel established by the Department of Justice and 
     comprised of law enforcement, judicial, and

[[Page 24862]]

     scientific experts, has urged that post-conviction DNA 
     testing be permitted in the relatively small number of cases 
     in which it is appropriate, notwithstanding procedural rules 
     that could be invoked to preclude such testing, and 
     notwithstanding the inability of an inmate to pay for the 
     testing;
       (11) only a few States have adopted post-conviction DNA 
     testing procedures;
       (12) States have received millions of dollars in DNA-
     related grants, and more funding is needed to improve State 
     forensic facilities and to reduce the nationwide backlog of 
     DNA samples from convicted offenders and crime scenes that 
     need to be tested or retested using upgraded methods;
       (13) States that accept such financial assistance should 
     not deny the promise of truth and justice for both sides of 
     our adversarial system that DNA testing offers;
       (14) post-conviction DNA testing and other post-conviction 
     investigative techniques have shown that innocent people have 
     been sentenced to death in this country;
       (15) a constitutional error in capital cases is incompetent 
     defense lawyers who fail to present important evidence that 
     the defendant may have been innocent or does not deserve to 
     be sentenced to death; and
       (16) providing quality representation to defendants facing 
     loss of liberty or life is essential to fundamental due 
     process and the speedy final resolution of judicial 
     proceedings.
       (b) Sense of Congress.--It is the sense of Congress that--
       (1) Congress should condition forensic science-related 
     grants to a State or State forensic facility on the State's 
     agreement to ensure post-conviction DNA testing in 
     appropriate cases; and
       (2) Congress should work with the States to improve the 
     quality of legal representation in capital cases through the 
     establishment of standards that will assure the timely 
     appointment of competent counsel with adequate resources to 
     represent defendants in capital cases at each stage of the 
     proceedings.
       Amend the title to read as follows: ``A bill to improve the 
     quality, timeliness, and credibility of forensic science 
     services for criminal justice purposes, and for other 
     purposes.''.
                                 ______
                                 

                     BIRMINGHAM PLEDGE LEGISLATION

                                 ______
                                 

                   SESSIONS AMENDMENTS NOS. 4346-4347

  Mr. BROWNBACK (for Mr. Sessions) proposed two amendments to the joint 
resolution (H.J. Res. 102) recognizing that the Birmingham Pledge has 
made a significant contribution in fostering racial harmony and 
reconciliation in the United States and around the world, and for other 
purposes; as follows:

                           Amendment No. 4346

       Strike all after the resolved clause and insert the 
     following:
     That--
       (1) Congress recognizes that the Birmingham Pledge is a 
     significant contribution toward fostering racial harmony and 
     reconciliation in the United States and around the world;
       (2) Congress commends the creators, promoters, and 
     signatories of the Birmingham Pledge for the steps they are 
     taking to make the United States and the world a better place 
     for all people; and
       (3) it is the sense of Congress that a particular week 
     should be designated as ``National Birmingham Pledge Week.''.
                                  ____


                           Amendment No. 4347

       Strike the preamble and insert the following:
       Whereas Birmingham, Alabama, was the scene of racial strife 
     in the United States in the 1950s and 1960s;
       Whereas since the 1960s, the people of Birmingham have made 
     substantial progress toward racial equality, which has 
     improved the quality of life for all its citizens and led to 
     economic prosperity;
       Whereas out of the crucible of Birmingham's role in the 
     civil rights movement of the 1950s and 1960s, a present-day 
     grassroots movement has arisen to continue the effort to 
     eliminate racial and ethnic divisions in the United States 
     and around the world;
       Whereas that grassroots movement has found expression in 
     the Birmingham Pledge, which was authored by Birmingham 
     attorney James E. Rotch, is sponsored by the Community 
     Affairs Committee of Operation New Birmingham, and is 
     promoted by a broad cross section of the community of 
     Birmingham;
       Whereas the Birmingham Pledge reads as follows:
         ``I believe that every person has worth as an individual.
         ``I believe that every person is entitled to dignity and 
     respect, regardless of race or color.
         ``I believe that every thought and every act of racial 
     prejudice is harmful; if it is in my thought or act, then it 
     is harmful to me as well as to others.
         ``Therefore, from this day forward I will strive daily to 
     eliminate racial prejudice from my thoughts and actions.
         ``I will discourage racial prejudice by others at every 
     opportunity.
         ``I will treat all people with dignity and respect; and I 
     will strive to honor this pledge, knowing that the world will 
     be a better place because of my effort.'';
       Whereas commitment and adherence to the Birmingham Pledge 
     increases racial harmony by helping individuals communicate 
     in a positive way concerning the diversity of the people of 
     the United States and by encouraging people to make a 
     commitment to racial harmony;
       Whereas individuals who sign the Birmingham Pledge give 
     evidence of their commitment to its message;
       Whereas more than 70,000 people have signed the Birmingham 
     Pledge, including the President, Members of Congress, 
     Governors, State legislators, mayors, county commissioners, 
     city council members, and other persons around the world;
       Whereas the Birmingham Pledge has achieved national and 
     international recognition;
       Whereas efforts to obtain signatories to the Birmingham 
     Pledge are being organized and conducted in communities 
     around the world;
       Whereas every Birmingham Pledge signed and returned to 
     Birmingham is recorded at the Birmingham Civil Rights 
     Institute, Birmingham, Alabama, as a permanent testament to 
     racial reconciliation, peace, and harmony; and
       Whereas the Birmingham Pledge, the motto for which is 
     ``Sign It, Live It'', is a powerful tool for facilitating 
     dialogue on the Nation's diversity and the need for people to 
     take personal steps to achieve racial harmony and tolerance 
     in communities: Now, therefore, be it
                                 ______
                                 

           AMERICAN MUSEUM OF SCIENCE AND ENERGY LEGISLATION

                                 ______
                                 

               MURKOWSKI (AND OTHERS) AMENDMENT NO. 4348

  Mr. BROWNBACK (for Mr. Murkowski (for himself, Mr. Frist, and Mr. 
Bingaman)) proposed an amendment to the bill (H.R. 4940) to designate 
the museum operated by the Secretary of Energy in Oak Ridge, Tennessee, 
as the ``American Museum of Science and Energy,'' and for other 
purposes; as follows:

       Strike all after the enacting clause and insert the 
     following:

     ``SECTION 1. DESIGNATION OF AMERICAN MUSEUM OF SCIENCE AND 
                   ENERGY.  

       ``(a) In General.--The Museum--
       ``(1) is designated as the ``American Museum of Science and 
     Energy''; and
       ``(2) shall be the official museum of science and energy of 
     the United States.
       ``(b) References.--Any reference in a law, map, regulation, 
     document, paper, or other record of the United States to the 
     Museum is deemed to be a reference to the `American Museum of 
     Science and Energy'.
       ``(c) Property of the United States.--
       ``(1) In general.--The name American Museum of Science and 
     Energy is declared the property of the United States.
       ``(2) Use.--The Museum shall have the sole right throughout 
     the United States and its possessions to have and use the 
     name `American Museum of Science and Energy'.
       ``(3) Effect on other rights.--This subsection shall not be 
     construed to conflict or interfere with established or vested 
     rights.

     ``SEC. 2. AUTHORITY.

       ``To carry out the activities of the Museum, the Secretary 
     may--
       ``(1) accept and dispose of any gift, devise, or bequest of 
     services or property, real or personal, that is--
       ``(A) designated in a written document by the person making 
     the gift, devise, or bequest as intended for the Museum; and
       ``(B) determined by the Secretary to be suitable and 
     beneficial for use by the Museum;
       ``(2) operate a retail outlet on the premises of the Museum 
     for the purpose of selling or distributing items (including 
     mementos, food, educational materials, replicas, and 
     literature) that are--
       ``(A) relevant to the contents of the Museum; and
       ``(B) informative, educational, and tasteful;
       ``(3) collect reasonable fees where feasible and 
     appropriate;
       ``(4) exhibit, perform, display, and publish materials and 
     information of or relating to the Museum in any media or 
     place;
       ``(5) consistent with guidelines approved by the Secretary, 
     lease space on the premises of the Museum at reasonable rates 
     and for uses consistent with such guidelines; and
       ``(6) use the proceeds of activities authorized under this 
     section to pay the costs of the Museum.

     ``SEC. 3. MUSEUM VOLUNTEERS.

       ``(a) Authority To Use Volunteers.--The Secretary may 
     recruit, train, and accept the

[[Page 24863]]

     services of individuals or entities as volunteers for 
     services or activities related to the Museum.
       ``(b) Status of Volunteers.--
       ``(1) In general.--Except as provided in paragraph (2), 
     service by a volunteer under subsection (a) shall not be 
     considered Federal employment.
       ``(2) Exceptions.--
       ``(A) Federal tort claims act.--For purposes of chapter 171 
     of title 28, United States Code, a volunteer under subsection 
     (a) shall be treated as an employee of the government (as 
     defined in section 2671 of that title).
       ``(B) Compensation for work injuries.--For purposes of 
     subchapter I of chapter 81 of title 5, United States Code, a 
     volunteer described in subsection (a) shall be treated as an 
     employee (as defined in section 8101 of title 5, United 
     States Code).
       ``(c) Compensation.--A volunteer under subsection (a) shall 
     serve without pay, but may receive nominal awards and 
     reimbursement for incidental expenses, including expenses for 
     a uniform or transportation in furtherance of Museum 
     activities.

     ``SEC. 4. DEFINITIONS.

       ``For purposes of this Act:
       ``(1) Museum.--The term `Museum' means the museum operated 
     by the Secretary of Energy and located at 300 South Tulane 
     Avenue in Oak Ridge, Tennessee.
       ``(2) Secretary.--The term `Secretary' means the Secretary 
     of Energy or a designated representative of the Secretary.''.
                                 ______
                                 

                    HEALTH CARE FAIRNESS ACT OF 1999

                                 ______
                                 

                 FRIST (AND OTHERS) AMENDMENT NO. 4349

  Mr. BROWNBACK (for Mr. Frist (for himself, Mr. Kennedy, Mr. Jeffords, 
Mr. Dodd, Mr. DeWine, Ms. Mikulski, Mr. Enzi, Mr. Wellstone, Mr. 
Hutchinson, Mrs. Murray, Ms. Collins, Mr. Akaka, Mr. Bond, Mr. 
Lautenberg, Mr. Hatch, Mr. Cleland, and Mr. Sessions)) proposed an 
amendment to the bill (S. 1880) to amend the Public Health Service Act 
to improve the health of minority individuals; as follows:

       Strike all after the enacting clause and insert the 
     following:

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Minority 
     Health and Health Disparities Research and Education Act of 
     2000''.
       (b) Table of Contents.--The table of contents of this Act 
     is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.

  TITLE I--IMPROVING MINORITY HEALTH AND REDUCING HEALTH DISPARITIES 
THROUGH NATIONAL INSTITUTES OF HEALTH; ESTABLISHMENT OF NATIONAL CENTER

Sec. 101. Establishment of National Center on Minority Health and 
              Health Disparities.
Sec. 102. Centers of excellence for research education and training.
Sec. 103. Extramural loan repayment program for minority health 
              disparities research.
Sec. 104. General provisions regarding the Center.
Sec. 105. Report regarding resources of National Institutes of Health 
              dedicated to minority and other health disparities 
              research.

TITLE II--HEALTH DISPARITIES RESEARCH BY AGENCY FOR HEALTHCARE RESEARCH 
                              AND QUALITY

Sec. 201. Health disparities research by Agency for Healthcare Research 
              and Quality.

        TITLE III--DATA COLLECTION RELATING TO RACE OR ETHNICITY

Sec. 301. Study and report by National Academy of Sciences.

                 TITLE IV--HEALTH PROFESSIONS EDUCATION

Sec. 401. Health professions education in health disparities.
Sec. 402. National conference on health professions education and 
              health disparities.
Sec. 403. Advisory responsibilities in health professions education in 
              health disparities and cultural competency.

 TITLE V--PUBLIC AWARENESS AND DISSEMINATION OF INFORMATION ON HEALTH 
                              DISPARITIES

Sec. 501. Public awareness and information dissemination.

                   TITLE VI--MISCELLANEOUS PROVISIONS

Sec. 601. Departmental definition regarding minority individuals.
Sec. 602. Conforming provision regarding definitions.
Sec. 603. Effective date.

     SEC. 2. FINDINGS.

       The Congress finds as follows:
       (1) Despite notable progress in the overall health of the 
     Nation, there are continuing disparities in the burden of 
     illness and death experienced by African Americans, 
     Hispanics, Native Americans, Alaska Natives, and Asian 
     Pacific Islanders, compared to the United States population 
     as a whole.
       (2) The largest numbers of the medically underserved are 
     white individuals, and many of them have the same health care 
     access problems as do members of minority groups. Nearly 
     20,000,000 white individuals live below the poverty line with 
     many living in non-metropolitan, rural areas such as 
     Appalachia, where the high percentage of counties designated 
     as health professional shortage areas (47 percent) and the 
     high rate of poverty contribute to disparity outcomes. 
     However, there is a higher proportion of racial and ethnic 
     minorities in the United States represented among the 
     medically underserved.
       (3) There is a national need for minority scientists in the 
     fields of biomedical, clinical, behavioral, and health 
     services research. Ninety percent of minority physicians 
     educated at Historically Black Medical Colleges live and 
     serve in minority communities.
       (4) Demographic trends inspire concern about the Nation's 
     ability to meet its future scientific, technological and 
     engineering workforce needs. Historically, non-Hispanic white 
     males have made up the majority of the United States 
     scientific, technological, and engineering workers.
       (5) The Hispanic and Black population will increase 
     significantly in the next 50 years. The scientific, 
     technological, and engineering workforce may decrease if 
     participation by underepresented minorities remains the same.
       (6) Increasing rates of Black and Hispanic workers can help 
     ensure strong scientific, technological, and engineering 
     workforce.
       (7) Individuals such as underepresented minorities and 
     women in the scientific, technological, and engineering 
     workforce enable society to address its diverse needs.
       (8) If there had not been a substantial increase in the 
     number of science and engineering degrees awarded to women 
     and underepresented minorities over the past few decades, the 
     United States would be facing even greater shortages in 
     scientific, technological, and engineering workers.
       (9) In order to effectively promote a diverse and strong 
     21st Century scientific, technological, and engineering 
     workforce, Federal agencies should expand or add programs 
     that effectively overcome barriers such as educational 
     transition from one level to the next and student 
     requirements for financial resources.
       (10) Federal agencies should work in concert with the 
     private nonprofit sector to emphasize the recruitment and 
     retention of qualified individuals from ethnic and gender 
     groups that are currently underrepresented in the scientific, 
     technological, and engineering workforce.
       (11) Behavioral and social sciences research has increased 
     awareness and understanding of factors associated with health 
     care utilization and access,-patient attitudes toward health 
     services, and risk and protective behaviors that affect 
     health and illness. These factors have the potential to then 
     be modified to help close the health disparities gap among 
     ethnic minority populations. In addition, there is a shortage 
     of minority behavioral science -researchers and behavioral 
     health care professionals. According to the National Science 
     Foundation, only 15.5 percent of behavioral research-oriented 
     psychology doctorate degrees were awarded to minority 
     students in 1997. In addition, only 17.9 percent of practice-
     oriented psychology doctorate degrees were awarded to ethnic 
     minorities.

  TITLE I--IMPROVING MINORITY HEALTH AND REDUCING HEALTH DISPARITIES 
THROUGH NATIONAL INSTITUTES OF HEALTH; ESTABLISHMENT OF NATIONAL CENTER

     SEC. 101. ESTABLISHMENT OF NATIONAL CENTER ON MINORITY HEALTH 
                   AND HEALTH DISPARITIES.

       (a) In General.--Part E of title IV of the Public Health 
     Service Act (42 U.S.C. 287 et seq.) is amended by adding at 
     the end the following subpart:

 ``Subpart 6--National Center on Minority Health and Health Disparities

     ``SEC. 485E. PURPOSE OF CENTER.

       ``(a) In General.--The general purpose of the National 
     Center on Minority Health and Health Disparities (in this 
     subpart referred to as the `Center') is the conduct and 
     support of research, training, dissemination of information, 
     and other programs with respect to minority health conditions 
     and other populations with health disparities.
       ``(b) Priorities.--The Director of the Center shall in 
     expending amounts appropriated under this subpart give 
     priority to conducting and supporting minority health 
     disparities research.
       ``(c) Minority Health Disparities Research.--For purposes 
     of this subpart:
       ``(1) The term `minority health disparities research' means 
     basic, clinical, and behavioral research on minority health 
     conditions (as defined in paragraph (2)), including research 
     to prevent, diagnose, and treat such conditions.
       ``(2) The term `minority health conditions', with respect 
     to individuals who are members

[[Page 24864]]

     of minority groups, means all diseases, disorders, and 
     conditions (including with respect to mental health and 
     substance abuse)--
       ``(A) unique to, more serious, or more prevalent in such 
     individuals;
       ``(B) for which the factors of medical risk or types of 
     medical intervention may be different for such individuals, 
     or for which it is unknown whether such factors or types are 
     different for such individuals; or
       ``(C) with respect to which there has been insufficient 
     research involving such individuals as subjects or 
     insufficient data on such individuals.
       ``(3) The term `minority group' has the meaning given the 
     term `racial and ethnic minority group' in section 1707.
       ``(4) The terms `minority' and `minorities' refer to 
     individuals from a minority group.
       ``(d) Health Disparity Populations.--For purposes of this 
     subpart:
       ``(1) A population is a health disparity population if, as 
     determined by the Director of the Center after consultation 
     with the Director of the Agency for Healthcare Research and 
     Quality, there is a significant disparity in the overall rate 
     of disease incidence, prevalence, morbidity, mortality, or 
     survival rates in the population as compared to the health 
     status of the general population.
       ``(2) The Director shall give priority consideration to 
     determining whether minority groups qualify as health 
     disparity populations under paragraph (1).
       ``(3) The term `health disparities research' means basic, 
     clinical, and behavioral research on health disparity 
     populations (including individual members and communities of 
     such populations) that relates to health disparities as 
     defined under paragraph (1), including the causes of such 
     disparities and methods to prevent, diagnose, and treat such 
     disparities.
       ``(e) 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--
       ``(1) shall 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; and
       ``(2) shall maintain communications with all relevant 
     Public Health Service agencies, including the Indian Health 
     Service, and various other departments of the Federal 
     Government to ensure the timely transmission of information 
     concerning advances in minority health disparities research 
     and other health disparities research between these various 
     agencies for dissemination to affected communities and health 
     care providers.
       ``(f) Collaborative Comprehensive Plan and Budget.--
       ``(1) In general.--Subject to the provisions of this 
     section and other applicable law, the Director of NIH, the 
     Director of the Center, and the directors of the other 
     agencies of the National Institutes of Health in 
     collaboration (and in consultation with the advisory council 
     for the Center) shall--
       ``(A) establish a comprehensive plan and budget for the 
     conduct and support of all minority health disparities 
     research and other health disparities research activities of 
     the agencies of the National Institutes of Health (which plan 
     and budget shall be first established under this subsection 
     not later than 12 months after the date of the enactment of 
     this subpart);
       ``(B) ensure that the plan and budget establish priorities 
     among the health disparities research activities that such 
     agencies are authorized to carry out;
       ``(C) ensure that the plan and budget establish objectives 
     regarding such activities, describes the means for achieving 
     the objectives, and designates the date by which the 
     objectives are expected to be achieved;
       ``(D) ensure that, with respect to amounts appropriated for 
     activities of the Center, the plan and budget give priority 
     in the expenditure of funds to conducting and supporting 
     minority health disparities research;
       ``(E) ensure that all amounts appropriated for such 
     activities are expended in accordance with the plan and 
     budget;
       ``(F) review the plan and budget not less than annually, 
     and revise the plan and budget as appropriate;
       ``(G) ensure that the plan and budget serve as a broad, 
     binding statement of policies regarding minority health 
     disparities research and other health disparities research 
     activities of the agencies, but do not remove the 
     responsibility of the heads of the agencies for the approval 
     of specific programs or projects, or for other details of the 
     daily administration of such activities, in accordance with 
     the plan and budget; and
       ``(H) promote coordination and collaboration among the 
     agencies conducting or supporting minority health or other 
     health disparities research.
       ``(2) Certain components of plan and budget.--With respect 
     to health disparities research activities of the agencies of 
     the National Institutes of Health, the Director of the Center 
     shall ensure that the plan and budget under paragraph (1) 
     provide for--
       ``(A) basic research and applied research, including 
     research and development with respect to products;
       ``(B) research that is conducted by the agencies;
       ``(C) research that is supported by the agencies;
       ``(D) proposals developed pursuant to solicitations by the 
     agencies and for proposals developed independently of such 
     solicitations; and
       ``(E) behavioral research and social sciences research, 
     which may include cultural and linguistic research in each of 
     the agencies.
       ``(3) Minority health disparities research.--The plan and 
     budget under paragraph (1) shall include a separate statement 
     of the plan and budget for minority health disparities 
     research.
       ``(g) Participation in Clinical Research.--The Director of 
     the Center shall work with the Director of NIH and the 
     directors of the agencies of the National Institutes of 
     Health to carry out the provisions of section 492B that 
     relate to minority groups.
       ``(h) Research Endowments.--
       ``(1) In general.--The Director of the Center may carry out 
     a program to facilitate minority health disparities research 
     and other health disparities research by providing for 
     research endowments at centers of excellence under section 
     736.
       ``(2) Eligibility.--The Director of the Center may provide 
     for a research endowment under paragraph (1) only if the 
     institution involved meets the following conditions:
       ``(A) The institution does not have an endowment that is 
     worth in excess of an amount equal to 50 percent of the 
     national average of endowment funds at institutions that 
     conduct similar biomedical research or training of health 
     professionals.
       ``(B) The application of the institution under paragraph 
     (1) regarding a research endowment has been recommended 
     pursuant to technical and scientific peer review and has been 
     approved by the advisory council under subsection (j).
       ``(i) Certain Activities.--In carrying out subsection (a), 
     the Director of the Center--
       ``(1) shall assist the Director of the National Center for 
     Research Resources in carrying out section 481(c)(3) and in 
     committing resources for construction at Institutions of 
     Emerging Excellence;
       ``(2) shall establish projects to promote cooperation among 
     Federal agencies, State, local, tribal, and regional public 
     health agencies, and private entities in health disparities 
     research; and
       ``(3) may utilize information from previous health 
     initiatives concerning minorities and other health disparity 
     populations.
       ``(j) Advisory Council.--
       ``(1) In general.--The Secretary shall, in accordance with 
     section 406, establish an advisory council to advise, assist, 
     consult with, and make recommendations to the Director of the 
     Center on matters relating to the activities described in 
     subsection (a), and with respect to such activities to carry 
     out any other functions described in section 406 for advisory 
     councils under such section. Functions under the preceding 
     sentence shall include making recommendations on budgetary 
     allocations made in the plan under subsection (f), and shall 
     include reviewing reports under subsection (k) before the 
     reports are submitted under such subsection.
       ``(2) Membership.--With respect to the membership of the 
     advisory council under paragraph (1), a majority of the 
     members shall be individuals with demonstrated expertise 
     regarding minority health disparity and other health 
     disparity issues; representatives of communities impacted by 
     minority and other health disparities shall be included; and 
     a diversity of health professionals shall be represented. The 
     membership shall in addition include a representative of the 
     Office of Behavioral and Social Sciences Research under 
     section 404A.
       ``(k) Annual Report.--The Director of the Center shall 
     prepare an annual report on the activities carried out or to 
     be carried out by the Center, and shall submit each such 
     report to the Committee on Health, Education, Labor, and 
     Pensions of the Senate, the Committee on Commerce of the 
     House of Representatives, the Secretary, and the Director of 
     NIH. With respect to the fiscal year involved, the report 
     shall--
       ``(1) describe and evaluate the progress made in health 
     disparities research conducted or supported by the national 
     research institutes;
       ``(2) summarize and analyze expenditures made for 
     activities with respect to health disparities research 
     conducted or supported by the National Institutes of Health;
       ``(3) include a separate statement applying the 
     requirements of paragraphs (1) and (2) specifically to 
     minority health disparities research; and
       ``(4) contain such recommendations as the Director 
     considers appropriate.
       ``(l) Authorization of Appropriations.--For the purpose of 
     carrying out this subpart, there are authorized to be 
     appropriated $100,000,000 for fiscal year 2001, and such sums 
     as may be necessary for each of the fiscal years 2002 through 
     2005. Such authorization of appropriations is in addition to 
     other authorizations of appropriations that are available for 
     the conduct and support of minority health disparities 
     research or other health

[[Page 24865]]

     disparities research by the agencies of the National 
     Institutes of Health.''.
       (b) Conforming Amendment.--Part A of title IV of the Public 
     Health Service Act (42 U.S.C. 281 et seq.) is amended--
       (1) in section 401(b)(2)--
       (A) in subparagraph (F), by moving the subparagraph two ems 
     to the left; and
       (B) by adding at the end the following subparagraph:
       ``(G) The National Center on Minority Health and Health 
     Disparities.''; and
       (2) by striking section 404.

     SEC. 102. CENTERS OF EXCELLENCE FOR RESEARCH EDUCATION AND 
                   TRAINING.

       Subpart 6 of part E of title IV of the Public Health 
     Service Act, as added by section 101(a) of this Act, is 
     amended by adding at the end the following section:

     ``SEC. 485F. CENTERS OF EXCELLENCE FOR RESEARCH EDUCATION AND 
                   TRAINING.

       ``(a) In General.--The Director of the Center shall make 
     awards of grants or contracts to designated biomedical and 
     behavioral research institutions under paragraph (1) of 
     subsection (c), or to consortia under paragraph (2) of such 
     subsection, for the purpose of assisting the institutions in 
     supporting programs of excellence in biomedical and 
     behavioral research training for individuals who are members 
     of minority health disparity populations or other health 
     disparity populations.
       ``(b) Required Use of Funds.--An award may be made under 
     subsection (a) only if the applicant involved agrees that the 
     grant will be expended--
       ``(1) to train members of minority health disparity 
     populations or other health disparity populations as 
     professionals in the area of biomedical or behavioral 
     research or both; or
       ``(2) to expand, remodel, renovate, or alter existing 
     research facilities or construct new research facilities for 
     the purpose of conducting minority health disparities 
     research and other health disparities research.
       ``(c) Centers of Excellence.--
       ``(1) In general.--For purposes of this section, a 
     designated biomedical and behavioral research institution is 
     a biomedical and behavioral research institution that--
       ``(A) has a significant number of members of minority 
     health disparity populations or other health disparity 
     populations enrolled as students in the institution 
     (including individuals accepted for enrollment in the 
     institution);
       ``(B) has been effective in assisting such students of the 
     institution to complete the program of education or training 
     and receive the degree involved;
       ``(C) has made significant efforts to recruit minority 
     students to enroll in and graduate from the institution, 
     which may include providing means-tested scholarships and 
     other financial assistance as appropriate; and
       ``(D) has made significant recruitment efforts to increase 
     the number of minority or other members of health disparity 
     populations serving in faculty or administrative positions at 
     the institution.
       ``(2) Consortium.--Any designated biomedical and behavioral 
     research institution involved may, with other biomedical and 
     behavioral institutions (designated or otherwise), including 
     tribal health programs, form a consortium to receive an award 
     under subsection (a).
       ``(3) Application of criteria to other programs.--In the 
     case of any criteria established by the Director of the 
     Center for purposes of determining whether institutions meet 
     the conditions described in paragraph (1), this section may 
     not, with respect to minority health disparity populations or 
     other health disparity populations, be construed to 
     authorize, require, or prohibit the use of such criteria in 
     any program other than the program established in this 
     section.
       ``(d) Duration of Grant.--The period during which payments 
     are made under a grant under subsection (a) may not exceed 5 
     years. Such payments shall be subject to annual approval by 
     the Director of the Center and to the availability of 
     appropriations for the fiscal year involved to make the 
     payments.
       ``(e) Maintenance of Effort.--
       ``(1) In general.--With respect to activities for which an 
     award under subsection (a) is authorized to be expended, the 
     Director of the Center may not make such an award to a 
     designated research institution or consortium for any fiscal 
     year unless the institution, or institutions in the 
     consortium, as the case may be, agree 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 institutions involved for the fiscal year 
     preceding the fiscal year for which such institutions receive 
     such an award.
       ``(2) Use of federal funds.--With respect to any Federal 
     amounts received by a designated research institution or 
     consortium and available for carrying out activities for 
     which an award under subsection (a) is authorized to be 
     expended, the Director of the Center may make such an award 
     only if the institutions involved agree that the institutions 
     will, before expending the award, expend the Federal amounts 
     obtained from sources other than the award.
       ``(f) Certain Expenditures.--The Director of the Center may 
     authorize a designated biomedical and behavioral research 
     institution to expend a portion of an award under subsection 
     (a) for research endowments.
       ``(g) Definitions.--For purposes of this section:
       ``(1) The term `designated biomedical and behavioral 
     research institution' has the meaning indicated for such term 
     in subsection (c)(1). Such term includes any health 
     professions school receiving an award of a grant or contract 
     under section 736.
       ``(2) The term `program of excellence' means any program 
     carried out by a designated biomedical and behavioral 
     research institution with an award under subsection (a), if 
     the program is for purposes for which the institution 
     involved is authorized in subsection (b) to expend the grant.
       ``(h) Authorization of Appropriations.--For the purpose of 
     making grants under subsection (a), there are authorized to 
     be appropriated such sums as may be necessary for each of the 
     fiscal years 2001 through 2005.''.

     SEC. 103. EXTRAMURAL LOAN REPAYMENT PROGRAM FOR MINORITY 
                   HEALTH DISPARITIES RESEARCH.

       Subpart 6 of part E of title IV of the Public Health 
     Service Act, as amended by section 102 of this Act, is 
     amended by adding at the end the following section:

     ``SEC. 485G. LOAN REPAYMENT PROGRAM FOR MINORITY HEALTH 
                   DISPARITIES RESEARCH.

       ``(a) In General.--The Director of the Center shall 
     establish a program of entering into contracts with qualified 
     health professionals under which such health professionals 
     agree to engage in minority health disparities research or 
     other health disparities research in consideration of the 
     Federal Government agreeing to repay, for each year of 
     engaging in such research, not more than $35,000 of the 
     principal and interest of the educational loans of such 
     health professionals.
       ``(b) Service Provisions.--The provisions of sections 338B, 
     338C, and 338E shall, except as inconsistent with subsection 
     (a), apply to the program established in such subsection to 
     the same extent and in the same manner as such provisions 
     apply to the National Health Service Corps Loan Repayment 
     Program established in subpart III of part D of title III.
       ``(c) Requirement Regarding Health Disparity Populations.--
     The Director of the Center shall ensure that not fewer than 
     50 percent of the contracts entered into under subsection (a) 
     are for appropriately qualified health professionals who are 
     members of a health disparity population.
       ``(d) Priority.--With respect to minority health 
     disparities research and other health disparities research 
     under subsection (a), the Secretary shall ensure that 
     priority is given to conducting projects of biomedical 
     research.
       ``(e) Funding.--
       ``(1) Authorization of appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated such sums as may be necessary for each of the 
     fiscal years 2001 through 2005.
       ``(2) Availability of appropriations.--Amounts available 
     for carrying out this section shall remain available until 
     the expiration of the second fiscal year beginning after the 
     fiscal year for which the amounts were made available.''.

     SEC. 104. GENERAL PROVISIONS REGARDING THE CENTER.

       Subpart 6 of part E of title IV of the Public Health 
     Service Act, as amended by section 103 of this Act, is 
     amended by adding at the end the following section:

     ``SEC. 485H. GENERAL PROVISIONS REGARDING THE CENTER.

       ``(a) Administrative Support for Center.--The Secretary, 
     acting through the Director of the National Institutes of 
     Health, shall provide administrative support and support 
     services to the Director of the Center and shall ensure that 
     such support takes maximum advantage of existing 
     administrative structures at the agencies of the National 
     Institutes of Health.
       ``(b) Evaluation and Report.--
       ``(1) Evaluation.--Not later than 5 years after the date of 
     the enactment of this subpart, the Secretary shall conduct an 
     evaluation to--
       ``(A) determine the effect of this subpart on the planning 
     and coordination of health disparities research programs at 
     the agencies of the National Institutes of Health;
       ``(B) evaluate the extent to which this subpart has 
     eliminated the duplication of administrative resources among 
     such Institutes, centers and divisions; and
       ``(C) provide, to the extent determined by the Secretary to 
     be appropriate, recommendations concerning future legislative 
     modifications with respect to this subpart, for both minority 
     health disparities research and other health disparities 
     research.
       ``(2) Minority health disparities research.--The evaluation 
     under paragraph (1) shall include a separate statement that 
     applies subparagraphs (A) and (B) of such paragraph to 
     minority health disparities research.
       ``(3) Report.--Not later than 1 year after the date on 
     which the evaluation is commenced under paragraph (1), the 
     Secretary shall prepare and submit to the Committee on 
     Health, Education, Labor, and Pensions of the Senate, and the 
     Committee on Commerce of the House of Representatives, a 
     report concerning the results of such evaluation.''.

[[Page 24866]]



     SEC. 105. REPORT REGARDING RESOURCES OF NATIONAL INSTITUTES 
                   OF HEALTH DEDICATED TO MINORITY AND OTHER 
                   HEALTH DISPARITIES RESEARCH.

       Not later than December 1, 2003, the Director of the 
     National Center on Minority Health and Health Disparities 
     (established by the amendment made by section 101(a)), after 
     consultation with the advisory council for such Center, shall 
     submit to the Congress, the Secretary of Health and Human 
     Services, and the Director of the National Institutes of 
     Health a report that provides the following:
       (1) Recommendations for the methodology that should be used 
     to determine the extent of the resources of the National 
     Institutes of Health that are dedicated to minority health 
     disparities research and other health disparities research, 
     including determining the amount of funds that are used to 
     conduct and support such research. With respect to such 
     methodology, the report shall address any discrepancies 
     between the methodology used by such Institutes as of the 
     date of the enactment of this Act and the methodology used by 
     the Institute of Medicine as of such date.
       (2) A determination of whether and to what extent, relative 
     to fiscal year 1999, there has been an increase in the level 
     of resources of the National Institutes of Health that are 
     dedicated to minority health disparities research, including 
     the amount of funds used to conduct and support such 
     research. The report shall include provisions describing 
     whether and to what extent there have been increases in the 
     number and amount of awards to minority serving institutions.

TITLE II--HEALTH DISPARITIES RESEARCH BY AGENCY FOR HEALTHCARE RESEARCH 
                              AND QUALITY

     SEC. 201. HEALTH DISPARITIES RESEARCH BY AGENCY FOR 
                   HEALTHCARE RESEARCH AND QUALITY.

       (a)  General.--Part A of title IX of the Public Health 
     Service Act (42 U.S.C. 299 et seq.) is amended--
       (1) in section 902, by striking subsection (g); and
       (2) by adding at the end the following:

     ``SEC. 903. RESEARCH ON HEALTH DISPARITIES.

       ``(a) In General.--The Director shall--
       ``(1) conduct and support research to identify populations 
     for which there is a significant disparity in the quality, 
     outcomes, cost, or use of health care services or access to 
     and satisfaction with such services, as compared to the 
     general population;
       ``(2) conduct and support research on the causes of and 
     barriers to reducing the health disparities identified in 
     paragraph (1), taking into account such factors as 
     socioeconomic status, attitudes toward health, the language 
     spoken, the extent of formal education, the area or community 
     in which the population resides, and other factors the 
     Director determines to be appropriate;
       ``(3) conduct and support research and support 
     demonstration projects to identify, test, and evaluate 
     strategies for reducing or eliminating health disparities, 
     including development or identification of effective service 
     delivery models, and disseminate effective strategies and 
     models;
       ``(4) develop measures and tools for the assessment and 
     improvement of the outcomes, quality, and appropriateness of 
     health care services provided to health disparity 
     populations;
       ``(5) in carrying out section 902(c), provide support to 
     increase the number of researchers who are members of health 
     disparity populations, and the health services research 
     capacity of institutions that train such researchers; and
       ``(6) beginning with fiscal year 2003, annually submit to 
     the Congress a report regarding prevailing disparities in 
     health care delivery as it relates to racial factors and 
     socioeconomic factors in priority populations.
       ``(b) Research and Demonstration Projects.--
       ``(1) In general.--In carrying out subsection (a), the 
     Director shall conduct and support research and support 
     demonstrations to--
       ``(A) identify the clinical, cultural, socioeconomic, 
     geographic, and organizational factors that contribute to 
     health disparities, including minority health disparity 
     populations, which research shall include behavioral 
     research, such as examination of patterns of clinical 
     decisionmaking, and research on access, outreach, and the 
     availability of related support services (such as cultural 
     and linguistic services);
       ``(B) identify and evaluate clinical and organizational 
     strategies to improve the quality, outcomes, and access to 
     care for health disparity populations, including minority 
     health disparity populations;
       ``(C) test such strategies and widely disseminate those 
     strategies for which there is scientific evidence of 
     effectiveness; and
       ``(D) determine the most effective approaches for 
     disseminating research findings to health disparity 
     populations, including minority populations.
       ``(2) Use of certain strategies.--In carrying out this 
     section, the Director shall implement research strategies and 
     mechanisms that will enhance the involvement of individuals 
     who are members of minority health disparity populations or 
     other health disparity populations, health services 
     researchers who are such individuals, institutions that train 
     such individuals as researchers, members of minority health 
     disparity populations or other health disparity populations 
     for whom the Agency is attempting to improve the quality and 
     outcomes of care, and representatives of appropriate tribal 
     or other community-based organizations with respect to health 
     disparity populations. Such research strategies and 
     mechanisms may include the use of--
       ``(A) centers of excellence that can demonstrate, either 
     individually or through consortia, a combination of multi-
     disciplinary expertise in outcomes or quality improvement 
     research, linkages to relevant sites of care, and a 
     demonstrated capacity to involve members and communities of 
     health disparity populations, including minority health 
     disparity populations, in the planning, conduct, 
     dissemination, and translation of research;
       ``(B) provider-based research networks, including health 
     plans, facilities, or delivery system sites of care 
     (especially primary care), that make extensive use of health 
     care providers who are members of health disparity 
     populations or who serve patients in such populations and 
     have the capacity to evaluate and promote quality 
     improvement;
       ``(C) service delivery models (such as health centers under 
     section 330 and the Indian Health Service) to reduce health 
     disparities; and
       ``(D) innovative mechanisms or strategies that will 
     facilitate the translation of past research investments into 
     clinical practices that can reasonably be expected to benefit 
     these populations.
       ``(c) Quality Measurement Development.--
       ``(1) In general.--To ensure that health disparity 
     populations, including minority health disparity populations, 
     benefit from the progress made in the ability of individuals 
     to measure the quality of health care delivery, the Director 
     shall support the development of quality of health care 
     measures that assess the experience of such populations with 
     health care systems, such as measures that assess the access 
     of such populations to health care, the cultural competence 
     of the care provided, the quality of the care provided, the 
     outcomes of care, or other aspects of health care practice 
     that the Director determines to be important.
       ``(2) Examination of certain practices.--The Director shall 
     examine the practices of providers that have a record of 
     reducing health disparities or have experience in providing 
     culturally competent health services to minority health 
     disparity populations or other health disparity populations. 
     In examining such practices of providers funded under the 
     authorities of this Act, the Director shall consult with the 
     heads of the relevant agencies of the Public Health Service.
       ``(3) Report.--Not later than 36 months after the date of 
     the enactment of this section, the Secretary, acting through 
     the Director, shall prepare and submit to the appropriate 
     committees of Congress a report describing the state-of-the-
     art of quality measurement for minority and other health 
     disparity populations that will identify critical unmet 
     needs, the current activities of the Department to address 
     those needs, and a description of related activities in the 
     private sector.
       ``(d) Definition.--For purposes of this section:
       ``(1) The term `health disparity population' has the 
     meaning given such term in section 485E, except that in 
     addition to the meaning so given, the Director may determine 
     that such term includes populations for which there is a 
     significant disparity in the quality, outcomes, cost, or use 
     of health care services or access to or satisfaction with 
     such services as compared to the general population.
       ``(2) The term `minority', with respect to populations, 
     refers to racial and ethnic minority groups as defined in 
     section 1707.''.
       (b) Funding.--Section 927 of the Public Health Service Act 
     (42 U.S.C. 299c-6) is amended by adding at the end the 
     following:
       ``(d) Health Disparities Research.--For the purpose of 
     carrying out the activities under section 903, there are 
     authorized to be appropriated $50,000,000 for fiscal year 
     2001, and such sums as may be necessary for each of the 
     fiscal years 2002 through 2005.''.

        TITLE III--DATA COLLECTION RELATING TO RACE OR ETHNICITY

     SEC. 301. STUDY AND REPORT BY NATIONAL ACADEMY OF SCIENCES.

       (a) Study.--The National Academy of Sciences shall conduct 
     a comprehensive study of the Department of Health and Human 
     Services' data collection systems and practices, and any data 
     collection or reporting systems required under any of the 
     programs or activities of the Department, relating to the 
     collection of data on race or ethnicity, including other 
     Federal data collection systems (such as the Social Security 
     Administration) with which the Department interacts to 
     collect relevant data on race and ethnicity.
       (b) Report.--Not later than 1 year after the date of 
     enactment of this Act, the National Academy of Sciences shall 
     prepare and submit to the Committee on Health,

[[Page 24867]]

     Education, Labor, and Pensions of the Senate and the 
     Committee on Commerce of the House of Representatives, a 
     report that--
       (1) identifies the data needed to support efforts to 
     evaluate the effects of socioeconomic status, race and 
     ethnicity on access to health care and other services and on 
     disparity in health and other social outcomes and the data 
     needed to enforce existing protections for equal access to 
     health care;
       (2) examines the effectiveness of the systems and practices 
     of the Department of Health and Human Services described in 
     subsection (a), including pilot and demonstration projects of 
     the Department, and the effectiveness of selected systems and 
     practices of other Federal, State, and tribal agencies and 
     the private sector, in collecting and analyzing such data;
       (3) contains recommendations for ensuring that the 
     Department of Health and Human Services, in administering its 
     entire array of programs and activities, collects, or causes 
     to be collected, reliable and complete information relating 
     to race and ethnicity; and
       (4) includes projections about the costs associated with 
     the implementation of the recommendations described in 
     paragraph (3), and the possible effects of the costs on 
     program operations.
       (c) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated such sums as may be necessary for fiscal year 
     2001.

                 TITLE IV--HEALTH PROFESSIONS EDUCATION

     SEC. 401. HEALTH PROFESSIONS EDUCATION IN HEALTH DISPARITIES.

       (a) In General.--Part B of title VII of the Public Health 
     Service Act (42 U.S.C. 293 et seq.) is amended by inserting 
     after section 740 the following:

     ``SEC. 741. GRANTS FOR HEALTH PROFESSIONS EDUCATION.

       ``(a) Grants for Health Professions Education in Health 
     Disparities and Cultural Competency.--
       ``(1) In general.--The Secretary, acting through the 
     Administrator of the Health Resources and Services 
     Administration, may make awards of grants, contracts, or 
     cooperative agreements to public and nonprofit private 
     entities (including tribal entities) for the purpose of 
     carrying out research and demonstration projects (including 
     research and demonstration projects for continuing health 
     professions education) for training and education of health 
     professionals for the reduction of disparities in health care 
     outcomes and the provision of culturally competent health 
     care.
       ``(2) Eligible entities.--Unless specifically required 
     otherwise in this title, the Secretary shall accept 
     applications for grants or contracts under this section from 
     health professions schools, academic health centers, State or 
     local governments, or other appropriate public or private 
     nonprofit entities (or consortia of entities, including 
     entities promoting multidisciplinary approaches) for funding 
     and participation in health professions training activities. 
     The Secretary may accept applications from for-profit private 
     entities as determined appropriate by the Secretary.
       ``(b) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out subsection (a), 
     $3,500,000 for fiscal year 2001, $7,000,000 for fiscal year 
     2002, $7,000,000 for fiscal year 2003, and $3,500,000 for 
     fiscal year 2004.''.
       (b) Nursing Education.--Part A of title VIII of the Public 
     Health Service Act (42 U.S.C. 296 et seq.) is amended--
       (1) by redesignating section 807 as section 808; and
       (2) by inserting after section 806 the following:

     ``SEC. 807. GRANTS FOR HEALTH PROFESSIONS EDUCATION.

       ``(a) Grants for Health Professions Education in Health 
     Disparities and Cultural Competency.--The Secretary, acting 
     through the Administrator of the Health Resources and 
     Services Administration, may make awards of grants, 
     contracts, or cooperative agreements to eligible entities for 
     the purpose of carrying out research and demonstration 
     projects (including research and demonstration projects for 
     continuing health professions education) for training and 
     education for the reduction of disparities in health care 
     outcomes and the provision of culturally competent health 
     care. Grants under this section shall be the same as provided 
     in section 741.''.
       ``(b) Authorization of Appropriations.--There are to be 
     appropriated to carry out subsection (a) such sums as may be 
     necessary for each of the fiscal years 2001 through 2004.''.

     SEC. 402. NATIONAL CONFERENCE ON HEALTH PROFESSIONS EDUCATION 
                   AND HEALTH DISPARITIES.

       (a) In General.--Not later than 1 year after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services (in this section referred to as the ``Secretary''), 
     acting through the Administrator of the Health Resources and 
     Services Administration, shall convene a national conference 
     on health professions education as a method for reducing 
     disparities in health outcomes.
       (b) Participants.--The Secretary shall include in the 
     national conference convened under subsection (a) advocacy 
     groups and educational entities as described in section 741 
     of the Public Health Service Act (as added by section 401), 
     tribal health programs, health centers under section 330 of 
     such Act, and other interested parties.
       (c) Issues.--The national conference convened under 
     subsection (a) shall include, but is not limited to, issues 
     that address the role and impact of health professions 
     education on the reduction of disparities in health outcomes, 
     including the role of education on cultural competency. The 
     conference shall focus on methods to achieve reductions in 
     disparities in health outcomes through health professions 
     education (including continuing education programs) and 
     strategies for outcomes measurement to assess the 
     effectiveness of education in reducing disparities.
       (d) Publication of Findings.--Not later than 6 months after 
     the national conference under subsection (a) has convened, 
     the Secretary shall publish in the Federal Register a summary 
     of the proceedings and findings of the conference.
       (e) Authorization of Appropriations.--There is authorized 
     to be appropriated such sums as may be necessary to carry out 
     this section.

     SEC. 403. ADVISORY RESPONSIBILITIES IN HEALTH PROFESSIONS 
                   EDUCATION IN HEALTH DISPARITIES AND CULTURAL 
                   COMPETENCY.

       Section 1707 of the Public Health Service Act (42 U.S.C. 
     300u-6) is amended--
       (1) in subsection (b), by adding at the end the following 
     paragraph:
       ``(10) Advise in matters related to the development, 
     implementation, and evaluation of health professions 
     education in decreasing disparities in health care outcomes, 
     including cultural competency as a method of eliminating 
     health disparities.'';
       (2) in subsection (c)(2), by striking ``paragraphs (1) 
     through (9)'' and inserting ``paragraphs (1) through (10)''; 
     and
       (3) in subsection (d), by amending paragraph (1) to read as 
     follows:
       ``(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 of Civil Rights, and the Directors of other 
     appropriate departmental entities regarding recommendations 
     for carrying out activities under subsection (b)(9).
       ``(B) Health professions education regarding health 
     disparities.--The Deputy Assistant Secretary shall carry out 
     the duties under subsection (b)(10) in collaboration with 
     appropriate personnel of the Department of Health of 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.''.

 TITLE V--PUBLIC AWARENESS AND DISSEMINATION OF INFORMATION ON HEALTH 
                              DISPARITIES

     SEC. 501. PUBLIC AWARENESS AND INFORMATION DISSEMINATION.

       (a) Public Awareness on Health Disparities.--The Secretary 
     of Health and Human Services (in this section referred to as 
     the ``Secretary'') shall conduct a national campaign to 
     inform the public and health care professionals about health 
     disparities in minority and other underserved populations by 
     disseminating information and materials available on specific 
     diseases affecting these populations and programs and 
     activities to address these disparities. The campaign shall--
       (1) have a specific focus on minority and other underserved 
     communities with health disparities; and
       (2) include an evaluation component to assess the impact of 
     the national campaign in raising awareness of health 
     disparities and information on available resources.
       (b) Dissemination of Information on Health Disparities.--
     The Secretary shall develop and implement a plan for the 
     dissemination of information and findings with respect to 
     health disparities under titles I, II, III, and IV of this 
     Act. The plan shall--
       (1) include the participation of all agencies of the 
     Department of Health and Human Services that are responsible 
     for serving populations included in the health disparities 
     research; and
       (2) have agency-specific strategies for disseminating 
     relevant findings and information on health disparities and 
     improving health care services to affected communities.

                   TITLE VI--MISCELLANEOUS PROVISIONS

     SEC. 601. DEPARTMENTAL DEFINITION REGARDING MINORITY 
                   INDIVIDUALS.

       Section 1707(g)(1) of the Public Health Service Act (42 
     U.S.C. 300u-6) is amended--
       (1) by striking ``Asian Americans and'' and inserting 
     ``Asian Americans;''; and
       (2) by inserting ``Native Hawaiians and other'' before 
     ``Pacific Islanders;''.

     SEC. 602. CONFORMING PROVISION REGARDING DEFINITIONS.

       For purposes of this Act, the term ``racial and ethnic 
     minority group'' has the meaning

[[Page 24868]]

     given such term in section 1707 of the Public Health Service 
     Act.

     SEC. 603. EFFECTIVE DATE.

       This Act and the amendments made by this Act take effect 
     October 1, 2000, or upon the date of the enactment of this 
     Act, whichever occurs later.

                          ____________________