[House Report 116-571]
[From the U.S. Government Publishing Office]


116th Congress }                                          { Report
                        HOUSE OF REPRESENTATIVES
  2d Session   }                                          { 116-571

======================================================================
 
          NIMHD RESEARCH ENDOWMENT REVITALIZATION ACT OF 2019

                                _______
                                

 November 16, 2020.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

 Mr. Pallone, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 4499]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 4499) to amend the Public Health Service Act to 
provide that the authority of the Director of the National 
Institute on Minority Health and Health Disparities to make 
certain research endowments applies with respect to both 
current and former centers of excellence, and for other 
purposes, having considered the same, reports favorably thereon 
without amendment and recommends that the bill do pass.

                                CONTENTS

                                                                   Page
  I. Purpose and Summary............................................. 2
 II.  Background and Need for the Legislation........................ 2
III.  Committee Hearings............................................. 2
 IV.  Committee Consideration........................................ 2
  V.  Committee Votes................................................ 3
 VI. Oversight Findings.............................................. 3
VII.  New Budget Authority, Entitlement Authority, and Tax Expenditur 3
VIII. Federal Mandates Statement..................................... 3

 IX. Statement of General Performance Goals and Objectives........... 3
  X.  Duplication of Federal Programs................................ 4
 XI.  Committee Cost Estimate........................................ 4
XII.  Earmarks, Limited Tax Benefits, and Limited Tariff Benefits.... 4
XIII. Advisory Committee Statement................................... 4

XIV.  Applicability to Legislative Branch............................ 4
 XV.  Section-by-Section Analysis of the Legislation................. 4
XVI.  Changes in Existing Law Made by the Bill, as Reported.......... 4

                         I. Purpose and Summary

    H.R. 4499, the ``NIMHD Research Endowment Revitalization 
Act of 2019'', introduced on by Representatives Nannette Diaz 
Barragan (D-CA), Earl L. ``Buddy'' Carter (R-GA), and John 
Lewis (D-GA), authorizes the National Institute on Minority 
Health and Health Disparities (NIMHD) to facilitate research on 
minority health disparities through research endowments at 
current or former Centers of Excellence. Currently, only 
Centers of Excellence with an active status can access the 
NIMHD Research Endowment Program.

                II. Background and Need for Legislation

    The NIMHD Research Endowment Program was established by the 
Minority Health and Health Disparities Research and Education 
Act of 2000.\1\ By supporting the endowments of certain 
academic institutions, the goals of the program are to promote 
minority health and health disparities research capacity, 
increase the diversity of the scientific workforce, and enhance 
the recruitment and retention of underrepresented individuals 
in science.\2\ Funding is available annually for up to five 
years.
---------------------------------------------------------------------------
    \1\P.L. 106-525.
    \2\National Institute on Minority Health and Health Disparities, 
Research Endowment Program (REP) (accessed September 17, 2020).
---------------------------------------------------------------------------
    The Patient Protection and Affordable Care Act expanded the 
eligibility of the program to include institutions of higher 
education with an active NIMHD Center of Excellence.\3\ The 
condition that the program support active Centers of Excellence 
has inadvertently resulted in schools such as Morehouse School 
of Medicine, Georgia State University, Morgan State University, 
and the Charles R. Drew University of Medicine and Sciences 
being ineligible for support under this program due to their 
respective Center of Excellence statuses ending.
---------------------------------------------------------------------------
    \3\P.L. 111-148.
---------------------------------------------------------------------------

                        III. Committee Hearings

    For the purposes of section 103(i) of H. Res. 6 of the 
116th Congress, the following hearing was used to develop or 
consider H.R. 4499:
    The Subcommittee on Health held a hearing on June 17, 2020, 
entitled ``Health Care Inequality: Confronting Racial and 
Ethnic Disparities in COVID-19 and the Health Care System.'' 
The Subcommittee received testimony from the following 
witnesses:
           Rhea Boyd, M.D., M.P.H., Pediatrician and 
        Child Health Advocate, Palo Alto Medical Foundation
           Oliver T. Brooks, M.D., President, National 
        Medical Association
           Avik S.A. Roy, President, The Foundation for 
        Research on Equal Opportunity

                      IV. Committee Consideration

    Representatives Barragan, Carter (R-GA), and Lewis 
introduced H.R. 4499 on September 26, 2019, and the bill was 
referred to the Committee on Energy and Commerce. H.R. 4499 was 
then referred to the Subcommittee on Health on September 27, 
2019. A hearing on this bill was held on June 17, 2020.
    On September 9, 2020, H.R. 4499 was discharged from further 
consideration by the Subcommittee on Health as it was called up 
for consideration by the full Committee on Energy and Commerce. 
The full Committee met in virtual open markup session on 
September 9, 2020, pursuant to notice, to consider H.R. 4499 
and 37 other bills. No amendments were offered to the bill. 
Upon conclusion of consideration, the full Committee agreed to 
a motion on final passage offered by Mr. Pallone, Chairman of 
the committee, to order H.R. 4499 reported favorably to the 
House, without amendment, by a voice vote, a quorum being 
present.

                           V. Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list each record vote 
on the motion to report legislation and amendments thereto. The 
Committee advises that there were no record votes taken on H.R. 
4499, including the motion for final passage of the bill.

                         VI. Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII and clause 2(b)(1) 
of rule X of the Rules of the House of Representatives, the 
oversight findings and recommendations of the Committee are 
reflected in the descriptive portion of the report.

           VII. New Budget Authority, Entitlement Authority, 
                          and Tax Expenditures

    Pursuant to 3(c)(2) of rule XIII of the Rules of the House 
of Representatives, the Committee adopts as its own the 
estimate of new budget authority, entitlement authority, or tax 
expenditures or revenues contained in the cost estimate 
prepared by the Director of the Congressional Budget Office 
pursuant to section 402 of the Congressional Budget Act of 
1974.
    The Committee has requested but not received from the 
Director of the Congressional Budget Office a statement as to 
whether this bill contains any new budget authority, spending 
authority, credit authority, or an increase or decrease in 
revenues or tax expenditures.

                    VIII. Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

       IX. Statement of General Performance Goals and Objectives

    Pursuant to clause 3(c)(4) of rule XIII, the general 
performance goal or objective of this legislation is to amend 
the Public Health Service Act to provide that the authority of 
the Director of the National Institute on Minority Health and 
Health Disparities to make certain research endowments applies 
with respect to both current and former Centers of Excellence.

                   X. Duplication of Federal Programs

    Pursuant to clause 3(c)(5) of rule XIII, no provision of 
H.R. 4499 is known to be duplicative of another Federal 
program, including any program that was included in a report to 
Congress pursuant to section 21 of Public Law 111-139 or the 
most recent Catalog of Federal Domestic Assistance.

                      XI. Committee Cost Estimate

    Pursuant to clause 3(d)(1) of rule XIII, the Committee 
adopts as its own the cost estimate prepared by the Director of 
the Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974.

           XII. Earmarks, Limited Tax Benefits, and Limited 
                            Tariff Benefits

    Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the 
Committee finds that H.R. 4499 contains no earmarks, limited 
tax benefits, or limited tariff benefits.

                   XIII. Advisory Committee Statement

    No advisory committee within the meaning of section 5(b) of 
the Federal Advisory Committee Act was created by this 
legislation.

                XIV. Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

           XV. Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 designates that the short title may be cited as 
the ``NIMHD Research Endowment Revitalization Act of 2019''.

Sec. 2. Research endowments at both current and former Centers of 
        Excellence

    Section 2 amends the Public Health Service Act to direct 
the Director of the NIMHD to facilitate minority health 
disparities research and other health disparities research by 
providing for research endowments at current or former NIMHD 
Centers of Excellence under section 464z-4 of the Public Health 
Service Act and at current or former Health Resources and 
Services Administration Centers of Excellence under section 736 
of the Public Health Service Act.

       XVI. Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italics, and existing law in which no 
change is proposed is shown in roman):

                       PUBLIC HEALTH SERVICE ACT




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TITLE IV--NATIONAL RESEARCH INSTITUTES

           *       *       *       *       *       *       *



Part C--Specific Provisions Respecting National Research Institutes

           *       *       *       *       *       *       *



     Subpart 20--National Institute on Minority Health and Health 
                              Disparities


SEC. 464Z-3. PURPOSE OF CENTER.

  (a) In General.--The general purpose of the National 
Institute on Minority Health and Health Disparities (in this 
subpart referred to as the ``Institute'') 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 Institute 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 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 Institute 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 
Institute 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 Institute, and the directors of the 
        other agencies of the National Institutes of Health in 
        collaboration (and in consultation with the advisory 
        council for the Institute) 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 Institute, 
                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 Institute 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 
Institute 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 Institute may 
        carry out a program to facilitate minority health 
        disparities research and other health disparities 
        research by providing for research endowments--
          [(1) at centers of excellence under section 736; and
          [(2) at centers of excellence under section 464z-4.]
          (1) In general.--The Director of the Institute may 
        carry out a program to facilitate minority health 
        disparities research and other health disparities 
        research by providing for research endowments--
                  (A) at current or former centers of 
                excellence under section 736; and
                  (B) at current or former centers of 
                excellence under section 464z-4.
          (2) Eligibility.--The Director of the Institute 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 median 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 Institute--
          (1) shall assist the Director of NIH in carrying out 
        section 404I(c)(2) and in committing resources for 
        construction at Institutions of Emerging Excellence 
        under such section;
          (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 Institute 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) Intra-National Institutes of Health Coordination.--The 
Director of the Institute, as the primary Federal official with 
responsibility for coordinating all research and activities 
conducted or supported by the National Institutes of Health on 
minority health and health disparities, shall plan, coordinate, 
review, and evaluate research and other activities conducted or 
supported by the national research institutes and national 
centers. The Director of the Institute may foster partnerships 
between the national research institutes and national centers 
and may encourage the funding of collaborative research 
projects to achieve the goals of the National Institutes of 
Health that are related to minority health and health 
disparities.

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