[105th Congress Public Law 392]
[From the U.S. Government Printing Office]


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[DOCID: f:publ392.105]


[[Page 3523]]

          HEALTH PROFESSIONS EDUCATION PARTNERSHIPS ACT OF 1998

[[Page 112 STAT. 3524]]

Public Law 105-392
105th Congress

                                 An Act


 
 To amend the Public Health Service Act to consolidate and reauthorize 
   health professions and minority and disadvantaged health education 
 programs, and for other purposes. <<NOTE: Nov. 13, 1998 -  [S. 1754]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress <<NOTE: Health Professions 
Education Partnership Act of 1998.>> assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short <<NOTE: 42 USC 201 note.>> Title.--This Act may be cited 
as the ``Health Professions Education Partnerships Act of 1998''.

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

Sec. 1. Short title; table of contents.

 TITLE I--HEALTH PROFESSIONS EDUCATION AND FINANCIAL ASSISTANCE PROGRAMS

            Subtitle A--Health Professions Education Programs

Sec. 101. Under-represented minority health professions grant program.
Sec. 102. Training in primary care medicine and dentistry.
Sec. 103. Interdisciplinary, community-based linkages.
Sec. 104. Health professions workforce information and analysis.
Sec. 105. Public health workforce development.
Sec. 106. General provisions.
Sec. 107. Preference in certain programs.
Sec. 108. Definitions.
Sec. 109. Technical amendment on National Health Service Corps.
Sec. 110. Savings provision.

                Subtitle B--Nursing Workforce Development

Sec. 121. Short title.
Sec. 122. Purpose.
Sec. 123. Amendments to Public Health Service Act.
Sec. 124. Savings provision.

                    Subtitle C--Financial Assistance

              CHAPTER 1--SCHOOL-BASED REVOLVING LOAN FUNDS

Sec. 131. Primary care loan program.
Sec. 132. Loans for disadvantaged students.
Sec. 133. Student loans regarding schools of nursing.
Sec. 134. General provisions.

    CHAPTER 2--INSURED HEALTH EDUCATION ASSISTANCE LOANS TO GRADUATE 
                                STUDENTS

Sec. 141. Health Education Assistance Loan Program.
Sec. 142. HEAL lender and holder performance standards.
Sec. 143. Insurance Program.
Sec. 144. HEAL bankruptcy.
Sec. 145. HEAL refinancing.

                   TITLE II--OFFICE OF MINORITY HEALTH

Sec. 201. Revision and extension of programs of Office of Minority 
           Health.

[[Page 112 STAT. 3525]]

                     TITLE III--SELECTED INITIATIVES

Sec. 301. State offices of rural health.
Sec. 302. Demonstration projects regarding Alzheimer's Disease.
Sec. 303. Project grants for immunization services.

                   TITLE IV--MISCELLANEOUS PROVISIONS

Sec. 401. Technical corrections regarding Public Law 103-183.
Sec. 402. Miscellaneous amendments regarding PHS commissioned officers.
Sec. 403. Clinical traineeships.
Sec. 404. Project grants for screenings, referrals, and education 
           regarding lead poisoning.
Sec. 405. Project grants for preventive health services regarding 
           tuberculosis.
Sec. 406. CDC loan repayment program.
Sec. 407. Community programs on domestic violence.
Sec. 408. State loan repayment program.
Sec. 409. Authority of the director of NIH.
Sec. 410. Raise in maximum level of loan repayments.
Sec. 411. Construction of regional centers for research on primates.
Sec. 412. Peer review.
Sec. 413. Funding for trauma care.
Sec. 414. Health information and health promotion.
Sec. 415. Emergency medical services for children.
Sec. 416. Administration of certain requirements.
Sec. 417. Aids drug assistance program.
Sec. 418. National Foundation for Biomedical Research.
Sec. 419. Fetal Alcohol Syndrome prevention and services.

 TITLE I--HEALTH PROFESSIONS EDUCATION AND FINANCIAL ASSISTANCE PROGRAMS

            Subtitle A--Health Professions Education Programs

SEC. 101. UNDER-REPRESENTED MINORITY HEALTH PROFESSIONS GRANT 
                        PROGRAM.

    (a) In General.--Part B of title VII of the Public Health Service 
Act (42 U.S.C. 293 et seq.) is amended to read as follows:

           ``PART B--HEALTH PROFESSIONS TRAINING FOR DIVERSITY

``SEC. 736. <<NOTE: 42 USC 293.>> CENTERS OF EXCELLENCE.

    ``(a) In General.--The Secretary shall make grants to, and enter 
into contracts with, designated health professions schools described in 
subsection (c), and other public and nonprofit health or educational 
entities, for the purpose of assisting the schools in supporting 
programs of excellence in health professions education for under-
represented minority individuals.
    ``(b) Required Use of Funds.--The Secretary may not make a grant 
under subsection (a) unless the designated health professions school 
involved agrees, subject to subsection (c)(1)(C), to expend the grant--
            ``(1) to develop a large competitive applicant pool through 
        linkages with institutions of higher education, local school 
        districts, and other community-based entities and establish an 
        education pipeline for health professions careers;
            ``(2) to establish, strengthen, or expand programs to 
        enhance the academic performance of under-represented minority 
        students attending the school;

[[Page 112 STAT. 3526]]

            ``(3) to improve the capacity of such school to train, 
        recruit, and retain under-represented minority faculty including 
        the payment of such stipends and fellowships as the Secretary 
        may determine appropriate;
            ``(4) to carry out activities to improve the information 
        resources, clinical education, curricula and cultural competence 
        of the graduates of the school, as it relates to minority health 
        issues;
            ``(5) to facilitate faculty and student research on health 
        issues particularly affecting under-represented minority groups, 
        including research on issues relating to the delivery of health 
        care;
            ``(6) to carry out a program to train students of the school 
        in providing health services to a significant number of under-
        represented minority individuals through training provided to 
        such students at community-based health facilities that--
                    ``(A) provide such health services; and
                    ``(B) are located at a site remote from the main 
                site of the teaching facilities of the school; and
            ``(7) to provide stipends as the Secretary determines 
        appropriate, in amounts as the Secretary determines appropriate.

    ``(c) Centers of Excellence.--
            ``(1) Designated schools.--
                    ``(A) In general.--The designated health professions 
                schools referred to in subsection (a) are such schools 
                that meet each of the conditions specified in 
                subparagraphs (B) and (C), and that--
                          ``(i) meet each of the conditions specified in 
                      paragraph (2)(A);
                          ``(ii) meet each of the conditions specified 
                      in paragraph (3);
                          ``(iii) meet each of the conditions specified 
                      in paragraph (4); or
                          ``(iv) meet each of the conditions specified 
                      in paragraph (5).
                    ``(B) General conditions.--The conditions specified 
                in this subparagraph are that a designated health 
                professions school--
                          ``(i) has a significant number of under-
                      represented minority individuals enrolled in the 
                      school, including individuals accepted for 
                      enrollment in the school;
                          ``(ii) has been effective in assisting under-
                      represented minority students of the school to 
                      complete the program of education and receive the 
                      degree involved;
                          ``(iii) has been effective in recruiting 
                      under-represented minority individuals to enroll 
                      in and graduate from the school, including 
                      providing scholarships and other financial 
                      assistance to such individuals and encouraging 
                      under-represented minority students from all 
                      levels of the educational pipeline to pursue 
                      health professions careers; and
                          ``(iv) has made significant recruitment 
                      efforts to increase the number of under-
                      represented minority individuals serving in 
                      faculty or administrative positions at the school.

[[Page 112 STAT. 3527]]

                    ``(C) Consortium.--The condition specified in this 
                subparagraph is that, in accordance with subsection 
                (e)(1), the designated health profession school involved 
                has with other health profession schools (designated or 
                otherwise) formed a consortium to carry out the purposes 
                described in subsection (b) at the schools of the 
                consortium.
                    ``(D) Application of criteria to other programs.--In 
                the case of any criteria established by the Secretary 
                for purposes of determining whether schools meet the 
                conditions described in subparagraph (B), this section 
                may not, with respect to racial and ethnic minorities, 
                be construed to authorize, require, or prohibit the use 
                of such criteria in any program other than the program 
                established in this section.
            ``(2) Centers of excellence at certain historically black 
        colleges and universities.--
                    ``(A) Conditions.--The conditions specified in this 
                subparagraph are that a designated health professions 
                school--
                          ``(i) is a school described in section 
                      799B(1); and
                          ``(ii) received a contract under section 788B 
                      for fiscal year 1987, as such section was in 
                      effect for such fiscal year.
                    ``(B) Use of grant.--In addition to the purposes 
                described in subsection (b), a grant under subsection 
                (a) to a designated health professions school meeting 
                the conditions described in subparagraph (A) may be 
                expended--
                          ``(i) to develop a plan to achieve 
                      institutional improvements, including financial 
                      independence, to enable the school to support 
                      programs of excellence in health professions 
                      education for under-represented minority 
                      individuals; and
                          ``(ii) to provide improved access to the 
                      library and informational resources of the school.
                    ``(C) Exception.--The requirements of paragraph 
                (1)(C) shall not apply to a historically black college 
                or university that receives funding under paragraphs (2) 
                or (5).
            ``(3) Hispanic centers of excellence.--The conditions 
        specified in this paragraph are that--
                    ``(A) with respect to Hispanic individuals, each of 
                clauses (i) through (iv) of paragraph (1)(B) applies to 
                the designated health professions school involved;
                    ``(B) the school agrees, as a condition of receiving 
                a grant under subsection (a), that the school will, in 
                carrying out the duties described in subsection (b), 
                give priority to carrying out the duties with respect to 
                Hispanic individuals; and
                    ``(C) the school agrees, as a condition of receiving 
                a grant under subsection (a), that--
                          ``(i) the school will establish an arrangement 
                      with 1 or more public or nonprofit community based 
                      Hispanic serving organizations, or public or 
                      nonprofit private institutions of higher 
                      education, including schools

[[Page 112 STAT. 3528]]

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

[[Page 112 STAT. 3529]]

                    ``(B) that the health professions school involved 
                has an enrollment of under-represented minorities above 
                the national average for such enrollments of health 
                professions schools.

    ``(d) Designation as Center of Excellence.--
            ``(1) In general.--Any designated health professions school 
        receiving a grant under subsection (a) and meeting the 
        conditions described in paragraph (2) or (5) of subsection (c) 
        shall, for purposes of this section, be designated by the 
        Secretary as a Center of Excellence in Under-Represented 
        Minority Health Professions Education.
            ``(2) Hispanic centers of excellence.--Any designated health 
        professions school receiving a grant under subsection (a) and 
        meeting the conditions described in subsection (c)(3) shall, for 
        purposes of this section, be designated by the Secretary as a 
        Hispanic Center of Excellence in Health Professions Education.
            ``(3) Native american centers of excellence.--Any designated 
        health professions school receiving a grant under subsection (a) 
        and meeting the conditions described in subsection (c)(4) shall, 
        for purposes of this section, be designated by the Secretary as 
        a Native American Center of Excellence in Health Professions 
        Education. Any consortium receiving such a grant pursuant to 
        subsection (e) shall, for purposes of this section, be so 
        designated.

    ``(e) Authority Regarding Native American Centers of Excellence.--
With respect to meeting the conditions specified in subsection (c)(4), 
the Secretary may make a grant under subsection (a) to a designated 
health professions school that does not meet such conditions if--
            ``(1) the school has formed a consortium in accordance with 
        subsection (d)(1); and
            ``(2) the schools of the consortium collectively meet such 
        conditions, without regard to whether the schools individually 
        meet such conditions.

    ``(f) 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 Secretary and to the 
availability of appropriations for the fiscal year involved to make the 
payments.
    ``(g) Definitions.--In this section:
            ``(1) Designated health professions school.--
                    ``(A) In general.--The term `health professions 
                school' means, except as provided in subparagraph (B), a 
                school of medicine, a school of osteopathic medicine, a 
                school of dentistry, a school of pharmacy, or a graduate 
                program in behavioral or mental health.
                    ``(B) Exception.--The definition established in 
                subparagraph (A) shall not apply to the use of the term 
                `designated health professions school' for purposes of 
                subsection (c)(2).
            ``(2) Program of excellence.--The term `program of 
        excellence' means any program carried out by a designated health 
        professions school with a grant made under subsection (a), if 
        the program is for purposes for which the school involved is 
        authorized in subsection (b) or (c) to expend the grant.

[[Page 112 STAT. 3530]]

            ``(3) Native americans.--The term `Native Americans' means 
        American Indians, Alaskan Natives, Aleuts, and Native Hawaiians.

    ``(h) Funding.--
            ``(1) Authorization of appropriations.--For the purpose of 
        making grants under subsection (a), there are authorized to be 
        appropriated $26,000,000 for fiscal year 1998, and such sums as 
        may be necessary for each of the fiscal years 1999 through 2002.
            ``(2) Allocations.--Based on the amount appropriated under 
        paragraph (1) for a fiscal year, one of the following 
        subparagraphs shall apply:
                    ``(A) In general.--If the amounts appropriated under 
                paragraph (1) for a fiscal year are $24,000,000 or 
                less--
                          ``(i) the Secretary shall make available 
                      $12,000,000 for grants under subsection (a) to 
                      health professions schools that meet the 
                      conditions described in subsection (c)(2)(A); and
                          ``(ii) and available after grants are made 
                      with funds under clause (i), the Secretary shall 
                      make available--
                                    ``(I) 60 percent of such amount for 
                                grants under subsection (a) to health 
                                professions schools that meet the 
                                conditions described in paragraph (3) or 
                                (4) of subsection (c) (including meeting 
                                the conditions under subsection (e)); 
                                and
                                    ``(II) 40 percent of such amount for 
                                grants under subsection (a) to health 
                                professions schools that meet the 
                                conditions described in subsection 
                                (c)(5).
                    ``(B) Funding in excess of $24,000,000.--If amounts 
                appropriated under paragraph (1) for a fiscal year 
                exceed $24,000,000 but are less than $30,000,000--
                          ``(i) 80 percent of such excess amounts shall 
                      be made available for grants under subsection (a) 
                      to health professions schools that meet the 
                      requirements described in paragraph (3) or (4) of 
                      subsection (c) (including meeting conditions 
                      pursuant to subsection (e)); and
                          ``(ii) 20 percent of such excess amount shall 
                      be made available for grants under subsection (a) 
                      to health professions schools that meet the 
                      conditions described in subsection (c)(5).
                    ``(C) Funding in excess of $30,000,000.--If amounts 
                appropriated under paragraph (1) for a fiscal year are 
                $30,000,000 or more, the Secretary shall make 
                available--
                          ``(i) not less than $12,000,000 for grants 
                      under subsection (a) to health professions schools 
                      that meet the conditions described in subsection 
                      (c)(2)(A);
                          ``(ii) not less than $12,000,000 for grants 
                      under subsection (a) to health professions schools 
                      that meet the conditions described in paragraph 
                      (3) or (4) of subsection (c) (including meeting 
                      conditions pursuant to subsection (e));
                          ``(iii) not less than $6,000,000 for grants 
                      under subsection (a) to health professions schools 
                      that meet the conditions described in subsection 
                      (c)(5); and

[[Page 112 STAT. 3531]]

                          ``(iv) after grants are made with funds under 
                      clauses (i) through (iii), any remaining funds for 
                      grants under subsection (a) to health professions 
                      schools that meet the conditions described in 
                      paragraph (2)(A), (3), (4), or (5) of subsection 
                      (c).
            ``(3) No limitation.--Nothing in this subsection shall be 
        construed as limiting the centers of excellence referred to in 
        this section to the designated amount, or to preclude such 
        entities from competing for other grants under this section.
            ``(4) Maintenance of effort.--
                    ``(A) In general.--With respect to activities for 
                which a grant made under this part are authorized to be 
                expended, the Secretary may not make such a grant to a 
                center of excellence for any fiscal year unless the 
                center agrees to maintain expenditures of non-Federal 
                amounts for such activities at a level that is not less 
                than the level of such expenditures maintained by the 
                center for the fiscal year preceding the fiscal year for 
                which the school receives such a grant.
                    ``(B) Use of federal funds.--With respect to any 
                Federal amounts received by a center of excellence and 
                available for carrying out activities for which a grant 
                under this part is authorized to be expended, the 
                Secretary may not make such a grant to the center for 
                any fiscal year unless the center agrees that the center 
                will, before expending the grant, expend the Federal 
                amounts obtained from sources other than the grant.

``SEC. 737. <<NOTE: 42 USC 293a.>> SCHOLARSHIPS FOR DISADVANTAGED 
            STUDENTS.

    ``(a) In General.--The Secretary may make a grant to an eligible 
entity (as defined in subsection (d)(1)) under this section for the 
awarding of scholarships by schools to any full-time student who is an 
eligible individual as defined in subsection (d). Such scholarships may 
be expended only for tuition expenses, other reasonable educational 
expenses, and reasonable living expenses incurred in the attendance of 
such school.
    ``(b) Preference in Providing Scholarships.--The Secretary may not 
make a grant to an entity under subsection (a) unless the health 
professions and nursing schools involved agree that, in providing 
scholarships pursuant to the grant, the schools will give preference to 
students for whom the costs of attending the schools would constitute a 
severe financial hardship and, notwithstanding other provisions of this 
section, to former recipients of scholarships under sections 736 and 
740(d)(2)(B) (as such sections existed on the day before the date of 
enactment of this section).
    ``(c) Amount of Award.--In awarding grants to eligible entities that 
are health professions and nursing schools, the Secretary shall give 
priority to eligible entities based on the proportion of graduating 
students going into primary care, the proportion of underrepresented 
minority students, and the proportion of graduates working in medically 
underserved communities.
    ``(d) Definitions.--In this section:
            ``(1) Eligible entities.--The term `eligible entities' means 
        an entity that--
                    ``(A) is a school of medicine, osteopathic medicine, 
                dentistry, nursing (as defined in section 801), 
                pharmacy, podiatric medicine, optometry, veterinary 
                medicine, public

[[Page 112 STAT. 3532]]

                health, chiropractic, or allied health, a school 
                offering a graduate program in behavioral and mental 
                health practice, or an entity providing programs for the 
                training of physician assistants; and
                    ``(B) is carrying out a program for recruiting and 
                retaining students from disadvantaged backgrounds, 
                including students who are members of racial and ethnic 
                minority groups.
            ``(2) Eligible individual.--The term `eligible individual' 
        means an individual who--
                    ``(A) is from a disadvantaged background;
                    ``(B) has a financial need for a scholarship; and
                    ``(C) is enrolled (or accepted for enrollment) at an 
                eligible health professions or nursing school as a full-
                time student in a program leading to a degree in a 
                health profession or nursing.
``SEC. 738. <<NOTE: 42 USC 293b.>> LOAN REPAYMENTS AND FELLOWSHIPS 
                          REGARDING FACULTY POSITIONS.

    ``(a) Loan Repayments.--
            ``(1) Establishment <<NOTE: Contracts.>> of program.--The 
        Secretary shall establish a program of entering into contracts 
        with individuals described in paragraph (2) under which the 
        individuals agree to serve as members of the faculties of 
        schools described in paragraph (3) in consideration of the 
        Federal Government agreeing to pay, for each year of such 
        service, not more than $20,000 of the principal and interest of 
        the educational loans of such individuals.
            ``(2) Eligible individuals.--The individuals referred to in 
        paragraph (1) are individuals from disadvantaged backgrounds 
        who--
                    ``(A) have a degree in medicine, osteopathic 
                medicine, dentistry, nursing, or another health 
                profession;
                    ``(B) are enrolled in an approved graduate training 
                program in medicine, osteopathic medicine, dentistry, 
                nursing, or other health profession; or
                    ``(C) are enrolled as full-time students--
                          ``(i) in an accredited (as determined by the 
                      Secretary) school described in paragraph (3); and
                          ``(ii) in the final year of a course of a 
                      study or program, offered by such institution and 
                      approved by the Secretary, leading to a degree 
                      from such a school.
            ``(3) Eligible health professions schools.--The schools 
        described in this paragraph are schools of medicine, nursing (as 
        schools of nursing are defined in section 801), osteopathic 
        medicine, dentistry, pharmacy, allied health, podiatric 
        medicine, optometry, veterinary medicine, or public health, or 
        schools offering graduate programs in behavioral and mental 
        health.
            ``(4) Requirements regarding faculty positions.--The 
        Secretary may not enter into a contract under paragraph (1) 
        unless--
                    ``(A) the individual involved has entered into a 
                contract with a school described in paragraph (3) to 
                serve as a member of the faculty of the school for not 
                less than 2 years; and

[[Page 112 STAT. 3533]]

                    ``(B) the contract referred to in subparagraph (A) 
                provides that--
                          ``(i) the school will, for each year for which 
                      the individual will serve as a member of the 
                      faculty under the contract with the school, make 
                      payments of the principal and interest due on the 
                      educational loans of the individual for such year 
                      in an amount equal to the amount of such payments 
                      made by the Secretary for the year;
                          ``(ii) the payments made by the school 
                      pursuant to clause (i) on behalf of the individual 
                      will be in addition to the pay that the individual 
                      would otherwise receive for serving as a member of 
                      such faculty; and
                          ``(iii) the school, in making a determination 
                      of the amount of compensation to be provided by 
                      the school to the individual for serving as a 
                      member of the faculty, will make the determination 
                      without regard to the amount of payments made (or 
                      to be made) to the individual by the Federal 
                      Government under paragraph (1).
            ``(5) Applicability of certain provisions.--The provisions 
        of sections 338C, 338G, and 338I shall apply to the program 
        established in paragraph (1) 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, including the applicability of provisions 
        regarding reimbursements for increased tax liability and 
        regarding bankruptcy.
            ``(6) Waiver regarding school contributions.--The Secretary 
        may waive the requirement established in paragraph (4)(B) if the 
        Secretary determines that the requirement will impose an undue 
        financial hardship on the school involved.

    ``(b) Fellowships.--
            ``(1) In general.--The Secretary may make grants to and 
        enter into contracts with eligible entities to assist such 
        entities in increasing the number of underrepresented minority 
        individuals who are members of the faculty of such schools.
            ``(2) Applications.--To be eligible to receive a grant or 
        contract under this subsection, an entity shall provide an 
        assurance, in the application submitted by the entity, that--
                    ``(A) amounts received under such a grant or 
                contract will be used to award a fellowship to an 
                individual only if the individual meets the requirements 
                of paragraphs (3) and (4); and
                    ``(B) each fellowship awarded pursuant to the grant 
                or contract will include--
                          ``(i) a stipend in an amount not exceeding 50 
                      percent of the regular salary of a similar faculty 
                      member for not to exceed 3 years of training; and
                          ``(ii) an allowance for other expenses, such 
                      as travel to professional meetings and costs 
                      related to specialized training.
            ``(3) Eligibility.--To be eligible to receive a grant or 
        contract under paragraph (1), an applicant shall demonstrate to 
        the Secretary that such applicant has or will have the ability 
        to--

[[Page 112 STAT. 3534]]

                    ``(A) identify, recruit and select underrepresented 
                minority individuals who have the potential for 
                teaching, administration, or conducting research at a 
                health professions institution;
                    ``(B) provide such individuals with the skills 
                necessary to enable them to secure a tenured faculty 
                position at such institution, which may include training 
                with respect to pedagogical skills, program 
                administration, the design and conduct of research, 
                grants writing, and the preparation of articles suitable 
                for publication in peer reviewed journals;
                    ``(C) provide services designed to assist such 
                individuals in their preparation for an academic career, 
                including the provision of counselors; and
                    ``(D) provide health services to rural or medically 
                underserved populations.
            ``(4) Requirements.--To be eligible to receive a grant or 
        contract under paragraph (1) an applicant shall--
                    ``(A) provide an assurance that such applicant will 
                make available (directly through cash donations) $1 for 
                every $1 of Federal funds received under this section 
                for the fellowship;
                    ``(B) provide an assurance that institutional 
                support will be provided for the individual for the 
                second and third years at a level that is equal to the 
                total amount of institutional funds provided in the year 
                in which the grant or contract was awarded;
                    ``(C) provide an assurance that the individual that 
                will receive the fellowship will be a member of the 
                faculty of the applicant school; and
                    ``(D) provide an assurance that the individual that 
                will receive the fellowship will have, at a minimum, 
                appropriate advanced preparation (such as a master's or 
                doctoral degree) and special skills necessary to enable 
                such individual to teach and practice.
            ``(5) Definition.--For purposes of this subsection, the term 
        `underrepresented minority individuals' means individuals who 
        are members of racial or ethnic minority groups that are 
        underrepresented in the health professions including nursing.
``SEC. 739. <<NOTE: 42 USC 293c.>> EDUCATIONAL ASSISTANCE IN THE 
                          HEALTH PROFESSIONS REGARDING INDIVIDUALS 
                          FROM DISADVANTAGED BACKGROUNDS.

    ``(a) In General.--
            ``(1) Authority for grants.--For the purpose of assisting 
        individuals from disadvantaged backgrounds, as determined in 
        accordance with criteria prescribed by the Secretary, to 
        undertake education to enter a health profession, the Secretary 
        may make grants to and enter into contracts with schools of 
        medicine, osteopathic medicine, public health, dentistry, 
        veterinary medicine, optometry, pharmacy, allied health, 
        chiropractic, and podiatric medicine, public and nonprofit 
        private schools that offer graduate programs in behavioral and 
        mental health, programs for the training of physician 
        assistants, and other public or private nonprofit health or 
        educational entities to assist in meeting the costs described in 
        paragraph (2).

[[Page 112 STAT. 3535]]

            ``(2) Authorized expenditures.--A grant or contract under 
        paragraph (1) may be used by the entity to meet the cost of--
                    ``(A) identifying, recruiting, and selecting 
                individuals from disadvantaged backgrounds, as so 
                determined, for education and training in a health 
                profession;
                    ``(B) facilitating the entry of such individuals 
                into such a school;
                    ``(C) providing counseling, mentoring, or other 
                services designed to assist such individuals to complete 
                successfully their education at such a school;
                    ``(D) providing, for a period prior to the entry of 
                such individuals into the regular course of education of 
                such a school, preliminary education and health research 
                training designed to assist them to complete 
                successfully such regular course of education at such a 
                school, or referring such individuals to institutions 
                providing such preliminary education;
                    ``(E) publicizing existing sources of financial aid 
                available to students in the education program of such a 
                school or who are undertaking training necessary to 
                qualify them to enroll in such a program;
                    ``(F) paying such scholarships as the Secretary may 
                determine for such individuals for any period of health 
                professions education at a health professions school;
                    ``(G) paying such stipends as the Secretary may 
                approve for such individuals for any period of education 
                in student-enhancement programs (other than regular 
                courses), except that such a stipend may not be provided 
                to an individual for more than 12 months, and such a 
                stipend shall be in an amount determined appropriate by 
                the Secretary (notwithstanding any other provision of 
                law regarding the amount of stipends);
                    ``(H) carrying out programs under which such 
                individuals gain experience regarding a career in a 
                field of primary health care through working at 
                facilities of public or private nonprofit community-
                based providers of primary health services; and
                    ``(I) conducting activities to develop a larger and 
                more competitive applicant pool through partnerships 
                with institutions of higher education, school districts, 
                and other community-based entities.
            ``(3) Definition.--In this section, the term `regular course 
        of education of such a school' as used in subparagraph (D) 
        includes a graduate program in behavioral or mental health.

    ``(b) Requirements for Awards.--In making awards to eligible 
entities under subsection (a)(1), the Secretary shall give preference to 
approved applications for programs that involve a comprehensive approach 
by several public or nonprofit private health or educational entities to 
establish, enhance and expand educational programs that will result in 
the development of a competitive applicant pool of individuals from 
disadvantaged backgrounds who desire to pursue health professions 
careers. In considering awards for such a comprehensive partnership 
approach, the following shall apply with respect to the entity involved:
            ``(1) The entity shall have a demonstrated commitment to 
        such approach through formal agreements that have common

[[Page 112 STAT. 3536]]

        objectives with institutions of higher education, school 
        districts, and other community-based entities.
            ``(2) Such formal agreements shall reflect the coordination 
        of educational activities and support services, increased 
        linkages, and the consolidation of resources within a specific 
        geographic area.
            ``(3) The design of the educational activities involved 
        shall provide for the establishment of a competitive health 
        professions applicant pool of individuals from disadvantaged 
        backgrounds by enhancing the total preparation (academic and 
        social) of such individuals to pursue a health professions 
        career.
            ``(4) The programs or activities under the award shall focus 
        on developing a culturally competent health care workforce that 
        will serve the unserved and underserved populations within the 
        geographic area.

    ``(c) Equitable Allocation of Financial Assistance.--The Secretary, 
to the extent practicable, shall ensure that services and activities 
under subsection (a) are adequately allocated among the various racial 
and ethnic populations who are from disadvantaged backgrounds.
    ``(d) Matching Requirements.--The Secretary may require that an 
entity that applies for a grant or contract under subsection (a), 
provide non-Federal matching funds, as appropriate, to ensure the 
institutional commitment of the entity to the projects funded under the 
grant or contract. As determined by the Secretary, such non-Federal 
matching funds may be provided directly or through donations from public 
or private entities and may be in cash or in-kind, fairly evaluated, 
including plant, equipment, or services.

``SEC. 740. <<NOTE: 42 USC 293d.>> AUTHORIZATION OF APPROPRIATION.

    11(a) Scholarships.--There are authorized to be appropriated to 
carry out section 737, $37,000,000 for fiscal year 1998, and such sums 
as may be necessary for each of the fiscal years 1999 through 2002. Of 
the amount appropriated in any fiscal year, the Secretary shall ensure 
that not less than 16 percent shall be distributed to schools of 
nursing.
    ``(b) Loan Repayments and Fellowships.--For the purpose of carrying 
out section 738, there is authorized to be appropriated $1,100,000 for 
fiscal year 1998, and such sums as may be necessary for each of the 
fiscal years 1999 through 2002.
    ``(c) Educational Assistance in Health Professions Regarding 
Individuals for Disadvantaged Backgrounds.--For the purpose of grants 
and contracts under section 739(a)(1), there is authorized to be 
appropriated $29,400,000 for fiscal year 1998, and such sums as may be 
necessary for each of the fiscal years 1999 through 2002. The Secretary 
may use not to exceed 20 percent of the amount appropriated for a fiscal 
year under this subsection to provide scholarships under section 
739(a)(2)(F).
    ``(d) Report.--Not <<NOTE: Deadline.>> later than 6 months after the 
date of enactment of this part, the Secretary shall prepare and submit 
to the appropriate committees of Congress a report concerning the 
efforts of the Secretary to address the need for a representative mix of 
individuals from historically minority health professions schools, or 
from institutions or other entities that historically or by geographic 
location have a demonstrated record of training or educating 
underrepresented minorities, within various health professions 
disciplines, on peer review councils.''.

[[Page 112 STAT. 3537]]

    (b) Repeal.--
            (1) In general.--Section 795 of the Public Health Service 
        Act (42 U.S.C. 295n) is repealed.
            (2) Nontermination <<NOTE: 42 USC 295n note.>> of 
        authority.--The amendments made by this section shall not be 
        construed to terminate agreements that, on the day before the 
        date of enactment of this Act, are in effect pursuant to section 
        795 of the Public Health Service Act (42 U.S.C. 795) as such 
        section existed on such date. Such agreements shall continue in 
        effect in accordance with the terms of the agreements. With 
        respect to compliance with such agreements, any period of 
        practice as a provider of primary health services shall be 
        counted towards the satisfaction of the requirement of practice 
        pursuant to such section 795.

    (c) Conforming Amendments.--Section 481A(c)(3)(D)(i) of the Public 
Health Service Act (42 U.S.C. 287a-2(c)(3)(D)(i)) is amended by striking 
``section 739'' and inserting ``part B of title VII''.

SEC. 102. TRAINING IN PRIMARY CARE MEDICINE AND DENTISTRY.

    Part C of title VII of the Public Health Service Act (42 U.S.C. 293 
et seq.) is amended--
            (1) in the part heading by striking ``PRIMARY HEALTH CARE'' 
        and inserting ``FAMILY MEDICINE, GENERAL INTERNAL MEDICINE, 
        GENERAL PEDIATRICS, PHYSICIAN ASSISTANTS, GENERAL DENTISTRY, AND 
        PEDIATRIC DENTISTRY'';
            (2) by repealing section 746 (42 U.S.C. 293j);
            (3) in section 747 (42 U.S.C. 293k)--
                    (A) by striking the section heading and inserting 
                the following:
``SEC. 747. FAMILY MEDICINE, GENERAL INTERNAL MEDICINE, GENERAL 
                          PEDIATRICS, GENERAL DENTISTRY, PEDIATRIC 
                          DENTISTRY, AND PHYSICIAN ASSISTANTS.'';
                    (B) in subsection (a)--
                          (i) in paragraph (1)--
                                    (I) by inserting ``, internal 
                                medicine, or pediatrics'' after ``family 
                                medicine''; and
                                    (II) by inserting before the 
                                semicolon the following: ``that 
                                emphasizes training for the practice of 
                                family medicine, general internal 
                                medicine, or general pediatrics (as 
                                defined by the Secretary)'';
                          (ii) in paragraph (2), by inserting ``, 
                      general internal medicine, or general pediatrics'' 
                      before the semicolon;
                          (iii) in paragraphs (3) and (4), by inserting 
                      ``(including geriatrics), general internal 
                      medicine or general pediatrics'' after ``family 
                      medicine'';
                          (iv) in paragraph (3), by striking ``and'' at 
                      the end thereof;
                          (v) in paragraph (4), by striking the period 
                      and inserting a semicolon; and
                          (vii) by adding at the end thereof the 
                      following new paragraphs:
            ``(5) to meet the costs of projects to plan, develop, and 
        operate or maintain programs for the training of physician 
        assistants (as defined in section 799B), and for the training

[[Page 112 STAT. 3538]]

        of individuals who will teach in programs to provide such 
        training; and
            ``(6) to meet the costs of planning, developing, or 
        operating programs, and to provide financial assistance to 
        residents in such programs, of general dentistry or pediatric 
        dentistry.

For purposes of paragraph (6), entities eligible for such grants or 
contracts shall include entities that have programs in dental schools, 
approved residency programs in the general or pediatric practice of 
dentistry, approved advanced education programs in the general or 
pediatric practice of dentistry, or approved residency programs in 
pediatric dentistry.'';
                    (C) in subsection (b)--
                          (i) in paragraphs (1) and (2)(A), by inserting 

                      ``, general internal medicine, or general 
                      pediatrics'' after ``family medicine'';
                          (ii) in paragraph (2)--
                                    (I) in subparagraph (A), by striking 
                                ``or'' at the end; and
                                    (II) in subparagraph (B), by 
                                striking the period and inserting ``; 
                                or''; and
                          (iii) by adding at the end the following:
            ``(3) Priority in making awards.--In making awards of grants 
        and contracts under paragraph (1), the Secretary shall give 
        priority to any qualified applicant for such an award that 
        proposes a collaborative project between departments of primary 
        care.'';
                    (D) by redesignating subsections (c) and (d) as 
                subsections (d) and (e), respectively;
                    (E) by inserting after subsection (b), the following 
                new subsection:

    ``(c) Priority.--
            ``(1) In general.--With respect to programs for the training 
        of interns or residents, the Secretary shall give priority in 
        awarding grants under this section to qualified applicants that 
        have a record of training the greatest percentage of providers, 
        or that have demonstrated significant improvements in the 
        percentage of providers, which enter and remain in primary care 
        practice or general or pediatric dentistry.
            ``(2) Disadvantaged individuals.--With respect to programs 
        for the training of interns, residents, or physician assistants, 
        the Secretary shall give priority in awarding grants under this 
        section to qualified applicants that have a record of training 
        individuals who are from disadvantaged backgrounds (including 
        racial and ethnic minorities underrepresented among primary care 
        practice or general or pediatric dentistry).
            ``(3) Special consideration.--In awarding grants under this 
        section the Secretary shall give special consideration to 
        projects which prepare practitioners to care for underserved 
        populations and other high risk groups such as the elderly, 
        individuals with HIV-AIDS, substance abusers, homeless, and 
        victims of domestic violence.''; and
                    (F) in subsection (e) (as so redesignated by 
                subparagraph (D))--
                          (i) in paragraph (1), by striking 
                      ``$54,000,000'' and all that follows and inserting 
                      ``$78,300,000 for fiscal year 1998, and such sums 
                      as may be necessary for each of the fiscal years 
                      1999 through 2002.''; and

[[Page 112 STAT. 3539]]

                          (ii) by striking paragraph (2) and inserting 
                      the following:
            ``(2) Allocation.--
                    ``(A) In general.--Of the amounts appropriated under 
                paragraph (1) for a fiscal year, the Secretary shall 
                make available--
                          ``(i) not less than $49,300,000 for awards of 
                      grants and contracts under subsection (a) to 
                      programs of family medicine, of which not less 
                      than $8,600,000 shall be made available for awards 
                      of grants and contracts under subsection (b) for 
                      family medicine academic administrative units;
                          ``(ii) not less than $17,700,000 for awards of 
                      grants and contracts under subsection (a) to 
                      programs of general internal medicine and general 
                      pediatrics;
                          ``(iii) not less than $6,800,000 for awards of 
                      grants and contracts under subsection (a) to 
                      programs relating to physician assistants; and
                          ``(iv) not less than $4,500,000 for awards of 
                      grants and contracts under subsection (a) to 
                      programs of general or pediatric dentistry.
                    ``(B) Ratable reduction.--If amounts appropriated 
                under paragraph (1) for any fiscal year are less than 
                the amount required to comply with subparagraph (A), the 
                Secretary shall ratably reduce the amount to be made 
                available under each of clauses (i) through (iv) of such 
                subparagraph accordingly.''; and
            (4) by repealing sections 748 through 752 (42 U.S.C. 293l 
        through 293p) and inserting the following:
``SEC. 748. <<NOTE: 42 USC 293l.>> ADVISORY COMMITTEE ON TRAINING 
                          IN PRIMARY CARE MEDICINE AND DENTISTRY.

    ``(a) Establishment.--The Secretary shall establish an advisory 
committee to be known as the Advisory Committee on Training in Primary 
Care Medicine and Dentistry (in this section referred to as the 
`Advisory Committee').
    ``(b) Composition.--
            ``(1) In general.--The Secretary shall determine the 
        appropriate number of individuals to serve on the Advisory 
        Committee. Such individuals shall not be officers or employees 
        of the Federal Government.
            ``(2) Appointment.--Not <<NOTE: Deadline.>> later than 90 
        days after the date of enactment of this Act, the Secretary 
        shall appoint the members of the Advisory Committee from among 
        individuals who are health professionals. In making such 
        appointments, the Secretary shall ensure a fair balance between 
        the health professions, that at least 75 percent of the members 
        of the Advisory Committee are health professionals, a broad 
        geographic representation of members and a balance between urban 
        and rural members. Members shall be appointed based on their 
        competence, interest, and knowledge of the mission of the 
        profession involved.
            ``(3) Minority representation.--In appointing the members of 
        the Advisory Committee under paragraph (2), the Secretary shall 
        ensure the adequate representation of women and minorities.

    ``(c) Terms.--

[[Page 112 STAT. 3540]]

            ``(1) In general.--A member of the Advisory Committee shall 
        be appointed for a term of 3 years, except that of the members 
        first appointed--
                    ``(A) \1/3\ of such members shall serve for a term 
                of 1 year;
                    ``(B) \1/3\ of such members shall serve for a term 
                of 2 years; and
                    ``(C) \1/3\ of such members shall serve for a term 
                of 3 years.
            ``(2) Vacancies.--
                    ``(A) In general.--A vacancy on the Advisory 
                Committee shall be filled in the manner in which the 
                original appointment was made and shall be subject to 
                any conditions which applied with respect to the 
                original appointment.
                    ``(B) Filling unexpired term.--An individual chosen 
                to fill a vacancy shall be appointed for the unexpired 
                term of the member replaced.

    ``(d) Duties.--The Advisory Committee shall--
            ``(1) provide advice and recommendations to the Secretary 
        concerning policy and program development and other matters of 
        significance concerning the activities under section 747; and
            ``(2) not later than 3 years after the date of enactment of 
        this section, and annually thereafter, prepare and submit to the 
        Secretary, and the Committee on Labor and Human Resources of the 
        Senate, and the Committee on Commerce of the House of 
        Representatives, a report describing the activities of the 
        Committee, including findings and recommendations made by the 
        Committee concerning the activities under section 747.

    ``(e) Meetings and Documents.--
            ``(1) Meetings.--The Advisory Committee shall meet not less 
        than 2 times each year. Such meetings shall be held jointly with 
        other related entities established under this title where 
        appropriate.
            ``(2) Documents.--Not <<NOTE: Deadline.>> later than 14 days 
        prior to the convening of a meeting under paragraph (1), the 
        Advisory Committee shall prepare and make available an agenda of 
        the matters to be considered by the Advisory Committee at such 
        meeting. At any such meeting, the Advisory Council shall 
        distribute materials with respect to the issues to be addressed 
        at the meeting. Not later than 30 days after the adjourning of 
        such a meeting, the Advisory Committee shall prepare and make 
        available a summary of the meeting and any actions taken by the 
        Committee based upon the meeting.

    ``(f) Compensation and Expenses.--
            ``(1) Compensation.--Each member of the Advisory Committee 
        shall be compensated at a rate equal to the daily equivalent of 
        the annual rate of basic pay prescribed for level IV of the 
        Executive Schedule under section 5315 of title 5, United States 
        Code, for each day (including travel time) during which such 
        member is engaged in the performance of the duties of the 
        Committee.
            ``(2) Expenses.--The members of the Advisory Committee shall 
        be allowed travel expenses, including per diem in lieu of 
        subsistence, at rates authorized for employees of agencies under 
        subchapter I of chapter 57 of title 5, United States

[[Page 112 STAT. 3541]]

        Code, while away from their homes or regular places of business 
        in the performance of services for the Committee.

    ``(g) FACA.--The Federal Advisory Committee Act shall apply to the 
Advisory Committee under this section only to the extent that the 
provisions of such Act do not conflict with the requirements of this 
section.''.

SEC. 103. INTERDISCIPLINARY, COMMUNITY-BASED LINKAGES.

    Part D of title VII of the Public Health Service Act (42 U.S.C. 294 
et seq.) is amended to read as follows:

          ``PART D--INTERDISCIPLINARY, COMMUNITY-BASED LINKAGES

``SEC. 750. <<NOTE: 42 USC 294.>> GENERAL PROVISIONS.

    ``(a) Collaboration.--To be eligible to receive assistance under 
this part, an academic institution shall use such assistance in 
collaboration with 2 or more disciplines.
    ``(b) Activities.--An entity shall use assistance under this part to 
carry out innovative demonstration projects for strategic workforce 
supplementation activities as needed to meet national goals for 
interdisciplinary, community-based linkages. Such assistance may be used 
consistent with this part--
            ``(1) to develop and support training programs;
            ``(2) for faculty development;
            ``(3) for model demonstration programs;
            ``(4) for the provision of stipends for fellowship trainees;
            ``(5) to provide technical assistance; and
            ``(6) for other activities that will produce outcomes 
        consistent with the purposes of this part.

``SEC. 751. <<NOTE: 42 USC 294a.>> AREA HEALTH EDUCATION CENTERS.

    ``(a) Authority for Provision of Financial Assistance.--
            ``(1) Assistance for planning, development, and operation of 
        programs.--
                    ``(A) In <<NOTE: Grants. Contracts.>> general.--The 
                Secretary shall award grants to and enter into contracts 
                with schools of medicine and osteopathic medicine, and 
                incorporated consortia made up of such schools, or the 
                parent institutions of such schools, for projects for 
                the planning, development and operation of area health 
                education center programs that--
                          ``(i) improve the recruitment, distribution, 
                      supply, quality and efficiency of personnel 
                      providing health services in underserved rural and 
                      urban areas and personnel providing health 
                      services to populations having demonstrated 
                      serious unmet health care needs;
                          ``(ii) increase the number of primary care 
                      physicians and other primary care providers who 
                      provide services in underserved areas through the 
                      offering of an educational continuum of health 
                      career recruitment through clinical education 
                      concerning underserved areas in a comprehensive 
                      health workforce strategy;
                          ``(iii) carry out recruitment and health 
                      career awareness programs to recruit individuals 
                      from underserved areas and under-represented 
                      populations, including minority and other 
                      elementary or secondary students, into the health 
                      professions;

[[Page 112 STAT. 3542]]

                          ``(iv) prepare individuals to more effectively 
                      provide health services to underserved areas or 
                      underserved populations through field placements, 
                      preceptorships, the conduct of or support of 
                      community-based primary care residency programs, 
                      and agreements with community-based organizations 
                      such as community health centers, migrant health 
                      centers, Indian health centers, public health 
                      departments and others;
                          ``(v) conduct health professions education and 
                      training activities for students of health 
                      professions schools and medical residents;
                          ``(vi) conduct at least 10 percent of medical 
                      student required clinical education at sites 
                      remote to the primary teaching facility of the 
                      contracting institution; and
                          ``(vii) provide information dissemination and 
                      educational support to reduce professional 
                      isolation, increase retention, enhance the 
                      practice environment, and improve health care 
                      through the timely dissemination of research 
                      findings using relevant resources.
                    ``(B) Other eligible entities.--With respect to a 
                State in which no area health education center program 
                is in operation, the Secretary may award a grant or 
                contract under subparagraph (A) to a school of nursing.
                    ``(C) Project terms.--
                          ``(i) In general.--Except as provided in 
                      clause (ii), the period during which payments may 
                      be made under an award under subparagraph (A) may 
                      not exceed--
                                    ``(I) in the case of a project, 12 
                                years or
                                    ``(II) in the case of a center 
                                within a project, 6 years.
                          ``(ii) Exception.--The periods described in 
                      clause (i) shall not apply to projects that have 
                      completed the initial period of Federal funding 
                      under this section and that desire to compete for 
                      model awards under paragraph (2)(A).
            ``(2) Assistance for operation of model programs.--
                    ``(A) In general.--In the case of any entity 
                described in paragraph (1)(A) that--
                          ``(i) has previously received funds under this 
                      section;
                          ``(ii) is operating an area health education 
                      center program; and
                          ``(iii) is no longer receiving financial 
                      assistance under paragraph (1);
                the Secretary may provide financial assistance to such 
                entity to pay the costs of operating and carrying out 
                the requirements of the program as described in 
                paragraph (1).
                    ``(B) Matching requirement.--With respect to the 
                costs of operating a model program under subparagraph 
                (A), an entity, to be eligible for financial assistance 
                under subparagraph (A), shall make available (directly 
                or through contributions from State, county or municipal 
                governments, or the private sector) recurring non-
                Federal contributions

[[Page 112 STAT. 3543]]

                in cash toward such costs in an amount that is equal to 
                not less than 50 percent of such costs.
                    ``(C) Limitation.--The aggregate amount of awards 
                provided under subparagraph (A) to entities in a State 
                for a fiscal year may not exceed the lesser of--
                          ``(i) $2,000,000; or
                          ``(ii) an amount equal to the product of 
                      $250,000 and the aggregate number of area health 
                      education centers operated in the State by such 
                      entities.

    ``(b) Requirements for Centers.--
            ``(1) General requirement.--Each area health education 
        center that receives funds under this section shall encourage 
        the regionalization of health professions schools through the 
        establishment of partnerships with community-based 
        organizations.
            ``(2) Service area.--Each area health education center that 
        receives funds under this section shall specifically designate a 
        geographic area or medically underserved population to be served 
        by the center. Such area or population shall be in a location 
        removed from the main location of the teaching facilities of the 
        schools participating in the program with such center.
            ``(3) Other requirements.--Each area health education center 
        that receives funds under this section shall--
                    ``(A) assess the health personnel needs of the area 
                to be served by the center and assist in the planning 
                and development of training programs to meet such needs;
                    ``(B) arrange and support rotations for students and 
                residents in family medicine, general internal medicine 
                or general pediatrics, with at least one center in each 
                program being affiliated with or conducting a rotating 
                osteopathic internship or medical residency training 
                program in family medicine (including geriatrics), 
                general internal medicine (including geriatrics), or 
                general pediatrics in which no fewer than 4 individuals 
                are enrolled in first-year positions;
                    ``(C) conduct and participate in interdisciplinary 
                training that involves physicians and other health 
                personnel including, where practicable, public health 
                professionals, physician assistants, nurse 
                practitioners, nurse midwives, and behavioral and mental 
                health providers; and
                    ``(D) have an advisory board, at least 75 percent of 
                the members of which shall be individuals, including 
                both health service providers and consumers, from the 
                area served by the center.

    ``(c) Certain Provisions Regarding Funding.--
            ``(1) Allocation to center.--Not less than 75 percent of the 
        total amount of Federal funds provided to an entity under this 
        section shall be allocated by an area health education center 
        program to the area health education center. Such entity shall 
        enter into an agreement with each center for purposes of 
        specifying the allocation of such 75 percent of funds.
            ``(2) Operating costs.--With respect to the operating costs 
        of the area health education center program of an entity 
        receiving funds under this section, the entity shall make 
        available

[[Page 112 STAT. 3544]]

        (directly or through contributions from State, county or 
        municipal governments, or the private sector) non-Federal 
        contributions in cash toward such costs in an amount that is 
        equal to not less than 50 percent of such costs, except that the 
        Secretary may grant a waiver for up to 75 percent of the amount 
        of the required non-Federal match in the first 3 years in which 
        an entity receives funds under this section.

``SEC. 752. <<NOTE: 42 USC 294b.>> HEALTH EDUCATION AND TRAINING 
            CENTERS.

    ``(a) In General.--To be eligible for funds under this section, a 
health education training center shall be an entity otherwise eligible 
for funds under section 751 that--
            ``(1) addresses the persistent and severe unmet health care 
        needs in States along the border between the United States and 
        Mexico and in the State of Florida, and in other urban and rural 
        areas with populations with serious unmet health care needs;
            ``(2) establishes an advisory board comprised of health 
        service providers, educators and consumers from the service 
        area;
            ``(3) conducts training and education programs for health 
        professions students in these areas;
            ``(4) conducts training in health education services, 
        including training to prepare community health workers; and
            ``(5) supports health professionals (including nursing) 
        practicing in the area through educational and other services.

    ``(b) Allocation of Funds.--The Secretary shall make available 50 
percent of the amounts appropriated for each fiscal year under section 
752 for the establishment or operation of health education training 
centers through projects in States along the border between the United 
States and Mexico and in the State of Florida.

``SEC. 753. <<NOTE: 42 USC 294c.>> EDUCATION AND TRAINING RELATING TO 
            GERIATRICS.

    ``(a) Geriatric Education Centers.--
            ``(1) In general.--The Secretary shall award grants or 
        contracts under this section to entities described in paragraphs 
        (1), (3), or (4) of section 799B, and section 853(2), for the 
        establishment or operation of geriatric education centers.
            ``(2) Requirements.--A geriatric education center is a 
        program that--
                    ``(A) improves the training of health professionals 
                in geriatrics, including geriatric residencies, 
                traineeships, or fellowships;
                    ``(B) develops and disseminates curricula relating 
                to the treatment of the health problems of elderly 
                individuals;
                    ``(C) supports the training and retraining of 
                faculty to provide instruction in geriatrics;
                    ``(D) supports continuing education of health 
                professionals who provide geriatric care; and
                    ``(E) provides students with clinical training in 
                geriatrics in nursing homes, chronic and acute disease 
                hospitals, ambulatory care centers, and senior centers.

    ``(b) Geriatric Training Regarding Physicians and Dentists.--
            ``(1) In general.--The Secretary may make grants to, and 
        enter into contracts with, schools of medicine, schools of 
        osteopathic medicine, teaching hospitals, and graduate medical 
        education programs, for the purpose of providing support 
        (including

[[Page 112 STAT. 3545]]

        residencies, traineeships, and fellowships) for geriatric 
        training projects to train physicians, dentists and behavioral 
        and mental health professionals who plan to teach geriatric 
        medicine, geriatric behavioral or mental health, or geriatric 
        dentistry.
            ``(2) Requirements.--Each project for which a grant or 
        contract is made under this subsection shall--
                    ``(A) be staffed by full-time teaching physicians 
                who have experience or training in geriatric medicine or 
                geriatric behavioral or mental health;
                    ``(B) be staffed, or enter into an agreement with an 
                institution staffed by full-time or part-time teaching 
                dentists who have experience or training in geriatric 
                dentistry;
                    ``(C) be staffed, or enter into an agreement with an 
                institution staffed by full-time or part-time teaching 
                behavioral mental health professionals who have 
                experience or training in geriatric behavioral or mental 
                health;
                    ``(D) be based in a graduate medical education 
                program in internal medicine or family medicine or in a 
                department of geriatrics or behavioral or mental health;
                    ``(E) provide training in geriatrics and exposure to 
                the physical and mental disabilities of elderly 
                individuals through a variety of service rotations, such 
                as geriatric consultation services, acute care services, 
                dental services, geriatric behavioral or mental health 
                units, day and home care programs, rehabilitation 
                services, extended care facilities, geriatric ambulatory 
                care and comprehensive evaluation units, and community 
                care programs for elderly mentally retarded individuals; 
                and
                    ``(F) provide training in geriatrics through one or 
                both of the training options described in subparagraphs 
                (A) and (B) of paragraph (3).
            ``(3) Training options.--The training options referred to in 
        subparagraph (F) of paragraph (2) shall be as follows:
                    ``(A) A 1-year retraining program in geriatrics 
                for--
                          ``(i) physicians who are faculty members in 
                      departments of internal medicine, family medicine, 
                      gynecology, geriatrics, and behavioral or mental 
                      health at schools of medicine and osteopathic 
                      medicine;
                          ``(ii) dentists who are faculty members at 
                      schools of dentistry or at hospital departments of 
                      dentistry; and
                          ``(iii) behavioral or mental health 
                      professionals who are faculty members in 
                      departments of behavioral or mental health; and
                    ``(B) A 2-year internal medicine or family medicine 
                fellowship program providing emphasis in geriatrics, 
                which shall be designed to provide training in clinical 
                geriatrics and geriatrics research for--
                          ``(i) physicians who have completed graduate 
                      medical education programs in internal medicine, 
                      family medicine, behavioral or mental health, 
                      neurology, gynecology, or rehabilitation medicine;
                          ``(ii) dentists who have demonstrated a 
                      commitment to an academic career and who have 
                      completed postdoctoral dental training, including 
                      postdoctoral dental education programs or who have 
                      relevant advanced training or experience; and

[[Page 112 STAT. 3546]]

                          ``(iii) behavioral or mental health 
                      professionals who have completed graduate medical 
                      education programs in behavioral or mental health.
            ``(4) Definitions.--For purposes of this subsection:
                    ``(A) The term `graduate medical education program' 
                means a program sponsored by a school of medicine, a 
                school of osteopathic medicine, a hospital, or a public 
                or private institution that--
                          ``(i) offers postgraduate medical training in 
                      the specialties and subspecialties of medicine; 
                      and
                          ``(ii) has been accredited by the 
                      Accreditation Council for Graduate Medical 
                      Education or the American Osteopathic Association 
                      through its Committee on Postdoctoral Training.
                    ``(B) The term `post-doctoral dental education 
                program' means a program sponsored by a school of 
                dentistry, a hospital, or a public or private 
                institution that--
                          ``(i) offers post-doctoral training in the 
                      specialties of dentistry, advanced education in 
                      general dentistry, or a dental general practice 
                      residency; and
                          ``(ii) has been accredited by the Commission 
                      on Dental Accreditation.

    ``(c) Geriatric Faculty Fellowships.--
            ``(1) Establishment of program.--The Secretary shall 
        establish a program to provide Geriatric Academic Career Awards 
        to eligible individuals to promote the career development of 
        such individuals as academic geriatricians.
            ``(2) Eligible individuals.--To be eligible to receive an 
        Award under paragraph (1), an individual shall--
                    ``(A) be board certified or board eligible in 
                internal medicine, family practice, or psychiatry;
                    ``(B) have completed an approved fellowship program 
                in geriatrics; and
                    ``(C) have a junior faculty appointment at an 
                accredited (as determined by the Secretary) school of 
                medicine or osteopathic medicine.
            ``(3) Limitations.--No Award under paragraph (1) may be made 
        to an eligible individual unless the individual--
                    ``(A) has submitted to the Secretary an application, 
                at such time, in such manner, and containing such 
                information as the Secretary may require, and the 
                Secretary has approved such application; and
                    ``(B) provides, in such form and manner as the 
                Secretary may require, assurances that the individual 
                will meet the service requirement described in 
                subsection (e).
            ``(4) Amount and term.--
                    ``(A) Amount.--The amount of an Award under this 
                section shall equal $50,000 for fiscal year 1998, 
                adjusted for subsequent fiscal years to reflect the 
                increase in the Consumer Price Index.
                    ``(B) Term.--The term of any Award made under this 
                subsection shall not exceed 5 years.
            ``(5) Service requirement.--An individual who receives an 
        Award under this subsection shall provide training in clinical 
        geriatrics, including the training of interdisciplinary teams of 
        health care professionals. The provision of such training shall

[[Page 112 STAT. 3547]]

        constitute at least 75 percent of the obligations of such 
        individual under the Award.
``SEC. 754. <<NOTE: 42 USC 294d.>> QUENTIN N. BURDICK PROGRAM FOR 
                          RURAL INTERDISCIPLINARY TRAINING.

    ``(a) Grants.--The Secretary may make grants or contracts under this 
section to help entities fund authorized activities under an application 
approved under subsection (c).
    ``(b) Use of Amounts.--
            ``(1) In general.--Amounts provided under subsection (a) 
        shall be used by the recipients to fund interdisciplinary 
        training projects designed to--
                    ``(A) use new and innovative methods to train health 
                care practitioners to provide services in rural areas;
                    ``(B) demonstrate and evaluate innovative 
                interdisciplinary methods and models designed to provide 
                access to cost-effective comprehensive health care;
                    ``(C) deliver health care services to individuals 
                residing in rural areas;
                    ``(D) enhance the amount of relevant research 
                conducted concerning health care issues in rural areas; 
                and
                    ``(E) increase the recruitment and retention of 
                health care practitioners from rural areas and make 
                rural practice a more attractive career choice for 
                health care practitioners.
            ``(2) Methods.--A recipient of funds under subsection (a) 
        may use various methods in carrying out the projects described 
        in paragraph (1), including--
                    ``(A) the distribution of stipends to students of 
                eligible applicants;
                    ``(B) the establishment of a post-doctoral 
                fellowship program;
                    ``(C) the training of faculty in the economic and 
                logistical problems confronting rural health care 
                delivery systems; or
                    ``(D) the purchase or rental of transportation and 
                telecommunication equipment where the need for such 
                equipment due to unique characteristics of the rural 
                area is demonstrated by the recipient.
            ``(3) Administration.--
                    ``(A) In general.--An applicant shall not use more 
                than 10 percent of the funds made available to such 
                applicant under subsection (a) for administrative 
                expenses.
                    ``(B) Training.--Not more than 10 percent of the 
                individuals receiving training with funds made available 
                to an applicant under subsection (a) shall be trained as 
                doctors of medicine or doctors of osteopathy.
                    ``(C) Limitation.--An institution that receives a 
                grant under this section shall use amounts received 
                under such grant to supplement, not supplant, amounts 
                made available by such institution for activities of the 
                type described in subsection (b)(1) in the fiscal year 
                preceding the year for which the grant is received.

    ``(c) Applications.--Applications submitted for assistance under 
this section shall--
            ``(1) be jointly submitted by at least two eligible 
        applicants with the express purpose of assisting individuals in 
        academic

[[Page 112 STAT. 3548]]

        institutions in establishing long-term collaborative 
        relationships with health care providers in rural areas; and
            ``(2) designate a rural health care agency or agencies for 
        clinical treatment or training, including hospitals, community 
        health centers, migrant health centers, rural health clinics, 
        community behavioral and mental health centers, long-term care 
        facilities, Native Hawaiian health centers, or facilities 
        operated by the Indian Health Service or an Indian tribe or 
        tribal organization or Indian organization under a contract with 
        the Indian Health Service under the Indian Self-Determination 
        Act.

    ``(d) Definitions.--For the purposes of this section, the term 
`rural' means geographic areas that are located outside of standard 
metropolitan statistical areas.

``SEC. 755. <<NOTE: 42 USC 294e.>> ALLIED HEALTH AND OTHER DISCIPLINES.

    ``(a) In General.--The Secretary may make grants or contracts under 
this section to help entities fund activities of the type described in 
subsection (b).
    ``(b) Activities.--Activities of the type described in this 
subsection include the following:
            ``(1) Assisting entities in meeting the costs associated 
        with expanding or establishing programs that will increase the 
        number of individuals trained in allied health professions. 
        Programs and activities funded under this paragraph may 
        include--
                    ``(A) those that expand enrollments in allied health 
                professions with the greatest shortages or whose 
                services are most needed by the elderly;
                    ``(B) those that provide rapid transition training 
                programs in allied health fields to individuals who have 
                baccalaureate degrees in health-related sciences;
                    ``(C) those that establish community-based allied 
                health training programs that link academic centers to 
                rural clinical settings;
                    ``(D) those that provide career advancement training 
                for practicing allied health professionals;
                    ``(E) those that expand or establish clinical 
                training sites for allied health professionals in 
                medically underserved or rural communities in order to 
                increase the number of individuals trained;
                    ``(F) those that develop curriculum that will 
                emphasize knowledge and practice in the areas of 
                prevention and health promotion, geriatrics, long-term 
                care, home health and hospice care, and ethics;
                    ``(G) those that expand or establish 
                interdisciplinary training programs that promote the 
                effectiveness of allied health practitioners in 
                geriatric assessment and the rehabilitation of the 
                elderly;
                    ``(H) those that expand or establish demonstration 
                centers to emphasize innovative models to link allied 
                health clinical practice, education, and research;
                    ``(I) those that provide financial assistance (in 
                the form of traineeships) to students who are 
                participants in any such program; and
                          ``(i) who plan to pursue a career in an allied 
                      health field that has a demonstrated personnel 
                      shortage; and

[[Page 112 STAT. 3549]]

                          ``(ii) who agree upon completion of the 
                      training program to practice in a medically 
                      underserved community;
                that shall be utilized to assist in the payment of all 
                or part of the costs associated with tuition, fees and 
                such other stipends as the Secretary may consider 
                necessary; and
                    ``(J) those to meet the costs of projects to plan, 
                develop, and operate or maintain graduate programs in 
                behavioral and mental health practice.
            ``(2) Planning and implementing projects in preventive and 
        primary care training for podiatric physicians in approved or 
        provisionally approved residency programs that shall provide 
        financial assistance in the form of traineeships to residents 
        who participate in such projects and who plan to specialize in 
        primary care.
            ``(3) Carrying out demonstration projects in which 
        chiropractors and physicians collaborate to identify and provide 
        effective treatment for spinal and lower-back conditions.
``SEC. 756. <<NOTE: 42 USC 294f.>> ADVISORY COMMITTEE ON 
                          INTERDISCIPLINARY, COMMUNITY-BASED 
                          LINKAGES.

    ``(a) Establishment.--The Secretary shall establish an advisory 
committee to be known as the Advisory Committee on Interdisciplinary, 
Community-Based Linkages (in this section referred to as the `Advisory 
Committee').
    ``(b) Composition.--
            ``(1) In general.--The Secretary shall determine the 
        appropriate number of individuals to serve on the Advisory 
        Committee. Such individuals shall not be officers or employees 
        of the Federal Government.
            ``(2) Appointment.--Not <<NOTE: Deadline.>> later than 90 
        days after the date of enactment of this Act, the Secretary 
        shall appoint the members of the Advisory Committee from among 
        individuals who are health professionals from schools of the 
        types described in sections 751(a)(1)(A), 751(a)(1)(B), 753(b), 
        754(3)(A), and 755(b). In making such appointments, the 
        Secretary shall ensure a fair balance between the health 
        professions, that at least 75 percent of the members of the 
        Advisory Committee are health professionals, a broad geographic 
        representation of members and a balance between urban and rural 
        members. Members shall be appointed based on their competence, 
        interest, and knowledge of the mission of the profession 
        involved.
            ``(3) Minority representation.--In appointing the members of 
        the Advisory Committee under paragraph (2), the Secretary shall 
        ensure the adequate representation of women and minorities.

    ``(c) Terms.--
            ``(1) In general.--A member of the Advisory Committee shall 
        be appointed for a term of 3 years, except that of the members 
        first appointed--
                    ``(A) \1/3\ of the members shall serve for a term of 
                1 year;
                    ``(B) \1/3\ of the members shall serve for a term of 
                2 years; and

[[Page 112 STAT. 3550]]

                    ``(C) \1/3\ of the members shall serve for a term of 
                3 years.
            ``(2) Vacancies.--
                    ``(A) In general.--A vacancy on the Advisory 
                Committee shall be filled in the manner in which the 
                original appointment was made and shall be subject to 
                any conditions which applied with respect to the 
                original appointment.
                    ``(B) Filling unexpired term.--An individual chosen 
                to fill a vacancy shall be appointed for the unexpired 
                term of the member replaced.

    ``(d) Duties.--The Advisory Committee shall--
            ``(1) provide advice and recommendations to the Secretary 
        concerning policy and program development and other matters of 
        significance concerning the activities under this part; and
            ``(2) not later than 3 years after the date of enactment of 
        this section, and annually thereafter, prepare and submit to the 
        Secretary, and the Committee on Labor and Human Resources of the 
        Senate, and the Committee on Commerce of the House of 
        Representatives, a report describing the activities of the 
        Committee, including findings and recommendations made by the 
        Committee concerning the activities under this part.

    ``(e) Meetings and Documents.--
            ``(1) Meetings.--The Advisory Committee shall meet not less 
        than 3 times each year. Such meetings shall be held jointly with 
        other related entities established under this title where 
        appropriate.
            ``(2) Documents.--Not <<NOTE: Deadlines.>> later than 14 
        days prior to the convening of a meeting under paragraph (1), 
        the Advisory Committee shall prepare and make available an 
        agenda of the matters to be considered by the Advisory Committee 
        at such meeting. At any such meeting, the Advisory Council shall 
        distribute materials with respect to the issues to be addressed 
        at the meeting. <<NOTE: Deadline.>> Not later than 30 days after 
        the adjourning of such a meeting, the Advisory Committee shall 
        prepare and make available a summary of the meeting and any 
        actions taken by the Committee based upon the meeting.

    ``(f) Compensation and Expenses.--
            ``(1) Compensation.--Each member of the Advisory Committee 
        shall be compensated at a rate equal to the daily equivalent of 
        the annual rate of basic pay prescribed for level IV of the 
        Executive Schedule under section 5315 of title 5, United States 
        Code, for each day (including travel time) during which such 
        member is engaged in the performance of the duties of the 
        Committee.
            ``(2) Expenses.--The members of the Advisory Committee shall 
        be allowed travel expenses, including per diem in lieu of 
        subsistence, at rates authorized for employees of agencies under 
        subchapter I of chapter 57 of title 5, United States Code, while 
        away from their homes or regular places of business in the 
        performance of services for the Committee.

    ``(g) FACA.--The Federal Advisory Committee Act shall apply to the 
Advisory Committee under this section only to the extent that the 
provisions of such Act do not conflict with the requirements of this 
section.

[[Page 112 STAT. 3551]]

``SEC. 757. <<NOTE: 42 USC 294g.>> AUTHORIZATION OF APPROPRIATIONS.

    ``(a) In General.--There are authorized to be appropriated to carry 
out this part, $55,600,000 for fiscal year 1998, and such sums as may be 
necessary for each of the fiscal years 1999 through 2002.
    ``(b) Allocation.--
            ``(1) In general.--Of the amounts appropriated under 
        subsection (a) for a fiscal year, the Secretary shall make 
        available--
                    ``(A) not less than $28,587,000 for awards of grants 
                and contracts under section 751;
                    ``(B) not less than $3,765,000 for awards of grants 
                and contracts under section 752, of which not less than 
                50 percent of such amount shall be made available for 
                centers described in subsection (a)(1) of such section; 
                and
                    ``(C) not less than $22,631,000 for awards of grants 
                and contracts under sections 753, 754, and 755.
            ``(2) Ratable reduction.--If amounts appropriated under 
        subsection (a) for any fiscal year are less than the amount 
        required to comply with paragraph (1), the Secretary shall 
        ratably reduce the amount to be made available under each of 
        subparagraphs (A) through (C) of such paragraph accordingly.
            ``(3) Increase in amounts.--If amounts appropriated for a 
        fiscal year under subsection (a) exceed the amount authorized 
        under such subsection for such fiscal year, the Secretary may 
        increase the amount to be made available for programs and 
        activities under this part without regard to the amounts 
        specified in each of subparagraphs (A) through (C) of paragraph 
        (2).

    ``(c) Obligation of Certain Amounts.--
            ``(1) Area health education center programs.--Of the amounts 
        made available under subsection (b)(1)(A) for each fiscal year, 
        the Secretary may obligate for awards under section 751(a)(2)--
                    ``(A) not less than 23 percent of such amounts in 
                fiscal year 1998;
                    ``(B) not less than 30 percent of such amounts in 
                fiscal year 1999;
                    ``(C) not less than 35 percent of such amounts in 
                fiscal year 2000;
                    ``(D) not less than 40 percent of such amounts in 
                fiscal year 2001; and
                    ``(E) not less than 45 percent of such amounts in 
                fiscal year 2002.
            ``(2) Sense of congress.--It is the sense of the Congress 
        that--
                    ``(A) every State have an area health education 
                center program in effect under this section; and
                    ``(B) the ratio of Federal funding for the model 
                program under section 751(a)(2) should increase over 
                time and that Federal funding for other awards under 
                this section shall decrease so that the national program 
                will become entirely comprised of programs that are 
                funded at least 50 percent by State and local 
                partners.''.

[[Page 112 STAT. 3552]]

SEC. 104. HEALTH PROFESSIONS WORKFORCE INFORMATION AND ANALYSIS.

    (a) In General.--Part E of title VII of the Public Health Service 
Act (42 U.S.C. 294n et seq.) is amended to read as follows:

        ``PART E--HEALTH PROFESSIONS AND PUBLIC HEALTH WORKFORCE

   ``Subpart 1--Health Professions Workforce Information and Analysis

``SEC. 761. <<NOTE: 42 USC 294n.>> HEALTH PROFESSIONS WORKFORCE 
                          INFORMATION AND ANALYSIS.

    ``(a) Purpose.--It is the purpose of this section to--
            ``(1) provide for the development of information describing 
        the health professions workforce and the analysis of workforce 
        related issues; and
            ``(2) provide necessary information for decision-making 
        regarding future directions in health professions and nursing 
        programs in response to societal and professional needs.

    ``(b) Grants or Contracts.--The Secretary may award grants or 
contracts to State or local governments, health professions schools, 
schools of nursing, academic health centers, community-based health 
facilities, and other appropriate public or private nonprofit entities 
to provide for--
            ``(1) targeted information collection and analysis 
        activities related to the purposes described in subsection (a);
            ``(2) research on high priority workforce questions;
            ``(3) the development of a non-Federal analytic and research 
        infrastructure related to the purposes described in subsection 
        (a); and
            ``(4) the conduct of program evaluation and assessment.

    ``(c) Authorization of Appropriations.--
            ``(1) In general.--There are authorized to be appropriated 
        to carry out this section, $750,000 for fiscal year 1998, and 
        such sums as may be necessary for each of the fiscal years 1999 
        through 2002.
            ``(2) Reservation.--Of the amounts appropriated under 
        subsection (a) for a fiscal year, the Secretary shall reserve 
        not less than $600,000 for conducting health professions 
        research and for carrying out data collection and analysis in 
        accordance with section 792.
            ``(3) Availability of additional funds.--Amounts otherwise 
        appropriated for programs or activities under this title may be 
        used for activities under subsection (b) with respect to the 
        programs or activities from which such amounts were made 
        available.''.

    (b) Council on Graduate Medical Education.--Section 301 of the 
Health Professions Education Extension Amendments of 1992 (Public Law 
102-408) <<NOTE: 42 USC 295k note.>> is amended--
            (1) in subsection (j), by striking ``1995'' and inserting 
        ``2002'';
            (2) in subsection (k), by striking ``1995'' and inserting 
        ``2002'';
            (3) by adding at the end thereof the following new 
        subsection:

[[Page 112 STAT. 3553]]

    ``(l) Funding.--Amounts otherwise appropriated under this title may 
be utilized by the Secretary to support the activities of the 
Council.'';
            (4) <<NOTE: 42 USC 295k note.>> by transferring such section 
        to part E of title VII of the Public Health Service Act (as 
        amended by subsection (a));
            (5) by redesignating such section as section 762; and
            (6) <<NOTE: 42 USC 294o.>> by inserting such section after 
        section 761.

SEC. 105. PUBLIC HEALTH WORKFORCE DEVELOPMENT.

    Part E of title VII of the Public Health Service Act (as amended by 
section 104) is further amended by adding at the end the following:

                  ``Subpart 2--Public Health Workforce

``SEC. 765. <<NOTE: 42 USC 295.>> GENERAL PROVISIONS.

    ``(a) In General.--The Secretary may award grants or contracts to 
eligible entities to increase the number of individuals in the public 
health workforce, to enhance the quality of such workforce, and to 
enhance the ability of the workforce to meet national, State, and local 
health care needs.
    ``(b) Eligibility.--To be eligible to receive a grant or contract 
under subsection (a) an entity shall--
            ``(1) be--
                    ``(A) a health professions school, including an 
                accredited school or program of public health, health 
                administration, preventive medicine, or dental public 
                health or a school providing health management programs;
                    ``(B) an academic health center;
                    ``(C) a State or local government; or
                    ``(D) any other appropriate public or private 
                nonprofit entity; and
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require.

    ``(c) Preference.--In awarding grants or contracts under this 
section the Secretary may grant a preference to entities--
            ``(1) serving individuals who are from disadvantaged 
        backgrounds (including underrepresented racial and ethnic 
        minorities); and
            ``(2) graduating large proportions of individuals who serve 
        in underserved communities.

    ``(d) Activities.--Amounts provided under a grant or contract 
awarded under this section may be used for--
            ``(1) the costs of planning, developing, or operating 
        demonstration training programs;
            ``(2) faculty development;
            ``(3) trainee support;
            ``(4) technical assistance;
            ``(5) to meet the costs of projects--
                    ``(A) to plan and develop new residency training 
                programs and to maintain or improve existing residency 
                training programs in preventive medicine and dental 
                public health, that have available full-time faculty 
                members with training and experience in the fields of 
                preventive medicine and dental public health; and

[[Page 112 STAT. 3554]]

                    ``(B) to provide financial assistance to residency 
                trainees enrolled in such programs;
            ``(6) the retraining of existing public health workers as 
        well as for increasing the supply of new practitioners to 
        address priority public health, preventive medicine, public 
        health dentistry, and health administration needs;
            ``(7) preparing public health professionals for employment 
        at the State and community levels; or
            ``(8) other activities that may produce outcomes that are 
        consistent with the purposes of this section.

    ``(e) Traineeships.--
            ``(1) In general.--With respect to amounts used under this 
        section for the training of health professionals, such training 
        programs shall be designed to--
                    ``(A) make public health education more accessible 
                to the public and private health workforce;
                    ``(B) increase the relevance of public health 
                academic preparation to public health practice in the 
                future;
                    ``(C) provide education or training for students 
                from traditional on-campus programs in practice-based 
                sites; or
                    ``(D) develop educational methods and distance-based 
                approaches or technology that address adult learning 
                requirements and increase knowledge and skills related 
                to community-based cultural diversity in public health 
                education.
            ``(2) Severe shortage disciplines.--Amounts provided under 
        grants or contracts under this section may be used for the 
        operation of programs designed to award traineeships to students 
        in accredited schools of public health who enter educational 
        programs in fields where there is a severe shortage of public 
        health professionals, including epidemiology, biostatistics, 
        environmental health, toxicology, public health nursing, 
        nutrition, preventive medicine, maternal and child health, and 
        behavioral and mental health professions.

``SEC. 766. <<NOTE: 42 USC 295a.>> PUBLIC HEALTH TRAINING CENTERS.

    ``(a) In General.--The Secretary may make grants or contracts for 
the operation of public health training centers.
    ``(b) Eligible Entities.--
            ``(1) In general.--A public health training center shall be 
        an accredited school of public health, or another public or 
        nonprofit private institution accredited for the provision of 
        graduate or specialized training in public health, that plans, 
        develops, operates, and evaluates projects that are in 
        furtherance of the goals established by the Secretary for the 
        year 2000 in the areas of preventive medicine, health promotion 
        and disease prevention, or improving access to and quality of 
        health services in medically underserved communities.
            ``(2) Preference.--In awarding grants or contracts under 
        this section the Secretary shall give preference to accredited 
        schools of public health.

    ``(c) Certain Requirements.--With respect to a public health 
training center, an award may not be made under subsection (a) unless 
the program agrees that it--
            ``(1) will establish or strengthen field placements for 
        students in public or nonprofit private health agencies or 
        organizations;

[[Page 112 STAT. 3555]]

            ``(2) will involve faculty members and students in 
        collaborative projects to enhance public health services to 
        medically underserved communities;
            ``(3) will specifically designate a geographic area or 
        medically underserved population to be served by the center that 
        shall be in a location removed from the main location of the 
        teaching facility of the school that is participating in the 
        program with such center; and
            ``(4) will assess the health personnel needs of the area to 
        be served by the center and assist in the planning and 
        development of training programs to meet such needs.

``SEC. 767. <<NOTE: 42 USC 295b.>> PUBLIC HEALTH TRAINEESHIPS.

    ``(a) In General.--The Secretary may make grants to accredited 
schools of public health, and to other public or nonprofit private 
institutions accredited for the provision of graduate or specialized 
training in public health, for the purpose of assisting such schools and 
institutions in providing traineeships to individuals described in 
subsection (b)(3).
    ``(b) Certain Requirements.--
            ``(1) Amount.--The amount of any grant under this section 
        shall be determined by the Secretary.
            ``(2) Use of grant.--Traineeships awarded under grants made 
        under subsection (a) shall provide for tuition and fees and such 
        stipends and allowances (including travel and subsistence 
        expenses and dependency allowances) for the trainees as the 
        Secretary may deem necessary.
            ``(3) Eligible individuals.--The individuals referred to in 
        subsection (a) are individuals who are pursuing a course of 
        study in a health professions field in which there is a severe 
        shortage of health professionals (which fields include the 
        fields of epidemiology, environmental health, biostatistics, 
        toxicology, nutrition, and maternal and child health).

``SEC. 768. <<NOTE: 42 USC 295c.>> PREVENTIVE MEDICINE; DENTAL PUBLIC 
            HEALTH.

    ``(a) In General.--The Secretary may make grants to and enter into 
contracts with schools of medicine, osteopathic medicine, public health, 
and dentistry to meet the costs of projects--
            ``(1) to plan and develop new residency training programs 
        and to maintain or improve existing residency training programs 
        in preventive medicine and dental public health; and
            ``(2) to provide financial assistance to residency trainees 
        enrolled in such programs.

    ``(b) Administration.--
            ``(1) Amount.--The amount of any grant under subsection (a) 
        shall be determined by the Secretary.
            ``(2) Eligibility.--To be eligible for a grant under 
        subsection (a), the applicant must demonstrate to the Secretary 
        that it has or will have available full-time faculty members 
        with training and experience in the fields of preventive 
        medicine or dental public health and support from other faculty 
        members trained in public health and other relevant specialties 
        and disciplines.
            ``(3) Other funds.--Schools of medicine, osteopathic 
        medicine, dentistry, and public health may use funds committed 
        by State, local, or county public health officers as matching 
        amounts for Federal grant funds for residency training programs 
        in preventive medicine.

[[Page 112 STAT. 3556]]

``SEC. 769. <<NOTE: 42 USC 295d.>> HEALTH ADMINISTRATION 
                          TRAINEESHIPS AND SPECIAL PROJECTS.

    ``(a) In General.--The Secretary may make grants to State or local 
governments (that have in effect preventive medical and dental public 
health residency programs) or public or nonprofit private educational 
entities (including graduate schools of social work and business schools 
that have health management programs) that offer a program described in 
subsection (b)--
            ``(1) to provide traineeships for students enrolled in such 
        a program; and
            ``(2) to assist accredited programs health administration in 
        the development or improvement of programs to prepare students 
        for employment with public or nonprofit private entities.

    ``(b) Relevant Programs.--The program referred to in subsection (a) 
is an accredited program in health administration, hospital 
administration, or health policy analysis and planning, which program is 
accredited by a body or bodies approved for such purpose by the 
Secretary of Education and which meets such other quality standards as 
the Secretary of Health and Human Services by regulation may prescribe.
    ``(c) Preference in Making Grants.--In making grants under 
subsection (a), the Secretary shall give preference to qualified 
applicants that meet the following conditions:
            ``(1) Not less than 25 percent of the graduates of the 
        applicant are engaged in full-time practice settings in 
        medically underserved communities.
            ``(2) The applicant recruits and admits students from 
        medically underserved communities.
            ``(3) For the purpose of training students, the applicant 
        has established relationships with public and nonprofit 
        providers of health care in the community involved.
            ``(4) In training students, the applicant emphasizes 
        employment with public or nonprofit private entities.

    ``(d) Certain Provisions Regarding Traineeships.--
            ``(1) Use of grant.--Traineeships awarded under grants made 
        under subsection (a) shall provide for tuition and fees and such 
        stipends and allowances (including travel and subsistence 
        expenses and dependency allowances) for the trainees as the 
        Secretary may deem necessary.
            ``(2) Preference for certain students.--Each entity applying 
        for a grant under subsection (a) for traineeships shall assure 
        to the satisfaction of the Secretary that the entity will give 
        priority to awarding the traineeships to students who 
        demonstrate a commitment to employment with public or nonprofit 
        private entities in the fields with respect to which the 
        traineeships are awarded.

``SEC. 770. <<NOTE: 42 USC 295e.>> AUTHORIZATION OF APPROPRIATIONS.

    ``(a) In General.--For the purpose of carrying out this subpart, 
there is authorized to be appropriated $9,100,000 for fiscal year 1998, 
and such sums as may be necessary for each of the fiscal years 1999 
through 2002.
    ``(b) Limitation Regarding Certain Program.--In obligating amounts 
appropriated under subsection (a), the Secretary may not obligate more 
than 30 percent for carrying out section 767.''.

[[Page 112 STAT. 3557]]

SEC. 106. GENERAL PROVISIONS.

    (a) In General.--
            (1) Part F of title VII of the Public Health Service Act (42 
        U.S.C. 295 et seq.) is repealed.
            (2) Part G of title VII of the Public Health Service Act (42 
        U.S.C. 295j et seq.) is amended--
                    (A) by redesignating such part as part F;
                    (B) in section 791 (42 U.S.C. 295j)--
                          (i) by striking subsection (b); and
                          (ii) redesignating subsection (c) as 
                      subsection (b);
                    (C) by repealing section 793 (42 U.S.C. 295l);
                    (D) <<NOTE: 42 USC 295o.>> by repealing section 798;
                    (E) <<NOTE: 42 USC 295p.>> by redesignating section 
                799 as section 799B; and
                    (F) by inserting after section 794, the following 
                new sections:

``SEC. 796. <<NOTE: 42 USC 295n-1.>> APPLICATION.

    ``(a) In General.--To be eligible to receive a grant or contract 
under this title, an eligible entity shall prepare and submit to the 
Secretary an application that meets the requirements of this section, at 
such time, in such manner, and containing such information as the 
Secretary may require.
    ``(b) Plan.--An application submitted under this section shall 
contain the plan of the applicant for carrying out a project with 
amounts received under this title. Such plan shall be consistent with 
relevant Federal, State, or regional health professions program plans.
    ``(c) Performance Outcome Standards.--An application submitted under 
this section shall contain a specification by the applicant entity of 
performance outcome standards that the project to be funded under the 
grant or contract will be measured against. Such standards shall address 
relevant health workforce needs that the project will meet. The 
recipient of a grant or contract under this section shall meet the 
standards set forth in the grant or contract application.
    ``(d) Linkages.--An application submitted under this section shall 
contain a description of the linkages with relevant educational and 
health care entities, including training programs for other health 
professionals as appropriate, that the project to be funded under the 
grant or contract will establish. To the extent practicable, grantees 
under this section shall establish linkages with health care providers 
who provide care for underserved communities and populations.

``SEC. 797. <<NOTE: 42 USC 295n-2.>> USE OF FUNDS.

    ``(a) In General.--Amounts provided under a grant or contract 
awarded under this title may be used for training program development 
and support, faculty development, model demonstrations, trainee support 
including tuition, books, program fees and reasonable living expenses 
during the period of training, technical assistance, workforce analysis, 
dissemination of information, and exploring new policy directions, as 
appropriate to meet recognized health workforce objectives, in 
accordance with this title.
    ``(b) Maintenance of Effort.--With respect to activities for which a 
grant awarded under this title is to be expended, the entity shall agree 
to maintain expenditures of non-Federal amounts for such activities at a 
level that is not less than the level of

[[Page 112 STAT. 3558]]

such expenditures maintained by the entity for the fiscal year preceding 
the fiscal year for which the entity receives such a grant.

``SEC. 798. <<NOTE: 42 USC 295o.>> MATCHING REQUIREMENT.

    ``The Secretary may require that an entity that applies for a grant 
or contract under this title provide non-Federal matching funds, as 
appropriate, to ensure the institutional commitment of the entity to the 
projects funded under the grant. As determined by the Secretary, such 
non-Federal matching funds may be provided directly or through donations 
from public or private entities and may be in cash or in-kind, fairly 
evaluated, including plant, equipment, or services.

``SEC. 799. <<NOTE: 42 USC 295o-1.>> GENERALLY APPLICABLE PROVISIONS.

    ``(a) Awarding of Grants and Contracts.--The Secretary shall ensure 
that grants and contracts under this title are awarded on a competitive 
basis, as appropriate, to carry out innovative demonstration projects or 
provide for strategic workforce supplementation activities as needed to 
meet health workforce goals and in accordance with this title. Contracts 
may be entered into under this title with public or private entities as 
may be necessary.
    ``(b) Eligible Entities.--Unless specifically required otherwise in 
this title, the Secretary shall accept applications for grants or 
contracts under this title from health professions schools, academic 
health centers, State or local governments, or other appropriate public 
or private nonprofit entities for funding and participation in health 
professions and nursing training activities. The Secretary may accept 
applications from for-profit private entities if determined appropriate 
by the Secretary.
    ``(c) Information Requirements.--
            ``(1) In general.--Recipients of grants and contracts under 
        this title shall meet information requirements as specified by 
        the Secretary.
            ``(2) Data collection.--The Secretary shall establish 
        procedures to ensure that, with respect to any data collection 
        required under this title, such data is collected in a manner 
        that takes into account age, sex, race, and ethnicity.
            ``(3) Use of funds.--The Secretary shall establish 
        procedures to permit the use of amounts appropriated under this 
        title to be used for data collection purposes.
            ``(4) Evaluations.--The Secretary shall establish procedures 
        to ensure the annual evaluation of programs and projects 
        operated by recipients of grants or contracts under this title. 
        Such procedures shall ensure that continued funding for such 
        programs and projects will be conditioned upon a demonstration 
        that satisfactory progress has been made by the program or 
        project in meeting the objectives of the program or project.

    ``(d) Training Programs.--Training programs conducted with amounts 
received under this title shall meet applicable accreditation and 
quality standards.
    ``(e) Duration of Assistance.--
            ``(1) In general.--Subject to paragraph (2), in the case of 
        an award to an entity of a grant, cooperative agreement, or 
        contract under this title, the period during which payments are 
        made to the entity under the award may not exceed 5 years. The 
        provision of payments under the award shall be subject to annual 
        approval by the Secretary of the payments and subject to the 
        availability of appropriations for the fiscal

[[Page 112 STAT. 3559]]

        year involved to make the payments. This paragraph may not be 
        construed as limiting the number of awards under the program 
        involved that may be made to the entity.
            ``(2) Limitation.--In the case of an award to an entity of a 
        grant, cooperative agreement, or contract under this title, 
        paragraph (1) shall apply only to the extent not inconsistent 
        with any other provision of this title that relates to the 
        period during which payments may be made under the award.

    ``(f) Peer Review Regarding Certain Programs.--
            ``(1) In general.--Each application for a grant under this 
        title, except any scholarship or loan program, including those 
        under sections 701, 721, or 723, shall be submitted to a peer 
        review group for an evaluation of the merits of the proposals 
        made in the application. The Secretary may not approve such an 
        application unless a peer review group has recommended the 
        application for approval.
            ``(2) Composition.--Each peer review group under this 
        subsection shall be composed principally of individuals who are 
        not officers or employees of the Federal Government. In 
        providing for the establishment of peer review groups and 
        procedures, the Secretary shall ensure sex, racial, ethnic, and 
        geographic balance among the membership of such groups.
            ``(3) Administration.--This subsection shall be carried out 
        by the Secretary acting through the Administrator of the Health 
        Resources and Services Administration.

    ``(g) Preference or Priority Considerations.--In considering a 
preference or priority for funding which is based on outcome measures 
for an eligible entity under this title, the Secretary may also consider 
the future ability of the eligible entity to meet the outcome preference 
or priority through improvements in the eligible entity's program 
design.
    ``(h) Analytic Activities.--The Secretary shall ensure that--
            ``(1) cross-cutting workforce analytical activities are 
        carried out as part of the workforce information and analysis 
        activities under section 761; and
            ``(2) discipline-specific workforce information and 
        analytical activities are carried out as part of--
                    ``(A) the community-based linkage program under part 
                D; and
                    ``(B) the health workforce development program under 
                subpart 2 of part E.

    ``(i) Osteopathic Schools.--For purposes of this title, any 
reference to--
            ``(1) medical schools shall include osteopathic medical 
        schools; and
            ``(2) medical students shall include osteopathic medical 
        students.

``SEC. 799A. <<NOTE: 42 USC 295o-2.>> TECHNICAL ASSISTANCE.

    ``Funds appropriated under this title may be used by the Secretary 
to provide technical assistance in relation to any of the authorities 
under this title.''.
    (b) Professional Counselors as Mental Health Professionals.--Section 
792(a) of the Public Health Service Act (42 U.S.C. 295k(a)) is amended 
by inserting ``professional counselors,'' after ``clinical 
psychologists,''.

[[Page 112 STAT. 3560]]

SEC. 107. PREFERENCE IN CERTAIN PROGRAMS.

    (a) In General.--Section 791 of the Public Health Service Act (42 
U.S.C. 295j), as amended by section 105(a)(2)(B), is further amended by 
adding at the end thereof the following subsection:
    ``(c) Exceptions for New Programs.--
            ``(1) In general.--To permit new programs to compete 
        equitably for funding under this section, those new programs 
        that meet at least 4 of the criteria described in paragraph (3) 
        shall qualify for a funding preference under this section.
            ``(2) Definition.--As used in this subsection, the term `new 
        program' means any program that has graduated less than three 
        classes. Upon graduating at least three classes, a program shall 
        have the capability to provide the information necessary to 
        qualify the program for the general funding preferences 
        described in subsection (a).
            ``(3) Criteria.--The criteria referred to in paragraph (1) 
        are the following:
                    ``(A) The mission statement of the program 
                identifies a specific purpose of the program as being 
                the preparation of health professionals to serve 
                underserved populations.
                    ``(B) The curriculum of the program includes content 
                which will help to prepare practitioners to serve 
                underserved populations.
                    ``(C) Substantial clinical training experience is 
                required under the program in medically underserved 
                communities.
                    ``(D) A minimum of 20 percent of the clinical 
                faculty of the program spend at least 50 percent of 
                their time providing or supervising care in medically 
                underserved communities.
                    ``(E) The entire program or a substantial portion of 
                the program is physically located in a medically 
                underserved community.
                    ``(F) Student assistance, which is linked to service 
                in medically underserved communities following 
                graduation, is available to the students in the program.
                    ``(G) The program provides a placement mechanism for 
                deploying graduates to medically underserved 
                communities.''.

    (b) Conforming Amendments.--Section 791(a) of the Public Health 
Service Act (42 U.S.C. 295j(a)) is amended--
            (1) in paragraph (1), by striking ``sections 747'' and all 
        that follows through ``767'' and inserting ``sections 747 and 
        750''; and
            (2) in paragraph (2), by striking ``under section 798(a)''.

SEC. 108. DEFINITIONS.

    (a) Graduate Program in Behavioral and Mental Health Practice.--
Section 799B(1)(D) of the Public Health Service Act (42 U.S.C. 
295p(1)(D)) (as so redesignated by section 106(a)(2)(E)) is amended--
            (1) by inserting ``behavioral health and'' before 
        ``mental''; and
            (2) by inserting ``behavioral health and mental health 
        practice,'' before ``clinical''.

    (b) Professional Counseling as a Behavioral and Mental Health 
Practice.--Section 799B of the Public Health Service Act

[[Page 112 STAT. 3561]]

(42 U.S.C. 295p) (as so redesignated by section 106(a)(2)(E)) is 
amended--
            (1) in paragraph (1)--
                    (A) in subparagraph (C)--
                          (i) by inserting ``and `graduate program in 
                      professional counseling' '' after ``graduate 
                      program in marriage and family therapy' ''; and
                          (ii) by inserting before the period the 
                      following: ``and a concentration leading to a 
                      graduate degree in counseling'';
                    (B) in subparagraph (D), by inserting ``professional 
                counseling,'' after ``social work,''; and
                    (C) in subparagraph (E), by inserting ``professional 
                counseling,'' after ``social work,''; and
            (2) in paragraph (5)(C), by inserting before the period the 
        following: ``or a degree in counseling or an equivalent 
        degree''.

    (c) Medically Underserved Community.--Section 799B(6) of the Public 
Health Service Act (42 U.S.C. 295p(6)) (as so redesignated by section 
105(a)(2)(E)) is amended--
            (1) in subparagraph (B), by striking ``or'' at the end 
        thereof;
            (2) in subparagraph (C), by striking the period and 
        inserting ``; or''; and
            (3) by adding at the end the following:
                    ``(D) is designated by a State Governor (in 
                consultation with the medical community) as a shortage 
                area or medically underserved community.''.

    (d) Programs for the Training of Physician Assistants.--Paragraph 
(3) of section 799B of the Public Health Service Act (42 U.S.C. 295p) 
(as so redesignated by section 105(a)(2)(E)) is amended to read as 
follows:
            ``(3) The term `program for the training of physician 
        assistants' means an educational program that--
                    ``(A) has as its objective the education of 
                individuals who will, upon completion of their studies 
                in the program, be qualified to provide primary care 
                under the supervision of a physician;
                    ``(B) extends for at least one academic year and 
                consists of--
                          ``(i) supervised clinical practice; and
                          ``(ii) at least four months (in the aggregate) 
                      of classroom instruction, directed toward 
                      preparing students to deliver health care;
                    ``(C) has an enrollment of not less than eight 
                students; and
                    ``(D) trains students in primary care, disease 
                prevention, health promotion, geriatric medicine, and 
                home health care.''.

    (e) Psychologist.--Section 799B of the Public Health Service Act (42 
U.S.C. 295p) (as so redesignated by section 105(a)(2)(E)) is amended by 
adding at the end the following:
            ``(11) The term `psychologist' means an individual who--
                    ``(A) holds a doctoral degree in psychology; and
                    ``(B) is licensed or certified on the basis of the 
                doctoral degree in psychology, by the State in which the 
                individual practices, at the independent practice level 
                of psychology to furnish diagnostic, assessment, 
                preventive, and therapeutic services directly to 
                individuals.''.

[[Page 112 STAT. 3562]]

SEC. 109. TECHNICAL AMENDMENT ON NATIONAL HEALTH SERVICE CORPS.

    Section 338B(b)(1)(B) of the Public Health Service Act (42 U.S.C. 
254l-1(b)(1)(B)) is amended by striking ``or other health profession'' 
and inserting ``behavioral and mental health, or other health 
profession''.

SEC. 110. <<NOTE: 42 USC 293 note.>> SAVINGS PROVISION.

    In the case of any authority for making awards of grants or 
contracts that is terminated by the amendments made by this subtitle, 
the Secretary of Health and Human Services may, notwithstanding the 
termination of the authority, continue in effect any grant or contract 
made under the authority that is in effect on the day before the date of 
the enactment of this Act, subject to the duration of any such grant or 
contract not exceeding the period determined by the Secretary in first 
approving such financial assistance, or in approving the most recent 
request made (before the date of such enactment) for continuation of 
such assistance, as the case may be.

   Subtitle <<NOTE: Nursing Education and Practice Improvement Act of 
1998.>> B--Nursing Workforce Development

SEC. 121. <<NOTE: 42 USC 201 note.>> SHORT TITLE.

    This subtitle may be cited as the ``Nursing Education and Practice 
Improvement Act of 1998''.

SEC. 122. <<NOTE: 42 USC 296 note.>> PURPOSE.

    It is the purpose of this subtitle to restructure the nurse 
education authorities of title VIII of the Public Health Service Act to 
permit a comprehensive, flexible, and effective approach to Federal 
support for nursing workforce development.

SEC. 123. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.

    Title VIII of the Public Health Service Act (42 U.S.C. 296k et seq.) 
is amended--
            (1) by striking the title heading and all that follows 
        except for subpart II of part B and sections 846 and 855; and 
        inserting the following:

             ``TITLE VIII--NURSING WORKFORCE DEVELOPMENT'';

            (2) in subpart II of part B, by striking the subpart heading 
        and inserting the following:

                       ``PART E--STUDENT LOANS'';

            (3) <<NOTE: 42 USC 297c.>> by striking section 837;
            (4) by inserting after the title heading the following new 
        parts:

[[Page 112 STAT. 3563]]

                      ``PART A--GENERAL PROVISIONS

``SEC. 801. <<NOTE: 42 USC 296.>> DEFINITIONS.

    ``As used in this title:
            ``(1) Eligible entities.--The term `eligible entities' means 
        schools of nursing, nursing centers, academic health centers, 
        State or local governments, and other public or private 
        nonprofit entities determined appropriate by the Secretary that 
        submit to the Secretary an application in accordance with 
        section 802.
            ``(2) School of nursing.--The term `school of nursing' means 
        a collegiate, associate degree, or diploma school of nursing in 
        a State.
            ``(3) Collegiate school of nursing.--The term `collegiate 
        school of nursing' means a department, division, or other 
        administrative unit in a college or university which provides 
        primarily or exclusively a program of education in professional 
        nursing and related subjects leading to the degree of bachelor 
        of arts, bachelor of science, bachelor of nursing, or to an 
        equivalent degree, or to a graduate degree in nursing, or to an 
        equivalent degree, and including advanced training related to 
        such program of education provided by such school, but only if 
        such program, or such unit, college or university is accredited.
            ``(4) Associate degree school of nursing.--The term 
        `associate degree school of nursing' means a department, 
        division, or other administrative unit in a junior college, 
        community college, college, or university which provides 
        primarily or exclusively a two-year program of education in 
        professional nursing and allied subjects leading to an associate 
        degree in nursing or to an equivalent degree, but only if such 
        program, or such unit, college, or university is accredited.
            ``(5) Diploma school of nursing.--The term `diploma school 
        of nursing' means a school affiliated with a hospital or 
        university, or an independent school, which provides primarily 
        or exclusively a program of education in professional nursing 
        and allied subjects leading to a diploma or to equivalent 
        indicia that such program has been satisfactorily completed, but 
        only if such program, or such affiliated school or such hospital 
        or university or such independent school is accredited.
            ``(6) Accredited.--
                    ``(A) In general.--Except as provided in 
                subparagraph (B), the term `accredited' when applied to 
                any program of nurse education means a program 
                accredited by a recognized body or bodies, or by a State 
                agency, approved for such purpose by the Secretary of 
                Education and when applied to a hospital, school, 
                college, or university (or a unit thereof) means a 
                hospital, school, college, or university (or a unit 
                thereof) which is accredited by a recognized body or 
                bodies, or by a State agency, approved for such purpose 
                by the Secretary of Education. For the purpose of this 
                paragraph, the Secretary of Education shall publish a 
                list of recognized accrediting bodies, and of State 
                agencies, which the Secretary of Education determines to 
                be reliable authority as to the quality of education 
                offered.
                    ``(B) New programs.--A new program of nursing that, 
                by reason of an insufficient period of operation, is 
                not, at the time of the submission of an application for 
                a grant or contract under this title, eligible for 
                accreditation by

[[Page 112 STAT. 3564]]

                such a recognized body or bodies or State agency, shall 
                be deemed accredited for purposes of this title if the 
                Secretary of Education finds, after consultation with 
                the appropriate accreditation body or bodies, that there 
                is reasonable assurance that the program will meet the 
                accreditation standards of such body or bodies prior to 
                the beginning of the academic year following the normal 
                graduation date of students of the first entering class 
                in such a program.
            ``(7) Nonprofit.--The term `nonprofit' as applied to any 
        school, agency, organization, or institution means one which is 
        a corporation or association, or is owned and operated by one or 
        more corporations or associations, no part of the net earnings 
        of which inures, or may lawfully inure, to the benefit of any 
        private shareholder or individual.
            ``(8) State.--The term `State' means a State, the 
        Commonwealth of Puerto Rico, the District of Columbia, the 
        Commonwealth of the Northern Mariana Islands, Guam, American 
        Samoa, the Virgin Islands, or the Trust Territory of the Pacific 
        Islands.

``SEC. 802. <<NOTE: 42 USC 296a.>> APPLICATION.

    ``(a) In General.--To be eligible to receive a grant or contract 
under this title, an eligible entity shall prepare and submit to the 
Secretary an application that meets the requirements of this section, at 
such time, in such manner, and containing such information as the 
Secretary may require.
    ``(b) Plan.--An application submitted under this section shall 
contain the plan of the applicant for carrying out a project with 
amounts received under this title. Such plan shall be consistent with 
relevant Federal, State, or regional program plans.
    ``(c) Performance Outcome Standards.--An application submitted under 
this section shall contain a specification by the applicant entity of 
performance outcome standards that the project to be funded under the 
grant or contract will be measured against. Such standards shall address 
relevant national nursing needs that the project will meet. The 
recipient of a grant or contract under this section shall meet the 
standards set forth in the grant or contract application.
    ``(d) Linkages.--An application submitted under this section shall 
contain a description of the linkages with relevant educational and 
health care entities, including training programs for other health 
professionals as appropriate, that the project to be funded under the 
grant or contract will establish.

``SEC. 803. <<NOTE: 42 USC 296b.>> USE OF FUNDS.

    ``(a) In General.--Amounts provided under a grant or contract 
awarded under this title may be used for training program development 
and support, faculty development, model demonstrations, trainee support 
including tuition, books, program fees and reasonable living expenses 
during the period of training, technical assistance, workforce analysis, 
and dissemination of information, as appropriate to meet recognized 
nursing objectives, in accordance with this title.
    ``(b) Maintenance of Effort.--With respect to activities for which a 
grant awarded under this title is to be expended, the entity shall agree 
to maintain expenditures of non-Federal amounts for such activities at a 
level that is not less than the level of

[[Page 112 STAT. 3565]]

such expenditures maintained by the entity for the fiscal year preceding 
the fiscal year for which the entity receives such a grant.

``SEC. 804. <<NOTE: 42 USC 296c.>> MATCHING REQUIREMENT.

    ``The Secretary may require that an entity that applies for a grant 
or contract under this title provide non-Federal matching funds, as 
appropriate, to ensure the institutional commitment of the entity to the 
projects funded under the grant. Such non-Federal matching funds may be 
provided directly or through donations from public or private entities 
and may be in cash or in-kind, fairly evaluated, including plant, 
equipment, or services.

``SEC. 805. <<NOTE: 42 USC 296d.>> PREFERENCE.

    ``In awarding grants or contracts under this title, the Secretary 
shall give preference to applicants with projects that will 
substantially benefit rural or underserved populations, or help meet 
public health nursing needs in State or local health departments.

``SEC. 806. <<NOTE: 42 USC 296e.>> GENERALLY APPLICABLE PROVISIONS.

    ``(a) Awarding of Grants and Contracts.--The Secretary shall ensure 
that grants and contracts under this title are awarded on a competitive 
basis, as appropriate, to carry out innovative demonstration projects or 
provide for strategic workforce supplementation activities as needed to 
meet national nursing service goals and in accordance with this title. 
Contracts may be entered into under this title with public or private 
entities as determined necessary by the Secretary.
    ``(b) Information Requirements.--
            ``(1) In general.--Recipients of grants and contracts under 
        this title shall meet information requirements as specified by 
        the Secretary.
            ``(2) Evaluations.--The Secretary shall establish procedures 
        to ensure the annual evaluation of programs and projects 
        operated by recipients of grants under this title. Such 
        procedures shall ensure that continued funding for such programs 
        and projects will be conditioned upon a demonstration that 
        satisfactory progress has been made by the program or project in 
        meeting the objectives of the program or project.

    ``(c) Training Programs.--Training programs conducted with amounts 
received under this title shall meet applicable accreditation and 
quality standards.
    ``(d) Duration of Assistance.--
            ``(1) In general.--Subject to paragraph (2), in the case of 
        an award to an entity of a grant, cooperative agreement, or 
        contract under this title, the period during which payments are 
        made to the entity under the award may not exceed 5 years. The 
        provision of payments under the award 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. This paragraph may not be construed as 
        limiting the number of awards under the program involved that 
        may be made to the entity.
            ``(2) Limitation.--In the case of an award to an entity of a 
        grant, cooperative agreement, or contract under this title, 
        paragraph (1) shall apply only to the extent not inconsistent 
        with any other provision of this title that relates to the 
        period during which payments may be made under the award.

    ``(e) Peer Review Regarding Certain Programs.--

[[Page 112 STAT. 3566]]

            ``(1) In general.--Each application for a grant under this 
        title, except advanced nurse traineeship grants under section 
        811(a)(2), shall be submitted to a peer review group for an 
        evaluation of the merits of the proposals made in the 
        application. The Secretary may not approve such an application 
        unless a peer review group has recommended the application for 
        approval.
            ``(2) Composition.--Each peer review group under this 
        subsection shall be composed principally of individuals who are 
        not officers or employees of the Federal Government. In 
        providing for the establishment of peer review groups and 
        procedures, the Secretary shall, except as otherwise provided, 
        ensure sex, racial, ethnic, and geographic representation among 
        the membership of such groups.
            ``(3) Administration.--This subsection shall be carried out 
        by the Secretary acting through the Administrator of the Health 
        Resources and Services Administration.

    ``(f) Analytic Activities.--The Secretary shall ensure that--
            ``(1) cross-cutting workforce analytical activities are 
        carried out as part of the workforce information and analysis 
        activities under this title; and
            ``(2) discipline-specific workforce information is developed 
        and analytical activities are carried out as part of--
                    ``(A) the advanced education nursing activities 
                under part B;
                    ``(B) the workforce diversity activities under part 
                C; and
                    ``(C) basic nursing education and practice 
                activities under part D.

    ``(g) State and Regional Priorities.--Activities under grants or 
contracts under this title shall, to the extent practicable, be 
consistent with related Federal, State, or regional nursing professions 
program plans and priorities.
    ``(h) Filing of Applications.--
            ``(1) In general.--Applications for grants or contracts 
        under this title may be submitted by health professions schools, 
        schools of nursing, academic health centers, State or local 
        governments, or other appropriate public or private nonprofit 
        entities as determined appropriate by the Secretary in 
        accordance with this title.
            ``(2) For-profit entities.--Notwithstanding paragraph (1), a 
        for-profit entity may be eligible for a grant or contract under 
        this title as determined appropriate by the Secretary.

``SEC. 807. <<NOTE: 42 USC 296f.>> TECHNICAL ASSISTANCE.

    ``Funds appropriated under this title may be used by the Secretary 
to provide technical assistance in relation to any of the authorities 
under this title.

 ``PART B--NURSE PRACTITIONERS, NURSE MIDWIVES, NURSE ANESTHETISTS, AND 
                     OTHER ADVANCED EDUCATION NURSES

``SEC. 811. <<NOTE: 42 USC 296j.>> ADVANCED EDUCATION NURSING GRANTS.

    ``(a) In General.--The Secretary may award grants to and enter into 
contracts with eligible entities to meet the costs of--

[[Page 112 STAT. 3567]]

            ``(1) projects that support the enhancement of advanced 
        nursing education and practice; and
            ``(2) traineeships for individuals in advanced nursing 
        education programs.

    ``(b) Definition of Advanced Education Nurses.--For purposes of this 
section, the term `advanced education nurses' means individuals trained 
in advanced degree programs including individuals in combined R.N./
Master's degree programs, post-nursing master's certificate programs, 
or, in the case of nurse midwives, in certificate programs in existence 
on the date that is one day prior to the date of enactment of this 
section, to serve as nurse practitioners, clinical nurse specialists, 
nurse midwives, nurse anesthetists, nurse educators, nurse 
administrators, or public health nurses, or in other nurse specialties 
determined by the Secretary to require advanced education.
    ``(c) Authorized Nurse Practitioner and Nurse Midwifery Programs.--
Nurse practitioner and nurse midwifery programs eligible for support 
under this section are educational programs for registered nurses 
(irrespective of the type of school of nursing in which the nurses 
received their training) that--
            ``(1) meet guidelines prescribed by the Secretary; and
            ``(2) have as their objective the education of nurses who 
        will upon completion of their studies in such programs, be 
        qualified to effectively provide primary health care, including 
        primary health care in homes and in ambulatory care facilities, 
        long-term care facilities, acute care, and other health care 
        settings.

    ``(d) Authorized Nurse Anesthesia Programs.--Nurse anesthesia 
programs eligible for support under this section are education programs 
that--
            ``(1) provide registered nurses with full-time anesthetist 
        education; and
            ``(2) are accredited by the Council on Accreditation of 
        Nurse Anesthesia Educational Programs.

    ``(e) Other Authorized Educational Programs.--The Secretary shall 
prescribe guidelines as appropriate for other advanced nurse education 
programs eligible for support under this section.
    ``(f) Traineeships.--
            ``(1) In general.--The Secretary may not award a grant to an 
        applicant under subsection (a) unless the applicant involved 
        agrees that traineeships provided with the grant will only pay 
        all or part of the costs of--
                    ``(A) the tuition, books, and fees of the program of 
                advanced nurse education with respect to which the 
                traineeship is provided; and
                    ``(B) the reasonable living expenses of the 
                individual during the period for which the traineeship 
                is provided.
            ``(2) Doctoral programs.--The Secretary may not obligate 
        more than 10 percent of the traineeships under subsection (a) 
        for individuals in doctorate degree programs.
            ``(3) Special consideration.--In making awards of grants and 
        contracts under subsection (a)(2), the Secretary shall give 
        special consideration to an eligible entity that agrees to 
        expend the award to train advanced education nurses who will 
        practice in health professional shortage areas designated under 
        section 332.

[[Page 112 STAT. 3568]]

            ``PART C--INCREASING NURSING WORKFORCE DIVERSITY

``SEC. 821. <<NOTE: 42 USC 296m.>> WORKFORCE DIVERSITY GRANTS.

    ``(a) In General.--The Secretary may award grants to and enter into 
contracts with eligible entities to meet the costs of special projects 
to increase nursing education opportunities for individuals who are from 
disadvantaged backgrounds (including racial and ethnic minorities 
underrepresented among registered nurses) by providing student 
scholarships or stipends, pre-entry preparation, and retention 
activities.
    ``(b) Guidance.--In carrying out subsection (a), the Secretary shall 
take into consideration the recommendations of the First, Second and 
Third Invitational Congresses for Minority Nurse Leaders on `Caring for 
the Emerging Majority,' in 1992, 1993 and 1997, and consult with nursing 
associations including the American Nurses Association, the National 
League for Nursing, the American Association of Colleges of Nursing, the 
National Black Nurses Association, the National Association of Hispanic 
Nurses, the Association of Asian American and Pacific Islander Nurses, 
the Native American Indian and Alaskan Nurses Association, and the 
National Council of State Boards of Nursing.
    ``(c) Required Information and Conditions for Award Recipients.--
            ``(1) In general.--Recipients of awards under this section 
        may be required, where requested, to report to the Secretary 
        concerning the annual admission, retention, and graduation rates 
        for individuals from disadvantaged backgrounds and ethnic and 
        racial minorities in the school or schools involved in the 
        projects.
            ``(2) Falling rates.--If any of the rates reported under 
        paragraph (1) fall below the average of the two previous years, 
        the grant or contract recipient shall provide the Secretary with 
        plans for immediately improving such rates.
            ``(3) Ineligibility.--A recipient described in paragraph (2) 
        shall be ineligible for continued funding under this section if 
        the plan of the recipient fails to improve the rates within the 
        1-year period beginning on the date such plan is implemented.

 ``PART D--STRENGTHENING CAPACITY FOR BASIC NURSE EDUCATION AND PRACTICE

``SEC. 831. <<NOTE: 42 USC 296p.>> BASIC NURSE EDUCATION AND PRACTICE 
            GRANTS.

    ``(a) In General.--The Secretary may award grants to and enter into 
contracts with eligible entities for projects to strengthen capacity for 
basic nurse education and practice.
    ``(b) Priority Areas.--In awarding grants or contracts under this 
section the Secretary shall give priority to entities that will use 
amounts provided under such a grant or contract to enhance the 
educational mix and utilization of the basic nursing workforce by 
strengthening programs that provide basic nurse education, such as 
through--
            ``(1) establishing or expanding nursing practice 
        arrangements in noninstitutional settings to demonstrate methods 
        to

[[Page 112 STAT. 3569]]

        improve access to primary health care in medically underserved 
        communities;
            ``(2) providing care for underserved populations and other 
        high-risk groups such as the elderly, individuals with HIV-AIDS, 
        substance abusers, the homeless, and victims of domestic 
        violence;
            ``(3) providing managed care, quality improvement, and other 
        skills needed to practice in existing and emerging organized 
        health care systems;
            ``(4) developing cultural competencies among nurses;
            ``(5) expanding the enrollment in baccalaureate nursing 
        programs;
            ``(6) promoting career mobility for nursing personnel in a 
        variety of training settings and cross training or specialty 
        training among diverse population groups;
            ``(7) providing education in informatics, including distance 
        learning methodologies; or
            ``(8) other priority areas as determined by the 
        Secretary.'';
            (5) by adding at the end the following:

                            ``PART F--FUNDING

``SEC. 841. <<NOTE: 42 USC 297q.>> FUNDING.

    ``(a) Authorization of Appropriations.--For the purpose of carrying 
out parts B, C, and D (subject to section 845(g)), there are authorized 
to be appropriated $65,000,000 for fiscal year 1998, and such sums as 
may be necessary for each of the fiscal years 1999 through 2002.
    ``(b) Allocations for Fiscal Years 1998 Through 2002.--
            ``(1) Nurse practitioners; nurse midwives.--
                    ``(A) Fiscal year 1998.--Of the amount appropriated 
                under subsection (a) for fiscal year 1998, the Secretary 
                shall reserve not less than $17,564,000 for making 
                awards of grants and contracts under section 822 as such 
                section was in effect for fiscal year 1998.
                    ``(B) Fiscal years 1999 through 2002.--Of the amount 
                appropriated under subsection (a) for fiscal year 1999 
                or any of the fiscal years 2000 through 2002, the 
                Secretary, subject to subsection (d), shall reserve for 
                the fiscal year involved, for making awards of grants 
                and contracts under part B with respect to nurse 
                practitioners and nurse midwives, not less than the 
                percentage constituted by the ratio of the amount 
                appropriated under section 822 as such section was in 
                effect for fiscal year 1998 to the total of the amounts 
                appropriated under this title for such fiscal year. For 
                purposes of the preceding sentence, the Secretary, in 
                determining the amount that has been reserved for the 
                fiscal year involved, shall include any amounts 
                appropriated under subsection (a) for the fiscal year 
                that are obligated by the Secretary to continue in 
                effect grants or contracts under section 822 as such 
                section was in effect for fiscal year 1998.
            ``(2) Nurse anesthetists.--
                    ``(A) Fiscal year 1998.--Of the amount appropriated 
                under subsection (a) for fiscal year 1998, the Secretary 
                shall reserve not less than $2,761,000 for making awards

[[Page 112 STAT. 3570]]

                of grants and contracts under section 831 as such 
                section was in effect for fiscal year 1998.
                    ``(B) Fiscal years 1999 through 2002.--Of the amount 
                appropriated under subsection (a) for fiscal year 1999 
                or any of the fiscal years 2000 through 2002, the 
                Secretary, subject to subsection (d), shall reserve for 
                the fiscal year involved, for making awards of grants 
                and contracts under part B with respect to nurse 
                anesthetists, not less than the percentage constituted 
                by the ratio of the amount appropriated under section 
                831 as such section was in effect for fiscal year 1998 
                to the total of the amounts appropriated under this 
                title for such fiscal year. For purposes of the 
                preceding sentence, the Secretary, in determining the 
                amount that has been reserved for the fiscal year 
                involved, shall include any amounts appropriated under 
                subsection (a) for the fiscal year that are obligated by 
                the Secretary to continue in effect grants or contracts 
                under section 831 as such section was in effect for 
                fiscal year 1998.

    ``(c) Allocations After Fiscal Year 2002.--
            ``(1) In general.--For fiscal year 2003 and subsequent 
        fiscal years, amounts appropriated under subsection (a) for the 
        fiscal year involved shall be allocated by the Secretary among 
        parts B, C, and D (and programs within such parts) according to 
        a methodology that is developed in accordance with paragraph 
        (2). The Secretary shall enter into a contract with a public or 
        private entity for the purpose of developing the methodology. 
        The contract shall require that the development of the 
        methodology be completed not later than February 1, 2002.
            ``(2) Use of certain factors.--The contract under paragraph 
        (1) shall provide that the methodology under such paragraph will 
        be developed in accordance with the following:
                    ``(A) The methodology will take into account the 
                need for and the distribution of health services among 
                medically underserved populations, as determined 
                according to the factors that apply under section 
                330(b)(3).
                    ``(B) The methodology will take into account the 
                need for and the distribution of health services in 
                health professional shortage areas, as determined 
                according to the factors that apply under section 
                332(b).
                    ``(C) The methodology will take into account the 
                need for and the distribution of mental health services 
                among medically underserved populations and in health 
                professional shortage areas.
                    ``(D) The methodology will be developed in 
                consultation with individuals in the field of nursing, 
                including registered nurses, nurse practitioners, nurse 
                midwives, nurse anesthetists, clinical nurse 
                specialists, nursing educators and educational 
                institutions, nurse executives, pediatric nurse 
                associates and practitioners, and women's health, 
                obstetric, and neonatal nurses.
                    ``(E) The methodology will take into account the 
                following factors with respect to the States:
                          ``(i) A provider population ratio equivalent 
                      to a managed care formula of 1/1,500 for primary 
                      care services.

[[Page 112 STAT. 3571]]

                          ``(ii) The use of whole rather than fractional 
                      counts in determining the number of health care 
                      providers.
                          ``(iii) The counting of only employed health 
                      care providers in determining the number of health 
                      care providers.
                          ``(iv) The number of families whose income is 
                      less than 200 percent of the official poverty line 
                      (as 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).
                          ``(v) The rate of infant mortality and the 
                      rate of low-birthweight births.
                          ``(vi) The percentage of the general 
                      population constituted by individuals who are 
                      members of racial or ethnic minority groups, 
                      stated both by minority group and in the 
                      aggregate.
                          ``(vii) The percentage of the general 
                      population constituted by individuals who are of 
                      Hispanic ethnicity.
                          ``(viii) The number of individuals residing in 
                      health professional shortage areas, and the number 
                      of individuals who are members of medically 
                      underserved populations.
                          ``(ix) The percentage of the general 
                      population constituted by elderly individuals.
                          ``(x) The extent to which the populations 
                      served have a choice of providers.
                          ``(xi) The impact of care on hospitalizations 
                      and emergency room use.
                          ``(xii) The number of individuals who lack 
                      proficiency in speaking the English language.
                          ``(xiii) Such additional factors as the 
                      Secretary determines to be appropriate.
            ``(3) Report <<NOTE: Deadline.>> to congress.--Not later 
        than 30 days after the completion of the development of the 
        methodology required in paragraph (1), the Secretary shall 
        submit to the Committee on Commerce of the House of 
        Representatives, and to the Committee on Labor and Human 
        Resources of the Senate, a report describing the methodology and 
        explaining the effects of the methodology on the allocation 
        among parts B, C, and D (and programs within such parts) of 
        amounts appropriated under subsection (a) for the first fiscal 
        year for which the methodology will be in effect. Such 
        explanation shall include a comparison of the allocation for 
        such fiscal year with the allocation made under this section for 
        the preceding fiscal year.

    ``(d) Use <<NOTE: Deadline.>> of Methodology Before Fiscal Year 
2003.--With respect to the fiscal years 1999 through 2002, if the report 
required in subsection (c)(3) is submitted in accordance with such 
subsection not later than 90 days before the beginning of such a fiscal 
year, the Secretary may for such year implement the methodology 
described in the report (rather than implementing the methodology in 
fiscal year 2003), in which case subsection (b) ceases to be in effect. 
The authority under the preceding sentence is subject to the condition 
that the fiscal year for which the methodology is implemented be the 
same fiscal year identified in such report as the fiscal year for which 
the methodology will first be in effect.

[[Page 112 STAT. 3572]]

    ``(e) Authority for Use of Additional Factors in Methodology.--
            ``(1) In general.--The Secretary shall make the 
        determinations specified in paragraph (2). For any fiscal year 
        beginning after the first fiscal year for which the methodology 
        under subsection (c)(1) is in effect, the Secretary may alter 
        the methodology by including the information from such 
        determinations as factors in the methodology.
            ``(2) Relevant determinations.--The determinations referred 
        to in paragraph (1) are as follows:
                    ``(A) The need for and the distribution of health 
                services among populations for which it is difficult to 
                determine the number of individuals who are in the 
                population, such as homeless individuals; migratory and 
                seasonal agricultural workers and their families; 
                individuals infected with the human immunodeficiency 
                virus, and individuals who abuse drugs.
                    ``(B) In the case of a population for which the 
                determinations under subparagraph (A) are made, the 
                extent to which the population includes individuals who 
                are members of racial or ethnic minority groups and a 
                specification of the skills needed to provide health 
                services to such individuals in the language and the 
                educational and cultural context that is most 
                appropriate to the individuals.
                    ``(C) Data, obtained from the Director of the 
                Centers for Disease Control and Prevention, on rates of 
                morbidity and mortality among various populations 
                (including data on the rates of maternal and infant 
                mortality and data on the rates of low-birthweight 
                births of living infants).
                    ``(D) Data from the Health Plan Employer Data and 
                Information Set, as appropriate.

   ``PART G--NATIONAL ADVISORY COUNCIL ON NURSE EDUCATION AND PRACTICE

``SEC. 845. <<NOTE: 42 USC 297t.>> NATIONAL ADVISORY COUNCIL ON 
                          NURSE EDUCATION AND PRACTICE.

    ``(a) Establishment.--The Secretary shall establish an advisory 
council to be known as the National Advisory Council on Nurse Education 
and Practice (in this section referred to as the `Advisory Council').
    ``(b) Composition.--
            ``(1) In general.--The Advisory Council shall be composed 
        of--
                    ``(A) not less than 21, nor more than 23 
                individuals, who are not officers or employees of the 
                Federal Government, appointed by the Secretary without 
                regard to the Federal civil service laws, of which--
                          ``(i) 2 shall be selected from full-time 
                      students enrolled in schools of nursing;
                          ``(ii) 2 shall be selected from the general 
                      public;
                          ``(iii) 2 shall be selected from practicing 
                      professional nurses; and
                          ``(iv) 9 shall be selected from among the 
                      leading authorities in the various fields of 
                      nursing, higher, secondary education, and 
                      associate degree schools of

[[Page 112 STAT. 3573]]

                      nursing, and from representatives of advanced 
                      education nursing groups (such as nurse 
                      practitioners, nurse midwives, and nurse 
                      anesthetists), hospitals, and other institutions 
                      and organizations which provide nursing services; 
                      and
                    ``(B) the Secretary (or the delegate of the 
                Secretary (who shall be an ex officio member and shall 
                serve as the Chairperson)).
            ``(2) Appointment.--Not <<NOTE: Deadline.>> later than 90 
        days after the date of enactment of this Act, the Secretary 
        shall appoint the members of the Advisory Council and each such 
        member shall serve a 4 year term. In making such appointments, 
        the Secretary shall ensure a fair balance between the nursing 
        professions, a broad geographic representation of members and a 
        balance between urban and rural members. Members shall be 
        appointed based on their competence, interest, and knowledge of 
        the mission of the profession involved. A majority of the 
        members shall be nurses.
            ``(3) Minority representation.--In appointing the members of 
        the Advisory Council under paragraph (1), the Secretary shall 
        ensure the adequate representation of minorities.

    ``(c) Vacancies.--
            ``(1) In general.--A vacancy on the Advisory Council shall 
        be filled in the manner in which the original appointment was 
        made and shall be subject to any conditions which applied with 
        respect to the original appointment.
            ``(2) Filling unexpired term.--An individual chosen to fill 
        a vacancy shall be appointed for the unexpired term of the 
        member replaced.

    ``(d) Duties.--The Advisory Council shall--
            ``(1) provide advice and recommendations to the Secretary 
        and Congress concerning policy matters arising in the 
        administration of this title, including the range of issues 
        relating to the nurse workforce, education, and practice 
        improvement;
            ``(2) provide advice to the Secretary and Congress in the 
        preparation of general regulations and with respect to policy 
        matters arising in the administration of this title, including 
        the range of issues relating to nurse supply, education and 
        practice improvement; and
            ``(3) <<NOTE: Deadline. Reports.>> not later than 3 years 
        after the date of enactment of this section, and annually 
        thereafter, prepare and submit to the Secretary, the Committee 
        on Labor and Human Resources of the Senate, and the Committee on 
        Commerce of the House of Representatives, a report describing 
        the activities of the Council, including findings and 
        recommendations made by the Council concerning the activities 
        under this title.

    ``(e) Meetings and Documents.--
            ``(1) Meetings.--The Advisory Council shall meet not less 
        than 2 times each year. Such meetings shall be held jointly with 
        other related entities established under this title where 
        appropriate.
            ``(2) Documents.--Not <<NOTE: Deadlines.>> later than 14 
        days prior to the convening of a meeting under paragraph (1), 
        the Advisory Council shall prepare and make available an agenda 
        of the matters to be considered by the Advisory Council at such 
        meeting. At any such meeting, the Advisory Council shall 
        distribute materials with respect to the issues to be addressed 
        at the

[[Page 112 STAT. 3574]]

        meeting. Not later than 30 days after the adjourning of such a 
        meeting, the Advisory Council shall prepare and make available a 
        summary of the meeting and any actions taken by the Council 
        based upon the meeting.

    ``(f) Compensation and Expenses.--
            ``(1) Compensation.--Each member of the Advisory Council 
        shall be compensated at a rate equal to the daily equivalent of 
        the annual rate of basic pay prescribed for level IV of the 
        Executive Schedule under section 5315 of title 5, United States 
        Code, for each day (including travel time) during which such 
        member is engaged in the performance of the duties of the 
        Council. All members of the Council who are officers or 
        employees of the United States shall serve without compensation 
        in addition to that received for their services as officers or 
        employees of the United States.
            ``(2) Expenses.--The members of the Advisory Council shall 
        be allowed travel expenses, including per diem in lieu of 
        subsistence, at rates authorized for employees of agencies under 
        subchapter I of chapter 57 of title 5, United States Code, while 
        away from their homes or regular places of business in the 
        performance of services for the Council.

    ``(g) Funding.--Amounts appropriated under this title may be 
utilized by the Secretary to support the nurse education and practice 
activities of the Council.
    ``(h) FACA.--The Federal Advisory Committee Act shall apply to the 
Advisory Committee under this section only to the extent that the 
provisions of such Act do not conflict with the requirements of this 
section.''; and
            (6) by redesignating section 855 as section 810, and 
        transferring <<NOTE: 42 USC 298b-2, 296g.>> such section so as 
        to appear after section 809 (as added by the amendment made by 
        paragraph (5)).

SEC. 124. <<NOTE: 42 USC 296 note.>> SAVINGS PROVISION.

    In the case of any authority for making awards of grants or 
contracts that is terminated by the amendment made by section 123, the 
Secretary of Health and Human Services may, notwithstanding the 
termination of the authority, continue in effect any grant or contract 
made under the authority that is in effect on the day before the date of 
the enactment of this Act, subject to the duration of any such grant or 
contract not exceeding the period determined by the Secretary in first 
approving such financial assistance, or in approving the most recent 
request made (before the date of such enactment) for continuation of 
such assistance, as the case may be.

                    Subtitle C--Financial Assistance

              CHAPTER 1--SCHOOL-BASED REVOLVING LOAN FUNDS

SEC. 131. PRIMARY CARE LOAN PROGRAM.

    (a) Requirement for Schools.--Section 723(b)(1) of the Public Health 
Service Act (42 U.S.C. 292s(b)(1)), as amended by section 
2014(c)(2)(A)(ii) of Public Law 103-43 (107 Stat. 216), is amended by 
striking ``3 years before'' and inserting ``4 years before''.

[[Page 112 STAT. 3575]]

    (b) Noncompliance.--Section 723(a)(3) of the Public Health Service 
Act (42 U.S.C. 292s(a)(3)) is amended to read as follows:
            ``(3) Noncompliance by student.--Each agreement entered into 
        with a student pursuant to paragraph (1) shall provide that, if 
        the student fails to comply with such agreement, the loan 
        involved will begin to accrue interest at a rate of 18 percent 
        per year beginning on the date of such noncompliance.''.

    (c) Report Requirement.--Section 723 of the Public Health Service 
Act (42 U.S.C. 292s) is amended--
            (1) by striking subsection (c); and
            (2) by redesignating subsection (d) as subsection (c).

SEC. 132. LOANS FOR DISADVANTAGED STUDENTS.

    (a) Authorization of Appropriations.--Section 724(f)(1) of the 
Public Health Service Act (42 U.S.C. 292t(f)(1)) is amended by striking 
``$15,000,000 for fiscal year 1993'' and inserting ``$8,000,000 for each 
of the fiscal years 1998 through 2002''.
    (b) Repeal.--Effective October 1, 2002, paragraph (1) of section 
724(f) of the Public Health Service Act (42 U.S.C. 292t(f)(1)) is 
repealed.

SEC. 133. STUDENT LOANS REGARDING SCHOOLS OF NURSING.

    (a) In General.--Section 836(b) of the Public Health Service Act (42 
U.S.C. 297b(b)) is amended--
            (1) in paragraph (1), by striking the period at the end and 
        inserting a semicolon;
            (2) in paragraph (2)--
                    (A) in subparagraph (A), by striking ``and'' at the 
                end; and
                    (B) by inserting before the semicolon at the end the 
                following: ``, and (C) such additional periods under the 
                terms of paragraph (8) of this subsection'';
            (3) in paragraph (7), by striking the period at the end and 
        inserting ``; and''; and
            (4) by adding at the end the following paragraph:
            ``(8) pursuant to uniform criteria established by the 
        Secretary, the repayment period established under paragraph (2) 
        for any student borrower who during the repayment period failed 
        to make consecutive payments and who, during the last 12 months 
        of the repayment period, has made at least 12 consecutive 
        payments may be extended for a period not to exceed 10 years.''.

    (b) Minimum Monthly Payments.--Section 836(g) of the Public Health 
Service Act (42 U.S.C. 297b(g)) is amended by striking ``$15'' and 
inserting ``$40''.
    (c) Elimination of Statute of Limitation for Loan Collections.--
            (1) In general.--Section 836 of the Public Health Service 
        Act (42 U.S.C. 297b) is amended by adding at the end the 
        following new subsection:

    ``(l) Elimination of Statute of Limitation for Loan Collections.--
            ``(1) Purpose.--It is the purpose of this subsection to 
        ensure that obligations to repay loans under this section are 
        enforced without regard to any Federal or State statutory, 
        regulatory, or administrative limitation on the period within 
        which debts may be enforced.

[[Page 112 STAT. 3576]]

            ``(2) Prohibition.--Notwithstanding any other provision of 
        Federal or State law, no limitation shall terminate the period 
        within which suit may be filed, a judgment may be enforced, or 
        an offset, garnishment, or other action may be initiated or 
        taken by a school of nursing that has an agreement with the 
        Secretary pursuant to section 835 that is seeking the repayment 
        of the amount due from a borrower on a loan made under this 
        subpart after the default of the borrower on such loan.''.
            (2) Effective <<NOTE: 42 USC 297b note.>> date.--The 
        amendment made by paragraph (1) shall be effective with respect 
        to actions pending on or after the date of enactment of this 
        Act.

    (d) Breach of Agreements.--Section 846 of the Public Health Service 
Act (42 U.S.C. 297n) is amended by adding at the end thereof the 
following new subsection:
    ``(h) Breach of Agreement.--
            ``(1) In general.--In the case of any program under this 
        section under which an individual makes an agreement to provide 
        health services for a period of time in accordance with such 
        program in consideration of receiving an award of Federal funds 
        regarding education as a nurse (including an award for the 
        repayment of loans), the following applies if the agreement 
        provides that this subsection is applicable:
                    ``(A) In the case of a program under this section 
                that makes an award of Federal funds for attending an 
                accredited program of nursing (in this section referred 
                to as a `nursing program'), the individual is liable to 
                the Federal Government for the amount of such award 
                (including amounts provided for expenses related to such 
                attendance), and for interest on such amount at the 
                maximum legal prevailing rate, if the individual--
                          ``(i) fails to maintain an acceptable level of 
                      academic standing in the nursing program (as 
                      indicated by the program in accordance with 
                      requirements established by the Secretary);
                          ``(ii) is dismissed from the nursing program 
                      for disciplinary reasons; or
                          ``(iii) voluntarily terminates the nursing 
                      program.
                    ``(B) The individual is liable to the Federal 
                Government for the amount of such award (including 
                amounts provided for expenses related to such 
                attendance), and for interest on such amount at the 
                maximum legal prevailing rate, if the individual fails 
                to provide health services in accordance with the 
                program under this section for the period of time 
                applicable under the program.
            ``(2) Waiver or suspension of liability.--In the case of an 
        individual or health facility making an agreement for purposes 
        of paragraph (1), the Secretary shall provide for the waiver or 
        suspension of liability under such subsection if compliance by 
        the individual or the health facility, as the case may be, with 
        the agreements involved is impossible, or would involve extreme 
        hardship to the individual or facility, and if enforcement of 
        the agreements with respect to the individual or facility would 
        be unconscionable.
            ``(3) Date certain for recovery.--Subject to paragraph (2), 
        any amount that the Federal Government is entitled to recover 
        under paragraph (1) shall be paid to the United States

[[Page 112 STAT. 3577]]

        not later than the expiration of the 3-year period beginning on 
        the date the United States becomes so entitled.
            ``(4) Availability.--Amounts recovered under paragraph (1) 
        with respect to a program under this section shall be available 
        for the purposes of such program, and shall remain available for 
        such purposes until expended.''.

    (e) Technical Amendments.--Section 839 of the Public Health Service 
Act (42 U.S.C. 297e) is amended--
            (1) in subsection (a)--
                    (A) by striking the matter preceding paragraph (1) 
                and inserting the following:

    ``(a) If a school terminates a loan fund established under an 
agreement pursuant to section 835(b), or if the Secretary for good cause 
terminates the agreement with the school, there shall be a capital 
distribution as follows:''; and
                    (B) in paragraph (1), by striking ``at the close of 
                September 30, 1999,'' and inserting ``on the date of 
                termination of the fund''; and
            (2) in subsection (b), to read as follows:

    ``(b) If a capital distribution is made under subsection (a), the 
school involved shall, after such capital distribution, pay to the 
Secretary, not less often than quarterly, the same proportionate share 
of amounts received by the school in payment of principal or interest on 
loans made from the loan fund established under section 835(b) as 
determined by the Secretary under subsection (a).''.

SEC. 134. GENERAL PROVISIONS.

    (a) Maximum Student Loan Provisions and Minimum Payments.--
            (1) In general.--Section 722(a)(1) of the Public Health 
        Service Act (42 U.S.C. 292r(a)(1)), as amended by section 
        2014(b)(1) of Public Law 103-43, is amended by striking ``the 
        sum of'' and all that follows through the end thereof and 
        inserting ``the cost of attendance (including tuition, other 
        reasonable educational expenses, and reasonable living costs) 
        for that year at the educational institution attended by the 
        student (as determined by such educational institution).''.
            (2) Third and fourth years.--Section 722(a)(2) of the Public 
        Health Service Act (42 U.S.C. 292r(a)(2)), as amended by section 
        2014(b)(1) of Public Law 103-43, is amended by striking ``the 
        amount $2,500'' and all that follows through ``including such 
        $2,500)'' and inserting ``the amount of the loan may, in the 
        case of the third or fourth year of a student at a school of 
        medicine or osteopathic medicine, be increased to the extent 
        necessary''.
            (3) Repayment period.--Section 722(c) of the Public Health 
        Service Act (42 U.S.C. 292r(c)), as amended by section 
        2014(b)(1) of Public Law 103-43, is amended--
                    (A) in the subsection heading by striking ``Ten-
                Year'' and inserting ``Repayment'';
                    (B) by striking ``ten-year period which begins'' and 
                inserting ``period of not less than 10 years nor more 
                than 25 years, at the discretion of the institution, 
                which begins''; and
                    (C) by striking ``such ten-year period'' and 
                inserting ``such period''.

[[Page 112 STAT. 3578]]

            (4) Minimum payments.--Section 722(j) of the Public Health 
        Service Act (42 U.S.C. 292r(j)), as amended by section 
        2014(b)(1) of Public Law 103-43, is amended by striking ``$15'' 
        and inserting ``$40''.

    (b) Elimination of Statute of Limitation for Loan Collections.--
            (1) In general.--Section 722 of the Public Health Service 
        Act (42 U.S.C. 292r), as amended by section 2014(b)(1) of Public 
        Law 103-43, is amended by adding at the end the following new 
        subsection:

    ``(m) Elimination of Statute of Limitation for Loan Collections.--
            ``(1) Purpose.--It is the purpose of this subsection to 
        ensure that obligations to repay loans under this section are 
        enforced without regard to any Federal or State statutory, 
        regulatory, or administrative limitation on the period within 
        which debts may be enforced.
            ``(2) Prohibition.--Notwithstanding any other provision of 
        Federal or State law, no limitation shall terminate the period 
        within which suit may be filed, a judgment may be enforced, or 
        an offset, garnishment, or other action may be initiated or 
        taken by a school that has an agreement with the Secretary 
        pursuant to section 721 that is seeking the repayment of the 
        amount due from a borrower on a loan made under this subpart 
        after the default of the borrower on such loan.''.
            (2) Effective <<NOTE: 42 USC 292r note.>> date.--The 
        amendment made by paragraph (1) shall be effective with respect 
        to actions pending on or after the date of enactment of this 
        Act.

    (c) Date Certain for Contributions.--Paragraph (2) of section 735(e) 
of the Public Health Service Act (42 U.S.C. 292y(e)(2)) is amended to 
read as follows:
            ``(2) Date certain for contributions.--Amounts described in 
        paragraph (1) that are returned to the Secretary shall be 
        obligated before the end of the succeeding fiscal year.''.

    CHAPTER 2--INSURED HEALTH EDUCATION ASSISTANCE LOANS TO GRADUATE 
                                STUDENTS

SEC. 141. HEALTH EDUCATION ASSISTANCE LOAN PROGRAM.

    (a) Health Education Assistance Loan Deferment for Borrowers 
Providing Health Services to Indians.--
            (1) In general.--Section 705(a)(2)(C) of the Public Health 
        Service Act (42 U.S.C. 292d(a)(2)(C)) is amended by striking 
        ``and (x)'' and inserting ``(x) not in excess of three years, 
        during which the borrower is providing health care services to 
        Indians through an Indian health program (as defined in section 
        108(a)(2)(A) of the Indian Health Care Improvement Act (25 
        U.S.C. 1616a(a)(2)(A)); and (xi)''.
            (2) Conforming amendments.--Section 705(a)(2)(C) of the 
        Public Health Service Act (42 U.S.C. 292d(a)(2)(C)) is further 
        amended--
                    (A) in clause (xi) (as so redesignated) by striking 
                ``(ix)'' and inserting ``(x)''; and
                    (B) in the matter following such clause (xi), by 
                striking ``(x)'' and inserting ``(xi)''.
            (3) Effective <<NOTE: 42 USC 292d note.>> date.--The 
        amendments made by this subsection shall apply with respect to 
        services provided on or

[[Page 112 STAT. 3579]]

        after the first day of the third month that begins after the 
        date of the enactment of this Act.

    (b) Report Requirement.--Section 709(b) of the Public Health Service 
Act (42 U.S.C. 292h(b)) is amended--
            (1) in paragraph (4)(B), by adding ``and'' after the 
        semicolon;
            (2) in paragraph (5), by striking ``; and'' and inserting a 
        period; and
            (3) by striking paragraph (6).

    (c) Program Eligibility.--
            (1) Limitations on loans.--Section 703(a) of the Public 
        Health Service Act (42 U.S.C. 292b(a)) is amended by striking 
        ``or clinical psychology'' and inserting ``or behavioral and 
        mental health practice, including clinical psychology''.
            (2) Definition of eligible institution.--Section 719(1) of 
        the Public Health Service Act (42 U.S.C. 292o(1)) is amended by 
        striking ``or clinical psychology'' and inserting ``or 
        behavioral and mental health practice, including clinical 
        psychology''.

SEC. 142. HEAL LENDER AND HOLDER PERFORMANCE STANDARDS.

    (a) General Amendments.--Section 707(a) of the Public Health Service 
Act (42 U.S.C. 292f) is amended--
            (1) by striking the last sentence;
            (2) by striking ``determined.'' and inserting ``determined, 
        except that, if the insurance beneficiary including any servicer 
        of the loan is not designated for `exceptional performance', as 
        set forth in paragraph (2), the Secretary shall pay to the 
        beneficiary a sum equal to 98 percent of the amount of the loss 
        sustained by the insured upon that loan.'';
            (3) by striking ``Upon'' and inserting:
            ``(1) In general.--Upon''; and
            (4) by adding at the end the following new paragraph:
            ``(2) Exceptional performance.--
                    ``(A) Authority.--Where the Secretary determines 
                that an eligible lender, holder, or servicer has a 
                compliance performance rating that equals or exceeds 97 
                percent, the Secretary shall designate that eligible 
                lender, holder, or servicer, as the case may be, for 
                exceptional performance.
                    ``(B) Compliance performance rating.--For purposes 
                of subparagraph (A), a compliance performance rating is 
                determined with respect to compliance with due diligence 
                in the disbursement, servicing, and collection of loans 
                under this subpart for each year for which the 
                determination is made. Such rating shall be equal to the 
                percentage of all due diligence requirements applicable 
                to each loan, on average, as established by the 
                Secretary, with respect to loans serviced during the 
                period by the eligible lender, holder, or servicer.
                    ``(C) Annual audits for lenders, holders, and 
                servicers.--Each eligible lender, holder, or servicer 
                desiring a designation under subparagraph (A) shall have 
                an annual financial and compliance audit conducted with 
                respect to the loan portfolio of such eligible lender, 
                holder, or servicer, by a qualified independent 
                organization from a list of qualified organizations 
                identified by the Secretary and in accordance with 
                standards established by the Secretary. The standards 
                shall measure the lender's, holder's, or servicer's 
                compliance with due diligence standards and

[[Page 112 STAT. 3580]]

                shall include a defined statistical sampling technique 
                designed to measure the performance rating of the 
                eligible lender, holder, or servicer for the purpose of 
                this section. Each eligible lender, holder, or servicer 
                shall submit the audit required by this section to the 
                Secretary.
                    ``(D) Secretary's determinations.--The Secretary 
                shall make the determination under subparagraph (A) 
                based upon the audits submitted under this paragraph and 
                any information in the possession of the Secretary or 
                submitted by any other agency or office of the Federal 
                Government.
                    ``(E) Quarterly compliance audit.--To maintain its 
                status as an exceptional performer, the lender, holder, 
                or servicer shall undergo a quarterly compliance audit 
                at the end of each quarter (other than the quarter in 
                which status as an exceptional performer is established 
                through a financial and compliance audit, as described 
                in subparagraph (C)), and submit the results of such 
                audit to the Secretary. The compliance audit shall 
                review compliance with due diligence requirements for 
                the period beginning on the day after the ending date of 
                the previous audit, in accordance with standards 
                determined by the Secretary.
                    ``(F) Revocation authority.--The Secretary shall 
                revoke the designation of a lender, holder, or servicer 
                under subparagraph (A) if any quarterly audit required 
                under subparagraph (E) is not received by the Secretary 
                by the date established by the Secretary or if the audit 
                indicates the lender, holder, or servicer has failed to 
                meet the standards for designation as an exceptional 
                performer under subparagraph (A). A lender, holder, or 
                servicer receiving a compliance audit not meeting the 
                standard for designation as an exceptional performer may 
                reapply for designation under subparagraph (A) at any 
                time.
                    ``(G) Documentation.--Nothing in this section shall 
                restrict or limit the authority of the Secretary to 
                require the submission of claims documentation 
                evidencing servicing performed on loans, except that the 
                Secretary may not require exceptional performers to 
                submit greater documentation than that required for 
                lenders, holders, and servicers not designated under 
                subparagraph (A).
                    ``(H) Cost of audits.--Each eligible lender, holder, 
                or servicer shall pay for all the costs associated with 
                the audits required under this section.
                    ``(I) Additional revocation authority.--
                Notwithstanding any other provision of this section, a 
                designation under subparagraph (A) may be revoked at any 
                time by the Secretary if the Secretary determines that 
                the eligible lender, holder, or servicer has failed to 
                maintain an overall level of compliance consistent with 
                the audit submitted by the eligible lender, holder, or 
                servicer under this paragraph or if the Secretary 
                asserts that the lender, holder, or servicer may have 
                engaged in fraud in securing designation under 
                subparagraph (A) or is failing to service loans in 
                accordance with program requirements.
                    ``(J) Noncompliance.--A lender, holder, or servicer 
                designated under subparagraph (A) that fails to service

[[Page 112 STAT. 3581]]

                loans or otherwise comply with applicable program 
                regulations shall be considered in violation of the 
                Federal False Claims Act.''.

    (b) Definition.--Section 707(e) of the Public Health Service Act (42 
U.S.C. 292f(e)) is amended by adding at the end the following new 
paragraph:
            ``(4) The term `servicer' means any agency acting on behalf 
        of the insurance beneficiary.''.

    (c) Effective <<NOTE: 42 USC 292f note.>> Date.--The amendments made 
by subsections (a) and (b) shall apply with respect to loans submitted 
to the Secretary for payment on or after the first day of the sixth 
month that begins after the date of enactment of this Act.

SEC. 143. INSURANCE PROGRAM.

    Section 710(a)(2)(B) of the Public Health Service Act (42 U.S.C. 
292i(a)(2)(B)) is amended by striking ``any of the fiscal years 1993 
through 1996'' and inserting ``fiscal year 1993 and subsequent fiscal 
years''.

SEC. 144. HEAL BANKRUPTCY.

    (a) In General.--Section 707(g) of the Public Health Service Act (42 
U.S.C. 292f(g)) is amended in the first sentence by striking ``A debt 
which is a loan insured'' and inserting ``Notwithstanding any other 
provision of Federal or State law, a debt that is a loan insured''.
    (b) Application.--The <<NOTE: 42 USC 292f note.>> amendment made by 
subsection (a) shall apply to any loan insured under the authority of 
subpart I of part A of title VII of the Public Health Service Act (42 
U.S.C. 292 et seq.) that is listed or scheduled by the debtor in a case 
under title XI, United States Code, filed--
            (1) on or after the date of enactment of this Act; or
            (2) prior to such date of enactment in which a discharge has 
        not been granted.

SEC. 145. HEAL REFINANCING.

    Section 706 of the Public Health Service Act (42 U.S.C. 292e) is 
amended--
            (1) in subsection (d)--
                    (A) in the subsection heading, by striking 
                ``Consolidation'' and inserting ``Refinancing or 
                Consolidation''; and
                    (B) in the first sentence, by striking 
                ``indebtedness'' and inserting ``indebtedness or the 
                refinancing of a single loan''; and
            (2) in subsection (e)--
                    (A) in the subsection heading, by striking ``Debts'' 
                and inserting ``Debts and Refinancing'';
                    (B) in the first sentence, by striking ``all of the 
                borrower's debts into a single instrument'' and 
                inserting ``all of the borrower's loans insured under 
                this subpart into a single instrument (or, if the 
                borrower obtained only 1 loan insured under this 
                subpart, refinancing the loan 1 time)''; and
                    (C) in the second sentence, by striking 
                ``consolidation'' and inserting ``consolidation or 
                refinancing''.

[[Page 112 STAT. 3582]]

                   TITLE II--OFFICE OF MINORITY HEALTH

SEC. 201. REVISION AND EXTENSION OF PROGRAMS OF OFFICE OF MINORITY 
                        HEALTH.

    (a) Duties and Requirements.--Section 1707 of the Public Health 
Service Act (42 U.S.C. 300u-6) is amended by striking subsection (b) and 
all that follows and inserting the following:
    ``(b) Duties.--With respect to improving the health of racial and 
ethnic minority groups, the Secretary, acting through the Deputy 
Assistant Secretary for Minority Health (in this section referred to as 
the `Deputy Assistant Secretary'), shall carry out the following:
            ``(1) Establish short-range and long-range goals and 
        objectives and coordinate all other activities within the Public 
        Health Service that relate to disease prevention, health 
        promotion, service delivery, and research concerning such 
        individuals. The heads of each of the agencies of the Service 
        shall consult with the Deputy Assistant Secretary to ensure the 
        coordination of such activities.
            ``(2) Enter into interagency agreements with other agencies 
        of the Public Health Service.
            ``(3) Support research, demonstrations and evaluations to 
        test new and innovative models.
            ``(4) Increase knowledge and understanding of health risk 
        factors.
            ``(5) Develop mechanisms that support better information 
        dissemination, education, prevention, and service delivery to 
        individuals from disadvantaged backgrounds, including 
        individuals who are members of racial or ethnic minority groups.
            ``(6) Ensure that the National Center for Health Statistics 
        collects data on the health status of each minority group.
            ``(7) With respect to individuals who lack proficiency in 
        speaking the English language, enter into contracts with public 
        and nonprofit private providers of primary health services for 
        the purpose of increasing the access of the individuals to such 
        services by developing and carrying out programs to provide 
        bilingual or interpretive services.
            ``(8) Support a national minority health resource center to 
        carry out the following:
                    ``(A) Facilitate the exchange of information 
                regarding matters relating to health information and 
                health promotion, preventive health services, and 
                education in the appropriate use of health care.
                    ``(B) Facilitate access to such information.
                    ``(C) Assist in the analysis of issues and problems 
                relating to such matters.
                    ``(D) Provide technical assistance with respect to 
                the exchange of such information (including facilitating 
                the development of materials for such technical 
                assistance).
            ``(9) Carry out programs to improve access to health care 
        services for individuals with limited proficiency in speaking 
        the English language. Activities under the preceding sentence 
        shall include developing and evaluating model projects.

    ``(c) Advisory Committee.--

[[Page 112 STAT. 3583]]

            ``(1) In general.--The Secretary shall establish an advisory 
        committee to be known as the Advisory Committee on Minority 
        Health (in this subsection referred to as the `Committee').
            ``(2) Duties.--The Committee shall provide advice to the 
        Deputy Assistant Secretary carrying out this section, including 
        advice on the development of goals and specific program 
        activities under paragraphs (1) through (9) of subsection (b) 
        for each racial and ethnic minority group.
            ``(3) Chair.--The chairperson of the Committee shall be 
        selected by the Secretary from among the members of the voting 
        members of the Committee. The term of office of the chairperson 
        shall be 2 years.
            ``(4) Composition.--
                    ``(A) The Committee shall be composed of 12 voting 
                members appointed in accordance with subparagraph (B), 
                and nonvoting, ex officio members designated in 
                subparagraph (C).
                    ``(B) The voting members of the Committee shall be 
                appointed by the Secretary from among individuals who 
                are not officers or employees of the Federal Government 
                and who have expertise regarding issues of minority 
                health. The racial and ethnic minority groups shall be 
                equally represented among such members.
                    ``(C) The nonvoting, ex officio members of the 
                Committee shall be such officials of the Department of 
                Health and Human Services as the Secretary determines to 
                be appropriate.
            ``(5) Terms.--Each member of the Committee shall serve for a 
        term of 4 years, except that the Secretary shall initially 
        appoint a portion of the members to terms of 1 year, 2 years, 
        and 3 years.
            ``(6) Vacancies.--If a vacancy occurs on the Committee, a 
        new member shall be appointed by the Secretary within 90 days 
        from the date that the vacancy occurs, and serve for the 
        remainder of the term for which the predecessor of such member 
        was appointed. The vacancy shall not affect the power of the 
        remaining members to execute the duties of the Committee.
            ``(7) Compensation.--Members of the Committee who are 
        officers or employees of the United States shall serve without 
        compensation. Members of the Committee who are not officers or 
        employees of the United States shall receive compensation, for 
        each day (including travel time) they are engaged in the 
        performance of the functions of the Committee. Such compensation 
        may not be in an amount in excess of the daily equivalent of the 
        annual maximum rate of basic pay payable under the General 
        Schedule (under title 5, United States Code) for positions above 
        GS-15.

    ``(d) Certain Requirements Regarding Duties.--
            ``(1) Recommendations regarding language as impediment to 
        health care.--The Deputy Assistant Secretary for Minority Health 
        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).

[[Page 112 STAT. 3584]]

            ``(2) Equitable allocation regarding activities.--In 
        carrying out subsection (b), the Secretary shall ensure that 
        services provided under such subsection are equitably allocated 
        among all groups served under this section by the Secretary.
            ``(3) Cultural competency of services.--The Secretary shall 
        ensure that information and services provided pursuant to 
        subsection (b) are provided in the language, educational, and 
        cultural context that is most appropriate for the individuals 
        for whom the information and services are intended.

    ``(e) Grants and Contracts Regarding Duties.--
            ``(1) In general.--In carrying out subsection (b), the 
        Secretary acting through the Deputy Assistant Secretary may make 
        awards of grants, cooperative agreements, and contracts to 
        public and nonprofit private entities.
            ``(2) Process for making awards.--The Deputy Assistant 
        Secretary shall ensure that awards under paragraph (1) are made, 
        to the extent practical, only on a competitive basis, and that a 
        grant is awarded for a proposal only if the proposal has been 
        recommended for such an award through a process of peer review.
            ``(3) Evaluation and dissemination.--The Deputy Assistant 
        Secretary, directly or through contracts with public and private 
        entities, shall provide for evaluations of projects carried out 
        with awards made under paragraph (1) during the preceding 2 
        fiscal years. The report shall be included in the report 
        required under subsection (f) for the fiscal year involved.

    ``(f) Reports.--
            ``(1) In general.--Not later than February 1 of fiscal year 
        1999 and of each second year thereafter, the Secretary shall 
        submit to the Committee on Energy and Commerce of the House of 
        Representatives, and to the Committee on Labor and Human 
        Resources of the Senate, a report describing the activities 
        carried out under this section during the preceding 2 fiscal 
        years and evaluating the extent to which such activities have 
        been effective in improving the health of racial and ethnic 
        minority groups. Each such report shall include the biennial 
        reports submitted under sections 201(e)(3) and 201(f)(2) for 
        such years by the heads of the Public Health Service agencies.
            ``(2) Agency reports.--Not later than February 1, 1999, and 
        biennially thereafter, the heads of the Public Health Service 
        agencies shall submit to the Deputy Assistant Secretary a report 
        summarizing the minority health activities of each of the 
        respective agencies.

    ``(g) Definition.--For purposes of this section:
            ``(1) The term `racial and ethnic minority group' means 
        American Indians (including Alaska Natives, Eskimos, and 
        Aleuts); Asian Americans and Pacific Islanders; Blacks; and 
        Hispanics.
            ``(2) The term `Hispanic' means individuals whose origin is 
        Mexican, Puerto Rican, Cuban, Central or South American, or any 
        other Spanish-speaking country.

    ``(h) Funding.--
            ``(1) Authorization of appropriations.--For the purpose of 
        carrying out this section, there are authorized to be 
        appropriated $30,000,000 for fiscal year 1998, and such sums as 
        may be necessary for each of the fiscal years 1999 through 
        2002.''.

[[Page 112 STAT. 3585]]

    (b) Authorization for National Center for Health Statistics.--
Section 306 of the Public Health Service Act (42 U.S.C. 242k) is 
amended--
            (1) in subsection (m), by adding at the end the following:

    ``(4)(A) Subject to subparagraph (B), the Secretary, acting through 
the Center, shall collect data on Hispanics and major Hispanic 
subpopulation groups and American Indians, and for developing special 
area population studies on major Asian American and Pacific Islander 
populations.
    ``(B) The provisions of subparagraph (A) shall be effective with 
respect to a fiscal year only to the extent that funds are appropriated 
pursuant to paragraph (3) of subsection (n), and only if the amounts 
appropriated for such fiscal year pursuant to each of paragraphs (1) and 
(2) of subsection (n) equal or exceed the amounts so appropriated for 
fiscal year 1997.'';
            (2) in subsection (n)(1), by striking ``through 1998'' and 
        inserting ``through 2003''; and
            (3) in subsection (n)--
                    (A) in the first sentence of paragraph (2)--
                          (i) by striking ``authorized in subsection 
                      (m)'' and inserting ``authorized in paragraphs (1) 
                      through (3) of subsection (m)''; and
                          (ii) by striking ``$5,000,000'' and all that 
                      follows through the period and inserting ``such 
                      sums as may be necessary for each of the fiscal 
                      years 1999 through 2003.''; and
                    (B) by adding at the end the following:

    ``(3) For activities authorized in subsection (m)(4), there are 
authorized to be appropriated $1,000,000 for fiscal year 1998, and such 
sums as may be necessary for each of the fiscal years 1999 through 
2002.''.
    (c) Miscellaneous Amendments.--Section 1707 of the Public Health 
Service Act (42 U.S.C. 300u-6) is amended--
            (1) in the heading for the section by striking 
        ``establishment of''; and
            (2) in subsection (a), by striking ``Office of the Assistant 
        Secretary for Health'' and inserting ``Office of Public Health 
        and Science''.

                     TITLE III--SELECTED INITIATIVES

SEC. 301. STATE OFFICES OF RURAL HEALTH.

    Section 338J of the Public Health Service Act (42 U.S.C. 254r) is 
amended--
            (1) in subsection (b)(1), in the matter preceding 
        subparagraph (A), by striking ``in cash''; and
            (2) in subsection (j)(1)--
                    (A) by striking ``and'' after ``1992,''; and
                    (B) by inserting before the period the following: 
                ``, and such sums as may be necessary for each of the 
                fiscal years 1998 through 2002''; and
            (3) in subsection (k), by striking ``$10,000,000'' and 
        inserting ``$36,000,000''.

[[Page 112 STAT. 3586]]

SEC. 302. DEMONSTRATION PROJECTS REGARDING ALZHEIMER'S DISEASE.

    (a) In General.--Section 398(a) of the Public Health Service Act (42 
U.S.C. 280c-3(a)) is amended--
            (1) in the matter preceding paragraph (1), by striking ``not 
        less than 5, and not more than 15,'';
            (2) in paragraph (2)--
                    (A) by inserting after ``disorders'' the following: 
                ``who are living in single family homes or in congregate 
                settings''; and
                    (B) by striking ``and'' at the end;
            (3) by redesignating paragraph (3) as paragraph (4); and
            (4) by inserting after paragraph (2) the following:
            ``(3) to improve the access of such individuals to home-
        based or community-based long-term care services (subject to the 
        services being provided by entities that were providing such 
        services in the State involved as of October 1, 1995), 
        particularly such individuals who are members of racial or 
        ethnic minority groups, who have limited proficiency in speaking 
        the English language, or who live in rural areas; and''.

    (b) Duration.--Section 398A of the Public Health Service Act (42 
U.S.C. 280c-4) is amended--
            (1) in the heading for the section, by striking 
        ``LIMITATION'' and all that follows and inserting ``REQUIREMENT 
        OF MATCHING FUNDS'';
            (2) by striking subsection (a);
            (3) by redesignating subsections (b) and (c) as subsections 
        (a) and (b), respectively; and
            (4) in subsection (a) (as so redesignated), in each of 
        paragraphs (1)(C) and (2)(C), by striking ``third year'' and 
        inserting ``third or subsequent year''.

    (c) Authorization of Appropriations.--Section 398B(e) of the Public 
Health Service Act (42 U.S.C. 280c-5(e)) is amended--
            (1) by striking ``and such sums'' and inserting ``such 
        sums''; and
            (2) by inserting before the period the following: 
        ``, $8,000,000 for fiscal year 1998, and such sums as may be 
        necessary for each of the fiscal years 1999 through 2002''.

SEC. 303. PROJECT GRANTS FOR IMMUNIZATION SERVICES.

    Section 317(j) of the Public Health Service Act (42 U.S.C. 247b(j)) 
is amended--
            (1) in paragraph (1), by striking ``individuals against 
        vaccine-preventable diseases'' and all that follows through the 
        first period and inserting the following: ``children, 
        adolescents, and adults against vaccine-preventable diseases, 
        there are authorized to be appropriated such sums as may be 
        necessary for each of the fiscal years 1998 through 2002.''; and
            (2) in paragraph (2), by striking ``1990'' and inserting 
        ``1997''.

[[Page 112 STAT. 3587]]

                   TITLE IV--MISCELLANEOUS PROVISIONS

SEC. 401. TECHNICAL CORRECTIONS REGARDING PUBLIC LAW 103-183.

    (a) Amendatory Instructions.--Public Law 103-183 is amended--
            (1) in section 601--
                    (A) <<NOTE: 42 USC 300d-1-- 300d-3.>> in subsection 
                (b), in the matter preceding paragraph (1), by striking 
                ``Section 1201 of the Public Health Service Act (42 
                U.S.C. 300d)'' and inserting ``Title XII of the Public 
                Health Service Act (42 U.S.C. 300d et seq.)''; and
                    (B) <<NOTE: 42 USC 300d-3.>> in subsection (f)(1), 
                by striking ``in section 1204(c)'' and inserting ``in 
                section 1203(c) (as redesignated by subsection (b)(2) of 
                this section)'';
            (2) <<NOTE: 42 USC 300d-32.>> in section 602, by striking 
        ``for the purpose'' and inserting ``For the purpose''; and
            (3) <<NOTE: 42 USC 247b-5.>> in section 705(b), by striking 
        ``317D((l)(1)'' and inserting ``317D(l)(1)''.

    (b) Public Health Service Act.--The Public Health Service Act, as 
amended by Public Law 103-183 and by subsection (a) of this section, is 
amended--
            (1) <<NOTE: 42 USC 247b-6.>> in section 317E(g)(2), by 
        striking ``making grants under subsection (b)'' and inserting 
        ``carrying out subsection (b)'';
            (2) <<NOTE: 42 USC 247c.>> in section 318, in subsection (e) 
        as in effect on the day before the date of the enactment of 
        Public Law 103-183, by redesignating the subsection as 
        subsection (f);
            (3) <<NOTE: 42 USC 285f-2.>> in subpart 6 of part C of title 
        IV--
                    (A) by transferring the first section 447 (added by 
                section 302 of Public Law 103-183) from the current 
                placement of the section;
                    (B) by redesignating the section as section 447A; 
                and
                    (C) by inserting the section after section 447;
            (4) <<NOTE: 42 USC 300d-13.>> in section 1213(a)(8), by 
        striking ``provides for for'' and inserting ``provides for'';
            (5) <<NOTE: 42 USC 300k.>> in section 1501, by redesignating 
        the second subsection (c) (added by section 101(f) of Public Law 
        103-183) as subsection (d); and
            (6) <<NOTE: 42 USC 300n-1.>> in section 1505(3), by striking 
        ``nonprofit''.

    (c) Miscellaneous Correction.--Section 401(c)(3) of Public Law 103-
183 <<NOTE: 42 USC 247c.>> is amended in the matter preceding 
subparagraph (A) by striking ``(d)(5)'' and inserting ``(e)(5)''.

    (d) Conforming Amendment.--Section 308(b) of the Public Health 
Service Act (42 U.S.C. 242m(b)) is amended--
            (1) in paragraph (2)(A), by striking ``306(n)'' and 
        inserting ``306(m)''; and
            (2) in paragraph (2)(C), by striking ``306(n)'' and 
        inserting ``306(m)''.

    (e) Effective <<NOTE: 42 USC 242m note.>> Date.--This section is 
deemed to have taken effect immediately after the enactment of Public 
Law 103-183.
SEC. 402. MISCELLANEOUS AMENDMENTS REGARDING PHS COMMISSIONED 
                        OFFICERS.

    (a) Anti-Discrimination Laws.--Amend section 212 of the Public 
Health Service Act (42 U.S.C. 213) by adding the following new 
subsection at the end thereof:

[[Page 112 STAT. 3588]]

    ``(f) Active service of commissioned officers of the Service shall 
be deemed to be active military service in the Armed Forces of the 
United States for purposes of all laws related to discrimination on the 
basis of race, color, sex, ethnicity, age, religion, and disability.''.
    (b) Training in Leave Without Pay Status.--Section 218 of the Public 
Health Service Act (42 U.S.C. 218a) is amended by adding at the end the 
following:
    ``(c) A commissioned officer may be placed in leave without pay 
status while attending an educational institution or training program 
whenever the Secretary determines that such status is in the best 
interest of the Service. For purposes of computation of basic pay, 
promotion, retirement, compensation for injury or death, and the 
benefits provided by sections 212 and 224, an officer in such status 
pursuant to the preceding sentence shall be considered as performing 
service in the Service and shall have an active service obligation as 
set forth in subsection (b) of this section.''.
    (c) Utilization of Alcohol and Drug Abuse Records That Apply to the 
Armed Forces.--Section 543(e) of the Public Health Service Act (42 
U.S.C. 290dd-2(e)) is amended by striking ``Armed Forces'' each place 
that such term appears and inserting ``Uniformed Services''.

SEC. 403. CLINICAL TRAINEESHIPS.

    Section 303(d)(1) of the Public Health Service Act (42 U.S.C. 
242a(d)(1)) is amended by inserting ``counseling,'' after ``family 
therapy,''.
SEC. 404. PROJECT GRANTS FOR SCREENINGS, REFERRALS, AND EDUCATION 
                        REGARDING LEAD POISONING.

    Section 317A(l)(1) of the Public Health Service Act (42 U.S.C. 247b-
1(l)(1)) is amended by striking ``1998'' and inserting ``2002''.
SEC. 405. PROJECT GRANTS FOR PREVENTIVE HEALTH SERVICES REGARDING 
                        TUBERCULOSIS.

    Section 317E(g) of the Public Health Service Act (42 U.S.C. 247b-
6(g)(1)) is amended--
            (1) in paragraph (1)--
                    (A) in subparagraph (A), by striking ``1998'' and 
                inserting ``2002''; and
                    (B) in subparagraph (B), by striking ``$50,000,000'' 
                and inserting ``25 percent''; and
            (2) in paragraph (2), by striking ``1998'' and inserting 
        ``2002''.

SEC. 406. CDC LOAN REPAYMENT PROGRAM.

    Section 317F of the Public Health Service Act (42 U.S.C. 247b-7) is 
amended--
            (1) in subsection (a)(1), by striking ``$20,000'' and 
        inserting ``$35,000'';
            (2) in subsection (c), by striking ``1998'' and inserting 
        ``2002''; and
            (3) by adding at the end the following:

    ``(d) Availability of Appropriations.--Amounts appropriated for a 
fiscal year for contracts under subsection (a) shall remain available 
until the expiration of the second fiscal year beginning after the 
fiscal year for which the amounts were appropriated.''.

[[Page 112 STAT. 3589]]

SEC. 407. COMMUNITY PROGRAMS ON DOMESTIC VIOLENCE.

    (a) In General.--Section 318(h)(2) of the Family Violence Prevention 
and Services Act (42 U.S.C. 10418(h)(2)) is amended by striking ``fiscal 
year 1997'' and inserting ``for each of the fiscal years 1997 through 
2002''.
    (b) Study.--The <<NOTE: 42 USC 10401 note.>> Secretary of Health and 
Human Services shall request that the Institute of Medicine conduct a 
study concerning the training needs of health professionals with respect 
to the detection and referral of victims of family or acquaintance 
violence. Not later than 2 years after the date of enactment of this 
Act, the Institute of Medicine shall prepare and submit to Congress a 
report concerning the study conducted under this subsection.

SEC. 408. STATE LOAN REPAYMENT PROGRAM.

    Section 338I(i)(1) of the Public Health Service Act (42 U.S.C. 254q-
1(i)(1)) is amended by inserting before the period ``, and such sums as 
may be necessary for each of the fiscal years 1998 through 2002''.

SEC. 409. AUTHORITY OF THE DIRECTOR OF NIH.

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

SEC. 410. RAISE IN MAXIMUM LEVEL OF LOAN REPAYMENTS.

    (a) Repayment Programs With Respect to AIDS.--Section 487A of the 
Public Health Service Act (42 U.S.C. 288-1) is amended--
            (1) in subsection (a), by striking ``$20,000'' and inserting 
        ``$35,000''; and
            (2) in subsection (c), by striking ``1996'' and inserting 
        ``2001''.

    (b) Repayment Programs With Respect to Contraception and 
Infertility.--Section 487B(a) of the Public Health Service Act (42 
U.S.C. 288-2(a)) is amended by striking ``$20,000'' and inserting 
``$35,000''.
    (c) Repayment Programs With Respect to Research Generally.--Section 
487C(a)(1) of the Public Health Service Act (42 U.S.C. 288-3(a)(1)) is 
amended by striking ``$20,000'' and inserting ``$35,000''.
    (d) Repayment Programs With Respect to Clinical Researchers From 
Disadvantaged Backgrounds.--Section

[[Page 112 STAT. 3590]]

487E(a) of the Public Health Service Act (42 U.S.C. 288-5(a)) is 
amended--
            (1) in paragraph (1), by striking ``$20,000'' and inserting 
        ``$35,000''; and
            (2) in paragraph (3), by striking ``338C'' and inserting 
        ``338B, 338C''.
SEC. 411. CONSTRUCTION OF REGIONAL CENTERS FOR RESEARCH ON 
                        PRIMATES.

    Section 481B(a) of the Public Health Service Act (42 U.S.C. 287a-
3(a)) is amended--
            (1) by striking ``shall'' and inserting ``may''; and
            (2) by striking ``$5,000,000'' and inserting ``up to 
        $2,500,000''.

SEC. 412. PEER REVIEW.

    Section 504(d)(2) of the Public Health Service Act (42 U.S.C. 290aa-
3(d)(2)) is amended by striking ``cooperative agreement, or contract'' 
each place that such term appears and inserting ``or cooperative 
agreement''.

SEC. 413. FUNDING FOR TRAUMA CARE.

    Section 1232(a) of the Public Health Service Act (42 U.S.C. 300d-32) 
is amended by striking ``and 1996'' and inserting ``through 2002''.

SEC. 414. HEALTH INFORMATION AND HEALTH PROMOTION.

    Section 1701(b) of the Public Health Service Act (42 U.S.C. 300u(b)) 
is amended by striking ``through 1996'' and inserting ``through 2002''.

SEC. 415. EMERGENCY MEDICAL SERVICES FOR CHILDREN.

    Section 1910 of the Public Health Service Act (42 U.S.C. 300w-9) is 
amended--
            (1) in subsection (a)--
                    (A) by striking ``two-year period'' and inserting 
                ``3-year period (with an optional 4th year based on 
                performance)''; and
                    (B) by striking ``one grant'' and inserting ``3 
                grants''; and
            (2) in subsection (d), by striking ``1997'' and inserting 
        ``2005''.

SEC. 416. ADMINISTRATION OF CERTAIN REQUIREMENTS.

    (a) In General.--Section 2004 of Public Law 103-43 (107 Stat. 
209) <<NOTE: 42 USC 238f note.>> is amended by striking subsection (a).

    (b) Conforming Amendments.--Section 2004 of Public Law 103-43, as 
amended by subsection (a) of this section, is amended--
            (1) by striking ``(b) Sense'' and all that follows through 
        ``In the case'' and inserting the following:

    ``(a) Sense of Congress Regarding Purchase of American-Made 
Equipment and Products.--In the case'';
            (2) by striking ``(2) Notice to recipients of assistance'' 
        and inserting the following:

    ``(b) Notice to Recipients of Assistance''; and
            (3) in subsection (b), as redesignated by paragraph (2) of 
        this subsection, by striking ``paragraph (1)'' and inserting 
        ``subsection (a)''.

[[Page 112 STAT. 3591]]

    (c) Effective <<NOTE: 42 USC 238f note.>> Date.--This section is 
deemed to have taken effect immediately after the enactment of Public 
Law 103-43.

SEC. 417. AIDS DRUG ASSISTANCE PROGRAM.

    Section 2618(b)(3) of the Public Health Service Act (42 U.S.C. 
300ff-28(b)(3)) is amended--
            (1) in subparagraph (A), by striking ``and the Commonwealth 
        of Puerto Rico'' and inserting ``, the Commonwealth of Puerto 
        Rico, the Virgin Islands, and Guam''; and
            (2) in subparagraph (B), by striking ``the Virgin Islands, 
        Guam''.

SEC. 418. NATIONAL FOUNDATION FOR BIOMEDICAL RESEARCH.

    Part I of title IV of the Public Health Service Act (42 U.S.C. 290b 
et seq.) is amended--
            (1) by striking the part heading and inserting the 
        following:

      ``PART I--FOUNDATION FOR THE NATIONAL INSTITUTES OF HEALTH'';

        and
            (2) <<NOTE: 42 USC 290b.>> in section 499--
                    (A) in subsection (a), by striking ``National 
                Foundation for Biomedical Research'' and inserting 
                ``Foundation for the National Institutes of Health'';
                    (B) in subsection (k)(10)--
                          (i) by striking ``not''; and
                          (ii) by adding at the end the following: ``Any 
                      funds transferred under this paragraph shall be 
                      subject to all Federal limitations relating to 
                      federally-funded research.''; and
                    (C) in subsection (m)(1), by striking ``$200,000'' 
                and all that follows through ``1995'' and inserting 
                ``$500,000 for each fiscal year''.

SEC. 419. <<NOTE: Fetal Alcohol Syndrome and Fetal Alcohol Effect 
            Prevention and Services Act.>> FETAL ALCOHOL SYNDROME 
            PREVENTION AND SERVICES.

    (a) Short <<NOTE: 42 USC 201 note.>> Title.--This section may be 
cited as the ``Fetal Alcohol Syndrome and Fetal Alcohol Effect 
Prevention and Services Act''.

    (b) Findings.--Congress <<NOTE: 42 USC 280f note.>> finds that--
            (1) Fetal Alcohol Syndrome is the leading preventable cause 
        of mental retardation, and it is 100 percent preventable;
            (2) estimates on the number of children each year vary, but 
        according to some researchers, up to 12,000 infants are born in 
        the United States with Fetal Alcohol Syndrome, suffering 
        irreversible physical and mental damage;
            (3) thousands more infants are born each year with Fetal 
        Alcohol Effect, also known as Alcohol Related Neurobehavioral 
        Disorder (ARND), a related and equally tragic syndrome;
            (4) children of women who use alcohol while pregnant have a 
        significantly higher infant mortality rate (13.3 per 1,000) than 
        children of those women who do not use alcohol (8.6 per 1,000);
            (5) Fetal Alcohol Syndrome and Fetal Alcohol Effect are 
        national problems which can impact any child, family, or 
        community, but their threat to American Indians and Alaska 
        Natives is especially alarming;

[[Page 112 STAT. 3592]]

            (6) in some American Indian communities, where alcohol 
        dependency rates reach 50 percent and above, the chances of a 
        newborn suffering Fetal Alcohol Syndrome or Fetal Alcohol Effect 
        are up to 30 times greater than national averages;
            (7) in addition to the immeasurable toll on children and 
        their families, Fetal Alcohol Syndrome and Fetal Alcohol Effect 
        pose extraordinary financial costs to the Nation, including the 
        costs of health care, education, foster care, job training, and 
        general support services for affected individuals;
            (8) the total cost to the economy of Fetal Alcohol Syndrome 
        was approximately $2,500,000,000 in 1995, and over a lifetime, 
        health care costs for one Fetal Alcohol Syndrome child are 
        estimated to be at least $1,400,000;
            (9) researchers have determined that the possibility of 
        giving birth to a baby with Fetal Alcohol Syndrome or Fetal 
        Alcohol Effect increases in proportion to the amount and 
        frequency of alcohol consumed by a pregnant woman, and that 
        stopping alcohol consumption at any point in the pregnancy 
        reduces the emotional, physical, and mental consequences of 
        alcohol exposure to the baby; and
            (10) though approximately 1 out of every 5 pregnant women 
        drink alcohol during their pregnancy, we know of no safe dose of 
        alcohol during pregnancy, or of any safe time to drink during 
        pregnancy, thus, it is in the best interest of the Nation for 
        the Federal Government to take an active role in encouraging all 
        women to abstain from alcohol consumption during pregnancy.

    (c) Purpose.--It is the purpose of this section to establish, within 
the Department of Health and Human Services, a comprehensive program to 
help prevent Fetal Alcohol Syndrome and Fetal Alcohol Effect nationwide 
and to provide effective intervention programs and services for 
children, adolescents and adults already affected by these conditions. 
Such program shall--
            (1) coordinate, support, and conduct national, State, and 
        community-based public awareness, prevention, and education 
        programs on Fetal Alcohol Syndrome and Fetal Alcohol Effect;
            (2) coordinate, support, and conduct prevention and 
        intervention studies as well as epidemiologic research 
        concerning Fetal Alcohol Syndrome and Fetal Alcohol Effect;
            (3) coordinate, support and conduct research and 
        demonstration projects to develop effective developmental and 
        behavioral interventions and programs that foster effective 
        advocacy, educational and vocational training, appropriate 
        therapies, counseling, medical and mental health, and other 
        supportive services, as well as models that integrate or 
        coordinate such services, aimed at the unique challenges facing 
        individuals with Fetal Alcohol Syndrome or Fetal Alcohol Effect 
        and their families; and
            (4) foster coordination among all Federal, State and local 
        agencies, and promote partnerships between research institutions 
        and communities that conduct or support Fetal Alcohol Syndrome 
        and Fetal Alcohol Effect research, programs, surveillance, 
        prevention, and interventions and otherwise meet the general 
        needs of populations already affected or at risk of being 
        impacted by Fetal Alcohol Syndrome and Fetal Alcohol Effect.

[[Page 112 STAT. 3593]]

    (d) Establishment of Program.--Title III of the Public Health 
Service Act (42 U.S.C. 241 et seq.) is amended by adding at the end the 
following:

    ``PART O--FETAL ALCOHOL SYNDROME PREVENTION AND SERVICES PROGRAM

``SEC. 399G. <<NOTE: 42 USC 280f.>> ESTABLISHMENT OF FETAL ALCOHOL 
                            SYNDROME PREVENTION AND SERVICES 
                            PROGRAM.

    ``(a) Fetal Alcohol Syndrome Prevention, Intervention and Services 
Delivery Program.--The Secretary shall establish a comprehensive Fetal 
Alcohol Syndrome and Fetal Alcohol Effect prevention, intervention and 
services delivery program that shall include--
            ``(1) an education and public awareness program to support, 
        conduct, and evaluate the effectiveness of--
                    ``(A) educational programs targeting medical 
                schools, social and other supportive services, educators 
                and counselors and other service providers in all phases 
                of childhood development, and other relevant service 
                providers, concerning the prevention, identification, 
                and provision of services for children, adolescents and 
                adults with Fetal Alcohol Syndrome and Fetal Alcohol 
                Effect;
                    ``(B) strategies to educate school-age children, 
                including pregnant and high risk youth, concerning Fetal 
                Alcohol Syndrome and Fetal Alcohol Effect;
                    ``(C) public and community awareness programs 
                concerning Fetal Alcohol Syndrome and Fetal Alcohol 
                Effect; and
                    ``(D) strategies to coordinate information and 
                services across affected community agencies, including 
                agencies providing social services such as foster care, 
                adoption, and social work, medical and mental health 
                services, and agencies involved in education, vocational 
                training and civil and criminal justice;
            ``(2) a prevention and diagnosis program to support clinical 
        studies, demonstrations and other research as appropriate to--
                    ``(A) develop appropriate medical diagnostic methods 
                for identifying Fetal Alcohol Syndrome and Fetal Alcohol 
                Effect; and
                    ``(B) develop effective prevention services and 
                interventions for pregnant, alcohol-dependent women; and
            ``(3) an applied research program concerning intervention 
        and prevention to support and conduct service demonstration 
        projects, clinical studies and other research models providing 
        advocacy, educational and vocational training, counseling, 
        medical and mental health, and other supportive services, as 
        well as models that integrate and coordinate such services, that 
        are aimed at the unique challenges facing individuals with Fetal 
        Alcohol Syndrome or Fetal Alcohol Effect and their families.

    ``(b) Grants and Technical Assistance.--The Secretary may award 
grants, cooperative agreements and contracts and provide technical 
assistance to eligible entities described in section 399H to carry out 
subsection (a).
    ``(c) Dissemination of Criteria.--In carrying out this section, the 
Secretary shall develop a procedure for disseminating the Fetal

[[Page 112 STAT. 3594]]

Alcohol Syndrome and Fetal Alcohol Effect diagnostic criteria developed 
pursuant to section 705 of the ADAMHA Reorganization Act (42 U.S.C. 485n 
note) to health care providers, educators, social workers, child welfare 
workers, and other individuals.
    ``(d) National Task Force.--
            ``(1) In general.--The Secretary shall establish a task 
        force to be known as the National Task Force on Fetal Alcohol 
        Syndrome and Fetal Alcohol Effect (referred to in this 
        subsection as the `Task Force') to foster coordination among all 
        governmental agencies, academic bodies and community groups that 
        conduct or support Fetal Alcohol Syndrome and Fetal Alcohol 
        Effect research, programs, and surveillance, and otherwise meet 
        the general needs of populations actually or potentially 
        impacted by Fetal Alcohol Syndrome and Fetal Alcohol Effect.
            ``(2) Membership.--The Task Force established pursuant to 
        paragraph (1) shall--
                    ``(A) be chaired by an individual to be appointed by 
                the Secretary and staffed by the Administration; and
                    ``(B) include the Chairperson of the Interagency 
                Coordinating Committee on Fetal Alcohol Syndrome of the 
                Department of Health and Human Services, individuals 
                with Fetal Alcohol Syndrome and Fetal Alcohol Effect, 
                and representatives from advocacy and research 
                organizations such as the Research Society on 
                Alcoholism, the FAS Family Resource Institute, the 
                National Organization of Fetal Alcohol Syndrome, the 
                Arc, the academic community, and Federal, State and 
                local government agencies and offices.
            ``(3) Functions.--The Task Force shall--
                    ``(A) advise Federal, State and local programs and 
                research concerning Fetal Alcohol Syndrome and Fetal 
                Alcohol Effect, including programs and research 
                concerning education and public awareness for relevant 
                service providers, school-age children, women at-risk, 
                and the general public, medical diagnosis, interventions 
                for women at-risk of giving birth to children with Fetal 
                Alcohol Syndrome and Fetal Alcohol Effect, and 
                beneficial services for individuals with Fetal Alcohol 
                Syndrome and Fetal Alcohol Effect and their families;
                    ``(B) coordinate its efforts with the Interagency 
                Coordinating Committee on Fetal Alcohol Syndrome of the 
                Department of Health and Human Services; and
                    ``(C) report on a biennial basis to the Secretary 
                and relevant committees of Congress on the current and 
                planned activities of the participating agencies.
            ``(4) Time for appointment.--The members of the Task Force 
        shall be appointed by the Secretary not later than 6 months 
        after the date of enactment of this part.

``SEC. 399H. <<NOTE: 42 USC 280f-1.>> ELIGIBILITY.

    ``To be eligible to receive a grant, or enter into a cooperative 
agreement or contract under this part, an entity shall--
            ``(1) be a State, Indian tribal government, local 
        government, scientific or academic institution, or nonprofit 
        organization; and
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information

[[Page 112 STAT. 3595]]

        as the Secretary may prescribe, including a description of the 
        activities that the entity intends to carry out using amounts 
        received under this part.

``SEC. 399I. <<NOTE: 42 USC 280f-2.>> AUTHORIZATION OF APPROPRIATIONS.

    ``(a) In General.--There are authorized to be appropriated to carry 
out this part, $27,000,000 for each of the fiscal years 1999 through 
2003.
    ``(b) Task Force.--From amounts appropriated for a fiscal year under 
subsection (a), the Secretary may use not to exceed $2,000,000 of such 
amounts for the operations of the National Task Force under section 
399G(d).

``SEC. 399J. <<NOTE: 42 USC 280f-3.>> SUNSET PROVISION.

    ``This part shall not apply on the date that is 7 years after the 
date on which all members of the National Task Force have been appointed 
under section 399G(d)(1).''.

    Approved November 13, 1998.

LEGISLATIVE HISTORY--S. 1754:
---------------------------------------------------------------------------

SENATE REPORTS: No. 105-220 (Comm. on Labor and Human Resources).
CONGRESSIONAL RECORD, Vol. 144 (1998):
            July 31, considered and passed Senate.
            Oct. 13, considered and passed House, amended.
            Oct. 14, Senate concurred in House amendment.

                                  <all>