[Congressional Bills 103th Congress]
[From the U.S. Government Printing Office]
[H.R. 2202 Enrolled Bill (ENR)]
H.R.2202
One Hundred Third Congress
of the
United States of America
AT THE FIRST SESSION
Begun and held at the City of Washington on Tuesday,
the fifth day of January, one thousand nine hundred and ninety-three
An Act
To amend the Public Health Service Act to revise and extend the
program of grants relating to preventive health measures with respect to
breast and cervical cancer.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

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(a) Short Title.--This Act may be cited as the ``Preventive Health
Amendments of 1993''.
(b) Table of Contents.--The table of contents for this Act is as
follows:

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100d050da5aadf5ec6062012758f8b4f62b252b685e24e123eaa72e556b1998e

TITLE I

-BREAST AND CERVICAL CANCER

additional preventive health services for women.

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violence within families and among acquaintances.

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TITLE II

-INJURY PREVENTION AND CONTROL

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TITLE III

-TUBERCULOSIS

control of sexually transmitted diseases.

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TITLE IV

-SEXUALLY TRANSMITTED DISEASES

infertility arising as result of sexually transmitted diseases.

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TITLE VII

-MISCELLANEOUS PROVISIONS

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CERVICAL CANCER.
(a) Limited Authority Regarding For-Profit Entities.--Section
1501(b) of the Public Health Service Act (42 U.S.C. 300k(b)), as amended
by section 2008(c)(1) of Public Law 103-43 (107 Stat. 211), is amended--
(1) in paragraph (1), by striking ``paragraph (2)'' and
inserting ``paragraphs (2) and (3)''; and
(2) by striking paragraph (2) and inserting the following
paragraphs:
``(2) Limited authority regarding other entities.--In addition
to the authority established in paragraph (1) for a State with
respect to grants and contracts, the State may provide for
screenings under subsection (a)(1) through entering into contracts
with private entities that are not nonprofit entities.
``(3) Payments for screenings.--The amount paid by a State to an
entity under this subsection for a screening procedure under
subsection (a)(1) may not exceed the amount that would be paid under
part B of title XVIII of the Social Security Act if payment were
made under such part for furnishing the procedure to a woman
enrolled under such part.''.
(b) Special Consideration.--Section 1501 of the Public Health
Service Act (42 U.S.C. 300k) is amended by adding at the end the
following subsection:
``(c) Special Consideration for Certain States.--In making grants
under subsection (a) to States whose initial grants under such
subsection are made for fiscal year 1995 or any subsequent fiscal year,
the Secretary shall give special consideration to any State whose
proposal for carrying out programs under such subsection--
``(1) has been approved through a process of peer review; and
``(2) is made with respect to geographic areas in which there
is--
``(A) a substantial rate of mortality from breast or
cervical cancer; or
``(B) a substantial incidence of either of such cancers.''.
(c) Quality Assurance Regarding Screening Procedures.--
(1) In general.--Section 1503 of the Public Health Service Act
(42 U.S.C. 300m) is amended by striking subsections (c) through (e)
and inserting the following:
``(c) Quality Assurance Regarding Screening Procedures.--The
Secretary may not make a grant under section 1501 unless the State
involved agrees that the State will, in accordance with applicable law,
assure the quality of screening procedures conducted pursuant to such
section.''.
(2) Transition rule regarding mammographies.--With respect to
the screening procedure for breast cancer known as a mammography,
the requirements in effect on the day before the date of the
enactment of this Act under section 1503(c) of the Public Health
Service Act remain in effect (for an individual or facility
conducting such procedures pursuant to a grant to a State under
section 1501 of such Act) until there is in effect for the facility
a certificate (or provisional certificate) issued under section 354
of such Act.
(d) Statewide Provision of Services.--Section 1504(c) of the Public
Health Service Act (42 U.S.C. 300n(c)) is amended by adding at the end
the following paragraph:
``(3) Grants to tribes and tribal organizations.--
``(A) The Secretary, acting through the Director of the
Centers for Disease Control and Prevention, may make grants to
tribes and tribal organizations (as such terms are used in
paragraph (1)) for the purpose of carrying out programs
described in section 1501(a). This title applies to such a grant
(in relation to the jurisdiction of the tribe or organization)
to the same extent and in the same manner as such title applies
to a grant to a State under section 1501 (in relation to the
jurisdiction of the State).
``(B) If a tribe or tribal organization is receiving a grant
under subparagraph (A) and the State in which the tribe or
organization is located is receiving a grant under section 1501,
the requirement established in paragraph (1) for the State
regarding the tribe or organization is deemed to have been
waived under paragraph (2).''.
(e) Evaluations and Reports.--Section 1508 of the Public Health
Service Act (42 U.S.C. 300n-4) is amended--
(1) in subsection (a), by adding at the end the following
sentence: ``Such evaluations shall include evaluations of the extent
to which States carrying out such programs are in compliance with
section 1501(a)(2) and with section 1504(c).''; and
(2) in subsection (b), by inserting before the period the
following: ``, including recommendations regarding compliance by the
States with section 1501(a)(2) and with section 1504(c)''.
(f) Establishment of Coordinating Committee.--Section 1501 of the
Public Health Service Act (42 U.S.C. 300k) is amended by adding at the
end the following subsection:
``(c) Coordinating Committee Regarding Year 2000 Health
Objectives.--The Secretary, acting through the Director of the Centers
for Disease Control and Prevention, shall establish a committee to
coordinate the activities of the agencies of the Public Health Service
(and other appropriate Federal agencies) that are carried out toward
achieving the objectives established by the Secretary for reductions in
the rate of mortality from breast and cervical cancer in the United
States by the year 2000. Such committee shall be comprised of Federal
officers or employees designated by the heads of the agencies involved
to serve on the committee as representatives of the agencies, and such
representatives from other public or private entities as the Secretary
determines to be appropriate.''.
(g) Technical Corrections.--Title XV of the Public Health Service
Act (42 U.S.C. 300k et seq.) is amended--
(1) in section 1501(a), in the matter preceding paragraph (1),
by striking ``Control,'' and inserting ``Control and Prevention,'';
and
(2) in section 1505--
(A) in paragraph (3) (as amended by section 2008(c)(2) of
Public Law 103-43 (107 Stat. 211)), by striking ``public'' and
all that follows and inserting ``public and nonprofit private
entities; and''; and
(B) in paragraph (4), by inserting ``will'' before ``be
used''.

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ADDITIONAL PREVENTIVE HEALTH SERVICES FOR WOMEN.
(a) In General.--Title XV of the Public Health Service Act (42
U.S.C. 300k et seq.) is amended--
(1) by redesignating section 1509 as section 1510; and
(2) by inserting after section 1508 the following section:
``SEC. 1509. SUPPLEMENTAL GRANTS FOR ADDITIONAL PREVENTIVE HEALTH
SERVICES.
``(a) Demonstration Projects.--In the case of States receiving
grants under section 1501, the Secretary, acting through the Director of
the Centers for Disease Control and Prevention, may make grants to not
more than 3 such States to carry out demonstration projects for the
purpose of--
``(1) providing preventive health services in addition to the
services authorized in such section, including screenings regarding
blood pressure and cholesterol, and including health education;
``(2) providing appropriate referrals for medical treatment of
women receiving services pursuant to paragraph (1) and ensuring, to
the extent practicable, the provision of appropriate follow-up
services; and
``(3) evaluating activities conducted under paragraphs (1) and
(2) through appropriate surveillance or program-monitoring
activities.
``(b) Status as Participant in Program Regarding Breast and Cervical
Cancer.--The Secretary may not make a grant under subsection (a) unless
the State involved agrees that services under the grant will be provided
only through entities that are screening women for breast or cervical
cancer pursuant to a grant under section 1501.
``(c) Applicability of Provisions of General Program.--This title
applies to a grant under subsection (a) to the same extent and in the
same manner as such title applies to a grant under section 1501.
``(d) Funding.--
``(1) In general.--Subject to paragraph (2), for the purpose of
carrying out this section, there are authorized to be appropriated
$3,000,000 for fiscal year 1994, and such sums as may be necessary
for each of the fiscal years 1995 through 1998.
``(2) Limitation regarding funding with respect to breast and
cervical cancer.--The authorization of appropriations established in
paragraph (1) is not effective for a fiscal year unless the amount
appropriated under section 1510(a) for the fiscal year is equal to
or greater than $100,000,000.''.
(b) Conforming Amendment.--Section 1510(a) of the Public Health
Service Act, as redesignated by subsection (a)(1) of this section, is
amended in the heading for the section by striking ``funding.'' and
inserting ``funding for general program.''.

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Section 1510(a) of the Public Health Service Act, as redesignated by
section 102(a)(1) of this Act, is amended--
(1) by striking ``and'' after ``1991,''; and
(2) by inserting before the period the following: ``,
$150,000,000 for fiscal year 1994, and such sums as may be necessary
for each of the fiscal years 1995 through 1998''.

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Part D of title III of the Public Health Service Act (42 U.S.C. 254b
et seq.), as amended by section 2008(i)(2)(A) of Public Law 103-43 (107
Stat. 213), is amended by adding at the end the following new section:
``breast and cervical cancer information
``Sec. 340D. (a) In General.--As a condition of receiving grants,
cooperative agreements, or contracts under this Act, each of the
entities specified in subsection (c) shall, to the extent determined to
be appropriate by the Secretary, make available information concerning
breast and cervical cancer.
``(b) Certain Authorities.--In carrying out subsection (a), an
entity specified in subsection (c)--
``(1) may make the information involved available to such
individuals as the entity determines appropriate;
``(2) may, as appropriate, provide information under subsection
(a) on the need for self-examination of the breasts and on the
skills for such self-examinations;
``(3) shall provide information under subsection (a) in the
language and cultural context most appropriate to the individuals to
whom the information is provided; and
``(4) shall refer such clients as the entities determine
appropriate for breast and cervical cancer screening, treatment, or
other appropriate services.
``(c) Relevant Entities.--The entities specified in this subsection
are the following:
``(1) Entities receiving assistance under section 317E (relating
to tuberculosis).
``(2) Entities receiving assistance under section 318 (relating
to sexually transmitted diseases).
``(3) Migrant health centers receiving assistance under section
329.
``(4) Community health centers receiving assistance under
section 330.
``(5) Entities receiving assistance under section 340 (relating
to homeless individuals).
``(6) Entities receiving assistance under section 340A (relating
to health services for residents of public housing).
``(7) Entities providing services with assistance under title V
or title XIX.
``(8) Entities receiving assistance under section 1001 (relating
to family planning).
``(9) Entities receiving assistance under title XXVI (relating
to services with respect to acquired immune deficiency syndrome).
``(10) Non-Federal entities authorized under the Indian Self-
Determination Act.''.

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INTERPERSONAL VIOLENCE WITHIN FAMILIES AND AMONG ACQUAINTANCES.
Part J of title III of the Public Health Service Act (42 U.S.C. 280b
et seq.), as redesignated by section 2008(i)(2)(B)(i) of Public Law 103-
43 (107 Stat. 213), is amended--
(1) by redesignating sections 393 and 394 as sections 394 and
394A, respectively; and
(2) by inserting after section 392 the following section:
``interpersonal violence within families and among acquaintances
``Sec. 393. (a) With respect to activities that are authorized in
sections 391 and 392, the Secretary, acting through the Director of the
Centers for Disease Control and Prevention, shall carry out such
activities with respect to interpersonal violence within families and
among acquaintances. Activities authorized in the preceding sentence
include the following:
``(1) Collecting data relating to the incidence of such
violence.
``(2) Making grants to public and nonprofit private entities for
the evaluation of programs whose purpose is to prevent such
violence, including the evaluation of demonstration projects under
paragraph (6).
``(3) Making grants to public and nonprofit private entities for
the conduct of research on identifying effective strategies for
preventing such violence.
``(4) Providing to the public information and education on such
violence, including information and education to increase awareness
of the public health consequences of such violence.
``(5) Training health care providers as follows:
``(A) To identify individuals whose medical conditions or
statements indicate that the individuals are victims of such
violence.
``(B) To routinely determine, in examining patients, whether
the medical conditions or statements of the patients so
indicate.
``(C) To refer individuals so identified to entities that
provide services regarding such violence, including referrals
for counseling, housing, legal services, and services of
community organizations.
``(6) Making grants to public and nonprofit private entities for
demonstration projects with respect to such violence, including with
respect to prevention.
``(b) For purposes of this part, the term `interpersonal violence
within families and among acquaintances' includes behavior commonly
referred to as domestic violence, sexual assault, spousal abuse, woman
battering, partner abuse, elder abuse, and acquaintance rape.''.

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Section 394 of the Public Health Service Act, as redesignated by
section 201(1) of this Act, is amended to read as follows:
``general provisions
``Sec. 394. (a) The Secretary, acting through the Director of the
Centers for Disease Control and Prevention, shall establish an advisory
committee to advise the Secretary and such Director with respect to the
prevention and control of injuries.
``(b) The Secretary, acting through the Director of the Centers for
Disease Control and Prevention, may provide technical assistance to
public and nonprofit private entities with respect to the planning,
development, and operation of any program or service carried out
pursuant to this part. The Secretary may provide such technical
assistance directly or through grants or contracts.
``(c) Not later than February 1 of 1995 and of every second year
thereafter, the Secretary, acting through the Director of the Centers
for Disease Control and Prevention, 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 part during the
preceding 2 fiscal years. Such report shall include a description of
such activities that were carried out with respect to interpersonal
violence within families and among acquaintances and with respect to
rural areas.''.

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(a) Terminology.--Part J of title III of the Public Health Service
Act (42 U.S.C. 280b et seq.), as redesignated by section
2008(i)(2)(B)(i) of Public Law 103-43 (107 Stat. 213), is amended--
(1) in the heading for such part, by striking ``Injury Control''
and inserting ``Prevention and Control of Injuries''; and
(2) in section 392--
(A) in the heading for such section, by inserting
``prevention and'' before ``control activities'';
(B) in subsection (a)(1), by inserting ``and control'' after
``prevention''; and
(C) in subsection (b)(1), by striking ``injuries and injury
control'' and inserting ``the prevention and control of
injuries''.
(b) Provisions Relating to Public Law 102-531.--Part J of title III
of the Public Health Service Act (42 U.S.C. 280b et seq.), as amended by
section 301 of Public Law 102-531 (106 Stat. 3482) and as redesignated
by section 2008(i)(2)(B)(i) of Public Law 103-43 (107 Stat. 213), is
amended--
(1) in section 392(b)(2), by striking ``to promote injury
control'' and all that follows and inserting ``to promote activities
regarding the prevention and control of injuries; and''; and
(2) in section 391(b), by adding at the end the following
sentence: ``In carrying out the preceding sentence, the Secretary
shall disseminate such information to the public, including through
elementary and secondary schools.''.

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Section 394A of the Public Health Service Act, as redesignated by
section 201(1) of this Act, is amended by striking ``To carry out'' and
all that follows and inserting the following: ``For the purpose of
carrying out this part, there are authorized to be appropriated
$50,000,000 for fiscal year 1994, and such sums as may be necessary for
each of the fiscal years 1995 through 1998.''.

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(a) In General.--Part B of title III of the Public Health Service
Act (42 U.S.C. 242 et seq.), as amended by section 308 of Public Law
102-531 (106 Stat. 3495), is amended by inserting after section 317D the
following section:
``preventive health services regarding tuberculosis
``Sec. 317E. (a) In General.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, may make
grants to States, political subdivisions, and other public entities for
preventive health service programs for the prevention, control, and
elimination of tuberculosis.
``(b) Research, Demonstration Projects, Education, and Training.--
With respect to the prevention, control, and elimination of
tuberculosis, the Secretary may, directly or through grants to public or
nonprofit private entities, carry out the following:
``(1) Research, with priority given to research concerning
strains of tuberculosis resistant to drugs and research concerning
cases of tuberculosis that affect certain populations.
``(2) Demonstration projects.
``(3) Public information and education programs.
``(4) Education, training, and clinical skills improvement
activities for health professionals, including allied health
personnel and emergency response employees.
``(5) Support of centers to carry out activities under
paragraphs (1) through (4).
``(6) Collaboration with international organizations and foreign
countries in carrying out such activities.
``(c) Cooperation With Providers of Primary Health Services.--The
Secretary may make a grant under subsection (a) or (b) only if the
applicant for the grant agrees that, in carrying out activities under
the grant, the applicant will cooperate with public and nonprofit
private providers of primary health services or substance abuse
services, including entities receiving assistance under section 329,
330, 340, or 340A or under title V or XIX.
``(d) Application for Grant.--
``(1) In general.--The Secretary may make a grant under
subsection (a) or (b) only if an application for the grant is
submitted to the Secretary and the application, subject to paragraph
(2), is in such form, is made in such manner, and contains such
agreements, assurances, and information as the Secretary determines
to be necessary to carry out the subsection involved.
``(2) Plan for prevention, control, and elimination.--The
Secretary may make a grant under subsection (a) only if the
application under paragraph (1) contains a plan regarding the
prevention, control, and elimination of tuberculosis in the
geographic area with respect to which the grant is sought.
``(e) Supplies and Services in Lieu of Grant Funds.--
``(1) In general.--Upon the request of a grantee under
subsection (a) or (b), the Secretary may, subject to paragraph (2),
provide supplies, equipment, and services for the purpose of aiding
the grantee in carrying out the subsection involved and, for such
purpose, may detail to the State any officer or employee of the
Department of Health and Human Services.
``(2) Corresponding reduction in payments.--With respect to a
request described in paragraph (1), the Secretary shall reduce the
amount of payments under the grant involved by an amount equal to
the costs of detailing personnel and the fair market value of any
supplies, equipment, or services provided by the Secretary. The
Secretary shall, for the payment of expenses incurred in complying
with such request, expend the amounts withheld.
``(f) Advisory Council.--
``(1) In general.--The Secretary shall establish an advisory
council to be known as the Advisory Council for the Elimination of
Tuberculosis (in this subsection referred to as the ``Council'').
``(2) General duties.--The Council shall provide advice and
recommendations regarding the elimination of tuberculosis to the
Secretary, the Assistant Secretary for Health, and the Director of
the Centers for Disease Control and Prevention.
``(3) Certain activities.--With respect to the elimination of
tuberculosis, the Council shall--
``(A) in making recommendations under paragraph (2), make
recommendations regarding policies, strategies, objectives, and
priorities;
``(B) address the development and application of new
technologies; and
``(C) review the extent to which progress has been made
toward eliminating tuberculosis.
``(4) Composition.--The Secretary shall determine the size and
composition of the Council, and the frequency and scope of official
meetings of the Council.
``(5) Staff, information, and other assistance.--The Secretary
shall provide to the Council such staff, information, and other
assistance as may be necessary to carry out the duties of the
Council.
``(g) Funding.--
``(1) In general; allocation for emergency grants.--
``(A) For the purpose of making grants under subsection (a),
there are authorized to be appropriated $200,000,000 for fiscal
year 1994, and such sums as may be necessary for each of the
fiscal years 1995 through 1998.
``(B) Of the amounts appropriated under subparagraph (A) for
a fiscal year, the Secretary may reserve not more than
$50,000,000 for emergency grants under subsection (a) for any
geographic area in which there is, relative to other areas, a
substantial number of cases of tuberculosis or a substantial
rate of increase in such cases.
``(2) Research, demonstration projects, education, and
training.--For the purpose of making grants under subsection (b),
there are authorized to be appropriated such sums as may be
necessary for each of the fiscal years 1994 through 1998.''.
(b) Conforming Amendments.--Section 317 of the Public Health Service
Act (42 U.S.C. 247b) is amended--
(1) in subsection (j)--
(A) by striking paragraph (2);
(B) by striking ``(j)(1)(A)'' and inserting ``(j)(1)'';
(C) by striking ``(B) For grants'' and inserting ``(2) For
grants''; and
(D) in paragraph (1) (as so redesignated), by striking
``established in subparagraph (B)'' and inserting ``established
in paragraph (2)'';
(2) in subsection (k)--
(A) by striking paragraph (2);
(B) by redesignating paragraphs (3) through (5) as
paragraphs (2) through (4), respectively; and
(C) in paragraph (4) (as so redesignated), by striking ``of
section 317'' each place such term appears; and
(3) by striking subsection (l).

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INFECTIOUS DISEASES.
(a) Certain Duties.--Subpart 6 of part C of title IV of the Public
Health Service Act (42 U.S.C. 285f) is amended by inserting after
section 446 the following section:
``research and research training regarding tuberculosis
``Sec. 447. (a) In carrying out section 446, the Director of the
Institute shall conduct or support research and research training
regarding the cause, diagnosis, early detection, prevention and
treatment of tuberculosis.
``(b) For the purpose of carrying out subsection (a), there are
authorized to be appropriated $50,000,000 for fiscal year 1994, and such
sums as may be necessary for each of the fiscal years 1995 through 1998.
Such authorization is in addition to any other authorization of
appropriations that is available for such purpose.''.

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The Secretary of Health and Human Services, acting through the
Commissioner of Food and Drugs, shall implement a tuberculosis drug and
device research program under which the Commissioner may--
(1) provide assistance to other Federal agencies for the
development of tuberculosis protocols;
(2) review and evaluate medical devices designed for the
diagnosis and control of airborne tuberculosis; and
(3) conduct research concerning drugs or devices to be used in
diagnosing, controlling and preventing tuberculosis.

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CONTROL OF SEXUALLY TRANSMITTED DISEASES.
(a) Innovative, Interdisciplinary Approaches.--Section 318 of the
Public Health Service Act (42 U.S.C. 247c(d)(1)) is amended--
(1) by redesignating subsection (d) as subsection (e); and
(2) by inserting after subsection (c) the following subsection:
``(d) The Secretary may make grants to States and political
subdivisions of States for the development, implementation, and
evaluation of innovative, interdisciplinary approaches to the prevention
and control of sexually transmitted diseases.''.
(b) Authorization of Appropriations.--Section 318(e) of the Public
Health Service Act, as redesignated by subsection (a)(1) of this
section, is amended by amending paragraph (1) to read as follows: ``(1)
For the purpose of making grants under subsections (b) through (d),
there are authorized to be appropriated $85,000,000 for fiscal year
1994, and such sums as may be necessary for each of the fiscal years
1995 through 1998.''.
(c) Technical Corrections.--Section 318 of the Public Health Service
Act, as amended by subsection (a) of this section, is amended--
(1) in subsection (b)(3), by striking ``, and'' and inserting
``; and'';
(2) in subsection (c)(3), by striking ``, and'' and inserting
``; and''; and
(3) in subsection (d)(5)--
(A) in subparagraph (A), by striking ``form, or'' and
inserting ``form; or''; and
(B) in subparagraph (B), by striking ``purposes,'' and
inserting ``purposes;''.

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INFERTILITY ARISING AS RESULT OF SEXUALLY TRANSMITTED DISEASES.
(a) Technical Corrections.--Section 318A of the Public Health
Service Act (42 U.S.C. 247c-1), as added by section 304 of Public Law
102-531 (106 Stat. 3490), is amended in subsection (o)(2) by striking
``subsection (s)'' and inserting ``subsection (q)''.
(b) Authorization of Appropriations.--Section 318A of the Public
Health Service Act (42 U.S.C. 247c-1), as added by section 304 of Public
Law 102-531 (106 Stat. 3490), is amended--
(1) in subsection (q), by striking ``and 1995'' and inserting
``through 1998''; and
(2) in subsection (r)(2), by striking ``through 1995'' and
inserting ``through 1998''.

dd855961b0aa65b2047ea6184d71576ddab747f3c58d6aae1da5a5b80aa9ba97

(a) In General.--Section 306 of the Public Health Service Act (42
U.S.C. 242k) is amended--
(1) in subsection (c), by striking ``Committee on Human
Resources'' and inserting ``Committee on Labor and Human
Resources'';
(2) in subsection (g), by striking ``data which shall be
published'' and all that follows and inserting ``data.'';
(3) in subsection (i), by striking ``engaged in health planning
activities'';
(4) in subsection (k)(2)--
(A) in subparagraph (A), in the last sentence, by striking
``Except'' and all that follows through ``members'' and
inserting ``Members'';
(B) by striking subparagraph (B); and
(C) by striking the remaining subparagraph designation; and
(5)(A) by striking subsection (l);
(B) by redesignating subsections (m) through (o) as subsections
(l) through (n), respectively;
(C) in subsection (l) (as so redesignated), in the last
sentence, by striking ``(n)'' and inserting ``(m)''; and
(D) in subsection (n) (as so redesignated)--
(i) in paragraph (1), by striking ``(m)'' and inserting
``(l)''; and
(ii) in paragraph (2)--
(I) by striking ``(n)'' and inserting ``(m)''; and
(II) by striking ``(n)(2)'' and inserting ``(m)(2)''.
(b) General Authority Respecting Research, Evaluations, and
Demonstrations.--Section 304 of the Public Health Service Act (42 U.S.C.
242b) is amended by striking subsection (d).
(c) General Provisions Respecting Effectiveness, Efficiency, and
Quality of Health Services.--Section 308 of the Public Health Service
Act (42 U.S.C. 242m) is amended--
(1) in subsection (a)--
(A) in paragraph (1)--
(i) by striking subparagraph (A); and
(ii) by redesignating subparagraphs (B) through (E) as
subparagraphs (A) through (D), respectively; and
(B) in paragraph (2), by striking ``reports required by
subparagraphs'' and all that follows through ``Center'' and
inserting the following: ``reports required in paragraph (1)
shall be prepared through the National Center'';
(2)(A) by striking subsection (c);
(B) by transferring paragraph (2) of subsection (g) from the
current location of the paragraph;
(C) by redesignating such paragraph as subsection (c);
(D) by inserting subsection (c) (as so redesignated) after
subsection (b); and
(E) by striking the remainder of subsection (g);
(3) in subsection (c) (as so redesignated)--
(A) by striking ``shall (A) take'' and inserting ``shall
take''; and
(B) by striking ``and (B) publish'' and inserting ``and
shall publish'';
(4) in subsection (f), by striking ``sections 3648'' and all
that follows and inserting the following: ``section 3324 of title
31, United States Code, and section 3709 of the Revised Statutes (41
U.S.C. 5).''; and
(5) by striking subsection (h).
(d) Authorization of Appropriations.--Section 306(n) of the Public
Health Service Act, as redesignated by subsection (a)(5)(B), is
amended--
(1) in paragraph (1), by striking ``through 1993'' and inserting
``through 1998''; and
(2) in paragraph (2), in the first sentence--
(A) by striking ``and'' after ``1992,''; and
(B) by inserting before the period the following: ``, and
$10,000,000 for each of the fiscal years 1994 through 1998''.

c7d89f9df7a1963e48d634a4a404da2b154a9efcbf398624c2f6fa0f982dab32

TITLE V

-NATIONAL CENTER FOR HEALTH STATISTICS

(a) General Authority.--Section 1201 of the Public Health Service
Act (42 U.S.C. 300d) is amended--
(1) in subsection (a), in the matter preceding paragraph (1), by
inserting after ``Secretary'' the following: ``, acting through the
Administrator of the Health Resources and Services
Administration,''; and
(2) by adding at the end the following subsection:
``(c) Administration.--The Administrator of the Health Resources and
Services Administration shall ensure that this title is administered by
the Division of Trauma and Emergency Medical Systems within such
Administration. Such Division shall be headed by a director appointed by
the Secretary from among individuals who are knowledgeable by training
or experience in the development and operation of trauma and emergency
medical systems.''.
(b) Advisory Council.--Section 1201 of the Public Health Service Act
(42 U.S.C. 300d) is amended--
(1) by striking section 1202; and
(2) by redesignating sections 1203 and 1204 as sections 1202 and
1203, respectively;
(c) Reports by States; Evaluations by Comptroller General.--Section
1216(c) of the Public Health Service Act (42 U.S.C. 300d-16) is amended
by striking ``1993'' and inserting ``1994''.
(d) Report by Secretary.--Section 1222 of the Public Health Service
Act (42 U.S.C. 300d-22) is amended--
(1) in the first sentence, by striking ``1992'' and inserting
``1995''; and
(2) by inserting after the first sentence the following
sentence: ``Such report shall include an assessment of the extent to
which Federal and State efforts to develop systems of trauma care
and to designate trauma centers have reduced the incidence of
mortality, and the incidence of permanent disability, resulting from
trauma.''.
(e) Waiver Regarding Purpose of Grants.--Section 1233 of the Public
Health Service Act (42 U.S.C. 300d-33) is repealed.
(f) Technical Corrections.--Title XII of the Public Health Service
Act (42 U.S.C. 300d et seq.) is amended--
(1) in section 1204(c), by inserting before the period the
following: ``determines to be necessary to carry out this section'';
(2) in section 1212(a)(2)(A), by striking ``1211(c)'' and
inserting ``1211(b)'';
(3) in section 1213(a)--
(A) in paragraph (4), by striking ``Act'' and inserting
``Act)'';
(B) in paragraphs (8) and (9), by striking ``to provide''
each place such term appears and inserting ``provides for''; and
(C) in paragraph (10), by striking ``to conduct'' and
inserting ``conducts''; and
(4) in section 1231(3), by striking ``Rico;'' and inserting
``Rico,''.

7469ec519ed6b15277e18981ba9391a343c7d597d519a390d9caba8240e9187b

TITLE VI

-TRAUMA CARE SYSTEMS

Section 1232(a) of the Public Health Service Act (42 U.S.C. 300d-
32(a)) is amended by striking ``for the purpose'' and all that follows
and inserting the following: ``For the purpose of carrying out parts A
and B, there are authorized to be appropriated $6,000,000 for fiscal
year 1994, and such sums as may be necessary for each of the fiscal
years 1995 and 1996.''.

fb87d2c810846d619f17a0a6915b396498f65e63c219f1e393c2843f016db6d0

Effective October 1, 1994, section 241 of the Public Health Service
Act (42 U.S.C. 238j), as transferred and redesignated by section 2010(a)
of Public Law 103-43 (107 Stat. 213), is amended to read as follows:
``evaluation of programs
``Sec. 241. (a) In General.--Such portion as the Secretary shall
determine, but not less than 0.2 percent nor more than 1 percent, of any
amounts appropriated for programs authorized under this Act shall be
made available for the evaluation (directly, or by grants of contracts)
of the implementation and effectiveness of such programs.
``(b) Report on Evaluations.--Not later than February 1 of each
year, the Secretary shall prepare and submit to the Committee on Labor
and Human Resources of the Senate and the Committee on Energy and
Commerce of the House of Representatives a report summarizing the
findings of the evaluations conducted under subsection (a).''.

6c929f43b904a4791e3dc659638dc89e480b713d1488bf0fa54772fc91b99ab0

Section 307 of the Public Health Service Act (42 U.S.C. 242l) is
amended by adding at the end thereof the following new subsection:
``(c) The Secretary may provide to personnel appointed or assigned
by the Secretary to serve abroad, allowances and benefits similar to
those provided under chapter 9 of title I of the Foreign Service Act of
1990 (22 U.S.C. 4081 et seq.). Leaves of absence for personnel under
this subsection shall be on the same basis as that provided under
subchapter I of chapter 63 of title 5, United States Code, to
individuals serving in the Foreign Service.''.

564fee4581acb9e63e24e8f7d7567f57943b8031e0ef78af58b121da19dd6685

Part B of title III of the Public Health Service Act, as amended by
section 301 of this Act, is amended by inserting after section 317E the
following section:
``loan repayment program
``Sec. 317F. (a) In General.--
``(1) Authority.--Subject to paragraph (2), the Secretary may
carry out a program of entering into contracts with appropriately
qualified health professionals under which such health professionals
agree to conduct prevention activities, as employees of the Centers
for Disease Control and Prevention and the Agency for Toxic
Substances and Disease Registry, in consideration of the Federal
Government agreeing to repay, for each year of such service, not
more than $20,000 of the principal and interest of the educational
loans of such health professionals.
``(2) Limitation.--The Secretary may not enter into an agreement
with a health professional pursuant to paragraph (1) unless such
professional--
``(A) has a substantial amount of educational loans relative
to income; and
``(B) agrees to serve as an employee of the Centers for
Disease Control and Prevention or the Agency for Toxic
Substances and Disease Registry for purposes of paragraph (1)
for a period of not less than 3 years.
``(b) Applicability of Certain Provisions.--With respect to the
National Health Service Corps Loan Repayment Program established in
subpart III of part D of title III of this Act, the provisions of such
subpart shall, except as inconsistent with subsection (a), apply to the
program established in this section in the same manner and to the same
extent as such provisions apply to the National Health Service Corps
Loan Repayment Program.
``(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $500,000 for
fiscal year 1994, and such sums as may be necessary for each of the
fiscal years 1995 through 1998.''.

327e7b0c84d5b1e8eea76d340b7a93b3e05bb441d2f565a3f84c441a1662bf44

NUTRITION AND HEALTH.
Title XVII of the Public Health Service Act (42 U.S.C. 300u et
seq.), as amended by section 302 of Public Law 102-531 (106 Stat. 3483),
is amended by adding at the end the following section:
``biennial report regarding nutrition and health
``Sec. 1709. (a) Biennial Report.--The Secretary shall require the
Surgeon General of the Public Health Service to prepare biennial reports
on the relationship between nutrition and health. Such reports may, with
respect to such relationship, include any recommendations of the
Secretary and the Surgeon General.
``(b) Submission to Congress.--The Secretary shall ensure that, not
later than February 1 of 1995 and of every second year thereafter, a
report under subsection (a) is submitted to the Committee on Energy and
Commerce of the House of Representatives and the Committee on Labor and
Human Resources of the Senate.''.

54431f639cd2be2edb3d1326678740af48962d0ef0d1b5bf8dc58787fa38e098

PREVENTION REAUTHORIZATION SCHEDULE.
(a) Screenings, Education, and Referrals 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 ``through 1997'' and inserting ``through
1998''.
(b) Prostate Cancer Prevention.--Section 317D((l)(1) of the Public
Health Service Act (42 U.S.C. 247b-5(l)(1)) is amended by striking
``through 1996'' and inserting ``through 1998''.
(c) Cancer Registries.--Section 399L(a) of the Public Health Service
Act (42 U.S.C. 280e-4(a)) (as amended by section 2003(1) of Public Law
103-43) is amended by striking ``through 1996'' and inserting ``through
1998''.
(d) Health Promotion and Disease Prevention Research and
Demonstration Centers.--Section 1706(e) of the Public Health Service Act
(42 U.S.C. 300u-5(e)) is amended by striking ``through 1996'' and
inserting ``through 1998''.
(e) Title XIX Program.--Section 1901(a) of the Public Health Service
Act (42 U.S.C. 300w(a)) is amended by striking ``through 1997'' and
inserting ``through 1998''.
(f) Sense of Congress Regarding Schedule for Legislation.--It is the
sense of the Congress that, during the fiscal years 1994 through 1997,
authorizations of appropriations for the programs of the Centers for
Disease Control and Prevention should be provided only through fiscal
year 1998, and that for fiscal year 1999 and subsequent fiscal years
such programs, when considered by the Congress through legislation
providing further authorizations of appropriations, should be so
considered during a single year.

b77eb5e6b660817d1fb112d1c041ccff533bee87bbbda92a09b6f709caa44c64

(a) Payment of Certain Judgments.--Section 224(k)(2) of the Public
Health Service Act (42 U.S.C. 233(k)(2)), as added by section 4 of the
Federally Supported Health Centers Assistance Act of 1992, is amended by
adding at the end thereof the following new sentence: ``Appropriations
for purposes of this paragraph shall be made separate from
appropriations made for purposes of sections 329, 330, 340 and 340A.''.
(b) Compensation Regarding Certain Advisory Council.--Section
337(b)(2) of the Public Health Service Act (42 U.S.C. 254j(b)(2) is
amended--
(1) by inserting before ``the daily equivalent'' the following:
``compensation at a rate fixed by the Secretary (but not to
exceed''; and
(2) by striking ``Schedule;'' and inserting ``Schedule);''.

6f0896e20a9609c4288675f6eb538abe2440b67bc29db0a75bdec45fb59fb5f3

The Secretary of Health and Human Services is authorized to issue
interim final regulations--
(1) under which the Secretary may approve accreditation bodies
under section 354(e) of the Public Health Service Act (42 U.S.C.
263b(e)); and
(2) establishing quality standards under section 354(f) of the
Public Health Service Act (42 U.S.C. 263b(f)).

8583b320b790cd78d451239f524e2d0150aae9e01ff024d621d9fa30964cd41b

(a) Information.--Section 2126(b) of the Public Health Service Act
(42 U.S.C. 300aa-26(b)) is amended--
(1) by striking ``by rule'' in the matter preceding paragraph
(1); and
(2) by striking, in paragraph (1), ``, opportunity for a public
hearing, and 90'' and inserting ``and 60''.
(b) Requirements.--Section 2126(c) of the Public Health Service Act
(42 U.S.C. 300aa-26(c)) is amended--
(1) by inserting ``shall be based on available data and
information,'' after ``such materials'' in the matter preceding
paragraph (1); and
(2) by striking paragraphs (1) through (10) and inserting the
following:
``(1) a concise description of the benefits of the vaccine,
``(2) a concise description of the risks associated with the
vaccine,
``(3) a statement of the availability of the National Vaccine
Injury Compensation Program, and
``(4) such other relevant information as may be determined by
the Secretary.''.
(c) Other Individuals.--Subsections (a) and (d) of section 2126 of
the Public Health Service Act (42 U.S.C. 300aa-26) are each amended by
inserting ``or to any other individual'' after ``to the legal
representatives of any child''.
(d) Providers Duties.--Subsection (d) of section 2126 of the Public
Health Service Act (42 U.S.C. 300aa-26) is amended--
(1) by striking all after ``subsection (a),'' the second place
it appears in the first sentence and inserting ``supplemented with
visual presentations or oral explanations, in appropriate cases.'';
and
(2) by striking ``or other information'' in the last sentence.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.

f69c3d6bacd73b119b1fd0f9098f52cea71757ca11e110d16d4ba06e3056f7c4

Preventive Health Amendments of 1993

Other Sections