[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 1880 Enrolled Bill (ENR)]
S.1880
One Hundred Sixth Congress
of the
United States of America
AT THE SECOND SESSION
Begun and held at the City of Washington on Monday,
the twenty-fourth day of January, two thousand
An Act
To amend the Public Health Service Act to improve the health of minority
individuals.
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 ``Minority Health
and Health Disparities Research and Education Act of 2000''.
(b) Table of Contents.--The table of contents of this Act is as
follows:

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THROUGH NATIONAL INSTITUTES OF HEALTH; ESTABLISHMENT OF NATIONAL CENTER

bd379ac1053390ff1c6b039df1c052e782e96901869b806bb54db6dddc7b71c3

9e487b9410754437e67dcb8c3de16be92e071739d3b2cfa36ba2205ada37053e

TITLE I

-IMPROVING MINORITY HEALTH AND REDUCING HEALTH DISPARITIES

f4c0ff7811adfb8c3fe93df02fb6e10647c839b157286700448961deff2cd314

dedicated to minority and other health disparities research.
AND QUALITY

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d2638ceca3448f3dfba8964d3489cd6ee41d17ddda810647109254d53888e2a4

TITLE II

-HEALTH DISPARITIES RESEARCH BY AGENCY FOR HEALTHCARE RESEARCH

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TITLE IV

-HEALTH PROFESSIONS EDUCATION

health disparities and cultural competency.
DISPARITIES

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

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TITLE VI

-MISCELLANEOUS PROVISIONS

HEALTH DISPARITIES.
(a) In General.--Part E of title IV of the Public Health Service
Act (42 U.S.C. 287 et seq.) is amended by adding at the end the
following subpart:
``Subpart 6--National Center on Minority Health and Health Disparities
``SEC. 485E. PURPOSE OF CENTER.
``(a) In General.--The general purpose of the National Center on
Minority Health and Health Disparities (in this subpart referred to as
the `Center') is the conduct and support of research, training,
dissemination of information, and other programs with respect to
minority health conditions and other populations with health
disparities.
``(b) Priorities.--The Director of the Center shall in expending
amounts appropriated under this subpart give priority to conducting and
supporting minority health disparities research.
``(c) Minority Health Disparities Research.--For purposes of this
subpart:
``(1) The term `minority health disparities research' means
basic, clinical, and behavioral research on minority health
conditions (as defined in paragraph (2)), including research to
prevent, diagnose, and treat such conditions.
``(2) The term `minority health conditions', with respect to
individuals who are members of minority groups, means all diseases,
disorders, and conditions (including with respect to mental health
and substance abuse)--
``(A) unique to, more serious, or more prevalent in such
individuals;
``(B) for which the factors of medical risk or types of
medical intervention may be different for such individuals, or
for which it is unknown whether such factors or types are
different for such individuals; or
``(C) with respect to which there has been insufficient
research involving such individuals as subjects or insufficient
data on such individuals.
``(3) The term `minority group' has the meaning given the term
`racial and ethnic minority group' in section 1707.
``(4) The terms `minority' and `minorities' refer to
individuals from a minority group.
``(d) Health Disparity Populations.--For purposes of this subpart:
``(1) A population is a health disparity population if, as
determined by the Director of the Center after consultation with
the Director of the Agency for Healthcare Research and Quality,
there is a significant disparity in the overall rate of disease
incidence, prevalence, morbidity, mortality, or survival rates in
the population as compared to the health status of the general
population.
``(2) The Director shall give priority consideration to
determining whether minority groups qualify as health disparity
populations under paragraph (1).
``(3) The term `health disparities research' means basic,
clinical, and behavioral research on health disparity populations
(including individual members and communities of such populations)
that relates to health disparities as defined under paragraph (1),
including the causes of such disparities and methods to prevent,
diagnose, and treat such disparities.
``(e) Coordination of Activities.--The Director of the Center shall
act as the primary Federal official with responsibility for
coordinating all minority health disparities research and other health
disparities research conducted or supported by the National Institutes
of Health, and--
``(1) shall represent the health disparities research program
of the National Institutes of Health, including the minority health
disparities research program, at all relevant Executive branch task
forces, committees and planning activities; and
``(2) shall maintain communications with all relevant Public
Health Service agencies, including the Indian Health Service, and
various other departments of the Federal Government to ensure the
timely transmission of information concerning advances in minority
health disparities research and other health disparities research
between these various agencies for dissemination to affected
communities and health care providers.
``(f) Collaborative Comprehensive Plan and Budget.--
``(1) In general.--Subject to the provisions of this section
and other applicable law, the Director of NIH, the Director of the
Center, and the directors of the other agencies of the National
Institutes of Health in collaboration (and in consultation with the
advisory council for the Center) shall--
``(A) establish a comprehensive plan and budget for the
conduct and support of all minority health disparities research
and other health disparities research activities of the
agencies of the National Institutes of Health (which plan and
budget shall be first established under this subsection not
later than 12 months after the date of the enactment of this
subpart);
``(B) ensure that the plan and budget establish priorities
among the health disparities research activities that such
agencies are authorized to carry out;
``(C) ensure that the plan and budget establish objectives
regarding such activities, describes the means for achieving
the objectives, and designates the date by which the objectives
are expected to be achieved;
``(D) ensure that, with respect to amounts appropriated for
activities of the Center, the plan and budget give priority in
the expenditure of funds to conducting and supporting minority
health disparities research;
``(E) ensure that all amounts appropriated for such
activities are expended in accordance with the plan and budget;
``(F) review the plan and budget not less than annually,
and revise the plan and budget as appropriate;
``(G) ensure that the plan and budget serve as a broad,
binding statement of policies regarding minority health
disparities research and other health disparities research
activities of the agencies, but do not remove the
responsibility of the heads of the agencies for the approval of
specific programs or projects, or for other details of the
daily administration of such activities, in accordance with the
plan and budget; and
``(H) promote coordination and collaboration among the
agencies conducting or supporting minority health or other
health disparities research.
``(2) Certain components of plan and budget.--With respect to
health disparities research activities of the agencies of the
National Institutes of Health, the Director of the Center shall
ensure that the plan and budget under paragraph (1) provide for--
``(A) basic research and applied research, including
research and development with respect to products;
``(B) research that is conducted by the agencies;
``(C) research that is supported by the agencies;
``(D) proposals developed pursuant to solicitations by the
agencies and for proposals developed independently of such
solicitations; and
``(E) behavioral research and social sciences research,
which may include cultural and linguistic research in each of
the agencies.
``(3) Minority health disparities research.--The plan and
budget under paragraph (1) shall include a separate statement of
the plan and budget for minority health disparities research.
``(g) Participation in Clinical Research.--The Director of the
Center shall work with the Director of NIH and the directors of the
agencies of the National Institutes of Health to carry out the
provisions of section 492B that relate to minority groups.
``(h) Research Endowments.--
``(1) In general.--The Director of the Center may carry out a
program to facilitate minority health disparities research and
other health disparities research by providing for research
endowments at centers of excellence under section 736.
``(2) Eligibility.--The Director of the Center may provide for
a research endowment under paragraph (1) only if the institution
involved meets the following conditions:
``(A) The institution does not have an endowment that is
worth in excess of an amount equal to 50 percent of the
national average of endowment funds at institutions that
conduct similar biomedical research or training of health
professionals.
``(B) The application of the institution under paragraph
(1) regarding a research endowment has been recommended
pursuant to technical and scientific peer review and has been
approved by the advisory council under subsection (j).
``(i) Certain Activities.--In carrying out subsection (a), the
Director of the Center--
``(1) shall assist the Director of the National Center for
Research Resources in carrying out section 481(c)(3) and in
committing resources for construction at Institutions of Emerging
Excellence;
``(2) shall establish projects to promote cooperation among
Federal agencies, State, local, tribal, and regional public health
agencies, and private entities in health disparities research; and
``(3) may utilize information from previous health initiatives
concerning minorities and other health disparity populations.
``(j) Advisory Council.--
``(1) In general.--The Secretary shall, in accordance with
section 406, establish an advisory council to advise, assist,
consult with, and make recommendations to the Director of the
Center on matters relating to the activities described in
subsection (a), and with respect to such activities to carry out
any other functions described in section 406 for advisory councils
under such section. Functions under the preceding sentence shall
include making recommendations on budgetary allocations made in the
plan under subsection (f), and shall include reviewing reports
under subsection (k) before the reports are submitted under such
subsection.
``(2) Membership.--With respect to the membership of the
advisory council under paragraph (1), a majority of the members
shall be individuals with demonstrated expertise regarding minority
health disparity and other health disparity issues; representatives
of communities impacted by minority and other health disparities
shall be included; and a diversity of health professionals shall be
represented. The membership shall in addition include a
representative of the Office of Behavioral and Social Sciences
Research under section 404A.
``(k) Annual Report.--The Director of the Center shall prepare an
annual report on the activities carried out or to be carried out by the
Center, and shall submit each such report to the Committee on Health,
Education, Labor, and Pensions of the Senate, the Committee on Commerce
of the House of Representatives, the Secretary, and the Director of
NIH. With respect to the fiscal year involved, the report shall--
``(1) describe and evaluate the progress made in health
disparities research conducted or supported by the national
research institutes;
``(2) summarize and analyze expenditures made for activities
with respect to health disparities research conducted or supported
by the National Institutes of Health;
``(3) include a separate statement applying the requirements of
paragraphs (1) and (2) specifically to minority health disparities
research; and
``(4) contain such recommendations as the Director considers
appropriate.
``(l) Authorization of Appropriations.--For the purpose of carrying
out this subpart, there are authorized to be appropriated $100,000,000
for fiscal year 2001, and such sums as may be necessary for each of the
fiscal years 2002 through 2005. Such authorization of appropriations is
in addition to other authorizations of appropriations that are
available for the conduct and support of minority health disparities
research or other health disparities research by the agencies of the
National Institutes of Health.''.
(b) Conforming Amendment.--Part A of title IV of the Public Health
Service Act (42 U.S.C. 281 et seq.) is amended--
(1) in section 401(b)(2)--
(A) in subparagraph (F), by moving the subparagraph two ems
to the left; and
(B) by adding at the end the following subparagraph:
``(G) The National Center on Minority Health and Health
Disparities.''; and
(2) by striking section 404.

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TRAINING.
Subpart 6 of part E of title IV of the Public Health Service Act,
as added by section 101(a) of this Act, is amended by adding at the end
the following section:
``SEC. 485F. CENTERS OF EXCELLENCE FOR RESEARCH EDUCATION AND TRAINING.
``(a) In General.--The Director of the Center shall make awards of
grants or contracts to designated biomedical and behavioral research
institutions under paragraph (1) of subsection (c), or to consortia
under paragraph (2) of such subsection, for the purpose of assisting
the institutions in supporting programs of excellence in biomedical and
behavioral research training for individuals who are members of
minority health disparity populations or other health disparity
populations.
``(b) Required Use of Funds.--An award may be made under subsection
(a) only if the applicant involved agrees that the grant will be
expended--
``(1) to train members of minority health disparity populations
or other health disparity populations as professionals in the area
of biomedical or behavioral research or both; or
``(2) to expand, remodel, renovate, or alter existing research
facilities or construct new research facilities for the purpose of
conducting minority health disparities research and other health
disparities research.
``(c) Centers of Excellence.--
``(1) In general.--For purposes of this section, a designated
biomedical and behavioral research institution is a biomedical and
behavioral research institution that--
``(A) has a significant number of members of minority
health disparity populations or other health disparity
populations enrolled as students in the institution (including
individuals accepted for enrollment in the institution);
``(B) has been effective in assisting such students of the
institution to complete the program of education or training
and receive the degree involved;
``(C) has made significant efforts to recruit minority
students to enroll in and graduate from the institution, which
may include providing means-tested scholarships and other
financial assistance as appropriate; and
``(D) has made significant recruitment efforts to increase
the number of minority or other members of health disparity
populations serving in faculty or administrative positions at
the institution.
``(2) Consortium.--Any designated biomedical and behavioral
research institution involved may, with other biomedical and
behavioral institutions (designated or otherwise), including tribal
health programs, form a consortium to receive an award under
subsection (a).
``(3) Application of criteria to other programs.--In the case
of any criteria established by the Director of the Center for
purposes of determining whether institutions meet the conditions
described in paragraph (1), this section may not, with respect to
minority health disparity populations or other health disparity
populations, be construed to authorize, require, or prohibit the
use of such criteria in any program other than the program
established in this section.
``(d) Duration of Grant.--The period during which payments are made
under a grant under subsection (a) may not exceed 5 years. Such
payments shall be subject to annual approval by the Director of the
Center and to the availability of appropriations for the fiscal year
involved to make the payments.
``(e) Maintenance of Effort.--
``(1) In general.--With respect to activities for which an
award under subsection (a) is authorized to be expended, the
Director of the Center may not make such an award to a designated
research institution or consortium for any fiscal year unless the
institution, or institutions in the consortium, as the case may be,
agree to maintain expenditures of non-Federal amounts for such
activities at a level that is not less than the level of such
expenditures maintained by the institutions involved for the fiscal
year preceding the fiscal year for which such institutions receive
such an award.
``(2) Use of federal funds.--With respect to any Federal
amounts received by a designated research institution or consortium
and available for carrying out activities for which an award under
subsection (a) is authorized to be expended, the Director of the
Center may make such an award only if the institutions involved
agree that the institutions will, before expending the award,
expend the Federal amounts obtained from sources other than the
award.
``(f) Certain Expenditures.--The Director of the Center may
authorize a designated biomedical and behavioral research institution
to expend a portion of an award under subsection (a) for research
endowments.
``(g) Definitions.--For purposes of this section:
``(1) The term `designated biomedical and behavioral research
institution' has the meaning indicated for such term in subsection
(c)(1). Such term includes any health professions school receiving
an award of a grant or contract under section 736.
``(2) The term `program of excellence' means any program
carried out by a designated biomedical and behavioral research
institution with an award under subsection (a), if the program is
for purposes for which the institution involved is authorized in
subsection (b) to expend the grant.
``(h) Authorization of Appropriations.--For the purpose of making
grants under subsection (a), there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001 through
2005.''.

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DISPARITIES RESEARCH.
Subpart 6 of part E of title IV of the Public Health Service Act,
as amended by section 102 of this Act, is amended by adding at the end
the following section:
``SEC. 485G. LOAN REPAYMENT PROGRAM FOR MINORITY HEALTH DISPARITIES
RESEARCH.
``(a) In General.--The Director of the Center shall establish a
program of entering into contracts with qualified health professionals
under which such health professionals agree to engage in minority
health disparities research or other health disparities research in
consideration of the Federal Government agreeing to repay, for each
year of engaging in such research, not more than $35,000 of the
principal and interest of the educational loans of such health
professionals.
``(b) Service Provisions.--The provisions of sections 338B, 338C,
and 338E shall, except as inconsistent with subsection (a), apply to
the program established in such subsection to the same extent and in
the same manner as such provisions apply to the National Health Service
Corps Loan Repayment Program established in subpart III of part D of
title III.
``(c) Requirement Regarding Health Disparity Populations.--The
Director of the Center shall ensure that not fewer than 50 percent of
the contracts entered into under subsection (a) are for appropriately
qualified health professionals who are members of a health disparity
population.
``(d) Priority.--With respect to minority health disparities
research and other health disparities research under subsection (a),
the Secretary shall ensure that priority is given to conducting
projects of biomedical research.
``(e) Funding.--
``(1) Authorization of appropriations.--For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005.
``(2) Availability of appropriations.--Amounts available for
carrying out this section shall remain available until the
expiration of the second fiscal year beginning after the fiscal
year for which the amounts were made available.''.

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Subpart 6 of part E of title IV of the Public Health Service Act,
as amended by section 103 of this Act, is amended by adding at the end
the following section:
``SEC. 485H. GENERAL PROVISIONS REGARDING THE CENTER.
``(a) Administrative Support for Center.--The Secretary, acting
through the Director of the National Institutes of Health, shall
provide administrative support and support services to the Director of
the Center and shall ensure that such support takes maximum advantage
of existing administrative structures at the agencies of the National
Institutes of Health.
``(b) Evaluation and Report.--
``(1) Evaluation.--Not later than 5 years after the date of the
enactment of this subpart, the Secretary shall conduct an
evaluation to--
``(A) determine the effect of this subpart on the planning
and coordination of health disparities research programs at the
agencies of the National Institutes of Health;
``(B) evaluate the extent to which this subpart has
eliminated the duplication of administrative resources among
such Institutes, centers and divisions; and
``(C) provide, to the extent determined by the Secretary to
be appropriate, recommendations concerning future legislative
modifications with respect to this subpart, for both minority
health disparities research and other health disparities
research.
``(2) Minority health disparities research.--The evaluation
under paragraph (1) shall include a separate statement that applies
subparagraphs (A) and (B) of such paragraph to minority health
disparities research.
``(3) Report.--Not later than 1 year after the date on which
the evaluation is commenced under paragraph (1), the Secretary
shall prepare and submit to the Committee on Health, Education,
Labor, and Pensions of the Senate, and the Committee on Commerce of
the House of Representatives, a report concerning the results of
such evaluation.''.

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

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

ba8af79d44198e1b7fddc24096f2851104f0d01b948c06533effe4c187af2a98

(a) Study.--The National Academy of Sciences shall conduct a
comprehensive study of the Department of Health and Human Services'
data collection systems and practices, and any data collection or
reporting systems required under any of the programs or activities of
the Department, relating to the collection of data on race or
ethnicity, including other Federal data collection systems (such as the
Social Security Administration) with which the Department interacts to
collect relevant data on race and ethnicity.
(b) Report.--Not later than 1 year after the date of enactment of
this Act, the National Academy of Sciences shall prepare and submit to
the Committee on Health, Education, Labor, and Pensions of the Senate
and the Committee on Commerce of the House of Representatives, a report
that--
(1) identifies the data needed to support efforts to evaluate
the effects of socioeconomic status, race and ethnicity on access
to health care and other services and on disparity in health and
other social outcomes and the data needed to enforce existing
protections for equal access to health care;
(2) examines the effectiveness of the systems and practices of
the Department of Health and Human Services described in subsection
(a), including pilot and demonstration projects of the Department,
and the effectiveness of selected systems and practices of other
Federal, State, and tribal agencies and the private sector, in
collecting and analyzing such data;
(3) contains recommendations for ensuring that the Department
of Health and Human Services, in administering its entire array of
programs and activities, collects, or causes to be collected,
reliable and complete information relating to race and ethnicity;
and
(4) includes projections about the costs associated with the
implementation of the recommendations described in paragraph (3),
and the possible effects of the costs on program operations.
(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for fiscal year 2001.

339fc4a3958d0d53d260b092d568c4fb095fb6c2563292996a6d01ea570c57c5

TITLE III

-DATA COLLECTION RELATING TO RACE OR ETHNICITY

(a) In General.--Part B of title VII of the Public Health Service
Act (42 U.S.C. 293 et seq.) is amended by inserting after section 740
the following:
``SEC. 741. GRANTS FOR HEALTH PROFESSIONS EDUCATION.
``(a) Grants for Health Professions Education in Health Disparities
and Cultural Competency.--
``(1) In general.--The Secretary, acting through the
Administrator of the Health Resources and Services Administration,
may make awards of grants, contracts, or cooperative agreements to
public and nonprofit private entities (including tribal entities)
for the purpose of carrying out research and demonstration projects
(including research and demonstration projects for continuing
health professions education) for training and education of health
professionals for the reduction of disparities in health care
outcomes and the provision of culturally competent health care.
``(2) Eligible entities.--Unless specifically required
otherwise in this title, the Secretary shall accept applications
for grants or contracts under this section from health professions
schools, academic health centers, State or local governments, or
other appropriate public or private nonprofit entities (or
consortia of entities, including entities promoting
multidisciplinary approaches) for funding and participation in
health professions training activities. The Secretary may accept
applications from for-profit private entities as determined
appropriate by the Secretary.
``(b) Authorization of Appropriations.--There are authorized to be
appropriated to carry out subsection (a), $3,500,000 for fiscal year
2001, $7,000,000 for fiscal year 2002, $7,000,000 for fiscal year 2003,
and $3,500,000 for fiscal year 2004.''.
(b) Nursing Education.--Part A of title VIII of the Public Health
Service Act (42 U.S.C. 296 et seq.) is amended--
(1) by redesignating section 807 as section 808; and
(2) by inserting after section 806 the following:
``SEC. 807. GRANTS FOR HEALTH PROFESSIONS EDUCATION.
``(a) Grants for Health Professions Education in Health Disparities
and Cultural Competency.--The Secretary, acting through the
Administrator of the Health Resources and Services Administration, may
make awards of grants, contracts, or cooperative agreements to eligible
entities for the purpose of carrying out research and demonstration
projects (including research and demonstration projects for continuing
health professions education) for training and education for the
reduction of disparities in health care outcomes and the provision of
culturally competent health care. Grants under this section shall be
the same as provided in section 741.''.
``(b) Authorization of Appropriations.--There are to be
appropriated to carry out subsection (a) such sums as may be necessary
for each of the fiscal years 2001 through 2004.''.

3fd112179406b687010d10844fdde99f597e2934bfeda94331d707d8aae07d88

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

e6d1a1b56d25a76d8b6ab347b134359ce037888b87910a181f67591f179276ff

IN HEALTH DISPARITIES AND CULTURAL COMPETENCY.
Section 1707 of the Public Health Service Act (42 U.S.C. 300u-6) is
amended--
(1) in subsection (b), by adding at the end the following
paragraph:
``(10) Advise in matters related to the development,
implementation, and evaluation of health professions education in
decreasing disparities in health care outcomes, including cultural
competency as a method of eliminating health disparities.'';
(2) in subsection (c)(2), by striking ``paragraphs (1) through
(9)'' and inserting ``paragraphs (1) through (10)''; and
(3) in subsection (d), by amending paragraph (1) to read as
follows:
``(1) Recommendations regarding language.--
``(A) Proficiency in speaking english.--The Deputy
Assistant Secretary shall consult with the Director of the
Office of International and Refugee Health, the Director of the
Office of Civil Rights, and the Directors of other appropriate
departmental entities regarding recommendations for carrying
out activities under subsection (b)(9).
``(B) Health professions education regarding health
disparities.--The Deputy Assistant Secretary shall carry out
the duties under subsection (b)(10) in collaboration with
appropriate personnel of the Department of Health and Human
Services, other Federal agencies, and other offices, centers,
and institutions, as appropriate, that have responsibilities
under the Minority Health and Health Disparities Research and
Education Act of 2000.''.
DISPARITIES

28f6313536cb969321d1536b0b9a981dd1f3c2827542b91bf798d15c31c646a1

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

43d26ed3fc7013144011f279698ca499a65f44c423758d97869eebffef9b4b66

TITLE V

-PUBLIC AWARENESS AND DISSEMINATION OF INFORMATION ON HEALTH

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

145d61433e08cb6099c34f67ca6329b3851ef55ccdaa34d6cdf11981cdd0c2d3

For purposes of this Act, the term ``racial and ethnic minority
group'' has the meaning given such term in section 1707 of the Public
Health Service Act.

b3242c81909ea02b78b8b7ed3dd93c75216ccc3ef8d39b82d495c8269ffd78cf

This Act and the amendments made by this Act take effect October 1,
2000, or upon the date of the enactment of this Act, whichever occurs
later.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.

9e08eed4e104e36e327c8569c682063f82672463a3806449e32b74a64dffe653

Minority Health and Health Disparities Research and Education Act of 2000 — S. 1880

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