[106th Congress Public Law 525]
[From the U.S. Government Printing Office]
<DOC>
[DOCID: f:publ525.106]
[[Page 114 STAT. 2495]]
Public Law 106-525
106th Congress
An Act
To amend the Public Health Service Act to improve the health of minority
individuals. <<NOTE: Nov. 22, 2000 - [S. 1880]>>
Be it enacted by the Senate and House of Representatives of the
United States of America in <<NOTE: Minority Health and Health
Disparities Research and Education Act of 2000.>> Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF <<NOTE: 42 USC 202 note.>> CONTENTS.
(a) Short Title.--This Act may be cited as the ``Minority Health and
Health Disparities Research and Education Act of 2000''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings.
TITLE I--IMPROVING MINORITY HEALTH AND REDUCING HEALTH DISPARITIES
THROUGH NATIONAL INSTITUTES OF HEALTH; ESTABLISHMENT OF NATIONAL CENTER
Sec. 101. Establishment of National Center on Minority Health and Health
Disparities.
Sec. 102. Centers of excellence for research education and training.
Sec. 103. Extramural loan repayment program for minority health
disparities research.
Sec. 104. General provisions regarding the Center.
Sec. 105. Report regarding resources of National Institutes of Health
dedicated to minority and other health disparities research.
TITLE II--HEALTH DISPARITIES RESEARCH BY AGENCY FOR HEALTHCARE RESEARCH
AND QUALITY
Sec. 201. Health disparities research by Agency for Healthcare Research
and Quality.
TITLE III--DATA COLLECTION RELATING TO RACE OR ETHNICITY
Sec. 301. Study and report by National Academy of Sciences.
TITLE IV--HEALTH PROFESSIONS EDUCATION
Sec. 401. Health professions education in health disparities.
Sec. 402. National conference on health professions education and health
disparities.
Sec. 403. Advisory responsibilities in health professions education in
health disparities and cultural competency.
TITLE V--PUBLIC AWARENESS AND DISSEMINATION OF INFORMATION ON HEALTH
DISPARITIES
Sec. 501. Public awareness and information dissemination.
TITLE VI--MISCELLANEOUS PROVISIONS
Sec. 601. Departmental definition regarding minority individuals.
Sec. 602. Conforming provision regarding definitions.
Sec. 603. Effective date.
SEC. 2. <<NOTE: 42 USC 287c-31 note.>> FINDINGS.
The Congress finds as follows:
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(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
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to help close the health disparities gap among ethnic minority
populations. In addition, there is a shortage of minority
behavioral science researchers and behavioral health care
professionals. According to the National Science Foundation,
only 15.5 percent of behavioral research-oriented psychology
doctorate degrees were awarded to minority students in 1997. In
addition, only 17.9 percent of practice-oriented psychology
doctorate degrees were awarded to ethnic minorities.
TITLE I--IMPROVING MINORITY HEALTH AND REDUCING HEALTH DISPARITIES
THROUGH NATIONAL INSTITUTES OF HEALTH; ESTABLISHMENT OF NATIONAL CENTER
SEC. 101. ESTABLISHMENT OF NATIONAL CENTER ON MINORITY HEALTH AND
HEALTH DISPARITIES.
(a) In General.--Part E of title IV of the Public Health Service Act
(42 U.S.C. 287 et seq.) is amended by adding at the end the following
subpart:
``Subpart 6--National Center on Minority Health and Health Disparities
``SEC. 485E. <<NOTE: 42 USC 287c-31.>> 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.
[[Page 114 STAT. 2498]]
``(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) <<NOTE: Deadline.>> 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
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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
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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
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``(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 <<NOTE: 42 USC 281.>> 401(b)(2)--
(A) in subparagraph (F), by moving the subparagraph
two ems to the left; and
(B) by adding at the end the following subparagraph:
``(G) The National Center on Minority Health and Health
Disparities.''; and
(2) by striking section 404.
SEC. 102. <<NOTE: 42 USC 283b.>> CENTERS OF EXCELLENCE FOR
RESEARCH EDUCATION AND TRAINING.
Subpart 6 of part E of title IV of the Public Health Service Act, as
added by section 101(a) of this Act, is amended by adding at the end the
following section:
``SEC. 485F. <<NOTE: 42 USC 287c-32.>> CENTERS OF EXCELLENCE FOR
RESEARCH EDUCATION AND TRAINING.
``(a) In General.-- <<NOTE: Grants. Contracts.>> 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;
[[Page 114 STAT. 2502]]
``(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
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institution with an award under subsection (a), if the program
is for purposes for which the institution involved is authorized
in subsection (b) to expend the grant.
``(h) Authorization of Appropriations.--For the purpose of making
grants under subsection (a), there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001 through
2005.''.
SEC. 103. EXTRAMURAL LOAN REPAYMENT PROGRAM FOR MINORITY HEALTH
DISPARITIES RESEARCH.
Subpart 6 of part E of title IV of the Public Health Service Act, as
amended by section 102 of this Act, is amended by adding at the end the
following section:
``SEC. 485G. <<NOTE: 42 USC 287c-33.>> LOAN REPAYMENT PROGRAM FOR
MINORITY HEALTH DISPARITIES RESEARCH.
``(a) In General.-- <<NOTE: Contracts.>> The Director of the Center
shall establish a program of entering into contracts with qualified
health professionals under which such health professionals agree to
engage in minority health disparities research or other health
disparities research in consideration of the Federal Government agreeing
to repay, for each year of engaging in such research, not more than
$35,000 of the principal and interest of the educational loans of such
health professionals.
``(b) Service Provisions.--The provisions of sections 338B, 338C,
and 338E shall, except as inconsistent with subsection (a), apply to the
program established in such subsection to the same extent and in the
same manner as such provisions apply to the National Health Service
Corps Loan Repayment Program established in subpart III of part D of
title III.
``(c) Requirement Regarding Health Disparity Populations.--The
Director of the Center shall ensure that not fewer than 50 percent of
the contracts entered into under subsection (a) are for appropriately
qualified health professionals who are members of a health disparity
population.
``(d) Priority.--With respect to minority health disparities
research and other health disparities research under subsection (a), the
Secretary shall ensure that priority is given to conducting projects of
biomedical research.
``(e) Funding.--
``(1) Authorization of appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated such sums as may be necessary for each of the
fiscal years 2001 through 2005.
``(2) Availability of appropriations.--Amounts available for
carrying out this section shall remain available until the
expiration of the second fiscal year beginning after the fiscal
year for which the amounts were made available.''.
SEC. 104. GENERAL PROVISIONS REGARDING THE CENTER.
Subpart 6 of part E of title IV of the Public Health Service Act, as
amended by section 103 of this Act, is amended by adding at the end the
following section:
``SEC. 485H. <<NOTE: 42 USC 287c-34.>> 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
[[Page 114 STAT. 2504]]
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) <<NOTE: Deadline.>> 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) <<NOTE: Deadline.>> 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.''.
SEC. 105. <<NOTE: 42 USC 287c-31 note.>> REPORT REGARDING
RESOURCES OF NATIONAL INSTITUTES OF HEALTH
DEDICATED TO MINORITY AND OTHER HEALTH
DISPARITIES RESEARCH.
<<NOTE: Deadline.>> 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.
[[Page 114 STAT. 2505]]
TITLE II--HEALTH DISPARITIES RESEARCH BY AGENCY FOR HEALTHCARE RESEARCH
AND QUALITY
SEC. 201. HEALTH DISPARITIES RESEARCH BY AGENCY FOR HEALTHCARE
RESEARCH AND QUALITY.
(a) In General.--Part A of title IX of the Public Health Service
Act (42 U.S.C. 299 et seq.) is amended--
(1) <<NOTE: 42 USC 299a.>> in section 902, by striking
subsection (g); and
(2) by adding at the end the following:
<<NOTE: 42 USC 299a-1.>> ``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) <<NOTE: Reports.>> 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
[[Page 114 STAT. 2506]]
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
[[Page 114 STAT. 2507]]
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) <<NOTE: Deadline.>> Report.--Not later than 36 months
after the date of the enactment of this section, the Secretary,
acting through the Director, shall prepare and submit to the
appropriate committees of Congress a report describing the
state-of-the-art of quality measurement for minority and other
health disparity populations that will identify critical unmet
needs, the current activities of the Department to address those
needs, and a description of related activities in the private
sector.
``(d) Definition.--For purposes of this section:
``(1) The term `health disparity population' has the meaning
given such term in section 485E, except that in addition to the
meaning so given, the Director may determine that such term
includes populations for which there is a significant disparity
in the quality, outcomes, cost, or use of health care services
or access to or satisfaction with such services as compared to
the general population.
``(2) The term `minority', with respect to populations,
refers to racial and ethnic minority groups as defined in
section 1707.''.
(b) Funding.--Section 927 of the Public Health Service Act (42
U.S.C. 299c-6) is amended by adding at the end the following:
``(d) Health Disparities Research.--For the purpose of carrying out
the activities under section 903, there are authorized to be
appropriated $50,000,000 for fiscal year 2001, and such sums as may be
necessary for each of the fiscal years 2002 through 2005.''.
TITLE III--DATA COLLECTION RELATING TO RACE OR ETHNICITY
SEC. 301. <<NOTE: 42 USC 3501 note.>> STUDY AND REPORT BY NATIONAL
ACADEMY OF SCIENCES.
(a) Study.--The National Academy of Sciences shall conduct a
comprehensive study of the Department of Health and Human Services' data
collection systems and practices, and any data collection or reporting
systems required under any of the programs or activities of the
Department, relating to the collection of data on race or ethnicity,
including other Federal data collection systems (such as the Social
Security Administration) with which the Department interacts to collect
relevant data on race and ethnicity.
(b) <<NOTE: Deadline.>> 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
[[Page 114 STAT. 2508]]
of the Department, and the effectiveness of selected systems and
practices of other Federal, State, and tribal agencies and the
private sector, in collecting and analyzing such data;
(3) contains recommendations for ensuring that the
Department of Health and Human Services, in administering its
entire array of programs and activities, collects, or causes to
be collected, reliable and complete information relating to race
and ethnicity; and
(4) includes projections about the costs associated with the
implementation of the recommendations described in paragraph
(3), and the possible effects of the costs on program
operations.
(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for fiscal year 2001.
TITLE IV--HEALTH PROFESSIONS EDUCATION
SEC. 401. HEALTH PROFESSIONS EDUCATION IN HEALTH DISPARITIES.
(a) In General.--Part B of title VII of the Public Health Service
Act (42 U.S.C. 293 et seq.) is amended by inserting after section 740
the following:
``SEC. 741. <<NOTE: 42 USC 293e.>> 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 redes <<NOTE: 42 USC 296f.>> ignating section 807 as
section 808; and
(2) by inser <<NOTE: 42 USC 296e-1.>> ting after section 806
the following:
[[Page 114 STAT. 2509]]
``SEC. 807. GRANTS FOR HEALTH PROFESSIONS EDUCATION.
``(a) Grants for Health Professions Education in Health Disparities
and Cultural Competency.--The Secretary, acting through the
Administrator of the Health Resources and Services Administration, may
make awards of grants, contracts, or cooperative agreements to eligible
entities for the purpose of carrying out research and demonstration
projects (including research and demonstration projects for continuing
health professions education) for training and education for the
reduction of disparities in health care outcomes and the provision of
culturally competent health care. Grants under this section shall be the
same as provided in section 741.''.
``(b) Authorization of Appropriations.--There are to be appropriated
to carry out subsection (a) such sums as may be necessary for each of
the fiscal years 2001 through 2004.''.
SEC. 402. NATIONAL CONFERE <<NOTE: 42 USC 293e note.>> NCE ON
HEALTH PROFESSIONS EDUCATION AND HEALTH
DISPARITIES.
(a) <<NOTE: Deadline.>> 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) <<NOTE: Deadline. Federal Register, publication.>> Publication
of Findings.--Not later than 6 months after the national conference
under subsection (a) has convened, the Secretary shall publish in the
Federal Register a summary of the proceedings and findings of the
conference.
(e) Authorization of Appropriations.--There is authorized to be
appropriated such sums as may be necessary to carry out this section.
SEC. 403. ADVISORY RESPONSIBILITIES IN HEALTH PROFESSIONS
EDUCATION IN HEALTH DISPARITIES AND
CULTURAL COMPETENCY.
Section 1707 of the Public Health Service Act (42 U.S.C. 300u-6) is
amended--
(1) in subsection (b), by adding at the end the following
paragraph:
``(10) Advise in matters related to the development,
implementation, and evaluation of health professions education
in decreasing disparities in health care outcomes, including
[[Page 114 STAT. 2510]]
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.''.
TITLE V--PUBLIC AWARENESS AND DISSEMINATION OF INFORMATION ON HEALTH
DISPARITIES
SEC. 501. <<NOTE: 42 USC 287c-31 note.>> PUBLIC AWARENESS AND
INFORMATION DISSEMINATION.
(a) Public Awareness on Health Disparities.--The Secretary of Health
and Human Services (in this section referred to as the ``Secretary'')
shall conduct a national campaign to inform the public and health care
professionals about health disparities in minority and other underserved
populations by disseminating information and materials available on
specific diseases affecting these populations and programs and
activities to address these disparities. The campaign shall--
(1) have a specific focus on minority and other underserved
communities with health disparities; and
(2) include an evaluation component to assess the impact of
the national campaign in raising awareness of health disparities
and information on available resources.
(b) Dissemination of Information on Health Disparities.--The
Secretary shall develop and implement a plan for the dissemination of
information and findings with respect to health disparities under titles
I, II, III, and IV of this Act. The plan shall--
(1) include the participation of all agencies of the
Department of Health and Human Services that are responsible for
serving populations included in the health disparities research;
and
(2) have agency-specific strategies for disseminating
relevant findings and information on health disparities and
improving health care services to affected communities.
[[Page 114 STAT. 2511]]
TITLE VI--MISCELLANEOUS PROVISIONS
SEC. 601. DEPARTMENTAL DEFINITION REGARDING MINORITY INDIVIDUALS.
Section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 300u-
6) is amended--
(1) by striking ``Asian Americans and'' and inserting
``Asian Americans;''; and
(2) by inserting ``Native Hawaiians and other'' before
``Pacific Islanders;''.
SEC. 602. CONFORMING PROVISION REGARDING DEFINITIONS.
For purposes of this Act, the term ``racial and ethnic minority
group'' has the meaning given such term in section 1707 of the Public
Health Service Act.
SEC. 603. <<NOTE: 42 USC 281 note.>> EFFECTIVE DATE.
This Act and the amendments made by this Act take effect October 1,
2000, or upon the date of the enactment of this Act, whichever occurs
later.
Approved November 22, 2000.
LEGISLATIVE HISTORY--S. 1880 (H.R. 3250):
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HOUSE REPORTS: No. 106-986 accompanying H.R. 3250 (Comm. on Commerce).
CONGRESSIONAL RECORD, Vol. 146 (2000):
Oct. 26, considered and passed Senate.
Oct. 31, considered and passed House.
WEEKLY COMPILATION OF PRESIDENTIAL DOCUMENTS, Vol. 36 (2000):
Nov. 22, Presidential statement.
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