[Congressional Bills 103th Congress]
[From the U.S. Government Printing Office]
[S. 1318 Reported in Senate (RS)]
Calendar No. 192
103d CONGRESS
1st Session
S. 1318
[Report No. 103-135]
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to extend the program of grants
regarding the prevention and control of tuberculosis and sexually
transmitted diseases, to revise and extend certain injury control
programs, and to revise and extend the program of grants relating to
preventive health measures with respect to breast and cervical cancer,
and for other purposes.
_______________________________________________________________________
September 7, 1993
Reported with an amendment
Calendar No. 192
103d CONGRESS
1st Session
S. 1318
[Report No. 103-135]
To amend the Public Health Service Act to extend the program of grants
regarding the prevention and control of tuberculosis and sexually
transmitted diseases, to revise and extend certain injury control
programs, and to revise and extend the program of grants relating to
preventive health measures with respect to breast and cervical cancer,
and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
July 29 (legislative day, June 30), 1993
Mr. Kennedy (for himself, Mrs. Kassebaum, Ms. Mikulski, Mr. Hatch, Mr.
Wellstone, Mr. Riegle, Mr. Dodd, and Mr. Wofford) introduced
the following bill; which was read twice and referred to the
Committee on Labor and Human Resources
September 7, 1993
Reported by Mr. Kennedy, with an amendment
[Strike out all after the enacting clause and insert the part printed
in italic]
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to extend the program of grants
regarding the prevention and control of tuberculosis and sexually
transmitted diseases, to revise and extend certain injury control
programs, and to revise and extend the program of grants relating to
preventive health measures with respect to breast and cervical cancer,
and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
-S-E-C-T-I-O-N -1-. -S-H-O-R-T -T-I-T-L-E-.
-T-h-i-s -A-c-t -m-a-y -b-e -c-i-t-e-d -a-s -t-h-e -`-`-E-a-r-l-y
-D-e-t-e-c-t-i-o-n -a-n-d -P-r-e-v-e-n-t-i-v-e -H-e-a-l-t-h -A-c-t -o-f
-1-9-9-3-'-'-.
-T-I-T-L-E -I----T-U-B-E-R-C-U-L-O-S-I-S
-S-E-C-. -1-0-1-. -S-H-O-R-T -T-I-T-L-E-.
-T-h-i-s -t-i-t-l-e -m-a-y -b-e -c-i-t-e-d -a-s -t-h-e
-`-`-T-u-b-e-r-c-u-l-o-s-i-s -P-r-e-v-e-n-t-i-o-n -a-n-d -C-o-n-t-r-o-l
-A-m-e-n-d-m-e-n-t-s -o-f -1-9-9-3-'-'-.
-S-E-C-. -1-0-2-. -F-I-N-D-I-N-G-S-.
-C-o-n-g-r-e-s-s -f-i-n-d-s -t-h-a-t---
-(-1-) -b-e-t-w-e-e-n -1-0-,-0-0-0-,-0-0-0 -a-n-d
-1-5-,-0-0-0-,-0-0-0 -p-e-o-p-l-e -i-n -t-h-e -U-n-i-t-e-d
-S-t-a-t-e-s -h-a-v-e -b-e-e-n -i-n-f-e-c-t-e-d -w-i-t-h
-t-u-b-e-r-c-u-l-o-s-i-s-, -n-e-a-r-l-y -2-6-,-0-0-0 -n-e-w
-a-c-t-i-v-e -c-a-s-e-s -a-r-e -r-e-p-o-r-t-e-d -e-a-c-h
-y-e-a-r-, -a-n-d -o-v-e-r -1-,-7-0-0
-t-u-b-e-r-c-u-l-o-s-i-s---r-e-l-a-t-e-d -d-e-a-t-h-s
-o-c-c-u-r -e-a-c-h -y-e-a-r-;
-(-2-) -t-h-e -n-u-m-b-e-r -o-f -r-e-p-o-r-t-e-d -c-a-s-e-s
-o-f -t-u-b-e-r-c-u-l-o-s-i-s -h-a-s -r-i-s-e-n -f-r-o-m
-2-2-,-2-0-1 -i-n -1-9-8-5 -t-o -2-6-,-6-7-3 -i-n -1-9-9-2-,
-r-e-p-r-e-s-e-n-t-i-n-g -5-1-,-0-0-0 -m-o-r-e -c-a-s-e-s
-t-h-a-n -t-h-o-s-e -t-h-a-t -w-o-u-l-d -h-a-v-e -b-e-e-n
-e-x-p-e-c-t-e-d -s-i-n-c-e -1-9-8-5-;
-(-3-) -a -r-e-c-e-n-t -n-a-t-i-o-n-a-l -s-u-r-v-e-y
-d-i-s-c-o-v-e-r-e-d -t-h-a-t -1-4-.-4 -p-e-r-c-e-n-t -o-f
-a-l-l -a-c-t-i-v-e -t-u-b-e-r-c-u-l-o-s-i-s -c-a-s-e-s
-w-e-r-e -r-e-s-i-s-t-a-n-t -t-o -a-t -l-e-a-s-t -o-n-e
-d-r-u-g-;
-(-4-) -d-r-u-g -r-e-s-i-s-t-a-n-t -t-u-b-e-r-c-u-l-o-s-i-s
-s-t-r-a-i-n-s -c-a-n -c-o-s-t -m-o-r-e -t-h-a-n
-$-1-5-0-,-0-0-0 -t-o -t-r-e-a-t-, -a-n-d -e-v-e-n -t-h-e-n-,
-b-e-t-w-e-e-n -4-0 -a-n-d -6-0 -p-e-r-c-e-n-t -o-f -t-h-e
-p-a-t-i-e-n-t-s -r-e-c-e-i-v-i-n-g -s-u-c-h -t-r-e-a-t-m-e-n-t
-d-i-e-;
-(-5-) -i-n -1-9-9-2-, -t-u-b-e-r-c-u-l-o-s-i-s -c-a-s-e-s
-w-e-r-e -r-e-p-o-r-t-e-d -t-o -t-h-e -C-e-n-t-e-r-s -f-o-r
-D-i-s-e-a-s-e -C-o-n-t-r-o-l -a-n-d -P-r-e-v-e-n-t-i-o-n -b-y
-a-l-l -5-0 -S-t-a-t-e-s-, -a-n-d -c-a-s-e-s -r-e-s-i-s-t-a-n-t
-t-o -o-n-e -o-r -m-o-r-e -t-u-b-e-r-c-u-l-o-s-i-s -d-r-u-g-s
-w-e-r-e -r-e-p-o-r-t-e-d -i-n -a-t -l-e-a-s-t -3-6
-S-t-a-t-e-s-, -t-h-e -D-i-s-t-r-i-c-t -o-f -C-o-l-u-m-b-i-a
-a-n-d -P-u-e-r-t-o -R-i-c-o-;
-(-6-) -i-n -1-9-9-2-, -2-7 -p-e-r-c-e-n-t -o-f -t-h-e
-r-e-p-o-r-t-e-d -c-a-s-e-s -o-f -t-u-b-e-r-c-u-l-o-s-i-s
-o-c-c-u-r-r-e-d -i-n -f-o-r-e-i-g-n -b-o-r-n -p-e-r-s-o-n-s-;
-(-7-) -o-n-e -t-h-i-r-d -o-f -t-h-e -w-o-r-l-d-'-s
-p-o-p-u-l-a-t-i-o-n -h-a-r-b-o-r-s -t-u-b-e-r-c-u-l-o-s-i-s-;
-a-n-d
-(-8-) -a-m-o-n-g -i-n-f-e-c-t-i-o-u-s -d-i-s-e-a-s-e-s
-t-u-b-e-r-c-u-l-o-s-i-s -i-s -s-t-i-l-l -t-h-e -n-u-m-b-e-r
-o-n-e -k-i-l-l-e-r -i-n -t-h-e -w-o-r-l-d -w-i-t-h -a-n
-e-s-t-i-m-a-t-e-d -8-,-0-0-0-,-0-0-0 -n-e-w -c-a-s-e-s
-e-a-c-h -y-e-a-r -a-n-d -2-,-9-0-0-,-0-0-0 -d-e-a-t-h-s-.
-S-E-C-. -1-0-3-. -P-R-O-G-R-A-M-S -O-F -C-E-N-T-E-R-S -F-O-R
-D-I-S-E-A-S-E -C-O-N-T-R-O-L -A-N-D
-P-R-E-V-E-N-T-I-O-N-.
-(-a-) -P-r-o-v-i-s-i-o-n -o-f -S-e-r-v-i-c-e-s -f-o-r
-P-r-e-v-e-n-t-i-o-n-, -C-o-n-t-r-o-l-, -a-n-d
-E-l-i-m-i-n-a-t-i-o-n-.----S-e-c-t-i-o-n -3-1-7-(-j-)-(-2-) -o-f
-t-h-e -P-u-b-l-i-c -H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t -(-4-2
-U-.-S-.-C-. -2-4-7-b-(-j-)-(-2-)-) -i-s -a-m-e-n-d-e-d -i-n -t-h-e
-f-i-r-s-t -s-e-n-t-e-n-c-e -b-y -s-t-r-i-k-i-n-g -`-`-a-n-d-'-'
-a-f-t-e-r -`-`-1-9-9-1-,-'-' -a-n-d -a-l-l -t-h-a-t -f-o-l-l-o-w-s
-t-h-r-o-u-g-h -`-`-1-9-9-5-'-' -a-n-d -i-n-s-e-r-t-i-n-g -t-h-e
-f-o-l-l-o-w-i-n-g-: -`-`-, -$-1-0-4-,-0-0-0-,-0-0-0 -f-o-r
-f-i-s-c-a-l -y-e-a-r -1-9-9-4-, -a-n-d -s-u-c-h -s-u-m-s -a-s -m-a-y
-b-e -n-e-c-e-s-s-a-r-y -f-o-r -e-a-c-h -o-f -t-h-e -f-i-s-c-a-l
-y-e-a-r-s -1-9-9-5 -t-h-r-o-u-g-h -1-9-9-7-'-'-.
-(-b-) -S-t-a-t-e -T-u-b-e-r-c-u-l-o-s-i-s -P-l-a-n-.---
-S-e-c-t-i-o-n -3-1-7-(-j-) -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h
-S-e-r-v-i-c-e -A-c-t -(-4-2 -U-.-S-.-C-. -2-4-7-b-(-j-)-) -i-s
-a-m-e-n-d-e-d -b-y -a-d-d-i-n-g -a-t -t-h-e -e-n-d -t-h-e-r-e-o-f
-t-h-e -f-o-l-l-o-w-i-n-g -n-e-w -p-a-r-a-g-r-a-p-h-:
-`-`-(-3-)-(-A-) -W-i-t-h -r-e-s-p-e-c-t -t-o -a-n
-a-p-p-l-i-c-a-t-i-o-n -s-u-b-m-i-t-t-e-d -b-y -a -S-t-a-t-e -f-o-r -a
-g-r-a-n-t -u-n-d-e-r -t-h-i-s -s-e-c-t-i-o-n -f-o-r -t-h-e
-p-r-e-v-e-n-t-i-o-n-, -c-o-n-t-r-o-l -a-n-d -e-l-i-m-i-n-a-t-i-o-n
-o-f -t-u-b-e-r-c-u-l-o-s-i-s-, -s-u-c-h -a-p-p-l-i-c-a-t-i-o-n
-s-h-a-l-l -c-o-n-t-a-i-n -a -S-t-a-t-e -p-l-a-n -t-h-a-t
-d-e-m-o-n-s-t-r-a-t-e-s -t-h-a-t -a-m-o-u-n-t-s -r-e-c-e-i-v-e-d
-u-n-d-e-r -t-h-e -g-r-a-n-t -w-i-l-l -b-e -e-x-p-e-n-d-e-d -i-n -a
-m-a-n-n-e-r -t-h-a-t -e-n-s-u-r-e-s -t-h-a-t -t-u-b-e-r-c-u-l-o-s-i-s
-s-e-r-v-i-c-e-s -w-i-l-l -b-e -p-r-o-v-i-d-e-d -t-o -t-h-o-s-e -a-t
-t-h-e -h-i-g-h-e-s-t -r-i-s-k -o-f -c-o-n-t-r-a-c-t-i-n-g
-t-u-b-e-r-c-u-l-o-s-i-s-, -o-r -i-n -t-h-o-s-e -a-r-e-a-s -w-i-t-h
-t-h-e -h-i-g-h-e-s-t -r-a-t-e-s -o-f -t-u-b-e-r-c-u-l-o-s-i-s
-i-n-f-e-c-t-i-o-n-.
-`-`-(-B-) -S-u-c-h -p-l-a-n-s -s-h-a-l-l -d-e-m-o-n-s-t-r-a-t-e
-t-h-a-t -t-h-e -a-p-p-l-i-c-a-n-t -w-i-l-l -w-o-r-k -c-l-o-s-e-l-y
-w-i-t-h -a-n-d -p-r-o-v-i-d-e -s-u-p-p-o-r-t -t-o -e-n-t-i-t-i-e-s
-r-e-c-e-i-v-i-n-g -f-u-n-d-s -u-n-d-e-r -s-e-c-t-i-o-n-s -3-2-9-,
-3-3-0-, -3-4-0-, -3-4-0-A-, -o-r -t-i-t-l-e-s -V -o-r -X-I-X-, -a-n-d
-t-o -c-o-r-r-e-c-t-i-o-n-a-l -f-a-c-i-l-i-t-i-e-s-, -a-n-d
-n-o-n-g-o-v-e-r-n-m-e-n-t-a-l -o-r-g-a-n-i-z-a-t-i-o-n-s -s-u-c-h -a-s
-c-o-m-m-u-n-i-t-y---b-a-s-e-d -o-r-g-a-n-i-z-a-t-i-o-n-s-.
-`-`-(-C-) -S-u-c-h -p-l-a-n-s -s-h-a-l-l -d-e-m-o-n-s-t-r-a-t-e
-t-h-a-t -g-r-a-n-t -f-u-n-d-s -w-i-l-l -b-e -u-s-e-d -f-o-r
-d-i-r-e-c-t-l-y -o-b-s-e-r-v-e-d -t-h-e-r-a-p-y -o-r -o-t-h-e-r
-e-f-f-e-c-t-i-v-e -i-n-t-e-r-v-e-n-t-i-o-n-s -w-i-t-h -r-e-s-p-e-c-t
-t-o -p-o-p-u-l-a-t-i-o-n-s -w-i-t-h -t-h-e -h-i-g-h-e-s-t -r-a-t-e-s
-o-f -a-c-t-i-v-e -i-n-f-e-c-t-i-o-n -w-i-t-h
-t-u-b-e-r-c-u-l-o-s-i-s-.-'-'-.
-(-c-) -R-e-s-e-a-r-c-h-, -D-e-m-o-n-s-t-r-a-t-i-o-n
-P-r-o-j-e-c-t-s-, -E-d-u-c-a-t-i-o-n-, -a-n-d -T-r-a-i-n-i-n-g-.---
-(-1-) -I-n -g-e-n-e-r-a-l-.----S-e-c-t-i-o-n
-3-1-7-(-k-)-(-2-) -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h
-S-e-r-v-i-c-e -A-c-t -(-4-2 -U-.-S-.-C-.
-2-4-7-b-(-k-)-(-2-)-) -i-s -a-m-e-n-d-e-d---
-(-A-) -b-y -r-e-d-e-s-i-g-n-a-t-i-n-g
-s-u-b-p-a-r-a-g-r-a-p-h-s -(-A-) -t-h-r-o-u-g-h -(-D-)
-a-s -c-l-a-u-s-e-s -(-i-) -t-h-r-o-u-g-h -(-i-v-)-,
-r-e-s-p-e-c-t-i-v-e-l-y-;
-(-B-) -b-y -i-n-s-e-r-t-i-n-g -`-`-(-A-)-'-'
-a-f-t-e-r -t-h-e -p-a-r-a-g-r-a-p-h
-d-e-s-i-g-n-a-t-i-o-n-; -a-n-d
-(-C-) -b-y -a-d-d-i-n-g -a-t -t-h-e -e-n-d
-t-h-e-r-e-o-f -t-h-e -f-o-l-l-o-w-i-n-g -n-e-w
-s-u-b-p-a-r-a-g-r-a-p-h-s-:
-`-`-(-B-) -I-n -s-u-p-p-o-r-t -o-f -g-r-a-n-t-s -r-e-f-e-r-r-e-d
-t-o -i-n -s-u-b-p-a-r-a-g-r-a-p-h -(-A-)-, -t-h-e -S-e-c-r-e-t-a-r-y
-m-a-y -c-o-n-d-u-c-t -o-r -s-u-p-p-o-r-t -a-p-p-l-i-e-d
-r-e-s-e-a-r-c-h -a-n-d -t-r-a-i-n-i-n-g -r-e-g-a-r-d-i-n-g -t-h-e
-s-u-r-v-e-i-l-l-a-n-c-e-, -d-i-a-g-n-o-s-t-i-c
-m-e-t-h-o-d-o-l-o-g-i-e-s-, -p-r-e-v-e-n-t-i-o-n-, -c-o-n-t-r-o-l-,
-a-n-d -t-r-e-a-t-m-e-n-t -o-f -t-u-b-e-r-c-u-l-o-s-i-s-,
-i-n-c-l-u-d-i-n-g -i-n-t-r-a-m-u-r-a-l -p-r-o-j-e-c-t-s -a-n-d
-e-x-t-r-a-m-u-r-a-l -p-r-o-j-e-c-t-s-.
-`-`-(-C-) -F-o-r -t-h-e -p-u-r-p-o-s-e -o-f -c-a-r-r-y-i-n-g
-o-u-t -s-u-b-p-a-r-a-g-r-a-p-h -(-A-)-, -t-h-e-r-e -a-r-e
-a-u-t-h-o-r-i-z-e-d -t-o -b-e -a-p-p-r-o-p-r-i-a-t-e-d
-$-2-6-,-0-0-0-,-0-0-0 -f-o-r -f-i-s-c-a-l -y-e-a-r -1-9-9-4-, -a-n-d
-s-u-c-h -s-u-m-s -a-s -m-a-y -b-e -n-e-c-e-s-s-a-r-y -f-o-r -e-a-c-h
-o-f -t-h-e -f-i-s-c-a-l -y-e-a-r-s -1-9-9-5 -t-h-r-o-u-g-h -1-9-9-7-.
-T-h-e -a-u-t-h-o-r-i-z-a-t-i-o-n -o-f -a-p-p-r-o-p-r-i-a-t-i-o-n-s
-e-s-t-a-b-l-i-s-h-e-d -i-n -t-h-e -p-r-e-c-e-d-i-n-g -s-e-n-t-e-n-c-e
-i-s -i-n -a-d-d-i-t-i-o-n -t-o -t-h-e -a-u-t-h-o-r-i-z-a-t-i-o-n -o-f
-a-p-p-r-o-p-r-i-a-t-i-o-n-s -e-s-t-a-b-l-i-s-h-e-d -i-n
-s-u-b-s-e-c-t-i-o-n -(-j-)-(-2-) -f-o-r -c-a-r-r-y-i-n-g -o-u-t
-t-h-i-s -p-a-r-a-g-r-a-p-h-.-'-'-.
-(-2-) -T-e-c-h-n-i-c-a-l -a-m-e-n-d-m-e-n-t-.---
-S-e-c-t-i-o-n -3-1-7-(-j-)-(-2-) -o-f -t-h-e -P-u-b-l-i-c
-H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t -(-4-2 -U-.-S-.-C-.
-2-4-7-b-(-j-)-(-2-)-) -i-s -a-m-e-n-d-e-d -b-y
-s-t-r-i-k-i-n-g -t-h-e -l-a-s-t -s-e-n-t-e-n-c-e-.
-S-E-C-. -1-0-4-. -R-E-S-E-A-R-C-H -T-H-R-O-U-G-H -N-A-T-I-O-N-A-L
-I-N-S-T-I-T-U-T-E -O-F -A-L-L-E-R-G-Y -A-N-D
-I-N-F-E-C-T-I-O-U-S -D-I-S-E-A-S-E-S-.
-(-a-) -C-e-r-t-a-i-n -D-u-t-i-e-s-.---
-(-1-) -I-n -g-e-n-e-r-a-l-.----S-u-b-p-a-r-t -6 -o-f
-p-a-r-t -C -o-f -t-i-t-l-e -I-V -o-f -t-h-e -P-u-b-l-i-c
-H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t -(-4-2 -U-.-S-.-C-.
-2-8-5-f-) -i-s -a-m-e-n-d-e-d -b-y -i-n-s-e-r-t-i-n-g
-a-f-t-e-r -s-e-c-t-i-o-n -4-4-6 -t-h-e -f-o-l-l-o-w-i-n-g
-s-e-c-t-i-o-n-:
-`-`-r-e-s-e-a-r-c-h -a-n-d -r-e-s-e-a-r-c-h -t-r-a-i-n-i-n-g
-r-e-g-a-r-d-i-n-g -t-u-b-e-r-c-u-l-o-s-i-s
-`-`-S-e-c-. -4-4-7-. -I-n -c-a-r-r-y-i-n-g -o-u-t -s-e-c-t-i-o-n
-4-4-6-, -t-h-e -D-i-r-e-c-t-o-r -o-f -t-h-e -I-n-s-t-i-t-u-t-e
-s-h-a-l-l -c-o-n-d-u-c-t -o-r -s-u-p-p-o-r-t -b-a-s-i-c
-r-e-s-e-a-r-c-h -a-n-d -r-e-s-e-a-r-c-h -t-r-a-i-n-i-n-g
-r-e-g-a-r-d-i-n-g -t-h-e -c-a-u-s-e-, -d-i-a-g-n-o-s-i-s-, -e-a-r-l-y
-d-e-t-e-c-t-i-o-n-, -p-r-e-v-e-n-t-i-o-n -a-n-d -t-r-e-a-t-m-e-n-t
-o-f -t-u-b-e-r-c-u-l-o-s-i-s-.-'-'-.
-(-2-) -C-o-n-f-o-r-m-i-n-g -a-m-e-n-d-m-e-n-t-.---
-S-e-c-t-i-o-n -4-4-6 -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h
-S-e-r-v-i-c-e -A-c-t -(-4-2 -U-.-S-.-C-. -2-8-5-f-) -i-s
-a-m-e-n-d-e-d -b-y -i-n-s-e-r-t-i-n-g -a-f-t-e-r
-`-`-D-i-s-e-a-s-e-s-'-' -t-h-e -f-o-l-l-o-w-i-n-g-:
-`-`-(-h-e-r-e-a-f-t-e-r -i-n -t-h-i-s -s-u-b-p-a-r-t
-r-e-f-e-r-r-e-d -t-o -a-s -t-h-e
-`-I-n-s-t-i-t-u-t-e-'-)-'-'-.
-(-b-) -A-u-t-h-o-r-i-z-a-t-i-o-n -o-f
-A-p-p-r-o-p-r-i-a-t-i-o-n-s-.----S-e-c-t-i-o-n -4-0-8-(-a-) -o-f
-t-h-e -P-u-b-l-i-c -H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t -(-4-2
-U-.-S-.-C-. -2-8-4-c-(-a-)-) -i-s -a-m-e-n-d-e-d -b-y -a-d-d-i-n-g
-a-t -t-h-e -e-n-d -t-h-e -f-o-l-l-o-w-i-n-g -n-e-w
-p-a-r-a-g-r-a-p-h-:
-`-`-(-3-) -F-o-r -t-h-e -p-u-r-p-o-s-e -o-f
-c-a-r-r-y-i-n-g -o-u-t -s-e-c-t-i-o-n -4-4-7
-(-r-e-l-a-t-i-n-g -t-o -r-e-s-e-a-r-c-h -o-n
-t-u-b-e-r-c-u-l-o-s-i-s -t-h-r-o-u-g-h -t-h-e -N-a-t-i-o-n-a-l
-I-n-s-t-i-t-u-t-e -o-n -A-l-l-e-r-g-y -a-n-d
-I-n-f-e-c-t-i-o-u-s -D-i-s-e-a-s-e-s-)-, -t-h-e-r-e -a-r-e
-a-u-t-h-o-r-i-z-e-d -t-o -b-e -a-p-p-r-o-p-r-i-a-t-e-d
-$-4-6-,-0-0-0-,-0-0-0 -f-o-r -f-i-s-c-a-l -y-e-a-r -1-9-9-4-,
-a-n-d -s-u-c-h -s-u-m-s -a-s -m-a-y -b-e -n-e-c-e-s-s-a-r-y
-f-o-r -e-a-c-h -o-f -t-h-e -f-i-s-c-a-l -y-e-a-r-s -1-9-9-5
-t-h-r-o-u-g-h -1-9-9-7-. -T-h-e -a-u-t-h-o-r-i-z-a-t-i-o-n
-o-f -a-p-p-r-o-p-r-i-a-t-i-o-n-s -e-s-t-a-b-l-i-s-h-e-d -i-n
-t-h-e -p-r-e-c-e-d-i-n-g -s-e-n-t-e-n-c-e -m-a-y -n-o-t -b-e
-c-o-n-s-t-r-u-e-d -a-s -t-e-r-m-i-n-a-t-i-n-g -t-h-e
-a-v-a-i-l-a-b-i-l-i-t-y -f-o-r -s-u-c-h -p-u-r-p-o-s-e -o-f
-a-n-y -o-t-h-e-r -a-u-t-h-o-r-i-z-a-t-i-o-n -o-f
-a-p-p-r-o-p-r-i-a-t-i-o-n-s-.-'-'-.
-S-E-C-. -1-0-5-. -R-E-S-E-A-R-C-H -T-H-R-O-U-G-H -T-H-E -F-O-O-D
-A-N-D -D-R-U-G -A-D-M-I-N-I-S-T-R-A-T-I-O-N-.
-C-h-a-p-t-e-r -V -o-f -t-h-e -F-o-o-d-, -D-r-u-g -a-n-d
-C-o-s-m-e-t-i-c -A-c-t -i-s -a-m-e-n-d-e-d -b-y -i-n-s-e-r-t-i-n-g
-a-f-t-e-r -s-e-c-t-i-o-n -5-1-2 -(-2-1 -U-.-S-.-C-. -3-6-0-b-) -t-h-e
-f-o-l-l-o-w-i-n-g -n-e-w -s-e-c-t-i-o-n-:
-`-`-S-E-C-. -5-1-2-A-. -T-U-B-E-R-C-U-L-O-S-I-S -D-R-U-G -A-N-D
-D-E-V-I-C-E -R-E-S-E-A-R-C-H-.
-`-`-(-a-) -A-u-t-h-o-r-i-t-y-.----T-h-e -C-o-m-m-i-s-s-i-o-n-e-r
-o-f -F-o-o-d -a-n-d -D-r-u-g-s -s-h-a-l-l -i-m-p-l-e-m-e-n-t -a
-t-u-b-e-r-c-u-l-o-s-i-s -d-r-u-g -a-n-d -d-e-v-i-c-e -r-e-s-e-a-r-c-h
-p-r-o-g-r-a-m -u-n-d-e-r -w-h-i-c-h -t-h-e -C-o-m-m-i-s-s-i-o-n-e-r
-s-h-a-l-l---
-`-`-(-1-) -p-r-o-v-i-d-e -a-s-s-i-s-t-a-n-c-e -t-o
-o-t-h-e-r -F-e-d-e-r-a-l -a-g-e-n-c-i-e-s -f-o-r -t-h-e
-d-e-v-e-l-o-p-m-e-n-t -o-f -t-u-b-e-r-c-u-l-o-s-i-s
-p-r-o-t-o-c-o-l-s-;
-`-`-(-2-) -r-e-v-i-e-w -a-n-d -e-v-a-l-u-a-t-e
-m-e-d-i-c-a-l -d-e-v-i-c-e-s -d-e-s-i-g-n-e-d -f-o-r -t-h-e
-d-i-a-g-n-o-s-i-s -a-n-d -c-o-n-t-r-o-l -o-f -a-i-r-b-o-r-n-e
-t-u-b-e-r-c-u-l-o-s-i-s-; -a-n-d
-`-`-(-3-) -c-o-n-d-u-c-t -r-e-s-e-a-r-c-h
-c-o-n-c-e-r-n-i-n-g -d-r-u-g-s -o-r -d-e-v-i-c-e-s -t-o -b-e
-u-s-e-d -i-n -d-i-a-g-n-o-s-i-n-g-, -c-o-n-t-r-o-l-l-i-n-g
-a-n-d -p-r-e-v-e-n-t-i-n-g -t-u-b-e-r-c-u-l-o-s-i-s-.
-`-`-(-b-) -A-u-t-h-o-r-i-z-a-t-i-o-n -o-f
-A-p-p-r-o-p-r-i-a-t-i-o-n-s-.----T-h-e-r-e -a-r-e -a-u-t-h-o-r-i-z-e-d
-t-o -b-e -a-p-p-r-o-p-r-i-a-t-e-d -t-o -c-a-r-r-y -o-u-t -t-h-i-s
-s-e-c-t-i-o-n-, -$-5-,-0-0-0-,-0-0-0 -f-o-r -e-a-c-h -f-i-s-c-a-l
-y-e-a-r-.-'-'-.
-T-I-T-L-E -I-I----S-E-X-U-A-L-L-Y -T-R-A-N-S-M-I-T-T-E-D
-D-I-S-E-A-S-E-S
-S-E-C-. -2-0-1-. -S-H-O-R-T -T-I-T-L-E-.
-T-h-i-s -t-i-t-l-e -m-a-y -b-e -c-i-t-e-d -a-s -t-h-e
-`-`-S-e-x-u-a-l-l-y -T-r-a-n-s-m-i-t-t-e-d -D-i-s-e-a-s-e-s
-A-m-e-n-d-m-e-n-t-s -o-f -1-9-9-3-'-'-.
-S-E-C-. -2-0-2-. -E-X-T-E-N-S-I-O-N -O-F -P-R-O-G-R-A-M -O-F
-G-R-A-N-T-S -R-E-G-A-R-D-I-N-G -P-R-E-V-E-N-T-I-O-N
-A-N-D -C-O-N-T-R-O-L -O-F -S-E-X-U-A-L-L-Y
-T-R-A-N-S-M-I-T-T-E-D -D-I-S-E-A-S-E-S-.
-(-a-) -E-x-t-e-n-s-i-o-n -o-f -P-r-o-g-r-a-m-.---S-e-c-t-i-o-n
-3-1-8-(-d-)-(-1-) -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h -S-e-r-v-i-c-e
-A-c-t -(-4-2 -U-.-S-.-C-. -2-4-7-c-(-d-)-(-1-)-) -i-s -a-m-e-n-d-e-d
-i-n -t-h-e -f-i-r-s-t -s-e-n-t-e-n-c-e---
-(-1-) -b-y -s-t-r-i-k-i-n-g -`-`-(-b-) -a-n-d -(-c-)-'-'
-a-n-d -i-n-s-e-r-t-i-n-g -`-`-(-b-) -a-n-d -(-c-) -o-f
-t-h-i-s -s-e-c-t-i-o-n -a-n-d -s-e-c-t-i-o-n -3-1-8-B-'-'-;
-a-n-d
-(-2-) -b-y -s-t-r-i-k-i-n-g -`-`-t-h-e-r-e -a-r-e
-a-u-t-h-o-r-i-z-e-d-'-' -a-n-d -a-l-l -t-h-a-t -f-o-l-l-o-w-s
-a-n-d -i-n-s-e-r-t-i-n-g -t-h-e -f-o-l-l-o-w-i-n-g-:
-`-`-t-h-e-r-e -a-r-e -a-u-t-h-o-r-i-z-e-d -t-o -b-e
-a-p-p-r-o-p-r-i-a-t-e-d -$-1-3-2-,-0-0-0-,-0-0-0 -f-o-r
-f-i-s-c-a-l -y-e-a-r -1-9-9-4-, -a-n-d -s-u-c-h -s-u-m-s -a-s
-m-a-y -b-e -n-e-c-e-s-s-a-r-y -f-o-r -e-a-c-h -o-f -t-h-e
-f-i-s-c-a-l -y-e-a-r-s -1-9-9-5 -t-h-r-o-u-g-h
-1-9-9-7-.-'-'-.
-(-b-) -T-e-c-h-n-i-c-a-l -C-o-r-r-e-c-t-i-o-n-s-.---S-e-c-t-i-o-n
-3-1-8 -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t
-(-4-2 -U-.-S-.-C-. -2-4-7-c-) -i-s -a-m-e-n-d-e-d---
-(-1-) -i-n -s-u-b-s-e-c-t-i-o-n -(-b-)-(-3-)-, -b-y
-s-t-r-i-k-i-n-g -`-`-, -a-n-d-'-' -a-n-d -i-n-s-e-r-t-i-n-g
-`-`-; -a-n-d-'-'-; -a-n-d
-(-2-) -i-n -s-u-b-s-e-c-t-i-o-n -(-d-)-(-5-)---
-(-A-) -i-n -s-u-b-p-a-r-a-g-r-a-p-h -(-A-)-, -b-y
-s-t-r-i-k-i-n-g -`-`-f-o-r-m-, -o-r-'-' -a-n-d
-i-n-s-e-r-t-i-n-g -`-`-f-o-r-m-; -o-r-'-'-; -a-n-d
-(-B-) -i-n -s-u-b-p-a-r-a-g-r-a-p-h -(-B-)-, -b-y
-s-t-r-i-k-i-n-g -`-`-p-u-r-p-o-s-e-s-,-'-' -a-n-d
-i-n-s-e-r-t-i-n-g -`-`-p-u-r-p-o-s-e-s-;-'-'-.
-S-E-C-. -2-0-3-. -E-X-T-E-N-S-I-O-N -O-F -P-R-O-G-R-A-M
-R-E-G-A-R-D-I-N-G -P-R-E-V-E-N-T-A-B-L-E -C-A-S-E-S -O-F
-I-N-F-E-R-T-I-L-I-T-Y -A-R-I-S-I-N-G -A-S -R-E-S-U-L-T
-O-F -S-E-X-U-A-L-L-Y -T-R-A-N-S-M-I-T-T-E-D
-D-I-S-E-A-S-E-S-.
-(-a-) -T-e-c-h-n-i-c-a-l -C-o-r-r-e-c-t-i-o-n-.---S-e-c-t-i-o-n
-3-1-8-A -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t
-(-4-2 -U-.-S-.-C-. -2-4-7-c---1-)-, -a-s -a-d-d-e-d -b-y
-s-e-c-t-i-o-n -3-0-4 -o-f -P-u-b-l-i-c -L-a-w -1-0-2---5-3-1 -(-1-0-6
-S-t-a-t-. -3-4-9-0-)-, -i-s -a-m-e-n-d-e-d -i-n -s-u-b-s-e-c-t-i-o-n
-(-o-)-(-2-) -b-y -s-t-r-i-k-i-n-g -`-`-s-u-b-s-e-c-t-i-o-n -(-s-)-'-'
-a-n-d -i-n-s-e-r-t-i-n-g -`-`-s-u-b-s-e-c-t-i-o-n -(-q-)-'-'-.
-(-b-) -E-x-t-e-n-s-i-o-n -o-f -P-r-o-g-r-a-m-.---S-e-c-t-i-o-n
-3-1-8-A -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t
-(-4-2 -U-.-S-.-C-. -2-4-7-c---1-)-, -a-s -a-d-d-e-d -b-y
-s-e-c-t-i-o-n -3-0-4 -o-f -P-u-b-l-i-c -L-a-w -1-0-2---5-3-1 -(-1-0-6
-S-t-a-t-. -3-4-9-0-)-, -i-s -a-m-e-n-d-e-d---
-(-1-) -i-n -s-u-b-s-e-c-t-i-o-n -(-q-)-, -b-y
-s-t-r-i-k-i-n-g -`-`-a-n-d -1-9-9-5-'-' -a-n-d
-i-n-s-e-r-t-i-n-g -`-`-t-h-r-o-u-g-h -1-9-9-7-'-'-; -a-n-d
-(-2-) -i-n -s-u-b-s-e-c-t-i-o-n -(-r-)-(-2-)-, -b-y
-s-t-r-i-k-i-n-g -`-`-t-h-r-o-u-g-h -1-9-9-5-'-' -a-n-d
-i-n-s-e-r-t-i-n-g -`-`-t-h-r-o-u-g-h -1-9-9-8-'-'-.
-S-E-C-. -2-0-4-. -S-E-X-U-A-L-L-Y -T-R-A-N-S-M-I-T-T-E-D
-D-I-S-E-A-S-E -A-C-C-E-L-E-R-A-T-E-D
-P-R-E-V-E-N-T-I-O-N -C-A-M-P-A-I-G-N-S-.
-P-a-r-t -B -o-f -t-i-t-l-e -I-I-I -o-f -t-h-e -P-u-b-l-i-c
-H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t -i-s -a-m-e-n-d-e-d -b-y
-i-n-s-e-r-t-i-n-g -a-f-t-e-r -s-e-c-t-i-o-n -3-1-8-A -(-4-2
-U-.-S-.-C-. -2-4-7-c---1-) -t-h-e -f-o-l-l-o-w-i-n-g -n-e-w
-s-e-c-t-i-o-n-:
-`-`-S-E-C-. -3-1-8-B-. -S-E-X-U-A-L-L-Y -T-R-A-N-S-M-I-T-T-E-D
-D-I-S-E-A-S-E -A-C-C-E-L-E-R-A-T-E-D
-P-R-E-V-E-N-T-I-O-N -C-A-M-P-A-I-G-N-S-.
-`-`-(-a-) -G-r-a-n-t-s-.----T-h-e -S-e-c-r-e-t-a-r-y -i-s
-a-u-t-h-o-r-i-z-e-d -t-o -a-w-a-r-d -g-r-a-n-t-s -t-o -S-t-a-t-e-s
-a-n-d -p-o-l-i-t-i-c-a-l -s-u-b-d-i-v-i-s-i-o-n-s -o-f -S-t-a-t-e-s
-f-o-r -t-h-e -d-e-v-e-l-o-p-m-e-n-t-, -i-m-p-l-e-m-e-n-t-a-t-i-o-n-,
-a-n-d -e-v-a-l-u-a-t-i-o-n -o-f -i-n-n-o-v-a-t-i-v-e-,
-i-n-t-e-r-d-i-s-c-i-p-l-i-n-a-r-y -a-p-p-r-o-a-c-h-e-s -t-o -t-h-e
-p-r-e-v-e-n-t-i-o-n -a-n-d -c-o-n-t-r-o-l -o-f -s-e-x-u-a-l-l-y
-t-r-a-n-s-m-i-t-t-e-d -d-i-s-e-a-s-e-s -a-n-d -t-h-e-i-r
-s-e-q-u-e-l-a-e -b-y---
-`-`-(-1-) -e-x-p-a-n-d-i-n-g -a-c-c-e-s-s -t-o
-s-e-x-u-a-l-l-y -t-r-a-n-s-m-i-t-t-e-d -d-i-s-e-a-s-e
-s-e-r-v-i-c-e-s -t-h-r-o-u-g-h -c-o-l-l-a-b-o-r-a-t-i-o-n-s
-w-i-t-h -o-t-h-e-r -p-u-b-l-i-c -h-e-a-l-t-h -p-r-o-g-r-a-m-s
-a-n-d -w-i-t-h -n-o-n-g-o-v-e-r-n-m-e-n-t-a-l
-p-a-r-t-n-e-r-s-;
-`-`-(-2-) -i-m-p-l-e-m-e-n-t-i-n-g -c-o-m-m-u-n-i-t-y--
-b-a-s-e-d -b-e-h-a-v-i-o-r-a-l -i-n-t-e-r-v-e-n-t-i-o-n-s -t-o
-p-r-e-v-e-n-t -d-i-s-e-a-s-e -t-r-a-n-s-m-i-s-s-i-o-n-; -a-n-d
-`-`-(-3-) -e-s-t-a-b-l-i-s-h-i-n-g
-c-o-l-l-a-b-o-r-a-t-i-o-n-s -b-e-t-w-e-e-n -h-e-a-l-t-h
-d-e-p-a-r-t-m-e-n-t-s -a-n-d -u-n-i-v-e-r-s-i-t-y---b-a-s-e-d
-e-x-p-e-r-t-s -t-o -s-t-r-e-n-g-t-h-e-n -s-e-x-u-a-l-l-y
-t-r-a-n-s-m-i-t-t-e-d -d-i-s-e-a-s-e-s -p-r-e-v-e-n-t-i-o-n
-p-r-o-g-r-a-m-s-.
-`-`-(-b-) -A-p-p-l-i-c-a-t-i-o-n-.----T-o -b-e -e-l-i-g-i-b-l-e
-t-o -r-e-c-e-i-v-e -a -g-r-a-n-t -u-n-d-e-r -s-u-b-s-e-c-t-i-o-n
-(-a-)-, -a -S-t-a-t-e -o-r -p-o-l-i-t-i-c-a-l -s-u-b-d-i-v-i-s-i-o-n
-o-f -a -S-t-a-t-e-, -s-h-a-l-l -p-r-e-p-a-r-e -a-n-d -s-u-b-m-i-t -t-o
-t-h-e -S-e-c-r-e-t-a-r-y -a-n -a-p-p-l-i-c-a-t-i-o-n -a-t -s-u-c-h
-t-i-m-e-, -i-n -s-u-c-h -m-a-n-n-e-r-, -a-n-d -c-o-n-t-a-i-n-i-n-g
-s-u-c-h -i-n-f-o-r-m-a-t-i-o-n -a-s -t-h-e -S-e-c-r-e-t-a-r-y -m-a-y
-r-e-q-u-i-r-e-.
-`-`-(-c-) -P-r-i-o-r-i-t-y-.----I-n -a-w-a-r-d-i-n-g -g-r-a-n-t-s
-u-n-d-e-r -s-u-b-s-e-c-t-i-o-n -(-a-)-, -t-h-e -S-e-c-r-e-t-a-r-y
-s-h-a-l-l -g-i-v-e -p-r-i-o-r-i-t-y -t-o -a-p-p-l-i-c-a-t-i-o-n-s
-t-h-a-t -s-e-e-k -t-o -c-o-n-d-u-c-t -a-c-t-i-v-i-t-i-e-s -w-i-t-h
-g-r-a-n-t -f-u-n-d-s -t-h-a-t -f-o-c-u-s -o-n -t-h-e
-p-r-e-v-e-n-t-i-o-n -o-f -s-e-x-u-a-l-l-y -t-r-a-n-s-m-i-t-t-e-d
-d-i-s-e-a-s-e-s -a-m-o-n-g -w-o-m-e-n -a-n-d -o-t-h-e-r
-p-o-p-u-l-a-t-i-o-n-s -t-h-a-t -a-r-e
-d-i-s-p-r-o-p-o-r-t-i-o-n-a-t-e-l-y -a-f-f-e-c-t-e-d -b-y -t-h-e-s-e
-d-i-s-e-a-s-e-s-.-'-'-.
-T-I-T-L-E -I-I-I----I-N-J-U-R-Y -C-O-N-T-R-O-L -A-N-D -V-I-O-L-E-N-C-E
-P-R-E-V-E-N-T-I-O-N
-S-E-C-. -3-0-1-. -S-H-O-R-T -T-I-T-L-E-.
-T-h-i-s -t-i-t-l-e -m-a-y -b-e -c-i-t-e-d -a-s -t-h-e
-`-`-I-n-j-u-r-y -C-o-n-t-r-o-l -a-n-d -V-i-o-l-e-n-c-e
-P-r-e-v-e-n-t-i-o-n -A-c-t -o-f -1-9-9-3-'-'-.
-S-E-C-. -3-0-2-. -F-I-N-D-I-N-G-S-.
-C-o-n-g-r-e-s-s -f-i-n-d-s -t-h-a-t---
-(-1-) -v-i-o-l-e-n-c-e -o-r -t-h-e -t-h-r-e-a-t -o-f
-v-i-o-l-e-n-c-e -h-a-s -a-d-v-e-r-s-e -e-f-f-e-c-t-s -o-n
-t-h-e -h-e-a-l-t-h -a-n-d -s-a-f-e-t-y -o-f -A-m-e-r-i-c-a-n-s
-o-f -a-l-l -a-g-e-s-, -r-a-c-e-s-, -e-t-h-n-i-c-i-t-i-e-s
-a-n-d -e-c-o-n-o-m-i-c -c-o-n-d-i-t-i-o-n-s-;
-(-2-) -t-h-e -m-a-j-o-r-i-t-y -o-f -h-o-m-i-c-i-d-e-s
-a-n-d -v-i-o-l-e-n-t -a-s-s-a-u-l-t-s -a-r-e
-c-o-m-m-i-t-t-e-d -b-y -p-e-o-p-l-e -w-h-o -h-a-v-e
-r-e-l-a-t-i-o-n-s-h-i-p-s -w-i-t-h -t-h-e-i-r -v-i-c-t-i-m-s
-a-n-d -a-r-e -n-o-t -c-o-m-m-i-t-t-e-d -b-y
-s-t-r-a-n-g-e-r-s-;
-(-3-) -v-i-o-l-e-n-c-e -i-s -b-e-i-n-g -c-o-m-m-i-t-t-e-d
-i-n -p-r-i-v-a-t-e -a-s -w-e-l-l -a-s -p-u-b-l-i-c-, -i-n
-h-o-m-e-s-, -s-c-h-o-o-l-s-, -a-n-d
-n-e-i-g-h-b-o-r-h-o-o-d-s-;
-(-4-) -i-n-t-e-r-v-e-n-t-i-o-n-s -b-y -l-a-w
-e-n-f-o-r-c-e-m-e-n-t -a-n-d -c-r-i-m-i-n-a-l -j-u-s-t-i-c-e
-s-y-s-t-e-m-s -h-a-v-e -l-i-m-i-t-e-d -a-b-i-l-i-t-y -t-o
-p-r-e-v-e-n-t -v-i-o-l-e-n-c-e-;
-(-5-) -f-a-m-i-l-y -a-n-d -i-n-t-e-r-p-e-r-s-o-n-a-l
-v-i-o-l-e-n-c-e -r-e-p-r-e-s-e-n-t -s-e-r-i-o-u-s
-t-h-r-e-a-t-s -t-o -t-h-e -h-e-a-l-t-h -a-n-d -w-e-l-l--
-b-e-i-n-g -o-f -m-i-l-l-i-o-n-s -o-f -w-o-m-e-n -i-n -t-h-e
-U-n-i-t-e-d -S-t-a-t-e-s-;
-(-6-) -v-i-o-l-e-n-c-e -a-g-a-i-n-s-t -w-o-m-e-n -h-a-s
-s-e-r-i-o-u-s -h-e-a-l-t-h -c-o-n-s-e-q-u-e-n-c-e-s -f-o-r
-i-t-s -v-i-c-t-i-m-s-, -i-n-c-l-u-d-i-n-g -f-a-t-a-l-i-t-y-,
-s-e-v-e-r-e -t-r-a-u-m-a-, -r-e-p-e-a-t-e-d -p-h-y-s-i-c-a-l
-i-n-j-u-r-i-e-s-, -a-n-d -c-h-r-o-n-i-c -s-t-r-e-s-s--
-r-e-l-a-t-e-d -d-i-s-o-r-d-e-r-;
-(-7-) -v-i-o-l-e-n-c-e -a-g-a-i-n-s-t -w-o-m-e-n -h-a-s
-s-e-r-i-o-u-s -m-e-n-t-a-l -h-e-a-l-t-h
-c-o-n-s-e-q-u-e-n-c-e-s -f-o-r -i-t-s -v-i-c-t-i-m-s-,
-i-n-c-l-u-d-i-n-g -s-u-b-s-t-a-n-c-e -a-b-u-s-e-, -s-e-v-e-r-e
-p-s-y-c-h-o-l-o-g-i-c-a-l -t-r-a-u-m-a-, -a-n-d
-s-u-i-c-i-d-e-;
-(-8-) -f-e-w-e-r -t-h-a-n -5 -p-e-r-c-e-n-t -o-f
-i-n-j-u-r-e-d -w-o-m-e-n -a-r-e -c-o-r-r-e-c-t-l-y
-d-i-a-g-n-o-s-e-d -b-y -m-e-d-i-c-a-l -p-e-r-s-o-n-n-e-l -a-s
-b-e-i-n-g -v-i-c-t-i-m-s -o-f -d-o-m-e-s-t-i-c
-v-i-o-l-e-n-c-e-;
-(-9-) -h-o-s-p-i-t-a-l-s -a-n-d -c-l-i-n-i-c-s -d-o -n-o-t
-h-a-v-e -a -u-n-i-f-o-r-m -s-e-t -o-f -p-r-o-t-o-c-o-l-s
-f-o-r -t-h-e -i-d-e-n-t-i-f-i-c-a-t-i-o-n -a-n-d
-r-e-f-e-r-r-a-l -o-f -v-i-c-t-i-m-s -o-f -f-a-m-i-l-y -a-n-d
-i-n-t-e-r-p-e-r-s-o-n-a-l -v-i-o-l-e-n-c-e-, -o-r -f-o-r
-t-h-e -t-r-a-i-n-i-n-g -o-f -h-e-a-l-t-h -c-a-r-e
-p-r-o-f-e-s-s-i-o-n-a-l-s -t-o -p-e-r-f-o-r-m -s-u-c-h
-f-u-n-c-t-i-o-n-s-;
-(-1-0-) -a -n-a-t-i-o-n-a-l -s-u-r-v-e-i-l-l-a-n-c-e
-s-y-s-t-e-m -f-o-r -m-o-n-i-t-o-r-i-n-g -t-h-e -h-e-a-l-t-h
-e-f-f-e-c-t-s -o-f -i-n-j-u-r-y -s-h-o-u-l-d -b-e
-e-s-t-a-b-l-i-s-h-e-d -t-o -d-e-t-e-r-m-i-n-e -t-h-e
-n-a-t-u-r-e -a-n-d -e-x-t-e-n-t -o-f -f-a-m-i-l-y -a-n-d
-i-n-t-e-r-p-e-r-s-o-n-a-l -v-i-o-l-e-n-c-e -i-n -t-h-e
-U-n-i-t-e-d -S-t-a-t-e-s-; -a-n-d
-(-1-1-) -t-h-e -S-u-r-g-e-o-n -G-e-n-e-r-a-l -h-a-s
-i-d-e-n-t-i-f-i-e-d -d-o-m-e-s-t-i-c -v-i-o-l-e-n-c-e -a-s -a
-p-u-b-l-i-c -h-e-a-l-t-h -p-r-o-b-l-e-m -t-o -w-h-i-c-h -a-l-l
-h-e-a-l-t-h -c-a-r-e -p-r-o-v-i-d-e-r-s -m-u-s-t
-a-c-t-i-v-e-l-y -a-n-d -v-i-g-o-r-o-u-s-l-y -r-e-s-p-o-n-d-.
-S-E-C-. -3-0-3-. -F-A-M-I-L-Y -A-N-D -I-N-T-E-R-P-E-R-S-O-N-A-L
-V-I-O-L-E-N-C-E -P-R-E-V-E-N-T-I-O-N-.
-S-e-c-t-i-o-n -3-9-3 -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h
-S-e-r-v-i-c-e -A-c-t -(-4-2 -U-.-S-.-C-. -2-8-0-b---2-) -i-s
-a-m-e-n-d-e-d -t-o -r-e-a-d -a-s -f-o-l-l-o-w-s-:
-`-`-S-E-C-. -3-9-3-. -P-R-E-V-E-N-T-I-O-N -O-F -F-A-M-I-L-Y -A-N-D
-I-N-T-E-R-P-E-R-S-O-N-A-L -V-I-O-L-E-N-C-E-.
-`-`-(-a-) -R-e-s-e-a-r-c-h -a-n-d -T-e-c-h-n-i-c-a-l
-A-s-s-i-s-t-a-n-c-e-.----T-h-e -S-e-c-r-e-t-a-r-y-, -a-c-t-i-n-g
-t-h-r-o-u-g-h -t-h-e -D-i-r-e-c-t-o-r -o-f -t-h-e -C-e-n-t-e-r-s
-f-o-r -D-i-s-e-a-s-e -C-o-n-t-r-o-l -a-n-d -P-r-e-v-e-n-t-i-o-n-,
-m-a-y -c-o-n-d-u-c-t -r-e-s-e-a-r-c-h -a-n-d -p-r-o-v-i-d-e
-t-e-c-h-n-i-c-a-l -a-s-s-i-s-t-a-n-c-e -t-o -a-p-p-r-o-p-r-i-a-t-e
-p-u-b-l-i-c -a-n-d -n-o-n-p-r-o-f-i-t -p-r-i-v-a-t-e -e-n-t-i-t-i-e-s
-a-n-d -t-o -a-c-a-d-e-m-i-c -i-n-s-t-i-t-u-t-i-o-n-s -t-o -a-s-s-i-s-t
-s-u-c-h -e-n-t-i-t-i-e-s -i-n -p-e-r-f-o-r-m-i-n-g -r-e-s-e-a-r-c-h
-i-n-, -a-n-d -c-o-n-d-u-c-t-i-n-g -t-r-a-i-n-i-n-g -a-n-d -p-u-b-l-i-c
-h-e-a-l-t-h -p-r-o-g-r-a-m-s -f-o-r-, -t-h-e -p-r-e-v-e-n-t-i-o-n -o-f
-i-n-j-u-r-i-e-s -a-n-d -d-e-a-t-h-s -a-s-s-o-c-i-a-t-e-d -w-i-t-h
-f-a-m-i-l-y -a-n-d -i-n-t-e-r-p-e-r-s-o-n-a-l -v-i-o-l-e-n-c-e-.
-`-`-(-b-) -G-r-a-n-t-s-.----T-h-e -S-e-c-r-e-t-a-r-y-,
-a-c-t-i-n-g -t-h-r-o-u-g-h -t-h-e -D-i-r-e-c-t-o-r -o-f -t-h-e
-C-e-n-t-e-r-s -f-o-r -D-i-s-e-a-s-e -C-o-n-t-r-o-l -a-n-d
-P-r-e-v-e-n-t-i-o-n-, -m-a-y -a-w-a-r-d -g-r-a-n-t-s -t-o
-S-t-a-t-e-s-, -p-o-l-i-t-i-c-a-l -s-u-b-d-i-v-i-s-i-o-n-s -o-f
-S-t-a-t-e-s-, -a-n-d -a-n-y -o-t-h-e-r -p-u-b-l-i-c -a-n-d
-n-o-n-p-r-o-f-i-t -p-r-i-v-a-t-e -e-n-t-i-t-y -f-o-r---
-`-`-(-1-) -t-h-e -c-o-n-d-u-c-t -o-f -r-e-s-e-a-r-c-h
-i-n-t-o -i-d-e-n-t-i-f-y-i-n-g -e-f-f-e-c-t-i-v-e
-s-t-r-a-t-e-g-i-e-s -t-o -p-r-e-v-e-n-t
-i-n-t-e-r-p-e-r-s-o-n-a-l -v-i-o-l-e-n-c-e -w-i-t-h-i-n -t-h-e
-f-a-m-i-l-y -a-n-d -a-m-o-n-g -a-c-q-u-a-i-n-t-a-n-c-e-s-;
-`-`-(-2-) -t-h-e -d-e-v-e-l-o-p-m-e-n-t-,
-i-m-p-l-e-m-e-n-t-a-t-i-o-n-, -a-n-d -e-v-a-l-u-a-t-i-o-n -o-f
-d-e-m-o-n-s-t-r-a-t-i-o-n -p-r-o-j-e-c-t-s -f-o-r -t-h-e
-p-r-e-v-e-n-t-i-o-n -o-f -i-n-t-e-r-p-e-r-s-o-n-a-l
-v-i-o-l-e-n-c-e -w-i-t-h-i-n -f-a-m-i-l-i-e-s -a-n-d
-a-m-o-n-g -a-c-q-u-a-i-n-t-a-n-c-e-s-;
-`-`-(-3-) -t-h-e -i-m-p-l-e-m-e-n-t-a-t-i-o-n -o-f
-p-u-b-l-i-c -i-n-f-o-r-m-a-t-i-o-n -a-n-d -e-d-u-c-a-t-i-o-n
-p-r-o-g-r-a-m-s -f-o-r -p-r-e-v-e-n-t-i-o-n -o-f -f-a-m-i-l-y
-a-n-d -i-n-t-e-r-p-e-r-s-o-n-a-l -v-i-o-l-e-n-c-e -a-n-d -t-o
-b-r-o-a-d-e-n -p-u-b-l-i-c -a-w-a-r-e-n-e-s-s -o-f -t-h-e
-p-u-b-l-i-c -h-e-a-l-t-h -c-o-n-s-e-q-u-e-n-c-e-s -o-f
-f-a-m-i-l-y -a-n-d -i-n-t-e-r-p-e-r-s-o-n-a-l
-v-i-o-l-e-n-c-e-; -a-n-d
-`-`-(-4-) -t-h-e -p-r-o-v-i-s-i-o-n -o-f
-e-d-u-c-a-t-i-o-n-, -t-r-a-i-n-i-n-g -a-n-d -c-l-i-n-i-c-a-l
-s-k-i-l-l-s -i-m-p-r-o-v-e-m-e-n-t -p-r-o-g-r-a-m-s -f-o-r
-h-e-a-l-t-h -c-a-r-e -p-r-o-f-e-s-s-i-o-n-a-l-s -t-o---
-`-`-(-A-) -r-o-u-t-i-n-e-l-y -i-n-t-e-r-v-i-e-w
-a-n-d -i-d-e-n-t-i-f-y -i-n-d-i-v-i-d-u-a-l-s
-w-h-o-s-e -m-e-d-i-c-a-l -c-o-n-d-i-t-i-o-n -o-r
-s-t-a-t-e-m-e-n-t-s -i-n-d-i-c-a-t-e -t-h-a-t -t-h-e
-i-n-d-i-v-i-d-u-a-l-s -a-r-e -v-i-c-t-i-m-s -o-f
-d-o-m-e-s-t-i-c -v-i-o-l-e-n-c-e -o-r -s-e-x-u-a-l
-a-s-s-a-u-l-t-; -a-n-d
-`-`-(-B-) -r-e-f-e-r -t-h-e -i-n-d-i-v-i-d-u-a-l-s
-t-o -e-n-t-i-t-i-e-s -t-h-a-t -p-r-o-v-i-d-e
-s-e-r-v-i-c-e-s -r-e-g-a-r-d-i-n-g -s-u-c-h
-v-i-o-l-e-n-c-e -a-n-d -a-s-s-a-u-l-t-,
-i-n-c-l-u-d-i-n-g -r-e-f-e-r-r-a-l-s -f-o-r
-c-o-u-n-s-e-l-i-n-g-, -h-o-u-s-i-n-g-, -l-e-g-a-l
-s-e-r-v-i-c-e-s-, -a-n-d -s-e-r-v-i-c-e-s -o-f
-c-o-m-m-u-n-i-t-y -o-r-g-a-n-i-z-a-t-i-o-n-s-.
-`-`-(-c-) -I-n-j-u-r-y -S-u-r-v-e-i-l-l-a-n-c-e
-P-r-o-g-r-a-m-.----T-h-e -S-e-c-r-e-t-a-r-y-, -a-c-t-i-n-g
-t-h-r-o-u-g-h -t-h-e -D-i-r-e-c-t-o-r -o-f -t-h-e -C-e-n-t-e-r-s
-f-o-r -D-i-s-e-a-s-e -C-o-n-t-r-o-l -a-n-d -P-r-e-v-e-n-t-i-o-n-,
-s-h-a-l-l -s-u-p-p-o-r-t -t-h-e -e-s-t-a-b-l-i-s-h-m-e-n-t -o-f
-n-a-t-i-o-n-a-l -s-y-s-t-e-m-a-t-i-c -s-u-r-v-e-i-l-l-a-n-c-e -o-f
-i-n-j-u-r-i-e-s-, -i-n-c-l-u-d-i-n-g -t-h-o-s-e -c-a-u-s-e-d -b-y
-f-a-m-i-l-y -a-n-d -i-n-t-e-r-p-e-r-s-o-n-a-l -v-i-o-l-e-n-c-e-.
-`-`-(-d-) -D-e-f-i-n-i-t-i-o-n-.----A-s -u-s-e-d -i-n -t-h-i-s
-s-e-c-t-i-o-n-, -t-h-e -t-e-r-m -`-i-n-t-e-r-p-e-r-s-o-n-a-l
-v-i-o-l-e-n-c-e -w-i-t-h-i-n -f-a-m-i-l-i-e-s -a-n-d
-a-c-q-u-a-i-n-t-a-n-c-e-s-' -m-e-a-n-s -a-n-y -i-n-t-e-n-t-i-o-n-a-l
-v-i-o-l-e-n-c-e-, -c-o-n-t-r-o-l-l-i-n-g-, -o-r -c-o-e-r-c-i-v-e
-b-e-h-a-v-i-o-r -o-r -p-a-t-t-e-r-n -o-f -b-e-h-a-v-i-o-r -b-y -a-n
-i-n-d-i-v-i-d-u-a-l -w-h-o -i-s -c-u-r-r-e-n-t-l-y -o-r -w-h-o -w-a-s
-p-r-e-v-i-o-u-s-l-y-, -i-n -a-n -i-n-t-i-m-a-t-e -o-r
-a-c-q-u-a-i-n-t-a-n-c-e -r-e-l-a-t-i-o-n-s-h-i-p -w-i-t-h -t-h-e
-v-i-c-t-i-m-. -S-u-c-h -b-e-h-a-v-i-o-r -m-a-y -o-c-c-u-r -a-t -a-n-y
-s-t-a-g-e -o-f -t-h-e -l-i-f-e-c-y-c-l-e -a-n-d -m-a-y
-e-n-c-o-m-p-a-s-s -s-i-n-g-l-e -a-c-t-s -o-r -a -s-y-n-d-r-o-m-e -o-f
-a-c-t-u-a-l -o-r -t-h-r-e-a-t-e-n-e-d -p-h-y-s-i-c-a-l -i-n-j-u-r-y-,
-s-e-x-u-a-l -a-s-s-a-u-l-t-, -r-a-p-e-, -p-s-y-c-h-o-l-o-g-i-c-a-l
-a-b-u-s-e-, -o-r -n-e-g-l-e-c-t-. -S-u-c-h -t-e-r-m -i-n-c-l-u-d-e-s
-b-e-h-a-v-i-o-r -w-h-i-c-h -c-u-r-r-e-n-t-l-y -m-a-y -b-e
-d-e-s-c-r-i-b-e-d -a-s -`-c-h-i-l-d -n-e-g-l-e-c-t-'-, -`-c-h-i-l-d
-a-b-u-s-e-'-, -`-s-p-o-u-s-a-l -a-b-u-s-e-'-, -`-d-o-m-e-s-t-i-c
-v-i-o-l-e-n-c-e-'-, -`-w-o-m-a-n -b-a-t-t-e-r-i-n-g-'-,
-`-p-a-r-t-n-e-r -a-b-u-s-e-'-, -`-e-l-d-e-r -a-b-u-s-e-'-, -a-n-d
-`-d-a-t-e -r-a-p-e-'-.
-`-`-(-e-) -A-p-p-l-i-c-a-t-i-o-n-.----T-o -b-e -e-l-i-g-i-b-l-e
-t-o -r-e-c-e-i-v-e -a-s-s-i-s-t-a-n-c-e -u-n-d-e-r
-s-u-b-s-e-c-t-i-o-n -(-a-) -o-r -(-b-)-, -a-n -e-n-t-i-t-y -s-h-a-l-l
-p-r-e-p-a-r-e -a-n-d -s-u-b-m-i-t -t-o -t-h-e -S-e-c-r-e-t-a-r-y -a-n
-a-p-p-l-i-c-a-t-i-o-n -a-t -s-u-c-h -t-i-m-e-, -i-n -s-u-c-h
-m-a-n-n-e-r-, -a-n-d -c-o-n-t-a-i-n-i-n-g -s-u-c-h
-i-n-f-o-r-m-a-t-i-o-n -a-s -t-h-e -S-e-c-r-e-t-a-r-y -m-a-y
-r-e-q-u-i-r-e-.-'-'-.
-S-E-C-. -3-0-4-. -A-D-V-I-S-O-R-Y -C-O-M-M-I-T-T-E-E-;
-R-E-P-O-R-T-S-.
-P-a-r-t -J -o-f -t-i-t-l-e -I-I-I -o-f -t-h-e -P-u-b-l-i-c
-H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t -(-a-s -a-m-e-n-d-e-d -b-y
-P-u-b-l-i-c -L-a-w -1-0-3---4-3-) -i-s -a-m-e-n-d-e-d -b-y
-i-n-s-e-r-t-i-n-g -a-f-t-e-r -s-e-c-t-i-o-n -3-9-3 -(-4-2 -U-.-S-.-C-.
-2-8-0-b---2-) -t-h-e -f-o-l-l-o-w-i-n-g -n-e-w -s-e-c-t-i-o-n-:
-`-`-S-E-C-. -3-9-3-A-. -G-E-N-E-R-A-L -P-R-O-V-I-S-I-O-N-S-.
-`-`-(-a-) -A-d-v-i-s-o-r-y -C-o-m-m-i-t-t-e-e-.----T-h-e
-S-e-c-r-e-t-a-r-y-, -a-c-t-i-n-g -t-h-r-o-u-g-h -t-h-e
-D-i-r-e-c-t-o-r -o-f -t-h-e -C-e-n-t-e-r-s -f-o-r -D-i-s-e-a-s-e
-C-o-n-t-r-o-l -a-n-d -P-r-e-v-e-n-t-i-o-n-, -s-h-a-l-l
-e-s-t-a-b-l-i-s-h -a-n -a-d-v-i-s-o-r-y -c-o-m-m-i-t-t-e-e -t-o
-a-d-v-i-s-e -t-h-e -S-e-c-r-e-t-a-r-y -a-n-d -s-u-c-h -D-i-r-e-c-t-o-r
-w-i-t-h -r-e-s-p-e-c-t -t-o -t-h-e -p-r-e-v-e-n-t-i-o-n -a-n-d
-c-o-n-t-r-o-l -o-f -i-n-j-u-r-i-e-s-.
-`-`-(-b-) -R-e-p-o-r-t-.----N-o-t -l-a-t-e-r -t-h-a-n
-F-e-b-r-u-a-r-y -1 -o-f -1-9-9-4 -a-n-d -o-f -e-v-e-r-y -s-e-c-o-n-d
-y-e-a-r -t-h-e-r-e-a-f-t-e-r-, -t-h-e -S-e-c-r-e-t-a-r-y-,
-a-c-t-i-n-g -t-h-r-o-u-g-h -t-h-e -D-i-r-e-c-t-o-r -o-f -t-h-e
-C-e-n-t-e-r-s -f-o-r -D-i-s-e-a-s-e -C-o-n-t-r-o-l -a-n-d
-P-r-e-v-e-n-t-i-o-n-, -s-h-a-l-l -s-u-b-m-i-t -t-o -t-h-e
-C-o-m-m-i-t-t-e-e -o-n -E-n-e-r-g-y -a-n-d -C-o-m-m-e-r-c-e -o-f
-t-h-e -H-o-u-s-e -o-f -R-e-p-r-e-s-e-n-t-a-t-i-v-e-s-, -a-n-d -t-o
-t-h-e -C-o-m-m-i-t-t-e-e -o-n -L-a-b-o-r -a-n-d -H-u-m-a-n
-R-e-s-o-u-r-c-e-s -o-f -t-h-e -S-e-n-a-t-e-, -a -r-e-p-o-r-t
-d-e-s-c-r-i-b-i-n-g -t-h-e -a-c-t-i-v-i-t-i-e-s -c-a-r-r-i-e-d -o-u-t
-u-n-d-e-r -t-h-i-s -p-a-r-t -d-u-r-i-n-g -t-h-e -p-r-e-c-e-d-i-n-g -2
-f-i-s-c-a-l -y-e-a-r-s-. -S-u-c-h -r-e-p-o-r-t -s-h-a-l-l
-i-n-c-l-u-d-e -a -d-e-s-c-r-i-p-t-i-o-n -o-f -s-u-c-h
-a-c-t-i-v-i-t-i-e-s -t-h-a-t -w-e-r-e -c-a-r-r-i-e-d -o-u-t -w-i-t-h
-r-e-s-p-e-c-t -t-o -d-o-m-e-s-t-i-c -v-i-o-l-e-n-c-e -a-n-d
-s-e-x-u-a-l -a-s-s-a-u-l-t -a-n-d -w-i-t-h -r-e-s-p-e-c-t -t-o
-r-u-r-a-l -a-r-e-a-s-.-'-'-.
-S-E-C-. -3-0-5-. -T-E-C-H-N-I-C-A-L -C-O-R-R-E-C-T-I-O-N-S-.
-(-a-) -T-e-r-m-i-n-o-l-o-g-y-.----P-a-r-t -J -o-f -t-i-t-l-e
-I-I-I -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t
-(-4-2 -U-.-S-.-C-. -2-8-0-b -e-t -s-e-q-.-) -(-a-s -a-m-e-n-d-e-d -b-y
-P-u-b-l-i-c -L-a-w -1-0-3---4-3-) -i-s -a-m-e-n-d-e-d---
-(-1-) -i-n -t-h-e -h-e-a-d-i-n-g -f-o-r -s-u-c-h
-p-a-r-t-, -b-y -s-t-r-i-k-i-n-g -`-`-I-n-j-u-r-y
-C-o-n-t-r-o-l-'-' -a-n-d -i-n-s-e-r-t-i-n-g
-`-`-P-r-e-v-e-n-t-i-o-n -a-n-d -C-o-n-t-r-o-l -o-f
-I-n-j-u-r-i-e-s-'-'-; -a-n-d
-(-2-) -i-n -s-e-c-t-i-o-n -3-9-2---
-(-A-) -i-n -t-h-e -h-e-a-d-i-n-g -f-o-r -s-u-c-h
-s-e-c-t-i-o-n-, -b-y -i-n-s-e-r-t-i-n-g
-`-`-p-r-e-v-e-n-t-i-o-n -a-n-d-'-' -b-e-f-o-r-e
-`-`-c-o-n-t-r-o-l -a-c-t-i-v-i-t-i-e-s-'-'-;
-(-B-) -i-n -s-u-b-s-e-c-t-i-o-n -(-a-)-(-1-)-,
-b-y -i-n-s-e-r-t-i-n-g -`-`-a-n-d -c-o-n-t-r-o-l-'-'
-a-f-t-e-r -`-`-p-r-e-v-e-n-t-i-o-n-'-'-; -a-n-d
-(-C-) -i-n -s-u-b-s-e-c-t-i-o-n -(-b-)-(-1-)-,
-b-y -s-t-r-i-k-i-n-g -`-`-i-n-j-u-r-i-e-s -a-n-d
-i-n-j-u-r-y -c-o-n-t-r-o-l-'-' -a-n-d
-i-n-s-e-r-t-i-n-g -`-`-t-h-e -p-r-e-v-e-n-t-i-o-n
-a-n-d -c-o-n-t-r-o-l -o-f -i-n-j-u-r-i-e-s-'-'-.
-(-b-) -P-r-o-v-i-s-i-o-n-s -R-e-l-a-t-i-n-g -t-o -P-u-b-l-i-c
-L-a-w -1-0-2---5-3-1-.----P-a-r-t -J -o-f -t-i-t-l-e -I-I-I -o-f
-t-h-e -P-u-b-l-i-c -H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t -(-4-2
-U-.-S-.-C-. -2-8-0-b -e-t -s-e-q-.-) -(-a-s -a-m-e-n-d-e-d -b-y
-P-u-b-l-i-c -L-a-w -1-0-3---4-3 -(-1-0-6 -S-t-a-t-. -3-4-8-2-)-, -i-s
-a-m-e-n-d-e-d---
-(-1-) -i-n -s-e-c-t-i-o-n -3-9-2-(-b-)-(-2-)-, -b-y
-s-t-r-i-k-i-n-g -`-`-t-o -p-r-o-m-o-t-e -i-n-j-u-r-y
-c-o-n-t-r-o-l-'-' -a-n-d -a-l-l -t-h-a-t -f-o-l-l-o-w-s -a-n-d
-i-n-s-e-r-t-i-n-g -`-`-t-o -p-r-o-m-o-t-e -a-c-t-i-v-i-t-i-e-s
-r-e-g-a-r-d-i-n-g -t-h-e -p-r-e-v-e-n-t-i-o-n -a-n-d
-c-o-n-t-r-o-l -o-f -i-n-j-u-r-i-e-s-; -a-n-d-'-'-; -a-n-d
-(-2-) -i-n -s-e-c-t-i-o-n -3-9-1-(-b-)-, -b-y -a-d-d-i-n-g
-a-t -t-h-e -e-n-d -t-h-e -f-o-l-l-o-w-i-n-g -s-e-n-t-e-n-c-e-:
-`-`-I-n -c-a-r-r-y-i-n-g -o-u-t -t-h-e -p-r-e-c-e-d-i-n-g
-s-e-n-t-e-n-c-e-, -t-h-e -S-e-c-r-e-t-a-r-y -s-h-a-l-l
-d-i-s-s-e-m-i-n-a-t-e -s-u-c-h -i-n-f-o-r-m-a-t-i-o-n -t-o
-t-h-e -p-u-b-l-i-c-, -i-n-c-l-u-d-i-n-g -t-h-r-o-u-g-h
-e-l-e-m-e-n-t-a-r-y -a-n-d -s-e-c-o-n-d-a-r-y
-s-c-h-o-o-l-s-.-'-'-.
-S-E-C-. -3-0-6-. -A-U-T-H-O-R-I-Z-A-T-I-O-N -O-F
-A-P-P-R-O-P-R-I-A-T-I-O-N-S-.
-S-e-c-t-i-o-n -3-9-4 -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h
-S-e-r-v-i-c-e -A-c-t -(-4-2 -U-.-S-.-C-. -2-8-0-b---3-) -i-s
-a-m-e-n-d-e-d---
-(-1-) -b-y -s-t-r-i-k-i-n-g -`-`-3-9-1 -a-n-d -3-9-2-'-'
-a-n-d -i-n-s-e-r-t-i-n-g -`-`-3-9-1-, -3-9-2-, -a-n-d
-3-9-3-'-'-; -a-n-d
-(-2-) -b-y -s-t-r-i-k-i-n-g -`-`-$-1-0-,-0-0-0-,-0-0-0-'-'
-a-n-d -a-l-l -t-h-a-t -f-o-l-l-o-w-s -t-h-r-o-u-g-h -t-h-e
-p-e-r-i-o-d -a-n-d -i-n-s-e-r-t-i-n-g
-`-`-$-6-0-,-0-0-0-,-0-0-0-'-' -f-o-r -f-i-s-c-a-l -y-e-a-r
-1-9-9-4-, -a-n-d -s-u-c-h -s-u-m-s -a-s -m-a-y -b-e
-n-e-c-e-s-s-a-r-y -f-o-r -e-a-c-h -o-f -t-h-e -f-i-s-c-a-l
-y-e-a-r-s -1-9-9-5 -t-h-r-o-u-g-h -1-9-9-8-.-'-'-.
-T-I-T-L-E -I-V----B-R-E-A-S-T -A-N-D -C-E-R-V-I-C-A-L -C-A-N-C-E-R
-A-M-E-N-D-M-E-N-T-S
-S-E-C-. -4-0-1-. -S-H-O-R-T -T-I-T-L-E-.
-T-h-i-s -t-i-t-l-e -m-a-y -b-e -c-i-t-e-d -a-s -t-h-e
-`-`-B-r-e-a-s-t -a-n-d -C-e-r-v-i-c-a-l -C-a-n-c-e-r
-A-m-e-n-d-m-e-n-t-s -o-f -1-9-9-3-'-'-.
-S-E-C-. -4-0-2-. -R-E-V-I-S-I-O-N-S -I-N -P-R-O-G-R-A-M -O-F
-S-T-A-T-E -G-R-A-N-T-S -R-E-G-A-R-D-I-N-G -B-R-E-A-S-T
-A-N-D -C-E-R-V-I-C-A-L -C-A-N-C-E-R-.
-(-a-) -L-i-m-i-t-e-d -A-u-t-h-o-r-i-t-y -R-e-g-a-r-d-i-n-g
-F-o-r---P-r-o-f-i-t -E-n-t-i-t-i-e-s-.---
-(-1-) -I-n -g-e-n-e-r-a-l-.----S-e-c-t-i-o-n
-1-5-0-1-(-b-) -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h
-S-e-r-v-i-c-e -A-c-t -(-4-2 -U-.-S-.-C-. -3-0-0-k-(-b-)-) -i-s
-a-m-e-n-d-e-d---
-(-A-) -b-y -s-t-r-i-k-i-n-g -`-`-S-t-a-t-e-s-.---
-A -S-t-a-t-e-'-' -a-n-d -a-l-l -t-h-a-t -f-o-l-l-o-w-s
-t-h-r-o-u-g-h -`-`-m-a-y -e-x-p-e-n-d-'-' -a-n-d
-i-n-s-e-r-t-i-n-g -t-h-e -f-o-l-l-o-w-i-n-g-:
-`-`-S-t-a-t-e-s-.---
-`-`-(-1-) -I-n -g-e-n-e-r-a-l-.----A -S-t-a-t-e
-r-e-c-e-i-v-i-n-g -a -g-r-a-n-t -u-n-d-e-r
-s-u-b-s-e-c-t-i-o-n -(-a-) -m-a-y-, -s-u-b-j-e-c-t -t-o
-p-a-r-a-g-r-a-p-h-s -(-2-) -a-n-d -(-3-)-, -e-x-p-e-n-d-'-'-;
-a-n-d
-(-B-) -b-y -a-d-d-i-n-g -a-t -t-h-e -e-n-d -t-h-e
-f-o-l-l-o-w-i-n-g -p-a-r-a-g-r-a-p-h-s-:
-`-`-(-2-) -L-i-m-i-t-e-d -a-u-t-h-o-r-i-t-y
-r-e-g-a-r-d-i-n-g -o-t-h-e-r -e-n-t-i-t-i-e-s-.----I-n
-a-d-d-i-t-i-o-n -t-o -t-h-e -a-u-t-h-o-r-i-t-y
-e-s-t-a-b-l-i-s-h-e-d -i-n -p-a-r-a-g-r-a-p-h -(-1-) -f-o-r -a
-S-t-a-t-e -w-i-t-h -r-e-s-p-e-c-t -t-o -g-r-a-n-t-s -a-n-d
-c-o-n-t-r-a-c-t-s-, -t-h-e -S-t-a-t-e -m-a-y -p-r-o-v-i-d-e
-f-o-r -s-c-r-e-e-n-i-n-g-s -u-n-d-e-r -s-u-b-s-e-c-t-i-o-n
-(-a-)-(-1-) -t-h-r-o-u-g-h -e-n-t-e-r-i-n-g -i-n-t-o
-c-o-n-t-r-a-c-t-s -w-i-t-h -p-r-i-v-a-t-e -e-n-t-i-t-i-e-s-.
-`-`-(-3-) -P-a-y-m-e-n-t-s -f-o-r
-s-c-r-e-e-n-i-n-g-s-.----T-h-e -a-m-o-u-n-t -p-a-i-d -b-y -a
-S-t-a-t-e -t-o -a-n -e-n-t-i-t-y -u-n-d-e-r -t-h-i-s
-s-u-b-s-e-c-t-i-o-n -f-o-r -a -s-c-r-e-e-n-i-n-g
-p-r-o-c-e-d-u-r-e -u-n-d-e-r -s-u-b-s-e-c-t-i-o-n -(-a-)-(-1-)
-m-a-y -n-o-t -e-x-c-e-e-d -t-h-e -a-m-o-u-n-t -t-h-a-t
-w-o-u-l-d -b-e -p-a-i-d -u-n-d-e-r -p-a-r-t -B -o-f -t-i-t-l-e
-X-V-I-I-I -o-f -t-h-e -S-o-c-i-a-l -S-e-c-u-r-i-t-y -A-c-t
-i-f -p-a-y-m-e-n-t -w-e-r-e -m-a-d-e -u-n-d-e-r -s-u-c-h
-p-a-r-t -f-o-r -f-u-r-n-i-s-h-i-n-g -t-h-e -p-r-o-c-e-d-u-r-e
-t-o -a -w-o-m-a-n -e-n-r-o-l-l-e-d -u-n-d-e-r -s-u-c-h
-p-a-r-t-.-'-'-.
-(-2-) -C-o-n-f-o-r-m-i-n-g -a-m-e-n-d-m-e-n-t-.---
-S-e-c-t-i-o-n -1-5-0-5-(-3-) -o-f -t-h-e -P-u-b-l-i-c
-H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t -(-4-2 -U-.-S-.-C-.
-3-0-0-n---1-(-3-)-) -i-s -a-m-e-n-d-e-d -b-y
-i-n-s-e-r-t-i-n-g -b-e-f-o-r-e -t-h-e -s-e-m-i-c-o-l-o-n
-t-h-e -f-o-l-l-o-w-i-n-g-: -`-`-(-a-n-d
-a-d-d-i-t-i-o-n-a-l-l-y-, -i-n -t-h-e -c-a-s-e -o-f
-s-e-r-v-i-c-e-s -a-n-d -a-c-t-i-v-i-t-i-e-s -u-n-d-e-r
-s-e-c-t-i-o-n -1-5-0-1-(-a-)-(-1-)-, -w-i-t-h -a-n-y
-s-i-m-i-l-a-r -s-e-r-v-i-c-e-s -o-r -a-c-t-i-v-i-t-i-e-s -o-f
-p-r-i-v-a-t-e -e-n-t-i-t-i-e-s-)-'-'-.
-(-b-) -S-p-e-c-i-a-l -C-o-n-s-i-d-e-r-a-t-i-o-n -f-o-r
-G-r-a-n-t-s-.----S-e-c-t-i-o-n -1-5-0-1 -o-f -t-h-e -P-u-b-l-i-c
-H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t -(-4-2 -U-.-S-.-C-. -3-0-0-k-) -i-s
-a-m-e-n-d-e-d -b-y -a-d-d-i-n-g -a-t -t-h-e -e-n-d -t-h-e-r-e-o-f
-t-h-e -f-o-l-l-o-w-i-n-g -n-e-w -s-u-b-s-e-c-t-i-o-n-:
-`-`-(-c-) -S-p-e-c-i-a-l -C-o-n-s-i-d-e-r-a-t-i-o-n-.----I-n
-m-a-k-i-n-g -g-r-a-n-t-s -u-n-d-e-r -s-u-b-s-e-c-t-i-o-n -(-a-)
-a-f-t-e-r -t-h-e -d-a-t-e -o-f -e-n-a-c-t-m-e-n-t -o-f -t-h-i-s
-s-u-b-s-e-c-t-i-o-n-, -t-h-e -S-e-c-r-e-t-a-r-y -s-h-a-l-l -g-i-v-e
-s-p-e-c-i-a-l -c-o-n-s-i-d-e-r-a-t-i-o-n -t-o -p-r-o-j-e-c-t-s
-t-h-a-t -h-a-v-e -b-e-e-n -p-e-e-r -r-e-v-i-e-w-e-d -a-n-d
-a-p-p-r-o-v-e-d -a-n-d -t-h-a-t -i-n-v-o-l-v-e -a-r-e-a-s -t-h-a-t---
-`-`-(-1-) -h-a-v-e -h-i-g-h -c-e-r-v-i-c-a-l -o-r
-b-r-e-a-s-t -c-a-n-c-e-r -m-o-r-t-a-l-i-t-y -r-a-t-e-s-; -o-r
-`-`-(-2-) -h-a-v-e -a -h-i-g-h -i-n-c-i-d-e-n-c-e -o-f
-c-e-r-v-i-c-a-l -o-r -b-r-e-a-s-t -c-a-n-c-e-r-.-'-'-.
-(-c-) -E-x-e-m-p-t-i-o-n -f-r-o-m -M-a-t-c-h-i-n-g
-R-e-q-u-i-r-e-m-e-n-t-s-.----S-e-c-t-i-o-n -1-5-0-2-(-b-)-(-1-) -o-f
-t-h-e -P-u-b-l-i-c -H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t -(-4-2
-U-.-S-.-C-. -3-0-0-l-(-b-)-(-1-)-) -i-s -a-m-e-n-d-e-d -t-o -r-e-a-d
-a-s -f-o-l-l-o-w-s-:
-`-`-(-1-) -T-y-p-e-s -o-f -c-o-n-t-r-i-b-u-t-i-o-n-s-.---
-`-`-(-A-) -G-e-n-e-r-a-l -r-u-l-e-.----N-o-n--
-F-e-d-e-r-a-l -c-o-n-t-r-i-b-u-t-i-o-n-s
-r-e-q-u-i-r-e-d -i-n -s-u-b-s-e-c-t-i-o-n -(-a-)
-m-a-y -b-e -i-n -c-a-s-h -o-r -i-n -k-i-n-d-,
-f-a-i-r-l-y -e-v-a-l-u-a-t-e-d-, -i-n-c-l-u-d-i-n-g
-e-q-u-i-p-m-e-n-t -o-r -s-e-r-v-i-c-e-s -(-a-n-d
-e-x-c-l-u-d-i-n-g -i-n-d-i-r-e-c-t -o-r
-o-v-e-r-h-e-a-d -c-o-s-t-s-)-. -A-m-o-u-n-t-s
-p-r-o-v-i-d-e-d -b-y -t-h-e -F-e-d-e-r-a-l
-G-o-v-e-r-n-m-e-n-t-, -o-r -s-e-r-v-i-c-e-s
-a-s-s-i-s-t-e-d -o-r -s-u-b-s-i-d-i-z-e-d -t-o -a-n-y
-s-i-g-n-i-f-i-c-a-n-t -e-x-t-e-n-t -b-y -t-h-e
-F-e-d-e-r-a-l -G-o-v-e-r-n-m-e-n-t-, -m-a-y -n-o-t
-b-e -i-n-c-l-u-d-e-d -i-n -d-e-t-e-r-m-i-n-i-n-g
-t-h-e -a-m-o-u-n-t -o-f -s-u-c-h -n-o-n--
-F-e-d-e-r-a-l -c-o-n-t-r-i-b-u-t-i-o-n-s-.
-`-`-(-B-) -D-o-n-a-t-e-d -t-r-e-a-t-m-e-n-t
-s-e-r-v-i-c-e-s-.----I-n -m-e-e-t-i-n-g -t-h-e
-n-o-n---F-e-d-e-r-a-l -c-o-n-t-r-i-b-u-t-i-o-n
-r-e-q-u-i-r-e-m-e-n-t -o-f -t-h-i-s -s-e-c-t-i-o-n-,
-t-h-e -S-t-a-t-e -i-n-v-o-l-v-e-d---
-`-`-(-i-) -m-a-y-, -w-i-t-h -r-e-s-p-e-c-t
-t-o -a -g-r-a-n-t -a-w-a-r-d-e-d -f-o-r -a
-p-r-o-g-r-a-m -u-n-d-e-r -p-a-r-a-g-r-a-p-h
-(-1-) -o-r -(-2-) -o-f -s-e-c-t-i-o-n
-1-5-0-1-(-a-)-, -u-s-e -t-h-e -v-a-l-u-e -o-f
-a-n-y -d-o-n-a-t-e-d -o-u-t-r-e-a-c-h
-s-e-r-v-i-c-e-s -a-s-s-o-c-i-a-t-e-d -w-i-t-h
-t-h-e -d-e-l-i-v-e-r-y -o-f -b-r-e-a-s-t
-a-n-d -c-e-r-v-i-c-a-l -c-a-n-c-e-r
-s-c-r-e-e-n-i-n-g-s -c-o-n-d-u-c-t-e-d
-u-n-d-e-r -t-h-e -p-r-o-g-r-a-m-, -a-n-d
-t-h-e -v-a-l-u-e -o-f -a-n-y
-a-d-d-i-t-i-o-n-a-l -d-o-n-a-t-e-d
-b-r-e-a-s-t -o-r -c-e-r-v-i-c-a-l -c-a-n-c-e-r
-d-i-a-g-n-o-s-t-i-c -o-r -t-r-e-a-t-m-e-n-t
-s-e-r-v-i-c-e-s -p-r-o-v-i-d-e-d
-s-u-b-s-e-q-u-e-n-t -t-o -t-h-e
-s-c-r-e-e-n-i-n-g -c-o-n-d-u-c-t-e-d
-u-n-d-e-r -t-h-e -p-r-o-g-r-a-m-; -a-n-d
-`-`-(-i-i-) -m-a-y -n-o-t-, -w-i-t-h
-r-e-s-p-e-c-t -t-o -a -g-r-a-n-t
-a-w-a-r-d-e-d -f-o-r -a -p-r-o-g-r-a-m
-u-n-d-e-r -p-a-r-a-g-r-a-p-h -(-3-)-, -(-4-)-,
-(-5-) -o-r -(-6-) -o-f -s-e-c-t-i-o-n
-1-5-0-1-(-a-)-, -i-n-c-l-u-d-e -t-h-e
-v-a-l-u-e -o-f -a-n-y -d-o-n-a-t-e-d
-b-r-e-a-s-t -o-r -c-e-r-v-i-c-a-l -c-a-n-c-e-r
-o-u-t-r-e-a-c-h-, -d-i-a-g-n-o-s-i-s-, -o-r
-t-r-e-a-t-m-e-n-t -s-e-r-v-i-c-e-s-.-'-'-.
-(-d-) -Q-u-a-l-i-t-y -A-s-s-u-r-a-n-c-e -R-e-g-a-r-d-i-n-g
-S-c-r-e-e-n-i-n-g -P-r-o-c-e-d-u-r-e-s-.---
-(-1-) -I-n -g-e-n-e-r-a-l-.----S-e-c-t-i-o-n -1-5-0-3 -o-f
-t-h-e -P-u-b-l-i-c -H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t -(-4-2
-U-.-S-.-C-. -3-0-0-m-) -i-s -a-m-e-n-d-e-d---
-(-A-) -i-n -s-u-b-s-e-c-t-i-o-n -(-a-)---
-(-i-) -i-n -p-a-r-a-g-r-a-p-h -(-1-)-,
-t-o -r-e-a-d -a-s -f-o-l-l-o-w-s-:
-`-`-(-1-) -t-o -e-n-s-u-r-e -t-h-a-t-, -a-f-t-e-r -a
-l-i-m-i-t-e-d -p-e-r-i-o-d -o-f -t-i-m-e -a-n-d
-t-h-e-r-e-a-f-t-e-r -t-h-r-o-u-g-h-o-u-t -t-h-e -p-e-r-i-o-d
-d-u-r-i-n-g -w-h-i-c-h -a-m-o-u-n-t-s -a-r-e -r-e-c-e-i-v-e-d
-p-u-r-s-u-a-n-t -t-o -t-h-e -g-r-a-n-t-, -e-x-c-e-p-t -f-o-r
-t-h-e -p-e-r-i-o-d -o-f -t-h-e -f-i-r-s-t -y-e-a-r -w-h-e-n -a
-5-0 -p-e-r-c-e-n-t -m-i-n-i-m-u-m -s-h-a-l-l -a-p-p-l-y-,
-n-o-t -l-e-s-s -t-h-a-n -6-0 -p-e-r-c-e-n-t -o-f -t-h-e
-g-r-a-n-t -i-s -e-x-p-e-n-d-e-d -t-o -p-r-o-v-i-d-e -e-a-c-h
-o-f -t-h-e -s-e-r-v-i-c-e-s -o-r -a-c-t-i-v-i-t-i-e-s
-d-e-s-c-r-i-b-e-d -i-n -p-a-r-a-g-r-a-p-h-s -(-1-) -a-n-d
-(-2-) -o-f -s-e-c-t-i-o-n -1-5-0-1-(-a-)-, -i-n-c-l-u-d-i-n-g
-m-a-k-i-n-g -a-v-a-i-l-a-b-l-e -s-c-r-e-e-n-i-n-g
-p-r-o-c-e-d-u-r-e-s -f-o-r -b-o-t-h -b-r-e-a-s-t -a-n-d
-c-e-r-v-i-c-a-l -c-a-n-c-e-r-s-;-'-'-; -a-n-d
-(-i-i-) -i-n -p-a-r-a-g-r-a-p-h -(-4-)-,
-t-o -r-e-a-d -a-s -f-o-l-l-o-w-s-:
-`-`-(-4-) -t-o -e-n-s-u-r-e -t-h-a-t -n-o-t -m-o-r-e
-t-h-a-n -4-0 -p-e-r-c-e-n-t -o-f -t-h-e -g-r-a-n-t -i-s
-e-x-p-e-n-d-e-d -t-o -p-r-o-v-i-d-e -t-h-e -s-e-r-v-i-c-e-s
-o-r -a-c-t-i-v-i-t-i-e-s -d-e-s-c-r-i-b-e-d -i-n
-p-a-r-a-g-r-a-p-h-s -(-3-) -t-h-r-o-u-g-h -(-6-) -o-f
-s-e-c-t-i-o-n -1-5-0-1-(-a-)-, -e-x-c-e-p-t -i-n -t-h-e
-c-a-s-e -o-f -t-h-e -f-i-r-s-t -y-e-a-r -d-u-r-i-n-g
-w-h-i-c-h -t-h-e -m-a-x-i-m-u-m -e-x-p-e-n-d-e-d -f-o-r
-t-h-e-s-e -p-u-r-p-o-s-e-s -s-h-a-l-l -n-o-t -e-x-c-e-e-d -5-0
-p-e-r-c-e-n-t -o-f -t-h-e -g-r-a-n-t-.-'-'-; -a-n-d
-(-B-) -b-y -s-t-r-i-k-i-n-g -s-u-b-s-e-c-t-i-o-n-s
-(-c-) -t-h-r-o-u-g-h -(-e-) -a-n-d -i-n-s-e-r-t-i-n-g
-t-h-e -f-o-l-l-o-w-i-n-g-:
-`-`-(-c-) -Q-u-a-l-i-t-y -A-s-s-u-r-a-n-c-e -R-e-g-a-r-d-i-n-g
-S-c-r-e-e-n-i-n-g -P-r-o-c-e-d-u-r-e-s-.----T-h-e -S-e-c-r-e-t-a-r-y
-m-a-y -n-o-t -m-a-k-e -a -g-r-a-n-t -u-n-d-e-r -s-e-c-t-i-o-n -1-5-0-1
-u-n-l-e-s-s -t-h-e -S-t-a-t-e -i-n-v-o-l-v-e-d -a-g-r-e-e-s -t-h-a-t
-t-h-e -S-t-a-t-e -w-i-l-l-, -i-n -a-c-c-o-r-d-a-n-c-e -w-i-t-h
-a-p-p-l-i-c-a-b-l-e -l-a-w-, -a-s-s-u-r-e -t-h-e -q-u-a-l-i-t-y -o-f
-s-c-r-e-e-n-i-n-g -p-r-o-c-e-d-u-r-e-s -c-o-n-d-u-c-t-e-d
-p-u-r-s-u-a-n-t -t-o -s-u-c-h -s-e-c-t-i-o-n-.-'-'-.
-(-2-) -T-r-a-n-s-i-t-i-o-n -r-u-l-e -r-e-g-a-r-d-i-n-g
-m-a-m-m-o-g-r-a-p-h-i-e-s-.----W-i-t-h -r-e-s-p-e-c-t -t-o
-t-h-e -s-c-r-e-e-n-i-n-g -p-r-o-c-e-d-u-r-e -f-o-r
-b-r-e-a-s-t -c-a-n-c-e-r -k-n-o-w-n -a-s -a
-m-a-m-m-o-g-r-a-p-h-y-, -t-h-e -r-e-q-u-i-r-e-m-e-n-t-s -i-n
-e-f-f-e-c-t -o-n -t-h-e -d-a-y -b-e-f-o-r-e -t-h-e -d-a-t-e
-o-f -t-h-e -e-n-a-c-t-m-e-n-t -o-f -t-h-i-s -A-c-t -u-n-d-e-r
-s-e-c-t-i-o-n -1-5-0-3-(-c-) -o-f -t-h-e -P-u-b-l-i-c
-H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t -r-e-m-a-i-n -i-n
-e-f-f-e-c-t -(-f-o-r -a-n -i-n-d-i-v-i-d-u-a-l -o-r
-f-a-c-i-l-i-t-y -c-o-n-d-u-c-t-i-n-g -s-u-c-h
-p-r-o-c-e-d-u-r-e-s -p-u-r-s-u-a-n-t -t-o -a -g-r-a-n-t -t-o
-a -S-t-a-t-e -u-n-d-e-r -s-e-c-t-i-o-n -1-5-0-1 -o-f -s-u-c-h
-A-c-t-) -u-n-t-i-l -t-h-e-r-e -i-s -i-n -e-f-f-e-c-t -f-o-r
-t-h-e -f-a-c-i-l-i-t-y -a -c-e-r-t-i-f-i-c-a-t-e -(-o-r
-p-r-o-v-i-s-i-o-n-a-l -c-e-r-t-i-f-i-c-a-t-e-) -i-s-s-u-e-d
-u-n-d-e-r -s-e-c-t-i-o-n -3-5-4 -o-f -s-u-c-h -A-c-t-.
-(-e-) -S-t-a-t-e-w-i-d-e -P-r-o-v-i-s-i-o-n -o-f
-S-e-r-v-i-c-e-s-.----S-e-c-t-i-o-n -1-5-0-4-(-c-) -o-f -t-h-e
-P-u-b-l-i-c -H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t -(-4-2 -U-.-S-.-C-.
-3-0-0-n-(-c-)-) -i-s -a-m-e-n-d-e-d -b-y -a-d-d-i-n-g -a-t -t-h-e
-e-n-d -t-h-e -f-o-l-l-o-w-i-n-g -p-a-r-a-g-r-a-p-h-:
-`-`-(-3-) -G-r-a-n-t-s -t-o -t-r-i-b-e-s -a-n-d
-t-r-i-b-a-l -o-r-g-a-n-i-z-a-t-i-o-n-s-.---
-`-`-(-A-) -T-h-e -S-e-c-r-e-t-a-r-y-, -a-c-t-i-n-g
-t-h-r-o-u-g-h -t-h-e -D-i-r-e-c-t-o-r -o-f -t-h-e
-C-e-n-t-e-r-s -f-o-r -D-i-s-e-a-s-e -C-o-n-t-r-o-l
-a-n-d -P-r-e-v-e-n-t-i-o-n-, -m-a-y -m-a-k-e
-g-r-a-n-t-s -t-o -t-r-i-b-e-s -a-n-d -t-r-i-b-a-l
-o-r-g-a-n-i-z-a-t-i-o-n-s -(-a-s -s-u-c-h -t-e-r-m-s
-a-r-e -u-s-e-d -i-n -p-a-r-a-g-r-a-p-h -(-1-)-) -f-o-r
-t-h-e -p-u-r-p-o-s-e -o-f -c-a-r-r-y-i-n-g -o-u-t
-p-r-o-g-r-a-m-s -d-e-s-c-r-i-b-e-d -i-n -s-e-c-t-i-o-n
-1-5-0-1-(-a-)-. -T-h-i-s -t-i-t-l-e -a-p-p-l-i-e-s
-t-o -s-u-c-h -a -g-r-a-n-t -(-i-n -r-e-l-a-t-i-o-n
-t-o -t-h-e -j-u-r-i-s-d-i-c-t-i-o-n -o-f -t-h-e
-t-r-i-b-e -o-r -o-r-g-a-n-i-z-a-t-i-o-n-) -t-o -t-h-e
-s-a-m-e -e-x-t-e-n-t -a-n-d -i-n -t-h-e -s-a-m-e
-m-a-n-n-e-r -a-s -s-u-c-h -t-i-t-l-e -a-p-p-l-i-e-s
-t-o -a -g-r-a-n-t -t-o -a -S-t-a-t-e -u-n-d-e-r
-s-e-c-t-i-o-n -1-5-0-1 -(-i-n -r-e-l-a-t-i-o-n -t-o
-t-h-e -j-u-r-i-s-d-i-c-t-i-o-n -o-f -t-h-e
-S-t-a-t-e-)-.
-`-`-(-B-) -I-f -a -t-r-i-b-e -o-r -t-r-i-b-a-l
-o-r-g-a-n-i-z-a-t-i-o-n -i-s -r-e-c-e-i-v-i-n-g -a
-g-r-a-n-t -u-n-d-e-r -s-u-b-p-a-r-a-g-r-a-p-h -(-A-)
-a-n-d -t-h-e -S-t-a-t-e -i-n -w-h-i-c-h -t-h-e
-t-r-i-b-e -o-r -o-r-g-a-n-i-z-a-t-i-o-n -i-s
-l-o-c-a-t-e-d -i-s -r-e-c-e-i-v-i-n-g -a -g-r-a-n-t
-u-n-d-e-r -s-e-c-t-i-o-n -1-5-0-1-, -t-h-e
-r-e-q-u-i-r-e-m-e-n-t -e-s-t-a-b-l-i-s-h-e-d -i-n
-p-a-r-a-g-r-a-p-h -(-1-) -f-o-r -t-h-e -S-t-a-t-e
-r-e-g-a-r-d-i-n-g -t-h-e -t-r-i-b-e -o-r
-o-r-g-a-n-i-z-a-t-i-o-n -i-s -d-e-e-m-e-d -t-o
-h-a-v-e -b-e-e-n -w-a-i-v-e-d -u-n-d-e-r
-p-a-r-a-g-r-a-p-h -(-2-)-.-'-'-.
-(-f-) -E-v-a-l-u-a-t-i-o-n-s -a-n-d -R-e-p-o-r-t-s-.---
-S-e-c-t-i-o-n -1-5-0-8 -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h
-S-e-r-v-i-c-e -A-c-t -(-4-2 -U-.-S-.-C-. -3-0-0-n---4-) -i-s
-a-m-e-n-d-e-d---
-(-1-) -i-n -s-u-b-s-e-c-t-i-o-n -(-a-)-, -b-y -a-d-d-i-n-g
-a-t -t-h-e -e-n-d -t-h-e -f-o-l-l-o-w-i-n-g -s-e-n-t-e-n-c-e-:
-`-`-S-u-c-h -e-v-a-l-u-a-t-i-o-n-s -s-h-a-l-l -i-n-c-l-u-d-e
-e-v-a-l-u-a-t-i-o-n-s -o-f -t-h-e -e-x-t-e-n-t -t-o -w-h-i-c-h
-S-t-a-t-e-s -c-a-r-r-y-i-n-g -o-u-t -s-u-c-h -p-r-o-g-r-a-m-s
-a-r-e -i-n -c-o-m-p-l-i-a-n-c-e -w-i-t-h -s-e-c-t-i-o-n
-1-5-0-1-(-a-)-(-2-) -a-n-d -w-i-t-h -s-e-c-t-i-o-n
-1-5-0-4-(-c-)-.-'-'-; -a-n-d
-(-2-) -i-n -s-u-b-s-e-c-t-i-o-n -(-b-)-, -b-y
-i-n-s-e-r-t-i-n-g -b-e-f-o-r-e -t-h-e -p-e-r-i-o-d -t-h-e
-f-o-l-l-o-w-i-n-g-: -`-`-, -i-n-c-l-u-d-i-n-g
-r-e-c-o-m-m-e-n-d-a-t-i-o-n-s -r-e-g-a-r-d-i-n-g
-c-o-m-p-l-i-a-n-c-e -b-y -t-h-e -S-t-a-t-e-s -w-i-t-h
-s-e-c-t-i-o-n -1-5-0-1-(-a-)-(-2-) -a-n-d -w-i-t-h
-s-e-c-t-i-o-n -1-5-0-4-(-c-)-'-'-.
-(-g-) -T-e-c-h-n-i-c-a-l -C-o-r-r-e-c-t-i-o-n-s-.----T-i-t-l-e
-X-V -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t -(-4-2
-U-.-S-.-C-. -3-0-0-k -e-t -s-e-q-.-) -i-s -a-m-e-n-d-e-d---
-(-1-) -i-n -s-e-c-t-i-o-n -1-5-0-1-(-a-)-, -i-n -t-h-e
-m-a-t-t-e-r -p-r-e-c-e-d-i-n-g -p-a-r-a-g-r-a-p-h -(-1-)-,
-b-y -s-t-r-i-k-i-n-g -`-`-C-o-n-t-r-o-l-,-'-' -a-n-d
-i-n-s-e-r-t-i-n-g -`-`-C-o-n-t-r-o-l -a-n-d
-P-r-e-v-e-n-t-i-o-n-,-'-'-; -a-n-d
-(-2-) -i-n -s-e-c-t-i-o-n -1-5-0-5---
-(-A-) -i-n -p-a-r-a-g-r-a-p-h -(-3-)-, -b-y
-s-t-r-i-k-i-n-g -`-`-n-o-n-p-r-i-v-a-t-e-'-' -a-n-d
-i-n-s-e-r-t-i-n-g -`-`-n-o-n-p-r-o-f-i-t
-p-r-i-v-a-t-e-'-'-; -a-n-d
-(-B-) -i-n -p-a-r-a-g-r-a-p-h -(-4-)-, -b-y
-i-n-s-e-r-t-i-n-g -`-`-w-i-l-l-'-' -b-e-f-o-r-e
-`-`-b-e -u-s-e-d-'-'-.
-S-E-C-. -4-0-3-. -E-S-T-A-B-L-I-S-H-M-E-N-T -O-F
-D-E-M-O-N-S-T-R-A-T-I-O-N -P-R-O-G-R-A-M -O-F
-G-R-A-N-T-S -F-O-R -A-D-D-I-T-I-O-N-A-L
-P-R-E-V-E-N-T-I-V-E -H-E-A-L-T-H -S-E-R-V-I-C-E-S -F-O-R
-W-O-M-E-N-.
-(-a-) -I-n -G-e-n-e-r-a-l-.----T-i-t-l-e -X-V -o-f -t-h-e
-P-u-b-l-i-c -H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t -(-4-2 -U-.-S-.-C-.
-3-0-0-k -e-t -s-e-q-.-) -i-s -a-m-e-n-d-e-d---
-(-1-) -b-y -r-e-d-e-s-i-g-n-a-t-i-n-g -s-e-c-t-i-o-n
-1-5-0-9 -a-s -s-e-c-t-i-o-n -1-5-1-0-; -a-n-d
-(-2-) -b-y -i-n-s-e-r-t-i-n-g -a-f-t-e-r -s-e-c-t-i-o-n
-1-5-0-8 -t-h-e -f-o-l-l-o-w-i-n-g -s-e-c-t-i-o-n-:
-`-`-S-E-C-. -1-5-0-9-. -S-U-P-P-L-E-M-E-N-T-A-L -G-R-A-N-T-S -F-O-R
-A-D-D-I-T-I-O-N-A-L -P-R-E-V-E-N-T-I-V-E -H-E-A-L-T-H
-S-E-R-V-I-C-E-S-.
-`-`-(-a-) -D-e-m-o-n-s-t-r-a-t-i-o-n -P-r-o-j-e-c-t-s-.----I-n
-t-h-e -c-a-s-e -o-f -S-t-a-t-e-s -r-e-c-e-i-v-i-n-g -g-r-a-n-t-s
-u-n-d-e-r -s-e-c-t-i-o-n -1-5-0-1-, -t-h-e -S-e-c-r-e-t-a-r-y-,
-a-c-t-i-n-g -t-h-r-o-u-g-h -t-h-e -D-i-r-e-c-t-o-r -o-f -t-h-e
-C-e-n-t-e-r-s -f-o-r -D-i-s-e-a-s-e -C-o-n-t-r-o-l -a-n-d
-P-r-e-v-e-n-t-i-o-n-, -m-a-y -m-a-k-e -g-r-a-n-t-s -t-o -n-o-t
-m-o-r-e -t-h-a-n -3 -s-u-c-h -S-t-a-t-e-s -t-o -c-a-r-r-y -o-u-t
-d-e-m-o-n-s-t-r-a-t-i-o-n -p-r-o-j-e-c-t-s -f-o-r -t-h-e
-p-u-r-p-o-s-e -o-f---
-`-`-(-1-) -p-r-o-v-i-d-i-n-g -p-r-e-v-e-n-t-i-v-e
-h-e-a-l-t-h -s-e-r-v-i-c-e-s -i-n -a-d-d-i-t-i-o-n -t-o -t-h-e
-s-e-r-v-i-c-e-s -a-u-t-h-o-r-i-z-e-d -i-n -s-u-c-h
-s-e-c-t-i-o-n-, -i-n-c-l-u-d-i-n-g -s-c-r-e-e-n-i-n-g-s
-r-e-g-a-r-d-i-n-g -b-l-o-o-d -p-r-e-s-s-u-r-e -a-n-d
-c-h-o-l-e-s-t-e-r-o-l-, -a-n-d -i-n-c-l-u-d-i-n-g -h-e-a-l-t-h
-e-d-u-c-a-t-i-o-n-;
-`-`-(-2-) -p-r-o-v-i-d-i-n-g -a-p-p-r-o-p-r-i-a-t-e
-r-e-f-e-r-r-a-l-s -f-o-r -m-e-d-i-c-a-l -t-r-e-a-t-m-e-n-t
-o-f -w-o-m-e-n -r-e-c-e-i-v-i-n-g -s-e-r-v-i-c-e-s
-p-u-r-s-u-a-n-t -t-o -p-a-r-a-g-r-a-p-h -(-1-) -a-n-d
-e-n-s-u-r-i-n-g-, -t-o -t-h-e -e-x-t-e-n-t
-p-r-a-c-t-i-c-a-b-l-e-, -t-h-e -p-r-o-v-i-s-i-o-n -o-f
-a-p-p-r-o-p-r-i-a-t-e -f-o-l-l-o-w---u-p -s-e-r-v-i-c-e-s-;
-a-n-d
-`-`-(-3-) -e-v-a-l-u-a-t-i-n-g -a-c-t-i-v-i-t-i-e-s
-c-o-n-d-u-c-t-e-d -u-n-d-e-r -p-a-r-a-g-r-a-p-h-s -(-1-)
-a-n-d -(-2-) -t-h-r-o-u-g-h -a-p-p-r-o-p-r-i-a-t-e
-s-u-r-v-e-i-l-l-a-n-c-e -o-r -p-r-o-g-r-a-m--
-m-o-n-i-t-o-r-i-n-g -a-c-t-i-v-i-t-i-e-s-.
-`-`-(-b-) -S-t-a-t-u-s -a-s -P-a-r-t-i-c-i-p-a-n-t -i-n
-P-r-o-g-r-a-m -R-e-g-a-r-d-i-n-g -B-r-e-a-s-t -a-n-d -C-e-r-v-i-c-a-l
-C-a-n-c-e-r-.----T-h-e -S-e-c-r-e-t-a-r-y -m-a-y -n-o-t -m-a-k-e -a
-g-r-a-n-t -u-n-d-e-r -s-u-b-s-e-c-t-i-o-n -(-a-) -u-n-l-e-s-s -t-h-e
-S-t-a-t-e -i-n-v-o-l-v-e-d -a-g-r-e-e-s -t-h-a-t -s-e-r-v-i-c-e-s
-u-n-d-e-r -t-h-e -g-r-a-n-t -w-i-l-l -b-e -p-r-o-v-i-d-e-d -o-n-l-y
-t-h-r-o-u-g-h -e-n-t-i-t-i-e-s -t-h-a-t -a-r-e -s-c-r-e-e-n-i-n-g
-w-o-m-e-n -f-o-r -b-r-e-a-s-t -o-r -c-e-r-v-i-c-a-l -c-a-n-c-e-r
-p-u-r-s-u-a-n-t -t-o -a -g-r-a-n-t -u-n-d-e-r -s-e-c-t-i-o-n
-1-5-0-1-.
-`-`-(-c-) -A-p-p-l-i-c-a-b-i-l-i-t-y -o-f -P-r-o-v-i-s-i-o-n-s
-o-f -G-e-n-e-r-a-l -P-r-o-g-r-a-m-.----T-h-i-s -t-i-t-l-e
-a-p-p-l-i-e-s -t-o -a -g-r-a-n-t -u-n-d-e-r -s-u-b-s-e-c-t-i-o-n
-(-a-) -t-o -t-h-e -s-a-m-e -e-x-t-e-n-t -a-n-d -i-n -t-h-e -s-a-m-e
-m-a-n-n-e-r -a-s -s-u-c-h -t-i-t-l-e -a-p-p-l-i-e-s -t-o -a -g-r-a-n-t
-u-n-d-e-r -s-e-c-t-i-o-n -1-5-0-1-.
-`-`-(-d-) -F-u-n-d-i-n-g-.---
-`-`-(-1-) -I-n -g-e-n-e-r-a-l-.----S-u-b-j-e-c-t -t-o
-p-a-r-a-g-r-a-p-h -(-2-)-, -f-o-r -t-h-e -p-u-r-p-o-s-e -o-f
-c-a-r-r-y-i-n-g -o-u-t -t-h-i-s -s-e-c-t-i-o-n-, -t-h-e-r-e
-a-r-e -a-u-t-h-o-r-i-z-e-d -t-o -b-e -a-p-p-r-o-p-r-i-a-t-e-d
-$-3-,-0-0-0-,-0-0-0 -f-o-r -f-i-s-c-a-l -y-e-a-r -1-9-9-4-,
-a-n-d -s-u-c-h -s-u-m-s -a-s -m-a-y -b-e -n-e-c-e-s-s-a-r-y
-f-o-r -e-a-c-h -o-f -t-h-e -f-i-s-c-a-l -y-e-a-r-s -1-9-9-5
-t-h-r-o-u-g-h -1-9-9-8-.
-`-`-(-2-) -L-i-m-i-t-a-t-i-o-n -r-e-g-a-r-d-i-n-g
-f-u-n-d-i-n-g -w-i-t-h -r-e-s-p-e-c-t -t-o -b-r-e-a-s-t -a-n-d
-c-e-r-v-i-c-a-l -c-a-n-c-e-r-.----T-h-e
-a-u-t-h-o-r-i-z-a-t-i-o-n -o-f -a-p-p-r-o-p-r-i-a-t-i-o-n-s
-e-s-t-a-b-l-i-s-h-e-d -i-n -p-a-r-a-g-r-a-p-h -(-1-) -i-s
-n-o-t -e-f-f-e-c-t-i-v-e -f-o-r -a -f-i-s-c-a-l -y-e-a-r
-u-n-l-e-s-s -t-h-e -a-m-o-u-n-t -a-p-p-r-o-p-r-i-a-t-e-d
-u-n-d-e-r -s-e-c-t-i-o-n -1-5-1-0-(-a-) -f-o-r -t-h-e
-f-i-s-c-a-l -y-e-a-r -e-q-u-a-l-s -o-r -e-x-c-e-e-d-s
-$-1-0-0-,-0-0-0-,-0-0-0-.-'-'-.
-(-b-) -C-o-n-f-o-r-m-i-n-g -A-m-e-n-d-m-e-n-t-.----S-e-c-t-i-o-n
-1-5-1-0-(-a-) -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h -S-e-r-v-i-c-e
-A-c-t-, -a-s -r-e-d-e-s-i-g-n-a-t-e-d -b-y -s-u-b-s-e-c-t-i-o-n
-(-a-)-(-1-) -o-f -t-h-i-s -s-e-c-t-i-o-n-, -i-s -a-m-e-n-d-e-d -i-n
-t-h-e -h-e-a-d-i-n-g -f-o-r -t-h-e -s-e-c-t-i-o-n -b-y
-s-t-r-i-k-i-n-g -`-`-f-u-n-d-i-n-g-.-'-' -a-n-d -i-n-s-e-r-t-i-n-g
-`-`-f-u-n-d-i-n-g -f-o-r -g-e-n-e-r-a-l -p-r-o-g-r-a-m-.-'-'-.
-S-E-C-. -4-0-4-. -F-U-N-D-I-N-G -F-O-R -G-E-N-E-R-A-L -P-R-O-G-R-A-M-.
-S-e-c-t-i-o-n -1-5-1-0-(-a-) -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h
-S-e-r-v-i-c-e -A-c-t -(-a-s -a-m-e-n-d-e-d -b-y -s-e-c-t-i-o-n
-4-0-3-(-a-)-(-2-)-) -i-s -a-m-e-n-d-e-d---
-(-1-) -b-y -s-t-r-i-k-i-n-g -`-`-a-n-d-'-' -a-f-t-e-r
-`-`-1-9-9-1-,-'-'-; -a-n-d
-(-2-) -b-y -i-n-s-e-r-t-i-n-g -b-e-f-o-r-e -t-h-e
-p-e-r-i-o-d -t-h-e -f-o-l-l-o-w-i-n-g-: -`-`-,
-$-2-0-0-,-0-0-0-,-0-0-0 -f-o-r -f-i-s-c-a-l -y-e-a-r
-1-9-9-4-, -a-n-d -s-u-c-h -s-u-m-s -a-s -m-a-y -b-e
-n-e-c-e-s-s-a-r-y -f-o-r -e-a-c-h -o-f -t-h-e -f-i-s-c-a-l
-y-e-a-r-s -1-9-9-5 -t-h-r-o-u-g-h -1-9-9-7-'-'-.
-T-I-T-L-E -V----M-I-S-C-E-L-L-A-N-E-O-U-S -P-R-O-V-I-S-I-O-N-S
-S-E-C-. -5-0-1-. -E-V-A-L-U-A-T-I-O-N-S-.
-S-e-c-t-i-o-n -2-7-1-1 -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h
-S-e-r-v-i-c-e -A-c-t -(-4-2 -U-.-S-.-C-. -3-0-0-a-a-a---1-0-) -i-s
-a-m-e-n-d-e-d -t-o -r-e-a-d -a-s -f-o-l-l-o-w-s-:
-`-`-e-v-a-l-u-a-t-i-o-n -o-f -p-r-o-g-r-a-m-s
-`-`-S-e-c-. -(-a-) -I-n -G-e-n-e-r-a-l-.----S-u-c-h -p-o-r-t-i-o-n
-a-s -t-h-e -S-e-c-r-e-t-a-r-y -s-h-a-l-l -d-e-t-e-r-m-i-n-e-, -b-u-t
-n-o-t -l-e-s-s -t-h-a-n -.-2 -p-e-r-c-e-n-t -n-o-r -m-o-r-e -t-h-a-n
-1 -p-e-r-c-e-n-t-, -o-f -a-n-y -a-m-o-u-n-t-s -a-p-p-r-o-p-r-i-a-t-e-d
-f-o-r -p-r-o-g-r-a-m-s -a-u-t-h-o-r-i-z-e-d -u-n-d-e-r -t-h-i-s -A-c-t
-f-o-r -a-n-y -f-i-s-c-a-l -y-e-a-r -b-e-g-i-n-n-i-n-g -a-f-t-e-r
-S-e-p-t-e-m-b-e-r -2-0-, -1-9-9-3-, -s-h-a-l-l -b-e -m-a-d-e
-a-v-a-i-l-a-b-l-e -f-o-r -t-h-e -e-v-a-l-u-a-t-i-o-n
-(-d-i-r-e-c-t-l-y-, -o-r -b-y -g-r-a-n-t-s -o-f -c-o-n-t-r-a-c-t-s-)
-o-f -t-h-e -i-m-p-l-e-m-e-n-t-a-t-i-o-n -a-n-d
-e-f-f-e-c-t-i-v-e-n-e-s-s -o-f -s-u-c-h -p-r-o-g-r-a-m-s-.
-`-`-(-b-) -R-e-p-o-r-t -o-n -E-v-a-l-u-a-t-i-o-n-s-.---
-`-`-(-1-) -I-n -g-e-n-e-r-a-l-.----T-o -p-r-o-v-i-d-e
-i-n-f-o-r-m-a-t-i-o-n -f-o-r -l-e-g-i-s-l-a-t-i-v-e
-d-e-l-i-b-e-r-a-t-i-o-n-s -c-o-n-c-e-r-n-i-n-g -F-e-d-e-r-a-l
-h-e-a-l-t-h -p-r-o-g-r-a-m-s-, -t-h-e -S-e-c-r-e-t-a-r-y
-s-h-a-l-l-, -n-o-t -l-a-t-e-r -t-h-a-n -J-a-n-u-a-r-y -1 -o-f
-e-a-c-h -y-e-a-r-, -p-r-e-p-a-r-e -a-n-d -s-u-b-m-i-t -t-o
-t-h-e -C-o-m-m-i-t-t-e-e -o-n -L-a-b-o-r -a-n-d -H-u-m-a-n
-R-e-s-o-u-r-c-e-s -o-f -t-h-e -S-e-n-a-t-e -a-n-d -t-h-e
-C-o-m-m-i-t-t-e-e -o-n -E-n-e-r-g-y -a-n-d -C-o-m-m-e-r-c-e
-o-f -t-h-e -H-o-u-s-e -o-f -R-e-p-r-e-s-e-n-t-a-t-i-v-e-s -a
-r-e-p-o-r-t -t-h-a-t -i-d-e-n-t-i-f-i-e-s -a-n-d
-s-y-n-t-h-e-s-i-z-e-s -t-h-e -f-i-n-d-i-n-g-s -o-f -t-h-e
-e-v-a-l-u-a-t-i-o-n-s -c-o-n-d-u-c-t-e-d -u-n-d-e-r
-s-u-b-s-e-c-t-i-o-n -(-a-) -b-y -p-r-o-g-r-a-m -a-r-e-a-.
-S-u-c-h -r-e-p-o-r-t -s-h-a-l-l -a-l-s-o -i-n-c-l-u-d-e -t-h-e
-p-l-a-n-s -o-f -t-h-e -S-e-c-r-e-t-a-r-y -f-o-r -t-h-e
-s-u-b-s-e-q-u-e-n-t -y-e-a-r-'-s -e-v-a-l-u-a-t-i-o-n-s-,
-i-n-c-l-u-d-i-n-g -p-r-o-g-r-a-m-s -a-n-d -i-s-s-u-e
-a-r-e-a-s-.
-`-`-(-2-) -F-i-v-e -y-e-a-r -r-e-v-i-e-w-.----A
-r-e-p-o-r-t -s-u-b-m-i-t-t-e-d -u-n-d-e-r -p-a-r-a-g-r-a-p-h
-(-1-) -s-h-a-l-l -c-o-n-t-a-i-n -a -d-e-s-c-r-i-p-t-i-o-n -o-f
-t-h-e -f-i-n-d-i-n-g-s -o-f -t-h-e -S-e-c-r-e-t-a-r-y -w-i-t-h
-r-e-s-p-e-c-t -t-o -e-v-a-l-u-a-t-i-o-n-s -c-o-n-d-u-c-t-e-d
-u-n-d-e-r -s-u-b-s-e-c-t-i-o-n -(-a-) -o-r -o-t-h-e-r
-p-r-o-v-i-s-i-o-n-s -o-f -l-a-w-, -d-u-r-i-n-g -t-h-e -5--
-y-e-a-r -p-e-r-i-o-d -p-r-i-o-r -t-o -t-h-e -y-e-a-r -f-o-r
-w-h-i-c-h -t-h-e -r-e-p-o-r-t -i-s -b-e-i-n-g
-s-u-b-m-i-t-t-e-d-. -S-u-c-h -d-e-s-c-r-i-p-t-i-o-n -s-h-a-l-l
-p-r-o-v-i-d-e -t-h-e -C-o-m-m-i-t-t-e-e-s -r-e-f-e-r-r-e-d
-t-o -i-n -p-a-r-a-g-r-a-p-h -(-1-) -w-i-t-h
-i-n-f-o-r-m-a-t-i-o-n -c-o-n-c-e-r-n-i-n-g -p-r-o-g-r-a-m
-c-h-a-n-g-e-s -t-h-a-t -t-h-e -S-e-c-r-e-t-a-r-y
-i-n-t-e-n-d-s -t-o -i-m-p-l-e-m-e-n-t -i-n -r-e-s-p-o-n-s-e
-t-o -s-u-c-h -f-i-n-d-i-n-g-s -i-n -o-r-d-e-r -t-o
-i-m-p-r-o-v-e -t-h-e -h-e-a-l-t-h -o-f -t-h-e -A-m-e-r-i-c-a-n
-p-e-o-p-l-e -a-n-d -t-h-e-i-r -r-e-c-e-i-p-t -o-f -n-e-e-d-e-d
-a-n-d -e-f-f-e-c-t-i-v-e -p-u-b-l-i-c -h-e-a-l-t-h
-s-e-r-v-i-c-e-s-.-'-'-.
-S-E-C-. -5-0-2-. -F-E-D-E-R-A-L -B-E-N-E-F-I-T-S -F-O-R
-O-V-E-R-S-E-A-S -A-S-S-I-G-N-E-E-S-.
-S-e-c-t-i-o-n -3-0-7 -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h
-S-e-r-v-i-c-e -A-c-t -(-4-2 -U-.-S-.-C-. -2-4-2-l-) -i-s
-a-m-e-n-d-e-d -b-y -a-d-d-i-n-g -a-t -t-h-e -e-n-d -t-h-e-r-e-o-f
-t-h-e -f-o-l-l-o-w-i-n-g -n-e-w -s-u-b-s-e-c-t-i-o-n-:
-`-`-(-c-) -T-h-e -S-e-c-r-e-t-a-r-y -m-a-y -p-r-o-v-i-d-e -t-o
-p-e-r-s-o-n-n-e-l -a-p-p-o-i-n-t-e-d -o-r -a-s-s-i-g-n-e-d -b-y -t-h-e
-S-e-c-r-e-t-a-r-y -t-o -s-e-r-v-e -a-b-r-o-a-d-, -a-l-l-o-w-a-n-c-e-s
-a-n-d -b-e-n-e-f-i-t-s -s-i-m-i-l-a-r -t-o -t-h-o-s-e -p-r-o-v-i-d-e-d
-u-n-d-e-r -c-h-a-p-t-e-r -9 -o-f -t-i-t-l-e -I -o-f -t-h-e
-F-o-r-e-i-g-n -S-e-r-v-i-c-e -A-c-t -o-f -1-9-9-0 -(-2-2 -U-.-S-.-C-.
-4-0-8-1 -e-t -s-e-q-.-)-. -L-e-a-v-e-s -o-f -a-b-s-e-n-c-e -f-o-r
-p-e-r-s-o-n-n-e-l -u-n-d-e-r -t-h-i-s -s-u-b-s-e-c-t-i-o-n -s-h-a-l-l
-b-e -o-n -t-h-e -s-a-m-e -b-a-s-i-s -a-s -t-h-a-t -p-r-o-v-i-d-e-d
-u-n-d-e-r -s-u-b-c-h-a-p-t-e-r -I -o-f -c-h-a-p-t-e-r -6-3 -o-f
-t-i-t-l-e -5-, -U-n-i-t-e-d -S-t-a-t-e-s -C-o-d-e -t-o
-i-n-d-i-v-i-d-u-a-l-s -s-e-r-v-i-n-g -i-n -t-h-e -F-o-r-e-i-g-n
-S-e-r-v-i-c-e-.-'-'-.
-S-E-C-. -5-0-3-. -L-O-A-N -R-E-P-A-Y-M-E-N-T -P-R-O-G-R-A-M-.
-P-a-r-t -J -o-f -t-i-t-l-e -I-I-I -o-f -t-h-e -P-u-b-l-i-c
-H-e-a-l-t-h -S-e-r-v-i-c-e -A-c-t -(-a-s -a-m-e-n-d-e-d -b-y
-s-e-c-t-i-o-n -2-0-0-8 -o-f -P-u-b-l-i-c -L-a-w -1-0-3---4-3-) -i-s
-a-m-e-n-d-e-d -b-y -i-n-s-e-r-t-i-n-g -a-f-t-e-r -s-e-c-t-i-o-n -3-9-3
-t-h-e -f-o-l-l-o-w-i-n-g -n-e-w -s-e-c-t-i-o-n-:
-`-`-S-E-C-. -3-9-3-A-. -L-O-A-N -R-E-P-A-Y-M-E-N-T -P-R-O-G-R-A-M-.
-`-`-(-a-) -I-n -G-e-n-e-r-a-l-.---
-`-`-(-1-) -A-u-t-h-o-r-i-t-y-.----S-u-b-j-e-c-t -t-o
-p-a-r-a-g-r-a-p-h -(-2-)-, -t-h-e -S-e-c-r-e-t-a-r-y -m-a-y
-c-a-r-r-y -o-u-t -a -p-r-o-g-r-a-m -o-f -e-n-t-e-r-i-n-g
-i-n-t-o -c-o-n-t-r-a-c-t-s -w-i-t-h -a-p-p-r-o-p-r-i-a-t-e-l-y
-q-u-a-l-i-f-i-e-d -h-e-a-l-t-h -p-r-o-f-e-s-s-i-o-n-a-l-s
-u-n-d-e-r -w-h-i-c-h -s-u-c-h -h-e-a-l-t-h
-p-r-o-f-e-s-s-i-o-n-a-l-s -a-g-r-e-e -t-o -c-o-n-d-u-c-t
-p-r-e-v-e-n-t-i-o-n -a-c-t-i-v-i-t-i-e-s-, -a-s
-e-m-p-l-o-y-e-e-s -o-f -t-h-e -C-e-n-t-e-r-s -f-o-r
-D-i-s-e-a-s-e -C-o-n-t-r-o-l -a-n-d -P-r-e-v-e-n-t-i-o-n
-a-n-d -t-h-e -A-g-e-n-c-y -f-o-r -T-o-x-i-c
-S-u-b-s-t-a-n-c-e-s -a-n-d -D-i-s-e-a-s-e -R-e-g-i-s-t-r-y-,
-i-n -c-o-n-s-i-d-e-r-a-t-i-o-n -o-f -t-h-e -F-e-d-e-r-a-l
-G-o-v-e-r-n-m-e-n-t -a-g-r-e-e-i-n-g -t-o -r-e-p-a-y-, -f-o-r
-e-a-c-h -y-e-a-r -o-f -s-u-c-h -s-e-r-v-i-c-e-, -n-o-t
-m-o-r-e -t-h-a-n -$-2-0-,-0-0-0 -o-f -t-h-e -p-r-i-n-c-i-p-a-l
-a-n-d -i-n-t-e-r-e-s-t -o-f -t-h-e -e-d-u-c-a-t-i-o-n-a-l
-l-o-a-n-s -o-f -s-u-c-h -h-e-a-l-t-h
-p-r-o-f-e-s-s-i-o-n-a-l-s-.
-`-`-(-2-) -L-i-m-i-t-a-t-i-o-n-.----T-h-e
-S-e-c-r-e-t-a-r-y -m-a-y -n-o-t -e-n-t-e-r -i-n-t-o -a-n
-a-g-r-e-e-m-e-n-t -w-i-t-h -a -h-e-a-l-t-h
-p-r-o-f-e-s-s-i-o-n-a-l -p-u-r-s-u-a-n-t -t-o
-p-a-r-a-g-r-a-p-h -(-1-) -u-n-l-e-s-s -s-u-c-h
-p-r-o-f-e-s-s-i-o-n-a-l---
-`-`-(-A-) -h-a-s -a -s-u-b-s-t-a-n-t-i-a-l
-a-m-o-u-n-t -o-f -e-d-u-c-a-t-i-o-n-a-l -l-o-a-n-s
-r-e-l-a-t-i-v-e -t-o -i-n-c-o-m-e-; -a-n-d
-`-`-(-B-) -a-g-r-e-e-s -t-o -s-e-r-v-e -a-s -a-n
-e-m-p-l-o-y-e-e -o-f -t-h-e -C-e-n-t-e-r-s -f-o-r
-D-i-s-e-a-s-e -C-o-n-t-r-o-l -a-n-d
-P-r-e-v-e-n-t-i-o-n -o-r -t-h-e -A-g-e-n-c-y -f-o-r
-T-o-x-i-c -S-u-b-s-t-a-n-c-e-s -a-n-d -D-i-s-e-a-s-e
-R-e-g-i-s-t-r-y -f-o-r -p-u-r-p-o-s-e-s -o-f
-p-a-r-a-g-r-a-p-h -(-1-) -f-o-r -a -p-e-r-i-o-d -o-f
-n-o-t -l-e-s-s -t-h-a-n -3 -y-e-a-r-s-.
-`-`-(-b-) -A-p-p-l-i-c-a-b-i-l-i-t-y -o-f -C-e-r-t-a-i-n
-P-r-o-v-i-s-i-o-n-s-.----W-i-t-h -r-e-s-p-e-c-t -t-o -t-h-e
-N-a-t-i-o-n-a-l -H-e-a-l-t-h -S-e-r-v-i-c-e -C-o-r-p-s -L-o-a-n
-R-e-p-a-y-m-e-n-t -P-r-o-g-r-a-m -e-s-t-a-b-l-i-s-h-e-d -i-n
-s-u-b-p-a-r-t -I-I-I -o-f -p-a-r-t -D -o-f -t-i-t-l-e -I-I-I -o-f
-t-h-i-s -A-c-t-, -t-h-e -p-r-o-v-i-s-i-o-n-s -o-f -s-u-c-h
-s-u-b-p-a-r-t -s-h-a-l-l-, -e-x-c-e-p-t -a-s -i-n-c-o-n-s-i-s-t-e-n-t
-w-i-t-h -s-u-b-s-e-c-t-i-o-n -(-a-)-, -a-p-p-l-y -t-o -t-h-e
-p-r-o-g-r-a-m -e-s-t-a-b-l-i-s-h-e-d -i-n -t-h-i-s -s-e-c-t-i-o-n -i-n
-t-h-e -s-a-m-e -m-a-n-n-e-r -a-n-d -t-o -t-h-e -s-a-m-e -e-x-t-e-n-t
-a-s -s-u-c-h -p-r-o-v-i-s-i-o-n-s -a-p-p-l-y -t-o -t-h-e
-N-a-t-i-o-n-a-l -H-e-a-l-t-h -S-e-r-v-i-c-e -C-o-r-p-s -L-o-a-n
-R-e-p-a-y-m-e-n-t -P-r-o-g-r-a-m-.-'-'-.
-S-E-C-. -5-0-4-. -E-S-T-A-B-L-I-S-H-M-E-N-T -O-F
-R-E-Q-U-I-R-E-M-E-N-T -O-F -B-I-E-N-N-I-A-L -R-E-P-O-R-T
-O-N -N-U-T-R-I-T-I-O-N -A-N-D -H-E-A-L-T-H-.
-T-i-t-l-e -X-V-I-I -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h
-S-e-r-v-i-c-e -A-c-t -(-4-2 -U-.-S-.-C-. -3-0-0-u -e-t -s-e-q-.-)-,
-a-s -a-m-e-n-d-e-d -b-y -s-e-c-t-i-o-n -3-0-2 -o-f -P-u-b-l-i-c -L-a-w
-1-0-2---5-3-1 -(-1-0-6 -S-t-a-t-. -3-4-8-3-)-, -i-s -a-m-e-n-d-e-d
-b-y -a-d-d-i-n-g -a-t -t-h-e -e-n-d -t-h-e -f-o-l-l-o-w-i-n-g
-s-e-c-t-i-o-n-:
-`-`-b-i-e-n-n-i-a-l -r-e-p-o-r-t -r-e-g-a-r-d-i-n-g -n-u-t-r-i-t-i-o-n
-a-n-d -h-e-a-l-t-h
-`-`-S-e-c-. -1-7-0-9-. -(-a-) -B-i-e-n-n-i-a-l -R-e-p-o-r-t-.---
-T-h-e -S-e-c-r-e-t-a-r-y -s-h-a-l-l -r-e-q-u-i-r-e -t-h-e
-S-u-r-g-e-o-n -G-e-n-e-r-a-l -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h
-S-e-r-v-i-c-e -t-o -p-r-e-p-a-r-e -b-i-e-n-n-i-a-l -r-e-p-o-r-t-s -o-n
-t-h-e -r-e-l-a-t-i-o-n-s-h-i-p -b-e-t-w-e-e-n -n-u-t-r-i-t-i-o-n
-a-n-d -h-e-a-l-t-h-. -S-u-c-h -r-e-p-o-r-t-s -m-a-y-, -w-i-t-h
-r-e-s-p-e-c-t -t-o -s-u-c-h -r-e-l-a-t-i-o-n-s-h-i-p-, -i-n-c-l-u-d-e
-a-n-y -r-e-c-o-m-m-e-n-d-a-t-i-o-n-s -o-f -t-h-e -S-e-c-r-e-t-a-r-y
-a-n-d -t-h-e -S-u-r-g-e-o-n -G-e-n-e-r-a-l -r-e-g-a-r-d-i-n-g -t-h-e
-p-u-b-l-i-c -h-e-a-l-t-h-.
-`-`-(-b-) -S-u-b-m-i-s-s-i-o-n -t-o -C-o-n-g-r-e-s-s-.----T-h-e
-S-e-c-r-e-t-a-r-y -s-h-a-l-l -e-n-s-u-r-e -t-h-a-t-, -n-o-t -l-a-t-e-r
-t-h-a-n -F-e-b-r-u-a-r-y -1 -o-f -1-9-9-5 -a-n-d -o-f -e-v-e-r-y
-s-e-c-o-n-d -y-e-a-r -t-h-e-r-e-a-f-t-e-r-, -a -r-e-p-o-r-t -u-n-d-e-r
-s-u-b-s-e-c-t-i-o-n -(-a-) -i-s -s-u-b-m-i-t-t-e-d -t-o -t-h-e
-C-o-m-m-i-t-t-e-e -o-n -E-n-e-r-g-y -a-n-d -C-o-m-m-e-r-c-e -o-f
-t-h-e -H-o-u-s-e -o-f -R-e-p-r-e-s-e-n-t-a-t-i-v-e-s -a-n-d -t-h-e
-C-o-m-m-i-t-t-e-e -o-n -L-a-b-o-r -a-n-d -H-u-m-a-n -R-e-s-o-u-r-c-e-s
-o-f -t-h-e -S-e-n-a-t-e-.
-`-`-(-c-) -A-u-t-h-o-r-i-z-a-t-i-o-n -o-f
-A-p-p-r-o-p-r-i-a-t-i-o-n-s-.----F-o-r -t-h-e -p-u-r-p-o-s-e -o-f
-c-a-r-r-y-i-n-g -o-u-t -t-h-i-s -s-e-c-t-i-o-n-, -t-h-e-r-e -a-r-e
-a-u-t-h-o-r-i-z-e-d -t-o -b-e -a-p-p-r-o-p-r-i-a-t-e-d -s-u-c-h
-s-u-m-s -a-s -m-a-y -b-e -n-e-c-e-s-s-a-r-y -f-o-r -e-a-c-h -o-f
-t-h-e -f-i-s-c-a-l -y-e-a-r-s -1-9-9-4 -t-h-r-o-u-g-h -1-9-9-8-.-'-'-.
-S-E-C-. -5-0-5-. -A-L-I-G-N-M-E-N-T -O-F -C-U-R-R-E-N-T -C-E-N-T-E-R-S
-F-O-R -D-I-S-E-A-S-E -C-O-N-T-R-O-L -A-N-D
-P-R-E-V-E-N-T-I-O-N -R-E-A-U-T-H-O-R-I-Z-A-T-I-O-N
-S-C-H-E-D-U-L-E-.
-(-a-) -P-r-o-s-t-a-t-e -C-a-n-c-e-r -P-r-e-v-e-n-t-i-o-n-.---
-S-e-c-t-i-o-n -3-1-7-D-(-(-l-)-(-1-) -o-f -s-u-c-h -A-c-t -(-4-2
-U-.-S-.-C-. -2-4-7-b---5-(-l-)-(-1-)-) -i-s -a-m-e-n-d-e-d -b-y
-s-t-r-i-k-i-n-g -`-`-t-h-r-o-u-g-h -1-9-9-6-'-' -a-n-d
-i-n-s-e-r-t-i-n-g -`-`-t-h-r-o-u-g-h -1-9-9-7-'-'-.
-(-b-) -C-a-n-c-e-r -R-e-g-i-s-t-r-i-e-s-.----S-e-c-t-i-o-n
-3-9-9-L-(-a-) -o-f -s-u-c-h -A-c-t -(-4-2 -U-.-S-.-C-. -2-8-0-e--
-4-(-a-)-) -(-a-s -a-m-e-n-d-e-d -b-y -s-e-c-t-i-o-n -2-0-0-3-(-1-)
-o-f -P-u-b-l-i-c -L-a-w -1-0-3---4-3-) -i-s -a-m-e-n-d-e-d -b-y
-s-t-r-i-k-i-n-g -`-`-t-h-r-o-u-g-h -1-9-9-6-'-' -a-n-d
-i-n-s-e-r-t-i-n-g -`-`-t-h-r-o-u-g-h -1-9-9-7-'-'-.
-(-c-) -H-e-a-l-t-h -P-r-o-m-o-t-i-o-n -a-n-d -D-i-s-e-a-s-e
-P-r-e-v-e-n-t-i-o-n -R-e-s-e-a-r-c-h -a-n-d -D-e-m-o-n-s-t-r-a-t-i-o-n
-C-e-n-t-e-r-s-.----S-e-c-t-i-o-n -1-7-0-6-(-e-) -o-f -s-u-c-h -A-c-t
-(-4-2 -U-.-S-.-C-. -3-0-0-u---5-(-e-)-) -i-s -a-m-e-n-d-e-d -b-y
-s-t-r-i-k-i-n-g -`-`-t-h-r-o-u-g-h -1-9-9-6-'-' -a-n-d
-i-n-s-e-r-t-i-n-g -`-`-t-h-r-o-u-g-h -1-9-9-7-'-'-.
-(-d-) -S-e-n-s-e -o-f -C-o-n-g-r-e-s-s-.----I-t -i-s -t-h-e
-s-e-n-s-e -o-f -C-o-n-g-r-e-s-s -t-h-a-t-, -b-e-g-i-n-n-i-n-g -o-n
-t-h-e -d-a-t-e -o-f -e-n-a-c-t-m-e-n-t -o-f -t-h-i-s -A-c-t -a-n-d
-c-o-n-t-i-n-u-i-n-g -t-h-r-o-u-g-h -f-i-s-c-a-l -y-e-a-r -1-9-9-7-,
-a-l-l -A-c-t-s -r-e-g-a-r-d-i-n-g -t-h-e -a-u-t-h-o-r-i-z-a-t-i-o-n
-o-r -r-e-a-u-t-h-o-r-i-z-a-t-i-o-n -o-f -C-e-n-t-e-r-s -f-o-r
-D-i-s-e-a-s-e -C-o-n-t-r-o-l -a-n-d -P-r-e-v-e-n-t-i-o-n
-p-r-o-g-r-a-m-s -s-h-o-u-l-d -b-e -a-u-t-h-o-r-i-z-e-d -o-n-l-y
-t-h-r-o-u-g-h -f-i-s-c-a-l -y-e-a-r -1-9-9-7-. -B-e-g-i-n-n-i-n-g -i-n
-f-i-s-c-a-l -y-e-a-r -1-9-9-7-, -C-o-n-g-r-e-s-s -s-h-o-u-l-d
-r-e-a-u-t-h-o-r-i-z-e -t-h-e -C-e-n-t-e-r-s -f-o-r -D-i-s-e-a-s-e
-C-o-n-t-r-o-l -a-n-d -P-r-e-v-e-n-t-i-o-n -a-n-d -i-t-s
-p-r-o-g-r-a-m-s -i-n -o-n-e -c-o-m-p-r-e-h-e-n-s-i-v-e -A-c-t-.
-A-f-t-e-r -f-i-s-c-a-l -y-e-a-r -1-9-9-7-,
-r-e-a-u-t-h-o-r-i-z-a-t-i-o-n -o-f -s-u-c-h -C-e-n-t-e-r-s -a-n-d
-i-t-s -p-r-o-g-r-a-m-s -s-h-o-u-l-d -o-c-c-u-r -o-n -a -r-e-g-u-l-a-r
-c-y-c-l-i-c-a-l -b-a-s-i-s-.
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Early Detection and Preventive
Health Act of 1993''.
TITLE I--TUBERCULOSIS
SEC. 101. SHORT TITLE.
This title may be cited as the ``Tuberculosis Prevention and
Control Amendments of 1993''.
SEC. 102. FINDINGS.
Congress finds that--
(1) between 10,000,000 and 15,000,000 people in the United
States have been infected with tuberculosis, nearly 26,000 new
active cases are reported each year, and over 1,700
tuberculosis-related deaths occur each year;
(2) the number of reported cases of tuberculosis has risen
from 22,201 in 1985 to 26,673 in 1992, representing 51,000 more
cases than those that would have been expected since 1985;
(3) a recent national survey discovered that 14.4 percent
of all active tuberculosis cases were resistant to at least one
drug;
(4) drug resistant tuberculosis strains can cost more than
$150,000 to treat, and even then, between 40 and 60 percent of
the patients receiving such treatment die;
(5) in 1992, tuberculosis cases were reported to the
Centers for Disease Control and Prevention by all 50 States,
and cases resistant to one or more tuberculosis drugs were
reported in at least 36 States, the District of Columbia and
Puerto Rico;
(6) in 1992, 27 percent of the reported cases of
tuberculosis occurred in foreign born persons;
(7) one third of the world's population harbors
tuberculosis; and
(8) among infectious diseases tuberculosis is still the
number one killer in the world with an estimated 8,000,000 new
cases each year and 2,900,000 deaths.
SEC. 103. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND PREVENTION.
(a) Provision of Services for Prevention, Control, and
Elimination.--Section 317(j)(2) of the Public Health Service Act (42
U.S.C. 247b(j)(2)) is amended--
(1) by inserting ``(A)'' after the paragraph designation;
(2) in the first sentence by striking ``and'' after
``1991,'' and all that follows through ``1995'' and inserting
the following: ``, $200,000,000 for fiscal year 1994, and such
sums as may be necessary for each of the fiscal years 1995
through 1997, of which not more than $50,000,000 may be made
available in each such fiscal year for grants under
subparagraph (B)''; and
(3) by adding at the end thereof the following new
subparagraph:
``(B) With respect to amounts made available to carry out this
subparagraph, the Secretary, acting through the Director of the Centers
for Disease Control and Prevention, may use such amounts to make
emergency grants for the prevention, control, and elimination of
tuberculosis. The Secretary may make such a grant only if the
geographic area in which activities under the grant are to be carried
out has, relative to other areas, a substantial incidence of cases of
tuberculosis or a substantial rate of increase in such cases.''.
(b) State Tuberculosis Plan.--Section 317(j) of the Public Health
Service Act (42 U.S.C. 247b(j)) is amended by adding at the end thereof
the following new paragraph:
``(3)(A) With respect to an application submitted by a State for a
grant under this section for the prevention, control and elimination of
tuberculosis, such application shall contain a State plan that
demonstrates that amounts received under the grant will be expended in
a manner that ensures that tuberculosis services will be provided to
those at the highest risk of contracting tuberculosis, or in those
areas with the highest rates of tuberculosis infection.
``(B) Such plans shall demonstrate that the applicant will work
closely with and provide support to entities receiving funds under
sections 329, 330, 340, 340A, or titles V or XIX, and to correctional
facilities, and nongovernmental organizations such as community-based
organizations.
``(C) Such plans shall demonstrate that grant funds will be used
for directly observed therapy or other effective interventions with
respect to populations with the highest rates of active infection with
tuberculosis.''.
(c) Research, Demonstration Projects, Education, and Training.--
(1) In general.--Section 317(k)(2) of the Public Health
Service Act (42 U.S.C. 247b(k)(2)) is amended--
(A) by redesignating subparagraphs (A) through (D)
as clauses (i) through (iv), respectively;
(B) by inserting ``(A)'' after the paragraph
designation; and
(C) by adding at the end thereof the following new
subparagraphs:
``(B) In support of grants referred to in subparagraph (A), the
Secretary may conduct or support applied research and training
regarding the surveillance, diagnostic methodologies, prevention,
control, and treatment of tuberculosis, including intramural projects
and extramural projects.
``(C) For the purpose of carrying out subparagraphs (A) and (B),
there are authorized to be appropriated $26,000,000 for fiscal year
1994, and such sums as may be necessary for each of the fiscal years
1995 through 1997. The authorization of appropriations established in
the preceding sentence is in addition to the authorization of
appropriations established in subsection (j)(2) for carrying out this
paragraph.''.
(2) Technical amendment.--Section 317(j)(2) of the Public
Health Service Act (42 U.S.C. 247b(j)(2)) is amended by
striking the last sentence.
SEC. 104. RESEARCH THROUGH NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS
DISEASES.
(a) Certain Duties.--
(1) In general.--Subpart 6 of part C of title IV of the
Public Health Service Act (42 U.S.C. 285f) is amended by
inserting after section 446 the following section:
``research and research training regarding tuberculosis
``Sec. 447. In carrying out section 446, the Director of the
Institute shall conduct or support basic research and research training
regarding the cause, diagnosis, early detection, prevention and
treatment of tuberculosis.''.
(2) Conforming amendment.--Section 446 of the Public Health
Service Act (42 U.S.C. 285f) is amended by inserting after
``Diseases'' the following: ``(hereafter in this subpart
referred to as the `Institute')''.
(b) Authorization of Appropriations.--Section 408(a) of the Public
Health Service Act (42 U.S.C. 284c(a)) is amended by adding at the end
the following new paragraph:
``(3) For the purpose of carrying out section 447 (relating
to research on tuberculosis through the National Institute on
Allergy and Infectious Diseases), there are authorized to be
appropriated $46,000,000 for fiscal year 1994, and such sums as
may be necessary for each of the fiscal years 1995 through
1997. The authorization of appropriations established in the
preceding sentence may not be construed as terminating the
availability for such purpose of any other authorization of
appropriations.''.
SEC. 105. RESEARCH THROUGH THE FOOD AND DRUG ADMINISTRATION.
Chapter V of the Food, Drug and Cosmetic Act is amended by
inserting after section 512 (21 U.S.C. 360b) the following new section:
``SEC. 512A. TUBERCULOSIS DRUG AND DEVICE RESEARCH.
``(a) Authority.--The Commissioner of Food and Drugs shall
implement a tuberculosis drug and device research program under which
the Commissioner shall--
``(1) provide assistance to other Federal agencies for the
development of tuberculosis protocols;
``(2) review and evaluate medical devices designed for the
diagnosis and control of airborne tuberculosis; and
``(3) conduct research concerning drugs or devices to be
used in diagnosing, controlling and preventing tuberculosis.
``(b) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, $5,000,000 for each of the
fiscal years 1994 through 1997.''.
SEC. 106. CONVERSION OR RENOVATION OF PUBLIC HEALTH FACILITIES.
Section 1610 of the Public Health Service Act (42 U.S.C. 300r) is
amended by adding at the end the following subsection:
``(c)(1) With respect to services for the prevention, control, and
elimination of tuberculosis, the Secretary may make grants to public
and nonprofit private entities for--
``(A) conversion of existing facilities into outpatient
medical facilities or facilities for long-term care to provide
such services for such populations;
``(B) renovation of inpatient facilities; or
``(C) renovation of facilities to provide such services
with respect to incarceration.
``(2) The amount of any grant under paragraph (1) may not exceed 50
percent of the cost of the project for which the grant is made unless
the project is located in an area determined by the Secretary to be an
urban or rural poverty area, in which case the grant may cover up to 75
percent of such costs.
``(3) There are authorized to be appropriated for grants under
paragraph (1), $25,000,000 for fiscal year 1994, and such sums as may
be necessary for each of the fiscal years 1995 through 1997.''.
TITLE II--SEXUALLY TRANSMITTED DISEASES
SEC. 201. SHORT TITLE.
This title may be cited as the ``Sexually Transmitted Diseases
Amendments of 1993''.
SEC. 202. EXTENSION OF PROGRAM OF GRANTS REGARDING PREVENTION AND
CONTROL OF SEXUALLY TRANSMITTED DISEASES.
(a) Extension of Program.--Section 318(d)(1) of the Public Health
Service Act (42 U.S.C. 247c(d)(1)) is amended in the first sentence--
(1) by striking ``(b) and (c)'' and inserting ``(b) and (c)
of this section and section 318B''; and
(2) by striking ``there are authorized'' and all that
follows and inserting the following: ``there are authorized to
be appropriated $132,000,000 for fiscal year 1994, and such
sums as may be necessary for each of the fiscal years 1995
through 1997.''.
(b) Technical Corrections.--Section 318 of the Public Health
Service Act (42 U.S.C. 247c) is amended--
(1) in subsection (b)(3), by striking ``, and'' and
inserting ``; and''; and
(2) in subsection (d)(5)--
(A) in subparagraph (A), by striking ``form, or''
and inserting ``form; or''; and
(B) in subparagraph (B), by striking ``purposes,''
and inserting ``purposes;''.
SEC. 203. EXTENSION OF PROGRAM REGARDING PREVENTABLE CASES OF
INFERTILITY ARISING AS RESULT OF SEXUALLY TRANSMITTED
DISEASES.
(a) Technical Correction.--Section 318A of the Public Health
Service Act (42 U.S.C. 247c-1), as added by section 304 of Public Law
102-531 (106 Stat. 3490), is amended in subsection (o)(2) by striking
``subsection (s)'' and inserting ``subsection (q)''.
(b) Extension of Program.--Section 318A of the Public Health
Service Act (42 U.S.C. 247c-1), as added by section 304 of Public Law
102-531 (106 Stat. 3490), is amended--
(1) in subsection (q), by striking ``and 1995'' and
inserting ``through 1997''; and
(2) in subsection (r)(2), by striking ``through 1995'' and
inserting ``through 1997''.
SEC. 204. SEXUALLY TRANSMITTED DISEASE ACCELERATED PREVENTION
CAMPAIGNS.
Part B of title III of the Public Health Service Act is amended by
inserting after section 318A (42 U.S.C. 247c-1) the following new
section:
``SEC. 318B. SEXUALLY TRANSMITTED DISEASE ACCELERATED PREVENTION
CAMPAIGNS.
``(a) Grants.--The Secretary is authorized to award grants to
States and political subdivisions of States for the development,
implementation, and evaluation of innovative, interdisciplinary
approaches to the prevention and control of sexually transmitted
diseases and their sequelae by--
``(1) expanding access to sexually transmitted disease
services through collaborations with other public health
programs and with nongovernmental partners;
``(2) implementing community-based behavioral interventions
to prevent disease transmission; and
``(3) establishing collaborations between health
departments and university-based experts to strengthen sexually
transmitted diseases prevention programs.
``(b) Application.--To be eligible to receive a grant under
subsection (a), a State or political subdivision of a State, shall
prepare and submit to the Secretary an application at such time, in
such manner, and containing such information as the Secretary may
require.
``(c) Priority.--In awarding grants under subsection (a), the
Secretary shall give priority to applications that seek to conduct
activities with grant funds that focus on the prevention of sexually
transmitted diseases among women and other populations that are
disproportionately affected by these diseases.''.
TITLE III--INJURY CONTROL AND VIOLENCE PREVENTION
SEC. 301. SHORT TITLE.
This title may be cited as the ``Injury Control and Violence
Prevention Act of 1993''.
SEC. 302. FINDINGS.
Congress finds that--
(1) violence or the threat of violence has adverse effects
on the health and safety of Americans of all ages, races,
ethnicities and economic conditions;
(2) the majority of homicides and violent assaults are
committed by people who have relationships with their victims
and are not committed by strangers;
(3) violence is being committed in private as well as in
public, in homes, schools, and neighborhoods;
(4) interventions by law enforcement and criminal justice
systems have limited ability to prevent violence;
(5) family and interpersonal violence represent serious
threats to the health and well-being of millions of women in
the United States;
(6) violence against women has serious health consequences
for its victims, including fatality, severe trauma, repeated
physical injuries, and chronic stress-related disorder;
(7) violence against women has serious mental health
consequences for its victims, including substance abuse, severe
psychological trauma, and suicide;
(8) fewer than 5 percent of injured women are correctly
diagnosed by medical personnel as being victims of domestic
violence;
(9) hospitals and clinics do not have a uniform set of
protocols for the identification and referral of victims of
family and interpersonal violence, or for the training of
health care professionals to perform such functions;
(10) a national surveillance system for monitoring the
health effects of injury should be established to determine the
nature and extent of family and interpersonal violence in the
United States; and
(11) the Surgeon General has identified domestic violence
as a public health problem to which all health care providers
must actively and vigorously respond.
SEC. 303. FAMILY AND INTERPERSONAL VIOLENCE PREVENTION.
Section 393 of the Public Health Service Act (42 U.S.C. 280b-2) is
amended to read as follows:
``SEC. 393. PREVENTION OF FAMILY AND INTERPERSONAL VIOLENCE.
``(a) Research and Technical Assistance.--The Secretary, acting
through the Director of the Centers for Disease Control and Prevention,
may conduct research and provide technical assistance to appropriate
public and nonprofit private entities and to academic institutions to
assist such entities in performing research in, and conducting training
and public health programs for, the prevention of injuries and deaths
associated with family and interpersonal violence.
``(b) Grants.--The Secretary, acting through the Director of the
Centers for Disease Control and Prevention, may award grants to States,
political subdivisions of States, and any other public and nonprofit
private entity for--
``(1) the conduct of research into identifying effective
strategies to prevent interpersonal violence within the family
and among acquaintances;
``(2) the development, implementation, and evaluation of
demonstration projects for the prevention of interpersonal
violence within families and among acquaintances;
``(3) the implementation of public information and
education programs for prevention of family and interpersonal
violence and to broaden public awareness of the public health
consequences of family and interpersonal violence; and
``(4) the provision of education, training and clinical
skills improvement programs for health care professionals to--
``(A) routinely interview and identify individuals
whose medical condition or statements indicate that the
individuals are victims of domestic violence or sexual
assault; and
``(B) refer the individuals to entities that
provide services regarding such violence and assault,
including referrals for counseling, housing, legal
services, and services of community organizations.
``(c) Injury Surveillance Program.--The Secretary, acting through
the Director of the Centers for Disease Control and Prevention, shall
support the establishment of national systematic surveillance of
injuries, including those caused by family and interpersonal violence.
``(d) Definition.--As used in this section, the term `interpersonal
violence within families and acquaintances' means any intentional
violence, controlling, or coercive behavior or pattern of behavior by
an individual who is currently or who was previously, in an intimate or
acquaintance relationship with the victim. Such behavior may occur at
any stage of the lifecycle and may encompass single acts or a syndrome
of actual or threatened physical injury, sexual assault, rape,
psychological abuse, or neglect. Such term includes behavior which
currently may be described as `child neglect', `child abuse', `spousal
abuse', `domestic violence', `woman battering', `partner abuse', `elder
abuse', and `date rape'.
``(e) Application.--To be eligible to receive assistance under
subsection (a) or (b), an entity shall prepare and submit to the
Secretary an application at such time, in such manner, and containing
such information as the Secretary may require.''.
SEC. 304. ADVISORY COMMITTEE; REPORTS.
Part J of title III of the Public Health Service Act (as amended by
Public Law 103-43) is amended by inserting after section 393 (42 U.S.C.
280b-2) the following new section:
``SEC. 393A. GENERAL PROVISIONS.
``(a) Advisory Committee.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, shall
establish an advisory committee to advise the Secretary and such
Director with respect to the prevention and control of injuries.
``(b) Report.--Not later than February 1 of 1996 and of every
second year thereafter, the Secretary, acting through the Director of
the Centers for Disease Control and Prevention, shall submit to the
Committee on Energy and Commerce of the House of Representatives, and
to the Committee on Labor and Human Resources of the Senate, a report
describing the activities carried out under this part during the
preceding 2 fiscal years. Such report shall include a description of
such activities that were carried out with respect to domestic violence
and sexual assault and with respect to rural areas.''.
SEC. 305. TECHNICAL CORRECTIONS.
(a) Terminology.--Part J of title III of the Public Health Service
Act (42 U.S.C. 280b et seq.) (as amended by Public Law 103-43) is
amended--
(1) in the heading for such part, by striking ``Injury
Control'' and inserting ``Prevention and Control of Injuries'';
and
(2) in section 392--
(A) in the heading for such section, by inserting
``prevention and'' before ``control activities'';
(B) in subsection (a)(1), by inserting ``and
control'' after ``prevention''; and
(C) in subsection (b)(1), by striking ``injuries
and injury control'' and inserting ``the prevention and
control of injuries''.
(b) Provisions Relating to Public Law 102-531.--Part J of title III
of the Public Health Service Act (42 U.S.C. 280b et seq.) (as amended
by Public Law 103-43 (106 Stat. 3482)), is amended--
(1) in section 392(b)(2), by striking ``to promote injury
control'' and all that follows and inserting ``to promote
activities regarding the prevention and control of injuries;
and''; and
(2) in section 391(b), by adding at the end the following
sentence: ``In carrying out the preceding sentence, the
Secretary shall disseminate such information to the public,
including through elementary and secondary schools.''.
SEC. 306. AUTHORIZATION OF APPROPRIATIONS.
Section 394 of the Public Health Service Act (42 U.S.C. 280b-3) is
amended--
(1) by striking ``391 and 392'' and inserting ``391, 392,
and 393''; and
(2) by striking ``$10,000,000'' and all that follows
through the period and inserting ``$60,000,000'' for fiscal
year 1994, and such sums as may be necessary for each of the
fiscal years 1995 through 1997.''.
TITLE IV--BREAST AND CERVICAL CANCER AMENDMENTS
SEC. 401. SHORT TITLE.
This title may be cited as the ``Breast and Cervical Cancer
Amendments of 1993''.
SEC. 402. REVISIONS IN PROGRAM OF STATE GRANTS REGARDING BREAST AND
CERVICAL CANCER.
(a) Limited Authority Regarding For-Profit Entities.--
(1) In general.--Section 1501(b) of the Public Health
Service Act (42 U.S.C. 300k(b)) is amended--
(A) by striking ``States.--A State'' and all that
follows through ``may expend'' and inserting the
following: ``States.--
``(1) In general.--A State receiving a grant under
subsection (a) may, subject to paragraphs (2) and (3),
expend''; and
(B) by adding at the end the following paragraphs:
``(2) Limited authority regarding other entities.--In
addition to the authority established in paragraph (1) for a
State with respect to grants and contracts, the State may
provide for screenings under subsection (a)(1) through entering
into contracts with private entities.
``(3) Payments for screenings.--The amount paid by a State
to an entity under this subsection for a screening procedure
under subsection (a)(1) may not exceed the amount that would be
paid under part B of title XVIII of the Social Security Act if
payment were made under such part for furnishing the procedure
to a woman enrolled under such part.''.
(2) Conforming amendment.--Section 1505(3) of the Public
Health Service Act (42 U.S.C. 300n-1(3)) is amended by
inserting before the semicolon the following: ``(and
additionally, in the case of services and activities under
section 1501(a)(1), with any similar services or activities of
private entities)''.
(b) Special Consideration for Grants.--Section 1501 of the Public
Health Service Act (42 U.S.C. 300k) is amended by adding at the end
thereof the following new subsection:
``(c) Special Consideration.--In making grants under subsection (a)
after the date of enactment of this subsection, the Secretary shall
give special consideration to projects that have been peer reviewed and
approved and that involve areas that--
``(1) have high cervical or breast cancer mortality rates;
or
``(2) have a high incidence of cervical or breast
cancer.''.
(c) Exemption From Matching Requirements.--Section 1502(b)(1) of
the Public Health Service Act (42 U.S.C. 300l(b)(1)) is amended to read
as follows:
``(1) Types of contributions.--
``(A) General rule.--Non-Federal contributions
required in subsection (a) may be in cash or in kind,
fairly evaluated, including equipment or services (and
excluding indirect or overhead costs). Amounts provided
by the Federal Government, or services assisted or
subsidized to any significant extent by the Federal
Government, may not be included in determining the
amount of such non-Federal contributions.
``(B) Donated treatment services.--In meeting the
non-Federal contribution requirement of this section,
the State involved--
``(i) may, with respect to a grant awarded
for a program under paragraph (1) or (2) of
section 1501(a), use the value of any donated
outreach services associated with the delivery
of breast and cervical cancer screenings
conducted under the program, and the value of
any additional donated breast or cervical
cancer diagnostic or treatment services
provided subsequent to the screening conducted
under the program; and
``(ii) may not, with respect to a grant
awarded for a program under paragraph (3), (4),
(5) or (6) of section 1501(a), include the
value of any donated breast or cervical cancer
outreach, diagnosis, or treatment services.''.
(d) Requirements With Respect to Type and Quality of Services.--
(1) In general.--Section 1503 of the Public Health Service
Act (42 U.S.C. 300m) is amended--
(A) in subsection (a)--
(i) in paragraph (1), to read as follows:
``(1) to ensure that, after a limited period of time and
thereafter throughout the period during which amounts are
received pursuant to the grant, except for the period of the
first year when a 50 percent minimum shall apply, not less than
60 percent of the grant is expended to provide each of the
services or activities described in paragraphs (1) and (2) of
section 1501(a), including making available screening
procedures for both breast and cervical cancers;''; and
(ii) in paragraph (4), to read as follows:
``(4) to ensure that not more than 40 percent of the grant
is expended to provide the services or activities described in
paragraphs (3) through (6) of section 1501(a), except in the
case of the first year during which the maximum expended for
these purposes shall not exceed 50 percent of the grant.''; and
(B) by striking subsections (c) through (e) and
inserting the following:
``(c) Quality Assurance Regarding Screening Procedures.--The
Secretary may not make a grant under section 1501 unless the State
involved agrees that the State will, in accordance with applicable law,
assure the quality of screening procedures conducted pursuant to such
section.''.
(2) Transition rule regarding mammographies.--With respect
to the screening procedure for breast cancer known as a
mammography, the requirements in effect on the day before the
date of the enactment of this Act under section 1503(c) of the
Public Health Service Act remain in effect (for an individual
or facility conducting such procedures pursuant to a grant to a
State under section 1501 of such Act) until there is in effect
for the facility a certificate (or provisional certificate)
issued under section 354 of such Act.
(e) Statewide Provision of Services.--Section 1504(c) of the Public
Health Service Act (42 U.S.C. 300n(c)) is amended by adding at the end
the following paragraph:
``(3) Grants to tribes and tribal organizations.--
``(A) The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, may
make grants to tribes and tribal organizations (as such
terms are used in paragraph (1)) for the purpose of
carrying out programs described in section 1501(a).
This title applies to such a grant (in relation to the
jurisdiction of the tribe or organization) to the same
extent and in the same manner as such title applies to
a grant to a State under section 1501 (in relation to
the jurisdiction of the State).
``(B) If a tribe or tribal organization is
receiving a grant under subparagraph (A) and the State
in which the tribe or organization is located is
receiving a grant under section 1501, the requirement
established in paragraph (1) for the State regarding
the tribe or organization is deemed to have been waived
under paragraph (2).''.
(f) Evaluations and Reports.--Section 1508 of the Public Health
Service Act (42 U.S.C. 300n-4) is amended--
(1) in subsection (a), by adding at the end the following
sentence: ``Such evaluations shall include evaluations of the
extent to which States carrying out such programs are in
compliance with section 1501(a)(2) and with section 1504(c).'';
and
(2) in subsection (b), by inserting before the period the
following: ``, including recommendations regarding compliance
by the States with section 1501(a)(2) and with section
1504(c)''.
(g) Technical Corrections.--Title XV of the Public Health Service
Act (42 U.S.C. 300k et seq.) is amended--
(1) in section 1501(a), in the matter preceding paragraph
(1), by striking ``Control,'' and inserting ``Control and
Prevention,''; and
(2) in section 1505--
(A) in paragraph (3), by striking ``nonprivate''
and inserting ``nonprofit private''; and
(B) in paragraph (4), by inserting ``will'' before
``be used''.
SEC. 403. ESTABLISHMENT OF DEMONSTRATION PROGRAM OF GRANTS FOR
ADDITIONAL PREVENTIVE HEALTH SERVICES FOR WOMEN.
(a) In General.--Title XV of the Public Health Service Act (42
U.S.C. 300k et seq.) is amended--
(1) by redesignating section 1509 as section 1510; and
(2) by inserting after section 1508 the following section:
``SEC. 1509. SUPPLEMENTAL GRANTS FOR ADDITIONAL PREVENTIVE HEALTH
SERVICES.
``(a) Demonstration Projects.--In the case of States receiving
grants under section 1501, the Secretary, acting through the Director
of the Centers for Disease Control and Prevention, may make grants to
not more than 3 such States to carry out demonstration projects for the
purpose of--
``(1) providing preventive health services in addition to
the services authorized in such section, including screenings
regarding blood pressure and cholesterol, and including health
education;
``(2) providing appropriate referrals for medical treatment
of women receiving services pursuant to paragraph (1) and
ensuring, to the extent practicable, the provision of
appropriate follow-up services; and
``(3) evaluating activities conducted under paragraphs (1)
and (2) through appropriate surveillance or program-monitoring
activities.
``(b) Status as Participant in Program Regarding Breast and
Cervical Cancer.--The Secretary may not make a grant under subsection
(a) unless the State involved agrees that services under the grant will
be provided only through entities that are screening women for breast
or cervical cancer pursuant to a grant under section 1501.
``(c) Applicability of Provisions of General Program.--This title
applies to a grant under subsection (a) to the same extent and in the
same manner as such title applies to a grant under section 1501.
``(d) Funding.--
``(1) In general.--Subject to paragraph (2), for the
purpose of carrying out this section, there are authorized to
be appropriated $3,000,000 for fiscal year 1994, and such sums
as may be necessary for each of the fiscal years 1995 through
1997.
``(2) Limitation regarding funding with respect to breast
and cervical cancer.--The authorization of appropriations
established in paragraph (1) is not effective for a fiscal year
unless the amount appropriated under section 1510(a) for the
fiscal year equals or exceeds $100,000,000.''.
(b) Conforming Amendment.--Section 1510(a) of the Public Health
Service Act, as redesignated by subsection (a)(1) of this section, is
amended in the heading for the section by striking ``funding.'' and
inserting ``funding for general program.''.
SEC. 404. FUNDING FOR GENERAL PROGRAM.
Section 1510(a) of the Public Health Service Act (as amended by
section 403(a)(2)) is amended--
(1) by striking ``and'' after ``1991,''; and
(2) by inserting before the period the following: ``,
$200,000,000 for fiscal year 1994, and such sums as may be
necessary for each of the fiscal years 1995 through 1997''.
TITLE V--MISCELLANEOUS PROVISIONS
SEC. 501. EVALUATIONS.
Section 2711 of the Public Health Service Act (42 U.S.C. 300aaa-10)
is amended to read as follows:
``evaluation of programs
``Sec. 2711. (a) In General.--Such portion as the Secretary shall
determine, but not less than .2 percent nor more than 1 percent, of any
amounts appropriated for programs authorized under this Act for any
fiscal year beginning after September 20, 1993, shall be made available
for the evaluation (directly, or by grants of contracts) of the
implementation and effectiveness of such programs.
``(b) Report on Evaluations.--
``(1) In general.--To provide information for legislative
deliberations concerning Federal health programs, the Secretary
shall, not later than January 1 of each year, prepare and
submit to the Committee on Labor and Human Resources of the
Senate and the Committee on Energy and Commerce of the House of
Representatives a report that identifies and synthesizes the
findings of the evaluations conducted under subsection (a) by
program area. Such report shall also include the plans of the
Secretary for the subsequent year's evaluations, including
programs and issue areas.
``(2) Five year review.--A report submitted under paragraph
(1) shall contain a description of the findings of the
Secretary with respect to evaluations conducted under
subsection (a) or other provisions of law, during the 5-year
period prior to the year for which the report is being
submitted. Such description shall provide the Committees
referred to in paragraph (1) with information concerning
program changes that the Secretary intends to implement in
response to such findings in order to improve the health of the
American people and their receipt of needed and effective
public health services.''.
SEC. 502. FEDERAL BENEFITS FOR OVERSEAS ASSIGNEES.
Section 307 of the Public Health Service Act (42 U.S.C. 242l) is
amended by adding at the end thereof the following new subsection:
``(c) The Secretary may provide to personnel appointed or assigned
by the Secretary to serve abroad, allowances and benefits similar to
those provided under chapter 9 of title I of the Foreign Service Act of
1990 (22 U.S.C. 4081 et seq.). Leaves of absence for personnel under
this subsection shall be on the same basis as that provided under
subchapter I of chapter 63 of title 5, United States Code to
individuals serving in the Foreign Service.''.
SEC. 503. LOAN REPAYMENT PROGRAM.
Part J of title III of the Public Health Service Act (as amended by
section 2008 of Public Law 103-43) is amended by inserting after
section 393A (as added by section 304) the following new section:
``SEC. 393B. LOAN REPAYMENT PROGRAM.
``(a) In General.--
``(1) Authority.--Subject to paragraph (2), the Secretary
may carry out a program of entering into contracts with
appropriately qualified health professionals under which such
health professionals agree to conduct prevention activities, as
employees of the Centers for Disease Control and Prevention and
the Agency for Toxic Substances and Disease Registry, in
consideration of the Federal Government agreeing to repay, for
each year of such service, not more than $20,000 of the
principal and interest of the educational loans of such health
professionals.
``(2) Limitation.--The Secretary may not enter into an
agreement with a health professional pursuant to paragraph (1)
unless such professional--
``(A) has a substantial amount of educational loans
relative to income; and
``(B) agrees to serve as an employee of the Centers
for Disease Control and Prevention or the Agency for
Toxic Substances and Disease Registry for purposes of
paragraph (1) for a period of not less than 3 years.
``(b) Applicability of Certain Provisions.--With respect to the
National Health Service Corps Loan Repayment Program established in
subpart III of part D of title III of this Act, the provisions of such
subpart shall, except as inconsistent with subsection (a), apply to the
program established in this section in the same manner and to the same
extent as such provisions apply to the National Health Service Corps
Loan Repayment Program.
``(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $500,000 for
each of the fiscal years 1994 through 1997.''.
SEC. 504. ESTABLISHMENT OF REQUIREMENT OF BIENNIAL REPORT ON NUTRITION
AND HEALTH.
Title XVII of the Public Health Service Act (42 U.S.C. 300u et
seq.), as amended by section 302 of Public Law 102-531 (106 Stat.
3483), is amended by adding at the end the following section:
``biennial report regarding nutrition and health
``Sec. 1709. (a) Biennial Report.--The Secretary shall require the
Surgeon General of the Public Health Service to prepare biennial
reports on the relationship between nutrition and health. Such reports
may, with respect to such relationship, include any recommendations of
the Secretary and the Surgeon General regarding the public health.
``(b) Submission to Congress.--The Secretary shall ensure that, not
later than February 1 of 1995 and of every second year thereafter, a
report under subsection (a) is submitted to the Committee on Energy and
Commerce of the House of Representatives and the Committee on Labor and
Human Resources of the Senate.
``(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 each of the fiscal years 1994 through 1997.''.
SEC. 505. ALIGNMENT OF CURRENT CENTERS FOR DISEASE CONTROL AND
PREVENTION REAUTHORIZATION SCHEDULE.
(a) Prostate Cancer Prevention.--Section 317D((l)(1) of such Act
(42 U.S.C. 247b-5(l)(1)) is amended by striking ``through 1996'' and
inserting ``through 1997''.
(b) Cancer Registries.--Section 399L(a) of such Act (42 U.S.C.
280e-4(a)) (as amended by section 2003(1) of Public Law 103-43) is
amended by striking ``through 1996'' and inserting ``through 1997''.
(c) Health Promotion and Disease Prevention Research and
Demonstration Centers.--Section 1706(e) of such Act (42 U.S.C. 300u-
5(e)) is amended by striking ``through 1996'' and inserting ``through
1997''.
(d) Sense of Congress.--It is the sense of Congress that, beginning
on the date of enactment of this Act and continuing through fiscal year
1997, all Acts regarding the authorization or reauthorization of
Centers for Disease Control and Prevention programs should be
authorized only through fiscal year 1997. Beginning in fiscal year
1997, Congress should reauthorize the Centers for Disease Control and
Prevention and its programs in one comprehensive Act. After fiscal year
1997, reauthorization of such Centers and its programs should occur on
a regular cyclical basis.
SEC. 506. BREAST AND CERVICAL CANCER INFORMATION.
Title XXVII of the Public Health Service Act (42 U.S.C. 300aaa et
seq.) is amended by adding at the end the following new section:
``SEC. 2715. BREAST AND CERVICAL CANCER INFORMATION.
``(a) In General.--Each of the entities referred to in subsection
(b) shall make available, to such individuals as the entities determine
appropriate, information (in a culturally competent manner) concerning
breast and cervical cancer, including if appropriate, information on
the need for breast self-examinations and the skills for such self-
examinations, and shall refer such clients as the entities determine
appropriate for breast and cervical cancer screening, treatment or
other services.
``(b) Entities.--The entities referred to in subsection (a) are--
``(1) a migrant health center receiving assistance under
section 329;
``(2) a community health center receiving assistance under
section 330;
``(3) an entity receiving assistance under section 340;
``(4) an alcohol or drug treatment entity or mental health
entity receiving assistance under title V or title XIX;
``(5) a family planning project described in section 1001;
``(6) an entity receiving assistance under title XXVI;
``(7) a clinic that treats sexually transmitted diseases
and is authorized under section 318;
``(8) an entity receiving funds to provide primary health
services to residents of public housing under section 340A;
``(9) a non-Federal entity authorized under the Indian
Self-Determination Act; and
``(10) a tuberculosis clinic receiving assistance under
section 317(j)(2) or 317(k)(2).''.
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